When Tests Fail

I was thinking, as it seems a lot of late considering the situation and circumstances, about why the Gastroenterologist couldn't find and didn't report any "abnormal" with my recent test (colonoscopy and lab tests). In her words, "Everything is normal", and despite the obvious symptoms of something being wrong, she decided the problems were IBS, age and food sensitivities.

As the old saying goes, "Yeah, right." But in defense of her, from her perspective, and while there was reason to investigate the problems more and didn't, she went with the obvious. Except that at the same time, she dismissed the obvious of why the results failed. There are two reasons.

First, with a colonoscopy you have to do the preparation preceedure which is 2 quarts of a liquid which flushes and cleanes the intestinal tract. I mean really flush and cleanse, no pun intended. It's terrible stuff and causes terrible reactions. The problem is that, while food and all the normal stuff in the testinal tract is flushed and the tract wall cleansed, any signs of problems is also flushed away.

The colonoscopy is designed to look for obvious physical problems, such as infections, perferations, etc of the wall, protrubing polyps, and other problems. Lacking those, the diagnosis is that everything is normal. Except, what was lost in the flushing and cleansing which would have indiciated problems, no one will know because that's all down the toliet.

Second, the lab test looks for the obvious. When everything is normal, then obviously to them, everything is normal. But that only accounts for the signs of the normal biochemical processes. It misses one obvious issue and raises the question.

What if normal is abnormal? This is what Pseudomembranous colitis is, an abnormal and uncontrolled growth of the normal bacteria in the intestinal tract. In some cases the infection, of which only a few have been recognized, leave signs in the wall of the tract. But what of the other bacteria which don't leave signs but create the same symptoms?

What if the preparation proceedure removes all the obvious signs of any abnormal and uncontrolled growth of bacteria? And wouldn't the abnormal growth of any normal bacteria in the intestinal tract produce similar symptoms but won't necessarily be obvious?

This is something they can't answer, partly because they don't know and partly because they don't test for them since it's harder and not obvious. So they call it your imagination, but in medical terms like IBS, age and food sensititives. It's the line from the Dire Straits song, "You have industrial disease. Next patient please."

So that's where I'm at. The symptoms haven't changed for the last 3 years now and more so since last October. But the test show everything is normal and thus it's my imagination. Tell my intestinal tract that. It's not listening.

Fear of Eating

I wrote about food and my body, and about the battle between my taste buds and my digestive system. It finally occurred to me that I have a fear of eating. Not the many definitions of fear of eating, but a simple fear of eating, despite that I really like to eat and really like food, because I don't know how my body, and more so my digestive system, will work and react.

I used to keep a list of foods I could eat without problems, foods I keep trying now and then to see, and hope, I can eat them more, foods I know I will have problems and foods I just can't eat. During the last nearly three years that list was always changing and it still continues to change. For brief periods during these years, I could throw the lists away and eat almost anything and the body was ok.

Since last fall, the list has changed weekly and sometimes in days, and for periods nothing was on the list. It's created a situation where I fear eating because I don't know what I can eat because the digestive system just won't work. Nothing changes it and nothing helps it. And as quickly as the system stopped working, it would work, I mean (hint) really work.

I don't have answers anymore. Not even the Gastroenterologist has answers beyond IBS, age and food sensitive, and of course the obvious advice you hear everywhere, eat right, watch your diet, exercise, get the proper amount of sleep, and so on down the litany of common sense. And you pay a specialist for it?

So, that's my life for now. Eat and hope it works today, tomorrow and a few days on, or not and be ready when it doesn't.

Laurel and Hardy

Somedays I feel like my body is like Stanley Laurel and Oliver Hardy. My appetite and taste buds are Stanley and the rest of my body Oliver, meaning what I crave, cook and eat will leave the rest of me with a fine mess as Oliver always said, "Well Stanley, here's another fine mess you got us in." I've written that at times food is my enemy, and of late more so like Laurel and Hardy.

The problem is that I love fried chicken, especially crunchy deep fried chicken. Recently a store (their on-line store) had a good one on sale. It's the same brand, Breville, as my other recent acquistion, a convection oven. The oven is way cool for cooking a lot of foods. You don't have to worry about watching it or the time to take it out when it's done.

The only real issue I have with it is broiling things, like bacon or other foods which splatter. Don't, simply don't. It's messy. Use a real oven where you can put a big pan around or under it. Otherwise I use it several tiimes a week, often for a favorite baked chicken. Yeah, after fried chicken is baked or roasted chicken.

Anyway, I got the deep fryer up and running, prepared breaded chicken parts, and cooked up a platter of chicken. The Stanley in me felt good and the food was really good. Ok, I need to find a good breading recipe. But alas it was short-lived as these days are with food and the Oliver reminded me later into the night and the next morning.

Needless to say I won't give up. I suspect, ok hope, it was the spices than the chicken or the deep frying as I've had deli fried chicken without problems. And I can work toward really good stuff, homemade potato chips and french fries and the best, doughnuts. If you have had a fresh homemade doughnut, you're missing a great food.

And on the horizon now is, according to Jimmy Buffett, the eighth deadly sin, Pizza. Stanley is alive and well despite the problems and medications. Oliver will do what it does and wants, and yes, I'll learn about it and live with it, but that's later.

Consistently and Constantly

What do you do when you're taking a medication and the side effects are worse than the benefit of the drug? And you have to take the drug consistently and constantly, meaning you have to take it at the same time every day and not skip a day. It's one of those drugs, or at least it's what the pharmaceutical company and doctor(s) say, that you can't skip one without problems.

Yet people miss them and they even provide instructions when you do. That's not my point here, it's the side effects. I'm taking a statin drug to lower my LDL or bad cholesterol for the 20% blockage in my pulmonary artery. And the side effects are making my life miserable, especially with the digestive system which I've written about and seemed to be improving, but this drug made it worse.

If it weren't for the physician to send me to a cardiologist as a precaution, we wouldn't have found the blockage. My heart (muscle) and arteries on and around the heart are fine, nothing wrong. The problem is just the pulmonary artery. But it started nearly 20 years ago and has been, or at least from what I know personally, been about the same for the 10 years.

And that's the question, when you do decide to discontinue a drug because you want to than the physicians and specialists say you should?

I have just over 2 months on the high dosage (one month of half dosage and then full dosage) before I have another evaluation, with a blood test, to see if it's working. If so, and toward the goal, they'll either discontinue the drug or lower the dosage. if not, then it's a decision of directions, continue the dosage and continue personal changes, medical intervention or something else I don't know.

That's the question. At 20%, it's significant but not significant to interfer with life that I can as I have make adjustments. The goal with the drug is something I've never done, get my cholesterol below the upper limit of normal (LDL < 100) and more so get it to about 70. If the drug can't lower it significantly, it's a question if or when it will get worse.

That's the conumdrum, we don't know what will happen until April, but until then the drug is unliveable on a daily basis. When my Dad was just a few years older, he was on 11 drugs for a variety of medical problems and just over half of the drugs were for countering the effects or interactions of the drugs. It turned him into a physical wreck.

And watching him then, I can't see becoming him. And even if it's just one drug, to me it's one drug too many. Yes, I take a number of supplements every day and have for nearly two decades. Some are the normal recommended supplements and some help with the body and aging. Their effects are small but over the years have kept things from getting worse beyond normal aging.

So, that's the question I face. I hate the side effects of the drug and the drug is one of choice. Necessary, probably and helpful, absolutely. But at a price of my daily life.

When an answer isn't

When is an answer isn't an answer? When the answer isn't an answer. When the answer is they know you're right from your perspective but they don't have anything to prove you wrong, only something to prove them right. Really.

Well, I went for my followup for the colonoscopy three weeks ago. Ok, They took the video, took some samples for biopies and whatever else they do when they shove the scope up your ass (fortunately you're sedated and likely asleep, I was). Anyway, despite the evidence my digestive system hasn't been normal for nearly 3 years, worse for about a year, and even worse for 3 month, there isn't anything obvious.

They didn't see any signs of an infection or other condition. The lab and biopsy results were normal. And so all they can offer was more of the same rhetoric about lifestyle changes, meaning watching foods and diet, drink less coffee, drink more water - the recommended 6-8 (8 oz) glasses per day except that's never been studied let alone proven to be beneficial as your body extracts water from any liquid and not just water itself, so any 6-8 glasses of liqiud will do - and get more exercise.

And above all, find a food regime that works and stick with it. Gee, that's sound medical advice from a Gastroenterologist? I mean I'm not doubting her or her advice, it's good and sound, but it's nothing I couldn't get from any physician or even a naturopathic doctor. Or even any health or nutritional specialist. And for that I paid good money.

The truth is, as she kinda' admitted, they really don't know very much about the digestive system beyond the obvious problems when they are obvious, like something physical or someting lab tests or biopies can find. Anything else is simply beyond their knowledge, partly because the system is complex and partly because the state of knowledge isn't very good beyond the obvious.

I'm sure she thinks I'm a nutcase, like many other nutcases, er people, she sees and hears about digestive problems. And that's why it's call Irritable Bowel Syndrome, the catch-all condition when they can't tell and can't determine anything wrong outside the experience of the patient. We're not dumb, although some medical professionals would like to think we're imagining things, and they're not stupid.

I could tell she knew she wasn't convincing me and it appeared to me she wasn't convinced of her own advice will help beyond the rhetoric already said. She's always kept asking if I had more questions like my expression was that obvious I'm not convinced, and I had to eventually say no and accept the reality this is what I will have to live with, or hope it improves by itself because they don't have anything to offer.

In the end we're just at a place we know what's wrong and they don't know what's wrong to find a treatment. There's a gap of knowledge in between our experience and their knowledge, and there is no bridge connecting both sides because the knowledge just doesn't exist to build it let alone to answer the questions.

And so until they do, I don't think I'll go back again unless it's really obvious to me it will be obvious to them.