Nearly A Piece of My Mind

Today started very strangely. Here's some background:

Ever since my surgery and radiation in 2005, I have been unable to blow my nose effectively. So, every morning and evening, without fail, I rinse out my nose with over half a gallon of salted distilled water using a sinus rinse bottles.* I call this process "nouching."

Anyway, as I was rinsing this morning, I felt something hard and sharp behind my nose. I rinsed some more, and spit out a piece of my skull.

Huh?

That's right. A piece of my skull. It's about a third of an inch to a side and more or less cubic. And holy plucking schmidt! It's a piece of my skull! And, it may surprise you, but it does not look healthy. It looks like peanut brittle (though less tasty) or pumice (though less useful for removing corns). I could probably crush it to powder between my finger and thumb. And did I say that it's from my skull?

What does this mean? Is my head about to collapse into a mass of bone powder and goo? Probably not. Although the appearance of a piece of my skull in the bathroom sink was an unpleasant surprise, I know that the big part of my skull between my nose and brain is dead. I'm not sure how that leaves me alive and more-or-less healthy, but my doctors have assured me that I am alive and am in reasonable health. I'm not sure they entirely know why either. 

So, I left messages for my primary care doc, my local ENT doc, and my F'in Famous Cancer Hospital ENT doc. One nurse I spoke to said, "wow. That's different!" To say the least. I've heard back from Dr. Hygiea, Greco-Roman Goddess of otolaryngology, *** and she wants me to get a CT scan. That will have to wait.

See, I am currently spending the week in the British Virgin Islands. I called around. There is one ENT doc in the whole country. He might be able to see me in March. He will be in for emergencies tomorrow, but he'll be away for a week after that. So, if my brain lining rips and my CSF leaks onto my shoes, or if my head collapses onto my spine so that I am a human bobble-head, I'll have to get air-lifted to St. Thomas or San Juan.

I'm actually not really worried. This is just the sort of thing that happens when you have a large chunk of dead bone in the middle of your head. Really, the dangerous part is that dead bone, like a splinter, can fester and cause infections. So, all else being equal, the more of it that comes out, the better. It's like Mom always said, "better out than in." 

Tomorrow, I'll go snorkeling and look for whales.

Be well,

Tom

* By the way, I recommend this wholeheartedly to my patients. If you have a cold, sinusitis, or allergies, rinsing helps clear out the gunk. Do it as much as you can stand. The concept is disgusting, but, sometimes, it can help you avoid antibiotics, and involves no toxic products whatsoever. ENT docs love them. http://shop.neilmed.com/Products/Sinus-Rinse. The salt packets can be expensive, but pharmacies have started selling generic versions which are cheaper.

** I'm certainly not about to carry a giant jug of water on top of my head like some women in Africa. That could get ugly.

*** This is a pseudonym. 

Here's a baby gray whale checking us out in 2013. We're looking for humpbacks tomorrow. I hear there's a newborn nearby.

Well, That Was Fun!

As of last update, I was in the emergency department at Ben and Jerry's Hospital getting worked up for an episode of double vision. After a normal CT scan and MRI, I had to wait overnight for a visit from the eye doctor and for an echocardiogram to make sure there wasn't a big, floppy blood clot throwing off bits and pieces into my brain.

That was the day before yesterday. They put me in a room in 'observation' (part of the emergency room where they keep you if you are there for more than a few hours, but they don't want to admit you). Surprisingly, if you have your own room and are hard of hearing like me, you can sleep pretty well in the ER. You take your hearing aids out, put in earplugs, and it's pretty quiet. There are pluses to bad hearing. K, on the other hand, slept terribly, worrying about me.

Yesterday, late in the morning, a technician wheeled in her ultrasound machine and got an echocardiogram of my heart. This involves the tech rubbing a microphone covered with KY Jelly on my chest. Those of you who have been pregnant may be familiar with a similar experience. It's a rather slimy. To everyone's relief, there is not a great big blood clot flopping around inside my heart waiting to fly off into my brain!

Finally, the ophthalmologist came by. He examined my eyes. I'm always jealous of ophthalmologists. They have all sorts of cool equipment to look into eyes. I only get to use the wimpy kind of ophthalmoscope primary care docs get. It makes me feel inferior. Thankfully, he did not rub it in.

The ophthalmologist agreed that the most likely explanation for my episode of double vision is that my extreme fatigue had amplified the inherent weakness of the muscles that move my right eye.* I had been really tired that day. Not only was there an early-morning meeting at my office, the night before, I had a migraine and had foolishly treated it with caffeine in addition to ibuprofen. I slept terribly that night.

Shortly after the ophthalmologist left, K showed up. I was ready to go home. Sadly, because someone had to put an official read on the echo and various notes had to be written, I had to wait until late afternoon to go home. Still, I had time to take the dog for a walk. It was a pretty short ordeal for a Tumoriffic episode.

That's all, folks!

T





* The muscles that move my right eye (extraocular muscles) are weak due the radiation and surgery I received in 2005. Generally doesn't bother me unless I look down or way to the right.

** I have been getting migraines lately, probably because I just got progressive lenses, and I'm not used to them.

Saying 'goodbye' to the ER and 'hello' to my new friend. 

Embarrassing Update From the Emergency Room

So, the news has been so boring lately, I thought I would spice things up.

Yesterday morning, I was driving to work. Suddenly, there were twice as many cars in front of me as had been there the moment before. Every car had grown a twin. I blinked my eyes, but it was still true. I had double vision. Luckily, if I kept one eye closed, it went away, so I avoided dying in a flaming wreck. After a few minutes, things returned to normal. I went to work, saw my patients, and went home.

That evening, thinking that maybe my primary care doc, Dr. N, should know about this, I sent her a message. Foolish me.

Today, after I had seen a few patients, I got a call from Dr. N. She was laughing. She said, "Tom, what would you tell a patient if they sent you a message saying what you said to me?"

"Um," I tried figure out something to say other than the obvious, but there was no way around it. "I'd send them to the emergency room." And she laughed at me some more.

Reluctantly, I cancelled the rest of my appointments. I grabbed some papers off my desk, and drove home. Then, my delightful neighbor, G drove me here, the emergency room of Ben and Jerry's Hospital. *

After several hours, I have had an unremarkable CT and MRI (by my unique standards). I did not have a stroke. However, I don't get to go home tonight. We still don't know for sure what happened.

The most likely explanation is that Donald Trump. That's right. His fault. Some kind of executive order. Donald Trump.

Another possibility--the one that really seems most likely to me--is fatigue. I was ridiculously tired that morning. My work was holding a meeting at a truly ungodly hour. The muscles surrounding my right eye are weakened from all the radiation, and I think the fatigue just brought this out. This was one of the ways I reassured myself until Dr. N embarrassed me into coming here. I still think it's number one.

Next, it is possible that I had a TIA--a transient ischemic attack. ** This happens when there is a blockage in blood vessel in the brain that is temporary. This could be due to narrowing of the small vessels from all the radiation I had to my brain (a known phenomenon and probably the reason for my two strokes ***). This is quite possible. That was the other way I reassured myself. I'm already on medicine for this, so I am already doing everything that can be done.

But, then, there's the kicker. The other possibility, however remote, is that I have a big, ugly clot in the left side of my heart that just threw off some little bits that travelled to my brain. If that's the case, I'm in for an operation to get the clot out before something really exciting happens. So, I'm here in the ER for the night, waiting for an echocardiogram.

Hopefully, by tomorrow, I'll be home with the wife, the kid, the cat, and the dog.

Be well,

T




* See http://www.tumoriffic.org/LLC.htm.

**  It can also mean other things. According to the Urban Dictionary, a Tia is "a cool, smart-mouthed girl that always has something smart to say to everything. (http://www.urbandictionary.com/define.php?term=Tia) According to the Online Slang Dictionary, it may stand for "thanks in advance," "this is awkward," or "the ignorant ass." (http://onlineslangdictionary.com/meaning-definition-of/tia). It also means 'aunt' in Spanish. Or it stands for "Trump in America."

*** See August 14, 2006 (mislabelled 2007) in http://www.tumoriffic.org/Part%20III.htm and http://tumoriffic.blogspot.com/2012/03/tumoriffic-moves-to-unused-doctor.html. The latter needs a serious rewrite. I haven't looked at it in years, and it's really confusing. Sorry.