Wellington · Living

I got the blood test Monday to see what my new life post-Graves Disease will be like. And the answer is: you're not post-Graves! Ugh!

I saw the endocrinologist yesterday morning at the beginning of a marathon day. And he gave me the surprise news: on the Monday test results, my thyoid levels actually went up from the value at the last blood test before the radiation treatment. Monday's was in fact two times the previous amount. So after irradiating my thyroid to kill it, it's instead pumping out twice the thyroid.

I admit, my first reaction was concern: I feared that we'd instead turned my thyroid into SUPER Thyroid, an incredible hulk of thyroid production. Dr. Safer seemed a little surprised too. However, according to the literature, this can happen. The theory is that the radiation "irritates" the thyroid, causing a kind of last gasp burst of thyroid production. The killed cells are dead, but the survivors, while irritated, try to do twice the work. Eventually, they fail to keep up, and give up, and it's all good. At least, that's the theory. It will be just my luck if I'm the guy whose thyroid survivors turn out to be plucky heroes.

So, in fact for the past four weeks I've continued to be hyperthyroid, and this explains the loss of five more pounds in January. Le sigh. And all we can do, apparently, is to wait six more weeks to see what happens. If, in six weeks, the plucky survivors have miraculously kept up thyroid production, I'll go back on medication, since it's dangerous to be hyperthyroid for too long, and we'll try this again at some far flung future date.

So, more waiting while I lose weight. I don't think I've ever rooted as hard AGAINST the plucky underdog as I am now. DIE BASTARD THYROID DIE!

Well, it's been nearly 24 hours of being radioactive, and I haven't seen much conclusive evidence of new superpowers.

I do have the ability to spew beta radiation from my neck, at least for 24 more hours or so.

I do have the ability to tag nearly anything with my bodily excretions such that the city will freak out if such an object goes into the trash. Apparently their radiation detectors pick it up, and if traced to me, I would have to pay upwards of $3,000 for the ticket, in order to pay the city's expense of having specialists called in to look at said garbage and say "It's medical iodine, you idiots." This power will only last about two weeks, thank goodness, although having a Spidey-Tracer so easily used (Spitoo!) could come in handy.

I have not seen super strength, but in a month or so, when I'm hypothyroid and can finally gain weight, I may see some strength increases. I'm bound to get something, as I lost 10 pounds in the past month, and I know I've got the muscle memory to gain it back quickly.

Life as Beta-Ray Bill is not what the comics promised.

Alas, dear thyroid, I may miss you in days or weeks to come, but right now: DIE MUTHERFUCKA. That's right. Choke in I-131. Bwah ha ha ha hah ha!

As for being a beta-radiation source so far: no superpowers. I would have appreciated flight, washboard abs, or loads of muscles, but none yet. I'll keep y'all informed.

The other reason I checked my messages tonight was in the (small, feeble, pathetic) hope that I'd have received a call setting up some doctors' appointments. Of course, no.

I had blood drawn last week Wednesday, and saw my endocrinologist this Wednesday just past. As expected from two months ago, I am more hyperthyroid, or "toxic" as my doctor puts it. I have deteriorated nicely as planned. He was on the fence: maybe I was toxic enough to drink the Kool-Aid, maybe not. I didn't hesitate: give me the Kool-Aid. That may have been do to the fact that, despite having gotten up super early to get there early for my early appointment, and getting called into the office right on time, I waited an hour in his exam room before someone thought to tell him I was in. It left me really, really not wanting to have to do doctor's appointments all the fucking time.

By "drink the Kool-Aid", what I really mean is drink radioactive iodine in order to kill my hyperactive thyroid gland, or "radioactive ablation." I've been wanting to do it for years, even with my sister (the IRS one) telling me not to do it after she went through it. Now, finally, I have a diagnosis from a doctor that says I should: fuck you, thyroid, you're finally going down.

Of course, this requires setting up appointments with other doctors, so DOOM. As I was told by many: getting appointments with Radiology is difficult. I know myself from first hand from last time when we did a scan of my thyroid without killing the fucker: it took weeks to arrange: weeks of dropped calls, lost messages, broken promises to call back, etc. Now, on top of that, that appointment must be coordinated with Dr. Lee, the one man who can apparently sign off on permitting me to poison myself in this way. I figure I'll get this straightened out a few months from now. At which point, no one will be on the fence about whether my condition is bad enough yet.

Which, let's face it, is depressing. I'm at the point where I'm sleeping with my eyes open again, my hands have tremors, and, confirmed at Wednesday's appointment, I've lost five pounds. I don't think I've had a unprovoked adrenal surge yet, but that just may be because I haven't been relaxed enough in the past month to notice. I don't want to be sick anymore. I want to know I'm at least making progress. Being well: that would be nice. I will most likely end up hypothyroid after, and take a few months to work that out, but at least I'll be headed towards stable.

OK, maybe the weight loss has more to do with not getting to the gym. But still: I want this thyroid OUT. I'm thinking if this takes too long, I'll just go get some uranium and make a choker out of it, and wear that until I'm better.

So, yes, waiting for Radiology to call, in the hopes that whatever date they decide will be soon (and Dr. Lee can make.)

CALL, MUTHERBUTTSEXXORS!

I just got back from my first four month check-in with my endocrinologist after having gone into remission. The verdict is: it's not going to last. My TSH values are still in the normal range, but at the absolute bottom. And the rate of decline, well, Dr. Safer showed me a chart of all my TSH values over time, pointing out my remissions and relapses. As I'd suspected, my remission periods have been getting shorter and shorter, and my relapses are more accelerated: once my thyroid starts to act up, it goes to toxic fast. This is all pointing to the fact that I'm never going to be able to train my thyroid back into normalcy for long, and eventually I won't even be able to train it at all. At which point, I'll be on medication all the time.

So, this is the beginning of the last relapse. In two months, we'll check my levels again, and meet. There's a very slim hope that I might level off at normal, in which case, we go back to waiting. But most probably I'll be fully in relapse. If I am, and at very low levels of TSH, i.e. "toxic" levels of thyroid, we're going to try radioactive ablation. This will, barring extreme luck with the procedure, make me hypothyroid for the rest of my life, and so on medication for the rest of my days. But there will be no more relapses into hyperthyroidism; there won't be enough thyroid left. Honestly, after eight years of dealing with this, with only a few dozen or so months in remission, taking medication forever doesn't seem like a big deal, especially medication that millions of people are on all the time.

In basic health news, I lost a bit more weight (now 197 lbs.), my blood pressure continues to be stellar (136/66), and my resting pulse rate was 66. So I'm still in the best shape of my life. I'm going to be a little more worried about weight loss from here on in, especially as we know I'm going hyperthyroid, so the next few months will see a return of "hungry Bill," if for the last time.

Ugh, I've been pretty bad at the journaling recently. Like, there was this whole fabulous whirlwind tour of D.C. for that_cad's birthday, with swirlychick and breaking_open and in a brief but fabulous cameo, maxineofarc. That entry will hopefully come once I get the time to figure out how the Facebook plugin destroyed my iPhoto Export function, since such an entry requires pictures. I can't figure out how to get rid of the "plugin" either. Some photos made it to Facebook, but nowhere else. Stupid grumble grumble.

Also, we had our stunning conclusion of the Steam Wars game last night, which was trés awesum. And that_cad's got a game in the wings that looks to be ultracool as well. But... no time.

So, this post will have to be about yesterday's trip to the doctor, so I can at least keep track of my medical history, as that's kinda important. Especially if I want to be around to catch up on my journal.

The appointment yesterday was with my allergist, for a routine check-in on my allergies, so we could determine how I do in the winter. At least, that was what it was set up to be, eight months ago. ( Instead, now the versatile Dr. Little is taking the lead on my whole pulmonary embolism thingy. )

So, barring unforeseen issues, I'm good to be healthy by the time my birthday rolls around and I'm old. Just three more months...

Oh, and according to the weight scale in Dr. Little's office: I'm 217 pounds, sans shoes, a new personal high. No doubt my PCP will not be pleased when she sees it in the computer records. But my RHR was 72, my BP was 130/28, so I'm not letting her concern from those standard BMI tables get me down. Well, as long as my next body fat caliper test is lower than the last one.

Man, I remember how much I used to like shelving JAMA and other journals like it at the Crerar Library: easy to sort, easy to spot the hole in the shelves, easy to clear a full cart in ten minutes.

But I digress. This is my personal journal of medicine, not JAMA, my own primary-care-physician visit edition. It went pretty well, but there's some bits worth noting for the future. Like, how I was asked five times if I wanted a flu shot. Apparently, this year the flu vaccine is in. No rationing for the young and elderly this time, no, as I walked into the waiting room, a nurse asked me if I wanted a flue shot. I told her I was just here for an appointment, and sat down. She asked me if she could give it to me while I was waiting. I thought, hey, here's my chance to sneak one in, so I took it. But no, it wasn't sneaking one over on the oldsters. My check-your-vitals nurse offered me one, and then my PCP offered me one, and then I got offered one when I went into the specimen collection office to get blood taken. Woo hoo, flu shots for everybody!

Another note for the future: the manual taking of your blood pressure is still very subjective, so take the Important! Warning! Live-Change-Now! instructions with a grain of salt. Oh wait: never go near salt again. That was my PCP's assessment. I came to her several pounds of fat lighter, more muscular, with a better resting heart rate (65, woo hoo!), and despite all that she decided we needed to focus on my "high end of normal" blood pressure. Apparently, out of all the stuff I'm already working on, I need to cut salt out of my diet, so much that it was 50% of what we talked about (read: she lectured me about.) I apparently need to cook for myself even more, since I can't trust restaurants not to put salt in stuff. Oh-kay. But, please note: the nurse that came in to take my vitals took my blood pressure, then took it again to be sure. She put me down at 118/78. My PCP took my blood pressure, decided she still wasn't sure, and took it again, for an official score of 138/78. First time she took it: 122/78. What was wrong with that? Last time, when I had 5% more body fat, my blood pressure was 120/80: I could see it on her screen. OK, she's a the doctor, with all the training, so I'll listen. But uh, next time, if my blood pressure again reads around the low 120's over 78 or 80, for even one of the times they take it, I'm not gonna have a zOMG! High! Blood! Pressure! reaction.

And, as a real funny: she told me I should probably maintain my current weight, and not gain too much more (her scale said 213.) When I gave her a really blank stare, she didn't get it. So I had to remind her of the whole happy point that I'm not dropping five pounds every two weeks, like I was back in August. Remember, when I finally met you in person? Gaining weight: it's a GREAT thing. I'm not going to stop. And if it's all muscle, and I'm losing fat, hi, you don't get to complain. OK, if I get stupidly huge and endanger my life with too low a body fat percentage, fine, but we aren't even close to that. Pul-lease. Don't gain too much more: ha! Having seen me dig my heels in on this, she told me to check with my endocrinologist about this when I see him in a month or so: fine. I know what he'll say: AWESUM, DUDE! HI-FIVE! (Well, I hope he will.)

Maybe all this was overcompensation for a lack of having anything else to tell me. The blood tests I'd had to take again finally came back, and they were all negative for increased clotting risk. So we have no idea what brought on the clots: I don't match any normal profile for clotters under 50. Honestly, I take it as good news that I'm not likely to get them again, or at least that there's nothing in my system that makes me more likely than the general healthy population to get them. But still, it worries a little. Which brings me to my final notable moment. So, she's looking back over my history in the computer, and she sees I've been over to the Pulmonary clinic, and asks, "Oh, you *did* see a lung specialist, good. What did Dr. Little say?" Whowhatnow? Um, Dr. Little is my allergist: yeah, I know he's over in the Pulmonary Clinic, but he's just been fixing my allergies. Oh, no, wacky, it turns out he's the BMC go-to lung man, knows a lot about pulmonary embolisms, and now she wants me to see him, in the hopes his second opinion might help find a smoking gun. And, weirdly enough, I already have a scheduled appointment with him for January (for an allergy follow up in the winter, when I usually have none, so he can do some more sensitive tests.)

OK, remember when I couldn't get in to see my PCP: I was still waiting for an appointment with her? And I had that ear infection? I instead ended up seeing my allergist first, 'cause I could get an appointment with him, and he took care of making sure it was OK. At the time, he found it funny, because he'd just re-certified his GP boards, and here he had the opportunity to be my PCP for an appointment. Now he's going to be my lung specialist as well as my allergist. Hell, I wish he really *was* a GP, 'cause then I'd ask him to be my PCP. I saw him on July 2nd, but didn't have the embolism until July 22nd, and haven't seen him since. If I'd known, I would have gone to see him right then, instead of waiting to see my PCP in August, waiting until November for her to think of him, and so seeing him in January, six months after the event.

C'est la vie. I'm healthy, I'm getting stronger, and I think my second and third opinions set up for December and January are going to confirm that.

Wow I feel good. I feel energized, and properly tired, and hungry, and, I don't know, like a man. And this despite a pretty messy week, health-wise.

Monday I got a call, to come in and pick up a prescription. Monday night that_cad and I did a bit of WoW, and Tuesday morning I got up early and headed over to my (the Boston) Medical Center. And then I proceeded to lose a day and a half of work.

The higher dose of Coumadin caused a problem. The whole reason they take my blood like vampires is to make sure the INR levels don't go too high. It's bad. Well, mine did. So it was off to bleed me dry and make me wait while they saw if I had liver damage or internal bleeding or any number of things. The funny thing was, I was feeling a little light-headed and distracted Monday, so who knows, maybe it was a good thing. But as far as I know, they poked and prodded and bled me for no reason than to warn off evil spirits, because nothing changed. Except that I was now once again behind at work. One good thing: I got to pop back home from time to time, so I could pick up a new book. I finished four.

Then came Wednesday morning's appointment with my endocrinologist, the one I'd had scheduled for months. And yes, I had a relapse of Graves' Disease. And, with the last blood test (nosferatu!), my levels had come to the perfect state to take the radioactive iodine and be "cured" (at least of hyperthyroidism.) [pause for shoe drop....] But, since I was on blood-thinners, and it was clear that I am having difficulty setting the dose, he didn't think we should risk it. It's too likely the sudden drop in metabolism would make the high Coumadin dose jump too high before they could correct. Yes, I could have drunk the iodine that day, and been more or less cured by Friday, but now I have to wait again, for six months, when I'm off the Coumadin. Joy. Oh, and did I mention I lost five more pounds?

Anyway, Dr. Safer put me back on the good ol' Tapazole. I'm now taking between six and six and a half pills a day. Nine, if you count the Flonase nasal inhaler and eye drops for my allergies. But I should finally be in a holding pattern, depending on Monday's blood test (going to Count Floyd, I believe.)

So, after all that crap, why do I feel good today? Well, see, I went and worked out. Yes, I'm free again to do so. But even better yet, I worked out with a trainer. I've decided I'm sick of fucking around. Last Sunday, I took my nephew out for his seasonal clothes shopping (like last year.) And, naturally, being a teenager, he'd grown. But Sam? Went from a Large to an X-L. We couldn't find dress shirts that fit him without getting custom ones. Afterwards, all I could think about was that since about 1990, when I took my first weight training class, I've been trying to get stronger, gain muscle, etc. Sam was born in 1991. Oh, I've made various progress along the line. But his nearly sixteen years of life, he's gotten to the point where he can bench press his weight. Where he can do more than three chin-ups. Where his shoulders fill out a shirt. And in all that time of flutzing about, trying out various gyms and programs, with various breaks, etc, I've gotten about fifteen more pounds on. And more body fat.

It probably didn't help my mood that I've been held back from working out for three months.

So today, after a bunch of interviews and shopping around, I joined Fitness Together, a one-on-one personal training regiment, that's about six blocks down Columbus from my house. It was not cheap. It wasn't even reasonable. It is expensive, period. But it's the full thing: dedicated one-on-one training, with real weights, a diet plan, "accountability journals" of what I eat, tests every four weeks, the works. I can probably afford it for about six months. And that's that. I'll be scheduling my life and work around these appointments (Wed and Fri, 7:30pm, and Sat 9:45am.) There can be some adjusting, but considering what I just put down to get in this, not much. And I'm taking it deadly seriously this time. This is my last big shot. I'm going to learn how the hell to really do this. And when the Coumadin treatment is done, and I get the Graves' taken care of, I'll be a new man. Just in time for my [shudder] twentieth high school reunion. Which my nephew will be at, since he's at the school now. Punk.

The first session went really well. The two trainers know what they're about, and "FT" has the right equipment: all of it. They did all the things I couldn't when I was trying to go to "Phase III" of S2B: working out my max weights, etc. Plus spotting for every rep, without having to beg. And I've got my comprehensive fitness test scheduled for next Wednesday night. I do apologize to folks who'll have to schedule stuff around this. I hope you'll understand. But I'm doing this.

Hell of a 24 hours, work-wise, and this morning was supposed to be pretty bad, too. Instead, I finally got something positive from all this medical stuff.

I went in for a follow-up appointment with my gum guy, Dr. Palys. Now, I have a low threshold for pain: I sometimes frighten other doctors with my blasé attitude. But as readers of this journal know, Dr. Palys can bring on the pain like nobody. In fact, he's still the top of my list of most painful experiences in my life ever, even above the time I snapped my radius and saw my own bone marrow.

So I was not looking forward to this follow-up, as he had made some dark hints at the last visit, but was waiting for X-rays. It's never good when he schedules an hour. So I came in, and right off he asked me the usual first question about my health. So I had to do the little debrief about the embolism, and blood-thinners, Graves' relapse, etc. It was all there in my chart from when I'd been in for the X-rays and had to tell the technician. Well, five minutes later, the hour appointment was over. You see, he'd examined me, and saw that while my gums aren't getting worse, they aren't getting better, and this despite the facts that I've upped my personal care regiment, had the [shudder] gum scrape, and have cleanings three times a year instead of two. So his plan was going to prep me for gum surgery. I just shuddered writing that.

Instead, he has to hold off. One, it may be that my failure to repair has to do with systemic problems. (Um, duh.) And two, he can't risk doing gum surgery while I'm on blood-thinners, as it screws up the post-op healing process. So the threat of gum surgery, or in fact any further "care" from this man is lifted, for at least six months. Huzzah for warfarin!

Now, don't think he didn't get away with doing something to me. I had to make an appointment to get fitted for a night guard for the grinding, in two weeks. But I'll take a night guard over gum surgery (I just shuddered again. Really.) anytime!

I'm also happy because my big sister is involved in this thing at work, and is putting the smack down (is that the right wrestling term?) on the big crisis. One of the people peripheral to the whole crisis had the nerve to send a big, wide-distribution email this morning, at 8:00am, asking why this couldn't all be done today, because she's going on vacation tomorrow. I quote: "We are starting to bump up against our final deadline so we really don't have much time to wait for this." Cathy's smack down was so measured, so beautiful, right down to the parting shot: " I'm on my way to Montreal in a few minutes, but feel free to give me a call on my cell at 781-xxx-xxxx if you want to discuss." I had to text her cell immediately to congratulate her on her triumph of embarrassment.

I have actually met my primary care physician. In person, herself, no interns. In fact, I don't think you can even call just us acquaintances anymore, since she gave me a testicular exam.

But that's about all I can tell you. Apparently the super sekrit special blood tests they ordered up three weeks ago didn't send their results to her. She can see the order, and that they were supposed to go to her, but no. Oh, I can tell you this: I've lost five pounds in the past two weeks. I say five, even though the scale said I'd lost twelve, since this time they told me to take my shoes off. Maybe it's all the shoes, although I'm fairly sure whatever I was wearing at the last weight-in didn't weigh that much.

Yes, folks, it's the Graves Disease diet again. Lose all the weight you want, effortlessly, as long as you don't mind that it's all muscle mass, leaving behind the fat. Let me tell you, when she went to palpitate my stomach, the tire was quite an embarrassment. It's still only a bicycle tire, but it's moved to back-country mountain bike size. The embarrassment was a little balanced when she stated she was impressed by the lack of shot bruises (only six showing) after two weeks of self-injections. And I guess it's nice to have the low blood pressure again. But still, I'm looking forward to next week's appointment with Dr. Safer. Not only will I finally have proof I have the damn disease for Tufts, but we'll get to talk radioactive iodine, and killing the sucker off. That, and Dr. Murabito did promise that if I got back on thryoid medication, and my next blood clot factor test was in range, she didn't see a reason I couldn't start working out again. That should be about two weeks, assuming the super sekrit special blood tests don't come back with something.

I do like having a female doctor. One, they can't remind me of my father. Two, I get along better with women, I always have. Three, I'm happy to support women getting higher into the old boy professional. But really, it's more about number four: things like testicular exams are much more clinical, no worry, no embarrassment.

Wasting time? Apparently with a nuke. I'm almost believing I've lost time; I swear I looked down at my watch today once today, then again a second later, and fifteen minutes had passed.

I have gotten nothing almost nothing done today. OK, there was an hour or two of talks with folks to get them working on the right stuff, and maybe an hour of debugging some issues for folks. But my own projects/tasks? Nada.

Instead, I've been sucked into the Internets. First there was some looking up stuff, then there was catching up in journals from over the weekend, then there was... I don't even know. Like I said, lost time. I think at one point I caught myself using Google to look up the origins of "zOMG", specifically around the lower case zed.

[break]

OK, well, there was almost fifteen minutes of work. And here I am again, posting nothing. And it's 5:00pm.

Let's see. What to write about? Not much to say. I took a blood test on Friday that said my INR was still too low, so I had to up my dose of warfarin, while continuing on the injections "for just two more days". Well, my blood test this morning came back: my INR level is still too low, after a "sizable" dosage of 10mg a day. So I'm *still* on the shots, through Friday at least, and I'm up to a "rather large" dosage of 15mg a day. Once again, I think my endocrine system has doctors puzzled. The doctors running the Coumadin Clinic haven't had to go above 10mg a day "in a long while." They believe it has to do with my Graves', what with my once-again hyperactive metabolism burning through anything in my system. If 15mg doesn't work to get my INR up by this coming Friday, they're a little wary of "large" dosages like 20mg a day, but will have to put me on it. If 20mg per day doesn't work... I might be on injections for a long while. And that's all they know. So working out, getting out, having a good time? All on hold until we figure this out.

In the fake world, things are going a little better. Osmé formed a guild last week, or more precisely, helped facilitate the organization of my Alliance-side guild's Horde-side "better half". (Or at least "better looking" half.) Really, I'm just stealing some of bryant's Wildly Inept Pacifist member-base, plus friends and others with Oh Too Beautiful Belfs. But still, it's kinda cool to have the listing in the Armory for my very own "Certified Haughties", however loose and informal a group.

I also got me and that_cad a group to instance with for baby's first dungeon, to run this Wednesday night. Organizing said guild had something to do with it, but really it's just that bryant, cityofbeige, and michele_blue are willing to join the two of us. Since we'll all see each other in person tonight, it's not that much of an accomplishment. However, the Certified Haughties does give us a backup option for forming parties. When I get together a bunch of Haughties for instance running who I've never met, then it will be a real accomplishment. Considering everyone's starting at pretty much the same (low) level, you never know...

Fallowgrey continues to rock, with all kinds of kick-ass gear. He had another run of luck running Razorfen Downs where his rolling off on rare gear all turned up good numbers. Plus the fun of sticking it to the Undead Scourge: it's great to play a priest as Crowd Control for once. Then I took Arkibal out for some extended play, and he's rocking right along in the Scarlet Monastery. Tanking is so very different, and a little harder with a pally. Of course I go and give myself a challenge, instead of just taking a warrior. But I think I'm getting the hang of it. I was setting up for doing an escort quest when the jerk I'd helped with stage one blew me off and left our two-man party. So I tried it with just Arkibal, to see if the name "Protection Paladin" really meant anything. And it did: I soloed an escort quest two levels higher through enemy territory, although I was sucking fumes on mana for half of it. I was pretty happy with that.

Other than that, I'm mostly just killing time, trying to drum up excitement about anything: work, Steam Wars, croquet, anything. And I'm not finding it. It's worrying me a little that maybe the double-dose of Lovenox plus higher-than-usual levels of warfarin are having an effect on my mental state. But it could just be a lull at work, coupled with the inability to work-out that's doing it. I don't know. All I know is that time is flying by.

I think in my last post I forgot to say that I'm home from the hospital (thus the "discharge" report), and home from work, probably for much of the next week. I've got a bunch of clinics to go to so I can learn how to be a hemophiliac– I kid, the clinics are so we can work out the proper dosage of my anticoagulants ("blood thinners") so I'm not in danger of being a hemophiliac and not in danger of further clots. I'm also hoping to see my PCP (finally) and I'm also feeling like I'd like to be only a minute from my emergency room for a bit. Oh, and I'm trying to get to the point where I can breathe properly, although as of this morning it seems to be back to where it was Sunday afternoon, when it just felt like a weird muscle pull.

( The Full Story )

So, quite a Sunday/Monday. I'm writing this at the Uptown Espresso coffee place across the street, so despite being out on a sick day, I'm out and about (well, a block away.) I'm not going to be able to allow myself to be sedentary again for a while; I sit for an hour, and suddenly I'm worrying about blood pooling. Of course, it can't really clot right now, so I'm not in danger, but for my mental health, I'll be out and about walking around. Hopefully things will be back to a regular schedule soon. Don't worry, walking is all I'm doing. I can't run for a week, not just because of my lung, but also because the wound my nightmare nurse gave me could open up. But walking, yes, I'll be doing that. No blood pooling for me, no sir.

I'm not really a pessimist, or an optimist. I really believe in balance: good stuff is always followed by bad, but bad stuff is always followed by good. So, yeah, I got a big bonus, I was a little sick, but relaxing at home: where was the other shoe?

Well, it dropped Sunday evening. Here's the official version from my discharge summary:

Pt is a 37 yo with PMHx of Grave's [sic] Disease that presented with a two-day hx of calf pain and a one-day hx of Left anterolateral chest pain, palpitations and dizziness. Pt. was found to have multiple small bilateral segmental and subsegmental filling defects in the lung per CT. Pt was also found to have a pulmonary nodule in the Right middle lobe. D-Dimer was 721. Pt was started on therapeutic Lovenox and Coumadin. Followup was arranged for Coumadin clinic. Pt. is to follow with endocrinology regarding his Grave's [sic] Disease as previously scheduled. Labs were drawn for a hypercoagulability workup (Factor V Lieden, Anti-thrombin, Homocysteine levels, Protein C and S). Pt was provided instructions regarding Lovenox injections.

The scarier, if shorter, way to put this: Saturday I had a deep vein thrombosis in my left calf that instigated pulmonary embolisms on Sunday. Wow, just typing the word embolism is scary!

But, scary as it sounds, I'm going to be OK: it was serious, but my dad the doctor talked about it with little concern, and stated a few times that clots traveling to the lungs and sticking there was the best, most natural outcome. It's getting stuck in a vein, or traveling to the brain that's the bad outcome. Apparently people have pulmonary embolisms all the time and just think their shoulders are sore, go on with their lives, and are fine. The lungs are built to absorb blood clots, because they happen, and in healthy people, that's where they're going to accumulate. I will be put on blood thinners for the next six months, as a precaution, while they try to figure out if I'm susceptible to blood clots, which can be bad, or whether this was just due to being inactive for a couple days, which can cause deep vein thrombosis from blood pooling in the calves (much more likely.) If it is DVT from my inactivity over the end of last week, let me warn you people: don't let World of Warcraft suck you in for hours and hours! Get up and move! You do NOT want this particular trip to the hospital.

I'll write up the full story later; it's fun: my first time having a fire truck pull up to my home(*), my first ride in an ambulance, my first oxygen mask, my first morphine (oh yeah!) But yeah, the other shoe dropped, and with a vengeance. And the funny thing: the heaviest, worst shoe had nothing to do with the pulmonary embolisms. Among all the blood tests they gave me, because I had told them I'd once had Graves' Disease, they did the TSH thyroid level test. And my levels are not good. I have relapsed, once again: they want me to talk to Dr. Safer (that's the "Pt is follow with endocrinology" above.). My problem is, I said to myself if I had another stress-related relapse, that was it, I had to leave my job. I don't know that this is anything for sure, or that it was stress that did it. It might be thrown off by the shocks to my system this past weekend. But if not, and if it is stress... I don't know. My whole future is a little murky.




(*) I have had a fire truck at my house before, when karlchristian and my place had a fire over ten years ago in Philly, but neither of us was there (or knew what was happening), and the fire truck was gone before I got home.

So, as some of you know, I picked up an ear infection on my Virginia Beach trip. I think it started out as simple case of swimmer's ear, but then one night the pressure built up and there was an eruption in my ear canal. Don't worry, I don't think my eardrum was hurt. But ever since then, there's been weeping of gross fluids from my left ear, and itchiness like I can barely stand.

It was mostly just annoying at first. I only got four days of swimming in. After I got the infection, I couldn't swim freely, as I didn't wish to put my head underwater for fear of making it worse. But that wasn't so bad. Having nieces who wanted to learn to swim without getting too deep, wading in up to my shoulders worked OK. I didn't get as much physical activity as I'd hoped would offset the excessive vacation eating, but not a big deal. And it was fun teaching the girls to swim; they were at that magic point where in a single hour, they got from fear to near total confidence in the water.

But now, almost a week and a half later, it's a bit more than just annoying. I've cleaned out the mess every day, twice a day, with rubbing alcohol and careful, careful Q-tip use, but it's still lingering. My pillows are disgusting. My primary care physician's office is entirely unhelpful: no appointments available for weeks. I don't feel like going into the emergency room; I'd rather tough it out than wait six hours for care, and distract my local doctors from more important emergency cases. I wish I could afford a POS plan, instead of HMO, so I could just go to the Doc-in-a-Box and get it taken care of. But no, I have to call in the referral, and the referral service from my PCP's office had nothing.

I didn't think I'd miss the University's UHS plan, but man I'm missing the ability to walk over to the UHS Student Clinic and just get service anytime during the workday. Tufts is edging towards getting dropped, if I can find a way of keeping my allergist and endocrinologist.

In the meantime, I'm keeping my ear clean, taking vitamins and eating healthy. I think I'll make it without antibiotics without damage, which is probably good as I won't help to create the resistant strain of ear badness. And I can still hear through my left ear, if severely volume-reduced by the sound barely getting through the gunk. I'll have my PCP take a look when I finally get to meet her in August. Assuming her office doesn't just arbitrarily move the appointment again. But seriously, we're nearly one year and counting without me having met the woman for our initial appointment, and that's just sad.

Oh My GOD IN HEAVEN work just exploded in horror today. And it's all the INS's fault. EVIL. Not that I have to tell many of you out there that. The INS/ICE/DHS just came in and destroyed my work week. Work month. Work life.

I'm... I'm. Wow.

OK, it's not like the New Bedford disaster. I'm not facing an empty office. No one's been deported, yet. But it ain't pretty.

And it's not like I wasn't back up to working ungodly hours and covering for a bunch of people and getting terribly pressured and my doctor said Tuesday morning I'm overweight, with high blood pressure, and a week away from another stress-induced relapse of the Graves'. Oh no, I'm all that. But now I'll be covering more duties. Joy.

Of course, there's no one I can vent to at work, as it hit us all at the same time. My boss looks like he was just shot and heard his mother has cancer, all at once. And legal policy about work-stoppage leaves means we can't discuss details. Reasons for taking a leave are as sacred as Social Security numbers; trust me, I've had to hide them or even the ability to guess at them in all our databases. But... ugh... I want to vent! More than just INS BAD. Kill-with-Ice-Pick Bad. Stabbity-stab-stab-stab victim in Murder on the Orient Express BAD.

Yet I cope. And people wonder how I can stay calm in personal crises. It's the constant practice, the experience. That, and I'm listening to my "Welcome to the Working Week" playlist:


Welcome To The Working Week - Elvis Costello
Pressure Drop - Toots & The Maytals
Birth, School, Work, Death - The Godfathers
Let the River Run - Carly Simon (i.e. the theme from Working Girl)
Whistle While You Work - Diana Ross & The Supremes
Stress - Jim Infantino
Minimum Wage - They Might Be Giants
9 to 5 (Single) - Dolly Parton
Work Song - Les Miserables: The Original London Cast
Put Your Hand Inside The Puppet Head - They Might Be Giants (Memo to myself...)
Supermodel (You Better Work) - RuPaul
Money - Cabaret: The New Broadway Cast Recording
Pressure - Billy Joel Music
Car Wash - Rose Royce
Brother, Can You Spare a Dime? - Bing Crosby
She Works Hard For The Money - Donna Summer
Three Pounds Ten - Broadside Electric
Under Pressure - Queen
Deliver Us - Ofra Haza (from Prince of Egypt soundtrack)


Any additions?

I'm not full: that's not the word. I could eat more. But I just don't want to. At all. Ever again. I don't want food in my mouth, whether my body would take it or not.

I'm "not hungry" just doesn't cover it quite right.

This week sees the beginning of putting together and starting Phase I (of IV) of the new program. It's kind of a "getting acquainted" stage, (  where I'm changing my diet and working on a few trouble spots )

I couldn't even bring myself to buy the amount of food they were prescribing. I can get away with that this week and maybe next, but by October I'm supposed to be eating more. More? I can wrap my rational mind around what I'll be ingesting, but my body is in total disbelief. I may never be hungry again.

In other health news, I can't say good or bad, I had a followup appointment with the new endocrinologist. The official answer: I don't currently have Graves' Disease. ( That's how he put it. )

Oh, and according to their official scale, I now weigh 202 pounds (with shoes on, same as last time). I've been weighing myself in the gym consistently, in the same way, on the same scale, once a month. I haven't gained 2 pounds; I'm still actually 195 pounds. But I expect by the next official endocrinology check-up in the spring for that to have changed. You can't chuck this many egg whites into a furnace and not expect some kind of build-up.

That subject was just for unappropriate, who I thought of the second I heard the nurse say "The four pricks all hit at once."

Hi, there.

I'm home from CO. It was another adventure getting home. I got to drive through a major river canyon, and over a dirt road pass in a thunderstorm. Then I drove over three hours downhill the entire way. An hour of that was in traffic on 70 after 40 comes in. I hope they check the brakes of that rental like I told them to; not much brake left when I got to the airport. My plane came into Boston on time (a first!): at 5:45am. I got home, collapsed, and woke up hours later in a not-cold sweat. Jeezy-kreezy, people, who turned the hot on? I'm missing eleven thousand feet already, and my blisters haven't healed yet.

Anyway, I awoke just in time to get my comprehensive allergic reaction test, also known as the Prick Test. Yes, unappropriate, go ahead and have a good snicker.

It was both informative and entertaining. It was actually one of the more interesting four hours I ever spent in a doctor's office. I had a good book, and hey, I got to watch myself slowly breakout all over the place. There was this one exciting bit, when I was racing Ragweed vs. D.R. (one of the dustmites) for who'd get bigger fast. Ragweed won by a good two centimeters! Excitement!

The informative bit: it turns out I'm not allergic to a lot of things I thought I was. There was not a peep out of the molds, all five of 'em. Twice. You have to get them injected under the skin if their pricks fail to excite you. (It's all for you, Nick.) Mold fails to excite me, or, in this case, my allergic reactions. I am also not allergic to dogs.

I am however very much allergic to pollen. No, I can't be more specific than that. Or rather, I can, but I don't need to be. I could say Oak, Ragweed, Pine, Birch, et al., but it's all covered under pollen. All the spots on my right arm except one (the control) burst into flaming red glory. They're supposed to leave the goo on for ten minutes, after two, the nurse decided to just call it, wipe the residue off, and put on an anti-inflamatory cream. They measure the red spots for diameter of reaction; once they all blend into each other, they just call it the original distance between the pricks and leave it at that.

Oh, funny bit: The ash (as in the tree) didn't inflame to the size of the others; it just got a little red. So for a bit there, it wasn't clear that I was allergic to all pollen. Just to make sure it was absolutely all, I got the ash sample shot under the skin as an extra test. My upper shoulder is still red.

So, yeah, pretty much all pollens, and all the dust mites, and, sadly, cats. Yeah, I know. Apparently not dogs, but definitely cats. I thought a lot about that on the way back to my apartment, covered in dust and cat hair. Covered. COVERED. You wouldn't believe the place. Stasha got a little warm over the past week.

I thought a lot about it, because I'd gotten this new policy this year: stop putting up with things that keep me from being entirely healthy. That's why I got the drug cocktail, and the prick test, and the second opinion on my Graves' disease. I'm sick of being the pale sickly guy.

But then, what do I do about Stasha?

Well, the first thing is to put the air conditioner in the window, and cool the damn place down! That cut down on the hair explosion.

God, maybe after Stasha, I'll have to become a dog person. Weird. Of course, the little doggie will have to go out in a bubble when any plants are in bloom. 'Cause that's the only explanation the doc had for my usual reaction to dog fur: it's not the fur, it's the pollen mixed in it. I need a dog trained NOT to roll in the grass. Or dust. Or air.

Anyway, I'm back on antihistamines, and it fells great! The doctor, his assistant, and the two nurses all laughed and laughed when I told them I went to Colorado in the height of the best wildflower season in years, and couldn't take any drugs! What fun!

But now it's on my permanent record: NEEDS DRUGS BAD. POLLEN KILLS.

I am writing this in a slightly radioactive state. I guess we'll see later what affect, if any, it had on my writing. Belf mu ithinca, ya kow?

That was a joke. I don't think I could set off a Geiger counter.

It took an hour and a half and many hallway discussions to get me to this point, so I'm gonna write about it. Even if the experience isn't over. I wish I could say that my experiences at the professional BMC restored my faith that somewhere, American medicine was being practiced efficiently, but ( it hasn't. )

In the end, the radioactive technician walked up, handed me two pills and a glass of water, and watched me take them. Then I was free until 2:30pm, free to eat anything, and go about my normal day. He was nice enough to ask me if I knew the way back in. I recited the three ladies names at the desks, so he'd know I'd "read the signs".

I tell you, Neo had it easier. He just showed up and Morpheus handed him the two pills. OK, well, maybe except for the hideous gut worm probe thingy being implanted. Maybe, maybe not.

Anyway, I'm off to see the sun. Maybe it will look different when I'm radioactive. Then it's back to the center to see what new twist they can throw at me.

Well, it's official. I'm a big boy now. I weighed in at over two hundred pounds at the new doctor's office this afternoon. Two hundred. Even if I'm still retaining fluids from altitude changes (unlikely), I still managed to tip the scales over the limit on an official scale, recorded into my permanent medical record.

The problem is, I have no idea where this weight is. OK, the ol' spare tire was a little larger, but only by gay standards. C'mon, I still have a 33" waist. By straight standards I'm still frickin' skinny. Hey, straight (non-body-builder type) guys have been heard to comment I have abs.

I guess, despite all my disbelief, the weight gain must be in muscle mass. But where? You don't put on ten pounds and not notice it, right? Or at least, I never have. And it's not like I was making it to workouts regularly. Two hundred. Wow.

( In other news, the new doctor(s) seem good. )

I also saw Parag today. He was friendly and helpful as usual. And, I think because it's his annual day to get paid, his write up of my finances was slanted a little more rosy. Still, I could use the good news. Things are looking considerably better than I thought after the condo meeting. The news I can start talking about tomorrow has helped. Tax refunds, should I ever get some of the paperwork, should help, too. And he continues to be complementary about my saving practices; apparently our saving goal, originally set for 2009, will probably be met by the end of next year, even with the possible condo special assessments and higher rates. Having someone help you earn 10-17% on your savings certainly helps.

All in all, if I could only hear, I'd feel relaxed and ready to drive back into work tomorrow. Maybe my ears will pop tonight.

( I'm feeling much better )

( My weekend was chock full. )

Other than that, there isn't much news. September should fly by. I'm in four games (but only 2.5 a week), and haven't been to the gym in weeks (I was sick, though). I'm going to have to figure how to fit gaming and gyming in together, but I'm not going back to TKD, so at least that isn't in the mix.