Changing Medications (Level of Trust Required)

[ProfessorTomoe 1,308]

8 hours ago, The Old Hack said:

Give her my regards. So good to hear that you are having fun together, fun is one of the best recovery aids I know. Also thank her for the pictures!

She says thank you! She also has finally come to terms with my "webcomic friends," I believe. I think she treated me like I had imaginary friends when I would talk about forum goings-on prior to all of this, despite my protestations to the contrary. 

[ProfessorTomoe 1,308]

3:40 a.m. CDT 20170522. Up early, taking my first hydrocodone dose of the day a bit early. Woke up with spinal nerve pain shooting into my hip. Figured I'd better head it off at the pass before it got too bad. I'm very quickly coming to the realization that Tuesday, one of the most traumatic and painful days of my entire life, was all for nothing.

I am considering switching spine doctors, unless this one can pull a miracle out of his arse at my follow-up appointment (and his accounts department can explain their way out of why the fark we're staring at a $1,000.00+ potential bill for drug testing, possibly to be followed by an identical twin). Mrs. Prof has a possible lead via a friend's husband who suffered similar symptoms.

Just realized that the "ant bite" I've been scratching at for the last ten minutes is actually one of the failed IV insertion attempt holes from Friday. My veins hate IV needles. I think they can see them coming. They roll out of the way and hide the minute the needle touches the skin. No massive blotches from started failed attempts this time, just a couple of large gauge holes that are bruising and itching. Only took them two tries on Friday. Only took the nurse one try on Tuesday, but that was the kind I really hate—you hear, "Big stick!", and then before you know it you've got a painful needle in your hand. No lidocaine/Xylocaine to numb the pain before and alleviate the pain afterward. And believe me, I can feel those damned IVs inside my veins. I used to get laughed at for saying that, but now they've proved that the inside of blood vessels contain nerves. I think it's been put forward as one possible cause for fibromyalgia (which I do not have, thank the Maker).

Oh, one thing I didn't mention that really put the boot into my emotional state the other day: I got a summons for Jury Duty. Mrs. Prof laughed, then stopped quickly when she realized what she was doing. I'm on "stand-by" status June 13: basically, I've got to call in during a 90-minute period on that day to learn whether or not I'm supposed to show up in downtown Dallas thirty minutes after the end of the period. I'll still be wearing my moon boot, and the jury instructions say absolutely no shorts. Tell me how you're going to get a pair of long pants to cooperate with a steel, foam, and Velcro post-op boot. Can't be done, not with my wardrobe. No, at some point I'm going to have to go to my primary care physician and request a "medical excuse," which I'll have to return via mail.

Easier said than done. Mrs. Prof is very quickly getting tired of missing work to drive me to medical appointments. She wants me to try and schedule any appointment with my PCP for the same day as my podiatrist follow-up. I can't handle all of the intricate telephone ballet work she wants me to do to interleave the appointments on the same day, either mentally or physically. Add to that the little item that the only way I can make sure I get the time right is to get her on the phone with me—otherwise, she huffs, throws her shoulders around, and in an exasperated tone, tells me to "just get an appointment," knowing full well that she'll raise hell at me if I get the time wrong.

Add to this the fact that I've got to add yet another doctor to my list. Fortunately, he's not a new doctor—he's the ENT who operated on my sinuses back in 2015. He's supposed to figure out what's causing my chronic laryngitis and help me track down a cure for my coughing. However, that's just one more doctor's appointment I'll have to attend, and I'll need transportation, thanks to the spinal nerve pain, and thanks to Mr. Controlled Substance 4x a Day. I might have been able to handle this back in 2009, but not after everything that's happened in between then and 2017.

AAUUGGHH. I've gone from the anxiety and depression from the other day to the anxiety and frustration of today. My nerves are wearing thin (pun intended) at a proportional rate to Mrs. Prof's. She's even getting tired of getting drinks for me. I'm capable of getting them, but at less than ¼ of the speed and about 20 times the pain, not to mention the fall risk.

Things are getting dysfunctional. I believe we're going to require a sit-down talk, and even that's going to take up precious time that she'll likely claim she doesn't have. Forget what I said earlier—the depression is still there.

[The Old Hack 2,448]

58 minutes ago, ProfessorTomoe said:

Things are getting dysfunctional. I believe we're going to require a sit-down talk, and even that's going to take up precious time that she'll likely claim she doesn't have. Forget what I said earlier—the depression is still there.

Oh Lord. I really do not blame you for feeling overwhelmed. Is there anything else we can do to help? If nothing else, help with carfare for one of the critical doctor's appointment days might get Mrs. Prof off the hook for driving you.

[ProfessorTomoe 1,308]

14 minutes ago, The Old Hack said:

Oh Lord. I really do not blame you for feeling overwhelmed. Is there anything else we can do to help? If nothing else, help with carfare for one of the critical doctor's appointment days might get Mrs. Prof off the hook for driving you.

Thanks for the offer, but I don't know how much good it would do. We're not in an area where public transportation is easily reached, and services such as taxis, Uber, and Lyft most likely wouldn't come out to our suburb. Garland and Rowlett, Texas are part of a pretty large area of sprawl (read: low profit/high rates before they'll even consider coming out here). We're just going to have to grab Mjolnir and hammer something out between the two of us.

[Pharaoh RutinTutin 1,586]

3 hours ago, ProfessorTomoe said:

she treated me like I had imaginary friends when I would talk about forum goings-on prior to all of this, despite my protestations to the contrary. 

That really hurts.  Some of us ARE imaginary.

[The Old Hack 2,448]

2 hours ago, Pharaoh RutinTutin said:

That really hurts.  Some of us ARE imaginary.

Indeed. My life philosophy is existentialist inverse solipsism. Thus I believe that I am made up but that everything else is real.

[ProfessorTomoe 1,308]

10:53 a.m. CDT 20170522. Mrs. Prof apparently had some time to mull things over, because she came out of the chute this morning willing to work with me on getting appointments scheduled. I've pushed back my cardiologist to July (since I just saw a heart doctor within the last couple of weeks), scheduled an appointment with my PCP in its place on Thursday for blood tests and (hopefully) to get a medical excuse to get out of jury duty. I've also scheduled my referral to the ENT for my coughing/laryngitis for a couple of weeks down the road. These items don't include my foot surgery follow-up appointment this Friday and my lumbar epidural (useless) injection follow-up appointment on June 1st.

Mrs. Prof also got onto the phone and took both Spine Team Texas and the lab to task over the "Non-Participating Provider" letter foreshadowing a $1,000.00+ medical bill. Everyone is swearing up and down that they're "in network" and that there shouldn't be a problem. My anxiety level is still high over this, and her level of belief in the providers is still low.

Been waking up twice as of late: once at about 3:00 a.m., soon after which I take my hydrocodone, and again at around 9:00 a.m., which is the least comfortable of the two (and is also followed by hydrocodone plus my "drug cocktail"). Lots of groaning and moaning from pain with the second wake-up due to right side spine/hip/leg/foot pain. I'm keeping my left foot elevated until the follow-up with the podiatrist Friday. It's not making things easy on me between the hours of 4am and 9am.

[mlooney 3,417]

Just got hit, so to speak, with a behavior side effect of Adderall.

Around noon, A Thought popped into my skull.  "What do I have to do to install Linux on a ChromeOS laptop.

About an hour ago I had finished that whole thing.  And to be freaking honest here, I'm not 100% sure why I did that.  At least I didn't brick it.  In doing so, I found out how to root a ChromeOS box, so I may just go ahead and return it, if possible, to Chrome but rooted.

[ProfessorTomoe 1,308]

16 minutes ago, mlooney said:

About an hour ago I had finished that whole thing.  And to be freaking honest here, I'm not 100% sure why I did that.  At least I didn't brick it.  In doing so, I found out how to root a ChromeOS box, so I may just go ahead and return it, if possible, to Chrome but rooted.

Wow. Must be a "learn something new every day" drug.

I'm going to probably be reaching toward your level of Abilify dosage, although not coming close to it, after my Thursday appointment with my PCP. Mr. Depression has decided to pay me a visit again after all of the hell of the past week, and he's hanging around this time. My PCP is the one controlling my Abilify dose, not my psychiatrist (they've worked it out between them).

[mlooney 3,417]

Well, yeah I got learned today.  And the Chromebook is back to being chrome, but rooted.  Rooting a Chromebox is scary easy, but doing so WILL nuke all your existent files.

Of course a ChromeOS machine doesn't really have that much local storage, so there is that.

[ProfessorTomoe 1,308]

I just finished trying to take my first stand-up shower since my foot surgery last week.

I wasn't ready. Dear Lord, I wasn't ready. That frigging HURT.

The boot goes back on until my podiatrist says I can take it off.

[The Old Hack 2,448]

6 hours ago, ProfessorTomoe said:

I just finished trying to take my first stand-up shower since my foot surgery last week.

I wasn't ready. Dear Lord, I wasn't ready. That frigging HURT.

The boot goes back on until my podiatrist says I can take it off.

Ouch. I am sorry to hear. I hope you feel better soon.

[ProfessorTomoe 1,308]

I got the post-op Three-View X-ray report on my broken toe. There's a lot of medicalese in it, but if you're interested in stuff like that, here it is:

Quote

Impression
IMPRESSION: To percutaneous orthopedic pins involving the neck of the first proximal phalanx.
The bones appear severely diffusely demineralized.
There are thought to be remote fracture deformities involving the distal tibia and distal fibula.
Questionable increased sclerosis of the talus with possible minimal flattening of portions of the talar articular surface. Cannot exclude the possibility of underlying changes of avascular necrosis.
Multifocal osteoarthritic changes.
Transverse lucency involving the proximal shaft of the fifth metatarsal which is concerning for nondisplaced fracture, possibly insufficiency/stress related.
Moderate corticated plantar fascial spur.

Narrative
PROCEDURE: FOOT 3 VIEWS LT
INDICATION: Post Op.
COMPARISON: None available
TECHNIQUE: Frontal, oblique, and lateral radiographs of the left foot.
FINDINGS: There are two percutaneous orthopedic pins involving the neck of the first proximal phalanx. Evaluatiion of the phalanges is limited by bony, soft tissue, and hardware overlap. There is bandaging material diffusely.
The bones appear severely diffusely demineralized.
There is a fracture deformity of the distal fibula which is thought to be remote.
Osteoarthritic changes at the tarsometatarsal joints ranging from moderate to severe.
Moderate osteoarthritic changes at the interphalangeal joints. Mild degenerative changes at the first and second metatarsophalangeal joints.
Transverse lucency involving the proximal shaft of the fifth metatarsal.
There are degenerative changes at the tibiotalar joint which are not well evaluated.
There is a moderate corticated plantar fascial spur.
There is irregularity of the posterior cortex of the distal tibia, with appearance most suggestive of remote fracture.
There is some questionable increased sclerosis of the talus with possible minimal flattening of portions of the talar articular surface.
Achilles insertional enthesophyte.

Read if you wish. I don't know exactly what it says, but terms like "avascular necrosis" make me wonder if I've got something else going on that might explain my Chronic Pain Syndrome.

[Yzjdriel 22]

4 minutes ago, ProfessorTomoe said:

I got the post-op Three-View X-ray report on my broken toe. There's a lot of medicalese in it, but if you're interested in stuff like that, here it is:

Read if you wish. I don't know exactly what it says, but terms like "avascular necrosis" make me wonder if I've got something else going on that might explain my Chronic Pain Syndrome.

Owch.  Taking that as far toward layman's terms as possible, it lit up like a Christmas Tree.

 

I would agree that the AVN is contributing to your CPS.  Lack of bloodflow to your bones (which are living tissue, after all, and thus require blood and oxygen) can cause them to become weak: prolonged restriction of bloodflow will cause the bones to die.  You will usually feel pain when you place any kind of pressure on the affected joint in the early stages of AVN.  In extreme cases, a surgical procedure may be required.

[ProfessorTomoe 1,308]

40 minutes ago, Yzjdriel said:

Owch.  Taking that as far toward layman's terms as possible, it lit up like a Christmas Tree.

Of course, now that I mentioned the test results to Mrs. Prof, she has gone into full-bore argument mode, wondering why none of my other exams (including a CT-scan) have caught any of this. She has a nasty habit of doing an "anti-freak-out," as it were, acting as though I'm turning into a hypochondriac or something (I've never figured her out on that). Raised voices ensued. I think I've finally got things stopped down, but good grief—I didn't need one of these sessions at this hour of the morning (7:53 a.m. CDT 20170525).

Speaking of things I didn't need, I hope I didn't need to stop drinking water after midnight for my blood tests today. The only non-water thing I've taken has been my hydrocodone, and there's no way in HELL I'm going without that again. Once last week was enough, thankyouverymuch.

[Yzjdriel 22]

1 hour ago, ProfessorTomoe said:

Of course, now that I mentioned the test results to Mrs. Prof, she has gone into full-bore argument mode, wondering why none of my other exams (including a CT-scan) have caught any of this. She has a nasty habit of doing an "anti-freak-out," as it were, acting as though I'm turning into a hypochondriac or something (I've never figured her out on that). Raised voices ensued. I think I've finally got things stopped down, but good grief—I didn't need one of these sessions at this hour of the morning (7:53 a.m. CDT 20170525).

Speaking of things I didn't need, I hope I didn't need to stop drinking water after midnight for my blood tests today. The only non-water thing I've taken has been my hydrocodone, and there's no way in HELL I'm going without that again. Once last week was enough, thankyouverymuch.

Even excessive amounts of water intake shouldn't have any effect on your blood so long as you make use of the lavatory before getting your blood drawn, so you should be alright in that regard.

[ProfessorTomoe 1,308]

12:35 p.m. CDT 20170525. Mrs. Prof changed her tune after the appointment with my primary care physician. He had apparently read a report from the podiatrist or the hospital, one or the other. In either case, he said what he'd thought were numerous fractures were actually signs of something called Charcot foot, where the bone demineralizes due to a "loss of good capillary flow" to said bone. It would explain the ease of my fracture, the avascular necrosis, and many other problems with my left foot as listed in the report I posted. Very nasty sounding, and not much I can do about it at the moment. It's going to be brought up with my podiatrist at tomorrow's appointment.

In addition, he doubled my Abilify dose to 10 mg and wrote a note to get me out of Jury Duty. I'm e-mailing the Jury Duty note shortly.

[Yzjdriel 22]

25 minutes ago, ProfessorTomoe said:

12:35 p.m. CDT 20170525. Mrs. Prof changed her tune after the appointment with my primary care physician. He had apparently read a report from the podiatrist or the hospital, one or the other. In either case, he said what he'd thought were numerous fractures were actually signs of something called Charcot foot, where the bone demineralizes due to a "loss of good capillary flow" to said bone. It would explain the ease of my fracture, the avascular necrosis, and many other problems with my left foot as listed in the report I posted. Very nasty sounding, and not much I can do about it at the moment. It's going to be brought up with my podiatrist at tomorrow's appointment.

In addition, he doubled my Abilify dose to 10 mg and wrote a note to get me out of Jury Duty. I'm e-mailing the Jury Duty note shortly.

Well at least something good came of this.

[mlooney 3,417]

17 hours ago, ProfessorTomoe said:

I wasn't ready. Dear Lord, I wasn't ready. That frigging HURT.

The boot goes back on until my podiatrist says I can take it off.

 

I don't want to be "that guy", but yeah, leave it on until he says you can take it off.  And maybe a few days past that.

And, if by some wild chance you end up giving yourself a stress fracture in the last week of Basic Training, the final 2-mile run is going to freaking hurt.  Make sure you senior drill sergeant and the battery medic know about the fracture.  Hopefully, the ambulance will be parked at the end of the track.  If I didn't pass that test, I would have been held back in Basic, which means I would have missed my AIT opening slot, and the one after that was 11 months to go.  If you think I wanted to be a D/s flunky and dog robber for almost a year, you must be crazier than I am.

[ProfessorTomoe 1,308]

1 hour ago, mlooney said:

I don't want to be "that guy", but yeah, leave it on until he says you can take it off.  And maybe a few days past that.

And, if by some wild chance you end up giving yourself a stress fracture in the last week of Basic Training, the final 2-mile run is going to freaking hurt.  Make sure you senior drill sergeant and the battery medic know about the fracture.  Hopefully, the ambulance will be parked at the end of the track.  If I didn't pass that test, I would have been held back in Basic, which means I would have missed my AIT opening slot, and the one after that was 11 months to go.  If you think I wanted to be a D/s flunky and dog robber for almost a year, you must be crazier than I am.

I think this reply deserves a hearty "No [Redacted] Sherlock" in response. I will take your advice to heart ... and to foot.

4:56 p.m. CDT 20170525. Of course, once a doctor tells both Mrs. Prof and me about something I may be headed toward (i.e., Charcot foot), that's pretty much a green light for me to get all research-y like.

I don't like what I'm finding.

A lot of my research into the probelm mentions diabetic neuropathy as a cause. However, I could swear that all of my neuropathy tests have been negative. My A1C numbers have been around 6.1 for the last couple of years. Now, last week was an exception—they took my fasting glucose in the hospital, but I was so damned stressed out that it ventured into the mid-130 range, but that's still lower than Mrs. Prof's.

I had my blood and urine tested again today to see if my metformin dose needs to be adjusted and/or if I need to start doing daily testing (I haven't for years).

Something my doctor told me that I haven't found in the research yet: movement helps get rid of Charcot foot. I'm giving him the benefit of the doubt on this. Only problem is that I'm dealing with Chronic Pain Syndrome with a great deal of it coming from my left ankle, left over from the 2009 dual broken ankle disaster. His comment was that the two are probably intertwined, and that he admitted it's going to be hell trying to get me moving when every step hurts in the best of circumstances.

Mrs. Prof (who is taking a nap in the bedroom and just made the rudest of noises) made a suggestion on the way home from the doctor's office—get me into aquatic therapy. Again. God, I hate indoor therapy pools. They're either in cavernous, chlorine-atmosphered echo chambers or in small, noisy, overbooked steam rooms. Both are usually accompanied by freezing cold dressing rooms, with the small ones at least offering one the dignity of being able to lock the changing room door.

(Don't even think about mentioning outdoor therapy pools. Read on.)

What neither offer is the basic human dignity of not wanting to be seen in a bathing suit, with or without a T-shirt. I am no Charles Atlas. I am more like a World Atlas. Okay, that's an exaggeration, but I'm flabby and weigh around 335 as of today (I'm estimating that by subtracting my approximate steel boot weight from what the scale showed). I don't like to be partially undressed in public anymore. Pool or no pool, indoor or outdoor, whatever the reason. I don't like it.

Somehow, I've got to get this across to Mrs. Prof in a way that won't engender a "So?" response from her. I couldn't figure that problem out when she brought up the subject in the Ridgeline on the way home, so I had to end the discussion with a clumsy "Not now." (N.B.: we've been on different wavelengths all day today.) I think I'm going to have to wait until tomorrow after the podiatrist appointment, see if we're communicating better, and try dropping it on her then.

Oh, backtracking for a second: remember when I said that my doctor agreed to increase my Abilify from 5 mg to 10 mg? He did it almost happily, without hesitation. He said he could tell that my depression levels are way up compared to my baseline. Something needed to be done, and he was glad to do it.

And guess why I'm so depressed lately? (That's a rhetorical question.)

P.S.: I almost typed "derpressed" in the above line. Yeah, that's close, but I don't think it's a valid psychiatric diagnosis. Derpression. Maybe it oughta be.

[Don Edwards 548]

10 hours ago, ProfessorTomoe said:

I got the post-op Three-View X-ray report on my broken toe. There's a lot of medicalese in it, but if you're interested in stuff like that, here it is:

Read if you wish. I don't know exactly what it says, but terms like "avascular necrosis" make me wonder if I've got something else going on that might explain my Chronic Pain Syndrome.

I read it. There's one thing that really struck me about it, that I absolutely HATE to see in a medical report (or lots of other professional contexts):

..appear...

...thought to be...

...questionable... possible...

 

[ProfessorTomoe 1,308]

2 minutes ago, Don Edwards said:

I read it. There's one thing that really struck me about it, that I absolutely HATE to see in a medical report (or lots of other professional contexts):

Ambiguity is all they have to work with in most cases until someone starts cutting and digging around, I guess. My PCP took a lot of that ambiguity away with the Charcot foot warning this morning. We'll see if the podiatrist stays the course tomorrow afternoon.

[ProfessorTomoe 1,308]

4:22 a.m. CDT 20170526. One thing that I can tell you that is NOT ambiguous at the moment is the fractured sesamoid bone in the ball of my left foot. It genuinely hurts at the moment. I think I got the timing off on my hydrocodone last night, because I woke up at 3 am and the sesamoid bone was yelling for attention. I held out as long as I could, then finally took my pain pill at about three-fifty-something.

Woke up dehydrated as hell. Have already gone through most of a 32 oz. mug of Crystal Light tea with lemon. Going to have to get another soon.

Ye olde right spinal nerve issue gave me hell while trying to get restful sleep overnight. I kept moving around to find a non-painful position. Finally said, "[Redacted] it" and got up. (That's about when my sesamoid bone started hurting anyway.) This might have something to do with the fact that I didn't have my morning "drug cocktail" yesterday due to fasting for my blood tests. I haven't had any Topamax in almost 48 hours, which might be the cause. Heh. And here I was, under the impression that the Topamax wasn't doing anything for me other than helping me lose weight. I could be mistaken. (Granted, Topamax alone does not alleviate my spinal nerve pain—it must be the combination of hydrocodone and Topamax that's doing the most good.)

Today is podiatrist day. I hope he won't make us wait as long as he did at the last appointment, which was a ridiculously long time. It set off Mrs. Prof's grouch response.

Looking at the dynamic between Mrs. Prof and myself for a moment: we're basically at each other's mercy. I'm totally dependent upon her to get me to doctor's appointments, surgeries, and other medical destinations. Her patience is wearing thin, I think in part because she can't see what's causing my right leg issue. At the same time, I'm frustrated with setting up new appointments, since she turns on the "heavy sigh of frustration" machine when I have to consult her for appropriate dates (she has to take off work, and she's already used almost half of her available Family and Medical Leave (FMLA) time already with the year not half over.

Don't get me wrong here. The gifts you guys sent from our Amazon Wish Lists went a long way to alleviate our tension and depression, especially for Mrs. Prof. She can't wait to look through the trail camera files each night and see what she's captured (BTW, she posts a lot more on her Facebook account—I cherry-pick from those to avoid overflowing the forum). It's just the amount of time that this has gone on ... sigh. All the way back to the beginning of February, with no signs of improvement and no end in sight. Hell, even when I nearly died back in 2009, we were able to see a light at the end of the tunnel, and I was able to provide my own transportation six weeks after I got out of the hospital. Things are moving in the exact opposite direction now.

I meant for this to be a simple update, talking about being thirsty and in a bit of pain. That plan went sure sideways rather quickly. Sigh, again. And again.

[The Old Hack 2,448]

44 minutes ago, ProfessorTomoe said:

I meant for this to be a simple update, talking about being thirsty and in a bit of pain. That plan went sure sideways rather quickly. Sigh, again. And again.

Prof, don't be so worried about it. This is the venting thread, remember. We're here to offer what support we can, and if it helps, it pleases me no end that our small gestures of support have taken at least a little of the strain off of you and Mrs. Prof. Keep writing here when you need to and we will offer support as we are best able. I think I speak for the entire community when I say you are well beloved here and that your contributions are a not insignificant part of what makes this a good place to be.

[ProfessorTomoe 1,308]

16 minutes ago, The Old Hack said:

Prof, don't be so worried about it.

'Tis in my nature to worry. Part of the basic equipment package.

18 minutes ago, The Old Hack said:

I think I speak for the entire community when I say you are well beloved here and that your contributions are a not insignificant part of what makes this a good place to be.

Much obliged, as always. I just wish I had more positive updates to provide, that's all. The root of my problem, exposed.