Halloween is the Worst Holiday

I love Halloween. I always have. This year, I flew to Orlando with family and friends, just for a Walt Disney World holiday. As we did the last time we were there, we took in a night of Mickey's Not-So-Scary Halloween, which is just a barrelful of laughs and fun. Everybody dresses in costume, especially the kids, and we all go around collecting candy at different way stations through the Magic Kingdom.

And there it is. Candy. I am not obsessed by chocolate, which is what several friends claim. I'm addicted to sugar. Since I'm diabetic, it's not a cute thing any more.

I'm still trying to get rid of the Halloween candy because, of course, I bought too much candy. I usually get between 15 - 30 kids that night, but I buy just in case the entire contingent of grammar school kids in the Bay Area will show up. And I used to advise people with the same problem that you have to buy candy you don't like. Except that there is no candy I don't like.

My knee is perfect, by the way. No problems, no pain, not even a little stab if I get out of bed wrong. So, apparently, I get rid of one problem and move on to the next one. Diabetes, however, is always with me.

Cortisone Is a Wonder Drug

Not quite two full days after the cortisone shot to my right patella, my knee feels no pain at all. Whew.

Yesterday, almost all day, I felt little stabs of burning pain. I thought that actually might be from the shot itself, as I had never quite felt that kind of pain before. It was different. Or, the burning sensation might still by the xylocaine.

Whatever. My right knee, right now, feels FANTASTIC! Hopefully this will continue!

A Shot in the Knee

I got a shot in the knee this afternoon. When I reported for the treatment, the x-rays from Tuesday had still not arrived from NorCal Imaging. So she called before she gave me the shot, and their oral report was "advancing arthritis." Phew, that doesn't sound so good. But no other damage. So the shot was on.

She had Kristi with her (who works on Fridays), a med student, and told her about the "holy trinity," where you move the swab over the area three times with that horrible-looking brown stuff, to make sure it's cleansed. She then swiped an area where the syringe would go in, and we were ready.

She had mixed a vial of Xylocaine in with the Cortisone and placed it in the syringe. She felt for the patella, and slipped the needle in just to the left of the bone. Then she moved the needle for two other angles to release the steroid into that portion of the knee.

It hurt a little, but not nearly as much as I remember it hurting the first time I received a cortisone shot in the knee. She told me the xylocaine would create a burning sensation, and then would numb the area. I only felt pain, but perhaps that was the burning.

I have to say that my knee felt fabulous within minutes. However, three hours later, the xylocaine has worn off and I feel some pain in the knee. That's to be expected, I understand.

Dr. Miller told me that the limit for cortisone shots is 3 times per year per knee. That's a lot better than I had previously thought.

It might take a few days, but I have no doubt my knee will feel a lot better. Yay for modern medicine and the deft touch of Dr. Laura Miller!

It's Isn't All About Cancer, You Know...

My knee gave me a fit at Disney World. We walked something like an average of 5 miles a day. My knee constantly hurt, especially when I climbed up (and fell from) the train steps. And the three blisters didn't help, either.

I made an appointment with Dr. Miller as soon as I got back. I couldn't feel it, but she felt some grating and some warmth from swelling. Today -- this afternoon -- I am scheduled for a cortisone shot. It helped last time.

For the life of me, though, I can't remember whether it was the left knee or right knee that got the cortisone shot last time. This was maybe 4-5 years ago. It does matter, because you're only supposed to get a maximum of 2 shots per body area. After that, cortisone does bad things. Actually, cortisone can do bad things to you anyway. I have a few friends for which that's true.

The stupid thing is, today the knee feels pretty good. It's felt pretty good the last two days. So, instead of the 8 pain level I reported last week, it's about a 3.

But I think I'll shut up about that unless directly asked. I still want that shot.

I Get Most of My Injuries at the Ballpark

I've read many times that most accidents occur in the home. (Which is always a warning to clear your passageways, etc.) And I've also read that most car accidents occur within a mile or less of your home.

In my case, my accidents occur outside the home. The latest is a bruise I picked up yesterday. I had just driven to the game at 3pm, got out of my car, walked in the parking lot and turned the corner, and a car door opened and hit me in the right forearm. It stung momentarily, but I knew it would grow into a big, honking bruise. Because I bruise quite easily these days.

I will watch the bruise turn different colors before it disappears in about two weeks. But it's nothing to what happened to me last July when a foul ball at the Oakland Coliseum hit me in the right breast. That took months to fade away.

And the biggest injury in my life was when I took a fall at night on a speed bump across the street from Disneyland. That was two years ago. My left leg still has lingering problems from that, but nothing serious. And I had the chipped tooth replaced.

I am well aware -- well, I became well aware after that fall, which took place two years ago -- that falls will be my worst enemy. My partner is currently checking on an elderly couple who live in Alameda. When she discovered that one of them had fallen multiple times the previous night, she rushed him to the emergency ward. Falls are no joke. In this case, however, it isn't the result of the fall(s) that she worried about. It was the cause.

So, from these experiences, I can only conclude that (1) I am getting older, and (2) getting older is no fun. I can't do much about opening car doors or foul balls unless I just stay home. My son says I should wear a rubber suit when I go out. Do you think that would help?

Back to Dr. Miller

A few days, a robot called me to ask me if Friday was a good day for an appointment. I pressed "1" to confirm. What a strange way to get a doctor's appointment. I had no idea who the doctor was or why I was scheduled. But it turned out to be business as usual. It was indeed Dr. Laura Miller of Lifelong in Oakland, and it was a follow-up to my blood test in July. Dr. Miller had warned me that the last CT scan I had -- the one that showed I no longer had any sign of cancer -- had a dye in its preparation that reacted negatively sometimes to Metformin, a diabetes drug that I take. The blood test was a precaution. And everything looks fine. My A1C, as measured in May, is 6.1. Stellar. My blood pressure today was 116/63. Couldn't ask for better. My weight is up (hey, I was in Las Vegas all last week!), but we didn't talk about that. We did talk about the fact that Dr. Stern wanted me to have frequent follow-up pelvic exams (PAP smears?), as 5% of uterine cancer patients see recurrence of the cancer within the first five years. We agreed that I would see Dr. Poddatoori and discuss how we would go about this. Dr. P. is on maternity leave presently, so I told Dr. Miller I'd try to make an appointment with Dr. P. in December. And so we left, agreeing that I would come back to see Dr. Miller in either November or December. Curiously, she told me that Lifelong is going to electronic medical records. And that meant, the fall-out, was that doctors would see fewer patients as they learn the system. Interesting, but a positive note that my records could be viewed by any medical staff anywhere, provided, I hope, I give permission.

Those Tests Are Out to Get Me...

This is a continuation of the last blog entry, in which Dr. Stern's Stephanie told me that, although all the tests to detect cancer were negative, I need follow-up Pap smears for the next several years.

My initial thought was, "No, no way." That's still my thought. When I said to Stephanie, "I don't think I'll do that," I was waiting for counterargument. Is there something else you could recommend, could I be sedated, etc. She didn't answer with any other recourse.

The pelvic exams that were ordered by my doctor, Dr. Miller, were the reason I put off any exams for a year. Just as I had suspected, the 30-year separation from having any pelvic exams have not lessened the pain, and the ultrasound was unbearable and could not be performed. So, I just stopped mentioning it to my doctor. She didn't follow up on that issue until she wanted a full-blown physical, and at that point I talked with her about it. As it turned out, I had cancer, and that delay gave the disease further chance to spread.

Dr. Stern did warn me this morning that if I were to show any signs of bleeding, I should come back to his office immediately.

It was at that point that I figured out that he was telling me that I could make my own medical decisions -- fine -- but that there were certain warning signs to which I should pay attention. And he apparently figured out that I might be more willing to talk with Dr. Poddatoori about such things, or that she could figure out some sort of compromise, like sedation, etc.

In fact, Ruth and I made a pact: any signs of bleeding returning and I have to submit myself to Pap tests. I agreed begrudgingly. I can't figure out what's worse sometimes -- the cancer or the actual tests. I realize that's cavalier on my part, but please forgive me. I have never felt the ravages of cancer, even though I've had it twice. I've been rescued, both times, by surgery.

While my luck has continued along those lines, I don't feel that lucky. My purgatory involves a sharp instrument stuck up my vagina. Ouch.

Follow-Up to Cancer Surgery: The Good, the Bad, and the Ugly

I've been hoping and dreading this moment -- all at the same time -- where I walked into my oncologist's office, and he tells me the results of the post-surgery tests, tests which determine whether I still have cancer. Those tests are negative, thank goodness.

The CA-125 blood test, which is a unique test for cancer, was 18 prior to the surgery. It's now 7, a considerable drop, and in a very good place. The CT scan was negative. Dr. Stern told me that I shouldn't need either test again (at least at this point).

However, there are follow-up tests. Stephanie told me that because I had endometrial cancer, there is a risk that the cancer could occur. Therefore, I should have Pap smears every 3-6 months after surgery for the first two years, and then every six months for 3-5 years.

I was in shock. I had been told by Dr. Poddatoori, my gynecologist, that I would never have to have a Pap test ever again. The uterus is gone, the ovaries are gone, but there's still risk. Dr. Stern told me there's a 5% chance the cancer could recur. Then he paused and added, "Or greater."

I don't do Pap tests. In fact, when Dr. Poddatoori found out that I had had my last Pap test before she was born, her reaction made me trust her and like her so much more. She understands that I can't do a pelvic exam easily. Last time I had to be so sedated that the procedure was done in a hospital, and she performed it. (This was just prior to the surgery to remove the uterus, etc.) It's too painful.

I told Stephanie that I doubt if I would ever do that, and apparently she reported that to Dr. Stern, because when we got in to see him, he recommended that I go to see Dr. Poddatoori for follow-up instead of him. He suggested I see her after three months.

I'm still a bit freaked out. I don't feel like celebrating, like I thought I would. Still, I have a plan. And I think ice cream is definitely in my future. Because, damn it, life is too short.

Kidney Problems....?

I did get that phone call, yesterday, from Dr. Laura Miller, my general practitioner. Thankfully, my iPhone is working again. What a wonderful doctor.

She had called to say that she had seen the note from the people who did my CT Scan last week. I was to consult with her about resuming Metformin, my diabetes medication. When I told her I had already resumed the meds, she was fine with it, but told me to stop using it until after I had had a specific blood test.

The blood test will show whether there's increased creatinine in my bloodstream, and whether the kidneys are at risk. All because of the dye I consumed during the CT scan.

According to Medicine.Net, "Creatinine is a chemical waste molecule that is generated from muscle metabolism. Creatinine is produced from creatine, a molecule of major importance for energy production in muscles. Approximately 2% of the body's creatine is converted to creatinine every day. Creatinine is transported through the bloodstream to the kidneys. The kidneys filter out most of the creatinine and dispose of it in the urine."

So, what's the problem with a CT scan as it relates to kidneys? According to the University of Michigan Health System (www.med.umich.edu), "serious kidney damage... can be caused by the iodine-containing 'dyes' that doctors use to enhance the quality of such (CT) scans."

"People whose kidneys are already vulnerable, including many older people and those with diabetes or heart failure, are the most at risk from contrast agents..." The University of Michigan concluded from their study in 2008 that, "Mild to moderate kidney damage occurs in one in four high-risk people who have CT scans, and in as many as one in ten people with normal kidney function. In some cases, it causes acute kidney failure."

Dr. Miller looked at my last blood tests, and concluded that I have normally-working kidneys at this point, the point before the CT scan, that is. I swung by Lifelong this morning, picked up the lab paperwork she had prepared for me, and got to LabCorp by 9am. At midnight last night, as I was falling asleep, I remembered that I could make a LabCorp appointment, and so I did. The whole world shows up in that tiny little waiting room between 8am and 10am, because they're all fasting.

The photo shown is a CT scan of normal kidneys, top-down view.

So, the blood test is done. I am to resume Metformin this afternoon. Dr. Miller will call me if the lab results show there's a problem (probably in a couple of days). I tell you, if the cancer doesn't kill you, the tests will. Amazing.

My iPhone Has Fallen & It Can't Get Up

My iPhone hasn’t worked for the better part of two weeks now. That single event has changed my life.

It’s quiet now. It’s peaceful. I don’t automatically reach for the phone, looking to check to see if I got an email or a text message. Looking at Twitter to see what’s trending now. The iPhone is the epitome of instant gratification for a neurotic. And the lack of it is very freeing. I have to sit still, maybe read that book I’ve been saving. Actually sit down and talk to people.

Yeah. I hate it.

Seriously, though, what really bothers me is that the doctors' offices can't get hold of me, if need be. My instructions at the CT scan on Friday was, don't take metformin (diabetes medication) until 48 hours from now; then they gave me a piece of paper saying, don't take metformin 'til you contact your doctor. They told me they faxed this to the doctor's office. So it could very well be that Dr. Miller is trying to call me. (What I'm going to do is start taking the metformin on Monday. That is well past the 48 hours, and I'm not feeling any ill effects from the scan.)

I will keep trying to get my iPhone fixed. It's my third visit to the Apple Genius Bar tomorrow. However, I think that title is a misnomer...