Saturday, July 29, 2023

My Concussion: fixing my hearing

Shortly after I wrote my anniversary blog post, I began researching panic attacks after concussions. I found a great website that detailed all the tests I should have pursued after being diagnosed with a concussion and what I learned led me to getting my hearing checked.

I found a highly rated audiologist with a free two-hour evaluation and made an appointment. The audiologist sent me a video about the damage hearing loss (or in my case, hearing distortion) does to a person's cognitive abilities. People with hearing problems have an increased risk of dementia due to lack of auditory stimulation, which leads to the degeneration of the auditory nerve. Hearing problems can also cause social isolation, depression, cognitive overload, memory problems, increased risk of falling and deterioration of the quality of life. I think I had everything on this list except depression.

I went into my appointment thinking that I had a noise sensitivity and would need ear filters. After going through multiple tests, I discovered that I was hearing differently in each ear. In one ear, I had high frequency hearing loss and in the other ear I had low frequency hearing loss. This unusual condition is called asymmetric hearing loss. My poor brain has been trying to process different sounds from each ear and that's why I have been getting overwhelmed in places like crowded restaurants where it's too noisy and loud. I also was missing words when listening to people talk, especially if there is background noise. As a result, I had a hard time concentrating on what I was hearing and finding the right word when talking. No wonder it was so difficult to write!

My tests showed that if I didn't get corrective hearing aids, I would have an increased risk of dementia, falling and cognitive decline. Asymmetric hearing loss also caused my brain to generate a new, inefficient auditory pathway, which overloaded it easily. So, I chose to get hearing aids in each ear. They will be gradually tuned so that my brain can catch up and reprogram itself. It will take six months for my brain to be fully reprogrammed, but I am already hearing well enough to eat in noisy places without any problems. Some noises are still too loud, though. I can tune down the hearing aids a little bit, but sound reducing head phones work better. I will have to bring this up at my next appointment.

I received my hearing aids on May 15th and left for a two week trip to the UK on July 12th. On the whole, I did fine with loud noises. But one day I became overwhelmed and had a panic attack. We were visiting what we thought would be peaceful Kew Gardens, outside of London. I went there in 1976, found it quiet and fascinating, and was eager to show it to my family. But since my 1976 visit, Heathrow Airport grew and now large, low-flying airplanes are constantly flying over the Gardens, bringing their disruptive noise along with them. What a surprise!


July 20, 2023 at Kew Gardens

Here is an interesting post about living under the flight-path of Heathrow Airport during the pandemic: https://hacan.org.uk/?p=78676

Tuesday, May 2, 2023

My Concussion: One Year Anniversary

Today is May 2, 2023, one year to the day after my concussion. In many ways, I feel like it was a lost year. For months, I easily became overwhelmed when driving and shopping, continued to be sensitive to light and noise and experienced panic attacks for the first time in my life. I felt disoriented and tired and had daily headaches for a long time. And I never regained my sense of smell.

My daughter has a podcast called Live from Suckville in which she interviewed me about my concussion last June, which was still early in my recovery. If you want to listen to it, it is Episode 9 on this website: https://soundcloud.com/user-168118630 


From June until now, it took me months before I finally went to the eye doctor for my annual checkup. I learned then that my eyes were misaligned, probably caused by the concussion. Now I understood why I had such a hard time mentally focusing on the book I've been working on for over two years (and still haven't finished), reading, shopping, driving and concentrating. When I was shopping, I was seeing in 2-D and it seemed like everything was coming at me all at once. I'd have to run out of the store in a panic. When I was driving in a middle lane on the freeway, my peripheral vision was all messed up when cars passed me on both sides and I had to pull over so my husband could drive. When I received my first pair of prism eye glasses, my headache intensity considerably lessened, my eyes felt much less tired, I could now handle shopping and driving and could see in 3-D again. (Prism glasses reflect light in such a way that misaligned eyes are corrected). It was amazing how much easier life became.

 

But I still had almost constant headaches. They felt like they were on the top of my head, where I fractured my skull, but I think they were tension headaches coming from somewhere else. So I went back to the concussion doctor, who I last saw 3 weeks after my concussion. She thought that perhaps I had suffered whiplash when I hit my head and the headaches could be caused by that. I then went to a physical therapist in March who gave me neck exercises and acupuncture (he called it dry needling). After three weeks of treatment, my headaches are essentially gone, although I still have to practice the neck exercises every other day.

 

I also went to a speech and language therapist in March because I noticed I had trouble finding words sometimes when speaking. After two hours of tests, I was relieved to learn I don't have brain damage and my trouble with words had to do with cognitive fatigue. Cognitive fatigue is caused by my brain being exhausted and depleted of energy, which significantly slowed down my recovery. My brain was trying to heal damaged areas at the same time it was trying to function normally by rerouting around these damaged areas. Doing additional work like this takes a lot of energy and if I tried to "push through", I ended up totally exhausted and couldn't think or concentrate. To correct this, I made it a habit to periodically evaluate my energy level. If it was low, I needed to take a break--for me that meant performing diaphragmatic breathing and neck exercises--to restore my energy level and then go on with what I was doing. I also stopped multitasking, which was a quick way to exhaust myself and, at the same time, not do a very good job with what I managed to get done. Which explains why I'm now on the third revision of a manuscript that is not even finished yet!!

 

So, I can see in 3-D now, I no longer have headaches, I can concentrate a lot better than before and I can go shopping with ease--as long as the music isn't too loud and the store isn't too crowded. Which brings me to one more problem I haven't solved yet: noise sensitivity.  Beginning in late February, my husband and I have been traveling, which means going out to eat. And I noticed noisy restaurants put me into a panic because I can't filter out background noises from regular noises. Loud music, talking, silverware clattering on plates, bright lights and movement all jumble together and overload my senses, making me very anxious. I've had to run out of restaurants several times just to get somewhere quiet. Through trial and error, asking restaurant staff to turn their music down or seat me in their quietest corner and at a side table with my back to the wall so all the noise will come from one direction helps quite a bit. Otherwise I can't handle it. I made an appointment with the speech and language therapist next week for suggestions about ways to overcome this. I'm especially worried because we are planning a family trip to the UK in mid-July. 

 

Which brings me full circle: I still can't smell anything. It's hard to explain how losing this sense impacts my daily life. It's a sense we take for granted; until it's gone. So going out to eat, which is such an important part of socializing, especially when traveling, is now more of an ordeal than anything else. And the smell of roses or the rain or baking bread or brewing coffee has to be remembered rather than reinforced. Because I don't get the "whole picture" now, everyday life is harder to remember and always seems like something is missing. Cooking dinner has become cooking for others, not for me. I have protein smoothies every morning for breakfast because the cold temperature and smooth, thick mouthfeel is more rewarding than something I can't taste, may not agree with me or has a displeasing mouthfeel. Lunch is whatever I can grab to satisfy my hunger and dinner is what agrees with me. I've lost about five pounds because I don't eat sweets anymore except ice cream or gelato, which gives me that cold, velvety mouthfeel as well as sweetness. But cake, pie, cookies . . . Why eat all those empty calories if I can't taste them? I can taste dark chocolate, though, especially when I melt it in my mouth. 

 

What I have learned from this experience is that it could have been much worse. Also, I have a wonderful husband and family who support me, a beautiful peaceful place to live in and good friends. How could I ask for more??

Wednesday, August 3, 2022

Learning to Fly: My Concussion

 

“I’m learning to fly, but I ain’t got wings. Coming down is the hardest thing.”

Tom Petty

 

Three months ago, my son Kyle and I were hiking on a steep slick-rock pour-off. I fell forward and flew over him, hit the ground and conked my head. Kyle and I were trying to catch some little frogs and return them to the muddy pond on the bottom of the slick-rock. He was bending over to grab one of these little frogs below me and I was standing above him with my boots gripping the steep slope. 

Now, slick-rock is a misnomer as it is not slick at all. It's actually a gritty, rough sandstone that grips the bottom of one's shoes and is deceivingly easy to walk on. And a pour-off is where the rain concentrates after a storm to flow downhill on rock, also known as a seasonal waterfall. So, I'm standing above Kyle, not thinking about my surroundings. I leaned forward and the next thing I knew, I was on the ground with an aching head. 

Kyle heard me say, “Ah, ah,” right before I flew over him. He tried to grab my flailing arm but he couldn’t catch it. But somehow I twisted around in mid-air, landed on my right butt cheek and hit the back of my head on the surprisingly hard ground. I probably fell about six feet.

My glasses were flung off, but they weren’t broken or anything. Kyle called out, "Dad, Mom fell," to my husband Scott, who was waiting for us nearby. By the time Scott reached me, I was sitting on a rock, feeling dizzy. Both Scott and Kyle agreed that I should go to the hospital and helped me walk back to the car. After stopping by the house to change, Scott and I drove to the emergency room. 

A CT scan showed a crack in my skull on the top of my head, although I have no idea how I hit it there, and two small brain bleeds in the subarachnoid and subdural layers of tissue between my skull and my brain. (I'd never heard of these layers before and had to look them up later). The doctors diagnosed me with a concussion and kept me in the hospital overnight to make sure the bleeding had stopped. Although they woke me up every hour to make sure my pupils were equal, I knew where I was, I could focus on how many fingers they were holding up, and I was grateful to be there. 

 


 

I had another CT scan the next morning that showed the bleeding had in fact stopped so they let me go home. That’s when I discovered I had a very sore and swollen right butt cheek, which developed into a large salad bowl-sized hematoma (deep bruise) that is still swollen and bruised two months later, but not sore anymore—thank goodness. The top of my head remains sore and I still have a lump on the back of my head.

I hadn’t thought about concussions much before this happened to me, but now I’m fairly well versed. Basically concussions happen when your brain slams against your skull and anything in the way can get injured. I think I’ve had most of the symptoms of a mild to moderate concussion: fatigue, dizziness, headaches, ocular migraines (the fun part of migraines—aura but no headache), light and noise sensitivity, easily over-stimulated and, worst of all, a loss of my sense of smell. That means I can’t taste anything except what the taste buds on my tongue detect: sweet, salty, sour, bitter and umami, the savory taste of cooked meat and vegetables.

Before I lost my sense of smell, I didn't understand the difference between taste and flavor. Think of when you last had a cold and couldn't breath in through your nose. You couldn't taste your food very well because you couldn't smell what you were eating. However, you could still pick out some flavors  because the chewed up food in your mouth also passes by your olfactory nerves a second time when you breathe that in. The molecules coming from the outside of your body tell you what you are going to eat via your nasal cavity. The molecules coming from inside your mouth give you the ability to distinguish between flavors. Taste buds plus aroma, both from your nose and mouth, equals flavor.  

If you have damaged your olfactory nerves, you can't detect flavor and have to enjoy foods by how they feel in your mouth (mouthfeel), what your taste buds can detect, and how you feel after you eat. I hope I get my sense of smell back, but have a feeling it has been damaged beyond repair.

Here is a good link if you want to learn more about the sense of smell: https://www.physio-pedia.com/Olfactory_Nerve

Or if you prefer just looking at a diagram, here is the photo that comes with the above article:



What you can't tell from the photo above is how thin the bony barrier (called cribriform plate) is between the brain and the nerves in my nose that detect smell molecules. These nerves are called olfactory nerves and terminate in the olfactory bulb, which transmits the detected smell molecules to the brain. These nerves dangle down from the top of the nasal cavity and are easily damaged if a person suffers a traumatic brain injury (TBI). When the brain slams against the nerves, it can shear them off or severely damage them and there is no telling if they will regrow or not. Meanwhile, I’m sniffing everything I can find: essential oils, spices, plants, the air after it rains, etc. and hoping the repeated scent onslaught will bring my sense of smell back. But so far no luck.


Wednesday, March 2, 2022

Hidden Enemies-at a bargain

I identified with the main character in the recent Netflix movie Tick Tick BOOM. He had been working on a musical for 8 years and in one week would be showing the musical for the first time. Only one problem--he had to write one more key song. He sat at the computer and started a sentence. Then he corrected the sentence, then he deleted the sentence, then he rewrote the beginning of the sentence. He sat there, watching the cursor tick and tick and tick . . . 

In 2020, I changed my book Remember Me from past tense to present tense. Remember Me received first place in the suspence category in the 2019 Next Generation Indie Book awards and Honorable Mention at the Hollywood Book Festival. So I know it must be a half-way decent read.

I also published another book Hidden Enemies. This book received an Honorable Mention at the 2020 Next Generation Indie Book Awards.

Since these books are difficult to find by searching Amazon.com, here is my author link: https://www.amazon.com/stores/M-A-Florence/author/B00915SFSE?ref=ap_rdr&store_ref=ap_rdr&isDramIntegrated=true&shoppingPortalEnabled=true

Back then, I was inspired then and I had a lot to say. Then the pandemic hit . . . and I have been languishing. I am working on another book, but it's going slowly. And now, for the first time, I understand writer's block. 

I have done a terrible job of marketing my books and have made very few sales. So at least someone would read them,  I decided to donate my books to the library yesterday and talked to the person in charge. He said if they are self-published, he needs to take a look at any book reviews on Amazon as well as the books themselves. I left him one copy of each book, plus Red Flag Warning that I had to regain my rights from Infinity years ago when they went out of business and republish myself (long story). 

I took a look at all my books on Amazon.com and Hidden Enemies had nothing, zero, zilch reviews and the book was marked down to $5.59 (from $12.95)! First of all, I asked two people who have read my book to submit reviews and they did. Thank you Mike and John. Then I asked the self-publishing service KDP what was going on with the price change. 

They responded, "Melanie, per our Terms and Conditions, we retain discretion to set the retail customer price for the books we sell. Our decision to discount products is based on a number of considerations, which vary over time. However, the discount doesn’t affect royalties earned from orders placed on Amazon. Your royalties will continue to be calculated from the list price you provided on your KDP account, in this case you will continue to earn royalties as if the book was being sold for $12.95." 

So, I have a book bargain for you!! And I hope you take me up on it.

Monday, April 19, 2021

Finding SIBO

Finding SIBO

 

What is SIBO you ask? Well, it took me a long time to find out. But now I know why my digestive system has been out of whack since I had my cancerous appendix removed in February 2017 and a subsequent right hemicolectomy 16 days later. (A right hemicolectomy is the term for an operation that removes the beginning of the large intestine: which consists of the cecum and the appendix, the small finger-like projection on the bottom of the cecum). A general picture of the digestive system shows the appendix hanging down from the cecum:


Not long after I recovered from my surgery, I began getting mild acid indigestion. I kept a food diary and discovered soy products were part of the problem. So I stopped drinking soy milk, and eating tofu and protein bars made with soy. That worked for a while; then the acid indigestion came back. So  I stopped taking fish oil pills, which can--surprisingly--cause acid indigestion in some people. That didn't help much, so I decided to start taking my vitamins after eating breakfast, instead of at night. No change. Then I gave up coffee. I gave up wine and beer. I gave up chocolate. I put myself on a high alkaline/low acid diet. Nothing helped. 

I got to the point where I was taking Tums before going to bed every night, waking up multiple times with acid indigestion, taking more Tums, and paying the price of all this indigestion and lack of sleep the next day.  I turned to the internet and found a help group consisting of people like me who had digestion problems after having a intestinal surgery, especially a right hemicolectomy. Bingo. All these people had tried a lot of different diets that were not always successful and most were still searching for a cure. I further discovered that when my surgeon removed my cecum and appendix, he also removed a one-way valve that separates the large and small intestines. It's called the ileocecal valve.

In a complete digestive system, food travels one way: from mouth to stomach to small intestine to large intestine and then out of the body. The direction of this process is controlled by peristalsis (the muscular contraction of the esophageal and intestinal walls), sphincters and valves. Basically, digestion consists of mechanical breakdown (chewing), and chemical and enzymatic breakdown (acids in the stomach; bile and enzymes in the small intestine). Most of the nutrients are absorbed into the bloodstream from the small intestine and only a small number of specific bacteria inhabit it. The digested food then travels through the one-way ileocecal valve to the cecum, which absorbs water, vitamins and electrolytes, then into the colon where a large number of bacteria break down waste products and produce vitamin K.

From studying the digestive process, I learned that missing an ileocecal valve is not a good thing. Without this valve, bacteria from my large intestine can back up into the small intestine, colonize there and wreak havoc. I finally found SIBO: Small Intestinal Bacterial Overgrowth. 

I went to my primary doctor and he put me on antibiotics, which helped for a while. But the acid ingestion came back with a vengeance. I needed a permanent fix. So I tried different diets until I finally happened upon a miracle: a diet that switched me from absolute misery to symptom-free. It's called the specific carbohydrate diet (SCD) and is outlined in the book "Breaking the Vicious Cycle. Here is a link: http://www.breakingtheviciouscycle.info/home/

This book was written for people with large intestine problems, but it works for me. On this diet, I'm starving the bacteria that traveled up from my large intestine by cutting out foods that contain easy-to-digest carbohydrates. For example, flours, sugars and refined grains. I also gave up bread and gluten. The very day I started this diet, my symptoms disappeared. Not only did I find SIBO, I discovered how to lose it! 


Thursday, September 20, 2018

Self-publishing with CreateSpace (Now called KDP)

Notice: The name publishing name CreateSpace has been changed to KDP (Kindle Direct Publishing), but otherwise it's still a product of Amazon.com and works the same way. KDP is a self-publishing service that doesn't cost a cent, if you do everything yourself. I've published 3 novels using KDP already and they are available on Amazon.com. I also finished rewriting the novel Red Flag Warning and am in the process of publishing it, too, on KDP.


Why am I publishing this book again on KDP?

1.  In 2012, before I knew about inexpensive do-it-yourself publishing, I paid Infinity Publishing to be my publisher for this book. I'd  already gone through the traditional publishing model, where I searched for an agent and sent chapters to what few publishers took unsolicited manuscripts. After some time passed without results, I learned about "vanity presses" as they were called then. I talked to some fellow writers who had self-published and decided on Infinity Publishing. After paying for them to design the cover and put my book into print, they put it on Amazon.com for me in paperback and kindle versions. I only sold a few copies, which was OK.

2. After I wrote a few more books and published them on KDP I saw that Red Flag Warning had been marked way up in price. I contacted Infinity Publishing about it and they changed the price back to what it should have been. But when I searched the Infinity Publishing website, I found that it had been sold to another company. My feelers went up when the website also did not work very well. I contacted the agent again about buying author copies and learned there were a minimum number of copies I had to order and it was expensive. Not so with KDP. An author pays how much it costs to print each book, with no minimum  number of copies required, plus shipping. I then looked up Infinity Publishing in the Better Business Bureau and it got an "F". That did it for me. I asked them to free me from my contract, which they did.

3.  Now was my opportunity to have total control of Red Flag Warning! I reviewed the manuscript, which I saved, and saw many ways to improve my writing. KDP allows the flexibility to change a book at any time. One still has to go through all the steps again, which can be a pain, but at least the author has the opportunity to change his/her book without payment. In the finished project, my story is exactly the same, but I made it smoother and faster to read.

4.  I get 100% of the royalties for any books and kindle copies sold!
 

Drawbacks to using KDP

 
1.  If you want a decent cover, you need to hire a graphic designer to do it for you. For my book Remember Me, I did just that (my son's girlfriend, who is a graphic designer).


As you can see, she did an excellent job and it helped me win several awards--first place in the 2018 Next Generation Indie Book Awards in the suspense category and an honorable mention in fiction in the 2018 Hollywood Book Festival. Since many writers enter these contests, I finally feel validated that I'm a good writer.  For Red Flag Warning, I am using the front cover I paid for and had to make up the back cover myself (which is not nearly as polished as theirs--but that's how it goes).

2.  There are a lot of steps to go through and you need to check everything to make sure it is correct. Self-publishing also requires a thorough edit and knowing how to set up a book. Some people will pay for an editor, but I am very lucky to have my husband and a few friends point out my mistakes. Since I was originally trained as a botanist and am largely self-taught as a writer, I definitely need the help! As for setting up the book, the author needs to have fairly extensive word processing skills. I was forever looking things up at first, but now I think I have the hang of it.

3.  The author must market him/herself. I'm not much of a marketer so I'll probably never become famous or make a lot of money on my books. Oh well; all I want is to get my books out there and to be read by someone, instead of piles of paper in a drawer. If a person doesn't have an Amazon.com account, that can be a drawback as far as sales go, too. But there are ways around that. That's one reason I send out this blog!





Saturday, October 17, 2015

Synopsis of "Remember Me"





Hello faithful readers,

I'm feverishly working on fixing up my approximately 90,000 word manuscript, Remember Me, and am now on Chapter 32 out of 36. Almost done!!

Here is the synopsis of the story. I'm hoping to get it published with the help of an agent I knew when I lived in Chantilly, VA. I hope you find it interesting.



Remember Me
Synopsis

San Francisco University neuroscientist ROBIN LUND is puzzled by her lab chimpanzee Chelsea’s behavior. The experimental memory and learning drug Mem-G, which is designed to restore short-term memory recall in dementia sufferers, appears to be enabling Chelsea to experience ancestral memories encoded in her DNA. 

To more fully understand this drug, Robin illegally begins taking it herself. What she learns is both stunning and dangerous: her mother is not who she thought she was and a man her mother once knew wants Robin dead. Her mother knew this man as ANDRE TREMBLAY but now he goes by the name of DR. MARC BORDEAUX. Dr. Bordeaux is now Senior Vice President of Zerbico Pharmaceutical Company, the corporation that formulated the drug Mem-G. 

As Robin embarks on a journey of self-discovery, Dr. Bordeaux will do everything he can to prevent her from uncovering his criminal past. NICK EVANS, an ex-cop, helps Robin stay one step ahead of Dr. Bordeaux while she explores Mem-G nightly and travels to her hometown, Denver, to find out what happened to her mother. Dr. Bordeaux’s relentless pursuit continues, leading to a final chase that ends up at a police station. There, both she and Nick turn over evidence linking Dr. Bordeaux to the crime that put Robin’s mother in prison, where she died shortly after Robin was born.