Stents Out, Blood Taken, Two Days Before Thanksgiving

I got my stents out this morning!  Hurray, I can breath freely again.  And the bonus was that the MRIs I have had revealed a "deviated septum," which I believe I acquired in my late twenties playing squash with a very competitive Cornell MBA student.  I was living in Ithaca at the time, finishing my dissertation in American history and teaching sociology at Ithaca College.  I remember well that after he served, smartly jumping to the middle of the court, he, six foot at least, swung his racket back and hit me right across the bridge of my nose.  When I showed up to teach the next day I looked like a raccoon with big black eyes, and my students were very solicitous in their concern, if not curiosity, about how I acquired this look.  At any rate, the ENT surgeons who purposefully broke my  nose in order to gain access to the nasal cavity for the neurosurgery have done me the favor of rerouting my septum.  At my six month post-operative MRI I look forward to seeing a perfect nose!

Yesterday Dr. Law and I spoke extensively about next steps.  Today, after the stent removal, I went for a blood test for protein analysis; it should be a pretty good indication of whether I may, or may not, have amyloidosis.  Neither Dr. Law nor I believe this to be the case, but of course it must be ruled out given the surgical pathology.  As noted in a previous post, that disorder is a very serious one, indeed potentially fatal.   I don't have any other symptoms of that disease, for example organ function problems.  Also, medical literature of this rare finding of an amyloid on the trigeminal nerve notes that in none the U.S. cases (where I appear to be lucky number 14), did the patients have a systemic disorder.  Third, coincidentally, Dr. Law and I have come up with the same theory about the origins of the amyloid: that it is the failed attempt of the immune system to attack an oral herpes virus.  

Please, reader, note that we recognize this idea is just a theory, but it is nevertheless true that herpes viruses live in nerve cells, and oral herpes, which manifests in the lips and gums, live in the trigeminal nerve that serve those areas.  Activated by stress, sunlight or low immunity, the herpes virus rears its ugly sores.  The immune system tries to react by sending (protein) platelets to kill the virus, but alas, it cannot, and so, perhaps, these platelets collect and form what becomes an amyloid.  At least that is my theory and I am sticking to it.

A year or so ago when I first went to a neurologist for the symptoms, I introduced the idea of the herpes virus as a source of the problem.  I did so because since my first outbreak, when I was 18 and had returned from a wild spring break in Florida flush with mononucleosis, I have had subsequent outbreaks.   These sores act for me as a barometer of my fatigue or stress levels, and I have contributed to their outbreak, probably, because I love to be outside in the summer biking, boating, hiking and working without putting on gobs of suntan oils, knowing, but at the time not caring much, that the sun just might incite a sore.  Who would have thought it could, possibly, lead to this problem?  Time waits for no woman, and getting older often comes with compromises we could hardly imagine as spry, healthy youth.

About the pain, the good doctors have not recommended any more narcotic type drugs, but have allowed me to go back to anti-inflammatory, over the counter type medication, disallowed prior and subsequent to surgery because of its blood thinning properties.  It has made a difference, and understandably so, because inflammation of the nerve caused the pain.  In order to maximize this advance I will begin either tomorrow or Thursday a one week course of low dose steroids.  I am waiting until then because it is a bit of a regime (x number of pills one day, y another, and so on) and because I understand that the steroids mask other infections and cause insomnia.  Sleep has been my best friend of late.  I have clocked a highly unusual 10 or so hours a night.  I want to take full advantage of this time where sleep aids recovery before launching into another minor medical adventure.

Long term outcome, assuming that no systemic disorder is involved: the amyloid will continue to grow, effectively chocking off the nerve, which will cause it to atrophy and die.  I will have no feeling on the right side of my face, and ultimately mastication problems because this nerve serves the muscle connected to the jaw.  At the ENT practice today, I asked for a follow up appointment or call from Dr. Strominger to discuss how I might prepare myself for this outcome, and if there are any approaches that medical science has to compensate for the effects to the jaw.  I look forward to his call.

Now for a more metaphysical reflection, which at this time of year naturally turns towards Thanksgiving.   My favorite president, Abraham Lincoln, made Thanksgiving a national holiday, and rightly so.  If he, in his search for reconciliation of profound, awful discord that wrenched our union, could find a date to memorialize gratitude, then most certainly we can take a lesson from history and make forgiveness, reconciliation and gratitude prominent themes in our own lives.   I am going to try to make it mine, and I wish for all of you, amidst the turkey, football and Aunt Mable's favorite cranberry sauce, the opportunity for spiritual renewal.