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arganoidAs I mentioned in the last chapter, on the 18th of November 2008 I had a tube inserted into my throat via the nose. This had to remain in place for 24 hours, so that acid levels in my oesophagus could be measured. I had to press buttons on the attached monitoring device to record when I was eating and when I was lying down. I also made my own notes, detailing exactly when and what I ate, and even when I burped. I had hoped to keep track of how bad my throat soreness was during the day, but it turned out this was impossible - the discomfort of the tube was bad enough to completely mask the usual soreness. Although by this point, the usual soreness was not as bad as it used to be, so that's not quite as bad as it sounds. Nevertheless, having the tube in was deeply unpleasant. The worst times were when its position shifted slightly and my gag reflex kicked in. At times like this, I strongly considered pulling the tube out. As you might expect, getting to sleep with the tube in was very difficult, but I did just about manage to last the full 24 hours without chickening out.
I received the results about two weeks later. My GP told me that the tests hadn't shown anything unusual. I asked him for a printout of the results so I could examine them in more detail.
The detailed results stated that there were a total of 23 minutes of reflux, which is apparently not abnormal. However, I was interested to read that the longest period of reflux (8 minutes) occurred just before 3pm. According to my notes, this was about half an hour after I had finished eating several bowls of cereal with soya milk. As I stated in the previous chapter, by this point I had switched to from cow milk to soya milk since cow milk seemed to worsen my throat symptoms. But I had increasingly begun to realise that soya milk was causing just as many problems - in fact, of all the foods and drinks I ingested, soya milk was the only one which consistently seemed to lead to a worsening in my symptoms within a short period of time (about an hour).
So, on one hand the results are telling me that I don't have abnormal levels of reflux, but the same results indicate that I had a high level of reflux at a time that I would normally expect my throat symptoms to worsen. (As I said in the first paragraph, I couldn't tell if my symptoms did worsen on this particular occasion since the unpleasant sensation of the tube in my throat drowned out any other sensations)
The results also included a graph showing reflux throughout the 24 hours. I had hoped to compare this to my notes, to see if there were any other foods that seemed to correlate to increased reflux. However, the resolution of the printout was so low that it was impossible to get any useful information. I plan on speaking to the hospital to see if I can get more detailed results.
But if I do have reflux, why was there no sign of this on the two occasions when my throat was examined using a nasal endoscope? Well, according to someone I spoke to who also suffered from LPR, visible reddening of the relevant bits of the throat due to acid reflux can take months or years to appear. This is from memory, I may update this when I find the email. It is also the case that LPR is very poorly understood compared to 'normal' reflux (i.e. gastro-oesphageal reflux disease or GORD/GERD). The Wikipedia article states that "LPR is still considered somewhat controversial because there is no gold standard test for its diagnosis". For more info on LPR, see the links at http://argnet.fatal-design.com/rsi.php (my own RSI/voice strain page, which links to these blog posts but which people who only read the blog may be unaware of).
I'm now writing in February 09. It's hard to say whether either my RSI or my voice are better than they were a few months ago. It may be that they are marginally better, but as usual the variability of both conditions is high. Since I've been rating the severity of both my RSI and my voice symptoms on a daily basis, I soon hope to produce some graphs to see if these show an improvement on average, although this will be a very inexact science due to the subjective nature of discomfort - e.g. I can't guarantee that a rating of 2.5 for my RSI symptoms today represents the same level of discomfort as the same rating used six months ago.
It may be a while before I write again (no change there), since for now I intend to focus on fixing the Wikipedia article on RSI. As it stands, the article describes RSI as "the most recent manifestation of illness concepts that link use of the arm to injury or disease". It uses phrases like "stigmatization and demonization of hand use". The article as it stands seems to imply the existence of a sinister cabal of people who for some reason want everyone in the world to stop using their hands for anything. For more info on why the page may have been changed to this, see here:
http://en.wikipedia.org/wiki/Talk:Repetitive_strain_injury#Do_the_page_authors_hate_the_concept_of_RSI.3F
I received the results about two weeks later. My GP told me that the tests hadn't shown anything unusual. I asked him for a printout of the results so I could examine them in more detail.
The detailed results stated that there were a total of 23 minutes of reflux, which is apparently not abnormal. However, I was interested to read that the longest period of reflux (8 minutes) occurred just before 3pm. According to my notes, this was about half an hour after I had finished eating several bowls of cereal with soya milk. As I stated in the previous chapter, by this point I had switched to from cow milk to soya milk since cow milk seemed to worsen my throat symptoms. But I had increasingly begun to realise that soya milk was causing just as many problems - in fact, of all the foods and drinks I ingested, soya milk was the only one which consistently seemed to lead to a worsening in my symptoms within a short period of time (about an hour).
So, on one hand the results are telling me that I don't have abnormal levels of reflux, but the same results indicate that I had a high level of reflux at a time that I would normally expect my throat symptoms to worsen. (As I said in the first paragraph, I couldn't tell if my symptoms did worsen on this particular occasion since the unpleasant sensation of the tube in my throat drowned out any other sensations)
The results also included a graph showing reflux throughout the 24 hours. I had hoped to compare this to my notes, to see if there were any other foods that seemed to correlate to increased reflux. However, the resolution of the printout was so low that it was impossible to get any useful information. I plan on speaking to the hospital to see if I can get more detailed results.
But if I do have reflux, why was there no sign of this on the two occasions when my throat was examined using a nasal endoscope? Well, according to someone I spoke to who also suffered from LPR, visible reddening of the relevant bits of the throat due to acid reflux can take months or years to appear. This is from memory, I may update this when I find the email. It is also the case that LPR is very poorly understood compared to 'normal' reflux (i.e. gastro-oesphageal reflux disease or GORD/GERD). The Wikipedia article states that "LPR is still considered somewhat controversial because there is no gold standard test for its diagnosis". For more info on LPR, see the links at http://argnet.fatal-design.com/rsi.php (my own RSI/voice strain page, which links to these blog posts but which people who only read the blog may be unaware of).
I'm now writing in February 09. It's hard to say whether either my RSI or my voice are better than they were a few months ago. It may be that they are marginally better, but as usual the variability of both conditions is high. Since I've been rating the severity of both my RSI and my voice symptoms on a daily basis, I soon hope to produce some graphs to see if these show an improvement on average, although this will be a very inexact science due to the subjective nature of discomfort - e.g. I can't guarantee that a rating of 2.5 for my RSI symptoms today represents the same level of discomfort as the same rating used six months ago.
It may be a while before I write again (no change there), since for now I intend to focus on fixing the Wikipedia article on RSI. As it stands, the article describes RSI as "the most recent manifestation of illness concepts that link use of the arm to injury or disease". It uses phrases like "stigmatization and demonization of hand use". The article as it stands seems to imply the existence of a sinister cabal of people who for some reason want everyone in the world to stop using their hands for anything. For more info on why the page may have been changed to this, see here:
http://en.wikipedia.org/wiki/Talk:Repetitive_strain_injury#Do_the_page_authors_hate_the_concept_of_RSI.3F
no subject
Date: 2009-02-21 05:57 pm (UTC)"A repetitive strain injury (RSI), also known as CTD, occupational overuse syndrome, or work related upper limb disorder (WRULD), is any of a loose group of conditions resulting from overuse of a tool, such as a computer keyboard or musical instrument or other activity that requires repeated movements. It is a syndrome that affects muscles, tendons and nerves in the hands, arms and upper back. The medically accepted condition in which it occurs is when muscles in these areas are kept tense for very long periods of time, due to poor posture and/or repetitive motions."