Mohs Monday

Today was the Mohs surgery. The good news was it was one and done. That is one scrapping (and it literally was like she was scraping my skull), one biopsy, and no cancer. And then the bad news. Since the one site came back positive, there was a second area the doctor was worried about right next to it. Since we had the lab on standby, we did a biopsy of it. Yes, it was also basal cell carcinoma. But the good news is was also one and done. And for the bonus round, the second site was close enough that both should be covered by a single (large) bandage.

The second site of cancer means my chances of another carcinoma in the next 5 years is above 50% now. The only caveat is that the doctor believes it may have been all one cancer before the previous doctor did the freezing. So it may have been just one site then that got separated. It doesn't change the aftercare regimen, just the worry factor.

As of now, as far as we know, Steve is cancer free. Now I just need to deal with the weight gain from the last two weeks. Unfortunately I don't have many hours at the hospital (my exercise regimen of choice) in the next month (probably months).

Scalp Scab 2.0

Today I debut Scalp Scab 2.0. Three weeks ago I had a little bit of skin taken off the top of my head and then my new dermatologist recommended cauterizing the tissue around it, whereas before we just froze it off. A week later I started writing what is below.

In case you didn't know, I do write a lot that I don't actually post. There's a lot reasons for that. In this case it was fear. Fear of the future, fear of sharing, fear of just who was reading, fear of this coming out at the job. There was also a lot of "WTF are you whining about, Buchheit" going on in my head.

But today is Scalp Scab 2.0. See, last weekend while replacing a bathroom sink I scraped Scalp Scab 1.0 off. Today is the first day without a bandage again. What I find strange is that between lots of other events, braces, etc, I have received the most comments on having a bandage on my head. And it hasn't all been positive.

Anyway, time to post this.

So, I think I've mentioned before about how with my family's medical history that cancer is the gun pointed at my head. In the past six years that gun has clicked on (mostly) empty chambers, but this past week it finally fired.

I have basal cell carcinoma. It's a non life-threatening cancer that's highly treatable and only metastasizes after the cancer has aged a long time. It's highly curable and the most common treatment is what is called a Mohs Procedure. They cut out as much as they can see and then take a slice of skin to process in the office to see if there is any cancer. If there is, back onto the chair and they cut out more and then take another slice. This goes until either the area cut becomes too large or a slice shows no sign of cancer. Typically only one surgery is needed. There's no need for chemo. Just a large bandage for a while.

There is, however, a lot of followup. For the next few years I'll go to the dermatologists office twice a year to get checked out. With one instance the chances for another skin cancer (well, any cancer) increases so that means heightened vigilance.

The cancer is at the top of my head in the center of my monk's cap (male pattern baldness). About two years ago I saw a different dermatologist and had the dry, red patch frozen off. She didn't think it was anything and all roads (for her) led to freezing the area so I just went with that. Well, it returned so this time I found a specialist in skin cancers and demanded a biopsy (this doctor was also fairly confident that it was pre-cancerous and we went with that treatment plan, which for her meant cauterizing the edges). It's the biopsy that came back positive.

As a kid we didn't have sunscreen and we were constantly out of doors. In the Summer that meant a good deal of sun burn. Even as an adult I find it weird to put on sunscreen (and I often forget to, even when I have it). During this last vacation I didn't wear it while we were in Glacier Bay, and I got burnt again. I have been wearing hats, however. Ever since I had a piece of my ear frozen about four years ago (by the previous doctor). And now I guess I'll need to develop a habit of wearing hats.

Now you all know. I have cancer. Baby's first cancer is basal cell, which is a lot better than it could have been.

Fuck cancer.

I wrote that two weeks ago, the night I found out. And then never posted it. I don't know. Maybe I remember my Grandfather's cancer, how we talked about it in whispers. I think about, "what if people I work with find out?" And "what if people I know find out?" And mostly, "why the fuck am I so depressed and focused on this? It's not life threatening, it's highly curable."

And then the little voice says, "You have cancer."

I'm too young (not really, not anymore). I'm not published, yet. I should write more. The night thing is going back to normal. Focus on story. Get it done.

"You have cancer. Right now, you have cancer."

Jesus, Buchheit, get it together. People around you have real medical issues (you're going to have to deal with). You need to write these stories and publish them (both outwardly announced projects and secret squirrel projects). You have reviews coming up. You need to stop something happening at the night thing (or at least make management aware).

"You have cancer. Right now, you have cancer growing on your head."

Fight, fight, fight, you bastard. You've expected this all your adult life. Considering just what you're really facing, this is nothing. It's early. They'll get it all. And when it comes back, you'll get it all again. It's not like you'll need a colostomy or a drain, month of radiation or lose what's left off your hair to chemo.

What's this Sargasso of the soul? Come on. You can't self-destruct and it's not worth it. You've got at least twenty more years, stop wasting time.

"You have cancer. Right now, you have cancer growing on your head. You're body is trying to kill you."

So, yeah, wind out of the sails right at the moment. I'm sure it'll get better. At some point my inner asshole will take over and then "Damn the torpedoes!" But the vats of piss and vinegar and dry. All I have left is snark. It'll take some wall or some one to try and stop me, then my back will get up. But right now I'm just paddling in circles.

I keep telling myself, "It'll get better." I know it'll get better. But that other voice is pretty insistent.

The State of Steve

Sorry for not posting today. I actually have the day off, one of the benefits of working for a government contractor (actually, the long story is that it was our Good Friday off, but then that was broken out to be a floating holiday, which became cumbersome to manage, so they just choose Presidents Day). And I though I was going to get a lot done. There were some household chores that needed to be done. I did get those done. Then there was some homework. Which I didn't think would take too long, but ended up soaking up the rest of the day. So I didn't get to the writing parts I had wanted.

One of the things that was also supposed to happen today was to close on a refinance of the house. The papers they sent on Friday, however, were dated for Friday. And banks are also closed today, so we couldn't do that. We're refinancing to get a lower rate. While the rate we are getting isn't the lowest out there, it is actually a second mortgage which means the cost is zero. So while we're paying a full percentage point higher than what we could get, because there are no costs we stand to save an extra $2500. As you know, Bob, we're paying off our loan faster than our schedule (if you can afford to do it early, it really is a great deal). Right now we're looking at another 5 years of payments (if we can keep to our same monthly rate of paying). Now, with the lower rate we would have shaved off almost a full year and saved around $4000, but it was going to cost us $3000 to do that. So final savings would have been around $1000 (if we could keep to payments). One of the goals was to get lower minimum payment as we head into the reboot where I will be going to school full time (in a year or two). So having a lower monthly minimum would be a big help if it comes down to it. So with the higher percentage, we only gain a month and a half of possible payments, and we're only saving around $3500. But because there's no costs involved, all that is ours. And the minimum monthly payment is only $20 more.

On the health side of things, I gained around 12 lbs over the holidays. So far it's been rough getting it off, but I think I'm on a good curve downward now. Although when I did my weigh in last week I was still 4 lbs heavier than my last one. Whoops. I've had a cold for the past week, and that's been knocking me down as well. I eventually had to go and beg for the Sudefed behind the counter to help dry up the head (H1 blockers, yeah!). The calf muscle continues to get better. I think I'm going to try going without the brace this week. I'm still using a cane when I'm out, but not in the house (yes, I should, but it's a pain in the ass, and I don't walk around all that much at home). The worse thing, however, is my pinched nerve is acting up. More than likely it's flared up from being twisted around at work by trying to elevate the leg and having been moved to an office to work on uber Top Secret project. Plus being on the phone with the boss for a few hours before saying, "Hell, I'm in an office, I'll put this on speaker." It's still strange to feel pain in my shoulder and arm, but know the actual problem is in my vertebra.

I really hate that pain, btw. It's difficult to get into a comfortable position. Also, the therapy I'm using is a cervical tension devise which isn't much fun (especially with a stuffed up nose, and the chin strap pretty much keeps the mouth closed).

And then there's that project at work. I can't talk about it too much, but let's just say that the stress is driving me crazy. Not to mention that it's not like I don't already have a metric ton of work to do, most of which is already late. Sigh. This being the only designer in a half billion dollar company (which means there should be 3 of us, at least) is starting to drag a little.

And finally we come to the writing, of which there has been a paltry amount of words since the beginning of the year. Between work, commute, classes, chores, etc there has been little time left for me. I could probably scrap out a few hours in the week, but I find myself just mindlessly watching TV. Only when it's time to go to bed do I think, "Damn, I should have been writing just then." And then I forget the next time. Sigh. Must. Get. Back. In. Groove. So, I've moved the laptop to the table. Hopefully this will be a reminder to work on the writing. I wrote a lot of Bladesman at the table. And that's where I am now (having finally finished the homework).

Sorry for the typos (of which I'm sure there's more than a few). I was also using this entry as a test bed. One, it's been about 10 minutes to type all this. And I typed it directly into the blogger interface (which I haven't done for ages). So the good news is that I can get words out. Now I just need to directed them toward the WIP.

So that's me. Hope you all have been faring better.

Pop goes the calf muscle

Well, that wasn't any fun at all. Last night, while bending over to give a welcome home kiss to Bette, my calf muscle popped. Not good. When I wasn't able to move my foot in a dorsiflexion manner while standing up without massive pain an hour later, it was time to go to the urgent care (before it closed).

Fifty dollars (our copay) and an hour and a half later and I have a prescription for Tylenol #3 and an order to see my orthopedist. The urgent care doc was pretty sure I did something to the Achilles Tendon, but couldn't determine the extent of the injury. But at this point we're discussing a healing time (and crutches) between a few months and half a year with possible surgery. Since I don't have weakness, we're hoping it's not going to be surgery.

I hate being laid up. And using crutches in the house sucks. Not to mention, it's my right leg, which means driving is going to be a problem. And did I forget to mention that since it's not been cold enough, the predominate weather condition on the ground equals slush. And all my classes are on the upper floors (but fortunately there are elevators).

Healthy, Wealthy and Wide

Or something like that. It's been a while since I've done a health update. In general, I'm doing okay.

On the weight side of things, there hasn't been much progress. Okay, there was, but my week at an Indian Casino and sitting in a seat most of the day lead to a major rollback. I had been down to 301 in the middle of November (last weigh in with doctor), but as of monday I was at 315. Not good. And unfortunately my regular exercise (15 minute fast walk at noon, and walking up 3 stories every Monday and Wednesday for class) is no longer happening. On top of that I'm taking Claritin as a prophylactic to keep my nose clear. Allergy medicines are becoming known for helping put on the weight. Since the was smoking at the casino, I was taking a pill several times a day. I need to get back to using the Wii. It's been over a year since I've been able to use it regularly. the good news is weight goes up, but weight goes down too. That's good news, because as long as the weight is moving it means I can still lose weight (without severe dieting). The other good news is that when I can control the snacking at work (we have free snacks, it's a poisonous thing) and drink my own tea, I lose weight.

The big D has been at bay this year. There's been a few little d episodes, but those are normal. Given the levels of stress this past year, I think that's somewhat of a miracle. There have been two weeks when I haven't had Welbutrin (scheduling issues with getting refills and having most evenings scheduled). And each time I haven't felt the edges of the big D. I would have stretched the experiments longer, but both times were high-stress moments (see not being able to stop at the drug store on the way home because of being busy). Maybe in the New Year we'll try to go off for a long time and see if the big D comes stalking at my door.

It's now been about two months with the CPAP machine. I'm definitely sleeping better. In fact, there has been dreaming (of the normal type). But now I have some experience with the machines, so here is what I've learned. The different companies that produce machines and masks have very different products. Between the sleep tests, my wife's CPAP, and finagling samples, I have been able to try out a lot of equipment. IMHO, Philips Respironics is leading the pack (and I would avoid Fisher & Paykel - just my advice). I have their CPAP machine (with warm mist - technically a BiPAP - which means the machine adjust pressure as I breath out), and have pretty much stayed with their masks. I didn't think with my allergies and nose problems I'd be able to use just a nose mask, but I really love my ComfortGel Nasal Mask (large). I don't have much of a "red line" problem, or nasal soreness with it. There have been a few nights where I've had to switch to a full mask (I have a couple of those). Even with the warm mist, I get dry mouth very quickly. And if I have to breathe through my mouth with the mask, I feel like those guys doing the G testing in centrifuges (with the lips and checks flapping). the full face mask I like to use is a ResMed. Between the two masks I have more leak problems with the ResMed. I have more issues with the Fisher & Paykel.

There are several things to keep in mind with the masks. They should fit comfortably. I typically wear them higher than I think they're supposed to be worn, but then I also don't have a sore nose bridge either.

Another thing to think about with masks is how they come apart for cleaning. This may not seem like a big thing, but trust me on this one. And, again, the Respironics has the engineering advantage. The ComfortGel mask easily separates into components that are easy to wash and easy to put back together. The ResMed is a little less easy. The F&P is the worse. Also, cleaning the machine shows the same breakdown (in fact, the F&P machine that my wife has is a pain in the arse to clean). While the manuals say to clean everyday, I do it about once a week and we're doing fine (if I go longer, I'll add a little vinegar to the dishsoap mix).

Another thing to keep in mind is how to adjust the mask. You might be tempted to make the mask as tight as you can stand to keep the seal. I would advise you to adjust your mask to be as loose as possible, but still not leak.

So there it is. Lots of ups and downs, but pretty well averaged over the year.

More fun with biochemistry

Tobias brings up a good point in the comments of today's linkee-poo about drinking "throw-back" pops (which use cane sugar) versus their high fructose cousins. To explain why he's seeing the effect he is, I basically explain the other part of how your body responds differently to fructose. So I thought I'd bring my comment up to the top level.

Hey Tobias, that (feeling sated faster with sugar based pops than with corn syrup based pops) is because of how you digest the different sugars (liver process), and how your hypothalamus monitors the bloodstream and the resulting reactions. First up, you have to know that the preferred form of sugar for your body is glucose. It's what insulin is geared to help facilitate. So when your liver has a choice of either processing glucose (or glycogen, which is the polysaccharid of glucose) and fructose or galactose, it will process the glucose first (it has to process the other two, which requires more energy, so it "decides"1 to hold off on the other two to prefer the form of sugar your body can use right away). You liver will actually store fructose in glycogen before processing it through to your blood stream (leading to fatty liver).

So, when you drink that "throw-back" pop, more glucose gets into your blood faster. (Just a note here, processed sugar contains both glucose and fructose with a little galactose). Whereas when you drink the high fructose corn syrup you liver first processes the fructose to glycogen, stores it as fat, and then cuts up the glycogen to release the new formed glucose.

Now, why that makes you feel sated faster has to do with your hypothalamus which rides shotgun over (many functions including) your levels of suspended glucose in your blood. More glucose sets off a cascade of events including increased insulin release (as well as other hormones and proteins). Part of that cascade includes "telling" you (through chemical markers) that "too much glucose = you're full." Again, satiation is a whole cascade of events.

Your hypothalamus doesn't check for fructose. So even the bits that spill over the first past of the liver won't trigger your brain to say, "Whoa, I'm full." It's only after your liver 1) runs out of glucose to process that it will 2) look to your glycogen stores to make and send out glucose.

That explains the delay to feel sated. It also explains why if you drink fast enough, after you feel sated and stop ingesting pop, you will then feel as if you over ate (because your glucose levels are spiking before your insulin can crash your blood glucose levels, which is the "sugar crash")

1 If this is through competitive inhibition or other functions like blocking RNA transcription, I don't know.

Once while swimming cross turtle creek, man them snappers right at my feet

So I'm driving home when this story comes on the radio. That's a story about how those enforcers of vaccines are now peddling the HPV vaccines for boys. And I thought, well now we have a whole new category of people who will refuse to be vaccinated for something. I mean, it's only to help prevent spread of the virus among girls, right (actually, yeah, that is how it is transfered, because boys are dirty - take a shower, slacker, and use soap this time).

And then they hit this fact, HPV can cause penile cancer. Okay, well, it was in the actual radio segment, but it's not on the web page (whatsamatter NPR, have you decided to stop corrupting our youth?). On the webpage they only talk about "genital warts and… cancers of the head and neck, as well as the anus." But I was thinking, "Wow, prevents cancers of the penis, so it won't shrivel up and fall off? They'll be stacked up 3 deep to get the shots."

And then I thought, "ZOMFG! My favorite toy can get cancer? Shoot me now."

Okay, well, yeah I already knew that (although testicular and prostate cancer is more of a problem). And penile cancer turns out to be squamous cell carcinoma, or skin cancer. Just where have you been letting that hang that you're getting too much sunshine there?

But cancers of the head, neck and anus? Umm… Doing it wrong?

(Disclaimer. Yes I know about bi and homosexual men. Yes, cancer is serious. Yes I'm in the high risk group for testicular and prostate cancers due to my Mom having breast cancer and my maternal uncle having prostate cancer. Guess who has two thumbs and probably the genetic disposition for those. Thank you very much. Yes, both men and women should check themselves - or have a partner do it - for breast and testicular/vaginal cancers, boys should get the glove snap and PSA test and girls should get pap smears. Do it for yourself, do it because it's fun - okay, well, maybe not the glove snap or pap smear, YMMV - and do it because it's important.)

It's Not a Halloween Mask

On friday I got my CPAP machine. It's a very nice. I decided to try a nasal mask (that the mask that just fits over the nose). During my trial test, I used full masks, but found I was just breathing through my nose. So I figured just a nasal mask would do well.

Friday night it worked great. If I opened my mouth the resulting wind tunnel effect would wake me up (I only did it twice). Getting used to the pressure is difficult. With the health care provider we set the ramp up pressure to 4. Last night I felt that was a little low so I cranked it up to 5.5, and that felt a little better.

Last night, however, my fear of going right to a nose mask became real. About 7am my nose was too blocked up to keep going, and I was too tired to switch out masks (I still have one from the sleep study). So tonight I think I'll go to the full mask and see how that works.

But I have to say, yesterday I did feel much better. I still wake up to roll over, something that started when I broke my leg. Not fun. Hopefully I'll be able to correct for that soon. I also hope I won't be so tired during the week anymore.

Healthcare Scheduling

Okay, remember all the brouhaha during the debate about "socialized medicine" and "the long waits you have" and how our US system is "the greatest in the world."

You may also remember that I've been having sleep studies. After complaining about bad sleep for 3 years I finally got a referral to a local sleep center. The appointment when I got the referral was June 24th. The first sleep study was on July 24th. I made a follow up with my primary care doctor on August 19th (3 weeks, it should only take 2 weeks to get the report). He didn't have the report ready then.

It wasn't until Sept. 9th that I had the results. Diagnosis, "Moderate Sleep Apnea" in case you're wondering. So I needed a follow up sleep study to determine if I could use CPAP. That only took two weeks. So I had my follow up on Sept 22nd.

I just got a call (today) that I need to meet with one of the "sleep doctors". Want to know when the appointment is?

November 16th. That's when I'll also probably get my machine (or at least I'm hoping). If not, that'll be another appointment.

For those of you playing the at home game, that's nearly 5 months after the initial referral with two of those appointments a month or more apart.

Tell me again how we don't have delays in our system. Oh, and for the Nov 16 appointment, I'll have to use half a day of PTO to go to the appointment.

Healthcare snippets

Well, I guess the amount of money I spent on the sleep study was worth it. I was diagnosed with "moderate sleep apnea." You can take that to mean that I'm following the precept of "everything in moderation." Or that I'm just a slacker when it comes to health. Or I'm waiting for the movie instead of reading the book. Your choice. I have to go back for another sleep study (to determine CPAP capability). Thankfully the one maxed out our deductible. I think that's a good thing.

Tonight I caught up with one friend who is having health problems. He's on medicare and needs a heart valve replacement. However, his tests come up with his situation of needing a new valve, but it's not in the severe category (even through he was in the hospital the other day because his blog tests indicated there were clots forming, but they weren't able to locate any clots). Some may say, "This is the government rationing care," but it's actually a result of "cutting waste." About ten years ago, he would have qualified. But because he isn't deemed "sick enough" (read, "hey, you may survive with this condition for the rest of your life"), he doesn't qualify for the procedure. Because he might be faking it. Say, did you notice that there's all this talk about continuing to cut/restructure Medicare?

The other one was a friend who told me tonight he has prostate cancer. He doesn't know yet how far progressed. The good news is more men are surviving prostate cancer (just as more women are surviving breast cancer). Fuck cancer.

So, how are you all doing?

One day you find ten years have got behind you. No one told you when to run. You missed the starting gun.

The other day, as a fellow student was giving their "My Life" presentation in class, I found out that someone I had pegged as five years older than myself was actually five years younger. There was a moment of, "Holy crap, do I look older than him?"

I think those of us who have lived long enough remember when we recognized transitions. For me, the death knell for being a young whelp came when the nephews and I were hiking at Nelson's Ledges. For those of you who don't know, the ledges are a large limestone formation that has been worn away by running water forming deep channels in the rocks. You can hike on top or down below. We were on top, and at one of the deeper channels when I suddenly had an urge to run and leap across to the other side. I was only 5 yards or so. And then a part of my brain that had been heretofore quiescent spoke up and said, "Are you fucking insane. That's a 40' dead drop. If you miss, more than likely you're not making it out of here."

Yep. Put any thoughts of being spry in the box and close the lid. I was old at that moment.

There was another time, also with the nieces and nephews, that we went to the Health Museum. There was a circular mirror you crawled into. The kids were in there and they wanted me to come in. So I crawled under the wall and stood up. That's when I said, "Who's that bald guy?"

That sound? That's another nail being banged in.

I guess we all have opinions of ourselves that differ from the person we see in the mirror. For me, while I've overtly accepted my weight, male pattern baldness (and now thinning hair), and the various oddities of my body as it ages, in my mind is a picture of me at 18. Fortunately I've remembered the difference at crucial moments (like at Nelson Ledges). So far.

There's also the fact that it takes me longer to get over some illness. Or exhaustion. Used to be able to sleep in one day and bounce right back up. Now I don't so much bounce as moan, roll over and go back to sleep. And let us not forget the ability to eat a whole pizza and not have it phase me. The creaks and pops of moving in the wrong direction and not being able to twist myself like I used to, all of them add up to my body trying to tell me, "Keep this up and I'm gonna hurt you."

When I went out for the nephew's bachelor party a few weeks ago, one of the bars had a sign saying, "We card everybody" outside. I got out my license only to be waved in my the bouncer with a, "Seriously?" look on his face.

Bang.
Bang. Bang.

When can I apply for my Golden Buckeye card? You can get some good discounts with that. So, I've realized that I'm no longer a hunk. Have you had that moment where you realized you're no longer a babe or a hunk?

Linkee-poo, special edition on cancer

"The worst case scenario here is we accidentally treated a 9-11 responder's cancer even though his cancer may not be proven to have its genesis on 9-11." While, "yes, this," also somewhat a part of the whole "Fukushima/Chernobyl disaster and cancer, not a direct link" debate. You might remember me pointing out that, "well, all those increases in cancer can't be directly tied to Chernobyl" argument. Welcome to its US cousin.

Speaking of cancer, Jay Lake speaks of his own cancer. He also points to this xkcd on the subject of survivability.

It's a hard struggle, and my heart goes out to Jay. Staring one's own mortality in the face isn't easy, even when you've done it before and are prepared. It is made especially harder with the stories we tell ourselves of the "fight until the last breath" struggle, "stay strong", or the "miracle remission," or the ever popular, "you'll be okay/things will turn out okay" and finally the guilt ridden, "you have so much to live for." Couple that with the myth of "tell Laura, I love her" death bed scenes. Death is not the nice person he's made out to be in modern movies. He is like how the ancients saw him, a thief in the night.

I've promised to write a post on "Cancer and Me", this is not it. It's complex, and cancer is the barrel of the Armalite I look down every morning. At sixteen I watched cancer devour my Grandfather. Watched it take him away from me, piece by piece. And I know, when the cancer came back the year before, he knew what it was. It wasn't his first dance with that devil. He knew why he was losing so much weight. By the time the rest of us did, and imposed our version of the story of his life on him, it was too late. His surgical team changed direction mid procedure from "eradication" to "palliative care." The person who taught me what it meant to be a man, what it meant to love someone fully - cancer ripped him from me just as I was becoming a man and trying to love someone fully.

I have gone into days of my life with a chip on my shoulder and embracing the philosophy of "today is a good day to die." I know what that phrase really means (as, unfortunately, too many kids now know). And I've put on that cloak of invincibility to swagger forth and either use my shield or come home on it. I know what a life struggle is like, know the lay of the land for that particular Hell.

Two more people I know were diagnosed with cancer this year. Last night at class, one of my class mates shared her story of "walking" her parents down with their cancers. I should have gone up and hugged her. I know that pain, and that fear. You may also remember this year I had a sarcoma removed (on my ear). Given my family history, you can bet I wigged out a little.

Fuck cancer.

One way the stories we tell ourselves screw things us concerns the whole debate of "not giving pain meeds" to terminal patients, or "heroic extremes" to keep someone alive (the opposite of "can you pull the plug?" conversations that go on behind shuttered windows). It's a pervasive myth we hold. It's part of why Terri Schiavo's ordeal was allowed to go on for so long (and also why that fight was personal to me).

When it comes to it, I will probably fight hard. That's just the way I'm put together. Other people have their own stories to live, and each one is just as valid and acceptable as the next. But, if I get like my Grandfather or Grandmother in their last months, get the damn Hospice involved. I am not your fucking made-for-TV movie.

Studying Sleep

I was hoping to live blog it, but the fee wireless internet refused to be wireless, then free, and by the time we hit the internet part I just wanted it to be over. Last night I had a sleep study. For those of you playing at home, you should know I've been trying to lose weight for about 4 years now. I seem to be stuck just north of 300 (I've been less, but quickly went back up, probably if I had the time and energy to exercise regularly again, I could break back through).

Ever since I broke my leg nine years ago now (wow, 9 years), I've never been able to sleep well unless I've been totally exhausted. See, for 3 days after I shattered my left fibula, I was just in a wrap to wait until the swelling went down. It was very painful. This was also the time I found that I can't take Vicodin (I love that drug, but it makes me paranoid with delusions, not fun). I had to be careful of my ankle (with the break, and with walking upstairs afterward, my ankle was 5" out of position), so I would wake up to reposition (having to have my ankle elevated above my heart didn't help). And then when I was in a cast and brace I had to do the same thing (also had to have the foot elevated, but also had to be careful). I've just never relearned the trick to sleeping through the night.

Since then I've become a horrible snorer (I snored before, but not like now). So add breathing problems plus every time I need to roll over I come to full consciousness. Not a recipe for a good night's sleep. Have I mentioned that I'm now fairly tired all the time. I have black bags under my eyes (and I never had them before, even when I would work 72 hours straight). Sometimes driving home late at night, I have difficulty staying awake (which I'd never have a problem before, behind the wheel = awake in my life). I've also experienced the feeling of, "Where am I, how did I get here/get this far?" while driving. That's so not me.

So I took the sleep study. They wire you up like a Christmas tree with a bunch of goop to hold and transfer electrical impulses to the wires. They put a nasal monitor (actually 2, one for pressure, one for speed) on. And then tell you to sleep.

Well, they tell you to sleep on your back, which isn't my preferred position. So I tried laying on my back. For about 45 minutes. I did doze (it's about the only time last night I remember dreaming - mostly about the sleep study), but not fully. And then I said, "Screw it", turned on my left side and bingo! I was asleep.

You know, until I had to roll over.

Which then I must have pulled too much at a wire and they had to come in a reconnect my legs (they connect pickups to your legs to see if you kick or move too much). About halfway through I tried my back again, with the same results.

In the morning you take a very hot shower after they pull the wires off. They can't get the goop out, so you need to "melt it off." While finishing up I asked the nurse how I did.

Of course she couldn't tell me. That would be practicing medicine, or something.

But I was able to find out I "did well until around midnight." And while it wasn't bad enough for them to "split the study" (ie. half sleep study, half determine optimal pressure for CPAP machine), they hinted heavily that I would probably be back for that second part.

I should know in three weeks. I guess I passed the audition.

You may ask yourself… TMI?

I have to remember to drink more water. When I was at Modern I was often joked about for bringing in four to five bottles of water a day. Lots of "Thirsty, eh" comments. Well, no. It was a way of keeping hydrated and knowing how much I should be drinking during the day.

At the current job we have bottled water available in the office fridge. Instead of the "Spring water" I normally buy, this is "purified water" (which means tap water, but we run it through some filters). Okay. I can deal with that. One because I'm not paying for it, but two because water is really H2O and that's what I'm after (this isn't a life style thing).

But without a visual reminder or the heft of hauling it in, I find myself drinking less. Which I think is leading to me eating more (the hyperphagia I talked about). Many times, when we're thirsty, our bodies interpret that impulse as being hungry. Another symptom I notice is on the other end. While the colon (your large intestine which consists of the Cecum, Ascending, Transverse, Descending, and Sigmoid colon and then the Rectum) is there to remove water and liquids from the digested food, you still need to be hydrated to pass out the stool. Which I've also had trouble with lately. TMI?

So, yeah. Need to get back into the habit of drinking more at work. It's a little hard when things are as stressful and fast paced as they are now. I've got so many balls in the air I'm having difficulty remembering them all. No wonder than I find myself at the end of the day having only consumed two bottles of water (about 1 liter). Not good.

Wait, was that a weekend?

This weekend just sort of evaporated. I remember being there for it, but much of it was taken up by "Holy Cow, it's (insert time here) already? I've gotta get (chore) done." Add in a healthy dose of studying and there's a weekend that just goes "poof."

Medical Terminology isn't like other classes I've had. Judging where I'm at is difficult. Did I really learn that term, or am I faking it with the clues? Some of it is the subject of the class, some of it is the presentation, and some of it is having spent the past several decades learning to speak plainly, I now need to reverse that course. So if you say "cardiomytosis" I can get you talking about inflammation of the heart muscle. However if you say "kidney stone" and I going to be able to come up with "renal calculus"? I don't' know. It's easier (and clearer to me) to just say "kidney stone."

So, obviously, I didn't get any posting or writing done.

On the side of "there' hope for us all," Jay Lake lake is on the other side of his chemo and feeling the musely love. Go, Jay, go. But remember the spoons.

And thinking of health, I haven't talked about that for a bit. Over the past few months I've had both a serious ear infection and a serious allergic reaction that gave me hives. I'm not sure what that's all about, but I really hope to not repeat it. My guess is that they were stress related.

I've been gaining a little weight as of late. The new day job has free snacks, free pop/coffee/tea, and with all the meetings of late, extra food in the lunch room. Definitely a toxic atmosphere for someone trying to lose the weight. I think the last time I talked about weight was when I broke below 300 for the first time. Of course then I went back up, and down. I'm glad to report that 300 is now the top of the cycle. And I'm working on keeping it that way.

At the end of last week I hit 300 again. It seems weird to me that when I was 310, 300 felt light. Now having ranged into the 280s, the same weight feels uncomfortable heavy. I think part of that is all the new weight seems to be going to my gut, which is the dangerous kind of weight. Before, as I've told other people, I was deceptively overweight because the fat was evenly distributed over my body. It bothers me that if I gain any extra weight, it doesn't redistribute that way. And, as I said, gut fat is the dangerous kind. The kind that leads to heart disease.

But hopefully I've hit the top of the curve and I'm on my way back down. It feels that way because I am voraciously hungry, which tends to be the case when I'm losing the poundage. And with each swing that hunger gets stronger.