Saturday, December 15, 2018

Managing #Aortic #Dissection, Making A Switch From Coffee to Marshmallow Root Tea in Mornings

Coffee has bee shown through studies to be good for one's health in a number of ways.
Aortic Dissection.  Replacing coffee with marshmallow tea for Barrett's Syndrome caused by my medications.

But I quit coffee.

I'm now drinking marshmallow tea in the morning and I love the taste.

Marshmallow tea is easy to make.  Pour simmering water over the root in a quart mason jar and let seep overnight.  Heat up the tea the next morning in your rice steamer.

Marshmallow root has a long history of healing inflamed tissue.

After reading yesterday's post about my Barrett's esophagus (hey I learned how to spell esophagus) I know marshmallow tea is a healthier choice over coffee for me, personally.

So far so good.  Marshmallow tea has a rich bold flavor like java with an 'awakening' aroma.

I'll update as I see how marshmallow tea interacts with a complicated body chemistry of #aorta medications.

#Dissection life is ever changing!

Friday, December 14, 2018

Aortic Dissection Meds, Trouble From Ingesting Them Incorrectly

Seven years of daily aspirin, warfarin, amlodipine, ACE inhibitors and other medications to help manage my aortic dissection have unfortunately given rise to another health challenge.
#Aortic #Dissection meds may have contributed to development of Barretts Esophagus

My new health challenge probably would have been completely unavoidable if I had incorporated a few simple habits into my medication routine.

My endoscopy last week indicated I have severe esophageal erosion, more commonly referred to as Barrett's Esophagus.  Barrett's may lead to esophageal cancer.

Not all cases of Barrett's Esophagus will lead to cancer, however esophageal cancer is one of the most deadly forms of cancer known.

Typically Barrett's Esophagus is caused by acid reflux.  Risk factors may include obesity, smoking, drinking and acid reflux due to hiatal hernia.  I do have a small hiatal hernia but have never experienced acid reflux.

I don't smoke or drink and my BMI is on the low side of normal at 20-21.

Connective tissue disorder issues (#Marfan Syndrome) may have contributed to the small amount of hiatal hernia yet my doctor seemed to think my Barrett's may have been caused by years of aspirin use, and more importantly, the way I took the aspirin and other meds.

Interestingly my small intestines and stomach showed no dysplasia or significant issues.

But my esophagus was inflamed, severely inflamed.  The biopsies showed major changes to the esophageal cells but no cancer yet.

I am now scheduled to have an endoscopy every two years to make sure that if Barrett's does progress into cancer, it will be caught early and hopefully in a treatable stage.

The photo in the top right of the picture above is taken under a special light on the endoscope to highlight the area of Barrett's.

Perhaps the changes to my esophagus could have been prevented if I had followed the procedures here for proper taking of medications.

As I do now but did not do for the first seven years post dissection, I take a couple of sips of water first, before placing medications in my mouth.  Those few sips help lubricate your esophageal lining and facilitate the capsules or tablets movement on their way down to the stomach.

Once I take my meds I immediately drink a full 8 oz. glass of water.

Before my recent Barrett's diagnosis however I'd pop my meds in mouth and take a sip of coffee to swallow them down.  From time to time I'd even notice that they may not have all gone completely down and I'd take another sip.

Importantly the stomach and small intestines can handle most medications.  Our esophagus though is much less resilient.

Interestingly, once the esophageal lining cells have been damaged, intestinal type goblet cells colonize the esophagus.  These changes can be a precursor to adverse health conditions.

Swallowing aspirin over seven years each morning with a sip of java, has eaten away at my throat.  In fact, some days I'd even chew metoprolol and swallow without water hoping to slow down a really fast pulse even quicker.

Barrett's is not always attributed to oral medication administration yet it can really help reduce risk simply by taking a few sips first then a glass of water after swallowing one's meds.

Aspirin may not affect everyone the same way I believe it has me.  But as of now I am off aspirin and taking my medications with plenty of water.  As always discuss any changes to your life with your doctor before attempting them.

Live and learn.  #Dissection Life teaches me something new each day.

Monday, December 3, 2018

#Aortic Disability Issues Shouldn't be So Difficult to Understand for Non-Disabled

#Aorta Two objects on a table, one is my Telmisartan the other a screw driver bit for my drill.
Come on.  I mean the hardware store manufacturers understand ins and outs of how tools work.  Maybe that's because they were once tool people themselves.

I would suppose most pharmaceutical company employees are not disabled.  Probably some are health challenged themselves or may be disabled.  Yet my perception is that most of them are just rich.

O.K. That last sarcastic comment was underserved.  I am grateful for all my medicines without which I would be roaming the rainforests looking for the right medicinal sprout, leaf, flower or bark.

Disability and aortic dissection life is difficult enough without thoughtless non-disabled persons medical packaging designers making life more stressful.

The two items on my coffee table above are A. a single Telmisartan pill for my blood pressure I take every morning and B. a screw driver bit for my electric drill (actually its a battery powered drill).

So what's the big difference besides the obvious variant uses???

I need reading glasses to see small objects up close.  I also need them to read.

And I keep all my many various size screwdriver bits in a box, all jumbled up.  Yet if I have to use one particular type or size I don't need to stop and put on my glasses and jumble fumble trying to find the right size in the full box because some very intelligent tool person gave thought beforehand realizing an inexpensive color coding stripe might really make life easier for someone looking for a particular size/shape screw driver bit.

I call that genius.  Thoughtful genius.  Probably because the person who came up with the color indicator idea had 'been there done that' looking through a box of almost identical looking screwdriver bits for the right size, wasting a lot of time and probably building up anxiety in the process.

But nope for the Telmisartan.  Four corners and one of the corners has a tab that is confusing at best for a short clipped fingernail to find and pull back.

#Aorta Dissection Life, Telmisartan is difficult at best to open.
The back of the pill container does say 1. Tear . Peel.

But where do I tear & why is it so difficult to peel?  Reminds me of a roll of masking tape that is five years old.  You know, that roll where tape comes off in tiny pieces and is impossible to slide a fingernail under any of the layers.

I'm not complaining.  Telmisartan is a great drug IMHO, better so than Losartan for me because of lipophyllic properties and longer lasting effects.  Does a better job at keeping my aorta from dilating more.

In fact last CT showed a decrease in aortic diameter though I am suspecting the decrease is a variance in the way different radiologists read the CTs.

So cheers for Telmisartan.

Now why can't the pharmaceutical companies take a clue from the tool manufactures and color the corner of the pill envelope where the tear here part is with a noticeable symbol or color?

I don't usually lose my reading glasses but it is a hassle to put them on just to open a telmisartan package.

Even more hassling is the, nope - its not this corner, nope - its not this corner, nope - its not this corner, nope - its not this corner, wait - is it this corner?  Did I miss the tear here?

A really good answer would for the medical industry to hire more health challenged persons or at least seek input from disabled end users as to 'improvements in efficiency'.

I am sure there are persons out there who have become so frustrated with trying to open these little packets of meds that their stress levels soar as do their bloood pressure.  Maybe they even invent curse words I've never imagined.  Possibly hammers have been taken to these obnoxious little packages.  Its a shame that attempting to use a blood pressure medication actually raises blood pressure.

But this is typical disability life, not only for aortic dissection survivors but for all of those who have to struggle to open a package of meds.

Yes I'm sure the medical industry can retort with the packaging safety issue answer.  But that's not excuse, or if they think it is it is a really lame response.

Just add a little red arrow to the package pointing to the corner to tear.

Doing so might make the blood pressure medication a whole lot more effective.

Want to be the best pharmaceutical company around?  Make sure you hire or seek input from the medically challenged.

And while you are at it, please add a colored arrow or symbol on the corner I am supposed to 'tear'.







Saturday, December 1, 2018

Aortic Dissection, Bridging Lovenox From Warfarin For Outpatient Procedures

High tech hypodermic syringes full of low molecular weight heparin fill the refrig door.

Low molecular weight heparin is commonly know as Lovenox.  My cardiologist bridges me off warfarin using Lovenox for a couple days prior to surgical or  other procedures.

Typically I stop taking warfarin two days before an endoscopy or colonoscopy and give myself Lovenox injections.

Lovenox does not usually or significantly affect PTT or INR.  Yet Lovenox is also considered an antithrombotic substance and reduces blood clot formation.

Since my St. Jude mechanical valve can provide a platform for clot formation I require Lovenox when abstaining from warfarin.

Aorta Dissection, Lovenox (Low Molecular Weight Heparin)
My GI doctor likes my INR to be below 2 when conducting an endoscopy, which I will be having done this upcoming Monday. So I need wean myself off warfarin to drop my INR.

All the medications I've been taking may have been having a negative impact on the mucosa lining in my digestive tract.  I suspect aspirin is the primary culprit, along with too much coffee.

So I picked up the preloaded Lovenox syringes from the pharmacy.  Honestly the syringes appeared to look like something out of a fiction flick.

The syringes had an automatic cap enclosure that would spring up to cover the needle once I injected myself with Lovenox.  Obviously the purpose of the auto closure cap was to keep someone else from being pricked by a needle in the trash.

Aorta Dissection, Lovenox (Low Molecular Weight Heparin)
Being a pumphead recipient though, complicated instruments with multiple twists, turns, pulls and pushes, springs and levers can be despairingly confusing.

Well, I asked the pharmacist.  How does one use these syringes?  Do I need to take the cap of the needle?

Hmmmm, he replied.  Let me see.  The pharmacist looked at the syringes.  I've never seen these automatic cap closure types before.  No, I think the cap stays where it is.  You should be able to push the cap against your stomach and the needle goes through the cap and injects you with the Lovenox, then springs back inside.

Oh. Ok, I said.  Thank you.  I'll give it a try at home.

At the house I opened the package and removed the syringe, wiped the injection area with rubbing alcohol and gently pressed the cap against my right stomach area.

Nothing happened.

Maybe I have to push the plunger harder, I surmised and tried again.

No needle, nothing, nada.

Sheeeeez.  I examined the hypodermic closely with my reading glasses on to see if I was missing something.  There were no directions on the package.

Ok.  One more time really hard and I jabbed.

Nothing.  Fortunately I'd not destroyed the syringe or had the Lovenox squirt out the sides of the plunger.

Fortunately too there is you tube.

So I found a link on how to use a self closing hypo and the cap does need to be removed first.

Ahhhh as a bona fide pumpheader I possess valuable how-to tools with my youtube magnifying glass option.

Injection done and complete.  Another tomorrow then endoscopy Monday.  Then a couple more days of Lovenox and warfarin until I'm back above 2.5.

I am so proud of being able to navigate this high tech world of medicine even better than my pharmacist in this instance.

Lol.  Dissection Life.

Tuesday, November 27, 2018

Aortic Dissection Life Lessons Learned Seven Years Post Op

Δακρυόεν γελάσασα
Its been seven years today since severe back and jaw pain prompted me to drive to Memorial Hospital in Jacksonville.

Unfortunately I didn't think to call 911 and parked in the parking garage on the opposite end of the hospital campus from the ER.

Walking from the car I just really wanted to sit down in the cold night and close my eyes. But I kept walking until the glazing lights of the Emergency Room sign shown close by.  Sliding glass doors opened, I walked up to the desk and thankfully the ER doctor on call quickly ordered a CT scan.

And the the rest that followed is detailed on other pages in my blog here.

But what has living for seven years with a Dacron ascending aorta, a St. Jude mechanical valve and an existing extensive dissected descending aorta taught me?

Medical technology is amazing and with every day new procedures are perfected.  No longer is an ascending dissection always lethal.  The first year I was sure I was going to die any day.

I still think I could die any day but so could any of us.  Even my cardiothoracic surgeon often says, "if I didn't see you sitting here talking to me I'd think from your CT scans you would either be dead or on an operating table".  Yet I still wake each morning.  I call it successful adaptation and LUCK.

Seven years has dulled the anxiety of living on a thin line between life and death.  Living with a connective tissue disorder (Marfan Syndrome - for more info visit The Marfan Foundation website) I know genetic challenges are always present.  Today I am really surprised but happy and grateful when I awaken each morning.

Seven years has impressed on me the importance of awareness.  Every ER medical staff should think CT scan first sign of chest or jaw pain.

Seven years I've read and repeated the 'Ritter Rules' every day.

Seven years is time enough to reflect on love of family and show me how much I appreciate my wife, parents, children, grandchildren, siblings and nieces and nephews.

Seven years has given me an opportunity to make and reestablish amazing friendships.

Seven years opened my eyes to how much people really care and will do to help.

Seven years has allowed me to meet many other aortic disease survivors, many of whom I am close friends with, one whom I've emailed back and forth every day for six years, others of whom have untimely passed away.

Seven years has expanded my neuroplasticity to where my mind is now open to on-going learning.  Even though my cognitive function has been compromised due to small strokes from my time on the heart-lung bypass pump, other brain areas have opened up offering opportunities to see life as I never could have before.

Seven years have replaced once fluent speech with ability to express ideas through fun and (I think) amazingly beautiful art rather than spoken broken words.

Seven years has allowed me to take an extra step each day, strengthening my body from not being able to sit up to now move about (though my cane or crutch is always at hand).

Seven years has been time enough for me to learn appreciation of nature and just how beautifully amazing our universes and cosmos are.

Seven years has gone by so quickly I've learned accumulation of things is of no interest to me, rather giving and sharing love is much more my want.

Seven years has been plenty of time to learn about a natural diet of real food.  I call this way of eating 'LIFE', or Local In-Season Fresh Eats and I avoid sugar, processed foods, am a vegan/pescetarian for most days and feel healthier for it.

Seven years has taught me to appreciate the hard work of nurses, doctors, technicians and all health care workers and yet too I've learned that I must be my number one health advocate.

Seven years has taught me what disability life is truly about.  Though cities have many disability assistance efforts, it is amazing to see just how difficult disabled living in the 'normal' system can actually be. However as with speech difficulties replaced with other abilities, so too living in a world designed for 'normal' healing persons spurred me on to discover new abilities and open new doors and explore new ways of surviving near death.

Seven years has been plenty of time to learn arts of adaptation.  Adaptation is survival.

Seven years has gifted me with love for each breath, each moment.

Seven years has allowed me to see the children become launched and self supporting.

I've talked to my parents on the phone every day for seven years now.

Seven years has taught me to love rubbing my wife's feet and realize she is my best friend.

Seven years allowed me to experience the best healing therapy - finding what you love to do best and plunging headlong into the fun of what you love to do.

Seven years has brought along 221 million (221,000,000) successful opening and closings, or 'beats' of my St. Jude mechanical aortic valve.  That is precision bionic manufacturing.  In another seven years that'll be close to half a billion beats.

Seven years has allowed me to listen to the songs of birds.  I am especially fascinated by the mockingbird's mimicking tunes, the wren's fuss and osprey's screech.

Seven years has given me the opportunity to study flower petals and sepals in detail and realize mother nature is the ultimate artist and teacher of color theory.

Seven years is only a minuscule amount of time compared to the age of the earth and in fact seven years has flown by so fast it seems like a blink of an eye.

Those seven years have molded my brain to where I know that I do not know.  So now I am free to learn and experience new each moment without cliché meme type prejudice.

And seven years is only the beginning.

I am so very grateful for it all.  I would not be who I am today without walking through the aortic dissection experience.

I am so very grateful for all those I love today.

I am so very grateful for the earth, sun, moon, nature, fresh air, clean water, fresh food, good medicine and so much more.

My words I want to write won't form in my mind even though I want to say so much more about gratitude and love.

But I am really very happy for every challenge, every joy, every experience these seven years have gifted to me.

I don't wish aortic dissection on anyone.

To all those succumbed to dissection and rupture, RIP.  We miss you and always will.

My aortic dissection has been my genesis.

It has been a hell of a seven year ride.  One I'd never trade away.

Δακρυόεν γελάσασα, Homer, Iliad VI.















Salt Implicated in Aneurysm and Aorta Dilation

#Aorta health is supported with low sodium diet
A low sodium diet can provide benefits to #aorta health. 

The study linked here suggests a highly probably relationship between salt intake and aorta aneurysm and aorta diameter dilation increases.

I know personally if I eat salty food during a day my evening blood pressure will increase, systolic by up to ten to twenty points.

Salt causes our body to retain water and promotes swelling.

Limiting salt intake and adopting a lower sodium diet can pay off with aortic health support.

Friday, November 16, 2018

Beta Blockers after Aortic Dissection & Weight Gain



Beta blockers, specifically metoprolol, were prescribed to me after my dissection.  For seven years I've taken 200mg of metoprolol each day.

Beta blockers are one of the main medications used to managed descending aortic dissections because of their effect at suppressing the hormone epinephrine.

Epinephrine is also known as adrenaline.  Suppression of epinephrine slows my pulse down and somewhat decreases my blood pressure.

A slower pulse and decreased blood pressure places less stress on my dissected aorta, lessening risk of further damage.

One of the side effects for many on beta blockers is weight gain.

Because our heart beats slower our metabolism drops.  Over the years I've noticed my caloric requirements have been substantially reduced due to my slower pulse and metabolism.

Staying active is important while on beta blockers if your doctor approves.  I find walking is the best way for me to balance my slower metabolism with my beta blocker medication.

Check out this link for an interesting article about beta blockers and weight gain.