My Life as a Semicolon ; ): Gulp!

Friday, November 02, 2018

Gulp!

Even though my story basically started as one big question mark, I try not to be one to wallow in speculation and anticipation. So I wasn't going to write about this until I had some answers. I also don't want to make it into a bigger deal than it is. But here I am.

Remember how I'd started living to eat and put on some weight (maybe 40 pounds) over the past eight years? And couldn't seem to find an exercise regime, diet, or age that would change that? Well, my body took matters into its own hands (as it tends to do). About three months ago, I started having trouble swallowing. It was sporadic, kind of felt like I was choking (though I never was), but made it unpleasant to eat -- for myself and others. There's nothing like having a coughing fit when you're an aneurysm/stroke/heart attack/seizure survivor. As a walking preexisting condition, I'm seen as a touch vulnerable. Even though everyone has food or drink go down the wrong pipe once in awhile; when I do it, people assume I'm having a conniption.

At first -- much as I've settled into a"new normal" that's hardly new -- I was concerned my condition was somehow stroke related.So when the little burps and periodic heartburn started, I was pleased to write the whole thing off as "reflux". My doctor concurred and tried me out on prescription Zantac.

After another couple of weeks, I didn't find the symptoms were diminishing but instead had been enhanced by gloriously melodramatic regurgitation if I ate too much. And by "too much," I'm talking about more than four or five bites of whatever solid food was in front of me.

I've switched to a low-acid reflux diet, Prilosec instead of Zantac, make sure I eat seated upright, avoid talking while eating,and restrict myself to more frequent, smaller meals in small bites, just to keep my calories up. Ensure and other so-called "nutrition shakes" have become my friends. It's vaguely reminiscent of when I was on a feeding tube with a Jevity drip, except that I never actually tasted Jevity. During those two weeks long ago, I probably lost 10-15 pounds. During my recent couple months of liquid diet coupled with involuntary Bulimia, I've lost about 25 pounds.

Yes, yes, I'm the envy of all who haven't watched me repeatedly upchuck the same three bites of food.

It is admittedly unpleasant to behold, not to mention PTS-inducing for anyone who's nursed me back to health since the stroke (i.e. my family and friends). No, it's not terribly enjoyable for me either, but I've gotten used to managing it; with the incentive that the less I eat and subsequently bring back up, the less guilty and infantilized I feel. Not that there's anything infantilizing about literally having your own sick wiped off your face by your wife or co-workers

And I'm not saying the weight loss hasn't been a fringe benefit. After having to essentially buy a new wardrobe to accommodate my weight gain, it was nice to find a more economical, one-handed-friendly belt to satisfy my fashion needs.

And now -- to finally get to the point -- I've seen a gastroenterologist who doesn't necessarily think it's reflux or stroke related but rather one of those things that can just happen to people in their, "fourth or fifth decade of life." Once again, hooray for middle age!

On Monday, I'm scheduled for an upper endoscopy, which will hopefully be able to identify and remedy the issue.

I am having a little existential angst over the prospect of a camera on a tube going down my throat but am trying to remain true to my mantra of old -- "I am open to the universe." I am Doris Day: Que será, será.

Hopefully, exciting video footage to follow.

Take luck and care with the luck you're caring for (sorry I couldn't find a better Brian Regan clip).

1 comment :

Rosafaerie3:40 PM, November 03, 2018
Aww, Ken...I'm sorry you've been dealing with that. Sounds like no fun at all, and generally worrisome. I hope your appointment on Monday goes well and that the scope finds the problem. ♥
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My Life as a Semicolon ; )

Friday, November 02, 2018

Gulp!

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Activities	Immediately after Stroke(early Oct. 2010)	When I left MGH/arrived at NERHP(mid-Oct. 2010)	When I left the rehab (12/21/10)	Now (02/21/13)
Eating	I started with an an NG-Tube, which was inserted during my original surgery and soon was given a G-tube, during a separate surgery. My primary source of nutrients was called Jevity, which is not as much fun or tastyas it sounds.I actually have no idea what it tastes like, but it looks and smells like a combination of coffee milk and Yoo-Hoo	Still on an all-liquid diet of Jevity through my feeding tube.	Early in my stay at the rehab, I took a Modified-Barium-Swallow test with my speech therapist in order to confirm that the stroke had not damaged my ability to swallow or my gag reflex. After passing the test, I was allowed to eat solid food, though even that came in stages. For instance, I rememberthe first group of foods were "mechanical soft" and I drank "nectar thick" liquids"	I try to eat a healthy diet and have no specific restrictions.
Therapy	approximately one hour a day of OT and PT.	approximately three hours a day of OT, PT, and speech therapy (speech encompasses talking, drinking, eating, and cognitive functions.	approximately three hours a day of OT and PT. I was discharged from speech therapy relatively early on, once it was determined that my cognition, speech, and swallowing were relatively fine	After leaving inpatient at the rehab, I began outpatient OT and PT twice a week and also had in-home OT and PT twice a week. after receiving the results of my neuropsych evaluation, speech therapy was added back in. I then had to eliminate some therapy in order to free up time for my return to work. In 2012 I did no formal OT or PT but tried other forms of therapy like chiropractic and Feldenkrais. I am also going to try craniosacral therapy. I've regularly seen a psychologist throughout my recovery.
Walking	None	None	walking with close supervision and the support of an AFO brace and quad cane	walking independently, with the support of a KAFO brace and a straight cane, now equipped with a standing tip(which I love). I periodically walk without cane or brace, when the occasion calls for it (like carrying something).
Toileting	during my original surgery, I was given a Foley cath– an internal catheter – which remained in place for quite a while. It think after not producing enough in my catheter bag, I was given another internal catheter – this time a Straight cath. They can only stay in for relatively short time,I think, so I was granted the opportunity to try aTexas Condom Cath. After that proved unsuccessful, I was given what was simply called a Urinal, but which I referred to as my "pee jug"	Urinal	urinal at night, toilet during the day	all toilet all the time; no assistance required
Bathing	bed/sponge baths	bed/sponge baths,though after about two weeks inpatient at the rehab, I started showering periodically with assistance	showering, seated, with minimal assistance	showering, seated, with no assistance, standing with some assistance
Dressing	maximum assistance required	maximum assistance required	some assistance required	no assistance required, except with some jackets and zippers
Balance	could not stand or sit up straight	could not stand or sit up straight	could stand and sit for short periods of time	can stand and sit without assistance for relatively long stretches of time
Left Leg/Foot	no movement	no movement	large movement from hip and quad.weak in hamstring. no movement in ankle or toes	still weak in hamstring, but much stronger in leg overall. Some ankle motion, but nothing in my toes.
Left Arm/Hand	no movement	no movement	large movements from the shoulder and bicep. Some hand grip. No finger extension.	similar to when I left the rehab, though large movements are easier and my grip is a bit stronger.
Speech	Little and/or slurred	slurred Jamie often remarked that I had a "flat affect."	relatively clear.	most people say they don't notice any issues with my speech, but I still notice some slurring when I raise my voice (which, of course, never happens in a house with two young boys) or when I try to string together too many thoughts or syllables at once; I can't seem to whistle like I used to, my pitch is a little off when singing; and I can't curl my tongue anymore.
Pain	negligible	negligible	negligible	headaches periodically, but no general pain
Aneurysm	primarily removed	no change	no change	as far as we know, no change
Seizures	gone	no change	no change	gran-Mal seizure while sleeping, in August 2012.
Skull	a portion was missing (on purpose)	no change	cranioplasty completed	scars are healing well. There are some "irregularities" in how the plates have healed, especially with the plastic skull flap. That's not unusual. Sensation is returning to areas of my scalp where nerves were severed during surgeries. Sometimes this can cause odd sensations, but not pain per se. I do have some pain when yawning.
Medication	antiseizure meds,Heparin anti-clotting shots to my belly (which is standard for bedridden patients), beta blocker for high blood pressure, though, that was primarily a reaction to my heart episode, not an actual issue with high blood pressure; Lipitor to lower cholesterol, though, that also was prescribed primarily in reaction to my heart episode and the stroke. Baclofen for spasticity.	no change	no change	I'm no longer on the beta blocker, since my blood pressure has stabilized. I've also reduced my Lipitor intake, because my liver enzymes were not reacting well with it.Since I am no longer in bed as much, I did not need the Heparin shots once I returned home. Anti-seizure meds were increased after my 2012 seizure. Lexapro for mild depression.
Heart	some sort of heart episode had occurred, but no direct cause – other than brain surgery – was identified	no change	chemical stress test did not identify any long-term damage caused by heart attack or risk factors for future concerns	no change
Falls	None, though if I had been left alone, I certainly would've fallen over	same	no falls during my time at the rehab, though, I had a couple close calls during transfers from my wheelchair, or when trying to move too quickly	I've had a few falls at home, up through 2012, but have also regularly practiced getting up from the floor during PT. I have to be cautious but not fear falls
Wheelchair	the only way I could be moved was by wheelchair or gurney, primarily gurney	same	I did use the wheelchair for "long"trips down the hall.	When first at home, the wheelchair was the easiest way to get me around or in and out of the house and car. I no longer use it except on excursions that would require a great deal of walking, such as at the airport.
Stairs	None	same	some use of "practice stairs." And actual stairwells, always with supervision	when first at home, I stayed on the ground floor of the house at all times, but now go upstairs to sleep and shower, as well as down to the basement for exercise. I still mostly go one step at a time (as opposed to stepping "reciprocally"), but only need supervision when there is no railing on my right side – up or down. Regularly exercise at work by reciprocally climbing three flights of stairs.
Driving	none	same	same	Car modified for one-handed operation, I got my license back at the end of January 2013.
Sleep	this fight, the noise of the hospital, I generally slept okay. I was pretty exhausted and at times still groggy from anesthesia.	same	I went through some periods of sleeplessness due to noise in the rehab and was given some sleeping aids, which helped.	I've been sleeping pretty well, aside from typical interruptions of young children. Diagnosed with mild sleep apnea in February 2013.
Work	none	none	none	From 7/11 through 12/11, ramped up from part-time at home to fulltime from home . From 1/12-6/12, ramped up from part-time in the office to fulltime in the office, which continues.
Mood	upset by my circumstances but generally positive	same	same	I think working has given me a boost to a certain extent. I try to be positive, though certainly get frustrated at times. I'm also on Lexapro, in part because a study showed a connection between SSRIs and neurological healing. At worst, the study found that patients were less depressed and more motivated to work toward recovery.
Exercise	Little to none	same	I considered all therapy to be exercise.	Again, therapy has been exercise. Without formal therapy, I do regular stretching and have recently added a treadmill to our inventory of equipment. This will hopefully help improve my stamina in preparation for time in the office, as well as help me focus on walking pace and form. I've also been using ourWii balance board, which includes fun, but safe ways for me to put my balance to the test.
Tactile sensitivity	slightly diminished– if tested subtly, for instance, with a Q-tip, I could not easily identify which finger on my left hand was being touched.	same	improved	relatively normal, though I am somewhat hypersensitive to heat and cold.