Sick again

 I was concerned about what was happening. Midway through our vacation last week, my voice suddenly disappeared. The pain in my throat was so severe that swallowing became difficult, and it even kept me awake at night. Despite this, I managed to make the rest of the vacation a good experience for Shelley. That was important to me because she had lost her father two weeks earlier, which had been very difficult for her. It was clear how much he meant to her, as I observed them together for 12 hours each day during his last two days.

In my process of overcoming personal challenges, I often prefer composing songs rather than jotting notes in a diary. Over the past 35 years, I have written more than 100 songs. The advent of artificial intelligence has been a wonderful development, allowing me to set some of my lyrics to music. This has been nice. One such song I composed reflects on Shelley and my father's final days, capturing my observations during that time.

Put on the Husker shirt makes him look proud and tall

Angels hang outside the window, waiting to take it all

His hands were worn as hickory, his heart is so soft and low

And I knew by the silence, it was time to let Papa go

She holds his hand steady, and he tries to smile

Like he was saying, “Come sit with me a while.”

The clock stops ticking, like he knew what I knew

There ain’t a storm that teaches a lesson, Of what goodbyes can do

[Chorus]

Time to let papa go (time to let papa go)

Lay him down slow (lay him down slow)

If love is a river, it still has to flow

But it’s Time to let Papa go (time to let papa go)

The lights burn gold, from the halo on his head

Songs on the radio say, There is more to be said

He clings to her hand tightly, trying to be strong

But he knows he must let go, life is almost gone

She tells him old stories, and he squeezes her hand tight

Like saying “keep your heart open.”, “Don’t you lose your light”

Then his room got quieter; there is quiet outside

As she kissed his rough forehead, I saw her whole world in my eyes

REPEAT CHORUS

She recalls the lessons he provided during his time

He gave her strong roots; this is a reason and a sign

She will carry his stories deep into her chest

When her hands get shaky, she’ll do her best

REPEAT CHORUS

REPEAT CHORUS

Oh, they loved him with all their heart

Now they have to  let him go

I digressed - as I often do!  After returning from the trip, I went to the doctor. I thought of four possible causes:

1. I had been bitten by two ticks, one of which was embedded deep in my skin. It was very small and light brown. I was concerned about Lyme disease because I was experiencing tingling and a couple of headaches. 
2. We are at 8,500 feet, and the air is dry. I thought that, and the potential for altitude sickness was the cause. Especially since I started feeling bad 18 hours after being at a higher elevation.
3. I thought it might be strep throat, but since Shelley wasn't getting sick, I wasn’t sure that was valid. 
4. I thought I might be having major problems with my GERD. I do know that his throat issues can often be caused by acid reflux, which has been a problem for me. At home, I sleep with the head of my bed elevated anywhere from 8 to 10 inches. On the trip, however, that was not possible. I was lying flat and eating late, which is common.

The doctor conducted a comprehensive series of tests and X-rays. The results were reassuring, ruling out Lyme disease, tick-borne illnesses, and strep. The X-ray also showed no signs of pneumonia or other related complications. However, a concerning aspect was that my hemoglobin level was again low at 41 ug/dL, significantly below baseline at 61 ug/dL. Additionally, my iron saturation index was 11%, which is below the normal baseline of 15%. Further tests revealed that my MCH was low at 25.4 pg/mL compared to the baseline of 26.5 pg/mL, and my MCHC was 30.9 g/dL, below the standard of 34.5 g/dL. My physician said to rest and come back if it doesn’t improve.

Despite the favorable results, I continue to experience dizziness and fatigue, and there has been no improvement in my voice or throat. After conducting research, I believe these symptoms may be related to GERD. Specifically, I suspect Laryngopharyngeal Reflux (LPR), also known as "silent reflux." This condition involves acid reaching the larynx and pharynx without typical heartburn, resulting in chronic hoarseness, a sensation of a lump in the throat, and a persistent need to clear the throat. Chronic acid exposure can cause inflammation (laryngitis), and over time, may lead to the formation of nodules or polyps on the vocal cords, which can alter the pitch and strength of the voice, as illustrated in this video. I plan to resume proton pump inhibitors (PPIs), despite my reservations, due to their potential impact on memory and long-term cognitive health. In the past, I have noticed memory issues when taking them.

What I hate most is that I was doing well for three weeks, losing weight, and then I got sick. As an afterthought, I wondered if the illness might have been COVID. Then I had two good weeks, and this illness hit. I really am getting tired of this roller coaster! 

I need to carry on!