You may have noticed that I quieter than usual in recent months. I deal with health problems.
Two things: my vision and my MS.
My vision problems have nothing to do with MS and to do everything my surgeon do cheerfully referred to as "high short-sighted." High myopia is defined as -6.00 diopters or more. My last requirement is not far from the triple; I am a mega-super-high myopia. One of the problems associated with high myopia posterior subcapsular cataract (age-related cataract generally core). My vision is more fully corrected with glasses or contact lenses. In fact, even without the waterfalls was dicy: Most contact lens manufacturers do not make the order; those who gained about $ 800 per year (usually ended up being about a mile, when the damage check ... losing a lot of contact lenses, if you can not see) have.
Not to be able to see, but not see shit in the situation when you walk with crutches is dangerous. So I took the decision to have surgery: total replacement lens in both eyes. I accommodative intraocular lenses and now I am busy to get me to read again. Well, I will if I am healed. I just (Tuesday) I had done the second eye. And according to the surgeon, it may take three to six months before you get your best view.
At this moment I see ... everything. Distance with a bright eye, delightfully tight. Midrange very well with both. But the vision is intermittent. The postoperative inflammation and various drops (two anti-inflammatories, antibiotics) I have to take four times a day for the next week that everything covered with Vaseline. Or maybe that is the real Vaseline in the soup, I also. But damn, I had no idea that the world is so bright! The colors are very different; I knew I had to see the world through a yellow filter for most of my life?
For high myopic colleagues: If you can afford it, do it. It will change your life. Three caveats, however.
- Money: Most insurance companies in the United States focus on, if you really cataract surgery, and they will not cover accommodative IOLs fantasy at all times. Because these lenses have a special prize imagination, make sure that your bank account is over.
- Pain. One of the things I tell everyone it is about the surgery that you do not feel anything. They are, or at least no eyes strangely shaped high myopia. It hurts. So much. This is obvious, because it means that the shape of the eyeball rare, it is a difficult business to get the target in the right place for me there is additional material is also something of a stabilizing ring. Anyway, there were many things that are gouged strong push in my eyes. It's not funny. But, well, surgery does not last as long. (Although, of course, more to myself than anyone else, sigh.)
- No problems. Most people who undergo cataract surgery, not so terrible myopia done. For them it is a bit uncomfortable for a week or two with eyes different corrections. But for those of us who are more than -16 D the world is an alarmingly dangerous place. I have more than bruises he was Karate makes and taken too much. But healing ...
And so now my MS.
Short version: I lost six months of my life to a new drug for MS that took me in terrible pain, the kind of pain that makes it reasonable to kill; I'm not kidding, I had to get drugs into oblivion. Everyone. Simple. Day. I stopped the medication and within a few days, the pain was gone. My MS is stable. But six months, the effects of opiates and heavy physical activity zero, no joke, that over-take time to shake up either.
Long version: Last fall, shortly before Hild was published in the United States, which began Tecfidera, ie, dimethyl fumarate pill, marketed by Biogen. This is a (supposedly) improved version of an earlier industrial chemical is a methyl ester of fumaric acid. Variations have been used for years in Germany for the treatment of psoriasis. (Even in China for the fumigation of furniture ...) can cause side effects, of course. I have carefully read the list. I did a little research so that I could weigh all the pros and cons. (There are many disadvantages., See below.) We had blood tests. I decided to try it.
The first two weeks, the first dose, were fine. Certainly, within the parameters I expected: uncomfortable, annoying, but transitory. The price was right. (The sales price is $ 63,000 per year, but through the good offices of friendly people who get it for free.) Then I went to full dose and in two weeks I had the first idea of the difficulty.
Quick aside: I hurt my elbow in the summer when archery is. After a few days of ice and rest I care to archery rebound and looked good. Occasionally strange flash nerve, however, led me to a neoprene sleeve use to keep the ulnar nerve in place.
Anyway, on a Sunday afternoon in early October, had just in Portland for the annual show BANP where I had arrived to make a speech to 200 booksellers breakfast on Monday morning. I felt good, therefore, eager, energetic, out with knock-your-socks that charms me (I hoped), also gossip Monday morning bagel speech. We checked into the hotel. We arrived in the hotel room. And then my heart went crazy.
I had a previous heart beat faster. I had cardiac arrhythmias 2 But this time, my heart just ran me. It was like the worst panic attack in the world. Then it got worse. 120 then 140, then 180 beats per minute. I could not breathe. Then flashed the pain in both arms, luckily only for a second. So ... he went. My heart slows down. I could breathe. I was back to normal, but not relaxed.
When I returned to Portland, I went to my neurologist. He said one of the side effects listed above was Tecfidera peripheral nervous system arousal: heart rate, breathing and pain blinks were probably part of it too. (Apparently one of the reasons why people with heart attack pain radiating arms is because your peripheral nervous system goes haywire when trying to find a way to survive.) But that eventually should go out. Probably.
Hild is out. I had the opportunity rapid heartbeat for a few minutes, but nothing like Portland, flashes and no pain. I began to relax. My book was published! Great-Great.
Then one night, on the weekend after Thanksgiving, everything went to hell. It was like Portland, but much worse. The pain shot down his left arm again. Then my left leg. Then, through my chest, my neck, my head. Then all joined together in this forest fire sheet with a blank mind. The whole left side of my body is inflamed body. I could not believe it. I could not speak. Just scream and squirm. Mad with grief. If I could have killed him arrested had tried (but do not think and I could not have done). But I could not consistency at all. Kelley called an ambulance.
I had never called an ambulance for me in this country. I do not remember much, except that four ETS-three men, one woman, pumped full and radiant resistance appeared in the sound of the bells and whistles, and then acted like I was having a heart attack all. When it became clear that it was not that they were confused. Next stop, ER. It was a nightmare: another ER in the city only had a terrible fire, so that severely ill patients were beaten from there. The beds, patients, intravenously, action. Total chaos. But while I was with the triage nurse, the pain began to subside. I began to think. I could say my name. The recovery was quick. And then, because I felt perfectly fine, and there was nothing they could do, but I admit, I hang morphine IV for repeat offenders, and hopefully, I went home.
Long story short: in the coming days, there were several. For no apparent plan. No one could understand what was going on. My neurologist had Thanksgiving / Hanukkah stopped / to meet his first grandchild. My internist cared for MRI and other advisors. I filled a prescription for Percocet, which I swallowed as Smarties. More than it should. When my internist found that the roof taken. (I called twice a day, every day, even on the day of Thanksgiving / Hanukkah.) From there I was under strict instructions: This number more. If the pain does not go to the emergency room, it is common practice, fentanyl is, and ask them to call me.
My neurologist has returned. Study of MRI. He put me on prednisone for the theory that I had a relapse. It makes no difference.
Gradually I found that the worst thing took about 40 minutes. At first I thought it was just because this is the time to really work for oxycodone, but then something as automatic calendar always had opiates in my system and again 40 minutes I started. Then I realized (believe me, it's hard to see anything when you lost) it seems to be another reason, but could not quite nail. I started connecting all the pill, when, what for pain, when, how long after I did that this happened My days were at home sitting very, in a special chair and on the clock until I take more pills very quiet .. Without the pills, I'm not sure I stay healthy.
And that's pretty much what I did. I could not walk. I could not sit at my desk. I could not sit at the kitchen table. I could not carry a cup of tea. Everything seemed the cascade of pain trigger. Sits very, very quiet with my opiate buzz blood was the only thing she refused. (This is why I canceled both. 3) And believe me, I would kill to defend my grandmother. Session is still running.
I lost weight, I was eating well (opioids do not appear to stimulate the appetite, food or beer affect), but I was losing muscle. Many muscles. And he shook my tendons and shortening.
And then, one morning, Kelley said, I think it's these damn drugs at about the same time I watched Tecfidera pill in hand, did not want to take. So I do not take the pill. I did not that night. Or the next day. Or another. And the pain began to subside. I relaxed a bit in the Percocet, stretching the hours between doses. The pain was always in order, except my elbows got 4 other opiates. I studied my notes. Definitely a pattern.
I went to my neurologist. This is something to do with the use of my left elbow, I say. And something to do with the bloody Tecfidera. Kelley nodded. Hate this drug, she said. Hate it that.
And between us realize that we: my ulnar was triggers pain signals (normal) damage. But because of my illness, my proximal nerve (where it meets the neck demyelinated CNS) was not painful gating these signals reliably. And because of my peripheral nervous system Tecfidera accelerated to the point that the doors off the hinges blew pain. No Tecfidera meant revolutions. No revolutions meant that he could soothe the nerves proximal. Pain-gating resumed. My wounded would like any injured elbow elbow normally do.
So now I have a few expensive pills do not need in the closet. My experience was duly forwarded to the FDA and hope that no one goes through it. I had a lot of treatment on the elbow as far as I can sit at my desk and come back-and then, of course, I closed with a bunch of tests, interviews and blog posts for publication in the UK Hild., And eye surgery. And now a lot of physical therapy to do; I have to learn to walk again. But first I need to learn to see, and need my eyes to heal. And anyway I have of the British press, touring the United States and, oh yes, the writing HILD II.
So I was a little distracted. But I'm back.
1 For those of you who do not know how this works, pharmaceutical companies billions of dollars on the line sponsors many studies for potential new drugs. But they argue that the publication for those who are potential blockbusters to show in a positive light. So, all you is about to read is also biased by nature, no matter how brave medical journals trying (or not) to ensure impartiality. No one outside of the circles of the licensee to make money really knows about drugs on the market, no matter how many letters they have after their name or how smart or how esteemed or respected or revered. Let be said of anyone else. I knew it. But I thought, how could it be bad?
2 Since the fixed my diet and the problem has largely disappeared. And a lot of shit Benadryl makes it a rule about my filter.
3 I have some local events. If you saw me from the end of November and April, I was stoned out of my gourd. Apparently, most people do not know. (A data point of interest.)
4 me No matter the pain in the elbow. There is nothing, nothing compared to Flash, Shooting, soaking, washing, and the agony of Tecfidera more proximal nerve demyelination, more peripheral nervous excitement.
