Journal

2023 - Week 39 Cooking

I went to my follow up primary care provider appointment, and I’m back to being just barely mildly anemic, which, by comparison, feels pretty good. I have one more test this week, small intestine study, and after that I should be at about as normal as it gets. Everything else appears to have gone back to normal and I’m supposed to stop taking my iron supplement. So progress. I started using the iOS 17’s mood tracking to keep closer track of what is going on, and even though the times of darkness are there from time to time, so far, content or neutral feelings are what mostly gets recorded. Which is as I generally expect.

Balloons from Hospital Stay - Helium Loss

After my hospital stay, we brought home the balloons and they slowly lost height over time. I had a funny idea of making it into a race to the bottom, which people seemed to enjoy. So here is the photo set over time (June 18, 2023 through August 21, 2023).

Hopefully Máni will be able to make it back into the living room, now, since the balloons scared him. The same with the ceiling fan, which is why we never turn it off now, so perhaps that talks to some trauma he had as a very young kitten (son of a feral mother).

2023 - Week 34 Cooking Results

Sausage

Chili and cheese hot dogs…they were ok.

Bangers and Potatoes

I thought I had some additional potatoes then the ones I bought at the farmer’s market. However, they had gotten a bit gross, so I tossed them. So less potatoes, but bangers…good things.

Eggs and Bacon Sandwich

Delayed

Chicken Salad with Kimchi

I followed this for the most part, but did end up skipping some of the oil, and the sesame seeds, though I added toasted sesame seed oil and then adding mayo. I figured it probably wouldn’t be great to eat tiny seeds when I was about to have a colonoscopy. I liked this overall it was nice, however when I was fasting the next day to prepare for the colonoscopy, it was there, tempting me, calling me to eat some of it. But I resisted.

I had my 4th or 5th colonoscopy earlier this week, less than 5 years after my previous one. The prep was a bit different, though that may be that I forgot the last time, and a kind of annoying change. Waking up early, drinking the last quarter (more like fifth) of the solution wasn’t exactly how I wanted to spend my morning. Things turned out ok. One benign polyp. After we stopped by 5 boroughs bagels. I ate the bagel with smoked salmon and capers, while Shannon drove us home. I felt awake, but after trying to watch a show, I started to nod off. I went upstairs and napped for a good 3 hours. That night, we picked up sandwiches at the Cheese Shop for dinner.

Going out to pickup dinner on Saturday, I realized that Ingersol Live was going on as parking was challenging. I did find a spot, and got in and out right quick.

2023 - Week 33 Cooking Results

Sausage

Bacon and Cheddar, good things.

BLT

The tomatoes were starting to go, so I grabbed some of the cherry tomatoes and sliced them for adding to the sandwich. That plus hook’s 3 year, mayo, bacon and a sourdough bread. Good Things.

Eggs, Tomato and Bacon Scramble

Chopped up a tomato added that after the bacon was almost done, then let the eggs fill in the space. Pretty good.

Skillet Tortellini with Sausage and Cherry Tomatoes

This is so easy to put together and with the fresh cherry tomatoes, good things.

Brazilian Chicken and Rice

Easy to put together. bought a new spice grinder for the purpose of grinding annatto. The one I had before is more ore less basically useless. I added a bit of extra water, to control the rice a bit more, and everything really cooked up as expected. As I’m not quite sure what a Brazilian flavor profile is like, i’m not sure what else to add to this, but I did add a couple of dashes of hot sauce for my own bowl. It was good, easy to do and has lots of leftovers.

Lamb Burgers with Corn with Cherry Tomatoes, Ricotta Salata

In trying to get that iron in my diet, lamb and beef are around the same, so why not do that?. Good things. I made a side salad and used feta instead of the Ricotta. Everything came together pretty well and I was happy. The combination of the tomatoes and the corn with some fat and acid, was quite good.

I made my first trip down to the farmer’s market, since I went to the hospital in June. It was nice to get there early enough to avoid the general ruckus, but still feel the presence of others. I even didn’t have my headphones on for most of it. I picked up a few things, ate some breakfast and then headed home. It was pressing my abilities a little but I got through without feeling faint, which is a positive. I have been feeling a lot more normal and with the normal amount of energy.

Progress

After a couple weeks with quite a bit of an iron supplement, my latest hemoglobin reading was up to 10.8 g/DL (up 2.2), so I’m gaining ground on getting back to normal after a bit of a set back.

Things that seem to be returning to normal is the relative difficulty, because of to much energy, falling asleep before 10:30 PM, now that seems more to be a bedtime marker, like I have previously set my watch to remind me.

However, my ferrous sulfate reading is still a bit low, looking at the history, it’s quite a bit lower then the reading from several years ago, but that seems as a meaningless context right now. I suspect I’m using almost all the ferrous sulfate is being used to generate blood. But I guess we’ll see the next time around.

After a just shy of 8 weeks of sobriety, I broke my streak by having a bit of Connemara peated whiskey on the rocks. This was after we got home from seeing Barbie (which was delightfully subversive). This was a general test to see how it impacts me. Generally it went about as much as I expected.

Setback

While I haven’t been normal, I had felt that I was getting better, but about a week and a half ago I started to feel drained, even with the lower marks that I expect. Friday 7/7 I even had to take a nap before the end of the work day. I messaged my provider earlier in the day and asked for another CBC test, which he approved.

After I got the test, on 7/10, it was noted that my hemoglobin had dropped a bit to 8.6 g/dL, which is still above the level that I left the hospital, but lower then 6/19 test after my last doctor appointment.

I have taken a a nap here and there during the day, limiting it to 15 minutes usually, and I was prescribed a lot of (OTC) iron supplement.

This is not the first time I’ve been on iron, as I have had anemia in the past, but it’s been the first time in a while.

I have a follow up blood test in a couple of weeks, to see how my body is doing, but it’s certainly frustrating to not be me.

As it stands, because I am uncertain what the impact will be, I am now at an unintentional 6 weeks (42 days) of sobriety.

2023 - Week 28 Cooking Results

Sausage

I used the second set of the Smoking Goose’s Kitchen Sink Sausage. Still quite good.

(Western) Iowa Loose Meat Sandwiches

Last time, I thought that it would be 2.5 teaspoons, and I think I was about right. Another half a teaspoon probably wouldn’t hurt, but again, this is pre-ground Costco pepper, so there is probably some loss here. I went back to the spongy plain white buns, but used a pre-sliced “sharp cheddar” (known mass market brand) and that added a bit, but not exactly what they wanted. Topped with ketchup and mustard, as it should be. I think that’s about what it should be and I’m pretty happy here.

Brown Butter Scallion Noodles

Super fast. I added some pre-cooked chicken and toasted them with the noodles. Good dinner.

Spicy Potato, Bok Choy and Shallot Hash

I suppose the potatoes that I go where not “Medium” as one of them were larger then the half pound that, after dealing wit h that this came together with a bit of the Bok Choy from Blue Gate to make a nice meal. I used the Lola’s Original hot sauce and it was a nice meal.

Beef Stir-Fry with Bok Choy and Green Beans

As my wife is not a huge fan of (non-ground) beef, I had to be very careful in the slicing and cooking of this as to make it relatively tender. I made this on a Saturday since there was a lot of prep and waiting. I meant to start earlier but I had done some kitchen cleaning, when up stairs and meant to just catch my breath a bit, but ended up falling asleep for a bit. I eventually got up and took a shower and started cooking. I made some Moroccan mint tea at the same time as well. I did make one minor error where I combined the sauce into the beef, but was able to adapt a bit but pulling the meat out and then cooking the sauce a bit longer when it would’ve normally gone in. I also added a bit more oyster sauce at the end to cover for that adaptation. Overall, pretty good.

Egg and Sausage Muffins

Crooked Gap breakfast sausage patties, Eggs, a bit of Challerhocker. Good times.

2023 - Week 27 Cooking Results

Sausage

I saw Smoking Goose’s Kitchen Sink Sausage at the cheese sho, so we bought that. Quite good.

Mac & Cheese

ehhh…I mean I had to add more spices, cause I had to. I Alton’s remains my favorite.

Hamburgers

With the 4th of the July on hand, we stayed in cause I pushed myself way to much over the past weekend. So some burgers, some chips and dip and an early night.

Broiled Salmon With Chile-Lime Mayonnaise

I didn’t find the harissa at the store I was in, the one I had in my fridge was a wee bit moldy, so that got tossed. So I used a bit of the Momofuku chili crunch (standard) the mayo and the brushed the salmon with that and broiled then baked. Not a bad audible call.

Hot Honey Peanut Noodles

Very fast, quite good, simple.

I had planned on going to the Mountain Goats show on this past Wednesday, but after over exerting myself, and having to have a end of day and close to end of day naps, I figured it would be very hard to stand for 2-4 hours in a warm humid concert (possible), as the combination of heat and humidity makes me tired real fast. My doctor took my suggestion and I’ll be able to get a mid appointment blood test to check on my levels.

Recovery

The first day we were out Shannon drove me to run a couple of errands. Since my menu plan was shot for the week, I needed to get new buns, and I got to pick up the things I had ordered from Blue Gate. We went to pick up from Blue Gate at Peace Tree Des Moines Branch first. I was able to do do that one fine. But when we went to the Beaverdale Fareway, not a large grocery store, We got to the check out, and I started to feel faint, so I walked out to the car to go sit down.

Shannon went to the grocery store for me the next day. I did however start cooking. The first meal I made for myself was some properly seasoned fried eggs, and an english muffin.

As the days past, I was able to making further and further through he day without taking a nap. I did some email triage to make sure time sensitive items got addressed, and I pass them off to one of my co-workers that ran with it, and I truly appreciate that. On Thursday 6/15, and Friday 6/16 I did some half days, after 6/14 I got through the entire day without taking a nap. I did end up taking a nap after the half days, because working is mentally harder than playing Civilization 6, apparently, or at least the lazy way that I play it, most of the time.

As a note, my manager, director and VP were fully supportive of me playing it by ear so if I needed to call a day or just take a break, this is fully allowed, I pressed myself to go back to work, cause I was getting bored.

The week of 6/18, we drove to Cedar Rapids to go to Isaac & Ashley’s baby shower. This worked out well. I learned that if ate to much, I would get really tired, as I suspect my GI tract needed the blood above the rest of my body, and as I don’t have a lot to spare. I worked a full week, which was mostly follow up from things I had missed. Maybe not a full week, I had a hospital follow up appointment with my doctor on 6/19, a meeting with my therapist on 6/20 and a dentist appointment on 6/22, but pretty close to a full week. I made it through the week ok. Saturday, I made the Blue gate pickup myself, ran to get coffee, and because I thought I was feeling up to it, we made an overdue Costco run. I was not prepared to do a Costco run. about 2/3rd through the run my face was getting cold, so as we started the middle isle I let Shannon finish while I caught my breath on a barcalounger they had on display. Afterwards, I was able to help check out, load the car, and partially help with the unloading into the house. I got tired again and had to sit down. Eventually, I got the kitchen related things put away, played some video games, and then took a nap.

We went out with Dave and Jo to Gursha (Ethiopian, quite good), then Black Cat Ice Cream (always good), then saw Asteroid City at the Varsity. As Dave said, Asteroid city was the most Wes Anderson movie of Wes Anderson Movies, and he’s not wrong. I do need to see it again, at least.

Today I’ll go to the grocery store by myself.

I went to see my doctor 10 days after I left the hospital. My hemoglobin went from 8.3 g/dL to 9.1 g/dL. Based on that estimate, I am gaining about 0.08 g/dL per day. This means I have about 61 days from that doctor appointment (~8/19/23) until my hemoglobin is in the normal range, assuming a constant rate. Looking at the recovery rate for donating blood and etc, it does seem like this is about right.

So for now, I need to make sure I don’t eat too much, or I’ll get too tired, watch the intake of caffeine, and I have been completely sober for just over 3 weeks. Tuesday, I’m free to do what I want, but I am uncertain how with my reduced blood effectiveness it’ll impact me, so I’ll I’m not quite sure how I’m going to move forward, as far as that goes.

I am gradually returning to normal, and for now, that’s what I can count on.

A Hospital Trip

I’m going to tell the story from my analysis after the fact, and hopefully with a bit of notes. Thanks to my brother in law, Brent Johnson for help editing for mistakes and clarity. Any further editing and clarity mistakes remain mine.

On Friday 6/2/2023 or Saturday 6/3/2023 I started to feel a bit run down, but no more than I’m normally used to. Sometimes I don’t sleep enough, sometimes due to my occasional anemia, and sometimes my depression acts up, so it is often hard to tell why I’m tired. So even though I didn’t feel well, it wasn’t far outside the normal variance, so I didn’t give it too much thought.

Sunday I took an extra nap, which is not that outside of the norm either.

Monday morning, 6/5/2023, I woke up tired. I worked my way through my morning routine. I fed the cats their dental chews and drank water, and got in my morning exercise, which was overly hard to finish. Went downstairs and ate breakfast, which would be the only coffee I had during the week. Since I was running a bit early, decided I could sneak in a 20-minute nap. Set my watch and closed my eyes. My alarm went off too soon, but I got up, showered, made coffee for work, and started my day with email.

It wasn’t too long until I started to feel worse. Not just tired but a little nauseated. During the first meeting of the day, I decided I was just going to take the day off, which was not a big deal since I didn’t have any other meetings, and if I was sick, why fight working through the day. So after the meeting was finished, I headed upstairs to check my temperature.

Walking from the basement to the upstairs (2 flights) is not something that normally gives me a run, but as I was heading from the main level to the upper level, I could see my vision start to close in, as if I was going to pass out.

While this has happened before, it’s not something that happens frequently or even yearly, so I thought maybe something else was going on. I took my temp; it was mildly elevated. As I started walking downstairs, I once again felt my vision start to close in, like I was going to pass out. I made it to the couch and sat down to figure out what I wanted to do.

The last time I stone cold passed out, I figured it was a one off, and it really was, but at the time my primary care provider had told me that I should’ve gone to the hospital. So I started googling my symptoms—yes, I know, a terrible thing to do—and while I had no primary symptoms of a heart attack, I did have a number of secondary symptoms. I had shortness of breath, cold sweat, nausea, and stomach discomfort.

I decided it best not to go upstairs to get socks or shoes, or go downstairs to logout of my work computer or get my headphones.

I called for emergency services. I told them that I thought I was having a mild heart attack. The emergency dispatcher got EMT services on the way to my house in short order. She told me to make sure the door was unlocked so they could get in. I got up to do that, felt very tired and almost lost it again, but I was able to unlock the door and sit back down.

I texted my wife:

  • I call 911

  • I think I am having a mild heart attack

Before my wife was able to respond, the EMTs arrived and started testing a number of things: glucose level, some other checks. They told me that it didn’t appear that I was having a heart attack and asked me what I wanted to do. Being that there were 4 or 5 or 6 men facing me, they did provide a calming air and wanted to know what I wanted to do, so I told them that even if it probably wasn’t a heart attack, something wasn’t right, and I told them that I wanted to go the hospital. They asked me which one, and I said Methodist. So they helped me get up and walked me out of the house and onto a stretcher. They locked the door behind us, loaded me into the ambulance and we were off.

They got me strapped in, setup lines for an EKG, and drew a line for fluids or other items in my left arm, which held on like a champ during the entire event.

By the time Shannon was able to text me back, she got my phone’s auto “focus” driving message while the ambulance (the second one I’ve taken in my life; the first coming after I was hit by a car on a bicycle) drove me the relatively short distance to the hospital.

They got me in and dropped me off in the Emergency Department and after a few critical checks the ED made the call to go through normal process and sent me out to the waiting room. I was able to exchange a few texts with Shannon and she headed down from her work. She met me in the children’s part of the ED waiting room. After a short wait we met with the triage nurse, and she ran the same checks—very similar to the ones the EMTs did, plus a bit more, I think, and they thought I could wait some more. I reported that my nausea was getting worse, so she gave me a barf bag, and we rolled out to wait for a room.

This is where I took action.

Okay, not really.

Shannon says I vomited and passed out. I only vaguely remember this part. I remember starting to vomit and waking up to lots people wiping me off. So I apparently vomited in the bag and on myself. There was a combination of blood and breakfast. This got me immediately roomed, my clothes taken off, and gowned. My memory is all very fuzzy for me. My clothes, keys, wallet, and phones ended up in a plastic bag. They started some fluids through the IV site the EMTs had started.

Next up, I got an x-ray to check for heart things. I got a CT scan to check for mid to lower body issues and there was some evidence of what was happening. That led to a debate on what to do next. The x-ray was normal, but the CT scan said that there was evidence of stomach bleeding, so they wanted to schedule me for an upper GI endoscopy and eventually get me to a room to wait.

I thought that perhaps I could still go home, but the nurse disabused me of the notion that I was leaving anytime soon. I told her that the language the doctor had used suggested I might be able to leave soon(ish) as he didn’t specify how long I was going to be observed, but I suppose I should’ve known.

No food. No drink. Just ice. Start texting people updates…family, boss, team lead, friends. I also slept, because I was really tired. My wife collected my devices, ran home to put my work phone on the charger, got me headphones, and brought back my CPAP machine.

To give you a sense of just how weak I was, I got physically exhausted playing a hand or two of solitaire on my phone.

Early in the morning, patient transport moved me to the endoscopy area, where I have been more than a few times. I waited in the staging room for the endoscopy room to clear up. They got me set up with normal drips and monitors since my procedure wasn’t scheduled until something like 9:13 or so. After a short wait, they brought Shannon to the waiting room and took me into the endoscopy room.

I think the good doctor was a wee bit late, but I only have a vague sense of that, as one of the drugs they put me on sort of messed with my memory. To keep me awake (ish) to avoid troubles with my sleep apnea, they did a combination of the forget this drug and local anesthesia. I remember vaguely falling asleep with the tube guard (a plastic ring to protect my teeth from it and it from my teeth) in my mouth. I also vaguely remember some issues of closing off the bleed, but again, I wouldn’t necessarily trust my perception here. I woke up back in my room and spent a good chunk of the morning and afternoon passing in and out of consciousness.

Interestingly enough, after tests I started getting buzzes on my watch notifying me of test results, often before the people on the floor (probably because I get notifications about all things me, while they only get notifications of critical things for the area). These notifications gave me results on my blood draw, or whatever, and let me know how I was doing. So I got to monitor my own numbers, which was nice. I did have to look up a thing here and there as I didn’t know what everything meant.

Generally this is where the pattern started. Blood draw for tests at 5 a.m. and noon-ish, Glucose tests around every “meal,” changes of drips at 4 hours or 12 hours, and temp, blood pressure, and oxygen level checks four times a day.

Eventually they let me start to “eat” very simple foods that wouldn’t stress the stomach or leave much residue. This included a bunch of things I wouldn’t normally eat (due to the sugar content). I ate what I could tolerate, which wasn’t that much, which, as I think about it, probably wasn’t great for my body’s blood generation, though I was still on a drip to keep me hydrated..

As we were waiting for the next thing, Shannon made the best joke of the stay, “My goal for discharge is to become a magnetic whiteboard eraser.” Though after mentioning this to the nurse, I did get discharge goals.

This is where I learned that my body retains things in my gastrointestinal tract and likes to hide things from time to time. So even though I was no longer bleeding from my stomach (as I learned from my second endoscopy), the end stage of my gastrointestinal tract likes to hide things. So this could be due to the amount of things ate (not much), to just general pockets. I know I have diverticula, so i suppose residue could have hidden in there.

My 5 a.m. test on Thursday (my third 5 a.m. test of the week) for hemoglobin dropped from the previous day, so they were concerned that I might still be bleeding. This caused a bit of confusion and conflicting orders between the GI doctor and Internal Medicine doctor. One wanted to get me prepped for a scope, while the other thought that if I ate “breakfast,” they could reserve a spot for tomorrow.

But evidence of blood, which would turn out to be evidence of my less-than-speedy GI tract, showed up, so I ended up getting another endoscopy early Thursday afternoon.

Between the evidence and the procedure, they confirmed my blood type (again) and gave me another unit of blood, and while I might have gotten some blood during my first endoscopy, this time I actually got to see them do it. Lots of physical process, scanning, double checking, taking my blood ID tag sticker to tie it to the bag of blood, authenticating with a password on my medical record to record it happening, signatures—it seemed like a lot, but when you think about how much of a shock to the system a bad blood transfusion can be and how precious blood is, it starts to make sense. I did ask if I got a discount since I was a 5+ gallon donor of blood, and that got a laugh.

Blood and Saline

The second endoscopy confirmed that the first endoscopy was done well enough, and I probably wasn’t bleeding. So they updated me to a low-fiber diet. I ordered dinner: turkey with gravy on white bread, with green beans, a biscuit, and a banana. Per my text to my family: “the turkey is dry, the gravy is meh, but I mean, still good” and “beats cream of wheat.”

Dinner

Friday morning, after my 5 a.m. hemoglobin test jumped 1.2 g/L to 8.2 g/L (still low), they removed the last drip I was on. That brought about a lot of excitement. After discussions between Shannon and I and both doctors, and then more discussions that the doctors had among themselves, they decided that if my hemoglobin level went up again, I’d get to escape. The test was scheduled for 4 p.m. It turns out the person doing the blood tests had a couple of issues, and didn’t get to us until after a STAT was placed on the order. As soon as I got the result that it went up another 0.2 g/L, we started packing up.

The nurse mentioned that almost immediately after the result came in, the discharge orders came in. We cleaned up the room, packed my things, and just waited for the paperwork to go through. My two lines got taken out and we were headed home at 5:18 (okay, maybe 5:19) on Friday evening—4.5 days after the ordeal began.

We picked up some food on the way home, and I got to say hello to our cats for the first time all week.