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Friday, February 17, 2017

Parotid Duct Obstruction Treatment: Day Eight ─ Hell in the Doctor's Office │ A Smell Test May Be Able to Predict Dementia/Alzheimer's Onset Nine Years Early

With the parotid duct obstruction infectious swelling on the left side of my face now weeping pus after bursting open Wednesday night while I was sleeping, I have to retire to bed with the site covered over ─ I hood helps keep any padding in place.

It was 11:01 p.m. by the time I was settled under the covers last evening.

I had a 10:00 a.m. appointment scheduled for this morning at Jim Pattison Outpatient Care and Surgery Centre ─ an ertapenem IV drip. I was also to be seeing Dr. Yaz Mirzanejad, an infectious diseases specialist. I had first seen him last Tuesday morning,

My youngest step-son Poté was available to drive me to the appointment, just over a mile away from where we live.

I have been getting antibiotic IV drips since last Friday afternoon, originally starting with clindamycin.

Dr. Mirzanejad had not seen me since Tuesday, so he had yet to see for himself just how much pus is exuding from the infection. I had been scheduled to have the site drained next Monday morning, but he now does not see that as required.

In some exuberance, he could not help but attempting to express some pus for himself. He was so impressed with what he expulsed that he even suggested that I lie on my side upon an examining table, but then he seemed to change his mind ─ maybe he was not prepared to become so engaged.

He didn't visit with me for too long; and once the drip was done, I was released. I now had an appointment to keep with ENT specialist Dr. Mark Miller. Poté didn't have to start work today until 2:00 p.m., I believe, so he had said to summon him when I was done at Jim Pattison.

I decided to walk ─ it was perhaps just over half a mile. But I used a hard pace. And I was outside his door at 9656 King George Boulevard at 11:05 a.m. The appointment was on the books for 11:00 a.m., but Dr. Miller knew about the IV drip and my appointment with Dr. Mirzanejad, so he had told me to just come when it was over.

There was someone else being treated ahead of me. And when it finally came time for my examination once the other patient had gone, the medical receptionist said that she was going to lock up the office because she was going to assist in what was to follow.

I was bidden to lie upon an examination table.

After examining the raw opening of the swelling and noting how it was indeed excreting pus, he followed Dr. Mirzanejad's lead and had himself a go at expressing a mess of pus from the opening.

This was of course painful for me, and he realized it.

Next came the long needle to inject freezing into the site.

Without much of a wait, he then proceeded in earnest to expel everything that he possibly could from the infection, changing the positioning of his fingers over and over.

I was often fluttering my booted feet as I gripped the table sides mightily, and growling expressions of pain were frequent. Once, I even involuntarily hurled forth the 'F word.'

Meanwhile, his assistant was softly stroking my temple and forehead ─ a small measure, yes, but it was still welcome. I am unaccustomed to gentle physical contact, and she is a pleasant enough looking woman.

Dr. Miller asked her for some sort of tool with a blade curved at the end, and which apparently had a clamp. I never saw it, but it seemed to be used to pull at something in the wound ─ there was what felt like a sustained unpleasant tug for a time.

During all of these various experiences of pain, it occurred to me to wonder if my heart could fail me ─ I am 67, after all. And at one point when I was lying with my face and body relaxed, Dr. Miller even asked me if I was alright ─ I think he needed assurance that I had not passed out.

He exclaimed how delighted he was with what he had been able to force from the infection, and commended me on performing my role in this rather well. I suppose that was because I did not once lay hands upon his and interfere with what he was doing, even when the pain was sometimes extreme.

Instead of fluttering my arms and hands and interfering with what he was attempting to focus upon, I resolutely gripped the table-sides and tensed my upper body, gritting my teeth and often clenching my closed eyes. 

When he was done, he next proceeded to use a prod of some sort and start packing the infection cavity with some kind of antibiotic ribbon dressing ─ feeling that stuff slowly getting stuffed into the cavity was definitely no pain-free highlight of the entire office experience.

But even that was soon enough completed.

When I mentioned that I had a walk of about five blocks to get home, he sought assurance that I felt capable, and offered that he had not administered anything that should affect my balance adversely.

Sure, I could have summoned Poté, but he's got work to concern himself with. Maybe he was resting up.

The day was partially sunny and mild ─ a nice one for a fast-paced bit of hiking. Too, I felt I needed the physical activity to try and unwind from everything I had been through.

Once home, I was soon lying in bed to attempt to relax. I had not taken an Advil at all yesterday, and I hadn't intended on any today. But maybe by the late afternoon or evening, I may decide otherwise, There is also something to be said for pain relief as a means of facilitating sleep, so we shall see how I hold up.

I have had to apply a face cloth or something similar over the dressing to hold it in place, and I have a hood over the cloth to keep it in place, too. I found that bloody fluid was tricking down into the beard on my chin and dripping off. I think I have successfully gotten that stopped.

Dr. Mirzanejad has asked me to shave the site of the infection by Monday, but I am going to have to feel a whole lot better than I do today. It's not going to happen before Sunday.

Tomorrow, I have another ertapenem IV drop scheduled for 10:00 a.m. at Jim Pattison.

There were no selfies today, since the swelling has always been covered over.

By the way, my wife Jack texted me from Vancouver soon after I was home from Dr. Miller's manipulations:
Hi how going, hope u r doing ok, I have my MRI yesterday and today for my accident last two years
She had been rear-ended in her car, and is still complaining of adverse symptoms from the accident.

We're quite a pair!

I just came across a Google notification sent to me a couple of days ago concerning a collage Google had made of some photos that Jack took during a trip back to Thailand to see her mother in early 2013:


I suspect that all of those photos in the collage were taken at Suvarnabhumi Airport, after she first landed in Bangkok, and before she had continued on to Udon Thani.

I will try to find the original photos and now post them, starting across the top of the collage:






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Have you ever heard that a failing sense of smell can be a clue to the potentiality of developing dementia like Alzheimer's disease in an older person?

It is not a new concept, but a recently published study did much to affirm its value:

JacksDailyDose.com

MedicalXpress.com

The first report suggested trying to smell peanut butter ─ I found that to be quite curious. So I did a bit of research and found this January 20, 2016, article at Alzheimers.netCan’t Smell Peanut Butter? Alzheimer’s May Be the Culprit.

I need to buy a goodly quantity of peanut butter ─ we've essentially been out of it for some while. But there is no way that I am in any condition to be going public with the bloody mess that my face is as of today.

I had said that I took no photos of me today, but I now see that Google has also created a collage of the three photos that I took of myself yesterday while standing outside of Jim Pattison after the antibiotic IV drip, and waiting for Poté to come and pick me up:


After I had gone home that day, I was hungry, so I had some of my wife Jack's congee. That was around 2:00 p.m. The effort of working my jaws just enough to 'chew' the rice porridge re-opened the spot where everything had broken open the previous night. When I checked myself after eating, there was a fair quantity of grey puss oozed into my beard, with more waiting to work up and out.

Yes, it's great to be me.

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I had to go and lie down for a nap to escape this ongoing recurrence of annoying pain. As yet, no pain-killers, though.

I am going to close now with a journal entry from 41 years ago when I was 26 years old, and living in a basement housekeeping unit in New Westminster.

I was paying rent for the small affair in a house located on Ninth Street, and one or two houses up from Third Avenue.

My bedtime the evening before was 8:30 p.m.
TUESDAY, February 17, 1976

I'm guessing, but around 12:30 a.m. last night David came knocking lightly, but lengthily; he even spoke out. Before that I'd had some sort of WD.

I rose about 5:45 a.m.

It was raining with some light snow when I laundered, having the place to myself until I'd finished when 2 separate people came in; I bought Skull and TV Guide.

Well, I guess my incentive $50 aren't coming; I intend postponing its earned follow-up for Thursday when I take in my declaration of assistance.

I set off for a long walk, but turned homeward after a couple blocks. It wasn't raining. There just isn't any decent place to walk; nothing but city and residential areas, which I found myself unable to suffer without any goal.

Too, I felt conspicuous out in the public in the light of day.

I did some work on a letter to Terri.

This place is cold! It remained so, and very much, all the remainder of the boring day.

In all, I ate 1 pancake.

Bed should be 8:30 p.m.
My old friend Philip David Prince would have been my attempted visitor. He had his own room elsewhere in New Westminster, so it was no truly great inconvenience to him for me to have ignored his knocking.

I believe that I generally laundered at a laundromat that may have been located on Sixth Avenue, up by the public library.

I had to guess about that Marvel comic I bought ─ I cannot remember any series called Skull the Slayer.

For maybe a couple of years, I had been working one day a week as a truck swamper for a New Westminster charitable organization. They were part of an employment incentives programme in place with the government. Working entitled me to the Single social assistance rate, plus an extra $50 above that.

Well, the funding for the charitable organization came to an end and my contract had to be terminated, but my final $50 payment had yet to show up. Apparently I was going to the social assistance office in two days to submit that I was still in need of the social assistance.

Discouraged by having no place worthwhile to walk, I returned home and did some work on a letter to Terri Martin, an American pen-pal I had.

It sure does sound like an empty day.
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