Friday, March 30, 2012

Updates, Updates, Updates...

    Not the most SEO-friendly blog post title, but whatever :-)

    So! Updates!  I'm fairly certain the post-jaw surgery anemia I've been dealing with is almost "fixed".... I say this because (1) I've taken the iron supplements since week 7 and I am almost at 16 weeks post-surgery, (2) I've been informed it takes 100 to 120 days to recover the hemoglobin and essentially "feel better", and (3) I've started feeling better. It was rough though!!! I will never look lightly at anemia again...
"Ferrous" Bueller -- My Iron Mouse (mus ferrous)

   Last Friday I completed a 10-day round of antibiotics, which I'll go into in a moment, and today leaves me with one week left before I start to wean myself off my Nexium. Now I'll talk about that haha

Acid-Reflux, Nexium, H. Pylori & The BEST News EVER

     When I saw my PCM (primary Care Manager) a few weeks ago regarding my concerns over the anemia and its symptoms, I learned something I hadn't known before. Often, in people diagnosed with acid-reflux or GERD before they're in their 30s, the underlying cause is an infection involving a particularly stubborn bacteria known as helicobactor pylori, or H. Pylori for short. 

     In 2006, after several years of increasing nausea and a temperamental appetite, I sought treatment to make sure nothing more serious was wrong. Now, there were other symptoms but I've decided not to go into great detail here because it's not really relevant. What's relevant is I was diagnosed with acid-reflux and put on Prilosec. I remained on Prilosec for over 3 years, until it stopped working effectively. I didn't actually know it had stopped working, because I didn't have heartburn-like symptoms. I had gotten sick and when the cold dissipated, I retained a "chronic sick voice" for several months which I thought might have been my tonsils. When I saw a doctor for that, he said it was actually the acid-reflux acting up and he put me on Nexium after trying to double my Prilosec which was ineffective.

   Long story short -- My current doctor ran a series of labs for me to reassure me that my anemia is just iron-deficiency and not a vitamin deficiency, and in that process he ran two labs for H. Pylori. I had not been examined for an H. Pylori infection prior to this, and it's 2012 so I've been on acid-reflux medicine daily for just about 6 years.

   The first lab came back with the vitamin panel and was NEGATIVE for an acute infection. I wasn't aware there was another test so when I got that news I was mildly disappointed. The next day my doctor called and said the IgG test came back as POSITIVE so we would treat the H. Pylori infection and after that, I should be able to slowly come off the stomach meds.

I don't remember the last time I was so excited over lab work!
Probably never haha

    H. Pylori is a little more complex than I'm making it out to be, but since this is a blog post I'd prefer to keep the overly-technical stuff to a minimum.... I like the stuff I post here to be more "conversational"....
    ANYWAY, this type of bacteria often comes from food or water that is obviously contaminated with it. It's typically stubborn, in the sense that it can sometimes develop a resistance to the antibiotics. To help improve treatment outcome, the typical treatment is comprised of 2 types of antibiotics and a proton-pump inhibitor. Nexium, which I was on to begin with, is a proton-pump inhibitor or PPI, and the antibiotics are Clarithromycin, which targets H. Pylori specifically (among other types of bacteria), and Amoxicillin, which serves as a sort of "back-up" for the Clarithromycin. The two are taken for a LONG round of antibiotics, 10 days... after that, the PPI is continued for maybe 2 weeks to manage symptoms and then the patient slowly weans off the PPI. 


SLOW is key because when you suppress your stomach acid for a long time, GERD symptoms are going to hit hard if you stop the PPI too quickly and your adjustment to being PPI-free will be more difficult.

     So... I started with the two antibiotics BUT I quickly remembered that I'm a bit sensitive to antibiotics in capsule-form, and I had to have the Amoxicillin exchanged for a chewable variety by Day 3. Since I needed 1000mg and the only options were the capsules, which made me sick to my stomach, or 250mg chewable tablets or an 875mg tablet... four 250mg chewable Amoxicillin tablets twice a day was the only real option. It was rough....
The Clarithromycin was 1 pill twice a day, swallowed not chewed...

1 Clarithromycin, 4 chewable Amoxicillin

They have to be chewed before being swallowed... there's a flavor... it's sweet and possibly "banana" but it's not very pleasant and there were 4 of them, twice a day haha

     I finished the 10 days and I've done 1 of the remaining 2 weeks on Nexium. Next Friday, April 6, will be the end of those 2 weeks so after that I will start weaning off the Nexium. Since it's a 40mg capsule and I take it only once a day, weaning off is a bit tricky and it may be a trial-and-error experience for several weeks but ultimately I should be able to work up to 7 straight days without the PPI and from there going without it should be no problem.

    Will I still have acid-reflux symptoms?  Probably... but I shouldn't have them all the time and they should be manageable, for the most part, with a dose of Alka-Seltzer or Tums. 

    Will I be able to eat whatever I want?  Probably not haha... I have a sneaking suspicious that liquor will still probably upset my stomach but I've never been much of a "drinker" anyway so not really a big deal. It would be nice to be able to cook with wine from time to time, however, so I'll cross my fingers on that one.  I likely will still have to tone down any spicy foods and avoid too much bread, pasta, and acidic foods like pasta sauce and citrus juices, but a little is okay.  I'll post more on this as I work through the details.

    I just.... I'm so surprised that in all this time no one thought to check for H. Pylori and then when I see my current doctor about something unrelated, I learn about this bacteria and they test for it only to FIND IT.... and my current doctor is still a RESIDENT!! So... I feel a little cheated, in a sense, because I've been on a PPI for over 6 years and if the underlying cause was a stomach infection, I could have been treated for this 6+ years ago and not need the PPI this whole time.

But no use crying over spilled milk!

Work, The Jaw Surgery Playbook & Recipes

     As I get over the anemia, I'm getting more work done which is great. I hate when I fall behind because it affects my clients but it also affects my income which stresses me out. I'm doing better though, so hopefully I'll be getting much more done during the week and able to take back my weekends haha
The work I'm doing right now is writing product descriptions for a furniture company
Sometimes my output is slow but it's often because of things like this (above) where it's a ton of items that are all basically the SAME item, but each needs a unique description...
Apparently, the picture is funnier to me than to the people I've shared it with haha

    I am still working on the website, obviously since it's still "incomplete".... I'm working on a couple of galleries to add for pictures, recipes and videos and once I start getting more content up I'll add videos for all the main entries to make the information more accessible for people that absorb info better when it's presented in an audio-visual way. Or if you're just lazy and don't want to read haha

    The first recipe book is "complete" in that it contains all the recipes and nutrition info I used during my initial 6 weeks of recovery. But it's also "incomplete" in that I am still creating more recipes. I think I might leave that first one alone, though, since it's nearly 100 pages. I'll compile the other recipes into a second recipe book, and also my soft-foods recipes into a recipe book for weeks 6 or 7-12, aka the second half of recovery. By week 12, the bones throughout the jaw that were cut for surgery are about 80% full-strength, but they're technically "healed" by week 6 so food tolerance will vary from patient to patient, depending on lots of factors.
The cover of my Jaw Recovery Playbook Recipe eBook (PDF)

    As always, feel free to contact me directly if you need advice, tips, information or if you want my recipes for your recovery. Or if you just want my recipes... I've shared them with a few other people who are not jaw surgery patients, but who are into health and fitness or bodybuilding, since the recipes are mostly higher-protein, high-protein/high-fiber, low-sugar, etc.  

    There's a link to the site at the top of this blog, you'll see it at the top along with other links to my other websites and/or profiles, or just go to www.JawRecoveryPlaybook.com

What's Next?

    I've given in and made Atom his own blog.  His cuteness should have its own platform and not just be tossed in with my pictures, blog posts, ramblings, etc. Sooo... feel free to check out Atom's Blog, "Just Atom"... there's a link to that at the top as well, or you can go to www.JustAtom.blogspot.com  He's linked to his own G+ profile as well, so be sure to stop over there and follow him on Google+ too :-)
Atom... in all his cuteness!



Friday, March 9, 2012

Because I am sooo mature...

     I wanted to make sure my doctor didn't forget about me so I called him this morning to leave him a message.  That's how the military system works - you leave the message, they send it to either your doctor/provider or to the clinic's nurse who then forwards it to your doctor if it's not something she can do for them.  Like, if I called for a refill on a medicine then the nurse could handle that but if I'm asking specific questions then she usually forwards it to the provider.

     When I was there on Wednesday about the anemia, I had said to my doctor that if he didn't help me get better, and I got worse (because I feel like CRAP!) then my husband might have to literally DRAG me into the clinic and I'll be going, "Help me, Dr. Churchman.... you're my only hope...."  And I joked, "Years ago you served my father in the Clone Wars..."  It might not be my "most desperate hour" but I certainly feel in need of help....

    I was happy, though, when he laughed and understood the references saying he loves those movies.  So do I :-)  For years they were my favorite!  Now, granted, my doctor is much younger than I am haha, but it was nice to feel like we had something in common so we can build rapport even if he is leaving soon and I'll end up with a new PCM (primary care manager).

Getting blood drawn on Wednesday for a ton of vitamin and other tests to make sure my anemia is just from iron-deficiency... I really REALLY appreciate the time my doctor took to listen to me and to put in for all the tests even if he (and the staff doctors) are certain it's just iron-deficiency anemia after my surgery.  

   So... he was supposed to call me in a day or two to go over my lab work and let me know that I just have to tough this out (probably haha).  And I, knowing how overworked and forgetful residents can be, decided to call him this morning and leave him a message as a reminder.

    I practiced ALL MORNING so I'd be able to say it without laughing!

    Then I recorded myself leaving the message with the message-taking people haha

    I had to edit the video to cut out personal information, but I asked to leave a message for Dr. Churchman to call me back about the results of my lab work from Wednesday and, if there was any serum left could he run a... wait for iiiiitttt.... "midichlorian count" YES!!! -- then I spelled out "midichlorian" so the message would be right.


    I was laughing afterward, wondering how long it would take him to realize what I was asking or if he'd get it right away.... I had this mental image of my poor doctor going to ask one of the staff doctors how they code for a midichlorian count and then realizing last minute, as he said it aloud, what I had done, shake his head and tell them never mind haha!

    Now... I didn't do this as a "prank" so I don't want to give the wrong impression.  But it's still funny so I hope he gets the message and finds it funny too.  It's one of those things where, the doctors get kind of stressed out so when I feel like doing something nice (or funny) will help reduce a little of that stress when working with me, I try to take the time for that little bit of extra effort.

Thursday, March 8, 2012

Praising Military Medical Providers

   While I was at the hospital yesterday (Walter Reed in Bethesda), I dropped off a package for the OMFS Commander.  I wrote her a letter, which I tried to keep short but it was like 4 pages haha... I wanted her to know how pleased I was with the quality of care I received throughout my surgery and recovery and I wanted her to know that it's not just the surgeons, the enlisted personnel and the civilian staff are all excellent there.

     I gave her the letter in both printed and electronic form so she got the printed letter that I signed, plus the files which I digitally signed and burned to a disc. On the disc I included the current PDF of my Jaw Recovery Playbook recipes, so she could have that if she wants it, and I tossed in one of the cards I made to share the site with other patients. I gave her just one in the envelope with her letter and disc, but I also left a stack of about 50 cards with the package so she could give them to the surgeons to share with patients if she wants.

    I know it seems like a lot, but this is a military facility and a training hospital and I think it's important for the commanders to know when they're doing something good and when their department is making a difference for patients. With the ICE system, most of the time the only time a patient says anything is when they have a complaint and that can actually undermine productivity if the complaint isn't really helpful.  Now, since I've filed my fair share of complaints, I wanted to make sure that I put effort into my praise for this experience and the people involved so that's why I chose to submit a letter instead of go through the ICE system.

Don't Let Your Only Comments Be Negative Ones

    Walter Reed isn't the only training hospital in the military healthcare system, so I also want to strongly encourage other patients within the military medical system, whether Army, Navy or otherwise, to do the same. If some part of your healthcare experience was just excellent, or if all of it was excellent.... don't wait! Put it into words and get it to the right people!

   Not good with words?  Don't let that be your excuse!  Contact me and I will help you put it into words and tell you how to figure out where to send or bring it.  Trust me, if you ever had a bad experience with healthcare, you should know how valuable this type of praise and "thank you" is.  Our thank you letters and praise help shape the way the military healthcare system provides our care... Don't keep good experiences to yourself, share them.


Jaw Surgery Recovery Updates - Week 12 (with 日本語 vocab)

     Soooo.... three months after jaw surgery, huh?  Seems like so long, yet at the same time, not really....

     I believe that by week 12 my bones should be about 80% full strength. Sometimes, it doesn't feel like it haha.  I still hesitate with a brief flash of total panic as I try to bite into stuff, but I'm sure that will subside as I grow more accustomed to my new bite.

     Anemia sucks.  There's no two ways about that.  I've never been anemic before so all these symptoms can get REAL scary.  Initially, my GYN gave me iron supplements for 4 weeks and told me to go back to the lab for a repeat CBC. I assumed that meant that by 4 weeks it would be better.  I assumed incorrectly!

    I went to see my PCM (primary care manager) yesterday, Wednesday March 7th, and he explained that it takes 100 to 120 days to recover the hemoglobin.  THAT would have been nice to know 5+ weeks ago when I was given the iron supplements in the first place.

    To be on the safe side, and perhaps to appease me, he's running a bunch of lab work to make sure it's just the iron-deficiency, so at least I get to feel better knowing we'll make sure it is what they think.  He also gave me more iron supplements to keep me on them for another 3-4 months but he changed the frequency and amount I will take.

    Interestingly, the iron supplements they prescribe are ferrous sulfate and, from what I understand, your body only absorbs about 10% of the iron in those pills even if you take them with something high in Vitamin C to aid absorption.  I picked up a second iron supplement to see if I can't get iron more efficiently.  Honestly, I'd rather not take something that's just being wasted and flushed by my body so perhaps I'll be able to absorb more iron by using the two different forms.

     Below are parts 1 and 2 of the videos I made talking about the anemia. It became two videos when the mailman knocked on the door in the first video setting the dogs off barking haha




Japanese Anemia Vocabulary

     Since I didn't include them in the videos, here are the words I gave for the anemia-related Japanese vocabulary:

  • Anemia
    • 貧血 (ひんけつ)
  • Iron-Deficiency Anemia
    • 鉄欠乏性貧血 (てつけつぼうせいひんけつ)
  • Pernicious Anemia
    • 悪性貧血 (あくせいひんけつ)
  • Acid Reflux
    • 呑酸 (どんさん)
  • Tinnitus (ringing in the ears)
    • 耳鳴り (みみなり)
  • Lightheadedness (when standing up)
    • 立ち眩み (たちくらみ)
  • Heart Palpitations
    • 心悸亢進 (しんきこうしん)
  • Shortness of Breath
    • 息切れ (いきぎれ)
  • Double Vision
    • 複視 (ふくし)


Example Sentences for a few:
  • My ears are always ringing.
    • 私はいつも耳鳴りがしているんです。
  • I have ringing in my ears.
    • 耳鳴りがします。
  • I get lightheaded when standing up.
    • 立ち眩みがします。