Medical update

"And all this because of one small elective surgery..."

"Yup", I say.

Met a new doc today. I've been waiting months to see this one, his clinic is constantly backed up. So, since my condition isn't painful or detrimental, in this case, I took whatever appointment they had and waited.

I drove about an hour to see him. He's the ear, nose, and throat doctor that all the other ENT's I've seen about my throat click problem told me I should see. I first wrote about this problem Here.

The ways those guys have to examine things is really so unpleasant.... numb the throat with a spray, put a tube through the nose down the throat to see vocal cords. Then another scope thing to see the esophagus. I coughed, I tried to do what he needed to see stuff for the test. The exam lasted almost an hour.

By the end, he said he's not sure if he can help me. He's also not sure he can't, He's sending me for more tests and also for vocal rehabilitation (I've lost the upper range of my voice since my last surgery a year and a half ago). So, after I get a CT scan of my neck, and a swallow test (which sounds dreadful), I'll go back to him with the results, and he'll see if he can fix whatever "it" is. I've also had a chronic cough for over a year.

So far the biggest thing that came out of it is this: I should avoid any more intubations. (as if it's something I schedule in my day planner on a regular basis!)...
He said that if he can get this dislocation thing fixed, it'd be too fragile to intubate again. If he can't fix it, another intubation could cause more damage. I told him I'm going to need a hip replacement soon. He said to do it under epidural anesthesia. I confided in him after a little bit of thinking it over, that I have been quite traumatized by surgeries, and I didn't think I could do one awake, even if I wasn't feeling anything at all. He suggested other methods of "twilight sleep" + an epidural. He wrote it all down on the notes he was writing for me to take to my GP. He said anytime I may need another surgery, show the anesthesiologist and surgeon this letter.

The med student who was observing with the doctor today really got some interesting things to go learn about. He hadn't yet learned about Necrotizing Fasciitis or strep A....

Another strange thing from Sarah's life of medical anomalies.

(OMG! I was just doing a bit of research to find a picture to publish here, and I stumble on a fact: It is extremely rare, but one can get PVNS tumors in the throat. Anywhere there is synovial ducts and fluid, actually. Know that PVNS is a rare disease, no matter where it is, but I thought it was only in shoulders, knees, or hips. The doc did say he saw nodules today, and tumors from PVNS in the neck must be very small... in a few articles I read they called them nodules. WHAT???????)

OK, I am not going to put up pictures for you of anatomy of the throat and the cricothyroid joint that may be dislocated in me. Instead, I will put up pictures of two of my kids dressed for Purim yesterday. It's much easier to handle than thinking that the PVNS may be growing in my throat.

I had a red-haired girl in a black wig being a bad-luck black cat, and a Brooklyn basketball player. :)

those are *my* boots...

thanks for the cool basketball duds, uncle Peter!

We made it through Purim 2017. I layed low because of being in the year of mourning, and that suited me fine.... layed low, 

not including the round trip drive to the doctor and the difficult exam.

An update from hibernation

The wind and rain has been so cold, and the sun rarely warming anything during the day. I have been taking the opportunity to hibernate. I am so cold, always. I wear three layers to everyone else's one or two. I put the heater on, but it takes too long to warm the rooms. I've always been more of a summer/heat/beach person.

I'm stying right in here, thank you very much.

But you didn't come here to read about the weather in Be'er Sheva. I just don't know how to start writing. I'm going for calmness, equilibrium, and quiet spaces. Things have been possible lately. I say it that way because during the time period that Sabrina was getting sicker and passing away, things were impossible on every level. I stepped away from everything after she died... well, after my father (who had pneumonia) left after she died.... well, after Ya'akov's hernia surgery after she died.... you get my drift. No more drama. I almost couldn't bear to see the hospital any more. My soul needs calming. It's been through so, so much. So I think I am able to give it calming now. I am able to step away from, or avoid loudness, or take it in small quantities if I am up to it. Like shopping with my 14 year old girl. The stores today's girls want to go into... makes me crazy with the loud music and perfumed air. She knows I have a half-hour limit there. I'm so old. :)

I am sorry to report that I am in pain all the time... again.

That hip surgery I had October 2015? It's effects are gone. Osteo-arthritis in full bloom. Very painful, practically every step. I have been following a low-inflammation diet, taking cartilage supplements, and... it's back anyway. At the time my orthopedist said he didn't know how much time be "bought" me before needing a hip replacement, but now we know.

Thing is... hip replacement surgery? Now?

Next month I finally have my appointment with the throat/swallow guru of the country to finally [hopefully] correct my dislocated cartilage in my throat from that last surgery. I have waited six months to see this guy, my throat clicking away with each and every swallow.

Now I need to do another surgery, and intubation, and all the pain of recovery and physical therapy and no driving and and and and and??? (actually driving is already getting hard for me... I feel it creeping into my life- cutting out quality of life things because of pain. I've been here before too many times.)

I can wait, it's not an emergency, of course. The arthritis gets worse, but not that quickly. But I know I will not go on pain meds, so I don't have much to rely on as this is worsening. I just am doing less. Even playing ping-pong with Azriel kills my hip, and that's really not so strenuous. But he's so cute and loves it so much, I hate {{again}} having to say no to him because of my physical or emotional shortcomings at any given time. The kid barely ever knew me not sick.... or I should say, as strong as I was before I got sick in 2007.

Shabbat is approaching. I'm glad I got to write a bit... thanks for hanging in there with me.

Love from cold and rainy (and hail-y!!) Be'er Sheva.

Life after intubation

Weird title, I know. I mean, intubation in and of itself isn't especially traumatic, unless it's done in a trauma situation, which my last surgery was not by any means. It is just a necessity of having surgery.

So why bother writing about it?
Well, seems that something happened in my throat during the intubation (or extubation when they take out the breathing tube) from my surgery two months ago.

Since the surgery I've had three symptoms which haven't gone away:
1. a very disturbing "click" in my throat EVERY time I swallow. Food, drink, saliva... every time, all day and night, whatever I swallow passes over some bump, I feel the bumpy road, and it makes a clicking noise. A million times a day. Annoying as hell.

2. a cough, inconsistent, but present, also all day. It's not a "sick" kind of cough, it just exists.

3. Loss of upper range of my singing/talking voice. Any sort of animated vocal inflections sometimes come out as just air, no sound. Again, inconsistent, but frustrating.

This has been going on for two months, since my surgery. I kept waiting for it to get better on it's own, and it isn't. Yesterday I finally went to an ENT to check it out.

He was excellent. Did some tests, one of which was using a fiber optic tiny camera to see my vocal cords & airway. Not a lovely feeling, but not painful. He said that aside from a little swelling on one side of my esophagus, it looks completely normal. He was looking for a ridge of cartilage out of place. He presumed he'd see that after hearing my symptoms. He had a few patients in his practice over the years who had that after an intubation. But he didn't see the signs he thought he'd see to diagnose it. (sounds like all the illnesses I've had- they mask themselves as nothing until they keep getting worse and become a big, nasty 'something').

He felt the click with his own hand on my throat. He heard it with a stethoscope on my throat (the sound is *much* more amplified for me because it is happening in my head). But yet he didn't see it with the fiber optic camera. He was puzzled.

He called a speech therapist who specializes in throat trauma. He called while I was there in his office, which I thought was very conscientious and caring of him. The speech therapist said he'd see me, and we made an appointment for Jan 3rd.

He wrote a referral for a few more tests. One is a swallow test, where you swallow things from thick to liquid in a slow succession and analyze each type of action. The other is some sort of imaging using radiation, but I forgot the name of it.

We talked for some time, the appointment was about an hour... *extremely* unusual for a doctor who isn't a psychiatrist, right? He told me about a guy who works in a hospital in Rechovot, about an hour away from me. This guy was trained by the Guru of Gurus in Boston. Well, it turns out that I actually was treated by that Guru of Gurus when I was having singing issues when I lived in Boston! Going back about 25 years, I was having problems of my upper vocal register getting airy and cut off while I was singing (I used to sing in a Jewish choir called "the Zamir Chorale of Boston"). This otolaryngologist I was referred to did a full work-up of my singing, and diagnosed polyps on my vocal cords. He offered to operate to remove them, but I never went through with the surgery. My horn playing was at the forefront of my career, and I couldn't take off time for a fairly trivial problem.

Well that budding vocal diagnostician became the most famous otolaryngologist on the planet over the next 20 years (his name is Dr. Steven Zeitels). So the guy in Rechovot is one of his most talented protegees. Interesting, right? My ENT tried to call him, also, while I was in his office, but that doctor didn't answer.

After the appointment I went home. As soon as I walked in the door, my cell phone rang. It was the ENT! I was quite surprised. He wanted to tell me that he was able to talk to the guy in Rechovot after I left. He explained the situation to him, and didn't have good news for me. That doctor said he has seen two patients over his career (-two-) with the exact same problem. It is extremely unusual, and it never went away. Never. went. away. My ENT said it may be one of those things that I'll have to get used to, like when someone has a ringing in their ear constantly has to get used to it. That did *not* make me happy in the slightest. Already my life is such that I have been forced to get used to pains and strange nerve events in my leg. These things come about, and I have learned to keep a straight face and incorporate it into the regular way I am. But this swallowing thing, it's *really* distracting. Everything I swallow trips over a bump on it's way down. And along with that pronounced feeling comes a sound, amplified in my head. May never go away? Good God, that is a depressing thought.

It's another Sarah Klein anomaly. One more thing to add to the strange and atypical medical occurrences in my life.

I'll do the recommended tests, and see that speech therapist in a few weeks and see where it leads me. My ENT (who I saw yesterday) said that it's not *definitely* irreparable, but I have to know that's a possibility.

In short... don't have surgery. Strange (sometimes awful) things happen, and if you can put up with the issue without operating on it, better to do that. Take my word for it. Weigh out your options carefully... shit happens. Take my word for it.

(I'll be off-line for a few days, going for a two day visit with my lovely sister-in-law in Modi'in, not bringing the laptop. My phone- with internet- is never too far from my reach, though. :)