“It's not denial. I'm just selective about the reality I accept.”

"It's not denial. I'm just selective about the reality I accept." - Bill Watterson, author of Calvin & Hobbes

Day 83

I like that: selective reality. I guess I've had a lot of that over the last decade or two. This journey keeps unveiling new issues I never even knew I had. The latest: a hiatal hernia. What a surprise that turned out to be. You may recall me noting earlier that the physician that performed my EGD said there were no issues with my esophagus, stomach or duodenum, and that worse-case-scenario was that I might have to take some antibiotics if any of the cultures he took turned out to show a bacterial infection. I received the final results Saturday (didn't read until last night) and guess what: no bacteria, but I have a hiatal hernia.

Recommendation: lose weight (ha!), continue any acid reducer medication for 3 months and then discontinue (I've been on that stuff for over a decade), and change diet -- no citrus, no mint, no caffeine (thankfully I'm off that already), no chocolate (ditto to the caffeine), no fatty or fried foods (ditto again), no garlic, no onions, no spicy foods. Yikes... what's left? And then it goes on to say avoid the following: peas, lentils, beans, many vegies (including artichokes, asparagus, broccoli, brussel sprouts (that's an easy one at least! -- I knew those couldn't possible be good for you anyway), cabbage, cauliflower, cucumbers, green peppers, radishes, raw potatoes), many fruits (apricots, bananas, melons, peaches, pears, prunes, raw apples), wheat and wheat bran, eggs, carbonated drinks, fruit drinks, beer, red wine, sugar and sugar substitutes, and if you're lactose intolerant (thankfully I am not), no milk or other dairy products. Sheesh!!

Anyway, suffice it to say this report was inconsistent with what the doctor told John and I after the procedure, so I called his office first thing this morning to see if there could be a potential mix-up. I should have predicted that he'd be out of town today, shouldn't I? Hopefully I'll hear back from him tomorrow. I think I'll be selective about the reality I accept to this until I talk to him.

In the meantime though, you know me, I did do some more research. Turns out that a lot of us are walking around with small hiatal hernias and they don't do anything about it unless they interfere with swallowing or breathing -- any good stuff like that. It's defined as a loose connection between the esophagus and the stomach with some of your stomach protruding into it. Can cause lots of nasty things like internal bleeding if severe... I have to believe if my selective reality is discounted tomorrow that it's not severe given how I feel.

I also called the surgeon's office to see if this could be a roadblock and was reassured by the coordinator telling me not to worry -- the surgeon will ask for a copy of the films and if it's a potential problem, and if I am elsewise cleared for the bypass, he'll just fix that while he's re-routing all of my plumbing. Fascinating.

In the meantime I read up more on the "PET Myocardial Perfusion Study / Adenosine Protocol" also. The good news is that as of 2004 there had only been two reported deaths from the procedure and both were with patients that had severe pre-existing heart issues. And as advertised, side affects (80% of the population experience, higher for women (another thing I should have predicted no doubt)) include a 30 minute long hot flash accompanied by nausea. Other things he failed to note as potential side affects are headache and chest pain. They administer the adenosine in a six minute infusion and assuming three minutes into it you're reasonably OK, then they add the radioisotope. I can hardly wait.

Speaking of waiting, I am going to have to hurry up and wait to see if my insurance company approves the PET study. I called the woman that coordinates insurance approvals for the cardiology group, and she hadn't even received the request from the doctor yet, even though I say him 4 days ago. The practice is huge -- lots of cardiologists working together, no doubt to afford all that expensive equipment they have -- and in 3 locations. The woman that does the insurance auths is in a different location and the courier runs between locations Wednesday nights. I let her know the doc noted on the request that he wants me to have it in the next 2 weeks. It remains to be seen whether she'll do anything about it before the courier shows up this Wednesday... I think perhaps I will not hold my breath! This is one case where denial would likely work against my psyche.

Back to the wound care doctor tomorrow. John said this morning my lower one looks great and the big upper one looks pretty good. I am hoping the doc doesn't feel the need to debride it again tomorrow... time will tell I suppose. Another place where I think I'll be selective about my reality until I have to be otherwise! ;)