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. 

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 11^th 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.

Aging

I turn 39 this year.  This post isn’t about feeling old, getting old, etc.  I don’t think 39 is old, though I know a lot of people who do.  They can go stuff it.  

I am starting to physically feel achy in places, I’m not as flexible as I once was (working on this), and I notice my memory is going a bit but I chalk that up to job stress.  My metabolism has obviously slowed down.  I didn’t think I’d have a 23yo body all my life.  I think people who don’t want to age or don’t think they will age are idiots, sorry, but what did you think was going to happen??  

This post is more about responsibility as I age, because this is what I’m having the most trouble with.  My parents are 75 and 71 now.  I’m a (mostly) only child, and I do live near them, about 20 minutes away.  Their house is IMHO too big for them and the upkeep has become more of an issue over the past 5 years or so and property taxes keep going up.  Dad would love to move, and I support that, but Mom doesn’t want to move, so they are not moving.

For years, I’ve wanted to move to another part of the country.  There are many reasons for this:

• People in this part of the country are selfish, mean, abrasive, and hard to get along with, 
• I just get bored easily and moving seems like a way to keep things interesting, 
•  Other parts of the country are beautiful and I’d like to experience them for more than a few days at a time, 
• Well, why not move? 

But that hasn’t happened, for several reasons.  Right now the main reason is I don’t want to leave my aging parents alone as they age and I’ll be frank here:  this is a bit smothering for me.  Most everyone might not understand that, but I wasn’t raised with a strong sense of family.  The sense of familial obligation is alien to me, yet I feel this strong push that I should stay here because that is what everyone expects of me.

I hate this feeling.  I feel like I'm being selfish, yet I feel I only have one shot at this life and, dammit, I should be able to live it as I want to, or as close as possible.  But here I am, here I seem to remain. 

(I think I’m going to start adding theme songs to my posts for kicks and giggles.  This post’s theme song is Jack Johnson’s Home). 

2013, Part 2

Family:  In July, my long-lost older sister came out to visit with her daughter.  For those of you who missed the whole story, I did post about it back when it happened…but here’s the nutshell:   my father had a daughter through his first marriage, but after his ex remarried and moved across the country, they lost touch.  40 years later, I got a message from her on Facebook, can you believe it, and she had for all this time thought she was an only child.  I had known about her, but she didn’t know about me.  It’s like Jerry Springer without the chair throwing.

So we invited her to come out for dad’s 75^th birthday, and she did!  The closer the time got, the more nervous we all were.  Was this a good idea?  Was this going to work out?  Was this REALLY a good idea???  

But it was!  Everything worked out swimmingly.  Dad was sooooo excited.  My sister is deaf and while we were worried about communications problems, there were really none to be had.  She could read lips well enough (especially if you slowed down and enunciated well) and Crystal was there to translate if need be.  

And….to be honest….it was really weird.  I mean, yes I have a sister and yes, it is nice to know I have more family.  But we spent nearly 40 years not knowing each other and the relationship people just assume we’d pick up, well, we never had a sibling relationship in the first place, so what’s to pick up?  It is odd and hard to explain.  

Work:  The day job has gone very well this year.  The office has been successful, our numbers of subscribers is growing each month, and we are making headway into agency and association partnerships more and more.  

It is starting to get boring, however, finding 4 topics to write a newsletter about every single week.  Somehow I get it done though.  Somewhere about April I hit my stride and it wasn’t a struggle anymore.  I can take a topic and write on it after a bit of research and it’s good to go.  That switch took quite a load off my mind, now I know I can come right up to the deadline and not be too freaked out if the newsletter isn’t done.

Back in February, I wrote on a topic that is becoming an issue in states where pot has been legalized.  It, um, er, got picked up by nationwide media and my agency’s external affairs office had a cow.  A big, fat, loud mooing cow.  I see it as good publicity (and how often does this particular agency get good publicity, eh?) but they didn’t like that their name was mentioned in the same sentence as “marijuana.”  Too damn bad. 

The government shut down for nearly 3 weeks in October and I was on unemployment.  It wasn’t that bad.  The vacation we had scheduled happened to fall during that time.  My company acted like a bunch of ninnys and terminated us all, paid us out all our vacation, and if the shutdown had lasted after 10/31 we would have been without health insurance.  They claim they thought we wouldn’t be eligible for unemployment unless we were terminated.  I think they did it so they wouldn’t have to pay our benefits.  

My small jewelry business is still going, slowly but steadily.  It is mostly a hobby business, and I’m not making as much as I was, but I do occasionally pop out some earrings, a pendant, or whatever and list it.  I’ve actually been crocheting more than jewelry making, but I’m not selling that.

Various other things:  Matt bought a portable sawmill this year.  This has been an ongoing plan, but he actually did it, it is on the property, and he has used it.  Right now, though, it won’t run.  He’s in the process of “fixing” it, and has been for, um, 4 weeks.  I’d rather not talk about it.

2013: A Year Happily Behind Me

Dog:  In November 2012, we had our 13yo yorkie Max put down.  He’d been headed steadily downhill all year, he’d lost his sight in his good eye, gotten feeble, and on that particular day he’d fallen.  By chance, my husband was home from work and he called me like 3 times, panicked and unwilling/unable to make that final decision (poor dear), and I finally made it.  I told Matt to call the vet and tell them we were bringing Max in to be put down (Matt did), and I headed home from work to deal with the crisis.

I drove to the vet and back because I knew Matt really wasn’t up to it.  When the vet techs warned us it happened fast, I had no idea it happened *that* fast.  Holy cow.  He was there, then his eyes just went vacant.  That was the only time I’ve seen Matt cry.  We had originally for years talked about burying Max in the yard, but Matt just couldn’t do it and we left him for the vet to manage.  We got a paw print card and some fur in a card from the vet a week later.

Around that same time in November somewhere near Greenville, SC, a puppy was born.  This puppy was destined to wind up in a shelter, get rescued by a group who brings dogs from southern high-kill shelters north, and eventually this puppy wound up meeting us at a rescue event I Shanghaied Matt to in early March 2013.  Tillman, a (we think) beagle dachshund mix, came home with us the end of March.  He is higher-energy than Max was, but has a stronger pack mentality and just adores being with us.  He housetrained quickly, but in other training he is stubborn (all-hound) and we have a hard time keeping his attention.

Tillman broke his front left leg in early June.  It required surgery, and now he has 5 pins in it.  We’d had him at a kennel for a play-day while I had an outpatient procedure done (see Health, below) so that gee, maybe I could have some relaxation time after my procedure.  But no.  We had to run all over hell and back that day, me to the hospital, Matt to take Till to our regular vet, and then both of us down to Annapolis Fucking Junction (almost 2 hours away) to the Doggy Orthopedic Surgeon for the surgery.

Between the cost of this surgery and the cost of Max’s eye surgery 5 years ago, I could have paid off half my student loan.  I can’t tell you how stressful that time was for Matt and I, financially and otherwise.  We had to take Till to the (nearby) vet nearly every week for almost 6 weeks due to his growth and needing the cast redone, the bandages changed, the stitches removed or cleaned, etc.  Then, after he’d healed, he developed mange and we had to go to get him dipped 3 times.  Oy.

We are happy with Tillman.  He is closer to us that Max was in many ways.  Max was a great first dog for me.  Tillman is much more hound and therefore much wilder, I think, than that spunky little terrier was.  Tillman is also lovier, if that is possible. 

Health:  In May, we took Tillman to Rehoboth Beach, DE, (see Vacations, below) to a dog-friendly B&B.  While there, I got sick.  I had diarrhea, which is not usually my problem.  I have existing GI problems but they are all stomach-related, not lower GI.  I didn’t get off the toilet for an hour, let’s just leave it at that.  I did throw up once.

After we decided I was stable, we headed home.  We were leaving that morning anyway and I wanted to get going on the 3+ hour trip.  I started out feeling fine, but the closer to home we got, the worse I felt.  I couldn’t put my finger on it, though, it wasn’t nausea, it was just….weird.  

I got home, we all three took naps.  I woke up a few hours later and threw up blood.  Looked like coffee grounds.  I wasn’t positive that’s what it was, but I made an apt with the doc the next day and she confirmed it.  She told me if I had continued to throw up blood I should have gone to the ER because I could have bled out and died.  She said the most likely cause was that I busted a blood vessel when I threw up at the B&B and was bleeding into my stomach from that. 

However, she treated me like I might have a bleeding ulcer.  I was on a soft, bland diet for weeks and on a chalky gunk that was supposed to coat my stomach to protect it but actually made me feel oogy.  Between that, being sick, and being scared to eat anything at all in case I scratched whatever was bleeding back open, I lost 15lb.  I saw my GI Specialist, got an endoscopy (the day Tillman broke his leg), was told I didn’t have a bleeding ulcer but he couldn’t see any reason for my bleeding, so it was probably something minor that had already healed.

I do have Barrett’s Esophagus, though.  (“Well, give it back!”)  It is a pre-cancerous condition I had before (undiagnosed) when I was not medicated for my acid for 9 years.  My doc doubled up my Prilosec prescription.  He also told me I’m not to eat after 6pm, I can’t have caffeine, alcohol, citrus, tomatoes, large meals, etc.  I am supposed to eat 4-5 small meals during the day.  

I’m doing some but not all of this.  I really want to get off the Prilosec as it has some unfortunate long-term deficiencies in several minerals and vitamins.  My bloodwork doesn’t show these, thank goodness, but I still want….need to know if I can manage my acid and hiatal hernia without major medication.  

So, I am trying a variety alternatives (MSM, aloe juice, Bromelain enzymes) to see if I can manage it while at the same time weaning myself off the Prilosec.  It seems you have worse issues if you stop cold turkey.  By the end of 2013, I am at about a half dosage, roughly 10mg morning and night, and not seeing any acid problems.  

I also go for a second opinion at the end of January 2014, as I have a lot of questions and don’t want to go back to my current GI for a variety of reasons….one being the 2^nd opinion guy sounds like he will work with you on alternate plans, diet guidance, etc.  Stay tuned.

Garage:  Not much happened here, which is a huge bone of contention with me.  It has been nearly 3.5 years since we tore down the old garage.  The new one is up, no siding, doors and windows are in, roof is on.  I can’t park the car in it.  It is full of stuff (stacks and stacks of cut wood, our kayaks, a couple pieces of furniture, tools, etc, etc).  

We have hired someone who is currently out of work but has oodles of construction experience to do work for us, and that should be starting soon.  

Vacations:May is off-season for Delaware and we’d had good luck with off-season trips there before so we went for it.  This time wasn’t a good weather weekend.  It was cold, windy, and rainy.  Tillman LOVED the beach, though, and we both had a great time.

Matt and I also took a week+ and drove down to Georgia and back to visit with family, see the sights, and try to figure out if Tennessee or North Carolina would be nice to move to.  TN, no (except for the fried chicken we had).  NC, you beccha.