Tuesday, September 21, 2021
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Medical Roadmap to Hunting and Fishing

Understanding your Medical Challenges to Hunting and Fishing

 

By Derek Benoit

5/12/2021

 

My starting point, post bowel resection and ostomy creation. Yes, the beard has come off, and the hair has been mowed by professional landscapers.

 

Overcoming your medical (and other) barriers to hunting and fishing requires a plan. To create this plan, you need to fully understand your situation, in as much detail as possible. Working with your various specialists, especially if they’re coordinating toward your hunting and fishing goals, and telling them your goals will make sure you’re all on the same page. Buy a notebook, and take it with you to your appointment. Create a list of physical requirements for each activity your looking to start doing, or looking to try for the first time. Plan for “recovery” goals (illness, injury) and “adjustment” goals should a permanent change in physical ability exist or be expected.

 

Here is my own personal “situation analysis.” Important to note is that the “overlooked details” section of your notes is NOT meant to be a beat-yourself-up, exercise in drowning one’s self in guilt. It’s a section for honest reflection about what may have been missed, fallen by the way side, or done differently that could have helped improve outcome. Apply this knowledge moving forward!

 

 

Timeframe: Toddler years to present

Situation: Type 1 diabetes

Observations:  inconsistent control from week-to-week, month-to-month, etc.

Overlooked Details: more exercise (more youth sports participation) would have likely helped with blood sugar control to some extent, also established better fitness habits moving forward

 

 

Timeframe: childhood to present

Situation: lack of mobility and flexibility in ankles and feet

Observations: “heel strike” runner through high school and college; made exercise increasing difficult as I got older (which you could argue included lazier and heavier)

Overlooked Details: physical therapy evaluation and options would have saved me a great deal of wear and tear, helped increase my exercise, and contributed to better diabetes management over time.

 

 

Timeframe: November 2011; May 2012

Situation: began dialysis in November 2011, Renal Transplant took place mid May 2012

Observations: result of long-term wear and tear from type 1 diabetes

Overlooked Details: I should have started the insulin pump as a course of treatment as soon as it became widely available. I assumed it would be “too complicated.”

 

 

Timeframe: May 2018 (following multiple hospitalizations for renal complications, and a year of GI symptoms forcing missed days at work)

Situation: Diabetic gastroparesis (diagnosed later in August of 2018) forces me out of work. Disability status granted by judge’s finding in January of 2020.

Observations: symptoms so severe in terms of distension, bloating, fatigue, and inability to keep food down that I was mostly bedridden for months, experiencing lack of sleep, and losing a huge amount of weight via atrophy and malnutrition. Weight dropped to 101lbs at lowest.

Overlooked Details: Should have sought second opinions regarding GI symptoms years earlier. Transplant medications known to cause issues with nausea, vomiting, and indigestion. Once the third medication change was made and symptoms kept returning and worsening, GI specialist should have been consulted.

 

 

Timeframe: Week of Christmas 2020-late February, 2021

Situation: Plantar fasciitis forced complete stoppage of exercise, allowing gastroparesis to come back with a vengeance. Became essentially bed ridden by symptoms for several months.

Observations: Prior two months saw excellent progress with gastro symptoms via exercise. Result was increased healthy weight (roughly 130lbs) increased calorie intake, and “movement” of waste.

Overlooked Details: became lazy in terms of meal supplementl nutrition/protein intake, possibly increasing risk of injury; inconsistent warm up/stretching routine; never addressed ankle mobility/flexibility/plantar fasciitis

 

Timeframe: Final week of February, 2021

Situation: hHospitalized with major active GI bleeding

Observations: initially diagnosed as ischemia of transverse colon, believed to be brought on by dehydration related to afore-mentioned gastroparesis episode. Required 9 units of blood before bleed could be resolved.

Overlooked Details: Status as transplant recipient increased risk of bacterial ulcers, which can be exacerbated by prescription steroids used as immunosuppression therapy. Long-term off-and-on heart burn and reflux symptoms were not significant, and overlooked on my part. This was a major mistake and should have been more aggressively reported to transplant staff, and later gastroenterologist following diagnosis of diabetic gastroparesis.

 

 

Timeframe: Good Friday, 2021

Situation: Admitted to ER with extreme abdominal pain

Observations: determined that finding from previous hospitalization of ischemia of transverse colon was possibly inaccurate. Circumferential ulceration of the transverse colon in that unique, finite 10cm section believed to be prior perforation (slower duration event?) of said bowel section. MAJOR procedure to resection the bowel required. Temporary ostomy “installed.”

Ultimately, pyloric/peptic ulcers in stomach and upper small intestine were more active than believed (no bleeding, etc. noted during prior GI exams (endoscopy or colonoscopy), therefore were neither capped nor cauterized. Pyloric/peptic ulcers led to acid, digestive juices, etc., eating progressively through multiple locations in large and small intestines. Resection of bowels was life-saving necessity.

Overlooked Details: Status as transplant recipient increased risk of bacterial ulcers, which can be exacerbated by prescription steroids used as immunosuppression therapy. Long-term off-and-on heart burn and reflux symptoms were not significant, and overlooked on my part. This was a major mistake and should have been more aggressively reported to transplant staff, and later gastroenterologist. Should have been more proactive.

 

Post-Surgical Medical Goals:

  • Complete recovery from bowel resection procedure
  • Continue to increase walking distance and frequency as rehab
  • Continue “basic” post-surgical physical therapy (mild body exercise) routine
  • Become proficient with continuous glucose monitor and start using insulin pump once again
  • No “core” work or lifting anything more than 10lbs until 6 weeks post-surgery
  • Continue nutritional supplement intake along with gastroparesis-friendly meals
  • Stick to low-blockage foods to compensate for removed portions of bowel, especially large intestine
  • Maintain fluid intake to thwart dehydration (major risk of dehydration with bowel resections)
  • Eventually reattach/recombine “prepared” ends of bowels left after re-sectioning
  • Evaluate option of removing portion of stomach responsible for acid production-risk management measure against possible future pyloric ulcers, given status of transplant patient

 

Outdoor and Fitness Goals:

  • Continue to press walking distance and frequency-use as “launch pad” for cardio fitness?
  • Once cleared to do so, work on core strength and stability
  • Re-enter “official” physical therapy program to treat plantar fasciitis-will allow longer strides, better biomechanics, faster speeds, and open up more fitness opportunities
  • Commit to fitness program of some kind (Beachbody? Mountain Tough? Elk Fit)
  • Be physically able to handle all hiking, weight carrying, dragging, etc. for whitetail deer hunting season this fall
  • Build legitimate “mountain hunting” cardio conditioning, core, leg strength
  • Ability to hike several miles in uneven terrain, with heavy backpack
  • Be able to hike several miles over sand with surf bag, in waders, for surf fishing
  • Build all around strength and fitness to support desire to begin offshore fishing (canyons, specifically, especially for yellowfin, bigeye tuna, billfish)

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