A Very Near Brush With Death

Right. Step one is a special super thank-you to my bud Ernie Reardon, without whom I would probably not be talking to you all. I’m going to do something really nice for him. Of course he probably won't let me.

Earlier this month on 7 November, I went back to the Gastrointestinologist because my acid reflux was acting up again. He suggested I resume Nexium 2x per day instead of 1x per day. I had, as instructed dropped back to 1x per day after 90 days. His assistant, also an MD, suggested Claritin-D/24hr and he agreed. Not a big deal, especially since we know I’ve got allergies to dust and such. (See previous blog posts). I resumed the 2x Nexium 8 November.

I began taking the Claritin-D on 9 November before bed. It kept me from sleeping making me restless, so I started taking it in the morning instead, starting 11 November. Since it was a 24hr pill, this shouldn't matter. I also had left, on 10 November, for my trade show in Las Vegas (also a previous blog post). The Claritin-D worked remarkably well and my severe morning reflux issues almost entirely vanished after a few days.

Over the course of that week in Las Vegas, I noticed my heart seemed to be beating faster, but I thought it might be my imagination. After all, I was at a trade show in Las Vegas, where there are rumours people drink a bit more than they normally do, you're surrounded by smokers, there's a lot going on that might cause more excitement than you would normally get in a given day. That and all the wonderful food. The rapid heartbeet kept up even after I returned home. It slowly worsened -- coming and going both fast and slow -- and I wasn’t sure what it was. I didn’t connect it to the Claritin-D. A possibly nearly fatal mistake.

By 22 November, Thanksgiving Day, it felt like my heart was beating really fast, then really slow, and then back to normal for a few hours, but when it started going I thought it was going to burst right out of my chest. I had no way to confirm my feelings except putting my hand on my chest and feeling it – admittedly not very scientific. It was, indeed, very noticeable. I did not have the "heart attack symptoms" such as pain in the arm, blue coloured fingers and toes, chest pain, shortness of breath, and so on. So I didn't panic and think I was having a heart attack.

During this time, I became extremely fatigued, falling asleep often even mid-day, sometimes getting light-headed. As the week progressed my heart got louder and louder, so I could hear the pounding in my ears, and even see spots in front of my eyes in time with each beat. I realized something was amiss, but I didn't know what. I decided, perhaps, on Monday if it wasn't better I might get around to calling the doctor. As a guy, I wish to report that it's true: we hate going to the doctor.

It so happened the evening of Friday, 23 November, I ran into my friend Ernie on-line (AIM). We chit-chatted and he asked how I was. So, I told him. He said it sounded like an Arrhythmia. Ernie has a medical background and uses big medical words I don't know. So, I peeked at Google – Google knows everything, trust me. It so happened that several of the matches specifically mentioned Claritin-D. I followed the link and saw a mention very rare side-effect of which is not listed on the box.

So I stopped taking it, to see if I would get better. At that time, I also sent a fax to the doctor’s office letting him know what I discovered. I figured if it got worse, I’d call emergency. I exercised on Saturday morning for 45 straight minutes (ice skating) with no problem, though that’s about 1 hour less than normal. It didn’t kill me though.

The GI doctor called me first thing Monday morning and told me to see my primary care doctor and then have my doctor call him. I saw my doctor today (Tuesday) as soon as he got back in town. I decided I’d rather wait until today and see my doctor rather than some random doctor in the hospital.

He spent quite some time with me. We did x-rays, EKG, and all sorts of other tests. All these results were compared with the base-line tests we did after my 40th birthday when I had a complete physical. Happily, it appears I have suffered no serious damage and that all of this was a reaction to the Claritin as it built up in my system. We are awaiting (Friday) results of my blood spectrum and toxicology reports. He's checking my thyroid as well, but based on my weight we're pretty sure that's not it.

Irregular heart rhythms can also occur in "normal, healthy" hearts. But I first got mine a few days after starting the Claritin-D. According to WebMD, although arrhythmias may be normal in certain settings, they can be life threatening in other situations. This is because certain abnormal heartbeats that result from electrical dysfunction in the heart make the heart unable to pump enough blood to keep a person alive. In other cases, irregular heartbeats can lead to blood clots, which can cause a stroke or brain damage and other tissue damage.

This really sucks, too. You know why? The Claritin worked very well and reduced my Acid Reflux to negligible levels indicating it is indeed at least partially allergen related. However, both doctors insist under no circumstances may I take any allergy drugs of any type for at least one month and then, only after a full consultation.

Today's Medical Report

Today was my appoint with Dr. V. Alin Bottoman, who I saw because a friend highly recommended him. If you haven’t read my insurance saga, it might be appropriate reading. You may read that at: April 2007. My previous medical update is at March 2007 – and lastly if you don’t remember when it started there’s this blog post September 2006 and this post August 2006. That will get you up to date. Done reading? Good. Now, I can start where we left off. This bit will take you from the March 2007 post to today.

As you’ve seen, I spoke with Doctor Newman a few days later and he said the results were excellent. There were no tumours, ulcers, or any sign of any problem whatsoever. He said I had a very small hiatal hernia, which is normal in people my age and it was nothing to worry about and wouldn’t be the cause of the reflux. As you can also see, as evidenced by my anti-insurance posts, I went back to Doctor for my follow up visit. He used the camera through the nose device, said nothing was wrong, and referred me back to Doctor Newman who he said was my doctor for everything except the granuloma. Not overly happy with being shunted off, I called Doctor Newman who said to continue the twice per day Nexium and add a Zantac mid-day. I’m doing that, but I don’t want to take drugs long-term. Something caused this, and if we can find the cause we can fix it.

The simple fact is my acid reflux is not getting better despite all these medications. I can taste it in my mouth on-and-off on some days – a sour taste in the mouth. I have embarrassing large quantities of gas all day and all night. My throat is very sore, especially on my left side near the top and swallowing is a chore -- if I press the spot with my finger, I can swallow with almost no pain. I find that odd. My voice sounds terrible. The problem is worse in the morning, especially when I first wake up.

My stomach has a constant dull ache that has only started since the Endoscopy (though I don’t think that it’s related) – I suspect it’s the gas build-up. I am also getting sharp-stabby pains in a few very specific spots of my stomach, also which started since the Endoscopy. They don’t last long (2 or 3 seconds) but I sure as hell can notice them. One spot is worse than the other two. It happens 3 or 4 times per day, randomly and in varying degrees. And now, you’re up to today before Doctor Botoman. Aren’t you glad I had all this free time to type this for your reading pleasure?

The doctor’s office gave me a ream of paperwork to fill out: questionnaires, surveys, and the usual health crap. Then, of course, I waited. There’s nothing like a doctor’s office to wait in for the sheer boredom effect. Then they called me in and the nurse came in with a laptop and asked me many detailed questions, and typed them into the computer. Prior to my visit, I had faxed a two-page report on everything that happened to date (which, happily, was already in my folder). I also vented about my Aetna problem and she laughed (friendly) and said they’re all bad so I shouldn’t be too mad. Then she said the doctor would be with me shortly. She also informed me I look like him (I disagree) and I’d see when he came in.

A good 35 minutes later, he appeared. And he immediately apologized for the delay. I liked him already. No doctor has ever apologized for the wait. He explained the network went down and he needed all the stuff the nurse typed in so he had to wait for it to come up. He asked me lots more questions.

First, he agreed that there’s obviously something wrong despite the fact there was nothing on the Endoscopy. Second, he believes Nexium doesn’t always work in some cases and I may be one of them. He is postulating that my body is metabolizing the Nexium faster than it’s released from the capsules though he recommends I continue to take it 2x per day for at least 3 more months. He also said the morning dose is far more important than the evening dose which is against conventional wisdom.

(The part from here to the end of the post is heavily edited for on-line viewing. I've left most of it out; lots of gory details, and the bulk of the results. The report is available to friends and family by inquiring via e-mail.)

First up for me is a poop test. Once I pass that I get my first pH test which is done by inserting several electrodes into my nose and down into my esophagus which stay there for 24 hours. I then wear what looks like a purse for 24 hours (it contains the recording devices and such).

He feels there are several outcomes. If I do nothing, I have an extraordinarily high-risk of esophageal cancer, and can die from it. Associated with that, I run a higher risk of many other severe and possibly fatal medical conditions. As such, this is a very Bad Option, though some days it looks pretty good :)

There are several options: all of which involve surgery, none of it minor. There’s actually an even worst-case option, and that is the source is not found. Since the drugs aren’t working, this would present Big Problems.

However, he’s confident we’ll figure it out. My Acid Reflux suddenly changed and there has to be a cause. It’s a matter of systematically finding that cause. He doesn’t want to operate unless there is absolutely no other choice, and I whole-heartedly agree.

And if you’re not a doctor, please don’t offer advice. Some of the helpful advice I’ve received so far has seriously worsened my condition, so if you’re not a Gastrointestinologist, your advice is appreciated deeply but entirely unwelcome.