Sunday, Aug 23
For Aug 22 CPAP. Reported figures. 6 hrs 11 min with AHI=1.94 Events: 11 H, 4 CSR, 1 CA. No major mask leaks (max=16 L/min); no oximeter.
Finished and published the blog. John is recovering some. Keeping food down, and actually ate the majority of a chicken pot pie for lunch.
Our temperature made it to 78° today; with no wind, and apparently less smoke in the valley.
I’ve been fighting with music. Finally, after about 4 different keys, timing, and arrangements, I settled on a nice rendition of Shenandoah, but had to change some notes and keys to fit the way I believe it should be. It is not unusual for scores to have errors, and this one, although on a teacher’s site, was full of them. Maybe it was a test, to see who was paying attention.
Monday, Aug 24
For Aug 23 CPAP. Reported figures. 7 hrs 23 min with AHI=0.41 Events 2 H, 3 CSR, 1 PP. No major mask leaks (max=12 L/min); no oximeter.
Our farrier arrives at noon for trimming two horses, Ebony & Myst. He was earlier than expected because someone failed to keep their appointment. John had picked some squash before he arrived. We had one neighbor stop and pick up yellow squash and tomatoes, and on our way to town, we delivered to 3 others, and picked up another bag of cookies from another neighbor on our way home. Nice treats for all involved.
I finally made significant progress on finishing one piece of music, with the help of Dr. Dave, who sent me some different scores of Take Me Home, Country Roads (John Denver, et al.) with the score I’m doing clearly presented on two pages. This will be a great addition to our music for the next 2-1/2 months.
Tuesday, Aug 25
For Aug 24 CPAP. Reported figures. 5 hrs 45 min with AHI=1.39 Events: 8 H, 4 CSR (all at end of session). No major mask leaks (max=11 L/min); no oximeter..
Early morning 8:02 call from our doctor’s nurse, that four bacteria had been ruled out as John not having (ecolae, salmonella, and 2 others).
Then 20 minutes later a call from our Dr. saying if there wasn’t something identified soon in the culture, for John to come in Friday. They made an appt., and meanwhile we were to pick up a refill on the nausea pill he’s been taking. Then, on the road to Yakima, the Dr got through the dead cell reception spaces, with a call to say it was Giardia, and it was treatable (where a virus would not have been). He was calling in a prescription to our pharmacy that we could pick up on our way home. We did, and then on the north end of EBRG, we dropped off a full set of Canon printer cartridges we bought for our 89 year old friend in Ellensburg.
We left early to take John’s car to Subaru for a 10:30 a.m. appointment and then by the Yakima Heart Center for my ICD check. We learned that I have 4% left on my battery, so I can expect an alert from the system in November (it’s read every night at 2:00 a.m. from a landline connection that ties in to the medical community in Yakima to warn them of any events of concern). Then, when the battery alert happens, they will have me schedule a health history review. Then I will get a date set, change the dosage of blood thinners to make ready for the surgery. There’s a window for all this of 90 days after the alert. That change in my ICD’s battery will probably occur in January, at Yakima Memorial Hospital (by surgeon, Dr. Pham, a nuclear cardiologist). The details are yet to be determined. Stay tuned.
Shopped at Costco for the inks (mentioned above) and chocolate covered almonds for our neighbor. Just bought regular stuff for us. John didn’t feel like having his regular artery clogging “Polish Sausage with Bun & Toppings”, so we shared a chicken Caesar salad for lunch (while we watched all the funny-looking people) and had a Very Berry (Strawberry) frozen Yogurt Sundae, split into 2 cups – for the trip home.
Wednesday, Aug 26
For Aug 25 CPAP. Reported figures. 7 hrs 34 min with AHI=0.93 Events: 7 H, 2 CSR. No major mask leaks (max=6 L/min); no oximeter.
I worked on dishes and cleaning ants off our counter. They seem to be coming and going under the switch cover for our disposal. They are quite tiny. We’ve killed a bunch, but maybe it is time for a more aggressive tactic. I worked on dishes, arranged clothes to take to the clothing share (part of the Buy Nothing Ellensburg group) for next week, and arranged for John to write his documentary on his illness to the patient portal in Cle Elum (today is our Dr.’s day off). John has started working on another documentary report for me to share later in this blog. I’m working on music to take to the food bank group (mandolin, banjo, fiddle, and guitar) to test for our other larger group for the next two & ½ months. These are several new pieces, for which we will check the chords, notes, and lyrics. We made a few corrections, in several songs. Songs include: Oklahoma Hills, Shenandoah. Sweet Betsy from Pike, Take me Home, Country Roads, The Cowboy’s Dream, Whoopee Ti Yi Yo – Git Along Little Dogies, and Shall We Gather at the River. There are more new ones to be added before next week, for Thursday, our first performance of this play list.
The chow at the food bank was great today, and we had an appreciative audience, with people coming up at the end to thank us for the music. We play away from the entrance and exit door, so they have to make a special trip down to tell us, when we break to go through the buffet ourselves. They didn’t seem to mind our practicing music on them. We started early, and only went over the noon hour a few minutes, before switching to the songs for which the audience who wants to follow along, has a set of the lyrics. Normally we play from noon to 12:30, and then sit with a few members of our fan club, and have our lunch, and conversations.
Today was a very smoky day in our valley from fires north of us.
The pictures below do not do it justice, but you get the idea. The large orange ball is the sun filtered through a heavy layer of smoke in the valley, and the other orange sun in the trees, taken later in the evening, still displays the changed color from the smoke. Note also the stressed Ponderosa pines in our back yard. The creek is just beyond them, and their roots (some more so than others) can reach the water table, but the drought and hot temperatures this summer have stressed them. {This picture (only) can be seen a bit larger by clicking on it.}
The orange sun was so spectacular to the naked eye** that our 14 yr old neighbor called us on her cell phone to be sure we saw it. She was standing at the back fence of her family’s property just east of us. Photos don’t do it justice. [**search for – Moon Illusion – on Wikipedia to find this is a confusing issue.]
Thursday, Aug 27
For Aug 26 CPAP. Reported figures. 5 hrs 49 min with AHI=0.17 Events: 1 H, 1 CSR. No major mask leaks (max=7 L/min); no oximeter.
John packed the pick-up with-canopy completely for delivery to the transfer station (aka “dump”). I worked on emails, honchoing music and clothing distribution for next Tuesday. We left in time to stop by 4 places before dropping me off at Hearthstone to play our July/August playlist for the last time this year. Next week starts a new list with some totally new songs included. That will take us through Sept, Oct, and half of Nov. Then, mid-Nov, we start on our Thanksgiving, winter, and Christmas playlist. January starts anew with a yet different playlist.
We had a nice time and an appreciative large audience today with a good crowd of players, at Hearthstone Cottages.
While we were playing, John delivered 280# of trash to the transfer station. In addition, he went to two grocery stores for goodies, including picking up one of my heart meds.
Our supper was Stroganoff with our own squash, onions, tomatoes, and grocery-bought mushrooms, red grapes on the side, and cheesecake with ice cream and our strawberries on top. Nice to have John eating again and feeling like cooking our meals.
Friday, Aug 28
For Aug 27 CPAP. Reported figures. 6 hrs 7 min with AHI=0.33 Events: 2 H, 1 CSR. No major mask leaks (max=7 L/min); no oximeter.
Today, we started the day with a trip to town to visit our friend, Julie, and her 3 yr old daughter, who were in Ellensburg (from Nevada), for the past week fixing up their house they have owned since 2003. Her two boys stayed with their father because their school has been in session for 2 weeks. {In EBRG school starts later because of the County Fair and Rodeo and then mid-school breaks are much shorter.} I think they always wanted to move back to town, but it doesn’t look possible now. It was Julie’s birthday today. We did not even take her a b.d. cake, but sent her a card she could access on her I-phone. We went early in the cool of the morning, because her mother-in-law was coming at noon to take her out for lunch. From there we went to the other end of town, to check out some keys for a gal I’m looking after her house, cat, plants, and mail for the next 2 months, while she and her son drive east and south and back here in a big loop.
She wasn’t at home, and because I was dialing the wrong phone number, we didn’t meet up, but I checked the house key in the front door, and it worked. Then I went around a long block in the subdivision to the location of all the mailboxes. Checked that key and it did not work. Back another day this weekend to sort out what I missed today. Luckily, they don’t leave until Wednesday.
Once home, I took a photo of a Truck Dolly I picked up last week for $5. John had searched and found a like one, in slightly better condition, for $175 (asked price). I was feeling good about my find. Mine is serviceable.
My $5 one has worn out Glide Belts, a frayed belt, and worn steel-covering plastic pads. Still, it is very usable.
We had another bit of leftover stroganoff with new squash, mushrooms, onions, our garden-ripe Early Girl tomatoes, and red grapes on the side. Dessert was a little sliver of red velvet cake and of cheesecake, vanilla ice cream, with strawberries on top.
After bedtime, our oldest dog Meghan, 15, apparently had a seizure. I don’t know how to describe it other than this way, and it is the first such activity we have ever witnessed with her. She started by sitting up, then standing, and turning her head back and forth, as if she had something caught in her teeth. I then I wondered if she was biting her tongue. She lay on her side and I tried to comfort and hold my hand on her. Her four legs were running at a breakneck speed, but finally slowed. I called John from bed and he carried her outside in case she was dying (and lost fluids). She was very wobbly, and walked a few feet and fell on her side. He waited 20 minutes, and went back into the yard and found her at the far end of the yard, stood her up and she was wandering in circles, and then propped herself next to the fence. He came in and we decided it was not too cold to leave her outside. She had access to the doggie door, if she became able to return inside the house.
We did not get to bed until after midnight, and neither one of us had a decent night’s sleep.
Saturday, Aug 29
For Aug 28 CPAP. Reported figures. 7 hrs 8 min with AHI=0.28 Events: 2 H. No major mask leaks (max=8 L/min); no oximeter.]
Started with a surprise that Meghan was still alive and with us. She was up walking around the back yard, and came onto the patio to be let in the back door.
Both of the older dogs–Meghan, nicknamed Skittles, the one with the problem last night is 15, and Dan is 14. The oldest a Brittany in our house lived to slightly over 16.5 yrs, many died at 12 or 13, and at least one before that, of natural causes.
It’s strange, but this morning both she and Dan ate a morning meal of canned food. Now they just asked for a second helping and I obliged. We wonder if Dan (who goes into the irrigation ditch, lays down and drinks) also had a case of Giardia, but he managed to expel it on his own? He is eating again and motoring around, but 3 weeks ago he had no muscle strength in his back legs and had to be helped up the ramp. He lost a ton of weight (over many months) too, because he quit eating. Never noticed diarrhea. Neither of the old dogs hears or sees well, but do do both.
Then it started raining, but now at 10:45, the sun just arrived. John has fed the animals outside, and I fed the ones inside. We are ready to have a brunch of veggies and eggs, in a frittata-type concoction, with bacon pieces, sausage, and an orange on the side. John’s been out a bit, got sprinkled on, came in, put on a dry shirt. Later repeated that sequence. Oh well. Where the fires are burning they are getting the same weather and it helps. High winds and downed trees in the Seattle area are causing havoc with 450,000 without power tonight. Many photos are on the KOMO news site.
We plan to spend today putting out the blog, including the story of the past month of John’s gastrointestinal event, in his words. We even had a telephone visit from a public nurse, whom I actually have known in the community through music. He interviewed John about his experiences, knowledge, and suspected acquisition. They were definitely on the same page. I found it interesting that the state was notified of such cases, and County Health is doing follow-up interviews. We learned there are 400-600 reported cases of giardiasis in WA each year. Actual numbers are unknown because some folks apparently don’t get very sick and don’t contact medical professionals.
Just this morning, John shared his current documentary with me, to add to the blog this week– here goes:
John’s report on Giardia
with some info pulled from [this link].
Giardia lamblia exists in two forms, an active form called a trophozoite, and an inactive form called a cyst. The active trophozoite attaches to the lining of the small intestine with a “sucker” and is responsible for causing the signs and symptoms of giardiasis. The trophozoite cannot live long outside of the body; therefore, it cannot spread the infection to others. The inactive cyst, on the other hand, can exist for prolonged periods outside the body. When it is ingested, stomach acid activates the cyst, and the cyst develops into the disease-causing trophozoite. It takes ingestion of only ten cysts to cause infection. [my bold]
{I wonder how many can fit in a drop of water? My best guess is that our irrigation water is the source – that is, Naneum Creek. Seems that a single drop of water, or less, would be enough. For example, Annie, our Brittany dog sometimes gets very muddy, on her own, but doesn’t like for me to try to wash her off. I occasionally lower her into the ditch and try to splash water on her legs and underside. Lots of fun. Water flies everywhere. I sometimes get droplets on my glasses. Surely seems as if I could get some smeared across my lips. I have also eaten a fresh strawberry or cherry tomato without first taking inside and washing – not often. The next line below suggests why I might not remember such an incident as compared to, say, someone that drank from a stream during a hike.}
Symptoms and signs of giardiasis do not begin for at least seven days following infection, but can occur as long as three or more weeks later.
{I first noticed fatigue on July 31. I checked Mayo Clinic and other such web sites after getting other symptoms. Some things only last 1 to 3 days, so for an adult, the suggestion is to wait it out that long before seeking treatment. So, on the 4th day, feeling a bit better – I relaxed. The next day, feeling the need for something, I ate a handful of chocolate baking chips. Bad idea! About 15 minutes later, they came back up. I did not eat for a day – then started with a small amount of canned pears. Seemed OK, so I repeated.}
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{I need to find out about the following.} The most common treatment for giardiasis is Metronidazole. It has an efficacy rate of 75% to 100%, but it often causes gastrointestinal side effects such as nausea and a metallic taste as well as dizziness and headache. Despite its effectiveness, Metronidazole is not approved by the FDA in the U.S. for treatment of giardiasis {but is approved (still) for many other things. This was the medication prescribed for me.}
The approved one is Tinidazole. It is chemically similar to Metronidazole—a drug with some unpleasant side effects that is used in the United States as first-line therapy for amoebae. Tinidazole has similar side effects but has a shorter treatment course.
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Tuesday, Aug. 11th, Nancy went to a we’re-closing-down Barbeque at Royal Vista Nursing Home and met our Doctor there. He’s been the visiting physician in charge there for many years. She has played music there many years in several different venues. When he saw her, he asked where I was. She told him, and he said, “Bring John to see me.” We did that Thursday AM. Got pills called Ondansetron (AKA Zofran) to prevent nausea and vomiting. Got a stool kit consisting of a big plastic hat to ‘go’ into and two vials with strange chemicals to place the item of interest into. I had quit eating and so had no stool either. Took the pills and starting eating in small quantities. Only took a week to ‘go’ and then get the test kit vials to the lab at the hospital. I had been assured that they did not want the plastic hat back. [A lab tech friend in the Cle Elum office told us a woman tried to return one to her a few years ago.] We saw her when getting a blood draw in the lab, at the visit.
Therefore, the samples went in on Thursday morning. Cultures do not happen in hours as does the blood work. Blood work was fine. Folks at the lab reported on no-shows on Monday (such as ecolae, salmonella, and 2 others) – then found the Giardia. We were on the road to Yakima on Tuesday morning and Dr. Paul Schmitt called. The road has long hills and deep cuts into the basalt layers. The cell phone kept fading and cutting off completely. He was going to have a prescription called into our EBRG pharmacy – we got it at about 3:30. That stuff is called Metronidazole, mentioned above. I did take another anti-nausea pill – but then no more of those.
I did not feel sick going to Yakima or coming back and had a small chicken Caesar salad while there. Took the first pill at about 4 PM and another near Midnight (it is a 5-day deal, with one every 8 hours).
As near as I can tell, I lost about 25 pounds in 25 days. I don’t know for sure, at what weight I started. It is now Saturday Noon (8-28), and I have eaten regularly since Tuesday Noon. Interestingly (or not), everything I am eating is apparently being redistributed to my body tissue. Nothing is allowed through, although the kidneys and bladder are working well.
The Metronidazole pills will end Sunday afternoon.
=======now Nancy=========
John’s been resting while I finished this draft, and I need to make 2 composite collage photos to add before he starts on WordPress entry.
After his nap he’s been out and beginning to restart all the delayed projects – a bit at a time. Thankfully he was able to feed the animals and water plants all along. {Just barely – says John}
Hope your week was fine.
Nancy and John
Still on the Naneum Fan