My Present to You for 2018

Ok, a couple of years ago I asked everyone to stop giving me presents for Christmas and birthdays. Seriously, if I want something, I pretty much buy it if I can afford it…and if I can’t afford it, then it is surely more than anyone should spend for me on a present. Instead, give money to a charity of your choice while thinking of me. In exchange, my gift to you is similarly a donation to charity. The first year (2016), I selected the North Texas Food Bank. 2017 found my donation (and those from many of my friends and family) going to the American Cancer Society.

I’ve decided that my gift to you this year is…that I’m still here. Wait, what! Just kidding. I just donated a square, a circle, a triangle, and a dodecahedron amount to the Ronald McDonald House Charities (https://www.rmhc.org/) North Texas chapter. The RMHC provides housing and support for families who have children going through serious medical situations so that the family can be near the facility providing for their medical care.

Nearly 20 years ago I went to a B’nai B’rith charity dinner where the keynote related a story that I’ve heard several times, since, but still find worth repeating.

A man is walking along the shore where a freak tide has washed tens of thousands of starfish up onto the beach where they will all surely perish. As he walked along, he would stoop down and pick up one starfish after the other and throw them far out into the water. Someone watching this walked up to him and said, “Why are you bothering? There are so many, the few you are throwing back into the water won’t make any difference.” The man reached down, picked up another starfish and threw it out into the depths. “To that one, I made a difference.”

So, toss a few coins in a bucket this weekend while thinking of me, and make a difference.

Throat Blog — Gut Reactions

So, I’ve been having some digestive and gallbladder issues for about 10 weeks, now. I met with a surgeon to discuss options for getting the tube taken out of my gallbladder. She actually remembered me from last year when I had the emergency small intestine blood clot surgery. She walked in as part of the surgical team, expecting to see someone laying in bed holding onto life by their fingernails. Instead, I was up and in the guest chair. She said that they were all amazed…none of them had any idea that I could even move myself. But, once that clot was out and the pain removed, I was really not in that bad of shape.

But, wait, I digest…er…digress. Actually, definitely digress, as digestion is the problem I’ve been having. So far, all the doctors seem pretty inclined to blame it all on my gallbladder. But, I have several issues with that. First, my main and persistent symptom (steatorrhea) started 4-6 weeks before I started having any overt gallbladder issues. Then, the first three trips to ER with gallbladder pain, all CT scans showed that there was nothing wrong with my gallbladder (at least, not that could be detected by CT). While there are some small gallstones, none of them were blocking my bile ducts…and none even seemed large enough to do so.

The GI doctor I went to actually planted a seed of an idea that has taken some root. He gave me strong antibiotics to treat a suspected case of SIBO (small intestine bacteria overgrowth). He mentioned that this could have been caused by an area of my intestine where food was moving very slowly for some reason. After getting the tube put into my gallbladder to keep it drained, I immediately scheduled an appointment to discuss what it would take to have it removed (the tube and/or my gallbladder, if that is what it takes). Meanwhile, symptoms continued, although the gallbladder pain has mostly receded. And, I though some more about what the GI doctor said. Then I tied together a couple of words I knew from the various procedure I had and put them into a Google search. The first word was “anastomosis.” In my case, this refers to where my intestines were reconnected after nearly 4 feet were removed. The other word was “stenosis.” I knew this from some neck/back problems I’ve had…cervical stenosis is the narrowing of the channel where the nerves pass through the spinal cord.

My suspicion is that my intestines have narrowed, either due to scar tissue, collapse, or swelling, around where they were sewn back together So, I searched with the terms “anastomosis” and “stenosis” to see what would come up. And what came up was a condition called “anastomotic stenosis.” Pretty dang close. This is not very unusual for people who have had a gastric bypass procedure, and is treatable several different ways, depending on how it has specifically developed. Beyond just the steatorrhea and gallbladder symptoms, several other things have been going on that would be consistent with this:

  • Very fast to get full when I eat (so I’m slowly losing weight)
  • Very slow to get hungry, again
  • Localized borborygmi (borborygmi is the gurgling sound that emanates from your gut). Borborygmi is normal, but usually doesn’t always occur in exactly the same place. For me, shortly after I eat I get a lot of the sound of air bubbling and gurgling and it is always in my upper right abdomen…right where the reconnection point is.

I think it could also explain the gallbladder issues…if the anastomosis area became inflamed, it is very close to my gallbladder and bile ducts and the inflammation could have spread to those areas, as well, affecting their function. It could explain the steatorrhea…since my food is basically sitting in 1 foot of small intestine for a very long time, it could interfere with the proper digestion/absorption of fats.

So, I gave my suspicion to the surgeon. She was quite doubtful regarding my self-diagnosis, but agreed to order an upper GI to either confirm or eliminate that as a possibility. Her diagnosis is still that all the problems can also be explained by gallbladder.

She wondered why I did not go back to my original surgeon, who was just down the hall. Well, basically, it is because that isn’t who my appointment was made with. So, she scheduled me for a couple of tests and advised me to make another followup appointment to go over those test with him in the next couple of weeks.

Well, that sounded great. But, I can’t get in to get the upper GI until 12/26. So, instead of maybe having an answer in a couple of weeks, this looks to drag on for another month or more. Meanwhile, part 2 of my voice restoration surgery is tomorrow, appointment with my GI doctor on Thursday and I have at least one, and maybe 2 appointments with the team that put the tube into my gallbladder next week (I think someone messed up and double-booked me).

So, look for an update later this week on how the new voice is. Hopefully I can start yelling at people on the freeway, again, real soon.