I haven't posted anything in a week because there hasn't really been anything new to report. The past week has been largely more of the same. Overall I'm doing better and I feel that I am still progressing but I've still had a fair amount of chronic pain for which I am still taking a Vicodin about once every 4 hours.
The problem at hand seems to be in getting my bowels to a state of normalcy. I've pretty definitively linked my bowel issues to this sciatic pain that has primarily setup shop around my right knee just above in the femur and just below in the shin. Oddly, my knee itself doesn't hurt. Laying down/sleeping is still the primary way it all seems to come together so I am still waking up in the night with the pain as well as waking to the pain in the morning. What has changed is that it doesn't really go away all day. The meds keep it under control, but I have to take them regularly to keep it that way.
The issue is that I seem to be in a constant state of constipation these days making several hurried yet unproductive trips to the bathroom throughout the day. Once I finally do make a trip that is productive, it is then followed by a bout of diarrhea over a couple of hours which then turns back to constipation. The doc has me upping the laxatives to try and deal with it, but it's been difficult to find the right balance. Fortunately my appetite seems to be fine but I haven't been choosing the best diet either and that's something that I need to work on which will probably help.
One thing that is odd is that my whole schedule seems to have shifted somewhat. For a long time, I was getting groggy between 2 and 5 and the afternoon, so much so that I would often have to lay down and take a nap, even if it was just for 30 minutes. That period now seems to have shifted to the 5-7 hour and is usually followed by whatever bowel issue I'm having that day. This results in my not really getting to bed, and to sleep, until around 1 or 2 o'clock in the morning which leaves me really groggy when I get up in the morning. It seems like I've been spending a lot of not-so quality time in the bathroom after my wife goes to bed as every time I get up and walk out, I'm faced with a sudden urge to return. I hate to admit this, but I have, on several occasions, fallen asleep while sitting on the toilet. Here's to hoping this phase of my journey ends sooner that later.
Thursday, February 28, 2013
Friday, February 22, 2013
The Last Two Days Have Been a Pain in the...
This past week has run the usual gamut of ups and downs. It started off on an unusually high note on Sunday as I got up and went to church with the family. This was the first Sunday that I've felt up for it since November. I made it through without any issues so we decided to celebrate my newly returned appetite by going to Macaroni Grill for lunch afterwards. I surprised myself by eating a normal meal, perhaps even a little more than one should at a "normal" sitting. The rest of the day went pretty well although I didn't really feel much like dinner later on, but that was more about the large lunch that I'd had than any feelings of sickness or appetite loss.
Monday was a holiday and is mostly a blur at this point as nothing stands out in my memory as particularly good or bad about the day.
Tuesday was a pretty good day as well for me, however my wife was under the weather which left me having to balance work with making sure that she and the girls were taken care of throughout the day. After I took the girls to gym practice it started taking a bit of a turn for me. After going to bed I didn't sleep for long before waking up with pain in my right leg. This started a cycle of bouncing between sitting up in the living room waiting for meds to kick in then going to bed until the pain came back and repeat until morning came and I had to get up. I think I only got about 3 hours sleep in all.
Wednesday, the pain was pretty persistent all day as I had to take a Vicodin, or two, regularly throughout the day and into the night without it completely going away. Accompanying this was some pretty severe constipation throughout the day which was pretty much the source of it all. I finally got it to pass that evening only to be kept up half the night with diarrhea. Every time I'd star to go to bed, I'd have to run back to the bathroom. This kept up until around 2 or 3 when I was finally able to get to bed and sleep.
I got up today feeling much like I did on Wednesday but somehow things calmed down by noonish and I felt better the rest of the day. I put in a call to the pain specialist to follow up with him from my appointment last week. I told him about the recent days' events and he said that it was unfortunately very common among patients in my situation to have bouts of extreme constipation followed by diarrhea. He said the main concern is the constipation since it is causing the pain and told me to up my dosage of the laxative that I'm taking. So we'll try that and see what happens. It took me a while to get to bed tonight and now I'm up here at 2:00 AM with some minor constipation as the roller coaster ride continues. We'll see what the extra dose of laxative does for me. I was hoping to get some sleep tonight as I've only been averaging 3-4 hours per night, but it's not looking to be in the cards. Perhaps I'll be able to catch up this weekend.
For some reason, it has seemed extra cold in the house the last couple of days. My wife has felt the same, though she had a low grade fever for at least a couple of them. It's weird, because the house has been at the same temperature that it's always been but for some reason it just seemed drafty even though this house is sealed up pretty good. The temps outside have been cooler, in the 20s and 30s with a wind chill in the teens, and somehow that cold has felt to me like it has permeated the house. The girls, of course, have been running around in short sleeves and bare feet without any complaints so I think that it must just be a side effect of feeling crummy. This morning I just couldn't seem to get warm so layered up in a t-shirt, sweater and heavy hoodie in order to get warm. I also had to put on some thick wool socks which seemed to make the most difference. All of this despite keeping the fire going strong in the wood stove all day.
I still tell people who ask how I'm doing that I'm trending upward and I do believe that to be the case, though it seems to be upward in a 3 steps forward, 2 steps back kind of movement. Overall, when I think how things have been just a few weeks ago, I am doing better. The toughest thing to realize is just how short of a time I've been at this. I'm still just under 3 months since my diagnosis and even less time under treatment. Though it has seemed like forever, it's really just been a blink of an eye and so much has been packed into that blink that it's already tough to think back and remember it all. I had hoped to be mostly back to normal by now, but what do I know about it. I really have no experience to point to in this. I'm sure there are some out there who have been through it before who would read this blog and be in disbelief at how far I've come in such a short time. As I've said before, patience has never been a virtue that I've embraced.
Monday was a holiday and is mostly a blur at this point as nothing stands out in my memory as particularly good or bad about the day.
Tuesday was a pretty good day as well for me, however my wife was under the weather which left me having to balance work with making sure that she and the girls were taken care of throughout the day. After I took the girls to gym practice it started taking a bit of a turn for me. After going to bed I didn't sleep for long before waking up with pain in my right leg. This started a cycle of bouncing between sitting up in the living room waiting for meds to kick in then going to bed until the pain came back and repeat until morning came and I had to get up. I think I only got about 3 hours sleep in all.
Wednesday, the pain was pretty persistent all day as I had to take a Vicodin, or two, regularly throughout the day and into the night without it completely going away. Accompanying this was some pretty severe constipation throughout the day which was pretty much the source of it all. I finally got it to pass that evening only to be kept up half the night with diarrhea. Every time I'd star to go to bed, I'd have to run back to the bathroom. This kept up until around 2 or 3 when I was finally able to get to bed and sleep.
I got up today feeling much like I did on Wednesday but somehow things calmed down by noonish and I felt better the rest of the day. I put in a call to the pain specialist to follow up with him from my appointment last week. I told him about the recent days' events and he said that it was unfortunately very common among patients in my situation to have bouts of extreme constipation followed by diarrhea. He said the main concern is the constipation since it is causing the pain and told me to up my dosage of the laxative that I'm taking. So we'll try that and see what happens. It took me a while to get to bed tonight and now I'm up here at 2:00 AM with some minor constipation as the roller coaster ride continues. We'll see what the extra dose of laxative does for me. I was hoping to get some sleep tonight as I've only been averaging 3-4 hours per night, but it's not looking to be in the cards. Perhaps I'll be able to catch up this weekend.
For some reason, it has seemed extra cold in the house the last couple of days. My wife has felt the same, though she had a low grade fever for at least a couple of them. It's weird, because the house has been at the same temperature that it's always been but for some reason it just seemed drafty even though this house is sealed up pretty good. The temps outside have been cooler, in the 20s and 30s with a wind chill in the teens, and somehow that cold has felt to me like it has permeated the house. The girls, of course, have been running around in short sleeves and bare feet without any complaints so I think that it must just be a side effect of feeling crummy. This morning I just couldn't seem to get warm so layered up in a t-shirt, sweater and heavy hoodie in order to get warm. I also had to put on some thick wool socks which seemed to make the most difference. All of this despite keeping the fire going strong in the wood stove all day.
I still tell people who ask how I'm doing that I'm trending upward and I do believe that to be the case, though it seems to be upward in a 3 steps forward, 2 steps back kind of movement. Overall, when I think how things have been just a few weeks ago, I am doing better. The toughest thing to realize is just how short of a time I've been at this. I'm still just under 3 months since my diagnosis and even less time under treatment. Though it has seemed like forever, it's really just been a blink of an eye and so much has been packed into that blink that it's already tough to think back and remember it all. I had hoped to be mostly back to normal by now, but what do I know about it. I really have no experience to point to in this. I'm sure there are some out there who have been through it before who would read this blog and be in disbelief at how far I've come in such a short time. As I've said before, patience has never been a virtue that I've embraced.
Sunday, February 17, 2013
Appetite for Reconstruction
My appetite seems to be coming back on it's own without any artificial assistance. I don't know this is due to the radiation effects leveling off, acclimation to the new regime of pain meds, having my bowels become a little more regular, getting rid of the Thrush, or perhaps some combination of the above, whatever the cause, I'm finding myself getting hungry on occasion, primarily during my midnight awakenings. I also find myself being more interested in eating. Even when I don't necessarily feel hungry, I am having an easier time eating whatever is placed before me.
An interesting twist to all of this is that generally, I'm most interested in eating foods on the more healthy side. For some reason, the more junky foods still have little or no appeal to me and I find myself having to force them down whereas the healthier stuff has no problem. Funny how the body can do adapt in times of stress and relay what is needed most. I'm not ready for the all you can eat buffet yet, then again, I've never really been a fan of them, and I'm not sure if I'm back to consuming the required daily minimum of calories, but I've definitely turned the corner from complete disinterest in eating and am feeling a little more "normal" in that respect.
On a related note, because of the weight loss concerns, my doctor recommended that I avoid the "low fat" foods, especially dairy, suggesting that I eat whole milk yogurt, etc... I generally agree with this anyway, finding the whole "low fat" craze to be more marketing than good nutrition, but since being given this directive, I've found that it's damn near impossible to find products made with whole milk. Today I went to the grocery store to pick up a few things and yogurt was one of the things on my list. I prefer the greek style yogurt as it tends to be less sweet than the "regular" yogurt. Out of the entire 12 foot yogurt counter, there was only one selection of whole milk yogurt. All of the rest were either low fat or fat free which seems largely pointless, especially since most of these fat deprived options are full of sugar and other sweeteners. They're not really low calorie, they've just replaced good calories with bad. Cottage cheese was another. I struck out on finding whole milk cottage cheese, so I went with he highest fat option that I could find, a startling 4%.
An interesting twist to all of this is that generally, I'm most interested in eating foods on the more healthy side. For some reason, the more junky foods still have little or no appeal to me and I find myself having to force them down whereas the healthier stuff has no problem. Funny how the body can do adapt in times of stress and relay what is needed most. I'm not ready for the all you can eat buffet yet, then again, I've never really been a fan of them, and I'm not sure if I'm back to consuming the required daily minimum of calories, but I've definitely turned the corner from complete disinterest in eating and am feeling a little more "normal" in that respect.
On a related note, because of the weight loss concerns, my doctor recommended that I avoid the "low fat" foods, especially dairy, suggesting that I eat whole milk yogurt, etc... I generally agree with this anyway, finding the whole "low fat" craze to be more marketing than good nutrition, but since being given this directive, I've found that it's damn near impossible to find products made with whole milk. Today I went to the grocery store to pick up a few things and yogurt was one of the things on my list. I prefer the greek style yogurt as it tends to be less sweet than the "regular" yogurt. Out of the entire 12 foot yogurt counter, there was only one selection of whole milk yogurt. All of the rest were either low fat or fat free which seems largely pointless, especially since most of these fat deprived options are full of sugar and other sweeteners. They're not really low calorie, they've just replaced good calories with bad. Cottage cheese was another. I struck out on finding whole milk cottage cheese, so I went with he highest fat option that I could find, a startling 4%.
Thursday, February 14, 2013
In a Thrush
Last night I went to bed at 10 and was up at 11 with my leg hurting. I had already taken 2 Vicodin at that point so I couldn't take anything more for some time. I was so sleepy that I felt like passing out, but couldn't seem to do so laying down so I went into the living room, sat on the floor cross-legged, piled up 3 throw pillows in my lap, threw a blanket over my shoulders and put my head down on the pillows. I managed to sleep that way for about an hour and a half then woke up with my leg asleep and went back to bed. I managed to sleep for about another hour and was up at 1:45 with the pain again. I had had pretty bad constipation all through the day and the pain from it was adding to the pain in my leg. I finally gave in and gave myself an enema. That seemed to do the trick and afterwards, I took a Vicodin and sat in the living room until the pain in my leg subsided. I then went back to bed and slept the rest of the night without incident.
I still think that it's somehow tied to my bowel issues as it seems that the sciatic pain increases with my level of constipation and subsides once it is resolved. Today, I had the pain early on, and took a Vicodin when I got up at 8:00 and another at 10:00 because the first dose wasn't quite doing it, but then I had a bowel movement around noon and had no more pain until around 5:30 and overall felt pretty good in between.
At the start of all of this, I was getting incredibly drowsy everyday between 2:00-4:00 to the point that I had to nap because I couldn't shake it. That now seems to have vanished and in it's place I now have the Ugh Hour between 5:30-7:00. It seems like lately that is the low point of my day. No matter how good or bad of a day I've had up to that point, I seem to end up feeling like crap to one degree or another during that time frame. Afterward things usually get better again like I'm literally coming up out of a trough. It doesn't help that this comes during my "girl time", the time of day between when I finish work and when the girls go to bed. It's really the only time I get to fully interact with them during the week and it sucks to suddenly start feeling like crap around that time. Hopefully, like everything else so far, this is a transitory phenomenon.
I had a follow up visit with the pain management specialist today. Told him that overall my pain seems to be under control except for this pain in my right leg of the last few days. It's been pretty bad the last couple of days, manifesting mostly in my shin and around my knee, but occasionally all the way up the leg following the sciatic nerve. It's been pretty sharp and I've had to go back up on the Vicodin as a result, taking it pretty much every 4 hours and having to double up a couple of times yesterday. I also repeated my bowel correlation theory to him. He told me to increase the Neurontin dosage to 3 times per day instead of 2.
I informed him that for the last week or so, I've started having difficulty swallowing my larger pills, especially the 600mg calcium supplement that I've been taking. It sometimes gets stuck in the back of my throat and I have to gag it back up. Then over the last couple of days, I've noticed similar difficulty in swallowing certain foods, especially breads, so I asked him to take a look at my throat to see if there was anything going on back there. He determined that I have thrush, which I've now learned is a yeast infection that manifests in the back of the throat. This is not unexpected given my low white cell count and could partially explain some of my appetite issues. He gave me Fluconazole for the thrush which is interesting to read the packaging as it's apparently predominately prescribed to women for vaginal yeast infections. Most of the documentation goes on about all the possible side effects related to that usage and thus my journey into Menopause continues. I am glad that he found something to treat and it wasn't something like swollen glands or a psychosomatic condition. Maybe this will improve my ability to eat over the next few days.
Last I told him about my reservations in taking the anti-depressant to improve my appetite. He explained that there are basically 3 options for increasing appetite medicinally. The first is a steroid which isn't an option for someone in my condition. (He explained in a little more detail but those details now escape me) The second is a THC derivative which apparently isn't a good idea to take in combination with Methadone. That only leaves the Mirtazapine. He said that he understood the concerns with taking anti-depressants, but assured me that it's the minimum dose and he has used it with many other patients without negative effects. I guess that I'll give it a try and see what happens. It's only once per day at bedtime and I can always stop taking it.
On a positive note, the doc was able to look up my lab results from the blood test I had last week and found that my PSA level was back down to 3 from the 12 that it was when I was diagnosed. Of course, it's only one data point wh ich does not make a trend, but it's much more than I had hoped for. I'll take good news anytime.
I still think that it's somehow tied to my bowel issues as it seems that the sciatic pain increases with my level of constipation and subsides once it is resolved. Today, I had the pain early on, and took a Vicodin when I got up at 8:00 and another at 10:00 because the first dose wasn't quite doing it, but then I had a bowel movement around noon and had no more pain until around 5:30 and overall felt pretty good in between.
At the start of all of this, I was getting incredibly drowsy everyday between 2:00-4:00 to the point that I had to nap because I couldn't shake it. That now seems to have vanished and in it's place I now have the Ugh Hour between 5:30-7:00. It seems like lately that is the low point of my day. No matter how good or bad of a day I've had up to that point, I seem to end up feeling like crap to one degree or another during that time frame. Afterward things usually get better again like I'm literally coming up out of a trough. It doesn't help that this comes during my "girl time", the time of day between when I finish work and when the girls go to bed. It's really the only time I get to fully interact with them during the week and it sucks to suddenly start feeling like crap around that time. Hopefully, like everything else so far, this is a transitory phenomenon.
I had a follow up visit with the pain management specialist today. Told him that overall my pain seems to be under control except for this pain in my right leg of the last few days. It's been pretty bad the last couple of days, manifesting mostly in my shin and around my knee, but occasionally all the way up the leg following the sciatic nerve. It's been pretty sharp and I've had to go back up on the Vicodin as a result, taking it pretty much every 4 hours and having to double up a couple of times yesterday. I also repeated my bowel correlation theory to him. He told me to increase the Neurontin dosage to 3 times per day instead of 2.
I informed him that for the last week or so, I've started having difficulty swallowing my larger pills, especially the 600mg calcium supplement that I've been taking. It sometimes gets stuck in the back of my throat and I have to gag it back up. Then over the last couple of days, I've noticed similar difficulty in swallowing certain foods, especially breads, so I asked him to take a look at my throat to see if there was anything going on back there. He determined that I have thrush, which I've now learned is a yeast infection that manifests in the back of the throat. This is not unexpected given my low white cell count and could partially explain some of my appetite issues. He gave me Fluconazole for the thrush which is interesting to read the packaging as it's apparently predominately prescribed to women for vaginal yeast infections. Most of the documentation goes on about all the possible side effects related to that usage and thus my journey into Menopause continues. I am glad that he found something to treat and it wasn't something like swollen glands or a psychosomatic condition. Maybe this will improve my ability to eat over the next few days.
Last I told him about my reservations in taking the anti-depressant to improve my appetite. He explained that there are basically 3 options for increasing appetite medicinally. The first is a steroid which isn't an option for someone in my condition. (He explained in a little more detail but those details now escape me) The second is a THC derivative which apparently isn't a good idea to take in combination with Methadone. That only leaves the Mirtazapine. He said that he understood the concerns with taking anti-depressants, but assured me that it's the minimum dose and he has used it with many other patients without negative effects. I guess that I'll give it a try and see what happens. It's only once per day at bedtime and I can always stop taking it.
On a positive note, the doc was able to look up my lab results from the blood test I had last week and found that my PSA level was back down to 3 from the 12 that it was when I was diagnosed. Of course, it's only one data point wh ich does not make a trend, but it's much more than I had hoped for. I'll take good news anytime.
Tuesday, February 12, 2013
Gettin' There
The last couple of days have been OK. At this point, the pain is largely under control with the medication as long as I don't do anything to irritate it. Staying in the same position for too long, or sitting in a comfy chair, can irritate the pain points and cause the pain to come on where it wasn't before. For some reason, the more comfortable the seating, the less comfortable it is for me. I spend much of my day sitting on the floor as that is often the most comfortable position for me and affords the ability to stretch as needed.
Felt pretty good on Monday overall, but was stuck on several back to back conference calls from noon-5 which didn't help with the pain situation, primarily just from sitting for too long in more or less the same position. By the end of the day, I was a little stiff and sore.
Today I had to go into the office. I didn't have a lot of choice in the matter as I had an interview to conduct as well as a couple more meetings. Of course, because I needed to get up and go on in, my body decided that I needed to be up extra early so I woke up an hour and a half before anyone else in the house. Even the girls weren't stirring yet. The day wasn't bad for what it was. I made the drive in OK, though I was a little sore when I got there. That was partly due to my arriving at the 4 hour mark since I had taken my last Vicodin, but was mainly from the ride in the car. Another Vicodin took care of that and I was OK through my meetings. I didn't have an opportunity to eat lunch until about 2:30 which I only ate half of. I just wasn't feeling it. Something didn't feel right, though that probably had to do with what was going on a little lower than my stomach. When I got out of my next meeting at 4:00, the pain had started up. I had been sitting for too long and was a couple of hours past due for medications. Still had the bowel thing going on which was probably contributing to the pain. Managed to get home OK, but the pain was still there, so I took another pill. After that, I felt OK but wasn't hungry for dinner. I realized shortly after the girls went to bed just how tired I was from getting up so early and not having any opportunity fro rest, or to sit on the floor. Overall, it was a good experience. It was good to get out of the house and it was good to be back in the office, even if it was just for a day. I ended up going on to bed early and now here I am, awake at 2AM. We'll see what Wednesday brings. I can stay home and I shouldn't have to sit on too many calls. History has shown that the day after an outing can often be more of a recovery, but perhaps I'm a little past that now.
The last two days have been too busy to call the doctor. I still need to have that discussion with him about the anti-depressant. Hopefully I will have time and remember to do so tomorrow.
Felt pretty good on Monday overall, but was stuck on several back to back conference calls from noon-5 which didn't help with the pain situation, primarily just from sitting for too long in more or less the same position. By the end of the day, I was a little stiff and sore.
Today I had to go into the office. I didn't have a lot of choice in the matter as I had an interview to conduct as well as a couple more meetings. Of course, because I needed to get up and go on in, my body decided that I needed to be up extra early so I woke up an hour and a half before anyone else in the house. Even the girls weren't stirring yet. The day wasn't bad for what it was. I made the drive in OK, though I was a little sore when I got there. That was partly due to my arriving at the 4 hour mark since I had taken my last Vicodin, but was mainly from the ride in the car. Another Vicodin took care of that and I was OK through my meetings. I didn't have an opportunity to eat lunch until about 2:30 which I only ate half of. I just wasn't feeling it. Something didn't feel right, though that probably had to do with what was going on a little lower than my stomach. When I got out of my next meeting at 4:00, the pain had started up. I had been sitting for too long and was a couple of hours past due for medications. Still had the bowel thing going on which was probably contributing to the pain. Managed to get home OK, but the pain was still there, so I took another pill. After that, I felt OK but wasn't hungry for dinner. I realized shortly after the girls went to bed just how tired I was from getting up so early and not having any opportunity fro rest, or to sit on the floor. Overall, it was a good experience. It was good to get out of the house and it was good to be back in the office, even if it was just for a day. I ended up going on to bed early and now here I am, awake at 2AM. We'll see what Wednesday brings. I can stay home and I shouldn't have to sit on too many calls. History has shown that the day after an outing can often be more of a recovery, but perhaps I'm a little past that now.
The last two days have been too busy to call the doctor. I still need to have that discussion with him about the anti-depressant. Hopefully I will have time and remember to do so tomorrow.
Sunday, February 10, 2013
Night Pain
Sunday, 3:30AM and I'm up, after about 4 hours sleep, with pain in my right leg. This seems to be becoming a regular thing except this time it was not accompanied by the need to go to the bathroom. It's interesting that this pain tends to favor the right where all of my previous pains had a tendency toward the left. I wish I could figure out the root cause of what aggravates it, especially if it has anything to do with how I am laying in bed. Unfortunately, I don't have a lot of options for adjustment as I am unable to sleep on my sides or stomach at all, so I'm left with trying to figure out minor adjustments that I can make to sleeping on my back.
In some ways this feels like it's back to square one as this is how it all started before I was diagnosed. I would wake up in the night, in severe pain and have to walk around, stretch or whatever I could do to minimize the pain until the pain medication kicked in. Back then, it was Tylenol or Ibuprofen that would do the trick and it was when they no longer worked that saw me visiting the doctor on that Friday morning when it all started. Every pain that I've had thus far has been transient, happening for a while and then moving along to manifest in some new form. Hopefully this will be like the rest. It's entirely possible that hydration could be a factor here as well. I know that I didn't drink as much as I should have yesterday, but it was a Saturday which tends to mean that I felt like crap all day without any particular explanation. Hopefully once my Vicodin does its thing, I'll be able to get another 4 hours and wake up feeling completely different.
In some ways this feels like it's back to square one as this is how it all started before I was diagnosed. I would wake up in the night, in severe pain and have to walk around, stretch or whatever I could do to minimize the pain until the pain medication kicked in. Back then, it was Tylenol or Ibuprofen that would do the trick and it was when they no longer worked that saw me visiting the doctor on that Friday morning when it all started. Every pain that I've had thus far has been transient, happening for a while and then moving along to manifest in some new form. Hopefully this will be like the rest. It's entirely possible that hydration could be a factor here as well. I know that I didn't drink as much as I should have yesterday, but it was a Saturday which tends to mean that I felt like crap all day without any particular explanation. Hopefully once my Vicodin does its thing, I'll be able to get another 4 hours and wake up feeling completely different.
Saturday, February 9, 2013
Musical Prescriptions
WARNING - Today's entry may contain TMI. If you don't want to read TMI, then skip this entry and wait for the next update.
The last few days have been more of the same, pain seems mostly under control, bowels as regular as can be expected, and no appetite to speak of. The pain that I do have mostly comes in the morning or otherwise after awaking from sleep.
The hip pain has returned briefly, but I think that I've found a positive correlation between that pain and the need to defecate. The three times that I've felt it this week have each been when I've woken up in the middle of the night with an urgent need to go to the bathroom. Once my bowels have cleared, the pain goes away pretty quickly. Somehow when my bowels are full, they swell just enough to push on something which causes this pain. Don't know whether they push directly on the nerve, or if they push on something else that pushes on the nerve, but it's been the same each time I've experienced that specific pain.
On a somewhat related note, I've woken up the last two nights with pain lower down in my legs. I know that this pain is tied to the whole sciatic thing, but for some reason is only being felt down around my knee. It's not in the knee itself, but is in the lower thigh, just above the knee and in the shin just below it. This pain does not, however, seemed to correlate to my bowels in any way that I can tell. It feels ike it's down in the bones which would make sense given my condition, but I've learned that these pains don't necessarily originate from the point where they are felt, all that I can do is just describe them as best I can and rely on the doctors to do the math. In both instances, I've woken up for one reason or another, not really noticing the pain until I get up, but once I'm vertical, it is there with a vengence. The pain level has been up there, perhaps as high as a 7, though when you get above 5 or 6, it's hard for me to really say what the number is. I've always had a fairly high pain tolerance. The first night, it took two Vicodin to make it go away. Tonight it took only one, but it took a full hour for it to take effect. I hope this is something transient like all of the others and won't be around much, if any, longer.
Being that today was Thursday, I called the pain management doctor to discuss my progress since our last changes. I told him about all of the above, the appetite concerns, and also mentioned to him that since we went to the regimen on the laxative of a single dose in the morning and a double at night, that I've had to wake up to use the toilet in the middle of every night. I informed him that I've since reversed the dosage and he agreed with that course. I also mentioned to him that I needed a refill of the Methadone. Since he now has me taking two 5mg pills at each dosage, they're going pretty quick, especially since he had originally prescribed them for one per dosage, and I only have a couple of days' worth left. He said that he'd go ahead and write me a prescription for 10mg pills so that I wouldn't have to take two pills each time and he did the same with my Neurontin. Even though I have refills remaining on the original Neurontin prescription, he also has me taking two of those at each dosage, so he again decided to save me the hassle and give me a new prescription for a double sized pill. Last, he was giving me a prescription for something to help with the appetite problem. The prescriptions would be left with the front desk at his office and I could come pick them up anytime. Thus began our irritating adventure for the day.
My wife had some errands to run, so she agreed to stop and pick up the prescriptions for me and drop them off at the pharmacy. When she arrived at the pharmacy, they informed her that they were out of the Methadone and that it was on "backorder". So she called me to see what I wanted to do. I asked if it was just the 10mg dosage that they were out of and they responded that no, they were out of all dosages of it. I told her not worry about it, to just bring it home with her and I'd call around to find out who could fill it. As I started to do so, I found that every pharmacy that I called was out of it and had it on backorder, except for Wegmans. The woman at the Wegmans pharmacy told me that they are not allowed to say over the phone whether they can fill it or not, since it's a narcotic, and that I would have to drive over there and hand it to them in order for them to say whether they have it in stock or not. I was a little perturbed by this and explained to her that the previous two pharmacies I had called had told me that they didn't have any in stock. She then sarcastically said, "fine, let me ask the pharmacist if we can tell you if we don't have any in stock". She briefly put me on hold and then came back to confirm that they were indeed out of it. In all, I called 7 pharmacies and got the same response from all of them. I was starting to smell a script and from the anecdotal comments that I got, am fairly certain that this is some FDA or other government bureaucracy "war on drugs" BS.
The prize for most far fetched(or perhaps most creative) goes to the one woman that I spoke with who told me that this medicine "is not used much any more" as the reason that they didn't have any. So apparently my real problem is just that my doctor is prescribing archaic medicine. Perhaps I should ask him about upgrading to leeches?
The story that I pieced together is that they're not supposed to tell anyone over the phone whether they have any particular narcotic in stock and that supplies to the pharmacy are rationed. Each pharmacy gets a certain allotment on a periodic basis, the frequency and day of delivery also cannot be conveyed, and when they have sold out of what they have, then there's nothing that they can do until the next allotment arrives. This sounds a lot like the nonsense that Nanny Bloomberg recently imposed on the NY city hospitals. I also suspect that it had to do with the quantity of my prescription, because each asked for the quantity before they would divulge that they were out of it.
Out of luck, I called my doctor back. I was getting a little worried because I had exactly two days worth of the Methadone left and it was an hour before his office closed on a Friday. I wasn't sure what I was going to do come Monday. The person that I spoke to verified that they aren't supposed to say whether or not they have it in stock and does limit the supply that pharmacies have on hand, so yes, the government expects patients to drive all over town presenting their prescription to each pharmacy in person until they find one that is able to fill the prescription. All in the name of stopping a handful of addicts from gaming the system or planning a robbery or something. Never mind the enormous inconvenience that it places on legitimate patients who are either in too much pain to be driving all over town, or are affected by the medication in such a way that they are unable to drive, or that have to rely on someone else to drive around town and deal with this on their behalf. Yes, let's inconvenience the many legitimate patients in the name of foiling the few miscreants out there who may cause trouble.
Anyway, she offered to call one of the pharmacies, that they work with, on my behalf and call me back. After a little back and forth, it was determined that this pharmacy would only be able to partially fill the prescription, but didn't want to do that out of concern that the insurance may not allow for it to be split up. The did, however, have sufficient quantity of the 5mg dosage that they could fill it for me, so I had to drive up to the doctor's office and exchange my 10mg prescription for a new one with 5mg pills. I had to sign for the exchange and everything. I promptly trotted over to the pharmacy to drop it off. Since they were closing in 40 minutes, I expected to just drop it off and have to come back on Saturday to pick it up, however they weren't overly busy and were able to fill it while I waited. Mission accomplished. On the way home, I stopped at the original pharmacy and picked up the other two that my wife had dropped off earlier in the day.
Lesson learned. If you have a prescription for any medication that requires you to hand deliver the prescription to the pharmacy, when the doctor is not allowed to fax it over, make sure you start the process of getting a refill at least a week before you run out in case some bureaucratic nonsense requires your pharmacy to wait for an undisclosed new shipment to arrive.
Upon returning home and examining my new medicine that is supposed to help with my appetite, I realized that what he gave me is an anti-depressant. After reading the information sheet that accompanied it, I realized that increased appetite is a side effect of the drug, and not its primary purpose. I'm not too keen on taking a drug for it's unintended purpose and I'm not thrilled with the idea of taking an anti-depressant especially since I'm not depressed and I've heard all kinds of horror stories about what they can do to people. I've decided to hold off on taking it until the doc and I have a chat on Monday to address these concerns. He's done right by me so far with the pain meds, but I'm really going to have to weigh the concern over weight loss against the concerns of taking an anti-depressant. I may also call my Oncologist and see what he has to say about it.
The last few days have been more of the same, pain seems mostly under control, bowels as regular as can be expected, and no appetite to speak of. The pain that I do have mostly comes in the morning or otherwise after awaking from sleep.
The hip pain has returned briefly, but I think that I've found a positive correlation between that pain and the need to defecate. The three times that I've felt it this week have each been when I've woken up in the middle of the night with an urgent need to go to the bathroom. Once my bowels have cleared, the pain goes away pretty quickly. Somehow when my bowels are full, they swell just enough to push on something which causes this pain. Don't know whether they push directly on the nerve, or if they push on something else that pushes on the nerve, but it's been the same each time I've experienced that specific pain.
On a somewhat related note, I've woken up the last two nights with pain lower down in my legs. I know that this pain is tied to the whole sciatic thing, but for some reason is only being felt down around my knee. It's not in the knee itself, but is in the lower thigh, just above the knee and in the shin just below it. This pain does not, however, seemed to correlate to my bowels in any way that I can tell. It feels ike it's down in the bones which would make sense given my condition, but I've learned that these pains don't necessarily originate from the point where they are felt, all that I can do is just describe them as best I can and rely on the doctors to do the math. In both instances, I've woken up for one reason or another, not really noticing the pain until I get up, but once I'm vertical, it is there with a vengence. The pain level has been up there, perhaps as high as a 7, though when you get above 5 or 6, it's hard for me to really say what the number is. I've always had a fairly high pain tolerance. The first night, it took two Vicodin to make it go away. Tonight it took only one, but it took a full hour for it to take effect. I hope this is something transient like all of the others and won't be around much, if any, longer.
Being that today was Thursday, I called the pain management doctor to discuss my progress since our last changes. I told him about all of the above, the appetite concerns, and also mentioned to him that since we went to the regimen on the laxative of a single dose in the morning and a double at night, that I've had to wake up to use the toilet in the middle of every night. I informed him that I've since reversed the dosage and he agreed with that course. I also mentioned to him that I needed a refill of the Methadone. Since he now has me taking two 5mg pills at each dosage, they're going pretty quick, especially since he had originally prescribed them for one per dosage, and I only have a couple of days' worth left. He said that he'd go ahead and write me a prescription for 10mg pills so that I wouldn't have to take two pills each time and he did the same with my Neurontin. Even though I have refills remaining on the original Neurontin prescription, he also has me taking two of those at each dosage, so he again decided to save me the hassle and give me a new prescription for a double sized pill. Last, he was giving me a prescription for something to help with the appetite problem. The prescriptions would be left with the front desk at his office and I could come pick them up anytime. Thus began our irritating adventure for the day.
My wife had some errands to run, so she agreed to stop and pick up the prescriptions for me and drop them off at the pharmacy. When she arrived at the pharmacy, they informed her that they were out of the Methadone and that it was on "backorder". So she called me to see what I wanted to do. I asked if it was just the 10mg dosage that they were out of and they responded that no, they were out of all dosages of it. I told her not worry about it, to just bring it home with her and I'd call around to find out who could fill it. As I started to do so, I found that every pharmacy that I called was out of it and had it on backorder, except for Wegmans. The woman at the Wegmans pharmacy told me that they are not allowed to say over the phone whether they can fill it or not, since it's a narcotic, and that I would have to drive over there and hand it to them in order for them to say whether they have it in stock or not. I was a little perturbed by this and explained to her that the previous two pharmacies I had called had told me that they didn't have any in stock. She then sarcastically said, "fine, let me ask the pharmacist if we can tell you if we don't have any in stock". She briefly put me on hold and then came back to confirm that they were indeed out of it. In all, I called 7 pharmacies and got the same response from all of them. I was starting to smell a script and from the anecdotal comments that I got, am fairly certain that this is some FDA or other government bureaucracy "war on drugs" BS.
The prize for most far fetched(or perhaps most creative) goes to the one woman that I spoke with who told me that this medicine "is not used much any more" as the reason that they didn't have any. So apparently my real problem is just that my doctor is prescribing archaic medicine. Perhaps I should ask him about upgrading to leeches?
The story that I pieced together is that they're not supposed to tell anyone over the phone whether they have any particular narcotic in stock and that supplies to the pharmacy are rationed. Each pharmacy gets a certain allotment on a periodic basis, the frequency and day of delivery also cannot be conveyed, and when they have sold out of what they have, then there's nothing that they can do until the next allotment arrives. This sounds a lot like the nonsense that Nanny Bloomberg recently imposed on the NY city hospitals. I also suspect that it had to do with the quantity of my prescription, because each asked for the quantity before they would divulge that they were out of it.
Out of luck, I called my doctor back. I was getting a little worried because I had exactly two days worth of the Methadone left and it was an hour before his office closed on a Friday. I wasn't sure what I was going to do come Monday. The person that I spoke to verified that they aren't supposed to say whether or not they have it in stock and does limit the supply that pharmacies have on hand, so yes, the government expects patients to drive all over town presenting their prescription to each pharmacy in person until they find one that is able to fill the prescription. All in the name of stopping a handful of addicts from gaming the system or planning a robbery or something. Never mind the enormous inconvenience that it places on legitimate patients who are either in too much pain to be driving all over town, or are affected by the medication in such a way that they are unable to drive, or that have to rely on someone else to drive around town and deal with this on their behalf. Yes, let's inconvenience the many legitimate patients in the name of foiling the few miscreants out there who may cause trouble.
Anyway, she offered to call one of the pharmacies, that they work with, on my behalf and call me back. After a little back and forth, it was determined that this pharmacy would only be able to partially fill the prescription, but didn't want to do that out of concern that the insurance may not allow for it to be split up. The did, however, have sufficient quantity of the 5mg dosage that they could fill it for me, so I had to drive up to the doctor's office and exchange my 10mg prescription for a new one with 5mg pills. I had to sign for the exchange and everything. I promptly trotted over to the pharmacy to drop it off. Since they were closing in 40 minutes, I expected to just drop it off and have to come back on Saturday to pick it up, however they weren't overly busy and were able to fill it while I waited. Mission accomplished. On the way home, I stopped at the original pharmacy and picked up the other two that my wife had dropped off earlier in the day.
Lesson learned. If you have a prescription for any medication that requires you to hand deliver the prescription to the pharmacy, when the doctor is not allowed to fax it over, make sure you start the process of getting a refill at least a week before you run out in case some bureaucratic nonsense requires your pharmacy to wait for an undisclosed new shipment to arrive.
Upon returning home and examining my new medicine that is supposed to help with my appetite, I realized that what he gave me is an anti-depressant. After reading the information sheet that accompanied it, I realized that increased appetite is a side effect of the drug, and not its primary purpose. I'm not too keen on taking a drug for it's unintended purpose and I'm not thrilled with the idea of taking an anti-depressant especially since I'm not depressed and I've heard all kinds of horror stories about what they can do to people. I've decided to hold off on taking it until the doc and I have a chat on Monday to address these concerns. He's done right by me so far with the pain meds, but I'm really going to have to weigh the concern over weight loss against the concerns of taking an anti-depressant. I may also call my Oncologist and see what he has to say about it.
Tuesday, February 5, 2013
Hunger Games
Overall, today was a pretty good day and I think that from an overall perspective, I am definitely getting better. Pain wasn't much of an issue today and I only had to take 2 Vicodin all day. The goal is to not take any Vicodin. After that, the goal will be to be able to stay in one position for more than 10 minutes without developing discomfort or pain. One thing at a time, I guess. I've still got a case of the sleepys and had to take a nap twice again today. That seems to be my biggest barrier to productivity at the moment, just being able to shake the drowsiness and focus.
My weight loss was a bit of a wake up call. While I'm happy to be at 184 as that is probably the weight I should be at, I don't want to drop any more and now that I'm consciously trying to make sure that I eat enough, I'm finding that easier said than done. Nothing is particularly appetizing to me and I just don't get hungry. It's weird, when I eat, I don't really have a problem eating, I just have no interest in it. When I do eat, it takes very little for me to feel full and I don't feel like coming back for seconds later. My wife went to the store today and bought some things that she's hoping will make it easier for me to get calories as opposed to eating a regular meal. We'll see how that goes.
It occurred to me that when I was on the Fentanyl patches that I didn't have this problem at least not to this extent. I did still have an appetite though it wasn't very voracious. I would get hungry at meal time, but not much in between and I could eat a sensible portion without feeling stuffed, but I was usually good with that amount and didn't need to go back for seconds. I hadn't really noticed until the doctor pointed out my weight loss yesterday, but the loss of appetite does seem to have coincided with my starting the Methadone and Neurontin. Appetite loss is listed as a side effect of these drugs, but it was with the Fentanyl as well. Perhaps the side effect is stronger with these meds. Then again, I made this change in the middle of my radiation treatment so it could be a combination of the meds and the radiation. The radiation is over, but the effects are supposed to carry over for several weeks so perhaps my appetite will get a little better once the carry over from the radiation has ended. Too many variables and too many questions without any way to get a real answer other than through trial and error. Either way, I'm going to bring it up with the pain management Doctor on Thursday to see if he has any suggestions for better dealing with it.
My weight loss was a bit of a wake up call. While I'm happy to be at 184 as that is probably the weight I should be at, I don't want to drop any more and now that I'm consciously trying to make sure that I eat enough, I'm finding that easier said than done. Nothing is particularly appetizing to me and I just don't get hungry. It's weird, when I eat, I don't really have a problem eating, I just have no interest in it. When I do eat, it takes very little for me to feel full and I don't feel like coming back for seconds later. My wife went to the store today and bought some things that she's hoping will make it easier for me to get calories as opposed to eating a regular meal. We'll see how that goes.
It occurred to me that when I was on the Fentanyl patches that I didn't have this problem at least not to this extent. I did still have an appetite though it wasn't very voracious. I would get hungry at meal time, but not much in between and I could eat a sensible portion without feeling stuffed, but I was usually good with that amount and didn't need to go back for seconds. I hadn't really noticed until the doctor pointed out my weight loss yesterday, but the loss of appetite does seem to have coincided with my starting the Methadone and Neurontin. Appetite loss is listed as a side effect of these drugs, but it was with the Fentanyl as well. Perhaps the side effect is stronger with these meds. Then again, I made this change in the middle of my radiation treatment so it could be a combination of the meds and the radiation. The radiation is over, but the effects are supposed to carry over for several weeks so perhaps my appetite will get a little better once the carry over from the radiation has ended. Too many variables and too many questions without any way to get a real answer other than through trial and error. Either way, I'm going to bring it up with the pain management Doctor on Thursday to see if he has any suggestions for better dealing with it.
Monday, February 4, 2013
Adamantium Injection
Went to see the Oncologist today. He didn't have much to say, but when he dictated his notes into his laptop, I heard him say the word "improving" so I guess that's a good thing. He also ordered a blood test to get my current PSA level.
Apparently the sample has to be sent elsewhere for PSA analysis and will take a couple of days, but they were able to get basic results back while I was there. It showed that my white cell count is low which I'm told means that I'm susceptible to infections and am to call the doctor if I get a fever above 100.5. My wife tells me that it's common for cancer patients undergoing treatment to have a low white cell count so I guess it's nothing to be concerned about.
After that, I got my monthly Xgeva shot. The last time I felt miserable for a couple of days after receiving the shot, but so far there is nothing to report with this one.
The one thing of concern was that I've apparently lost 15 lbs since my last visit a month ago. The doctor told me to stop losing weight and that if I lose another 15 by next time, it will be cause for concern. The problem has been that I just have no appetite and when I do eat, I can't eat very much without getting full, so I guess I'll have to start making a conscious effort to eat more frequently and eat more fattening foods. The nurse suggested that I get whole milk dairy products and/or add protein supplements to my food. They suggested drinking Ensure or Carnation Instant Breakfast or the like. I'll do what I can. The last few days my stomach has been rather unsettled so the idea of eating anything hasn't been very attractive.
My friends visiting from Dallas, dubbed "The Funny Men" by my daughters, returned home today. Even though I spent much of the weekend feeling like crap, I thoroughly enjoyed having them visit. It has been a long time since the 4 of us have spent any time together outside of a meal out with all of the families and it was nice to have a weekend of guy time with them. It was incredibly thoughtful of them to come all the way up here to see me like this and I really appreciate them for it.
The rest of the day was spent with me fighting off drowsiness. I'm not sure where it was coming from, but every time I would try to do something useful, I would just be overcome with sleepiness. As a result, I also didn't eat much today, but when I did, I had to force it.
Lastly, I checked in with the pain specialist today and relayed my current situation and the fact that most of my pain now manifests itself in my legs just above and below the knee. He believes it to be an extension of the pain I was having in my hips and therefore changed my neurontin dosage again as well as the Lactulose due to the complications with my bowels over the weekend. Same as before, make the change and check back in in a few days. At this point, I'm not scheduled to see any more medical personnel for another month unless something arises between now and then which would necessitate an unscheduled visit. I guess I'll just sit tight and see what happens.
Apparently the sample has to be sent elsewhere for PSA analysis and will take a couple of days, but they were able to get basic results back while I was there. It showed that my white cell count is low which I'm told means that I'm susceptible to infections and am to call the doctor if I get a fever above 100.5. My wife tells me that it's common for cancer patients undergoing treatment to have a low white cell count so I guess it's nothing to be concerned about.
After that, I got my monthly Xgeva shot. The last time I felt miserable for a couple of days after receiving the shot, but so far there is nothing to report with this one.
The one thing of concern was that I've apparently lost 15 lbs since my last visit a month ago. The doctor told me to stop losing weight and that if I lose another 15 by next time, it will be cause for concern. The problem has been that I just have no appetite and when I do eat, I can't eat very much without getting full, so I guess I'll have to start making a conscious effort to eat more frequently and eat more fattening foods. The nurse suggested that I get whole milk dairy products and/or add protein supplements to my food. They suggested drinking Ensure or Carnation Instant Breakfast or the like. I'll do what I can. The last few days my stomach has been rather unsettled so the idea of eating anything hasn't been very attractive.
My friends visiting from Dallas, dubbed "The Funny Men" by my daughters, returned home today. Even though I spent much of the weekend feeling like crap, I thoroughly enjoyed having them visit. It has been a long time since the 4 of us have spent any time together outside of a meal out with all of the families and it was nice to have a weekend of guy time with them. It was incredibly thoughtful of them to come all the way up here to see me like this and I really appreciate them for it.
The rest of the day was spent with me fighting off drowsiness. I'm not sure where it was coming from, but every time I would try to do something useful, I would just be overcome with sleepiness. As a result, I also didn't eat much today, but when I did, I had to force it.
Lastly, I checked in with the pain specialist today and relayed my current situation and the fact that most of my pain now manifests itself in my legs just above and below the knee. He believes it to be an extension of the pain I was having in my hips and therefore changed my neurontin dosage again as well as the Lactulose due to the complications with my bowels over the weekend. Same as before, make the change and check back in in a few days. At this point, I'm not scheduled to see any more medical personnel for another month unless something arises between now and then which would necessitate an unscheduled visit. I guess I'll just sit tight and see what happens.
Sunday, February 3, 2013
Good with the Bad.
I finished my radiation treatment on Friday, so now I can return to a more normal schedule without my day being bisected by a trip to the treatment center. Next up is an Xgeva shot and visit with the Oncologist on Monday.
The last few days have been booth good and bad. The good is that my back pain has mostly gone. I still feel it now and then, but it's no longer ever present and on my mind. The hip pain has subsided somewhat as well. I'm still getting it, but not as reliably and not every time I get out of bed. The bad is that the hip pain seems to have moved down into my thighs and shind just below the knee. The shin pain seems to be the new ever present with the thigh being the pain du jour that pops up after being too long in one position. The Vicodin helps with it as well as the others, I know only because if I'm late in taking them, it is worse, but the shin pain seems to defy the meds. It is better after taking the medication, but doesn't go away completely. On the bowel front, the good is that the ick has gone and I feel more normal in that regard, however the constipation is back. I've gone back to taking the full double dose of the prescriptioon laxative, but so far it doesn't seem to have mattered much. I guess time will tell on that one.
On the good side, my wife conspired with 3 old friends from Dallas for them to come up to visit me in Maryland for the weekend. That was a nice and completely unexpected surprise. Since moving to Maryland 11 years ago, I really only see these guys over an occasional dinner whenever I'm back in Dallas and it's usually in a group with all of our families. It's nice to get to spend some extended time with just the guys, with the exception of my daughters' ever present interruptions of "the funny men". I took them out to Antietam yesterday to visit the battlefield. It was bloody cold out with the temp in the mid-20s and a seemingly constant wind blowing, but fortunately the driving tour doesn't require one to get out of the car to still take it all in. On the bad side, I didn't feel well most of the day and throughout our excursion. My breakfast, which I had at a local diner where the best that you can say about the food is that it's mediocre, came back up on our way back from Antietam. That put a bit of a downer on the day with the guys. The good news is that I felt a lot better after expunging the breakfast, but the bad news is that I didn't feel up for going out for crabs with them for dinner. No out of towner can come up here without having the crab experience, so my wife gracoiously went with them and it sounds like they had a good time without me. They're coming back to the house today to hang out and watch the Super Bowl. I think we may stay put today. So far, I've woken up feeling pretty good, with no pain or stomach issues. Let's hope this is a good sign for the rest of the day.
The last few days have been booth good and bad. The good is that my back pain has mostly gone. I still feel it now and then, but it's no longer ever present and on my mind. The hip pain has subsided somewhat as well. I'm still getting it, but not as reliably and not every time I get out of bed. The bad is that the hip pain seems to have moved down into my thighs and shind just below the knee. The shin pain seems to be the new ever present with the thigh being the pain du jour that pops up after being too long in one position. The Vicodin helps with it as well as the others, I know only because if I'm late in taking them, it is worse, but the shin pain seems to defy the meds. It is better after taking the medication, but doesn't go away completely. On the bowel front, the good is that the ick has gone and I feel more normal in that regard, however the constipation is back. I've gone back to taking the full double dose of the prescriptioon laxative, but so far it doesn't seem to have mattered much. I guess time will tell on that one.
On the good side, my wife conspired with 3 old friends from Dallas for them to come up to visit me in Maryland for the weekend. That was a nice and completely unexpected surprise. Since moving to Maryland 11 years ago, I really only see these guys over an occasional dinner whenever I'm back in Dallas and it's usually in a group with all of our families. It's nice to get to spend some extended time with just the guys, with the exception of my daughters' ever present interruptions of "the funny men". I took them out to Antietam yesterday to visit the battlefield. It was bloody cold out with the temp in the mid-20s and a seemingly constant wind blowing, but fortunately the driving tour doesn't require one to get out of the car to still take it all in. On the bad side, I didn't feel well most of the day and throughout our excursion. My breakfast, which I had at a local diner where the best that you can say about the food is that it's mediocre, came back up on our way back from Antietam. That put a bit of a downer on the day with the guys. The good news is that I felt a lot better after expunging the breakfast, but the bad news is that I didn't feel up for going out for crabs with them for dinner. No out of towner can come up here without having the crab experience, so my wife gracoiously went with them and it sounds like they had a good time without me. They're coming back to the house today to hang out and watch the Super Bowl. I think we may stay put today. So far, I've woken up feeling pretty good, with no pain or stomach issues. Let's hope this is a good sign for the rest of the day.
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