Kathy is retired!  Last Wednesday was her last day at work, and on Thursday she flew out for a weekend with 9 women friends she has known for 35 years.  She flies back tomorrow.

She will spend her first months of retirement preparing the house for the market and our belongings for the move to Mérida.  I will keep working for a few months.  In November we are going to travel to Isla Mujeres, Playa del Carmen, Mérida and perhaps to down near the Belize border – to Mahahual and Xcalak.  The southern part of the trip depnds on whether we are looking for a rental in Mérida as we prepare for our move.

The timing is not all settled yet, but it is possible that the move will happen in November.  Depends of a thing or two the timing of which we do not completely control

That is the short version of the news from the Northwest.

Hi everyone,

My two previous posts were about the end of the 6  month diagnostic journey I had been on, got to the diagnosis, and referred to the surgery, a left adrenalectomy.   The surgery happened on Friday, Feb 1.

At 4:45 am a Comfort car from Metro West Ambulance Service arrived to pick us up.  Kathy is legally blind and does not drive, so…..Got checked in at the hospital, taken back and prepped, talked with the anesthesiologist – who told me about some scary risks and what they had by my side to deal with any of them, were they to happen.   They also gave me some happy juice through my IV at this time.  After that Kathy got to come back and spend some time with me.  I do not remember anything past that point until I was in the recovery room.

The laparoscopic surgery took about an hour, a bit less than expected.  The surgeon said my height provided plenty of room for all the organs, so it was not way crowded in there.  There were four small incisions made – the largest post-op dressing is about 1.5 inches square.

I was in the hospital for 4 nights.  The nursing and medical staff were outstanding!!  Even the lab techs who left my arms looking well-used.  Kathy was there for all of it.  Our sister-in-law, Laurie, was a champ – transporting Kathy and spending time with us.  We really appreciate that.  Don’t tell her, but a very nice dinner out is in her future.  That took care of the weekend, with Kathy spending the first night at a hotel across the street from the hospital.

On Monday, Kathy took public transportation (bus and light rail) to come see me and to get home.  She had to get home because we have an old cat who needs medication daily.  Anyway, each way took about 2 hours, taking the bus downtown and then a light rail to a stop about a 10-15 minute walk from the hospital.  On Tuesday Kathy came via the public transportation option, and when she arrived I was dressed in my street clothes.  Discharge Day!!   Laurie was able to transport us home.

Was the surgery worthwhile.  You can review the past couple of posts to review the hyperaldosteronism and its effect on my hypertension.  I was on 4 blood pressure meds before the surgery, taking a total of 6 doses.  Here is the current state of affairs:

Pre-op I was taking
100 mg a day of Atenolol,

80 mg a day Lisinopril
37.50 mg of Maxside
10 mg daily of Norvasc

Most pressures were in the 144-150 over 85-98 range

Today I am taking:

75 mg a day of Atenenol
10 mg a day of Norvasc

Most Pressures have been in the 127-143 over 78-90 range

I am beyond delighted!  I am also not taking any potassium supplements.  My expectations have been met and exceeded

If you do a search on youtube for adrenalectomy, you can find some videos.

I am going to have a left adrenalectomy on Feb. 1.

It should improve the BP, resolve the potassium deficiency, reduce cardiovascular risk and extend my quality lifespan.

There is a motel across a small side street from the medical center. Kathy will get a room there for a couple of nights since she stopped driving quite a few years ago.

Gotta get there at 5:30 am. Hope my surgeons are morning people

Got the results of the test. Here is what the endocrinologist wrote to me:

“Your adrenal vein sampling’s aldosterone results are back and I have carefully reviewed and analyzed them.

These data suggest that you have a LEFT aldosterone producing adenoma. CT in December 2012 had shown: “nodularity of the lateral limb of the left adrenal gland inferiorly measuring 2.3 x 1.0 cm.”

I offer you consultation with a surgeon to consider adrenal surgery in the hopes that it will help your blood pressure and low potassium (with successful surgery, blood pressure is rarely cured, but often improved, that is requiring fewer blood pressure medications and potassium supplements)

Alternative to surgery is very successful and effective medication therapy (with Spironolactone or in those intolerant to Spironolactone, Eplerenone).”

Don’t you just love doctor language

I requested the consultation with a surgeon. I think these are usually done laparoscopically. More hurry up and wait.

Hi everyone,

It has been some time since I have posted.  There has been quite a bit going on, much of it medical.  Kathy has had cataract surgery and that has improved the very narrow field of vision she has remaining.  This is a very good thing.

I have been diagnosed with primary hyperaldosteronism.  This is not all bad – it may be partly responsible for my high blood pressure and totally responsible for my chronic potassium deficiency.  It has, however, been a long arduous road from suspicion to diagnosis involving referral to a endocrinologist and multiple tests, including two that required me to do a 24 hour urine collection and take that to the lab.

On Friday I spent 5 hours at the hospital while I was prepped for, taken into a cardiac catheter lab, had catheters inserted through my femoral vein.  These were used to take blood samples from my left and right adrenal gland veins, along with “reference” samples from nearby veins.   This was not great fun, but the people were nice and they gave me a pretty frock to wear (see below).

Here I am before the procedure

There was the little thing about atrial fibrillation that happened during the procedure, but I felt pretty good throughout it.  It also took them a bit longer than they expected, so they shot a little anti-coagulant into the vein to prevent problems from clotting. These happenings extended my stay in the recovery room to make sure the EKG technician had all the time he needed with me, and to make sure that I did not bleed from the anti-coagulant.

So, that meant (having been on an IV for hours), that I really needed to pee.  By really needed, I mean I was in pain from needing to pee.

Real. Pain.

While the nurse thought that I should be able use a urinal laying down (DO NOT raise your head up, that could make you bleed), the flow not happening in that position, not even after she gave me an injection of some sort relaxant.  I did feel more relaxed and less agitated, but……  So, she called in this nice young man who inserted a tube into my urethra to drain my bladder.  This was all quite an experience.  Fortunately the next time I felt the urge I was given permission to urinate the usual way.  Like I said, they were nice folks taking good care of me.

This may not sound too bad to many of you, but remember that I am a man and that men are wussies.  Don’t believe me?  Ask Kathy, she will tell you . Anyway I will get the results this week and those should, hopefully, point us to either surgical or pharmacologic treatment.

In any event, around April or May we’ll head to the Mexican consulate to apply for an immigration status to move to Mexico.  Assuming approval, we’ll have six months to move to Merida, and then 30 days to check in with the local immigration office.  Lots to do here still, but we are looking forward to this being our last winter in Portlandia.

Hope all of you are doing well.  Now that we are moving towards clarity on medical stuff maybe I’ll go off radio silence more often.

Have a ballpark figure of $6,000 for a 20 foot container from Portland, OR to Progreso, Yucatán. We’ll see how that holds up once the fellow does the complete work-up.

In other news, Merlin Cat Smith* has high blood pressure and renal insufficiency. Back to the vet on Saturday, but sounds like some special food and blood pressure medicine.*

Merlin Cat Smith was on a prescription I picked up for him in Illinois when he was a young lad with an infection. Usually called Merlin, that is his full, formal name.

That’s all for now.

Hi everyone,

The house is painted. The fall/winter rains have started.

Kathy is legally blind, according to her doctors. She is meeting with the Social Security Administration in early November to see what they think about that and about her eligibility for benefits.

My last meeting of my regional professional association is in early November, right after my penultimate meeting of my statewide professional association. Landmarks, these are. I just finished the presidential cycle of the regional (Oregon, Washington, Idaho and British Columbia) association last year.

Time to move on to indoor projects and to the sorting of belongings. We plan to scan in many of our photos from over the decades and to sell or give away a lot of stuff.

It is happening.