[My] Life in Wisconsin

Showing posts with label caseysick. Show all posts
Showing posts with label caseysick. Show all posts

Frazzled and Frayed

Good Afternoon All;
Knock, knock... Is anyone here? 
I don't know how many of you are still around since Multiply seems to be nearly defunct already. (And with over 2 months yet to go that they have promised to stay open). I have much yet to retreive from my site- blogs and such- and am hoping that by the time I do get 'er up and running that the kinks will be worked out of this export program... I see more than a few posts complaining of that export system yet, so, even with my dial-up I will be patient. If i have too many problems I shall have to beg Mr. Greg to do it for me. *sigh*  Wonder how sick and tired he will be of me, and my computersaurus after that? Glad it takes TONS to make him be upset enough to even cuss... hehehe

Casey's surgery (hysteroscopy) is over; though I am SO sorry to say I couldn't go. Grrrrrrrr...  My car decided that this was the proper morning to pee antifreeze all over the garage floor. Damn, hey? (and I'd only wanted to warm it up a little as the chilly air hurts to be breathed in)! After that, I wasn't going to take a chance on driving in the hopes of getting there on time. 

Fortunately for everyone involved, Greg had previously taken today off. He was planning on bringing her anyway, so all that was left was for everyone to miss my presence. hehehe
I should have just said, "Thank God for Greg" and been done with it. I can't tell you how many times in the past few months that I have told Casey to tell him exactly that. I hope she has passed it on every time.

She called here about an hour ago, saying that they were back home- She sounded absolutely WUNNAFUL!!!
Of course she is sore, and more than a little hungry. They stopped at Fazoli's on the way home, and picked some food up so they could enjoy a late lunch/ early supper. Sounds good.

With my car in need of my mechanic hindsight tells me that I should have bought more the last time I went grocery shopping. Oh well. I can make do with whatever I have on hand. Mostly. 
Oh Lordy i am so tired. And it is [still] going be a very LONG evening- That is, *if* I stay awake for the Packer Game. I shall try. 

Not much other news around here- Though I am still perplexed by a phone call of apology I'd received from a friend 2 weeks ago...
I will go into that at a later posting. Suffice to say that I don't take being screamed at too well. And my heart is ONLY capable of taking BS for a time- Then it simply gives up. This time it gave up by simply hanging up. 
But like I said, that will keep.
For now.  
The important thing today was to keep everyone up-to-date about my little CaseyAnne.

My love to all.

XOXO
Me

PS
Do
 let me know if you will be still around this site for a while?
And please, also let me know where I will be able to find you after Multiply closes for good? 
I do have a few of your destinations already, but no everyones...

Casey- Liver Biopsy

Start:     Aug 10, '12 08:00a
Location:     Hospital

Liver biopsy - Results

Alternative Names

Biopsy - liver; Percutaneous biopsy

Normal Values:

The liver tissue is normal.

What abnormal results mean:

The biopsy may reveal a number of liver diseases.
[These include] cirrhosishepatitis, or infections such as tuberculosis.

It may also indicate cancer.

This test also may be performed for:


  • Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington, School of Medicine; George F. Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program, San Diego, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

References

Lomas DJ. The liver. In: Adam A, Dixon AK, eds. Grainger & Allison's Diagnostic Radiology: A Textbook of Medical Imaging. 5th ed. New York, NY: Churchill Livingstone; 2008:chap 35.

Liver. Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger & Fordtran’s Gastrointestinal and Liver Disease. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2010:section IX.


Read more
http://www.umm.edu/ency/article/003895res.htm#ixzz2393aV3L4

Casey's Liver. (And a little about me).

Another collective rant...

Good Morning all;
I have been away again, so you best grab a cup of coffee. hehehe


First- most importantly, Casey is OK-
** If you missed the update in my comments section in my previous blog,  we still do not have a definitive diagnosis- We do know that the CAT Scan showed more than a few 'growths' on her liver.

Once admitted, Casey was sent to the oncology floor. 


The hospital employs "hospitalists". 
Medicinenet.com defines a hospitalist as "the physician that organizes the communication between different doctors caring for a patient, and to serve as the point of contact for other doctors and nurses for questions, updates, and delineating a comprehensive plan of care. They are able to track test results and order necessary follow-up tests promptly.

One thing this hospitalist mentioned, beside the bad stuff, was "fatty liver"
This is what I read up on and learned:
  • "occurring in people who are overweight or obese"
  • "Only a liver biopsy can establish a definite diagnosis and determine the severity of the condition."
This hospitalist dude ordered an ultrasound...
Casey questioned WHY they would do an ultrasound when this had already been confirmed by the scan? (A very good question too).
She also questioned WHY it took over 14 hours to schedule an ultrasound that takes about 5 minutes? (Another great question).

As I told you, Casey did leave the hospital. 
"A-M-A", (against medical advice), late that same afternoon when this hospitalist doctor there told her that he would NOT work with Minnesota on her case.  

WTF?!

NOT working with the doctors who are familiar with her medical history??? 
NOT even taking 5 effing minutes to ask them for pertinent information (that he might well "need" to know)? 
Not to mention that he would NOT even contact them!

He flat out told her, "I'm a doctor. I will not call anyone else. It is my own policy not to confer with anyone else."

The pompous bastard apparently forgot who works for whom! 
How dare he?!?

Casey shot back, "You are just a hospitalist. You are not my doctor. I am leaving, and I will drive to Minnesota if I have to."

With that, he was completely irate! She did not mean to anger him further- But like any one else on earth, and in almost any given situation, people respond IN KIND.
Casey is no different!
_________________________________


As for me, there is a whole slew of crap going on.
In May I had an eye exam...

When he did the cursory peek he told me that I have some cataracts...
They were nothing for me to worry about; (maybe in 10 years or so).
THEN, he did the eye exam itself.
OK, they were worse than he'd originally thought- (Perhaps I had more like 5 years).
He then thought to put me in front of a machine that actually takes a picture of the inside of your eye. I have forgotten what it is called, but it was VERY bright.
Afterward, he stared at the 'picture' then then spoke again. "Anne, I am going to prescribe you some new glasses for now. They should help you to see a little better. Let me know in a few months if you still cannot see any better. Your cataracts are much more advanced than I had originally seen."

Damn! How did I go from having 1o years to see decent, to having just a few months? (And that, only *if* the new glasses did the trick)...

But they did! And for the rest of May, and the month of June- 
But then I woke up one day, and it was July...
Lord almighty, when he's right he's right. 

As of now, I can barely see the printed page, let alone to type. If you are not making your blogs bigger then I have an awful problem reading them. I check pictures (that won't enlarge), with a magnifying glass.

I wish I could talk to my computer and it would type everything I say; -cusswords and all. hehehe

With my elbows and shoulders hurting so badly I can barely type. (I have been writing this, on and off, since about 8 this morning). My fingers sort of do not cooperate with my brain, which is still mostly working.
I make all of my screens extra larg- Sometimes I read faster than I can scroll. hehehe  
Hey, it works; but my eyes tire so quickly.

Or maybe that's just me?!?
For the last 3 nights I have barely slept a wink. More like extended naps. (About 2 hours each night). I do nap sometimes during the day, but am not real good at that. But I enjoy the heck out of shutting my eyes and trying to hypnotize myself to sleep/nap. 
Don't laugh! It's fun; and mostly it works. (Just not for the past 3 nights).  hehehe

Hell, I should probably post a whole bunch of things I can do because the list my own doctors tell me not to do keeps on growing and growing. And I am more than tired of it all.

Someone asked me a while back how did I manage to keep going and not throw in the towel and say 'adios'.
I'm not really sure- Just that maybe I don't have that gene, or whatever. 
Besides, I'm as gutless as all get-out. hehehe
Not sure if I would ever be able to do that to Casey-(or Punk for that matter).
Might be a different story if I was worse.

Oh wait.
I had to be tested for a few things- Autoimmune disorders, and an h~Pylori test to see if my ulcer came back. I have been asking for 6+ years to have this test (re)done, and doctors have refused.
They want to do an EGD. 
Finally, tired of all the nastier symptoms, I sort of demanded the test. She was upset and said I still had to have an EGD.
"No. Not yet. Let's see when my h~Pylori, comes back. If it is negative, I will talk about having this EGD done. If it is positive then I will need to be treated for that first; and see if my symptoms go away."
(She too, had almost forgotten that she works for me; and not the other way around).

Please do not misunderstand.  I honestly DO admire and respect (most) doctors and nurses... until they give me a reason not to anyway.
Having had Casey sick now for almost 8 years, it still throws me to see people (drs, nurses, ANYone) treating her like a dumb sockpuppet. We have had such an extensive education. And no, I am not even remotely comparing myself to a dr.  It's just that when things are done out of order, I reserve my INFORMED right to question it. 
In this specific case, and instead of eliminating the symptoms in a fairly cost effective way, they want to jump to the very expense (and invasive) things... Makes no sense to me.
They wonder why my blood pressure is whacked???  (Really)???

When all was said and done my h~Pylori test came back positive.  Shocker, no?
***sigh***

The autoimmune test results came back too
2 were plainly negative, and 2 came back highly "suspect" (questionable). 

Again I must ask myself if these are things I wish to worry over, or if these are things I can live happily on the side of basic ignorance. 
Remember that our bodies are quite well~functioning machines (for the most part).
Aside from pancreatitis, major coronaries, cancer, and bacterial infections (to name a few) our bodies can/DO heal themselves well. One only needs to take care- And always MAKE time for ones-self. That is the ultimate thing.  Guilty as charged, it is also what I failed to do, for too many years. 
I will not make that mistake again.

It's actually a very simple, and basic, concept- If you are thinking you need a break, you DO! Pull over from life for a while, smile, then relax for at least 20 minutes.  Eyes closed and add earplugs if at all possible); no thoughts, (only quiet and comforting ones), and no other minor responsibilities. That time, that responsibility is ONLY for yourself.
If you don't take care of you then who will?

Besides, you do NOT want to end up like me- In a body that had been neglected for 3 decades.  I tried not to be selfish too- It didn't do me any good.  And I don't mean that manicures are more important than meals. It's OK to relax. Really.
There is a reason for everything- And I didn't listen to my back; blaming it on my arthritis. When I was 35 my doctor wanted me o have a scan of my back. I wonder now what may have been revealed? Then again, I didn't listen to that nag on my shoulder that kept telling me to go IN. 
I do have a few other things going on- None so important as my vision though. I know already that I will need the cataract surgeries- and picture myself with a patch on my eye, a brace on my back, and a broken front tooth. I will be ready for Halloween, that's for sure. 
I broke that one about a month or so ago. Went in to the dentist- and he needs to refer me out, as I need more work than they are capable of doing at the clinic. 
Fine by me.
They said they would make that appointment with an oral surgeon. That they will call me when it is all set up.

A few days later they have mailed me a 7-page letter. I rip it open to find out when this appointment is- To realize that it only has the names and phone numbers of dentists in Wisconsin that will do magic on my mouth.
I call the ones that are close- enough. Those that I know I will be able to drive to. 
My back just doesn't like long trips
Lo and behold, no one is taking new patients.  
No wonder they mailed me that list!  Mad about that too. hehehe

So here I sit...
It's OK- (It has to be, right)? And really only hurts every now and then- 
But once again I know I should have made the time (and literally begged) when I knew that my insurances would cover it all being done at a hospital. 

I'd best close- I have rambled on enough for ages, and for all of you that don't post blogs anymore. I do hope you are all somehow still around?

May you all have a 'wunnaful' weekend!
My love to all.

XOXO,
Me

Casey Very Ill-



Hi all;
I must apologize for my virtual absence. 
I do have a very good excuse, but will get to that tomorrow. Maybe.
In the meantime, and as always, know that each visit, letter, note, and message were/are greatly appreciated. 

I am OK as I await some test results for autoimmune disease(s). .

Casey had to drive Greg down to Appleton last night. His dad is a dentist and that is where his practice is. Greg has had a few problems with his teeth, and needed a 2nd extraction. Kind of a rough one for him- He hadn't wanted to take his pain killers, and having had that previous extraction some 3 weeks ago, thought he wouldn't need them... However, this one was worse, all the way around- With Casey driving he could take some as soon as he was capable of doing so afterwards- 
By the time they got back to Green Bay he was loopy, but Casey was in extreme pain. This time not only with her right flank pain, but with her back seizing up on her as well- She waited for it to pass. 
After 2 hours to realize it was not going to get better anytime soon, she drove herself to the hospital. 
By 3 she was admitted.
Greg brought her 'hospital stuff' but had to go back home.
I am on my way shortly to begin the worry all over again.

I am just sickened- She has been sick- and pained for some time now.
She has a nasty infection somewhere- Her white blood cells are "sky high" And to remember she has no spleen. 
Among other things, the CAT Scan they did showed "many lesions" on her liver.
I do not know the definition of "many". 

They are thinking to do a biopsy... And perhaps many other things.
Jocko (ER doc) did not have a worried look on his face. He had a very 'scared' look.

Please keep her in your hearts?  My love to all. And always.
Will know more--- later?

Would those of you that know people that would want to know about this please let them know for me? 

XOXO
Anne

Casey. Punk. And me too.

Good Morning All;
I have been sitting and standing and trying to catch up on some laundry- 
The way my back feels, (and in a new spot), is that I am waiting for this next vertebra to crack. (I know this 'feeling' too). 
I am so careful. 
I wish the feeling would just go away- or crack already. 
It's much like having a very bad kink within.

I had gone to my pain appointment much earlier this month; having changed the time myself to accommodate another appt in the same building, & not wanting to make 2 separate trips. Mistakenly I had thought the doctor she had given me was one that I had already met, and liked. 
My bad.
As it was, a 'new' [to me] doctor walked in, stated that he was going to change my meds, took my cane and told me to walk. (Keep in mind that I was having a particularly bad back day to begin with). 
I would not walk without taking his hands, and taking some very tentative steps (in case this bonzo decided to pull away his hands as my support).
Then he tells me to sit. 
He repeats himself- BECAUSE I WASN'T MOVING/SITTING FAST ENOUGH!
Oh shit, (I could go on and on... But to save you the letter I wrote to my regular doctor, I won't).
Suffice to say this guy was an ass. 
He had not even LOOKED at my chart when he chose to  change my medication regimen!! WTfH???
I am still furious at being treated like dirt by someone who doesn't even KNOW me!

And yes, I held on to that letter for 2 weeks, rereading it to make sure I still felt the same way. 
I did, and do.  And yes, my doctor now has it.

Unfortunately since I can barely move, I have to call in and make another appt- an earlier one than the one I now have, because this regimen is NOT working for me.
I could blame it all on the fiasco about the death of yet another superstar who doesn't know how to read a Rx bottle, but this was weeks before her death- 
And it's shit like that that really upsets me. So I won't go even write about that crap.

Not much other news...

Punk is still sick- Not really 'sick' sick- but barfs every now and then. Vet said it is a birth defect in her throat- But I am wondering WHY this would only present itself now??? He had no answer for that, save that she needs to lose some weight. (But she has weighed the same now, approximately, for a few years)...

Let's see...
Oh, in case you missed it, I posted about Casey's next surgery in my calendar here... Poor kid. 
What I didn't write is that her Paps came back bad, and now she will also be having a colposcopy.
She has more courage and love than most people have in their little fingers.

I hope all is well with everyone. 
Forgive me please for not writing, and not commenting on your own blogs. I see many pages of new stuff that I cannot even get to. 
*sigh*  - I will never catch up.

XOXO
me

Casey's Next Surgery

Start:     Feb 21, '12 07:00a
From her last visit to Minneapolis, and once again Casey's stomach is not emptying correctly. (This is not specifically the delayed gastric emptying that she was operated on for previously- but close).

She has been having much pain, (daily, hourly), and has now been referred to another surgeon.
We met with him yesterday afternoon.
He has described the surgery as quite simple, even 'outpatient'. (Say "YAY")!

During another EGD, (esophagogastroduodenoscopy ), her surgeon will go to the very bottom of her stomach and cut the pyloric sphincter so her food can more easily move onward.
As it is now, her stomach must actually (severely) cramp up to be able to pass her food onward; thus accounting for the awful radiating pain.
Please keep her in your thoughts.

XOXO
Me

Diagnosis and Treatment of Upper Gut Motility Disorders


No you don't have to read it if you prefer not to. I am just blogging this to save it for... later

A whole lot of possibilities...


Procedure Profile - Diagnosis and Treatment of Upper Gut Motility Disorders

Complex Digestive Disease Center -

Center for Neurogastroenterology and Motility


Upper Gut Motility Disorders

Upper gut motility disorders involve functional disorders within the esophagus, stomach, and small intestine. There are three primary components to functional gastrointestinal disorders: motility, GI tract sensation, and brain-gut dysfunction, all of which affect both the lower and upper gut.

Motility: Normal motility or peristalsis is an orderly sequence of muscular contractions from top to bottom. In functional GI disorders, muscular spasms can cause pain, or contractions can be very rapid or very slow, altering the speed or direction of gut transit.


Normal Peristalsis

GI Tract Sensation: The stomach nerves are sometimes so sensitive that even normal contractions can induce pain or discomfort in response to physiological stimuli, such as digesting a meal.

Brain-Gut Dysfunction: The regulatory connection between brain and gut function may be impaired, causing disharmony in the way the brain and gastrointestinal systems communicate altering the transit of luminal contents.

Esophageal Manometry

Esophageal motility encompasses four distinct areas of the esophagus: pharynx, upper esophageal sphincter, esophageal body, and lower esophageal sphincter.

Pharyngeal Manometry tests pharynx contractions or tone to diagnose movement dysfunctions that can lead to misdirected swallowing.

Upper Esophageal Sphincter (UES) Manometry tests UES tone, pressure, and relaxation. The UES may fail to relax or be unsynchronized with the pharynx causing peristaltic dysfunction or the sensation of an object being stuck in the throat.

Esophageal Body Manometry tests the muscle contractions and esophagus peristalsis.

Lower Esophageal Sphincter (LES) Manometry tests sphincter tone and relaxation ability.
High-resolution esophageal manometry testing utilizes a small tube containing solid state pressure sensors. The tube is inserted through the nose into the esophagus to measure esophagus contractions and the relaxation of the LES. The high-resolution system provides accurate measurement and timing of pharyngeal and upper esophageal sphincter contractions. Esophageal manometry also measures the pressure and contractions of the LES muscle, identifying or ruling out LES muscle weakness. To measure esophageal pH levels, an esophageal impedance catheter or a Bravo™ pH capsule is used. The catheter measures impedance caused by reflux of either acidic or non-acidic fluid from the stomach. The catheter is the diameter of a string of spaghetti and is inserted through the nose for 24 hours. The Bravo capsule, temporarily attached to the esophageal lining, captures pH levels over a 48-hour period.



Bravo™ Capsule Recording Graph


Esophageal Motility Disorders

Achalasia: Characterized by the absence of esophageal contractions, achalasia is caused by nerve degeneration in the esophagus and LES, thus preventing food passage into the stomach. Persons with achalasia experience progressive difficulty with eating and drinking, usually with symptoms of vomiting and chest pain. These patients can be treated with pneumatic dilatation or laparoscopic myotomy.

Dysphagia: Ineffective swallowing can occur for many reasons. Stroke or nerve and muscle diseases affecting the tongue and throat are very common causes. Dysphagia also can cause food to back up in the esophagus, resulting in vomiting. High-resolution manometry records pharyngoesophageal coordination with high fidelity.

Gastro Esophageal Reflux Disease (GERD): The major symptoms of GERD are heartburn, sour mouth, and hoarseness with throat pain and chest pain. GERD, left untreated, can cause severe damage to the esophageal lining. In addition to a low LES pressure, GERD patients may also have transient LES relaxation that is unrelated to swallows.

A special sleeve manometer, Dent Sleeve, is used to measure the pressure in the pyloric sphincter, the ring of smooth muscle creating the boundary between the stomach and the small intestine. Pressure sensors in the manometer can also measure contractions of the stomach and upper intestine. If the pyloric pressure is elevated, the effect of Botox injection on the pyloric pressure can be immediately measured. In addition to the Dent Sleeve, a new solid-state catheter is also being used to measure the pyloric pressure.

Stomach Manometry


Dent Sleeve manometer in pylorus.

Gastric emptying studies measure the flow of solid or liquid meals as they empty into the small intestine. Gastric emptying is controlled by contraction and tone of the stomach wall. California Pacific utilizes a computer-controlled pump called the barostat which shows whether the upper stomach relaxes adequately during eating and how much filling of the stomach it takes to cause pain or discomfort.


Raw EGG and Data Anaylsis

The electrogastrogram (EGG) is a diagnostic tool used to measure the electrical control of the stomach’s contractions. EGG frequently identifies dysrhythmias, especially after meals, in patients with gastroparesis, chronic dyspepsia, anorexia nervosa and bulimia, cyclic vomiting syndrome, and other conditions characterized by a delayed gastric emptying. Dysrhythmias can be caused by specialized muscular conduction system abnormalities, present in the stomach.

Stomach Motility Disorders


Gastric Electrical Stimulation

Gastroparesis-Delayed Gastric Emptying:

Many gastroparesis patients have difficulty eating, and experience severe, chronic vomiting and nausea.
Some patients may even require tube-feeding to ensure adequate nutrition. There are a number of causes for gastroparesis, including diabetes mellitus, anorexia, bulimia, lupus, and brain disorders. How-ever, nearly 40% of the cases have an unknown origin. Patients who have not responded or are intolerant of conservative therapies are candidates for injection of Botox into a hypertensive pyloric sphincter or Gastric Electrical Stimulation (GES). GES is used only when medication is ineffective in controlling symptoms that can be serious, including mal-nutrition and severe dehydration.

Functional Dyspepsia (Nonulcer Dyspepsia): An abnormal gastric accommodation reflex or decreased relaxation of the fundus (upper body of the stomach) may cause functional dyspepsia. Patients’ symptoms include pain or discomfort and bloating in the upper abdomen, fullness, and nausea. New drugs are currently being used to normalize the accommodation reflex.

Small Intestine (Duodenum, Jejunum, and Ileum) Manometry

Antroduodenal Manometry: testing measures the pressure waves in the stomach and adjacent small bowel. Part of diagnostic testing includes measuring muscle contraction and responses to physiological stimuli (i.e. meals, erythromycin) using a manometer. A lactulose breath test is used to estimate small intestinal transit, as well as small bowel bacterial overgrowth. Additional diagnostic testing, in conjunction with nuclear medicine, includes measuring stomach emptying and transit in the small intestine using a nuclear medicine scan.

Small Intestine Motility Disorders

Intestinal Pseudo-Obstruction Or Blockage: Resulting from either weak or chaotic peristalsis, intestinal pseudo-obstruction presents with symptoms of abdominal bloating, pain, nausea, and vomiting which vary in severity and frequency. Abnormal small bowel contractions can result in muscle ineffectiveness, which in turn affects peristaltic movement. Scleroderma or other autoimmune diseases can cause weak contractions, while chaotic contractions are often caused by nerve abnormalities in the myenteric plexus.

State-of-the-Art Motility Diagnostic Tools

High-Resolution Esophageal Manometry: Solid-state pres-sure transducers allow for simultaneous recording of the entire esophagus. The rapid and high- fidelity recording provides an accurate description of esophageal motility disorders. A similar system is used to measure pyloric pressures.

Barostat Studies: Barostat studies measure the tone and compliance (stretch) of the esophagus and upper stomach. It also measures gastric accommodation and gastric sensation. Barostat studies can show whether the upper stomach relaxes adequately during eating and how much filling of the stomach it takes to cause pain or discomfort. An intra- gastric balloon measures resistance and volume changes. Filling the balloon bit by bit with air, the motility specialist is able to determine volume related abdominal pressure pain levels, in addition to esophageal and stomach muscle tone and elasticity. In some patients, a barostat is used to diagnosis GERD and GERD related conditions that may be due to altered esophageal and stomach pressures.

An advantage of the barostat for gut measurement is its close contact with the stomach wall. Manometry testing can accurately detect stomach wall contractions in the esophagus, pylorus and small intestine. However, it does not accurately measure gut tone.

Bravo pH Test: The Bravo pH test offers patients with severe chronic reflux disease a viable option to an upper GI or 24-hour pH test. With the Bravo pH test, a tiny pH transmitter—about the size of a vitamin capsule—is attached to the esophageal lining. The capsule sends esophagus pH level data to a pager-sized recording device worn around the waist.

Patients are able to continue their regular daily routine and consume normal meals. After 24 to 48 hours the transmitter capsule is naturally sloughed off and eliminated through a normal bowel movement. After two days, the patient returns the recording device to the motility office for data analysis.


Esophageal Impedance Acid Reflux

Esophageal Impedance/ Simultaneous Motility: Esophageal impedance measures the reflux of not only acidic gastric contents, but also non-acidic material. This test is very useful for the evaluation of patients with continued GERD symptoms who are prescribed adequate doses of acid suppression. A combination with manometric recordings gives a full description of the underlying pathophysiology, allowing for better therapy.

Electrogastrogram (EGG): Similar to an electrocardiogram (EKG) of the heart, the EGG records the electrical signals that travel through the stomach muscles controlling the muscles’ contractions. Additionally, EGG measures stomach-wall nerve activity before and after food ingestion, as well as the conduction and coupling between muscle cells. The new EGG system records on four channels simultaneously, allowing for complete activity data collection in a short time frame.
EGG is a non-invasive test, relatively inexpensive, and easy to perform. Electrodes are placed cutaneously on the abdominal skin over the stomach. While the patient is lying down relaxing, the electrodes record the electrical activity of the stomach. Initially, the gastric electrical activity is recorded after fasting, then again after a small meal is ingested. Sometimes EGG is done in conjunction with or after gastric emptying studies to diagnose and manage functional dyspepsia and idiopathic gastroparesis.
Utilizing computer analysis, the power of the stomach muscle electrical current is measured. In a normal stomach muscle, the regular electrical rhythm generates an increased current after a meal. In persons with stomach muscle or nerve irregularities, the post-meal electrical rhythm is irregular or the voltage does not increase.

Pyloric Manometry: Pyloric pressures can be measured using either the water-perfused Dent Sleeve or the e-sleeve from the high-resolution manometry system. The contribution of the pylorus to altered gastric emptying can be immediately measured and treated.

Antroduodenal Manometry: Measuring pressure waves in the stomach and adjacent small bowel before and after physiological stimuli (i.e. meals, erythromycin), and recording the pressure changes in the antrum and duodenum provides information about how well the muscles and nerves in the stomach and small intestine work. A manometry catheter is placed over a guide within the stomach and small intestine. The catheter records the muscle signals and pressure changes in the fasting state and also as food or liquid are digested. Test data is down loaded onto a computer upon completion of the study allowing for thorough evaluation of gastric and small intestinal motor function. Antroduodenal manometry records the presence of muscle contractions and their site of initiation, direction of propagation, frequency, and duration.

Motility Disorder Treatments

Although motility disorders are functional, many can be controlled or corrected with surgical interventions. Surgical interventions are usually performed using minimally invasive or interventional endoscopic techniques.

Botox Injection in the pyloric sphincter helps gastric empting by paralyzing the LES or the pylorus. The response can be measured by pyloric manometry and gastric emptying studies.

Endoscopic Gastroplication Or Laparoscopic Fundoplication can lessen GERD symptoms and LES dysfunction.

Gastric Electric Stimulator Enterra™ Therapy, implanted laparoscopically, is a device for treating gastroparesis, improving gastric emptying and symptoms.

New Drug And Treatment Options in research clinical trials offer patients access to current investigational protocols for upper gut motility disorders.

Patient Referral and Insurance Coverage

Patients need a referral from their primary care provider or physician specialist prior to scheduling their gastrointestinal motility evaluation. Many pre-evaluation laboratory and radiological results can be forwarded to the Center for Neurogastroenterology and Motility prior to consultation.

Most motility diagnostic testing is covered by Medicare, Medi-Cal and private insurance companies. In order to avoid unexpected medical expenses, it is always best for patients to contact their insurance company prior to treatment and confirm coverage for this service, as well as obtain prior authorization.

Images courtesy of William J. Snape, Jr., M.D.

Casey. Minnesota.

hehehe

Hi All;
L-O-N-G day today. But we have learned one important thing.
The ERCP/EGD/EUS (whatever it was called), found nothing out of the ordinary in her stomach- Save to reveal that Casey's anastomotic ulcer has healed nicely. That is a very good thing, (she cannot afford to be losing any more of her stomach).
The contents of her stomach are also slow to empty as the muscle at the duodenum is very very constricted. I am not sure if that can be 'cut' to relax it; like the manometry etc at Froedtert Hospital did to the foremost sphincter in her pancreas- (way back when). I forget what that was called, and my computer is so slow tonight that I am not going to go click on "Froedtert" either.

Problem is that no one has learned where her blood is going, and why she is so dangerously anemic all the time.
I do not know what the next step(s) will be; save for a few more (some invasive), tests that can possibly be done, safely, in Green Bay.

My child has taught me much.

Please keep her in your thoughts and prayers.

My love to all.
Have a 'wunnaful' Wednesday!

XOXO, and G' night.
me

PS
My apologies for not replying to my latest posts. My fingers are not cooperating much- and I swear ALL of my bones hurt tonight. (Fookin' Reclast poison that I had last April).
I promise to reply as soon as I can.
Thank you to everyone who took a moment to reply! :-)

A Few Thoughts for Casey, for Christmas, for You!


Congratulations Miss Casey!
3 years, and counting!!!



Good Morning All;

I have a feeling that this Christmas is going to be a very different one for us all. (Although I have no idea where that thought comes from).
Feeling very Grinch-like, I have already canceled Christmas in Flintville- (OK everyone, only at my house). hehehe

My cousin, Joannie, called last week to offer me a tree! They grow their own, but sadly, I had to decline. We will celebrate when Casey is feeling better- and after she heals from her surgery/ies.
I offered to celebrate her birthday and her Christmas together, and received an emphatic "NO"
hehehe
So funny!

Perhaps we shall have Christmas in July then!


For now it is "off to Minnesota, and for her to find out (I hope) where she is losing her blood, and how.

Hard to believe that yesterday we celebrated her 3rd year since her TP/AIT. We would not have had her to love had she not had that surgery. In fact, at the rate her organs were failing, she would not have been able to sustain herself past October of 2010 (and that was actually a very optimistic guess on Dr. S.'s part).

I have wash in- and dishes to do yet.
Punk has been 'off her feed' as they say- But not sick-sick. I think she is a bit sad, though I don't know why that is either.  And yes, the 'off her feed' bit is only an expression- She will eat, sick or not. (Kinda like me that way).
hehehe

After seeing the news this morning, I am reminded of the year that Casey marched in the Macy's Thanksgiving Day Parade. As Captain of the Color Guard, she had a 'wunnaful' time. (Yes, she was already quite sick at that time, though we didn't realize it... yet).

* Mark your calendars!!!
This year, Pulaski Red Raider Marching Band will be marching in the Rose Bowl Parade, again, this year!!!
(Casey was even Captain of the Color Guard for a few years)!
WOOT!
WOOT!  
And how cool is it that Wisconsin will be playing?!
An exciting time for all, but the young lady I know that is loving every minute of it is Miss Ashley!
 Here she is, a few years ago (when I still had my Chrtistmas Brunch).

Brandy, Me, Casey, and Ashley! Christmas 2006
Miss Brandy, Myself, Casey, and Miss Ashley too.

My very best to all of the band! They will do perfectly!
Soooo make plans to be watching The Rose Bowl Parade this year!
And of course to be watching the game too
January 2, 2012.
5 Reasons the Wisconsin Badgers Will Beat the Oregon Ducks
* Sorry, Will. hehehe

Speaking of games- (and in reply to Slurkie's question in my guestbook)...
I didn't do anything different...
Well maybe if I would have had my best packers shirt on, as I had for the past 13 games
)... Grrr...
Or, maybe I shouldn't have watched...

We took our 1st loss in 364 days yesterday. (Repeat Grrrr). But there are still ways to obtain that home field advantage, and that is important; although the sports bars all do well, regardless if it is at Lambeau Field, or not.
As do we, as fans. I am quite sure which 'side' I am on- There are people upset about the loss- (boo-hoo), and there are those that say it is best to get the stress of continuing the "W's" out of the way before the playoffs.
No-Brainer, kids.
But I am wondering what the heck Thers did different to obtain Indianapolis' lone "W" for the year?
hehehe

I'd best close for now...
I hope everyone is having a "wunnaful" week!
Hope too, that everyone in the path of the blizzard has full cupboards and furnaces.
- And please, to keep Casey in your good warm thoughts too?

XOXO
Me

Casey, my Right hand Elf! 2004 Christmas
Casey- My Elf- 2004                   

For The Love of Sam! (And Casey's Blood Transfusions).


Happy Sunday!
Here I go again! A Morton salt day for blogging!
hehehe

As you know, Papa Chuck and our young Sam have moved back to Green Bay!
We met at the mall in Ashwaubenon as soon as was possible for all of us to get together. (3 or 4 days after they got here)


Grandma Me!, Daddy Charles, and Young Sam      Casey and Chuck
Sam, Charles, and I-                             Charles and CaseyFace

Oh what joy this brings to me...

Wheeeeee!
Too much fun!

And what a very happy and well-behaved young man too! I am impressed!


"I got some pennies!"
Smilin' Sam!
Grandma had a few pennies in her pocket- to add to his own...



Fun!!!
"Hey Grandma, you watchin?"   But of course. hehehe
(I wouldn't miss a minute)!



Sam, "FUN" On the Slides!
Sam, coming down the slide! He even stopped, mid-slide, so I could take the picture!


Samuel - Chuck's Forearm
Chuck shows off his "Samuel" tattoo!


Sam, Cute, (and worn out)!
"Still watchin' Grandma?"
Oh you bet I was!


Picking up the books- Daddy asked, and no fussing- He just did it!
When it was time to go, and even though he had not made the mess, Daddy asked him to please pick up the books and put them away.
This he did with no complaining whatsoever- And a wee bit of help from Auntie Casey!

Speaking of Casey...

With her blood once again being so dangerously low, the doctor sent her to the hospital to have 2 transfusions.


Casey at St. Mary's
Poor nurse--- as she goes in search of a vein that won't roll or collapse...


"Pull out Betty! PULL OUT! You've hit and artery!" hehehe
Yeah OK, that'll do it.
But it's going the wrong way! (As if she has any to spare)!?


Casey Ordering lunch
After everything got rolling, she got to order lunch! 
*** St Mary's Hospital has a Chocolate Cake that she would order for breakfast, lunch, and dinner if she could!



Greg and I
Greg and I, looking at the cutest 24 year old we know!

A few minutes later, Greg's sister Kim stopped up to see how everything was going!
Another sweetheart!


Kim, Casey and Greg


And just in case you missed the similarities, here is brother and sister!

No denying that strong DNA!  So cute they are!

Greg and Kim
Greg and Kim!

I left before it was over- as they run the blood very slowly-
At the rate it was going it would have been 7pm before she was done.
I was really surprised when the phone rang around 4:30 and they were on their way home already!

Now...
With Casey's blood dropping, even as I type, she will need to return to Minneapolis once more.
They will do some minor surgery to find out where she is losing blood from.
She has no occult blood in her stool, so they are thinking that perhaps it has something to do with one of the surgeries bleeding into her abdomen.
Her appointment is for next Tuesday, the 20th.
Merry Christmas Casey- if they decide they need her to stay there.
At least if they do, it will be to fix her -  again.
I will keep y'all informed.

Please keep her in your prayers?  Sam and Charles too- it is hard to start all over again- But oh!, so worth it!

XOXO
Me

Now if only I could get new pics of all my grandbabies.
~~"Hint-Hint" to William, and Jenné, Katie, and Kristin, and...
hehehe