Monday, October 31, 2011

Sweet Potato: The New Super Glue

I was emptying out the dishwasher this evening, and it was pretty easy to notice that evidently sweet potato likes to stick to things and hang around long after the dishes are done.  We are one of those freaky groups of people too that actually wash all the dishes by hand prior to putting them into the dish washer.  I guess I always thought that the pre-wash was just to remove gross physical debris and the dish washer provided the sterilization, much like how we would prepare surgical instruments for the next surgery.  My husband has been noting for the past week that the fat from the lamb hangs around on plastic storage containers and leaves a greasy film on everything.  Well, the lamb option for my elimination diet may have to be changed soon anyway; Publix is all sold out of lamb due to us.  I feel like such a gross carnivore that only eats baby sheep.

While writing this, I could not help but notice how nice and fragrant by hands smell as I rest by chin on my hand.  Oh wait...that would be the Cascade dish detergent, which I am sure my super-allergic self is not supposed to have any contact.  Why would my dishes require a perfume?

I had my physical therapy session today.  My therapist's office is in this multi-story, multi-professional suite.  Every office section has a Halloween costume contest each year.  The therapy group I see dressed in the theme of Peter Pan, with my physical therapist dressing as Nana, the family dog.   The costume was good; too good.  I kept laughing every time I tried to talk to her, even when I would be trying to get all emotional about my pain levels.  I think this would be the first time that the dog every palpated the veterinarian!
Happy Halloween!
           Josie

The Numbers:  October 30, 2011:  Diet - lamb, sweet potato, pear, carrots.  Medications - Prosed DS every 8 hours, small amount gelnique SID, amitriptyline SID, Zertec SID.  Pain level - hey it wasn't perfect but I will take today.  I think I was about a 3 with urinary pain and a 2 on vulvodynia discomfort.  Wish to have many days like this one.  Lupron appears to be leaving the system, some spotting noted.  Good riddance. 

October 31, 2011:  Diet- lamb, sweet potato, pear, carrots.  Medications - Prosed DS every 8 hours, small amount gelnique SID, amitriptyline SID, Zertec SID, Vagifem.  Pain level - 10-12pm - 5 on bladder pain.  PT today and TENs seemed to help.  Vulvodynia discomfort about a 4 today.

Saturday, October 29, 2011

The Second Exam Room

I need some cheering up, so I'm going to tell one of my most recent favorite stories:

The curse of veterinary relief work is that when you start out that first year, you have to basically interview and negotiate for every stinking day of work.  Is your practice philosophy similar to the owner's?  Do you mesh well with the staff?  Do you communicate well to this client base?  I adore the meeting of each new staff member and the tour of each clinic.  But, during that first day, when I know I am being watched, I can become a little anxious.


Well, about three weeks ago, I was having one of those first days at My Current Clinic.  I was working extra hard to show each client that I was a friendly, compassionate, and skilled veterinarian .  I was finishing an examination of the dog in the Second Exam Room when I turned to exit into the practice's pharmacy.  To my left, I suddenly saw a small dark cat dart through the doorway of the exam room and into the pharmacy.  I gasped and took a few steps forward to follow after it.  Almost every veterinarian can tell you a story about the cat that escaped from the owner and found its way into some hole in wall of the old clinic building.  Or, worse yet, work that cat will find a way to work through the dropped ceiling tiles, into the attic, and out the roof to the outside world.  My sole intention was to grab this cat before it had any similar ideas.  However, after I had darted towards it, I realized there was nothing to chase.  I looked through the pharmacy - no cat.  I looked back in the Second Exam Room - fortunately the owner was busying herself with looking out that back window and not staring at the freak who just provided her dog with his rabies vaccine and chases imaginary cats.  I am mortified.  "I really need to learn to control my stress better," I chastise myself.  Fortunately, I see no staff present, and breathe a sigh of relief that my secret may actually remain safe with me.  I tell no one of the incident.


A couple of weeks later, this clinic experiences one of those crazy busy Fridays, when you feel like you spend the whole day running from one exam room to the other, never quite keeping up and never quite doing the kind of quality job that you intended to do when you first got out of bed that morning.  So, by the time we close down for the evening, I am exhausted and still need to complete examination notes for my afternoon patients while the technical staff is ready to leave.  Heidi kindly asks if I would like to borrow her key to the building, so I can stay late to finish the notes after the staff heads home.  That all around sounds like a very unwise option.  My committed belief in Murphy's Law would make tonight the night that a drawer full of cash disappeared or a bottle of ketamine walked away without explanation.  I decline the offer and decide that I would arrive in the next morning early with the opening staff to finish my notes.  This decided, we start to head out the back door, when Tabitha makes the joke that maybe I was unwilling to stay alone in the building because I am "afraid of the ghost."  I pause, "What ghost?"  Heidi then goes on to explain that people often hear or see an animal in the second examination room...sometimes a small dark cat.

Happy Halloween!
             Josie

The stats:  Food - water, lamb, carrots, sweet potato, and the pear for dinner which I simmered in water for 20 minutes prior to eating (tasty).  Hats off to my husband, who figured out how to determine a good cut of lamb, because it tastes so much better than the past few days.  The pain has been at a constant 6-8 today (poor me!), predominantly bladder pressure, urethra, and the characteristic vulvodynia "acid burn" in the evening.  Medications: Day 4 of methylprednisolone, amitriptyline SID, prosed DS TID, Zyrtec SID, and flexeril in the morning.  Still not convinced the flexeril worked...and may be the cause for the burn.  But at this point, I could blame anything on anything.  Started small amount of Gelnique over bladder.   I will pat myself on the back for handing out Halloween candy for 2 hours tonight at my church's Trunk or Treat and not eating one single piece.

Friday, October 28, 2011

It's all Happy Birthday, but all I get is Easter Dinner.

I cannot say I am sad that this week is ending, and that I received a job cancellation for working at my current clinic on Saturday.  Normally, a cancellation makes me very angry, especially when I had previously turned down a day of work somewhere else (which I had).  Somehow, though, I just can't keep up this week, and I'm not even exercising or cleaning the house.  It's a blessing that work is done for the week, even with making a few less dollars.  I guess when you are commuting to physical therapy 3.5 hours each way twice a week plus 2 visits to the doctor's office for a pain flare up, you lose a little bit of free time.  Maybe it's the steroids I was put on this week.  Who knows.

I had my first real food test today, but I made it through easily. One of the technicians at my current clinic had a birthday.  And, there was a marble birthday cake with frosting.  I love birthday cake.  I'm trying to allow myself a group of coworkers who don't know that medical issues continually invade my mind, as I want a group of peers somewhere that view me as "normal".  Yet, how does a self-professed sugar junkie as myself avoid the piece of birthday cake?  Honestly, a "No, thank you" was all that was needed.  I also noted that I did not spend the afternoon in a sugar slump either - I stayed awake, alert, and friendly.  My physical therapist told me yesterday that lamb and sweet potatoes for a meal are not so bad.  She says it's like having Easter dinner every day.  She asked if I could have mint jelly with it.  I don't think I've ever had mint jelly, but it certainly sounds forbidden.

Until next time,
       Josie

The stats:  October 27 2011:  Only food: water, lamb, sweet potato, carrots, pear.  Pain level - 5 on the drive up to PT (bladder and urethra), which was brought to a 2 during TENS therapy.  Car trip home after 3pm urination (which may have been over concentrated) Pain Level of 8-10 (bladder).  In obgyn's office at 4-5:30pm and hormone panel (FSH, estradiol, progesterone) submitted that evening. (A side note to my friends out there - If you ever want a good nurse to pull your blood for laboratory work, go to the city ER in the evening.  You will be the easiest lab stick of the entire night, probably the only patient who is not hypovolemic!)  Medications: methylprednisolone Day 3, Prosed DS every 8 hours, amitriptyline SID, vagifem, and flexeril for emergency pain flare.  Did the flexeril work?  I still don't know.

October 28, 2011  water, lamb, sweet potato, carrots, pear.  Pain level hovering at about a 3- urethra and vaginal burning.  Medications: methylprednisolone Day 4, Prosed DS TID, amitriptyline SID.  Home PT stretches and strengthening exercises BID .  Dilators.  Flexeril post-PT.

Wednesday, October 26, 2011

Science Diet Lamb and Rice

Worked a  long shift today, and of course at some point I see a little dog with a suspected food allergy.  (I say "little" but I guess I should qualify the use of that word.  This sweet little dog was actually quite large, due to obesity.  The poor thing would do well as the footstool/ottoman that our living room sadly needs).  Trust me when I say that the irony of all of this was not lost on me, as I thought about the 3rd meal of lamb and sweet potato that I have eaten in the past 24 hours.  Wow, this sucks.  I knew this would suck, and it really really sucks.  That dog should come to live at my house; we could share food. But, since the dog is this fat, I guess I have quite a suspicion that it might not be following his elimination diet too well. 

It is kind of funny how lamb ended up being my novel protein.  I have eaten it, I believe, a total of 3 times in my life.  I avoid it for ethical reasons.   I mean, who would want to eat a baby sheep?   I wish I had avoided bacon for ethical reasons.

This log of my journey into my elimination food trial would not be complete without the mention of last night's  loading dose of my steroids.  Yuck!  I was up until about 2:30am (which means that my poor husband was up just as long), urinating repeatedly, panting/pacing, and altogether just freaking out like a dog with Cushing's disease.  Fortunately, the morning greeted me with some calmness.  But, here's a thought I had not anticipated: think about staying up half the night and not getting to drink a Coke or coffee in the morning.  Not cool.

Regards,
            Josie

Today's diet:  lamb, sweet potato, carrots, pear
Medications - Day 2 on methylprednisolone, Prosed DS TID, amitriptyline SID.
   Early afternoon dizziness (lack of sleep or steroids?)
   Burning at 3:00 pm urination.
   Over-all obgyn aches and pains (cramping at region of right side ovary)
   Mood - in the pits   

Tuesday, October 25, 2011

Dr. Oz's Elimination Diet

There is a Number One absolute rule about starting a hypoallergenic elimination diet.  I know this, because I am a veterinarian and weekly try to talk my clients into running a hypoallergenic food trial on their allergic dog or cat.  I would guess that no matter how much I beg them to stick with the diet, probably only about 25% ever strictly complete it.  The true number is probably way less, since people lie so often to their vets on compliance issues.  Maybe it's only 5 or 10%.  They aren't lying because they are bad people; I don't think that at all.  But, it's so hard to stick to it, especially if you are constantly trying to keep all the other aspects of life in check.  There simply may not be enough time in the day to make sure that Fido is staying out of Fluffy Kitty's Meow Mix, and Junior is always dropping cheddar cheese Goldfish crackers from his highchair.  So, that is what brings me to the Number One rule: obey the elimination diet, without fail.  Just a crumb, just a taste of the offending item can trigger the allergic attack.  Ironically, if you are lucky, the attack will be severe enough to make you realize, "Hey! I messed up here!".  Then, you can take a step back, take your steroids, and start again.  But, I think most of the time, the antigen is not enough to fully wake you up to the mistake you have made.  Maybe your dog's skin just stays a little itchy.  In the end, nothing is severe enough to make you realize that your dog has continued to ingest the offending antigen all along, and you finish up by stating, "Hey, Doc!  Your food trial didn't work.  I guess Fido isn't allergic to beef like you said he is."  All this, and Fido's and Fluffy Kitty's food all arrives in a pre-packaged bag (although an expensive one); all you have to do is pour. 
       
People appear to be a little different.  I just can't open up the bag and eat from it.  I guess I should be thankful that I get some variety, although the chore of trying to eliminate all possible offending items while maintaining ingestion of all important nutrients seem to be a bit of a challenge.  Even worse, is that constant need to write down what I ate, how I felt, what it was like to use the toilet.  Just the thought of over-analyzing everything in a little journal makes me squirm.  And, when I am uncomfortable, I want to vent.  In case you haven't figured it out by now, I'm starting a food trial...tonight.  The food trial does not really come from Dr.Oz.  I just like him, and I see that he has recommended elimination diets in the past on his show.  Somehow, it makes the decision to start one a little easier.  There is a quiet excitement to it, like we might really learn something through this that could directly impact our lives for the better.  He seems so friendly.

So, as I eat my Last Donut (from Dunkin - strawberry jelly with a regular sugar coating), I can just say that this blog is a gift to all of my 178 Facebook "friends".  I will spare you my venting.  My venting I am sure will be read by no one, quietly floating around in the quiet anonymity of cyber space.  Just for me to read, and record, my daily progress.

For now, we won't think about Rule #2: don't start elimination diets during the holidays.
       With Joy,
               Josie

Day 1: started at 9:00 pm
Food for the day: 7:00 am Life cereal with coconut milk. 
                           10:15 am Feel sorry for myself Dove milk chocolate
                           11:30 am Shoot!  I wasted 1 hour and 15 minutes feeling sorry for myself.  Now, I have to eat this stupid bologna, American cheese, Ritz cracker Lunchable because my job interview is in 30 minutes.  Ooh!  It came with Sour Patch Kids.  Did not drink the Capri Sun (what's in those anyway?)
                           5:00pm Trader Joe's flat pizza.  Boston cream pie yogurt
                           8:30 pm  Last Donut (see abovc)
                          
Medication:  1st day of methylprednisolone sodium succinate (my body is going to love this one), Prosed TID, amitryptilline, vagifem
Tomorrow:  For real Day 1 of Diet trial.  4 chosen foods: Lamb, pear, carrots, sweet potato.  I hate sweet potatoes.