Friday, December 05, 2008

Visiting my Doctor

Isn't that just a marvelous logo? It seems to promise such wonderful, blessed relief, from all that ails us. Just imagine -- "Healing for life".

Now I apologize in advance. Both for the laboriousness and length of this missive, as well as the quality of the content. Cannot be helped.

Of all recent events memorable, the one thing I seem to find to be exclusively a deplorable experience is the doctor visits. I cannot put my finger on exactly the explanation for these bad experiences -- I am certain that it is my own sad deficiency, and no fault of the doctor. In any case, it has been years since I had an active confrontation with any doctors. The men I have dealt with lately are of mild temperament and pleasant personality. My only specific gripe has been over several personal clashes with members of the attending nursing staff, but that is another long tale, one that I have detailed in other posts.

I have in mind to inventory some specific details about what currently is bothering, from my own perspective. Doctors seldom take the time to get this story, and they always seem in a rush for the next appointment. As a result, when I finish a visit, I often find myself standing there with another half-finished thought on my tongue while I am watching the back of the doctor walking away. This is particularly frustrating to me right now, as I struggle to speak at anything like a normal pace, trying to articulate something that I understand so poorly in the first place.

The first event I would like to describe in detail is my initial stroke experience. I was swinging a heavy wood maul at the moment, in spite of getting up from bed feeling ill. I remember thinking at the time that I might feel better if I just did some kind of work. Then, within a moment's time, I felt something that seemed like mounting tremendous pressure inside my head, accompanied by a loud rushing noise, like waves crashing on the seashore, sounding in my ears. The pain and pressure I might have found comparable to instances where I incurred a very solid blow on the head from an overhanging tree branch, but it was obviously coming from inside my head. The noise in my ears was obviously not a sound coming from the environment around me, but to me, sounded as loud as the nearby roar of jet engine exhaust, or some other loud blasting noise, resounding in my ears. The sensation and the noise reached a crescendo together, then diminished suddenly, but left a loud ringing in my ears. At that moment I was struck by sudden weakness and instability, and felt that I was fainting. I had gray spots beginning to obscure my peripheral vision. Although I was no longer thinking very clearly, it came to me that I wanted to sit down in the shade, and rest. As I dropped the implement I was holding, I tried to make my way across the driveway to the house, where my dad was sitting on the porch. I wobbled precariously like a drunk, and as I sat down on the porch, tried to explain to my dad that I "felt like my legs came all unhinged", but I don't think my mumblings were very coherent. After resting in the shade for several minutes, I felt somewhat recovered, and noticed no severe persisting ill effects. We went to dinner in Mount Pleasant a short time thereafter, and though I continued with a generally unsettled feeling, I noted no pronounced weakness or other physical impairments at the time.

The following morning, I woke up to discover partial paralysis on my right side, both in my arm, and leg. A stroke was immediately the suspicion. My leg was still sufficiently mobile that I could move myself, albeit with some difficulty, and my dad and mom ushered me into the car and drove me to the hospital.

In the second incident, I was injured falling down in my bathroom, getting out of the shower. Suffice it to mention that I suffered a broken coccyx, which continues to provide an uncomfortable and sometimes painful reminder of my precarious lack of balance and equilibrium.

In the third incident, I was again injured in a falling accident, this time resulting in some strained ligaments in my rib cage. The occasional discomfort from this injury has eased somewhat.

Fourth, I have experienced almost continuously since the July stroke, a low-grade headache, with some accompanying migraine-like phenomena. I have experienced occasional migraines throughout my life, since earliest memory. At about the age of thirty-five or forty, I quit experiencing the shatteringly severe headaches, but still had irregular bouts with characteristic migraine aura -- scintillating scotoma, paresthesia in mouth, lips, hands, arms, legs, and feet. And other weirdness I associated with the migraine experience. I grew somewhat accustomed to these experiences, enough so that I seldom mentioned them or complained about them, but worked out my own methods for coping.

Anyway, I have suffered from something very similar to this migraine experience, continually, since July. It is not the same thing as migraine, since that always seemed to be a fairly short-term experience, but this condition seems to be chronic. The aura-like experience comes and goes. The headache with accompanying nausea vary greatly in intensity, but never quite go away completely. Ringing ears of varying degrees of volume also accompany the headaches.

I complained to everyone who asked about how I was feeling since last July, but doctors and therapists generally offered no specific response, or recommended over-the-counter NSAIDs like Tylenol for managing the pain. Nothing has been effective at all for diminishing the headaches. Though the Tylenol was sometimes a relief from the other discomforts.

I also resorted to my mom's Tramadol prescription, from time to time. Although I could not discern that it did anything to diminish the intensity of severe headache pain, it did put me to sleep. I would generally note that the headache pain persisted on awakening.

The doctors at the rehab center seemed absolutely horrified when I told them I had been routinely self-medicating with huge quantities of extra-strength Tylenol. I said it mattered little to me, only to escape from the immediate pain, but admitted that the drugs were not providing any significant relief anyway. In concession to his concern about the drugs I was taking, I told Dr. Fyans to forget about administering any pain relievers, and concentrate exclusively on blood pressure control. I already had arrangements to visit a neurologist, so I supposed this was reasonable.

Anyway, the migraine-like symptoms continue, getting better or worse from day to day, but never completely disappearing. This in spite of the drug prescribed by the neurologist. He said the stuff takes some time to take effect. We'll see.

Let's see, a couple of other things to explain. The next is TIA. Transient Ischemic Attack. In the vernacular, a mini-stroke.

I have experienced many episodes similar to that which I first detailed, but varying in intensity and seemingly in severity.

These episodes do not seem typical for most stroke victims. Some of the nursing staff that I described these experiences to characterized them as "freaky". I only know what I experienced.

In one event while I was in the rehab center, my blood pressure was monitored while I experienced a series of what I interpreted as TIAs. Blood pressure readings of well over the 200/180 mark, for some time. A series of repeated episodes where the pounding pressure mounted to seemingly explosive levels. Unbelievable headache pain, well beyond anything I ever experienced before. Accompanied by the loud rushing noise sounding in my ears. During this series of events, I complained of feeling very nauseous, and felt like I was going to faint. The nurse attending was apparently somewhat alarmed, because he kept yelling at me to tell him if I remembered where I was, and what my name was, and such. I think this went on for several minutes with me in semi-lucid state. I remember thinking that there seemed to be a lot of people running around me, making a big fuss, but I was viewing it all from such a haze of pain that I didn't feel much concern -- I just wanted my head to stop hurting, and knew these guys had nothing to help that.

Anyway, that particular event subsided. I remember starting to weep and cry, it hurt so bad, and I told them I just wanted to stop hurting. Eventally I regained some relative lucidity, and my blood pressure dropped and stabilized. The headache pain gradually relented, but not as quickly as the blood pressure event.

I have become sensitized to these TIA events, and have been noting when they occur now. Periodically, I will experience a whole series of them in fairly close sequence, something on the order of one every five to fifteen manutes. This can go on for a number of hours throughout the day. The duration and severity vary widely, as does the frequency.

I cannot think of anything else to say in describing these events, except that nobody else seemed to have ever heard of such a thing. Perhaps I am just hallucinating. But this is what I am experiencing.

One other matter. I need medical attention for the skin growth on the center of my back. It is beyond my ability to see easily, but I know it feels irritated when I turn in the bed now, so it appears not to be healing properly.

Next installment:  My Hospital Experience

3 comments:

pgk said...

I had to look up several words in this post in order to understand it completely. It is a remarkably well-written, professional, and valuable piece of medical history. Educational, too.

I recommend that if you haven't done so already, you print this out and give it to your parents, Ben your rehab guy, all of your doctors, and anybody else you can think of who might be able to help you. Your bishop. Your home teachers. Any professional friends you have who are EMTs.

I'm telling you, Jim -- what you've done here is very important and you need to get it into others' hands. It's not a matter of complaining, but of communicating.

Thank you for making what must have been a huge effort to write it all up.

pgk said...

Just a gentle reminder: TAKE THIS TO YOUR DOCTOR!

Billy Bob Bambino Bombabious Baby the Third said...

I agree completely. Please always remember that we can't see what's going on inside of you (literally and metaphorically) and the only way to get the help you need is to tell someone... I know that's not the "Cobabe" way to do things (I am a Cobabe, and I understand... I lived with your brother for a number of years) but it's the only way to get it.

I wrote you an extensive comment to an earlier entry that the internet ate. I don't know what happened to it. It was full of feeling and left me so drained that I couldn't bear to rewrite it. WHY?!?

The point of the comment, however, was to let you know how much I love you and that you mean a lot to me. Your suffering is my suffering. Your pain is mine. And I am grateful for your strength, for that is mine, too.

We read in Ezekiel this morning as a family. It was chapter 18. I recommend you look at it - it is so full of hope and love, and ironically justice. In particular, verses four-nine:

Behold, all souls are mine; as the soul of the father, so also the soul of the son is mine: the soul that sinneth, ith shall die. But if a man be just, and do that which is lawful and right, and hat not eaten upon the mountains, neither hath lifted up his eyes to the idols of the house of Israel, neither hath defiled his neighbor's wife, neither hath come near to a menstrous woman (!), and hath not oppressed any, but hath restored to the debtor his pledge, hath spoiled none by violence, hath given his bread to the hungry, and hath covered the naked with a garment, he that hath not given forth upon usury, neither hath taken any increase, that hath withdrawn his hand from iniquity, hath executed true judgement between man and man, hath walked in my statutes, and hath kept my judgements, to deal truly; he is just, he shall surely live, saith the Lord GOD.

The rest of the chapter talks about the redemptive power or repentance - how people may be forgiven of just about anything if they will repent and turn from their wickedness.

The last two verses are perhaps the most powerful:

Cast away from you all your transgressions, whereby ye have transgressed; and make you a new heart and a new spirit: for why will ye die, O house of Israel? For I have no pleasure in the death of him that dieth, saith the Lord GOD: wherefore turn yourselves, and live ye.

What hope! What joy! What mercy!

It reminded me of me. My life, where I have been and where I would like to go. Life is so short. Our time here is so brief.

You have brought this lesson home to me. You have taught me through your example how I should live my life. You have turned to the Lord, and you will live.