Hiya!
Another update. The pain in my stomach was bad the night before, so yesterday I went into the emergency room at my hospital. After a 5 hour wait (!) they put in an IV to administer pain and anti-nausea meds, as well as fluids. Here's the funny part; I rated my pain (on a scale of 1-10) when I entered at a 6-7, but just minutes after the pain med push in the IV, it went up even higher (maybe to an 8), and stayed that way for a good 40 minutes. During that time they did bloodwork, chest x-ray and ultrasound.
Good news - the bloodwork was all normal and the chest x-ray is okay. The ultrasound did show some fat in my liver, which can cause stretching and expansion, and can account for the pain. A CT scan would be more accurate and give more info, but the doc didn't want to do that unless necessary because I've had so many of those in the last couple of years. In his words, he didn't want me to 'light up like a Christmas tree'. He also though it was possible I had a stomach issue (an ulcer perhaps) and wants me to follow up with my primary care and a gastrointestinal specialist.
So I'm seeing my PCP on Friday (when my next INR was already scheduled), and hopefully he'll have a referral for the specialist before then (since he can access my hospital records right now - he's in that network). The ER doc gave me scripts for pain (percecet) and for acid control (xanax).
My PCP in Tucson had long ago noted (as a result of an earlier scan) that my liver was about 1 cm. larger than normal, but I have no idea if this scan showed the same or a different result - I'll ask on Friday. So for now it's basically reduce acidic foods and follow-up with the GI specialist. What a pain, but at least I got a good night's sleep last night.
Here's the odd connection (to me, at least). Several times before last spring, I attempted to start an exercise program using my stationary recumbent bike, but each time I developed tenderness in that region and ultimately stopped. Then I started swimming in May, and added in the bike but at a lower level. As the months passed I added more of the bike to even out the two forms of exercise. And now the tenderness is back, with some added sharper/longer pains periodically. It makes me wonder if the biking motion was resulting in additional pressure on that somewhat enlarged organ (my liver) and if that was irritating it. Or even if the bit of extra muscle I'd been developing was adding pressure to that area. I really have no idea, but it will be interesting to follow up with the GI guy and see.
Since I had my gall bladder removed in 1990, there could be another connection. Stomach fluids are of course acidic, to break down food, and gall bladder bile is caustic - to counteract the acidic stomach fluid. Without the gall bladder, stomach acid can be a bigger problem. I don't have a history of 'heart burn' from stomach acid (except during the time leading up my gall bladder being removed), but if I've developed an ulcer, then that could be more of an issue now. Of course the previous history of a bunch of chemo can have caused a lot of things, so that's one possibility. If so the Xanax should help, so I'll be watching that. Again, looking forward to the GI visit to resolve this!
Tuesday, February 4, 2014
Sunday, February 2, 2014
Status Update: Feb. 2, 2014
Hi everyone, and for those who follow American Football, happy Super Bowl day! It's actually on right now, as a matter of fact. I'm way behind on keeping up with my blog, but will try to get back on track this month.
The last two months were full of tests, although I've covered many of them in my last entries. The last things done were the monthly INR and porta-cath flush. I've been on 5 mg. of Warfarin for quite a while now, and it was keeping my INR steady at ~2.5 (the range is 2-3), but my Jan. reading went to 3.1 and they reduced my dosage to 2.5 mg. two days out of the week. I thought for sure the numbers would drop below 2 with that level, but instead they've stayed mid-range, so the dosage change stays for now. So far we haven't been able to figure out what made the change.
Blood work was done during my Dec. porta-cath flush and it was noticed that my creatinine level had been climbing over the last six months. It's been out of range high ever since the transplant, but normally not enough to worry over. My oncologist did lab work again during the flush in mid-February, but the number had reversed itself back down toward the high end of the range, although still not in it. Good that it didn't continue climbing at any rate - one less thing to worry about. I'm pretty sure she'll run the tests again during my next flush (in late Feb.) so we can see if it's stabilizing.
In general I've just felt a bit off since December, between the weird high blood pressure upon standing, the tightness in my throat/neck, and some tenderness in my abdomen - enough to keep me from continuing my exercise program. During the downtime I actually gained 3 pounds back (which I suppose might be considered a good sign as being sick usually causes me to lose weight). I've restarted the exercise in a limited way - bike only, not swimming, and definitely not the heat of the sauna, in case that played a role in some of the earlier respiratory issues. I'm back to doing the same number of miles on the bike, but in two 30-minute sessions, rather than one, to see if the abdomen tenderness gets better or worse. If it improves, or at least doesn't get worse, I'll try to get back to same miles, in a 55 minute session. February will be my 'get back on course' month (hopefully), and I'll start tracking the numbers again in March.
Just to play it safe I'll probably go see a gastroenterologist - need to ask my primary care physician for a referral for that, and I've been avoiding it. We checked out so many issues these last few months, and all came up negative - I think he's beginning to believe the symptoms are psychosomatic, and I'm beginning to wonder the same, if it weren't for the fact they felt quite real. On the general schedule, I also expect my oncologist to schedule a PET scan after my next appointment in late February. For me, that's the BIG test. I used to have it done quarterly after the transplant, and am now down to annually.
The flip side of the coin is that I've gotten a lot of writing done. I think (hope) that I've finished the final drafts of books 1 and 2 of my young adult series, and am about a third done with the first draft of book 3. Hopefully I'll finish the first draft by the end of the month - we'll see. I'm detail outlining book 4 now too, so I'm hopeful that I'll actually go right into that 4th and last book of the series right after the 3rd one, doing the first drafts back to back. Fingers crossed on everything, of course.
The last two months were full of tests, although I've covered many of them in my last entries. The last things done were the monthly INR and porta-cath flush. I've been on 5 mg. of Warfarin for quite a while now, and it was keeping my INR steady at ~2.5 (the range is 2-3), but my Jan. reading went to 3.1 and they reduced my dosage to 2.5 mg. two days out of the week. I thought for sure the numbers would drop below 2 with that level, but instead they've stayed mid-range, so the dosage change stays for now. So far we haven't been able to figure out what made the change.
Blood work was done during my Dec. porta-cath flush and it was noticed that my creatinine level had been climbing over the last six months. It's been out of range high ever since the transplant, but normally not enough to worry over. My oncologist did lab work again during the flush in mid-February, but the number had reversed itself back down toward the high end of the range, although still not in it. Good that it didn't continue climbing at any rate - one less thing to worry about. I'm pretty sure she'll run the tests again during my next flush (in late Feb.) so we can see if it's stabilizing.
In general I've just felt a bit off since December, between the weird high blood pressure upon standing, the tightness in my throat/neck, and some tenderness in my abdomen - enough to keep me from continuing my exercise program. During the downtime I actually gained 3 pounds back (which I suppose might be considered a good sign as being sick usually causes me to lose weight). I've restarted the exercise in a limited way - bike only, not swimming, and definitely not the heat of the sauna, in case that played a role in some of the earlier respiratory issues. I'm back to doing the same number of miles on the bike, but in two 30-minute sessions, rather than one, to see if the abdomen tenderness gets better or worse. If it improves, or at least doesn't get worse, I'll try to get back to same miles, in a 55 minute session. February will be my 'get back on course' month (hopefully), and I'll start tracking the numbers again in March.
Just to play it safe I'll probably go see a gastroenterologist - need to ask my primary care physician for a referral for that, and I've been avoiding it. We checked out so many issues these last few months, and all came up negative - I think he's beginning to believe the symptoms are psychosomatic, and I'm beginning to wonder the same, if it weren't for the fact they felt quite real. On the general schedule, I also expect my oncologist to schedule a PET scan after my next appointment in late February. For me, that's the BIG test. I used to have it done quarterly after the transplant, and am now down to annually.
The flip side of the coin is that I've gotten a lot of writing done. I think (hope) that I've finished the final drafts of books 1 and 2 of my young adult series, and am about a third done with the first draft of book 3. Hopefully I'll finish the first draft by the end of the month - we'll see. I'm detail outlining book 4 now too, so I'm hopeful that I'll actually go right into that 4th and last book of the series right after the 3rd one, doing the first drafts back to back. Fingers crossed on everything, of course.
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