A Medical Odyssey: Every Decision Matters

Written by Paul Zannucci on 10:42 AM

<--Lou Gehrig

We like to claim that luck, good or bad, drives a lot of our lives. We like to claim that where we are has everything to do with where we started, the color of our skin, the abuse of others. It is an essential base of the liberal mindset that most things are beyond our control. The truth is that decisions matter. I am currently experiencing a bad bacterial infection that just won't go away because it is being complicated and aided by TMJ. It's all a part of a medical odyssey that includes being told twice that I had a fatal disease. Strangely, I can relate it all, including this infection, directly back to two decisions I made as a youth, and one I made when I was older.

The first decision came in middle school when I took up a bet regarding physical prowess. I won the bet, which awarded me bragging rights and a set of matching inguinal hernias. The second decision came when I went off on my first "just the guys" outing at age sixteen. Without parents around, a gang of us decided to take a skiing weekend in the mountains of North Carolina. On the way, we stopped at a convenience store and purchased what every Southern boy needs at age 16, beer and snuff. I've always been able to put the beer down, but the nicotine held me hostage for over twenty years. I'm thankful, at least, that it was Skoal and not Marlboros.

Back to middle school, my parents took me to the doctor regarding my hernias. Way ahead of his time, the doctor said they were only small and just to keep an eye on them. That sounded good to me. Keeping an eye on them slowly moved to eyeing them with weary agony my senior year in college. Years of weight lifting and sports had ripped the left hernia wide open and made the right one a bit worse. The doctors agreed the left one needed work right away. The surgeon said the right one could continue to wait. One hernia gone and life goes on...and on...and on...

After college, most of the weight lifting quit. Exercise at the track was good enough. That right hernia grew very slowly. Every now and then it would give me problems when jogging or after a great deal of lifting, but it was mostly an afterthought. Something like fifteen years later (don't worry about the math), I contracted pneumonia--and not the "walking" kind. After a few months of nonstop, lung wracking coughs, my hernia was in pretty bad shape. I didn't have time for that, though, and just kept going. Exercise became nearly impossible and when I had to occasionally stop what I was doing to cram painfully trapped intestines back into my abdominal muscle cavity (not always indiscreetly), I decided to see the doctor. The hernia was about the size of a grapefruit.

Since I was going to be out of business for a couple of weeks (I refused laparoscopic surgery for the tried and true "open method"), I decided to multitask on my health and quit Skoal, a habit I hid from all but my wife, at the same time. So now I'm lying in bed, two hernias finally taken care of, wearing a nicotine patch.

Unfortunately, right before surgery, I had caught a cold. Coughing after hernia surgery is not recommended--the pain is excruciating. Between that and being laid up in bed, I decided nothing would be better than some tobacco. There would be time to quit later. I knew that ripping off the patch and using tobacco was dangerous, but I didn't care. I waited a few minutes then pulled out my emergency Skoal. True bliss. Maybe ten minutes later I had a coughing fit and something odd happened. A dark red streak of lightning appeared in my right eye's vision.

This was all I needed. Something weird with my eyes. I did some research and quickly ascertained that I had screwed up by overdosing on nicotine which constricted the vessels in my eyes. Combined with the blood thinning pain medication I was on after surgery, coughing caused a small vessel in the eye to leak. My vision was getting more and more obstructed. I called my eye doctor to see what he wanted me to do, and they wanted to see me right away.

One visit to the eye doctor got me an appointment with a retina specialist, though my vision was clearing. My theory that I had overdosed on nicotine while on blood thinning medication wasn't playing well. The retina specialist said it appeared I might have an underlying condition, likely atherosclerosis, and that I needed to see my internist. My internist couldn't see the vessels in my eye as well as the retina specialist. After ruling out causes like diabetes and Lupus, it was determined that my 136 cholesterol score was simply "too high for my genetics" even though I had no one in my family with heart disease. I must have hardening of the arteries, we thought, so I was put on Crestor. One month later my cholesterol was 63, and I was dying of rhabdomyolysis, that rare but dangerous condition you always hear about in the statin drug commercials.

I essentially lost the use of my arms and hands. The pain was tremendous. Not to worry, though. I was taken off Crestor and told my condition would improve. We would monitor my liver and when everything was back to normal, maybe we'd cut my dosage in half. Fast forward three months, and I was still having a difficulty gripping items and couldn't toss a ball a few feet to my toddler daughter. Blood tests showed that my muscles were still being broken down. Three months later, I was in a similar condition, and I started to have muscle twitches all over, non-stop, 24 hours a day. I call my doctor.

At the doctor's office, I'm told that ALS is likely my problem. A second internist comes in and examines me, arriving at the same conclusion. I probably have ALS. They call the premier neuromuscular specialist in the area and get me an appointment that's about three weeks away. I wander off in a daze and break the news to my family, my church, etc. There's still hope, but both doctors agreed that I likely was dying of ALS. That night I beg my way out of helping with Vacation Bible School because I'm so distracted. I go and sit in the chapel and pray instead. Later, not being officially diagnosed with anything, I go on a life insurance binge and buy $650,000 worth. I feel like I'm cheating and fear that the policies won't be honored. I don't really care. I'm just a dead guy waiting for confirmation from the neurologist.

Finally the wait is over, and I walk like a zombie into the neurologist office. They spend a great deal of time shooting electricity through my body, sticking me with long needles while watching a computer screen. Finally, they stop torturing me and the printer starts shooting out page after page of data. The neurologist is looking at the sheets (the pages are connected by perforations) as they come off the printer. Silently he examines them as I lay on the table. Finally, I can't stand it any more, and I say, "Pretty bad?"

"No, you're fine. I'm just looking through everything."

The feeling that washed over me at that moment was indescribable. I'd likely get to watch my 2 and 4 year old kids grow up after all. The neurologist told me it was the Crestor. That it caused long term changes that could take up to 18 months to get over--if you ever get completely over it. I was diagnosed with Cramp Fasciculation Syndrome caused by Crestor and sent on my merry way.

Not long after, I was told I didn't actually have hardening of the arteries after all. Maybe it had something to do with nicotine overdose and blood thinners.

I have since improved a great deal. I am no longer limited in any real way, but I continue to twitch and have pain and exercise takes a lot longer to recover from. In an effort to help my muscles and get more oxygen to them, I was put on a CPAP machine (I've always been a snorer). This was just recently. In fact, I purchased it right before I went on vacation to the beach. When you wear a CPAP at night, you have to keep your mouth shut. Apparently, during sleep I wasn't just shutting my mouth, I was clinching it. My jaw joints swelled and after swimming in the ocean and the pool, I caught a nasty bacterial infection that's not going quietly into that good night. My doctor told me yesterday I need to have a mouthpiece made by my dentist so that I don't have this happen again and gave me more drugs. Hopefully I'll be able to hear and chew soon. It's really annoying to have to suffer through this due to taking a bet in middle school, starting Skoal in high school, and ripping off a nicotine patch in frustration.

I can go back through my story here and find lots of people to sue. The store that sold me my Skoal even though I was underage; the manufacturer of Skoal; the doctors who incorrectly told me I had atherosclerosis; the people who make Crestor. And it sure would be nice if the government had paid all those medical bills. But me? I'm just glad to still be around and have a chance to make more decisions that will influence my future and the future of those around me--hopefully for the better.

By the time I was told that I likely had ALS, I had been off of nicotine for several months. Thinking I was dying and wanting nothing more than the comfort of that wonderful and terrible drug, I refused. As hard as it was, I saw no sense in piling a bad decision onto a bad situation. Now I'm free of the ALS fear and the nicotine, both.

Decisions matter, and I'm getting a tiny bit better every day--and it's coming from me. Isn't that better than expecting the government to come in save the day or to subsidize your own bad decisions? It sure feels better to me. And, yes, sometimes things don't go our way. Sometimes luck, good or bad, does play a role. Lou Gehrig stood before the New York Yankee fans, confirmed to have a disease that would soon be named for him, and told them he was, "The luckiest man on the face of the Earth." I have often felt shamed by that statement, that show of bravery. When that day comes for me, when either my decisions or circumstances create a situation that is too grave to overcome, I hope to go out as strongly, as positively, as did Lou Gehrig. Blaming no one. Just happy to have been here with a chance.

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  1. 7 comments: Responses to “ A Medical Odyssey: Every Decision Matters ”

  2. By The Lonely Conservative on August 14, 2008 at 2:25 PM

    Wow, I laughed, I cried...seriously, I'm glad you're okay. I just had the EMG/NCS test done. Getting shocked was one thing, then the needles in the arm was another. I looked like a junkie by the time they were done and I didn't even get a tattoo!

  3. By Paul Zannucci on August 14, 2008 at 2:29 PM

    Geez, you had to go through that thing, too? That's not a great deal of fun after awhile.

  4. By The Lonely Conservative on August 14, 2008 at 3:38 PM

    Not fun but compared to child birth it was a breeze. I used to be a worker's comp claims adjuster and had a few claimants that were pretty big guys run out without getting it done. They were either big babies or big fakers, or both! So I sort of laughed the whole way through it.

  5. By Paul Zannucci on August 14, 2008 at 6:13 PM

    I do it eight times a day before I'd cough once after having my hernia operated on. Part of my difficulty was that I thought I was being diagnosed with ALS, so my nerves were shot, and then suddenly I'd get a jolt of electricity. Still, I remember it as one of the best days ever. After all, I left with a smile.

  6. By MonkeyCrash on August 14, 2008 at 7:37 PM

    Gald you're okay. Just remember that doctors only "practice" medicine. I have a friend with ALS. He's only 23. We all have our crosses to bear, but some are heavier than others. Glad you don't have to worry about that one.

  7. By Paul Zannucci on August 14, 2008 at 8:26 PM

    ALS is a terrible blow at any age. At 23 it borders on unacceptable. I find that people with the disease almost universally have a strange sort of strength that everyone admires. It's a terrible, terrible disease.

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