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Thursday, December 5, 2019

Raising Awareness of BAM

To be fair, I haven't done a ton of research because honestly, there isn't a ton out there. BAM is not a condition that gets diagnosed very often and is overlooked by even gastroenterologists. I'm also not 100% sure that I suffer from it.

Let me start at the beginning. As most of you know, a few months ago I got my gallbladder out. I was blessed with not having any issues or side-effects from the removal. But then I decided to start fasting twice a week with the 5:2 diet. Never having had any side effects from fasting prior to my surgery, I didn't expect this.

TMI

Every morning after my fast, I have a single bout of diarrhea. (My old PCP told me that it "can't be diarrhea because that would infer more than one instance in a day" ; not an exact quote but I digress). So, I don't know what you would call having watery stools only once, but that is what happened - because the day before I had only ingested roughly 500 calories, most of it in my dinner that I'd had about 14 hours prior.

I couldn't attach it to anything specific. I could change my dinner, I could skip my coffee, I could eat breakfast before coffee - it didn't matter. About 98% of the time, twice a week, I would have this issue. I tried Imodium first. Once. When that caused more problems than it solved, I researched. I discovered a condition called BAM.

Bile acid malabsorption (BAM) is a condition that occurs when your intestines can't absorb bile acids properly. This results in extra bile acids in your intestines, which can cause watery diarrhea.

also:

In other cases, BAM results from an underlying condition. For example, it’s been estimated that about one-third of people with irritable bowel syndrome and diarrhea (IBS-D) have BAM. 

But mainly, I think it's due to the combination of not having a gallbladder and not having food to digest. See, when you don't have a gallbladder, your liver trickles a constant stream of bile into your small intestine. Generally, this wouldn't be a problem if you're constantly in a cycle of eating or digesting food. But when you fast, your small intestine is empty. If I'm not properly reabsorbing the bile that is going unused, it could cause diarrhea when I finally do eat a meal. 


I had read that a cholesterol-lowering medication could help with the condition. The medication binds with the bile acids in the intestine, forcing the liver to use cholesterol to make more bile (sounds like a vicious cycle to me but okay), which in turn lowers your cholesterol. But because of how it functions, it could also potentially be used to treat BAM. So, I went to my PCP, who promptly gave me an incredulous look and said it probably wouldn't work but prescribed it to me anyways.

Guess what? It does.

That's right, bitches. I diagnosed and cured myself. I mean, I needed the script from my PCP - who is no longer my current practitioner, but whatever. Do your research, even if you don't understand half the words you're reading. I obviously don't have a medical degree, but I know enough about basic biology to make some educated guesses. And if your PCP doesn't agree but doesn't offer up any other possible solutions, then get a second opinion. Advocate for your health.

Thursday, November 21, 2019

Pain Tolerance Level: Epilation

I'd been considering epilation for a long time, but due to being a scardy Kat, I never pulled the trigger. The cost of epilation is not that cheap for starting out, and with millions of comments out there saying that it hurts like a %$&#&* and "you will bleed and be swollen but it'll be worth it", I felt like I just needed to back away slowly.

Don't you just love that it looks like she's epilating something 
that's already been waxed?

But after years of shaving my underarms almost daily (due to fair skin and dark hair), the whole idea of it was getting on my nerves. Even after shaving my arms would not be smooth because my skin is not flat and taut in that area. I needed a better solution.

So did I finally take the plunge and buy an epilator? Nope. I tried waxing first. Or, to be more specific: sugaring. It is fairly easy to make your own "wax" at home, melting nothing but sugar, water, and some lemon juice. I made a hard wax on accident by cooking the mixture too long. So instead of it being pliable and pulling off with strips, I had to wait until it hardened and straight pulled it off by itself.

Advantages of sugaring:
1. Basically free
2. Quick pain and then it's over
3. Only have to do it once every 3-4 weeks

Disadvantages of sugaring:
1. Messy as heck
2. Don't heat the sugar too hot or it'll take forever to cool before you can apply it
3. You have to wait for it to cool completely before you can pull it off (this can be a problem if it is humid or hot where you are - it may never harden properly)
4. Only can do it once every 3-4 weeks. Sugaring requires a decent amount of growth before it can stick to the hair in order for you to pull it out. Which means you're running around with hairy underarms, and that kind of defeats the purpose. Especially for me, where you can see even 2-days growth.

The cons outweighed the pros here, so after a few months of trying it out, I decided to buy an epilator. The plus side of doing it this way is that, now that your hairs have been traumatized by being pulled out over and over, epiliating will be less painful. And it was certainly less painful - and a flip-ton easier to do. No fuss, no mess, just epilate and move on with your day. Plus you don't have to wait as long to do it, which I definitely need.

Now I can't wait to try this on my legs. Wish me luck!

Friday, October 18, 2019

5:2

Pretty ambiguous title, huh? What I'm referring to is the 5:2 diet - but I hate calling it that, it's more of a method; an anti-diet, if you will. The 5 and 2 correspond to days of the week. 5 days you eat normally, and 2 days a week of your choosing, you fast by eating 500 calories or less.

I know how you're looking at me right now. I got that look from both my co-worker and my boyfriend. Look, I get you 100%. It sounds miserable. I thought I would be miserable. And I've already done diets like this before. I tried the alternate-day diet, which is fasting every other day. I tried it for about a month but gained weight on it, possibly due to the fact that I was forced to eat an entire day's worth of food in an 8 hour period and then not eat the whole next day. It was tough with my schedule. I also did hCG, which is 500 calories every day for 42 days.

This, however, is a lot simpler. There are two rules:
1. Eat whatever you like 5 days a week (try to keep it healthy and reasonable, but nothing is off-limits)
2. Eat 500 calories (600 for men) or less 2 days a week. Technically, nothing is off-limits here either, but you want to ration your calories carefully, as you will be hungry, so you should eat foods that will help best with that.
3. Keep your 2 fasting days separate. It's not really a rule, you CAN do them consecutively if you want to, but it would be a lot of unnecessary suffering.

Basically, this diet achieves a "calorie restricted/reduction" diet without actually restricting calorie intake 5 days a week, which can be easier for some folks who have a hard time with the broad scope of "daily calorie restriction" (like me). I like to follow rules, I need structure, so just saying "hey, eat less every day" doesn't really work for me.

There are apparently a bunch of researched benefits of fasting (and busted myths, like "starvation mode") and you can read about them here. But I wanted to focus on the lifestyle benefits of fasting; the things that most people don't realize.

1. Cost savings. You're not eating 2x a week!!
2. Sleep in!! You're not making coffee or eating breakfast. Take more time for yourself
3. Ketosis, or something similar. I've read that it might take a day or two to kick your body into ketosis, but if your 500 calories includes very little carbs, you're essentially doing Keto for a day and possibly burning fat instead of glucose.
4. Flexibility. Have dinner with your parents on Monday? Change your fast to Tuesday. Free surprise lunch from your boss? Eat it today and change your fast to another day.
5. "You can have it tomorrow". This is basically the clincher. Unlike a typical calorie restricted diet, you are not restricted every day. Those cookies in your cupboard are easier to ignore if you tell yourself that you can eat them tomorrow. It makes a ton of difference.

I wanted to give you my personal experience with 5:2 so far. History: I've always struggled with keeping my calorie intake reasonable because it's really hard for me to say no to extra sweets (like in the break room) I kind of go overboard. I don't exercise besides walking and sometimes hiking, and it takes real effort for hunger not to control me constantly.

So here's the gist: it's not as hard as you imagine it to be. It sounds completely undo-able, but I choose days that are the busiest for me to keep my mind off of my stomach. 90% of it is probably psychological; but hell, if it works then great. The hunger can spike from time to time, but it does go away within a few minutes. If not, then I make some tea. (Morracan Mint - the warmth and the mint help with hunger pangs). I have nothing for breakfast, a hard boiled egg for lunch, and save my calories for dinner when it's the hardest to avoid my kitchen. I've been told that it gets easier with time, as well. The craziest part is that I go to bed not hungry and I don't wake up the next morning with ravenous hunger. And the next day, when I can choose to eat like a pig, I just don't. I'm not any more hungry on my off days.

It's kind of amazing. And I can't wait to see my progress on the scale with my nutritionist!

Monday, October 14, 2019

Unintentional Computer Upgrade

I used to rock an Intel core i3-8750K with a Gigabyte Aorus Z370 Gaming 5 motherboard. I had full intentions of upgrading my PC recently but when repairing the heated seats in my car was going to cost me $600, (which is roughly what the upgrade would have cost including a new case), I decided that a warm toosh for winter was more important.

Then my computer had other ideas. Without going into too much grisly detail, my NVME m.2 (SSD) decided it didn't like Windows anymore, was spitting out BSODs, and finally tossed a boot error that I couldn't even fix with a format/fresh install of Windows. Buying another NVME drive did not help, as all it did was throw me into a Recovery screen or boot with a black screen of nothing. The errors were so bizarre that after two frustrating days of trying to fix it, I figured something must be wrong with my motherboard and I needed to pony up to upgrade my computer now instead of later. Just to make sure I was dotting my i's and crossing my t's, Patrick and I took the whole system apart and looked at the motherboard with a flashlight for any burns, scrapes or leaks. Nothing; it looked pristine. So, I ordered a new motherboard and CPU.

I was not at all excited for this. The unexpected nature of this upgrade dulled my enthusiasm due to having paid $620 for heated seats and then another $400 for my upgrade when I wasn't ready for it. And to make matters even more annoying, while I was waiting for my upgrade to arrive, I decided to "test bench" my system, which basically means I put it together outside of my case, with an old laptop HDD to see if it was the NVME slots that were causing the problem.

And it booted up. I was floored. And to add icing to this bitter cake, I unplugged the HDD, put the new NVME back in, and it booted up just fine, again.

Wut.

So now I had a system that was once again running smoothly for no discernible reason, and I just spent $400 I didn't have on a new one. But the problem is that I don't know what to do with this one, now. It seems to be unreliable. I wouldn't even want to give it to anyone for free as a primary machine because of those weird issues.

I also miss my RGB. I switched over to a Ryzen 5 3600 with an Asus X570 wifi motherboard (I had a choice between Gigabyte and Asus in my budget and seeing as how Gigabyte soured me with these weird issues, I went for Asus) and not only do the X570 motherboards not have flashy RGB like my old board did (I mean, look at the glow on that thing!) Asus's "aura sync" software is buggy beyond usable and what RGB it does have either doesn't work or can't be controlled. Yeah, it's a first world problem but dammit.

On the plus side, after receiving my new supplies, I was able to set up both NVME drives in a Raid 0 just because I could (so two, 250gb drives now become one blazing fast 500gb drive), and I decided to run some tests on my new CPU, which I bought specifically for rendering/conversion over gaming. So rendering an episode of Good Eats: Reloaded (my original test here - which also explains what m.2 and NVME is) was 7 minutes faster. And converting a batch of RAW files (620 - for a time lapse) took only 30-45 minutes. On my old machine, a batch of 1200 files took 6 hours to complete, and I couldn't even use my computer at the time because it was using every available resource. So yes, besides the lack of RGB my new system is pretty bomb and I am really happy with it. I just wish I didn't have to go into debt to make it happen!


Tuesday, October 8, 2019

When it Rains, it Pours

It's been a long time since I got visited by the 3 amigos (when shit happens in threes), but it has never been all in one day, before! The last time was in 2012 that I remember - I posted about child #3 here, and Children #1 and #2 here.

Child #1 is my computer acting up. For a few days it had BSOD'd a couple of times due to software/driver issues, which I think started after the latest Windows update, most likely. I pretty much ignored it until yesterday when...

Child #2: Odin, my gerbil. I'd had him for almost 3 years. Yesterday morning, he looked dull and sick, and I figured it was his time. (Gerbils live 2-4 years on average). He'd been getting slower with age. Not nearly as energetic and annoying as he used to be. I told Patrick that he was probably dying. I told him not to mess with him or his cage that day and I would check on him when I got home from work. When I got home yesterday evening, he was pressed up against the glass. His eyes were closed and he was barely breathing. I didn't want to move him or anything for fear of making it worse. He was still hanging in there, though, that little trouper.

That's when Child #1 reared it's ugly head: I got a BSOD that was fatal. After backing up some of my files, my SSD finally went kaput. There was nothing more I could do but try to wipe the drive and start over with a fresh copy of windows.

In the meantime, Patrick and I watched as Odin took his final breath. He was gone. Knowing that I would be inheriting Patrick's cat in the coming months, I wasn't planning on replacing my gerbil with another, so Patrick got rid of his home and toys as we set up to go bury him at my parent's house, where the Pet Cemetery of my past animals resides. I set up my computer to install Windows, and we left for the burial.

When we got back, I decided to check my mail. Oh child #3, I thought you'd never come. While my surgery bill for my cholecystectomy was only $580, turns out the anesthesia bill is much more. $900. Damn. I'm looking at this bill while seeing PC death on my computer screen because the boot sectors of the drive have apparently been corrupted. And although I try a few fixes through Command Prompt, nothing was working. So I resign myself to spending $70 on another SSD in order to get my computer up and running again.


I called the anesthesia people today, and they accept Multicare's financial aid, so there is a silver lining to all of this, at least. My bill should be reduced greatly, and I'll find out within a week or two. The other bit of good news is that I purposely have my boot drive as pretty much just that - a boot drive. Nothing of value resides on it, so it's no big deal to lose it (although come on - it was only a year old!!) so, there's that. And regarding Odin... I knew for the last couple of months that it was coming. Isn't it strange how you know your animals so well that you can just tell when things change or don't seem right? Odin lived a long, healthy life and died of old age. That's the best any momma could hope for. So of course I'm sad that I lost him, but I'm also glad that he lived as long as he did.

I'm also so incredibly glad that I have Patrick's support and that he happened to be there that evening with me. I might have broken down without him. He's so amazing and I don't know what I'd do without him.


Thursday, September 26, 2019

Cholecystectomy 9/6/19

Well I'm back - I made it out alive, and I'm here to recount my story for ya'll.

The process actually starts a week before, when I had to grab my surgery packet that included wipes that would make me less bacteria-heavy prior to surgery. I also had to do a CBC at the lab. So two days prior to surgery I get a call confirming my arrival time: which is 2 hours prior to my actual procedure. I was to check-in at 10:30.

The night prior to my surgery day, I showered at 11pm and ate my last meal (I was to be NPO after midnight), and then I used the wipes all over my body. It was going to kill the bacteria on my skin and stop it from reappearing up to 12 hours after. I had already cleaned my sheets so they were ready for me when Patrick and I finally went to bed. (He showered too, but we stayed separated, just as a precaution.) I didn't get very much sleep but it didn't really matter.

Mom met us at the hospital and we all went inside together. Allenmore is under construction so it's a tad confusing. I signed in and waited to be called back. We were then put into a pre-surgery room with a bed, chairs, and equipment. I was going to need to give a urine sample (for a pregnancy test, I guess) strip naked, wipe my abdomen down with another set of wipes, and put on a gown. After that, it was just a parade of people in and out of the room as we waited. My favorite person was a nurse named Roy. He was incredibly nice, made sure that I was perfectly at ease, and he actually reminded me a lot of Patrick. He was only in my room long enough to set me up with my IV, but it was a nice experience. I remember meeting the anesthesiologist, which, as you know from my prior post, the most worrisome part of my ordeal. He told me he'd been doing this "longer than I've been alive" and that I'd be perfectly fine. He was definitely confident, but also bordering on cocky. When Dr. Burns finally came by, I made sure to ask him to take pictures. Although he could do that, he could not, unfortunately, cut open the gallbladder because pathology wants their specimens in tact. Darn.

I also wasn't going to be waking up with Patrick peering over me like I'd thought because my first step was the Recovery Room where they make sure everything is stable and that my pain is managed before moving me to "step two" where family and friends can come visit. Finally, 12:30 rolled around, and it was time. Patrick had been inches away from me for the last two hours and it was really hard to separate. They both followed me down the hall as far as they could before I was rolled away.

I'M NOT CRYING, YOU'RE CRYING.

I had a short conversation with the nurse before heading into the operating room probably to calm my nerves. She asked what I did for a living and I told her that I worked with a GYN/Oncologist surgeon. She said that it must be difficult knowing what's going on behind the scenes when you're about to have surgery, and I told her that I'm also the one who checks in all of his post-ops knowing that they all made it out just fine. (This conversation seems reversed, doesn't it?)

I was brought into the operating room, which looked little like the theater you find on shows like The Resident, and moved me over to the table. As they were getting prepped, the anesthesiologist came over to me and said "this will help relax you" as he put a needle in my IV access. And then he placed a mask on me and said "this is oxygen". I didn't even have a chance to count backwards. I was out before I even knew I was out.




 Sorry for the crummy pictures - I wasn't the one taking them ;D

I do remember having a dream shortly before waking. I wonder if this is normal. I awoke in Recovery, and I remember it being a tad difficult to breathe. The air coming from my mask was warm, and I probably still had some air in my abdomen that they couldn't get out.

[Pro tip: Do not, I repeat DO NOT watch your type of surgery on youtube before having it done to yourself. I was lucky enough having not thought of that step before doing this. But yes, they do blow up your abdomen with air so that they can root around inside.]

They had to give me a couple of Fentanyl doses in order to get my pain under control. Oh, also, I had been given a Scopolamine patch behind my ear prior to surgery that was going to help with nausea for a couple of days, since narcotics make me nauseated. Patrick had filled my prescription of oxycodone and anti-nausea meds while I was out. The whole thing took a very long time. The surgery itself was only about an hour, though.

According to Patrick, Dr. Burns came out to talk with them while I was recovering to let them know how the surgery went, and he did mention that he could feel large, oddly-shaped stones in my gallbladder. The nurse also told me that it was really good idea that I had gotten this taken care of.

Step two finally came around and I got to say hi to Patrick and my mom. I was so happy that they were there with me. We were given all the instructions for my after-care by a post-anesthesia nurse. After a bit, they took away my bed and put me in a chair, which my body did not agree with at all. All that Fentanyl made me super nauseous and I needed to lay down so they brought in a reclining chair for me. I was given an anti-nausea pill and waited 30 minutes for it to take effect. Once that was done it was 5pm and time to go home.

I had to be watched for 24 hours, and Patrick had to work at 11am on Saturday so mom came over to finish the watch. I hadn't taken a single narcotic after the surgery (and I didn't want to either) but was kept on a regimen of 500mg tylenol every 6 hours and an ice pack on my abdomen every 2. Besides being sore, tired, and not hungry, I was perfectly fine. It hurt to use my abdominal muscles of course, so getting out of beds and chairs was difficult, but other than that everything turned out great. My 4 incisions are almost completely healed and I've got no pain. Not only that, but I've got no issues with IBS or fatty foods. It couldn't have turned out better and I'm so lucky.

Sunday, September 1, 2019

My First Real Surgery

Technically, I've had minor surgeries before; both Lasik and a colonoscopy. But - I have never been under general anesthesia. I am perfectly confident in my surgeon, but I am terrified of going under. It's kind of funny actually, since I work with a surgeon. I've seen hundreds of his patients go under anesthesia and come out perfectly fine - and those surgeries are scary and intensive. What I'm doing is a gallbladder removal [cholecystectomy].

If you know me at all or follow this blog, you're probably aware that I've had gallstones (link to my blog about it here) since my first attack in February of 2006. This pretty well describes my whole feeling about the stones and why I've waited this long to get it taken care of. I actually didn't mention how it could possibly exasperate my IBS-D, but honestly, those attacks are pretty rare these days as well because my diet is much better than it used to be.

My deciding factor to get the surgery was three-fold:

1. I qualified for 80% FA through Multicare even after my insurance paid. Without this assistance I never would have gone through with it.

2. I had 2 attacks in the span of 2 months (after going 6+ months between attacks) and both required TWO Vicodin to get under control. That was certainly not normal and concerned me a great deal. Especially now that narcotics are on such a tight leash, I'd be lucky to ever get a refill again after my current supply runs out (which I've had for 3+ years now)

3. My mom said "what if you get a life-threatening attack while in Canada?" Touche. The last thing I need is gallstone pancreatitis when I'm away from home.

Like I mentioned already, I'm perfectly confident in my surgeon. Cholecystectomies are one of the easiest surgeries to do, and Dr. Burns does roughly 5 a week. I've got no comorbidities that would make the surgery more difficult. But I have no idea how I would react under general anesthesia. No one does when it's their first time. I keep being told that everything will be fine (allergic reactions to anesthesia are, in fact, very rare) but hello - I'm allergic to an allergy medication, remember? (Allegra). I gets the hives and a swollen upper lip, which the company confirms is a "severe reaction". So yeah, I'm a bit freaked out over this. So much so that I've filled out a Health Care Directive and Power of Attorney just in a case.

And of course, I will chronicle my surgery from start to finish in case anybody is curious!

Oh, also (look away now if you don't want to be grossed out), I will have Dr. Burns take a picture of my gallbladder once its out! Here is an example pic: