When we are no longer able to change a situation–just think of an incurable disease…–we are challenged to change ourselves” — Viktor Frankl, Man’ s Search for Meaning.
Borderline. According to my doc, I’m borderline. This is great, provided things get better. I’m confident (by which I mean really, really hoping) they will.
So as I’ve mentioned before, I have heartburn issues. They started a few months ago after a bout with a rather nasty, unrelenting flu that just wouldn’t leave. Mind you, I’ve had heartburn issues since I was 18, but these would come for about a week, then go for a year. These started getting worse over the past few years, but nothing I’d consider out of the ordinary: if I overate, or ate a wrong food, I’d get heartburn. The solution was simple: avoid overeating.
Not so this time, however. Heartburn started and stayed, for months. For a while I treated this with calcium tablets, but after a few weeks I decided to (listen to The Wife and) go to my doc to see what was going on. Of course, deciding to do something and actually doing it are two totally different things. I decided, but didn’t go. I was ashamed to, after having been there almost weekly for the past month with non-specific symptoms of something, I didn’t quite know what. Frankly, I think most of it had to do with anxiety, but not so then.
Anyway, so I waited. And kept in my junky-eating ways, until one day I got some of the worst pain I’ve ever felt, gnawing away at my abdomen like an alien burrowing through my intestines. This was on a Saturday, and by Monday I was at the doctor’s office, getting blood work done. Within a few days I went in for an ultrasound. Both of these were to check my liver and pancreas to make sure they were working properly. The suspect then became my gallbladder.
Went to a gastroenterologist who told me to get a HIDA/CCK done. This is where they lay you down under a Geiger-counter and inject you with some radioactive stuff to make your gallbladder expand, then contract. Needless to say, it made me nauseous and bloated as hell. The result was an ejection fraction of 19%, meaning the gallbladder was pumping at about 1/5th normal strength.. Recommendation was to take it out, but I resisted. The doc gave me some meds and I was on my way.
A few months later I returned to the doc. Heartburn was still there, even after changing my diet and losing weight. The next test was a “gastric emptying exam”, where I was to be the recipient of a deliciously bad radioactive egg sandwich. Mind you, this wasn’t just any sandwich: this was a scrambled egg sandwich (made with egg substitute), on white bread and with strawberry jelly. As if the strawberry jelly on an egg sandwich wasn’t disgusting enough, the egg was laced with a radioactive isotope. Maybe they were hoping to feed the alien in my intestines, I don’t know.
So I ate the sandwich, laid down under some type of scanner and then watched as the food stay in my stomach for a while, then start moving down my intestines. A week later came back to the gastroenterologist for the result: 50% gastric emptying was achieved in 80 minutes. As you can see, this test was to find out how fast my stomach would empty its contents. The expected time was around 70 minutes, but the lowest range of “normal” was at 90 minutes. I told him before he received the paperwork from the lab that my emptying rate at the end of the test looked to be at about 50% and described to him the progression. After looking at the paperwork he suggested I become a radiologist. Officially the diagnosis was inconclusive. A bit lower and I would have been officially diagnosed with gastroparesis. A bit higher and… well, I would be in the same position, I suppose.
So you’re probably wondering what gastroparesis is, and why, if I don’t officially have it, I’m talking about it.
Gastroparesis is a condition where the stomach contents empty slower than they should. (Whether it’s common or uncommon depends on who you ask, but from the numbers I’ve seen it seems that while incidents are low on an annual basis, prevalence is fairly sizable in most populations.) Sometimes this is just a bit slower, like in my case. Other times it can get bad, to the point where tubes have to be inserted in order to deliver nutrition to the person. A number of things can cause gastroparesis, but a third of all cases are considered to be “idiopathic”, meaning they have no known cause. A large percentage (perhaps including some of those idiopathic cases) are caused by post-viral syndromes. In other words, if someone, for example, had a bad flu that wouldn’t go away, and the flu bug made its way into the nervous system and attacked the vagus nerve–the nerve responsible for a great deal of the autonomic functions of the digestive system–then the impairment of this nerve could conceivably cause the stomach to not pump properly, or the gallbladder to quit functioning as it should. That’s not to say this is what happened to me, but it is certainly a possibility given my particular case. Other causes include diabetes (which I don’t have), autoimmune conditions, multiple sclerosis, Parkinson’s, autonomic neuropathy… the list goes on.
Now why am I talking about it? Because I’m having a bunch of the symptoms–heartburn, weight loss, early feeling of fullness, nausea, stomach twitching, and stomach pain being the most common–and despite the official diagnosis, being borderline to me means that I have it, but not to the point where I’ll be given any medication for it. (Normally motility agents, such as Reglan and–outside the US–Domperidone get prescribed. These help improve the stomach’s emptying by stimulating the stomach muscles.) Given my history, the doctor suggested first taking care of the anxiety issues, which is what I’m working on now. (Part of this, of course, is moving back to Tampa, which I’ll be doing by the first week of October. I really do believe that my health has deteriorated while in south Florida.) Additionally, he said that losing weight, exercising, acupuncture and moving to six small meals a day should control the heartburn. He also still recommends the gallbladder removal, but I told him I’ll request another HIDA/CCK be done in about a year to see whether there’s any change in function. If it’s considerably better, then it stays. If it’s considerably worse, then it’ll probably go. If it’s the same, then… I’ll consider that a victory. Additionally, he wants to see how the gastric emptying is like in about a year. If it’s improving, then we’re on the right road. If it’s deteriorating then we have to look into what may be the underlying issue. Needless to say I want the former.
So that’s where I’ve been. That’s why I haven’t written. Between the stuff for the house and my health concerns (really, I do tend to be too much of a hypochondriac), I just haven’t felt like writing. The fact that I’m forcing myself to do this is because I figured I had to get SOMETHING out, and this was the most pressing item on my mind.
Now that this is out, I’ll leave it as is and leave the matter alone. I’m watching my diet, exercising, and losing weight. For now, this is all I can do. Hopefully my case is one of those which stands a good chance of recovery, because while I’m not overtly concerned over what might happen the next year, I can’t help but wonder how this will affect my life when I’m in my 40’s or later. Whatever the case may be, I know this: I have a wife who’s more supportive than I could have ever imagined, and a family who’s there for me at times when I don’t even seem to be there for myself. What else can a guy really ask for? Other than for good health, I mean.
Within the week I’ll have some pictures of the new house, I promise.