Saturday, January 25, 2014

Gut Feelings, 3

I’m off coffee, which wasn’t too difficult because I only drank a cup a day and that I nursed along all morning.  More out of habit than for the caffeine kick it would seem.  I’ve switched to Dandy Blend and like that very much.  I almost never have any citrus.  I think I miss that the most, I used to have lemon or lime in my water all the time at home, and grapefruit and clementines every day during the winters.  I use zest instead of juice in recipes to get the flavor without the acid.

Tomatoes I do have occasionally; when I eat pasta, I usually put a tablespoon or two of sauce on my pasta, then embellish it with some olive oil.  That seems to work well.  Alcohol is trickier.  I seem to be OK with beer, but not with wine.  I haven’t had a mixed drink with liquor since before May.  Oh, that’s not true, I did have a small glass of the mint julep liquor I made and it seemed to go ok.  But my favorite cocktail was the Sidecar:  lime juice, sweet and sour mix, brandy, orange liquor.  Doubt I’ll ever have one of those again.

I do still cook with onions and garlic, but I find I’m cooking less because I have less time to do it in.  I find we’re eating more pre-prepared meals: frozen veggies, a burger, and another easy to prepare side.  Tacos from a kit, just veggie chopping.  A frozen chicken spinach lasagna.  Chicken on the grill with 2 sides.  Bagged salad.  Applesauce we canned last fall.  For anything more than this, planning and prep needs to go into it, and I am the only one in the house that does that.  So, it is all on me.  Another stressor.

I’m going to the gym once a week for their BodyFlow class, which I love.  A mix of Tai Chi, yoga, and Pilates (heavy on the yoga, though).  I can’t believe it, but I started running with Tillman a few weeks ago.  Right now it is only once a week for about half an hour.  We run until I can’t breathe, then walk until I recover.  Rinse and repeat.  I may add a 2nd gym trip in each week, but I want to talk to the doctor first.

Ah, yes.  The doctor.  I’ve decided to get a 2nd opinion so I have an appointment this week with another GI specialist.  This one is a DO, not an MD, so we will see if he is willing to play ball with me in my decision to get off my meds.  I have a LOT of questions and the thought of going back to my other GI did not appeal.  Last time I was in there and asking questions, he did a lot of head shaking and Tsking.  It really rubbed me the wrong way.  I like him, and I like the “get you off all meds” stance, but don’t treat me like that when I have questions!!

I did a lot of research about the Omeprazol (Prilosec, Nexium) that I’ve been on for 15 years.  I don’t like what I’m reading.  Besides deficiencies in B vitamins, calcium, magnesium, and others, it also appears that if you stop taking it cold turkey you get what they call “acid rebound.”   It is better explained here, but basically your stomach goes into overdrive making more acid than ever before, which means your symptoms are worse than ever before.  Most people go back on the meds immediately when this happens.  It also happens with H2 meds (Pepcid, Zantac).

So, the only thing to do is to wean yourself off or bear the brunt of 3-6 MONTHS of intense burn.  I’ve been weaning since September.  I’m now at a half dose, 10mg 2x/day, and things seem to be going ok.  I’m having a bit more heartburn than had on 40mg/day, but barely.  It is manageable with diet and that’s the whole point.  It is much much much more difficult to change your diet and lifestyle than to just say “Oh, I can take a pill for that!” but that’s what I’m trying to do.

The new GI also does nutrition and diet counseling, and that is half the reason I’m excited to switch.  I want to lose more weight, I want to eat better so I don’t have to take these meds.  I don’t understand why steak one night is fine but another night causes me problems.

So, I’m excited!  I will let you know what he says. 

Thursday, January 23, 2014

The Tillminator

In November 2012, we had our 13yo Yorkie Max put down.  He was blind and feeble, and had taken a fall that day, and I ultimately made the decision that it was time.  That was the only time I have ever seen my husband, Matt, cry.  

Max was an awesome dog, a 15lb typical Yorkie who thought he was a Rottweiler.  He'd chased a herd of deer out of our yard, was a Might Chipmunk Killer, and just the sweetest thing.  He was my first dog, and I couldn't have asked for a better introduction into the World of Dogs.

A few months went by and I was in serious dog withdraw.  In March I Shanghaied Matt to a local Tractor Supply Store where I knew they were having an adoption event.  We needed chicken feed and it seemed like a good idea.  This is who we met there:

Caution!  Will Double in Size in 2-4 Months

They had Tillman listed as a Dachshund mix, and you can see why with the long body and markings.  We looked at a few puppies (Matt wanted to get a puppy and I wanted to get a rescue) and decided that we were interested in this little guy.  I filled out an application, we went through all the hoops, had a meet-and-greet with Tillman, and decided to take him home.

Tillman was born in Greenville, SC, and was rescued by the group who specializes in getting dogs out of high-kill shelters in the south and bringing them north.  He was born November 2012....the same month we had Max put down.  When we rescued him, he was 4 months old.  We did puppy basic training at a dog training facility right near our house, and that went.....ok.  Hounds are notoriously stubborn.

In June, Tillman was playing with a larger dog at a kennel while I had an outpatient procedure, and the little tyke broke his front left leg.  It was bad, he needed surgery which cost us $800,000 and Matthew's right kidney.  Kidding.  He has 5 pins in his leg now, and had to wear a cast for 4 weeks.
If you experience an erection lasting longer than 4 hours, seek medical attention.
It.  Didn't.  Slow.  Him.  Down.  One.  Bit.

In fact, if you didn't get out of the way fast enough he would stomp on your toes with his stump.  Hard.  It was a difficult 4 weeks.  He was used to sleeping with us by then, but we couldn't have him up on the bed for fear of him falling or trying to jump off, so we put an exercise pen (X Pen) in the bedroom with his bed in it.  We tried to put him downstairs but he would whine and bark, so we had to put it in the bedroom.  Then he was fine.  

I'm wearing my red today.
Then, we had to cart the damn thing downstairs into the kitchen so we could set it up there while we were at work.  I had to come home at lunch to let him outside and take the cone off his head so he could eat and drink.

Every damn day.  

Tillman is a hoarder.  We will give him something bigger than he can crunch and swallow, and he will wander around the house for 20 minutes looking for a place to bury it.  Most often it is in the laundry.  

Is it secret?  Is it safe?
We have decided to just call him a "hound mix" because we have no idea what all is in there.  Maybe beagle, dachshund, coonhound, lab, and/or bassett.  He has a black spotted tongue, extra floppy mouth skin, webbed paws, and loves the water.

Hey guys!  Look what I did with the ball!

He is a ham, he makes us laugh.  He likes to play ball, loves to look out the window at what is going on, and he is a snuggler.  Loves to be on your lap or beside you.  He cuddles with me almost every night, all night.  I don't mind this.  Maybe it is in my DNA, as humans have been living and sleeping with dogs for millenia.

This really does NOT look comfortable...for either of them, really.
After he healed up from his broken leg, we took him to an additional 8-week training.  He did ok, more of the stubborn coming out.  We manage.  He's not good on a leash because he likes to pull, but we got a pinch collar for him and that works well.  He holds his leg at a funny angle, and when he first gets up from sleeping he has a limp.  We're giving him a supplement from Only Natural Pets for that and his immune system.  It seems to be helping, but he'll have these problems for the rest of his life.
But it does not slow him down one bit.  I've been taking him running once a week, and he's fine with that.  He's a high energy dog and that's forcing us to be more high energy, too.

In fact, it's snowing again today, and I will be forced to take the little tyke out for a run/romp in the snow!

Monday, January 20, 2014

Gut Feelings, 2

In 2012, I started to notice I was having a bit more heartburn again.  I started taking Tums more.  I had no idea, and still don’t, why this was happening.  I hadn’t changed my medication dose in a while, I hadn’t changed my eating or drinking habits.  No idea why this was happening.

In May 2013, we went on a mini-vacation to the beach for a weekend.  Our last morning there, I got sick.  We had gotten take out tacos and stuff the night before so I’m guessing it was something from there.  I had diarrhea, which I never have.  My issues are always upper GI.  My body was desperately trying to flush something out, though, and let’s just leave it at that.  I did throw up once.

After we decided I was stable, we left on the 3hr drive home.  It started out fine, but the longer we were on the road the oogier I felt.   It wasn’t nausea, but I just did not feel right.  We got home, we both crashed and took naps.  I woke up about 2-3 hours later, drank some water, and about 20 minutes later threw up blood in the form of what looked like coffee grounds (how it  normally looks when this happens).  Hm.  

I went to the doctor the next day and she confirmed it.  She decided to treat me like I had a bleeding ulcer, the worst case scenario, but said most likely I had broken a blood vessel when I threw up the first time and had been slowly bleeding into my stomach.  I hear that is not too uncommon, actually.  The good thing it was only once; if I had continued to throw up blood, I could have bled out and died.  She prescribed me a horrible chalky liquid to drink 4xday to coat my stomach, and I was to take an OTC Zantac twice a day.  And see my GI specialist.

2 weeks later, I did and he took me off the liquid chalk because it was upsetting my stomach.  I had lost 15lb in the 4 days after being sick, mostly because I was scared to death to eat anything because I might tear open whatever had bled.  I still had little appetite, too, and I was on soft food.  I ate a LOT of applesauce, cottage cheese, and bananas.

2 weeks after that, I had an endoscopy, 6 years since the first one.  He saw no reason for the bleeding, but by then a month had passed.  No bleeding ulcer.  We’re going with the “broken blood vessel” theory. He did show me pictures later of my lower esophagus, red and inflamed.  Barrett’s Esophagus again.  But I don’t understand why.  I mean, I’m guessing it was caused by the increased heartburn I was experiencing.  But the last time I had it (in college, remember?) I was not medicated for my heartburn.  Now I am, why did I have the increased heartburn?

He increased my dose of Omeprazole to 20mg 2x/day.  He took me off the Zantac.  I’m not supposed to eat after 6 (difficult, I don’t get home from work until about 5:30), no citrus, caffeine, fatty foods, fried foods, tomatoes, onions, or garlic.  No lifting heavy objects.  No bending or twisting.  He specifically said, get this, “No gardening.”  When I asked about the kayak, he said to go out for a short run and see how I felt (felt fine, so we’ll just go with that).  

To say I’m frustrated is an understatement.  I am SO frustrated when I think about all this.  And angry.  I mean on one hand, I’m very grateful that this is worst medical problem I have.  It could be a lot worse, I know.  But I am dealing with some pretty major lifestyle changes and I’m struggling with them.  I’ll get into that and my decision to try to get off my meds in part 3. 

Friday, January 17, 2014

Gut Feelings

As I mentioned in my 2013 review, I had a health scare last year.  Since May, it has become a big deal for me, something I think about or deal with on a daily basis.  In my research I have noticed a lot of other people with similar problems also looking for information or help or just wanting to know someone else out there is dealing with the same kinds of issues, so I want to document a bit on how I am trying to take my power back when it comes to my health.

I have suffered from daily heartburn since I was in 11th grade.  I didn’t know it, but I had a hiatal hernia. I carried Tums in my pocket every day through the rest of high school and through 5 years of college.  After graduating and getting (a haircut and) a real job, I finally had health insurance (which my parents never had) and went to the doctor, where I was finally diagnosed after having an Upper GI test.  They put me on a prescription for a fairly new drug called Prilosec.  This was around 1999.

During college, I also started to have trouble swallowing.  This was a side effect from what eventually was coined Barrett’s Esophagus.  That was never diagnosed for me, but I’m sure that’s what was going on.  

After starting Prilosec, I was a new person!  I didn’t have daily, almost constant heartburn, could live, eat, work, sleep, do just about anything.  I wasn’t taking Tums constantly, and eventually stopped carrying them with me because I didn’t need them.  My swallowing issues disappeared.

Years went by, and in 2007 after I had some ongoing possible gallbladder pain, my PCP sent me to a gastro specialist.  The gallbladder thing turned out to be nothing major, but he did do an endoscopy on me to look around.  He told me at the time that there appeared to be nothing other than the hiatal hernia.  My stomach didn’t seem to move food along as quickly as it should, so he prescribed Reglan for me, a low dose.  Around now I was also switched from Prilosec to Nexium, the next generation of the med.

Looking back on it I see that since the time I was first put on meds I have very, very slowly started to develop problems eating.  I would have a normal dinner, then wake up in the middle of the night, say 2-3am, and my dinner was still in my stomach and I felt sick.  Really not good. 

This started to happen more and more, and sometimes during the day I would develop indigestion from whatever I had eaten, and it would just sit there in my gut, and I eventually would throw it up.  I learned a few ways to mitigate that to help my stomach move things in the right direction and those would work most of the time, but occasionally I would still get sick.  

At some point around here, I was switched from Nexium to generic Prilosec (Omeprazole) at a dose of 40mg a day, which was eventually reduced to 20mg a day.  My GI specialist, whom I like very much, told me his goal was to get me off all meds and he believed it was possible with proper dietary changes, weight loss, and lifestyle changes.  I lost 30lb in 5 years, started exercising more, and did change the way I ate some.

I discovered certain foods just stopped agreeing with me.  The worst was pork or pork products like sausage.  Again, these things came on very slowly, so slowly that I couldn’t figure out what was causing it.  

I now believe the drugs I’m on, over time, have changed my digestion so that while I am on them I am pretty much not digesting food but more likely fermenting it.  Prilosec and Nexium are supposed to reduce your stomach acid to less than 10% of your norm.  You need stomach acid to digest properly, therefore no acid, no digestion.  Many studies have now shown serious common deficiencies in B12, calcium, and a variety of other vitamins or minerals occurring often in people who take PPIs or H2 inhibitors, for exactly the same reason: you need acid to break down and/or absorb these things.

This is my backstory.  It is important to me to get this out, especially in light of an incident in May that really woke me up to my gut problems, how the drugs I’m on are affecting me, and what I’m deciding to do about it.  I will talk about that soon.  

I also want to put in a standard disclaimer: this is my story and my experience.  I’m not a doctor, and my decisions and choices are made by and for me.  I talk about them here for informational purposes only; you are on your own.