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.
Showing posts with label specialists. Show all posts
Showing posts with label specialists. Show all posts
Wednesday, January 19, 2011
Sunday, December 19, 2010
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.
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.
Wednesday, July 7, 2010
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. :)
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. :)
Wednesday, June 3, 2009
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
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
Friday, May 29, 2009
Every minute counts!
Stroke Centers and Rehabilitation Facilities
If you or someone you know is experiencing stroke symptoms, call 911 immediately. Every minute matters!
There are different ways that stroke care facilities can demonstrate their commitment and ability to treat stroke and to provide rehabilitation support. Please read on for more information and to find a stroke center or rehabilitation provider near you.
Stroke Center Network Members
Members of National Stroke Association’s Stroke Center Network exhibit a strong and clear commitment to providing quality stroke care at their facility. Members represent a wide range of organization type and capacity related to the stroke care they provide.
Click here for a list of Stroke Center Network members in your area.
Stroke Rehabilitation and Recovery Network
National Stroke Association’s Stroke Rehabilitation and Recovery Network represents various types of facilities that are committed to providing rehabilitation care for stroke survivors (they may or may not support other types of rehabilitation needs).
Click here for a list of Stroke Rehabilitation and Recovery Network members near you.
Primary Stroke Centers Certified by The Joint Commission
The Joint Commission is an independent organization that awards a Certificate of Distinction for Primary Stroke Centers to centers that make exceptional efforts to foster better patient outcomes related to stroke care. This certification program was developed according to the Brain Attack Coalition's "Recommendations for the Establishment of Primary Stroke Centers."
Click here to access a searchable database of the more than 500 Primary Stroke Centers that have been certified by The Joint Commission.
State-Certified Stroke Centers
Some states have instituted their own certification program for primary and/or comprehensive stroke centers. These include the states of Delaware, Florida, Massachusetts and New York. Each state’s certification requirements and processes are different, so please contact a particular state’s department of health to find out more.
Rehabilitation Facilities Certified by the Commission on Accreditation of Rehabilitation Facilities (CARF)
CARF is an independent agency that accredits rehabilitation providers who meet a rigorous set of guidelines for service and quality.
Click here to access a searchable database containing CARF-certified providers. The CARF-certified facilities found on this site provide rehabilitation support for a variety of conditions and may or may not provide stroke-specific care.
To request a list of rehabilitation facilities in your area that are CARF certified for stroke, please send an email to awhitney@carf.org.
If you or someone you know is experiencing stroke symptoms, call 911 immediately. Every minute matters!
Sunday, May 3, 2009
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.
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...
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...
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