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ProfessorTomoe

Changing Medications (Level of Trust Required)

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Prof, variations in your blood sugar could be the cause, or part of the cause, of your sine waves.

(But then, there are some serious oddities in my experience with medical conditions. My wife is one of those weird people who can tell when her blood pressure is up a bit for no apparent reason. And she had to stop taking one medication that lowers blood pressure, because it raised her blood pressure.)

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2 hours ago, mlooney said:

Just in case you were wondering a nominal sine wave that has varied high and low points is called "Amplutude Modulation."  Yeah, as in AM radio.

Right, right. I remember that much. "DC Offset" was what I was looking for, in recording terms. I've been offset so that the mean of my signal is centered around a negative Y value.

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1 hour ago, Don Edwards said:

Prof, variations in your blood sugar could be the cause, or part of the cause, of your sine waves.

(But then, there are some serious oddities in my experience with medical conditions. My wife is one of those weird people who can tell when her blood pressure is up a bit for no apparent reason. And she had to stop taking one medication that lowers blood pressure, because it raised her blood pressure.)

I wondered about my blood sugar as well. I haven't been able to time out the highs and lows to match what I've eaten. If my sine waves flatten back out after my metformin supply is replenished, then that'll answer the sine wave question.

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Damn it damn it damn it damn it damn it et cetera ad nauseam.

I absolutely HATE IT when doctors start changing scheduled appointments. I know they're human, and I know that they get enough patients who change appointments on them. But when I have a nurse call me and tell me that "something's come up," and under her breath she lets slip that it's a stinking CONFERENCE, I have no tolerance for that. Conferences don't just pop up, damn it!

I've got three doctor's appointments, one lab-only appointment, and one house call tomorrow (!), and all of them were carefully scheduled around Mrs. Prof's available times. Now, I have two of the doctor's appointments on the same day, meaning one of them is going to have to go somewhere else, and I'm going to have to deliver the bad news to Mrs. Prof after she's dealt with a day of Jury Duty which, as the hours grow later and later, does not seem like it's going her way. She is most likely not going to be a happy camper when I tell her that we need to find yet another open time slot.

And you wanna guess which doctor it was whose nurse called and made the change? Yep—the doctor from Spine Team Texas! Oh, how I've grown to detest them lately. They offered to let me keep my same time, but instead of seeing the doctor, I'd be seeing a physician's assistant. NOPE. I want to look that doctor straight in the eyeballs and give him EVERY SINGLE MINUTE of the 14 hours plus worth of agony I went through in order to get an injection that did me absolutely no good whatsoever. If I could borrow Eric Draven's empathic power from "The Crow," I'd give him those hours. I don't need them anymore.

Damned rescheduling. Damned last-minute CONFERENCE rescheduling. He's really going to have to convince me to keep from changing doctors.

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2:38 p.m. CDT 20170530. Just realized that I didn't put a time on the above rant. Probably a good thing, because it might have upset the time vortex if I had.

I got an e-mail from my primary care physician through the patient portal system a short while ago, prior to the incident which spawned the rant. It has to do with my left foot fracture. To wit:
 

Quote

From: The Office of [Redacted], MD
To: [Me]
Date: 05/30/2017 11:27 am
Subject: Re: Fwd: Message from patient using FollowMyHealth.com.
Hello [Me]:
Remember, you don't have Charcot foot yet. It is a complication of diabetes that will often show up first with frequent fractures of the foot and decreased bone mineralization. It is something we are working to prevent.

I'm impressed he [the foot doctor–ed.] came to your home to take out the stitches!

The infection also explains the elevated white blood cell count.

Dr. [Redacted]

My doctor apparently misunderstood the timeline concerning the house call, as you can see. It's scheduled for tomorrow (Wednesday, May 31st 2017).

I also wonder if the infection explains the myelocites. Either way, I've got a lab-only appointment set for June 8th to get re-checked.

Man, this is complicated. Too many doctors, as usual, and too many lab tests to go with them.

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Oh, hallelujah! Mrs. Prof didn't get selected for Jury Duty. She just checked in via phone. The relief was evident in her voice.

She's picked up my prescriptions and shower what-nots from CVS and is taking some "me time" to get her nails done. Can't say I blame her.

I needed some good news today. Glad to finally get it.

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On 5/20/2017 at 11:10 PM, ProfessorTomoe said:

Not to bypass your kind words, tOH (which are very much appreciated), but we received more cat toys today, presumably via the Amazon Wish List. Mrs. Prof wanted me to say a big "Thank You!," and tell you all that our cat says, "Meow!"

Glad to hear they liked them!  Give kitty a snuggle from me!

On 5/21/2017 at 0:11 PM, ProfessorTomoe said:

More CDs arrived from Amazon! More rare tracks. Thank you!!!

At least one or two of those were me, too.  Anything we can do to make this easier on you, short of quitting our jobs and moving there to be your full-time chauffeur and nursemaid, let us know!

13 hours ago, The Old Hack said:

We can only hope that things will improve from here on. :/ At least your orthopodist is kind enough to give you that house call. Getting the stitches out will be good and he will be able to tell if the injury is behaving (i. e., healing) properly.

We've very occasionally done a house call, but in our case the limiting factor is often the fact that we have to have a tech along to hold the cat or dog for stuff like blood draws or injections.  Not to mention pets hiding under beds or in junk-filled basements.  At least your podiatrist can be reasonably sure you won't try to bite him as he's dragging you out of a closet....

Tell him all your imaginary friends online thank him for the house call!  My dad's PCP did a couple of those, too, and I know my current PCP has been known to do them -- it's a rare breed now, but they're not extinct in the wild yet!

Hmm, maybe you should offer him some of that ale you can't drink yourself, as a thank-you?  ;-)

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I'm not sure if my cough is just allergies or if I've got some sort of sinus infection and/or walking pneumonia developing.  I had a little bit of a cough before going to Orlando, and hoped it was allergies to something local that would clear up in a different climate.  It seemed to be not so bad the first several days, not going away but possibly lessening a bit.  Then I switched from the practically-brand-new Sapphire Falls Universal resort to Disney's Pop Century.  This place is old enough that they're in the process of remodeling buildings eight and nine, which form a sort of triangle with building seven.  Guess which building they put me in.  Yup, the old but not yet remodeled one right next to the construction.

I'm beginning to wonder if the old building has a mold problem, because that's the one thing that had a definite reaction on my allergy tests, and my cough seemed to be worse in the morning, after sleeping in that room all night, than it was during the day, out and about in the pollen and whatever else.  If I'd notice the pattern earlier, maybe I could have asked for a different room, but it being Memorial Day weekend, I'm not sure they'd have had one to give me.

Today my sinuses ache and my cough seems to still be worse.  I've been taking an antihistamine and pseudoephedrine, and have now added a honey cough drop.

Maybe it's just a cold?  I wouldn't mind a cold, they at least go away after a week or two!

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9:02 a.m. CDT 20170531. A new problem has arisen, almost literally. I am developing edema (fluid swelling) in my right foot—the one without the broken toe, but with the broken ankle hardware still in place. It's also the one that developed the long, purple bruise down the front of my shin after the spinal steroid injection. That bruise got somewhat worse a few days later after the podiatrist fixed my broken toe. However, I've just now noticed the edema in the foot. It's swollen to the point where it leaves a depression when you press on it.

I'm leaving a sock off of it so the podiatrist can get a good look at it when he comes out to remove my left toe stitches today.

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39 minutes ago, ProfessorTomoe said:

9:02 a.m. CDT 20170531. A new problem has arisen, almost literally. I am developing edema (fluid swelling) in my right foot—the one without the broken toe, but with the broken ankle hardware still in place. It's also the one that developed the long, purple bruise down the front of my shin after the spinal steroid injection. That bruise got somewhat worse a few days later after the podiatrist fixed my broken toe. However, I've just now noticed the edema in the foot. It's swollen to the point where it leaves a depression when you press on it.

I'm leaving a sock off of it so the podiatrist can get a good look at it when he comes out to remove my left toe stitches today.

*nod* Let us hope it is easily treatable. I am glad that the podiatrist is coming this very day. He sounds competent, he should know what to do.

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36 minutes ago, The Old Hack said:

*nod* Let us hope it is easily treatable. I am glad that the podiatrist is coming this very day. He sounds competent, he should know what to do.

10:45 a.m. CDT 20170531. The podiatrist has finished his appointed task and has left, although I think he put my boot back on a bit too tight around the toe. My stitches are out, my foot is re-bandaged, and according to him the Augmentin is doing its job wonderfully in getting rid of the infection in my toe. It's also doing its job wonderfully in giving me the runs, which I had in abundance last night (urrrrrgh). Otherwise, I'm doing fine and I'm supposed to see him again around June 8th or 9th.

I still don't know when the pins are coming out, but he said I most likely wouldn't need even a local anesthetic when he removes them.

I showed him the letter from my primary care physician about the Charcot foot "warning," and he concurred. Thought it was a good idea to be careful.

I also showed him the edema in my right foot. His advice was to elevate it and "pump" it, like you'd work the gas pedal of your car. Said that'd help get the fluid back where it belongs.

In other news: somehow, the conversation moved to computers (he worked on my foot in my living room, where my laptop sits), and he admitted he was concerned that he might have been vulnerable to the WannaCry ransomware since he's still running Windows 7. I told him that Windows 10 was a bit different, but then I introduced him to my favorite little utility: Stardock Software's Start10, which takes the (IMHO) clunky Windows 10 menu and lets you flip back and forth between it and the more familiar Win7 interface with a click of a button. Costs $4.99 USD, and I couldn't use Win10 without it. /* end shameless plug */

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11:28 p.m. CDT 20170531. I'm going to post a couple of pictures. They're not gruesome, but they're not pretty by any means. They're of my bruising and swelling on my right foot and leg.

If you'll recall, the podiatrist told me to "pump" my foot to get rid of the edema/swelling. One problem with that: it aggravates the nerve pain that runs from my spine down my hip and leg into my foot. It's also the reason why I can't drive at all. In other words, it's not going to work.

I can't figure out how to use the spoiler feature with pictures, so be warned. No gore, just eww. tOH, if you can edit this to use spoilers (and if you feel they're necessary), please feel free.

Here we go, starting with my inner ankle of my right foot:

large.foot20170531_01b.jpg

The scar is where my hardware was inserted when I broke my foot. I've got screws implanted beneath. On a normal day, there's no bruising and no swelling. The bruises developed after my lumbar caudal epidural steroid injection, and the swelling developed over the past 24 hours or so.

Picture number two is of my right leg:

large.foot20170531_02b.jpg

You can see the bruising along the shin. Again, that developed after the lumbar injection. It got a bit more pronounced after the left big toe surgery, where they put air compression leggings on me before going into surgery. I think. (I was a bit groggy.) Again, you can see my hardware scar on the inside of my ankle. What isn't as evident is the edema in my foot. That's because my foot is tilted to capture all of the bruising.

There are no pictures of my left foot. It's in a boot, which is rather boring,. ;)

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8 minutes ago, ProfessorTomoe said:

If you'll recall, the podiatrist told me to "pump" my foot to get rid of the edema/swelling. One problem with that: it aggravates the nerve pain that runs from my spine down my hip and leg into my foot. It's also the reason why I can't drive at all. In other words, it's not going to work.

At least try to keep it elevated. It may not be the same, but at the very least it should help or slow the swelling down.

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59 minutes ago, The Old Hack said:

At least try to keep it elevated. It may not be the same, but at the very least it should help or slow the swelling down.

Elevating is a bit painful, for the same reason. It's not as painful, but it's still uncomfortable. I'm going to have to figure out a new pillow configuration for sleeping.

Hoo! It's getting late. I'm starting to see double. I could use a cup of covfefe.

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My sister banged up her knee a couple of weeks before out trip, and the bruises migrated downwards from there all the way to her ankle by the time she headed back home.  N=1 but maybe a sign your bruises taking a similar path isn't all that unusual, FWIW.

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10:48 p.m. CDT 20170601. The month of May sucked so bad. June isn't starting off much better. I've been feeling off my feed all day, even when sleeping with my feet elevated. Tonight, things got worse. The edema in my right foot began hurting. Bad. Stabbing pains, short duration, but most uncomfortable and on multiple occasions.

I asked Mrs. Prof to do what my primary doctor suggested—get a heating pad for me so that I could put it on my bruised shin, in the hopes that it would help the edema have a drain outlet. Didn't work after the first try, of course. In any case, if my edema is still in place tomorrow, I'm going to try and get an appointment with my primary doctor. Edema shouldn't hurt like a spike stuck through your foot.

Energy levels have been back on the sine wave again, with a rather large negative DC offset. I haven't spent much time in the y > 0 territory today. It isn't due to a lack of metformin—I finally got that filled Tuesday. It's not the antibiotic, either, nor is it from a lack of sleep. It might have something to do with the edema, but I sure as hell hope it doesn't. That would be very bad indeed.

One step forward, two stumbles back. I'd say, "give me a break," but I've already got one.

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2:38 a.m. CDT 20170602. Note the time. I got less than three hours of sleep, when you factor in the  extra time it took for me to get to sleep after typing up the above entry. My spine pain and my edema pain combined to form Voltron a nastier pain that managed to wake me up. Figured I'd get up and get some protein in me, so I got some Sam's Club sausage-wrapped mozzarella sticks.

Now, remember that I had the heating pad hooked up last night. Also know that it's hooked up to an extension cord which is entwined with the computer cables which called my fall that resulted in my broken toe in the first place. I remembered all of this as I stood, cane in hand, ready to go to the trashcan to toss out the debris from my snack. I lifted my left, steel-booted foot, and sure enough, the cables shifted all over the place. Fortunately, I did not. I was braced for such an event. I re-arranged the cables, stepped over them successfully, and made it into the kitchen and back.

The last time I looked at my online doctor's record, I am officially listed as being a "fall risk." I don't think I want to discuss that one further.

Good night again.

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6:08 a.m. CDT 20170602. Less than four more hours of sleep, but a little bit longer stint than last time. Managed to get some tea and take care of morning physical requisites without falling, but Mrs. Prof is going to be pissed that I left an empty tea jug on the kitchen counter. I couldn't refill it.

I'm not feeling the stabbing pain in my right foot edema this morning, but the bottom of my right foot is feeling sore.

My back/hip/leg nerve is giving me a medium-level searing pain. I think I'd better put this aside and get my drug cocktail inside me before the pain gains an advantage against me.

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8:40 a.m. 20170602. Hoo boy. Here we go again. I called and got an appointment with my primary doctor for today for the painful edema in my right foot, a little over an hour ago. A few minutes ago, I got a call from his nurse. She asked which foot the edema was in (to make sure it wasn't in the recently operated-on foot). I told her and heard her relay the message back to my doctor. I could hear him talk to her—he sounded worried. Anyway, the end result is that my appointment with the doctor has been cancelled and I've been given a "stat" referral to get an ultrasound done on my right leg and foot. I'm waiting for a call from whomever is going to be doing the ultrasound.

Not the way I wanted to end the week. However, an ultrasound is what Mrs. Prof has been wanting for a couple of days now. She gets her wish.

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4:15 p.m. CDT 20170602. Venous ultrasound done of my right leg. I do not have a DVT.

Note that I said right leg above. Nothing about a foot. According to the ultrasound tech, an arterial ultrasound includes the foot—not a venous one. WTF?

I guess my doctor wanted to rule out a DVT before going anywhere else with my diagnosis. Thanks, doc, but [redacted]! It's my smegging foot that hurts like hell and looks like a balloon! Why not go for both on the same ultrasound appointment?

Anyway, I was away from the house when his nurse called with the "no DVT" news, along with a request to call his office back. I have done so and am waiting for them to call me. Again.

EDIT: got the call. I'm now on 20 mg of furosemide, a.k.a. Lasix (a diuretic), for the next five days. After I take those pills, I call back for further instructions, if any.

Edited by ProfessorTomoe
New pill added to drug cocktail

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35 minutes ago, ProfessorTomoe said:

EDIT: got the call. I'm now on 20 mg of furosemide, a.k.a. Lasix (a diuretic), for the next five days. After I take those pills, I call back for further instructions, if any.

This would try the patience of several saints. :( I really do not blame you for being unhappy. I hope we can get some good news for a change soon!

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3 hours ago, The Old Hack said:

This would try the patience of several saints. :( I really do not blame you for being unhappy. I hope we can get some good news for a change soon!

Thank you, as always. Mrs. Prof is at a friend's place after doing some volunteer cat work (and stopping by a pet food place—our cat is getting tired of what we've been feeding him and is turning his nose up at it). Once she's done with the friendly gab, she's going to the pharmacy to get the Lasix, some Gatorade, and a good, broad-spectrum B vitamin, just in case. She knows pretty much squat about vitamins, though—I hope she asks the pharmacist for help.

Oh, well. I'll take what I can get. If things start going downhill, I can always send her back and then get her to talk to the pharmacist.

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3:37 p.m. CDT 20170603. Mrs. Prof picked a decent enough Vitamin B supplement, I guess. She got plenty of Gatorade, which I'm mixing 50/50 with my Crystal Light lemon tea to keep the sugar intake down. I do have one concern, though—I wonder if I'm pissing out my hydrocodone. Just enough to make things hurt again. I wonder because walking, which was getting a bit easier with my left foot up through yesterday, is now painful, especially in the area of my cracked sesamoid bone. My right spine/hip/leg/foot is in pain again. Finally, the edema area is hurting again.

On another concern, I wrote the following on Facebook much, much earlier today:

Quote

I seem to be completely unable to bring my body heat up to a non-shivering point after waking up. Coffee helps, but it's not a panacea. I've gone through two cups (both provided by [Mrs. Prof], thank goodness—both my feet are hurting bad this morning), but I'm still sitting here wearing a blanket and shivering. The shivering has become a daily ritual. I don't know which of my medications in my shoebox is causing it, but I wish it'd knock it off.

The only response came from someone who had gone through cancer and was in remission. He said I should get my white blood cell count checked. If you've been reading this thread (you have the patience of a SAINT if you have, for which I am incredibly grateful), you'll know that my white blood cell count is out of whack. The sub-WBC counts, including neutrophils and monocytes, have also been off at times (neutrophils almost all the time), and right now I'm dealing with a supposed re-emergence of myelocytes. I still don't see how this would cause one to be unable to come up to a working temperature after waking up. I don't have low blood pressure—I had high blood pressure, but it's under good control with medicines.

However, I've always run relatively cold: anything over 97.6 is considered a fever for me. I've always loved cold weather, despite being a 5th generation Central Texan. One of my favorite feelings was getting out in the weather around Austin when the air was still and the temperature hit a frosty 9°F. It made my nerves come to life.

So, why do I feel like I need a pancho when I wake up in the morning now? I'm only 53, damn it. My A1C is 6.1 as of last week. Am I getting that freaking physically old? WTF is going on with my morning metabolism? To be honest, I have absolutely no idea what the hell I would Google in a case like mine.

If someone can point me to some online resources that might explain this, I would be most thankful and appreciative. Thank you.

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6:18 a.m. CDT 20170604. Day 2 on the Lasix. I'm going through the Gatorade rather quickly, despite mixing it with Crystal Light tea. It goes through me as fast as I go through it.

Had a bit of a scare last night. I tried to get up from the sofa to use the bathroom just as Mrs. Prof was headed to bed, but I got so dizzy that I had to call for her help. She led me down the hall, waited, then led me back to the sofa. Not something I'd like to repeat.

I noticed that my antibiotic has a refill on it. I've gone ahead and called it in, since I'll run out of it on Monday. I'll call the podiatrist and explain the whole Lasix situation to make sure whether or not I should continue taking the Augmentin until I'm out of the Lasix. Probably not a bad idea, since as I said earlier I feel like I'm losing my hydrocodone concentration thanks to the Lasix.

Combating the shivering a bit today by wearing one of my black sleep caps. I'd been folding them up and using them just to cover my eyes because I've got some kind of sore on my right ear that refuses to go away. If they'll help me keep from losing body heat, then to hell with the sore in the morning. I'll take them off later.

Just realized that I'll be taking my last Lasix on the day before my lab work for my primary care doctor. I might as well try to get in an appointment after 10 a.m. (past Mrs. Prof's black-out period) so that he can look at the results first-hand. He can also look at this ear while he's at it. I'll talk to Mrs. Prof about it when she gets up.

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