Out at work

We had a staff meeting yesterday.  Towards the end, my boss announced that another department is doing a “fitness challenge” and wanted a volunteer from our office to participate.  I’m a little fuzzy on all the details but the general gist is this.  All departments recruit at least one member to sign up for a certain time period of semi-public sharings about how many times they took the stairs, walked a mile, ate some kale, shit like that.

This is so not me.

My boss said “I did it last year and it was a pain in the ass, so I’m not doing it this year.” and then we went around the room and each of us tried to get out of it in various ways.  Our office coordinator, an unbelievably cheerful and accommodating person, said “I already was recruited by X department” (she has a lot of friends in X department) “and last year I did it with Y”.  Assistant director didn’t say anything, but put his finger on his nose, the universal gesture of “not it!”  So, me.  “I’d do it if I could think of some way to adapt it to me and my health stuff, but let’s see, taking the stairs?  Not something I do.  Food?  Let’s see, I can’t eat before noon, so the whole ‘healthy breakfast’ thing is out…and there’s an increasing number of things I can’t eat, many of them are what’s considered ‘healthy’.  I don’t know how I’d do this without a mass disclosure of a lot of health stuff, and while I think it would be good for people to have the educational experience, I’m not sure that I want me and my body to be the lesson in such a public way.”

So, in other words, “not it!”

It makes me apprehensive to have to bow out of these sorts of things.  I worry that at some point, I will be seen as taking too many liberties, too many “special” circumstances.  But damn, it’s work, you know?  I need my energy at work for WORK, not for sprinting up and down flights of stairs while the training montage music for Rocky plays.  My big “fitness” challenge is managing to do my PT exercises, and you know, I’m just not in the mood to share those with the group.  I have to deal with public judgement in a bad way almost daily.  Why ever would I sign myself up for participation in an activity where my abilities will be officially compared to my (mostly healthy) peers?  That’s like inviting a really bad day, every day.  No thanks.

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Crash

(caution:  this post is a little graphic)

 

Little brother was in a car accident last night.  He’s ok, got admitted though since he had chest pain, a clear seatbelt mark along his chest and neck, and an abnormal EKG.  He’s had EKG abnormalities before, but his last EKG was a while ago and not at the hospital the ambulance took him to.  Oh for better medical records.  Without a recent EKG to compare it to, they went the conservative approach and admitted him for cardiac monitoring.  I’m glad, since until they came back in to announce that, little brother was insisting on going home with my parents to Small Pilgrim Town in the Middle of Nowhere, where the local hospital is Ye Olde Baby Shack and practices emergency medicine with the skill of a team of drunk frat boys playing Operation.

It was interesting to see how the ER staff treated him.  Overall, I’m pretty happy with it (other than the rotating teams of residents plus med students, fellows plus residents, and random attendings who don’t announce their specialties or names).  So it was a CT and an admit for him.  I’m glad they admitted him.  I remember my ex telling me about a car accident patient he saw who he almost discharged.  Everything seemed fine.  No apparent injuries.  As he was getting ready to discharge her, he noticed she had two little cuts at the base of her nostrils.  He thought that it was from a nose piercing that got caught and ripped (this was the 90s, nose piercings abounded) but on a whim, he told me, he reached down and gently nudged her nose.  “And it just lifted right up!  Holy shit!”  he said he had a hard time not yelling that while examining her.  Instead, he said “you know, I’m actually gonna have surgery come in for a moment…” and hightailed it out of the room to cancel the discharge.  It turns out that although she didn’t remember it, she had impact to her face. Steering wheel was what husband figured, although I guess it could have been airbag.  Again, the 90s, and not all cars had airbags.  “I can’t believe I almost discharged her” he said the next day.  “Can you imagine if she’d gone home?” and he shuddered, imagining horrifying scenarios having to do with what would have happened to her nose had she gone to bed and rolled over onto her face.  This was not the first or last “almost discharged” or did discharge only to have a parking lot readmit my ex ran into in the 7 years we were together.

It’s easy to miss some things.  This is something I know, something patients are not supposed to know, or are supposed to pretend they don’t know.  And patients are not always aware of what is important about their story.  It can be hard to know what “what happened” means in an acute or emergency situation.  I imagine eliciting a correct and complete history must be one of the more difficult things that doctors have to do.

Hair today

My hair is finally staying on my head.  Well, more is staying.  For about a year now, it’s been falling out.  It isn’t breakage, I can see a little bulb at the bottom of the stray hairs I find.  And, thankfully, I am still growing new hair.  The crown of my head is wreathed with wee new hairs, the kind that are so short they stand up nice and straight.  I can tell it’s thinning though.  Can’t keep up with the shedding.  My hairdresser and husband assure me that I am growing new hairs (and as I said, I can see them sticking up there, fly away doesn’t begin to describe this), but I know how my hair feels on my head.  I know how it should feel to run my hand through it, or to brush it.  It is lessened.  And every shower has been a small funeral for my hair, piles of it swirling around the drain filter, waving in the water like a particularly leggy sea creature.

For the last few weeks though, there’s been less loss.  And I think the crown of new hairs are starting to calm down a bit.  Maybe lasting longer, reaching a level of maturity that previously had been denied to them?  But what was cutting them down so early?  My money’s on malnutrition.   Sometime this year, I think in early summer, I discovered that my non-dairy creamer was triggering a lot of bad GI stuff.  I cut it out, replaced it with rice milk (which I settled on after trying several replacements), and the weight started coming back on.  My gut calmed down an order of magnitude.  Well, how about that.  Then I started a low nickel diet.  Again, more help.  Less gut pain, less flushing, food staying in longer, fewer mouth sores….Then I had a serious back-slide around christmas.  It didn’t take long to narrow down the possible culprits and remove them from my diet (I’m going with the whole grain english muffins, although the cider I was drinking around that time might have contributed.  I still haven’t gotten the nerve up to try reintroducing it to my diet).  With a much calmer baseline gut, I was able to recognize when another particular food set it off.  Peppers.  Damn.  Ok, no more peppers.

Around the time of the peppers, I also made a concerted effort to find and stick with a vitamin.  The tendency of nutritional supplements to contain a cornucopia of bizarre elements stymied me a bit at first (who the fuck puts nickel in a vitamin?!?) but now I’m on a generic little multivitamin and have been for a few weeks.  And my hair is staying on my head.

 

I am proud of myself for having worked out a lot of the food triggers for my GI symptoms.  It was NOT easy.  And I don’t feel like I had a hell of a lot of help from the docs who should have been helpful in this particular domain, i.e. the GI docs.

 

hip, hip…

…not hooray.  Opposite of hooray.  My right hip has decided to act up.  The right hip.  The “good” one, relatively speaking.  Last night just before bed,  I was having short, sharp, intense pains in what I refer to as the “ass-al region” on the right.  I woke up pre-alarm clock to a very bad feeling in my right hip, all through the back and to the outside.  Did I bend into pretzel shapes while I was sleeping?  Was the hip slowly moving out of joint like some planet entering a new transit?  A horoscope of misery?  “Hip trine knee – this transit will be a pain in the ass, literally!”

What to do.  Wait and hope is where I’m leaning.  Otherwise, see PCP, get referral, see ?ortho? and hope it’s not a sports doc who doesn’t have the time for someone who can’t leap tall buildings in a single bound?  Act like it’s just the hip when really it’s the whole damned set of joints.  I am not looking for a diagnosis, just hoping I didn’t injure myself.  With unstable joints like mine, it is NOT hard to do.  Sitting, standing, walking, and even sleeping wrong can be enough.

migrainous? they don’t even know us!

Ba-dum-dum.

Migraines are like a bad joke.  Have five days off of work?  How about a migraine?  Feeling better and  thinking you’ve turned a corner on the health stuff?  Boom, have a migraine!

I blame the massive weather shift that brought a 30 degree temperature drop, high winds, and (the all important) pressure shifts.  Sitting in my living room with the lights dimmed, sunglasses on, and my phone’s display set to the lowest brightness I can get, I found myself looking up weather and migraine.  I found the most absurd “article” on it at the Mayo Clinic.  Normally, I like their patient info pages.  They’re better than Web MD, for example.  But they do fall short here and there.  E.g., if you look up “blood pressure” and select the Mayo link that says in the search results “Blood pressure chart: What your reading means – MayoClinic.com – blood pressure chart can help you understand what your blood pressure reading means.” you are taken to a page that gives the following information:

Here’s a look at the four blood pressure categories and what they mean for you. If your readings fall into two different categories, your correct blood pressure category is the higher category. For example, if your blood pressure reading is 125/95 millimeters of mercury (mm Hg), you have stage 1 hypertension.

Top number (systolic) in mm Hg   Bottom number (diastolic) in mm Hg Your category* What to do**
Below 120 and Below 80 Normal blood pressure Maintain or adopt a healthy lifestyle.
120-139 or 80-89 Prehypertension Maintain or adopt a healthy lifestyle.
140-159 or 90-99 Stage 1 hypertension Maintain or adopt a healthy lifestyle. If blood pressure goal isn’t reached in about six months, talk to your doctor about taking one or more medications.
160 or more or 100 or more Stage 2 hypertension Maintain or adopt a healthy lifestyle. Talk to your doctor about taking more than one medication.

Can anyone tell me what’s wrong with this picture?  A blood pressure of 80/46 is apparently normal and you should maintain the healthy lifestyle that you currently have.  Yep.  No need to worry that you might fall down or pass out.  You’re fine!  Because you’re not hypertensive!  Of course, when you look around a little more, you’ll see that although the page is titled “Blood pressure chart: what your reading means”, there is a superordinate heading that reads “High blood pressure (hypertension)”  When you search for “low blood pressure” on the Mayo site, you don’t get a chart with ranges or “what to do”.  Nope.  You get a front page that tells you that “In severe cases, low blood pressure can be life-threatening.” but then goes on to tepidly describe that “blood pressure varies from person to person, a blood pressure reading of 90…or less systolic blood pressure…or 60 mm Hg or less diastolic blood pressure…is generally considered low blood pressure.”

This is a lot like what happens when you look up BMI on the web.  Even reputable sites have a skew towards discussions of obesity and high BMI.  If you’re underweight, well, apparently you can go fuck yourself.  There are two categories above normal but one below.  Apparently there is no difference between being a little underweight and being a walking skeleton with a host of serious health risks.

I should not have been surprised to see that their page titled “Migraines:  are they triggered by weather changes?” was so bad that it made me laugh.  Here was the part that I just laughed out loud at, emphasis added by me.
If you feel your migraines are triggered by weather, you may be understandably frustrated. After all, you can’t change the weather. However, you can learn which weather changes start a migraine and take steps to lessen their effects:

  • Keep a headache diary, listing each migraine, when it happened, how long it lasted and what could have caused it. This can help you determine if you have specific weather triggers.
  • Monitor weather changes and avoid triggers if at all possible. For example, stay indoors during very cold or windy weather if these factors appear to trigger your migraines.
  • Take your migraine medication at the first sign of a migraine.
  • Make healthy lifestyle choices — eat healthy foods, exercise regularly, get enough sleep and keep your stress under control. These factors can help reduce the number and severity of your migraines.

 

I was indoors all damned day Monday, and hey guess what?  It found me anyhow!  There’s really fuckall you can do about migraines triggered by pressure changes.  Truly, not a damned thing, other than up your prophylactic meds, try like hell to avoid any other triggers that are within your control, and clear your schedule.  If I had to write that, here’s what I’d write.

If your migraines seem to be worse or occur more frequently during certain weather, here are some you can steps to take to make sure you don’t drive off a cliff, get horribly and embarrassingly ill at work or in public, fall over and hurt yourself, or vomit on someone:

  • Keep a headache diary, listing your migraine symptoms and how you felt in the 12 hours preceding it.  This will make you feel like a hypochondriac but it can help.  It will help you to identify “prodromal symptoms” – i.e. early warning signs that a migraine is coming on and which you can then use as a signal to slow down, get someplace safe, dark, and quiet, and medicate if necessary.  It can also help you to figure out if your migraines have any rhyme or reason at all or if they just take you at any old time and fuck up your life.  
  • Monitor weather changes and plan accordingly.  If you find that severe temperature exposure is a trigger, try to stay in a temperature controlled environment as much as possible.  Your friends and associates will think you’re a pussy, but tough shit.  It’s your head and body, not theirs.  If you find that pressure changes trigger migraines, you’re just screwed unless you have access to a hyperbaric chamber.  Stay home and medicate.  
  • Take your migraine medication at the first sign of a migraine, but if you get migraines too often, a smarty pants doctor  will tell you that your medication use is triggering your headaches through rebound.  Ha ha!  Joke’s on you.  
  • Make healthy lifestyle choices.  They may not help if you have chronic daily headache, but at least you’ll look great!  Also, when you see that sanctimonious, smarty pants doctor who thinks that all you need is a can do attitude to overcome your chronic health problems, you will be able to tell him that you eat healthy foods, exercise even when you’re dizzy and pukey, take ambien to fall asleep when your migraine comes with insomnia, and live a pampered life of luxury that includes being unemployed, childless, and surreptitiously medicating your family and friends with mood stabilizers to keep them sane and stress free.  Congratulations.  You may still have headaches and other migraine symptoms but hey, gold star for effort!

Do I sound bitter?  I guess it’s three days of migraine.  Sunday, Monday, and yes, Tuesday at work a big fat migraine.

hijacking brunch

I wrote about my little brother’s invitation to brunch.  As it neared, I checked out the restaurant he had chosen.  After we passed on going last weekend, he wrote to me and my husband saying “Ok, next Sunday” and declared that we’d be going to the one with the “FABULOUS” menu.  Here’s what I discovered as a result of my research, between Yelp and a work friend of my husband who has been to the chosen restaurant because it is near where he and his wife live.

  • This place is a favorite for drunk/morning after university students.  Smart students, given where it is, but studenty nonetheless.  
  • Expect to wait in line for over an hour unless you can manage to be there promptly at 9:00 AM (and I don’t eat at 9:00 AM).
  • Waiting in line means standing in line, there is no space for sitting and waiting.  
  • The waitstaff are hipsters and can be a mixed bag in terms of civility and competence.  
  • The bathroom is in the basement, at the bottom of some sketchy stairs, and is often gross (huge thank you to the Yelp reviewer who mentioned this).

This all added up to a big fat no for me.   A recipe for passing out is prolonged standing and waiting to be seated at a restaurant while smelling and thinking about food for my first meal of the day or arriving so early that eating will set off gut cramps and I will have to hobble down the stairs to the gross basement bathroom where I may end up on the gross floor of said gross bathroom, semi-conscious.  blood orange mimosa

I began trying to contact my brother to discuss changing our plans for brunch.  I tried to text and then eventually call him.  I started out mild, with emojis of pandas and guns (that one did get his prompt reply, quoting Girls, “What does that even MEAN?!”) but after sending me random emojis back for about an hour, he went on cell and email silence.

Nothing out of him after Friday.  Saturday night, my husband and I researched other brunch places in Big City nextdoor and found a nice one in a rather recently gentrified part of town where little brother likes to hang out (brownstones, dog parks, classy barber shops offering “hot lather shaves”, and  if you haven’t guessed yet, gay friendly).  They took reservations for brunch (i.e. no line) and so boom, I reserved.  And sent little brother an email/text invite saying “For various reasons, I have hijacked brunch.  We are going to a grown up restaurant for brunch in [the Gay End] at 1:30 PM.  I hope that works!”

Thankfully, it did.  A little last minute wrangling for plans, and little brother showed up a little late, full of high stressy energy, and immediately ordered the blood orange mimosa (oh yes).  Work’s been tough for him.  I worry when things get like this for him.  His health is tenuously good right now, but can go so bad so fast.  Little brother was happy with the choice, although he did explain that the fabulous menu place was full of grad students more than undergrad.  “They’re still dirty and unmannered” I declared, drinking my second cup of delicious, grown up restaurant coffee and using my cloth napkin.  Oh and the restroom at Gay End grown up restaurant?  Lovely.  Just lovely.  Single unit, clean, not full of overpowering chemical air “fresheners”, nice music.

It turned out this change of venue was extra good for me since the massive weather change we are having this weekend kicked off a migraine.  I was ok through brunch, but took a fioricet with my first coffee there since I had that crinkly feeling to my perception that is one of the more subtle migraine prodrome symptoms.  By the time we got home, I was nauseous, tippy, everything was too bright, too loud, and then the pain started.  I don’t always get an actual headache with my migraines.  Yesterday I did.  Lucky me.

barometric pressure and temp Jan 14 to 21

(change (weather)) + (lack of(sleep)) = migraine

I spent about an hour in bed, then made my way to the couch, where my husband and I sat watching a bad Star Trek-athon.  I recall mentioning to him on the way home as the migraine become unmistakably present that had we gone to the studenty place with the fabulous menu, the migraine would have been cresting just as we were eating, and being really thankful that I took the bull by the horns and hijacked brunch.

AM OT, PT, OMG

Knowing that you have a PT appointment in the morning is like having to go to gym class.  It’s usually not as bad as you imagined, but it is still something that makes you groan when you get up in the morning.

That was my experience today.  After waking up at 4:00 AM drenched in sweat.  Again.  I fell back asleep finally, then woke up to a frozen iPhone cheerfully blinging at me that it was time to get up.  Unable to just “snooze” it, I did a hard shut down (yep, half asleep even) thinking “oh hah, I don’t have to go to work today, I’m working from home!”  then fell back asleep until husband’s much later alarm went off.  Then I looked at the powerless iPhone still clenched in my hand, and remembered I have gym class…I mean PT today.  Crap.

I’m working from home today and tomorrow.  Right now, I’m taking a break.  A bad break since I should take a full break from the computer when I’m taking a work break, so say the occupational and physical therapists.  They are right, of course.  I’ve been working for the last hour and a half straight, editing calculus figures for a student who is blind.  This means lots and lots of mouse.  So break away from the computer in a moment.  On a related note, I really need to get a better mic for my dragon use.  I have the crap one that comes with it.  I may as well talk through a tin can with a wire plugged into my line in jack.  USB microphone is the way to go.  I had a gorgeous one that I bought at my last job, it was so fancy and nice.  I need one of those.  So I can blog and stuff without hurting the hands.

I am “discharged” from PT and OT, sort of.  I’ve been going for a month.  I’ve definitely made some progress.  Less pain, and better strength.  Baby steps.  PT guy said that we had two options.  We could do today’s evaluation and then continue to add exercises or we could take a break, I can keep doing the exercises he gave me (really just 4 very low impact things for core strength), and then come back for more PT when I’ve built up the strength. I said “I’m leaning towards option B”.  So B it is.  With the caveat that if I have questions or need a refresher, I can call and come in.  That’s cool.  Works for me.  I’m definitely in the baby steps phase.  I was thinking of making some kind of exercise chart.  I need visuals, otherwise I just sort of poop out and go “meh” and don’t do what I should do.  I’m  thinking something with star stickers.  I’ll post a pic if I make one.

In other news, my husband and I bought a couch as our christmas present to ourselves and we just got word that it’s in and can be delivered soon.  Wooo!  We’re probably going to postpone delivery until February since that’s the first weekend slot that’s open.  I am already working at home today and tomorrow this week (medical appointments, more on that in a moment) and I don’t love the idea of taking another day off right away unless I have to.  So, yay!  New couch is coming!

Tomorrow’s appointment is with the dentist.  I get the first of my four metal fillings taken out of my head.  I’m looking forward to moving a step closer to being metal free but not looking forward to the experience or the aftermath of sucking in metal vapor.  I’m going to ask for nasal O2 and advise them to be liberal with the suction.  From what I’ve heard, this helps.  I’m also going to premedicate with a crapload of benadryl and H2 blocker.  And husband is going with me (a) since I’ll be benadryl drunk and (b) in case I have a bad reaction to the metal vapors.  This is the dentist who said “I’m a little worried about anaphylaxis…”  And kudos to her for even considering it.  I figure that since the dental clinic is not only affiliated with, but also mere steps away from, Man’s Greatest Hospital if I’m gonna have a big awful reaction to having these things taken out, I’d rather have it there.

Invitation

The following is a brunch invite from my brother, only slightly altered to preserve anonymity.  It came with PDFs of menus.

I’m available either day.
Option #1
+DONUT MUFFIN or STICKY BUNS, Fairly easy, near-by parking (particularly on Sunday’s), & a [Dyspatient] vetted WC.
-The menu is bit too “been-there, done-that”, other than the muffin/buns
Option #2
+Look at that FABULOUS MENU – eggs-in-a-hole! Caribbean Waffle! Drunkard’s French Toast!
-Parking is not so easy, & the WC is a big “?”
Let me know.
This made me laugh. I’m glad that people around me are starting to get it.  At least some.  At least sometimes.  I like this because it takes into account that walking can be tough for me (parking) and that I do need a place where the bathroom (as he calls it, “WC”) is not a hole in the ground or a trough.

🙂

metal free vitamins

Type that into Google and you will find a large number of hits.  Useless hits, unless what you’re looking for are pages with the words parsed thusly:  “….metal.  Free Vitamins!”

Not so helpful for someone looking for vitamins that do not include copper, nickel, iron, etc.  I ran into similar problems using the term  “mineral free”, although variations on that did get me some results that are useful.  It seems there are mineral free multivitamin supplements out there, but they are truly mineral free, as in no magnesium or calcium either.  This is not what I want, but it may be what I end up with since the nickel (and possibly copper) are hell on my stomach.  It’s finally feeling better post multi-vitamin and mineral supplement that I foolishly started (and stopped) taking.  My hair, on the other hand, is actually staying in my scalp, so I think I could definitely do with a multi-vitamin.

I’m a little amused, but in an irritate way, when I run across the “my doctors says you don’t need to take vitamin supplements if you eat a health diet” people.  It’s fine when this is said to someone who IS healthy and whose body actually digests the food they eat.  Not fine for someone like me.  It makes me feel like over-disclosing about my GI symptoms just to give them a little reality check.  I don’t, but it’s tempting.  And then there are the vitamin freaks.  I’m not a fan of that approach either.  I do not think that taking an antioxidant enema is going to fix all my woes and balance my checkbook to boot.  Nope.  And I am fully underwhelmed by the notion of taking so much vitamin C that I actually induce GI problems (seriously, someone told me that…”if it does that, it means you’re taking enough.  Back off a little then build back up slowly to that dose”).  There is little to nothing in my life for which I can muster up that much faith.

I feel like hitting one of the local health food store chains and putting the staff to work.  My experience with these folks has not been great…ok, I’ll not candy coat it.  They have been, in my experience, morons.  However, perhaps they are at least literate morons and can read a pill bottle label.  I imagine going in and saying “I’m willing to buy about $100 worth of vitamins today, but only the right ones.  Who can find me the most efficient multi-vitamin supplementation pill or combo of pills that is lactose free and does not have trace metals, WITHOUT microminerals, but with macrominerals?”  But I have a feeling they’d come back with arms full of malarkey like muscle milk and pomegranate nose spray.

 

Friend time

I had a little time with an old friend yesterday.  She was up for a conference that my office was hosting, came up the night before and left in the evening afterwards.  It was good to see her.  There are so many things that she didn’t know about.  “Why didn’t I know you had a thyroid cancer scare?”  I thought she had, but I guess because I hadn’t thought of it as a “cancer scare” and more as another possible explanation for my symptoms that didn’t pan out.  I don’t tend to share those widely I guess.  I do on here, that’s different.  It’s an anonymous blog.  I feel safer sharing here, even with a low readership.  Maybe because of it.

Her being here threw off my routine a little, and I hadn’t been getting good sleep this week anyhow.  It’s been off as a baseline, then this weekend, we had inlaws who made plans to go to a ridiculously late show in Big City Nextdoor.   I didn’t join them in the ridiculously late plans (and did take a perverse pleasure in seeing inlaw who had made these plans flagging at 8:00 PM and saying “My god, what was I thinking buying tickets to the 10:00 PM show?!”) but I did end up staying up til they got home.  I knew I’d just get woken up when they got in even if I had managed to fall asleep.  So my schedule’s way off.  And it’s been unseasonably warm.  Those two together are enough to provoke migraine, which is what I had yesterday pre-conference.  Oh and the conference room was overheated.  So I was a bit of a mess.

I am thrilled that she was here, but I’m also a little thrilled that my home is now guest free for a while.  I’d like to get back on my schedule, if for no reason other than that it’s my busy time at work now that the semester is starting. I need to be sleeping (or at least trying) at a normal time and getting up and going at a normal time.  I hope my body falls in line.  We’re planning to visit again in April, on a weekend so it’s not in the middle of everything.  Looking forward to it.