Hey all. Sorry for my absence of late, but I have been one sick puppy. I mentioned that I just wasn’t feeling great the last few weeks and the bloodwork I had done may explain some of it. Apparently my thiamine (B1) was low and after looking up the symptoms that can be caused by low thiamine levels, I saw that it explained quite a few of the problems I was having:
"The most common symptoms of thiamine deficiency are irritability, fatigue, poor concentration and memory loss. These are the early thiamine deficiency signs. If the deficiency continues, then peripheral nueropathy can take place due to damage to the peripheral nervous system. The symptoms of this condition are muscle weakness, mainly in the legs, loss of sensation, and tingling or burning sensation in the legs."
I bolded the symptoms I was having in addition to the gastrointestinal problems the article goes on to describe as "other symptoms" of thiamine deficiency. So, I'm going to see about getting some B1 and start taking my supplements the way I should.
I don't know if the thiamine problem led to the problem that ultimately landed me in the hospital this week, but I suppose it could have contributed to it. Sunday night, I was in the ER because I thought I was developing a blood clot in my right calf. It had been tender to the touch and I wasn't sure if it was a clot or low potassium, but I continued to watch for signs of swelling, fever in the area, itching, etc. By Sunday night, my ankle had started to swell and itch and I mentioned it to Erik who freaked out and demanded that I go to the hospital. I tried to talk him out of it because honestly, I figured I would be fine until the next day. I had to work that night for a few hours and I just wasn't up to a trip to the ER. Erik wouldn't hear it though. Ever since my surgery, he's been extremely cautious when it comes to my health which I guess is a good thing. Anyway, he came home from work, we went to the ER where we spent about 4 hours.
They did an ultrasound of my leg, and I actually learned something I didn't know about blood clots...they aren't so concerned about clots in the peripheral or superficial veins (like the one we suspected was in my calf), but more in the deep veins that run along the front of the leg. The ultrasound didn't find a clot in those veins so they sent me home with orders to try to walk every couple of hours (since I'd been feeling like crap for over a week, I hadn't been getting much activity) and hydrate my body as much as I could since my blood was kind of thick which meant I was dehydrated (again!).
The next day my leg was actually feeling better so I thought I was on the mend. That night, I made dinner and by the time I sat down to dinner with the guys I just felt SO exhausted. Erik could hear it in my voice...it gets very hoarse when I'm super dehydrated (which makes sense really as my vocal folds are probably as dry as the rest of my body). I was talking to him about how I was feeling and was gesturing or signing (I can't remember) with my hands and I just dropped my hands in my lap and said "I'm so tired, even using my hands like this wears me out." He ordered me to keep drinking for the rest of the night and I agreed that dehydration was probably my biggest problem.
Some of you may wonder what my problem is with staying hydrated. Sometimes, it is just that I get busy and don't think about drinking. If I don't have something right by me, I get working and put it off until I've lost valuable hours of hydration opportunity, but lately I've been more diligent about making sure I always have something nearby.
Another factor that makes staying hydrated a challenge is that getting TOO much liquid on my stomach seems to make me nauseous. I can't drink straight water anymore (it upsets the Ph of my stomach and brings on instant nausea) so I always have to "doctor" it with at least a bit of lemon and stevia/splenda (I'm currently trying to switch from splenda to stevia and agave at the urging of my good friend Nick). So, I have to find the perfect "balance" between drinking enough to keep my body hydrated, yet not so much that it makes me nauseous. I still haven't gotten this down quite yet.
Finally, probably the BIGGEST foil to staying hydrated are my damn blood pressure meds. I've been on lisinopril HCTZ which has a diuretic in it so if I take it, it makes me instantly pee out most of the fluids I'm ingesting which means I have to drink twice as much as I probably would need to drink otherwise. My primary care doc recently prescribed the lisinopril without the diuretic, but I'm trying out the prescriptions by mail thing and it has taken them FOR-FREAKING-EVER to get my meds to me. I stopped my blood pressure meds for a week prior to the ER clot visit because of the hydration issues and my BP in the ER was super high so I had to start them again. I'm hoping the new BP meds come tomorrow. We'll see how I do without the diuretic. I'm hoping that the BP will eventually take care of itself as I get more weight off, but I don't know. I have a family history of high BP, so it may just be the luck of the draw. Regardless, getting the weight off and getting more active aren't going to make the problem worse right?
So....that brings us to Wednesday morning. I woke up for work and actually felt ok. I had absolutely NO appetite, but that isn't unusual for me really. I usually get signed in for work, get set up and then make myself a protein shake or coffee. I typically wait until my first break to make my breakfast. I noticed that I was having what felt like gas pains in my upper stomach area. It was the sort of pain/cramping that starts...gets worse as the gas expands an area of your intestine and then subsides. Although I'd only had a few bites of sausage and egg taco the night before (my first foray into low carb tortillas ...they were delicious by the way), I began to wonder if my rearranged guts were having a problem with the tortilla. I asked Erik how he was feeling and he mentioned that he wasn't feeling all that great either, but the night before he went on a binge that made me ill to watch so I couldn't really use him as a gauge. Tanner was fine so I couldn't figure out what was causing my problem. The pain seemed to get worse as time went by so I went and laid down in between calls hoping that if I straightened out, maybe the gas would work through my system. I even took some gas x strips to no avail.
I then realized that I had forgotten to take my effexor the day before and withdrawal from effexor can cause gastrointestinal problems so I took the pill and forced myself to eat a bite or two of the sausage and egg the night before to make sure it didn't upset my stomach. The food came right back up within a minute or two. I think it was at that point that I knew we weren't just dealing with a "gas" problem.
I told my supervisor that I wasn't feeling good and was going to have to go for the day and immediately called my doctor's office. The PA mentioned that sometimes bready products (even low carb products) can sometimes cause a blockage and that warm orange juice can sometimes help break it up. She made an appointment for me that afternoon, but told me to come in earlier if I had any other problems. I immediately warmed up some orange juice, took a few sips and within a minute was having a fairly violent vomiting episode. By then, I was shaking, white as a sheet and in such pain I was doing Lamaze breathing to cope. I texted Erik to come home and get me to the doctor.
We got to the doctor's office where they had me do a barium swallow. Even as sick as I was, I was AMAZED to SEE what my new stomach looked like on this test! Seriously guys, I had no freaking idea it was as small as it is. Just to give you a way to visualize it...my spine looked about the size of a sturdy PVC pipe and my stomach in comparison to that looked like a fuzzy piece of yarn...THAT THIN! Until she pointed it out, I was trying to figure out why the barium looked like it was going through a vein or artery when I knew it was moving through my digestive system. The "vein" was actually my stomach. Now granted, it wasn't full or stretched at all, but it certainly explains why a few bites fills me up...AMAZING.
We could see the barium work through my stomach and then just pool in an area just outside my stomach which made them think that I did have some kind of obstruction. They decided to admit me to the hospital so that they could get some bloodwork done and do a CT scan to see what was really going on.
They discovered that, once again, I was very dehydrated and started pumping me with fluids. I think I probably had about 5 bags of fluid before I even started peeing again (incidentally, I went into the hospital at 347 and came home at 358...I wasn't eating in the hospital so that should tell you how much they were pushing the fluids). The first CT they did showed that I had an area of my small intestine that was "thickened" and the blood supply to that area showed some irritation. They mentioned something about my white count being high and something else being out of whack. They said that what they saw could be caused by several different things ranging from a viral infection to Chron's disease. The only way to really diagnose the problem was to go in surgically, but of course nobody was interested in doing that right off the bat. They elected to keep me there for observation and redo the CT scan in a few days to see if it was resolving on its own.
That night I needed demerol to get any kind of sleep at all as the cramping was fairly constant. I seriously felt like I was in the final stages of labor as the pain had begun to radiate out to include my entire abdomen and back. Lying on my side hurt because any pressure on my abdomen hurt as if I had done a day's worth of situps or let someone use my abdomen for kick boxing practice. The demerol did help though and, apart from the fact that hospitals seem to think the middle of the freaking night is the perfect time to get all the ordered labwork done, I got some sleep.
To make this very long and probably very boring story just a tad shorter...I began to show improvement slowly. I was able to go for longer periods the next day without pain meds and soon, my bowel started talking to the nurses again and the next CT scan showed that whatever was going on in my small intestine seemed to be improving. The doctors are assuming I had some kind of infection in that section of my bowel which was probably complicated by the dehydration and I was discharged Friday evening.
Today is the first day I've felt somewhat like my old self although I'm still pretty gun-shy about eating. The last few days I lived on mashed potatoes and mac and cheese..totally NOT on my diet, but they were the only things that didn't make me want to hurl when I thought about eating. This morning I had a few bites of scrambled egg and chorizo and will probably attempt a protein shake here in a few minutes.
I think I'm probably over this latest hump, but I'd be lying if I didn't admit that it has really depressed me. I'll probably whine a bit more about that in another post though. I'll get over it and I'm sure as I start to feel better, it will subside, but for now....yeah I'm feeling pretty low :(
Incidentally, apart from the dehydration, I don't think this intestinal problem was due to the surgery at all. I probably would have gotten sick regardless of the surgery.