insanity

Test from my iPhone.

Yesterday I was able to help some friends put together the engine of a car they had been working on. They had already taken apart and cleaned the engine days or weeks before and yesterday was the day when things were going to be put back together. I got there around 2pm and we kept on working well after the sun went down. I mostly helped with fetching tools and holding parts, but I did get to do some fun stuff like put in the spark plugs and then take them right back out again (some noobs forgot to gap them ;)). In the end though, the car did not survive it’s maiden voyage with a nice clean engine and it needed to be pushed back to the house.

While this sort of repair was above and beyond the kind of car work I used to do with my dad when I was growing up, it reminded me of those days and how much I enjoyed that time, even if I did sometimes whine about it. He’d usually do the repair work on one of our chronically ill cars and he’d always need someone to help. If we weren’t changing out a water pump in the Taurus we were replacing rusty parts on the LTD and doing everything we could so that it would pass inspection for just one more year.

Probably the most memorable of the LTD repairs was the time we had to find new front doors for it or it wouldn’t pass inspection. We’d shop for parts at junk yards, but usually parts were few and far between and doors without rust were just not going to happen. As luck would have it, one day we ran across a place that had a car with doors that would fit my LTD! Problem was it was a repossession or impound or something, and we would have to wait for 30 days or so for the owner to claim it before we could start ripping it apart. This car - a Mercury I believe - was in pristine shape, inside and outside. When the waiting period expired, we robbed it of its baby blue doors when we probably should have just bought the whole darn thing and junked the LTD. Sometimes I wonder what happened to the rest of that car.

I was home from college for a weekend and we set to replacing the doors. For the driver’s side door we thought it would be a good idea to also replace the hinges, but we quickly realized that it was very difficult get everything lined up properly with only two people. For the passenger door we skipped the hinges and that installation went a lot easier. Once that was done we had to swap the locks since we didn’t get the keys to the new doors. We only had enough time to do the driver’s side door, so I took the other lock with me and swapped them on my own.

It’s stuff like that that makes me happy that I no longer drive a clunker, but it also makes me sad too. Yesterday was the first time in years that I have gotten to work on a car, and I hadn’t fully realized how much I missed that, but more importantly, how much I miss those times that I used to have with my dad.

I haven’t posted anything here in a while, so I figured it was about time.

I’ve been playing with a Wordpress plugin that will let me easily add pictures from Flickr to my posts. So far I’ve only gotten it to partially work - I can see my pictures in the admin section, but adding them to posts goes south. There’s an update for Wordpress that I should probably do and also a new version of the plugin, so hopefully between one of those things I will finally get it working. Then maybe there will be more posts!

Work has been crazy this month. We switched from a home-grown (by another university, not us) front end to our DNS and DHCP to a commercial product two weekends ago. The migration was not without its problems so I’ve basically spent most of last week and then some getting the data cleaned up. On Thursday I managed to break DNS pretty awesomely and spent 2.5 hours on the phone with support while they figured out what I did (cnames the same as zones = bad, and I knew this but in my defense the cname ended up being totally wrong and not what I intended to enter).

On the Achalasia front, I’ve been poking around trying to find out how much of the surgery I need would be covered by my insurance. If I were to have the surgery in-network, it appears that I won’t have to pay anything, but if I go out of network which is the most likely situation, my insurance will only pay a portion of it (70% I think). It’s an expensive surgery, so I’m not sure I could afford that option right away. There may be a chance that my insurance will make an exception for me because my condition is rare and the consequences of having the surgery done by an inexperienced surgeon could end up costing more in the end. I have yet to actually speak with any surgeons though.

From the summary I received in the mail today (still waiting for the huge report with the graphs):

The lower esophageal sphincter was examined. Interestingly some swallows show complete relaxation. However, other swallows show evidence of incomplete relaxation. The mean relaxation percentage for the entire 10 wet swallowed is 75% which is below normal. Swallow #11 shows no evidence of relaxation and swallow #14 shows almost complete relaxation. The pressure in the esophageal body is higher than the gastric pressure.

Esophageal body: Complete aperistalsis is noted.

Upper esophageal sphincter: Upper esophageal sphincter study shows normal contraction and relaxation.

This study is consistent with achalasia.

Spoke to my GI doctor yesterday and he said that the results of the manometry point to me having achalasia. His recommendation is still surgery. I have an appointment with him in 2 weeks and we’ll go over the test results and talk about my options. In the meantime he’s going ask around to find me surgeons who have tons of experience with achalasia. I’ve found a mailing list of people with this and have already absorbed tons of information.

I have an update for those of you following my medical saga at home. On Thursday I reported to Lancaster General Hospital for my test, an esophageal manometry. Strangely, I was not very nervous, most likely because I spent the entire week trying to figure out where I was to go and what I needed to do to prepare. I never got the paperwork that I was told would be mailed to me, so all I knew was that I had to go SOMEWHERE at 10:30 on Thursday.

The test was interesting and incredibly uncomfortable. The nurses numbed my nostril with a q-tip on a stick, going farther and farther back until I could start to taste it. The numbing agent was gross and it caused me to gag a little bit. Once they were done with the numbing, it was time to get to the fun - insertion of the tub. It was a very thin tube, about the size of a coffee stirrer, but on the end it had these little nubbies on it. The nubbies were where the sensors were located, and they made the tube about twice as thick in those places. I gagged a great deal while they were getting the tube in but once it was in it wasn’t so terrible.

With the exception of breaks between tests, I was not to swallow unless I was told to. The more I swallowed, the longer the test would take. However, when you’re laying mostly flat on your back with saliva pooling in your mouth, it is next to impossible to curb the reflex to swallow, especially when the only thing you have to do is think about it. The test had three parts. During the first part, the tube was gradually pulled out and occasionally I was given a few drops of water and told to swallow. Sometimes it felt like an eternity between swallows.

The second part required me to swallow 20 times at 20 second intervals, without any non-scheduled swallows in between. This part was pretty easy and went really fast. However, this was also the point where I (and the nurses) realized that my swallowing was not normal. At first they were giving me water when the timer got to 5 seconds, but after a couple of swallows I think it was obvious that it was taking more than 15 seconds for the water to pass all of the sensors, so I started getting water when there was only 1 second left.

During the last part, which was the most uncomfortable, the sensors were in my esophagus and I could feel them each time I had to swallow. Fortunately, this part didn’t last long and before I knew it, I was done. All that was left was removal of the tube, which was done by yanking it out on the exhale portion of a deep breath. From start to finish the test took about an hour, but it really didn’t feel like it was that long.

The nurses couldn’t tell me any more than the fact that the data did not look normal. The 90 pages of data was sent to my doctor and I have no idea how long it will take for him to get time to go over the results and call me back. It would seem to me that this test is likely to confirm the diagnosis of achalasia, of course it still could be something completely different. That’s just my luck.

Stay tuned for an update whenever I get the results. With any luck I’ll get some pretty pictures or graphs to post.

I survived the endoscopy. I was very much asleep through the process so I have no complaints. The nurses, anesthesiologists, and doctor were all very nice and patient with my spasticness. It was definitely different from the other times I’ve been put to sleep for dental work. This was more like a hospital setting complete with gown and a bed and all the monitors.

As luck would have it, the original diagnosis of EE was incorrect. There was no narrowing of my esophagus and no tumors (yay). Instead, the problem appears to be with my lower esophageal sphincter, which is where the esophagus and stomach meet. The new diagnosis is Achalasia (link is to Wikipedia, the extent of my research so far). Basically, the muscles aren’t doing their jobs to move food down into my stomach.

I have to schedule another test (scheduled for Feb 23) where there will jam a probe into my esophagus and stomach via my nose and measure the pressure while I swallow. Unfortunately, that means I have to be awake for it. The results of this test will confirm or deny this new diagnosis.

If achalasia is confirmed there are three options: get surgery, requiring me to vacation for a few days at Hershey Medical Center, dilation of the sphincter, or suck it up and go on like I am until it gets worse. The doctor recommends the surgery, and I’m inclined to agree, however I might wait a while before I let anyone cut into me. I am going to wait to cross that bridge until I have to.