Saturday, September 29, 2007

Here is a success story

Approximately ten months ago I had a bowel resection. The "suspicious mass" was malignant, however it was caught so early that my prognosis is excellent. The oncologist used the word, "you're cured." Periodic colonoscopies should prevent further occurrence. That is not to say that some other form of cancer might rear its ugly head, but I fall into the same risk category as others who have not had colon cancer. That is good news.

Recovery at home was tough. However I have a number of essays in this blog covering issues that I encountered during home recovery that may be valuable information to others going through a bowel resection.

In addition to the surgery I am/was being medicated for hypertension (high blood pressure) high cholesterol, type II diabetes and atrial fibrillation. In addition I encounter an irregular heart beat. Some of that information is also documented in this blog.

Now after 10 months, numerous trips to various physicians I am able to report substantial progress. While I was undergoing home recovery my weight dropped significantly because of lack of appetite. The surgery was in January, in March I decided to continue the weight loss in the form of a calorie counting diet. I had lost approximately 26 pounds in the two month period since surgery. In addition in March I had an atrial fibrillation episode that hospitalized me for two days while that settled out.

Now some ten months after surgery I am able to tell anyone interest that I have lost a total of 60 pounds and dropped 4 - 6 inches off my waist line and am in the process of retooling my wardrobe. Everything from my hats to my shoes are looser. I am walking 40 to 60 minutes a day at a 3.5 mph clip. I have completely eliminated the Metformin and Glipizide I was taking for type II diabetes. I have eliminated one of the two hypertension medications and upon advice of a cardiologist retained one medication, fosinoprol sodium (Amapro) because it has been shown to reduce the risk of heart attack. My resting blood pressure averages 107/75 now.

I have dropped one of my two cholesterol medications called Tricor. Tricor targets triglycerides and my last blood test indicated my triglyceride level at 41 and normal range is 40 - 200. With that much upward room my physician agreed with me that eliminating Tricor is an acceptable risk.

My daily walking pattern had started to whip my heart into shape. As you may know as your heart becomes stronger your pulse rate slows down. The capacity of your heart to pump blood increases so the frequency it beats can slow. My pulse rate has slowed to the low 40's which my physician and I felt was too slow. To control the atrial fibrillation problem I was taking Lanoxicaps (digoxin) and a new drug called propafenone (Rythmole). The cardiologist told me to stop taking Lanoxicaps immediately after my physician called him to discuss the slow heart rate I was encountering. The cardiologist made an appointment for me to see another cardiologist that specialized in the electrical performance of the heart. When I saw this new physician and he learned that I had only had two A-Fib episodes in the past 18 - 20 years he basically said you do not have an atrial fibrillation problem. Two episodes in that period of time do not constitute a heart arrhythmia but are considered lone episodes whose cause is unknown. I know what the cause was, those were two times in my life I was undergoing extreme personal stress. Regardless this new cardiologist agreed that dropping the digoxin was OK as he felt it had no therapeutic effect at this time. (Digoxin slows the heart rate.) This doctor also felt that the propafenone was not necessary. In fact, propafenone can contribute to heart palpitations or irregular heart beat. We are now weaning me off the drug, in three months I well wear a Holter Monitor for 24 hours and if there are no episodes of A-Fib then the propafenone (Rythmole) will be dropped. I believe that will be the outcome.

When all is complete I will be a cancer survivor. I will have lost over 60 pounds. I will have in place a regular exercise program to strengthen and maintain my heart. I will have eliminated the type II diabetes medication. I will halve the cholesterol and hypertension medication and eliminated the antiarrythmia medication. I will be left with an irregular heart beat that most people encounter, they just can't feel it. My heart palpitations have reduced already, the sensation has become almost imperceptible, and I feel the best I've felt in 20 years.

Only time will tell if I am able to maintain this routine. I intend to! I document all of my progress in the form of a spread sheet filled with blood pressure, pulse and glucose information. It is my method of obtaining positive reinforcement. I can say that I've come a long way, I feel good, and hopefully the follow-up colonoscopy in November will document the success of the surgery.

I have learned that it is necessary for you to take an active part in your health maintenance. Doctor's do not know all of your past history. The usual blood tests and various test for specific symptoms do not tell the full story. I have spent a lot of hours studying on the problems I was encountering and have learned a great deal. This has assisted me in asking intelligent questions and add specific information as it relates to "me." This has allowed the physicians I pay to assist me in my health maintenance to make more informed decisions. I am another of those who have learned through painful experience that you have to take charge of your own health, all doctors can do is advise on what they know. So good luck and take charge!

Tuesday, September 4, 2007

Changes I have made

I have written in this blog about home recovery from bowel resection surgery. That is now 36 weeks past. I have also written about some recent episodes of premature ventricular contraction (heart palpitations) that have been aggravating me. On the other hand I haven't written too much about the good, so here it is.

For whatever reason I was never worried that the cancer that was removed from my colon had spread. I slept soundly prior to the surgery, and recovery was tough but I've pretty much gotten through it. Prior to surgery though I was pretty unhappy with my general health. I had a check up in November that lead to scheduling a colonoscopy and that part is history. However, my blood glucose level had increased, my 1-AC was 7.6 and the physician was speculating on whether or not I should start taking insulin shots to stay in better control. I was also having a pain that began under my right shoulder blade in my back and felt like a muscle pull. Turned out to be a mild gall bladder attack. It was not a stabbing pain, nor was I sick at my stomach, but I just did not feel well. I was frustrated and knew that much of what could be done to improve my health lay in my own hands. I just could not summon the will power to make the changes necessary.

The bowel resection surgery put a whole lot in perspective. I gained additional insight into my wife's feelings, I came to appreciate her even more than I did already. I have to deal with new feelings on my own mortality and I know I do not want to put her through the grief and stress of burying her husband.

I weighed 276 pounds the day before surgery. Surgery knocked about 26 pounds off my frame. I wasn't dieting at the time, but I was so sick during recovery that my appetite all but disappeared. I had a lot of gas and upset stomach and food did not taste good for over six weeks. Then came the heart arrhythmia problem and the medication I was taking then really made food taste foul so there wasn't much I enjoyed about eating. It was more like just get some sustenance in you and get through the meal.

Two days before I ended up in the hospital with an A-Fib attack I found an online site that had a calorie counting program, weight log and exercise log. After looking at if for some time I decided to make the plunge. Twenty years ago I had a very successful period where I ran, watched what I ate and got my weight down to around 220. I felt good, full of energy, and I recall the pleasure life held for me then. I wanted to feel that way again, but now I'm 62, can you recapture that feeling of well being at my age?

So I started logging what I ate. The program helps you set a calorie goal based on the desired weight you wish to achieve. In addition there is the positive feedback of the weight loss chart that allows you to see success and provides a very positive feedback mechanism to help boost your morale.

For years I've taken blood pressure medication, cholesterol medication and glucose control medication. My attitude was as long as the symptoms are under control eat what you want, just take more pills if necessary. My blood pressure was always fairly good, but the diastolic number seemed high. Much of the time the diastolic numbers ran in between 140 and 160. I had begun an exercise program three years ago and dropped from an all time high of 309 pounds to the 276 area and felt pretty good about that. In fact, I had even eliminated one of the diabetes medications for a time until I got off the program and started to climb in weight, then back to full meds.

So, with the shock of recovery, the demoralizing A-Fib episode, and the general disgust of where I was at health wise I decided to undertake the calorie counting and weight loss program I know. I log this information. I have extensive spread sheets where I enter daily blood pressure, pulse rate and glucose level readings. I make charts, I log calorie intake and list weight. My routine in the morning is jump on the scale, see where I am today. I then wait about ten minutes until I am awake and measure my blood pressure and pulse with a cuff I keep near my bed. I take the blood pressure readings sitting up, but I really haven't been moving too much. I call all this stuff my baseline readings because if I take these readings during the day there are too many variables that can effect them. After all, I believe it is all relative, if you achieve a reduction in blood pressure while at rest the average may be higher during the day, but it will be lower than before.

So far my blood pressure diastolic readings have dropped from a monthly average in March of this year of 122 to and August average of 106 or an 18% reduction in diastolic pressure. My systolic readings were an average of 80 in March. As of August the monthly average dropped to 72 or a 10% reduction. My pulse rate remains around 60, however you must also understand that with the A-Fib medication and blood pressure medication I am still on, the pulse rate is chemically retarded. Even the higher levels don't sound too bad, but remember I was taking two types of blood pressure medication which chemically lowered the pressure. I now take only one type of blood pressure medication and my readings are lower than before.

Glucose is a real success story. The readings will be odd though. In March 07 the average glucose level was 81, the August 07 average is 91. Yes, it has gone up, however I am completely off all diabetes medication and have been for over a month now. I watch what I eat, I don't snack too much, and I try to control my carb intake, but the medical community has told us that exercise and weight loss are two of the largest factors in diabetes type II control and they are correct. I have checked my glucose level after a meal and find my body responding well to the increase glucose levels. One time I took a glucose reading at about 1 1/2 hours after a meal and it was 149, an hour later it had dropped to 118. So I am off all diabetic medication and doing well.

In April I began walking. My stamina was not too great and I walked for about 30 minutes, the pace was quite slow at about 2.5 miles per hour. Then in May I pinched my Sciatic nerve and could not walk for about a two months. In July I picked back up on the walking and now walk a minimum of 40 minutes each morning before work and my pace has picked up to about 3.5 miles per hour. On weekends and times I don't have work obligations I will walk for 50 minutes at the same pace. The exercise has helped weight loss, but more so I believe it to be a big factor in blood pressure and diabetes control.

I recently had a complete blood panel done. The purpose is to measure where my body is at chemically. How are the mineral levels, the cholesterol and various organ functions. I did have an episode of PVC increase about a month an a half ago that scared me. It has gotten better and after much investigation I believe I understand heart palpitations much better than I did. The medical community pretty much considers PVC's benign if there is no underlying heart damage or disease. Tests conduct in March indicate I have no heart damage. Seven years ago I had a heart cathartization procedure that indicate artery blockage, three years ago the same procedure indicated no blockage and a echo cardiogram before surgery this year confirmed no blockage. So I believe my heart is generally in good shape, it just does not beat regularly. I believe the exercise also helps the PVC problem, most mornings I just walk them out and they stay gone for much of the day. In recent days the frequency of irregular heart beats has diminished and the sensation I feel has gotten very mild.

Another reason for the blood panel is I want to drop one of my cholesterol drugs. Gall stones frequently are hardened kernels of cholesterol. My gall bladder attacks I mentioned earlier have all but ceased. However, on the the drugs I take precipitates cholesterol out of the blood stream and can lead to gall stones. If exercise effects blood pressure and type II diabetes the medical community also says that exercise lowers cholesterol. My cholesterol readings are under 200, in fact, while I was in the hospital for the A-Fib episode two cholesterol panels read 178 then 148, and I was not exercising very much at the time. I do take two types of medication for cholesterol control. If exercise and diet lower cholesterol levels then maybe they have dropped to a level where I can get off one of the medications. That is my goal. I should know later this month when I go back to discuss the results with my physician. I do know I will really feel successful if I can get off the one medication.

Finally, my weight, before surgery I weighed 276, when I started my information tracking in March I had dropped to 250. Today I weigh in at 220 and hope to lose some more weight before I attempt stabilization. I have to get a new wardrobe, I gone for a 44-46 to a size 40 waist and I even tried on one pair of 38's. While they fit they were a little snug but another 10 or 15 pounds might get me out of the 40 waist size. I am generally feeling better than I have in the last 20 years. My energy level is better than before surgery, but I anticipate it getting still better. One person who had abdominal surgery told me she felt it was over a year before she had regained her stamina before surgery.

The future has a lot of promise. However, I am 62, how long will the quality of life be good, I hope for a long time. One thing I know is I have to be vigilant, I love food, I can pack the weight back on in a heart beat. However, this I also know, the more I learn about my body's operating relationships the better I am able to make good choices. I do not have a history of yoyo diets or weights, but I have gotten off track and my health has suffered. Being a recovering alcoholic gives me insight on recovery. I remember many drunks saying at an AA meeting they did not know if they had another recovery in them, they hoped this recovery would work. Well I don't know if I have another weight reduction program in me, my body has sent me messages for years that I'd better take care of it. Now with a new awareness of exercise and diet and general health I hope I am better equipped to stay in the game for the long haul.

Life is good, but its tough. Growing old is tough, and you have to be strong and dedicated to weather the process, some aren't and don't.

Sunday, September 2, 2007

Week 35 Recovery

I am feeling very well. I still have some bowel issues, I still go a little a lot. However, I believe my body will be adjusting to its new situation for some time. My heart is agitating me, I have palpitations that come and go and don't seem related to any reason for showing up. They are not with me always, but I've had some episodes that get a little upsetting because they go on for so long. Everything I've investigated and looked at tell me they are benign and not a risk. That's easy to say if you don't experience them.

My wife and I went on a day trip yesterday and had a great time exploring some new territory near us. Found a large reservoir created by the Corp of Engineers. It has some great recreational areas and is less than two hours from where we live. We were gone for over six hours and I was pretty comfortable all of that time. When we did get back for about ten minutes after arrival any movement I made seem to bring on a series of palpitations. I could get them to stop by standing still, but then the smallest effort would bring them on again. Finally after a little while they left. Last night in bed I had to finally sit up to get my heart to get back to rhythm but once established I was able to lay down and go to sleep with no difficulty.

I have tried for some time to discern a pattern to the onset but just get ideas not any correlation. I still wonder why they came on within the last month and a half so fiercely and they have gotten better but still remain at a fairly high level. Is the whole thing attributable to stress? I just don't know. What I do know is exercise seems to knock them down. Hunger and fatigue do seem somewhat related to onset, but why is beyond me. I guess I just have to keep on truckin.