Friday, May 9, 2014

Various Appts, not much else.

This week has brought a few more appts (imagine that, right!?) with normal Pain Mngmt f/up (required by federal or state prescribing laws for opioid med prescriptions) and 3 mo f/up with Physical Med Rehab dr (Caldera) for botox injections which are done in the neck, across shoulders and upper spine + some of thoracic (mid-spine) region to calm muscle spasticity. PT as well but that is close to home, the same city as my parents live and not to far from where I live.

Pain Mngmt wasn't really anything new, if anything we talked more about what's going on with other aspects of my care (how the shunts have been, cardiac issues especially) and she asked about what I've been working on/if I am working on anything big for GS or other things I am involved in. (Sun School ends in 2 wks, 3 of us Teachers have been meeting to put together and finish our final group project activity as well as the craft (making kites for all the kids, 'soaring with God') for all grade level kids.) Anyways she is involved with one of the Pain Academies and always talks about different things she/they are working on around Pain prescribing/awareness and bringing attention to Chronic pain issues (specifically in recent years how pain mngmt has been vilified).
Someone she is working with is apparently interested in working with patients at some point down the road and so she I guess wanted to give a heads up. I obviously have plenty to do either way but if need be would help where needed if I could to help as lack of awareness around what medications can do for chronic pain pts is a huge issue.

Dr.Caldera, my PMR doc is pregnant which I knew last time, (her 4th kid) so will be out come July for 3 months (i'll see one of her partners, a dr actually who worked w/my Neurosurgeon after my 2nd shunt was placed for the next set of injections) but talked about a group she has been wanting to start for some time and is hoping to get off the ground in Fall once she is back. This would be focused for her Adult pts who have Congenital disorders so this includes disorders like MPS (something your born with), CP, SB, and other congenital disorders that affect the muscles and which pts age out of Pediatric services.
Some pts like myself do still have some Pediatric specialists who also treat adult pts and some Specialists who are duelly trained in Adult and Pediatric specialties (so joint Internal Med. and Pediatric Residencies or like Neurosurgery where they do a fellowship after training is complete in Peds Neurosurg. But other pts due probably to the type of specialists they see do not access to Pediatric Specialists once they age out (I guess).
In any case the idea she had was patients would be able to exchange information, specialists, resources and just generally stories + help each other which seems like a good idea. =)

Headaches have been somewhat ok, last weeks adjustment helped a little more, and really a little more is better than nothing more. Do I wish it was as good as some of the times or for instance like w the external drains? ABSOLUTELY! But I guess this is better than nothing? I'll take what I can get at the moment and only hope something improves or at the very least nights and mornings get better.. I can hope!
I am supposed to schedule a f/up with Dr.Bragg so will do that in a couple wks if I con't to feel at minimum this 'ok'. Ugh, I am tired of asking her for help, tired of the stupid shunts and tired, tired, tired of the headaches and thus related symptoms so I just hope things will stay the way they are and I don't have to call/see her sooner!?!? - It's not that I don't like her (I do) just that I don't know that she knows how to help right now and I feel at a loss b/c I know these headaches suck and I know it's the exact same symptoms at a different degree than other times (always been variable at different times) and I honestly just feel whiny, not that she makes me feel this way but seriously how do you just keep asking for help, over and over and over again for the same issue?

Last but not least (sorry if these updates are kind of boring, I am not much for regaling people with stories, I basically only blog for the purpose of updating about the goings on w/the medical stuff) the new cardiac med, Digoxin atleast doesn't seem to have side effects and though it hasn't slowed heart rate down (the real goal) it seems from what I've read it can take a few wks for it really to kick in fully?
I have to re-test INR again Monday while at ERT and give Cardiology a heads up when my Infusion Nurse takes the lab over so when the NP/Nurse calls I guess will let them know if HR is still as high as it seems to be now. It is definitely annoying (feels a little like a constant butterfly fluttering in your chest!?! SOB is a slight bit better but that to, it's not like it's really noticeable to anyone else b/c it's not as if it is the 'SOB with activity' but instead is just the random and worse at night SOB that makes it hard to get enough air or deep enough breath I guess-hard to explain that one. Same as was before the AVR.

On an un-related to med. stuff note, for Sun School and Mother's Day this wknd I bought some wooden bird houses and bird seed + am having the girls paint and/or decorate these houses + write a little note to their Mom's and we'll attach to the bird house (there's a rope at the top) a little saying 'Spreading the seeds of God's word'.
Hopefully the girls like the idea, seems a little different than the more average/more often flowers or having them make a card and has an applicable Christian theme... Our story also happens to be 'The workers in the Vineyard', so while not directly related it does go along with one of Jesus other parables. I really try to find crafts that have wider, real life application as a reminder that God's hand is in life all around us. I always hope this is effective, who knows?
Thanks for stopping by,
Erica

Thursday, May 1, 2014

It is what it is... but what is it? Who knows..

I guess this is a bit of a continuation from Monday's Cardiology (and overall) update.
I really wasn't sure if I should have the VP Shunt adjusted and hemmed and hawed about it earlier in the week even though I did think it could help. In the end I did opt to make an Appt with one of Dr.Bragg's NP's today and have that shunt adjusted by a small amount.

Meanwhile last night I had posted on my fb about how uncomfortable the area around the seeming TPL Shunt draining end had been and especially how much worse it was last night (but I also was fairly certain it would improve as it has done this 'get worse, get better, get worse' over a few wks now with last night by far being the worst symptoms wise though). Anyways, apparently Dr.Bragg saw this post as she was walking through the waiting room while I was waiting earlier today and stopped briefly to say she saw the post, would mention the symptoms to the NP's and she wondered was it cardiac related (I don't know)? I just said to her I was sorry it always seems like one thing or another and I hate that I seem to need to ask for their advice or help so often. As she usually is she was gracious but non-the-less I never feel great when new issues crop up and feel quite frustrated by these symptoms. =/
Sue, the NP turned the VP Shunt down by 1 setting (both shunts are at '40' now and opted to do a repeat CXR since we weren't sure what came of the Cardiology one (see further down). As seems to most often be the case, b/c why would my body ever want to give a clear cut answer (!!!!) the CXR looked fine, ie no CSF collection in the lung space, the shunt tubing is not out of place and overall seemed about the same as previous, after surgery per Sue and Radiology's report.
Although I hate being emotional I did break down in tears b/c although I don't really want there to be something big wrong I also just wish there was an answer as this clearly isn't getting better and I am frustrated at my body, especially lately. Couldn't I just have some time where there was just nothing going on and the MPS stayed at bay, ie things where calm?!? =/
Sue I think felt pretty bad and I do think she believed me, which atleast helps. I just think (and cant blame them) they don't know what to do. Dr.Bragg didn't want to adjust the TPL Shunt to drain less (Sue thought maybe this would help the discomfort) as she didn't want to do 2 different things at once, which I do really understand. Sue also asked if I thought I should be admitted so they could try adjusting the shunt over a period of days (I guess) which I didn't want to do as I feel like sure we could try that but overall otherwise I would just be sitting there and I can feel bad at home as easily as I can feel bad in-pt.. Here I can atleast do things when I feel somewhat better + hopefully the minor shunt adjustment will make a small adjustment in the headaches if not in the breathing/pleural area? We agreed if symptoms don't improve by next week i'll call and let them know, and if need be come back again (next wk is really busy with other appts and meetings) which doesn't sound great either as I've already been there 3 wks in a row.
I guess I also just hope it improves between now and then by some slim chance as I truly just don't want to keep having to ask Dr.Bragg for help?

Cardiology INR
Cardiology (Nancy, NP) called with the INR results as even though these where done on Monday morning and I saw them Monday afternoon after ERT I forgot to ask about the result and Dr.Earing vaguely discussed the results as a part of the overall other few labs he had requested separately. I hadn't realized Dr.E was including the INR result when he went over the other lab results and to didn't know when to re-test (I hadn't thought to ask till later as there is often a lot to remember as is already!)
In any case the INR was slightly low at 1.9, whereas my range is 2.0-3.0 but per Nancy who called today with the results and next testing request said that Dr.Earing was ok keeping the Coumadin dose the same and re-test in 2 wks (from last mon). I am glad atleast the dose wasn't tweaked!
She also commented how she had been updated about the cardiac symptoms and the seeming Neurosurg. issues and to please keep them updated either via email or via their ACHD Nurse line + also give a heads up when I retest in 1 1/2 wks.
They don't feel the discomfort with breathing is cardiac related as both Dr.Earing and Nancy both separately stated to the affect of "it would be unusual this far out from OHS for a patient to have lung issues/fluid collection related to heart issues" + the Chest Xray's both their's and now the one done at Dr.Bragg's where clear for fluid build up.
Non-the-less they would like to be kept updated to what becomes of these symptoms.

To put it mildly I feel incredibly frustrated today which seems to be the story of my life related to the MPS these days and just wish once lately there could be a clear cut, relatively straight fwd answer?!? I do kind of wish Cardiology and Neurosurgery would talk to each other though I also get it's not as if I am either of their only pt and both are extremely busy.
I just wonder though if it wouldn't help for one to exchange thoughts with the other? I don't really know..
Stay tuned, Thanks for stopping by,
Erica