Showing posts with label medication. Show all posts
Showing posts with label medication. Show all posts

Thursday, May 6, 2021

COVID-19 Follow Up

 COVID-19 Follow Up

To follow up after my March 3rd post about Leena getting sick with COVID-19 and testing positive....

I probably had it the first time in March of 2020, after I was exposed to it at the office, before New York City closed offices down.  One of my coworkers came to work sick, with a fever and coughing up a storm.  That time I had about three weeks of an on again off again sore throat and fever.  Both were so mild my wife didn’t realize it, and at times I had to remind her I wasn’t feeling well.  At that time tests were only available to the terribly sick, the wealthy, and the powerful, so I never got tested and can only speculate what I had.

Then I had it in March this year, 2021, and while it wasn’t the worst, most painful illness I’ve had, it was far from pleasant.  Both me and my wife had it, but we were fortunate enough not to have it so severely we needed hospitalization.

In hindsight, the first effects of it in me turned up before I knew I was sick.  I knew I was exposed to it, because my wife was sick with it, and had tested positive.  About a week or so after her test I read a news article about the governor of Mississippi, which had his photo.  And for a few days every time I was by a mirror I kept silently remarking how Tate Reeves was my doppelgänger, how we looked so uncannily alike, as though we were twins.

Me and Tate Reeves, side-by-side


Around the same time I also noticed a lot more red spots on my skin.  I’ve had acne problems since puberty, but that week I had more reddish, prominent bumps around.  Not large numbers, not like a rash, but red bumps on my face, my arms, my belly…. It’s rare I don’t have any, but this was more than I’d normally have at one time.

After a few days of that, one evening I had a sore throat.  I felt it, but I held out hope that I was merely dehydrated, although drinking water didn’t help.  The next day my throat was still more sore and I was unquestionably sick and my whole body felt sick.

Then I had a weekend and I developed a mild cough.  Monday I actually felt slightly less sick, overall, but the cough was worse, more coughing more often, while still not being terribly forceful.  I went for a COVID-19 test that afternoon at a nearby clinic, and two days later it came back positive.

Tuesday, though, Tuesday it all got worse.  Tuesday morning I woke up to eat breakfast and begin work, but all I could do after I ate was lie down on the floor and take a nap for an hour and a half.  Then I got up and worked, not feeling well, having trouble focusing.  I had a headache and I felt like I had a fever, even though our thermometer never measured a temperature above 98.6 degrees F.  Whenever I tried to speak I coughed.

The following day was worse.  After breakfast I felt everything from the day before, sick, sore throat, cough, with an even worse headache, and adding in nausea.  I took my 90 minute on the floor by the computer, and when I woke up realized I couldn’t work, so I sent some emails that I was sick.

I slept on the living room floor till my wife woke up in the bedroom (she’s on a wildly different schedule than me) and then I slept in the bedroom, waking up now and again to use the bathroom and sip some water.

That evening I took a shower, a long, hot shower.  It felt nice.  I just sat in the tub, reclining against the back of it, feeling the hot water hit my belly to ease the nausea, slam into my throat to ease the cough, and pound my face and forehead to massage away the headache.  

I was in there for an hour and a half or so, then I got up and I was dizzy.  I could barely stand, wobbling on my legs all over.  I bashed my nose against the tiles of the tub, and while trying to gauge how much blood was pouring out I lost my balance and crashed out of the shower, banging my head against the tiled floor.  I found myself looking up at the toilet, my feet still in the tub.  

I called for my wife, who came in and helped me sit up.  She got me a few glasses of water and held an ice pack to my bleeding nose for a while until I’d calmed down.  

Following the bathroom incident I felt like the peak of the COVID-19 infection had passed.  The next few days I still had a headache, still felt sick in my body, still had a sore throat and cough, but it wasn’t as bad as leading up to the shower.

I took the next couple of days off from work, spending most of the time sleeping.  By the end of the following weekend I no longer felt sick all over.  The headache was gone and I felt normal, except for being fatigued and having a cough when I tried to speak aloud much.  Cough drops didn’t work on it, cough syrup did little, if anything.  Cherry flavored candy helped as long as I sucked on them, not ones that purported to be cough drops, just plain old candy.  Other flavors, not so much.

Now it’s close to two months since the first symptoms and I still feel tired more easily.  If I’m active I get to the end of my energy a lot faster than I would’ve before COVID-19.  I’ve had Raynaud’s Syndrome as long as I can remember, but now my fingers and toes, and my arms, are much colder for the current weather than they would’ve been in previous spring seasons.  When my wife wants to test out the new air conditioner in preparation for summer, I’m fighting it because I feel cold.

For other health reasons I’ve been checking my blood pressure almost daily, and during the couple of weeks I was sick with COVID-19 my blood pressure was noticeably higher.  

So that was COVID-19 for me…. I’m lucky I didn’t have it as bad as millions of other people have.

Monday, March 1, 2021

The Heart of the Matter

The Heart of the Matter

So, in November last year I finally went to a new primary care physician to discuss my long-running high blood pressure issues.  I'd been putting it off for a few years because I didn't want to get into things with yet another new doctor after my previous two both left New York City...  

But Leena had gone to her for a skin issue and really liked her, so she talked me into going.  I actually picked this doctor because I knew her name at the clinic since she was well established there when I first started going for another doctor in 2014.

So, Dr. A. talked to me, took some blood and later when we followed up via video call (coronavirus pandemic, you know...) she changed my high blood pressure medication and put me on a statin for cholesterol, which she described with "sky rocket".  The new medications were giving me headaches, but as they were lowering my blood pressure she didn't want to change them without my seeing a cardiologist first.

When I saw the cardiologist, Dr. T. he didn't believe me that the medications were causing the headaches, which started the day after I started those medications, but was willing to change the prescription to ease my mind at a minimum. 

Dr. T. was concerned about my state of health, my long running high blood pressure, that I got out of breathe when I was active, and my family history, since my father had a heart attack and quadruple bypass at 64 years old and one of my grandfathers died of a heart attack at 62 (granted, he'd been a lifelong smoker, which wasn't my case).  Dr. T. said things like my father's heart attack usually started showing signs about fifteen years in advance, and that puts me easily into the beginning of that 15 year range compared to my father's heart attack...

Dr. T. also scheduled me for a CAT scan, a "CTA Coronary Artery" at the hospital for a week and a half ago.  I went for that, which involved spending an enormous amount of time waiting my turn, and then feeling like I peed my pants when they injected me with the radiocontrast dye (I didn't, it just felt that way when the warmth spread through my body, getting to my crotch region...)

And Monday last week I met with Dr. T. at his office where he reviewed all the images from the CAT scan and some other ultrasound images done that morning.

He then told me that the scans of blockage scored me in the 89th percentile for men aged 51.  Um, ok.  I had to ask if that meant 89th percentile good, or 89th percentile bad.  He then clarified that it was bad.  So, these are like golf scores, a lower number is far better...  It turns out I have more blockage in my heart's arteries than 88% of men aged 51.

Well, I figure that's trivial to beat.  Later this year I'll turn 52, invalidating the whole statistic.  

Dr. T. recently uploading the results to the MyChart system so I could read it and here's an excerpt of the key parts.

1. The calcium score is 119 in the 89th percentile for age, gender and ethnicity.

2. There is no calcified aortic plaque.

3. Normal LM. 

4. 25-50% stenosis of the proximal LAD due to mixed plaque with a high risk feature of spotty calcification. Normal remaining LAD.

5. 50-69% stenosis of the ostial to proximal large high D1 due to mixed plaque with a high risk feature of low attenuation plaque.  50-69% stenosis of the mid D1 due to non-calcified plaque. Norma distal D1. Normal branch of D1. 

6. <25% stenosis of the proximal LCx due to non-calcified plaque.  Normal remaining non-dominant LCx. Normal OM1.

7. Normal proximal RCA. Mid RCA is ectatic with 50-69% stenosis in the mid segment due to mixed plaque with a high risk feature of low attenuation plaque and spotty calcification. <25% stenosis of the distal RCA due to mixed plaque. Normal RPLA and RPDA.

I sent this to my wife with this description, including links to Wikipedia:

Here's a Wikipedia article that explains the arteries in question.  

And here's a grabshot of the vector drawing in the Wikipedia article:

Wikipedia drawing of coronary arteries.

Note that the picture is reversed, showing the patient's left side on the right and right side on the left.  This is because the picture is drawn the way a doctor would see it looking at the patient.

In the picture you can see the LAD mentioned in the doctor's #4 item.  It's on the right side of the picture.  This is 25-50% blocked (I'm not sure why there's a range that size, whether it's because different parts of the artery are blocked different amounts, or because that's as accurate as the scan can get).

His #5 item refers to D1, which is on the lower right side of the picture.  This is blocked 50-69%.

His #6 item is LCx which is in the middle of the right hand side of the picture.  This is blocked less than 25%.

His #7 item is RCA which is on the left middle side of the picture.  This is blocked 50-69%

For now Dr. T. has increased my blood pressure and cholesterol medications as well as including a new one, a beta blocker.  He suggested (was it a suggestion or an order?) a no cholesterol diet.  And I'm to follow up with him later this month to see where to go from there.

He talked about maybe scheduling another procedure to look closely at the blockages with a camera inserted up in there, and possibly inserting stents.  I assume it wasn't an immediate life threatening emergency or he would've done more than sending me home with some medication prescriptions for now.

Dr. T. also emphasized my need to get a sleep study from a sleep specialist.  I was lazy about scheduling that, with the idea that it would be a lot less stressful to deal with one specialist's area of my body at a time.  

At home we're trying to deal with my diet.  I need to be more careful about not cheating as much, since now the damage that's doing is more concrete and less abstract.  But convincing Leena to change how she's cooking for me is harder because she doesn't want to believe she's been cooking food that's unhealthy for my heart as it is.  She wants to think she's been doing everything perfectly.

I also made an appointment with the sleep specialist for next week...

Wednesday, October 8, 2014

Middle Age Motherfucker!

While getting my life on track following some health issues last month, it dawned on me that I'm totally a middle-aged man now.  On Facebook I saw a post by a college buddy's wife and we swapped some messages and we're both in the same boat now.  So, I banged out a ranty email about this to another college buddy...

Middle Age Motherfucker!

It sure hit me last month, like a BB to the nuts(1).

I ended up in the emergency room two weeks ago because my blood pressure was through the fucking roof.  I had a headache like never before, and decided to go to the urgent care clinic up the street.  The doctor there checked my blood pressure and said the risk of a stroke was severe and sent me straight to the ER, no walking, either ambulance or taxi for the two blocks (we chose taxi).

He gave me a pill for it, and some notes to take to the ER...

The pill worked, so the ER doctors didn't "do" anything except monitor me for five hours, then prescribe some blood pressure medicine to take daily, pretty much for life (or until I make lifestyle changes that'll make me healthy enough I won't require it.)  The doctor there also gave me advice including following up with a primary care physician, especially since I'm now 45 and entering middle age and can expect upcoming age-related health issues.

Two days later, when the headache receded enough that I could look at the computer and phone screens without cringing in pain I began what I'd put off for twenty years, finding a primary care doctor.  You know small town life, well, Waldport only had one doctor (whose son was one of my classmates) and once I finished college and started working the big city, Portland, the choices were too overwhelming that I never got a doctor or went for visits.  Now in NYC, the choices are even more so. In our insurance company's listings there were hundreds of primary care doctors within 10 blocks of our apartment...  The hospital had a referral service so she started listing them and I stopped her after the second clinic, then called that clinic who had one doctor available that afternoon, and now she's "my doctor".

Actually, luckily, after the first visit we really like her.  Leena really, really liked her.  We told her about how I got to the ER and what was done since and she talked a bit about diet, said I was definitely overweight and needed to lose some pounds, and took some blood samples, and EKG and measured my blood pressure several times and we talked quite a bit...  Since the problem and medication were still new to me she didn't want to change much, except for me to avoid obviously bad foods...

Last week she called with results of the blood tests and said my cholesterol is very high and put me on the famous Lipitor (another nail in the end of youth coffin for me...)

We have a two week follow-up with her later this week and she gave me a preview on the phone, that she wants to talk a lot more about food...

I saw a Facebook post from Craig's wife, and he's going through the same shit.  Overweight, high blood pressure and all that.  And similar problems, he felt fat, but whenever he talked to people about eating better and shedding weight, they just said "what? you're not fat..."

I get that all the time, even now after the doctor's appointments my coworkers are telling me I'm not fat, I'm not overweight, the doctor is stupid.  Never mind that I knew I was fat ten years ago, when I bent down to put my socks on and couldn't breath because I suddenly had a gut in the way...  I was getting out of breath walking up steps and everyone's all "you're not overweight..."

So, yeah, I'm on three prescription medications now, my blood pressure is high and my cholesterol is very high.  I'm a middle-aged man.  What the fuck happened?

How about us all sucking down a bottle of Oregon Springs(2) and walking down to the Market Casket(3) to buy some junk food...

Anyway, Leena's sprung into action.  She has a mission now, get me back to health.  She was learning to cook in January, but with lots of oil and salt, so now she's researching online and learning to cook healthier foods to help lower my blood pressure and cholesterol.  She found out how to get to the nearest fish market to bake salmon for me instead of frying beef, and she's learned to cook some vegetables so they actually taste good (hint, lots of garlic).

The fresh salads are also a reminder of lost youth...  As a kid I always used massive amounts of French salad dressing to choke down a salad and the grown-ups used olive oil and balsamic vinegar.  This week I found myself looking at a salad and trying oil and vinegar so it wouldn't be plain old, boring vegetables....  And I kind of liked it...  Until I thought about that thing with the kids and grown-ups.

In two weeks I'm noticeably less chubby, my watch is loose on my wrist and my feet are slipping out of my sandals.  So, it's a start...

notes:
(1) the first day of our sophomore year he was showing his new BB gun, pointing it at me.  I said "hey, don't point it at me" and he said "it's not loaded" then preceded to pull the trigger, with a bunch of BBs shooting and bouncing off the door, just below my crotch (good thing he lowered it...)

(2) we drank a shit-ton of Oregon Springs vodka back then...  it was the cheapest liquor we know of at either of the Klamath Falls liquor stores.

(3) just a funny nickname for the grocery store near our college campus, the Market Basket.

Thursday, October 7, 2010

Headache Medicines

So, after the last follow-up with the neurophysician in Pune in which I asked him about getting completely off the medicines he'd prescribed for the nasty headache and migraines I was having, he agreed to lower the dosage, first to 10mg for a month and then cut it out.

The schedule worked out to stopping it sometime around now.  I didn't calculate the exact date, but having two four-day weekends in a row here in New York seemed good.  Tuesday night last week was the last time I took either of the medicines, figuring that would get me through Wednesday at work and if I had withdrawal issues I'd have four days to recover.

I didn't get a headache till Sunday, but even then it was pretty mild and didn't really interfere with my plans (about which I still need to process the photos and blog).  Monday, Tuesday and Wednesday this week I had headaches.

Monday was the worst of them, and I took four aspirin in the morning before work which helped ease it.  By later in the afternoon it was getting pretty bad and I felt a bit nauseas, too.  Going out after work to deposit my paycheck in the cool rain helped and I didn't notice the headache too much while I was doing that and eating pizza near the ATM.

Tuesday and Wednesday weren't so bad, but it was definitely there.

Today, however, I was in a rush to get out the door and grab a bag of garbage to take downstairs that I completely forgot the aspirin pills.  I didn't remember until I got to work and didn't have a headache at all.

So, this is good.  Hopefully the headaches are back under control again.  And hopefully the side effects will start easing off, too, especially that nonstop ringing in my ears.

Saturday, August 28, 2010

Final Follow-up with the Neurophysician

A couple of weeks ago we followed up with the neurophysician about how the medication-based treatment of my headaches has been going. I quickly found on previous visits that when he'd ask me how things were going he wouldn't let me really talk and say what I felt I needed to say, before cutting me off and him talking. So, I got in the habit of writing the details.

This visit was the first one after we got the printer, so I was able to elaborate even more by typing instead of hand-writing, and include a picture, found using Google, to demonstrate what I was trying to say.

With the last visit you increased the dosage of Amitone from 10mg per day to 25mg per day. But we still had a strip of unused 10mg pills, so you said to take two a day, or 20mg, until they ran out, then get the 25mg pills.

The first week, using 20mg a day, I had no headaches whatsoever.

When switching to 25mg per day, I started with the same headaches I had on 10mg per day. After a week of that I went back to 20mg per day, but no change, still had the same headaches, and then after a couple of weeks went back to the prescribed 25mg per day.

Overall I'm still getting headaches a couple of times most weeks. Usually they're not as severe as they were before the month-long one that prompted us to go to you, and the Suminat 50 almost always halts them.

With the increase of Amitone from 10mg to 25mg, the unpleasant side effects are also noticeably worse:
  • The confusion and disorientation when waking up after dawn in the mornings is much worse than when taking 10mg, and that was much worse than not taking anything. If I happen to see myself in a mirror at those times, I don't recognize myself and think there's a stranger in the room.
  • The ringing sound in my ears is louder and more persistent. My ears were ringing pretty steadily for some months before we visited you the first time, but as the dosage has increased, so is the ringing.
  • I've gotten very fat… Despite actually cutting down my meal portions and eating a lot less junk food (e.g. potato chips, Kur Kure, etc.) I'm gaining weight and getting fatter and fatter.
  • When I'm tired and the lights are dim I'm getting more and more hallucinations. These include seeing insects and spiders crawling all over the bed and my arms, though I know they're not real so I don't panic, or seeing things, birds, bats, butterflies, some look real, some look like glass, floating up and into the ceiling.
  • When I look at many things that are brightly colored, they sparkle at those times, too, shimmering like they were covered in glitter, looking a bit like this photo:









At first he started answering me about the hallucinations, that they were absolutely normal and everyone experiences them, and write the medical term on the sheet, something including the root "som" which I know has to do with sleep.

But then he said "this is really well written" and handed it to an assistant (or intern or whatever) and said "insert this into his file, I'd like to keep it on record".

After discussing with him I asked if we could work on eliminating the medications altogether and he put together a plan, one week on 20mg a day of Amitone, then down to 10mg a day for a month and then stop it. He recommended keeping on with the Betacap, which he'd actually forgotten he prescribed until we asked about it, as well as recommending I keep using the Suminat when I get a migraine.

He wrote down what he thought were some of the brand names for the same drugs in the U.S. but didn't know which were prescription-only and which might be over-the-counter. He also gave me an address to email him if I need any advice while I'm in the U.S.

Sunday, May 16, 2010

Side Effects

The thing about a migraine-type experience is that it's like being only half alive. You find yourself walking through this tomb world, everything gets far away and kind of dull and dead.
- Perkus Tooth in Jonathan Letham's Chronic City

So, I've been taking the two medications as a prophylactic for my migraines since early March now. One is an antidepressant and one is a beta blocker. For the most part they're working. While I'm not completely without migraines, they've reduced an awful lot. And for when I do get them, there's a triptan I can take that usually relieves one.

But wow, there's side effects, too...

  • Every time I wake up I'm extremely confused and disoriented. Especially if I go to sleep when it's dark and wake up when it's light. Then I have no idea where the light came from or who's shining it through the curtains. The doctor assures me it's normal, everyone wakes up confused in the morning, but if I compare the roughly 14,800+ times I've waken up before I was on the medications with the 70 times I've woken up after taking it, I know the difference.
  • Hallucinations, especially when I'm tired. When I wake up from sleep, the view from the bed is almost always that I'm on the edge of a huge chasm, and the little foot board that sticks up from the bed is a railing to keep me from falling off. The dressing table, a couple of feet away, looks to be a mile away, across the chasm. Whoever's in the mirror on the dressing table when I wake up, I usually don't recognize them for a couple of minutes and I'd swear there's someone else in the room.
  • One hallucination I had was when Leena came in on a weekend morning I waved to her in the doorway, but my impression of it was that I was holding a picture postcard of her, with the doorway being the white border around it.
  • Songs get stuck in my head more often. It's harder to get them out once they're there, even when I'm concentrating on other things. I think early on, before I recognized this I may have blurted out some lyrics at work when someone asked me a question. It's probably a good thing I haven't been in a Soundgarden mood much to listen to Louder than Love.
  • I'm a lot more angry than I was before taking the medications. I've lost a bit of my former easy-going nature. I think I've snapped at coworkers, and I know I've written at least one email at work I regret (not the concepts, but I think I could've phrased things a bit gentler).
  • Impotence, I just have no interested in sex since starting the medications. On the other hand, before that I had the interest but was in too much pain to do anything about it, so maybe it's not a bad trade-off for the short term. But it still makes me wonder, "what the fuck's wrong with me?" (which of course, I can answer...)
Hopefully I won't be on these medications for too much longer. From what I've read the usual time is in the neighborhood of six months, give or take a little. Although the one night I forgot to take it (actually, I was super-sleepy and couldn't remember if I took it or not and didn't want to double the doses in case I had) I had a bad, bad headache the second day after that, the worst one since I started it, so maybe I'm not ready to quit them yet...