June 2005 Archives

Carole made great time on the drive home from Cambria, and we were early enough for me to pick up my motorcycle at home and drive back to the hospital. My ticket for the parking garage was stamped 7:37pm, plenty of time to make my 7:45pm check-in time.

Huntington's staff in admitting were very professional. After check-in, I waited with a nice guy named Daniel, who seemed to be in his late twenties. We discussed our reasons for being there, jobs - the usual stuff. The polysomnographers met us in the admitting lobby around 8:20pm and escorted us to the study area.

After a brief review of the process, I changed into my sleeping clothes and brushed my teeth. (I was going to wear my new silk pj's, but chose swim trunks instead to make it easier to attach the leads on my legs.)

Laura then started to hook up all the leads needed for the study. First was an elastic belt around my waist (to measure the effort I spend breathing), and another around my upper chest (to measure overall respirations). Next I sat in a chair in the lobby area, and three or four leads were placed in my scalp - it was most uncomfortable when she scraped my sunburned areas to prep for the leads - just like an EEG. Two leads were put on my chest to monitor my heart, then one by each eye to measure eye movement; one on the front of my neck (to sense snoring) and one on the back of my neck (which Laura didn't explain), and finally a lead was put on each side of my jaw to measure teeth grinding.

I went in my room to read for about half an hour while Laura hooked up another patient. Next, we tried on three different CPAP masks for fit and comfort. Only the first one fit well, and none were comfortable. Laura explained that my doctor had ordered a split study - if she noticed certain respiration patterns, she was to come in and fit a CPAP mask for the rest of the night.

Laura then had me lay down on my bed, and a lead was placed on each calf to measure leg movements. Finally, a pulse-ox sensor was taped to my right index finger and a nasal sensor was fitted, and I was ready. I felt like a Borg, and was no certain that sleep would come easily. I spent a few minutes doing various movements so Laura could calibrate the instruments, followed by lights-out at around 10:30pm. Laura instructed me to sleep on my back for 30-45 minutes. The room was somewhat warm, so I was on top of the covers.

I don't normally sleep on my back, so after what seemed like a long enough time I carefully rolled onto my side. When I sleep on my right side, I usually put my right hand under my right cheek, but the glowing LED pulse-ox sensor made that impractical.

At some point during the night the A/C came on and pulled half the quilt over me. I finally had to find a way to delicately get all the way under the covers, and pulled one of my scalp lead out. Laura came in to re-glue it, and re-taped my leg leads while she was at it.

The rest of the night was weird - a lot like the way I sleep when I'm backpacking. I had a couple of different dreams - in one I was reffing a soccer game, and another I was watching waves hitting a rocky shore - but I didn't feel like I slept well. I woke up around 6:30am and felt rested, but not totally.

Laura came in and disconnected all the leads, with only moderate discomfort. I cleaned up as best I could using a washcloth and a towel, and changed back into the clothes I wore last night.

I mentioned that she had not come in with a mask during the night, and she said no, she hadn't. The results go to Dr. Shubin for analysis, but the lack of a mask seems to indicate that I don't have obstructive sleep apnea.

I filled out a one-page questionaire, said good bye to Laura, and shuffled out to the parking garage. There was no one in the booth to take my $3 on the way out.

I had a decaf Americano and a low-fat muffin at the nearby Starbucks and read the Thursday LA Times. The short ride to work was cold. The shower was quite pleasant, in spite of the poor state of the shower head, the interminable time it takes to get hot water, and the sunburn on my scalp.

Carole and I spent two nights in Cambria for our anniversary in late June, 2005.

Carole and I spent our 25th anniversary in Cambria.

My nephew Sheehan, along with Jeremy's girlfriend (and my friend) Sarah, graduated from Temple City High School on Friday. My sister Carol was able to get a ticket for me at the last minute, so I got to view the festivities first hand.

Carol came with my dad, and Sheehan's other grandparents, Frank and Sylvia King. The ceremony was thankfully brief, and the speeches were short and to the point (except for Mr. Plutko, who's speech seemed to be out of a book of such things, delivered in a not-loud-enough monotone.

We met up with Sheehan and Sarah on the field afterwards, and took a lot of pictures. Sheehan went out to dinner with the King's, followed by Grad Night back in the school gym.

We met up again on Saturday afternoon for a family get-together to celebrate Sheehan's accomplishment. Francine and Gabriela came down from Fresno with Francine's daughters Bekkah and Maggie. Bekkah has the sullen teenage thing down pat, while Maggie has learned that her big smile will get her out of any trouble. Francine's mom Del joined them. My dad was there, along with all of us; the King's were in full force, and Dimitrius came too, with his understanding wife, and his mom Yaya. There were plenty of stories - both funny and corny - plus swimming, ping pong, and lots of good food from Petrillo's. My headache dampened me a little bit, but everyone seemed to have a nice time celebrating.

My nephew Sheehan and friend Sarah graduated from Temple City High School on June 24, 2005.

I had to go back to the oral surgeon's office this morning. My upper left wisdom tooth was so close to my sinuses that a small passage was opened when he extracted it. Apparently this happens in a small number of cases, and 99% of the time the passage seals itself. The doctor's office gave me a pre-printed card with instructions on how to deal with it, along with ten more days of antibiotics and some more Percocet.

After I get my new meds, I'm strongly leaning towards some serious pain relievers and bed rest, at the cost of seeing Batman with Carole and Mandy. Such is life.

wisdom teeth:

third (last) molars that usually erupt at age 18-25 (when "wisdom is attained")

I went to Dr. Lytle, the oral surgeon, this morning to have my three remaining wisdom teeth removed. (The other one was taken out fifteen years ago as part of some work on an adjacent tooth.) I also had tooth #19 removed while they were in there. An old root canal hasn't worked properly, to the point that it was best to remove it completely.

I guess I'm doing okay. I'm a little wierded out from the meds - two different pain meds and an antibiotic - but the pain is more than managable. I'm very tired, but Carole thinks that's to be expected. I bled pretty good for a couple of hours, but my high platelet count came to the rescue. I'm on soft, cold foods only today, which is a little boring, and my stomach feels a little funny, but it hasn't been the worse day I've had lately.

In about four months, after everything is healed, I return to the oral surgeon to have an implant post inserted in place of the now missing #19. Early next year, Dr. Crabtree will build and install an implant crown, and I'll be (almost) as good as new.

Update, Friday June 17th - I made scrambled eggs and toast for breakfast, and the right side of my mouth started bleeding a little. While I was on my way to bed to rest some more, I stopped to get a DVD out of the family room cabinet, and my left nostril started bleeding, quite a bit, for no apparent reason. Abandoning the DVD search, I went straight to bed, with gauze in both sides of my mouth, and kleenex in my nose. After an hour or so, both sites stopped bleeding.

I was able to do a few things around the house - maybe a little too much. I did a load of dishes, started a load of laundry, and snaked out the back drain which was causing the bathtub to backup. I moved my motorcycle out of the garage so Carole could get her car out, let Buddy out of the back bathroom after the gardeners left, and started the sprinkler in the back yard. Nothing much, but I don't want to push it too much.

Update, Monday June 20th - More problems with bloody noses, this time in the shower. There's seems to be some wierd connection between my upper left wisdom tooth and the bleeding in my left nostril. Whenever I blow my nose, both my nose and my upper left wound start to bleed. The worst problem is the nausea caused by the antibiotic - erythromycin. My stomach has felt weird since Thursday.

My son Jason graduated from Cal Poly Pomona yesterday with a Bachelor of Arts degree in Business Administration, focus on eBusiness, with a minor in Philosophy. I'm very proud of him.

A bunch of relatives came out to commencement in the morning: my Dad, sister Carol, and her son Sheehan; Jason's girlfriend Jenny; Suzi, William, and Shane; Cary, Karen, Samantha, John, and Jake; and of course me, Carole, Jeremy, and Justin. Afterwards, we met up at the Tony Roma's in Montclair, where the company was better than the food, which in turn was better than the service. Michael and Rob joined us for lunch. Crystal and family stayed in Big Bear to help Pat care for my father-in-law Harvey, who's recovering from surgery, and they all sent their best wishes.

Good job, Jas.

The Red Cross has a limit of 24 platelet donations in any 52-week period, and it seems I was especially busy last year, so today was the first time in six weeks I was allowed to donate. I brought my current Netflix selection Empire Strikes Back, and Luke had just arrived at Cloud City when I finished up my donation.

Fieldsheer Sonic Air Glove - Motorcycle USA Superstore

It seems I was too rash in weaning myself off the Neurontin I had been taking to control my migraines. After a few days of difficult side effects caused by too sudden of a withdrawal, I'm now back up to two pills a day. I intend to ease up by going to 1.5 pills a day (two pills one day, followed by one pill the next) next week, then one pill per day the following week, then one pill every other day for a week, and finally one pill every third day for a week.

My sister Carol works in the Student-Faculty Programs office at CalTech, and they do a lot of great work, primarily with the Summer Undergraduate Research Fellowship (or SURF) program. She called me up today to get ideas on a small, portable public address system, for occasional use when they have a meeting of more people than unamplified voices can reasonably reach.

Here's some ideas we bounced around, based on her budget and the amount of power they need:

• Stageworks LG100 Little Giant PA System
• ApmpliVox Wireless Audio Portable Buddy
• GoSpeak Ultra-Portable Voice Amplication System

The GoSpeak is the slickest, but the Stageworks looks like the best overall value.

Yes, there are situations where you need to click the mouse three times in quick succession to get what you want.

My Windows 2000 system has the Desktop toolbar enabled. The Desktop toolbar sits right-justified with the tray, and pops up to display items sitting on the desktop itself. Desktop items that are folders can expand to show the contents of the folder and any sub-folders for that item.

If you traverse the folder listings in the Desktop toolbar pop-up, but you want to open up the selected folder instead of traversing it with the expanded pop-up, you have to triple-click the item. Once causes it to expand (just like you slid off the right side of the menu); three times causes the selected folder to open ala My Computer. What about twice, you say? Well, if you double click just after the pop-up lists expands, it will also open the selected folder, but if you're not quick enough, two clicks get you bubkis.

My headaches have been getting progressively worse - more pain, more often. I've been working with Dr. Liao for the last 18 months, and we've made some progess, but have also had setbacks.

After five months of 15+ headaches per month, I started taking Neurontin on Sept. 1, 2004. The prescription was for three a day, but initially I took two 300mg capsules a day, and my headache count went way, way down. I never felt completely comfortable with the side effects, but overall the tradeoff was well worth it. Dr. Liao ordered a cat scan, which came back normal. She also told me to have Dr. Chao do a physical eye exam at my next eye appointment, which also came back normal.

In January, my headache count began creeping up. Early in the month, I started taking the third Neurontin every day, with no big change. I saw Dr. Liao for a regular checkup, and she referred me to a neurologist, Dr. Wogenson, in a nearby group practice. He gave me the once over, and upped my Neurontin by one cap a day per week until I reached six per day. He seemed very rushed, and dictated his report using a system on his phone while I was sitting there.

The increased Neurontin didn't seem to have much effect on the number of headaches, but the side effects were even more pronounced. When I went back in a month and mentioned the side effects to the doctor, he said it was part of the normal acclimation process. He ordered an EKG, which came back normal (causing howls of laughter from my family).

I continued under the strain of weird but unspecific side effects. At my next visit to Dr. Wogenson, I mentioned that I was unhappy with the progress of the treatment, and he was sympathetic. After a couple of hours on WebMD and Google, I had a list of items I wanted to explore, and we reviewed them. Years ago, Carole told me that I sometimes stopped breathing during sleep. My research told me it probably wasn't sleep apnea, but it might be worth checking out. Dr. Wogenson agreed, and referred me to another neurologist in his group, a Dr. Shubin. We also talked about acupuncture and biofeedback, but Dr. Wogenson wanted to rule out sleep apnea before pursuing anything else.

Dr. Shubin is a busy man. The first available appointment was five weeks out, so I was on hold for a while. I continued to take my six Neurontin's per day in the meantime. At a regularly scheduled check-up with Dr. Liao, I told her about my general unhappiness with the neurologists of the world, and she was very helpful - as always. She prescribed a new daily medication, Elavil, on top of the Neurontin. We also had a nice discussion of acupuncture, and she encouraged me to give it a try. (Needles don't scare me.)

When the appointment with Dr. Shubin finally arrived, I had to wait almost an hour past my scheduled time before going back, which is always frustrating. He asked a bunch of questions, poked and prodded, and finally prescribed an overnight sleep test. The first available follow-on appointment with Dr. Shubin wasn't until mid-July -- I'm glad it wasn't a big deal to get things done quickly.

On my trip with Carole to Arizona, I was towards the end of nine days straight with a migraine. It was then that I decided I had to ditch the Neurontin. It had helped back in September, but now it seemed to have no benefit in reducing the number of headaches. In fact, the side effects seemed to be getting worse, and when I did have a breakthrough headache it was more intrusive and more resistant to the Imitrex.

After making the decision to cut out the Neurontin, I started by going down to four per day right away. I've whittled it down, bit by bit, and today is my first day with no Neurontin since September of last year. I'd only taken the Elavil for a short while, and stopped it cold-turkey.

Last week, I went to see Dr. Han, an acupuncture therapist at the Pasadena Rehabilitation Institute. We had a long evaluation session, which required some suspension of disbelief, and we scheduled a follow-on for yesterday to review a treatment plan and go over fees.

I went in to the appointment yesterday with an open mind, but today I'm having my doubts. The recommended treatment plan is two visits a week, with one visit for acupuncture, and a second visit for nutrional counseling and treatment of my appendectomy scar with a cold laser. The nutritional counseling consists of some odd tests to determine which combination of supplements I need to take to improve my overall energy flow.

I agreed to give this program a try, and we did a cold laser treatment, followed by acupunture. As far as I can tell, a cold laser is little more than a cool looking flashlight. The acupuncture lasted for about five minutes, and was about what I expected. There was some pressure, but no pain involved.

Since then, I'm beginning to have some doubts about the whole deal. There's plenty of scientific evidence about the efficacy of acupuncture, and I'm happy enough with that. The whole pitch for expensive nutritional counseling, a combination of supplements determined through energy flow tests (also at some expense), and cold laser treatments, seems more like a scam, targeting helpless people who are desperate to relieve their pain even if it doesn't pass the smell test.

Only the acupuncture is covered by health insurance, and reimbursable under my health spending account. The rest of it is totally out of pocket, to the tune of $300 per month. Now, if I had confidence that my $300 per month was going to help my headache problem, I'd be happy to pay it. But today, I have my doubts.