My Health LaurenceHolbrook.com

Health Index


 

"Growing old ain't for sissies!", Bette Davis.

 


Annapolis Asthma, Pulmonary and Sleep Specialists - Steven C. Resnick M.D. - 410 266-1644

8:00 AM Monday, January 24, 2005

 

Narcolepsy is marked by the ability to quickly fall asleep and enter REM sleep during a nap - The first two naps, I didn't fall asleep - the last three naps I fell asleep - the fourth nap, I entered REM - because of the fourth nap REM, they had me take a fifth nap - I exhibited no REM during that nap - my MSLT (Multiple Sleep Latency Test) pretty much rules out narcolepsy -

 

His primary diagnoses is 780.54, Hypersomnia Sleep - likely caused by [prior] alcohol abuse - Interesting to note that Ideopathic Hypersomnia is similar to Narcolepsy, patients with either are 'compelled' to take naps - Ideopathic Hypersomnia patients do not exhibit REM during the naps - he also diagnosed 870.53, Sleep Apnea -

 

I asked directly about waking up feeling like I was in a fight, nausea, kicked off covers, etc - He said he didn't know -

 

He did reiterate that the tossing and turning during sleep wasn't any particular cause for concern - I do so much of it that I find that hard to believe, but he's the expert -

 

He asked if I 'called out' it my sleep - not having a sleep partner [that speaks English anyway], that's something I wouldn't know for sure - I told him I think I can remember having dreams (nightmares?) that I think I am trying to talk, but can't, no matter how hard I try

 

I asked about CFS (Chronic Fatigue Syndrome) also known by many other aliases and FM (Fibromyalgia) - he said folks with those problems typically sleep all the time - neither is likely in my case - CFS and its variants is a 'collective term' for "something's wrong, we don't know what it is" - FM is a musculoskeletal pain and fatigue disorder -

 

He also coded 989.84 Smoker/Tobacco Abuse - I'm going to try and quit again (try the hypnotitst routine) - I wished I shared his enthusiasm for the benefits - if I do succeed, I'll undoubtedly gain a few more pounds and have even more trouble hauling my 'lard ass' around than I already do - and the extra weight will aggravate the apnea, although it would be good for my CAD - and may prolong my life span, giving me more time to bitch about sleep doctors -

 

He said treatment method is largely trial and error - for starters he prescribed 14 days of Ambien - he only wants to try a 'temporary' dosage of Ambien, hoping that might 'encourage' longer sleep episodes - he is not thinking, suggesting or recommending long term usage -

 

I should try to improve my 'sleep hygiene'

 

 

The only two I don't do are highlighted - avoiding naps is going to be damn near impossible - I tried to point out that I can force myself to stay up for as much as two days continuously, then go to bed at 11:00 PM - I will almost positively be awake by 2:00 AM - I rarely sleep more than 3-4 hours, irrespective of how tired I am - I can force myself to stay awake, by moving around, walking, smoking, etc - but if I sit still, I will fall asleep for a couple hours -

 

He recomended that I keep the CPAP set to 10 cm H2O rather than the 8 cm H20 recommended in this most recent study -

 

Next appointment, Monday, February 21, 2005 at 1:40 PM


January 24, 2005 Personal notes:

 

Over the last 47 days [12/08/2004 to 01/24/2005], I have slept an average of 6 hours per day - I had 89 usage periods with an average sleep episode of 3 hours -

 

What's exciting to me is that I have had 12 episodes of over 5 hours - that compares with about 14 episodes over 5 hours in the 567 days between 05/09/2003 and 11/27/2004

 

If I could only figure out how to increase the number of 5 hours episodes -

 

Next appointment comments:

 

A couple days ago, I was over a friend's house and took a nap - and she made the following comment, "your were like calling out like moaning of some sort - it was crazy" - I wasn't aware of anything during that nap - I can't remember any specific incidents in my sleep at home, but I can remember dreaming that I was paralysed, like I'm in a stroke or something and can't call out no matter how hard I try - I usually can't remember anything about them, except that I was scared -

 

I have nightmares and try to call out in my sleep - seems not to happen with CPAP -

 

Sleep study recommended 'treatment of nasal obstruction or allergic rhinitis may improve sleep-related breathing disorders -


Monday, January 5, 2005 - 12:00 noon

Michael Schwartz - (410) 761-4444

7310 Ritchie Highway, Suite 508 Glen Burnie, Maryland  21061

 

[Today's datre is Monday, January 24, 2005 - forgot to write notes immediately following, forgot more than I remember]

 

Short general discussion of using Xanax and other drugs to help sleep - basically decided to wait and see what Resnick comes up with -

 

Fecal occult blood detection test

 

Blood test - A1C and Lipid panel

 

414 Other forms of chronic ischemic heart disease - 414.0 Coronary atherosclerosis

 

401 Essential hypertension - 401.1 Benign

 

272 Disorders of lipoid metabolism - 272.0 Pure hypercholesterolemia

 


November 4, 2004, Thursday, 12:30 PM - Annapolis Asthma, Pulmonary and Sleep Specialists - Steven C. Resnick M.D. - 410 266-1644

 

Resnick read my polysomnograms

 

 

Come to think of it, that's another question I need to ask him – for some reason, I didn't think to directly ask him about that -

 

It was suggested (by a friend) that I might have fibromyalgia - I have read about that, but dismissed it - I believe that the polysomnogram EEG would show alpha wave activity inappropriately intruding into the delta waves of deep sleep - and I would have expected that the specialist would have 'picked up' on that -

 

 

I'll follow up with the narcolepsy test and perhaps I'm rushing things (it will be 2 years in March), but I think I may need to look elsewhere -

 

And if it is CFS, the prospects don't look good - I am really surprised that a sleep specialist wouldn't have more knowledge of CFS - to be honest, my family doc seemed more aware of CFS -

 

I did added a copy of a CFIDS Fact Sheet from the CFIDS (chronic fatigue and immune dysfunction syndrome) web site

 

I feel like a mushroom -


October 22, 2004 Ophthalmologist Appointment - Vincent Notarangelo - (410) 354-1061

 

Vision - Great news

·         Right (operative) eye has  20-20 vision –

·         Left (‘good’) eye has 20-30 –

·         Close up (within arms length is blurry) but simple magnifying glasses for reading seem to work fine


October 7, 2004, Thursday – Health Update

 

 

I hated to, but I did miss the appointment with the sleep therapist – I had no choice, there was no way I could have driven to Annapolis - and I wasn't able to communicate on a human level -

 

Just for grins, here is a total list of meds -

 


Health Update Tuesday, September 28, 2004

 

It has been roughly a year and 10 months since my first sleep study -

I finally hope to have some answers with sufficient detail to provide future direction

___________________________________________________________________

Cataract surgery recovery - just starting to be able to see with right eye - nothing spectacular, vision is terrible but I can discern objects - itching and drainage are the only aggravations –


September 27, 2004, Monday, 2:00 PM - Podiatrist visit - Dawn M. Gretz - 410 761-1666

 

Nail trim - nothing remarkable or unremarkable to report


September 27, 2004, Monday, 9:00 AM - Doctor's visit - Michael Schwartz - (410) 761-4444

 

 


Wednesday, September 22, 2004, Wednesday, 8:00 AM - Cataract Surgery – Harbor Hospital – Dr. Vincent Notarangelo - (410) 354-1061

 

Surgery a success, well at least there wasn't a negative patient care outcome -

 

It is microscopic surgery and you must remain stationary for an hour - I told them 10 maybe 15 minutes, but I'd never make an hour, they decided to knock me out -

 

Not much to report - painless -

 

Minor complaints coming to - a little 'woozy', light headedness - starved and cramps - terrible thirsty, so much so that I couldn't swallow - eye is either taped shut or open (forget which) covered with a patch and some kind of metal physical protection screen [sorta like an athletic cup only for your eye instead of your testicles] - that's a bit annoying, but not painful - I keep reaching to take my glasses off -

 

Tomorrow all that comes off - wear the metal screen at night - drops to do -

 

See Eye Doc on Friday -


September 21, 2004, Tuesday, 8:00 AM - Ophthalmologist Appointment – Dr. Vincent Notarangelo - (410) 354-1061

 

Had an ultra sound scan of my right eye yesterday - kind of a bummer is that the doc said it is 'real bad', meaning that I will need bifocals after surgery - it normally takes 6 weeks for everything to 'settle down' before I can get new glasses - my diabetes will slow that process down even more, probably 2 months -


September 1, 2004 - 12:50PM Wednesday - Albert K. Wong - Dermatologist - (410) 787-2111

My psoriasis is mostly clearing up - to be honest, I was a bit lackadaisical applying the Psorcon E - a lot of dumb reasons, partly related to my sleep deficiency - I purchased a prescription reminder program and have been much more consistently taking the prescribed dosages of all my medicines, including the Psorcon E - and in the last month or so, the psoriasis has really abated dramatically - I have almost none of the ugly, scaly, crusty crap  - I do have a lot of red blotches and while not pretty, I'm not too embarrassed to wear a short sleeve T-shirt, exposing my elbows, finally - when my elbows were encrusted with the scaly crap, I was afraid of offending my friends and kept long sleeve T's on -

A couple of tips for fellow psoriasis suffers:

If you have psoriasis in your scalp, he said to mix the Psorcon E with water to reduce it's viscosity so it will get through the hair and onto the scalp -

The doc said regular applications of skin creams will help keep the psoriasis under control - he said almost any such product would help such as those that contain lanolin - he mentioned two brand names, Vaseline Intensive Care and Eucerin - it was clear in my mind, they won't subdue an advanced flare-up, but they can help keep extend the period of controlled psoriasis -

Also, doc said, "off the record" that tanning is one of the best remedies for controlling psoriasis - preferably in the sun, but tanning beds are just as effective - he said it was prolly the only situation you will ever hear a dermatologist suggest sun-bathing - he did say SOME exposure to the sun/tanning lamps, but do NOT get sun burned - he prolly said it "off the record' because insurance companies are more than likely not going to pay for tanning salon visits -

So far, I haven't tried either, but I intend to at least get some skin cream -

I asked him if I had to apply this cream for 'the rest of my life...' - He also said the course of psoriasis is unpredictable - sometimes it completely clears up, never to be heard from again - sometimes it 'goes into remission' and then later starts to flare-up into a more aggressive episode - and sometimes it can be frustratingly persistent - basically, "ya neva kno..."


August 30, 2004 – Health Update

 

The results of my June 23, 2004 sleep study are available

 

I added the Sleep videos - pay attention to the file size warnings if you are on a Dialup line - the largest is 10 Meg - there is info about and links to the videos here:

 

Also be aware that I have some bad news - I am virtually totally blind in my right eye because of cataracts - although not good, this doesn't appear to be as bad as it sounds, yet –

General cataract info

 


August 16, 2004, Monday 9:00 AM - Doctor's appointment - Schwartz,  Michael - 410 761-4444

 

Issues

There was no improvement in my conditions -

That I wanted off the anti-depressant (Zoloft) because I don't think it's helping any -

I was convinced that I was suffering from sleep deprivation - that's why I'm falling asleep at my desk, why I am always tired, why I am so lethargic and so on -

All 4 sleep studies have warned of 'hyper somnolence' [excessive sleepiness, drowsiness - Medically, a state between sleeping and waking]- caution while driving, etc - Doc doesn't know why, neither do I –

 

I did record a video of some of my sleep - in 2 hours of sleep, I 'appeared' to sleep 'normally' for about 30 to 40 minutes - the remaining time I did a lot of leg crossing, uncrossing, etc - I now know why my covers are in a ball when I wake up - I made an animated gif, but the files are terribly large –

 

SLEEP VIDEOS

 

I also have been aware of having 'some' nightmares - the $64,000 question is how much and how much is excessive? - I believe that's why I wake up in a sweat - I can sort of remember trying to call out and not being able to talk - which the Doc said is not unusual -

 

Nightmares are not unusual - who's to say

 

The 4th sleep study (6/23/04) indicated to set the CPAP to 10cmH2O (it is currently at 12cmH2O) - the 'flawed' study (5/24/04) said to set it to 9cmH2O - because of the time lapse from the 3rd study to the doctor and then to John Hopkins (who control the CPAP machine) who then called me to tell me to set it to 9cmH2O didn't know about the 'flawed' study - I called Sleep Services of America and they thought it best to set it back to 12cmH2O until the results of the 4th sleep study were evaluated -

 

Doc's plan is

Maybe we are getting somewhere, finally...


August 9, 2004 – Thallium Stress Test – Monday 10:00am David B. Aielo – 410 768-6600

 

I haven't seen the results, but the card doc called the next morning to say no change - come back in a year -


June 14, 2004 -  Doctor's appointment - Monday 9:45 am Allan V. Garfinkel, D.D.S.- (410) 761-4684

 

Just got back from having 3 teeth pulled - actually quite painless - one little tinge when put the second shot of xylocaine in my upper lip - and one other quick jolt when he was cleaning out some infection on the lower right - otherwise, nothing -

 

The two lower teeth that he pulled were severely infected - which he said was a real time bomb when combined with the open heart surgery - I dunno about the top tooth - forgot to ask -

 

Can't talk, but primarily due to the swelling and numbness from the xylocaine and the gauze pads I have to bite down on to stop the bleeding - but otherwise ok and relatively pain free -

 

Tomorrow will prolly be a lot worse, but I'll wait until tomorrow to worry about it -

 

Next appointment is Monday at 9:00am to have the stitches removed -


June 8, 2004 – Health Update - Tuesday

 

I'm getting more and more convinced that poor sleep is the root cause -

 

And sleep depravation is causing the 'narcolepsy' type sleeping (falling asleep) - If I'm driving my car (like on a long trip) or at home, I just pull over and have a nap - it doesn't seem to happen on the motorcycle (???) - at my desk in work, I'm trapped -

 

Furthermore, I was reading about restless leg syndrome (RLS) and periodic limb movement disorder (PLMD) -

 

RLS is usually associated with sleep-onset insomnia - and I don't have either - but PLMD is associated with 'frequent and rhythmic leg kicking once asleep" and "if PLMD is predominant, sleep-maintenance insomnia or daytime hyper somnolence is more likely" - could this be the reason my covers are in a ball and I wake up feeling like I've been in a fight??? –

_______________________________________________________________

Three teeth to be pulled Monday, June 14th - likely to be a sick and sore puppy for a couple days -


June 7, 2004 -  Doctor's appointment - Monday 9:45 am Schwartz,  Michael - 410 761-4444

Lots of good news, but still no improvement in my basic complaints -

Friday, May 21, 2004 Blood Test results

Repeat comment on April 23, 2004 A1C (diabetes) blood test

Schedule another A1C test about June 7, 2004 [I think too soon, needs to be July 23]

 

Depression - no change -

Unfortunately, sleep test results not available - yet - and I'm really interested in this study more so than the others, because I woke up feeling like crap - I'm hoping (again!) that they can identify the cause -


May 25, 2004 – Arundel Medical Center Sleep Study - Tuesday

 

I just got back from my third sleep study - as usual, I don't know anything - and it was the usual game, the folks giving the study are only technicians and can't comment on what took place -

 

On Sunday night [early Monday morning], I had slept from 3 am to 10 am - and from 11 am to 3 pm - a total of about 11 hours -  

 

I'm not sure of the times, but they didn't get me wired and ready to go until about 1 am [early Tuesday morning] - the room was a bit warm and I was dressed in sweats, so I was slightly sweaty and a little uncomfortable from the temperature - because this was a 'titration' study [fancy word to check the amount of pressure required for the CPAP to function properly], they first had me sleep with no machine, ostensibly for 2 hours or so - as I recall it was an exceptionally long time for me to fall asleep, maybe 20 or 30 minutes - they woke me, put on the mask and started the machine - again it took me a lot longer than usual to fall asleep - they woke me (or I woke up, not sure which) about 7:00 am - I felt lousy like I usually do - a little sweaty from the temperature - worn out and lifeless - I had a pain in the lower part of my neck on the right side - I had a mild headache -  

 

My guess is that I slept about a total of 5 hours -  

 

Basically I am very tired and drained [STILL!!!] - You would think that someone could tell me 'how' I slept without violating anyone's medical ethics, while it is still fresh in my mind - I suppose in a couple weeks, my doc will have a report and I'll discuss the recommendations with him -  

 

I really think that 'poor quality' sleep is the cause of most of my problems -  

 

Of course poor sleep quality could be aggravated by other issues such as thyroid - I just had some blood work done and I think the doc included checking my thyroid -

 

I included the first two sleep study results here - March 19, 2003 was with no machine and recommended getting a machine - May 5, 2003 was to establish the pressure for the CPAP - after the May 5th test, I remember that I did feel a bit better than usual when I woke up, indicating that the machine might have helped improve things, although I only slept 4-1/2 hours - Unfortunately, after sleeping with the machine at home, I never (or rarely) felt that good again -

 

I get the feeling that the ONLY objective of these sleep studies is to support the use of a CPAP machine and to encourage a consultation with a sleep specialist - if Sleep Services of America is not a sleep specialist, what the heck are they???          

 

Next doctor's appointment (Michael Schwartz, MD) is June 7th, 9:30 am -


April 29, 2004 - Health Update -Thursday

 

I'm sorry it took so long to issue the results of my Monday's doctor's appointment, but a lot is going on, I received several reports and I'm having trouble keeping it all-straight –

 

In the sleep study report, there's a reference to hyper somnolence, which sounds like what I've been experiencing - I didn't discuss this with Doc because I didn't know about it until after I left the office - for those that might be interested, here are two links on hyper somnolence:

 

http://www.diagnose-me.com/cond/C495062.html

http://sleepdisorders.about.com/cs/sleepdeprivation/a/idiopathic.htm

 

Hyper somnolence is excessive sleepiness. People with hyper somnolence, as opposed to fatigue, often fall asleep unintentionally. Once hyper somnolence has been confirmed, the first cause to be ruled out should be inadequate sleep time insufficient sleep). Most people require at least 7 hours of sleep per night and often closer to 8, men generally requiring less than women.

 

I hope I'm not grasping at straws or off on a wrong tangent, but perhaps the repeat sleep test might confirm that my sleep hasn't improved as hoped - also, there is a strong link between hyper somnolence and depression - furthermore (and very troublesome), there is a strong hint that these conditions maybe a precursor to Alzheimer's -

 

There's a lot of information here, but the sleep report (which I only summarized the results in the attachment) was 'eye-opening' -

 

If you're confused, I don't blame ya - I sure am -

 

And I sincerely can't say thank you enough all for your indulgence while I try to work through all this -

 

Larry

___________________________________________________________________________

April 26, 2004 -  Doctor's appointment - Monday 9:45 am

Schwartz,  Michael - 410 761-4444

Next Doc appointment - Monday, June 7th 9:45 am

                                                    

Issues

 

 

Discussed

 

 

Doc said something was wrong(?) - Need blood work done

 

Glucose Level - Hemoglobin A1C (the 3 month average blood sugar test) - normal is below 6.0%

 

Date       Quest Laboratory results - approximate mg/dl level

09/12/03 7.7% about - 170 mg/dl

04/23/04 5.7% about - 111 mg/dl

 

I thought current sugar level (4/23) from Quest Laboratory was 'normal' - Doc said it was 'better' -

[Comparison,  Quest Laboratory measured an instantaneous reading of 117 mg/dl, I measured 123 mg/dl instantaneous test (finger-stick) shortly after]

 

Doc

 

Colonoscopy results - November 7, 2003

 

 

Diagnoses

 

____________________________________________________________________________________

Things to do:

 


April 19, 2004 – Monday – chipped tooth

 

I had poked two pretty severe wounds in my tongue - I managed to see my dentist (Lyndell Schwartz) Friday morning (April 23) - he took all of 5 seconds to grind the edge of the tooth smooth - it took another couple/three days for my tongue to heal enough to be able to eat - I never should have waited - live and learn -


Tuesday, March 23, 2004 –

 

Personal note: I didn't see/hear or get a chance to check out the news release on the TV yesterday, but I am taking Zoloft –

 

Dentist Appointment 11:30am - Frederick J. Quarantillo, D.D.S. PRACTICE LIMITED TO ENDODONTICS - 410 799-4008

 

Nothing happened – confusion over which teeth were to be ‘repaired’ – and some teeth that were to be repaired look ‘un-repairable’ -


 

Monday March 22, 2004 – Cardiologist’s Appointment 2:00pm David Aiello, MD - 410 768-6600

 

 

Because of the above, the exercise that I have been doing and the fact that it occurs very sporadically, he believes the tightness in my chest is not heart related –


Monday, March 15, 2004 – Doctor’s Appointment 9:45am Michael Schwartz, M.D. - 410 761-4444

 

Personal problems

 

 

I forgot to write the actions of this appointment, prolly forgot more than I remember

 

I think he repeated EKG

____________________________________________________________________________________

Things to do:

 


Monday, March 1, 2004 – Doctor’s Appointment 9:00am Michael Schwartz, M.D. - 410-761-4444

 

Next appointment 3/15/04 9:45am

 

Personal problems

 

·         Inordinate energy to accomplish basic, simple tasks

·         Can't get anything but the bare minimum done

·         Only do one thing at a time

 

Doc thinks that I have a major case of depression - interestingly, he said that almost all of his CABG patients suffer from it - perhaps something to do with the extended period of anesthesia - he stressed that this type of depression is not logical, especially when it's not due to traumatic life events - it's a chemical imbalance that exists - lots of folks say party with some friends, or go hunting and kill things, but those activities won't help - it's not an emotional problem that I'm dealing with  - I do circulate with friends and am happy to do so - and generally feel happy, i.e. not 'bluesy' -

 

Did an EKG –

Doc said wasn't good, baseline is wavering - but he also said that's somewhat normal for me -

 

Heavy feet - then legs rubbery -

Doc says caused prolly by low blood sugar - I never thought to check blood sugar -

 

Wake up feeling like I was in a fight - covers in a ball -

Doc NC

 

Exercise is going OK, but still tense when I'm doing it

Doc wants to try nitro patch

 

Results from UMMC - Reviewed catheterization

Doc said results not great, see Cardiologist

 

Results from UMMC - No report for the chemical stress test

 

Don't think Zoloft is helping -

Briefly discussed other drugs, Doc says increase Zoloft to 100mg

 

Colonoscopy - remove pollops

Doc will get report

 

Drugs causing problems - Norvasc

Didn't mention

 

Two teeth need to be pulled

Didn't mention


Thursday, January 15, 2004 - Health Update

Nothing much has happened and I don't know much more than I did since the last time, but a couple folks had asked how things are going, so I thought I'd issue an update -

I've had two visits to the Joslin Clinic (for Diabetes at North Arundel Hospital) - eating was discussed in general - they gave me a couple pamphlets on food nutrition for restaurant & fast food - she set a goal for sugar level at 170, which I was at anyway - actually was quite a bit less (about 140) -

Measuring sugar level is a very tricky problem - the doctor is only going to believe the 3 month average test that he has done - he said normal is a maximum of 140 at 2 hours after eating - 80 to 120 the rest of the time - well how do you know when it's two hours after you eat? - What is my reading at 4 hours? - And you can't stick yourself 12 times a day -

To be honest, I stopped messing with it over the holidays - I'll start back in again recording it, but I'm not sure what a good schedule is - it seemed like cutting out soft drinks, eat more fish and other simple changes 'might' be enough to keep it reasonable -

Weight was down a bit, maybe 15 pounds which is a good thing - still smoke, which is a bad thing -

Still no word on the results of the artery catheterization and chemical stress tests done at UMMC - the doc did tell the gals to get a copy of the reports which hopefully they will have when I go in again -

I've been to the dentist 3 times - once for investigation and a cleaning - once for a filling and once for a temporary filling, which I never heard of - apparently one of the decays was very deep and he put in a 'medicated' filling that will stay for a month or so - the medication is supposed to quiet the nerve down because it is so close to the cavity - the next visit he will remove the temporary and replace it with a permanent filling -

I got two teeth that need to be pulled - he's going to send me to an oral surgeon to do that - then more talk about what to replace the missing teeth with -

My feet cleaned up real well from the athlete's foot -

The psoriasis hasn't been quite so responsive - most of the bad, crusty spots are gone, except my elbows and a very little bit on my back and side - lots of red spots still on my legs -

I have been sleeping more lately - probably averaging 7 hours - but it's not contiguous - I still never sleep more than 3 or 4 hours at a crack - I don't know that the CPAP machine has helped much - it has been useful in two areas, one I don't think I snore (like who cares??? - the dog never minded anyway) and the second is that I don't think I grind my teeth (bruxism) - so that is a good thing - the nurse did wake me up in the hospital because I had stopped breathing a couple times, so I guess it's helping with that issue as well, but that's not something that I am even aware of -

Still very tired throughout the day - still fall asleep at my desk sporadically - it's weird, you'd think after being dragged out all day, when the evening came I'd be dog tired and sleep well - but what happens is once I get home, at 10 or 11pm, then I'm primed and ready to rock 'n' roll - I can read and write programs all night long with no problems -

The doc put me on Zoloft, which is an anti-depressant - I can't say as I feel a whole lot different as a result of that either, although it's only been a month or so - I need to give it some time before I/we pass judgment -


Friday, November 7, 2003

Still to come, diabetic dietician at Joslin Clinic on Monday 2:00 PM, November 24, 2003 - Follow up with Doc on Tuesday 5:00 PM, December 6, 2003 -

Dr. Kurian, colonoscopy -

This procedure went quite well and is painless, except for the prep (aration). Can't eat the day before (something my system doesn't tolerate well, I don't need to eat a lot, but if I don't eat a little something, I get headache, unstable gait, generally miserable) - no aspirin - and two Fleet phospho-soda enemas -

Results are preliminary - generally all looked good - he did remove one pollop, but otherwise generally clear and pink all through the entire lower intestine -

 


Tuesday, November 4, 2003 - Doctor's visit

Not much came from this visit  -

80 to 120 is a 'good' sugar level reading - 140 2 hours after eating a big meal would also be good - Doc said he'd run test to recheck in December - I haven't been taking my readings after meals, although I am going to try to do so more in the future -

Still don't have UMMC heart results (catheterization and chemical stress test) -

Interesting discussion on Diet Pepsi Slurpee - only available at 7/11 - It uses 3 sweeteners ( tagatose, erythritol, and sucralose) and none of which are the usual sweeteners in diet colas - tagatose is an interesting ingredient, because to some extent it may counter the effects of diabetes - I included a page of information on Diet Pepsi Slurpees for those you may be interested -


 

Tuesday, October 28, 2003 - Dermatologist visit

 

The rash I had (and to some extent still have) is Psoriasis - I don't know much about, what causes it, etc - I appended what appears to be reliable information to this update -

 

When I was first infected several months ago, It was all over my chest, some of my back, all over my legs, my elbows and the base of my scalp - at the minute, there's a little, very light discoloration on my chest - my legs still have some large red areas, but no hardness - my elbows still have 4 inch diameter 'crusty' spots -

 

The dermatologist prescribed Psorcon E, which is some kind of a high potency steroid - he say did exposure to the sun was usually helpful -

 

He concurred with Podiatrist diagnoses of my feet - athlete's foot and the fungus-infected toenail -

 

Still to come, regular doctor's visit Tuesday, November 4, colonoscopy Friday, November 7 and Joslin Clinic Monday, November 24 -

 


Tuesday, October 21, 2003 – Health Update

 

Let me see, where was I? - lol -

 

Still to go - dermatologist (10/28), Joslin clinic (diabetes dietician - 11/24) colonoscopy (11/07), family doctor (11/04) -

 

Sleep the last two weeks has been much better - averaging 7.3 hours per night, compared to maybe an average of 5 (4 to 6) the last 20 weeks -

 

Almost all of my sugar readings the last week or better have been in range, compared to about 38% of the readings the 3 weeks previous -

 

Maryland Vascular Lab performed the arterial study -

 

Pressures are great, 30 is passing, mine were 85 - technician explained that diabetes affects the blood flow in the tiny veins and arteries - the result, very little blood flow to the feet - as opposed to cholesterol which plugs the major veins and arteries -

 

Dr. Notarangelo, ophthalmologist -

 

My eyesight prescription had changed and he updated that for me -

 

Checked my eyes for cataracts (I think that means clouding of the fluid in the eyeballs) and said there was a little bit in my right eye - nothing to be concerned about now -

 

He explained that a major concern in diabetics is that the little blood vessels in the back of the eye get hard and then crack and bleed - and that's what causes blindness - I have none - YEA!

 

He also checked my eyeball pressures - high pressure indicates hardening of the eyeball and glaucoma - the pressure in mine were good -

 


Wednesday, October 15, 2003 - Podiatrist

 

She doesn't want me to cut my toenails - every 9 weeks make an appointment and let her do it (actually she is cute enough, I just might let her - lol) - she's afraid of an infection -

 

She also explained that with diabetes the feet don't feel pain, so it is easy to lacerate, freeze and/or burn a foot and not know it - don't walk around barefoot -

 

I have a fungus under my big toenail and she recommended Lamisil pills which would take a while to clean it up - she wants me to discuss with my doctor the wisdom of taking those pills in conjunction with everything else I'm taking -

 

She wanted a non-invasive arterial study (blood/pressure flow by sonogram) of my legs done -

 

She gave me a script for some ointment to clear a touch of athlete's feet up, which I've yet to pickup -

 


Friday, October 7, 2003 Doctor's appointment

 

My 3 month average test results are 170 mg/DL glucose - I have type II diabetes - My blood sugar has varied between 96 mg/DL and 232 mg/DL with an average of 154 mg/DL over the last month or so (self-monitored) - normal is about 80 to 140 - only 38% of my readings are in the normal range - going to attempt to treat it with diet only -

 

·                     Set an appointment with the Joslin clinic (diet control) in North Arundel Hospital

 

Because of the diabetes

 

·                     Get eyes checked by an ophthalmologist

·                     Get feet checked by a podiatrist

 

The results from UMMC (catheterization and chemical stress test) were not reviewed -

 

Sawbones couldn't remember why he suggested a 'head' MRI (afterwards, I wonder if he was thinking stroke? - I think they call them transit ischemia's in the brain) - this needs to be discussed again -

 

I generally have a happy disposition and attitude - however, I have (and have had for some time now) 5 of the 7 symptoms associated with depression -

 

 

Doc says depression can be caused by traumatic life events (I haven't had any of those recently) and/or chemical imbalances in the brain (very difficult to diagnose)

 

Zoloft was prescribed to see if that produces any improvement -

 

Doc doesn't think blood pressure medications are a major contributor to any of my current problems - although he did say that metoprolol can cause depression - his experience is that it was very rare, but it was debilitating, e.g. created crying jags - not my experience so far -

 

Next appointment is November 4, 2003 4:45 pm

 

Outstanding items

 

·                     Dental work

·                     Colonoscopy

·                     Fungus

 


09/12/2003 – Doctor’s Appointment

 

Doctor's visit -

 

·          Back to work Monday, September 15, 2003

 

·          Blood sugar was 140

·          BP was 110/80

 

He wouldn't confirm or deny diabetes diagnoses -

 

·          Apparently the test results taken at Harbor Hospital (Friday) somehow got lost -

·          [You should go to a hospital when you're having a heart attack????]

 

·          I don't think the University of Maryland Medical Center performed any diabetes tests -

 

·          At this point I had another blood test done - and based on those results he will do some kind of an 'averaging' test - which I think will be used to diagnose diabetes -

 

·          He does want me to monitor my blood sugar levels twice a day, once in the morning after getting up and a second time 2 hours after my last meal of the day -

 

He didn't have the catheterization and chemical stress test results from UMMC to be positive, but he believes there are no major heart problems - the CAD (coronary artery disease or hardening of the arteries) still needs to be controlled with medication and diet -

 

The BIG shocker is that he doesn't think the lethargy, sleep depravation and paroxysmal sleep is due to diabetes either - he 'thinks' it's from depression -

 

The plan at the minute is to

 

·          Resolve the 'level' of diabetes involved and get that under control, perhaps with some consultations with dieticians

 

·          Get some dental problems taken care of

 

·          Meet again on Tuesday, October 7, 2003

 

I'm beginning to wonder if this will ever end?

 


9/10/2003 - Current Issues & Tests

 

Temporary issue - no driving (or heavy lifting) for 3 days because of the catheterization -

 

Current Issues

 

Next meeting with doctor, I'll call tomorrow (9/10/2003) but will probably see him on Friday 9/12/2003 -

 

UMMC recommended diabetic, low salt, low fat, cardiac/heart healthy diet - prolly means limited to skim milk and green or yellow cardboard (lol)  - if I understand correctly, that so far my 'heart/CAD' condition is not terrible at this point, then a positive effort (by me) to change my diet may keep that part of my health from deteriorating more -

 

The impact and treatment of Diabetes - Wake up feeling totally washed out, sometimes a little nauseous and dizzy - Falling asleep at the terminal, which I've mentioned before is not like just falling asleep, it's more like going into a trance - it's like I 'step into a dream' and then come back out of it - Mornings and afternoons are definitely my worst times -

 

I have faithfully been using CPAP machine since 5/20/2003 and have yet to experience any significant improvement - it wasn't mentioned in the medical notes from UMMC, but the nurse did wake me up on two occasions for apnea - several folks have reported excellent results with CPAP - unfortunately, I haven't been as fortunate, yet...

 

Sleep depravation - I only sleep a few hours at a crack no matter how long I've been awake before I sleep - very rarely, I'll get 5 hours -

 

[Discuss amtripiline another name for Elival sometimes prescribed for depression, but it also works for sleep disorders]

 

Depression???

 

[lorezepam - may also help with quitting smoking??]

 


University of Maryland Medical Center  - 9/6/2003 to 9/9/2003

 

Medical records indicate that I was sent UMMC because of 2 abnormal EKG's and Troponin I (one of the heart attack indicator enzymes) slightly elevated (T I 0.5 to 0.6) - my thallium stress test of 8/18/2003 was in fact negative at a 60% heart rate -

 

In October 1996, my main 3 arteries to the heart were blocked - one at 100%, one at 90% and the third was either 40% or 60% - A LIMA and RIMA was done (at Union Memorial Hospital) to increase blood flow to the heart -

 

A diagnostic catheterization on 9/8/2003 revealed that the LIMA (Left Internal Mammary Artery Graft) was ok and that the native artery that was 100% blocked had started to provide some blood to the heart - the RIMA proved difficult to got at -

 

An Adenosine Thallium Stress test (chemical heart stimulation) on 9/9/2003 was done to evaluate the RIMA, which checked out OK - this test is normally done for 6 minutes, I could only take 4 minutes - Although I'm not sure what that means, I did go long enough for them to evaluate the results -

 

Harbor Hospital - 9/5/2003 to 9/6/2003

 

Sent by Doctor Schwartz - Basically for heart attack evaluation - Because of tightness in chest and an abnormal EKG at doctor's office -

 

HH did 3 sets of blood enzyme test, which showed a very slightly elevated enzyme level (indicative of a heart attack - I was told that my enzymes on one reading were .41, with .4 being the limit - heart attacks are usually indicated at 20 or sometimes as low a 5, but .01 over is a 'small' elevation -

 

HH measured blood sugar was 251 (units???)  - 80 to 140 is normal - I was told that one reading high like mine means I have diabetes - this is a 'new' discovery at this point - when the gal was rolling me up to my room, she asked how long I had diabetes, I said "I didn't" - she said, "I do now" - I had that one very low level (hypoglycemia) below 30 in September 2001 -

 

I don't have any specific medical records from HH, just what I can recall at this point -

 

 

9/4/2003 - Jim's Comments II

 

More Comments from Jim:

 

This sounds like it is all related but I would appreciate a Medical opinion with some blood tests to support the theory. With hypoglycemia you will see a decline in blood sugar and it could also be indicative of diabetes. Either way it is very treatable and would benefit all the symptoms you seem to be experiencing. They would need to factor in any medications, vitamins or herbs that you may be currently taking. If you become disenchanted with the Medical community, you might want to consider the holistic approach

 

 

9/4/2003 - More Notes

 

BTW, your comments reminded me - In September 2001, I was about to have a blood sample drawn and mentioned to the nurse that I felt very 'anxious' - on a whim, she checked blood sugar and said it was extremely low - I think she said it was below the reading level of her instrument, which was like 35 (sorry, but I don't remember the units) - after her 'discovery', we discussed it a bit - I remembered having several similar 'events' in the past - I used to go have a drink or two and chill - or perhaps a coke and a snickers - and it would pass - she said, just to eat a little something like cheese crackers and keep something handy in case I felt that way again -

 

I can't say that I have been bothered with it much since then, at least not like I used to before -

 

And I can't say that what I felt yesterday was exactly the same, but it was similar and had elements of the same thing - the inability to concentrate and being distracted by chest discomfort and perhaps the skin jittery or general agitation/anxiousness -

 

 

9/4/2003 - Jim's Comments I

 

Comment from Jim:

 

I read your comments with great interest. You said that you did get some relief when you had something to eat. I would ask that you inquire if you have been adequately evaluated for diabetes or hypoglycemia. Both conditions can improve with either carbohydrates or sugars in the system. The symptoms might include feeling weak, lethargy, shortness of breath, and depression. You may see that you have to urinate more frequently, experience increased thirst and possibly vision problems or numbness in extremities. My guess is that they evaluated possible diabetes but maybe not hypoglycemia. Both can be determined with good blood tests designed to identify conditions.  Hope you are feeling better and would be interested in the results of your sleep disturbance treatment.

 

 

9/3/2002 - Experience

 

I slept terribly Tuesday night - woke up feeling like I had been in a fight - usually lay back down again and have a nap - instead I loafed around a bit and come into work - started feeling 'uncomfortable' walking into work - hard to describe -

 

·                      Skin all jittery is best I can describe -

·                      Some chest discomfort -

·                      No problem breathing -

·                      Stomach cramping -

 

I stayed for a couple hours - didn't feel any better - left -

 

On the way out, I was starting to feel worse - I had never taken a nitro before and thought well I'll try one and see what happens - took one, sat down for 10 or 15 minutes - nothing changed -

 

I was running very short on sleep and I hadn't eaten - so on the way home, got a sandwich - this was about 4pm -

 

Started feeling better mid-evening - napped 3 or 4 times, a couple of naps for about 3 hours and the last one for 5 hours - I had a lot more total sleep last night than I have had in quite a while -

 

Woke up again this morning (9/4), feeling like I had been in a fight (again), stomach cramping plus a bad leg cramp - the leg cramp worked out - chest discomfort is gone -

 

I assume after I eat something, stomach cramps will go away -

 

I dunno what's going on -

 

I just had another stress test done (8/18) - I did a little better this time than the previous test, which the Card Doc thought for me was decent considering the medication I was taking -

 

In a short phone conversation about the results, I did manage to get a couple questions in -

 

·                      The Card Doc said that I did slightly better this time than last time (in March I believe) -

·                      He said the blockage to the backside of my heart had improved some (???) -

·                      About having trouble walking sometimes, he asked how I knew it was my heart -

·                      And in response to my question about poor sleeping and lethargy, he said he didn't think it was caused by circulation/heart issues -

 

On the issue of depression - I don't feel depressed and have generally been pretty happy - and nothing unusual has happened recently -

 

·                      I am a bit disappointed about how my health is going and dealings with the medical world in general -

·                      It has been problematic getting information out of the doctors -

·                      Change in insurance plans -

·                      I am a bit frustrated dealing with aging, reduced short term memory and deteriorating eye sight -

 

I have generally been happy with my job performance -

 

·                      I am occasionally still able to come up with 'break through' solutions -

·                      I also have completed several projects in record time that baffle others -

·                      I usually get very positive feedback from those I help -

 

There is a down side -

 

·                      'Getting things done' seems to take massive amounts of effort -

·                      I can't 'multi-task' like I used to -

·                      I don't feel well appreciated, but that doesn't seem unusual in Northrop Grumman -

·                      Currently, I am concerned that I am the holdup on 3 or 4 projects -

 

Until yesterday, I hadn't felt incapacitated by it all -

 

 

6/30/2003 - CPAP Progress

 

I honestly can't say as there is much improvement, if any - although my number of hours sleeping has increased - I was doing 30/week and am now up to 40/week - although that's almost 6 hours/day, I think most of it is happening on the weekend and I am still running on low during the week - I think I may be nodding off at my terminal a little less during the day - hard to say for sure

 

I might have had my expectations too high - I was expecting to feel a 'burst of energy' - and apparently several folks have experienced a marked improvement -

 

I'm not giving up - still working with it

 

 

5/21/2003 - Notes from a CPAPer

 

That's good news about your new CPAP machine. I broke the rules and used tap water after going thru several gallons (3) of distilled water. Tap water can cause deposits to form in humidifier water tank. You will get used to laying down the same way each night after putting on your headgear. Sounds difficult, but I was surprised how well I adapted since I toss and turn (I can tear up a bed). It will only take a few nights of trial and tribulation. What kind of mask are you wearing? If you are wearing a mask that just covers your nose you must learn to sleep with your mouth closed. If you cannot seem to learn to do so you should have or acquire a chinstrap that will keep your mouth shut while you sleep. While sleeping with your mouth open I don't think the humidifier will help the dry throat problem.  Larry you will get used to putting the mask on each night, as it will become part of your every night ritual preparing yourself for bed. Concerning the leaks, do not adjust the straps too tight. I did exactly that and have a new scar on the bridge of my nose to show for my haste in trying to fix the leaks. Not to mention that I refused to sleep with out the CPAP and was very uncomfortable with the mask for several nights while my nose healed. Try several slight adjustments and you will be surprised the effect the small changes will have on the masks ability to seal even with facial hair. I will guess the twelve you see is the positive pressure your machine is set to produce while operating

 

 

5/21/2003 - CPAP Beginning Usage

 

I'm going to wait a couple days before I send a broadcast email, but I got the CPAP yesterday - I did get a humidifier, but I didn't use it last night - didn't get a chance to get some distilled water -

 

I did have trouble falling asleep with it (which I didn't in the sleep test) and I woke up after 1-1/2 hours - but after I sat up for a few minutes, I managed to get back to sleep and slept 4more hours, which I think was pretty good for me - throat was little sore (dried out) when I woke up the first time, but not as bad when I woke up this morning -

 

Don’t know that I'm particularly improved yet, but it was only one night -

 

Kind of stupid putting the mask on - probably a lot more embarrassing to deal with if you have wife, kids, etc around - but living alone, it's really not a big deal - more laughable than anything else -

 

It's hard for me to tell if it is all working ok - I think I got leaks plugged, but it seems like the smallest change in position can alter how well the damn thing seals on my nose -

 

I have a Breas PV10, which is set for 12 (inches of water?) -

 

·                      Very quiet

·                      Variable ramp time

·                      Calendar data analysis program

·                      External 12 and 24 volt capability

·                      Panel lock function

·                      Power failure alarm

·                      Remote control

·                      Pressure display

·                      Auto switching power supply

·                      Alarm clock

 

Plus this thing monitors usage - calendar data analysis program - (compliance software for the insurance company, who else - lol?) - I'd like to know what those numbers are just so that I know it's working too -

 

The gal said that it cost $1500 for everything plus $300 for the humidifier - the insurance company will probably (after a couple of months) pay about $1000 for it and I'll get nicked for $200 or so - the prices I saw for the unit were less than $500, of course hose, mask (about $100) were all extra -

 

 

5/6/2003 - General Status

 

This is from the URI I had - I was off from work for 2 weeks screwing around with it - this office visit was in mid-March, but it led to two sleep tests and a cardiologist visit - the cardiologist said there was some blockage to the back of the heart, but he didn't think 'bad' enough to mess with yet - he did give me a script for nitroglycerin just in case - apparently the CABG (Coronary Artery Bypass Graft) that I had done a few years ago was still working pretty good, but it only addressed blood flow to the front of my heart -

 

 

5/6/2003 - Sleep Test II

 

Well I took 2nd sleep test last night - as usual, I still don't know much -

 

In spite of the equipment, I did sleep 5-1/2 hours continuously, and that is a record for me - I haven't slept that long in one session but a couple times in the last 6 or 8 months - today, I did a bit better than usual - I was terribly drowsy this morning, but through the afternoon, I was much better - both these items give some hope that the CPAP may alleviate the insomnia and the narcolepsy -

 

The mask was not uncomfortable and the air pressure wasn't annoying - it was easy to exhale into - a thermistor, which is on a small, hard plastic strip on top of my mustache was cutting into my nostril a bit - we were able to 'wiggle' it all around so it didn't aggravate me too much - but that was only for the test, actual CPAP usage involves only the mask - the worst problem is that it is very difficult to talk - when you open your mouth the pressure forces air from your nose out of your mouth - vision is fine, but the mask obscures a good portion vision field, watching TV could be problematic - sex, while not a major activity for me, is probably best before or after donning the mask - unless you really don't want to talk to your spouse, or get a huge chuckle out of watching them choke to death when they try emanate some appropriate mating call -

 

For the test they monitor a lot, they have a microphone on your throat, cameras in the room, measure your respiration; I think both volume and temperature, eye movement, oxygen level in your blood stream besides all the usual cardiac measurements -

 

Got to wait a few weeks for my doc to get the report - and then a consultation with him and then prolly the insurance company to figure out what they are willing to pay - I'm sure they have some rule that a clerk in big Hartford Connecticut office building will proudly produce showing that it is covered and they will pay $100 and I'll get to pay $500 or $600 (lol) - if we just get insurance companies to spend the money on our medical bills instead of huge office buildings filled with clerks, we'd all be better off - oh well -

 

The attached pics give you some idea of the scene - please don't notice the split ends in my 'doo - I'll be lucky if I ever get sex again after my gf's see these pics -

 

 

4/11/2003 - Sleep Test II Scheduled

 

One more little tidbit -

 

Apparently my sleep test demonstrated some or a lot of sleep apnea - the folks at the AA Medical Center who did the sleep test called and my doctor has asked them to do another test to be fitted for a CPAP (Continuous Positive Airway Pressure) mask - it is scheduled for May 5th -

 

I have since spoken to several folks that are using a CPAP and all are very enthusiastic about the very positive improvement in their well being - let's hope it works for me -

 

For those who might be interested, here is one checklist of sleep apnea symptoms, which I have most of -

 

·                        Snoring, interrupted by pauses in breathing

·                        Excessive sleepiness or daytime fatigue

·                        Gasping or choking during sleep

·                        Obesity (BMI > 30)

·                        High blood pressure (hypertension)

·                        Restless sleep

·                        Poor judgment/concentration, depression, irritability and/or memory loss

·                        Large neck size (>17" in men; >16" in women)

·                        Morning headaches

·                        Sexual dysfunction

·                        Frequent urination at night

 

 

4/4/2003 - Thallium Stress Test I Consultation

 

Well I finally have some answers, but still no results -

 

Some years ago, I had a Coronary Artery Bypass Graft (CABG) done utilizing the Internal Mammary Arteries (IMA's) which increased blood supply to the front of my heart - [RIMA & LIMA - October 1996]

 

Apparently the recent Thallium Stress test showed signs of reduced flow on the backside of my heart, although I did well in the exercise portion of the test (surprised me too!?!) -

 

The cardiologist's advice was "if it ain't broke, don't fix it", meaning at this point there's no clear advantage in doing any of the available options - He did equip me with a prescription for nitro, in case - and he wants to monitor the situation, meaning come back in 3 months and repeat the test -

 

More importantly to me, he thinks that my lack of sleep is not related to any circulatory type issues, at least heart wise -

 

All references to the carotid arteries was apparently a mistake -

 

The bottom line: I am apparently going to continue living so that I can enjoy feeling drained, lacking enthusiasm and stamina, narcolepsy, sleep depravation and apnea -

 

Sleep test results yet to come...

 

 

3/22/2003 - Sleep Test I Comments

 

I don't know the results of my test and won't know for a couple weeks yet - several folks have reported GREAT results with the CPAP -

 

She said I stayed asleep long enough to get a good reading, but not long enough to try out the machine - so I don’t know what they are going to recommend for me - I have had a lot of trouble staying awake lately - at first, I really wasn't interested in the CPAP, but so many have said it has made a HUGE improvement in their lives, I'm getting excited that it may help me -

 

 

3/20/2003 - Sleep Test I

 

I took sleep test last night - the gal said that I fell asleep quickly, had 'signs' of apnea, but didn't stay asleep long enough to try the CPAP (mask-continuous positive airway pressure) - I slept a couple hours at the beginning and then couldn't get back to sleep - I did have a couple of dreams (in color, YAHOO!), which she said was good because that's REM sleep -

 

What's really weird is that I had been up pretty much the whole night before with a gas pain - yet, I could only sleep for a couple hours - and to be honest, I don't dream much - it is a very rare occurrence -

 

Now if I sit in a meeting or in front of my computer terminal, I can't keep my eyes open -

 

It is a no brainer test - they wire you up with a couple dozen wires, watch your heart, eye lids, thermistor in your nose, oxygen on your finger, etc - I wished I’d taken a camera - you look like something drug out of Friday the 13th - ya'll would've had a good laugh - and then they expect you to sleep like that - lol -

 

Their doctor has to read the charts, and then sends a report to my doctor - and maybe in a couple weeks I'll know more -

 

I guess my dreams of an 'instant cure' are evaporating here -

 

 

3/19/2003 - URI I status

 

I had a terrible gas pain last night - I haven't had one of those since I was a kid - it was terribly painful - went to Doc today - he thought 'possibly' the antibiotic could be causing the stomach/diarrhea problems - said to stop the Amox, he's closed tomorrow and see how stomach/diarrhea is on Friday -

 

 

3/18/2003 - URI I Status

 

Not much change right up until Sunday - Much improved Monday and Today - Sweats/Chills/Nausea/Dizzy gone - Coughing frequency subsided greatly, but the intensity is just as bad when they hit -

 

Although the medical world will never agree to it, some of the coughing aggravation is caused by my heart surgery - in other words, a certain amount is normal for me -

 

Diarrhea added to the list - maybe from the Amox??? - Which unfortunately has to be taken to it's completion (3/24) - it was terrible on Monday, tolerable today -

 

Assuming diarrhea eases up a bit more, going to try to come back to work tomorrow -

 

 

3/15/2003 - General Status

 

Back in January I had a thallium stress test done - doc said, if there was anything wrong, he'd call - when I went into see him about CFBP thingy, he looked at stress test and sent me 'back' (????) to cardiologist - why didn't cardiologist discuss it when I was there???? - Doc didn't mention anything before - it's that carotid cabbage whatever I wrote in the other email I have no clue what that is all about -

 

Sleep tests for the 19th have been scheduled for a few weeks now - and I am hopeful may improve a lot of things going on in my life - like weight gain, feeling tired all the time, more stamina, etc - part of the CFBP thingy may be that I'm run down from poor sleep -

 

I don’t know what the blood tests are for -

 

I also got this fungus growing on my skin all over the place - you can peel it off like a scab, but it just keeps growing - he doesn't think it's skin cancer and has sent me to a dermatologist to figure that out with -

 

 

3/14/2003 - URI I More Information

 

Thanks for the info - the doc was really pressed for time and we didn't get much chance to discuss it - I was kind of surprised that he sent me back to the cardiologist - he indicated before that if things weren't good, he would get a hold of me - so that kind of bothered me, but I didn't get a chance to discuss it with him -

 

The upper respiratory thing, if I’m not mistaken I had a very similar go around with in August 2000 - what I’m recalling is almost an exact duplicate of symptoms - first couple, 3 days dizzy, nauseous, chills, sweats, fever - then a few days of very painful coughing, especially at the bottom of my lungs, sort of like pleurisy - and this attack seems virtually identical - x-ray clear is good - we'll see if the medicine man's potions help improve things -

 

 

3/14/2003 - Jim's Comments

 

Comment from Jim:

 

Thanks Larry, the carotid artery examination is to be sure there is no Blockage. That is a good idea to have done, if a problem they can treat or roto-rooter. If not that would be even better. There may have been something on the thallium test or the combination of elevated cholesterol that makes him wants to be sure there is no blockage. Hope everything comes out good. The upper respiratory problems have been particularly bad this year. It took almost five months for mine to clear. I hope that is all your facing. Anyway, I hope you're feeling better.

 

 

3/14/2003 - URI (Upper Respiratory Infection) I & Thallium Stress Test I follow up

 

I attended an 11:30 am appointment with the doctor - I had only two things to discuss, one was a skin condition that has been deteriorating and the other the 'cold, flu, bronchitis, pneumonia' issue -

 

He's not sure what the skin condition is, probably a fungus and has sent me to a dermatologist - although he didn't seem too concerned, which I guess is a good thing -

 

Apparently I had something pretty bad, whatever it was - he prescribed Amox and Guaifenesin syrup -

 

He sent me for a chest X-ray, which came back clear -

 

I need to schedule a fasting blood test -

 

He asked me to go BACK to the cardiologist who did the stress test for a carotid artery cabbage for abnormal thallium ETT - I have no clue what all that means, but it don't sound good -

 

I still have the sleep test scheduled for the 19th -

 

He didn't give me an OK to return to work date - I don't believe the return to work date is related to the blood test, stress test, sleep test or the dermatologist consultation -

 

I think that's everything I know that happened in the last couple of hours -

 

 

10/17/2000 - High Blood Pressure III

 

I took BP it was 170/130 - doc took it said 150/100 -

 

·                      Cleared for work -

·                      More pills -

·                      Added diuretic -

·                      Jacked Metoprolol 50% -

 

Also he wanted a lot of blood test done - fast tonight - do those in the morning - got to pick up return to work form from doc's - should be in later in the morning depending

 

 

10/10/2000 - High Blood Pressure II

 

Now there's a real oxymoron for you -

 

Went to sawbones - BP was 190/140 - it had been up to 240/140 - for those not in the know 140/90(max) would be good - I was taking 50 mg Metoprolol twice a day

 

·                      He doubled that to 100mg twice a day

·                      He added Norvasc 100mg once a day (Calcium blocker)

·                      And some anti stress lorezepam 1mg up to 3 times a day

 

He estimated that he'll have this under control and I should be able to return to work Monday - we'll see?

 

Next appointment Oct 16th - he said if it doesn't start to come down in the next 3 days or so, to call him

 

He did say one thing interesting - the blood pressure of people whose kidneys have small connection tubes is very difficult to control

 

 

9/29/2000 - Sleeping Difficulties

 

Doctor's appointment got pushed to October 9 -

 

Sleeping much better (which I think was a 'root' cause of the problem to begin with - I hadn't slept literally for a week - coupled with the stress of moving, vehicle problems, friend's dying, high blood pressure, etc increased my anxiety level to a dull roar)

 

 

9/25/2000 - High Blood Pressure Problems

 

Biggest problem going right now is trying to get blood pressure under control - I don't remember all details accurately, but for the first day or two in the hospital, BP was reasonably normal 160/90 - then it started to soar and has been on a roller coaster ever since - I'm not sure exactly, but they tried some 30 different drugs trying to get it to settle down - Dr. Skulsky has started a regimen of metoprolol which for the first day or so seems to be working - he said to check in two weeks, I called and set a Friday am appointment to get it checked and see how it's going - assuming that works out well should be back into work Fri. or Mon. next week - from what I've seen so far I'd say that's a big   if

 

He stopped the zestril, made my feet swell and gout - gave me prednisone to clear that up and I can walk quite a bit better

 

He gave me lorazepam for nerves and anxiety (plus I wasn't sleeping) and that stuff seems to work pretty good as well

 

Don't know all the answers - don't know much for that matter -

 

·                      Anxiety level had risen so high that I couldn't sleep -

·                      I hadn't slept in a week -

·                      Used too much alcohol to try to calm nerves (stupid idea, but worth a shot) -

·                      Had stopped taking HPB pills years ago (another stupid idea) -

·                      Loss of friends, stress of moving, etc -

 

I don't think I had a heart attack - they did 3 enzyme tests, 2 I know were clear, don't know about the 3rd - doc never said, but I think he would have –