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Tuesday, February 21, 2017

Parotid Duct Obstruction Treatment: Day Twelve │ U.S. State-By-State Commonest Injuries │ Stress Finally Proven to Be Fully Responsible for Heart Disease?

With an ertapenem IV drip scheduled for 11:00 a.m. this morning at the Jim Pattison Outpatient Care and Surgery Centre, I went to bed last night with little concern about not having a ride, nor my ability to comfortably be able to arrive there on time without one.

Jim Pattison is a little over a mile from where I live.

Besides, I was hopeful that this was going to be my last such visit. I have been getting antibiotic IV drips since the 10th ─ how bloody long are these to go on?

I had first noticed some sensitivity in the temporomandibular joint area on the left side of my face around the first of the month, When there was a swelling that I could feel to be the size of a quarter (25¢ piece) by the next day, I did some research about TMJ dysfunction, and found sites where people did indeed complain of swelling and pain.

After about three or four days, the swelling had progressed to resemble having a boiled egg embedded in my cheek.

And after about eight days, it had grown to resemble the size of a large orange, or a small grapefruit. My nights were now an abject misery, and at night I started trying to lie on my good side against a wall of bedding because there was no relief stretched out ─ perhaps being horizontal was adding blood pressure to the swelling and causing more pain.

On day nine, it was no longer possible for me to endure the pain, so I took the first of three Advils I was to have that day. But my night that night was as excruciatingly sleepless as the previous two, if not even worse.

So on February 10, I knew that I had to visit a medical walk-in clinic ─ the nearest was at Cedar Hills ─ 96th Avenue & 128th Street here in Surrey ─ roughly four blocks from where I live.

When I was finally seen, it was by Dr. Arun Bhatt; and he correctly assessed my "most impressive" swelling as the result of a blockage of the duct of the parotid gland. An abscess had formed due to a subsequent infection. The man was most solicitous, and was adamant that I not walk the nine or so blocks to the emergency section of the Surrey Memorial Hospital ─ he insisted on summoning me a taxi.

And so were my medical adventures to begin. Between the clinic I had visited that morning, and the hospital itself as well as another doctor's office near to it, I was occupied for something over 11 hours that day. I even had a CT scan, and was begun on a clindamcyin IV drip ─ I was to receive two of these for the next three days until I was switched over to the daily ertapenem antibiotic.

The night of February 15/16 was to see the great swelling ─ which had come to develop a rather large white area about the size of a small thumbnail ─ break open as I slept. It had been covered over with a dressing, so the mass of thick, greyish pus that oozed forth never went anywhere but into my beard.

Thereafter I was to have an appointment with an ENT specialist I had already seen twice previously, and when he saw the opening in the swelling that led into the infection's cavity, he ─ upon injecting freezing into the area with a rather great needle ─ began manually expressing everything that he possibly could from the cavity by changing the positioning of his pressing thumb and fingers, whilst I lay upon an examination table whose sides I were gripping mightily as my booted feet fluttered and kicked from the pain; and I growled aloud ─ even profaning with the 'F word' once.

Today there is not much swelling at all, but they keep the cavity packed with a ribbon dressing that is 'salted' to help draw forth any infectious matter. However, it also weeps a clear liquid like lymph or plasma ─ I have even wondered if it mightn't be saliva issuing from the gland via the potentially broken obstructed duct, for the fluid does a good job of keeping my shirts wet with a soaked swath as much as six inches lengthwise, and a few inches wide.

The liquid output is especially profuse if I have been eating. In fact, the first time this happened a few days ago, I was astonished by what I thought was my sloppiness at slipping spoonfuls of congee into my partially opened jaws. The front of my shirt was soon drenched, yet my moustached and bearded lips were dry ─ I could not understand how I was losing so much of the meal onto my shirt.

Only later did I figure out that my wound was weeping. Painless, but most annoying. So I sleep with a fleece hood knotted under my chin because even the wound dressings do not prevent the fluid from seeping out from under the covering. Better a drenched hood than my pillow and bedding.

Anyway, yes, I had plenty of time this morning to walk the mile (and a little more) to get to Jim Pattison. I was also to be seeing an infectious diseases specialist that I had seen two or three times before.

But it was not to be the same doctor. This morning, it was a Dr. Wong ─ I never saw his name in print, so I have no idea what his first name is.

Unfortunately ─ and remember, he has not previously seen me ─ despite my dramatic improvement, he does not yet want my daily antibiotic treatments halted. I am to come in for two more days, and he will see me on the last day (Thursday). Maybe then I will be prescribed antibiotics in pill form.

I have the IV catheter in my left arm at all times ─ it is the small tube into which the antibiotic drip is affixed to drip into my vein. Certainly it is all wrapped up nicely, but I have no mindset to be exercising with that thing attached, and my arms are ─ as I have said before ─ beginning to resemble those of a frail old man's from this lack of exercising.

At the age of 67, it is going to be a bugger to recapture what fitness I have lost.

So knowing that I cannot get back at it for at least another two days is dispiriting.

And when I was giving my schedule for the visits the next two days, I noticed that tomorrow's session was recorded as taking place at 2:15 p.m. Well, I have an 11:15 a.m. appointment with my ENT specialist, whose office is about halfway the distance to Jim Pattison.

It would mean that I would have to walk the slightly more than four blocks to his office in the late morning. and then return home until well into the afternoon, and then walk past his office and on until I had covered more than a mile for this antibiotic IV drip.

This would truly butcher my day, and I am getting absolutely fed up with being housebound and unable to do anything with my days but hike to bloody medical appointments!

So I voiced my dilemma, and was able to get rescheduled for the IV drip at 10:00 a.m. Provided there is no delay with the antibiotic IV procedure tomorrow, I ought to be out of Jim Pattison by 11:00 a.m. at worst, and able to just barely make my 11:15 a.m. ENT specialist appointment as I head back on home.

Two birds killed with one stone...or walk.

It was good getting back home today. There may have been more sunny breaks than cloudy periods ─ but I am unsure. It was a little nippy on the hands, though ─ not too warm out there yet.

I had a feed of my wife Jack's cooking left over from yesterday; and then I found it necessary to lie down for a good while, enjoying an obviously needed nap. It was actually a little difficult making myself get out of my nice warm bed. I generally find myself unpleasantly cool in the house.

And I was fully clothed in bed.

I took no photos of myself today, but Google has again created a collage of some of my wife Jack's photos from her early 2013 trip back to Nong Soong, Thailand, to visit her mother. The family home is in the rather large village of Nong Soong, which is perhaps a 15-minute drive from Udon Thani.

The photos were probably more likely taken on February 22 than February 21, for I doubt very much that Jack's digital camera had its date settings changed for the trip ─ who thinks of doing that? And Thailand is ─ according to some research I have just now done ─ exactly 15 hours ahead of us here in Surrey, B.C.

But Google knows not that ─ it only knows the probably incorrect data embedded into the photos uploaded into an album from the trip. Here is the collage:

If the photos were taken while Jack and some of her gang were traveling around on a pick-up truck, then the location is likely not Nong Soong...but I wasn't there, was I?

Here are the original photos ─ the chap in the red and black plaid shirt or jacket is Daisha, one of Jack's best friends from her childhood:


If you are American, you might find the following item of interest ─ I am quoting it in full from about four days ago via NewMarketHealth.com:
Data is typically pretty dull, as are most medical records.

But put them together and you've got a painfully complete, if not somewhat amusing, picture of how Americans get hurt. Or more specifically, how they get hurt depending on what state they're in.

For example, if you happen to be in Nebraska, you're in danger of "overexertion." For Washington State, the big risk appears to be "spine dislocation." For the entire state of Texas, they've got insect bites to worry about, while in Maine, it's a broken ankle (from all that snow, maybe?).

But perhaps the biggest head scratcher in this map of pain is a "suffocation" belt of sorts that seems to exist in a large section of the far west, extending from Idaho to New Mexico. The suffocation hot spot was Utah, where it was over three times more common, and Idaho, where it was close to twice as likely, compared to other locales.

The map is the work of a company called Amino, a health-care start up that matches patients with doctors. What they did was to take medical codes, those five-digit numbers your doctor uses to describe why you came to see him, and searched their database just for ones related to injuries.

What they came up with, as they explained it, are the most "disproportionately frequent" injuries in each state. (The most common way people get hurt everywhere are bruises or wounds, the company said).

Another stand out was the fact that New York leads the country in fist fights! New York's "unarmed fight or brawl" data accounts for a whopping ten percent of fist fights in America that result in the participants receiving medical attention.

It all boils down to the fact that it's a dangerous world out there.

So, wherever you are, or wherever you're planning on going -- be careful! 
This would sem to be the source of that report, if you care to check it out:


Even I as a Canadian am rather surprised that 10% of all injuries in America resulting from "unarmed fight or brawls" occur in the State of New York!


So just how bad is stress? 

Well, where heart disease is concerned, if you can believe Dr. Marc S. Micozzi, people need to start getting their doctors to look at things like C-reactive protein levels in the blood, and not cholesterol; C-reactive protein rises as an indicator of inflammation.


It's all good to know. But if a person is stressed through situations no longer in their control, such as enormous debt or permanently lost health, then there is possibly an insurmountable hurdle ahead to do much at all about relieving the stress.

Heck, I don't even like thinking about it.

Anyway, I have usually closed my posts with a journal entry from 41 years ago, but there are none in my journal from now until the next entry on March 6. I became hospitalized after my appendix had burst on February 20, 1976.
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