Thursday, November 29, 2007

egd v2.0, diagnosis still pending

I had one of these in 2004, but I didn't remember that. I had to search the blog here to find the date when I was filling in my paperwork.

2004 was a bit of a rough year, so it doesn't surprise me that I couldn't remember it. I did remember that it was completely normal, though.

Today was a day mostly spent sleeping, which was kind of nice. The procedure itself is gone, permanently lost in the mists of Versed. (I love Versed.)

I had this test because I'm having a lot of trouble swallowing and my throat is sore all the time. Results of the test, so far:

1. Normal esophagus.
2. Gastric mucosal abnormality chracterized by erythema.
3. Normal examined duodenum.

What that means:
1. There's nothing wrong with my throat, which is a relief, but doesn't explain why it hurts all the time.

2. The inside of my tummy is red. Being compulsive, I looked up the ICD Code (537.89), and found: gastric or duodenal prolapse or rupture (nope); intestinal metaplasia of gastric mucosa (yep); passive congestion of the stomach (nope). Again with the compulsive thing, I looked up intestinal metaplasia, and found that "intestinal" means having to do with the intestines (duh), and "metaplasia" means "a change of cells to a form that does not normally occur in the tissue in which it is found." The big deal with intestinal metaplasia is that it is a risk factor for gastric cancer. (rolls eyes)

3. My duodenum's fine, too.

Biopsies were taken of the esophagus and the "gastric mucosa", and results of those biopsies are of course still pending.

About 3:30 this afternoon, the phone rang, it was the imaging center to schedule an esophgram/ugi/small bowel flouroscopy-barium swallow ordeal test, ordered by this same doctor. That one won't be until the end of December, so I won't have any kind of answer on all this until next year.

Of course if it's serious, they'll get back to me a lot sooner than that.

Monday, November 26, 2007

Torchwood 1.12: Captain Jack Harkness

"Out of Time" writer Catherine Tregenna returns with the next chapter in the story of broken-hearted Owen (Burn Gorman). But "Captain Jack Harkness" is not just another story of love gone awry across a rift in time; it gives us a long-overdue glimpse into our Captain Jack's past.

Read the whole thing at The House Next Door.

Sunday, November 25, 2007

so far away

A close and very dear relative on the East Coast is in hospital, pending serious surgery. He has been in and out of the hospital for a couple of weeks now, and it just seems to be one thing after another.

There's no reason to think the prognosis should be anything but good, but his surgery, originally scheduled for tomorrow, has been pushed off indefinitely until he clears an opportunistic infection he picked up over the last day or so.

We're stuck out here, 2,500 miles away, and the phone doesn't provide much comfort. It's natural to want to do something in times like this, but we can't even go visit at the hospital. It's frustrating. All we can do is wait, and pray.

gone, gone, gone

I polished off the pie this morning.

I figured I should say something about the holiday, and the accompanying feast. The day was quiet, and cool, and lovely. We ate our Thanksgiving dinner at mid-day, outside, and it was perfect. We had the usual menu: roast turkey, gravy, pureed cauliflower, acorn squash, stuffing, green beans, cranberry sauce, and rolls.

Wednesday was an all-day-in-the-kitchen affair. With the kids' help, I made pumpkin pie with graham cracker crust, then an apple pie, and a cherry-blueberry pie. I went with a combination of 2/3rds organic shorting and 1/3 unsalted butter for the pie crust, and was very pleased with both the texture and the taste. After the pies, I attacked the veggies, and got the cauliflower, squash, and green beans into their appropriate dishes ready to be reheated the next day, and then moved on to the stuffing. The bread I cut into cubes and let air dry; the onions and celery I let carmelize in sweet butter. I used my own chicken stock to moisten the dried bread, and was it ever fantastic. For once I ignored the Bell's Seasoning box directions and kept adding liquid until it seemed right; I'm tired of too-dry stuffing, and the dense bread that I use definitely sops up the liquid much more than your typical supermarket bread would. I ended my long day in the kitchen with Cook's Illustrated Anytime Dinner Rolls, a new recipe for me: alas, I misread it, and used 1+1/2 cup of milk, instead of 1+1/4, and that left me with very sticky dough, into which I had to knead a lot more flour (I couldn't bear to chuck it and start over, although I probably should have.)

Did I mention I brined the turkey for the first time, ever?

On the day itself, I put the turkey in the oven, breast-side down, at 400 degrees, at 10AM, and flipped it breast-side up at 11:30-ish. It came out, perfectly roasted, just before noon. The rolls went in at 12:20 for 25 minutes at 375, and then the cauliflower, squash, and stuffing went in at 350 when the rolls came out.

Somehow or other, it all worked out. Everything was delicious, and I had turkey stock simmering on the back of stove all Thursday night. The only problem is, we've already run out of turkey -- the bird was only 11 pounds. I'll have to get a bigger one at Christmas. I'd like to have more.

And I'd like some more pie, too. The kids devoured the apple much too quickly. Not so much with the pumpkin and cherry-blueberry, although they were eaten, too. I just think next time I'll make two apple pies and get it over with. I used the Cameo apples this time, and while I did see a little bit of shrinkage, it was really fine, using the corer/peeler/slicer gadget. And it was really, really delicious.

Ironically I haven't had much of an appetite for the past week or so; I think it's the new medication the g/e has me on. I even appear to have lost a few pounds, which seems odd, timing-wise. I can't explain it, but that's OK, because I've been having pie for breakfast, guilt-free. Don't know what I'll do tomorrow, now that it's gone.

persistence is futile

I'm hoping not. I hauled myself out of bed ridiculously early on Friday morning (that would be 4:00AM) and was at Target by 4:20; there were about 50 people ahead of me in the line. The time passed quickly, and like everyone else, I chatted with the people next to me in line. We compared stories of previous years and experiences; we were glad it wasn't too cold, and we enjoyed the full moon. Not all of us were there trying to snag a Wii, just three out of the four in my immediate area.

When the doors opened at 6AM, we dashed over to "the boat," the counter at the small electronics, video game, and camera department. I was right in front, and saw one of the young men there handing out Wii consoles to hands reaching over me. I was there, just not tall enough or pushy enough, I guess, and came away empty handed.

Which is why I got up ridiculously early again today -- they've sometimes got 'em for Sunday mornings -- but today there were none to be had. I wasn't alone this morning, either. It's a bizarre social event, waiting for a store to open so you can try to buy something that's practically unattainable for it's retail price. (For double that, or close to, you can find plenty on ebay and Amazon.)

Ah, well. Lots more opportunities between now and Christmas, and if I have to, I'm quite prepared to wrap and deliver an IOU. But I'd rather not, and the prospect is making me cranky even though I went back to bed when I got home. Tiredness and disappointment are bad combination.

Tuesday, November 20, 2007

npo

I set my alarm to wake me this morning at 5:45 so I could take me meds and drink some water. It worked in that it woke me up enough to take the meds (at 6:05, when the snooze button went off), but I only managed a few sips of water. I can't drink a whole glass of water and then go back to sleep, it's too much.

So now that I'm well within that 4-hour "nothing to eat or drink" window, I'm thirsty. Not just thirsty, dehydrated-thirsty. My eyelids are sticking to my eyes. Oh, how I would love a nice cup of tea, or something. Only 3 hours to go!

trials...

Went for my over-due blood test this morning; took three sticks to hit a vein. I don't blame the tech at all, I have really lousy veins. But it does hurt when they smack the back of your hand really hard to get the veins to pop up. Especially when my RA is acting up already.

Discovered last night that the dishwasher is dead. Checked the circuit breaker, it was fine. DH ended up doing dishes at midnight while I bailed out the water remaining in the bottom of the machine. Called Sears; we have an appointment for Friday morning. (Thursday being Thanksgiving, and Wednesday being prep day, the timing of this leaves much to be desired.)

Today, drove up to Mesa to get a new thermal fuse, as that's often the culprit in cases like this. Alas, it wasn't. Further sleuthing indicates it may be the door latch, another cheap part ($8 -- the fuse was $18). Since it will cost $65 for the Sears guy to walk in the door, it's probably worth it for me to drive up to Mesa again for the door latch. I'm just wondering if I should also get the circuit board ($85) while I'm at it.

Bright side: the parts place in Mesa is called Appliance Parts Depot, and they have an awesome website with all kinds of repair advice on it: check it out.

Religious Education tonight, my tiny Confirmation Class of 5th & 6th graders. One of my students transferred to Tuesday nights, leaving me with only 6 students. Tonight we covered The Beatitudes, and it was like pulling teeth to get any kind of response out of them. It was very difficult to connect this material to their lives, at least I did not feel as if I was making any kind of connection. Bright side: further reading in Tod Lindberg's excellent The Political Teachings of Jesus.

Tomorrow: a 4-hour fast followed by a gastric emptying study; I get to eat a radioactive hard-boiled egg and then lie under a scanner for 90 minutes while the machine records the movement of the food through my system. Sounds like a good time for a nap! I have to remember to set my alarm early so I can take my medication without interfering with the fasting time.

In other news, there's a very good chance I finished all the necessary shopping for Thanksgiving dinner, etc, today. Three different stores trying to track down Spectrum Organic Shortening. Sheesh. First order for tomorrow is to make up my lists and be sure, because I don't want to have to shop on Wednesday, when the entire rest of the world will be shopping.

I'm also stressing about getting that other winter holiday's shopping done.

Usually, at this time of the night, I'd be typing this to the rhythmic sloshing of the dishwasher. It's too quiet tonight, I miss it. I have a general feeling that something's not right, and I suppose it could just be the broken dishwasher, but it feels as if it's something more important. I don't know what, though. I suppose I'll have to wait and see.

Monday, November 19, 2007

Torchwood 1.11: Combat

The intersection of the alien and the human is front and center in "Combat," as disaffected young men seek meaning, Fight Club-style. Our Torchwood team regulars struggle to deal with the accumulated consequences of actions we've seen over the course of the season, and Owen (Burn Gorman) becomes the nexus around which everything revolves.

Read the whole thing at The House Next Door.

Wednesday, November 14, 2007

flashback

I ended up working today with the pre-kindergarten 4-year-olds. The aide was called away on personal business and I happened to be at the school, dropping off DS1's water bottle, when the sub coordinator snagged me.

It seems like an eternity since I've been in a pre-school setting, but DS2 is only in first grade! That means it has been only 2 years since his pre-school days, but his pre-school wasn't full-time, and that makes a big difference.

I enjoy being around little ones when I'm subbing because I know it's just for a day or two. If I had to do it every day, my well of patience would run dry long before the end of the day on Friday. Even worse, I'd have nothing left for my own kids by the end of each school day, which would be so horrid I don't even want to think about it. As with creative energy, I only have so much patience in a day, and when it's gone, it's gone.

There's a new boy in the class, he has only been attending a few weeks, and he's struggling with everything. Spent all morning saying he was tired, then refused to rest at the state-mandated nap time, which was substantial -- I think it was an hour and a half! By the end of the day (2:30) he was exhausted, poor thing. He spent his whole day in opposition to everyone, wanting to play at reading time, wanting to sleep at play time, wanting to talk when it was time to listen; he reminded me in many ways of my DS1 at that age.

When his mom came to get him, she had his little sister, probably about a year old, on her hip, and I could see there an explanation for a lot of what was going on. It's so hard for little ones to adjust to having another person in the family, especially if the new person is getting everything when they demand it.

With kids like that, who spend the day saying "I want, I want," without paying any attention at all to what they are supposed to be doing (all of which are age-appropriate and not usually considered onerous), the hardest thing is finding the motivator, the key that will incent the kid to behave. They don't respond to the usual carrots or sticks, typical consequences mean nothing to them. So you have to dig around to find out what consequence does mean something, and then latch onto it. I had the worst time trying to find a meaningful consequence for DS1 when he as at that age; to this day, I can't remember what I even came up with. It was such a struggle.

That's the other key, really: minimize the struggles. Find a way to say "yes" as much as possible. So when he said, "I want to play now," I would respond, "You can play when the story is over." In other words, the Delayed Yes. There's also the Conditional Yes, in which you bargain good behavior for something he wants, which is different than a bribe because the bribe is paid out on the expectation of good behavior, and that never works. Payment has to come afterwards, or you're just teaching the kid to be manipulative.

Finally, even at 4 years old, the idea of making good choices is so important. But with 4-year-olds, it helps to point out when they're not making a good choice. For example, I could've said this afternoon when the kid was refusing to let himself rest (it was so sad, really), "I remember you saying all morning how sleepy you were, but right now you're choosing not to sleep. Do you think that's a good choice? Because I think a better choice for someone who was so tired would be to rest now."

By the end of the day the teacher was asking me to come in every day and be his one-on-one aide. There's no money in the budget for it, and I really couldn't do it every day, but it was still a nice compliment. And I can look at how DS1 is doing and realize yeah, he's turning out pretty well, so I guess I'm not completely offbase with these ideas.

Tuesday, November 13, 2007

Torchwood 1.10: Out of Time

"Out of Time", gorgeous throughout, ostensibly tells the story of three individuals lost in time thanks to a temporal anomaly caused by the Cardiff Rift. At its heart, it continues Torchwood's nihilistic view of existence. A series that consistently argues that this present reality is all there is while simultaneously featuring a main character with a death wish suffers from both confusion and clinical depression. Ten episodes in, Torchwood still hasn't figured out what it's about, but it appears to be getting closer.

Read the rest at The House Next Door.

Monday, November 12, 2007

diagnosis pending

I saw Dr. G, my gastroenterologist, about the reflux problem. Here's the plan:

1. Switched my meds from twice-daily Prilosec to twice-daily Zegerid, which has twice the dosage of omeprazole plus bicarbonate of soda. So far the only thing that has helped me actually feel better is the every-4-hours Mylanta, but that had other side effects.

2. Scheduled an EDG (upper endoscopy, I've had one before) for the end of this month; he's concerned about the swallowing problems. (Me, too.) He doesn't think I have a hiatal hernia, though, because the last EDG didn't show any herniation. I'm thinking anything can happen with the way things work for me, so I won't be suprised either way.

3. I will be scheduled for an emptying study, to see if my problem is caused by food leaving my stomach too slowly (gastroparesis). Considering I've had a "rapid transit" problem for years now (ameliorated somewhat by the cholestyramine I've been taking for the past year or so), the idea that food is transitting any part of my digestive system too slowly is pretty funny. [Interesting aside: the gastroparesis link above says that cholinergic drugs can cause it...cholestyramine is a cholinergic drug.]

4. Back to his office in mid-December for the recap on everything, to find out what is to be done. I hope the Zegerid works better than it has today, otherwise it's going to be a very long month.

(Meanwhile, I'm having another video stroboscopy study the week before, so we'll be able to get a good look at how my vocal folds are functioning, and see how well they're holding up to the constant acid washing.)

I tried Protonix once before and it made me very sick, that's why I'm hoping I'm broken in a way that's physically fixable. This is ridiculous, here I am wanting to go under the knife again! Sheesh.

Saturday, November 10, 2007

fix me

I'm broken again. Finally got a chance to go see Dr. O, my ENT (fabulous, I recommend him to everyone.) As usual, he listens to what I have to say, does a thorough examination, and then explains what's happening, and what to do about it.

I have a couple of things going on. First of all, my turbinates are causing my chronic head congestion and post-nasal drip. Using Nasonex is helping some, but it's a stopgap, and I still end up with that weird feeling of pressure inside my ears, a lot. Not to mention the never-ending post-nasal drip. I'm scheduled for turbinate reduction surgery in mid-December; he'll fix my deviated septum while he's in there.

The second issue is my chronic sore throat and trouble swallowing. I thought that these were two separate things, the first caused by the damned post-nasal drip, the second a result of post-surgical scarring.

Nope, and nope. I wrote about this once before: what do I know?; just over two years ago. It's amazing how easy it is to forget stuff. The sore throat problem has little to do with the PND, although it may be exacerbating it. Both problems are caused by acid reflux; my esophagus is so irritated that it has become swollen and inflamed, which of course makes it harder to swallow.

I've been taking Prilosec for a couple of years now; somewhere along the line the dose was doubled. I never really thought about the fact that it wasn't working until Dr. O pointed it out -- I'm managing so many poorly functioning physical systems that the acid stomach wasn't even registering. But as soon as the doctor said "reflux," I realized that the acid problem has been pretty awful, and I can't say for how long. For example, I feel queasy if my stomach is empty, particularly in the morning. All of the other reflux symptoms are there in spades, as well. How could I just ignore them for so long?

You know: busy, life, all that.

Dr. O suggested I change the way I'm taking the meds, switching me from one in the morning & one in the evening to both pills, a half hour before dinner, to give me more acid-reducing power overnight when production really cranks up.

Since that didn't help, I called Dr. G, my gastroenterologist, and basically said: "Help!" I'm seeing him Monday, in the meantime, his conveyed through his nurse that I'm to take 2 tablespoons of Mylanta every four hours. (Ick) It's helping, though. But I don't want to take it before I go to bed, because that's when I take my iron, and I'm pretty sure the calcium and magnesium will screw up the iron absorption. I think I'll take a ranitidine tonight, because already I can feel the burning in there, and it's not going to get better on its own.

Perversely, I'm hoping I have a hiatal hernia, or some physical defect that can be fixed (please please please), even if it means going under the knife again. I can't stand having these dysfunctional systems that are sort-of, kind-of treated via medication. It sucks, and I take too many pills as it is.

Today in the teacher's lounge, at lunch, when I shook my noon supplements out of their box, two teachers gasped: Is that every day? Yes, I joked -- better living through chemistry. Then the 10-second run-down on what everything is ("These two are for my arthritis, this is calcium I need to take because of my thyroid thing, this is Vit D to help the calcium metabolise properly, these are digestive enzymes...) Even so, I do a passable imitation of a healthy person.

Back to fixing me... I'm also scheduled for another video stroboscopy, wherein they film what's going on in the throat. I'm curious to see how it looks. I'm thinking Dr. G will schedule something to fix me. I'm miserable, and we've already met our health insurance deductibles for the year. Now would be a good time to get going on making me better.

[Inevitably: what am I doing that's causing all this? Don't know, don't even know if that's a valid question. Aftermath of the surgery is one aspect of it, but how big a factor, I can't say. More likely it's just genetic; I'm still hoping it's something that can be fixed instead of managed.

Tuesday, November 06, 2007

Torchwood 1.9: "Random Shoes"

"Random Shoes" plays as if an episode of Doctor Who wandered off and got lost, only to find itself somehow on Torchwood. Part police procedural, part ghost story, this episode presents a structural, if not thematic pair to Who's late season two episode, "Love and Monsters.

Read the rest over at the House Next Door.

Monday, November 05, 2007

"But I was thirsty!"

I have a habit of leaving a glass of water on the kitchen counter.

I know where that paw has been.



A slow, but satisfying, drink.



Oookaay....I had a habit.

haven't done this in a while...

Can you spot the scar?


My neck dissection surgery was just over two years ago. I haven't needed any treatment for my thyroid cancer since then.

In case anyone is wondering how I'm feeling about all this: YAY!

nine



DD had a nice, low-key birthday weekend. It was low stress for me, as she opted to have an ice cream cake (thank you, Baskin Robbins), and to go out for dinner rather than having me make her favorite dinner at home... lasagna.

Since I didn't have to make a triple-layered heart-shaped cake with pink frosting and blue roses as I have for the past two years, and since I didn't have to make lasagna, the weekend seemed positively carefree.

damn couch


It's a trap.

We've taken the sectional from the living room and put it in the family room, in front of the tv.

It's so delightfully comfortable that at the slightest lull in interest in whatever program I'm supposedly watching, I fall asleep. Then I wake up a half hour or 45 minutes later.

It's late, I should go to bed, but I had that nap! This is messing me up. Clearly, I shouldn't sit down to watch tv in the evenings without being ready to just pack it in for the night. Then when I finally wake from my tv nap, I can just trudge off to bed for real, without having to become fully conscious again.

I am not that well-organized. Many times I feel as if I positively need that nap to give me enough energy for the getting-ready-for-bed routine. It doesn't take all that long -- sort out pills for next day, clean teeth, put on pjs, fall into bed -- but I do need to be relatively cognizant of what I'm doing with my medication. And since I take my last meds of the day right before I go to sleep, that seems to be the best time to fill up the box with the next day's dosages.

I'll figure something out. Meanwhile, isn't that a nice looking rug I found at IKEA? (inexplicably missing from their online catalog) With 3 children and 2 cats we chose the "inexpensive and easily replaced" type of area rugs.

Thursday, November 01, 2007

pumpkin madness

Every year, we get pumpkins for the kids to make jack-o-lanterns. Specifically: DH makes the jack-o-lanterns. Scraping out pumpkin guts is not my thing.

This year, I spared him having to run around looking for a pumpkin patch the day before Halloween by buying the pumpkins over the weekend. I figured we were all set for the jack-o-lantern production since, really, what else besides pumpkins do you need?

Silly me: time.

You see, here in the greater Phoenix area, day time temperatures are still in the 90s. If you carve a pumpkin too soon before the big day, you'll be left with nothing but a heap of slimy goo on Halloween. So, no pumpkin carving until October 30, the earliest! Even better if you can wait until the day itself.

The expectation was, DH & the kids could do the jack-o-lanterns on Tuesday. But Tuesday night I had a support group meeting, carpooling with several members up to Scottsdale. I left at 6PM and didn't get home until after 10; the meeting was huge; four new members and lots of returns. I hoped to see 3 jack-o-lanterns smiling at me when I got home, but no such luck: DD had killer math homework, and DH helped her to finish it so she could get to bed on time.

That left me, of course, in charge of pumpkins yesterday. Oy.

I like jack-o-lanterns, I just don't like having to gut the pumpkins:

DS2 took this photo. I thought he was shooting the pumpkin, not me; see how thrilled I was?


I complained so much about the pumpkin guts that the kids insisted on taking a close-up:
It looks like so much cottony stuff, but in reality, it's slimy, ropey, clingy strings, randomly loaded with pumpkin seeds. And it's tenacious.


Through trial and error, I discovered the perfect pumpkin gutting tool:
Pampered Chef's plastic scraper -- small enough to get inside the pumpkin, strong enough to scrape the ropey, slimy strands off the walls.(See note, below)


While I was scraping, I had the kids design their jack-o-lanterns on paper; once the pumpkins were cleaned out, carving in the designs was short work. I love how every year they change just a bit, and I love how such simple designs can convey such varied expressions. Here they are by day:



And, for the full spooky effect, by night:



---
Note: from November 1 through November 16, 2007, ThyCa Phoenix is holding a fund-raising event. A percentage of each purchase made via Pampered Chef will be donated to thyroid cancer research. Pampered Chef ships anywhere in the US. For your purchase to be considered part of this event, click on the "Order Products" button in the lower left corner. On the next screen, enter THYCA in the "Host's first name/Organization" box, then click "search for host." On the next screen, click on "THYCA", and then begin shopping.