.
I was talking with a longtime business associate on the telephone today. We were catching up. After talking about business, we talked about my stroke. Then we talked about my friend Mimi's son who suffered a devastating brain injury resulting from a blow to the head that caused permanent disability. York shared with me the story of his 17-year-old daughter.
York's daughter is an athlete, a soccer player and cheerleader. York mentioned to me that he and his wife were concerned about their daughter because she had suffered her third concussion. Her doctors were insisting on a significant amount of time off from sports to recover from this concussion. Sometimes, I wonder if people realize the long-term brain damage that can result from fairly simple injuries.
As a boy and young adults, I suffered at least for concussions resulting from being knocked out. First, I was a gymnast. I got knocked out twice! On the first occasion, we were standing in line waiting to do the pommel horse. We always did limbering up exercises while waiting in line. The guy in front of me went into a hand stand, only his heels hit me in the chin and knocked me cold. Many months later, I was working on perfecting my hand stand on the parallel bars, but on one of the handstands, my right elbow did not lock. Instead of just letting myself down, I tried for a couple of seconds to lock the right elbow ... oops... bad decision ... the right elbow folded and I went on my head, knocking myself out again.
In the gymnastics off-season, I was a swimmer and diver. I was doing a reverse jackknife from the high platform. I have to admit, I was kind of a mediocre diver. On this dive, I didn't jump far enough away from the platform, cracked my head, and knocked myself out. Fortunately, it made a lot of noise, so the coach got me out of the pool right away.
They say, three times, a charm. Fooled again! I was no angel in high school. Like the lines of that old rocks soong, I was smokin' in the boys room. Some bully walked in and grab the cigarette out of my mouth and broke it. Bullies are we like to pick on the little kid. He really made me angry. I made some smart remark to him. Then he started getting physical, like all bullies. Being a small guy, always one of the one or two smallest in my class I didn't wait for it to escalate. I had no interest in getting knocked around. Most of the jerks in school at lease knew that I was a gymnast, and usually just left me alone. But this particular jerk apparently was new. He started pushing me and shoving me and asking me if I wanted the fight. I just kept backing up. I just kept avoiding a confrontation. But then he made a fist, and cocked his arm, ready to hit me. That was it. I wasn't going to get hit. There was no more room to back up or to get around him and get out the door. So, very quickly, and I might also add, unexpectedly, grabbed him around the neck, put them on the floor and choked him. I guess I embarrassed them to. The next day, he walked up the hallway and approach me from behind, at my locker. I never saw him. He tapped me on the shoulder and KO'd me with a roll of quarters in his fist. I was out quite a while! I got suspended for a day. He got expelled.
Repeated head injuries, even those which seem minor at the time, can have dramatic, long-term effects. How many boxers ended up like Mohammed Ali? He only got knocked out a few times in his career. However, the cumulative effect could have easily precipitated the Parkinson's disease which he suffered not too long after his retirement. How many of us could be walking around with ticking time bombs locke up inside our skull? I will probably never know if those repeated knockouts in my youth contributed to the TIAs, and ultimately the stroke that I suffered, there is certainly a high likelihood of correlation.
If you or someone you love has ever been hit in the head and dazed or knocked unconscious, do yourself a huge favor. Learn it, know, and watch for the signs of stroke. Like the saying, you can never be too rich or too thin, you can never be too cautious or too overly concerned when it comes to worrying about head injuries.
Thursday, November 4, 2010
Monday, November 1, 2010
Practice makes perfect? Or: That’s why they call it the practice of medicine. 0080
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Doctors amazed me. In fact, the entire medical establishment amazes me. think about it. Nurses care for you. They take care of you. nurses treat you. One says, “I am a nurse.” Or, one may say, ”He or she is a nurse.” But you never hear anybody say, “She practices nursing.” on the other hand, you often hear of a cardiology practice or in internal medicine practice, or “She practices internal medicine.”
Frankly, I don’t want someone who’s going to practice on me! I want someone who knows what they’re going to do. I want somebody who practiced on somebody else. Or, at least I want somebody was being supervised by somebody who doesn’t practice any more! Practice on the other guy. Treat me.
While I am at it, I have another bone to pick. If I need a plumber, I look up plumbers, and I select the best price with the best experience for the job I need done. I pay for it. The same goes for the people who cut my grass, clean my carpets, replace my Windows, and sell me car insurance. My employer doesn't pay my car insurance. (I wish they did.)
Now, I am typically not placing my life in any of those peoples hands. Sometimes, I may opt for the cheapest price. Sometimes, I may opt for the best price with the right level of experience. However, when it comes to medical care, in this country, we usually leave it up to someone else. This typically, we have the customer. We aren't a liar. Our employer is.
How many of us have employer paid health insurance? How many of us have HMO or PPO plans? How many of us have someone else tell us what Dr. we can see or what medical procedure or test we can have done? It’s a life-and-death decision which is handled by organizations that are looking for the cheapest price and are paid by somebody else, somebody else who isn't sick, injured or dying! The person footing the bill doesn't have a stake in the treatment. They wanted cheap, not good, not excellent. They are happy with people at practice.
We wonder why health care and health insurance is so expensive. Well, it's simple marketing. If I have one guy competing to sell me a peanut, and he's the only guy with a peanut, and all my neighbors want to buy that same one, the peanut is going to go to the highest bidder. But if there is thousands people selling peanuts, thousands of peanuts, and millions of buyers -- there is more competition. Peanuts get cheaper. We need millions of individuals to be competing for cheap healthcare and cheap insurance, not just thousands of companies. There are approximately 300,000,000 people in the United States. 300 million shoppers can definitely get a better price than 300,000, or the Fortune 1000, or the Fortune 100. There is very little economic incentive to cut medical costs in this country.
By the way, is everybody entitled to a $500,000 or million Dollar medical procedure? Is everyone entitled to the best possible care, the best care they're willing to pay for, or the best care they can afford ? Good question! Nobody is willing to pay me $1 million a year right now -- however, some insurance company might end up having a $1 million in medical expenses! That's just weird.
We maybe the doctors patient, but we are certainly not the doctors customer. That bothers me!. I don’t let my employer pick my grass cutter or my plumber -- and they’re not even going to kill me if they screw up! do I really trust corporate America with my life? Something is definitely wrong with this picture.
Doctors amazed me. In fact, the entire medical establishment amazes me. think about it. Nurses care for you. They take care of you. nurses treat you. One says, “I am a nurse.” Or, one may say, ”He or she is a nurse.” But you never hear anybody say, “She practices nursing.” on the other hand, you often hear of a cardiology practice or in internal medicine practice, or “She practices internal medicine.”
Frankly, I don’t want someone who’s going to practice on me! I want someone who knows what they’re going to do. I want somebody who practiced on somebody else. Or, at least I want somebody was being supervised by somebody who doesn’t practice any more! Practice on the other guy. Treat me.
While I am at it, I have another bone to pick. If I need a plumber, I look up plumbers, and I select the best price with the best experience for the job I need done. I pay for it. The same goes for the people who cut my grass, clean my carpets, replace my Windows, and sell me car insurance. My employer doesn't pay my car insurance. (I wish they did.)
Now, I am typically not placing my life in any of those peoples hands. Sometimes, I may opt for the cheapest price. Sometimes, I may opt for the best price with the right level of experience. However, when it comes to medical care, in this country, we usually leave it up to someone else. This typically, we have the customer. We aren't a liar. Our employer is.
How many of us have employer paid health insurance? How many of us have HMO or PPO plans? How many of us have someone else tell us what Dr. we can see or what medical procedure or test we can have done? It’s a life-and-death decision which is handled by organizations that are looking for the cheapest price and are paid by somebody else, somebody else who isn't sick, injured or dying! The person footing the bill doesn't have a stake in the treatment. They wanted cheap, not good, not excellent. They are happy with people at practice.
We wonder why health care and health insurance is so expensive. Well, it's simple marketing. If I have one guy competing to sell me a peanut, and he's the only guy with a peanut, and all my neighbors want to buy that same one, the peanut is going to go to the highest bidder. But if there is thousands people selling peanuts, thousands of peanuts, and millions of buyers -- there is more competition. Peanuts get cheaper. We need millions of individuals to be competing for cheap healthcare and cheap insurance, not just thousands of companies. There are approximately 300,000,000 people in the United States. 300 million shoppers can definitely get a better price than 300,000, or the Fortune 1000, or the Fortune 100. There is very little economic incentive to cut medical costs in this country.
By the way, is everybody entitled to a $500,000 or million Dollar medical procedure? Is everyone entitled to the best possible care, the best care they're willing to pay for, or the best care they can afford ? Good question! Nobody is willing to pay me $1 million a year right now -- however, some insurance company might end up having a $1 million in medical expenses! That's just weird.
We maybe the doctors patient, but we are certainly not the doctors customer. That bothers me!. I don’t let my employer pick my grass cutter or my plumber -- and they’re not even going to kill me if they screw up! do I really trust corporate America with my life? Something is definitely wrong with this picture.
Stoned again! Redux: living with kidney stones (0070)
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When it rains, it pours. Right after I had my stroke, I went to the doctor about a pain in my back on the right side. My family doctor sent me to a specialist. The specialist decided that I had kidney stones.
I have had kidney stones before. Now for those of you who are uneducated, there are two distinct types of kidney stones. The most common kind is caused by calcium buildup to the kidney the second, and by far more rare, is the uric acids Crystal buildup in the kidney resulting from a condition called gout. the symptoms are similar, but the treatments are completely different. For uric acid crystals, they pump you up with fluids and wait. The stone resolves itself. Usually. With calcium-based kidney stones, they generally do a process called lithotripsy where they use ultrasonic vibrations to smash the stone to sand. You then eliminate it naturally, well, sort of naturally. Mistake number one. I have a history of gout. I told the doctor that. Even so, he still recommended lithotripsy. That's what happens when you go to a surgeon. He recommends what he knows.
I talked to a number of people about lithotripsy. I talked to both doctors and patients. Basically, the cure can be worse than the disease. Unless your stones are killing you, don't do it. Based on that advice, I didn't. And, of course, the doctor was not happy. However, realizing that the stones resulted of the gout, the doctor prescribed allopurinol, which is fine. However, with a list of all my meds in his hands, he prescribed potassium citrate. Other than the fact that that drug interacts with every other medication I was taking, and which the doctor had on his list, it was fine.
Well, it nearly killed me. It crashed my blood pressure. Everybody asked me what he prescribe. Now I'm debating whether to sue over. I probably won't. Bad karma.
When it rains, it pours. Right after I had my stroke, I went to the doctor about a pain in my back on the right side. My family doctor sent me to a specialist. The specialist decided that I had kidney stones.
I have had kidney stones before. Now for those of you who are uneducated, there are two distinct types of kidney stones. The most common kind is caused by calcium buildup to the kidney the second, and by far more rare, is the uric acids Crystal buildup in the kidney resulting from a condition called gout. the symptoms are similar, but the treatments are completely different. For uric acid crystals, they pump you up with fluids and wait. The stone resolves itself. Usually. With calcium-based kidney stones, they generally do a process called lithotripsy where they use ultrasonic vibrations to smash the stone to sand. You then eliminate it naturally, well, sort of naturally. Mistake number one. I have a history of gout. I told the doctor that. Even so, he still recommended lithotripsy. That's what happens when you go to a surgeon. He recommends what he knows.
I talked to a number of people about lithotripsy. I talked to both doctors and patients. Basically, the cure can be worse than the disease. Unless your stones are killing you, don't do it. Based on that advice, I didn't. And, of course, the doctor was not happy. However, realizing that the stones resulted of the gout, the doctor prescribed allopurinol, which is fine. However, with a list of all my meds in his hands, he prescribed potassium citrate. Other than the fact that that drug interacts with every other medication I was taking, and which the doctor had on his list, it was fine.
Well, it nearly killed me. It crashed my blood pressure. Everybody asked me what he prescribe. Now I'm debating whether to sue over. I probably won't. Bad karma.
You are what you carry (0061)
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First, a serious note. Then we'll have time for a little humor.
Physically, my recovery was pretty remarkable. I got out of the wheelchair. I forced myself to. I got my right arm out of the sling. I could walk on cement, concrete and hard surfaces. I started walking with a cane, one of those canes that has four legs on it. Gradually, I started walking on grass and uneven surfaces.
But, as my physical improvement progressed, the disruption of my sleep schedule continued. On top
of that, the almost year long euphoria evaporated. I was beset by a crushing, suicidal depression. I literally wanted to end it all. Fortunately, I have a higher than average IQ. I could see, could realize what was happening to me. I’m convinced that it was by sheer willpower alone that I didn’t just slit my wrists. Every time those thoughts entered my head I thought about my kids. I thought about my mother. I thought how upset they would be. And frankly, even though I am a physical and financial mess, I still managed to help my kids and my mother. I think that’s the only thing that kept me going.
Now it's time for a funny, illustrative story of strokes in human behavior.
Okay, I admit it. I'm getting old. But you people under 50 should really watch this TV show. I mean, the guy was cool. He lived in a wild West, always dressed up, didn't even limp, but carried this amazingly cool black cane with a silver handle, kind of a ball shaped affair. Very debonair.
I went from being paralyzed in the hospital, to negotiating my way in a wheelchair when I went home to finally walking with a serious lip. For a long time, my right arm was in a sling and totally useless. But now things are getting better.
I switched to a regular cane. I got better and better at it. Now, in familiar surroundings, I walk without a cane. I noticed something. If you limp, and have a weak arm, and don’t walk with a cane -- people look at you funny and young children (at least the bratty ones) snicker. However, a man with a cane... that is sophistication. A man with a cane is someone to be reckoned with. A man with a cane gets doors opened for him.a man with a cane is called Sir!
Of course, that depends on what kind of cane you carry, I discovered. I have a fancy, jet black, L-shaped affair that I got to go with my tuxedo for my son’s wedding. It is very debonair! Walking with a that cane garners instant respect. I had one of those aluminum jobs with the foam rubber on the handle. It was better than limping nakedly, but only marginally. I think people take pity on somebody with one of those aluminum and foam rubber jobs. However, my jet black number, that gets respect. isn’t it amazing how appearances affect behavior?
I eventually got my arm out of the sling. I was in the sling because the weight of my arm hanging down was actually separating my shoulder joint! Again, with therapy, I gradually got back the use of my arm. It’s not like it was. I have no fine motor skills. I can pick things up. I can hold a hammer. I can do things that don’t require fine motor control. So, I guess, typing is out of the question Thank God I was left-handed!
Maybe I'll just mosey on down, and get myself a derby hat!
Back when the west was very young, There lived a man named Masterson.
He wore a cane and derby hat, They called him Bat - Bat Masterson.
A man of steel the stories say But women's eyes all glanced his way
A gambler's game he always won. His name was Bat - Bat Masterson The trail that he blazed is still there. No one has come since, to replace his name. And those with too ready a trigger, Forgot to figger on his lightning cane.
Now in the legend of the West, One name stands out of all the rest. The man who had the fastest gun, His name was Bat - Bat Masterson.
-- Theme song from Bat Masterson TV show
First, a serious note. Then we'll have time for a little humor.
Physically, my recovery was pretty remarkable. I got out of the wheelchair. I forced myself to. I got my right arm out of the sling. I could walk on cement, concrete and hard surfaces. I started walking with a cane, one of those canes that has four legs on it. Gradually, I started walking on grass and uneven surfaces.
But, as my physical improvement progressed, the disruption of my sleep schedule continued. On top
of that, the almost year long euphoria evaporated. I was beset by a crushing, suicidal depression. I literally wanted to end it all. Fortunately, I have a higher than average IQ. I could see, could realize what was happening to me. I’m convinced that it was by sheer willpower alone that I didn’t just slit my wrists. Every time those thoughts entered my head I thought about my kids. I thought about my mother. I thought how upset they would be. And frankly, even though I am a physical and financial mess, I still managed to help my kids and my mother. I think that’s the only thing that kept me going.
Now it's time for a funny, illustrative story of strokes in human behavior.
Okay, I admit it. I'm getting old. But you people under 50 should really watch this TV show. I mean, the guy was cool. He lived in a wild West, always dressed up, didn't even limp, but carried this amazingly cool black cane with a silver handle, kind of a ball shaped affair. Very debonair.
I went from being paralyzed in the hospital, to negotiating my way in a wheelchair when I went home to finally walking with a serious lip. For a long time, my right arm was in a sling and totally useless. But now things are getting better.
I switched to a regular cane. I got better and better at it. Now, in familiar surroundings, I walk without a cane. I noticed something. If you limp, and have a weak arm, and don’t walk with a cane -- people look at you funny and young children (at least the bratty ones) snicker. However, a man with a cane... that is sophistication. A man with a cane is someone to be reckoned with. A man with a cane gets doors opened for him.a man with a cane is called Sir!
Of course, that depends on what kind of cane you carry, I discovered. I have a fancy, jet black, L-shaped affair that I got to go with my tuxedo for my son’s wedding. It is very debonair! Walking with a that cane garners instant respect. I had one of those aluminum jobs with the foam rubber on the handle. It was better than limping nakedly, but only marginally. I think people take pity on somebody with one of those aluminum and foam rubber jobs. However, my jet black number, that gets respect. isn’t it amazing how appearances affect behavior?
I eventually got my arm out of the sling. I was in the sling because the weight of my arm hanging down was actually separating my shoulder joint! Again, with therapy, I gradually got back the use of my arm. It’s not like it was. I have no fine motor skills. I can pick things up. I can hold a hammer. I can do things that don’t require fine motor control. So, I guess, typing is out of the question Thank God I was left-handed!
Maybe I'll just mosey on down, and get myself a derby hat!
Stroke and Insomnia...Sleepless in Seattle (0050)
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Pace ... sit ... watched TV... read ... pay some more ... lay in bed with eyes closed ... lay in bed with eyes open ... pace ... I think I will go crazy if this doesn't quit soon. Insomnia. The inability to sleep. It was driving me nuts.
The average person needs eight hours of sleep a night. There are basically three sleep stages. The eight hours is divided into a) about 2 1/2 hours of various sleep stages to get to sleep, b) 2 1/2 hours of various sleep stages to wake up, and c) three hours of deep, restful, dreamless sleep known technically as somnambulism, otherwise known as deep sleep (getting there and waking up are called REM, initials for rapid eye movement, characteristic of that form of sleep).
Some people, either naturally or through training, can get to deep sleep very quickly. Those people need the ability to sleep three hours, and spend whatever time it takes to fall asleep and wake up. falling asleep and waking up times seem to have no effect on the body.
When I was younger, As a result of training, I used to sleep only about four hours a day. It gradually became more as I grew older. but basically, anybody can train themselves to fall asleep and wake up quickly. I used to be able to sleep on planes trains and automobiles. Basically, if I was moving and not driving, I slept. It was a very useful skill.
For the first several months after my stroke, sleeping was not the problem. I'd sack out of 8 or 9 PM and wake up by 5 or 6 AM. It was actually a very nice schedule. I also noticed, I might trip to Connecticut, but I hadn't lost my skill of falling asleep on the airplane. Life was good.
It was after I got to Connecticut that I started having problems. At first, I attributed to a new environment, doing something exciting, lots of reasons. two years after my stroke, I still found that I had major, periodic sleep disturbances.
Pace ... sit ... watched TV... read ... pay some more ... lay in bed with eyes closed ... lay in bed with eyes open ... pace ... I think I will go crazy if this doesn't quit soon. Insomnia. The inability to sleep. It was driving me nuts.
The average person needs eight hours of sleep a night. There are basically three sleep stages. The eight hours is divided into a) about 2 1/2 hours of various sleep stages to get to sleep, b) 2 1/2 hours of various sleep stages to wake up, and c) three hours of deep, restful, dreamless sleep known technically as somnambulism, otherwise known as deep sleep (getting there and waking up are called REM, initials for rapid eye movement, characteristic of that form of sleep).
Some people, either naturally or through training, can get to deep sleep very quickly. Those people need the ability to sleep three hours, and spend whatever time it takes to fall asleep and wake up. falling asleep and waking up times seem to have no effect on the body.
When I was younger, As a result of training, I used to sleep only about four hours a day. It gradually became more as I grew older. but basically, anybody can train themselves to fall asleep and wake up quickly. I used to be able to sleep on planes trains and automobiles. Basically, if I was moving and not driving, I slept. It was a very useful skill.
For the first several months after my stroke, sleeping was not the problem. I'd sack out of 8 or 9 PM and wake up by 5 or 6 AM. It was actually a very nice schedule. I also noticed, I might trip to Connecticut, but I hadn't lost my skill of falling asleep on the airplane. Life was good.
It was after I got to Connecticut that I started having problems. At first, I attributed to a new environment, doing something exciting, lots of reasons. two years after my stroke, I still found that I had major, periodic sleep disturbances.
Reconnecting (0040)
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Before my stroke, I was a highly active, some would say hyperactive person. I was pretty much a daredevil. I tried bungee jumping, parasailing, motorcycle riding. Once, my wife and I actually got in a cage to pet a full grown female tiger! (Personally,I still marvel that we did that! That definitely scared me. Also, by the way, Tigers smell bad! ) I loved to fly airplanes. I was a private pilot and spent most of my flight hours in a four passenger Cessna Skyhawk. I loved it. My wife was a bit of a daredevil two. She took flying lessons with me. Unfortunately, my kids weren’t quite so adventuresome. They refuse to get in a private plane with me!
Well, my son doesn’t even want to get into a commercial airliner. There wasn’t much that I wouldn’t try at least once.
With that type of personal history, more than a few people wondered why I seemed so euphoric in the hospital. My condition certainly precluded a lot of activities that I used to enjoy.
I spent more than a month in the hospital and in the rehabilitation ward, recovering from my stroke. One thing that amazed many people, including my family, including me…was my unusually good mood. Here I was – no income, in the hospital, paralyzed on the right side and unable to walk or use my right arm or hand. You would think that would be a very depressing thing. But I wasn’t depressed at all. My kids and my mother, at the time, attributed it to some really good rugs they must have been giving me. It wasn’t until I got back home that I realized that I was now taking the same drugs that I was taking in the hospital. There were no magic mushrooms to perk up my mood. Just stuff to keep the blood pressure down, fight off blood clots and keep the gout under control. That’s it.
What accounted for my unusual attitude in the hospital? If you couldn’t walk or use your right arm, scooting around in a wheelchair, and were now dependent upon the people around you when you were fiercely independent before – that would seem like a prescription for depression.
After talking with my stroke doctor, Dr. Hayes, I figured it out. I had lived a high-pressure lifestyle. The highs were enormously high. The lows were cavernously low. Very little time was spent in the middle ground. Although I love my kids and my kids love me, my romantic relationships managed to alienate them. My relationships were volatile. I was an all or nothing person.
The euphoria that I experienced after my stroke wasn’t due to drugs and wasn’t experiential. It was because, for the first time in my life, I really treasured those simple things in life that we take for granted in our daily lives, that we forget about when we are busy – family and friends. Disabled as I was, the workforce would have to wait. My kids, my mother, a few of my close friends were the most important things in my life. Their presence, their happiness and their companionship was what made me happy.
While I was sick I lost my house and most of my personal possessions! I only had a couple of van loads of stuff left. It was a very buddhist-like existence, forsaking the things of this temporal world. But I had family and friends. My partner Adam had been my friend for more than 20 years and he stood by me. My friend Arnie, ditto.
As my recovery progressed, I found a few more of those old friends. Bill, Tara, Andrew and Sheila, Jonathan, Mimi, Charlotta, Adam2 and Zannell, Frank, Manny, and more than I can even remember have stayed in touch and supported me throughout my ongoing recovery. That’s worth more than cash -- well, it’s worth more than cash as long as you can still afford to eat.
Good Drugs Dude!
Once you have an ischemic stroke, a stroke caused by a blood clot, you spend the rest of your life on drugs. Here is the cocktail they had me on in the beginning, and modified today.
Plavix is the first drug introduced. Plavix has largely replaced the previous clot reducer, heprin, which had far more side effects. Plavix reduces the chance of having a second incident.
Metforemin is a drug that replaces the need for insulin in type II diabetics. Diabetes is common in stroke victims as the damage to the brain frequently reduces the body's ability to regulate its own insulin production.
Lipitor, known technically as atorvastatin, reduces the amount of bad cholesterol, known as low-density lipoprotein, LDL, while at the same time, usually increasing the amount of good cholesterol, high-density lipoprotein, a or HDL. The build up of LDL in the blood stream often contributes stroke.
Lisinopril is in a group of drugs called ACE inhibitors. ACE stands for angiotensin converting enzyme. Lisinopril is used to treat high blood pressure (hypertension), congestive heart failure, and to improve survival after a stroke.
Vesicare, in my case, was prescribed but eventually eliminated. One of the side effects of stroke and paralysis of one side of the body is often incontinence (unpredictable urination). However, as my condition continued to improve, this drug was eliminated.
In my particular case, I have long had a history of gout, or the build up of uric acid crystals in the body originally, this condition caused the joints in my lower extremity, hips, knees and feet to swell and become painful as the uric acid crystals build up in the joints. There are two types of gout. Overproduction of uric acid and the inability to eliminate uric acid. In my case, it was not the body's ability to eliminate uric acid, but rather the overproduction of uric acid which caused the problems. I was prescribed allopurinol to reduce my body's production of uric acid.
Prior to my stroke, Gout had become a bigger problem. Instead of just accumulating in my joints, were eliminated, the uric acid started building up in my kidney. The resul was kidney stones. Most people get kidney stones as a result of a buildup of calcium in the kidneys, and various medical procedures including lithotripsy are required. With gout however the production of uric acid can result in uric acid kidney stones rather than calcium kidney stones. However, the symptoms are the same.
Post stroke, I was affected by kidney stones. However, the pain associated with the kidney stones did not occur as the nervous system was deadened on the right side of my body. Eventually I discovered the problem and went to a doctor who wanted to perform lithotripsy. After talking to many people who lithotripsy done, and upon finding out that it was indicated only for calcium kidney stones, I opted for the process of patiently waiting for them to dissolve. However, the doctor who was treating me for kidney stones also prescribed allopurinol, since I hadn't taken it for years. He also prescribed potassium citrate, which is often given in conjunction with allopurinol.
There's just one problem! Potassium citrate adversely interact with virtually every other drug that I was prescribed. I'm still not quite sure why, given a list of the drugs I was currently taking, the doctor didn't notice that. I'm even more distressed that the pharmacy which runs a drug interaction program didn't bother to tell me either! My normal blood pressure is around 120 to 140 over 70 to 80. On two separate occasions my blood pressure dropped to 60/40. That's nearly dead! It took two trips to the emergency room before the emergency room attendants discovered that the potassium citrate was interacting with the other drugs, all the other drugs, but I was taking.
Frankly, I'm lucky to be alive. People have died from such drug interactions.
Add section about strokes and depression.
Note: as write about cycle -- originally had ADD, very fast cycle. And the TIAs and stroke recovery progressed, cycles lengthened. Discuss amplitude pre-and post-stroke.
Before my stroke, I was a highly active, some would say hyperactive person. I was pretty much a daredevil. I tried bungee jumping, parasailing, motorcycle riding. Once, my wife and I actually got in a cage to pet a full grown female tiger! (Personally,I still marvel that we did that! That definitely scared me. Also, by the way, Tigers smell bad! ) I loved to fly airplanes. I was a private pilot and spent most of my flight hours in a four passenger Cessna Skyhawk. I loved it. My wife was a bit of a daredevil two. She took flying lessons with me. Unfortunately, my kids weren’t quite so adventuresome. They refuse to get in a private plane with me!
Well, my son doesn’t even want to get into a commercial airliner. There wasn’t much that I wouldn’t try at least once.
With that type of personal history, more than a few people wondered why I seemed so euphoric in the hospital. My condition certainly precluded a lot of activities that I used to enjoy.
I spent more than a month in the hospital and in the rehabilitation ward, recovering from my stroke. One thing that amazed many people, including my family, including me…was my unusually good mood. Here I was – no income, in the hospital, paralyzed on the right side and unable to walk or use my right arm or hand. You would think that would be a very depressing thing. But I wasn’t depressed at all. My kids and my mother, at the time, attributed it to some really good rugs they must have been giving me. It wasn’t until I got back home that I realized that I was now taking the same drugs that I was taking in the hospital. There were no magic mushrooms to perk up my mood. Just stuff to keep the blood pressure down, fight off blood clots and keep the gout under control. That’s it.
What accounted for my unusual attitude in the hospital? If you couldn’t walk or use your right arm, scooting around in a wheelchair, and were now dependent upon the people around you when you were fiercely independent before – that would seem like a prescription for depression.
After talking with my stroke doctor, Dr. Hayes, I figured it out. I had lived a high-pressure lifestyle. The highs were enormously high. The lows were cavernously low. Very little time was spent in the middle ground. Although I love my kids and my kids love me, my romantic relationships managed to alienate them. My relationships were volatile. I was an all or nothing person.
The euphoria that I experienced after my stroke wasn’t due to drugs and wasn’t experiential. It was because, for the first time in my life, I really treasured those simple things in life that we take for granted in our daily lives, that we forget about when we are busy – family and friends. Disabled as I was, the workforce would have to wait. My kids, my mother, a few of my close friends were the most important things in my life. Their presence, their happiness and their companionship was what made me happy.
While I was sick I lost my house and most of my personal possessions! I only had a couple of van loads of stuff left. It was a very buddhist-like existence, forsaking the things of this temporal world. But I had family and friends. My partner Adam had been my friend for more than 20 years and he stood by me. My friend Arnie, ditto.
As my recovery progressed, I found a few more of those old friends. Bill, Tara, Andrew and Sheila, Jonathan, Mimi, Charlotta, Adam2 and Zannell, Frank, Manny, and more than I can even remember have stayed in touch and supported me throughout my ongoing recovery. That’s worth more than cash -- well, it’s worth more than cash as long as you can still afford to eat.
Good Drugs Dude!
Once you have an ischemic stroke, a stroke caused by a blood clot, you spend the rest of your life on drugs. Here is the cocktail they had me on in the beginning, and modified today.
Plavix is the first drug introduced. Plavix has largely replaced the previous clot reducer, heprin, which had far more side effects. Plavix reduces the chance of having a second incident.
Metforemin is a drug that replaces the need for insulin in type II diabetics. Diabetes is common in stroke victims as the damage to the brain frequently reduces the body's ability to regulate its own insulin production.
Lipitor, known technically as atorvastatin, reduces the amount of bad cholesterol, known as low-density lipoprotein, LDL, while at the same time, usually increasing the amount of good cholesterol, high-density lipoprotein, a or HDL. The build up of LDL in the blood stream often contributes stroke.
Lisinopril is in a group of drugs called ACE inhibitors. ACE stands for angiotensin converting enzyme. Lisinopril is used to treat high blood pressure (hypertension), congestive heart failure, and to improve survival after a stroke.
Vesicare, in my case, was prescribed but eventually eliminated. One of the side effects of stroke and paralysis of one side of the body is often incontinence (unpredictable urination). However, as my condition continued to improve, this drug was eliminated.
In my particular case, I have long had a history of gout, or the build up of uric acid crystals in the body originally, this condition caused the joints in my lower extremity, hips, knees and feet to swell and become painful as the uric acid crystals build up in the joints. There are two types of gout. Overproduction of uric acid and the inability to eliminate uric acid. In my case, it was not the body's ability to eliminate uric acid, but rather the overproduction of uric acid which caused the problems. I was prescribed allopurinol to reduce my body's production of uric acid.
Prior to my stroke, Gout had become a bigger problem. Instead of just accumulating in my joints, were eliminated, the uric acid started building up in my kidney. The resul was kidney stones. Most people get kidney stones as a result of a buildup of calcium in the kidneys, and various medical procedures including lithotripsy are required. With gout however the production of uric acid can result in uric acid kidney stones rather than calcium kidney stones. However, the symptoms are the same.
Post stroke, I was affected by kidney stones. However, the pain associated with the kidney stones did not occur as the nervous system was deadened on the right side of my body. Eventually I discovered the problem and went to a doctor who wanted to perform lithotripsy. After talking to many people who lithotripsy done, and upon finding out that it was indicated only for calcium kidney stones, I opted for the process of patiently waiting for them to dissolve. However, the doctor who was treating me for kidney stones also prescribed allopurinol, since I hadn't taken it for years. He also prescribed potassium citrate, which is often given in conjunction with allopurinol.
There's just one problem! Potassium citrate adversely interact with virtually every other drug that I was prescribed. I'm still not quite sure why, given a list of the drugs I was currently taking, the doctor didn't notice that. I'm even more distressed that the pharmacy which runs a drug interaction program didn't bother to tell me either! My normal blood pressure is around 120 to 140 over 70 to 80. On two separate occasions my blood pressure dropped to 60/40. That's nearly dead! It took two trips to the emergency room before the emergency room attendants discovered that the potassium citrate was interacting with the other drugs, all the other drugs, but I was taking.
Frankly, I'm lucky to be alive. People have died from such drug interactions.
(Reference exploding pill story here).
Add section about strokes and depression.
Note: as write about cycle -- originally had ADD, very fast cycle. And the TIAs and stroke recovery progressed, cycles lengthened. Discuss amplitude pre-and post-stroke.
Reconnecting
Before my stroke, I was a highly active, some would say hyperactive person. I was pretty much a daredevil. I tried bungee jumping, parasailing, motorcycle riding. Once, my wife and I actually got in a cage to pet a full grown female tiger! (Personally,I still marvel that we did that! That definitely scared me. Also, by the way, Tigers smell bad! ) I loved to fly airplanes. I was a private pilot and spent most of my flight hours in a four passenger Cessna Skyhawk. I loved it. My wife was a bit of a daredevil two. She took flying lessons with me. Unfortunately, my kids weren’t quite so adventuresome. They refuse to get in a private plane with me! Well, my son doesn’t even want to get into a commercial airliner. There wasn’t much that I wouldn’t try at least once.
With that type of personal history, more than a few people wondered why I seemed so euphoric in the hospital. My condition certainly precluded a lot of activities that I used to enjoy.
I spent more than a month in the hospital and in the rehabilitation ward, recovering from my stroke. One thing that amazed many people, including my family, including me…was my unusually good mood. Here I was – no income, in the hospital, paralyzed on the right side and unable to walk or use my right arm or hand. You would think that would be a very depressing thing. But I wasn’t depressed at all. My kids and my mother, at the time, attributed it to some really good rugs they must have been giving me. It wasn’t until I got back home that I realized that I was now taking the same drugs that I was taking in the hospital. There were no magic mushrooms to perk up my mood. Just stuff to keep the blood pressure down, fight off blood clots and keep the gout under control. That’s it.
What accounted for my unusual attitude in the hospital? If you couldn’t walk or use your right arm, scooting around in a wheelchair, and were now dependent upon the people around you when you were fiercely independent before – that would seem like a prescription for depression.
After talking with my stroke doctor, Dr. Hayes, I figured it out. I had lived a high-pressure lifestyle. The highs were enormously high. The lows were cavernously low. Very little time was spent in the middle ground. Although I love my kids and my kids love me, my romantic relationships managed to alienate them. My relationships were volatile. I was an all or nothing person.
The euphoria that I experienced after my stroke wasn’t due to drugs and wasn’t experiential. It was because, for the first time in my life, I really treasured those simple things in life that we take for granted in our daily lives, that we forget about when we are busy – family and friends. Disabled as I was, the workforce would have to wait. My kids, my mother, a few of my close friends were the most important things in my life. Their presence, their happiness and their companionship was what made me happy.
While I was sick I lost my house and most of my personal possessions! I only had a couple of van loads of stuff left. It was a very buddhist-like existence, forsaking the things of this temporal world. But I had family and friends. My partner Adam had been my friend for more than 20 years and he stood by me. My friend Arnie, ditto.
As my recovery progressed, I found a few more of those old friends. Bill, Tara, Andrew and Sheila, Jonathan, Mimi, Charlotta, Adam2 and Zannell, Frank, Manny, and more than I can even remember have stayed in touch and supported me throughout my ongoing recovery. That’s worth more than cash -- well, it’s worth more than cash as long as you can still afford to eat.
Good Drugs Dude!
Once you have an ischemic stroke, a stroke caused by a blood clot, you spend the rest of your life on drugs. Here is the cocktail they had me on in the beginning, and modified today.
In my particular case, I have long had a history of gout, or the build up of uric acid crystals in the body originally, this condition caused the joints in my lower extremity, hips, knees and feet to swell and become painful as the uric acid crystals build up in the joints. There are two types of gout. Overproduction of uric acid and the inability to eliminate uric acid. In my case, it was not the body's ability to eliminate uric acid, but rather the overproduction of uric acid which caused the problems. I was prescribed allopurinol to reduce my body's production of uric acid.
Prior to my stroke, Gout had become a bigger problem. Instead of just accumulating in my joints, were eliminated, the uric acid started building up in my kidney. The resul was kidney stones. Most people get kidney stones as a result of a buildup of calcium in the kidneys, and various medical procedures including lithotripsy are required. With gout however the production of uric acid can result in uric acid kidney stones rather than calcium kidney stones. However, the symptoms are the same.
Post stroke, I was affected by kidney stones. However, the pain associated with the kidney stones did not occur as the nervous system was deadened on the right side of my body. Eventually I discovered the problem and went to a doctor who wanted to perform lithotripsy. After talking to many people who lithotripsy done, and upon finding out that it was indicated only for calcium kidney stones, I opted for the process of patiently waiting for them to dissolve. However, the doctor who was treating me for kidney stones also prescribed allopurinol, since I hadn't taken it for years. He also prescribed potassium citrate, which is often given in conjunction with allopurinol.
There's just one problem! Potassium citrate adversely interact with virtually every other drug that I was prescribed. I'm still not quite sure why, given a list of the drugs I was currently taking, the doctor didn't notice that. I'm even more distressed that the pharmacy which runs a drug interaction program didn't bother to tell me either! My normal blood pressure is around 120 to 140 over 70 to 80. On two separate occasions my blood pressure dropped to 60/40. That's nearly dead! It took two trips to the emergency room before the emergency room attendants discovered that the potassium citrate was interacting with the other drugs, all the other drugs, but I was taking.
Frankly, I'm lucky to be alive. People have died from such drug interactions.
The Exploding Pill: a bit of humor.
As I mentioned, I have had a condition known as gout, for years. I was first diagnosed when I was about 17 years old by a doctor who was also a family friend. Prior to that, I have complained of pain in my knee for about two years and had the diagnosed with all kinds of strange ailments. None of them actually turned out to be true. . However, my mother sent me off to her friend. Knowing my history, he smiled the minute I walked in. You have gout! That's what he told. He didn't even ask me any questions or look at my knee. My mom had filled him in on the symptoms. Of course, he had to do some blood tests to verify. He was right.
That was back in the 1970s. The treatment of choice for gout, at the time, was a pill called Colchicine. I took it every day. However, I was warned, take it with food. Well, I was late for work. I popped the Colchicine, hopped in the car and started to drive to work. Suddenly, I had indigestion. It wasn't bad, just a little uncomfortable. Then I burped! Blue smoke came billowing out of my mouth accompanied by a horrible aftertaste! I had no idea what was, but the discomfort when away, and I didn't think about it for a while.
A couple of weeks later, I was relating the story to a coworker. I hadn't figured it out, but driving to work I mysteriously belched blue smoke! I cited the smoke and the foul taste. And she immediately started laughing. I agree, it was funny. But not that funny. Then she told me that she had a similar experience. She asked me if I had gout. I said yes, of course. Then she asked me if I was taking Colchicine. Yes, I answered unexpectedly. As she advised me that she also had gout, that she had been prescribed Colchicin, that they told her to take it on a full stomach -- and she didn't. The consequence was that pill blew up in her stomach causing her to belch blue smoke, have a lousy taste in her mouth, and, since she was obviously smarter than me, call a doctor! He told her what happened, said she was lucky, and told her not to take the damn bill on empty stomach.
Add section about strokes and depression.
Note: as write about cycle -- originally had ADD, very fast cycle. And the TIAs and stroke recovery progressed, cycles lengthened. Discuss amplitude pre-and post-stroke.
With that type of personal history, more than a few people wondered why I seemed so euphoric in the hospital. My condition certainly precluded a lot of activities that I used to enjoy.
I spent more than a month in the hospital and in the rehabilitation ward, recovering from my stroke. One thing that amazed many people, including my family, including me…was my unusually good mood. Here I was – no income, in the hospital, paralyzed on the right side and unable to walk or use my right arm or hand. You would think that would be a very depressing thing. But I wasn’t depressed at all. My kids and my mother, at the time, attributed it to some really good rugs they must have been giving me. It wasn’t until I got back home that I realized that I was now taking the same drugs that I was taking in the hospital. There were no magic mushrooms to perk up my mood. Just stuff to keep the blood pressure down, fight off blood clots and keep the gout under control. That’s it.
What accounted for my unusual attitude in the hospital? If you couldn’t walk or use your right arm, scooting around in a wheelchair, and were now dependent upon the people around you when you were fiercely independent before – that would seem like a prescription for depression.
After talking with my stroke doctor, Dr. Hayes, I figured it out. I had lived a high-pressure lifestyle. The highs were enormously high. The lows were cavernously low. Very little time was spent in the middle ground. Although I love my kids and my kids love me, my romantic relationships managed to alienate them. My relationships were volatile. I was an all or nothing person.
The euphoria that I experienced after my stroke wasn’t due to drugs and wasn’t experiential. It was because, for the first time in my life, I really treasured those simple things in life that we take for granted in our daily lives, that we forget about when we are busy – family and friends. Disabled as I was, the workforce would have to wait. My kids, my mother, a few of my close friends were the most important things in my life. Their presence, their happiness and their companionship was what made me happy.
While I was sick I lost my house and most of my personal possessions! I only had a couple of van loads of stuff left. It was a very buddhist-like existence, forsaking the things of this temporal world. But I had family and friends. My partner Adam had been my friend for more than 20 years and he stood by me. My friend Arnie, ditto.
As my recovery progressed, I found a few more of those old friends. Bill, Tara, Andrew and Sheila, Jonathan, Mimi, Charlotta, Adam2 and Zannell, Frank, Manny, and more than I can even remember have stayed in touch and supported me throughout my ongoing recovery. That’s worth more than cash -- well, it’s worth more than cash as long as you can still afford to eat.
Good Drugs Dude!
Once you have an ischemic stroke, a stroke caused by a blood clot, you spend the rest of your life on drugs. Here is the cocktail they had me on in the beginning, and modified today.
- Plavix is the first drug introduced. Plavix has largely replaced the previous clot reducer, heprin, which had far more side effects. Plavix reduces the chance of having a second incident.
- Metforemin is a drug that replaces the need for insulin in type II diabetics. Diabetes is common in stroke victims as the damage to the brain frequently reduces the body's ability to regulate its own insulin production.
- Lipitor, known technically as atorvastatin, reduces the amount of bad cholesterol, known as low-density lipoprotein, LDL, while at the same time, usually increasing the amount of good cholesterol, high-density lipoprotein, a or HDL. The build up of LDL in the blood stream often contributes stroke.
- Lisinopril is in a group of drugs called ACE inhibitors. ACE stands for angiotensin converting enzyme. Lisinopril is used to treat high blood pressure (hypertension), congestive heart failure, and to improve survival after a stroke.
- Vesicare, in my case, was prescribed but eventually eliminated. One of the side effects of stroke and paralysis of one side of the body is often incontinence (unpredictable urination). However, as my condition continued to improve, this drug was eliminated.
In my particular case, I have long had a history of gout, or the build up of uric acid crystals in the body originally, this condition caused the joints in my lower extremity, hips, knees and feet to swell and become painful as the uric acid crystals build up in the joints. There are two types of gout. Overproduction of uric acid and the inability to eliminate uric acid. In my case, it was not the body's ability to eliminate uric acid, but rather the overproduction of uric acid which caused the problems. I was prescribed allopurinol to reduce my body's production of uric acid.
Prior to my stroke, Gout had become a bigger problem. Instead of just accumulating in my joints, were eliminated, the uric acid started building up in my kidney. The resul was kidney stones. Most people get kidney stones as a result of a buildup of calcium in the kidneys, and various medical procedures including lithotripsy are required. With gout however the production of uric acid can result in uric acid kidney stones rather than calcium kidney stones. However, the symptoms are the same.
Post stroke, I was affected by kidney stones. However, the pain associated with the kidney stones did not occur as the nervous system was deadened on the right side of my body. Eventually I discovered the problem and went to a doctor who wanted to perform lithotripsy. After talking to many people who lithotripsy done, and upon finding out that it was indicated only for calcium kidney stones, I opted for the process of patiently waiting for them to dissolve. However, the doctor who was treating me for kidney stones also prescribed allopurinol, since I hadn't taken it for years. He also prescribed potassium citrate, which is often given in conjunction with allopurinol.
There's just one problem! Potassium citrate adversely interact with virtually every other drug that I was prescribed. I'm still not quite sure why, given a list of the drugs I was currently taking, the doctor didn't notice that. I'm even more distressed that the pharmacy which runs a drug interaction program didn't bother to tell me either! My normal blood pressure is around 120 to 140 over 70 to 80. On two separate occasions my blood pressure dropped to 60/40. That's nearly dead! It took two trips to the emergency room before the emergency room attendants discovered that the potassium citrate was interacting with the other drugs, all the other drugs, but I was taking.
Frankly, I'm lucky to be alive. People have died from such drug interactions.
The Exploding Pill: a bit of humor.
As I mentioned, I have had a condition known as gout, for years. I was first diagnosed when I was about 17 years old by a doctor who was also a family friend. Prior to that, I have complained of pain in my knee for about two years and had the diagnosed with all kinds of strange ailments. None of them actually turned out to be true. . However, my mother sent me off to her friend. Knowing my history, he smiled the minute I walked in. You have gout! That's what he told. He didn't even ask me any questions or look at my knee. My mom had filled him in on the symptoms. Of course, he had to do some blood tests to verify. He was right.
That was back in the 1970s. The treatment of choice for gout, at the time, was a pill called Colchicine. I took it every day. However, I was warned, take it with food. Well, I was late for work. I popped the Colchicine, hopped in the car and started to drive to work. Suddenly, I had indigestion. It wasn't bad, just a little uncomfortable. Then I burped! Blue smoke came billowing out of my mouth accompanied by a horrible aftertaste! I had no idea what was, but the discomfort when away, and I didn't think about it for a while.
A couple of weeks later, I was relating the story to a coworker. I hadn't figured it out, but driving to work I mysteriously belched blue smoke! I cited the smoke and the foul taste. And she immediately started laughing. I agree, it was funny. But not that funny. Then she told me that she had a similar experience. She asked me if I had gout. I said yes, of course. Then she asked me if I was taking Colchicine. Yes, I answered unexpectedly. As she advised me that she also had gout, that she had been prescribed Colchicin, that they told her to take it on a full stomach -- and she didn't. The consequence was that pill blew up in her stomach causing her to belch blue smoke, have a lousy taste in her mouth, and, since she was obviously smarter than me, call a doctor! He told her what happened, said she was lucky, and told her not to take the damn bill on empty stomach.
Add section about strokes and depression.
Note: as write about cycle -- originally had ADD, very fast cycle. And the TIAs and stroke recovery progressed, cycles lengthened. Discuss amplitude pre-and post-stroke.
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