Sweet Relief

My hand was not a bit better today, and I was really suffering. My middle finger, part of my ring finger, part of my palm, and part of the back of my hand were hot, stiff, swollen, and itchy. So itchy! After taking Benadryl for more than 24 hours without a change (although being knocked out for a few hours after each dosage was a nice break from the agony), I was frustrated.

Topical creams and sprays did absolutely nothing for me. I found that icing it took away the itching and burning, so I would keep an ice pack on for 20 minutes, then off for 20 minutes. That's how I got through yesterday and this morning. But the swelling was getting worse. I could hardly move my finger. I thought ice was supposed to bring down swelling! It didn't make sense. My finger was hot, with pink streaks up the sides and onto my hand. This morning the itching spread to the knuckle above the sting.

When I got up at 2:00 pm from a three-hour, Benadryl/gabapentin-induced nap, I decided to take a shower. The water beating down on my hand while I washed my hair felt like fiery needles. I didn't know how I could take this for another two days. I was thinking that I couldn't go to church if I had to ice it every 20 minutes. And Monday... I have to test a child for several hours Monday morning. How on earth would I get through that? I couldn't like this. I couldn't go anywhere or do anything.

I prayed.

I read my scriptures, and I had an idea. It wasn't anything that I read, per se, it was just a thought that came while reading.

Massage.

That sounded crazy to me, because I knew that scratching or messing with an itchy spot made it worse. Aren't we advised not to touch mosquito bites? Then I understood that the histamine and dead cell innards and fluid were just hanging out in the finger, that they needed help to leave it. I needed to massage my hand to get things moving.

So I tried it. The itching got much worse! It was just burning now. It got worse for an hour... but then it got a little better. The skin of my finger seemed looser. Now the itching was horrible on the back of my hand, and there was a line of itching up my arm. I went on faith and kept massaging my hand. For the next two hours, it was about like it had been for two days. Then, in the last hour, it dropped off considerably. After four hours of massaging while cleaning, unpacking, cooking, etc., I stopped. The itching was not gone, but it was a million times better.

Now it is five hours since I began massaging my hand. I am occasionally massaging and applying deep pressure, especially to the hot area between my knuckles, and it has not gotten worse. I'd say that the itching is about a 4 on a scale of 0-10. Wow.

I am so grateful that Heavenly Father hears our prayers!

Wasps 1, Annie 0

On Wednesday, Laynie and I went to our old apartment to clean it and get the last of the stuff out.

About three hours in, I remembered the balcony chairs. They are the zero gravity kind--just cheapish ones from Target. I went out to fold them up and bring them down to the U-Haul van I had rented for the mega Goodwill trip that was sorely needed. I tried to fold one up and it was stuck. I realized that I had to release the latches under the arms. After doing that, it folded easily. I went straight for the latches on the second, grabbing both chair arms at the same time... and touched bodies. fluttering wings. Filament legs.

Things are kind of blurry after that. I think I was processing with the right side of my brain, because I can remember snapshots of what happened. I backed up quickly; the wasps swarmed the balcony. A few chased me. One caught me.

Right as I got to the door, a felt the stab into the knuckle of my right middle finger. I couldn't believe that I had been stung and how much it hurt.

I went in and stuck my hand under cold water. I was shocked. The wasp attack was unexpected and had happened so fast. I was shaking hard, the pain was really hitting now. It got worse and worse. I needed to think. I had no idea what to do. All I knew was that my mom was highly allergic to wasps, and I was scared that I might be allergic, too. I didn't want to have an anaphylactic reaction, because I didn't want to go to the ER. That was because a. I didn't want to pay to return the U-Haul van late, and b. I wanted to finish the apartment that day. And I didn't want to waste time and exhaust my body's already limited resources.

So I knew what I didn't want to do: go to the ER. But I didn't know what I ought to do. I couldn't think straight. My hand was shaking hard, and I didn't know if that was from a reaction or because I was scared and the adrenaline was flowing. I checked my other hand. Also shaking. I assumed that it was just because I was freaking out; I was relieved. I was still scared but felt calmer.

The pain kept increasing. I would give it about an 8, almost 9, on the pain scale. And I am talking about PAIN, not itching. It was nothing like a bee sting or bug bite. It swelled up horribly; the skin on my finger looked like it was about to burst.

Some snapshots my brain took from the next 45 minutes:

Icing my hand with a bag of shrimp. The only things left in the freezer were the shrimp, some tilapia, and a tub of strawberries. I found this mildly hilarious.

Texting Katie, who suggested a baking soda and water. Oh boy, if only the baking supplies weren't already at the new house. Wait! The refrigerator contained exactly one thing: a box of baking soda.

Feeling stabs of pain on my left knee. Come to find out I had a red, DC-shaped bruise forming right on my kneecap. No idea what happened.

I called the office to have someone get rid of the wasps. After an hour or two, the pain subsided. It turned into an ache with occasional stabs of pain. While waiting for maintenance to come, Laynie took pictures of me (will post when downloaded), and we studied the wasp-nest chair. I laid on the carpet near the sliding glass door, watching the wasps crawling around under the chair arm and flying to and from the nest. At one point, I counted 11 bodies on the arm, plus whatever was out and about.

A maintenance man from the apartment complex came out with an amazing, quick-acting, foam spray. It seemed to kill on contact. He took out 8 or 9 wasps, knocked the chair on its side, sprayed the nest thoroughly, and said to give it a few minutes before spraying it with a hose (which I didn't have). He said that the wasps that were away from the next would come back for the next few minutes but would quickly vacate the area, because they hate the poison. With that, he left. Dead wasps littered the porch. Later I found out (thanks, Google) that dead wasps emit an attack signal.

Four hunting wasps came and went... mostly came. There was at least one there nearly always. Laynie tried to get the chairs, but every time she went out onto the porch, a wasp would show up. They kept heading for Laynie, and she kept heading for the door. We gave up and went on a Goodwill run then returned the van.

As the afternoon wore on, the wasps did not give up. When I noticed one favoring the arm of the other chair, I had had enough. Wielding oven cleaner, I drove away the wasps and got the chairs down to the garage. The nest was huge! Six or seven inches long, three inches across, and an inch or so thick. Full of babies.

The ache in my finger continued yesterday, accompanied by itching. It felt like I had mosquito bites all over my finger and up the back of my hand. Alternating hydrocortisone cream and baking soda paste, it was manageable. Late in the evening, the itching began to increase. My middle finger was much warmer than the rest of my hand. It was very uncomfortable, so I took a Claritin. I didn't have any Bendryl.

I went to bed, but sleep was not to be mine. I lay awake until 2:30, mainly because I couldn't shut off my brain. Just thoughts, not worries. I was exhausted but couldn't sleep. My hand was itching, though not severely. I finally nodded off...

...but woke up at 4:00 because my hand was on fire. And I was generally hot. I went downstairs to check the thermostat, which was set a little too high by one of my roommates. I sprayed Benadryl spray on my hand and tried to go back to bed.

The itching intensity rapidly increased to "tear off my hand." I gave up and went back downstairs at 4:45.

I had a very difficult morning. I worked on this blog post, which was difficult one handed on an iPad. I was exhausted and my hand felt like burning needles were stabbing me. It was swelling up again. I got some relief from an oatmeal paste, but even that stopped working after a while. A little after 9:00, Laynie and I went to Giant to get Benadryl and and few groceries.

I got back and took the two Benadryl. I typically have an opposite reaction to Benadryl and Dimetapp: they make me wired, jittery. Not today! After an hour, I felt like I would pass out. I checked drug interactions online and found that Benadryl and another medicine I'm on, gabapentin, have a synergistic effect--they increase each other. It warned that someone should monitor the patient for CNS suppression, stopping breathing, etc. Uh oh. Katie was at work and Laynie was getting ready to go to a rehab appointment.

I'm not sure what time I passed out, but I woke up at 2:00 pm. I was still tired, but unfortunately my hand was on fire. My finger was quite swollen.

It hasn't been an easy afternoon since then. Ice... baking soda... Oatmeal... More ice... Stinging, itching, and burning.

I took one Benadryl at 3:30. It's almost 6:00, and I'm having difficulty staying awake. I have that weird feeling in my chest. Just not a happy camper. But I want to stay awake until at least 8:00, if possible.

Dr. Google says that I'm having a local allergic reaction. It will probably last five days. Three more days of this? Heaven help me...

A Wee Pioneer

I had a fun new adventure! Yesterday morning, I woke up at 2:00 because of pain.. sort of generalized back pain and sciatic nerve pain down both legs. Too hazy with sleep to recognize exactly what I was feeling. I went to the bathroom, trying to decide if it was really back or abdominal pain. The two can be confusing in the middle of the night... or I'm pain-impaired. I went back to bed but couldn't sleep. At 2:30, I gave up, took some ibuprofen, and sat down at the computer to play a game.

My back/stomach started feeling better! But by then I was wide awake. I kept playing on the computer.

Around 4:00, the pain came back, as well as strong urges to use the bathroom. Oh brother. I had already taken 600 mg of ibuprofen. Whatever, I took 400 more. Ran a bath.. Lay flat on my back.. Tried sitting.. Walking.. I was not a happy camper. And then, around 4:30, someone stuck me in the back with a knife.

I mean, I couldn't see the knife, but it was definitely there, in the right side of my back. It surprised me. I tried the bath thing and kept running to the bathroom without much luck. I just assume everything is a bowel problem, because for me, it usually is.

The pain got better. It had been an 8 but went down to maybe a 5. About half an hour later, it hit again, this time worse. Tears sprang to my eyes. I emailed my home teacher (it wasn't even 5:30 am, so I didn't want to call) to ask for a blessing on his way to work.

The pain started coming in ever-more-frequent waves, going down to a 7 and up to a 9. For me, gallbladder pain is a 10, and it wasn't quite there. But it was bad!

Laynie woke up around 6:20 to find me cowering on the bathroom floor. She told me to CALL our home teacher. I texted him as I took more ibuprofen. He got back to me pretty quickly, and I got my blessing before 8:00. Ugh, it wasn't what I wanted. I fully expected to be healed, but no: "slowly subside," "due time," "trust medical system." Doctors? Not my cup of tea.

There are about a million hospitals within half an hour of here, and my home teacher said he liked GBMC when his wife gave birth there. I had a not-so-enjoyable experience at Johns Hopkins (waiting five hours in excruciating gallbladder pain before a doctor even laid eyes on me, leaving the next day without answers), so I didn't think I wanted to go there. Northwest, 10 minutes away? I wouldn't leave my car in the parking lot--probably come back to no radio or tires. I decided to give GBMC a try.

I got right in! Score! I went straight to triage, right back to the actual ER, and saw a doctor within 20 minutes. Oh, yeah. I was loving it, although the waves of pain (still 9 at worst, 7 at best) were coming every 10 minutes. But I thought the end was in sight. The doctor immediately ordered dilaudid and something for nausea. The nurse tried to get blood but I was too dehydrated--managed to start an IV at least. I really didn't care what they did, as long as I got pain medicine SOON. They ended up giving me two doses of dilaudid, because the first one didn't do anything.

The dilaudid helped for a little while, but it seemed to wear off within an hour. Then my pain was ranging 8-10. Yup, 10. It was actually worse than gallbladder pain, although it didn't have quite the staying power. At least it was coming in waves and not being continually excruciating.

They gave me more dilaudid. I guess it helped. I had a CT scan of my abdomen and chest. Abdomen for obvious reasons (the pain was in the right side of my back, sort of near my waist), chest because I had pain when the doctor pushed on the right side of it--different pain than the other one. And some test was elevated that could mean a pulmonary embolism. Again, I didn't really care what they did, as long as they made the pain go away, so I said fine, scan my whole body if you want. Radiation shmadiation.

After I got back from CT, my pain was back up at 10. Laynie flagged down the nurse, and she stopped at the door to say, "I'm obviously in the middle of something; you're going to have to wait." Aaaah! I was in agony. I answered email and gave instructions for an IEP meeting I was missing--tried to distract myself. Mostly I held Laynie's arm and cried. The nurse came back in a while with a percocet pill.

Later (by now it was after noon) the doctor came in to say that I had a kidney stone in my right ureter. Great. I sort of thought that was what it was. Despite not having a family history of it, I knew there was a wee pioneer blazing trails through my unsuspecting innards. What else is going to cause single-sided pain in that area? On with it, make the pain go away. I was thinking that they should just put you under general anesthesia to pass kidney stones...

The doctor ordered toradol (anti-inflammatory and pain med) and flomax (old men with prostate problems medicine--relaxes the urinary system or something, less spasming as the stone goes through). And more nausea medicine, because I was pukey by that time. Still had pain fluctuating between 8 and 10.

Well, something started to work.. or maybe it was the combination of everything: dilaudid, percocet, toradol, and flomax. Suddenly my pain was fluctuating between 6 and 7. Beautiful. They kicked me out. Gave me some funnel sieves to pee in and sent me on my way.

Around 2:30, Laynie drove me home. She hit the cement base of a pole trying to navigate the tight ER circle. Poor Laynie. I screamed when the impact happened and freaked her out. I couldn't really be mad though--I cracked her front bumper when her car was pretty new, failing to a short sign in the little road around UVSC. And sadly this impact was not the first damage to my less-than-9-month-old car. The roofers dropped a canister and dinged the hood. The bumper was abraded, but I don't care, because it's plastic and won't rust. Poor little Bug, though.

On the way home, I got this weird feeling. It's hard to describe. Definitely psychotic. My heart raced, heat rushed through my limbs, and I had the uncontrollable urge to hit myself in the face. So I did. I slapped the sides of my face, and I kept saying (signing), "Something is wrong, something is wrong." I didn't want to slap my face, so I wrung my hands, bumped my knuckles, finally clapped my hands. That was good--closer to normal. I just had to keep the rhythm. Bad trip? The feeling subsided within 15 minutes and didn't happen again.

That's why you don't do drugs, kids.

Well, my pain didn't go past maybe 8 the rest of the day. The worst was over. Well, not really--the worst was controlled by drugs. Laynie went out and got my percocet and flomax prescriptions filled. I was dizzy, getting nauseated every time I picked up my head. I tried to sleep but kept getting woken up by small noises. I passed the rest of the afternoon in a haze. I ate chicken soup broth and saltines for dinner. I traded emails with friends. I texted with my sister. I texted with my dad, who is a PA. I think he specializes in urology. He said it would stop hurting when the stone got to the bladder. The doctor had said that could take hours or days. One thing dad had said made me feel better: it wouldn't hurt coming out. I could now pee with confidence.

I fell asleep at 8:30, knocked out by the percs. I got up a few times during the night and took medicine, but I slept a lot. I woke up feeling better but hating the drug side effects more. Dizziness to the point of vertigo, which caused nausea. But there was no way I was taking a chance that the crazy pain would come back.

Around 11:00, I started passing sand flecked with dark stuff that I thought was blood. Now I don't think so. I think it was bits sheared off the stone, which passed around 12:30. Hooray! It was dark red, looked like little spheres stuck together. Dad was right: it did not hurt coming out. It was only 3 mm.

So now I have the little devil in a specimen cup, ready for my urology appointment on Tuesday. They will analyze it and let me know what kind of stone it is and what kinds of foods to avoid or vitamins to take or whatever.

If you are thinking about my previous blog post and scratching your head, yes, I passed the stone at 12:30 and got to work by 2:30 for a 3:00 meeting. Because I rock. And I'm crazy: I was soooo dizzy. Of course Laynie was my chauffeur.

My little inquisitive guy asked why he didn't have speech today. It's Thursday, after all, and Thursday is speech day! So life goes on.

A Long Battle

Today I had my last regular visit to the dermatologist. That seems unreal to me, because I've seen him every month for 16 months now. And in honor of the occasion, my veins decided they would prefer to keep their blood, thanks very much. Well, they were willing to let go under the skin and out around the needle, but not actually through the needle. Sigh.

But the good news is that I've been off Accutane for a month, and so far, so good! Dr. D said it best: It's been a long battle. So glad it's over (knock wood).

Farewell, Old Friend

My Aquahpor addiction began last summer, as the Accutane medicine made my lips into dessicated shells of their former selves. They were so, so sensitive; they would blister if I ate anything salty, and they seemed to be trying to grow together. I tried a variety of lip products, which I had to use several times each minute and STILL was in excruciating pain. Lips apparently have a lot of nerve endings. After a week of torture, I hit on Aquaphor, and I have not looked back.

At first I only had to use the stuff every couple of hours, but as my skin started to clear up (hooray!), my lips became worse (boo). If I didn't have Aquaphor on, my lips would stick together within seconds, ripping skin off when they parted. This was not enjoyable. Eventually, I was up to a half-tube-a-day habit: I used the ointment about once an hour, plus every time I took a drink, and every 2-3 seconds while eating. I am not exaggerating. This is how it felt: 

More Aquaphor NOW!

I have two tubs at home, a large tube in my purse, and, conservatively, about five million small tubes of Aquaphor in my house, car, purse, laptop bag, church bag, and desk. If I suddenly found myself without Aquaphor, I would immediately get myself to the nearest CVS. I cannot live without it. While I have a love-hate relationship with Accutane, and I have LOVE, LOVE, LOVE, LOVE, LOVE relationship with Aquaphor.

I stopped using Accutane about three weeks ago, after 10 months on it. My derm says I was a pretty tough case, because people are usually on it for six months. My skin was just starting to clear after six months, but it's great now. I am nervous about whether it will stay that way, but that's another story.

Just now my lips became sore and I put on some Aquaphor.. then realized that I had not used it in two hours! Not since I woke up. And I ate breakfast! This is unprecedented in my peri-Accutane existence.

While I will be happy to live like a normal person again, I will always have a soft spot on my heart for Aquaphor.

Update

Laynie took me on a field trip to the mall today. I shuffled the length of the Towson mall and back. With breaks, of course. We also went to the grocery store, to get a fibrous cereal and more Prilosec. I was already exhausted and in pain by the time we got to the grocery store. Actually, Laynie was exhausted, too. But I needed that Prilosec! When I got home, I was in so much pain. I took more oxy and took a nap. I woke up kind of hallucinating.. haha.

So I definitely overdid it today. I had been doing pretty well, but now not so much.

Tomorrow my big plan is to go to the apartment office to get a box from UPS. Ummm... maybe I'll wait for Laynie, in case it weighs more than 10 pounds. I have no idea what it is. I can't remember what I've ordered. I can't remember much that didn't happen today. My other big plan is to play a computer game and take a nap.

Oh! Yesterday I talked to my best friend of 14 years, Jennie. That was so nice. Jennie is the kind of friend that not only will discuss bowel movements but can give useful advice. She has seven kids (and one on the way), so not much fazes her. Unfortunately, we only talk maybe once or twice a year... probably because she has seven kids and one on the way. But I still consider her one of my two best friends, the other being Laynie.

Getting There

I've rested a lot today, and I feel pretty good... when I'm lying down.

I've settled into a medication regimen: 600 mg of ibuprofen every 6 hours, and 5 mg of oxycodone every 2-3 hours. Yup, I gave in and took the oxycodone all day. Seriously, I do not think it helps my pain, but I'm giving it a try. It is still frustrating, because it makes me so dizzy and tired. It kind of makes me feel like a have the flu--that hard-to-pin-down, crappy feeling.

Walking hurts. A lot.

I'm getting better with sitting up. No problems sitting propped up, of course; I mean sitting up on my own. That was really painful yesterday, but today I can do it for probably 15 minutes at a stretch.

I missed a call from my mom while I was taking a nap. I did talk to my dad, though. He was annoyed that his flowers hadn't arrived, when they were supposed to be here yesterday. Maybe because it sleeted and snowed all day yesterday?

Still hoping my bowels start moving again. Seriously, my belly is hilariously bloated and swollen. I'm like a cartoon character. Need to pass gas. I've explained to my stomach that this is really getting unreasonable, but no luck.

Coughing hurts. A whole lot.

But on that note: my swallow is improving. I think. I hope. I need to be able to eat and especially drink without coughing after each swallow.

Katie stayed all day, which was nice. I don't think I will see Katie for a few days, because she has work and evening classes tomorrow and Tuesday.

I want to take a shower! I did wash the betadine off today, very carefully. But I can't take a shower for five days, so not until Wednesday. I think I will have to wash my hair in the sink tomorrow, though, because it's starting to nastify. I'll probably have to enlist Laynie's help with that. Good old Laynie.

Tomorrow I really want to call my good friend Jennie.

Surgery

I finally took the plunge. Surgery. Here I am at about 6:15 am, ready to go back. My girls Katie and Laynie were with me, and they forgot their cameras... good thing for phone cameras! I wasn't nervous yet. It didn't hit me until I walked into the OR.

Hazel, an anesthesia nurse, had started my IV. She signed and dated the tape. It HURT! Worst IV yet for me. She also took some blood from the crook of my elbow. That didn't really hurt. Too bad she didn't know to do that before she had my IV all taped up. The blood was for Dr. M-the-GI-guy's research study.

Let's get this party started!

I'll go ahead and apologize for a long post now. I've got nothing else to do today, and this is like my journal entry.

They wheeled me on my bed to the OR, and stopped outside. They had me get up and walk in. That was when the emotions hit. I realized it was really going to happen. I felt the tears welling up. The anesthesiologists were getting the table ready for me to get up on it, and I looked around the room. A little. I avoided looking near the table, because I didn't want to see any instruments. But I saw the radio in the corner. The room was big, and the table was small. I told the anesthesiologist (the REAL one, not his resident, who was more nervous than I was) that I was kind of scared. He was very reassuring and had me get up on the table and stretch out my arms onto the arm boards. Somebody put a pillow under my knees. I could see the strap they were going to use to keep my legs on the table, but she didn't put it on yet. The anesthesiologist said he was going to give me something to relax me. I do not remember a thing after that. I suppose that he didn't actually put me out yet, because the surgeon wasn't even in the room, but I don't know.

Dr. M-the-surgeon removed my gallbladder, which turned out to be badly diseased. It was contracted. He also removed my appendix, which was totally fine. I guess he figured as long as he was in there... Well, I had known that he probably would do that, because he put three procedures on the informed consent form: laparoscopic cholecystectomy, EGD (meaning upper endoscopy), and possible appendectomy. I signed it without looking. I was signing a lot of papers. Later (this is going back to before the surgery, obviously), a nurse brought it to me to verify my signature and read off the procedures. I was like huh? Whatever.

Dr. M-the-GI-guy was right: I did have actual reflux (the surgeon thought I was confusing heartburn with gallbladder pain), and it was a separate problem. I knew I liked that guy. He was smart. Dr. M-the-surgeon saw reflux during the endoscopy, even though I had taken Prilosec the night before and that morning. He did not see evidence of Barrett's esophagus, but he took biopsies. He also took biopsies from my stomach, and did something that will test for H. pylori. He found that I have a small hiatal hernia. I also have a grade II lax GEJ sphincter (that's the lower esophageal sphincter on the hiatal hernia picture). I wonder how many grades of laxity there are. Anyway.. that explains the reflux.

I had a tough time waking up from the anesthesia. Of course I was really groggy, and my eyes didn't want to open. The first thing I registered was pain--on my face! My cheeks and lips were burning. Darn Accutane has made my skin so sensitive. I think I've written before my Aquaphor addiction. As I woke up, the oxygen mask was only making my cheeks hurt worse, and I began to cry. The nurse (my best nurse out of the four I had) came over to see what was wrong, and I tried to sign pain and thirsty, and she didn't get it. Actually, I didn't even mean that I was thirsty. I meant dry, but somehow I signed thirsty. My brain was a little addled. The nurse seemed to think I was randomly moving my hand, and she kept asking me what was wrong. I finally realized that I was signing and of course she is not going to understand, so I whispered, "Vaseline. Dry." That's right, my first word upon waking up was not Mom, Dad, Katie, or Laynie... It was Vaseline. The nurse noticed the rash all over my face and got worried. She smeared Vaseline on my lips (sweet relief!) and had the post-anesthesia doctor, Dr. S, look at my face. They were getting kind of worked up about it, so I must have looked awful. I kept trying to say Accutane, and finally they got it. They put bacitracin on it and I felt much better. Except that my stomach hurt and itched. I asked what time it was: 11:30. I had gone into the OR at 7:15. Later I found out that I came out at 10:58. I guess I was under the knife for three and a half hours.

The surgeon came by to see me, and he told me that he removed my gallbladder, which was quite inflamed, and my appendix, which was healthy. Prophyaxis, you know. The more I think about it, the happier I am that he did that. That was all he said. A few minutes later, the anesthesiologist came by to see how I was doing. After he left, I was not doing too badly, and they were going to get Katie or Laynie to see me. The nurse came back to say that they weren't there. I figured they were still at audiology, because Laynie had a mapping appointment. I didn't care anyway. I didn't have a desire to see them. It wasn't that I actively didn't want to see them, I just didn't care. Then I felt like there was junk in my throat, and I had to cough. I had trouble coughing it all up, and I ended up making it worse for a while, and I couldn't breathe. The monitor was blaring its warning, and the nurse helped me sit up to cough it out. Finally I did, and I laid back down. My throat was so dry. It hurt to breathe! Every breath felt like little knives stabbing the back of my throat. I started to cry, and the nurse wasn't able to help me feel better, so she went to get Dr. S. I wanted to stop her, because I knew the doctor couldn't do anything about it. But I couldn't exactly yell after her. I could barely whisper.

While the nurse was gone, my throat began to settle down, and I wasn't feeling too horrible. But then I started crying uncontrollably. It hurt to cry, but I couldn't stop. Dr. S came, and I told her that I was fine, but I just couldn't stop crying. She and the nurse went out to the other side of the curtain to talk. I could hear them just fine. Dr. S said that the medicine (from the anesthesia?) was making me cry, that it would probably continue for a while, and just to reassure me. I opened my eyes and smiled at the nurse to let her know that I heard everything (still crying, ha). She came over and told me to get some rest. A few minutes later, the creepy crawlies started.

I felt like something was crawling under my skin, all over my whole body. I loved the pressure from the leg massager things, which were on my lower legs. I wished I had those all over. I kneaded my hands into the bed to try and get some pressure, wondering if this was how sensory disorders feel. This is going to sound crazy, but I reeeeeeeeeally wanted to beat my head, like just hit it with my hand, because I thought that would make the feeling go away. I didn't, because I figured the nurse would flip out. It was hard to contain that impulse, though. Finally, I fell asleep, or at least into a haze. I could hear the conversations around me. The guy in the curtain area next to mine had had some malignant tumors removed from his lungs. His family was loud. I wanted them to be quiet so I could sleep. I think I finally did sleep.

At around 1:30, I woke up doing a little better. The creepy crawly feeling was gone, whew. After a while, the nurse asked if I wanted to see my family, and I said OK, but my voice didn't work. She understood my mouth movements, though. Katie came to see me, and I still couldn't talk. I just couldn't get my voice going! I decided to sign. Poor Katie. I didn't have great motor control yet, and I was signing with only one hand. That conversation was basically one big miscommunication. She told me that the surgeon had spoken with them, that he removed my gallbladder and appendix, which I knew. She also told me about the hiatal hernia, which was news to me. She said that hiatal means small, and I tried to tell her no, hiatal is referring to the location of the hernia, as opposed to an inguinal hernia, etc. But I had more language inside than I could really express. Katie didn't understand me. I'm sure my fingerspelling was horrible. I tried to ask if I needed surgery to fix the hernia (thinking about my friend Deb from work, who had a hernia repaired last year), but Katie thought I was talking about pooping. If you know ASL, you will understand why confusing surgery with poop is a perfectly reasonable misunderstanding. I started getting my voice and the nurse came over. She was confused, to say the least! Katie left, and the nurse said, "I talk and you respond.. I talk and she responds.." Haha, I told her that we are both hearing, but we were just signing. Come to think of it, I don't know why Katie was signing back. My ears worked just fine. Putting out what she was taking in, I guess. I think Katie left pretty frustrated.

A little while later, Laynie came back to see me. I don't really remember much, except that we communicated fine. Laynie just reminded me that she was the one who told me that I only had two holes: an umbilical incision and a shorter incision (punture?) under my right ribs. I was surprised and didn't quite believe her, because Dr. M had said he would make three punctures and an incision. The nurse said, "Yeah, I think there are only two--I was looking for them before." Eh? When I was out? Haha. So she looked again and still only saw the two spots. Wow.

I've said a few times that my mouth was dry--this is something I struggled with all day. The nurse swabbed my mouth with water every now and then, but I was breathing through my mouth (guess I didn't need the cannula on my nose), so it kept drying out. I wasn't able to eat or drink yet. One thing I noticed was that I was aspirating the bits of water that would run down into my throat. I was hoping that a larger bolus (bigger swallow) would help, and I didn't worry too much about it.

Katie and Laynie took turns visiting me all afternoon and evening. Laynie took this picture of Katie in the waiting area. Little techie girl.

Of course, they wanted to get me up and eating, drinking, going to the bathroom. All of a sudden, I really needed to pee. Laynie was with me at that point. I wanted to try and get up to use the bathroom. When the nurse sat my bed up, the room spun. It spun more when I tried to sit on the edge of the bed. I wasn't able to sit up straight, and I wanted to lie back down. I just wanted them to leave me alone. All of a sudden I did not have to pee. The nurse got a wheelchair and was locking the wheels when the room spun again and a wave of nausea washed over me. I leaned against Laynie and began to cry. I told the nurse that I was nauseated, and she laid me back down and went to get medicine for that. First she had me use a bedpan. Weird. Then she got the medicine ready, warning me that it was going to make me sleep for a few hours, but I would feel much better when I woke up. It was called fenerdyl or fenerfen or something like that. The nausea subsided as soon as I laid down, but I wasn't thinking clearly enough to connect the nausea with the room spinning, so I didn't stop her from injecting the medication into my IV line. Within 10 minutes I was in a stupor, but it took a long time for me to fall asleep. I kept hearing conversations around me and machines beeping.

I woke up around 5:00, and Laynie was there again. I had to pee again, and they tried to get me up again. Same thing: the room spun and my stomach spun with it. All of a sudden I had a word for it: vertigo. I told the nurse that I was feeling nauseated and couldn't get up to use the bathroom, but I didn't think I needed nausea medication. I tried to explain the vertigo. She gave me nausea medication anyway, but a different one, which would not make me drowsy. I was fine with that. But I still wasn't able to get up, and I had to use a bedpan again. Then the nurse kicked Laynie out. That nurse kept kicking them out.

I wanted to get up, and of course everyone wanted me to. I was learning that if I fixed my eyes on something directly in front of me, the room would not spin, or at least not much. So I sat up in bed for a while, practicing that, and then I asked the nurse to help me to a chair. Oh, man, did my stomach hurt when I stood up! And it hurt sitting in the chair. The nurse offered to put my legs up, which helped tons! Dr. S came by to discuss pain, and I told her that I was having quite a bit of pain, maybe a 7/10. But I did not want something that would make me dizzy or lightheaded. I agreed to take IV Tylenol. I think it was called Toridol. It didn't really help, but I have a decent pain tolerance, and pain wasn't my main concern at that point. Pain wasn't what was keeping me from going home; vertigo was.

The nurse wanted to get me eating and drinking, and I was definitely down with this plan. It was about 5:30 by this time. She offered Pepsi or Sierra Mist, and I chose Sierra Mist. I would never drink caffeine. She was gone for a while, and Katie was there by that time. The nurse said, "OK, here are your crackers, and here's your Pepsi." Apparently they were out of Sierra Mist. And I had to drink something carbonated to try and get some of the air out (they pumped me full of air for the laparoscopic procedure), so water was out. Oh boy. There was no way I was drinking Pepsi. I knew it would all work out. Of course, Katie offered to buy Sierra Mist from the vending machines in the waiting room, and the nurse thanked her. Katie was gone for a while, reappearing with fruit punch. As in, non-carbonated fruit punch. The machine with Sierra Mist wasn't working or something. The nurse rejected the fruit punch and was ready to give me Pepsi. This was a different nurse, actually, the only one whose name I got. Earl. Big guy. At first I wasn't too sure about him, but I ended up liking him. I explained to him that I could not drink caffeine, and he was fine with that. Katie texted Laynie to get something carbonated for me. About 10 minutes later, Laynie texted back that someone needed to watch the bags if she was going to go looking for more vending machines. That whole time we had thought Laynie was off getting my drink, but I guess the texts took a while to be received. So I sent Katie out to the waiting room. It felt like forever before Laynie showed up with Sprite. She had had to go all the way to the cafeteria, which is two buildings away! I really appreciated that.

I got to drinking, and just as I had feared, I aspirated with every sip. Small bolus... large bolus.. it didn't matter. Chin tucks didn't help. "Hard and fast" swallows didn't help. I wasn't aspirating the entire bolus, but a little bit with each swallow. I was able to cough it back up every time, though (although I would often reaspirate it when I tried to swallow it again). I told Earl that I was aspirating, and he asked me what I thought was happening. He knew I was a speech pathologist, and swallowing is within my scope of practice. I paid closer attention. I thought it was a problem with the pharyngeal phase. When I put my hand on my throat during the swallow, I could feel my larynx elevating. But was it enough? Or maybe I wasn't adequately clearing the laryngeal vestibule--what most people would think of as the back of the throat. I could feel liquid still there after a swallow. Maybe the upper esophageal sphincter was snapping shut too quickly, before the entire bolus was in the esophagus? Maybe I the problem was really with the oral phase of the swallow, that I wasn't pushing the entire bolus back. What I wouldn't give for a barium swallow or FEES, just to satisfy my curiosity. Well, it's not worth it just for curiosity's sake.. but you know. I'm nerdy, what can I say?

It wasn't just the liquids either: I aspirated some crackers, as well. I had to laugh when I coughed after swallowing crackers and chewed up cracker hit the back of my hand HARD. It was like in the movies when a person is choking and someone does the Heimlich. I figured all of this was due to the anesthesia or maybe the intubation. Earl told Dr. S, who came over and was concerned. She checked my chart and noticed that I was an easy intubation. She considered keeping me NPO (which would have meant that I would have to stay in the hospital, I think), but she ended up letting me keep trying to eat. She said it was because I was an SLP and she trusted my judgment. Hm. I kept trying to eat, and I kept coughing after each swallow. The more I coughed the more my stomach hurt. My regular nurse (Earl was filling in for her because she was busy) came over to check on me. I told her that I was aspirating, and she said, "Oh, I'm sure you're not really aspirating. You're sitting up, so I know the food is going the right way." She was exactly the kind of nurse that drove me crazy during my hospital internship, because they send people home who are at risk for aspiration pneumonia! Nurses have to refer when patients are aspirating, so that the SLP can at least to a bedside swallowing evaluation. I explained to her that you can aspirate sitting up, and I am. She went off to find the doctor, still think she was right. She came back a little more contrite.

My surgeon walked snappily by at one point and asked how I was doing. I told him I was fine except that I was aspirating. He said, "You're dysphagic?" and laughed. He asked Earl to get me a spirometer, reminding me that I should know what to do with this, being an SLP and all. He wants me to use it to monitor my lung capacity and to work out my lungs. He said he would trust me to call if I needed to see an SLP. He was giving me a hard time about being an SLP with dysphagia.

After my adventures in aspiration, I wanted to use the bathroom. I asked Earl to help me. He went and made sure the bathroom was empty (smart), then came back to help me up. I still had vertigo, but I was getting better at finding a spot to focus on, which kept the room from spinning. Much. I crept very slowly to the bathroom, holding onto Earl. I noticed that he had placed a seat cover on the toilet for me. Thoughtful. I went a little faster on the way back--maybe a turtle's pace instead of a snail's pace. Turns were tough, but spotting helped. I finished my crackers and most of my Sprite (coughing all the time), and then it was time to discuss my release. Yes!!!

Earl was so sweet as he wheeled me down to where Laynie and Katie were waiting with the car. He warned me which way he was going to turn, so that I could find a spot to focus on. It worked, and the world didn't spin much.

Hooray, home! My vertigo was a little better. I was able to move my head about 30 degrees without things spinning, as long as I kept it level. Looking down was the worst. No, looking diagonally downward was the worst. We left the hospital at 8:00, and I was in bed by 9:30.

I got up about every two hours to use the bathroom. The pain was getting worse all the time. I had only taken Tylenol or ibuprofen since 6:00 pm. Dr. S said that the oxycodone that I got would help with incision site pain, but that Tylenol or ibuprofen would be best for crampy, internal pain. I occasionally felt a breathtaking stab of pain at my incision site, but mostly bad crampy pain. It was worst when I was standing. My whole stomach felt to tight. Still does, actually.

I got up at 5:45 and ended up taking oxycodone around 7:30. I'm not sure it helped. I think just sitting still helped. I have a low dose of oxycodone anyway, just 5 mg. I had a bad reaction to codeine in the past (it made me puke), so the doctors were playing it safe. I have 90 pills (89 now), but I doubt I will take more. At least it didn't make me puke.

Now I'm in a weird position. My brain is active, since I'm not on narcotics. I feel fairly decent, except for abdominal pain. But I can hardly walk. So I can't do anything! I think I will be tearing my hair out this week. I have never experienced anything like this. Normally if I am sick, I feel tired (which I am, but not too badly--just one nap today), light-headed, dizzy. You know. So I don't want to do anything. But now I want to do stuff but can't because I can't move well and I have all this pain! It's just weird.

So that's what happened. Wow, it has taken over two hours to type this blog post! My butt is asleep. Time to go.

Kicking Myself

I had an attack last night, which rudely woke me up around 11:30 and ended abruptly at 1:30. (The only nice thing about the attacks is that I have no question whether they are over and I can go back to whatever I am doing, because the pain drops off suddenly.) When I woke up, I initially only registered reflux, and I tried to ignore it (because I was sleeping). But it was really bad, so I sat up, which usually helps my reflux. Then I realized I was in a lot of pain. Et cetera, et cetera.

But here's why I am kicking myself:

When I met with Dr. M, the GI doctor, he was trying to figure the whole thing out and find a connection between the pain attacks and the reflux. I had told him that Prilosec worked wonders for the reflux, and he asked if it helped to take a Prilosec during a pain attack. It had never even occurred to me to do that. I just took ibuprofen and hoped for the best (although my pain laughs in the face of ibuprofen).

I should have tried it last night!!

This was probably (well, hopefully) my only chance to try that before the endoscopy on Thursday. See? Kicking myself!

Back in Denial

After the test on Friday and especially that night when the pain came back, I was totally facing my problems. On Saturday, when I was still feeling the aftershocks, it was hard to deny that something was definitely wrong and would need to be fixed. I even sent an email to various people I work with, warning them that I might be out at some point for surgery. Until now, I had only told Cindy, a teacher that I work pretty closely with, that I was even having problems.

Now I seem to be going back into denial, which is where I've been for weeks. This morning I started thinking that when I meet with the surgeon, he will probably say let's wait and see. Or he'll send me for an MRI and not find anything. He'll say that they just didn't wait long enough when they did the HIDA scan, and that's why it looked so bad.

My mind is playing tricks on me!

So now when I get a response to my email, I don't even want to read it. I don't want to think about it. Because I will probably have to take it back when I see the surgeon and he tells me everything is fine.

I Am a Health Hazard

My body is emitting gamma rays, even as I speak (OK, type). Cool, right?

Today I had a HIDA scan, which was not as bad as I thought, but the results were much worse than I thought. Honestly, I almost canceled the procedure earlier this week, because I thought my doctor was barking up the wrong tree. You see, I have had two episodes (well, now three: I'm coming out of one right now, which is why I'm awake at 1:30 in the morning) of what the ER doctor described as "epigastric" or "colicky" pain. If this is what babies have when we say they are colicky, let me tell you, it's no wonder they scream! I have pretty severe back pain, and it doesn't hold a candle to this.

I don't know why I haven't wanted to blog about this, and now suddenly I do. Maybe I was waiting until I actually knew what it was. I'm not sure I do, though, still.

For my HIDA scan, a very nice radiology technician or nurse or something, named Linda, started an IV (had to try two different places, sigh). Well, first she asked me the usual questions, like my name and birthday, whether I'm pregnant, and whether I still have my gallbladder. Are there doctors dumb enough to send a gallbladderless patient for a HIDA scan? You see, a HIDA scan checks the function of the gallbladder, sort of, and the condition of the bile ducts. She asked if I had had an ultrasound or CT scan, and when she heard that I had had both, she seemed to think that this test was overkill. I was still thinking yup, this test is going to be a waste of my money. Good thing I have excellent insurance.

Through the IV, Linda injected a radionucleotide, meaning some radioactive material. She explained that a camera would pick up the radiation coming from my body and track it as it moved into and from the gallbladder. When it was in the gallbladder, the second part of the test would begin: she would inject CCK, which would make my body think I had eaten a fatty meal. That would cause the gallbladder to contract, so that the machine could measure how quickly the bile emptied into the intestines. It could also "replicate my pain." Great.

So I laid in a scanner something like this, for about an hour:

The only difference was that the camera (the large, hovering rectangle) was much closer to my body. Maybe three inches from my chest. And my head was in an arc of machinery. It was a little claustrophobic at first, but I got used to it.

I laid there and watched Linda surf the web, checking out tote bag projects on Joann.com. She also spent a while chatting with another tech/nurse person. It was debilitatingly boring. Finally, after an hour and five minutes, the machine beeped, and Linda checked it. Nothing in the gallbladder. She had me lay there a while more and tried again. Nothing. She had me sit up for about 20 minutes, and she checked again. Nothing. She tried two other positionings... still nothing. She had me sit up for another 15 minutes. She tried all three positionings again and let me out of the contraption again. She said to go wait in the little waiting area in the hall while she went to show the radiologist my results. She said that they probably would not need to do the second part of the test.

While I was happy not to have the CCK and experience pain, I was thinking that this probably was not a good sign. The only thing I could think of was that the tracer hadn't made its was to the gallbladder, for whatever reason. Or that it had but was stuck in there.

After about 15 minutes, Linda came and got me to remove my IV. I was done. As she was removing my IV, she asked me again if I still had my gallbladder. Oh, my, that could not be good.

Linda said that the radiologist would take 3-4 days to review my scan and would let my doctor know, and my doctor, Dr. C, would call me. Remembering that the last time Dr. C was supposed to call me with lab results I ended up having to call her after a week and still not hearing back for another two days, I planned to call her on Wednesday.

Imagine my surprise when Dr. C called 20 minutes later. I hadn't even gotten home! She had me pull over to talk. There was no sign of the radionucleotide past my liver. Complete ductal obstruction. That's why Linda was asking if I had a gallbladder: nothing showed up there on the scan. Brother. Dr. C asked if I had had any more pain, and I really had had only minor pain since my last big episode, October 10. My fever was back all this week and I felt like my stomach was working something up the last two days, but nothing big yet. She warned that I might have another episode soon, if not from the obstruction then from the radionucleotide causing cramping. ?

Then she asked if I have a surgeon. Of course not... Why on earth would I have a surgeon? She had me take down a name and phone number. I have to call the surgeon on Monday. I still need to see the upper GI doc the day before Thanksgiving, since my reflux is still bad.

I wish I had asked if she knew why I had a total ductal obstruction. On the ultrasound, there had only been tiny gallstones. I guess the ultrasound could have missed something, or they may not have been as small as they seemed. I wonder if the CT scan should have picked them up. Anyway, there are other things that can cause a duct to be closed off, like the big casino. But I'm operating under the assumption that it's not that serious. What other assumption can I operate under and remain functional? There are other possibilities, too, but a nasty old gallstone parked in a duct is the most likely culprit.

So, as I mentioned before I'm coming out of a pain episode, which lasted about four and a half hours. I'm getting better at dealing with them, but boy, does time crawl by. At least I don't have to go to work tomorrow.

I put in a call to my dad. He's a nerdy physician assistant. I trust him more than most doctors. I do hope my doctor is a good one. At least she was observant enough to notice that my liver enzymes on the ER bloodwork were both over 300, which the ER doctor either overlooked or chose not to pursue.

Here is "me looking on the bright side:"

-I have great support from Laynie and Katie.

-I'm sure that the administrators and other powers that be, with both my employer and my current placement, will understand. (Not pay me for not working or anything, but at least not give me a hard time if I need to leave work with pain or take a few days off for the surgery.)

-I have excellent health insurance. Whew.

Do I Have a Tale for You...

I had the privilege of spending the night in the ER at Johns Hopkins. What an experience!

During my four hours in the waiting room (while in excruciating pain, mind you) and my eight hours in and out of Bed 28, I saw and heard some exceptional things. Actually, I think they are not exceptional but typical, which is sad. Let me present you with a series of vignettes.

A woman starts an argument with another woman in the waiting area. They move to the lobby, where things become physical. Right in front of the main security guard's desk.

A man in a wheelchair (NOT unusual--probably a quarter of the people waiting went out and got wheelchairs for themselves) "gets loud" with a woman in the waiting area. A female security guard tells him to cut it out, and he blames the woman for making him yell at her. The security guard tells him, "You a grown up man and you sayin' she made you? Can't nobody make you. You a grown up man." A valid point, to which said man replies, "Now you mad at me? I didn't do nothing, you tell her she gotta quit makin' me mad." The guard assures him that she is not mad at him. Wheeling him out, she continues, "I just disappointed that you say somebody made you, when you a grown up man and you supposed to know how to behave. Now, you know you can't stay here when you loud."

Sylvia Squires wanders through the waiting area aimlessly. She sits in various chairs, finally parking it at one of the registration windows, wanting to have a chat. The woman at that window seems to know her, and she ignores her. After a moment, the woman leaves Sylvia alone. Sylvia (I know her name because she said it so often) initiates a conversation with herself. Although I was actively trying to ignore her, I could not help but hear some of what she said, because she was three feet away from me. Sylvia is 51 years old, with two grown daughters. Their fathers were not Mexican. Her current boyfriend, however, is. He is a mean drunk who cannot hold his liquor, and he smacks her around all the time. He tried to throw her through a window. Sylvia, on the other hand, can drink all day and all night, without any deleterious effects. She hates Mexicans, because they have too many kids, like leeches. Sylvia is a sociable person, loudly inviting everyone in the waiting area to go out for drinks rather than wait any longer. As the night wears on, Sylvia becomes increasingly belligerent. Each time a nurse calls a patient's name, she yells, "Squires?? Do you have Squires?" They firmly tell her no, and she lets them know that they are smart mouths, and that she has been here since 6:00/4:00/5:30 (fill in a random time). Sylvia runs into an acquaintance, who is at the security desk, complaining that she has waited too long and would like her IV out. After 15 minutes, a nurse is available to do this for her. The friend looks back into the waiting area and notices Sylvia slumped over in a chair; she calls out, "Sylvia, are you OK?" No answer. Sylvia has fallen asleep. When I leave the hospital, eight hours later, Sylvia has not moved.

A young couple comes in, the girl obviously having abdominal pain and feeling poorly. She sits next to me and leans against her boyfriend, who stands in front of her, murmuring in Korean and stroking her head.

A man does laps in the waiting area in his wheelchair. He bumps into things and blocks people's path. 

A man comes out of triage reeking of urine. His dirty clothing and unkempt appearance bespeak a life different than mine. He encounters a "brother" in the waiting area, who is similarly attired and sports a black eye. Pee Man stands near the security desk, chatting with his brother, while the security people gag. The same female security guard who escorted loud man out of the building takes it upon herself to grab a can of air freshener and spray it directly at Pee Man's back for at least 10 seconds. This does not even touch the funk in the air, and it does not phase Pee Man. She goes through a set of double doors; five minutes later, she emerges with a set of scrubs and a plastic bag. She informs Pee Man that she cannot handle his stink, that he must change. He is understandably worried that someone might steal his blue jeans, and she reassures him, instructing him to carry them in the plastic bag. Pee Man reluctantly enters the men's bathroom and reappears in bulky scrubs, without the plastic bag. He leaves shortly, but for the next several hours, every person who walks through the ER waiting area (the elevators to the peds ER are at the back of the adult ER waiting area, so parents dragged children through the room from time to time) comments on the smell. An hour later, a triage orderly travels throughout the room, spritzing liberally with a fruity spray, smiling like Miss America. Her journey was more welcome than any beauty queen's.

In a monitored bed in the ER, a diabetic woman is there because she stopped taking all of her meds. Although she doesn't have any family and really doesn't care, she accepts the central line that must be placed in her neck. She asks for food and is told that she can eat a bunch of bananas, or she can have orange juice. She weakly accepts the juice.

Later, in that same bed, a man with a thick Baltimore accent has difficulty answering questions from the nurse and doctor. He provides tangential information with each answer, but I will spare you that. Has anyone ever discussed diabetes with you? No. So, when you were in the hospital a month ago, did they tell you that your blood sugar was high? Um, yeah, they gave me a shot for it. Oh, they did. And did they give you medicine to take home? No. Did you follow up with your primary care doctor? No. They didn't tell you to follow up with your primary care doctor? Well, I've been taking the medicine my doctor gave me. Medicine for what? Diabetes. Which doctor gave it to you? My regular doctor. So your regular doctor is treating you for diabetes? Well, yeah. Did you take your medicine today? Of course. Later: Does this hurt? Yes. Where does it hurt? On my leg. Where on your leg: the front or the back? What? Where exactly does it hurt? Where does what hurt? Your leg. When I push here, does it hurt on the front or the back? The back? OK, this is the front, and this is the back. Does it hurt on the front or the back? Oh, the front.

A woman lies snoring in a monitored bed in the ER. She was brought in because she was searching a manhole for a cat. There was no cat.

A Little Disappointed

I saw my dermatologist again yesterday. He told me that he was a little disappointed that my skin hadn't cleared up very much yet. Um, yeah, same here. He thinks it will just suddenly become much clearer, like practically overnight. Either that or he'll have to up the dose. Huh? Picklefrance, as McConn would say. At least my forehead and nose have only had maybe two zits this summer, compared with SEVERAL EVERY DAY, like they used to get. Like my stubborn jaw and chin still get. The medicine seems to be working from the top of my face to the bottom.

Dr. Damm managed to take my blood with minimal digging around, which I appreciated. Let me say again that I love having a dermatologist who used to be a phlebotomy tech... one stop shopping.

After my pregnancy test came back negative (duh), I got to take the FDA-mandated online quiz, which is always fun. The questions are different every month; here are a couple from the one I took today.

I got 100% on this quiz. I won't give away the answers, in case you, dear reader, are also jumping through the Accutane hoops. You're going to have to apply your intellect, as did I.

Owie

I got blood drawn again today for my Accutane. It hurt. I'm a tough stick.

But Dr. Damm did mention that he ran some labs with my bloodwork last month (although all he needed was a pregnancy test), and everything looked great. Apparently my lipid levels were particularly delightful.

Lip Drama

If it's that bad for a fetus (and it IS), what kind of harm is it doing to me?

That is a question I am choosing not to examine too closely. I have been on Accutane for 22 days, and I saw the effects almost immediately. Notice that I did not say "results;" I said "effects." My skin has not become clearer, and I did not expect it to. My dermatologist, Dr. Damm, educated me about the possible side psychological side effects of Accutane, and he impressed upon me the importance of not becoming pregnant while the drug is in my system. But he neglected to mention the less serious but quite annoying side effects. After three days on Accutane, my face started flaking off. I thought it was just getting the way it does sometimes and needed exfoliation, so I used a Vitamin C scrub. Big mistake! It hurt badly, so I was more careful after that. The dryness continued to get worse, and I began using moisturizer 3-4 times each day (normally I don't really need moisturizer). That did not help, and the moisturizer stung my skin. I switched from my fancy oil-free Kiehl's to a less fancy Aveeno skin calming moisturizer, which helped. I am now down to two applications each day and it's not terrible as long as I don't touch my face and get something going. Sort of like when you have a sunburn: if you peel a little, you'll be stuck peeling a lot, and then you'll be in pain and looking foolish.

Speaking of sunburns, that brings me to my next annoying side effect: dry lips. Dry does not begin to describe it. Painful, red, burning, peeling lips. I was not expecting this, so I was not prepared for it. If I had been proactive in using what I am using now, maybe it would not have gotten so bad. But I have never had a problem with dry lips. Normally I use lip balm maybe once before bed (unless I'm in Utah and it's winter time). I use Burt's Bees, because that's what Laynie uses. I'm not particular. Well, I wasn't.. now I am! Burt's Bees stung my lips and probably made it worse. I tried an old Aveeno lip balm I had in my desk at work. It was better than the Bees stuff, but I still had to use it way too often. On Friday (almost three weeks on Accutane), I was using the Aveeno lip balm 2-3 times each hour, and my lips were still bothering me.

It became worse over the weekend. By Sunday afternoon, I was using the lip balm every 2-5 minutes. And my lips constantly felt like they were burning. It got to where the smooth Aveeno lip balm actually felt rough on my lips. I was feeling desperate. So I went to Wal-Mart (between this and my IHOP comments, it looks like I shop on Sundays, which I normally do not... sigh) and bought practically every moisturizing lip product they had, as well as diaper rash creams. Someone on the internet suggested that for severely dry lips. It sounded disgusting, but, like I said, I was desperate.

After trying several products, I settled on Carmex. It stung when I put it on, but then it felt better than the rest. I was able to use it every 15 minutes or so and suffer through. By this time, little blisters had formed on my lips. I used Boudreaux's Butt Paste (great name) overnight, which felt decent. But it is an opaque gray paste, so it wasn't exactly a good remedy for the day time.

I used the Carmex on Monday, but I didn't feel like my lips were improving. I was in quite a bit of pain. After work on Monday, I went online and searched specifically for Accutane and dry lips, and I found a multitude of complaints of varying severity. Looks like my case was pretty severe as far as dry lips, but other people had a lot worse side effects, like hair loss. Yikes. Anyway, one person suggested Aquaphor. I thought that was like a lotion... I remembered it as a greasy lotion that came in a tub, which I used on Morgan's eczema when she was a baby. Well, worth a try. Monday night, I went to the grocery store and got some. Aquaphor is the best! I am using it about every hour at this point, and while it does sting a little if I put it on dry lips, it seems to be improving things rather than just being a stopgap measure, like the lip balms. And it has the added bonus of looking like I have on super shiny lip gloss. Whatever. I guess that if things don't get any worse, I can handle this. I only have severe pain now after I eat, because the lip stuff gets wiped off.

I have an appointment with Dr. Damm on Monday, and I will bring it up with him.

After all this, the Accutance had better clear up my skin!