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.

Freaking weekend

Been an interesting one. But I did get to learn something ... I like morphine. Maybe not a good thing to say but when you are in the hospital and in as much pain as I was in Saturday morning, the nurse comes in and says the doctor said I could give you some morphine. I just lay there and say "that is nice as long as it will" ... (she now has the syringe shooting it in my IV) ... "make me lose the pain .. how long does it take for this to work? I feel warm inside. You are nice." Nurse Jessie, "have you never had morphine before?" Me, "I don't think I ever had ... is this a silly smile on my face." Nurse Chris came in to tell me I have to drink half of the barium solution now and the other half in 30 minutes. Asks me my name ... I say, "I am loopy." He is like, "huh?" Nurse Jesse, "First time on morphine."

Finally at 7 am I get some sleep to be woken up in 30 minutes for the other half of the solution. To be woken up again to get rolled into the CT scan of my abdomen. Finally my favorite doctor (remembered me from a year ago in ER room number 2 - heart incident on March 5, 2009 - go back the to the first postings in this blog) came in to confirm what he had already told me he suspected. Gall bladder. Given drugs (a strength of Vicodin I did not even know existed) and stuff for the stomach and nausea. So crawled to the pharmacy, got meds, crawled home and then took the pain pill. That was pretty much it for Saturday.

On top of that I think I have a sinus infection and have been around too many people with strep this week so first order of business tomorrow is to get an appointment with my doctor. Get him to get the ultrasound and CT scan from the hospital and see where he wants to go with that. Hopefully convince him that I need something to kick this infection and then get on with this week.

All this after I was promoted to IT System Support Manager last Sunday and it was finally made official to my team on Friday (my day off). So it was truly a whirlwind week. I think I will be popping a pain pill here in a few short moments that will cast my into oblivion for a few hours. But some of you will hear about this through others on the coconut wireless so I figured I would lay it all out now.

So here is to a less eventful week ahead. That and a longer Christmas break as I am now truly a member of corporate America with the schedule that coincides with the home office. Wow first true M-F 8-5 job ever.

Peace to all.

3 months already???

Quarterly checkup today … yep another 3 months gone on by and blood work pulled last week. Actually it was a little bit on the scary side as the blood was pulled the day after I had a scare with blood loss. I guess that I am really aware when I lose blood now as I am on an anti-coagulant and will be for life. With that when I have an opportunity to lose blood I have an opportunity to lose lots of blood. Scary.

But got to sit down with the doctor today and go over my results. Talk about what has happened in the last couple of months, what is going on but today I was impressed. When I mentioned one of my concerns he counter offered with an option to write a prescription for a muscle relaxer (just 10). I countered with the fact that even though some people may think that I take choose to take hard core drugs when things are bad I do not.

Now let me step to the side and quantify that last statement above. Yes, if you would have asked me in the early 90’s or in 2005 if I took the strongest medicines I could get my hands on I would say yes. The 90’s my sinuses were so screwed up and the pain was intense. I popped pain pills like nobody’s business. In 2005 the ruptured disc in my back [done in 1988] finally shifted and sawed the heck out of the left leg nerve bundle. To sleep, I literally had to stand in the corner of the room and lean on my right shoulder. That was horrible. When they offered to shoot my spine up with pain drugs, even though I could have been paralyzed for life, I did not hesitate to say PLEASE!

So I had countered with the fact that I know I have done things in the past that have stressed my kidneys and liver out. I really have been working on eliminating drugs and have gone from 7 daily meds to 5 and cut two of them in half, as far as strength goes, and do not want to add more. I like life. So he countered with almost an hour of going over each level of what he tested in the blood work, comparison to what he has on record for me since 2007 and well showed me why he suggest what he suggests and why he listens to me when I counter.

That kind of relationship is hard to come by in the medical profession. To be able to interact with a doctor that has a prescribed amount of patients to meet due to insurance companies. To have a doctor tell you that you are wrong and justify it. To have him say that he is wrong and this is why he thinks I am right. No ego there. Just open talk. Someone who I am not fearful of discussing concerns with of any type nor will he be fearful of telling me the honest truth from where he sits. He will not prescribe medicine without cause and I especially like that he will not prescribe antibiotics for those things that do not need them. (i.e. we discussed today how people request antibiotics for colds and colds are viruses … antibiotics work on bacteria … thus why? … because advertising scares people into wanting what they do not need)

This discussion today highlighted the 2 levels of study done on the kidneys and their ability to be active and filter what needs to be filtered. I am well within the norms. The liver. Well within the norm. Blood sugar levels. Have been borderline for 3 years but I have maintained or decreased that. Further weight loss will be the key here to make them back off from the edge of being pre-diabetic. The blood cells themselves are in great shape. Right count in the number of blood cells which countered a thought that I might have had so much blood loss due to bleeding ulcer (not good for someone on anti-coagulant). No anemia. No deficiencies in all levels tested. Cholesterol remains great at 155. But more importantly it raised only due to the fact that my HDL went from 36 to 46. Phew. That lower than 40 number is not good at all for HDL. Now it is getting closer to where I would be happy but the doc is overjoyed that in 3 months I could move it 10 points.

So now we maintain and improve. I had my flu shot. I declined the muscle relaxant. Continued with the nasal steroid as the allergy season is intense upon us here in north Texas. Acknowledged that I have been at plateau too long at this weight and need to focus on moving that needle in the get off pre-diabetes watch list.Continue to watch what I eat, work on paying attention more to my bodies indicators and most poignantly from my doctor ... enjoy life.

Who should get the shot?

Time to get your flu shot, but just one this year

It's flu-shot season already, and for the first time health authorities are urging nearly everyone to get vaccinated. There is even a new high-dose version for people 65 or older.

What a difference a year makes: Crowds lined up for hours for scarce shots during last fall's swine flu pandemic, when infections peaked well before enough vaccine could be produced. This year, a record vaccine supply is expected — an all-in-one inoculation that now promises protection against that swine flu strain plus two other kinds of influenza.

Shipments began so early that drugstores are offering vaccinations amid their back-to-school sales.

But without last year's scare factor, the question is how many people will heed the new policy for near-universal vaccination. No more stopping to check if you're on a high-risk list: A yearly dose is recommended for virtually everyone except babies younger than 6 months — the shot isn't approved for tots that young — and people with severe allergies to the eggs used to brew it.
"Influenza is serious, and anyone, including healthy people, can get the flu and spread the flu," said Dr. Anne Schuchat of the Centers for Disease Control and Prevention. "Flu vaccines are the best way to protect yourself and those around you."

The CDC was moving toward that policy even before last year's pandemic brought home an inescapable fact: The flu virus doesn't just kill grandparents and babies and people with weak lungs or hearts, although they're particularly vulnerable. It also can kill healthy pregnant women and 30-somethings. And 5-year-olds.

"We were discussing how we were going to go get his Star Wars Halloween costume after he got out of the hospital ... and all of a sudden his eyes lost their focus," said Serese Marotta of Dayton, Ohio, describing for reporters how her son Joseph, 5, died of swine flu last October before vaccine was available in her community. She urged families to make vaccination a priority.

Here are some questions and answers about flu:

Q: I got vaccinated against both seasonal and that so-called H1N1 flu last year, so why do I need vaccine this year?

A: It protects against a different strain of the H3N2 influenza family that has cropped up, as well as last year's swine flu, part of the H1N1 family, and a Type B strain. Every year a different flu vaccine is brewed to match the constantly changing flu strains that circle the globe.

Q: Why is there a new high-dose version for seniors?

A: Your immune system weakens with age, so it doesn't respond as actively to a flu shot. Sanofi Pasteur's Fluzone High-Dose quadruples the standard dose for people 65 and older. This winter, scientists will track if that translates into less illness. Until that proof's in, the CDC says it's OK to choose either option.

Sanofi is finalizing how much to make, and availability may vary with location. For example, Dr. Marvin Bittner of the Veterans Affairs Medical Center in Omaha estimates the new shot might benefit one in four seniors and said his center has ordered enough for that population, while other VA clinics aren't ordering as much.

Q: Will I need just one shot?

A: Most people will, but any children under 9 getting their first-ever flu vaccine will need two, a month apart, to prime their immune systems.

Q: What if my child's first-ever vaccine was last year and she got one dose of seasonal and one dose of swine flu vaccine?

A: She wasn't primed enough and needs her two doses this year, said Dr. Michael Brady of Nationwide Children's Hospital, who co-authored the American Academy of Pediatrics flu vaccination guidelines out Monday.

Q: Will there be enough vaccine?

A: Manufacturers project 170 million doses. Obviously that won't cover the entire population, but the CDC knows its near-universal vaccination policy won't spark a stampede for shots. Before last year, flu vaccine was recommended for 85 percent of Americans but only about a third got vaccinated. Last year nearly all 114 million doses of seasonal vaccine were used, but as the swine flu outbreak slowed, just 90 million doses of the special vaccine were used out of nearly 162 million eventually produced for the general public.

Q: Who's at high risk from flu?

A: Young children, anyone 50 or older, anyone with chronic medical conditions such as asthma or heart disease, pregnant women. Also, health workers and caregivers of infants can infect the vulnerable unless vaccinated.

Q: Who can use the nasal spray vaccine?

A: FluMist is for healthy people 2 to 49, no pregnancy or underlying health conditions.

Q: When should vaccination start?

A: Chain pharmacies already have started vaccinating; protection will last all winter. It takes about two weeks to kick in, and flu typically starts circulating around November.

Q: How do I know it's safe?

A: Unprecedented safety monitoring last year turned up no rare side effects from the special swine flu-only vaccine sold in the United States. "We're hoping a lot of the myths people had about the influenza vaccine may be a little bit less of a concern," said pediatrics specialist Brady. Abroad, a few reports of narcolepsy after a European swine flu vaccine are being probed; that vaccine didn't sell here. An Australian seasonal vaccine dosed for young children won't be sold here after being linked to some fever-related seizures in that country.

Q: Why should I bother since fewer people than usual died last year?

A: Last year's U.S. toll: about 12,000 deaths, 60 million illnesses and 265,000 hospitalizations. New CDC statistics last week suggest flu strain mortality varies widely, from 3,000 in an exceptionally mild year to 49,000 in a recent really bad one — and it's impossible to predict how bad each year will be.

This week from the National Stroke Association - Blood Thinner Awareness

Blood Thinners

Always some good information in what NSA puts out. This week was the link above that had this important information in it.

Possible Side Effects

When taking a blood thinner it is important to be aware of its possible side effects. Bleeding is the most common side effect.

Call your doctor immediately if you have any of the following signs of serious bleeding:

• Menstrual bleeding that is much heavier than normal.
• Red or brown urine.
• Bowel movements that are red or look like tar.
• Bleeding from the gums or nose that does not stop quickly.
• Vomit that is brown or bright red.
• Anything red in color that you cough up.
• Severe pain, such as a headache or stomachache.
• Unusual bruising.
• A cut that does not stop bleeding.
• A serious fall or bump on the head.
• Dizziness or weakness.

Some people who take a blood thinner may experience hair loss or skin rashes, but this is rare.


Stay Safe While Taking Your Blood Thinner

Call your doctor and go to the hospital immediately if you have had a bad fall or a hard bump, even if you are not bleeding. You can be bleeding but not see any blood. For example, if you fall and hit your head, bleeding can occur inside your skull. Or, if you hurt your arm during a fall and then notice a large purple bruise, this means you are bleeding under your skin.

Because you are taking a blood thinner, you should try not to hurt yourself and cause bleeding. You need to be careful when you use knives, scissors, razors, or any sharp object that can make you bleed.

You also need to avoid activities and sports that could cause injury. Swimming and walking are safe activities. If you would like to start a new activity that will increase the amount of exercise you get every day, talk to your doctor.

You can still do many things that you enjoy. If you like to work in the yard, you still can. Just be sure to wear sturdy shoes and gloves to protect yourself. Or, if you like to ride your bike, be sure you wear a helmet.

Tell others.

Keep a current list of all the medicines you take. Ask your doctor about whether you should wear a medical alert bracelet or necklace. If you are badly injured and unable to speak, the bracelet lets health care workers know that you are taking a blood thinner.

To prevent injury indoors:

• Be very careful using knives and scissors.
• Use an electric razor.
• Use a soft toothbrush.
• Use waxed dental floss.
• Do not use toothpicks.
• Wear shoes or non-skid slippers in the house.
• Be careful when you trim your toenails.
• Do not trim corns or calluses yourself.

To prevent injury outdoors:

• Always wear shoes.
• Wear gloves when using sharp tools.
• Avoid activities and sports that can easily hurt you.
• Wear gardening gloves when doing yard work.

Common Medical Conditions

If you have any of the following medical conditions or are at risk for having them, your doctor may have given you a prescription for a blood thinner. A blood thinner helps your blood flow more easily and lowers your risk for developing blood clots in your body.

Atrial fibrillation. Atrial fibrillation (A-tre-al fi-bri-LA-shun), a type of irregular heartbeat, is a fairly common heart disorder that you may or may not feel. Sometimes your heart will beat too fast or out of rhythm and may cause blood clots. Sometimes atrial fibrillation is also called A-fib.

Blood clots in the lung. A blood clot that forms in another part of your body, such as in your leg, can break loose and move through the blood to your lungs. The clot then gets stuck within a blood vessel that brings blood to the lungs (called a pulmonary embolism, PULL-mun-ary EM-bo-lizm). If the lungs cannot get enough blood, they will be damaged, and you could stop breathing.

Blood clots. Blood clots (DVT, deep vein thrombosis, throm-BO-sis) form in a vein. The veins deep inside your leg, especially the calf and thigh, are the most common areas where clots occur. Blood clots can lead to damage of the blood vessels in your leg and break loose and cause other organ damage.

Family history. Some people are more likely to get blood clots because of a family history. You may have a genetic condition that causes your blood to form potentially dangerous clots.

Heart attack. A heart attack is caused by a lack of blood supply to the heart. The lack of blood happens when one or more of the blood vessels pumping blood to the heart are blocked.

Heart valve disease. Heart valve disease is any problem in one or more of the four valves in the heart. Heart valves keep blood flowing in one direction. They act as a door that swings open, allowing blood to flow through the sections of the heart.

Heart valve replacement. There are many types of artificial valves that are used to replace your own heart valve. The material used to make these valves may cause blood to stick and form clots.

Stroke. A stroke is caused by a blood clot that blocks a blood vessel in the brain. This blockage cuts off the blood flow to a part of the brain and can cause problems with your speech, swallowing, or movement of different parts of your body. You may be at a higher risk for a stroke if you've had a heart attack.

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. :)

This is what transpired

~~ yes ... to the family members who got the email you will recognize but one handed typing takes time so I cannibalized ~~

hello all,

if you have not garnered already my introduction into new year was extremely pleasant and then rapidly cut short. please tolerate no caps and any small issues with grammar as I am the one handed typist. but I wanted to fill you all in n what transpired, where I was and the impact to facets of my life.

for new years I had come down to see Tammy as I had the chance to see some of the people who are an integral part of her life at an alcohol free event. this led to an extremely late new years morning and a lazy day ... where I developed a migraine. took some medicine and pretty much slept on and off for the rest of the day.

one factor that could attribute ... my cpap was not hooked up in the bedroom thus I did not sleep with it.

I found out Saturday morning that the handle to the working toilet had broken and ventured to Katy hardware to get one and a monkey wrench. this is the fateful area. I left the store, was over the doormat and about to the edge of that one level step when my feet just disappeared and I knew there was no way to recover. plus there is that slight factor of the incline at those front parking spots.

now I knew it hurt and everyone came out but I was just laughing at the stupidity of myself and told all that I was ok. I did the quick assessment and nothing registered as broken so I finished up by getting gas and heading back. I got Tammy to make an ice pack that I had intended to use on my thigh but put on the arm instead. then I popped three Tylenol and fixed the toilet ... tried to figure out the pressure issue with the shower. once done I relaxed and noticed that pain in arm was escalating to a point that was going over the threshold of my bad back pain and asked Tammy to take me to Katy Herman (sp) to get an x-ray. good thing as it is broken.

popped pills, slept overnight and then headed back here to work on Sunday. sorry but I am a one handed driver and cannot answer my phone or respond to text when driving.

so saw Dr. Garcia after much teeth gnashing and cursing at dentists that wanted to charge me for not giving 24 hours notice (on a weekend when they have no option to do that). he was immediately concerned that with my continued weight loss (9 lbs since the end of October and I was wearing this cast and boots) my blood pressure was too low. in the dentists chair it had been 102/60(something) and we all know that bp goes up in dentist chairs. he is pretty sure that this drop in bp was the cause ... so we are adjusting meds and the good news is that the two of the 40.00 a month meds are leaving.

his other concern is my thigh. I pretty much have deep tissue hematoma going on there and with me on Aggrenox I have to keep icing that down to shrink the blood vessels and stop the bleeding. as he predicted the color started showing up today but the thigh muscle has been trashed so I have to take it easy or it will just give out on me.

what a joyous mess right?

so now I go to see Dr Daniels on Friday at 10:15 to see what the heck I need to do with this arm. 

meanwhile I find myself stymied at some of the things that have suddenly become so hard. how to pull on underwear and pants with only one hand. how to shower the right side of my body with my right hand. for that fact putting on deodorant under the right arm. how to close my front door and lock it ... it has always been a two hand job as you have to pull the door as you turn the key. hanging up sweaters on a rack to dry. even opening mail is a chore. I accurately guessed that everything would take twice as long for me to do and that is even underestimating some of the time frames.

but it is the situation that I am faced with now. this is what happens when you brag about not having a broken bone ... someone decides you need to be humbled.  it has impacted all of my plans for the month but we must adapt, be humbled, realize our limitations and move on.

it is 2010. I have a wonderful woman whom I love. I have an incredible family whom I love. I have wonderful cyber-friends.  I am humbled while being blessed.

I am trying to figure something out

In 2003 I was asked to start taking Niacin and before that a 5 grain Aspirin to stop the flushing side effects of the Niacin. Thus from 2003 I had been taking 325 mg of Aspirin a day. This was why I would bruise when a butterfly landed on my arm (well not that easy but you catch the thought). Now I do not bruise so much and am only taking 50 mg of Aspirin a day in the Aggrenox. The side effect of Aspirin as a constant is thinning the blood.

Aspirin prolongs the time that it takes for your blood to stop oozing (bleeding time). Aspirin does this by decreasing the ability of billions of tiny cells in the bloodstream to stick to each other. These cells are called platelets. Normally when there is an injury, platelets will adhere to the site of injury and stick to each other forming a plug or platelet aggregate, after which blood clotting is initiated. Blood will still clot when you take aspirin, but it will tend to ooze longer before it clots.

And in doing that little bit of research I just answered my own question. I was trying to determine why ... if I took that much Aspirin for so long did I have a clot that gave me a stroke. It is not that Aspirin does not create a clot it just takes more time. (So I could have had a stroke without this a lot earlier on in my life)

So how is less better? Good question let me take a look.

Dipyridamole
Dipyridamole inhibits the uptake of adenosine into platelets, endothelial cells and erythrocytes in vitro and in vivo; the inhibition occurs in a dose-dependent manner at therapeutic concentrations (0.5–1.9 μg/mL). This inhibition results in an increase in local concentrations of adenosine which acts on the platelet A2-receptor thereby stimulating platelet adenylate cyclase and increasing platelet cyclic-3',5'-adenosine monophosphate (cAMP) levels. Via this mechanism, platelet aggregation is inhibited in response to various stimuli such as platelet activating factor (PAF), collagen and adenosine diphosphate (ADP).

Dipyridamole inhibits phosphodiesterase (PDE) in various tissues. While the inhibition of cAMP-PDE is weak, therapeutic levels of dipyridamole inhibit cyclic-3',5'-guanosine monophosphate-PDE (cGMP-PDE), thereby augmenting the increase in cGMP produced by EDRF (endothelium-derived relaxing factor, now identified as nitric oxide).


Aspirin
Aspirin inhibits platelet aggregation by irreversible inhibition of platelet cyclooxygenase and thus inhibits the generation of thromboxane A2, a powerful inducer of platelet aggregation and vasoconstriction.

Whoa ... where are you going with the medical speak Philip. Well actually it helps me in giving me things to learn and that is what I love to do. Essentially Dipyridamole - the other part of Apprenox - is the extended part action that works with Aspirin to do the same thing but a different way. Dipyridamole keeps platelets in your blood from sticking together to form clots a little more aggressively than Aspirin does by itself. But in taking it in the form of medicine that I am there are beta and alpha half life factors involved in the Dipyridamole that have greater stability than the wonderful issues of Aspirin alone.

Plus I don't bruise when a butterfly flaps its wings in South Africa.

Did I learn anything new

So I am in a pattern of waiting once again. Dr. G went over my test results but really does not know a whole lot about PFO. (Click on PFO for a really good overview of what it is) But there is a cardiologist that he uses and knows that this cardiologist has worked with PFO's and closure of them many many times.

Thus I wait for the referral now.

Tick tock, tick tock.

Decisions

Well I have decided that it is time for me to make a decision. I need to call my Doctor tomorrow, which means I will probably have to go in to see him but I will deal with that when it happens. I need to talk to someone about this TEE and what the surgery will entail and what type of time frames we are looking at here.

I feel good, except for the headaches, but that is a side effect of the medicine. I really do. Tired and have not been sleeping well. I cannot put my finger on why. But I get my Darth Vader mask on the 19th and then learn to start sleeping with that on. I am so hoping that it makes a difference.

But I need to get moving on my heart and that issue. There is much to know, much to find out and then things that have to be decided upon after that by me. So phone call tomorrow.

By the way I tried broccoli slaw today and that was actually really nice. Chicken breast, broccoli slaw and Green Machine for dinner. Almost back to normal. But I had sushi both Friday and Saturday as there was so much and you never turn down an invitation from a beautiful woman to go and join her for sushi. :)

My momma didn't raise no fool!

BTW - Happy Mother's Day to all. "The moment a child is born, the mother is also born. She never existed before. The woman existed, but the mother, never. A mother is something absolutely new." ~ Rajneesh

Neurologist

Maybe I am becoming immune to more news, maybe I expected to hear what I heard. It is just another step.

Dr. Blair's office on the morning of the 2nd. Results of transcranial doppler performed by the heart center.

Mean doppler flows are ok
Doppler flow directions are ok
No spontaneous emboli

Then came the agitated saline injected in the right arm - monitored of right middle cerebral artery.

Injection at rest: zero hits
Injection with valsalva number one: 16 hits
Injection with valsalva number two: 26 hits

Impression:

Normal baseline transcranial doppler.
42 embolic tracks with valsalva during intravenous infusion of microbubble contrast. This represents a grade 3 right to left shunt.

Grade 3 right...what the heck does this mean. Let me explain - there are complex journals out there that talk about Grade III RLS and then others that are technical papers with strange images. But in normal person talk it means that I have a hole in my heart. We are all born with this and it closes up in most of us. They used to think it was only a small percentage that it stayed open in but when they see healthy (for the most part) people with strokes at a young age they started looking and 50% of those people the whole did not close up. So now we have about 25% of the people wandering around with holes in thier hearts. This holes can create disturbances that cause clots that can do exactly what they did to me.

So my brother and I are sitting there and I say OK. Now I know Dr. Blair's opinion is to operate and close that hole. But I need to have a transesophageal electrocardiogram. Now I know what a TEE is and I am not happy about it. You can click on the links to learn more but once again we are getting invasive.

Sad thing is that my doctor (Dr. Garcia) said that this is what we would have to do in the very beginning. I was not happy then and I am not happy about this now but I guess I will have to see a heart specialist to figure out exactly what needs to be done. Then the cardiac specialist and the neurologist can have a thumb wrestle to see whose opinion is good.

Oh and by the way I did have two TIA's not just the one. The one on the right side was the big one and the one on the left side was rather small. But it does confirm the suspicion from before that I saw two areas of disturbance on the MRI results. Sigh. Two strokes for the price of one...

The book

UltraPrevention by Mark Hyman and Mark Liponis (both MD).

I am reading it now from the beginning to the end. This way I think I go through all three parts. The myths and why they are there, then the five forces of illness and finally the 6 week plan. I had started with the last part yesterday and read that...but I think I need to go back to the beginning to understand why.

The background of the two doctors ends up involving both Eastern and Western Medicine so I am looking forward to this.

But the one thing I had found in the last part and just read a bit about is homocysteine and how that is a much better indicator of heart disease and stroke. I am going to do some independent research on this, and Kilmer McCully who discovered this in the 60's. Hopefully I can give you some places to go and look at online.

Back to work.