Fun and Games in the ER

I don't see things the way I used to.

To write this I have to look at it sideways, and sometimes I squint.  The number of lines can appear to change.  Two dimensions look like three.

Things blur.

Thursday my eyes felt a little crossed.  By Friday it was enough so that when I looked at distant objects, I saw two of them.

This could be anything.  Or so I thought.

Called our doctor he recommended seeing my ophthalmologist and if I couldn't talk to him, go to the ER because it could be something serious.  

So Mary drove to the ER at our local teaching hospital that I've been visiting far too often over the years, and I discovered some new things about it's secret corridors, passages and procedures.

And also that the MRI orifices stay open until deep into the night.

We had not had dinner when we rushed off at 5:30 or so to the Emergency room.  So I did not have my usual doses of antihistamine and nose sprays.  Or dinner for that matter.

Mary stolidly helped me though the process.  And the long waits.    

A likable young man asked me to remove my shirt, commenting that I hadn't been asked to do that in a while.

I told him that I was a fat old man so I don't like to remove it in front of people.

He then started put a needle into my arm and as I was muttering that I just went through that a week ago when I looked down and noticed that I had a catheter sticking out of my left arm.
 
Thus began this adventure in the ER, just a room or two over from where I think I was when I had come in to have my appendix removed.

I was given what appeared to be a standard neurological exam by an attractive young resident physician whose name sounded something like the name of one of the vets who work on our cats from time to time.

She chatted with her boss who was an attractive woman of perhaps my age who explained why my problem was probably not a tumor after a lengthy process that involved her waving her finger in front of my eye.

Thank GOD.

I always enjoy the company of attractive women, although given the amount of mutating chemo I've received over the years about all I can do is talk to them.  I feel a bit like someone examining a new and fascinating variety of fauna.

But I came to the realization that all I could do was be polite.

 An ophthalmologist was called for, and eventually one arrived.   A very tired ophthalmologist.

Drops in the eyes. Pressure test by pressing something that looked like a big ball point pen against my eyeball. More Drops.  Blinding light in the eye.

He had to fetch some other implements and get back to me.  It took a while.

He used a big lens.  He shined more light in my eyes.  He said my eyes are slightly crossed.

I looked up double vision on the web today and found the technical term: Diplopia.  That's it.

Diplopia was also on the exit papers.

I think he actually used the term Strabismus at some point in the conversation.   He said I should see my ophthalmologist.  He talked about corrective surgery.

Sometime in the middle of the long waits, Mary had found a blanket for each of us which we needed because our little curtained off area was right under the cold air outflow vent.   The blankets lessened the feeling that we were freezing to death.

Shortly after 11:30 I got to go take a ride in a dreaded MRI machine.   It has sounds like a wheezing bellows, loud low sirens, buzzes, vibrations and a peculiar jackhammer going off right in your ear.

I wonder sometimes, since I've been in these things before, how they managed to get that large an entertainment center around such a small doughnut hole.

The process was a little different this time than the other times I've been inside one of these bizarre contraptions.  No earplugs, just a towel around the top of my head and ears which fit inside the bird cage that holds my head.   Actually better than earplugs.  I tried the earplugs a couple of times in the past and they never worked.

The blanket was over me.  I got warm. Hot. Nauseated.  On top of that my sinuses were clogged because I had not had my evening's drugs to keep them unclogged.  I couldn't breathe properly

Nothing quite like hot nauseating suffocation while stuffed in a wiener shaped tube.

The technician sensed that I was in distress and removed the blanket and I felt a wave of relief.  But the nausea was hard to get rid of.  

Like all tortures, it ended. There is nothing as good as that first full breath. When you are magically slid out of the machine.

I recommend this as a torture, although I can't guarantee it will get people to talk, they will find it disturbing.  Especially with a little sleep deprivation; as was my case.

Well, back to the ER via the secret passages, and the cold room.  Since there was mere cloth between all of us various inmates, we got to listen to some of the problems that people had.  A young attractive woman bleeding and wanting to avoid a pelvic exam.  An old or not so old man with an uncomfortable case of cirrhosis of the liver; kidneys failing.  The ER doctor explaining that not all alcoholics get it but he had it so he had to stop drinking.

Eventually, sometime after 3:00 we were on our way back home.  The preliminary reading of the MRI indicated that nothing dangerous was going on inside my head. As we drove home where there was one person on the sidewalk, I saw two; there were two sets of yellow lines and the road either veered off in one direction or another depending on how I looked at it.

I thought to myself that I cannot drive like this.

The young nurse who catheterized me asked me what I did for work, and I said programming. Not referring to anyone in particular he said that a lot of the patients that came to the emergency room did not have jobs.    They simply had their bill paid for by the government.  Why work?

But he was working, I was working.  I told him it was for the good life.

A Doctor here a Doctor there, Doctor Doctor everywhere?

Monday I began my day with a fasting blood draw.  Tuesday I saw my oncologist at the cancer hospital and had another blood draw.

Both blood draws were from my left arm.  It's Saturday, and I still have a bruise, but mostly from the blood draw at the cancer hospital. 

My regular doctor's phlebotomist didn't leave a mark.

Next Monday afternoon I see my regular doctor and he'll explain how my blood work looks.

Just because my oncologist liked what he saw in my blood, doesn't mean my other doctor will.

My regular doctor is looking at my diabetes and cholesterol; but mostly the diabetes.  When my diabetes gets better, the lipids tag along.

I control the diabetes by eating fewer carbohydrates.  Breads are my favorite. Pasta.  The things I love.

If I can somehow reduce those kinds of food, and not eat too much of the proteins and fats, then my blood sugars come down.

I haven't had the appetite recently that I used to have, which might help. 


I think the oxygen has been helping too.

On a more cheerful note, I've been adjusting my medications again.  In a vain attempt to take the pain away, I had been having half of one 4 mg tablet of Tizanidine; I even went to the trouble of purchasing a pill slicer.  I noticed last Wednesday when I was in the staff meeting with my boss, and afterwards in a private session that I was turning into a zombie.

So I decided to add 25mg a day to my 50 mg of Zonisamide and drop the Tizanidine altogether.  Which I started last Wednesday evening.

The neck and head pain isn't quite so bad, and I don't feel quite so much like a mindless drone.

Work seems OK, but we will have to see what side effects crop up.

Last time I was at a higher dosage I had shortness of breath at odd times of the day, usually in the evening.

But I'm on O2 now and that helped so much with breathing during the day.

PS This is my third year of REMISSION!

Sleep study? Not on your LIFE!

Mary showed me the bill for the third, and final sleep study.  I would take a drink of something strong to ease the shock but I can't because of the drugs I'm on.

I am so thankful that the sleep studies are over.  I truly hate them.  The sterile room, the wires pasted to my skull and other body parts with glue; the smells; the camera in the corner.

The first two studies indicated that I was being drugged to death.  I was taking 200mg of Zonisamide and 12 mg of Tizanidine each evening and I wasn't breathing enough.

My blood oxygen level would drop to about 70% for over an hour in the night.  A CPAP machine did not help.

There are differing opinions about which drug was worse, but it might have been a case of the double whammy.  Academic articles about how they combine to truly sedate or whatever are behind an academic firewall and I don't have the credentials to read them. 

Not to mention understand articles written in dense medical language.
 
Since I'm not as overdosed now, it's not quite that bad.  But my natural state would be to die somewhat early because it's a chronic condition.  When I roll over onto my back if I weren't on oxygen, my blood oxygen level would drop to 83%. 

As one doctor explained to me: like high blood pressure, it's a long term problem.

Since I've been on oxygen and also since I've been wearing strap on bumpers I feel much better. More alive. Actually good for once.

So although I didn't enjoy the sleep studies, they were worth it.

Rubber Baby Buggy Bumpers

I am now the proud owner of a strange and brilliantly designed contraption that goes around my chest and has three "bumpers" on the back to make me into a side sleeper.

The picture in the advertisement is of a young woman sleeping comfortably on her side with this thing around her, preventing her from rolling over.

Like the O2 before it, this wrap around set of bumpers (there are 3) prevents me from rolling onto my back at night.  I think I feel better because of it.

Sometimes I roll over onto my back and mouth breathe, and when I do that I'm not breathing the O2 from the machine.  Yesterday, after using the device for one night I didn't have my usual down time in the afternoon.

What could possibly be wrong?

Why would I be writing this blog post at 5:00 am?  Well, I woke up and eventually looked at the clock around 3:45.  

I once saw a program about how often people change positions in the night.  Quite often.

I slept on my side. The same side. The same position. This is the down side.

My right knee and hip ached when I got up.  I tried sleeping on my other side, but my left shoulder and are are injured (stupid workout injury) and that was uncomfortable too.

But I'm starting to feel better, and I don't think I was oxygen deprived all night.

So I'm systemically better, but my joints and some muscles aren't feeling so great.

But I don't think that's such a bad trade off.  And I might modify this thing so it not only does it's job, but has a degree of comfort too.  So I'm optimistic as to outcome.