How I Survived My Adult Tonsillectomy

surviving adult tonsillectomyThree weeks ago I had a tonsillectomy and adenoidectomy. Much to my surprise, I’ve had people ask me to write a blog post full of TMI and the gritty details of recovering from an adult tonsillectomy. So here’s the full story…you may want to skip this post if you have a weak stomach.

I feel like I have a pretty good pain tolerance, but this surgery knocked me down good for two solid weeks, and I’m still not quite normal. I’ve had a few surgeries, and this was definitely the worst.

The Backstory

I had spend the previous 6 weeks battling peritonsillar abscesses. Three rounds of antibiotics (IV, shots, and oral) didn’t help. I was not positive for strep. Steroids only worked as long as I was taking them (and I gained 15 pounds in a week from them). In addition, I had a bout of viral tonsillitis and the worse sinus infection of my life within a 2 week period.

On my 3rd visit to urgent care, the doctor did a large variety of viral testing. The abscesses were cause by Epstein Barr, which meant I had an active episode of infectious mononucleosis. My ENT doctor said the only way to stop the abscesses was to have a tonsillectomy. So I scheduled it as soon as I could.

The Procedure

My tonsillectomy and adenoidectomy (T&A) was done at a surgical center under general anesthesia. This was a relief to me, as an urgent care doctor has suggested that I go to the emergency room to have the abscesses lanced (and would probably just numb me up and take out the tonsils). My doctor used electorcautery, which basically cuts out the tissue and seals it by burning it. Pleasant, eh?

The average T&A takes 20-30 minutes to complete. However, my procedure took 45 minutes because there was so much swelling from the peritonsillar abscesses. I was numbed up pretty well when I came back into consciousness. The nurse gave me a few refillable ice packs to help with swelling, and those became some of my most necessary items on my recovery.

Post-op Recovery

I got a prescription for both tablets and liquid Lortab Since my gastric bypass surgery, pain meds absorb differently. The liquid works more quickly, but the dose doesn’t last as long (about 4 hours). The tablets are harder to swallow, but tend to last closer to 6 hours. So I played around with a mixture of half-doses of liquid and tablets at once so it worked fast, but didn’t drug me out too much.

On my first night at home, I was surprised at how well I felt. I are some mashed potatoes with no problem, and came under the false assumption that recovery would be easy. Boy was I wrong.

tonsillectomy popcicles

Between post-op days 2 and 8, my pain and misery became progressively worse each day. I kept to a strict dosing schedule for my pain meds, but it never seemed to be enough. For the breakthrough throat pain, I gargled with “mouth magic,” which is a combination of viscous lidocaine and liquid antacid medicine. Unfortunately, the liquid numbs up your whole mouth. I was glad when the numbness wore off so it didn’t make me drool.

Eating and Drinking

The day before surgery, I did a lot of shopping…sports drinks like G2 and Propel, popsicles, mashed potato mix, cream of wheat, and broth-based soups. I am a big fan of the real fruit based quality Popsicles, but they ended up being far too acidic for the first two weeks. So many people recommended cheap twin pops and Otter Pops…and they were right. The artificial flavoring and slushy consistency was easier to swallow. Sometimes I mashed up the popsicles and mixed it with diet ginger ale.

One of the strangest things for me was how my tease buds changed. I hated the taste of plain water because it tasted like dirt, so I used sugar-free Italian syrups to flavor my giant cups of icy water. I craved black licorice, black olives, and anything really salty. I also craved curry, and it was funny how the slight burn of the mild yellow coconut curry I drank was soothing to the burning pain of the tonsillectomy. I also craved pumpkin at first, but got burned out on it after making pumpkin smoothies and pumpkin protein pudding.

sonic iceComfort Measures

Two of the items that were the biggest comfort measures were ice and a good humidifier. My friend Julie offered to be on ice delivery duty, and brought by gigantic coolers full of pebble ice. When she wasn’t able to be there, I got bags of Sonic’s pebble ice. Between the bags and coolers of ice, I went through over 100 pounds of ice in two weeks. Obviously some of the ice melted in the coolers, but it stayed a better non-clumpy consistency than it would in the freezer.

I used a cool mist humidifier constantly. I had it propped up on a table so the mist hit me directly in the face while I laid in bed. When I sipped water or sucked on ice, my throat stayed moist. But when I couldn’t handle swallowing, the humidifier helped make up the difference.

The day that surprised me the most was day 10…the day the scabs started coming off. Scabs in your throat sent like scabs on your skin. They are not thick and hard and red. They are white, thin, and slimy. And they hurt like a mother when they slough off. This will happen a few times.

Miscellaneous Details

Insomnia was a big issue for me. Because I was dealing with acute pain, my ability to sleep was dependent on how long my Lortab dose lasted. I spent a fair amount of time sleeping through the first 10 days, but never more than about 4-5 hours at once. I watched a lot of Netflix and read on my iPad, but dozed off really easily. I wanted to delve into some shows that I’ve been meaning to watch for a while, but my attention span was so short. I ended up spending most of my time watching Gossip Girl and 90210. Don’t judge.

Expect to drool a lot. Make sure you have something you can spit into when it’s too hard to swallow your saliva. For me, it was thicker than normal, and was much easier to spit out.

Around day 5, I started a gargle routine. First I would swish with warm salt water. Then with the viscous lidocaine. Then with water again. Then with mouthwash. That seemed to keep funky tastes out of my mouth…and keep my bad breath at bay. No matter how much I brushed my teeth, my mouth was not a happy place to be around.

I had a hard time with food getting stuck on the healing pockets of my throat once I was back to solids. They would fill up and have so much pressure, it could make me dizzy. I figured out this way to get them out with this open-mouthed gagging neck-scrunching move. It sounded frightening and looked even worse, but it was the only way I figured out to her the stuck food out when gargling wasn’t enough.

Three Weeks Later

At three weeks out, I still think a lot of food tastes funny. I want things that are strongly flavored…spicy (but not too spicy) and very salty. I crave drinks with lots of ice, and sip often to keep my mouth moist. My pain comes and goes, and is manageable with Tylenol. The only time it REALLY hurts is when I yawn…it feels like I’m stretching and breaking the newly healed tissues. There are some slightly raw spots in my mouth where the most recent scabs came off. I still feel fatigue, but I think it’s due to all that I’m doing (traveling, moving, etc) instead of just the surgery recovery. I’m up 10 pounds since August, but I know that’s a combination of so many weeks in bed, steroids, and being limited on physical activity. Once I’m back to the gym, I’m sure it will come off without too much hassle.

If I’d had the chance to get this done as a child or teen, I would have preferred it. So many years of strep throat and tonsillitis episodes have been rough, but it’s never been frequent enough to warrant surgery. If you ever get a peritonsillar abscess, get those tonsils out ASAP. Don’t wait 6 weeks like I did.

Narcolepsy, Necrophilia, and National Public Sleeping Day

insomnia and narcolepsyThis morning while trolling the interwebz, I found an article that caught my attention. Today is National Public Sleeping Day. According to the article, National Public Sleeping Day was established on February 28, 2011, and it is celebrated by taking a nap in public.

A 2012 study by the Centers for Disease Control and Prevention found that 40 million workers in the U.S. get fewer than six hours of sleep a night, significantly less than the seven to nine recommended by the National Sleep Foundation. 20% of vehicular crashes in the U.S. are caused by drowsiness, approximately 100,000 per year. Sleep deprivation is very often due to unrecognized sleep disorders like obstructive sleep apnea, narcolepsy, anxiety, and other social factors.

I’ve had a tough time with my sleep patterns since 2003, which is when I first began seeing a sleep disorders specialist. I was originally diagnosed with upper airway resistance syndrome. In patients with UARS, sleep quality is disrupted to the point of causing clinical consequences such as difficulty initiating or maintaining sleep (insomnia), non-refreshing sleep, or excessive daytime sleepiness. Further sleep tests, such as the multiple sleep latency test, confirmed that I also have 5 of the 5 markers for narcolepsy: Irresitable daytime sleepiness, sudden muscle weakness, sleep paralysis, hallucinations, and microsleeps with automatic behavior.

provigilFor the last 8 years, I’ve been treated with Provigil (or Nuvigil, which I didn’t like as much, but has a much more awesome website.) As I gained weight, the UARS progressed into Obstructive Sleep Apnea (OSA). In the past nine years, I’ve had 8 overnight sleep studies, met with 6 sleep specialists in 4 states, and came to the conclusion that the only thing that would successfully treat the symptoms of my sleep apnea was massive weight loss. All of my sleep doctors recommended bariatric surgery, which is one of the reasons I chose to have gastric bypass.

Most of the time, I feel like I can get enough sleep, either by medications, exercise, naps, or caffeine. But since the beginning of the year, my narcolepsy symptoms have been rearing their ugly head again. I’ve had several cataplexy attacks, microsleeps, and the neurological symptoms I often have when I’m having a particularly irresistible sleep episode mirror my episodes with reactive hypoglycemia. I have appointments in March with my sleep specialist, an ENT, and endocrinologist.

Many people have strange ideas about narcolepsy, and sometimes all they’re aware of is references in pop culture (like in the movie Patch Adams). One of the funniest things about telling people I have narcolepsy is when they reply “And that’s something you share publicly?” Apparently, many people confuse narcolepsy with necrophilia, which I indeed do not have. Phew!

So, here’s to a restful day. Fluff up those pillows and enjoy a nap for National Public Sleeping Day!

I’m Going Off Soda

giving up diet cokeI’ve been threatening to do it for year.

And now is the time.

Today is my 5th day completely soda/carbonation free. It’s actually day 8 in the process, but I caved to a can of Diet Mtn Dew when I had a headache on day 2.

There are a lot of reasons why I needed to give it up. First, it was an addiction, pure and simple. I couldn’t get through the day without a McDiet #PDR, or a “Route 44 Coke Zero with vanilla” at Sonic. I would wake up thinking of how bad I wanted a Coke to get me going in the morning. I wanted a drink to get me through the lull of the afternoon. I wanted a drink to help me focus at work. It was overwhelming.

Second, it was expensive. Many days I drank well over 100oz, much to the chagrin of my wallet. My husband called my daily need for soda my “pack a day” habit. Even trying to get the cheapest refills, it was easily costing me over $100 per month. I can think of a lot of things I’d rather spend $100 on a month.

Third, it was not good for my health. I’ve been taking mega-doses of Vitamin D and Calcium to make up for the mineral deficiencies that diet soda causes. Plus, it was stretching out my stomach. I can down a 32oz drink in no time, which made it that much easier to overeat. Although I got to the point that I would choose a soda over a decadent dessert…it still was a little messed up to be thinking that way. After watching this video, I knew I needed to do it:

I’m getting ready for a big change in my life that I’ve been preparing to undertake for over a year. If all goes as planned, it will happen sometime in February. It will change my life and my health for the better. I’m even working on a separate blog to document the process, which I will announce shortly. I’m even going to VIDEO BLOG on it, which I haven’t every ventured into before. I’m scared and excited at the same time.

So raise your glass (of water) and congratulate me on 5 days “sober” from soda. I’ll need support on this one. Just the sound of carbonation is a temptation.

While You Were Out

Hey readers…are you still coming to my sadly neglected blog?

It’s summer, and I’ve had a lot of things going on that has pushed my blogging efforts out of my daily/weekly routine. I haven’t posted anything in the month of July, so I thought I’d put in a quick catch-up post for those who care to know how I’ve spent my time.

  • Working as an SEO specialist at SEO.com by day, and desperately trying to get back up to speed on my medical coding practicum. When I was hired 7 months ago, I threw myself into my new job and left a year of full-time study at 95% completion. I’m ready to get it done and official. I’m ready to earn some letters after my name. So forgive me as I’m busy switching between HTML and ICD-9/CPT/HCPCS and trying to speak English the rest of the time.
  • Visited my long-time bloggy friend April Durham on a weekend whim roadtrip. Rosie and I hopped in the car within 30 minutes of concocting the idea, and drove north for a weekend of giggles, good food, and blog design. She gave my site an awesome blog makeover. If you haven’t seen the new look of cuteculturechick.com, hop out of your RSS feed and take a looksie.
  • Attended Type A Parent Conference in Asheville, NC. I decided to go to a conference I hadn’t been to before, and decided on #TypeAcon when I found out so many of my friends were speaking. I got some great blogging and social media tips, met Greg “The Frozen Food Master,” chatted with some great brands, partied and dined.I enjoyed the beautiful and eclectic city of Asheville in the Blue Ridge Mountains, and knocked North Carolina off of my list of states to visit to see all 50. Oh, and I drank as much Cheerwine as I could get my hands on.
  • Acted as an ambassador for Visit Salt Lake‘s SLC Summer Crew
  • Summertime tends to be difficult emotionally for me, and thankfully this year it hasn’t been quite as depressive as the past few years. I’ve been trying to living a more healthy lifestyle…trying to be more active, eat better, and lose weight (as always). I might not look a lot different, but my hair is getting pretty long
  • Next week I head to southern California to see family and attend BlogHer ’11. Later in the month I’ll be going on a white water rafting trip hosted by my company. Rosie’s going to be starting 5th grade (!!!) I hope to be ready to take the final exam and national certification exam for my medical coding.
  • How have you been spending your summer?

Wordless Wednesday: Overnight Monitoring

overnight pulse oximetry

Maybe this time, I’ll get the answer I need to help my sleep improve…

Retail Therapy

retail therapyWhat do you do when you’re too sick to be in public for very long, the gym is a cesspool of sweaty germs, it’s too cold to be outside, and your doctor tells you to exercise anyway?

Engage in retail therapy!

My pulmonologist recommended that I get 30 minutes of exercise a day, in 5 minute intervals. This order coincided with the deposit of a nice fat federal tax refund. There was a list of things I have been waiting to purchase for my home, and I decided that shopping would be the best way to get my exercise. I would drive there, walk around for 5 minutes and get what I need, check out and go home.

A coworker called me out on my Foursquare checkins, since the notifications pop up on his phone. He didn’t see how I could possibly be as sick as I claimed to be on Twitter. Well, this is why – I was getting my doctor-prescribed exercise in a useful and fun way. I usually went straight home, laid on my bed, and had a nebulizer treatment to recover. I won’t always be limited to short spurts of exercise, nor will I have the money for the purchases of the last week…but the week of lung hell that I just endured….retail therapy was just what the doctor ordered.

TMI Friday: Being on Steroids for Lousy Lungs can Give you a Better Rack

sexy hospital gownIn the past month, I’ve filled over 20 prescriptions. In addition to playing “profession patient”, I’ve become the Foursquare mayor of several different pharmacies and medical clinics. I feel like my local Walgreens is the pharmacy equivalent of Cheers – “where everybody knows your name” (In fact, thinking about it makes me want to drown my sorrows in a Flaming Moe).

It started with seeing the hormone doctor. He put me on progesterone, which was supposed to temper my mood swings, make me sleep through the night and help me lose weight. The hormone pills didn’t help… Despite having the obvious signs of progesterone deficiency, the lab results showed that my normal hormones with vitamin/mineral deficiencies. My Vitamin D was low enough that they gave me an osteoporosis-fighting prescription drug.

About a week later, I started retaining water like a bloated water balloon. My blood pressure reading was sky-high, despite no prior signs of hypertension. So I went to my primary care doctor who gave me Lasix, a diuretic to help my body drain off the water weight and lower my blood pressure. It literally gets you running to the restroom every 30 minutes. Lasix makes your body deficient in potassium, so I’m taking a potassium supplement too. I got some sexy compression stockings to help my circulation and force out excess fluid in my legs. And you know how I had to get my wedding ring cut off a few weeks ago? My replacement cubic zirconia ring, which is 2 sizes larger, is already too small because of the swelling in my hands.

Then the poor air quality caught up with me. I started coughing and wheezing when I was outside, or whenever I exerted myself for anything beyond climbing a flight of stairs. I was choking and coughing in my sleep, which is not a good sign with sleep apnea. I started having constant chest pain. When I presented for Ignite Salt Lake, I thought the tightness in my chest was from nerves…but it was pleurisy. I was in urgent care with an asthma attack 2 weeks ago, where they sent me home with steroids and a big box of nebulizer vials. Since then, I’ve been back to urgent care, spent a long day in the ER, and have seen my new pulmonologist. He’s treating my dyspnea and sleep apnea problems more aggressively, and he’s strongly suggesting surgery. After lab work, chest x-rays, pulmonary function tests, arterial blood gasses, and lots of waiting in freezing cold rooms in thin hospital gowns…I’m worn out. The meds have made me gain weight at a rate I can’t seem to control (although I know most is due to fluid retention rather than bad eating habits).

So what’s the perk with all these steroids and weight gain? My boobs. I wasn’t small to begin with, but I’ve gone up almost two full cup sizes so far in 2011. A new bra I purchased a month ago leaves me spilling out. My newest blouse needs to be safety-pinned between buttons. People are no longer making eye contact with me in public, but they’re definitely looking. I don’t know how much of this excess size will stick around when my body calms down, but it was perfect timing for filling out my Valentines Day linger aie. If you’re considering a breast augmentation, maybe you should try going on steroids first.

Happy TMI Friday everyone!

RIP Jack LaLanne

young Jack LaLanne

“I can’t die. It would ruin my image.”

“I do it as a therapy. I do it as something to keep me alive. We all need a little discipline. Exercise is my discipline. “

“How do you build up your bank account? By putting something in it everyday.Your health account is no different. What I do today, I am wearing tomorrow. If I put inferior foods in my body today, I’m going to be inferior tomorrow, it’s that simple.”

“Maybe you don’t believe in Jesus. But was Jesus a showman? Why did he go around making the blind see and the lame walk and those kinds of things? He did it to call attention to his philosophy.”

Jack LaLanne, the American fitness icon, passed away Sunday, January 23rd at age 96. He died of respiratory failure as a result of pneumonia complications. With so many years of health and vigor, some wondered if he would live forever. And as we see with Jack LaLanne’s passing, all good things must come to an end.

Francois Henri “Jack” LaLanne was born September 26, 1914 in San Franciscio. He was the son of French immigrants, and grew up addicted to sugar and junk food. He experienced bouts of rage, suicidal feelings, and at one time tried to burn his house down.  When he was 15, he heard health food pioneer Paul Bragg give a talk on health and nutrition. Inspired by Bragg’s teachings, Jack started focusing on his exercise and eating habits and studied human anatomy. He concentrated on bodybuilding and weightlifting.

Nicknamed the “Godfather of Fitness,” LaLanne was a bodybuilder, exercise and nutritional expert, TV personality, and even earned a star on the Hollywood Walk of Fame in 2002.  Quoting his obituary in the LA Times,

“Though LaLanne was for many years dismissed as merely a “muscle man” — a notion fueled to some extent by his amazing feats of strength — he was the spiritual father of the health movement that blossomed into a national craze of weight rooms, exercise classes and fancy sports clubs. LaLanne opened what is commonly believed to be the nation’s first health club, in Oakland in 1936. In the 1950s, he launched an early-morning televised exercise program keyed to housewives. He designed many now-familiar exercise machines, including leg extension machines and cable-pulley weights. And he proposed the then-radical idea that women, the elderly and even the disabled should work out to retain strength. Full of exuberance and good cheer, LaLanne saw himself as a combination cheerleader, rescuer and savior. And if his enthusiasm had a religious fervor to it, well, so be it.”

Jack LaLanne stretching

“Have you seen some of the crap they’re selling as exercise equipment now?” Jack wondered. “How about that Suzanne Somers? She should have been thrown in jail for selling the piece-of-crap Thigh Master. It just develops a little muscle on the inner thigh. What good is that? And have you seen Tony Little, the guy who screams on TV? He’s like an imbecile. He says you need this little thing to hold you while you do a sit-up. Why does the government let him get away with it?”

Jack LaLanne in his 90sAs a woman who has struggled with health and weight issues since my childhood years, Jack LaLanne has been somewhat of an idol to me. I have several of his books, and tried to adhere to his fitness and nutrition advice. I’ve consumed countless glasses of freshly juiced fruits and vegetables …. thanks to my persistence after watching his juicer machine infomercials. My father-in-law tries to be helpful by encouraging me to give Jack LaLanne’s advice a try…little does he know how much it’s been a part of my life already. He preached the gospel of eating right and being active…joking,

“It is a religion for me. It is a way of life. A religion is a way of life, isn’t it? Billy Graham was for the hereafter. I’m for the here and now.”

To the man of eternal health and vigor – Rest in Peace.

TMI Friday: I’m Not Crazy, It’s My Hormones

Monthly female cycleYou know when you’ve been sick for so long, you’re obsessed with finding out why? One of my favorite things to do when I can’t sleep is research health topics. I’m an insomniac who researches sleep disorders in the wee hours of the morning so I can try to make some sense of why I’m extremely exhausted, yet can’t sleep. I read book after book about overcoming depression, and follow the suggestions and mental strategies…yet I still struggle with keeping a consistent, happy psyche. Over the last six months, I’ve been having unbelievable mood swings, going from elation to devastation in a single conversation. It’s been VERY hard to deal with.

So I started researching what could be causing my mood swings, insomnia, inability to lose weight, etc. And suddenly a light blinked on in my head – It’s my hormones! After discussing symptoms with my primary care doctor and OBGYN, I was frustrated when they told me to come back in 6 months if the symptoms persisted. “Hormone swings are cyclical…” yadda yadda yadda. I suffered for several months, fairly certain that it was a hormonal imbalance…but not really getting any help from my doctor.

I started talking to people here and there, trying to get a gauge for the possibility of someone at my age with hormone imbalances. I got a referral to a doctor who specializes in hormone and metabolic disorders, but had to wait over a month to be seen. Last week was when I was finally able to get in to see Dr. Lundell. He had me mark a list of  20 different health concerns (brittle nails, libido extremes, inability to regulate temperature, hair loss, hirsutism, insulin resistance), and after the third checkbox, he said “I already know the problem. You have a progesterone deficiency, specifically in the secretory/luteal phase.”

Low progesterone effects brain chemicals that leads to depression, lethargy, mood imbalances and irritability. Low progesterone impacts a calming chemical called GABA, and there’s a decrease in pain-reducing corticosteroid production. A drop in progesterone can also cause women to feel more pain. When progesterone levels decrease, adrenal glands should take over and produce it. Most common symptoms of progesterone deficiency: inability to lose weight, depression, headaches and PAIN. (Check, check, check, check!)

So he ordered a battery of lab tests, set me up on hormone replacement therapy, and said that within a month I should be able to sleep through the night, my metabolism will spike up, mood swings will diminish, I’ll be able to decrease my dose of antidepressant and other lovely things. I am feeling optimistic about my new course of treatment.

It’s reassuring to know that I’m not crazy, it’s just my hormones.

Doing my Best

The last few months have really put me through the wringer, emotionally and physically. It has been incredibly difficult to go from an able-bodied, overzealous DO-er, to someone who has to accept help from others, and be satisfied with myself when I accomplish less than my usual best.

My mother has dealt with chronic pain for nearly 17 years, over half of my life. When she wasn’t able to do all that she needed to, I stepped in. I spent most of my teenage years being a nurturer, a teacher, a chauffeur, a cook, and serving my family whenever necessary. It was frustrating and overwhelming at times, but I was happy that I was able to serve. Although I never really understood my mother’s physical pain, I trusted that she was doing the best she could. I knew I had the ability to help…and I did. And still do.

Since I injured my back in December, my life has been like a parallel universe. I have little endurance and mobility. I am dependent on several medications to function AT ALL. I keep ice packs, heating pads, and “granny pillows” at hand. I go to physical therapy 3 times a week. The entire office staff at my doctor’s office know me by name. I’m on the phone sorting out bills with my insurance, hospitals, urgent care clinics, imaging centers, and medical supply companies nearly every day. I deal with symptoms that sometimes cripple my mobility, such as limb numbness from hip to toe, for hours at a time. I got my first bedsore this week. Sometimes I lose bladder/bowel function. Sometimes the cerebrospinal fluid pressure changes from the cysts in my back cause mindblowing headaches. Some days, I barely make it out of bed at all.

And this life does not suit me. At all.

I pray daily for the patience to endure my pain. I pray for the patience of my friends and family members, who are affected by my illnesses. I pray for the understanding of others, that although they may not know the particulars…they don’t judge me harshly for the things I’m not able to do. I pray that my husband doesn’t give up on me, and understands that I’m truly doing my best.

Did you hear that, world? I’M DOING MY BEST.

Please don’t give up on me. Please be patient with me. Please do not judge me for the things you don’t understand. And I’ll do the same for you.

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