?

Log in

No account? Create an account
Tapati
22 May 2013 @ 08:26 pm
Update: I am revising my memoir entries at another blog I have on wordpress: http://tapati.wordpress.com/

All of my memoir posts and other original posts are copyrighted. You are welcome to provide a link to my posts with a short excerpt to catch someone's attention, just as I do with others' material, but please don't reproduce entire posts. Thank you!

If you have followed the link from my guest posts on the No Longer Quivering blog, you may be interested in my other memoir entries. Please keep in mind that these are rough drafts intended to establish the sequence of events and reveal some of the themes of my writing. The finished product may look very different. I am also not putting everything online for obvious reasons.

If you find my memoir posts interesting, please consider supporting my writing efforts by using the Paypal donation button located on the right of my journal pages. Thank you so much.

 
 
Tapati
22 May 2023 @ 02:22 pm
City lights can be structured to avoid the haze of glare that obscures our stars. Learn more.

Tags:
 
 
Tapati
02 March 2018 @ 11:00 am
I finally went into Urgent Care for the upper R quadrant stomach pain after a prolonged episode at 7/10 and had an abdominal CT. I saw the excellent doctor who did not allow bias to stop him from taking me seriously years ago when I presented to Urgent Care having had cardiac symptoms over the weekend--and sent me directly up to the cardiologist I still see to this day. I got a referral to a gastroenterologist for a colonoscopy which I had yesterday.

Liver: There are signs of hepatic cirrhosis, including atrophy of the left
lobe, hypertrophy of the caudate lobe, and micronodular surface contour. The
liver is mildly enlarged. There is mild diffuse hepatic steatosis.
Gallbladder and bile ducts: The gallbladder is surgically absent.

Spleen: The spleen is mildly enlarged measuring 12 x 11 cm.

Adrenals: The adrenal glands are normal.

Kidneys and ureters: The kidneys are normal in size and attenuation, with no
focal masses or collections. No renal parenchymal or collecting system
calcifications are seen. There is no hydronephrosis bilaterally.

Stomach and bowel: Mild colonic diverticulosis is present primarily in the
sigmoid and descending colon, with no signs of acute diverticulitis. The
stomach is within normal limits. Radiopaque enteric contrast proceeds from the
stomach to the distal ileum, with no evidence of small bowel obstruction. The
small bowel is normal in appearance.

Appendix: A normal appendix is identified.

Bones/joints: Sternotomy residuals. Degenerative disc disease at the lower
lumbar levels. No acute fracture. No dislocation.
Soft tissues: Unremarkable.

Vasculature: Mild aortoiliac atherosclerotic calcification is seen. No
abdominal aortic aneurysm.


I was worried about my pancreas but it appeared to be normal and enzyme test results were fine. My colonoscopy showed nothing that would explain the pain which is very reminiscent of my former gallbladder pain especially in location (without that squeezing feeling from the spasms). Yet my new gastroenterologist insists that the liver, the only thing in the region that shows damage, can't be responsible for this pain because the liver has no nerve endings. This is true--internally. But my reading (such as Mayoclinic, not some junk science site) indicates you can have liver pain and that there are nerve endings on the surface. When the liver is swollen you can apparently have pain. It also seems likely that a patient with fibromyalgia would have pain if anyone would. I'm happy to suspect another culprit if anyone can identify it. Otherwise I feel like I'm being gas-lighted.

I don't even know what to do when I have pain at this point. I don't have any medication that helps it and I'm completely freaked out over having the same kind of pain that I thought I would never have to feel again after getting rid of my gallbladder. Mind you, I had **22 years** of gallbladder pain during which I was told it couldn't be my gallbladder and maybe I should "talk to someone." So my patience for being told my pain can't be there or be what it seems obvious it is from is nonexistent.

I almost didn't have the colonoscopy after all that prep because they forgot to clear it with my cardiologist even though I'd indicated I'd recently had a nuclear scan. There was a troubling finding in that scan that made them worry about how I'd hold up under the procedure. So we waited while they contacted my doc, complicated a bit by the early time of my appointment. Then they were surprised he knew me by name alone. My cardiologist met me way back in 2001 and I have an unusual name.
 
 
Tapati
27 February 2018 @ 03:03 pm
Don’t Suspend Doctors for Fighting White Supremacy

Unbeknownst to me, since my notifications were flooded from my tweet against White supremacy, the mother of a hospital patient started cyberbullying me on Facebook as a result of the uproar. She posted a screenshot of my tweet, claimed that I was pushing my political agenda at work, and invited all her friends to make disparaging remarks about me. I hadn’t met her at that point. When I did meet her weeks later after being assigned to care for her son, she rudely told me to leave the room in front of my whole team. Flustered and confused, I backed away.

...I soon found public Facebook posts in which the mother proudly stated that she was talking with administration officials at VUMC about having me fired or placed on leave and revoking my access to her son’s medical records. They have followed her advice to the letter.

Unfortunately, my experience is in no way unique. A 2009 study in the Journal of the National Medical Association found that almost a quarter of physicians of Asian ethnicity left at least one job because of workplace discrimination, compared with just 9% of White physicians. Right after the Charlottesville clashes last year, emergency room doctor Esther Choo detailed her own experiences attempting to treat White nationalists. She was often kicked out of the room when trying to save their lives. While leaving her heartbroken and confused, her story sparked a national conversation about bias and racism in the hospital setting.
 
 
Tapati
12 February 2018 @ 04:23 pm
Given my stomach pain I decided to give Dave's doc a try.

He was apparently unhappy that I left another doc and wanted to spend a substantial time discussing old doc and defending both old doc and orthopedic doc's lengthy weight loss lectures. When I tried to bring up stomach pain he said we were out of time and to make a new appointment and seemed to blame me for his next patient being seen late. Oh and he wants to order a thigh bp cuff to get a bp on my upper arm, saying the large cuff is not sufficient and that it's not possible to get an accurate bp on my forearm which he tried to do manually rather than by machine. None of my cardiologists have challenged a forearm bp reading. NO ONE HAS EVER SAID THIS.

Usually I'd try to stick it out and hope the doctor would eventually see the person behind the fat, I don't feel up to that right now. But I don't know what to do about my stomach pain and what I google seems potentially alarming. (This is what it's come to, googling because docs only want to talk about fat.)

I've wondered if I should just go to urgent care. Sitting there during flu season doesn't appeal to me but if it gets worse I may go in.

Somehow I need to find another doctor and now I will have left two primary care physicians in a row so that doesn't look good. It's like going to a job interview after quickly leaving two jobs in a row. Yet I've had PCPs that I've gotten along well with for years. It's not impossible! Just difficult to find them. Nothing about a doc's profile online with their HMO discusses how they approach fat patients--but maybe it should.
 
 
 
Tapati
Your Fat Friend asked a simple but important question:

Fellow fats: what has happened during your WORST experiences with health care providers? (Later in a separate tweet she asked for positive experiences, to be fair.)

The resulting thread is stunning.

https://twitter.com/yrfatfriend/status/961304516556500992

A few:

"I was maybe 9 or 10 when a MALE doctor who wasn't even my normal dr just a substitute told me that I would need to loose 30+ pounds to be like the "pretty " girls my age. He told me if i didn't loose weight I would die by the time I was 16. In reality i was 6 pounds over weight."

and

"I was twelve and had to go to a different doctor than my regular because he was out of town. Also had to go with my dad to the appointment since my mom was working. I told the doctor I was tired all the time and she told me the reason I was “always sick” was because I was fat. I hadn’t been to the doctor in over a year. For anything. I left crying. Two weeks later we found out I was tired all the time because I had mono."

also

"Told to get stomach-stapling surgery by a dermatologist, to treat my dermatitis..."

and wtf?

"1. I was given info for weight watchers when I actually had a dangerous blood infection that causes drastic weight loss/ weight gain- both of which I've experienced.
2. Therapist said my weight was the cause of my major depressive disorder and then fell asleep during the appt."


I want to print them all and send to every med school. Final one (many more at link, above)

"Was in the ER for an MS flare up. Which was causing temporary blindness in my right eye. The attending neuro-ophthalmologist went about trying to talk me into gastric by-pass. Clearly my fat was pressing down on my optic nerve and it wasn't my chronic illness. /sarcasm"

That one gave me flashbacks. Seriously no matter what I'm seen for, most docs wants me to have a gastric bypass.
 
 
Tapati
23 January 2018 @ 10:57 pm
Note that any nuclear scan will see the damaged area of my heart where I had a heart attack following my 2001 bypass surgery.

"Ejection fraction is a measurement of the percentage of blood leaving your heart each time it contracts." Even after my heart attack my EF was in the high 50s but it has gradually declined and I was told that was to be expected after a heart attack and that the force of my heart beating causes further deterioration of the damaged area.

However, the difference in these two results and their conclusions is cause for alarm along with my symptoms and having just lived through one of the most stressful years of my life. The chest pain I've had, the shortness of breath and that stress level is what made me ask for the test in the first place. I have an appointment with my cardiologist in early March but I wish it were in February.

Current results:

PROTOCOL: The patient received 6.3 mCi of Tech-99 Cardiolite and was imaged in the supine position. The patient then received a 4-minute infusion of adenosine without walking. At 2 minutes into the protocol, the patient received 20.2 mCi of Tech-99 Cardiolite and at the end of the procedure was reimaged in the supine position. The total dose of adenosine infused was 80.1 mg.
Tc-99m Sestamibi also known as Cardiolite, Rest. Tc-99m Sestamibi also known as Cardiolite, Stress. The total amount of radiation that the patient received in this study is estimated at 7.84 mSv or 784 mrem.
FINDINGS:
1. Hemodynamics: The Initial heart rate was 94 bpm; the blood pressure was 142/94. The heart rate rose to 100 bpm; the blood pressure peaked at 141/86.
2. EKG Portion: The baseline EKG revealed NSR LBBB LAD.
3. Adenosine Portion: No ischemic EKG changes were observed. No significant arrhythmias were provoked. Occasional PVCs. Nonspecific ST depression during adenosine noted
4. Perfusion Portion: Revealed a large fixed anteroapical/inferoapical defect with peri infarction ischemia involving the mid anterolateral wall. The summed stress score was 30, the summed rest score was 25, and the summed difference score was 5. The TID ratio was 1.10. Gated wall motion revealed mid anteroapical/inferoapical akinesis with an estimated EF of 35%.
OVERALL CONCLUSION:
Abnormal study with large anteroapical fixed defect c/w previous MI . Small region of peri infarction ischemia mid anterolateral wall with reduced EF 35%.

vs 2015 (after which I had a stent)

1. Hemodynamics: Initial heart rate 56; blood pressure 156/92. Heart
rate rose to 77; blood pressure rose to 165/94.
2. EKG Portion: Baseline EKG revealed sinus rhythm and evidence of an
anteroseptal myocardial infarction, age indeterminate.
3. Adenosine Portion: No ischemic EKG changes were seen. No significant
arrhythmias were provoked.
4. Perfusion Portion: Revealed a large region of decreased activity
involving the mid to distal anteroapical, inferoapical, and anterolateral
walls, with what appeared to be a small region of possible peri-infarction
ischemia involving the mid anterior wall. Quantitatively the summed
stress score was 23, summed rest score 16, and summed difference score 6.
TID ratio was 0.86. Gated wall motion revealed a reduced EF of 40% with
hypokinesia involving the distal anteroapical, inferior, inferoapical, and
inferolateral walls.
OVERALL CONCLUSION:
Abnormal study demonstrating a previous anterior myocardial infarction
involving the anteroapical and inferoapical segments with what appears to
be some mild reversibility in the mid anterior wall.
 
 
Tapati
12 January 2018 @ 12:47 am
https://twitter.com/yrfatfriend/status/951629172987781121

"Fellow fats: what otherwise routine activities do you have to work up the courage to do as a fat person?" Follow link above for answers.

Going to the doctor comes up frequently. Exercising in public, eating in public, shopping for clothes.
 
 
Tapati
http://www.baltimoresun.com/health/bs-hs-patient-video-20180110-story.html

The video shows what looks like four security guards, one with a wheelchair, walking away from a bus stop outside the hospital on the outskirts of Mount Vernon. A woman is seen near the bus stop dressed in a gown and socks. Her belongings are packed in plastic bags that have also been placed at the bus stop.

The video, which went viral, was posted to Facebook by Imamu Baraka, who is described in an online professional profile as a mental health counselor

“I just witnessed this with my own eyes,” Baraka wrote in his post. “I had no choice but to give this young lady a voice in this moment.”
 
 
Tapati
09 January 2018 @ 02:43 pm
Later this week my son turns 40. I can't help but think it's a miracle since he came so close to dying at age 13.

It amazes me that I've lived this long too.

Lakshmana's favorite birthday song https://www.youtube.com/watch?v=h_TFFdFGEFo