Mystery Doctor

Since I see my nephrologist so much, she has sort of become my primary care doctor. She will prescribe medication and appointments even outside of her specialty, which is taking care of my kidneys. Anyway, with the recent cast anxiety issues, my surgeon said to as my primary care doctor for anti-anxiety medication. No problem.

I just called the family practice clinic, and they cannot locate the last doctor I saw there. I have been going to that office for many years but back in 2018 or 2019, my doctor retired. I was then assigned to another family medicine doctor, Dr. Hoa Phan, and I did see her once in November 2020. Since it was during COVID, it was a video call. I even have proof from the Providence MyChart app:

Several months ago, the company that provided my wheelchair after surgery wanted to get authorization from my doctor. I gave them the name above, but they could not reach her. I finally sent them to my surgeon and promptly forgot about it. When I called today to make an appointment, the office staff could not find her name either. I understand she could have quit, but how do historical medical records disappear? Also, why can I see something from an app or web portal and the office cannot? Very weird.

Anyway, I managed to make an appointment in two weeks with another family medicine doctor, the same one that my parents see. My mom really likes him. I just want medication to help me stop freaking out about my cast.

“What is the worst-case scenario?”

Once again, it looks like I am on the path to the worst-case scenario. Here is a brief history of my health issues:

I pulled on a stubborn scab and fluid leaked out onto a small would causing a huge infection that took months to heal, including a week in the ER and subsequent hyperbaric treatments.
Blood test from above indicates renal issues when eventually resulted in dialysis and kidney transplant.
Even though it was initially caught at stage 3, kidney failure continued until I had to start dialysis.
Both volunteer live kidney donors caught up in years of testing while I was receiving dialysis treatments.
Possible a-fib incident turned into ER visit and open-heart surgery.
Peritoneal dialysis failed in less than three months requiring a return to in-clinic hemodialysis.
Simple ankle sprain turned into fracture then into dislocation. The surgery was successful, but I fractured another bone during recovery without even knowing how. Due to prior surgery, they may not be able to fix this fracture.

So here we are. I asked the surgeon what the worst-case scenario and he is blurts out amputation. So, from simply trying to impress my co-worker with my ancient skating skills to the possibility of losing my right foot in one quick fall.

Dear God, why does this keep happening to me?

Cast Claustrophobia

I think I have this:

Cast claustrophobia, also known as cast anxiety (CA), is a real condition that can cause extreme distress and anxiety while wearing a cast. It can be characterized by feelings of constriction and immobilization, and can even impede the healing process. Some patients may also experience pain, panic attacks, or thoughts of removing the cast.
Google Search AI

That is me, with the daily panic attacks. It started right after I received the new cast, and it has gotten worse every day. I felt terrible all day yesterday. Multiple times I felt I could not breathe and felt nauseous. The current panic attack started about eight hours ago and has prevented me from sleeping. There is no way I can make it through weeks of this. I tried some breathing exercises with no avail,a nd I really do not want to go to therapy or take anti-anxiety medications due to the cast.

There has to be a better way.

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Okay, super weird. After posting the above, I tried to take a nap. I was unsuccessful all morning, but I guess I was super tired. I managed to fall asleep for less than 20 minutes and when I woke up, all the hot/fold sensations were gone, and I could breathe normally. I did take a Norco 5/325 pill beforehand since I felt a neuropathy attack coming on the little toe on my right foot. Was it because I fell asleep? However, I woke up at 3:00 pm with my back burning. Did Norco block some kind of neurotransmitter? Was it hydrocodone or can just Tylenol work? I guess I will just have to wait to see if the symptoms come back. My right foot still feels like crap inside the cast though. That did not change.

CT Scan 20240528

I finally got a CT scan on my right leg/ankle/foot. It took a long time because the imaging center could not reach my surgeon’s office to get info for insurance approval. Last time, it only took a few days, not two weeks. My surgeon’s office is sometimes very difficult to reach. I had that experience when I tried to get my medical leave approved. Without insurance, the CT scan would cost me about $320.

The scan was very quick. It only took about five minutes. I must be the first patient since the CT machine room was very warm when I walked in. I was expecting the room to be freezing cold since all medical scanning rooms seem to be frigid. However, as the CT machine warmed up and started scanning, the air conditioning kicked in and the room got cold very quickly. I tried to take a photo while lying down but decided to keep my phone in my pocket.

The results will be ready this afternoon and sent to my surgeon. I am hoping and praying that my new condition is not too bad. I also want to ask to wear the airboot instead of getting another total-contact cast. I have been plagued with the symptoms of panic attacks for over a week and I cannot stand it anymore. Even now, after six hours, I am still experiencing the symptoms of the huge 3:00 am attack. Every website says the symptoms should only last up to 30 minutes but nothing has subsided for me yet.

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Here is what the scan looked like on the computer at my surgeon’s office. He could scroll through the layers of the scan.

Cascading Medical Concerns

Following up on my last post about daily panic attacks, I had a very mentally challenging day today. The only event I had on my calendar today was a call to Ukraine but that got cancelled. Then my friend wanted to come visit. I managed to text back an “ok” before falling back to sleep, just to be woken up when the friend arrived at my house. We spent the rest of the day watching animation and Korean movies.

All day, I have been experiencing mini panic attacks and perceived problems breathing. At some point, I decided to get my oximeter, my Apple watch for ECG function, a manual glucometer, and an infrared thermometer. I measured my blood oxygen levels when I had difficulty breathing and checked my heartbeat and rate as well. Since we did not have a stethoscope, my friend put her ear on my back and stomach to see if she could hear fluid in my lungs.

Since my surgeons suggested Charcot foot as the cause of my current issue, I read up about the condition. It seems to be caused by diabetes and high blood pressure, among other things. I did have issues trying to control my blood sugar this past month. Every little bit of carbs I ate would spike my blood sugar, sometimes to over 350, even though I shot a lot of Humalog. Is this just coincidence or three weeks of high blood sugar enough to dislocate my ankle? I felt the physical therapy routing was putting a lot of pressure on the dislocated joint too.

This was followed by the fear that my transplanted kidney was failing due to the acute high blood sugar. I did have plural effusion during dialysis where I had fluid in my chest cavity, causing difficulty breathing when I laid down. However, there were obvious bubbling noises when I exhaled, and I am still peeing a lot which should negate any fluid buildup in the body. I also do not have any edema in my left leg, and my right thigh has been a lot thinner since putting on the cast.

I am at a loss. The main issue right now is the general numbness and feeling of cold/hot/pressure from my right foot. I feel the same things in my left foot but having the right foot encased in a cast makes everything ten times worse. I will go for a CT scan in about six hours, and I hope I can get some clarity.

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It has been slightly over two hours and I feel like crap. I managed to fall asleep for a bit but woke up about ten minutes ago. It is 72°F in my bedroom and 76°F in my office, but I am freezing in both rooms, to the point that I was shivering. The buzzing is worse than ever, and I feel like I cannot breathe, even though my blood oxygen is at 99%. What the fuck is happening to me? It does feel like a panic attack but why?

Panic attacks are sudden periods of intense fear and discomfort that may include palpitations, sweating, chest pain or chest discomfort, shortness of breath, trembling, dizziness, numbness, confusion, or a feeling of impending doom or of losing control. Typically, symptoms reach a peak within ten minutes of onset, and last for roughly 30 minutes, but the duration can vary from seconds to hours. Although they can be extremely frightening and distressing, panic attacks themselves are not physically dangerous.
https://en.wikipedia.org/wiki/Panic_attack

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I just took all the readings I could at home, and there is nothing obviously wrong with me.

Blood pressure: 125/70
Pulse: 58
Oximeter: 99%
Blood sugar: either 128 (CGM) or 151 (finger prick)

However, I am still getting chills where the room temperature is 76°F but my neck and chest area is burning.

==========

Another ten minutes have passed, and I feel a tiny little bit better. I still have no idea what is happening to me, other than repeated panic attacks triggered by unknown reasons.

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Ahh, I spoke/wrote too soon. It has been only five minutes, and I am getting chills again and now feel either hungry or nauseous. I have been trying to keep my blood sugar under control, so I am eating a lot less and injecting more insulin than usual.

Daily Panic Attacks

The cast is really bothering me. It has been super difficult to fall asleep, and I am having occasional periods where it is hard to breathe. If I manage to distract myself and not think about my cast, then everything is fine. Sigh.

Some of the anxiety is from not knowing what is happening to my foot. I thought after two surgeries and five months of healing, I was getting better. However, now it looks like I may have Charcot foot, and in the worst-case scenario it may mean amputation. With my terrible health history, I am really worried.

I am just trying to get through each day and each hour. If I try to think too far ahead, the panic attack starts again. I am also having lots of difficulty sleeping. For example, I could not fall asleep until 5:00 am this morning. I was crazy tired, but when I lie down and close my eyes, all I can feel is the numbness in both feet from neuropathy, and all the worst-case scenarios repeating in my head.

Ukraine Call 20240522

I am still having Monday and Wednesday calls with my friend/student in Kyiv. This was coordinated through ENGin who matches Ukrainians wanting to learn English with native English speakers. Technically I am not a native English speaker but having lived most of my life in Canada and US, I can pass for a native speaker.

Anyway, since we missed the call on Monday, I was showing him my cast and x-rays, and some photos from my retirement graduation. Then he told me about a new government decree in Ukraine regarding the war. As of Saturday, May 18th, every male person has to go to the military recruitment center to get a “ticket” or number. If your number is within a certain range, then you need to go to the military training center and then war. There are now checkpoints between cities and towns, and random checks in Kyiv. My friend does not want to go to war, mainly because he cannot imagine himself killing someone else.

At this point, I was speechless. My problems seem minor in comparison to conscription and being sent off to a deadly war of attrition. It is such a terrible waste of life, and Ukraine will be fucked up for decades regardless of the outcome. Putin also has destroyed Russia since most countries, except other shitty dictatorships like China, Iran, and North Korea, will not do business with them. Just one single megalomanic and ruin the lives of millions.

I Hate Casts

I am not sure why, but the new cast is giving me panic attacks and heart palpitations. I think it is some sort of claustrophobia. Also, my general neuropathy is causing all sorts of sensory overload in my right foot.

One thing I did notice today was the cast is a lot looser on top. Usually, my leg swells up during the day because I am not propping them up. The above photo was right after I got the cast. My surgeon said my leg/foot was swollen from the dislocated ankle. Overnight, the swelling went down, and the cast was loose. I took the photo below during my dentist appointment and it was still very loose.

Even now, after an entire day of sitting and standing, the top of the cast is somewhat loose. I am hoping that the cast and not putting weight on my foot has reduced the dislocation and lessened the swelling. Hopefully.

I still do not have any idea how long the cast will stay on. I know this one will come off next Wednesday during my next appointment, but I am sure my surgeon will order another one put on.

I hate it.

New Ankle Problem

I started a post this morning about being called into the orthopedic surgeon’s office. Well, the news is worse than I expected. I should not be surprised because the worst always happens to me.

Here are some x-rays of my foot:

From top left to bottom, the dates are:

February 7, 2024
April 22, 2024
May 13, 2024
Today, May 20, 2024

You can see clearly that my ankle is dislocating downwards in the front. There is a growing hole right before you get to the toe bones. The problem was apparent on the May 13th x-ray, but much more obvious today. The other ankle surgeon at the office, a church friend, said that the bone is softer/weaker due to Charcot Foot, and usually that causes dislocations, fractures, and bone disintegration. By giving me another non-weight bearing cast, they hope to stabilize the ankle, and have it try to heal on its own.

Based on my luck so far, that is not likely. I will probably need more surgeries, including external fixators on the foot/ankle again. In the meantime, we are still waiting for another CT scan to get more clarity on what is happening.

Why does all this shit keep happening to me?

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In case you do not know what external fixators are, they are exactly what the name says: external hardware to fix broken bones in place. Here is what I got last time.

Ankle Update 20240520

I made a post last week about needing a CT scan on my ankle regarding missing bone material. During the appointment, my orthopedic surgeon said not to worry about it, and we will figure out what is happening after the CT scan. I went directly to the imaging clinic to make an appointment, which is currently scheduled for next Tuesday.

Well, the surgeon’s office just called asking about the CT scan. I let them know about the appointment I already made and mentioned that the time can move up my insurance gives approval sooner. The caller then said that my surgeon said we should not wait, and we should get the scan as soon as possible.

Ugh, should I start worrying now? Also, there used to be a large incision from the surgery at the bottom of my foot. It seemed to heal well, but now the spot seems to have caved in a bit. Not sure if that is worrisome as well.

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The surgeon’s office called again and now he wants to see me ASAP. I originally had lunch scheduled but I cancelled that so I can go into his office at 11:15 am. Also, it was a blister that formed at the incision point and it popped yesterday. I was wearing a black compression sock all day so it was not visible on the sock. However, I just checked the sock and there is definitely signs that there was fluid and there is a lot of dried residue on the sock.

Ugh. Why is everything so difficult?

Retired

After twelve years and eleven months, and twenty-nine years after getting my MBA degree, I am retired from my current company and retired from corporate finance. Since I have been on medical leave for the past four months, not much has changed except that I do not have a paycheck anymore.

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During the employee’s exit interview, the company gives you your last paycheck and accrued vacation as manual checks. I just looked at the two checks I received, and the authorized signature is mine. I was treasurer until 2018-2019 so that cannot be legit. I hope the checks do not bounce since I noticed after I deposited them on mobile app.

Final Work Tour

I gave a tour of our factory last night. Employees are allowed to give tours of our factory for friends and family. Since I am quitting on Friday, I got a request for a tour from a friend and her family. I purposely pushed the date out since my ankle is still not 100%.

The tour itself went well. I arrived at work a bit earlier than the 7:00 pm time to drop off some candy and pick up a box of my office stuff accumulated of the past thirteen years. The actual tour took about an hour since there were quite a few questions. About midway through the tour, I knew my ankle was going to hurt. Afterwards, I went to dinner with my friend, then drove her home. I arrived at home around 10:00 pm and just crashed. My ankle was very sore plus there were multiple neuropathy attacks. I finally took one pill from my dwindling supply of Norco, and I feel a lot better.

My friend works at a pharmacy, and she gave me some sample pills of gabapentin. I have discussed this medication with my endocrinologist but decided to put it off. After the ankle injury, I feel the neuropathy attacks have been more intense so maybe it is time to revisit my decision.

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While at work, I visited a co-worker friend in the Shareholder Services team to make sure that I received my stock vesting. We vest on May 15th and November 15th. The only reason I worked hard to push my retirement date to May 17th is to get my final block of shares. It is not an insignificant amount so I am glad I was able to get it before I quit.

Ankle Update 20240513

I saw the orthopedic surgeon this morning and there is potential bad news. It is difficult to see but it appears that I am losing bone from the tip of one of the screws in my foot. I made a composite of photos I took of x-rays.

There is definitely more bone in the April picture and just a shadow from this morning. The surgeon wants me to get a CT scan for a clearer image. He also went to consult with the other foot/ankle surgeon in his office, and both are uncertain what it could be. He did suggest Charcot Foot, which would fit since I am diabetic, but why so much change in three weeks? I was told to stop physical therapy until after he sees the CT scan.

If the bone is indeed deteriorating, one solution is to remove the bottom screw from my foot. We need to make sure that the ankle is properly fused to the metal rod. That would require another surgery, but it would be relatively minor and require much less recovery. Still sucks though.

Free Supercharging 2024

With everything being so expensive, I should utilize the free supercharging for my Model X more often. I found I can access my Tessie account on my computer and here is my supercharging record for this year:

The list adds up to 378 kWh of energy. I believe I pay $0.28 per kWh for tier 1 usage at my house. That means I saved $106 on my electric bill at home. Time spent at the superchargers however was about four hours. That equates to about $25/hour. Is that worth it? I guess if I had nothing else to do. None of the supercharging sessions were critical, meaning I could have made it home and charged overnight.

Tesla Door Repair

The stupid wing door is fixed. Evidently, the seal on the ultrasonic sensor was not seated correctly, causing a spurious signal. After getting the car back on Wednesday, the door has been opening and closing perfectly. I still hate the door mechanics, but at least it works now.

Also, I went to charge my car tonight at the supercharging station in Laguna Woods. The site is rated at 250 kW, but I got up to 256 kW. That is a lot of energy.

Another Tesla Loaner

I dropped off my new-ish Model X this morning at the Santa Ana service center. The passenger-side rear door is still messed up, even after they replaced the ultrasonic sensor. Once again, they gave me a loaner even though the car should be ready today.

This time, I got an older Model X. It still has a physical gear selector and turn signal stalk. I just started getting used to the new control schema but now I am confused again. At least the stupid wing doors work perfectly on the loaner cars.

Bob Hope Airport

Bob Hope Airport in Burbank is the smallest of the five commercial airports in the LA/OC area. It is also the only one I have not been to before. Last night, I went to pick up a friend traveling from San Jose on Southwest Airlines. It was about fifty miles away from my house and took over an hour each way, even at 9:00 pm.

Interestingly, both runways at Bob Hope Airport are longer than the single runway at John Wayne Airport, even though SNA has three large treminals. From the airport diagrams, it seems that SNA has a lot more private aviation traffic too based on all the hangers.

Pro-Hamas Protests

I attended UCLA and graduated in 1990. That was a long time ago, but I am still a proud alumnus. I am very disappointed and angry at these “pro-Palestinian” protestor who vandalize buildings and attack Jewish students across the country.

This is the front of Royce Hall, the iconic building of UCLA. Police finally cleared out a bunch of tresspassers in the quad between Royce Hall and Powell Library last week. I support protests but not this. I do not care what your cause is, but if you are vandalizing public buildings and threatening innocent by-standers, you are a fucking asshole. I am usually an independent on politics, but I am 100% behind Ukraine against Russia, and 100% behind Taiwan against the CCP. If you do this while protesting against Russia or the CCP, you are still a fucking asshole in my eyes. It is totally uncalled for.

In the current case, have any of these “protestors” said anything negative about Hamas? I think not. They protest about genocide but all of them want to wipe out Israel and the Jewish population. If the Canadian or Mexican military came across the border and did what Hamas did to Israel, I would support kicking the shit out of those countries, even though I am a Canadian citizen too. Has Hamas released all the hostages they took? Returned all the bodies of Israeli citizens killed in Gaza? Until they do, even thought it hurts civilians in Gaza, I support Israel 100%. Fuck Hamas and these bullshit protests.

Ankle Update 20240505

*https://www.cabrini.edu/blog/2020-2021-blogs/a-closer-look-at-cinco-de-mayo*

Happy Cinco de Mayo!

I have three weeks of physical therapy left. My therapist went on vacation this week, so another therapist helped me with massages and workout. I do feel there have been major improvements over the past five weeks, but it still bothers me a lot to walk. I can walk without a visible limp, but pain comes pretty quickly to my heel. Therapist said I need to put more weight on the front of my foot when I walk.

Unfortunately, the ankle seems to be permanently swollen. The surgeon said the swelling is normal, but for how long?

Farewell Office Party

I mentioned in several posts that I am retiring soon, and that date is now only two weeks away. My boss told me that they will throw me a retirement party on my last day, and I found out it will be lunch from 1:00 pm to 2:00 pm. I told this to a former co-worker who also worked twelve plus years at the same company. She quit right after maternity leave so she did not receive any going away party. She said she wanted to come so I asked my boss’s assistant, and they said okay. My first ex-coworker friend said we should also ask another ex-coworker to come. She also worked at the same company for twelve plus year, quit after maternity leave, and did not receive a party either. I actually met the second ex-coworker from a previous company, so I have known her for nineteen years.

I hope that was not too confusing. I really did not want a farewell party, but now I am looking forward to it. I hope there will also be some acknowledgement of my two ex-coworkers since we were really the foundation of the current department, and it was kind of sad that they left after maternity leave without coming into the office again.

There are a lot of recent hires so most of them probably will not know who we are anyway. Just come for the free food!