Sunday, November 24, 2019

Happy Thanksgiving from a couple of turkeys: oh heck, why not…

I love this picture of Mom & me.  It was taken at my sister Shawn’s house on Thanksgiving Day, 2002.  Of all the family photos I have, this is the only nice one I have of the two of us together. 

(As much as Mom loved to snap pictures of Dad and us kids, she hated having her own taken; so photos of her are few & far between.)

Anyway--a couple days before, Mom called me and asked when I was driving down for Thanksgiving. 

As I had just gotten my driver’s license (and a new car) that summer, and no longer needed to rely on a family member to come get me or bring me back to Pittsburgh, I said I’d make the trip Thanksgiving morning. 

Mom said “Oh.”  I asked if that was okay.   She said “You used to come down the night before and stay a few days…” 

Doug you turkey--what was I thinking?  I said I’d make the trip home as soon as I got off work Wednesday.  As I was one of the people scheduled to work the day before the holiday, I knew my boss would only require us to be in the office a half-day.  So I’d spend the night at Mom’s house (she now lived alone as Dad had passed in February 2001) and we’d head over to my sister Shawn’s house together the next day for Thanksgiving.

When I arrived at Mom’s, she came outside and said “Hi honey!  Why don’t you park in the garage instead of leaving your car in the driveway!”   Hmm… I’d driven down several times since getting my car a few months earlier, she never suggested I park in there before… was she expecting snow?    

A couple hours later, my sister Shawn pulled into the driveway.   Mom said “Shhh!  Hide in the other room, I don’t want Shawn knowing you’re here!”   Mom met her at the kitchen door (where Shawn had picked up some items for Mom from the grocery store on her way home from work).  Mom asked how her day went, Shawn said fine, but she had a lot to do tonight in preparation for tomorrow.  Mom asked if she was sure she didn’t need her to bring anything.  Shawn said no, she was good. 

Then I heard Shawn ask “I thought Doug was coming here today?”   Mom said yes, that’s what she thought too. 

Shawn said “Well, it’s dark now.  You know he has trouble driving at night, shouldn’t you call him and see if he’s okay?”  Mom said “You’re right.  OH DOUG…..!!”

I walked into the kitchen.  “Hey Shawn.”  Shawn said “Hey Doug.”   Mom said “Waitaminute!  That’s all you have to say?  You’re not surprised to see him here??”  Shawn rolled her eyes. “Oh Mom… when Doug came around the corner I figured you had him park in the garage.   Okay I’ll see you two tomorrow, the earlier the better.”  

After she left, Mom said “Can you believe her?”  I said yes Mom, I knew Shawn all too well.  Mom said “Did you remember to bring that can of cranberrry sauce like I asked?”   I said yes, even though Shawn already told us she was making a fresh cranberry salad.   Mom said “Aren’t you going to ask why I had you bring it anyway?”  I said nope, ‘cuz I knew HER all too well too!

Oh I know this is a dumb little story… but since Mom’s passing (15 years ago this December) I can’t help but look back and think about these happier moments when the holidays roll around.   I guess I’ve been feeling especially bummy this year… last year I spent Thanksgiving in the hospital (after getting a uretal stent placed for a blocked kidney).  This year, I’ll be spending it alone again (as I’m pretty much unable to talk or chew with this godawful jaw splint I’m wearing 24/7).  

But next year, come hell or high water… I’m going to make it to my sister’s house for Thanksgiving if it kills me!

shocked turkey

Wednesday, November 13, 2019

Mining for that silver lining yet again: I see it, but…

Sunday night I was talking to my sister Courtney (well, we were exchanging emails) and I wrote I had to wrap things up and go to bed.

I told her that before this whole ‘temporomandibular joint thing’ came along, I used to stay up until 1-2am simply because I could.  I’m retired!

I’d sleep a few hours, jump back up around 6:30am, then doze off & on thru the next day.  You know how some people are morning people or night people?  I liked to consider myself both.

But after finally seeing a doctor two weeks ago (the terrific Dr. Marvi) for my tmjd, and getting put on Naproxen and Nortriptyline at bedtime, I was instructed to take it at the same time every night and go to bed within one hour.  So I’ve been taking it nightly at 10pm, going to bed at 11pm, reading for 1/2 hour before zonking out for 7 hours.  At least now, I was getting a good night’s sleep.

My sister responded with this:

Please don't gag when you see me trying to find the "silver lining", and I'm definitely not saying that everything happens for a reason because it surely does not; but it sounds as if your schedule is straightened out now, at least.  After the pain & pressure works itself out, you'll have a better quality of life with your new sleep-schedule.

I wrote back that it wasn’t worth the TMJD, and she promptly replied with an apology.  But she was right; that was a silver lining, whether or not I liked how it came about.

It got me to thinking about other silver linings I’ve seen but didn’t appreciate at the time:

In 1993, my shady landlord was arrested and his tenants (myself and 2 others) were handed eviction notices.  But I found a nicer apartment in a MUCH nicer neighborhood, and wound up living there 23 years.

In 2001, my poor dad succumbed to cancer.  But it motivated me to get my driver’s license and a car, so I could begin making weekly visits to see my mom who lived 65 miles away.  She died 3 years later, but we got to spend a lot of time together before that.

In 2014, my dipshot boss told me I’d be taking on additional work (after I’d been requesting help for 10 years and ignored).  It pushed me into taking the “early retirement leap” I’d been mulling over for a couple years, but was afraid to do.  His stunt gave me the kick in the pants I needed.

It got me to thinking about these silver linings yesterday, when I went to Mercy Hospital yesterday for my second round with the TMJD treatment.   It did not go as I expected.  After Susan (the same nurse I had 2 weeks ago) took my weight & blood pressure, she said “You’ve lost 10 lbs since your last visit!   Dr. Marvi isn’t here today, but Dr. Syed will see you in a couple minutes.”   I followed her into Exam Room 2.

aleem-salikI’m moving up in the world—my PCP Dr. Marvi is a first year resident, Dr. Syed here is a third year resident!

A couple minutes later, another nurse comes in.  “Mr. Morris?  My name is Gina.  I’m going to take your blood pressure again.”   Um… okay.

A few minutes after that, Dr. Syed enters the exam room, wheeling some weird contraption in front of him. “Douglas?   Before we get started, I want to take your blood pressure once more.”   The machine makes some happy chirping noises, and whistles a happy little tune when it’s done.   He wheels it back out then re-enters.

DOC:   Douglas, what do you think has been helping you the most with your TMJD?

ME:   The Naproxen—and wearing this occlusal splint 24 hours a day.  (I open my mouth and tap the hard acrylic to show him.)

DOC:   I was afraid you’d say that.  I’m glad you’re wearing the splint—but the Naproxen is not meant for long-term use and I fear it’s damaging your kidneys.  It’s usually prescribed for 10 days dosage max.   You’ve been on it 14 days.

ME:   I’ve read enough about it to know it’s dangerous. 

DOC:   You’ve lost 9.8 pounds since your last visit.   I don’t know how you managed 10 lbs loss in 2 weeks time but…

ME:   From not chewing.  I’m living on vegetable juice, water, coffee, scrambled eggs, applesauce.

DOC:   But your blood pressure… Douglas.  It’s thru the roof.   It was in red-flag territory on your last visit.  Your upper number has gone up by 15-20 since then.  That’s why we took your blood pressure reading 3 times.  I’ve alerted the attending physician, and we want to get an EKG.  

(After the EKG…)

DOC:   Your heartrate is too high.  We need to put you on medication for hypertension beginning today.   And we are doubling the Nortriptyline you take at bedtime, but you need to cut your Naproxen dosage in half, or stop taking it altogether.  Have you considered surgery on your jaw.

ME:   You’re the doctor, but I’ve studied tmjd enough to know that surgery is ONLY a last resort, and only to restore range-of-motion… not for pain.

DOC:   I’ve treated 2 or 3 other tmj patients, and you’re just like them—they’re experts on it compared to us, I’ll admit that.  Alright, well, we just have to hope the Nortiptyline will lessen the muscles spasm.  Let me feel your face… you’re either running a fever or dealing with inflammation.

ME:   The inflammation comes & goes throughout the day.

DOC:   Okay.  Go to the lab across the street on the first floor, submit your blood & urine samples, pick up your Carvedilol—that’s a BP med—from the pharmacy asap and start the dosage today.  We will see you here again in 2 weeks.

ME:  Er… okay.  Do you think the high blood pressure is from the jaw disorder?  It hasn’t exactly been a walk in the park…

DOC:  You had high blood pressure last December, before that kidney stone operation and before your TMD began.  You should’ve been treated for it then.

ME:  Oh.

So, here I am the next day—my jaw feeling sorer than usual without that awesome Naproxen (it figures the good stuff turned out too good to be true) and a little dizzy from the blood pressure meds.   I suppose one can say if it wasn’t for the jaw thing, I wouldn’t have known I was in stroke territory….

So yes, there’s a silver lining here, but right now I’m having a tough time seeing it!


Tuesday, November 5, 2019

You may not be hearing much from me for awhile…

A couple days before my last post, I called UPMC Mercy Hospital and said I wanted to see a doctor about this facial pain that’s been going on since the day after my kidney surgery (nearly a year ago).   The woman on the other end said “Dear, that’s not how it works—you need to contact your PCP.”  

I said “Ma’am, you are my PCP.  Mercy treated me so kindly after several kidney stone attacks last year, I called UPMC Health Plan and asked if I could make Mercy Hospital my new PCP.  They said sure.”

The woman on the phone said “Isn’t that the nicest thing… alright, let me get your name & number, I’ll call you back!”  

She did an hour later, and told me to come in on Tuesday.  My new PCP would be Dr. Bhukari. 

Later when my friend Danielle called, I told her what was going on.  She googled my new PCP and said “She’s a first year resident”.   I said “Oh no!”   Danielle said “No, that’s a good thing!   She’ll probably pay close attention to everything you tell her and go out of her way to help!”   I wasn’t sure what to think, but Danielle turned out to be right on target.

On Tuesday I caught a bus downtown (gosh I love public transit) and getting there earlier than expected, walked about for an hour on Wood Street, Fifth Avenue & Smithfield, reminiscing about the decades I spent downtown working, the men’s shops and bookstores I used to visit (all gone now), the years of lunches and occasional happy hours with coworkers. 

For someone who grew up in a rural community, I loved working in the city, feeling a part of things... I don’t now.  I really miss those days sometimes.

I caught a second bus to Mercy Hospital, had my weight & blood pressure taken, and was scooted into an examination room.  Soon a very petite Indian (rather, Pakistani) woman in a white doctor’s coat entered the room, smiled & shook my hand.  My God, she doesn’t look much older than my 15 year old niece.   She said “Hello Mr. Morris?  May I call you Douglas?”  I said “You certainly can, Dr. Bhukari.”   She said “Oh please, call me Marvi.”   I said “You certainly can, Dr. Marvi.”    She laughed and said “Right away… I like you!”    That’s exactly how I felt too.

bukhari-marviDr. Marvi, who’s on a mission to find out everything wrong with me

She explained she was indeed a first-year resident, but she’d be reviewing my case with the attending physician.  She then asked what exactly was going on.

I said “Before I begin, I feel it’s important I give you my backstory… so I don’t get sent on another medical merry-go-round.”  She said okay and opened a small notepad to begin writing. 

I told her I first developed TMD in 2016, my dentist sent me to my PCP, who sent me to an ENT, who gave me a steroid pack which sent me to an ER, they in turn sent me to an endodontist, who sent me to an oral surgeon who said it wasn’t advisable to operate.  I got some physical therapy, then sat around in misery for 7-8 months before it healed on it’s own.

She said it sounded like a pretty traumatic experience.  I told her all was good for the next 20 months, until I had a series of kidney stone attacks last November and the urologist wanted to operate.  They did a laser lithotripsy, a 2-3 hour procedure, and put in a breathing tube while I was out.  I woke up the next morning with my face in a lot of pain; my TMJD had returned.  I KNEW this could happen, I even warned the doctors beforehand.

Dr. Marvi said “I’ve never worked with a TMD patient, but I do know any surgery involving oral intubation can bring on the affliction.”

I told her I’d been suffering with it for the past 11 months, waiting for it to heal.  Instead, it seems to be going in the opposite direction.  I took Advil & Montrin for months (before realizing it was doing more harm than good), wrap my face in moist heat wraps & ice packs daily, but the relief is minimal. 

The first time I had TMD, I was able to eat fairly regularly after a couple months.  This time around… just the opposite.  I ate at the start, but stopped eating most solid foods a couple months ago, it just became too painful.

Also, this time it’s not just the swollen muscles in my face, but it’s in both sides of my head, squeezing me like a vise.  I’m also dealing with ‘burning mouth syndrome’.   It’s all a hot mess.  

Dr. Marvi said “I see you’re 25 pounds lighter than your weigh-in last November.  I’m guessing that wasn’t intentional?”   I said no, but I know I needed to lose the weight anyway; one of the perks of having TMD.   She said she’d be reviewing everything with the attending physician, then asked if she could take some pictures of the inside of my mouth (with her smartphone??) and gave me a cursory examination.

During the exam, she said “Douglas may I ask you a very personal question?  Do you wax your legs?”  I laughed and said no, all the hair fell out several years ago.  She squeezed my calves then said “I know it’s not your reason for being here today, but in 2 weeks we’ll be doing a complete series of bloodwork.  I suspect you have hypertension and are pre-diabetic.”   Oh dear.

We talked some more (she asked if I was in a relationship—no, she asked if I liked cats—yes) then left to meet with the other doctor.  When she returned, she said “We’re going to put you on 1000 mg of Naproxen daily for the time being, and give you something to take before bed.  It’s an antidepressant called Nortriptyline, but it’s also used to manage persistent pain from affected nerves— it’s a cumulative treatment, so it may take a couple weeks to be effective.  I’m going to have you come back in 2 weeks so we can check on your progress… and do your bloodwork.  And 2 weeks after that… and 2 weeks after that.”

After thanking her, I headed out to the checkout station.  I asked the nurse “Will I be getting a new PCP everytime I come here?”  Dr. Marvi suddenly appeared from around the corner.  She said “No Doug!  I am your PCP now!  For the next 3 years!”   I smiled and said okay.  She then said “Your next appointment, I will be away doing a clinical study so you’ll be seen by another resident.  If you don’t like them, don’t be discouraged because I am your doctor now." 

I said ok, thank you.  My stomach rumbled and the nurse at the station asked if I was hungry.  I said yes and she said “You should visit the cafeteria, they have a ‘hot dog bar’ set up today.”   Before I could respond, Dr. Marvi said “NO DOUG.  I don’t want you eating all those nitrates or sodium.”   Ok, Dr. Marvi.   

(After she left, the checkout nurse said “You’re very lucky to have her as your new PCP.  People here are singing her praises.”   Good to know.)

And so, for the last week I’ve been taking those naproxen twice daily, which take the edge off—sometimes, and that nortriptyline before bed (which usually zonks me out).  I wake up, do the heat, ice & meds all over again.

It worries me though—that naproxen is pretty heavy-duty.  I can’t take it forever.

I will admit, it’s been rough.  Particularly this weekend, when I thought I’d tear my hair out.  Sunday afternoon I was sitting here holding a couple of frozen gel-packs to my face and feeling a lot of anxiety, wondering if this will ever end.  I decided to pray.

“God… you know I don’t believe in the whole Bible church thing.  Or in any supreme being, for that matter.  The last time I prayed was 15 years ago, when I begged you to spare my mom.  But now I’m praying for me.  I know I’m being a hypocrite, but please help me out, I need a little bit of relief here.”

The phrase “God helps those who help themselves” immediately sprang to mind, and I got on my blog here and looked up a couple TMJ-related posts from my first time with it in 2016.  I found one about having a custom occlusal splint made, and it made me stop & think for a second;  I’d almost forgotten the thing.  (I DO remember it costing me $300 for the fitting and the appliance.)

splints2019The fitting took place the first week of January, 2017.  By the time it finally arrived in mid-February, my jaw was starting to feel better;  I think I only wore it for a couple weeks.   (It separates your upper & lower teeth by a 1/2 inch, taking some pressure off of your rigid, spazzed out masseters.)  

Dr. Marvi HAD asked me if I owned a night guard, I told her I had a couple—a cheap, rubbery one from Wal-Mart that hurt my gums, and an expensive custom-fitted piece that was too tight on my teeth.  I haven’t worn either in ages.

It’s been almost 3 years, I wonder if the pricey one is still wearable?  I found it in it’s little blue container under my bathroom sink.  I rinsed it under some warm water and snapped it onto my upper teeth.  Ouch, it’s tight alright—but unlike the cheap rubber one, doesn’t chafe my gums.  After a few minutes, it felt a little more comfortable.  

I also detected a small (but noticeable) drop in pain in my jaw muscles.  It couldn’t have been more than 2 or 3%… but it was something.   

So I wore it to bed, and was surprised when I awoke and it was still snapped in place.  (That $5.00 green thing has never lasted thru a single night; I always awoke with it in my hand or under the covers.)  After brushing my (very tender) teeth, I thought “what the heck” and put it back in, wore it most of the day. 

And I think that’s just what I’m going to do for the time being—besides wearing it at night when I sleep, I’m going to wear it as often as possible during the daytime too. 

It’s impossible to eat with, but I can drink liquids with it in and that’s pretty much what I’m living on right now anyway.  It’s also difficult to talk with, but it’s not like I’m able to do much gabbing outside of email or on my blog here.

I’m just desperate to get my old life back.  I miss my family, my friends.  I miss eating real food.  I miss having a reason (or being able) to smile.  Wish me luck.


Friday, November 1, 2019

Corny as it sounds, friendship really is the best medicine

Last Friday evening, I was sitting here on my couch wondering what to do.  I was tired of looking at the TV, tired of looking at the internet, didn’t feel like picking up a book and was trying not to think about my sore jaw.  On a whim I picked up my phone, dialed my friend Erin’s number and was surprised when she picked up—“Hello Doug!” 

Erin and a 25 lbs heavier me from my last day in the office 4 years ago

I said “Erin?  What are you doing home on a Friday night?”  She said “I’m getting old Doug, I don’t have the energy to run around like I used to!”

(Erin’s in her early 40s, 15 years younger than me.)  I asked if she felt like talking, she said sure and as we began chatting, my TMD got angry and said “what the heck do you think you’re doing, Doug”  as my left masseter began to swell, closing off my salivary gland.  I was close to saying “Erin, bad idea—nevermind”  but I just—didn’t—care.  It had been a pretty rough day already (I’d walked to the store earlier, had a dizzy spell and fell against a US mailbox on my way home) and was feeling pretty sorry for myself.

We wound up on the phone for a good 4 hours.  It was probably the best Friday night (for my heart & mind, at least) I’ve had in months.

I first met Erin in 2007 when she joined my work-group at UPMC (but it feels like I’ve known her a lot longer).  She sat directly across the aisle from me, and surprised me one day when she began sharing her love of all things ‘Star Wars’.  What the—a girl who’s a sci-fi geek like me??   We’d often recount (crying & laughing) the previous night’s episode of Big Bang Theory to one another, and I still laugh when she asked me one day what I thought of The Walking Dead and I told her I had no need for zombies; I’d never seen it.  She said “DOOG!!  (Her nickname for me.)  YOU MUST WATCH!!”

She was right, of course—it became my No.1 favorite show for many years.

She left the company several years later, then returned (to a different department) a couple years after that, but we never lost touch.

fatheadswitherinErin & myself at Fathead’s, our favorite hamburger place on the Southside in happier times

I don’t think we’ve ever had a typical friendship, whatever that is.  I have a couple people I’m close to—my sisters Shawn & Courtney, my friend Danielle—who I pretty much keep in daily contact with via email.

If either doesn’t hear from me in a couple days, they’ll be quick to reach out and ask what’s going on.

Erin & I can go weeks—a couple months even—without hearing from one another and unlike my sisters & Danielle, we don’t text or email one another.  But we get on that phone, and talk like we just saw each other yesterday.   She’s funny, sweet, open with her feelings… a terrific listener. 

If there’s a pause in our conversation, she always seems to know just what to jump to next.  I think that’s what I like about our calls best.  (Every other person I know uses that moment of silence to let me know I’ve rambled on long enough!)

I know a couple times in our past, others have asked me or joked about us pursuing something romantic.  I can’t imagine it, neither could she.  But I had no problem asking her if she’d seen the movie Friends with Benefits when it came out a few years ago, and what she thought of the idea!

I can’t remember where I was going with this… to be honest, my brain has been a little fuzzy lately.  As this uncomfortable jaw disorder stretches into it’s 11th month (I’m very much hoping it’s in the home stretch), it sometimes inflames the temporal muscles on the sides of my head and gives me a hot, tingling panicky feeling.  The jaw isn’t enough for you, TMD?

That all-night chat with Erin didn’t exactly do wonders for my jaw…  but it was just what the doctor ordered.

Erin, if you’re reading this… thanks again.  Smile