Thursday, July 31, 2008

Mother Bobblehead is Back Home

Mother Bobblehead Hates Hospital Food

She was in for almost 2 weeks but she is finally back home. She is basically through with physical therapy and getting around with a walker. Personally I believe the walker is for psycological reasons only, as she kind of carries it more than she rolls it. I suspect she will be around without a cane in a week and a half.

I signed her and Father Bobblehead up for a three month membership to the local wellness center in Nocona, TX. It is actually a beautiful facility and I suspect Mom will enjoy it. I doubt Dad goes at all.

I also ordered them one of those "I've fallen and I can't get up" alrams from Lifeline. It gets here next week. For giggles, see the original commercial at RetroJunk.

The big dogs are being good, considering they are cooped up in the (very, very large) kennel for hours at a time. I am walking and watering them constantly. They are good boys.

That's it for now. Will write more later.

Sunday, July 27, 2008

Proglycem Shortage Announced

The FDA announced a Proglycem shortage, the one drug I really really need for my reactive hypoglycemia.

Teva announces Proglycem drug shortage
Date Posted: July 24, 2008
Teva has announced a shortage of Proglycem (diazoxide oral suspension) due to manufacturing delays. Presently, Proglycem is still available from Teva's emergency supplies.
Proglycem is used for the treatment of hypoglycemia.
For more information call (888) TEVA-USA

The actual FDA Announcement Here.

And the latest with the Bobblehead's own Screwy Endocrine System

The latest Endocrinologist I saw at UNM is concerned that my reactive hypoglycemia may still be caused by a pituitary disorder or by a tumor secreting insulin somewhere in my body. Haven't I already been down this path?

Latest on Bobblehead's Mom

Well, my mom is coherent, again. The drugs have been backing up in her system over days and days. Her protein levels are back to normal and so is her sodium and potassium. But her legs and ankles are terribly swollen with edema. She is still tired, refuses to eat, and her lower back hurts. All symptoms of renal failure and kidney damage.
The good news is we finally did confirm she saw a  nephrologist a few weeks ago. I have his name and number and we will be calling him first thing in the morning to confirm his prescriptions and to let him know a patient of his ended up in the hospital with renal failure only 2 weeks since he gave her a clean bill of kidney health.

Saturday, July 26, 2008

Slow Down On Atomic City

Bobblehead's mom went into the hospital for renal failure so I just drove into Nowhere Texas (Nocona). I will write more as I get a chance. Long story. Bobblelhead

Tuesday, July 22, 2008

What Is Wrong With People?

Will you shut up, already?

So, Bobblehead joined the countless number of individuals who went to see the Dark Knight this weekend. The movie was very good. Ledger's performance was spectacular. It is a tragedy that he burned himself out so early.


But this post is not about the movie. It is about the masses in the theater.

Bobblehead loves going to the movies. I enjoy the big screen, the sound. I just usually enjoy the theater experience.


The theater, a fairly new one in Santa Fe,NM, was not packed but it was fairly full. There was no doubt going in to this movie that it would be violent. It also would be loud, and long. It was rated PG-13. I saw any number of 10-12 year old boys and girls with their parents. I would not have brought my 10 year old. But that was okay.

What was upsetting was the number of really young kids in the theater. Babies, 3 year olds. They were loud. They got scared and started to cry. One boy behind me spoke through the whole film. It was more than annoying.

Kid's fault? Nope. Stupid parents.

I brought my kids to some movies I wanted to see (none which I thought would be this scary) also when they were younger. And if they acted up, we went out of the theater For the most part I stopped seeing a number of films for a while that did not have some sort of talking animal in it.

Is that enough to get me upset? Nope.

The guy in front of me (he was in his sixties so the asshat should have known better) kept answering his cell phone. He did get up (in front of me) and leave the theater every time it rang. It rang four times during the movie. I had my cell phone with me. The ringer was off.

Then I think it was bathroom express. People were coming and going in and out of the theater constantly. I had to get up numerous times to let people out. I had my head and chair bumped several time from the people behind me. It was a parade.

Maybe I am slowly getting to the age where I am becoming an old fogey but what the heck? When did we become so rude? Part of watching a movie on DVD or cable is that you can do what you want in your home without bothering everyone around you (except your family, but you get bonus points for bothering them!). I enjoyed the movie but I am in no rush to run out for an opening of a big movie again anytime soon.


[posted by ♠ Bobblehead ♠]

Sunday, July 20, 2008

Gastric Bypass and Hair Loss

Dale as newborn.jpg

Easy for the Bobblehead to speak, he always had hair!

One of the possible side effects of weight loss surgery, especially those that are malabsorption in nature (i.e., gastric bypasses such as duodenal switch), is possible hair loss.

Hair in humans is mainly cosmetic in appearance. So, when your body starts to starve itself by not getting enough calories, especially proteins and fats, the body is smart enough to shift the limited nutrition to vital functions. Hair follicles, not vital. Your hair can fall out.


OK, relax now. Actually, fall out is usually an over reach. Thin is more like it.

My hair thinned for the first 9 months. Bobblehead always had a good head of hair. See my baby picture. Darn, I was cute. But it was strange seeing my hair come out in the shower and on the pillow. I never noticed any bald spots and usually kept my hair very short anyhow, a crew cut or flat top. But it did thin some.

So did my other WLS friends.

But the good news is that I never had anyone tell me it was devastating. Again, usually noticed only by the person who had the hair loss.

And, about 9 months after surgery it stopped. My body started its long term adjustment and I absorbed enough protein. My hair was and continues to be fine.

As does everyone's.

Right before my surgery, a number of us drove from the Atomic City to Albuquerque to a WLS surgery support group to talk about duodenal switch versus RnY. There was a very heavy Hispanic woman in her 50s. Her biggest concern? Not death, bleeding out, heart failure, dumping, scars, fatigue, etc. You got it. Hair loss. Wow, I was stunned. I went through this WLS for my health and family, not for vanity. I had no response.

WLS surgery is scary enough as it is. Do not let this bother you.

To put things in perspective, a friend of mine has his wife in a precarious position. She survived lymphoma 20 years ago. Recently she was diagnosed with breast cancer. She is on massive chemotherapy. Major hair loss including her eye brows and eye lashes. She keeps on going. Strong.

Credit where it is due: I read a much more complete article on this topic in a fellow WLS blogger's site. Go read her post: Gastric Bypass Surgery Truth. It is a really good blog from a woman with a great perspective and sense of humor. She is on my "must read" blog roll. Tell her Bobblehead sent you.

Lastly, one of the side effects of the Proglycem I am taking for my hypoglycemia is, hair growth! Especially on the backs of my hands and my forehead. I have not seen any. Great, I might become a hairy Bobblehead...

[posted by ♠ Bobblehead ♠]

Bobblehead Give Up Coffee To Beat Migraines? Fuggedaboutit!

humorous pictures
more cat pictures

Bobblehead takes his with creme, sugar, and a shot of vanilla. And a No Doze for an added boost.

When it looked like one of my problems was actually acute migraines, I was urged to keep a migraine and food diary to look for possible triggers. Alcohol, especially wine, is a known triggers. Nitrates, nuts, cheese. All on the list. So is chocolate. Bobblehead give up chocolate? No problem. I am not too thrilled with chocolate and enjoy it but if I had to give it up, no problemo!

Oh, and coffee.


Give up coffee? What, are you out of your friggin' mind?!?

Actually, give up caffeine. Yup, coffee is on the short list for know triggers. The problem is caffeine is also on the short list for migraine treatments. Yes, you are damned if you do and damned if you do not.

Caffeine is a wonderful drug. It is the most consumed drug in the word according to National Geographic (the joys of countless hours reading whatever is around while waiting for doctors or lab tests). It is naturally in many foods and added to many others.

Caffeine is a vasoconstrictor. It is unusually good at slight raises of blood pressure and temporary feelings of alertness and euphoria. It is often added in over-the-counter and even prescription pain killers. It is linked to decreases in heart disease and even breast cancer. It has not terrible addictive properties. It is almost impossible to overdose on.

Flip side: It leeches magnesium from your body. Migraine sufferers often have a magnesium deficiency and this in itself is considered a trigger. The raises in blood pressure, while not usually a strain on the heart, is a strain on the vascular system and can increase the chance of stroke. The alertness (hold, I gotta take a sip of coffee....Hmm, that is better), is temporary and one usually "crashes" once the drug wears off. High doses lead to jitters. One does get addicted to caffeine. And, as in most addictions, withdrawal from caffeine leads to more jitters and irritability (like Bobblehead in the morning without his coffee). These lead to a problem well known to migraine sufferers: the rebound headache. Take a vasoconstrictor, go off, allow the veins and arteries to widen allowing more blood flow into certain areas quickly, add withdrawal symptoms, and, well, he's down for the count! More on caffeine and migraines here.

So, what do you do?

Go back to the original advice: keep a food and migraine diary. I did. I showed no correlation at all to anything I ate or drank with my headaches. Mine were always associated with stress, physical triggers (low blood sugar, fatigue, low atmospheric barometric pressure, flashing lights, people that pissed me off...okay, not that last one, but I did want to count that and get disability to keep from going to work!), and rotational motion sickness.

As for coffee...hold on, my cup is empty and I need a refill.

[posted by ♠ Bobblehead ♠]

Friday, July 18, 2008

Simply amazing macintosh video

Who says computers aren't sexy?

It is no secret that the Bobblehead is a mac head. I do use a Windows machine at work, and to be fair, they have gotten better than they used to be. But they are not...hip. The Mac and PC ads really do nail it. True, you can get the same effects in the amazing video above in a PC, but it might lack some coolness factor.See for yourself:

[posted by ♠ Bobblehead ♠]

Tuesday, July 15, 2008

Missing The Bike

At the top of Heartbreak

Bobblehead at the top of Heartbreak Hill, during the Santa Fe Century, 2007

I miss biking. I have no desire to do another triathlon, again. I proved I could do one. The swimming was rough but the running kills me. I just love to bike. I am slow, but who cares.

I have done a few miles around town but am scared what could happen if I am fatigued, 40 miles from anywhere, and my vertigo hits. It is probably not a smart thing to be on two wheels (in silly clothes and shoes not made for walking) and you cannot maintain balance to even stand, let alone propel a bike. But, what the hell. I will bike some more close to home and set my sights on next year.

Worse comes to worse, there are always trikes...

[posted by ♠ Bobblehead ♠]

More on Reactive Hypoglycemia and Duodenal Switch Weight Loss Surgery

Photo 21 of 25_1.jpg

Bobblehead, the day before his weight loss surgery: Weight 383 pounds.


Bobblehead last month, weight 180 pounds.

I have been following Jane's blog on her journey after Duodenal Switch 6 years ago. As a matter of fact, she was the first in the UK to have duodenal switch gastric bypass surgery. As I was writing my post on connections between WLS and reactive hypoglycemia Jane posted an article about gastric bypass as a possible cure for diabetes, even more than a sample group who just lost weight. Her blog, Dances with DS, is here:

I emailed Jane and mentioned some of what I was going through. I asked her to consider referring back to Atomic City. She wrote me back, and yes, she reads my blog on a regular basis as I do hers.

Jane is 6 years out, I am 5 1/2 years out. It is uncommon to see a weight loss patient continue to blog about WLS that far out. Being "thin" is "normal" for me, now (though I still see a 400 pound man in the mirror, not one at 180 pounds). Jane and I both want to give accurate pictures of weight loss surgery. It is not a magic bullet nor an easy way out. If you are considering WLS, you should be exposed to all of the information: The good, the bad, and the ugly.

Jane asked me some specific questions. I think it is in everyone's best interest to answer them via a blog. I have nothing to hide. Besides, she is asking good questions.

Jane: I was wondering not long ago on my blog about this very condition when I heard of several RNYers (Roux-en-Y Gastric Bypass) struggling to deal with it. I wonder how many of us DSers are out there suffering from it. Do you know of any others?

Bobblehead: The literature I read only mentions RnY specifically or generic "gastric bypass." The connection is that DS patients have a RnY. Basically, that is a reshaping the small intestine into a "Y" shape where actual digestion only takes place in a "common channel" right before the large intestine. In my case, the common channel is 100 cm long. Earlier patients had the length set arbitrarily. Later surgeries based it on a ratio compared back to the total length of the small intestine. As far as I can tell, I am the only DS patient I know about with this reactive hypoglycemia but I do not believe it. I would bet money that the ratio of RnY patients to DS patients on this is about 1.0. That portion of anatomy change is consistent.Reactive Hypoglycemia is similar to dumping, though, at least in reactions. Dumping occurs when food passes out of the "pouch" of an RnY patient quickly into the duodenum. The body responds by "dumping" a large amount of insulin into the blood. RnY patients usually only experience this with simple carbohydrates (especially alcohol) and can often balance this effect off with protein. Not me. Even a low carb high protein bar will cause my insulin levels to rise and my sugar to plummet. DS patients do not traditionally dump as the anatomy of the stomach entrance into the duodenum is unaltered where it is altered in RnY.
Jane: You say you had headaches - ouch - they sound really painful ... did you have any other 'leading up symptoms?'
Bobblehead: My headaches usually do not hurt my head...ah, the joys of basilar migraines. I see other clear triggers such as drops in air pressure and spinning motions (probably due to my inner ear problems). Flashing lights and other visual stimulation can bring on an attack. So can fatigue. But so far, with my glucose in check, it is clear to me that the main culprit is my hypoglycemia.
Jane: Where you diabetic pre-op? Do you need a special diet of any kind?
Bobblehead: I was not diabetic, although I had Metabolic Syndrome. I figured out that I cannot control this via nutrition. I cut out all raw sugars, went to only whole foods, high protein...Bobbleheadilicous no matter what.
Jane: Did you tell Dr Hess about this?
Bobblehead: I emailed Hess (my surgeon) via his web page. He is retired. He never wrote back. HELP: If anyone has contact information for Hess, please email it to me. You can reach me via the sidebar on the right side of this blog or leave a comment.
And, of course, we shared information on dogs. I have four. A Labrador, a Siberian Husky, a Pug, and a Chihuahua. And three cats, four...wait five birds as Mrs. Bobblehead text messaged me to tell me she bought a baby green-cheeked conure (now our second) in Texas on Sunday...Yes, it is a zoo.
Hope this helps.

[posted by ♠ Bobblehead ♠]

Sunday, July 13, 2008

Did my Gastric-Bypass Surgery Cause My Reactive Hypoglycemia?

Bobblehead would take 105 any old day!

I had Duodenal-switch gastric bypass going on 6 years ago. I have had some complications, most minor. An incisional hernia. Loose skin (gone). Bad, smelly BMs (pretty much gone).

But, as I have been writing about, I have had a helluva time with reactive hypoglycemia. I eat, my blood glucose drops. Bad. And that is partially what was driving my basilar migraines.

But is the gastric bypass to blame?

Most likely, yes.

There is more and more evidence in the literature suggesting this is a problem. One report says only 1-2% of bypass patients suffer it really bad. For me, Proglycem works very well. It just was 9 months of PURE HELL to get here from there.

Would I do the surgery again given what I know? Probably, yes. I am controlling where I am now. And again, I am the square peg in the round hole.

But I do not see enough doctors and hospitals promoting gastric bypass suggesting how severe this side effect really is. The Mayo Clinic suggests it might be a side effect but lists none of the preventions or treatments. another, Allina, suggests only nutritional advice (in a nutshell, nothing).

So, what should you do?

I recognize from watching Atomic City's traffic that there are potential weight loss surgery patients viewing this. The odds of you contracting this side effect are slim. The odds that if you do get reactive hypoglycemia it is as bad as the Bobblehead's, even slimmer. If you do, go to your endocrinologist and ask about Proglycem. Show him this web site and some of the journal articles I am linking to later in this post. It is a risk. But the odds you will get diabetes and have a obese BMI are much, much higher and the final effects are much, much more severe.

Articles and Web Sites (caution: these are from doctors for doctors!)

Hospitals Offering Gastric Bypass Surgery and Reactive Hypoglycemia

General Google Search linking Reactive Hypoglycemia and Gastric Bypass Surgery.

[posted by ♠ Bobblehead ♠]

And then there is Iran


You gotta give Iran credit. They keep on trying. No matter how many times they screw up.

Of course, you only need to get things right occasionally. Iran should be a non-threat. After all, without money, they cannot afford technologies (like Photoshop) that make them scary.

But, they got buckets full of money. And a hankering to spend it on technology such as nuclear reactors of peaceful projects (wink wink nudge nudge).


[posted by Bobblehead

Miss Kitty Is In A Wheelchair

Photo by Anders Wiuff

The Bobblehead is not happy about this

I got a text message from Mrs. Bobblehead yesterday as I was in the movies (Hellboy II which had an okay plot but was visually stunning). She told me that a fellow patient of of mother-in-law was now in a wheelchair.


"Miss Kitty" is a very cool person. Her Alzheimer's does not appear too advanced (I would wager she has Dementia as well). But it is difficult to tell. Her behavior is pretty good. But she has a difficult time orienting herself in time. Her short-term memory is shot. But the thing that makes Miss Kitty such a joy is her vivacious personality. She is quick to smile and laugh. She is the true cockeyed optimist. Her glass is always half-full.

Miss Kitty was born in Hawaii but grew up in New Jersey. When I see her I always ask how my "Jersey Girl" is doing. She lights up like a sunbeam. She has 2 daughters that I know of. As a girl she had a few sisters. But she was always her mom's favorite.

Jersey Girl was obvious a looker as a young woman. I am not sure of her age now (probably in her 70s) but the years have been kind to her looks. Looks aside, her almost stereotypical New Jersey accent sticks out in the Houstonian nursing home.

Many of the patients with her are in all kinds of personnel hell. Many (including my sweet mother-in-law) can barely speak. Many no longer walk. Most seem very angry and lash out. I cannot help but believe they live in perpetual fear. They do not know where they are, when they are, who are around them, etc. Fear brings on anger.

Not Miss Kitty. She seems to be always happy. Yet, I do see a balance in her emotions. I have seen her get miffed occasionally when a patient near her "goes off." Her response is not over the top.

I saw Miss Kitty in late June right before I left Texas for home. I always make it a point to chat with her (when she is not snoozing in an arm chair). I remember vividly telling my Jersey Girl I was leaving for the Atomic City in the morning. She gave me a big smile and said she would see me soon. "Soon" could mean anything to her.

Mrs. Bobblehead and I chatted on the phone last night. Yesterday she saw Miss Kitty in a wheelchair. She seemed down. I do not know the details but I have seen this pattern. This is often the first step towards a decline from which she cannot recover. I am keeping Miss Kitty in my prayers.

I abhor Alzheimer's. In many ways, I look at this as one of the worst diseases out...even more than some of the advanced cancers. Our cancer treatment has gotten better and seems to double in efficiency every 10 years. Yet I see no practical treatment, cure, or prevention for this condition that robs a person of their very soul and identity over a long time. It is frightening to watch a loved one go through this and even more maddening knowing you might be genetically targeted for this condition (as Mrs. Bobblehead might be).

Come on, Jersey Girl. Bounce back...

[posted by Bobblehead]

Friday, July 11, 2008

Alright, I get it!

It is really a funny thing. When I felt like crap, I wrote. Now that I am really feeling a lot better (great, actually) I have not been writing. On top of that, I was out of the state for a month and basically had no internet service (yet I survived!).

What was funny was that people I knew would come up to me and ask where were my new blog posts. I started to get emails from people in my past who were following my posts without me knowing it. Even more amazing to me were the emails from fellow bloggers, many of them migraine sufferers, asking where I was.

Well, I am back, baby!

I was talking to my wife, Li, and I realized that I did most of my posting in the wee hours of the morning. Having insomnia will do that. Now I am actually sleeping great. To boot, I have been getting up at 5am each morning (groan) and alternating walking the big boys and catching the 6am bus and going to the gym.

I am back at the gym! Hot damn! I am a little sore and am not lifting the weights I was but I am back. I broke down and rented a locker and now just keep some clothes and other stuff there. I shower and shave before I catch the bus so I am basically done after I work out (since I lost weight, I rarely perspire so even after a workout I am smelling fairly fresh. Fresh...not ripe).

In June we packed up the 4 of us, 4 dogs, 3 cats, 5 kittens, and 4 birds, and drove the 850 miles to Tomball, Texas. A few days there and then we drove to Jacksonville, Florida. I drove almost the entire way. Almost no Bobblyheaded moments. A few (one below), but not bad.

Medically, I am convinced I know what is finally going on. After arguing back and forth with neurologists, I convinced them that my daily hypoglycemia was a trigger for my Basilary Migraines. Sugar dropped below 60 and WHAM. Get it down around 50 and I was a loser for the entire day.

My endocrinologist at UNM has me on Proglycem, a medication to limit insulin production. It took about 6 weeks to fully kick in but when it did, I was almost perfect overnight. My sugar has been reasonable and even went over 100 after a glass of wine! Booyah! My fasting is now in the 70s to low 80s (occasionally it still is in the high 60s) but I do not have the reactive hypoglycemia with the medication. Before, my blood sugar would drop after I ate. Now it remains stable and actually rises appropriately. I am thrilled. Proglycem is an oral suspension. In other words, the medicine is mixed with water. I take a one mL eye dropper in the morning each and every morning and I am fine.

If I miss a dose...well, I did miss a dose in Lubbock, Texas. We were on the road and I did not take the medicine out of my bag and just plain forgot to take it. I had my complimentary crappy continental breakfast at our hotel and...then...I..I started to to to sloooow down. Bobble, bobble. It hit fast. I crammed honey and peanut butter down myself quickly to try to get my sugar up. In an hour I was fine and we made it the rest of the way to just outside of Houston. Missing one dose, just one day, killed me. I ran into a similar problem the next week. I was at the end of my bottle. The last dropper I took was basically all water, no drug was suspended. Bobblehead engines, engage! I cannot miss a dose.

I walked all through Disneyworld, hauled cow manure, walked my cousin's dog each morning, did yard work, went swimming, worked out in the gym, partied like it was 1899, and went went went. I did need the cane from time to time but the Bobblehead side of me remained pretty much suppressed.

I am now back in New Mexico, in the wonderful Atomic City. The family is still back in Texas but they will be coming home before school starts.

There is a storm rolling in. I am getting lightheaded. (I never said I was 100%). Damn low barometric pressure. Will try some feverfew before drugs.

There is a lot going on. I will try to write a little every day or two. I do miss it. My personality has always been that if I stopped something, even something I enjoyed, I would have a hard time getting back into the swing. Well, I am going to try.

As for all of you who have supported me when things were bleak and asked where I was when things got better, thank you. Can you feel the love?

[posted by Bobblehead]