Uncategorized

  • The Verdict is ...

    Stage 1

    We went to visit Dr. B about the tests on Delia's lymphoma. I was able to get some clarification on the CT scan results: the fact that the original tumor didn't show up means it has shrunk to under 5 mm from its original 18 mm, normal behavior for this kind of tumor. Lymph nodes in the lungs showed in the scan but appeared normal (in case of doubt, we could get a PET scan for confirmation).

    The big test, the bone marrow biopsy, was negative.

    That means the tumor is probably harmless except for the nerve pressure it causes when it expands, which it will tend to do now and then. Two treatment options are reasonable. The cheapest is to do nothing except watch and make sure it remains harmless, which involves check-ups three times a year. The other option is to zap it 20 times with radiation from the linear accellerator, which should cause it to vanish forever. Our insurance should cover almost all of the $28,000 ($1,400 per session).

    Delia, of course, cried with relief when she heard the news. She cried again each time she passed the good news to family members and friends. It has been an emotional evening.

    And I have absolutely no idea how the election has been going.

  • Lung Fungus Infection

    It's my turn to be sick now.

    Delia complained that I make strange whistling noises while I sleep. I, of course, was unaware of them. Delia said they were similar to the wheeze that developed when I coughed a lot. She said I was getting either asthma or pneumonia.

    I had an appointment with Dr. G today, so Delia insisted I mention the strange noises that haunted her while I was sleeping. The good doctor checked. I was running a fever and my lowest right side lung was making noises.

    I have an infected lung.

    It isn't asthma. It isn't yet pneumonia. Dr. G gave me a super-strong antibiotic to take for three days and prescribed an Albuterol inhaler for my lung noises. Delia is supposed to wake me if my lungs whistle so I can dose myself. If it doesn't clear up in a week, I go in for xrays.

    Then I asked if I could get a flu shot. He smiled. It seems that the combination of this antibiotic and a flu shot would be a killer. It would wipe me out. It would leave me sick as a dog. I'm not allowed to have a flu shot for at least a week after I finish the antibiotic.

    That's assuming I don't develop pneumonia.

    I didn't feel bad this morning. I didn't think there was anything wrong with me. Now that I've taken the first antibiotic tablet, I don't feel very well.

  • Preliminary Results

    There was a message from Delia's oncologist on the answering maching when we got home Friday: the results from the bone marrow biopsy aren't back yet but those from the CT scan are and no new tumors were found. That doesn't mean small tumors might not exist but there were no tumors large enough to appear on the scan, which is a good sign.

    With good blood chemistry and a good (negative) bone marrow biopsy, Delia's lymphoma can be classified as stage 1 and possible treatment, if any, can be decided on the basis of probable benefits compared to cost and side effects. Delia's tumor may have pressed on some nerves to cause the variety of symptoms she has had over the years, which could rule out simple surgery as the best treatment.

    We'll discuss her options with her doctor on Tuesday, after which she'll seek opinions from other experts she knows.

  • Pain

    The rain comes down, falling softly and steadily. It doesn't deviate from the vertical in its path, there being absolutely no breeze. sometimes it diminishes to a faint mist, but mostly it remains a pure, gentle, straight fall.

    It continues for hours. By the end of the day, half an inch will fall.

    I used to love the rain.

    I still do, but it was more of a wonder when I was younger and could take the time to enjoy it. I like the sounds the rain makes, especially a heavy rain on a metal roof.

    As a kid growing up in Southern California, I didn't hear that sound very often. Our house had thick adobe walls and a heavy tile roof. My only opportunity to hear rain on a metal roof was in the car. The car remained in the garage when we were at home, so I only heard rain on metal when we went somewhere. There were lots of other sounds then, too.

    Later, when we moved to Washington state and lived in several places around the Puget Sound, I got to hear plenty of rain.

    Recently, however, rain has also brought me pain.

    I have arthritis.


    At first I didn't know the pain was arthritis.

    I've always had problems with my knees, ever since I was a kid. In college I learned I could protect my knees by climbing stairs. Building up the big muscle on the front of the upper leg protects the knee. Going up stairs is good, going down stairs is bad because the paradoxical motion -- maximum muscle stress before movement begins -- puts extra stress on the knees. We thought the pain in my lower back was a kidney, and that is what the doctor kept checking for years. I ignored the pain in my hip.


    Opening oysters requires a special knife. The blade is short, heavy and triangular in shape. Oyster shuckers wear heavy gloves because the oyster shells are hard, sharp-edged and difficult to open. Handling the shells is too hard on bare hands. A slip of the knife could cause severe damage.

    Shelling oysters requires considerable skill, skill developed from practice.

    Why are they practicing on my spine? Why do I feel multiple knives stuck in my back, prying my vertebrae apare, popping my ribs away? Why can't they practice on oysters?

    Get those shuckers some oysters!

    Get them off of my back.


    At the time I had my first really bad episode of arthritic back pain, the husband of my wife's friend was experiencing similar pain. His pain was concentrated in his neck. It was worse than mine, bad enough that he couldn't walk unassisted during the initial attack. He didn't have arthritis; the Crab was walking in his bones. Cancer took him in just a couple of months.

    Several years ago, Delia started having pain in her teeth, jaw and neck. The doctors said it was TMJ inflamation -- Temporal-Mandibular Joint, the hinge of the jaw, with a form of arthritis -- and she should have a dentist adjust her bite. Then, for years, she complained of pain in her neck and left shoulder. The doctors blamed this on an old neck injury pinching the nerve and sent her off to therapy. For the past year, she has had pain and weakness in her left arm. The doctors blame it on stress.

    When she thought she felt a lump in her neck, she went to a different doctor, a throat specialist. He said there was nothing there. She insisted on having an ultrasound scan done. There was something there.

    They decided to do a biopsy. They took three small samples. While they were cutting, they reproduced all of the previous pains in the teeth, jaw, neck, shoulder and arm that Delia has been complaining about for a decade.


    Witness the proud mother duck with her brood, all trailing after her as she goes. What a fortunate creature.

    My own little ducks have become scattered. They no longer follow me. I don't know where they've gotten off to and I keep getting lost when I try to find them.


    I've been exercising to reduce the pain. It hurts to exercise, but strengthening my back supposedly will give it some immunity to the pain, the way building up my legs helps my knees. Or, at least, used to help my knees before my right knee developed arthritis. Right now, though, I hurt more, not less.

    I've also been attending physical therapy sessions. They were joking when they said that 'PT' also stood for 'Pain and Torment' or 'Punishment and Torture'. I'm no longer so sure it was a joke. They have managed to duplicate and intensify all of the individual pains I was suffering in the process of isolating their sources and causes.


    The rain comes in gusts now, blown at an angle by strong winds. It's heavier than it was the other day and it doesn't slack off. Over an inch will fall this time. Still, it's just rain. Rain brings pain to my arthritis.

    The pain is stronger, too. Not much, but it keeps sleep away. I could take a pill but I'm not ready to live in a fog. I'll tough it out a while longer, until the rain passes, and give the exercise and therapy a chance to work.

    But I have a new pain now: the Crab walks in my companion's bones.


    The doctor says it's a low grade lymphoma, a lazy cancer. Most people who get it die of something else. It tends to be harmless.

    We have to determine how severe the infestation is. If is is just one lymph node -- a single tumor 3/4 of an inch across -- then it is Stage 1 and may not even require treatment. The doctor says he himself is at Stage 1 with a tumor over an inch across.

    Stages 2 and 3 involve multiple tumors, Stage 3 having tumors both above and below the diaphragm. While more serious than Stage 1, they might require nothing more than continued observation. The tumors have a tendency to come and go without doing any harm.

    Stage 4, however, involves other kinds of tissue, usually bone marrow. It should be treated promptly, usually with immunotherapy or chemotherapy.

    Stage 4 is detected with a blood test and a bone marrow exam. Delia had her blood drawn this evening and is scheduled for the bone marrow test. The remaining stages are tested with a cat scan, which Delia will schedule soon.

    She should know exactly where she stands in 12 days.

    Waiting hurts. Whatever the outcome, Delia is living with the Crab. Knowing that and having to accept it also hurts.

  • Now I Are One

    I am officially handicapped. I got my placard in the mail.

    I get to park in handicapped spaces. I get to park in metered spaces without paying. I can demand full service at self-service prices when buying gasoline for my car.

    I doubt if I look handicapped ... except when I try to stand up after I've been sitting for a while.

  • Walking the Mall

    I've taken 5,639 steps so far today. I took about 4,500 of them at the Mission Valley Shopping Center, as part of a Mall Walkers group.

    It was my second session. My first session, on Tuesday, I followed the instructions and went through the warm-up exercises. That was a big mistake. The stretching and twisting of my back started me off in pain, the arthritis pain in my back that I'm trying to escape. The fast walk eased the pain a bit, though.

    2,000 steps is about a mile. The path we followed was designed to be as close to a mile as possible. The path was designed before they started adding a new food court to the mall, forcing a long detour. When the food court is completed, in another ten days, the walking distance should become almost exactly one mile per circuit again. We take two circuits in the early morning hours before the stores open for business.

    One restaurant was open, Ruby's. They start serving breakfast at 7:00. But our group of just over thirty seniors doesn't eat before setting out. We get a cup of senior's coffee for $0.53 at Target when the walk is over. A few of us do, anyway. We sit, sip, chat and rehydrate for about half an hour after the walk, until the other stores begin to open.

    Driving to the mall for my Oasis classes usually takes me twenty minutes or less. Driving in for the walking sessions has taken 45 minutes or more each morning. Early morning traffic on Highway 94 moves at about 20 miles per hour -- when it moves at all -- and the traffic on the Interstate 805 gets up to 35. The transitions onto and off of the freeways poke along very slowly.

    After my first session, I just came home and changed clothes. No snack. Of course my blood sugar went very low. When I figured it was time for lunch, I barely made it upstairs. Today I had a light snack when I got home. I still had low sugar problems at lunch time, but not as severe as the previous time. I made a giant all-vegetable salad for lunch and took over an hour to eat it.

    Today's session tired me a bit more than the first one did. That means I probably depleted my glycogen reserves, which is a good thing. If I can keep burning away the reserves, my body may start burning fat again, the way it used to. I'll have to continue to avoid carbohydrates for that to happen, though.

    If I participate in 27 walking sessions this fall season, they'll credit me with the cost of my pedometer. Counting my steps will become free. Attending all of the sessions has other benefits, too. Besides, if I had wanted a free pedometer, Cathy would have given me one. She has several. She gets them free from somewhere.

  • Spaghetti Squash Meal

    Cathy has made spaghetti squash several times this summer. We've all enjoyed it each time, but she made it like spaghetti each time, with a tomato based sauce. She wanted to make it again, but I asked her not to use a tomato sauce.

    She called me at mid-afternoon, asking me to take several ingredients out of the freezer, a pint of frozen whipping cream and a two-pound package of raw shrimp. She also asked me to peel and chop two heads (not cloves) of garlic. With these ingredients in hand, she retired to the kitchen to cook up the squash. Yes, all of the garlic went into the sauce, along with a full stick of butter. There was also some cayenne pepper in there and, toward the end, pine nuts and a cup of white wine.

    The only thing that accompanied the squash with shrimp mixture was the white wine. We didn't need anything else. The dish was delicious. The full flavor of the shrimp came through and its texture was great. Delia said she could smell the garlic as she drove up, but we couldn't really taste it in eating the dish. We may stink, but our past experience is that nobody will notice. As long as it isn't overcooked, garlic doesn't cause problems (except to mosquitoes).

  • Medical Jargon

    MRI Contradicts X-Ray

    Maybe my back isn't broken.

    The X-ray said it was but now the MRI may say it isn't.

    The element of doubt is due to my lack of understanding of the medical terms used, which I intend to look up in the near future. The following is quoted from the MRI report:


    Findings:

    Multiple level loss of nuclear volume with dessication throughout the entire thoracic spine most prominent in the mid and lower dorsal regions. Moderate type I signal at T10-11. Mild dorsal osteophytic ridging and lower thoracic spine with impingement on the ventral surface of the thecal sac unaccompanied by central canal stenosis or compression of grossly normal appearing thoracic cord. Vertebral bodies otherwise maintain normal stature and alignment. No other remarkable findings.

    Impression:

    Moderate chronic diffuse discopathic thoracic spondylosis without acute disc herniation, fracture, or bony destructive change or cord abnormality. No gross stenosis detected.


    In other words, my mid-spine has gotten stiff and dry with some signs of damage, and has developed a small hump, but the bony spine segments are unbroken, the discs are intact, the cord hasn't been harmed and nothing else that could be dangerous seems to be happening. It is probably fragile from the dryness and deformation.

    If anybody can improve on my offhand translation, I would appreciate their feedback.

    Even if it isn't broken, it sure hurts like hell tonight.

  • Chuck

    Delia made an interesting discovery yesterday: Near closing time, one of the local supermarkets puts half-price stickers on their meats. Delia discovered this because of the stampede that resulted. By the time she elbowed her way to the meats, the selection was greatly diminished. She did, however, pick up two good boneless chuck pot roasts, two packages of boneless pork chops and a fairly nice piece of round steak, all of them cut thick.

    We will let Cathy do the round steak. She has been experimenting with that cut and has become proficient. Delia will probably do the pork because she is afraid I'll undercook it. I inherited the chuck.

    After washing the meat, I mixed together flour, cayenne pepper, black pepper and garlic powder with which to coat it. After coating it thoroughly, I quickly fried it on both sides, then added just enough water to come up to the top of the meat (it didn't take much, as the meat pretty much covered the bottom of the pot), tossed in some quartered potatoes and onions, and set the temperature to low. Later, I added some celery -- which was a mistake. The celery tasted flat and produced large amounts of liquid.

    Both Delia and Cathy called to say they would be late, Delia because sales were good and Cathy because her friend Wendy had suffered a heart attack the previous evening and Cathy wanted to stop by for a quick visit on the way home. I shut off the stove and just let the meat sit until they arrived. Pot roast is very forgiving, though, and everything but the celery tasted good.

  • Sand Soup

    Delia asked me to make soup today. Then she got out the big soup pot and started filling it with water. I turned the water off. Delia put the still-frozen meat in the pot and returned it to filling with water. I shut the water off again.

    Delia got mad. She yelled at me for shutting the water off. I told her she could see I didn't want the pot filled yet because I had already shut the water off once. She yelled at me some more, then left the house to go to work.

    The meat we were using for the soup was beef shank, the big leg bones with hefty muscles. They had been cut with a band saw. The butcher doesn't clean off the fragments of bone after cutting the meat. Delia hadn't either.

    After I removed the meat from the pot, I looked inside. There was a surprising amount of grit visible on the bottom of the pot, as if somebody had tossed in a quarter teaspoon of beach sand from a coral beach (sand from a rocky beach or a volcanic beach would have been silicon-based instead of calcium-based, a totally different chemistry). I had to dump the water and rinse the pot. Then I carefully washed the meat, as should have been done initially.

    Delia has seen me washing meat before using it on many occasions. I have explained about the gritty pieces of bone left from the butcher sawing it. It isn't a new concept. When I explain it, she accepts the idea of my washing the meat. She just doesn't retain the concept for very long. She would never think to wash the grit off of any meat before using it. Nor will she notice the lack of grittiness in the soup. It won't occur to her.

    After washing the meat, I fried it on both sides in olive oil, then placed it in the bottom of the cooking pot. I then fried three onions in the pan I had used for the meat, adding my spices to the onions, finishing by adding enough barley to absorb all of the oil. When the barley was well roasted, I placed that mixture on top of the meat and (Delia would say finally!!!) filled the pot with water and some vinegar. Not only do oil and vinegar together marinate the meat, making it softer, the vinegar extracts calcium from the bones, making the soup tastier and healthier. Then I prepared and added diced potatoes, carrots and celery along with about two tablespoons of pinto beans. Once I got it to boil, I let it simmer for about three hours.

    The resulting soup was nearly white and almost thick enough to stand a spoon up in.

Recent Comments

Categories