News

Currently my dad has been in the air for a little bit less than 3 hours so another 5 to go. I really don't envy him. I am not a traveler who can sleep due to my need for control in those situations. So those overnight flights back to England always do me in. I am totally exhausted by the time we get there and I then have to get from London to Norwich. No easy feat on little or no sleep. At least my Uncle is picking him up from the airport.

Me, I have my 3 month check up today. Good news. My weight loss is now at 83 lbs for the total duration since March of 2009. I have lost and managed to keep it off. I continue to lose and that is good. Kidneys, liver and all those internal organ tests came back right where they need to be. My pre-diabetes number is shifting away from the diabetes side of the spectrum and that is a plus.

I like what my doctor told me today - he is really real sometimes - "it is good that you are moving away from the diabetes side of things but I don't want you to think that if we shift far away from that, that you will never have diabetes. Reality is, Philip, that the lifestyle you lived for so many years is going to haunt you for the rest of your life." It is a sobering thought but one that I have always understood. I like it when a doctor is both and optimist while being a realist.

Now however I have to go see a surgeon and that does send alarms up and down my spine. But I will go and see what he has to say. Second and third opinions are always a good thing. So we shall see where this all goes but guess what .. it is all good and necessary.

We live, we learn, we adjust and repair what we can and then, for kicks and giggles, we keep on living.

Good night.

In case you wondered

Neurologist told me they could not find my brain. He was totally serious and that made me stop in my tracks. This man does not joke around ... or does he. Is that the twitch of a corner of the mouth there. Thank God. I knew I had a brain, unless this is the afterlife?

Somewhat clean bill of health. Concern was rendered about these little headaches that come and almost incapacitate me but are gone in a matter of 5 to 10 minutes. We are looking for a trigger and going to rule things out.

Got another years worth of stroke medicine scripts and a free month supply ... nice, cos this is the expensive stuff.

Plus in 5 minutes and with a safety pin he gave me the diagnosis of carpal tunnel, without the $900 test that the other doctors insisted that I run. Gave me one simple exercise to work on to hopefully make some of this go away. If not we will cross that bridge together. (Well actually he said I could go first in case there were any trolls that wanted a toll ... I am seeing another side of this wise old man).

So now I move onward with changing lifestyles, loss and gain, hope and a smile on my face for I have life, my wonderful families love and some of the greatest friends a simple boy from the countryside in England could have ever wanted when he grew up.



Peace and love.

Cardiologist

So yesterday morning, at like the edge of the witching hour in the morning, I remembered that Sarah had called me at work (the end of last week) and said Dr. Malik had called her to let me know that my appointment had been moved to Tuesday morning. I never wrote that down so I am shocked at 2 in the morning I woke up and remembered. Although I thought 10:30 ... showed up at 9:55 and it was supposed to be 9:30. OOPS!

Had no idea why my heart doctor needed me there and neither did they. Eventually after much prodding and probing into the books we determined that it was just the annual follow up. Hmmm have catheters and what not shoved in arteries, scoping out right ventricles and atrium, checking the passageways trying to find a PFO that contributed to the strokes, never to be found and guess what you have a specialist in your world for life. Yippee.

EKG was done with some really cool sticky things that actually had a little tab on them so when my nurse was done she just pulled that tab and they released. She did not have to shave parts of my torso - thank God cos that ends up itching like the dickens and I really do not want to be scratching the torso at Tammy's family reunion when lots of these people will be meeting me for the first time (oh the pressure of that but I am not going there ... yet). But that was so cool.

So EKG showed that I am still an abnormal but normal person. Essentially the same abnormalities in my readings that have existed over a few but show nothing abnormal in the operation of my heart are just all the same as they have been and will be. Huh? Yeah that is what I think.

Heart sounds - okie dokie.
Lung sounds - okie dokie.
Artery sounds - okie duh dokie.
Extremity blood flow - peachy. (hmmm never thought of red blood as peachy but OK)

So I check out. Continue to lose weight, exercise, control cholestrol and get a stress test. I look at him and say "I work - is that not enough" Just kidding doc I have had those and I know. See you in a year.

Well that was nice. I think. Then again I assumed that my heart was still beating as I am still here. :)

Eye see

Well it is one of those trips that I had been putting off. The trip to the optometrist. But all in all not a bad adventure today. I had no appointment but like the fact that I impulsively cleaned the grout lines and washed the fan blades today I walked on in and said help. Kara Nguyen is a really nice lady and her team was great. I was really appreciating all the information she was giving me until the glaucoma test. The solution and then the yellow dye and they still freaking burn hours later.

But I did the extra testing they have that is electronic and shows peripheral vision loss. She strongly advised it due to the strokes and it may have been and extra $25 but the end result is absolutely no vision loss in that area. Actually I had one false positive response and I knew it as it happened and pointed it out. Thus another 100 for Philip. I am wondering if I should get another A on my report card for that one.

Kara did give me some rather interesting information about what happens to the eye after 40 and the hardening of the lens within the eye. Thus the need for bifocals for some and she sees that in my future but today it was still that my lenses were changing in prescription but I pretty much still need to only wear them for driving and maybe watching a movie in the theater or some function in a large hall where the stage is far away. I knew that the prescription needed to be adjusted but I am glad that for right now I do not need anything for reading.

She also walked through the fact that the eyes can also have a stroke and I did not know that. That the eye can have its own stroke. But she thought I should know in light of what I have gone through. I need to read up more on that one.

So glasses ordered and should be in the first part of next week. Thus my eyes can continue to see.

Neurologist

Tomorrow in the afternoon....me in a chair, Dr Blair opposite me in a chair. One a brilliant neurologist, one a mere man on a mission. Discussion of life, next steps, medicine, reaction and life. Result expected, continued direction, possible new places for knowledge and future in this world.

See ya

Time to Repair!!!

Today was really an information gathering session. Dr. Malik is one of the junior partners at the Heart Center of North Texas and really good at what he does. I found out from Cynthia (his nurse for 22 years) that he is booked through December of this year and most of next year is filling up. They fly in from other states and one of his specialties is closing PFO’s.

But the discussions he and I had were intense. Some things became clear to me. I had been reading about this but it was not as clear as he made it. We all develop little clots and such when we bruise or hurt our body. These clots are little and travel through the venous system, the blood going back to the heart. This enters the right chambers and is then pushed through the lungs. This serves two purposes. One is to apply the necessary oxygen to the hemoglobin in the red blood cells. The other is the lungs act as a filter. The filter the dust and such that we breathe in and they filter these little blood clots. The clean air returns to the left chambers of the heart where it travels out to supply the body and brain with oxygen.

Now a PFO that does not close after birth sits there as a little potential short cut from the right side to the left side of the heart bypassing the lungs. This can happen when we sneeze, when we cough, when we strain while sitting on the loo and what I just found out…when we have sleep apnea.

When I stop breathing at night my heart jumps when my body is forced to wake up and take a deep breath. This is the prime opportunity for that clot to move over from one side to the other. Then a TIA or stroke occurs.

I found him to be a very knowledgeable man speaking on both a high intellectual level and knowing that I was understanding this, then also dropping into layman’s terms easily when he could tell I was struggling with a concept.

He was rather interested in how the stroke happened, what symptoms I had and then did some physical examination and had me do some tests that seemed to be more neurological. The first things he said after the examination was that my breath and heart sounds were good. That my neurological disorders were still a little off but mostly normal, that I probably was having issues with numbers, that I was probably still having issues getting the message across and was jumbling up sentences. Sorry but WTF.

I have not really discussed with many that my brother is dealing with my finances as I just cannot deal with it. I had to ask the apartment manager how much my check needed to be written for as I cannot remember numbers. There were no sentences I had to write on the 8 pages of documentation I had to fill in and well he even knew that my short term memory was still a little off. Can I be Hurley here…Dude this guy was kinda creeping me out a little bit. But on the flip side I was impressed.

Good news is he believes that I will gain full functionality back as I am young. Then he dropped the bombshell on me that I have been skirting with avoiding. “Philip, you can keep taking the aggrenox for the rest of your life and not have the surgery but it is not a matter of if you will have another stroke it is a matter of when you will have another stroke if we confirm there is a hole in your heart.”

I know that is the case. I have not wanted to face that reality but it is true. So I have to make a decision. I have to make the decision. I have to make a decision about my life. I know there are lots of factors that have contributed to me being where I am today and most of them are of my own making. I did not take the weight off seriously. I procrastinated. I did not pursue the sleep apnea in Maui. I have made choices that I can change and work on now. I have time. But I cannot do anything about a hole between the right and left chambers of my heart and my body has already suffered. The organ that I need to live and live at the level of intelligence that I want to live at has suffered.

There is no one to make this decision for me. As terrified as I am of having someone invade my heart the prospect without this invasion is just as chilling.

I have to make a decision.

TEE is on the 11th – I go in at 9 and the process starts at 11 am.

Closing the hole in my heart (if the TEE confirms that) is scheduled for the 19th. I go in at 9 am, procedure at 11 – takes about 1-2 hours. Actual process is about 15 minutes long. I will be under anesthesia as they will have the ultrasound scope down my throat as well as going into my heart. I will stay overnight in the hospital and come home on the 20th.

I have made my decision. (my hand trembled when typing that last paragraph but my inner mind lets me know that it is right)

Plans change for the month of June but that is alright. We have to adjust as the world around us adjusts.

I have a direction and that direction is forward.

REPAIR, LEARN and most importantly LIVE

Diagnosis

I just read something that I believe in a whole bunch and had to share with everyone before it slips my mind.

We go to a doctor, we tell him our symptoms and we get diagnosed with something. Most of us go on with that diagnosis but many of us should be stopping right there. We need to know what is wrong and why it is wrong, what happened, why now? Just because a doctor slapped a moniker on this series of symptoms called a diagnosis does not give us an understanding of why.

Ask more, challenge for reasons, find out why this happened so that you can change.