Saturday, June 8, 2013

Life is like . .

Life is/or some parts are, like always being on a scouting trip to find a place for an archaeological dig.

On Wednesday June 5th I posted the below indented paragraphs as a comment to a posting of my own I had made on facebook. That original posting has so far gotten over 31 comments of sympathy and some of sympathetic outrage. I’m sure that if I looked I could easily find numerous quotes about how times of distress are when you learn the most about yourself. 

Words are the tool I use to process and draw in all the disparate factors that all too often cloud my mind. Words are symbols that represent specific patterns of mental images or concepts, those in turn are an interpretation of sensory input and/or clusters or cogitations of the aforementioned images or concepts. Ironically words by their very nature are removed by 3, 4 or more steps from what they represent. When deep emotions and/or the reptilian part of the brain, that evolved before mental images or concepts, are engaged in a real life; words become theoretical at best. 

In the last day or so puzzle pieces have slipped into place. 
I deeply loved doing massage for my living. After 10 years I had to give it up. Partly because my wrists and elbows were generating a great deal of pain from overuse. I was also burned out. I went to see a counselor, an MFCC. I told her about the many ways doing the work gave me joy. The part of her advice that sticks with me is “The price of being a sensitive person is; being a sensitive person”. That was 20 years ago, I understood what she meant. I tried to tell myself that it only applied to a situation like massage where I made a conscience effort to open up empathetically with all of my senses and emotions to hundreds of people on demand. 
Come to think of it after a year of working for a local ambulance company (1977) as a non-emergency driver when I was 19 I tend to think I went away with Post-traumatic stress disorder (PTSD). I only rode with the red lights flashing once. That's where I encountered my first dead guy. My job was taking people to medical appointments. It was the personal contact with people in serious long term distress of many kinds that I was unprepared for. My parents weren't helicopter parents by any means. They owned a fast food place and spent what time they could with us. I was still what can be described as a suburban kid raised in blissful isolation from the real world. Just as so many are today. The ambulance job was my first step into the real world.

After growing up and into middle age before knowing I really am differently wired with what is simplistically labeled ADHD. After 30 years of sporadic sometimes extended lack of REM from sleep apnea. Not to mention the mind bending side effects of statins and the things I used for relief from the mental noise like weed and booze. Then there were the 5000+ massages I gave, doors open. Whatever barriers I had originally or have pretended to have in more recent years are a myth. Life experiences give me the capacity for metal toughness in the form of what might be described as street smarts. My work these days while 97% low key have 'underbelly of society' moments that keep me sharp. In the end however I am a sensitive person and need to respect myself accordingly.
I never know what to think about this kind of electronic bulletin board kind gestures. Your kind words and thoughts have been a comfort. Thank You.
I got home at around 5 or 5:30 AM and as usual was soon asleep. The last few days had been stressful. 
The back door of my house is in a very small laundry room where the dogs sleep. There's a gate to keep them in there with a doggie door to the back yard. I think I heard one of them banging against the gate but I was asleep and didn't respond. Then Lit'll is by my bedside in a panic. She's 8 lbs of Chihuahua desperate to get my attention. I went to reach down to pick her up wondering how she got into the house. I live on a busy street and am used to weird noises. I heard something weird but it was coming from the back yard. I sprung up and went to the back door to see two big dogs. I stepped over the dog gate to see them shaking Wookie around in their teeth. Most of her was under them and I could only see a leg with her long red fur. I grabbed the closest thing to hand, a broom, and burst outside. The big dogs weren't angry they were just destroying a new toy like they might any other. I run to them yelling and swinging the broom. They trotted off up the retaining wall at the back of the lot and went behind the garage. One turned back briefly as if to say "Dude what's going on? Why are you being like this?" I yelled again and he left. I turned back to Wookie, who had limped into the laundry room and collapsed onto her favorite rug. She was breathing heavily and her abdomen was all bloody. I stroked her head spoke to her gently and went to pull on some clothes. My mind was racing. What the hell time was it? 8:35. Lit'll was leaping and whimpering at my side. Is the vet open? What is her damage? Will she make it? I was still too much asleep for all of this. Strange how in a crisis your emotions are all there but stand back, out of the way. I went back to the laundry room. Wookie was dead. I nudged her. She was not breathing, her black eyes frozen. I called the SPCA where I got her but they don't open till 9:30. No clues on their web site as to disposing of dead animals. I called the County animal shelter. The lady said it's okay to bury a pet in your yard away from water. I thought 'and have those dogs come back and dig her up?' She then said the shelter would take care of it for $10. They don't open till 2 PM on Wednesdays. The back 5 yards of my back yard behind the retaining wall is a dense jungle and on a steep grade. I don't actually climb up into it often but I needed to know where they got in. Will Lit'll be safe? The fences back there look intact but perhaps low enough for a big dog to jump over. Then I saw them, still in the yard of the vacant house next door. I backed down the hill and went around to the other yard. They were gone.  One is all white and is a pit bull I think. Both about 70 lbs each, the other one is has a similar build but is a different breed, white with brown patches. I think they live around the corner on North Baker not directly behind my house but one north, I think. I saw the all white one going to an event at NX cafe that is 2 doors down from there. I still needed sleep and can't do anything with Wookie till 2. I needed to tell someone so sat at the computer and posted it on facebook. Did a search fo a picture for my profile that reflected what I felt like. So tired I laid down with Lit'll glued to my side.Tried TV but couldn't focus on it. Rolled onto my side tried to relax and got close to sleep when there's a loud knock at the door. When Jehovah's Witnesses come to the door I usually let them say what they need to say then say no thank you and close the door. Today I didn't yell or curse but vented a great deal of anxiety and slammed the door. Turns out those guys do serve a purpose after all. The events above on repeat in my head I thought if I type it all out it will let me sleep. One moral to this story that really hurts is that Lit'll survived because she is ah-scared of everything. I didn't have to see it to know what happened. The minute Lit'll saw the intruders she gave a bark as she sped like a bullet for the house digging frantically at the gate to get to me. Wookie was the sweet friendly dog that wanted to make friends with everybody. That's why a couple of weeks ago when she got out a stranger lady had no trouble picking her up and taking her home. -Not liking what this implies. Maybe I can sleep now. But the shelter place opens in 75 minutes. I'll try to sleep anyway It's not like she going anyplace.
I kept wanting to say it was all so surreal. What with the stress and sleep deprivation it sure seemed that way. I demanded of myself to accept that is was real. Surreal is a type of art. The whole rest of the day I felt stunned. I loved the little dog but ‘Christ’ she was just a dog. The pain in my heart was a real pain. 

The trip to the shelter did get surreal at the end. She was in the back hatch cargo space of my

car. After I paid the office people I was directed to pull around to the side of the facility. Over the public address system came “We have a D as in David at the side entrance”. I am not a fan of euphemisms and detest political correctness but this might have been a good spot for it. Eventually a man over 40 that looked like a dust bowl refugee that had been transported into a modern day jumpsuit found the latch and opened the car’s back hatch. He hesitated then picked up her stiff carcass by the neck and walked off with her like that. 
Here is a link to an earlier post all about how I got Wookie.
Since Wednesday anytime I am at home Lit’ll is either in physical contact with me or at least where she can see me. I love this little one too but remember why I wanted a companion for her. The hunt is on. Serendipity having her way with me again I was invited to a fundraising event for the Friends of the Kern County Animal Shelter Foundation tonight. 
Also in this week's revelations was that I really am a pacifist at heart. While the reptile part of my brain went wild with thoughts of revenge I was not really feeling it in my heart. Those stupid dogs were just stupid dogs. Their stupid owner caused me pain, the cost of a new dog and all that. I may seek him out and will investigate further how they got into my yard. (In the 12 years I have been here this is the first time anything like this has happened. When people lived next door they had dogs. A couple that were big. They never got into my yard.) Intuition tells me harmony will resume one way or another.

Update June 11th - Today Lit'll woke me up at about 6:30, she heard something. I went to the back door and they were back. They took off immediately so I followed them to the empty house next door. After taking this picture I saw them again on the street and in my backyard. Thinking that it is a good thing no small children live at that house now. I emailed this photo and a description of the events and noting the lack of collars to County animal control. Animal control sent back an email to tell me "I have entered a call for my officer to go out." I hope that means something will be done. Lit'll need a new playmate her size.

Behind 3000 River Bl.

Monday, June 3, 2013

Idiopathic Pancreatitis

I actually started this post before the post below but never did come to any conclusions about what the heck caused my acute pancreatitis and if what a was feeling after my hospital stay was chronic pancreatitis. As I quote below acute pancreatitis is the most common thing people are admitted to hospitals for yet beyond the 2 most common causes for acute flare ups (alcohol and/or gallstones) the root causes can include any of 100 or more medications or substances. Or as I suspect in my case some of those and pressure on my abdomen from using a machine at the gym. As a fallible human when I started feeling more normal and didn't find much in the way of answers I lost interest in the topic. For now at least. If you like sciencey stuff or have an interest in what happen to me continue reading. Otherwise it's kinda dry stuff. 

I had done some searches but this last painful interlude really put me into overdrive. At the bottom of this post you'll see many links to some of the places I've looked for answers.

Besides making insulin your pancreas makes all of your various digestive juices. It contains many specialized cells that make various enzymes. Pancreatitis comes in 2 basic forms acute (painful inflammation) and chronic. Each of these has variations based on what has caused the condition. What put me in the hospital was the acute form. The chronic form is more of a dysfunction that make your body unable to digest food. These two problems are really quite different so I am not sure why they don't have names that are different. Must be a Latin thing. 

As you know, if you've used the internet for more than facebook, porn and eMail, the quality of information varies from cutting edge to harmfully dreadfully inaccurate.  

Abstracts of university studies like the ones I found through the National Institutes of Health are a solid source. Each one only tells a tiny portion of the story since they are based on usually a single hypophysis. These kind of studies are constantly challenged and slight changes in the structure of the studies that follow can get very different results. This is why the version of what is true in the practice of medicine is slow to change. They need to wait for results to filter down to some consistency. This is also a problem because the process of challenges continues after standards are established. Better ideas can come and go unnoticed depending on timing and industry politics. This is one reason I will always remain a skeptic of the healthcare industry. 

Established medical organizations and institutions also have websites. These can be trusted to give a version of the accepted knowledge on many topics. This is where my information gathering began to go off the rails. Each site has it's own take on what goes on. This video has the most 'to the point' explanation of the pancreas and pancreatitis.

Even this however is not consistent with other sources that are just as credible. 

After looking at a hundred web pages or so I found that there are a number of possible causes. 

"Acute pancreatitis occurs when intracellular protective mechanisms to prevent trypsinogen activation or reduce trypsin activity are overwhelmed."

"Its etiology and pathogenesis have been intensively investigated for centuries worldwide. In 1856, Claude Bernard suggested that bile reflux into the common pancreatic duct could trigger acute pancreatitis. Several subsequent studies led to theories fuelling the debate until 1901, when Eugene Opie proposed that gallstone migration into the common bile duct is the main cause of acute pancreatitis."

" . . acute biliary pancreatitis is bile-pancreatic duct obstruction, which increases pancreatic duct pressure, bile reflux, trypsin activation and pancreatic auto-digestion."

"In 10%-40% of patients however, no cause is identified (acute idiopathic pancreatitis). Identifying a cause in these patients is important, since the recurrence rate is high."

cholelithiasis (gallstones)
prolonged alcohol use
Idiopathic acute pancreatitis (it could be a lot of things.)
Microlithiasis (sludge)
infection (including mumps, hepatitis, rubella, and Epstein-Barr virus)
surgery that temporarily cuts off blood supply to the pancreas
injury to the abdomen
cystic fibrosis
cigarette smoking
family history of pancreatitis
Occult gallstones (This is when you have gallstones that hold séances)
Use of certain medications (such as corticosteroids, nonsteroidal anti-inflammatory drugs, and antibiotics such as tetracycline)

"The reported annual incidence of acute pancreatitis has ranged from 4.9 to 35 per 100,000 population. Acute pancreatitis is a leading cause of hospitalization in the United States." 

" The true nature of acute pancreatitis still remains to be elucidated. The causes of acute pancreatitis are various, and its mechanism is common." 

"Accurate assessment of disease incidence is difficult since mild disease may be missed. Similarly, death may occur before the diagnosis is made in severe and fulminant attacks. In one report, for example, the diagnosis of acute pancreatitis was not made until autopsy in 10 percent of patients."

A few days ago I mentioned that I had pancreatitis to some one who said 'oh yes my Mom had that, they said it was because she had too much irion." Oh geez I had done all these searches and hadn't run across that before. I did a search and found this
The major cause of chronic pancreatitis is alcohol abuse (in 90 percent of all cases). In the other 10 percent of all cases, chronic pancreatitis is a result of hemochromatosis (excess iron in the body) or heredity.
Yikes, every source indicates that a main cause is excess use of alcohol. (except the ones that don't mention it at all) Some say 60% some say 40% some have a different number. Few define just what amount of alcohol is excessive. Over a period of years is somewhat consistent. 

Then I proceeded to look up every drug or supplement that I have taken. Most are already on this list. I and a growing number of people have taken a dislike for the cholesterol lowering drugs called Statins*. In some cases you have to resort to looking things up by their class name. *HMG-CoA reductase inhibitors are on the list. Most of the things I take have been linked to pancreatitis in some way. None have a clear cut track record of being a consistent cause. I was suspicious of the Metformin I take for diabetes. Since it has something to do with insulin sensitivity. Turns out it does it's job through the liver and most of it's side effects are good.  

After all the web searching I don't have any firm answers. Even though my drinking has been mostly light and very sporadic (once or twice a month) the last dozen years I haven't ruled it out as a cause. The 25 years before had runs where I'd drink to excess 2 or 3 nights a week. I've never been any good at drinking by myself but during the holiday season with all it's social events, whew! 

Still what has triggered my attacks has yet to be established. The big one may have been Rye whiskey but this last one and the one last summer couldn't have been.

Did he say drain the stomach via a tube down the nose?

Comprehensive explanation of pancreatitis

Merck has created The Merck Manuals, a series of healthcare books for medical professionals and consumers. 

Ongoing studies

Drugs and drug classes associated with acute pancreatitis

Metformin effect on pancreatitis correlation is not causation.

The risk of acute pancreatitis associated with acid-suppressing drugs

However they pre blocked persons with other conditions that may be related.

Long-term use of novo-ranitidine may cause inflammation of the pancreas and the liver.
Read more:

Can Statins Cause Pancreatitis?

Drug Induced Pancreatitis Might Be a Class Effect of Statin Drugs

Add'l links

More trash talk about statins

Toxicity of Indomethacin 

And some good in prevention following a procedure

Plant poisons like cyanide also can cause pancreatitis

Cures, treatments and special Diets

Aloe vera juice