Fickle Finger of Fate Don't Bend So Much These Days or A High Five Might Bring Me Low

Okay, so where were we before being rudely interrupted by nostalgia? Oh, yeah, wobbling on the brink of old age and its requisite aches and pains. We'd just scooted to the doctor and been hustled off to an emergency colonoscopy, if you can call a week later hustling. It was a long week, too, because the "Big C" hovered about my brain like an angry wasp. Praise the Lord, and I don't say that flippantly, I mean it most sincerely, it wasn't that dire.

It was merely angioectasia in the cecum, a medium hiatal hernia, granularity and friability in the antrum and an ulcer in the distal bulb. The last was the bloody culprit, an ulcer (the only word I could recognize other than hernia in all that) in the duodenum (for those such as I who don't know where the distal bulb is). There is no sense to going to all those years of medical school and racking up all those student loads if you are going to talk in plain English. Just saying, "You got a bleeding hole in your gut," doesn't sound worth all that effort learning those sesquipedalian words. (I was an English minor in college so I should throw around words worth my effort too.)

We've rather dealt with my lower G.I. problems in past posts such as Glory Be, the Lord Must Know How Much I love Tomatoes. (By the way, once upon the time "potatoe' with the "e" was the correct spelling, and in fact was the preferred spelling within "The New York Times" until 1988. The Sun Valley Potatoe Growers still use that spelling. So you say "potato" and Dan Qualye said "potatoe, so lighten up you spelling elitist, by any such spelling it is still a starchy tuber. I know it is besides the point, but tomatoes reminded of that to-do over nothing.) Anyway, as I was staying, we've dealt with my intestinal perforations so let's move on to my other bodily ravages.

My gastroenterologist must have done something while poking about in there because my bleeding ulcer stopped seeping and he told me I could eat what I wished. Oh, I came out of that follow-up appointment clapping my hands, but three days later not so much. I couldn't clap. My right hand was swollen up, was red and hurt like a tank had run over it...twice. 

Yeah, I am use to these arthritis attacks. They put one in agony for  few days, ease up, go away and then after some nonspecific time period return to plague a different joint. Not so this time. Pain gripped me like grim death for a week, for two weeks and it spread from my middle finger to my index finger and back again, like it was playing tennis with my digits. Once again I was driven to another long-named doctor, a rheumatologist. 

I got some damage in that hand that I guess is permanent. My pinky finger has an unnatural bent to it and my pointing finger has no bend at all. It just pokes straight out there with a hook at the end. I must forever avoid fights for I can no longer make a fist. Still in all, the good doc put me on a steroid (Prednisone) for three weeks and the pain and swelling dissipated. You can't stay on that stuff long though or it turns you into the Hulk.

Now I am on an antimetabolite and antifolate substance called Methotrexate,  the same drug used in

 cancer chemotherapy. It comes with a long list of scary possible side effects (one of which is hair loss, but as you can see it is too late for that to worry me). 

The biggest threats to me are to my liver, thus I must go for blood tests every four weeks to assure that organ isn't fizzling out, and suppression of my immune system. This latter side effect has the somewhat positive effect of reducing my psoriasis. So if my liver goes and I die I will at least have pretty skin.

I find myself getting tired more these days, which is another possible side issue of this treatment. And so again I claim I now qualify as elderly. Oh, I also have to take a daily dose of Folic Acid. Remember that term for this stuff, antifolate? Yeah, it depletes your folic acid and you need a bit of that. If you don't have it you may have:  diarrhea, macrocytic anemia with weakness or shortness of breath, nerve damage with weakness and limb numbness, pregnancy complications (I doubt this!), mental confusion, forgetfulness or other cognitive declines, mental depression, sore or swollen tongue, peptic or mouth ulcers, headaches, heart palpitations, irritability, and behavioral disorders, impairment of DNA synthesis and repair, which could lead to cancer development.

Ain't we gots fun when we gets old?

Glory Be, the Lord Must Know How I love Tomatoes!

A lot of people not in the know think Adam and Eve ate an apple. I like apples, too, but if God wanted to challenge my obedience and make it difficult to resist temptation, the Forbidden Fruit would have been a Tomato. (And just recently it was, but more of that later.)

The tomato is a fruit, you know. How do you know? It has seeds. So are cucumbers, green beans and squash - fruit, that is, but this whole vegetable fruit thing gets all confused.

When I was a teenager one of my summer jobs was loading tomato trucks to haul this fruit to the ketchup (or catsup if you prefer) factories. That was hard labor. These were flatbed trailers on 18-wheelers, perhaps 50 feet long and over 8 feet wide and you stacked these bushel baskets well above my head, and I was six foot by then. That is a lot of hoisting and lifting and stacking, all out in the open farm fields of Lancaster County, Pennsylvania in the hot July and August sun.

This was Amish country and the baskets would arrive at truck side on horse drawn wagons. The

bearded-farmer and perhaps his fresh-faced son would hand up the baskets (which usually came on more than one wagon) and the truck driver and I would begin stacking them from the front to the back. For a teenage boy high on hormones the one reward (besides the pay of $10.00 per load) were the spectators. Those rosy-cheeked Amish girls would gather along the side and gawk at us all the live-long day, silent and smiling.  They had rosy cheeks and twinkling eyes and it made you feel quite the little celebrity.

One summer before I had worked the fields of a Chester County farm picking tomatoes. I was the guy shuttling along the vines filling the baskets. It was still July and August and the sun was still hot, and the  tomatoes were lighter one by one than lifting a whole basket, but the job was just plain miserable. It was dusty and every time you plucked off a fruit the Daddy-Long-Legs would come scrambling out of the vines and up your arms. And there weren't any pretty bystander females to boost your ego; nothing but some other dirt-encrusted, sweating guys swatting away the the Harvestman arachnids.

Now you're probably thinking with that kind of background relationship with tomatoes I would hate

them. But you'd be wrong. I love tomatoes. You give me a plate of sliced beefsteak tomatoes with some corn-on-the-cob and it is as good as a Thanksgiving dinner to me. I love tomatoes in my sandwiches, in my salads, stewed or as a soup. You'd be surprised, maybe, by how hard it is to escape the tomato. The stuff is in a lot of sauces, so you get pasta you often get some form of tomato extract draped upon it. They are in that covering under the cheese and pepperoni of your pizza and forming a dark, delicious lake around your franks and beans. There those pieces falling out of your taco and that color in your hoagie; oh man, the hoagie! And how many things go better with the aforementioned ketchup?

But three weeks ago I was told no more tomatoes, not in soups, not sliced, diced or chopped, not fried or stewed, not as juice, ketchup or sauce, probably told not even to look at pictures of them. This was the forbidden fruit along with onions and mustard and coffee and chocolate and...well, basically, if I liked it, I couldn't have it. Speaking, as we did earlier, of Adam and Eve, I kinda felt like they must have after being booted from the Garden. No more tomatoes, utter despair!

And you go to a restaurant and try and find anything on the menu that doesn't contain tomato, mustard, garlic, onions, spices or a whole chorus of joyeous songs of flavors now banned from my concert. Forgit'about it!

But today I went back to the Star Trek Doctor, who went where no man had gone before, peeking

through my body from both ends. That probing had occurred three weeks ago and today was the summarization of the voyage. Captain's Log May 1, 2013, the biopsies were negative. The bleeding ulcer in the duodenum was cauterized, I guess, at least no more bleeding, but the angioectasia in the cecum (dilated blood vessels in the colon) weren't because, "If it ain't broke, we don't fix it". There is nothing cancerous.  The only new medication is a prescription for omeprazole (the active ingredient in Prilosec), which will join my Levothyroxine as a morning ritual for the next 30 years. I know, I'm being awfully optimistic since I am almost 72 now.

I write this with appreciation to those who were concerned for my well-being and for the prayers of those I know prayed regularly for my health and cure.

I prayed, too, and God heard and answered kindly back. He gave me back the tomato!

Who Is that Old Man Dogging My Steps?

You're walkin' along, hummin' a song, when outta a clear blue sky; wham! Bam! You're feelin' like some old guy.

In case you missed it in a previous post, I recently underwent an emergency endoscopy and colonoscopy, not to mention a stat, immediate blood test of my hemoglobin. My hemoglobin was down, but not critically so.

The reason for all this was the day after Easter I had black and sticky stools, road tar, as the doctor called it. I know, discussing a bowel movement is a gross subject, but we're all adult here so man or woman up. What it meant was I was bleeding somewhere in the digestive tubes. This isn't exactly the thing you say, "Whoopee, look at me," about. After an initial reaction of, "Yeuw!" your next thought is, "Am I doomed?" Then you call the doctor. Well, in my case, ever optimistic, overly proud of my super-active immune system (I mean the blasted thing has never known when to stop thus giving me psoriasis, arthritis, Grave's Disease and a bummed up [now dead] thyroid, but also pretty well zapped colds and healed wounds quick) and phobic fear of people sticking needles through my flesh, I waited a couple more days. After all, if history proved correct, it'd go away.

Stupid history, it didn't go away.

And so I made a visit to Dr. Sue (my primary physician) who arranged the emergency oscopies a week later with a Dr. Beswick.  That is my primary
doctor pictured on the left. My friend Ron did not want to believe that my doctor looked like that, but indeed she do. Dr. Beswick is on the right. He looks like he looks, too.

Anyway, the upshot of all this inner perusing of my body showed I had an ulcer in the distal bulb, and obviously it's a bleeder.

It's also a rare little varmint. Naturally, I am always in the unusual minority in these things. Most people who get psoriasis don't get it to the extent I have. Many more women than men get thyroidism and almost nobody had it flip from hypo to hyper within a year. There are only about 5% of people who get an ulcer in the distal bulb.  (Where is this kind of luck when I buy Powerball tickets?)  95% of the duodenal ulcers posit themselves up at the top near the stomach. Mine decided on the more remote area to the back of the duodenum. The duodenum is the first section of the small intestines where food is further broken down after leaving the stomach. It isn't real long. The ulcers toward the top, near the stomach, perforate; those to the bottom where it narrows just before the next section of small intestines, bleed.

My guess is I am suffering from anemia, which is why I tend to tire easily and why my walks have

gone from four to five miles to a pathetic two. Apparently my anemic condition isn't dire enough to be too threatening or I'd be in the hospital, as Dr. Sue had warned she would do if my hemoglobin was too low. I am not experiencing any shortness of breath or confusion, beyond my normal confused state. I just get weary much sooner when I do anything.

Exactly what we do about the creepy old man dogging my footsteps I don't know yet. I meet with the doctor, the guy on the right, not the pretty one on the left, on May 1 and find out what we are going to do. I guess he'll have the biopsies' results then and we'll see if I got bacteria in there. If I do then antiboptics are a-comin' my way, do-dah, do-dah!

They use to think ulcers were caused by what you ate or by stress. Now they know there is a sneaky little creature named Helicobacter pylori (alias H. pylori) that's the culprit. I hate to tell you this, but he and his ilk are floating around in your guts too. It's a bacteria natural to those environs of our body. I don't think they know why old H. (can I call him H. for short) goes all postal on some of us.

Of course, the little beast has put police tape around a lot of foods I can eat. If they don't cause the ulcer, they do agitate it once it's there, so no mo' of certain foods for me for a while.

(Translation: if you like it, you probably can't eat it.)

On left, hoagies and chips, native foodstuff - can't eat!

Is that downright criminal, or what?


No hot dogs, no pizza, no cheesesteaks, no chili, no spice, no mustard, no ketchup, no tomatoes, no oranges, lemons or limes or grapefruits or pineapple or juices thereof, no carbonated beverages, no coffee, no tea -hot or iced - no chocolate milk, no chocolate period, no peppermint, no alcohol of course, no French fries - no fried anything, no black pepper and certainly no red pepper, no onions, sauerkraut, bell peppers, cauliflower or broccoli, no pickled vegetables, garlic, ginger or nutmeg. There is one bright spot - no Brussels sprouts!

I can have seafood, but I don't like seafood.

I can have cabbage juice; really, CABBAGE JUICE!  Yum!

Whoever that old man is dogging my steps, he has terrible tastes in food.



Man, don't that cabbage juice look good? (right)













Helicobacter pylori (H. pylori)  duodental

How to Get ready for Your Colonoscopy or A Night at the Races

As we meander, and drink and eat, our way through earthly life and earthly delights, we get to experience new adventures. Some of these may be the direct result of too much of those earthly delights. One such adventure is a kind of light at the end of the tunnel called a colonoscopy. It is something you keep hearing you should get when you reach a certain age.  I am actually past that recommended certain age and had never had this procedure. I am not big on doctors and hospitals and needles in the arm.

However on Palm Sunday after coming home from church I felt extremely tired and fell asleep for a couple hours on the sofa. When I woke up, I found I couldn't walk across our living room without feeling woozy and having to sit down.

I thought I was getting the flu back, specifically the stomach flu. I had been going through a wretched couple weeks as far as my body was concerned. Two weeks earlier arthritis visited my left wrist and

hand. I had never had an attack there before and this was one  like the invasion on D-day; Mr Arthur Itis brought his heavy forces to bear. The pain was intense and basically rendered my left hand useless. (Oddly coincidental that one year ago my mother had a stroke that took away her use of the left hand.)

The pain was so bad I began doing something I rarely do. I began popping pills, first Tylenol and then aspirin. Oh, I was swallowing two aspirin tablet every eight hours every day. Then in the middle of the following week I had an ache across my midsection and I felt tired and cold. I could not get warm at all. That was when I decided on The Flu. It seemed mild, though, until Palm Sunday afternoon. And then Monday morning came.

I awoke early as usual, but the need to get to the bathroom was not as usual. Yes, waking up and having to immediately empty the bladder is pretty common, but this was the sit down variety of things and that was not normal. It was urgent, and it was messy and it was a lot. Well, you expect that with the flu and I figured maybe this is the start of getting it out of my system, until I reached to flush and saw it was black.

When it is black, and sticky like road tar, it means one thing. I was bleeding internally somewhere.

Of course, first thing I did once cleaned up and dressed was Google the matter. What could cause this phenomena?  One of the possibilities was the stomach flu or more specifically gastroenteritis of the bacterial form, something more common in us older folk and has the symptoms I had. I decided to let some time go by and see if it all went away, as my sickness generally do, but not this time. I was weak and woozy and tired and cold as anything on Monday. I was able to walk a bit further on Tuesday, all the way across a room. Wednesday I was about the same, but things were still coming out black, so I called my doctor and got an appointment for the Thursday before Easter. (Yes, that's my doctor on the left. Yes, I have a female doctor. Now some may be wondering why I resist going to the doctor when she looks like that? I sometime wonder the same thing.)

Doctor Sue (first name), looked me over and expected I might have an ulcer. I drink a lot of coffee, drink some alcohol, was popping aspirin and pretty much eat whatever I want, plus this has been a stressful year. My blood pressure was up, my weight was down and she thought I was down a pint in blood. She wrote me an order for a hemoglobin test. She said go directly to the lab, do not pass go, do not collect $200. She put STAT at the top of the order. She said the results would reach her by 3:00 PM and if my hemoglobin was too low she would put me right in the hospital.

I didn't want to go into the hospital -- ever, but especially then. I wanted to be at Iron Faith Fellowship's Sunrise Service atop a hill at 6:00 AM Easter.  I did go to the lab, she did get her results, and although my hemoglobin was down some it wasn't terribly low, so I avoided hospital.

Dr. Sue arranged an emergency colonoscopy for me, which I could not avoid and that brings me to this week and this subject.  The video is of my day before the procedure as I went through the dreaded preparation. Oh, what tales of woe and terror I have heard about this preparation, especially during that week when I told the world it was coming. People chuckled knowingly, patted me on the back, consoled me and some wanted to see my reaction when I began to drink the required magic potion and so the resulting video. I promised my friend, Ron, I would record that moment.

I had seen his video doing it, his grimace, his attempted to sip it down, his frustration, his grasping his stomach in disgust and his gagging (photos of Ron's agony surround these lines)  and I knew he wanted to see my suffering in return.

If you watch my video, I suggest scrolling down to the bottom of my Blog and turning off the music. It will be better viewing if you click the little square of corners on the lower right of the video frame and make it full screen view. (Don't worry there are no gross images in this film, unless some think my face be gross enough.)

I certainly didn't look forward to last Wednesday with glee. I didn't really worry about it either. I just went about as normal and you know what? It came without me worrying anyway. I had to drink a half gallon of a special brew, doing one 8 ounce glass every half hour. I was amazed how quickly each half hour went by, but you know what they say, "Time flies when you're having fun."

After the elixir I was also amazed at how fast and often the results came as well and how they lasted

long into the night. I managed to fall asleep at some point only to be awoken at 3:50 for some more emptying. And before I knew it my sleepy wife and I were on our way to the Endoscopy Center of Delaware.  I am glad I insist on always leaving early for unfamiliar destinations. For a while it appeared I made a mistake and we would arrive a half-hour early. Traffic had zipped down I-95 despite construction. We were off the proper ramp and then realized we couldn't quite understand the Google Map claims of where streets were supposed to be. After a few missed turns we did manage to locate the center.

My wife is not an early riser. I would normally allowed her to sleep (my appointment was for 8:15 AM), but the center insisted I needed a driver to collect my carcass afterward, so she had to get up and come along, but not without reason. I was in no condition to drive home with the euphoric high I experienced from the anesthesia. I was as mellowed out as a projectionist at a Cheech & Chong film festival.

The people at the center from receptionist to physician couldn't have been nicer. The nurse got my IV in with almost no pain. She got me a blanket because I was cold. There was a reason for my shivers.

 "Take everything off, except your socks," she said, "and put on that gown."

 You know, that gown, the one with the air conditioned back.  (How do you tie those things anyway?)

"I can tie the neck for you," said the nurse, "but I'd just leave the waist untied."

I was hooked up and soon wheeled to another room. The doctor was there and a nurse and a technician and...people just kept joining the let's see what's up Larry party. The doctor suggested we get an Endoscopy as well as the Colonoscopy. We all signed some papers and I was prepped for attack from all sides. One of these strangers, who now had more familiarity with my nether regions than most, stuck this plastic bite do-dad between my teeth and told me to roll over on my side. The anesthesiologist put something through the IV and_________


_______And I woke up back in the dressing cubicle with my wife. I dressed as she went for the car. I was escorted out and we rode home with me repeating things over and over again just as giddy as can be.

These were the results of this Star Trek episode, people going where no person has gone before.

Angioectasia in the cecum
Medium hiatal hernia
Normal mucosa in the esophagus
Granularity and friability in the antrum compatible with gastritis (biopsy taken)
Ulcer in the distal bulb (biopsy taken)

Yeah, I looked all those things up on line, now it's your turn.

Upshot is, yeah, I got an ulcer.

The recommendations are:

Regular diet
Resume current medications
Follow-up with the Doctor in three weeks
If bacteria are present on the biopsies, may recommend treatment with antibiotics.

It other words, if I do have gastritis I'll get medication.  I will find out more on May 1 at my follow-up.

But now you have seen how really simple this all is, don't fear having one if over that certain age.