the ENT redux

He basically blew me off. (of course, there was that less than stellar review I wrote on the questionnaire they sent me after my first visit) We looked at the CT scan images of my nasal passages and he pointed out how constricted the left side is and how I don't breathe out of the left nostril because of this constriction which is why I breathe through my mouth and most people would have got that corrected. old news All this is damage from when I was 3 and broke my nose and my parents never saw fit to have it corrected later and then as an adult with no insurance and living and raising a family on an artist's income it was out of the question as long as it wasn't life threatening and it hasn't been life threatening. I am aware that my breath through one nostril is restricted, I take care to sleep with my nose and mouth not smooshed into the pillow, I don't like stuff around my face, I try to keep my nasal passages clear within reason. For the record, I can breathe out of my left nostril and only breathe through my mouth when I'm stopped up. It's not like what happens is a slow asphyxiation. When it happens it's sudden, one minute I'm fine and the next I can't breathe or just barely.

So he does the camera down the throat thing which didn't hurt (the attendant put numbing solution soaked cords in my nostrils first) and shows me my vocal chords and has me make noise and I see them constrict and he pointed the camera into my nasal passages. All looks good and right in there, no obvious malformations down there.

Then he kept pointing out this thing in the image of the CT scan in my nasal passage on the left adding to the constriction from the broken nose...a skin sac full of air. It was very clearly there (hmmm, I wonder if that's why the left side seems full so much more often) so a malformation there in that most people don't have this but I was born like this he says, born with it, that it shows up in about 15% of people. I'm like...OK, so this is something I've lived my whole life with and I'm not really sure what he's saying or recommending, it doesn't seem to be a problem that demands to be fixed to me unless it is or will get worse for which he didn't really have an answer. So yeah, OK, but what about the problem I'm here for, the whole suffocation/choking thing. Perhaps I should get a second opinion, he said, because he could not see anything wrong, perhaps another doctor would be able to see something he wasn't able to, and he was done. What a colossal waste of time and money. I got more attention and useful information from the speech therapist that helped administer the barium swallow test than from this doctor.

So no. I'll not be going through this again just to find out what I already know, that it's just one of many swallowing disorders that you learn to manage among the many weird things that affect and afflict the ever diverse physical form of a human body, unless something extreme happens. 

Maybe I am choking, or rather, aspirating and not suffocating, only instead of one big thing blocking my airway, it's small droplets (saliva or liquid) that take some effort to expel. Who knows. The only answer is the same...mindfulness. Mindfulness when I eat and drink so I may be a pretty dull dinner companion from here on out, just saying.

But, y'all, I kept my promise and went to the doctor about it.

waiting for the apocalypse

I've spent nearly all day for the last three days outside, like river days. Only on river days I was outside 24/7 though usually it was only 24/3 although I did a handful of weeklong trips or longer. I figured if these were going to be the last three days on this earth as we know it*, I would spend them outside tending to the growing things as if it was just any ordinary day.

Fortunately, cooler heads have prevailed, for now at least.

Friday Marc helped me shovel out the yard of dirt for the flower bed and Friday and Saturday I got it planted. So far...Cinco De Mayo rose, gardenia, plumeria, hibiscus, spirea, nile lilies, day lilies, spiderwort, and still room for more.

Sunday I tended to little things, repaired two wind chimes, repotted a few things, worked in the Little Backyard mostly. Gave everything a good watering.

Bees are swarming the cosmos and larkspur with the occasional butterfly and hummingbird.

*re Trump's evident desire to start a nuclear war with North Korea

working on my Wa

Well, that didn't last long. The moving on to better things but best be aware of what's going on even though I get it that people are tired of hearing about the continuing shit show in the WH. That said, I'm not going to talk about it again until the next list gets compiled because of course it will. Unless, of course he gets us in a war with North Korea before then.

Let's see, in the past week or so, I dug more grass out of the new flower bed finally getting it all out on Sunday. I also went over to the garden to ponder the new raised bed and the fact that the squash turned yellow and shriveled up and the onions have not grown a bit and so I know that the dirt that guy sold me was crap and I was going to just mix in some organic material but looking at it I got the shovel to explore and the top 3 or 4 inches was dry and hard as a rock even with the organic material that I added when I first got that cheap dirt and once I managed to get past that, the bottom 4 to 6 inches was wet and when I gathered up a handful and squeezed...clay. It was clay. 

So no amending that and I started at the end and started shoveling that crap out, spreading it around in all the low spots in the shop yard. I got a little over half out and ran out of good dirt. I had gone to get another yard of the good stuff and piled it up around the potatoes and that was what I had left. So after I did that, I carefully dug up the onion starts and replanted them in the good dirt so now I hope they will start growing. The squash was a lost cause but I have another clump growing nicely.

I went to another estate sale with my sister and found a shepherd's crook with two hooks that I bought. They had a really nice old fashioned lamp that I wanted but I didn't want to pay that much for it and I already have a lamp similar that I got at a previous sale that I still haven't rewired, and have no use for either anyway.

I went and got a CAT scan, one more step in the process of trying to figure out why I had those suffocating episodes, that's how I think about them now instead of choking, not that I expect they will figure anything out. I'm actually more interested in trying some Chinese medicine or acupuncture but I'll see this through. Although, Sunday night I was going to cancel the whole thing. I'd been fighting off some bug all week Marc gave me that he picked up at the family doo-wop in Dallas and the thought of having to swallow more barium or get iodine injected or have a miniature camera threaded through my nostril and down my throat just wasn't all that appealing. But I didn't and it turned out that the CAT scan was just of my head and throat and it was just this big donut shaped thing and I laid down on a table with my head in a cushion cradle and it was over in a few minutes.

Oh, and I went and got another yard of dirt Tuesday for the new flower bed that Marc tilled for me on Monday. I was looking at shoveling it out except that it finally rained Tuesday afternoon and gave me a break and still too wet out there.

my helpers

One thing with all this shoveling and digging, my arms and calves are looking pretty damn good.

up to and including day 78 but mostly just the last week or so

220 cities will lose passenger train service because of Trump's elimination of all federal funding for Amtrak's National Network Trains, hurting the very communities he promised to help.

Self admitted sexual predator Trump doesn't think sexual predator Bill O'Reilly did anything wrong.

Trump's Department of Homeland Security is trampling on the 1^st amendment by pressuring Twitter to reveal the identity of the rogue DHS Twitter account.

Trump claims to have the most successful 13 week presidency to date while he has been in office 11 weeks.

Trump's nominee for FDA Commissioner, Dr. Scott Gottlieb, thinks the FDA puts too much emphasis on consumer protection. Think about that. He also has received tens of thousands of dollars in speaking fees from the opioid industry, specifically the makers of oxycodone, has lobbied on their behalf, and doesn't believe it should be restrained or held accountable for it's part in the opioid epidemic in this country.

Military strikes under Trump have killed over 1,000 innocent civilians in Iraq and Syria in the month of March alone.

After scorning Syrian refugees and trying to refuse them entry, Trump cries crocodile tears for the victims after Assad's gas attack.

After claiming that HRC would be a warmonger during the campaign, Trump has refused to fill State Department positions essential for diplomacy and negotiating with foreign countries and instead bypassed Congress and launched an air missile attack on Syria in an act of war, an act that is illegal by our own laws and also by international law.

Trump informed Russia of the impending missile attack on Syria before he informed Congress. Syria was also informed and evacuated personnel and equipment in advance of the attack which destroyed six broken planes and a mess hall and left the runways and other essential buildings intact and killed several civilians.

Trump owns stock in the company that makes the missiles and profits every time one is used.

Trump basically gave his son-in-law Jared Kushner the task of being president.

After cutting funding to the Interior Department by $1.5 billion in his budget, Trump makes a show of donating the first three months of his salary, $78K, to the Park Service which is funded by the Interior Department.

Trump visits one of his properties every 2.8 days thereby transferring money from the National Treasury to himself. He plays golf every 5.6 days.

In another act of vindictiveness against former President Obama, the Republican Congress with bill H.R. 226, wants to rescind the elephant ivory protections that have been in place since 2014 thereby ensuring the continued poaching of elephants which are already on the endangered species list.

Perjurer AG Jeff Sessions says he will not renew the National Commission on Forensic Science, a roughly 30-member advisory panel of scientists, judges, crime lab leaders, prosecutors and defense lawyers chartered by the Obama administration in 2013.

In 3 months, Trump has already spent almost double Obama's annual travel budget and this does not include the cost of protecting his 3 residences...White House, Mar A Lago, NY penthouse.

Tourism is down markedly in response to Trump's attempted travel bans and the heightened security checks at the border including demanding traveler's phones, passwords, contact lists, and social media accounts as well as more extreme 'pat downs' and the risk of being detained. Mexicans in particular are going to Canada instead.

Trump's White House...one word. Nepotism.

Not satisfied with the illegal bombing of Syria, Trump is poking the hornet's nest by sending warships, under orders to take an aggressive stance, to patrol North Korea.

Already under investigation by the FBI and both houses of Congress, the Government Accountability Office has announced an investigation of Trump’s presidential transition over conflicts of interest.

AG Jeff Sessions, in a speech to border patrol agents on the US/Mexico border, refers to illegal immigrants as 'filth'. “This is a new era,” he said. “This is the Trump era.”

WH Spokesperson Sean Spicer, in some sort of weird defense of Trump, claimed that not even Hitler gassed his own people. Let that sink in.

Trump stripped protection of our smaller bodies of water and rivers by rescinding Obama's Clean Water Rule giving industry permission to dump toxic waste in these smaller bodies that are essential for the population's drinking water and health of wildlife.

on to more pleasant topics...

My tomatoes are growing lushly, the plants are almost as tall as the cages already with tomatoes growing and blooming profusely. The foliage is so dense and thick that the flowers weren't getting fertilized so I sprayed some bloom set on them and then last week I got in there with scissors and cut away some of the foliage and started picking off all the suckers that didn't already have open flowers on them. Tomatoes may be the only thing I get our of this spring garden. 

The potatoes are also growing lushly and are blooming but since I ran out of dirt to keep piling up around the plants early on I don't know how many potatoes I'm going to get. I don't even know when I'm supposed to harvest them. When the plants die down I guess. Now that they are blooming, it is too late to pile up more dirt?

The one clump of zucchini in the big bed is growing well but the one in the new raised bed, the one with the so-called magic caney soil? Hasn't grown, has turned yellow. And the onions haven't grown one bit. So, even with the 1/3 of the good expensive dirt mixed in, that caney soil is worthless. I'm going to have to spend this season building up the soil with organic material and then maybe it will grow something in the fall garden. The neighbor says it has to be topsoil which this wasn't but my sister got some caney topsoil once and it was full of nut grass and other weeds.

Stuff is blooming in the yard y'all...roses, poppies, mock dogwood, cosmos, rocket larkspur, evening primrose, baby blue eyes, volunteer zinnias, verbena, amaryllis, mexican petunias, love-in-a-mist, purple coneflowers, nun's orchid, and the day lilies are starting to send up scapes.

This maroon japanese iris has bloomed for the first time. I acquired the small clump of rhizomes three or four years ago and finally they are blooming.

But other things did not like the daffodils and the purple iris and the white iris, lots of foliage but no blooms. The little climbing jasmine that froze to the ground has come back but will not bloom this year and of all the things that froze last winter, all but three came back...the shrub with the little coral flowers, a small mexican bush sage, and the white orchid tree in a pot. I decided to go ahead and pull the dead carcass of the white orchid tree out of the pot today, reached down and yanked it one way and heard one of the roots snap and then looked down to see a cluster of small growth at the base of the small truck. DOH!!! 

So I cut off the dead part and watered it well and crossing my fingers that it still has several more good sized roots.

the ENT

Thursday I drove back to Bay City for my appointment with the ENT doc. The speech therapist urged me to write down everything that we talked about, the two types of attacks, all the little quirks that interfere with my swallowing, like not being able to swallow pills larger than a cold capsule or finding it hard to clear my throat at times (though the latter might be due to dehydration so I am trying to make a conscious effort to drink more water every day) and not to let him rush the appointment.

The ENT (ear, nose, and throat) doc spent a decent amount of time so no real complaint about that but I don't think he listened to me or was taking me seriously and so far I am not that impressed. Supposedly he read the list I had written up before he came in but he kept confusing the two things and didn't seem to understand that a speech therapist would be conducting the barium swallow (wanted to know how long I had been seeing a speech therapist; I'm not), and made some comment that one of my neck vertebrae was small and did it hurt (no), seemed surprised that I did yoga regularly, decided that I had difficulty swallowing because I was tense and anxious (no, I don't suffer from anxiety or depression or stress and these episodes happen typically when I am relaxed and having fun, I mean really, how tense can I be in my sleep), that it was allergies (the events are not seasonal and no, no classic allergy symptoms though my sinuses do get clogged at times), told me it because I breathe through my mouth (uh, no). When the subject of breaking my nose at age three came up...how do you know that he asked (because it happened to me, because my parents took me to the doctor and had it checked periodically), talking about some other detail of my throat he asked me why I thought that was (if I knew that I wouldn't be here). There was more but you get the idea. He finally settled on my sinuses and told me to use a particular nasal rinse (saline solution) and a lubricating nasal gel (aloe vera in it) three times a day every day for the two and a half weeks (three times a day, every day? I kept asking, seems a little excessive to me) til my next appointment when he is going to stick a little camera down my nose and take a look see. Oh joy.

And this nasal rinse isn't just inhaling a mist. This is pouring two ounces of solution into one nostril until it runs out the other or your mouth and then 2 ounces through the other nostril. More seriously ooky stuff.

Oh yeah, and he ordered an x-ray of my sinuses which I am waiting for them to schedule.

The best thing I took away from this visit was when I asked him if I wasn't choking but suffocating from some spastic muscle, if I pass out will it relax and I'll be able to breathe? He hedged his bets, “90% of the time, yes”. Whether or not they figure out what's going on, and my money is on not, it doesn't look like this is going to kill me.

I wonder if the episodes would pass quicker if I just let myself pass out rather than struggling to breathe through them.

barium swallow and modified upper GI

Some of you may remember last August when I was eating and then suddenly could not breathe (again) and Marc had to jump up and give me the heimlich and my granddaughter was sitting there witness to the whole pissy mess, if not you can read about it here, and I promised everyone I would go to the doctor about it.  Well, I had my annual last week and I mentioned to my primary care doc in an oh-by-the-way manner about the freaky spasms and the choking thing and before I was finished talking she was writing down orders for a barium swallow test, a modified upper GI test, a chest x-ray, and a referral to an ENT. So there was plenty of fun to be had in my immediate future.

I got the x-ray right away and they scheduled the other two tests for last Monday and they had to be on an empty stomach, so nothing to eat or drink past midnight. First I talked with a speech therapist trying to tease out exactly what happens and when and how often and for how long, if there is any unifying element. There’s two issues here, one the whole spasm thing where when I swallow, the food scrapes or scratches (or something but it's always a sensation so I know what's coming even if I'm powerless to stop it) the inside of my throat and I start coughing and then sneezing forcefully and more coughing and eyes tearing and my vocal cords freeze up and I can’t talk but I can breathe fine throughout the whole event. And then there are the three times when I couldn't breathe and I think I’m choking and Marc does the heimlich on me which opens my airway barely but enough air to work through it myself, inhaling with that horrible sound and exhaling as hard as I can until I can gradually breathe completely again. And then there's the times when I aspirate tiny amounts of liquid, a few drops getting past before the glottis or larynx closes off the airway. Or when food starts to fall into my esophagus before I'm ready to swallow. Eating, it's all fun and games kids.

The speech therapist isn't convinced I'm choking in the literal sense, in that she doesn't think I've aspirated liquid or food since there is no food being expelled when Marc heimlichs me and also because if I was choking in the literal sense, once the obstruction was expelled then the airway is immediately cleared and that's not what happens with me. It's more like I'm suffocating because my airway has been closed off. She says it's a possibility that my vocal cords (larynx) are responding to some sort of stimuli which causes them to flatten out and obstruct my airway. Turns out two things happen when you swallow...the glottis closes and the larynx flattens out, both of which act to protect the airway.

So the first test was to swallow this thin barium liquid while she and the radiologist watched and conferred on the x-ray. I was turned to the screen so I could watch too. The first thing I did when they turned the screen on and I could see my skull and jaw and teeth was laugh. I mean we all know there's a skeleton inside us but to see it in real time and watch myself swallow was weird. The point of this test was to see if whatever it is that happens that causes either the spasm or suffocation happens while they can watch but of course, it never does. There were four thicknesses of this stuff but she passed over the middle two and went straight to the thick 'pudding' of barium, then with a bit of graham cracker mixed in but still no cigar.

Then they had me drink a bit of fizzy stuff to get air in my stomach and then this other medium thickness barium stuff a few swallows at a time while they watched further down the esophagus and from different positions. I couldn’t see that part. Then I had to drink a whole cup of the thick barium which was about the consistency of a milk shake but it didn’t taste nearly as bad as I had feared and they took x-rays every 30 minutes or so until it reached where the upper and lower intestines came together. They said everything looked good and I could go. They’ll send the test results to both my doctor and the ENT I went to see the following Thursday. The speech therapist also gave me a lot of printed info on swallowing disorders and strategies for coping with it. I went home and finally got to eat around 3 PM.

TMI? Not yet.

It would have been nice had they given me a little warning about what to expect when it all came out the other end. Seriously ooky.