Wednesday, May 25, 2011

The Rest of the Story

It's been nine days since my surgery, and I am finally feeling like myself for the first time today.  I can breathe fairly clearly, but it takes great effort to actually feel the air flow when I inhale, which means there is still considerable swelling in the nasal passages.  This afternoon I have my follow-up with my doctor to see how things have healed.  The "seeing" part involves a nasal endoscopy, a procedure I endure about 6-9 times per year which involves having a camera inserted through each nostril and up into the sinuses.  The doctor moves it all around in order to see where there is swelling and disease, or possibly polyps.  Usually it's not more than a little bit uncomfortable for a few minutes, but today I am supposed to take a Percocet because my sinuses are still healing and that little camera will be bumping all around in there.  Since I just remembered yesterday about the Percocet instructions (he told me while I was being prepped for anesthesia last Monday), poor Jon is scrambling to figure out how to fit in taking an entire afternoon off to bring me to downtown Philadelphia.  It will work out, but he's worn out from taking care of me for a week and half, and juggling a bigger workload since a coworker abruptly quit last Friday.

Plus, we are still putting together the details of our moving plan, which is all of a sudden much more stressful than it seemed a few weeks ago.  We applied for a gorgeous pool home rental, and are waiting to hear back  so we can exhale a little bit.  With that "minor" detail almost resolved, the question of how exactly to transport our family & belongings is being revisited.  It's one of those conundrums where there are many unappealing options to choose from, and we just can't seem to make up our mind.  We have a representative from a large moving company coming tomorrow to give an estimate of our things.  That information will help us get more accurate quotes from the "you pack, we drive" people, and from there we will decide whether it's worth it to have someone else drive our stuff, or to just use the Ryder we've already reserved and make the long journey ourselves.

I realize I need to get back to my story but I am stuck.  I am not sure how to summarize the past two and a half years since my first surgery; I feel like I could write a book.  But it would be the most boring book ever!  Instead, I put together a timeline and posted it under "My Pages".  It is not completely finished, since it was done all from memory and I might add more details.  Jon is working on data collection.  He has a spreadsheet entitled "Poked and Prodded" that is based on data provided by our health insurance company for each and every "medical encounter" per family member.  As he says, "the data doesn't lie," and even though it counts each individual lab from getting blood work taken, each doctor's visit the same as a surgical procedure, it is quite staggering to see those numbers for me compared to him.  It's something like 100:9

These numbers simply reflect what I have been dealing with since this all began.  When you read about chronic sinusitis treatment, you will find that Functional Endoscopic Sinus Surgery (FESS) is supposed to be the end of the story.  According to Medline, this is only to be used when a patient fails to respond to all of the other medical interventions: topical and oral steroids, antihistamines, nasal irrigation, extensive antibiotics.  According to one study, FESS has an 80% success rate. Another study estimates slightly lower.  Either way, I have been in the minority, twice.

My first surgery did almost nothing to relieve my symptoms, and certainly had no long-term benefits.  I found a new ENT a few months later, quit yet another job to focus on getting my health back, and quickly agreed to have a revision surgery performed by my new doctor at Pennsylvania Hospital.  That second surgery took place in May 2009, almost two years exactly prior to this current one.  In the summer of 2009, I thought I had been cured. I even wrote a letter to my doctor thanking him, "for giving me my life back."  Only, it didn't last.  The fall of 2009 brought another round of infections, despite the diligent care I was taking to maintain my health.  After the second surgery, I went on a restrictive "Anti-Inflammatory" diet, followed closely the instructions to irrigate my nose and sinuses twice a day, with topical steroids, took each and every medication I was prescribed, and continued my regular exercise and other stress-reduction strategies.

Doctors did not understand why I continued to get sick.  One theory was that it was due to my constant exposure to germs via my young children.  Another was reflux, for which I took Prevacid or Priolec for years every day (even though it's supposed to be a two-week course, this was my instruction).  Yet another was regarding the cold air, especially once I developed asthma as a result of the chronic upper respiratory inflammation.  To this day we don't completely understand why.  But suffice it to say that I have been sick from September through May nearly 100% of the time for the past three years.  Summers have provided a respite for the past two years, since my second surgery.

By this February we had ruled out: autoimmune disease, compromised immune system, reflux, allergies, and mold in the home.  We had no variables left to control for, other than the environment.  Months earlier Jon had asked the doctor if he thought a change in environment or climate would help me, and his response was, "I think any change in environment would probably help at this point."  One night when I was lying sick on the couch, Jon looked at me suddenly and realized "we just can't do this anymore."  The denial that we'd been living in about the unending and debilitating nature of my illness was beginning to lift.  I realized I couldn't keep working.  I was, as my social work ethics literature states, a "compromised worker" because of how frequently I would endure sessions while feeling completely miserable.  And Jon realized that with his 100% remote job no longer requiring him to remain in the Northeast, he could easily move his base of operations to a climate that would possibly be better for me.  I realized-- and Jon agreed, since he'd experienced a pretty bad ear and sinus infection this winter and now knew what I felt like 80% of my life-- that I could not go on like this any longer.  I was not living my life to the fullest, and my family was suffering as well.

When we saw my doctor, we approached him with the idea.  He was advocating more surgery, to "open things up more," and he was not shocked by our plan.  In fact, he thought that having surgery, and then relocating, at least temporarily, to a year-round warm climate in an area with less industry and better air quality, was highly likely to be a successful combination for me.  If surgery should have worked the first two times, but didn't, it made sense to give it another shot, but with a new environment.  To do it again, and stay when history shows I break down every winter, seemed like sabotage.  And so we began the earnest prayers that would lead to confirmation over and over again that we were to give it a shot.  Research over the years had given us an idea of where might be a good place, but it was affordability combined with closer proximity to family and our life in the Northeast that led us to choose Southwest Florida as our new, long-term vacation home.

And so here we are, 9 days after surgery, totally crazed as we have our house half packed, not completely sure which home we are moving to or how we will get there.  But we know it will work out.  We have total confidence that the Lord has led us to this point, and He won't fail to provide for us now in the details that remain murky.

My prayer this week has been that of Jabez from 1 Chronicles 4:10:
"Jabez cried out to the God of Israel, 
'Oh that you would bless me and enlarge my territory!
Let your hand be with me, and keep me from harm so that I will be free from pain.' 
And God granted his request."

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