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Monday, March 13, 2017

On Mysteries, MRIs, and Miracles

This is Monday.  Last Monday, I had a visit with my PCP.  The hallucinations had not only not gone away, they had increased in frequency.  I was now seeing hundreds a day.  Hundreds.

Soooo.  He prescribed Tegretol, an anti-convulsant that reduces seizures by reducing nerve impulse activity in the brain.  In the literature on peduncular hallucinations which occurred post-catneterization (few tho they may be), Tegretol was one of the meds prescribed.  He gave me a pediatric dose, because I am ridiculously sensitive to drugs.  (Which may have been par to the problem to begin with.)

He also ordered an MRI.  :o

Okay.  I know MRIs don't hurt.  Really, I do.  But I'm claustrophobic.  I tried to get an MRI 15 years ago and it went badly.  I really thought it would be okay.  I told myself nothing would hurt and I just needed to remind myself of that while inside the tube.  How'd it go?  About 30 seconds after I was slid into the tube, I began to pound on the sides while screaming, "Let me out"  over and over again.  It was humiliating.

Needless to say, that little event was in the forefront of my mind the second my PCP said "MRI."  I knew it had to be done, tho.  After all, if it were exclusively the contrast dye, the hallucinations should have passed by then.  Something else could be going on.  The MD gave me a Xanax.  One Xanax.  A .5, to be exact.  I knew it wouldn't be enough.  I didn't know that the Tegretol counteracted the Xanax.  (It's used in detox clinics for just that purpose.)  Apparently my PCP didn't know it either.  But I digress.

So, I prayed a lot.  I had other people pray for me.  A lot of other people.  And by Thursday, I  felt their prayers. Until Thursday, every time I spoke of or wrote an email about the MRI, I began to cry. (Can you believe that?  I was so embarrassed.  I'm really not much of a crier.)

But on Thursday, as I typed out an email to my Pastor--no tears.  And I began to feel a peace settle in.

The MRI was Friday at 3:15.  Friday morning, the first Scripture that crossed my  mind was Jesus saying, "I am with you always."  And, then, in my daily Bible reading, I read these verses, "He [God] is your hiding place.  He will protect you.  He will fill your heart with songs of deliverance.  He will surround you with His love."

And, I knew.  That day...during that MRI...anxiety was going to be defeated.  It may look like I was surrounded by a tube, but I would be surrounded by God's love; I would be hidden in Him; and my heart would be filled with freedom's songs, not anxiety.

And that's exactly what happened.  It was the easiest test I ever had--start to finish.  Simple, relaxed, stress free.  If you knew my terror during my last attempt and the terror I felt every time I thought of it, you would know--it was a miracle.  God was my hiding place and I wasn't afraid.

Haha.  And the Xanax never kicked in.  The Tegretol nixed it.  Too funny.  (Even a .5 causes me to slur my speech a bit.  Not this time.  Nothin')

The other bit of good news is that the Tegretol, low dose tho it is, decreased the hallucinations from 100s to less than a dozen a day.  So far today, I've had only 3 or 4 and they are very fuzzy.

Nw.  The MRI results.

Like I said the MRI was at 3:15.  My doc was on the phone to me at 4:30.  (Never a good sign.)

Hallucination mystery solved.  Turns out I had had a microvascular infarct (Hear,  stroke) in the deep white matter of the parietal-occipital lobe. The catheterization caused  the stoke and the stroke caused the hallucinations.  My PCP doesn't  know if the hallucinations will resolve on their own or not.  (Yes, that makes tears come to my eyes.)

The Tegretol has some side effects.  It has a sedative effect and makes me just a little dizzy.  It also decreases the effectiveness of my Synthroid...which then effects the effectiveness of my insulin.  And I don't know what all of that will do to what has been a nice, steady weight loss.  Sigh.

We'll see.  God is able---and as I have said, God has been gracious unto me.  None of this is too much for Him. (Tho it is quite a bit too much for me.)

And that's the weigh it goes,

Deb

P.S.  Notice the blog design change.  No matter how much snow is in my front yard-->it is SPRING!


Tuesday, March 7, 2017

DNA Info from 23&Me on my weight

I just received an email from 23&Me delivering their new Genetic Weight Report .  I'm just going to cut and paste some things, with the 23&Me content in this font: DNA info.

If you aren't entertained by 23&Me presentation, the bottom line is that my DNA predisposes me to weigh about 13% more than average, not ideal weight.  That would be, per 23&Me about 180 pounds.  Let me say that a different way: Per my DNA, my body's most comfortable spot is about 180 pounds.  Above or below that is y own doing, either thru neglect or effort.  (Right now there is evidence  that neglect has been winning for a long time.)

23&Me provided fewer details than I would have liked--like I have a double copy of the Ghrelin gene.  They didn't go into detail about that kind of thing.  Here's what they did report:

The Genetic Weight Report looks at DNA variants you have that are associated with weight and breaks down whether you’re genetically predisposed to weigh more or less than average. It also highlights the different effects certain lifestyle factors have on weight for people with genetics similar to yours.

Debra, your genes predispose you to weigh about 13% more than average. The average weight for a woman your age who is 5'5" tall is 162 pounds, based on 23andMe participants of European descent.

We determined your result by looking at DNA variants associated with weight based on our research. Some variants have a stronger effect on weight than others, which our analysis took into account. Because of this, your proportion of higher to lower weight variants may not exactly align with your overall predisposition.

They went on to list lifestyle factors in people with my genetic disposition who were NOT overweight.  The factors were exciting in their everydayness.  :}  While many people do what they believe are all of the right things but do NOT lose weight or lose it painfully slowly, I have always known that when I do what I need to do, the weight comes off.  (Tho it is coming off a bit slower at my advanced age. sigh.)

Here's 23&Me's findings on what my genotype needs to do to lose weight:

Healthy Habits for Your Genetics 

We looked at 23andMe research participants with a genetic weight predisposition like yours and found certain lifestyle factors that were associated with the biggest weight differences. 
 
1.Avoiding fast food  Associated with weighing up to 17.8% less
 
2.Exercising   Associated with weighing up to 16.4% less .  People at a healthy weight exercised 2-3 times per week, on average.    
 
3. Limiting red meat  Associated with weighing up to 15.5% less     

4.Eating vegetables  Associated with weighing up to 12% less       
People at a healthy weight ate 2-4 servings of vegetables per day, on average.People who ate more than 7 servings of vegetables per day weighed up to 12.1% less than those who never ate vegetables

5. Eating fish Associated with weighing up to 11.9% less.
People at a healthy weight ate fish 1-2 times per week, on average.


If you notice, nowhere in this list is the advice that is given so often in "health" circles today which is to eat more healthy whole grains.   That's because my DNA report lit up for high risk for celiacs and gluten intolerance markers.  I guess I need to add some more veggies and exercise to my already low carb eats.  Of course, I already knew that.  :}

I also know why every time I try t lose weight, the struggle begins in earnest when I hit the 180 s.  This time I'll be prepared for that.  High as it sounds, 165 to 170 always felt like a good weight for me; maybe it is right.  We'll see.

                     
And that's the weigh it goes,

Deb

Oh.  I'm scheduled for an MRI on Friday.  I am very, very, very claustrophobic so I'm pretty anxious about it.  Prayers would be appreciated.

 

Saturday, March 4, 2017

God has been gracious unto me.

Fist a health report and then a little bizarre thing.

AS noted in the past post, my major coronary arteries are completely clear.  No plaque at all.  None.  Per doctor, "They're wide open with no sign of disease."  Can't get much better than that.

My carotid arteries have a "minor buildup of plaque which is not significant" and no cause for concern.  The little amount of plaque is causing no dysfunction.

Microvascular Disease.  I didn't know what this was, so I had the MD explain it and I looked it up online, too.

Turns out that women can have an arteriography that shows clear major arteries, but have a problem with the small (micro) vessels of their heart.  these are the tiny vessels that carry the blood from the major arteries of the heart into the heart tissue.  These tiny little vessels do not get blocked with plaque, usually, the get stiff and the walls can thicken, narrowing the vessel, thus slowing & reducing blood flow to the heart.

Although men do get microvascular disease,  women tend to get it without the accompanying major cardiac artery disease.  When their cath is clear they're often told they're just fine...go home, live well.  And they have a heart attack and die...with wide open cardiac arteries.

The women who get this are usually over 60,  diabetic, were first diagnosed with high blood pressure before menopause, and are sedentary. ( I was first diagnosed with HTN in my 30s and have been diabetic for 25 years.)  The MD told me that the diabetic retinopathy that I have is a form of microvascular disease, as is the neuropathy in my hands, feet and legs.  He said I surely have it throughout my body and it could certainly be the cause of the months long angina I've had.  Apparently, I am the poster girl for cardiac microvascular disease.

There is no cure.  There is no intervention like angioplasty or stents or by pass surgery for these little vessels.  Nothing but meds to reduce the BP (Already taking) and nitroglycerin to relax and enlarge the vessels a bit.  (He prescribed.)

And, then...  A surprise.  After the "you have it in your eyes, likely have it in you heart" prognostication, after the scrip to help treat it, after the clear cardiogram--an unexpected finding for this 65 year old, obese, diabetic, hypertensive woman.  When one has cardiac microvascular disease, the blood flowing out from the major cardiac arteries is slower than normal.  Which makes sense because those little vessels can't take the amount of blood they should take.  My blood flow?  NORMAL.  The MD studied the film--and is adamant; there was no "slow-flow" to be found.

Per MD, "There is no indication of cardiac microvascular disease found."  No need for the nitro. In fact, he actually said that he couldn't find any cardiac problems me whatsoever.  Whatsoever.

How about that?  If there's MVD I my heart, it's apparently too minor to show up.  Like I said,

God has been gracious unto me.   I am grateful and so aware that I earned every medical consequence that the MD expected to find...but didn't.  I have often said that if after God sent His Son to pay the price for my sins, He did nothing more for me, I still owed Him my eternal gratitude.  Even if His mercy stopped at the cross, I am His.  But it didn't stop there, did it?  It rolls on and I am without adequate words...
~~~~~~~~~~~~~~~


I kind of hate to add this bizarre piece after that astounding (tom me, anyway) praise report, but reality is what it is.  Even when it seems unreal.

When I got home from the hospital after the cath, I noticed that I was unable to read.  M vision was just fractured.  Picture a paper pulled from the printer too soon, leaving it with black streaks and misplaced, misshapen letters.  That's what the paper I tried to read looked like.

I shrugged it off.  My vision is easily put off, although this was pretty extreme even for me, and I'd been loaded up with Fentynal & contrast dye & who knows what else.  I tok a nap.  When I got up, my vision was better.  Not quite back to normal, but the streaks, etc were gone.  I sat down to watch TV, and then, I noticed...

There were purple-pink triangles floating thru the air.  Yep.  I was seeing hallucinations.  For goodness sakes, I thought, that Fentynal must be still doing it's thing.  I went to bed not long afterwards.

I no longer saw purply-pink triangles when I woke up; now I was seeing flowers and balls of ivy floating thru the air.  Every 30 minutes or so.  Full color, full detail, quite intricate pictures, in fact.  Well, okay then.

I was not having a psychotic break.  There was no sensory involvement other than the visual.  I knew they weren't real and they weren't frightening.  They were not triggered by my own thoughts, circumstance, or physical object.  Just these pretty waterfalls of flowers and paintings of flowers and ivy baskets.  They were animate, floating through the room and up like a child's balloon.

At this point, since I knew it wasn't psychosis, I thought it must have been the contrast dye or something.   I called the cardio guy. 

While I was waiting for the callback, I looked up "visual disturbances & cardiac catherization" on line.  Yep.  I found instances of other people having the kind of hallucinations I was having (Peduncular hallucinosis) along with other kinds of visual disturbances a few hours after the cath.  They  occurred from hours to two weeks, then left.

Well, I felt better.  Almost relaxed about it.  Almost.  (I mean, I was seeing things!)  I expected the MD to tell me that, on rare occasion, this happens and it would pass.

That's not exactly what happened because the cardio had never heard of this and refused to consider that the cath had triggered what was going on.  He said I had to go to the ER or  to my PCP.  In fact, when I refused the ER trip, he called my PCP without telling me!  My PCP call me and insisted I come in to see him. (It's a small town.)

 Long story short, I ended up at my PCP who said that we'd let it go until the two weeks were up, then, barring the onset of new symptoms before then,  if I was still seeing hallucinations, we'd have to run some tests.  He was only willing to wait because I took the articles in and showed him the reports of post-cath events like mine.  He also agreed to wait and see because he said if my brain was jazzed from the cath, adding more chemicals and stress via other tests might do more harm than good seeings how I have no symptoms of stroke or other urgency.   Per PCP,  it is unlikely that whatever's going on in my brain will require treatment (barring a tumor, which is unlikely since it would be awfully coincidental for it to just happen to show up immediately after the cath procedure.).  But we need to be sure.

This is Saturday.  Monday will be two weeks.  I'm still having the hallucinations.  They are less frequent and less sharp in focus, less detailed.  But they are still happening as of this writing, and they are fracturing my already poor vision.

I'll let you know what happens...keep praying, please.   My husband is having cataract surgery on the 16th and I don't want this extravaganza to be adding chaos right now.

And that's the weigh it's going!

Deb

P.S.  Even still, God has been gracious unto me.






Wednesday, March 1, 2017

Don't know quite how to put this...

I want to do an update r/t my health extravaganza--and then leave it behind!--but I'm not quite sure how to put it.  There's lots of moving parts...  I'm gong t try to write it in my head this evening while at my gr-dtr's gymnastics class and then get it on here.

Thank you to all who have been praying.  I rally appreciate it. 

Tuesday, February 21, 2017

And, then, there was a miracle...

Just to get us on the same page, let me give you some history.

I have been about 100 pounds overweight most of my life.  I weighed 207 pounds when I was in high school.  There have been brief periods, a year here or there, in which I weighed about 150, but that's the lowest I've ever gone. 

I eat terribly.  I'm don't eat massive amounts of  regular food at mealtimes (A fortunate thing or I'd weigh 400 pounds), but I eat calorie-dense food...mostly starchy carbs and sweets...and fat, of course.  Carbs and fat--a heart damaging combination and my food combo of choice.

I'm sedentary.

I have an anxiety-based personality, so I feel a lot of stress.

I've had high blood pressure, mostly uncontrolled, for 30 years.  When I worked at the hospital, I had to go have my BP checked every week.  It was always 200 over 100.  they did nothing.  Just checked it and sent me back to work.  I guess they figured if I stroked on the job, I was in a good place for it. (Seriously, tho, I never could figure out why they were monitoring it since there was never any response.  Just checking off the boxes, I suppose.)

Back in 2002, I was having some heart failure going on and while at work (in the hospital) a cardiologist saw my hands and ankles and insisted that I come to his office.  He called his office and made an appointment for me right then and there.  That ended up with a heart catherization. 

The results, 15 years ago, was that I had a coating of plaque. Not to the point of sludge, just a "glisten" of fatty plaque.  Stern warnings followed about eating/exercising, etc to avoid a build up.  I didn't listen.

2 1/2 years ago, I had an ultrasound on my carotids.  the findings were that every carotid had atleast mild fatty plaque build-up and at least one had moderate build-up; there was no functional impairment, however, so I marched on.  (No meds were given because I am unable to take statins or beta blockers.)

I've had diabetes for over 25 years, 15 of it on insulin.  Mostly uncontrolled, my average A1C is 7.5...at best.  On my good months.

I have a family history of BP and heart attacks.  (My father came home from work one day, saat down to watch TV and his heart blew apart.  Sudden death.  (He was not obese, by the way.)

Besides all of that, I've had continual, unrelenting tightness/mild chest pain for three months.

And, then, I had crushing chest pain off and on for three dqays, which led to the ER and the heart cath yesterday.

Poster girl for heart disease, right?

Both the cardiologist and my PCP prepared me to expect angioplasty, at least.  I was given daily nitroglycerin to take and a beta blocker (which I had to d/c after one day) to hold me until the cath.

Haha.  And then came Jesus!

Per MD after angiogram/cardiac cath:  There is no blockage.  There is no sludge.  There is no plaque whatsoever.  My arteries are "wide open"  No intervention needed. At all.

The MD told me and he went out into the waiting area and told my husband.  Wide open.  No plaque at all.

God was gracious unto me.  I deserved exactly what the MDs were preparing me to receive...but, Jesus had a different plan.  He said, "Yes" to my request for open arteries.  Above and beyond what anyone had reason to ask, imagine, or think, He said, "YES" and opened the arteries wide and clear.

I am overwhelmed with gratitude.   Thank you to those of you who prayed.

I still have the angina, tho, so the search is still on for the cause of that.  Still...the fact that there is no plaque in my arteries is simply amazing.

And that's the weigh it goes,

Deb

Copy of results part of angiogram.

RESULTS:

The left main coronary artery has no disease.
The LAD is a wrap around vessel with no disease. There is a moderate size first diagonal branch with no disease. Second diagonal branch is a small vessel.
The left circumflex is a large vessel with No disease. Obtuse marginal branches are moderate size vessels with no disease.
The ramus intermedius coronary artery is a moderate size vessel with no disease.
The right coronary artery is a dominant Vessel with no disease.
The left ventricular end diastolic pressure was mildly elevated to 20 mmHg. There was no significant gradient across aortic valve.

ASSESSMENT:  Normal coronary arteries

Thursday, February 9, 2017

The Medical News & Old Coping Skills

Heh.  The title should read, "Old NON-Coping Skills," but I'll get to that.

The medical news.

After about 3 months of daily chest tightness/mild pain, I had 3 days of severe pain on the left side of my chest and down the left side of my back (which I thought was a muscle cramp.)  The "cramp" got so bad that I could barely breathe and became nauseated.  So...I thought maybe I should go to the ER and have it checked out.  Just in case it wasn't a cramp.  That was Friday night.

Here's the rundown:

They gave me a nitroglycerin pill which alleviated the pain.
My electrocardiogram was normal.
The chest x-ray was normal.
The bloodwork was normal, including the cardiac enzymes.

So, I wanted to go home!  Clearly, it was just a severe muscle cramp.  The doctor, in front of my husband, said I needed to stay so I could have another round of bloodwork in six hours and get a stress test in the morning.  He blathered on about risk factors...and that I really, really needed that stress test. (Called Lexiscan.  A nuclear/chemical stress test with a photo component with Initials something like SPECT)

Fine.  I stayed.  Bill was on the edge of freak-out at me gong home.  Sigh.

The six-hour later bloodwork was normal.
The morning ECG was normal.
The morning chest x-ray was normal.

The stress test lab was out of the chemical needed and wouldn't have it until Monday.  I refused to stay until Monday and went home.

I had the Lexiscan/SPECT (?) test on Wednesday.  Despite some claustrophobia related hyperventilated during the photo part, it went well.

My heart response passed the "stress" part of the test.  I got an "appropriate response, normal" for that part.   It didn't pass the photo part of the test.

The bottom-line finding is:  anterior myocardial ischemia.
Translation:  I have a lack of blood flow and, therefore, a lack of oxygen to the front of my heart.

Here's what the internet says:
Myocardial ischemia occurs when blood flow to your heart is reduced, preventing it from receiving enough oxygen. The reduced blood flow is usually the result of a partial or complete blockage of your heart's arteries (coronary arteries). 

A couple of years ago I was told that I had moderate plaque buildup in my carotid arteries, but no functional loss.  While the carotids wouldn't cause the Ischemia to the front of my heart, if I had some buildup there, odds are it's somewhere else...and worse since there Is functional loss now.
 
Sooo.  I have a cardiologist appt on Tuesday.  We'll see.
 
Old NON-coping skills.
 
 I stayed on-plan...until yesterday when I got the scan results.  I managed until evening at which point
 all control was lost.  I ended up 1500 calories over budget.  Sighhhhhhhhhh.  So annoyed with myself.  I'm up 1.5 pounds this morning.
 
Three full  weeks without a cheat... lost.
 
I'm back on-plan so far today.  Thing is, it seems that it's too late for eating my way to health, anyway; the damage has been done.  And I'm the one who did it.  Ignoring medical advice for 25 years has finally caught up with me...
 
And that's the weigh it goes,
 
Deb

Wisdom is speaking in this passage from Proverbs:

"Listen to my [Wisdom's] instructions and be wise.  Don't ignore it.  Joyful are those who listen to me... For whoever finds me, finds life...but those who miss me injure themselves.
Proverbs 8: 33-36, abridged

 I should have listened.

Wednesday, February 1, 2017

Suddenly Weight Loss is Almost Incidental...Almost

Weight: 221 pounds  Morning glucose: 115

As mentioned in my last post, I had this "Aha!" moment in which I realized that overeating was crossing a spiritual boundary, just like adultery crossed a spiritual boundary, and was not just a physical/behavioral event.

I've been thinking about that.  It's a new concept for me, ya know?  It just keeps crossing my mind.

During one of these mind-crossings, a question arose.  It was: Is this not overeating mission something that must stand alone?  I mean, what if I don't lose weight?  Is not overeating a spiritual victory in and of itself?

Welllll....

The reason I'm doing this is TO LOSE WEIGHT.  Right?  Right?

Now here's a news bulletin:  Not so much, anymore.  Something else seems to be edging it out.

I can hardly believe it, but my focus, or at least my emotional emphasis, is eating within  God- set spiritual boundaries.  Boundaries  benefitting my body rather than fulfilling my lusts.

Ouch.  Didn't expect that "lust" thing to spill out of my fingertips just now, but that's what it is, isn't it?

Don't get me wrong!  I absolutely want to lose weight.  I would be extremely disappointed if I ate within reasonable limits and did NOT lose weight.

BUT.  My heart's focus is to live within the boundaries God has set for me with this eating thing.  That's a new attitude for me, that's for sure.  I'm a bit dismayed about that...   The fact that it's a "new" attitude in regard to food.  I shouldn't be.  I've been deceived for a long time.  Addiction does that, doesn't it?  So does lust.

I am so grateful for God's patience with me and for this revelation.  I just can't believe that it took so long for me to get it...and so grateful for the fact that  I've finally gotten it.  (And I sure hope that I keep hold of that whole "got it" thing!)

God is so good.

And that's the weigh it goes,

Deb