Updates.

On March 18, 2010, in Uncategorized, by Andrea

This is a two-fer as my folks would say.  So sit down, relax, and if you’re me, don’t think about the gabazillion things that have to happen between now and tomorrow when I hit the road.

Saw my GI today.  I still <3 him even though they didn’t call me with the results of my CT when they got them.  That got me a bit peeved.

So the CT was clear — in terms of gut things.  Another thing lit up like a fricken Christmas tree, though — a nice 4cm ovarian cyst.  So a call to my GYN is in order.  Yay me.  Cause, really?  Seriously? And since he pushed on me to ask me if it hurt (and no, it didn’t before), it now does.  Thanx, doc.

So we’re thinking an ulcer in the remnant.  He changed up my PPI to something stronger and added another med for a month.  After a month, if the pain is still there, then we will look at playing with a fun, new toy — a double-balloon enteroscopy.

Basically, this sucker allows the doctor to be able to push up into the remnant stomach and see what is going on.  Which is, admittedly, pretty cool.  And you damned well know that if I have this done, I will DEMAND PHOTOS, VIDEOS, ETC.  Cause.. cool.  Well, not pain-cool.  But the g33k in me is looking at the advances since my RNY and saying — cool.

So there’s that.

Also, as you may be aware, I’ve been doing a little experiment with Heme iron.  Just to catch you up:

12/2/2009
HGB – 12.6  (12.0 – 18.0 g/dl)
HCT – 39.7%  (37.0 – 51.0%)
Ferritin – 11.1  (11-137 ng/ml)
Iron – 41  (37 – 170 ug/dl)
TIBC – 310  (265 – 497 ug/dl)
Iron Saturation – 13%  (20-55%)

1/4/2010

HGB – 13.13  (12.0 – 15.0 g/dl)
HCT – 38.21%  (35.0 – 49.0%)
Ferritin – 16.3  (6 – 81 ng/ml premenopausal *which seems odd cause post is 14-186….?*)
Iron – 45  (28 – 182 ug/ml)
UIBC – 326  (130 – 375 ug/dl)
TIBC – 371  (180 – 545 ug/dl)
Iron Sat – Not measured

Got new labs:

3/8/2010

TIBC – 344  ( 250-450)
UIBC – 255 (150-375)
Serum Iron – 89  (35-155)
Iron Sat – 23%  (15-55%)
Ferritin – 23  (10-291 — with a notation that they are changing to 13-150 for Females)

So I’m thinking the Heme iron is working.  I’m going to keep at it for the long-haul because 23 still isn’t a GREAT ferritin, but it sure as hell beats the numbers I had before.  And this is in 3 months.  That’s quite a jump.

My only other update is a reminder that Beth and I will be going to Baltimore for FitBloggin — so while we will be “bloggin” the conference (apparently they are even providing internet service?) I don’t know how much I’ll be AROUND.  So if I’m quiet, I’ve not died or anything.  We promise to take many, many pictures and annoy you with how much fun (we hope) to be having.

Cont’d.

On March 11, 2010, in Uncategorized, by Andrea

Mmm...

Okay, so it’s been a crap ass couple of days.  Starting on Tuesday morning, I had the pain to end all pain.  Followed Wednesday with an EGD that set off a migraine that would not die.  Thursday had another bout of OMGPLEASEKILLMENOWBECAUSETHISREALLYMOTHERFUCKINGHURTS pain, but let’s add driving in an unfamiliar city with my kids in the backseat?!?  After I could breathe again (about an hour of sitting in an unfamiliar parking lot in Cary, NC — hi anyone who may have seen me!!) I went to my doc’s office where they decided that I REALLY needed a CT TODAY.

And so, I had a CT with contrast this morning.  This entailed me drinking 1/2 of the bottle of barium you see above.  People asked me what it tasted like — and I can’t tell you.  I don’t know what it tasted like — which is kinda scary?  In any case, I had half early this morning and was both scared and surprised to note that I’ve recently reviewed a protein shake that was worse than this was (despite the fact that I couldn’t distinguish a flavor…  very bad news for the protein shake in question.)

Go to the hospital.  Realize that my insurance has changed since last year and while I have hit my deductible (yay for an EGD), I still have to pay 10% of the cost of my scan.  (Last year it would have been covered in full.)  But hey, if I pay it in full today, they will give me a 30% discount!  I could talk about how much I really wish for a national health care initiative here — because the people who think the government will fuck us over with insurance?  Come look at how my expensive private pay is already doing it.  But I digress.

Get into the lobby of radiology, asked if I’m diabetic.  “No, I’m hypoglycemic.”  ???  “It means that my blood sugar goes too low if I don’t eat and then I pass out.”  “I wonder if I need to get blood work on you.. do you take medicine?”  Resolved, find a place to sit in the overly packed waiting room.  I begin to finish the other 1/2 of my barium per instructions.

At  some point, a woman comes in to sit next to me while I’m waiting.  Keep in mind that I’ve already got a pounding head from the drugs from the EGD on Tuesday, no food in my stomach, and off my maintenance meds for my headaches.  This lady reeks of stale cigarette smoke.  Not fresh smoke — I might have handled that better — but stale sweat and cig smoke.

Yeah, you guessed it.

So I barely keep the barium down and as I leave the restroom, the tech is ready for me.  I ask about getting pictures of the scan — for which I am given quite the disapproving glare.  I mean — if there could be a way to bottle this and use it at home I would have.  But I insist for at least ME looking at them “But we can’t tell you anything about them”  Yeah, like I expected you to anyway.

Get the IV for the IV contrast — my poor widdle vein is going to crap out soon and head into the CT room.

Now — if you’ve never had a CT, this is no big deal.  It doesn’t hurt at all.  It’s a big machine that has a table you lie on that moves in and out of an open ring (no enclosed spaces at all) and it tells you to hold your breath and then to breath again.  They do a scan w/o contrast, then start the IV.  This is, by far, the worst part as it makes you feel flush all over, a bit dizzy, and like you’ve peed your pants.  Then a few more scans, and then you’re done.

I took a quick glance at the screen — but disappointed that I couldn’t tell anything — including the size of my pouchie.  I would be interested to see how big it is these days, yannow?  But no.  And then am whisked out.

I pick up lunch for us, come home, take meds for the head, and immediately pass out for 3 hours.

I didn’t hear anything back today — although I’m not shocked.  I expect maybe Monday — Tuesday at the latest.  I get my occipital nerve block on Monday, and have two other appointments on Tuesday.. and already have a follow up with the GI on Thursday so we’ll just have to wait and see at this point.

I’m not sure if I want to hear something or not.  Hearing something would mean bad things.  But it would mean they know what’s wrong with me.  So I’m kinda torn.

Despite all of this, the question has been asked — “You’re still for WLS even through all of this?”

I’m going to say yes — a qualified yes, though.

I’m for WLS as long as you don’t go into it blindly like I did.  As long as you realize that there are complications that could occur around any corner, that you have to be diligent with your supplements, that you have to do blood work often, that this sort of thing is common post-op.  Things that Beth goes through are a bit more rare, but ulcers and internal hernias are quite a bit more common post op and people need to be aware that these are very, very real possibilities that cannot be avoided.  We can avoid deficiencies by taking proper vitamins and watching out blood work like hawks.  But one can’t stop an intussusception or a hernia in Peterson’s Space.  Have WLS — but do so with your eyes open.

EGD.

On March 10, 2010, in Uncategorized, by Andrea

3/10/2010 Full sheet

Okay so I’m home and I’m still feeling pretty crappy — but not from the drugs exactly.  I have a crappy ass headache — either from a change of weather, a lack of carbs from the fast (although I’ve eaten?), a combination of the drugs and the above?  I don’t know and frankly I don’t really care at this point.  I just don’t feel good.

In any case, I’m back.  And because people want to know what to expect during these routine tests before and after RNY, thought I would document everything about it.

I got to the hospital (Franklin Regional Hospital in Louisburg, NC — and let’s be frank — it’s tiny, but decent) at 7:10am.  We’re a bit late — it’s a 45 minute drive, and it’s hard to get the kids up and around that early.  Shortly after, I go for labwork.  I’m a woman of childbearing years, so it’s “pee in a cup” time — but I’ve had RNY and I’ve not been allowed to have anything to drink since midnight so there is no pee to pee.  So I give her a vein.  She’s a bit shocked, but goes for it (and gets another 3 vials “just in case” they will need it.. I like this tech).

As soon as I’m done with that, I get called back to the pre-op area.  Kiss my kids good-bye (not because I’m worried but because Kaitlin gets sad if I don’t say bye).  Walk back, get changed, get my IV.  And immediately go back to the room.

This room, of course is pretty interesting.  Monitors, blood pressure monitors, cardiac monitors, computers, drug lockups, various equipment, nurses — some of which can be somewhat scary and intimidating.

I’m put on a cardiac monitor, a blood pressure cuff, O2, and oxygen saturation monitor.  While waiting for the doc, joke around with the nurses, but also discuss with the nurse why I’m there.  She’s familiar with RNY and by hearing what my pain is, she knows what tools to have on hand just in case there’s a suture that needs clipped or a staple that needs pulling, or whatnot.

As soon as the doc comes in, he signs the release for the meds and in goes the versed.  Pretty soon, I get a spray in my throat to help numb my throat that tastes horrible.  Another within a few moments — and yes I remember these.  I know she pops the fentanyl in and I remember asking if that’s what she pushed, and remember her saying “We’ll see you in a little while…”

I remember, for the first time, actually waking up this time, with the camera down my throat.

I’ve had several EGD’s — this being my 3rd with this doctor — and this is the first time I’ve ever woken up.

I know I panicked a bit.  I remember being told to calm down — and I remember seeing the nurse push more meds.

And then I remember waking up in recovery.

9/17/2008

I’ve included some photos for you from the two procedures.  I have to apologize — while we have multiple computers (6?), several game systems (4?), etc — we don’t have a scanner.  But we DO have two DSLR cameras so I can take photos of the photos..

First photos are from 9/17/2008.  These are the ones from when I had 3 ulcers on my anastomasis.  When looking at these photos, the white “spots” are the ulcers.

9/17/2008

9/17/2008 -- One large ulcer visible

9/17/2008 - Ulcer visible on the far upper left

9/17/2008 - All 3 ulcers visible (Largest towards the back, then one closest to front, and one to side)

So that’s what my pouch and anastomasis looked like in mid-September.  Was put on Carafate 4x a day and Prilosec 2x a day for a period of time — 3 months I think?  When I still had pain, we did exploratory surgery and discovered that I also had a ton of adhesions.  But it’s very obvious that I had quite a bit of ulceration.

Today?

3/10/2010

3/10/2010

3/10/2010

3/10/2010

3/10/2010

3/10/2010

So what does all of this mean?

Well, there are no ulcers in my pouch.  There is not irritation in my pouch.  In fact, I was told it was one of the cleanest, healthiest looking stomachs seen by the Nurse who was taking care of me (not the Endo nurse, the recovery nurse).

So we are going to get a CT scan to rule out an internal hernia — which is the next thing.  And is a possibility since I did some heavy lifting on Sunday (mulching the front yard).  If that comes up negative, then the doc gets to order a new toy (and he’s a bit gleeful about it — he has to show a need for it with two patients — I’m number two..)  This new toy actually allows him to scope the remnant stomach — so yay for technology.  So for now I’m off the Carafate (since it won’t do me any good anyway), with no changes in diet and just adding Prilosec in case there’s ulceration in the remnant stomach.

This also goes to show that the occasional caffeine, coffee, soda, RedBull, spicy food, etc. will not hurt your pouch.  I mean, c’mon!  I had coffee on Monday morning before my attack, and some on Saturday morning — and I’m pink as can be.  Just goes to prove that these things are not as horrible as they’ve been vilified to be.

Now if you’ll excuse me?  I think it’s time for a nap.