Acid Reflux – not just for smoking, drinking, middle-aged men.

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Back in December, I had a bad cold and lost my voice, but got over it.  Mid-January, I started feeling like my voice was going out again, but this time, I didn’t have any cold symptoms.  My primary doctor, never one to over-prescribe (I prefer it that way), said, “Maybe you just have acid reflux.  Take some OTCs and see how it goes.”

Acid reflux?  I scoffed–I can count on one hand the number of times I’ve had heartburn in my entire life.  I eat pretty darn healthy, exercise regularly, drink rarely, and have an app that encourages me to get to bed at a reasonable hour.  I’m well under 50, not overweight, I don’t smoke, and I’m not a man.  How could I possibly have acid reflux?!

So, I took a couple Tums and some Pepsid, but it didn’t make any difference.  I also did what I usually do for my voice – herbal lemon lozenges, lemon ginger tea with honey, and lots of water and rest.  After trying to sing for a whole band practice, I became completely aphonic.  Not great for someone who uses their voice professionally.  After three days of being unable to make any sounds at all and now experiencing full-on heart burn ’round the clock, I went back to my doctor who was concerned but didn’t really have anything new to suggest except reflux.  I got a referral for an ENT and fortunately got an appointment an hour later.

The ENT did a nasolaryngoscopy and said that it looked a little irritated but there wasn’t much swelling so he wouldn’t even give me a cortisone shot to get my voice back.  He gave me a prescription for a powerful proton pump inhibitor – Protonix, and said, “If it works, you have reflux.”  He made it sound like no big deal.  He even said he goes off and on PPI’s periodically to manage his own reflux.

By the way, PPI’s ARE a big deal.  Being on them short term messes up your digestion because they lower the amount of acid in your stomach, so you don’t digest your food well, leading to diarrhea.  Also, they are not localized in their effects–they lower acid in your body systemically which isn’t good because you need acid for your lysosomes to properly remove cellular wastes.  In addition, there are a whole host of other health concerns from long-term use:

“…known risks, including C. difficile infections, which can cause chronic diarrhea; pneumonia; low magnesium levels, which can cause muscle spasms; heart palpitations and convulsions; and fractures of the hip, wrist, or spine. Fracture risks are generally highest in people who’ve taken high doses of the drugs for more than one year.”

from – http://www.webmd.com/heartburn-gerd/news/20160608/proton-pump-inhibitor-health-risks#1

I took the pills twice a day for several days and my voice slowly returned, but I was still experiencing heartburn, and an altogether new sensation–a feeling of a giant lump, like food, stuck at the back of my throat.  The technical term for this is globus pharyngis, and doctors aren’t really sure what causes it.  Some believe that there is a problem with the coordination of the swallowing muscles and perhaps they tense up and don’t relax, giving an uncomfortable sensation.  All I know is, it’s annoying, lasts for hours on end, and wasn’t improved at all by taking PPI’s.

Then I went to the library and did some research about reflux and GERD (gastroesophageal reflux disease) and found that while, yes, I was experiencing acid reflux, heartburn, and globus sensation, these don’t equal a diagnosis.  These are symptoms.

This is why I get annoyed with Western medicine–I wasn’t diagnosed.  I was treated symptomatically and it sort of helped, but not 100%, and new problems arose.  I also met with a GI specialist to get a second opinion as I didn’t want to be married to these heavy-duty pharmaceuticals forever.  He basically said the same thing as the ENT.  He also refused to do any further testing to find the underlying cause of the reflux, essentially saying, “What does it matter?  You’ll have to treat it the same way, no matter the cause: modified diet, PPIs or H2 blockers, sleep on a slant, don’t eat 4 hours before bed.”

But here’s the thing: you can have acid reflux for a number of reasons including: over-production of acid in the stomach, under-production of acid in the stomach (yeah, counter-intuitive), a stomach that is slow to empty, a hiatal hernia, a weak lower esophageal sphincter caused by lots of things (including taking muscle relaxants).

Also, some fun facts I discovered: having silent reflux might be the reason you are over-producing mucus and have a constant post-nasal drip.  It also makes you prone to getting more sinus infections, and can cause asthma-like symptoms or leave you short of breath.

Coughing Man - Arrows

Depending on the root cause of the reflux, there may be some different treatment options.  I found another GI who was willing to do an upper endoscopy.  This revealed that my reflux is caused by a medium-sized hiatal hernia.  After even more research, I learned that the current surgical treatments for this aren’t that amazing (fundoplication, Lynx, a type of laparoscopic surgery).  Also, I found I don’t have GERD, I have LPR (laryngopharyngeal reflux), a.k.a. “slient reflux” which is why I don’t get heartburn, but I get throatburn and lose my voice easily.  Still, at least I have a diagnosis and can keep up with any new treatment developments.

Overall, I’m still struggling.  I am having a hard time with eating in general, as sometimes foods that should be “safe” seem to give me a problem.  And if I over-eat, eat too quickly, or eat too close to bedtime, it doesn’t matter what it is–I turn into a Gremlin.

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Oh, and as far as home remedies, I haven’t found any that work.  I got a slant-pillow but I still wake up with a sore throat most mornings.  The whole drinking water and slamming your heels down thing doesn’t seem to magically move my stomach back into its rightful position.  Self-adjusting my abdominal fascia doesn’t offer any relief either.  And for Chrissake, do NOT drink shots of apple cider vinegar.  If that shit worked, there would be no other treatment for hiatal hernia.  Some people anecdotally swear they get relief from these, but I’m hear to tell you there isn’t any research to back that up, and this girl didn’t find it to be true (though I didn’t try the ACV, that’s just cray).

One non-dietary thing that does seem to help is lowering my stress level with better sleep, avoiding unpleasant stimuli, and meditation.  I don’t think it was a coincidence that my symptoms had a sudden onset right around the time a certain popular vote-loser took office and my stress levels ramped up significantly.

There are some theories as to why acid reflux, GERD and LPR are on the rise.  When I find something credible and research-based, you’ll be the first to know.  Stay healthy friends.

Health coverage.

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So, I am in a situation where I am currently without health coverage.  I don’t get too worried because I am generally healthy but it’s not ideal and I would like to be covered.  Unfortunately, I can’t get covered through my current employer and after talking to a representative for my home state, it’s become quite clear that there is no affordable coverage option.  The mid-level “silver” plan would be over$2000 a year with a $2000 deductible and many of the services I would need wouldn’t be part of the amount counted toward meeting the deductible.  On top of that, it would only be health coverage, not vision or dental which I really do need as well.  That would be even more money and not offered through the exchanges.

At that amount, I’m be better off paying out of pocket and eating the fine I’ll get at the end of next tax season because it will be cheaper than paying the premiums and the out-of-pockets toward reaching my deductible.

I truly do believe that public health should be mandatory but the average citizen is being given an “unfunded mandate” much like NCLB.  The tax deduction the government is offering me to offset the monthly premium is a joke.  I don’t see an affordable option with adequate coverage being offered.  Expand Medicare for all and take the for-profit angle out of the health coverage equation to offer a universal and affordable system to cover everyone. 

Broken Bones and Pulmonary Embolism

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Friends, it is with a very sad heart that I write this post.  A wonderful man was cut down in his prime this past Sunday.  One minute he was talking and laughing with his family, the next he was gone.  There were fist responders present but nothing could be done.  His cause of death was a pulmonary embolism secondary to a double-fracture in his foot ten days prior.

According to the Mayo Clinic’s website:

Pulmonary embolism occurs when a clump of material, most often a blood clot, gets wedged into an artery in your lungs. These blood clots most commonly originate in the deep veins of your legs, but they can also come from other parts of your body…

Occasionally, other substances can form blockages within the blood vessels inside your lungs. Examples include:

  • Fat from within the marrow of a broken bone
  • Part of a tumor
  • Air bubbles

It’s rare to experience a solitary pulmonary embolism. In most cases, multiple clots are involved. The lung tissue served by each blocked artery is robbed of fuel and may die. This makes it more difficult for your lungs to provide oxygen to the rest of your body.  (from: http://www.mayoclinic.com/health/pulmonary-embolism/DS00429/DSECTION=causes)

I have never in my life heard of a thing like this happening, but apparently, it’s not all that uncommon.  If you suspect that you have broken a bone, do everyone a favor: get thee to the hospital IMMEDIATELY.  Go see a good orthopedist and stick to the rehab regimen that doctor prescribes.  With your doctor’s consent, take aspirin to reduce the risk of blood clots.  Take the rest you need to heal properly and comply with your medical team’s advice.  Be well friends.

Uncle George, you are loved and sorely missed.  Rest in peace.

What is going on in Colorado??

 

I read a news piece last night about some poor girl in Colorado who was struck with BUBONIC PLAGUE.  She likely caught it from fleas off a dead squirrel in a campground where she was staying with her family.  Fortunately, she survived, but really, I think Colorado has been through enough lately.  Can it please get a break already?

 

By the way, do a thorough rodent search if you are staying in tents, cabins and outbuildings provided by a campground.  These animals carry plague, hantavirus, Lyme disease,  rat-bite fever and Typhus, to name just a tasty few.

 

Stay safe my fellow campers!

 

PS – Warm wishes of love, health and happiness to my two favorite Colorado residents J & G on their recent marriage!

Spotlight on Joint Health: Trochanteric Bursitis

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Some of you may never have heard of bursitis. may you never experience it first hand.  A bursa is a small fluid filled sac that acts as a cushion where bones, muscles and tendons rub against each other around a joint.
The bursa located in the hip by your trochanter can become inflamed for many reasons such as:

  • injury to the hip
  • overuse or injury to the joint
  • poor posture
  • stress on the soft tissues
  • hip bone spurs or calcium deposits

If you have loose joints, your pelvis can become misaligned, setting you up for bursitis.  If this happens, the iliotibial band will tighten up and exacerbate the rubbing and increase inflammation.  If you sit a good part of the day, if you frequently drive for long periods of time, if you don’t exercise and your core muscles are weak, you are more likely to develop this condition.  The pain can become so intense you might not be able to walk.  After sitting for long periods, you can have great pain upon rising.  This will also set you up for a vicious cycle because when you have pain and stiffness, you may not want or be able to exercise and stretch.
If it gets to that point, you likely will have to take an intensive short course of a steroid to quickly reduce inflammation and then begin your recovery process.  This involves intensive physical therapy with a practitioner who is well versed in anatomy and physiology and can determine if skeletal misalignment is part of the problem.  Do NOT seek help from chiropractors.  Their practice is NOT based on sound scientific studies and there are many cases of people being gravely injured by chiropractors.  A good PT is always the way to go.  They do what chiropractors do but with a background in evidence-based medical knowledge and none of the spiritual mumbo jumbo.
Therapy will likely involve the following elements:

 

  • electro-stim machines
  • hot compresses
  • cold compresses
  • skeletal adjustments
  • a series of stretches and exercises to strengthen the muscles of your: stomach, thighs, low back, and butt

The very best thing you can do to ensure your complete recovery and to prevent a relapse is to stick with your rehab exercise program.  Even after you feel better, keep it up.  Sit on a Swiss ball for a few minutes several times a day.   Make sure to engage your abdominal muscles often, especially when carrying heavy objects. Take Pilates classes.  Avoid bizarre body postures and extreme twisting positions if your joints are loose (especially women and especially just before your period–your joints are even looser then and you’re more prone to sports injuries).

If you frequently feel soreness or stiffness in your hip or in your pelvis where your thigh joins your trunk, if you have pain after long periods of sitting, get checked by an orthopedic specialist and rule out trochanteric bursitis.

Be well friends!

A mental health moment.

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Mood and emotions seem like quickly vacillating, arbitrary, amorphous “things” that are influenced and controlled by events and people around us.  “My (fill in the blank) is driving me crazy.”  “(Blank) is getting to me.”

Thoughts and emotions are products of your brain function and they work on a “feedback loop” that can  change your neural structure and function for better or worse.  While we still don’t know exactly how things work, neuroscience and psychology are working to get a better understanding of the brain structures involved in emotion and memory and to find out how we can work with them to improve our mental quality of life.  If you care to read up about it, focus your studies on the limbic system which is made of: the hippocampus (memory), the amygdalae (twin centers deep in the temporal lobes which process emotions), and the hypothalamus which provides a link between your nervous and endocrine systems.

Now to move away from the research stuff for a minute. What are some things that one can do to improve mood, emotional outlook, and one’s overall sense of mental well-being?

First, recognize that all thoughts and emotions are products of real, measurable chemical and electrical changes going on in various parts of your brain.  It’s not some magical event or weird vapor that passes over your mind.  It’s something concrete and factual.

Second, understand that when you exert some conscious effort, your mood and emotional reactions to situations CAN change.  Think about it this way: you have to exercise to build your physical strength.  You have to practice a musical instrument to improve your playing.  If you put some constructive work into your mood and emotions, they can improve as well.

Third, in the absence of any constructive, conscious work, your thoughts, mood and emotions will become more and more engrained.  If you get stuck on a negative track and allow your brain to keep thinking the same thoughts and soaking up the same chemicals that are released with the negative feelings, you are setting your brain up for more of the same.

Fourth, there are many tools and activities available to us that can help when we are not able to consciously “exercise” our emotional centers and get better on our own.  In no particular order, these include but are not limited to:

  • psychotherapy provided by HIGHLY trained QUALIFIED professionals–sorry social workers, but most of you seem woefully under-qualified and should not be in charge of counseling people with serious mental health issues.
  • “talk” therapy, i.e. working things through by talking with a trusted friend or mentor who can listen patiently and knows they don’t have to give you the right answer.  Also, talking to others (online or in person) who are going through what you are experiencing can be a great help too for putting things in perspective.  Postsecret is one of my favorite online forums to share in the lives and experiences of others.  You can even unburden yourself and send some postcards.
  • meditation has been shown to make measurable positive changes in the baseline functioning of the human brain.  You can do it by yourself or participate in group guided meditation classes.  Meditation is not strictly a spiritual practice and doing it does not mean you have to ascribe to a particular religion to participate and reap the benefits.
  • pharmaceuticals can be an incredible boon to people who have medical conditions that make it impossible to self-regulate.  There is a still stigma attached to people on “meds” but if it means the difference between suicidal depression and being able to function in daily life, I think you need to ignore the haters and get the help you need.  I strongly feel that drugs should always be used in conjunction with non-chemical methods for improving mood and emotional response.
  • pleasure therapy which is the term I use to describe “doing stuff that makes you feel happy.”  The more you involve yourself in happy activities, the more you train your brain to enter the “pleasure mode.”  It’s best if you find activities that are free, readily accessible, and get you involved with other (positive) people.  Shopping, food and sex can affect our brains on a very deep level and usually do make us feel happy, but they are often associated with many other complex emotions as well so I feel it’s best not to use them as a form of therapy.  Things like enjoying or making art and music, spending time with a pet, watching a funny movie or t.v. show, and exercising strenuously to release endorphins (the body’s pharmaceuticals) are some of my favorites.  Engage in these for a significant period of time (at least 20 minutes) a few times a week to feel the effects.  You may find that some of these activities also have a meditative quality to them as well.  Double points!
  • memory therapy which is spending time thinking about good times you’ve enjoyed (so get out there and do some pleasure therapy).  Picture the scene in detail and even write it down so you can go back and read it.  Wallowing in good memories is a great way to retrain your brain to think positively.

I am not some sappy-happy-go-lucky person and I was definitely not raised by positive people, but these are some things that I have found helpful.  Remember, you won’t change overnight and there will be some days when everything seems completely suck and you might backslide.  That’s okay.  It’s only too late to change when you are dead.  Until then, keep trying.  Hope you are well.

Bike riding.

For those of you fortunate enough to own one, bike riding is one of the most enjoyable outdoor activities I know.  If you don’t own one, some cities and towns are awesome enough to have a bike rental or co-op to join and get use of one.  It’s worth looking into.

Enjoy the feel of the wind cooling you off as you move past the scenery, and the knowledge that while you’re having fun, you are getting both a good cardio session as well as strength training for your lower body.  Engage your core and make sure to keep your shoulders open and down your back to get even more benefits.  Getting fresh air and sunshine beats pumping away in a dark crowded room smelling the sweat of others in a spin class.

Don’t let machismo or fear of flat hair deter you from wearing a helmet.  Traumatic brain injury is a sure-fire way to ruin everyone’s day.  Whether you’re on a ten-speed, mountain bike, or unicycle (saw a guy rocking one yesterday in town.  It was amazing.), put on your helmet, slap on some sunblock, grease your chain, top off the air in your tires and go for a bike ride.  You’ll feel good.

The Expensive and Painful Quest for Eternal Youth

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Reading April’s issue of Allure magazine, the EIC speaks of the need for self-tolerance and kindness regarding our imperfections and the natural changes that come with aging.  She talks about a self-image that adapts so that we don’t get hung up on achieving a look that froze in the time of our early twenties.  As soon as that one-page preface is through, we are bombarded with articles and advertisements dedicated to “anti-aging,” “anti-wrinkles,” “anti-sagging,” and one depressing description after another (couched in product placement) of all the unappealing things that will happen to our skin, hair, and body in general as time ticks past.

This is not to say that I am above the desire to maintain a youthful look.  Nevertheless, publications like this say one thing-briefly- (love and accept yourself) while spending the lion’s share of their time promoting the very opposite in the most aggressive fashion possible.  This has made me take a hard look at my own forays into the “anti-aging” game.  I purchase broad spectrum sunscreen.  Okay, this is a good thing which will also prevent melanoma.  I use expensive moisturizers.  Well, they have natural ingredients which is better for my health, the planet, and they aren’t animal tested.  All good things.  But the one thing I have no other justification for is my micro-needling treatments.  I feel guilty about it yet I am happy with the subtle improvements already.   a process which has been referred to as “poor man’s fraxel” to reduce lines, plump the skin, and cause a resurgence of collagen growth.

I spent an amount of money I’m ashamed to admit and I allow my doctor to poke thousands of tiny holes in my face with a 15 micron needle roller, after which I apply creams religiously.   When the process is complete, I will let ya’ll know if it was, in fact, worth the time, pain and expense.