(Written starting Friday, April 19th)

I didn’t know that today would be a big day.  I didn’t expect to be handed an outcome that both assures and explains and, because it does, allows me to let go in big, big ways!  I thought I would receive information…not this gift!!!  Here’s the scoop:

I had my follow-up with Neurology today.  The last follow-up with the last specialist – at least in this first big round of exploration.  The only specialist that had concerns to pursue and in the field of specialty that I considered the most intimidating.  We did three procedures after the initial consultation – an MRI of my brain, an in-office EEG and a 48-hr EEG.  The 48-hour EEG was supposed to happen only if we didn’t find anything on the in-office one, but then it happened because they did find some unusual activity and needed to get more information.

SO…Both the MRI and the 48-hr EEG were clean and boring – good thing!  Between these two, we rule out all the scary things – tumors, seizures, strokes, MS, etc.  The in-office EEG does confirm that I am “extra sparky” – or, more technically, I have unexplained excess impulses happening at times in my brain – primarily the left hemisphere.  The 48-hr EEG needed to confirm that the extra sparks were not indicative of seizure activity and did confirm that they clearly aren’t.  They know this particularly because there was no evidence of those extra impulses when I was sleeping, which is when the brain is the most vulnerable to them.  So, yes…I have some unusual brain activity, but we are not worried about this and it’s not overly rare.  Very similar outcome to the Echocardiogram that found several extra heart beats, but not enough to be at all worried about.  My joke to my UUCR choir last night – I have heart and brain to spare…now if I can just find extra courage I’ll be able to do the Wizard of Oz as a one-woman show!

It’s at this point that every other specialist has said, “sorry, I can’t help you.  There’s nothing here to explore.”  Which has been good news, but not satisfying news – because these symptoms and episodes were happening and worsening at times and that just didn’t jive!

I have been preparing myself to hear this same thing from neurology and trying to get to a place where I could accept that all that has happened was both unexplainable and perhaps entirely the effects of stress.  That was going to be a tough pill to swallow, though, given that this all started with a very physical event and that the symptoms have seemed to progressively worsen even though my stress level was improving and my management of it getting better.  Turns out that the neurologist (Dr. Ruben Cintron, who you’ll hear more about!) had a sequence of possibilities in mind from the initial consultation and needed to go through this ruling out process first.  Having done that, there are a couple different possible and plausible explanations that can account for pretty much everything that has happened/is happening.  Not another brick wall!

First, some new language (for me, anyway) – he believes that this is an “insult-related” condition.  Think of insult like injury – but it doesn’t have to be a physical trauma…it’s a negative event.  That means it’s not a condition or disease that is progressive or systemic.  He described two events that he thinks have had lasting effects and then agreed that stress has likely been a 3rd event that has exacerbated the other two.  So…in order…

Over April to October of 2011 I lost about 60 lbs on the Medifast diet.  This is considered both massive and rapid.  It was a fully supervised, condoned and balanced program, but that’s not really here nor there now.  Dr. Cintron considers this “insult number one” – massive, rapid weight loss will change body chemistry and stamina and physicality in big ways and will take quite a period of adjustment.  It’s also very likely that I developed some deficiencies.  We’ve been trying to prove that since I first went into my primary care with significant dizziness in October of 2011, but Dr. Cintron says that it’s not surprising that we wouldn’t find evidence of them.  Many deficiencies won’t show up in bloodwork since the bigger issue is whether the nutrients are getting from the blood into the brain – ya know, absorption.  You will recall that, having had a gastric bypass surgery in 2006, I already don’t absorb things normally.  My physicians and nutritionists knew this, but it’s just so possible that this plays a factor as well.  Even if it didn’t, the Medifast weight loss alone left my body in a more vulnerable state with a long adjustment period and, likely, with deficiencies that caused the original dizziness.

As you know, the weight loss itself uncovered significant body and emotional issues and sent me down a stressful, psychological spiral.  Stress like I’ve never experienced before.  We can be sure that this didn’t help anything and further compromised my physical state.

The second distinct insult was my reconstructive surgery last June and, more specifically, 11 hours under anesthesia.  This was already a potential game-changer for my body chemistry and added on top of the weakened state, can easily explain the additional symptoms that started to happen after that surgery – sudden fatigue, mental fogginess and, later on, the near-fainting spells.  I know I’ve heard that the affects of anesthesia can last for months – even years.  Well, that’s true.  And it means that the “damage” that was done to me could not only take 12-18 months to heal, but could have been progressive over these past many months since the surgery – getting worse before it gets better.

So, in short – a one-two punch of a weakened physical and chemical state from weight loss and anesthesia exacerbated by stress.  That’s explanation number one and could incorporate every single symptom that I have experienced.  Treatment is time, nourishment, stress management and minimizing exposure to anesthesia especially out to 18 months past my surgery last summer.  Prognosis is just fine – we should expect improvement and we have ruled out any irreversible damage.

Then, there is a possible other condition/complicator.  Many of my symptoms and a more recent one that I hadn’t written about yet (some visual disturbance – clear, jagged shapes that kind of crystallize my vision – has happened twice this past week…remember I’ve been very sick and was very tired both times) – are classic symptoms of  acephalgic and ocular migraines…in other words….migraines without the headaches!!

Dr. Cintron says it’s possible that my body has decided to explore some migraine activity here in my early 40s.  Doesn’t mean that I’ll have migraine headaches or worsening symptoms or consistent symptoms.  I might experience that or I might have some more of what I’ve experienced already or I might not – we’ll have to monitor some of that.  He would be interested in some neuro-psychological testing, but not right now.  He believes that I’ll feel better over the next few months and would wait until then unless I didn’t feel better and we thought I had hit a plateau.

So…SO!!!!  This means many things!

• It means that we have BOTH answers and assurance that “not much” is wrong.
• It means that neurology is the specialty to stay with AND it’s not a big, bad specialty AND I happen to have an amazing neurology practice that I’m working with.  Timeout for a plug:  Dr. Ruben Cintron and his practice, Neuroscience Consultants in Reston is about the most amazing medical experience that I have ever had.  Every single person I’ve worked with has been fantastic.  So kind, so patient, so knowledgable and willing to spend time and really dig in.  I couldn’t be more impressed or more grateful!
• It means that we can seriously lower the freak-out factor when something happens.  I can respond (slow down, rest, eat, something) but we don’t have to panic about what’s happening and what it means.
• It means that I have answers that make sense, which allows me to both stop this exhausting exploration and lay to rest many things about the last many, many months.
• This means that I can concentrate on getting better by investing in what’s next, figuring out what relaxing and balancing energy means to me (which, we know has been an ongoing process – but this enlightens it some), deciding what is good, normal nourishment for me, and settling in for awhile.
• This means that “Sparky” is an apropos, medically condoned new nickname!

What a huge day!!  What a huge gift!!  I’m not totally healthy, but I’m not in danger and I’m recovering.  These physical and emotional stresses are very real and very much a part of everything that has happened, but just a part.  It’s been a complicated time.  Had you gathered that?

I have many other things that I’m thinking about now and I’ve been so in my head while I’ve been out sick, but we’ll leave that for another day.  For now, I want to just really appreciate and spend time with this gift that I’ve been given.  Soak it in and look at it from different angles and relish the freeing up of stress and worry that has been hanging over me.  I see that so clearly now that it is lifting!!

I invite you to lift your worry for me too and accept this gift.  Let’s unfurl our brows and put a hold on the diagnostic research.  Not because we’re desperate for this answer but because we’ve been given answer enough to make sense – pretty much without exception!  I feel that I can trust this doctor and this practice and they and I have our eyes open.  If I don’t show improvement or if things shift – we are so aware now and have good resources around us!  That’s definitely a bridge to cross only if we come to it.

And, besides, I have enough to do between figuring out this “relax” thing and jumping back into my creative work!  That’s where I want to focus my time and energy.  And that’s what I want to engage with my community on.  That and just being here.  With you.  Or maybe just being.  That will be hard work for me!!