Achalasia talk...

I have achalasia.

I was lucky; the radiologist who performed my first barium swallow knew exactly what it was. Time between that test and my myotomy surgery was only four or five months. Many people with achalasia spend years trying to get their symptoms properly diagnosed. I was also lucky to have found an extremely knowledgeable support group online - the people in that group taught me a great deal about treatments, other symptoms, and so much more. The people in this group helped me immensely, and gave me the information I needed to educate a few of the professionals I came across. Who knows about a rare condition more than the very people that have it? I'd dare to say no one.

I. am. very. lucky.

My symptoms appeared in a textbook fashion. At first, I only had problems with dry food (bagels, rice, etc). Then over time, all food. Not long after, I got to the point that I couldn't even drink water without it 'sticking'. Only soda, with its carbonation, created enough pressure to push food and liquid through my LES. Then the truly horrible symptoms. I couldn't sleep laying flat; I had to raise my head. However, even still I would often wake up choking (aspirating - can easily lead to nasty pneumonia) on the food and liquid in my esophagus. I would get horrible chest pains that, according to others who've experienced both, were similar to a heart attack. And more gross and painful stuff, but you get the idea.

I had the barium swallow (that showed the barium was just sitting in my esophagus), an upper-GI endoscopy (to rule out cancer), and menometry (which proved that peristalsis wasn't happening, nor was my LES opening). The first two tests were no big deal. The third was .... not fun. All three of these are explained in the link above.

I had the laproscopic heller's myotomy surgery, with fundoplication, in December 2004. The surgeon cut my LES and wrapped part of my stomach around my esophagus to keep stomach acids from going back up through the, now cut, LES. Again, I've been lucky. I haven't had problems with acid reflux.

However, the surgery didn't relieve my symptoms for as long as I'd hoped. From the link above: "Surgery relieves symptoms in 70 to 90 percent of people. Symptom relief is sustained in about 85 percent of people 10 years after surgery and in about 65 percent of people 20 years after the surgery." But, only a few years later, food started 'sticking' again. Not as badly as before, and I haven't had the choking or chest pains, but eating is often uncomfortable. (Now I'm not feeling so lucky - only 15% don't get relief lasting at least 10 years. Mine didn't even last for five.)

I had a balloon dilation performed in 2009. The GI doc was conservative; he used a fairly small diameter balloon. I understand - perforation is most likely to occur during the first dilation procedure and perforation scares the crap out of me. His intent was to see how well it worked, and we could always do another if necessary. Well, something more will be necessary. I had only a couple of months of total relief after that procedure. I've been acting like an ostrich with my head in the sand about it, but it's getting worse and I really should have something done.

My worry is that I'm stretching out my esophagus by not getting the 'sticking' taken care of. A person can't regain lost elasticity, and I will probably live many more decades. Some people have had to have their esophagus removed (which requires the stomach to be pulled up to be reattached higher in the chest). I'd really rather avoid that, thanks.

But I'm also worried about acid reflux. Barrett's Esophagus can result from too much acid, and it can more easily lead to esophageal cancer. That's not easily treated, and in fact has a pretty horrible survival rate. Any treatment I get will increase my chances of acid reflux.

So, what to do... Something does need to be done, and I certainly shouldn't try to make the decision without professional advice.

Honestly, there's a test I'm sure I'll be asked to have redone and I'm hoping to avoid it. It was horrible the first time (manometry). Sure, it doesn't sound that bad, but it was painful. I don't know if it always is, or if the lady that was doing it did it wrong. All I know for sure is that I do NOT want to do it again. I need to get over the fear of it and get seen; maybe it won't need to be done again, and I'm procrastinating for no reason. Ugh.

In any case, the reason I'm writing this post... I have a Google Alert set up to email me whenever "achalasia" is in the news. I received an email today with not one but two articles in the same journal volume.

The first. Plain words summary: the myotomy surgery and balloon dilations have similar outcomes. Previously, it was generally thought that the surgery resulted in a longer term improvement.

The second. Plain words summary: there's a new method for the myotomy surgery that's done through the esophagus itself. The 'old old' way was to get to the esophagus from the back, deflating a lung, which obviously required a great deal of recovery. The 'new' way was laproscopic, from the front of the abdomen (and the method I had). A day or two in the hospital, but only five small inch-long scars. This 'new new' method results in no external scars at all, and from this (and other) recent journal articles, I've learned it's pretty successful in treating the problem. This particular study addresses this surgery even after a previous myotomy.

I'm now living very close to one of the best centers in the country for achalasia, the Cleveland Clinic. I really need to deal with the process of getting referred there for some sort of treatment for the symptoms I'm having now. I'll kick myself later if I don't take advantage of the geography before Darrell gets PCS orders. My problems aren't a huge problem currently; I'm only having to slow down while eating, take a type of breath I can't describe if I feel food not going down quite right, and food only gets badly stuck if I'm not drinking a lot during a meal.  (Strangely, soda not only doesn't help like it did before my surgery, it makes it worse.)  But, I'd be an idiot to not take advantage of the situation. Progress is being made, and perhaps I'm a good candidate for this new procedure. Or at the very least, I can get another dilation done by someone with a great deal of experience.

I just really hope I don't have to do that manometry test again. *shudder*

Wendy's!

The deal: if Kaden can get three days in a row of "green behavior" at school, we'd go to Wendy's so he could use his free frosty coupon.  Today was (finally) a day three!  Off to Wendy's we went.

Ordered the frosty.

He ate his dinner and promptly gave his frosty to Justin.

*shrug*  Oooookay.  *laugh*

I'm a professor again!

Passed my online training courses and just heard from my program chair - I'll be starting a Physical Geology (and lab) class in late January! I've missed teaching.

Studies the materials of the earth, its structure, surface features and the geologic processes involved in its development. This course includes laboratory experience.
1. Recognize and appreciate the vastness of geological time and illustrate this by example and/or metaphor.
2. Recognize and classify the common minerals and rocks by their observable characteristics.
3. Locate and identify geologic features using topographic and/or geologic maps.
4. Discuss the origin of intrusive and extrusive igneous rocks and recognize landforms associated with each.
5. Understand the weathering processes involved in the transition from bedrock to soil and sediment.
6. Discuss the processes involved in the formation of sedimentary rocks and relate them to modern and ancient depositional environments.
7. Understand the agents and processes of metamorphism and relate these to the various metamorphic rocks.
8. Analyze the causes and effects of earthquakes and relate seismology to the structure of the earth.
9. Describe the hydrological cycle and relate this concept to both the surface and subsurface waters.
10. Discuss the mechanics of Earth`s waters (e.g., running water, waves, tides and currents, groundwater), mass wasting, wind and glacial ice and relate these agents and processes to the origin of landforms.
11. Classify folds, faults, and mountains and discuss their origin.
12. Discuss the basic lines of evidence for continental drift, sea floor spreading, and plate tectonics.
13. Discuss the characteristics of plate boundaries and heat plumes and their relationships to earthquakes, volcanic and mountain building activities.
14. Read, analyze and apply written material to new situations.
15. Write and speak clearly and logically in presentations and essays.
16. Demonstrate the ability to select and apply contemporary forms of technology to solve problems or compile information.

Dinner!

Honey Sauced Chicken.  Seriously, yum.

Woo hooo!

Darrell's name is on the list!  And in the top 25%, so he should be promoted before summer.  No idea what that means yet regarding his next assignment.  Branch says they won't talk to him until his sequence number is called and he actually pins on the new rank.  (Velcros on the new rank?)  AND, my best friend's husband made the list too!  (Hi Dave!)

In other news, now that I'm working at the VA, I have more of a reason to pay attention to the Army-Navy game.  Sure, I'm an Army vet, but I didn't attend West Point.  I care more about my own alma mater (Kansas State) than West Point.  There's quite a bit of friendly service rivalry at the VA, as you can imagine...  It's 14-14 at the half, not bad!

ETA: Ah, so "we" lost.  Bummer, but at least this year it was a close game.

Board results out Thursday?!!??

In other news, the promotion board results for Darrell's possible promotion to master sergeant will be released on Thursday!! It usually doesn't happen until mid/late January. He, of course, is sure he won't get it. I understand that. It's a lot easier to deal with if you convince yourself you won't get it. I'm hopeful, but then this is his fourth time and I thought he'd get it each and every time.

If he's selected, he'll get a sequence number. It should be pretty low, since he's been qualified for promotion for years. If he's selected and gets a sequence number of, say, 7, then each month as the Army decides how many more E8s they need, they'll promote that many from the list. For example, say they need four in January. Sequence numbers 1-4 will get promoted that month. February they need three. Sequence numbers 5-7 get promoted that month, including Darrell. Get it? But it doesn't much matter what the sequence number is - if he's selected and gets a number, it's just a matter of time before his number is called (although obviously the bank account prefers sooner...)

If he's selected, we're almost surely moving this coming summer. There's only one E8 slot at the ROTC battalion here, and even though the guy there now is leaving this summer, there's already a guy on orders to replace him. Besides, they usually pick E8s that have held the rank awhile (and have already done a 1SG gig or two) to have that spot. We're okay with this - I'd rather move next summer and stay at the next duty station for a few years than to stay here and have Justin get even tighter with his friends here before having to leave (again).

Almost certainly, he'd get a first sergeant (1SG) spot in a unit getting ready to deploy to Afghanistan. That's where the need is. We're not expecting to have any say in where we go for this one.  I'd love a short list to choose from, but not expecting that to happen.

If he's not selected, it's another year before the next promotion board is held. Last year, they selected only five out of hundreds with his MOS. He would have to walk on water or be BFFs with a board member to have made it last year. The Army just didn't need a lot of his MOS promoted last year - it was nothing personal. Although he knows that's the case, it's still really hard to take. His evaluations are pristine. His experience is as good as he can possibly have - he's done everything he can do that's within his control. However, he doesn't compete as well against guys who have gone to all the super cool schools (airborne, air assault, ranger, pathfinder, etc). He's never had the opportunity to attend any of them, even though he's begged to his whole career. Not fair, but it is what it is.

So, we wait. We expected the wait. But yesterday we found out that the wait is only one more week instead of almost two months. Eeeeek!!  Also hoping for MY BFF's husband to make it.  Cross your fingers for us...

A little better...

The prednisone appears to be working.  Riley is breathing a lot easier tonight compared to last night.

I've asked the boys to sit on the floor whenever they're around him.  We're just going to love the heck out of this dog for as long as he is with us.

Wiggle seat update!

Kaden has had the wiggle seat in class for two days now.  He got green for behavior both days!  He's only gotten green twice since the school year started (well, once she started using the green-yellow-red thing).  Great job Kaden!  If he can do it again tomorrow, it's Wendy's for dinner!

Riley has cancer.

Riley's lungs are horribly squished by a massive tumor in his chest.  The tumor is causing a buildup of fluid that's making the problem even worse.  They drained two liters of fluid and still couldn't see his heart on the x-rays due to the tumor.

Our choices are bad and worse.  Without any treatment, he has maybe a couple of weeks.  With predisone, a little bit longer.  We (and the vet) feel he has enough quality of life to not put him down immediately, so we're going with the prednisone to shrink the tumor (if it works) to give him some more room to breathe.

Pretty soon, though, we're going to have to put him down.  Of course it's also Christmas, and I don't want to do it too close to the holiday.  We'll have to see how much the prednisone helps and make that decision when it's time.

The boys have been told.  Justin is a wreck.  Kaden just keeps drawing pictures of him over and over.  One for each of us, one for Riley, and I think one for the fridge.  

What a difference a day makes.

Riley is really sick.

Really sick. Darrell asked me to take him to the vet today because of some swelling in his neck, as well as obviously not feeling well. I figured it was just a cold that he'd get over - not a big thing.

I'm so glad Darrell had me take him. It's not a cold. Far from it.

I totally expected the vet to look him over, tell me it's an upper respiratory infection, here's some meds, yada yada. Instead, he listed to Riley's heart for a few minutes (which was hard since Riley's breathing is labored), checked him over, and then told me that he wants to admit Riley for xrays, bloodwork, fecal testing, who knows what else.  I felt like I'd been run over by a bus.

He threw out words like possible cancer, lung deflation, cardiomyopathy (heart failure), pneumonia.

I held it together until I got to the front desk, then started crying. I know it's a different situation, but I can't help by think back to Kiwi, the cutie pie black kitten we adopted in South Carolina that died ten days later. I called Darrell in the car in the parking lot. He didn't answer, so I planned to drive to his work. I knew he wasn't teaching, and would probably be able to talk with me. On my way over, I noticed his truck in our driveway (we live just off the main road through town). Thank goodness.

I went in, without Riley of course, and Darrell asked me where he was. I couldn't talk and freaked Darrell out. Finally I calmed down enough to tell him what was going on.

It came from nowhere, ya know? He's been 'fine'... We've only had him for six week - up until three days ago, he seemed 'normal'. At least as normal as he's been since we got him. Turns out that he's not 'fine' or 'normal' at all.

I thought he was just out of shape. No, he's got 50% lung capacity, which is why he was getting tired so fast. I thought he just breathed faster. No, he's got something wrong, pushing on his lungs, or maybe there's fluid in there, or something. I thought he just had a cold!

The vet called back just before 2. He says the bloodwork is fine - no viscosity issues, no abnormal readings. It's not heartworm or lyme. And the other stuff shows it's most likely his heart or he has a tumor. The vet asked if he could do an ultrasound on his heart, and if he could insert a tube to drain off some of the fluid in his chest cavity - both to relieve some pressure off of Riley's lungs, but also to see what type of fluid it is.

And that's where we are now. The clinic closes in about two hours - I'm expecting a call sometime before then.

We're so attached to this dog already. I know it's only been six weeks, but when you plan to have a pet in your family for the rest of it's life, you get attached, ya know? I just hope we're still talking YEARS of the rest of his life. Still too early to plan anything. It depends on what's wrong.

Darrell and I have been 'what-if'ing any of the possible scenarios, but really there's nothing to plan or decide until we know what the situation is.  I just told the boys that Riley's at the vet.  They haven't asked anything further.

I'm not mad at the rescue organization - there's no way they could have known. But the vet says that there's no way that Riley is only three years old. He's getting five or six. We wouldn't have adopted him if we'd known that. This is the exact situation we were trying to avoid. We wanted a young dog so that we weren't dealing with this kind of thing for many many years. Instead, six weeks later, here we are. It is what it is, and we'll deal with it, but I'm.... what, mad? I don't know. Certainly disappointed, devastated, sad. And yeah, a little bit mad.

We love him, that's for sure. This totally sucks.

It's starting...

The tree is up!

As much as I don't like putting up the tree, I love it once it's up.  You can't tell, really, in this picture, but I like a little bit of tree with my lights.  That takes forever, especially towards the top (having to keep putting my arms down for blood flow *laugh*).

So far, the dog has left the tree alone.  And since the cat has banned herself to the second floor (to stay away from the dog), the tree might be safe this year.

I love our tree.  I love the mish-mash of ornaments we've collected over the years.  I'll never understand the family Christmas trees that follow a different theme each time.

Sam's favorite mashed potatoes

And mine too. Oh my goodness.
Thanks Tyler!

Ingredients
4 pounds golden creamer potatoes, peeled and cut into quarters
1 bay leaf
Kosher salt and freshly ground black pepper
2 cups heavy cream
3 tablespoons unsalted butter

Directions
Put the potatoes into a large pot, add the bay leaf, 2 tablespoons salt, and cover with cold water. Bring to a boil over medium-high heat and cook until the potatoes are tender, about 20 minutes. Drain them well and remove the bay leaf. Meanwhile, heat the cream and butter in a small saucepan. Put the potatoes through a ricer or food mill into a bowl. Add the hot cream and season with salt and pepper. Mix together with a spoon.

Another yummy recipe

Crockpot meatballs.  Couldn't be much easier, and they're super tasty!

Christmas Crafts!

Carol, Justin, Kaden, and I (well, Darrell made one too) spent an hour or so making button ornaments today.  I originally saw the idea on Pinterest, and had hoped to make enough to send to everyone for Christmas gifts since our two income household became a one income household.  But now that I'll be gainfully employed soon, we're keeping most of them for ourselves.

Anyway, it's super easy.  The hardest part is finding the right buttons.  I found mine here.  I wish the average size was larger; we ran out of the big ones long before using up the small ones.  But, it was a fun and easy craft, even for Kaden.

I bought long pipe cleaners from Walmart and folded them in half.  Used the two ends to go through the buttons, then twisted the very ends for the loop to hang on the tree branch.  Ta-da!

Can't go wrong with cheese and bacon.

Bacon and Cheese Chicken.  Who would have thought to pair teriyaki with cheese/bacon?  Not me, but I'm glad she did.

Thank you, Anne.

You will most definitely be missed.

Promotion?

 

The annual E8 board has concluded and results will be released early next year.  Darrell's had a few chances at this promotion, but hasn't been selected.  Last year, out of over two hundred eligible 11Cs, five were selected.  With those numbers, you'd have to be BFFs with a board member or walk on water to be selected.

With the economy in the tubes, many senior NCOs have chosen to stay in the Army longer than they planned.  Since they're not getting out, there aren't as many openings for the rank below to be promoted.  This is the situation we're stuck in now.

However, the Army has started to make it more difficult to just stick around a few more years.  Soldiers with 20+ years in are finally leaving; whether by choice or not, it opens up higher probabilities that Darrell will make the list this next time.  As the Army draws down, his chances will likely improve each year.  But dang, he's been a Sergeant First Class for quite some time now.  We're hoping for better luck this time.

Pretty smart guy.

• Everybody is a genius. But if you judge a fish by its ability to climb a tree, it will live its whole life believing that it is stupid. 
• Education is what remains after one has forgotten what one has learned in school. 
• If you can't explain it to a six year old, you don't understand it yourself. 
• It is not that I'm so smart. But I stay with the questions much longer. 
• In the middle of difficulty lies opportunity. 
• I know not with what weapons World War III will be fought, but World War IV will be fought with sticks and stones. 
• If we knew what it was we were doing, it would not be called research, would it? 
• Insanity is doing the same thing, over and over again, but expecting different results. 
• I must be willing to give up what I am in order to become what I will be. 
• Whoever is careless with the truth in small matters cannot be trusted with important matters. 
• A ship is always safe at the shore - but that is NOT what it is built for. 
• The woman who follows the crowd will usually go no further than the crowd. The woman who walks alone is likely to find herself in places no one has ever been before. 

These are attributed to Albert Einstein. No idea if he actually said all or any of them.

Meet: Riley

Riley is our new-to-us boxer dog.  We've waited YEARS to get a dog; it never seemed to be the right time.

Well, our waiting is over.

We have many friends with boxers and we knew we wanted to adopt from a rescue organization that fosters their dogs to families rather than keeps them at a shelter somewhere.  Since we have younger kids and a cat, we had to wait a while before a dog became available that wouldn't harass one or the other.

Riley was found as a stray.  He's an estimated three years old and was super skinny when brought into the rescue.  He still has about ten pounds or so to gain to fill out all the way, but we're getting him there.

At some point in the near-ish future, we'll probably get another one.  We'll wait until the time is right, and until then continue to get to know Riley.

Kaden and the Wiggle Seat

Kaden is in kindergarten.  His birthday is only a few days before the cutoff.  Kaden is a boy.

Therefore, it is not too surprising that Kaden is having difficulty sitting still in class.  He's a very young kindergartner and he has a first year teacher.  His teacher is not young; she has a few children of her own.  However, she doesn't yet have a lot of experience in a kindergarten classroom.  It's been pretty challenging, and on the advice of friends with more experience than the teacher and I have, we're going to try out the Wiggle Seat.

From Google's first search result link:

If your child is full of energy and fidgets and wiggles, sitting in a desk chair for prolonged periods of time may be a particular challenge. Kids who have trouble sitting still may wobble their desks, rock their chairs, spring out of their seats, or otherwise do things to annoy the teacher without even realizing they're doing it. How to keep your child comfy on that unforgiving wooden slab? Here are five quick solutions to talk over with your child's teacher and try for everybody's relief.

Solution number one is a cushion generally called a Wiggle Seat.

Anyone who has been around Kaden more than a day or two knows his favorite color is yellow.  So, I Amazon-ed us a yellow wiggle cushion.  He'll bring it with him to class after thanksgiving break is over, but I figured we'd try it out at home during mealtime in the interim.

I'll keep ya posted.

Thanksgiving without Sam

For the first time in many years, we won't be going to my best friend's house for Thanksgiving. (Sob!) We're on our own! Yikes! My sister will be coming to visit, but it'll still be a smaller dinner than we've gotten accustomed to.

On the menu: turkey, ham, homemade mashed potatoes (using Sam's favorite recipe), stuffing (Stove Top), gravy, corn, honey carrots, rolls, pickles/olives, cheesecake, and apple pie. Darrell might toss in some sweet potatoes and store-bought pumpkin pie. I plan to brine the turkey (a la Alton Brown).

It's our first turkey at home since, I believe, our first Thanksgiving after we got married. If all fails, Pizza Hut is open - right?

Civilian living in the Army

Yes, we're still an Army family, but we're living in the middle of Army-nowhere. The nearest Army post is hours and hours away. I thought I'd like it, but I don't think I do.

Don't get me wrong, it's beautiful here. We loved living in Colorado Springs with the mountains right next to us. Although there aren't any mountains in view, we are living in a house less than two blocks from a small lake. A completely different kind of beautiful. I've never lived lakeside before, and we're looking forward to taking advantage of it. Apparently it will freeze over this winter - I've already seen flyers for an ice putt-putt fundraiser. Fun! And of course we hope to rent a boat at some point.

Also, we're in the lake effect region of the country. You'd think we would have gotten lots of snow in Colorado, but not where we were in the Springs. The average snowfall here is about 150 inches per winter season. Yikes!

So as much as we're enjoying the location, I'm missing the camaraderie. I haven't made any friends yet, there aren't any new-military-family events, and until next month, I haven't had a job. I've very much enjoyed taking some time off, but I'm starting to get stir crazy. I've read literally hundreds of books, taken the (new) dog for many walks, and enjoyed many naps, but I'm raring to get back into the working world. And for those of you who are my Facebook friends, you'll get this complaint again - I really miss the commissary! We've been so spoiled being able to buy groceries at super low prices. The sticker shock hits me every time I go to the store here.

We're not completely alone; Darrell isn't working by himself, after all. There's just no comparison between brigades worth of Soldiers and their families and a small office with less than a dozen coworkers. It's different, and it's reminded me of how much I really do like living in an Army community.

Dinner!

Easy Pulled Pork Sandwiches



I made this for dinner last night and finished off the leftovers for lunch. Super easy, and kid approved.

A year and a half?

I knew it'd been awhile since I posted here, but had no idea it had been that long.

As a blogger, I suck.

Anyway, update time. We now live in Pennsylvania. The nearest Army post is hours and hours away. I thought I'd love living like a civilian again, but actually I miss the whole Army lifestyle thing. The commissary especially, but also the camaraderie.

We've adopted a dog, Riley. He has some isolation anxiety issues to deal with, but is otherwise a great fit into the family. At some point in the semi-near future, we'll probably adopt another rescue boxer to keep him company. The cat is not pleased, but she'll just have to deal.

The boys are doing well in school. J has made some friends in the neighborhood and is playing the trombone again. K is loving kindergarten but is having problems sitting still. We're hoping a wiggle seat will help (basically a nubby plastic cushion to sit on).

I recently accepted a job offer and will be starting in early December. It's a federal position (yay!) but for now is intermittent. They hire their full time staff from their intermittent pool, so I'm hopeful for permanent full time work in 2012.

D is relaxing as much as possible in his instructor position. It's nice not having a deployment looming on the calendar, but this job isn't as laid back as we thought it'd be. Still, he's home for dinners and weekends most of the time. We'll take it!

The promotion board results will be out in January/February. If D makes the list, there's a good chance we'll be moving this coming summer. If not, we'll be here at least another year.

That's what we're up to at the moment. Hopefully it doesn't take me so long to update again...