Dr. Song follow-up and other 'lovely' updates

It's been a year since I had my cataract laser surgery and my In-Ocular-Lens (I.O.L.) implant. Today, I had my 'yearly' check -up with Dr. Song at the Waltham location for the Massachusetts Eye and Ear.

Traffic cooperated today and I arrived a half hour early to a packed waiting room.  It didn't seem to take too long before I was called in for my eye test(s) and dilation.  My vision continues to be very good in both eyes and I do not need corrective lenses.  My cataract in my left eye hasn't changed much since my last screening (about 6 months ago).  Everything checked out OK.  I was asked to return to waiting room so the dilation drops could take effect.

About 15 minutes later Dr. Song called me into his examination room.  He had mentioned that he was reviewing my chart/history and seemed surprised about my recent Triple A repair.  He asked how things were going (for my eyes).  I had mentioned that the only 'issue' I had was the halo effect I experience when I go into an area that has heavy fluorescent lighting and/or bright (LED) overheads. I mentioned that my brain assimilates after a period and I'm no longer aware of the anomaly.  He reminded me that this is caused by moisture buildup between the lens and the tissue at the bottom of the 'capsule'.  "This can be easily corrected," he said.  "We can monitor this and if it gets worse or becomes bothersome, we can discuss performing the procedure".   I agreed.  He then to check my eyes. The good news is: Everything looks good and I will need to see him next year.  [Yay]

I left his office and visited the receptionist for next year's appointment information.  Leaving the office the sun decided to make a rare appearance and I was glad to have remembered to bring my sun glasses in with me.  Between the bright sun and the dilated eyes, I'd be squinting without the glasses.

The ride home was uneventful.

Other medical updates

It must be a law or protocol to inform the patient of the results of any type of imaging performed.  Last December, I was notified that there was no cancer detected in my mammogram.  Well I did get the results of the CT scan I had done at UMass Medical on May 1st.

Primarily, the results were favorable for the final placement of the stent (repair of the Triple A) and there was no endo-leak.  However, there was a notation that the aneurysm was now a bit larger (6 cm.).  I recall my research and Dr. Schanzer's saying that the 'sac' will begin to shrink over time.  He did say that the risk of rupture (at the site) has been almost eliminated.  There is no blood supply or leak that could cause this.  This news is just a bit disconcerting to me.  But they are the professionals and I'm scheduled to see him in December.  I'm optimistic that things will be better. [Fingers crossed]

There were also two entries that surprised me.  Apparently I have a Hiatus Hernia (not Hiatal) and a distended gall bladder without stones.

• I did some research on the hernia.  The Hiatus is the end of the esophagus as it 'starts' the stomach. This condition can be caused by acid re flux (GERD) [Which I have]; straining; excessive coughing; sneezing, and some others.  There are no symptoms until it gets bad.  For many there are no real problems.  But with my luck....

• The distended gall bladder research indicated that the cause could be a blockage of the bile duct (generally a stone) or another serious type of illness - my cancer??  Once again the symptoms mimic other maladies (heart attack being one) and manifest as the condition worsens.  Treatment is exercise and proper diet or removal of the gall bladder.   I currently get a good amount of exercise (walking) and I'm good about making healthy choices when it comes to eating.  [Thank you, Weight Watchers]  So I'll have to 'be aware' of this.

The report also indicated that a copy would go to my PCP.  So I have some questions to ask Dr. Rees when I see him in August.  As Rosanne Rosannadanna used to say: It's always something!

More to come.

Follow-up with PCP - Dr. Rees

According to my instructions on my discharge paperwork that I received from UMass Medical, I had scheduled a follow-up visit with my primary care provider (PCP) - Dr. Rees.  He now works part-time and I was unexpectedly surprised when he showed his face.  He now 'Winters" in Florida and comes back to work in the Spring.  I have history with him, so his presence made me feel that much better.

Everything is run off computers these days, so with laptop in hand, he entered the examination room.  After greeting, he said that he was reading the 'file' and he has seen that I have been through a lot since our last face-to-face (August). But he expressed satisfaction in knowing it is all in the past (as I am).

He checked my vitals and reviewed my medication list and recent test results. "Things look good," he said.  He asked if I had any questions or needed to talk about any 'new business'.  I took the opportunity to state my case for not needing Atorvastatin.  I likened it to an honor student being forced to attend summer school.  My cholesterol numbers have been stellar - without medication, so having to take this was like a slap in the face.  Dr. Rees agreed with me.

He said, "Just because there are pills, doesn't mean that we have to take them all.  Atorvastatin is not a blood thinner and although it also used to treat heart disease, you don't have heart disease.  I would stop taking it."  Fine with me.  He asked that I come in for a lipid (cholesterol blood test) in about a month to ensure that my numbers are at their historical levels.

I'm glad to be off Atorvastatin, but I'm sure it will take a bit before I notice any side effects diminishing.  It should be interesting to see if my runny nose and hoarseness goes away...and anything else I've gotten used to.

Energy levels are improving and I'm almost to the point of wellness just prior to the procedure.  I was able to work in the yard today and mow the lawn.  It was a struggle toward the end, but I made it.

More to come.

It's May! (Sure doesn't feel it)

Happy May 1st everyone.  I guess the warm (summer-like) weather we had a few days ago just couldn't stick around long enough to greet the new month.  This is New England and more rain is predicted.  Drought, be gone!

I had my (little more than a) month follow-up since my Triple A repair (EVAR).  I fasted four hours prior to a CT scan.  But basically, when the exam is scheduled for 11:30, I had been fasting since night before.  I can handle the lack of food intake, but I'm in a perpetual fog without my coffee.

Checking in at Radiology at 11, I was given my mandatory SAT to complete.  Seems they are always giving me something to complete that requires my looking up answers.  For example, how old ma was when she passed.  I get my calculator app fired up and subtract 2001 from 1923 (year of death/year of birth).  I'm good at remembering the dates, but not so much on the number of years alive.  Same for dad.  I finished and waited...and waited.  Finally at 12:15 PM, I complained.  I did have a follow-up visit with Dr. Schanzer at 1PM and I was concerned. 

Don't know if it was happenstance or the squeaky wheel syndrome, but I was called in with a few minutes of my returning to my seat.  I was guided down a long corridor and was instructed to enter the imaging room.  There were two attendants and they were furiously working to get everything in order.  I was told to lie down and pull my pants down to my knees.  I was covered with a blanket while one attendant prepared my vein for the IV.  Before I knew it, the saline was coursing through my veins and both technicians left the room to view me from the control room.  They took about four passes. [They must have a recorded female voice that they use to provide instructions: "Take a deep breath and hold. Now exhale and breathe regularly."  I saw no woman in sight.]

I heard one attendant say, "Here comes the warm feeling".  At that point I could feel the "contrast" (nuclear dye??) enter my body and diffuse through my veins.  It was warm, but not painful.  My hot flashes seem stronger.  I took a few more rides in and out of the tube and was told that we were done.  I looked at the clock and the whole thing took about 15 minutes.  [Do shoulder shrug here.]

I left and thankfully, there was a kiosk right outside radiology and they had Starbucks.  [High Test].  I ordered a small back and a blueberry muffin.  Not cheap, but convenience has its price.  The coffee was wicked hot, but after a significant amount of blowing, I was able to caffeinated myself.  I felt my brain waking up.  [Almost heaven].

I had 15 minutes to get across the street and up to the third floor for Dr. Schanzer.  Walking while sipping I got there in 5 minutes.  I checked in and got another round of SAT paperwork to complete, but I was called before I finished.  Angela said she'd help me out.  She took my vitals and we stopped into my examination room.  She looked at the paperwork and asked the questions and entered the information to their computer system.  I was asked to strip down to my undershorts and was given a johnnie to cover my lap.  "Dr. Schanzer will be with you shortly", Angela said.

It seemed to be about 20 minutes of waiting before a colleague of Dr. Schanzer's arrived.  Apparently, Dr. Schanzer was delayed in the operating room.  She [can't remember her name] said that she reviewed the CT scan results and everything looked good.  She indicated that there was no leak, but they were going to monitor an artery (to the lumbar region) that will correct itself over time.  She said that I'll have a follow-up ultrasound in 6 months.  She said I could wait for Dr. Schanzer, but I didn't have to if I didn't want to wait any longer.  I indicated that I was here, so I'll wait.

Not long after, Dr. Schanzer knocked on the door and entered.  After apologizing for the wait, he reiterated what his colleague had told me.  He did explain that the artery they are watching is not leaking.  There is no blood source.  The body makes this correction over time.  [I recall some of my early research indicated that this condition is fairly common.  The body is smart and will re-route veins and arteries when one is (some are) no longer functioning.  There is also redundancy so there are many arteries/veins to take up the extra slack to ensure delivery of blood.]

Dr. Schanzer said I have no restrictions and he will see me in 6 months.  He shook my hand and I left to schedule the follow-up.

Yet another health issue can be closed (almost).  I no longer have to worry about a rupture at the most inopportune time.  Only if the sun were out today.  There's always tomorrow and the day after.....

More to come!

I'm ready for my close up, Mr Demille

Had my post tattoo follow up with Dr. Chatson today.  My tattoo was inked mid February, so he wanted me to come in, 'in a few months' to see how the finished product came out.  It's amazing what multiple plastic surgeries can do and a tattoo.  Other than some scars (that will fade with time), everything looks great.

He seemed please with the results also.  He rushed to get his camera.  Dr. Chatson had been taking pictures of the before, during and after phases of my reconstruction.  I'll be in his 'book' he shows to perspective patients. Of course there is no face shot, just that of 'the work'.

After he took a few shots some head on, some angled, he shook my hand and said it was a pleasure getting to know me.  He wished me luck and said there was no need to see him again unless there is a change that concerns me.

It's been almost two years since my first surgery (mastectomy).  It's been quite the journey, but time has sped by.  I can now close the chapter on my reconstruction.

Other medical updates:

After two weeks of a hellish recovery from my Triple A procedure, I have begun to return to some form of normalcy in week three.  My energy level has been tough to maintain, but I have been able to walk (almost daily) for about 3 miles.  Some days I make it past 4 miles.

Some of my side effects seem to have abated. 

• My back pain and flank pain has improved greatly although it's still there.  I believe being mobile helps lessen this.  
• I am beginning to return to normal sleep patterns.  I'm now sleeping about 7-8 hours a night versus the 15 I had experienced during the first two weeks.
• Still unexplained, my neuropathy in my thumb and finger flared up but is now calming down.  So strange.  I did pick up my guitar last Saturday for the first time.  A little rusty, but I've been playing more often.  I need to get back to playing piano and singing.  
• I've notice my voice is very tight (and out of shape).  The hoarseness I had seems to have abated, so I think it's time to start vocal exercises.
• I haven't resumed my daily in-house exercises yet although I should be doing that too.

I have a CT scan and a follow-up visit with Dr. Schanzer on May 1st. An update on this will be forthcoming.

More to come!

Two week follow-up

Trekked into UMass Medical, Worcester with my sister, who on this National Siblings Day was kind enough to drive me (again).  I had been restricted from diving since the procedure and although I could have driven myself, it would be just my rotten luck that something would happen when I wasn't supposed to be operating. Thanks, Les!

The weather was wonderful.  We wanted the windows open, but the wind made it difficult to converse. So we resorted to cracking the window when it got a bit stuffy.  I told her it was reminiscent of my daily hot flashes (from Tamoxifen).  Nice ride, great company and good conversation.

We didn't get lost this time, nor depended on the GPS to lead us to a road closure. We got the 'perfect' parking spot and made it right when I had planned to be there.  Prior to boarding the elevator to the 3rd floor we each visited our respective restrooms. [Insert inappropriate Bathroom Bill humor here.] I was truly surprised for a healthcare facility, the there were no paper towels or hot air hand dryers. Don't you just hate it when you follow all the directions and wash thoroughly with lots of soap and water and then find yourself going from dispenser to dispenser in search of that towel.  And it wasn't even April Fools Day. Pant legs took the excess moisture.

Arriving on the third floor, it wasn't long before an attendant took my information and copay when she gave me a clipboard for my SAT's and asked me to sit.  I had only completed the first two sheets before a nurse called my name and directed me into the inner sanctum. Traversing myriad hallways, I landed in an examination room and had my vitals taken.  The nurse helped me with the SAT paperwork and asked that I strip down below my waist and place a johnnie over my lap.

Shortly after Shauneen Valliere, NP entered, announced herself and extended her hand.  I was glad mine was dry. She asked how I was doing and I told her my difficulties with the recovery process.  She indicated that much of my trouble was a result of all the meds, anesthesia, and antibiotics I was given over a short time.  She said, "Although outwardly. it looks like not much has happened, inside that's not the case.  The body needs time to adjust and get back on schedule."

I discussed some of the side effects that have persisted and she seemed a bit perplexed with the pain that I had been having in my back and flank.  She said, "We don't have the most comfortable beds and you're spending so much time (lately) on your back, the pain could be from those.  Other patients had reported that side effects of the statin cause pain the large muscles (like the leg and thigh), but your pain could be something else."  As Dr Schanzer said, and she echoed, "Give it some time.'

Shauneen then looked at the surgical sight and mentioned the bruising.  It had been worse.  She then said she was going to press and to let her know if there was any pain.  She pressed harder and harder as if she was hoping there would be pain, but there was none. She seemed pleased.  She told me that I would be contacted to schedule a 3D ultrasound and CT scan to ensure that 'things landed where they were supposed to', and to check for endo-leaks.  She said early detection was critical.  After a few months, I would need another ultrasound, then yearly monitoring- for the rest of my life. [This was no surprise to me.]

I was given the green light to drive again, encouraged to resume my walking regimen (I had walked more than 6 miles over the last three days).  I asked about resumption of my exercising and she said, "Start slow."  At that, she wished me good luck and said, "You need no paperwork so you are free to go."

I met Leslie and we were on our merry way.  Arriving home I 'drove' to the grocery market and shopped and upon returning took a 4 mile walk in the summer-like weather.

So finally, I'm seeing the improvement that had eluded me.

More to come.

Week One of recuperation

Believe it or not, it's April.  Thank you Mother Nature for providing a not so funny April Fool's day storm.  Luckily for me, I didn't (and couldn't) be part of the clean-up, but true friends were there for me to dig me out and rake the roof.  Greatly appreciated!

We had a glimpse of Spring on Opening Day although I was not able to participate except enviously enjoying the sun and warmth through my windows.  This was short lived and we are back in the cold wet rainy pattern.  Can it be long before we are complaining about the heat and humidity?

This latest battle for health has been my toughest yet.  I thought round 4 of chemo was bad, but that was a walk in the park compared to my last week in hell.  Kicking off with extreme tiredness; no appetite; no sense of taste; constipation; general discomfort and malaise I gradually regained some sense of taste and was able to have some sustenance.  An angel of mercy dropped off some protein drinks, Pro-biotic Yogurt and other easy to eat munchies.  Initially all I wanted to (and could only) do was sleep.  When I was tired of sleeping, I slept some more.  I had zero energy.  Each time I stood up I could see my vision dissolve to black, then recover.  This was a side effect of my hypertension meds, but exacerbated by my lack of energy and body fuel (food).  Oddly enough, there was only minor discomfort at the surgical sites, but my back and flank could find no happy spot that would relive the pain.  I was fearful to take OxyContin because of those side effects (constipation) so Tylenol was substituted and it seemed to help - somewhat.  I did resort to MiraLax and after day four I had my first (very small) movement.  I've had subsequent voids, but each produced low output.  Granted I wasn't eating much.

As the days progressed, my improvements failed to be realized.  However my appetite was improving and I expanded my diet to oatmeal, roll-up sandwiches, cheese snacks (I know it's binding.) By the weekend I had cravings for foods and gravitated toward those, whether they were healthy choices or not.  I had already lost seven pounds so eating a candy bar was probably OK.  By the weekend I was craving pizza.  Another not so health choice, but it was hot and gooey and I was craving it. I really did nothing other than sleep, munch, watch some TV and surf the net.

I've been really concerned with the new meds prescribed.  My biggest concern was Atorvastatin.  It's generally given to treat high cholesterol, but fortunately for me my 'numbers' have been traditionally desirable without medication, so having to take this drug equates to a slap in the face.  I did discuss this with my doctor and agreed to 'try it for awhile'.  The paperwork I received from the pharmacy did say that it prevents heart attacks and strokes.  But there must be other drugs that do this without the side effects.

Side effects are different for each person, but for me they are as follows:

• Burping/gas - This is the only drug I take at 9PM.  I'm not sure if I'm in a horizontal position while it 'does its thing', but I feel discomfort from gas.  There's quite a bit of flatus while in bed or when standing from bed.  Although most has been gas, I have experienced burping to some extent.
• Sniffles/runny nose - A nuisance side effect.  Thank heavens for pocket Kleenex packets
• Unusual tiredness - This is a tough one to call, but as time goes on and I get more and more sustenance, one would think I'd have more energy.  For the most part this is true, but I'm still sleeping 12-15 hours a day (Including a two hour nap).
• Boring pain in the back and flank - this is the most worrisome side effect.  I'm prevented from finding comfort when sitting and can stand no longer than 15 minutes before having to sit and rest.  Prior to the procedure I had these pains, but to a much lesser degree.  Tylenol helps somewhat, but I hate throwing medicine at a pain caused by medicine.  This discomfort has cased my entire spine to feel 'stiff' and achy.  I'm hopeful that some other type of med can be used since this is the most debilitating.
• Headache - A nuisance side effect.  Sometimes dissipates when I take Tylenol.
• Constipation - I just can't seem to escape this one. 

I've read and re-read my discharge papers.  And there is nothing in the list that applies to me (or is happening)  requiring my notifying the physician.  There was one item - temperature exceeding 101 degrees, but my temperature has been pretty constant.

Other than those listed above, my next biggest challenge was state of mind.  Having gone through many health battles, keeping positive and finding inner strength has been nearly impossible.

I’m not certain how or why, but something happened as a result of my procedure last month.  I’m not the same person.  Or maybe, I’ve come to realize the person who I have become since my numerous health issues.  One could argue that I’m still in recovery and these thoughts and feelings may pass or resolve somehow, but I don’t think they can.  This has brought me to a great pause and self assessment.  I tried to turn these dark feelings into lyrics and was frightened by what came out of me.  I've found that I've come to the door of deep depression and had turned the handle.  I did not pass.  This is probably because I've had so much support from family and friends.  I will get through this, but I will be different on the other side.  After much deep deliberation, I have decided to retire from the performance aspect of music.**  I resigned my position in Fitch's Brew and will assist in a transition.  Not knowing what I still can do musically since the worsening of my neuropathy, I'm trending to downsizing and having fewer long term commitments.

More to come.

[Post Script:    **Clarification - I had many find my statements rash and alarming.  Some personally reached out to me.  After my explaining the background and reasoning, each had a better idea as to what I meant and were supportive.

Simply put, I will no longer pursue any musical activity that would require a significant physical commitment.   I can no longer fulfill the roadie/musician role.  I'm no longer 25 and the personal physical toll of a load in, set up, performance, breakdown and load out are no longer viable.  I can/will pursue situations where there is a minimal amount of physical exertion. I apologize for needlessly alarming my family friends and  readers.]

Day two at home

Feeling pretty miserable.  I can't seem to get comfortable or keep in a good position for too long.  I still have no appetite and anything I force feed myself seems particularly bland. Black coffee seems to go down alright, but the wanted side effects aren't happening.  I did take MiraLax, but that has failed to yield results.  I know there was a great concern about straining, so I'm waiting for the obvious biological sign that it's time.

While preparing my self for my first shower, I stumbled upon the Dramamine patch behind my ear and one errant electrode still stuck to my side.  Since I've removed that electrode, I haven't had any further upper back pain and chest pain.  Could I have been sleeping on this for an extended time and once off of it the pain begins?  Seems to be the only reasonable explanation. [ I've heard of similar bouts of pain when woman wear a wire bra for an extended period of time.]

My throat soreness has cleared up and my urethra pain is gone.  I was told to monitor the temperature of my extremities, but the nephropathy in my feet negates any sensation of cold toes.  So I'm wearing socks, even to bed.   I'm sure my lack of proper sustenance isn't helping my body to generate heat.  I've lost 5 pounds.  I just want to go.   Of course the mind travels to a dark place and wonders if my colon has been paralyzed. For someone who has been extremely regular all his life,  this is a great departure from schedules. I'm not in the best state of mind right now.

On the positive side, I've had no reason to take any pain meds.  I know the constipation is a result of meds I received in the hospital after the procedure.  Plus there is very little food in my stomach, but I have no appetite or taste.  [Looking back at older blogs I can see a similar pattern.]

[Post Script:  My sister Leslie said that a symphony has 4 movements.  I'm happy to report that I just caught the last movement (BM).  Hallelujah!]

I have lined up someone to do my shoveling (and hopefully rake the roof) if this storm materializes into the snow-magedon hyped predictions.

Happy April Fools Day.  More to come.