Prior to my recent four-day hospital stay, if asked how I would rate my overall health, I would have replied “excellent,” without any hesitation. Compared to some others, perhaps it is, but I now know it’s not as “excellent” as I once thought.
Case in point: while sitting on the toilet and straining a bit, my “excellent” health suddenly changed. I felt a surge of blood rise to my face and my head. The image in the mirror reflected an unfamiliar and scary blood-red face. While my vision was blurring, I tried to regulate my breathing, four seconds in, hold, and ten seconds out, without effect. I knew I had to get flat and slumped to the floor, thinking my head would explode. I broke out in a total body sweat and I felt weak and disconnected.
While on the floor, I experienced my worst nightmare: laying on the floor, pants down, and accomplishing what I set out to do in the beginning. Interestingly, I could have cared less about the visual imagery. I was dealing with painful abdominal cramping, blurry vision, overall weakness, and pressure in my head. What was happening?
My soul-wrenching, repetitive groaning alerted my wife who summoned my son from next door that I was in distress. I unwisely refused an ambulance. He googled the symptoms and became concerned that I had had a stroke. Whatever was happening, I was taken completely by surprise.
Upon arrival at the emergency room at 1:00 pm on 10 February, the first action of the staff was to take my blood pressure: 211/109 and at this point I felt relative calm. I can only imagine what my BP had been earlier. I was given rehydrating fluid in my IV, anti-nausea meds, a pain killer, and something to lower my BP. They then did a CT scan which identified colitis and diverticulitis so an antibiotic was added to the IV cocktail.
I had been taking a cholesterol lowering drug, blood pressure meds, and pills for anxiety for years. My blood work from my six-months routine doctor’s visit is always within acceptable limits and I felt confident I was doing my share to maintain my health. So, at the time, I thought my blood pressure had spiked for some unknown reason but nothing more. Only later did I discover I had several medical issues of which I was unaware. I bring this up because I suspect I’m not the only one who believes they are in good or excellent health, but may have medical issues that need to be identified and addressed.
Upon my discharge from Lakeland Regional Hospital on 13 Feb 22, I received a “Discharge Summary” listing my medical issues that were discovered during my hospital stay. Some of them are numbered and shown below. Some I knew about; but others were complete strangers.
1. Left-sided acute colitis: a chronic inflammatory bowel disease that causes inflammation in the digestive tract.
· Acute colitis is not hereditary and is treated with antibiotics
2. Extensive sigmoid diverticulosis: a condition in which small, bulging pouches develop in the digestive tract. Sigmoid is the lowest part of the intestines. If the pouches become infected, it is called diverticulitis.
· Hereditary factors: Diverticular disease is a common condition in older adults, as a majority of those over the age of 70 have the condition. Diverticular disease is hereditary.
3. Elevated liver enzymes often indicate inflammation or damage to cells in the liver. Inflamed or injured liver cells leak higher than normal amounts of certain chemicals which are detected in the blood tests.
· Not hereditary
· What causes a sudden increase in LFTS?
“Liver diseases, medical conditions, medications and infections can cause elevated liver enzymes as well as certain medications, such as cholesterol-lowering drugs (statins) and acetaminophen.” Jun 28, 2021
4. Hypertensive urgency is severely elevated blood pressure of 180 or higher systolic or 120 or higher diastolic. Upon admittance to the hospital, my BP was 211/109.
· Not hereditary. Genetics, age, anxiety, and dehydration, however, do play a role.
· Heart.org states that a reading of 180/120 without symptoms such as chest pain, shortness of breath, back pain, and numbness or weakness is not a “Hypertensive emergency.” Blood pressure readings above 180/120 with associated symptoms such as chest pains require immediate medical attention. Call 911. https://www.heart.org/en/health-topics/high-blood-pressure/understanding-blood-pressure-readings/hypertensive-crisis-when-you-should-call-911-for-high-blood-pressure
· Emergency action: Vasodilators are medications that open (dilate) blood vessels and thereby quickly lower BP. Vasodilator drugs require a prescription to treat conditions such as:
· High blood pressure (hypertension)
· Cardiac pain or heart pain (angina)
· Prevention of stroke
· Prevention of a heart attack
· Vasodilators are strong medications that generally are used only when other medications haven't controlled blood pressure adequately. https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/in-depth/high-blood-pressure-medication/art-20048154
5. Severe Stage IIIa: A person with stage 3 chronic kidney disease (CKD) has moderate kidney damage. Stage 3 kidney disease means that the kidney's function has been cut by half, and most patients experience ancillary problems like high blood pressure. https://www.webmd.com/a-to-z-guides/what-is-stage-3-kidney-disease-life-expectancy#:~:text=Stage%203%20kidney%20disease%20means,to%2051%25%20in%20ten%20years.
· CKD is most common among people ages 65 or older. Overall, 36.1% of older adults in the US have stage 3 or greater CKD. https://pubmed.ncbi.nlm.nih.gov/18987917/
· The prevalence of CKD in those older than 70 years of age is 46.3%. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3160131/
· Probably not hereditary, but some kidney diseases are passed from parent to child.
6. Hyperlipidemia is a condition in which there are high levels of fat particles (lipids) in the blood. Examples of lipids include cholesterol and triglycerides. These substances can deposit on blood vessel walls and restrict blood flow. This creates a risk of heart attack and stroke.
Hyperlipidemia doesn't cause any symptoms. The condition is diagnosed by routine blood tests. Treatments include medication, a healthy diet, and exercise. I have been on cholesterol lowering drugs since 2001 with good results, and my blood is checked every six-months. This current condition comes as a complete surprise.
· Hereditary factors: Familial combined hyperlipidemia also known as mixed hyperlipidemia is a disorder that is passed down through families. It causes high cholesterol AND high blood triglycerides.
Diabetes, alcoholism, and hypothyroidism make the condition worse. Risk factors include a family history of high cholesterol. https://medlineplus.gov/ency/article/000396.htm#:~:text=Familial%20combined%20hyperlipidemia%20is%20a,cholesterol%20and%20high%20blood%20triglycerides
7. Infrarenal abdominal aortic aneurysms are shown in the following three images and
consist of that part of the abdominal aorta located below the kidneys. Causes include:
· Age greater than 60
· Family history
· Genetic factors
· Hyperlipidemia (elevated fats in the blood)
· Hypertension (high blood pressure)
· Hereditary factors: Abdominal aortic aneurysm (AAA) may occur as part of an inherited syndrome. Having a family history of AAA increases the risk of developing the condition. https://rarediseases.info.nih.gov/diseases/9181/abdominal-aortic-aneurysm/cases/43970
· The prevalence of abdominal aortic aneurysm (AAA) is 4 to 8 percent, affecting predominantly males. https://www.uptodate.com/contents/epidemiology-risk-factors-pathogenesis-and-natural-history-of-abdominal-aortic-aneurysm
· The most common location is the abdominal aorta, specifically, the segment of the abdominal aorta below the kidneys.
· What causes an aortic aneurysm? Atherosclerosis (a build-up of plaque in the arteries), high blood pressure, and smoking. https://www.texasheart.org/heart-health/heart-information-center/topics/aortic-aneurysms/
· Activities involving extreme or maximal exertion, contact sports, sit-ups, push-ups, or pull-ups, and heavy lifting can increase the blood pressure and the stress on the aortic wall.
· “Thoracic aortic aneurysm (TAA) is associated with older age. Most TAAs are discovered incidentally and do not cause symptoms,” but they do increase in size. https://journals.sagepub.com/doi/full/10.1177/1358863X18807760, Oct 29, 2018
· My small TAA measures 2.6 x 2.6 cm. “Our protocol is to follow patients with TAAs between 4 and 5 cm with MRI on a yearly basis if symptoms become a concern. Once the aneurysm reaches 5 cm, we follow TAAs every 6 months and consider repair when they reach 6 cm.” https://evtoday.com/articles/2017-nov/ask-the-experts-when-and-how-do-you-survey-a-small-taa, Nov 2017.
8. Metabolic Acidosis: Metabolic acidosis is a serious electrolyte disorder characterized by an imbalance in the body's acid-base balance. Metabolic acidosis has three main root causes: increased acid production, loss of bicarbonate, and a reduced ability of the kidneys to excrete excess acids. https://en.wikipedia.org/wiki/Metabolic_acidosis#:~:text=Metabolic%20acidosis%20is%20a%20serious,kidneys%20to%20excrete%20excess%20acids.
· Not hereditary.
· Acute metabolic acidosis lasting from minutes to several days, often occurs during serious illnesses or hospitalizations, and is generally caused when the body produces an excess amount of organic acids.
So, what did I learn from all this? Unlike the way I felt about myself earlier, I now know I am vulnerable and mortal.
· My age and bad habits are taking their toll
· I’ll modify some of my behavior but probably retain others
· While on the toilet, don’t hold your breath, strain, or bear down
· I’m hoping some of these conditions will self-correct as I recover, but know I’ll be stuck with others
· I need to collaborate more closely with my doctor