Esophagus woes

On March 11th I went in for an Upper Endoscopy with Ultrasound and Biopsy for a cyst that was found at the end of last year. The plan was to scan it, poke it, and if benign leave it be.

The first procedure seemed to go smoothly enough, as an aside, I am allergic to the general anesthesia Propofol, getting a different concoction made for a much more comfortable experience. I got sent home with some antibiotics and would hear back later in the week for biopsy results. The cyst was determined to be non-cancerous!

First Procedure

The day following the procedure was good. However, Wednesday things went sideways. Slight fever, night sweats, chills, and a creeping pain in my esophagus, I was hoping things would improve, but by Friday I was in tremendous pain and could not speak without going into a coughing fit. I spoke with my doctor. He had me go to the Common Spirit St. Anthony Hospital Emergency Room. I was admitted and underwent a series of tests.

Things were in bad shape. The cyst doubled in size from 2.5cm to 5cm. They were concerned that it was a duplicating cyst, and that there was an infection. I was admitted to the hospital for treatment and monitoring. I stayed from March 15-19th. I was on a rotation of three IV anti-biotics and an antifungal to reduce any infection; with the hope and expectation the cyst would decrease in size and my body would be ready for removal the following week.

I went home Tuesday the 19th and continued to take oral antibiotics until the procedure to remove the cyst Tuesday March 26th. The procedure was called "XI Robot-Assisted Mediastinal and Esophageal Mass Excision". They went in with five incisions on my right side. They collapsed my right lung to get enough room and clearance to poke around in there and extract the cyst. 

Chest Catheter

The whole procedure took about 4 hours and was successful! I woke up with two chest catheters, two IVs, and a few other cords.

Good news was that the cyst was out. The official test results identified the mass as a duplication cyst, which makes me feel as if I should be playing the lottery at this point.

Esophageal duplication cysts are rare congenital anomalies that constitute between 0.5% and 2.5% of all esophageal masses. It is estimated that the incidence of esophageal duplication cysts is one in 8,200 ... (source)

Bad news was that I had two small tears in my esophagus which had to be patched. I was on IV feeding until March 29th. They did many x-rays and scans to ensure I was recovering well. This included an echo scan of my heart to make sure it was still working!

Pick Line

Because I couldn't have anything by mouth they had to give me a pick-line, which was pretty intense. It takes about 20 minutes to prep to put the line in, and about 5 minutes to install it. They ran 42cm long tube from my arm up to my heart. There is a high risk of infection, but it supports three lines at once and allows heavier nutrients to be used. 

On Friday they did a barium swallow test to see how well my esophagus had healed. The test is is an x-ray
while you drink liquid with a contrast, so they could ensure nothing was leaking from my esophagus to the rest of my body.

The test was a success, which allowed me to advance my diet to liquid only. After s few days it advanced again to full liquid (smoothies, peanut butter, and oil). On March 31st they were able to remove one of the two chest catheters. The relief was almost immediate. Thankfully drainage stayed low and they removed the final tube on April 1st. That evening they sent me home. 

Getting home was great, but with its own challenges. The first few nights sleep felt impossible. Sorting out the timing of medication was a feat by itself.

Food was another challenge as I remained on a full liquid diet for two weeks. The nutrition team was worried I would not be able to get enough nutrients or calories because of my soy allergy and keto diet. While the food at the hospital was pretty good, my allergies limited the selection severely. I was able to get enough calories thanks to Elle, who brought me amazing protein smoothies every day, which were very calorically dense and full of fats and protein! With her help, I was able to move to a mechanical soft diet after that and finally to a regular diet a week after. 

I followed up with my surgeon to have my stitches removed Friday April 12th. My doctor let me know it will be 6 weeks until I can go back to anything active. Until then no twisting (no DDR or dancing), stretching (no yoga or PT), or lifting more than 10lbs). I'm not excited about the physical limitations, I know it's part of the recovery process. I'm looking forward to dancing, gaming, and lifting heavy things again.

 Overall, I'm improving a bit each day. Everything is exhausting, the right side of my chest is still numb, and pain comes and goes in waves. I can drive as long as I'm not taking narcotics and most activity is followed by a nap or a long rest. I'm feeling good about the recovery and look forward to getting back to regular activity again.

Here are a few images that are bit more graphic. Mainly a better look at all the wires post operation and holes from the procedure.

Book Review: How to Stubbornly Refuse to Make Yourself Miserable About Anything

How to Stubbornly Refuse to Make Yourself Miserable About Anything: Yes, Anything
by Albert Ellis

This book provides a guide to REBT, Rational-Emotive Behavior Therapy. Developed in 1955 by Albert Ellis. The general tone of the book is confrontational and demeaning. The author expresses that life is hard and that is just the way it is, tough. That is echoed through-out. 

I found a summary of this work posted on Thought Co by Cynthia Vinney which summarized the practice well. "[REBT] proposes that psychological ailments arise from our perspective on events, not the events themselves"

With the frequent use of the words musterbation (rigid beliefs that lead people to think in absolute terms like “must” and “should”) and awfulizing (believing an experience or situation is literally the worst thing that could possibly happen) it took me some time to adjust to the flow of the text.

REBT provides tools for investigating underlying beliefs. The author suggests that we hold onto irrational beliefs (IBs) and that they influence our expectations and emotions. By carefully and critically investigating our IBs, we can use the scientific method to challenge ourselves. This can change our rage and depression to discomfort and disappointment. It is also stated that thinking in absolutist terms and holding expectations of how we/others should be treated is ignorant and destructive.

Questioning beliefs about how we, or anyone, ought to act is critical to REBT. Ellis states there are three primary underlying narratives to our Irrational Beliefs.

• I must do well and have the approval by people I identify as important
• Others must treat me fairly and nicely
• Conditions I live in must be comfortable and free of major hassles

By identifying and dissecting our IBs they will most commonly fall into one of these categories. Once we dill down, we can challenge the beliefs, actively dispute them, and adopt rational beliefs. This will improve our emotions, thoughts, and behaviors.

Another element of REBT is that an act or event does not define a person. If I or someone acts poorly, carelessly, or destructively, that does not define them. It is an act or event that occurred. I or anyone is capable being awful, it does not mean we are awful. It is possible to do and be better.

Additionally, the past does not absolutely dictate the future and should not define us. While we may hold fear that the past will happen again, it is not definite. To believe that the past makes the future absolute is an irrational belief. While it may happen again, we can, with knowledge and positive habits, mitigate the likelihood. It is not guaranteed. 

If someone treats me poorly or states I am a bad person, they are stating they are upset about an action or event that occurred. There may be an opportunity for me to improve, they may also be holding an irrational belief. It is important to accept what happened and not to identify with it. You can also use REBT (either with them if they are willing or without) to identify IBs and improve/change/dissolve the relationship. The relationship changing or ending will not literally end the world, thought it may be unpleasant or uncomfortable.

We can do and be better. We should critically evaluate our beliefs. Leverage learning, community, reward/punishment, visualization, exposure therapy, counselling, and practice. There is a clear message that it is hard work to improve and that failure is part of the experience. With the constant reminder that failing does not make you a failure, you just failed this time. Set reasonable goals and continue to strive for them, adjust when necessary.

I was frustrated with the frequent use of "musterbation" as if trying to force the word into existence. There is also an insistence that this practice is the best damn thing ever and if you can't do it you just aren't believing enough and should try harder. The level of pride in the practice is almost nauseating and dampens the message.

Overall, I found this book to be positive, encouraging self-empowerment and critical thinking. The core message and practices has helped many individuals and I expect will become part of my regular mental processes.

LAN All Night

A quick journey through time. 

My first LAN experience was back in high school. My brothers and I cut a hole in the wall to connect Xbox consoles and challenge each-other without the option of "screen looking". It completely changed my gaming experience.

In collage we would have regular garage LANs with copious amounts of beer, pizza, caffeine, and power surges. It was always a highlight and a great opportunity to connect, celebrate, and explore new game releases.

The first professionally organized event I attended was in 2007. "World Series of Video Games" (WSVG) with The University of Akron Computer Science Club. We packed a couple cars with our computers and drove to Kentucky. I met many nerdy and awkward people expressing their love of gaming.

Since then, I've explored events around the country ranging from large stadiums, computer repair shops, garages, and basements. The experience has always been exciting and energizing. Not only from copious amount of sugar and caffeine. But the opportunity to engage and connect with others sharing a passion for gaming and community. The rush of victory and defeat from people in the same room. Shouts of excitement and of anguish, all feeding into a shared experience and lasting memories.

LAN All Night was hosted in Dallas, May 14-16, 2021 with an online participation option. I heard about the event from a group of friends from Texas (we met at Dreamhack 2016). My brothers and I joined the fun playing games and hanging out virtually.

We competed in tournaments for Golf With Your Friends, Quake Champions, and Rocket League. I took first place in Golf and last place in Rocket League. This event had a long list of sponsors and a lot of prizes! They even gave out a prize for those who placed last in any given tournament. A poster signed by all of the event staff. So if you experienced a crushing defeat you still won something.

There were also non-gaming related events. I participated in a MS Paint competition. The theme was "llama's in space" the requirement was to use only Microsoft Paint. Staff members judged the artwork submitted live on Twitch, It was fun to see what people came up with and I was happy to participate. I received the highest score and won an event medal!

It was a great time and I'm glad I had the opportunity to connect with my brothers and friends in Texas. I look forward to attending more events in the future!

An update will be posted once all the prizes come in! 

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2021-06-22 Prize Update:

Book Review: Cynical Theories

Cynical Theories: How Activist Scholarship Made Everything about Race, Gender, and Identity—and Why This Harms Everybody by Helen Pluckrose
My rating: 5 of 5 stars

Is our reality a social construct? What are objective truths that should not be questioned?

Cynical Theories gives a history of several critical theories that have been moving into the societal spotlight. The author does not mask their option or concerns. They provide background, research, examples, and propose solutions.

I was encouraged to question objective truth and engage in open conversation. Rather than safeguarding my beliefs, if proven wrong, I can be confident I am moving toward truth.

Bad ideas cannot be defeated by being oppressed. They should be engaged and defeated in the marketplace of ideas. Through rigorous scrutiny we can refine what is useful within them.

View all my reviews

Having a Whale of a Time

This post is intended as informational.  It is an attempt to share my experience and to let others in my life know about some of my struggles.

Background:

Dissidia Final Fantasy: Opera Omnia is a mobile game. I have been very avoidant of any game on my phone for a couple years now. I find that whenever I have a game installed that requires constant attention I obsess over completing it, earning points, checking in daily and playing for several hours a day. I have a friend that is super excited about this game and was looking for more people to join him. I didn't take a lot of convincing, and I didn't express my obsessive tendencies clearly enough to warrant a second thought.

I started playing on April 18, 2019. This week I've completed all the permanent content that has been made available.

Permanent Content: 

• 28 Lost Chapters
• 13 World of Illusions 
• Maxed 10/12 Summons (Chocobo and Sylph are at 18), 
• Act 1 Chapter 1-11 + Interlude 
• Act 2 Chapter 1 & 2

I've maxed out on all in game resources. All my characters are a minimum of "Crystal Level" 50 and I've unlocked all chests for all 79 of my characters in ultimate Ifrit.

For anyone who plays the game, you may have a sense of how many hours of content and grinding I've condensed in the past two months. I'm curious how long it would take to complete the same amount of content casually. The friend that introduced me to the game started playing over a year and a half ago. He is still working on some of the permanent content if that gives any perspective. In addition, there is new and time limited content that is released weekly. So the story and other elements are to pacify you while they are working on development and it offers the user a way to "earn" in-game currency so they can still have their "free-to-play" model.

So what do I enjoy about this game?

The story is somewhat engaging and the content is somewhat challenging. My friend has played and enjoys most of the Final Fantasy franchise and is excited to talk about and share the experience with me.This game is very reliant on nostalgia and also is a way to get players interested in older games in the franchise.

What is challenging for me? 


It's mindless enough that grinding for hours keeps just enough of my attention that I can get some other things done poorly while playing. The "Hard" content needs slightly more focus and resource management. The "Heretic" quests, which are time limited, need powerful boosted characters or game knowledge and resource management. Most of the game is mind numbing and repetitive with little need for skill and more focus on time and money.

Weekly there are daily rewards, new and time-limited challenges, which require the weapons from the weekly draw to succeed. The new items cost in game currency, you can get this currency by completing content or spending money. If your objective is to beat the new challenges then spending in game currency is a must.


This game revolves around gambling. 

This is a gacha game. Also referred to as "gotcha game". Gacha games are Japanese mobile RPGs that follow the same principle as capsule toy machines "gashapon". To operate a gashapon you put in money and you get an item or a set of items. The items are limited and exclusive, you have a small percent chance to get a "rare" or "ultra-rare" item that no-one else or a fraction of the player-base has. If it is a physical item the resale value is high (think thousands). If it is a digital good there is no legal resale option. Instead it comes with a status, prestige, or sense of accomplishment.

Since I started playing in April I have spent $419.77. By spending over $100 a month for the two months I've been playing puts me a "whale" status. Which isn't a great thing.

Whales are gamers who spend roughly $100 a month on micro transactions. While a smaller percent of the population they make up a large portion of the revenue for game industries. There is shame and disdain that follows the title. Some players want to have all the same items and feel cheated, some get mad at the irresponsible use of money. There are a plenty of stories about players generating thousands or tens of thousands of dollars worth of debt. There isn't much of a positive angle, generally the accounts are locked to a person and resale is against TOS. So the money goes into the game and there is no way to cash out or resell without getting into some trouble.



So what have I leaned?

These style of games are not positive influences in my life. They take my focus and energy and I receive a temporary feeling of accomplishment seeing a "Complete" status or getting the newest item.

I have willpower, determination, and dedication for some aspects of my life and complete lack of control and reason in others. I go through phases of control and chaos. Some periods are better than others. Sometimes I catch myself and recoup, other times I need an intervention or a loss in my life to shock myself back out. At times a loss or shock will drag me in, as a way to relieve whatever anguish I'm looking to escape or avoid.



What now?

Since I've manage to reach my goal of completing all the set content in the game my hope is to move into a less obsessive amount of gameplay. I can play the new content and it shouldn't take up as much of my time. I'll need to either pass on the shiny new thing and be ok with that, or stop playing before I dump thousands of dollars in to the game. Sharing my experience and putting more thought into what I am doing and why helps me to process and tone things down.

Feel free to ask questions or share your own experiences! Have you gotten sucked into a gotcha game or stepped away from one?

Complexity

Here is another installment of the inner workings of my mind. I would like to think that I'm in a frame of mind that (mostly) chills me out and helps me find perspective.

As I have been working to write it out and make sense of it enough to share, it seems ridiculous. But I'm alright with that right now. 

I acknowledge that death is inevitable and with what I know, there is no way to avoid the end for myself or those around me. I'm not going down the whole "what is the point" path of despair, or "you only live once" flippant attitude. I work to be present in the moments I share with others and with myself. To immerse myself in activities I find valuable or fulfilling, knowing that my feelings, opinions, and experiences will most likely change.

This isn't too say I've mastered this, it is just what I strive for.

In my last post I talked about how I feel people lack perspective and empathy, how they are the superheroes in their own story, and ... actually if you haven't read it, I recommend you do. This post may make a little more sense with all that in mind.

I feel that where we disconnect from those around us is our unconscious process "othering". We may be able to agree that we are all individuals trying to survive conceptually, but as we make decisions and process our daily lives I would argue that we don't generally process all of those around us in our lives.

The process of making someone else an "other", a disposable character in our overarching life, seems to be an unconscious act. If we treated everyone as a primary character and interacted meaningfully with literally every person we crossed, it would be debilitating. When I take the effort to pull outside of my own head and my own narrative to see the person next to me, or the person who I feel may have hurt me, it changes how I choose to react. It doesn't change my feelings, I still feel hurt, confused, happy, or sad. I see feelings more as a hard wiring that I may not be able to change. But I can come to a place of acceptance and be more deliberate with my actions.

So, how can we acknowledge the perspective and struggle of others without taking from our own? My answer, I don't know.

There are so many layers and elements to this thought that I find myself stumbling over concepts, and I feel like I need to clarify or explain further. I get caught up in my thoughts. How do I clarify a point when I don't know what questions will follow? Am I able to re-explain? Do I just trash the whole idea? What was I explaining anyway?

I've found my mind makes those around me different, now that I've identified it, I have been working to alter it, to tweak it, to attempt to expand my perspective. It has changed how I interact with others and I feel I am able to better connect, though I may never understand why something was said, or why an action was taken. Its been a hell of a trip.

I spoke with a friend (thanks Dave!) about these thoughts and he helped me to find a word to sum up the experience:

sonder: n. the realization that each random passerby is living a life as vivid and complex as your own—populated with their own ambitions, friends, routines, worries and inherited craziness—an epic story that continues invisibly around you like an anthill sprawling deep underground, with elaborate passageways to thousands of other lives that you’ll never know existed, in which you might appear only once, as an extra sipping coffee in the background, as a blur of traffic passing on the highway, as a lighted window at dusk.

This can be a bit jarring, yet feel obvious. I would say it is the opposite side of the spectrum is believing that everyone else in the world is a robot, which is a whole different bag of complexity and concern.

So what now? It is unclear to me, but I'm OK with that. I value those in my life and will do what I can to be intentional with my time and theirs if they choose to share it with me. Also, accepting that I'll faultier and forget. 

For those who choose to other me and account for only themselves. They can continue to live in their own world, I don't need to be a part of it. And I'm good with that.

Calmer Than You

So I first approached this post as, how do I find calm? As I thought through it and picked through my brain it morphed more into personal truths. With that said, here is where I'm at currently in my life! If there are any items you would like me to expand on leave a comment! I could turn just about any of these items into a post on its own, but I have been working on this for a few weeks now and wanted to get it out there.

Everything is bullshit.

Everything? Yes. The why may become clear after reading through my other personal truths.

Facts are only facts until new data proves otherwise.

A lot of what people state as facts are personal antidotes or personal experiences that are applied to a all future experiences. There is nothing inherently wrong with this, it is how we navigate the world, how we learn, and how we stay alive. But I accept that I don't know everything and that there is more to learn. As far as I know, science is based on the scientific method. At times a new discovery shakes the very core of what is known and unknown. Keep this in mind when arguing a fact, dig into the research, look for bias, find perspective. Be open to new or conflicting ideas. That isn't too say reject everything, don't be a dick.

You don't matter, none of this matters.

Who can really see and process "the big picture"? We can't all step into The Total Perspective Vortex and grasp the full gravity of the universe without having our brains melt. I don't see my actions or ideas shaking the known universe or altering the future as it stands. I guess you could take it as a way to be humble? I don't try to place myself in the universe, I like to believe that my life has value, at least to myself and to those around me who care for me.

No-one deserves anything.

We can earn things, we can inherit, make opportunities, pay for things, but nothing is deserved. When we feel obligated and pressured to give our time, attention, love, energy, or any part of ourselves I find that it feels bad and it isn't something I want to do or entertain. Why would I put that pressure on anyone else? So I don't.

Age alone does not make someone an "adult".

For most of my life I've seen adults as another entity, another organism that demanded respect. As I've grown, my body and my mind has shifted, adapted, absorbed information. Now I see people I've grown with in the same lifestyle and mentality that they had in high-school or college. Never moving from that stage of life. I've also seen others grow into brilliance. Being older does not demand respect, it should be earned. Getting older does not make anyone wiser, stronger, or anything other than older. Growth takes time yes, it also takes energy, focus, and effort. We can learn from experience or ignore it and stagnate. I prefer to learn.

People lack perspective and empathy.

Ever get frustrated because someone seems to be acting irrationally given a situation? 

Ever feel like someone doesn't get what it feels like to ___? 

Wouldn't it be nice if they had more perspective? 

Wouldn't it be great if I had more perspective? 

Lets focus now on things we can influence.
How can I gain perspective? 

What other angle can I see this situation from? 

It doesn't mean that I'll make sense of the situation, or that the other view-point is more correct or even rational! Not narrating myself as the victim helps me to deal with the decisions of others without getting as frustrated. Hard times, bad experiences, happy experiences, strange life moments, all are opportunities to gain experience, moments we can develop empathy to share with others. To experience part of a similar emotion. When I had my first migraine I was crying in darkness thinking about how bad it felt and how, at the end of it, I would have a tool to help empathize with others who told me they were experiencing a migraine. The experience will not be the same, but I felt my own pain and loss of function to possibly better assist others.

Everyone is the hero of their own life story.

Everyone has a story about their lives where all of their actions are justifiable. While to others may see the decisions as detached from reality, logically flawed, morally questionable, or outright destructive the hero in this story may only be able to grasp their perspective and experience, completely ignorant or blind to how their actions affect the lives around them. I take this into account when trying to parse the actions of others. While this doesn't ultimately justify or make every action "correct" it provides me with some perspective. I can then choose how I react and how I interact with them in the future. If someone is always pulling out the extraordinary self-justifying story, I'll distance myself best I can.

Everyone should see a therapist.

We see doctors for our physical health and are encouraged to do so regularly. We encourage others to see family doctors, dentists, gynecologists, eye doctors, allergy specialists, and a long list of medical professionals to keep our body running. But what about our minds? What about mental health and well-being? This has been a way for me to get a reality check and to get a professional view as to what level of crazy I'm at. It has been a great reset or re-balance of perspective and has helped to pull me out of some dark defeated experiences. I encourage others to seek therapy and actively speak against those who bash or talk down the idea of mental health.

Lets talk options.

I'm a big fan of options. Knowing what my options are or thinking what other options I can come up with. These may be terrible ideas and options I would not choose, but a brainstorming session helps me to generate more ideas and options that may be more favorable. I get frustrated when I hear "this is the ONLY way", I see it more as "this is the only option I'm willing to consider". This turns a conversation into a battle and stunts ideas and exploration.

Your feelings are valid.

While feelings don't make a lot of sense a lot of the time you can't control them, acknowledge them, I can feel whatever I'm feeling without bashing my emotions and things I can't necessarily control.

You can't choose how you feel, you can choose how you act on those feelings.

I don't know about you, but I can't turn my feelings off. Am I feeling depressed and can't identify a source? Well alright, that is fine I can feel that. That doesn't mean I beat myself up and decide to change what I feel. No, I feel it, accept it, then move forward when I am able to. I covered more of this concept in my last post about The Happiness Trap. If you haven't read it or the post, check it out! If you think your feelings control you, this may help shift that.

Be comfortable with silence.

While we can't experience total silence (breath, heartbeat, wind, birds, trees) I push myself into moments of silence and sit with it. Not having every moment filled with music, conversation, and noise is maddening at first. But I have come to appreciate breaks in conversation, moments of mostly quiet, enjoying the breath and heartbeat of others. My mind may still race, but I don't feel anxiety when I can't find words to fill the space.

That's all I have so far! Thanks for sticking with me to the end there! A lot bouncing around my brain all the time here. It is challenging trying to identify how I can best translate my feelings into words. I'm not exactly sure why this makes me calm, but I'm happy to have had the experiences that got me to this state of mind.