Fated Strife

Well, I’ve not really had a chance nor felt like posting any entries lately. Hopefully I’ll get back to that soon. Angel has started summer school so we get to talk some after he gets home, he’s gotta take care of another class in July then in August he’s doing some EMT stuff. He’s still planning to come out here this year as far as I know so hopefully that’ll work out.

My migraines have gotten out of control. My Maxalt rarely aborts them (though at times it will but maybe one out of 8 it will). The past month I’ve been in the ER about 5 times, which to me is 5 too many times. My neurologist still has no open slots until the date scheduled for my appointment. The only reason for the ER is that most of these migraines when it gets to the pain phase (where the headache starts) the pain is severe, I have nothing here I can take for the pain and when it gets that bad I can’t lie down to try to sleep it off, I can’t really function, thus the injection of Dilaudid. Unfortunately its a very addictive opioid. The only disadvantage other than addiction is the risk of a rebound headache cause of the drug leaving your system and the fact that though it makes the pain tolerable it doesn’t fix the fact that the migraine is still going.

Today I saw my primary care doctor and he stated the normal deal that we’ve extinguished our options really and just gotta deal with the neurologist. One of the ER docs which I happen to see almost every time I’m there wants me to push for Stadol nasal spray to deal with the pain rather than an expensive trip to the hospital and all that. I’m weary of bringing the topic up because of the idea of drug seeking especially with such a powerful drug. It would be used in those times where the abortive drug did not work to stop the migraine and when the pain is severe.
Anyway, he prescribe Lyrica, which is an anticonvulsant and is used to to treat neuropathic pain among other things. This is being used for 2 reasons, one to see if it helps with the migraines (as anticonvulsants can help stop migraines from occurring) and to also help my back/hip/leg pain. Just started the Lyrica tonight so we’ll see how it does.

I had some injections on the nerves of my spine on Monday, relatively painless and quick. Got in around 9am, waited while Adam ran rampant around the office, went back to their holding area (Dr. Sullivan’s holding area is much nicer in respect to more room), waited for a bit finally saw the doctor who was saying since my pain doesn’t really seem to have a cause that can be found (though apparently 50% of back pain goes undiagnosed from what he said), but we’ll try this and see how it helps.
The first few days after that there was a great deal of discomfort after the local wore off, mostly down into my tailbone area so made sitting painful. The steroids seem to have started working some as there’s not as much pain in the area around the injections but there is still some pretty bad leg pain and in the low low back and butt, so hopefully it’ll work its way there and take care of it.

Dr. Sullivan’s office called today. I was informed my anemia is pretty moderate now, my hemoglobin is at 10.4. An all time low for me. I am pretty loaded up on B12 though but I still need to take that every other week. Monday I start on iron injections again for 4 weeks to see if that will help, if no change infusion is being considered again. I’m also on a new iron pill which I’m pretty sure it’s what I was on once before being put on what I was on at the time it was changed to the new stuff. The new medication is Tandem Plus, once daily. I go back to see them on the 19th to probably get a colonoscopy setup for my 2 year check up, see if any polyps have spawned, among other things. I’m sure thats going to be fun to prep for this time. The last time I had one scheduled the prep didn’t work out too well as I wasn’t cleaned out good enough so getting the scope even past the transverse colon or to the ileocecal junction would not be possible, though they did do an endoscopy that day for me to stretch and burn the ol’ esophagus.

My reflux was horrible today, as it has been these past few weeks. I’m thinking the LES is having some problems again and may need to be coagulated sometime to try to help with the reflux (with the PPIs I’m on).

Otherwise not much has been going on, sleeping, talking to Angel, watching Scrubs (my fill in for House while that’s on break until Fall). More posts coming soon I think.

Tags: Angel, anticonvulsant, dilaudid, emt, lyrica, maxalt, migraine, migraines, neurologist, neuropathic_pain, opioid, rebound_headache

Friday evening I had started to vomit some nasty looking brown crud (probably old blood), as well as severe dysphagia and odynophagia. The ER doctor I saw had me drink some water and attempted to call Dr. Sullivan. He was unavailable so called my primary doctor group’s GI doctor. Was informed to call Sullivan on Monday and get EGD setup and possibly dilation. I was given a prescription for Zofran (Ondesetron) for my nausea and vomiting since my promethazine has little effect on me anymore.

Flash forward to around 3am Saturday morning, went to the bathroom and was exiting and was hit with a big wall of nausea and proceeded to produce some tasty bloody emesis (bright red blood that is). I started to get dizzy and junk so went running out of the house to the ER again (easy to get there since it’s about 6 houses away). Got taken to acute care (versus ambulatory where I was earlier), saw the same doctor I did when I had my GI bleed awhile back. He did his usual thing and ordered X-rays of chest and abdomen.

That was around 03:30, after a few tries of getting ahold of the nurses in the ER (I used the call button and was asked what I wanted I responded I wanted to talk to a nurse or the doctor.), no one ever came. Finally I saw the LPN that had given me my IV nexium earlier when I arrived and asked him to check, this was around 4something. He checked and said there was a delay cause they had a trauma case that needed to have radiographs and junk done, and apparently around 3am the acute care doctor becomes the trauma doctor as well. I was angry that I was ignored for that amount of time without even an update, I would’ve gotten up and got a nurse myself but I could barely sit up.

Shortly after I talked to the LPN the radiology person came and apologized and got me back there, this was around 5something now and the sun was rising (was pretty surprised to see the sunlight already) and got my films done and went back to the room.

After that the pace picked up, ER doctor came back in said it looked like I had stool in my stomach (not poop poop but small intestine junk). I was going to be admitted, etc and they would get Dr. PROvance as he called him in since he was working hospital that day. Dr. Provance never showed up but another equally nice doctor did, he was just waking up too I think, was yawning, sniffling, just seemed asleep still. Asked about pain, said he’d get ahold of Dr. Sullivan, etc.

A bit after that a nurse came in with some syringes. First was more Ondansetron. Second I was surprised about, I noticed the amount in it was low so I had to ask what it was (actually I ask about everything they give me, I advise that others should too), she said it was morphine! Now, I’m used to the whole promethazine/dilaudid thing but I have never seen morphine like that outside of when I had my surgery. I was talking to her about nursing and seconds after it was injected my arm warmed up then my toes and so on and I lost my train of thought of what we were talking about.

Now it’s about 7, I’m using the reflection off the window on the room across from me, I think the man in there with his mom thinks I keep looking at him which I wasn’t, but I was using it to watch the nurses station there. My nurse was filling out a lot of paperwork for me. Finally she shows up and takes me to the transfer holding area. The nurses there were nice, my alarms kept going off cause of the horrible sticky stuff on the electrode things for the EEG. That, and the my heart was flipping out at times cause I just wanted to go home, was supposed to talk to Angel at 11 or so then. Waited around, listened to them talk about myspace, and how nice the GI doc they got me (since sullivan was unavailable today too) whose name they can’t pronounce. Turns out the lady GI doc they had was from the wrong group so they FINALLY ended up getting Dr. Shone from my medical group in.

I get wheelchaired up to A-500 where most people there are in for congestive heart failure and renal failure monitoring and junk. Got poked and prodded and such for awhile then Dr. Shone showed up. He’s from South Africa area and has an accent, a very nice guy though he scolded me for not contacting Dr. Sullivan sooner than on a Friday. He said they’re busy today but he’ll see when his nurses are available in the GI lab and get me in.

I wait around, the anxiety builds, and builds. I asked when it would be and they after noon. Mother and Adam came by and visited, and it was around 2pm things just got bad for me. I had my mom ask the desk if they had any idea when GI people would show up etc and no one ever came in and told me, mom and adam left room to get a cookie or something for him I think. I was also hungry, I was NPO (nothing by mouth basically) but I could have ice chips.

FINALLY around 2pm my PCT came in and we asked him and he went to check, nurse came in and told me that it was gonna be around 5pm before I got to go back and my mom had to take adam home, he took off down the hallway so she had to get them.

I had already ripped off the pads for monitoring and had my shirt back and then I just couldn’t stop crying. Was getting angry at the nurse though it wasn’t her fault, the ones at the desk never mentioned anything or such and they apologized like crazy to me.
I wanted to leave, to get home talk with Angel some and go to bed. She went to check with the doctor to see if I could but he declined because of the bleeding stating it could be pretty bad and just not vomiting it up. She gave me a syringe filled with morphine (there was more in there than was in what I had originally received) and I had been given half a lortab around noon so they said I had to have the morphine cause it was too soon for the lortab somehow.. It helped with pain a bunch and made me calmer. After I read through the phone book and their welcome to 500 floor notebook I was washing hands after touching stuff in the room. (though it is a hospital and most parts are clean, some aren’t so I play it safe). I heard them call for me and I leaned out of bathroom and said they’ll be up in a minute to get me. Got pants off and got in bed and waited. This was around 4 they got up there around 430 maybe sooner. Got along with the GI nurses pretty well, was even impressing them with my knowledge of medicine and gastroenterology. Got in GI lab, Shone was waiting there stretched out in a chair, occasionally laughing at my jokes and making his own. Nurses and Doctors are people too, it pays to talk to them and to be nice. Was told this would probably be their best person they had today since they were laughing a good bit and I just treated them with respect and kindness.

They worked on getting the new EKG tags on less hairy parts of my chest if possible cause I had already lost a bit of hair from the ones I had earlier. They started giving the benadryl, then the fentanyl, (I mentioned the other nurses that get me ready for EGD like to put the bite guard in pretty quick to shut me up) but they waited a bit so I could finish my sentence. Said I appreciate you all doing this on a weekend, for their kindness, etc. Then I was gone..

The best part of conscious sedation is that time just stops for me, no worry, stress, etc. I remember waking up asking when we were starting, something I have only done once before when I had my first endoscopy. Unfortunately they had some problems keeping me sedated properly so they had to up some dosages. I remember Dr. Shone mentioning the bleeding seemed to be from my Barrett’s Esophagus and that I was dilated since no signs of an active bleed. Got back to my room, took my electrodes off (think they accidentally left one on) and put it on my shoulder so I wouldn’t loose it before I got it home and was out of there finally. Removed most of the tape and junk from iv but left it in for them to remove.

I called Sullivan’s office today and left message that I needed to get an appointment with him per Shone’s orders.

Around 6:30 or so I found a slew of messages left from Angel, finally he got back on and we got to talk for 10 minutes or such.

Sat around for a bit then went to sleep.. somewhat sleep, had nightmares and just couldn’t seem to sleep that great (though as of that time I had been up over 24 hours, 36 almost).

Got to talk to Angel for 30 minutes which was great. Picked up my car earlier and so ends my weekend.

To top off the crap, my tooth I needed capped or pulled broke off partly, I think it was during the endoscopy cause it was still a whole tooth before that as far as I remember and I noticed it a bit after getting home. No big deal, but the tooth is pretty bad looking and such so I guess I gotta call the dentist in the morning too and see what it costs to pull and crap. It’s hurting pretty bad and I think some nerve has exposure so just adds to it.

Lunesta is kicking in, time for sleep.

Tags: ambulatory, Angel, dr_sullivan, dysphagia, egd, endoscopy, hospital, lunesta, morphine, nexium, ondansetron, opioid, pain, pain_killers, pain_meds, stomach, upper_endoscopy, zofran

Well yesterday sucked.. but before that we’ll talk about Wednesday.
I awoke around 07:00 plenty of time to go to the doctor which I did. He was actually there this time too rather than another canceled appointment. He checked out my back, listened to my problems etc. I’m going to be seeing a neurologist ASAP due to the frequency of my migraines again lately and the pain they bring. He prescribed Ultram ER (which is extended release Tramadol which IMHO is a crappy opioid for about most everyone though some say it works great for them.), it has made me pretty tired after taking them throughout the day (I take once daily) the pain has went away a very tiny bit. I guess you can say it took a bit of the edge off. He also put me on Flovent to manage my asthma and to keep me from having to use my albuterol so often since it’s indicated as a rescue med for attacks and such.

Today went with mother and them to walmart and came home after that. Colon has been all screwy which is off for my usually non functioning one.
Talked to Angel for a few minutes (hardly get to talk anymore) and frustration brings anger and such which I wish could’ve been avoided for out little talk but oh well.

Stomach has been calm for most of the evening while I sat here staring at the walls, it started up again around 11 but has calmed down finally.

Guess it’s time to go to sleep, just want this bad day to be over.

Tags: albuterol, Angel, asthma, crappy, flovent, frustration, migraines, neurologist, opioid, stomach, ultram_er, walmart