#Truth

Bodies aren’t meant to stay the same. We are supposed to grow and change. We shouldn’t be making people in their 30’s, 40’s, 50’s, etc. feel like they need to strive for the bodies they had in their teens and 20’s. Or making people feel like they ‘need to get their bodies back’ after they have had children. These mindsets aren’t healthy and change is inevitable.”

As I’ve written about before, I have to say that cancer (and to a lesser extent, simply getting older) was my own body image wake up call. Among the other things it changed in my life, cancer obliterated my decades-long obsession with losing weight. Except for during my 20s when I wore size 31 jeans, I’ve always been—in Sears catalog parlance—husky, and when the weight started padding on in my mid-30s, my mantra became, “If I could only lose another 20 lbs. I could…wear tank tops to pride parades, get a boyfriend, win the lottery, blah, blah, blah.” (Truth be told, even when I was wearing size 31 jeans I considered myself fat.) After I came through on the other side of the cancer treatment however, for the first time in my life, none of that was important any more. I was actually comfortable in my own skin and I learned that it was so much easier to just take care of myself, eat as healthy as possible, and simply accept who I was rather than to fixate on what size jeans I had to buy.

Anniversary

Twelve years ago this week I was told three life changing words: “You have cancer.”

It didn’t exactly come as a surprise. I’d been dealing with continual hoarseness with no definitive diagnosis since late 2000. But it was still one of those moments when time seemed to stand still.

I had no health insurance, but thankfully—somehow—I managed to qualify for Medicaid. This at least eased the worry of how I was going to pay for any required treatment and though I was now out of work (after the diagnosis and a week in the hospital my contracting position was “eliminated”) and eeking by on unemployment and the kindness of friends and family, I knew all my medical expenses would be covered.

I found both a great Otolaryngologist as well as a Radiation Oncologist. I approached this ordeal knowing that I would make it through to the other side of treatment and beat this thing that had been dropped into my life. That was never in question. I wasn’t about to let a clump of cells less than half the size of a pencil eraser destroy my life.

Alter my life, yes. Completely redirect the course I was on, yes—although neither of those were particularly conscious decisions.

The next six months were hell; there’s no denying that fact. Seven weeks of radiation therapy left my throat so burned and inflamed that all I could mange to eat was pudding, jello, and Ensure. Occasionally I could manage some well-cooked pasta with mild sauce. I laughed at the time that one unexpected and welcome side effect of all this was that I lost 40 pounds. I looked great.

Toward the end of the therapy however, I was so sore even the maximum dose of Oxycodone wasn’t helping alleviate the pain, and oftentimes I’d wake up in the middle of the night sobbing. I did a lot of reading during those long, sleepless nights.

I asked my doctors if I’d ever get my voice back (because there were several weeks when I was left unable to speak at all) and they said, “You won’t get your old voice back, but you will have voice.”

Considering the alternative, that was a welcome prognosis.

After the treatments were completed and my throat had healed somewhat, a biopsy was taken of the previously affected area in my larynx. The tests came back negative. The radiation had been successful. And thankfully this particular type of cancer was one that had one of the least chances of recurrence.

Over the next couple months, the pain and inflammation subsided and I was able to speak again (now with a voice that reminded me of an elderly woman or a young child, especially on the phone) and once again return to eating regular food.

Where did it come from? Everyone—including my doctors—were baffled because I’d never smoked and never drank to excess (the two leading causes of laryngeal cancer). But while I haven’t been tested, at this point it I would almost guarantee the source was HumanPappilomavirus, something that at the time was just starting to be correlated with the disease and contracted no doubt during an episode of unprotected oral sex during my wilder days in the underbrush of Golden Gate Park—or any number of other venues. (I won’t make apologies for not sticking a condom on every dick I sucked because I weighed the risks based on available knowledge at the time and found them acceptable.)

Anyhow…

When my five year anniversary arrived—the point at which one is generally labeled “cured” (or “in remission”)—I decided to mark the occasion by getting my first tattoo. Those of you who have been with me during this crazy blogging journey know how that turned out.

My semi-annual checkups kept coming back clean, so when the ten year anniversary rolled around I celebrated it with another tattoo (this time done properly) and breathed a healthy sigh of relief. Even though I’d been told repeatedly “You’re fine. You’re cured,” until that ten year anniversary arrived I’d always felt that perpetual Sword of Damocles hanging over my head. In fact, it wasn’t until my last checkup about six months ago that I reached the point where I felt I really could finally relax.

A Clean Bill of Health

I saw a new Otolaryngologist last week for my bi-annual post cancer treatment checkup. I wasn’t impressed with the guy who examined me two years ago, so I mentioned to my Primary Care Doc that I wanted to go to a new one.

Good news all around. After snaking that scope up my nose and down my throat (first time I got to see what she was seeing via a pair of attached display glasses), everything is good. Yeah, my larynx still looks like a war zone with one cord still immobile and the rest of the area remaining permanently swollen, but no sign of any recurring malignancy.

11 years and counting, baby!

Me, Most Mornings Between 3-4:30 AM

Insomnia is evil. I have no trouble falling asleep; in fact, it’s usually within seconds after my head hits the pillow. But for some reason almost every night between anywhere from 3 to 4:30 am, I wake up (usually from an intense dream) and can’t fall back asleep. I start worrying about what time it is and how soon my fucking alarm is going to go off, or even if I glance over and see I’ve still got over two hours before I have to be awake, my mind starts racing and at that point I’m fucked.

I so envy Ben’s ability to sleep for ten hours at a stretch and immediately fall back asleep if anyone wakes him up.

When I was in my 20s a trick I used on the rare instances I couldn’t get back to sleep after waking up in the middle of the night was to tell myself that nothing was so important that I needed to fret over it and lose sleep—especially since nothing could be done about whatever it was that was bothering me until morning anyway. If only that still worked…

Taking Advantage…

…of my insurance before it runs out at the end of August.

I’ve been a bad boy. I haven’t seen a dentist since we left Phoenix. I was reasonably confident that everything was okay, because I brush, floss, and rinse twice a day, but I really wanted a cleaning, so I made a last-minute appointment with the dentist my primary care doctor recommended. The hygienist complimented me. “Whatever you’ve been doing, keep doing it!”

There were a couple very minor issues; an ancient filling that should be replaced and a chipped incisor—but nothing that can’t wait until I’m working again and fully reinsured.

Very Cool!

From ARS Technica:

The use of silver in medicine is as old as Western medicine itself. Hippocrates is known to have used it to treat ulcers and wounds, the Romans almost certainly knew of its healing properties, and its use continued through the middle ages and up to the present day. In the antibiotic age, interest in silver may have waned a little. But with urgent need to fight antibiotic-resistant bacteria, there has been a resurgence in its use.

The reason is that silver can kill bacteria selectively, and more importantly, bacteria have been unable to develop resistance against it. Despite silver’s long medical history, we do not know how it operates.

A paper published today in the journal Science Translational Medicine sheds some light on silver’s success against bacteria. The most important finding is that silver—unlike most antibiotics—works in more than one way. This is perhaps why bacteria may find it difficult to build resistance to the chemical.

Here is silver’s multi-pronged approach: first, silver sticks very strongly to sulfur, found in parts of proteins. These sulfur groups normally bond to each other, holding proteins together and keeping the protein folded up in its correct shape. But if silver interacts with sulfur, then the protein cannot fold correctly, and thus it cannot do its job. Next, silver interferes with how bacteria use iron. Iron is often held in place within proteins by binding to sulfur. Since silver also interacts with sulfur, it blocks the iron from doing so. Finally, silver causes bacteria to produce extremely toxic substances called reactive oxygen species. These go on to cause damage inside the cell, harming the DNA, proteins, and even the membrane that surround cells.

The net result of this silver onslaught is bacteria with severe damage to their basic biochemistry. In addition, the membranes and walls that surround the bacteria are leakier after the silver treatment. This allows conventional antibiotics inside the cells; in their weakened state, the cells are much more susceptible to them. Bacteria are broadly classified into two groups, called Gram-negative and Gram-positive. Gram-negatives have an extra cell membrane that protects the bacteria, which makes it much more difficult for some antibiotics to penetrate the cell (examples include gentamicin and vancomycin). It seems that silver negates this advantage and allows even weaker drugs to do their jobs.

James Collins of Boston University, who led the research, showed that with added silver, less antibiotic drug is needed to kill the bugs. A great result in itself, but it gets better. Silver also reverses antibiotic resistance of E. Coli bacteria, making them, once more, susceptible to tetracycline.

These experiments not only worked in a Petri dish. When silver was added to standard antibiotics such as gentamicin and vancomycin, Collins could treat E. Coli infections in the bladder and abdomens of mice. Normally, these drugs have little effect on E. coli infections because they are designed to attack Gram-positive bacteria.

Finally, Collins showed that the mice themselves remain unharmed by silver. If he is able to repeat this work in humans, he may actually have a “silver bullet” for antibiotic resistance.

A Question for My Denver Area Readers

One of the things I miss most about Phoenix are the healthcare providers I had there. My Primary Care guy was amazing. My Ear-Nose-Throat physician was supposedly one of the best in the valley. My eye doctor was outstanding. Heck, I even liked my dentist. And working for the company I did down there, I had the added perk of only a $50 copay to any of our emergency rooms and any procedure I had performed at one of the hospitals didn’t cost me a thing.

Unfortunately, my luck in Denver hasn’t been as good. While my Primary Care physician is decent enough, he’s geographically undesirable. And since he only knows other doctors in his general area, that means anyone else I need to see (like an otolaryngologist for my yearly checkup) is also an hour drive from home. I found a decent eye doctor in Glendale (based on a referral I got through this blog a while back), so I’m hoping I can do the same again for my other providers.

I need a suggestion for a good primary care physician in central Denver/Glendale or the Greenwood Village/Lone Tree/Littleton area. Also a dentist. And if any of you have a therapist you can recommend, that would be great too. (With all that’s happened during the last six months, I’m reaching the point where I think I need to start seeing someone—at least until the mother-in-law moves out.)

Ten

With everything else that’s happened in my life since the start of 2013, I’m not surprised that a rather important anniversary slipped by under the radar.

I am now a ten-year cancer survivor.

April 1st came and went this year with none of the fanfare my 5-year anniversary garnered. I guess it was a combination of everything else that’s been going on coupled with a clean exam last November and the doctor’s pronouncement, “At this point, for all intents you’re cured and can relax. See me in two years,” that put this on the back burner in my mind.

That’s not to say I hadn’t thought about about it entirely. Almost immediately after getting inked for my 5-year anniversary (something that did not turn out the way I’d hoped; something you’ll remember if you’ve been reading the various incarnations of my ramblings for that long) I started wondering what I’d do for the big one-oh.

About a year ago it hit me.

Ten, ten, TEN:

Because I like dual meanings.

And who have I chosen to poke me, to guarantee that this time will not be a repeat of the last? Why, Erik of course!

Ben and I are planning a road trip in August, and a visit to Pea Ridge is definitely on the agenda.

Bottoming Out

No, not that kind of bottoming, you pervs.

Shortly after I received my cancer diagnosis in 2003 and preparing to undergo a PET scan, I—like millions of other Americans—was also diagnosed with Type 2 diabetes. Needless to say, this news coming on the heels of the cancer diagnosis—while not totally unexpected because of a family history of the disease—was nonetheless devastating. I remember leaving the PET center and sitting in the car with my father (because they couldn’t perform the scan until my glucose levels were brought down) and began to openly weep. I thought, “What more can possibly go wrong?”

I made an appointment to see my GP the next day and since he was not there, I was stuck seeing his entirely disagreeable nurse practitioner assistant. She ordered blood tests and the next day the results were in. Definitely diabetic. The NP phoned in a prescription for insulin and syringes, and booked an appointment for the following day so I could be trained in their use.

Upon returning the following day, I got to see the regular GP and he was aghast. “You don’t need insulin. We can bring these numbers down with oral medication.”

And so began my relationship with Metformin.

My numbers had been quite good with the oral medication until about four years ago when they slowly started creeping up. The dose was raised and they were brought back under control. For the last couple years, however, they’ve been totally out of control, despite now being on two different medications, and they weren’t showing any improvement.

That’s why, late last year, my current GP suggested we try an insulin regimen in addition to the oral medications. He started me out with a long-lasting, once-a-day shot that brought my numbers down about 70 points. Not good enough, because I was still only rarely hitting below 200.

About a month ago, we decided to change up to a 2-shot a day regimen of a 70/30 mix. My numbers were finally going below 200, but varying wildly during the day.

Yesterday I was searching for an online image of the insulin pen I was using (to incorporate in a medication reminder app—yes, I’m a total geek) and I made the unsettling discovery that what I’d been using for the last month wasn’t the 70/30 mix as my doctor had prescribed, but just the regular, short-acting insulin. After speaking with him last night, it was determined that indeed, I had been on the wrong drug for the last month—with the fault falling somewhere between him and the pharmacy. He phoned in a new scrip for the proper drug and told me to continue using what I had until I could pick it up.

Last night right before dinner I did my usual dosing with the short-acting insulin I’d been taking. By the time we got home and sat down to watch television, I started feeling a bit…off. I was lightheaded and everything was starting to look like the brightness and contrast had been turned up to full. Fearing that my glucose was high from dinner, I checked and couldn’t believe my eyes. My glucose was 86. I have never had a reading that low, not even when I was well-maintained through my oral meds. Fearing that either the test strip or the draw had been bad, I rechecked and it was 83. I checked again and it was 80.

I was crashing.

I had no idea why because I’d been using this particular dose for over a week with no ill effects, but being warned of this possibility by my doctor (but always feeling that I was reasonably safe because my levels had been consistently so high), I pulled out my emergency 12 oz. bottle of Dr. Pepper and downed it. About ten minutes later I checked again and my glucose was up to 90. Another ten minutes and it was 114. I checked before going to bed, and was up to (for me) a very respectable 141 and I was feeling much better.

I picked up the proper insulin this morning. My doctor has knocked me down to a low dose to begin with again, and I’ll slowly working my way up as needed as I’m back to being over 200 tonight…

 

 

One of the Unintended Consequences…

…of having a teacher as a romantic partner is that you get to experience each and every illness that the little germ-infected monsters bring with them into the classroom.

Yep, I’m down with the creeping crud again.

But at least the timing was advantageous. By sheer coincidence, I had an appointment scheduled with my new Primary Care Physician tomorrow morning. It was originally intended to just be a meet-and-greet sort of thing to establish medical care here in Denver, but since I’m going to be there anyway maybe he’ll have some magic bullet to knock this crap out of me.

Yeah, right.

My doctor in Phoenix has been great about authorizing refills for my various meds as they run out, but it’s been nine months since my last blood workup, and I really do need get back into a regular care routine—not to mention getting a referral to a local Otolaryngologist.  I’m way overdue for that exam.

In Memoriam

I’ve been wearing this brand of daily-wear lens since the early 90s. They’re no longer being made and nothing else (including the recommended substitutes that I tried a several weeks ago) fit as well. In fact, the manufacturer has phased out all their vial lenses for the more profitable disposable variety. I mean seriously, WTF?

And I’m not alone. A quick search on the interwebs reveal a lot of folks who are plenty pissed off that these lenses have been axed. Hopefully I’ll be able to stretch a few more months out of my last pair of CSIs before I’m faced with having to give up on contacts altogether and go back to glasses full time. (Yeah, the “new” lenses I tried are that bad.) Since I’ll once again be insured after the first of the year I’m hoping that I’ll be able to find a competent eye doctor who is willing to work with me to find a suitable substitute. (PSA: Avoid Target Optical.)

 

The Creeping Crud

Ben and I have both been down with the creeping crud the past few days, and I’m ready for it to be over. What a waste of a perfectly good weekend.

I guess it’s one of those unintended consequences of being partnered to a teacher; he’s exposed to little walking petri dishes day in and day out, much like I was when I worked at the hospital.  (I’ve never been as sick as often as I was when I worked there, despite the copious amount of hand washing and hand sanitizing I engaged in.) I just wish he wasn’t quite so inclined to bring the illness du jour home with him.

(I kid, I know it can’t be helped.)

Ben missed two days of work last week, and I was out on Friday. I think I got off relatively easy this time, as I’m feeling pretty good now that the headache from hell has disappeared and my sinuses are once again functioning relatively normally.  Ben, however, hasn’t been as lucky. He got hit with the full force of the crud and still isn’t feeling anywhere near back to normal.  Send him some good thoughts, okay?