Physical

Yesterday I had my annual physical, about six months late. Yeah, I know that it's not a good idea, but I see this doctor every three months anyway so it seems so pointless. Especially when every other doctor I see orders the same tests. So anyway, I had a few problems that I wanted him to address; it seemed like a good time to look into them.

The least scary of the problems is  that I have been losing my hair in groves. I'm able to see my scalp and I'm getting tired of constantly having to clean up my hair. He seems to think that it is a combination of things. Stress is a major cause of hair loss. He also pointed out that it has been 7 years since I lost all my hair to chemotherapy and hair has a 7 year shelf life.  My hair is all dying out at the same time rather than staggered as it should be.  He suggested that I use Rogaine to combat this. I'm giving it a try, but I'm telling you that my first impression is that I don't know about this.

The second problem is a lot more ominous. Since the early part of the winter, I have had a burning ache in my leg just above my right ankle. At first I thought that it may just be the effect of cold weather on old injuries. But with the temperature rarely getting below 90, I can't use that rationality any longer. Then I was hoping it would be just simple tendinitis. Actually I didn't really want it to be tendinitis because that would mean a course of steroids, and I don't like steroids. They make me fat and crazy. But that would keep the rabbit from becoming real. Unfortunately, the x-ray showed a thickening of the bone and that isn't so easy. Breast cancer mets to the bone are almost always lytic, or thinning of the bone. But rarely they can be blastic, which is a thickening. Also mets are rarely found below the knee, and this is right above my ankle, and there are calcifications in my ligament that aren't usually seen in breast cancer mets. So, it isn't really behaving like breast cancer, but still I have to get it checked out. I have an appointment with Dr. S in the middle of July, so I will talk to him about it then.

Dr. R. gave me prescriptions for Rogaine and for a topical NASAID and gave me some samples to get started. They are temperature sensitive so I am keeping them in my handbag. My  bag is beginning to look like a haphazard pharmacy.

Believe it or not this happens almost daily

Did you think about this before you sent it?

Really? You sent it to UPS Corporate Headquarters. Are you trying to solicit our business? Maybe you should start over and try again. We'd like to show you what we can do for you. You will love our logistics.

Food has been a challenge lately

I finally got the house to myself yesterday. I didn't want to cook for just myself, so I ate out. Sweet Tomatoes (Souplantation) has been advertising a Sunday breakfast buffet for quite a while. Their advertising show a beautiful buffet overflowing with yummy breakfast foods. That wasn't exactly what I found when after I paid the $11. The salad buffet was stocked, but who wants salad for breakfast? The only breakfast meat they offered was egg substitute. They had a few quiches and their regular assortment of muffins, but no real protein anywhere. It was very disappointing. After church, a friend and I went to a local restaurant that she likes. I ordered the fajita salad, and again I was disappointed. It just wasn't that great. I ended up just eating a protein bar for dinner. Then today, there was a substitute grill chef in the cafe'. I asked for two scrambled eggs with cheese. Instead of using a whole ladle of egg for each he only used half for each. Thankfully the cashier only charged me for one egg. Apparently I wasn't the only person who complained. Everything at lunch was a carb except for something they call Monterrey Chicken. It was a small chicken breast with guacamole and cheese on top. I got that but it was so dry I couldn't finish it. So here I am at break eating another protein bar and considering the fact that I need to start bringing my lunch again. I know I should stop complaining and be grateful that there is food.  But instead I decided to blog my pity party.

They don't sell this stuff in Woodstock

Fiesta Farmer's Market
Buford Highway, Chamblee GA

Sorry for the extra large picture, but I wanted to be sure you could read the signs. Yesterday, my day went like this, I woke up to find my brother and sister still at home. They told me they would be in North Carolina and I was being selfish and was looking forward to having the house to myself for a few hours.

I went to breakfast at Cracker Barrel and that made me miss Lizzie that much more. As I was sitting there feeling utterly sorry for myself a couple walked in with their two young children and sat at the table directly behind me. I was back to back with what appeared to be a three year old. Only this one did  not act like a three year old. He kept emitting shrill screams at every slight offence. I almost wanted to offer them my biscuits to fill his mouth with while he was waiting for their food. While I was talking with the waitress he screamed especially loud and threw a table knife that hit me in my shoulder. That was the one and only time I heard the parents address his behavior. His father angrily told him to quit and his mother apologized to me, explaining that he was tired. I already knew that. You could hear the tired in his screams. It took every ounce of tact that I had to not spit back "Then why are you not at home making him take a nap?" but I didn't. I paid for my food and went to Starbucks hoping to find a more mature clientele.

At Starbucks I read a email from Lizzie that said she needed a resume' but didn't feel she
had enough experience to put in one.  I emailed her and told her that just because she
didn't have a lot of work experience didn't mean that it would look bad on a resume'. To the contrary, having held a job with only one company while in high school and the first year of college speaks volumes about her dependability. So, I wrote a resume' that included her work experience and highlighted her academic success and AFJROTC experience. I was having trouble with chemo-brain and was unable to pull the words up for some of the things she did, but typed in a description in parenthesis and she can change it with the proper words. Many blog posts remain drafts because chemo-brain gets in my way. It's very frustrating. After emailing the resume' to Lizzie, I jumped on Facebook and found this picture on a friend's page. After looking at it for a while I decided to take a trip south to visit the farmer's market. I mistook Buford Highway Farmer's Market for a farmer's market that opened up in the neighborhood that I grew up in. The one that I actually went to is called Fiesta Farmer's Market.

When I was growing up Fiesta Plaza was called Buford Clairmont Mall. It was located a little less than a mile from my house and had white bread stores like New York Card Shop, Woolworths and Winn Dixie. It also has a movie theater, which was a big draw for me as a teenager. Needless to say, I spent quite a bit of time trolling the mall. Now it is called the Fiesta Plaza and has many ethnic shops that carry full lines of items for the Spanish, Chinese and Ethiopian customers that frequent there. The old neighborhood has changed quite a bit. But it was well worth the trip. There were many things in the market that I had no idea what they were of if they were a carb or not. But clearly a full half of the store was fresh fruits and vegetables that were very modestly priced. Another third of the store was fresh and frozen meat that was equally modestly priced. I was able to get a large pack of chicken tenderloins, 2 roasts, four ribeye steaks and a package of chicken drumsticks that were so large I was wondering if they were chicken or turkey legs, as well as enough fresh vegetables to last the week for $44 and some change. I plan to go back soon and taking a few friends with me. But I will tell you here and now, I saw some things that I wasn't aware they sold in a store in the USA.

Unforgivable

I have spent the last 11 years of my life bitter and angry at Joann, and at Tim for loving her. Then tonight a friend wrote on Facebook,

 "Therefore thou art inexcusable, O man, whosoever thou art that judgest: for wherein thou judgest another, thou condemnest thyself; for thou that judgest doest the same things." (Rom 2:1) It is often true, that what we don't like in others; we don't like in ourselves. Leave it to God to judge; for we will all be judged one day. Good Night and God Bless...Pray!"

Ok, this was a friend that I went to elementary school and Pioneer Girls with. She bullied and tortured me. She was never nice. I wrote back,

Isn't it wonderful to know that we are totally and wholly accepted and loved in Christ. God could not love us more for anything we do. And nothing that we can do, that can happen to us or that others can do or say about us will ever make Him love us less. We are loved now just as we are.


and then I realized that even while she was daily humiliating me, God loved her totally and wholly no matter what she was doing to me. But at the same time He loved me totally and wholly. And when that was hard to wrap my mind around, I realized that all along that He loved us both. He took the last 36 years and a whole world of spiritual growth and technology advancement to show me that we have the same heart.

Then I thought about Joann (the person that broke up my marriage) and that the same truth applies to her. I'm having more trouble with this one. I can't imagine Joann and I ever being Facebook friends, or encouraging each other with scripture. I have been angry that God loves her at all. But I can't change the fact that He does.

I have a lot to wrap my mind around.

Missing Birthdays

It was my daughter's birthday today and I'm kind of sad and missing her. This isn't the first one that she ever spent away from me; you'd be surprised at how many camps have their weeks in the middle of June, but...well, I don't know. This one feels different. She isn't with anyone who I actually know well and I'm not getting happy pictures of her blowing out candles. It's hard. I think that the first birthday that she ever spent away was when she was 12. I was in chemo at the time and I was glad for the distraction for her. I was glad that my church family who were the ones running the camp knew how hard it was for her and that it was her birthday. So they threw her a big party with cake and balloons and presents, because that's just the way this part of the body of Christ rolls. If she'd been with me she would have been watching me sick from chemo that day, not being able to lift my head up from the pillow for anything more than trips to the bathroom.

I talked to her. She said that she'd applied for jobs all day and hung out on the boardwalk. I asked her if she'd done anything special, and she said no. She didn't think anyone other than Thomas knew it was her birthday. That he isn't romantic enough to bake her a box mix cake or, I don't know, take her to Arby's, kind of worries me. Her father was like that and it hurt my feelings on too many occasions. Still, she seemed like she liked where she is at. She told me that she'd applied to a very close-by restaurant that she was interested in. I hope they were enchanted by her southern belle appeal and will hire her right away.

It just feels wrong not having her with me.  Hell! It feels wrong not having any of my kids near by.

19 years ago

Nineteen years ago I was in labor and watching the tonight show. Dana Carvey was on it and a nurse kept coming into tell me to quit laughing so hard.  Who was she? I remember Dana Carvey, but she only has a few hours in my memory. My daughter was born at 7:22 the next morning and has a wonderful sense of humor and timing.  Happy birthday Lizzie...Many, many more.

Depression and disrespect But

I have been struggling with depression today and that is hard enough. But how I dealt with it today wasn't in a positive day. I spent the day reading a lot of blogs, and unfortunately that isn't a good idea. I read a lot of blogs of medical bloggers and have come to the opinion that many of the doctors who blog feel that they are superior to their patients and so it is OK to judge them. Sometimes the judgmental attitude is blatant and in your face, as in this blog. He is actually very funny and to tell the truth, the most hits I've ever gotten on this blog was when he used one of my posts when the hosted Grand Rounds. But it makes me wonder first, why he just doesn't find another profession and second, what are the attitudes that my own physicians are having about contact with me. Sometimes the attitudes are more subtle. These are the ones that I worry about, like in this post. This is a guy that practices in the same city that I get treated in and after reading that post I wanted to just shake him. I know that he was just ranting and the post doesn't seem to address a  single point, but many. I understand that. There are situations that bother you on many levels and for many reasons. I can understand that, I have been there often. If you didn't follow the link this post makes no sense, so it isn't worth reading. He is talking about a tear in his shoulder muscle that has been troubling him. In the beginning it seems that he is discussing his ability to self refer and his contempt for reaching your out of pocket, so you decide to use the system to receive necessary medical attention. Yes, people are more willing to use their benefits if they have already reached their out-of-pocket. That is a natural reaction and I don't know anyone from the CEO of the Fortune 500 company that I work at down who doesn't do this. We aren't scamming the system. We have met our part of the agreement and now are using our benefits. At the company that I work at, we are told that this is part of our total compensation package. In other words,  how I get paid for the work that I do. I am not scamming the company that I work for, the hospital that I'm at or the insurance company who covers me. This is and agreed upon contract.

But then he takes a different turn and one that I could almost applaud. He derides the nurses' instance that he should see the NP instead of the Surgeon that he came to see. Look, I understand that an NP is OK to write a prescription, treat strep throat or perform a pap smear. Regular routine medical care is what they should be monitoring. But when there is a known problem, I want the expert that went to medical school. I don't want the practitioner with in house training. So when the NP sees me at my diet check up or looks at my normal blood work and tells me that my kidneys are working fine, I'm fine. But I don't want to see them at my oncologists office and it offends me that they think that's OK. I see both the NP and the EP at my cardiology appointments so I don't mind so much seeing both of them, but I'd be pissed if I thought both of them weren't perusing my ekg. But his argument was as follows:

" That might go over well with a public that accepts health care at face value, but it's not OK with me."


In other words, "Regular patients don't understand the difference in medical training, but I'm an insider and I do. Because I'm a doctor, I deserve better care." OK, he deserves the services of a surgeon because he is a doctor? Are you kidding me? I think I deserve to see the surgeon because I had stage 3 breast cancer and for the rest of my life, I am at a real risk that it will come back, or that I will produce a second primary cancer. Which argument would you think holds more value? I think that I need to see the EP because I have a finicky congenital heart condition that is so rare that most doctors who aren't EP's won't recognize on an EKG. If you were facing a choice of who gets to see the EP or the NP, who would you choose? It disturbs me that he thinks that he is better and more worthy of the surgeons attention because he is a doctor. And it also disturbs me that because the surgeon only sees him because he was willing to leave the office.

Then he goes on to a dissertation on who pays what depending on whether they are insured, the insurance company, or the hospital. OK, I can agree that we are all gaming the system. There are too many people who aren't able to pay today, but then the hospital over charges the patient and the insurance company to make up for those who aren't able to pay. The insurance company then limits the amount they will compensate and the amount that the covered patient is required to pay to compensate for the over charge. The people who get burned are the ones without insurance, who by the way are the ones who use the system because they can't pay.....really? How does this work?  He's right. We are all getting screwed royally.

But my biggest gripe was that he expected to see the surgeon because he is a hospitalist and thinks that he is more deserving of seeing the doctor because he is one...really? Give me a break!

Off Day

Lizzie has left for Maryland for the summer and with Tim now living in Alabama, I feel very much alone and pointless. Today the feeling is very heavy. I guess I'm beginning to realize how much of myself was wrapped around being a mother. Now that the role is diminished, I feel as if I don't know who I am. I know that this is a temporary emotion, but I'm not enjoying having it hanging around today.

Wow, I can actually see!

I picked up my new glasses today and I'm impressed with them. I was feeling a little anxious about them during the week, because the style is different than what I usually get. But when I put them on, I knew that I made a good choice. And oh yeah, I can actually see. Seriously, I only have 8% vision in my left eye, but with my new glasses I can close my right eye and still read. I am impressed.

People you pass everyday

Recently I realized a strangeness in my family that had always been there, but I just hadn't noticed it. My grandmothers were neighbors in a very small town in Alabama, they practically lived next door to each other. In my entire life, I don't recall either of them ever saying one word to or about each other. The only time I ever saw the two sides of my family together was at my parent's funerals. My grandfathers seemed to be congenial, but they weren't the greatest of friends. They went fishing together sometimes and were in the same Masonic group, still, they didn't invite each other to family events, and my grandmothers seemed to not realize that the other existed. That's odd enough, but other that my wedding, my mother never communicated with my mother-in-law. It didn't seem odd to me at the time because my mother-in-law lived in Mexico most of the time, but neither one of them ever reached out to the other. Being a missionary my mother-in-law reached out to hundreds of people she didn't know well on a monthly basis, but never my mother.

I was thinking about this when I was on the elevator while I was going down to the cafeteria for lunch. The elevator stopped on a floor and a group of people walked in. They were talking with each other, so I didn't interrupt to say hello. As we were going down I began thinking about how I see these people everyday. I know them well enough to recognize them when I see them in public, but many of them I have never said a single word to. So I decided that instead of sitting at my usual lunch table, I would find someone whom I see everyday, and I have never spoken to. It wasn't hard to do. I was walking through and saw Pamela. She sits in building one on the fifth floor beside the doors that go out to the rooftop garden. I pass her desk all the time when I take the garden to cross between buildings one and three. All I really knew about her was her name and where she sits. I asked her if I could join her and she seemed glad to have company. We immediately started chatting about children and grandchildren. It was a nice lunch, and I'm glad I decided to meet her. Today when I passed her desk, I stopped to say hi. I think that I'm going to find someone once a week until I've gotten to know the people that I've worked with for so many years.

Kindness

I love it when people are kind with me. It makes me feel loved and included. But I often find myself skeptical and judgmental. The older I get, the more I see and disdain that quality in me. Today Lizzie and I out of pure boredom found ourselves at a festival in downtown Woodstock. We were perusing the shops there when I came upon a very unusual fellow. We were in a very quirky antique shop that is wonderful and found a very unusual teen who kept uttering inappropriate phrases. After about 20 minutes his mother told me that he is autistic and has Tourette's. I told her that I had already decided that and that he wasn't going to change so we should just get over it. The poor woman started crying. She said that no one understands, and I believe her. Here is the thing. He didn't choose to be this way. His mother didn't raise him wrong. The chemistry in his brain is just wrong. It isn't either of their faults. I can't imagine having to explain if someone was focusing on every bleed that Jack has. Both of his parents are excellent; they aren't responsible for his bleeds. But this poor woman felt she needed to respond for every inappropriate outburst this kid had, and he had a lot.

It doesn't cost to observe and see where people are. This woman just needed to know that other people in a store knew that her son was ok and not a threat, even though he was acting in a different manner. She was touched when she knew someone understood.. I wish that I could just see the underlying fears in all the situations that I find myself in. This one was easy. But there are so many others that I just don't get the subtleness of. But I do know that people do deserve kindness. They deserve the luxury of not being judged in a casual manner. They need to feel that they are ok as they are.

I wish that I was starting that campaign. I think that it would be worthy.

Two subjects...Plate method and eye doctor appointment

I should have already have posted about this. Earlier this week the My Plate campaign from the USDA was announced. If you are a person who is familiar with diabetes, or a person with diabetes, this method is not new to you. The plate method has been around for a while. The problem is that it is based on the USDA's Pig Lot diet. I didn't coin the term, and I can't remember where I first read it. But I do know that it was in a doctor blog. The premise is this, three meals a day and two snacks. Meals can have up to 60 grams of carbohydrates (carbs) for men for meals and 30 to 45 for snacks. If you are female, you can safely eat 30 to 45 grams of carbs for meals and 15 grams of carbs for snacks. The problem is that if you are eating that many carbs you are fueling insulin production and triglyceride production if you are sensitive to carbs. Some of us just can't tolerate carbs and we are better off without them. I have heard this argument for years and kicked against the gord. But the last set of blood work that I got from Dr. B convinced me beyond belief. When I eat a low carb diet, my glucose, triglycerides, hdl, ldl, liver function, and kidney function are all normal. When I eat as I please, or according to the above mentioned diet, I'm in trouble. I am actually looking forward to hearing the result of my tests from Dr. R. I'm not telling you that you need to do this, but I know that I need to do this. My goal is for me is to do what makes my body healthy. And finally, I don't care if the USDA, AMA or the ADA approve of. This is what works for me and I am going to do what works for me.

So, I have been being hounded by my insurance company to improve my health. They want me to do things like lower my triglycerides, lower my stress level and get my eyes checked. I think they will be pleased with my triglycerides and today I got my eyes checked. I didn't do it for them, but I really have been needing a better pair of glasses. I just didn't want to be asked to pay over $100 for a pair of glasses when the company I work for assures me they are covering my ability to see my work. Let's face it, there are a lot of practioners who see the benefit package as a license to steal. Not that their services aren't valuable, but what usually happens at the eye doctor is I am told that I must have bifocals and that progressives are the only ones that will work for my eyes. Then I'm only shown the high end frames. I end up spending well over $100 for my covered at 100% exam and glasses.  At the recent health fair I met a local ophthalmologist and I liked him right away. He talked to people and explained things like cataracts and glaucoma. He seemed very genuine. I had an appointment with him for today. As a result I am getting a new pair of glasses that I hope will get my left eye to seeing again (it is legally blind), and will help with the strain in my right eye. What I encountered with this group was a lot of people who were more interested in me getting what I needed  in eyeware than selling me the highest price merchandise available. I went into the appointment expecting to be pressured into surgery and wanting contacts. The doctor wouldn't recommend either. He said that I could have Lasiks and have a temporary improvement in vision, but because I have developing cataracts, I would be better off waiting to have surgery for them.  He said that the contacts that were available for my conditions were hard to place and weren't as affective as glasses so he couldn't recommend them either. He said that he also wouldn't recommend bifocals because far distance wasn't much of an issue for me. He only recommended readers. That is the first time in 14 years I have heard that. Everyone else sold me progressives because they make more money on them. But they require constant adjustment and annoy me, so I am less likely to continue follow-up visits. I bought  a pair of glasses for a $42 co-pay. Still, I plan to ask for the prescription and buy a back-up pair from $39dollarglasses.com. But the bottom line is that I will be getting proper glasses. That makes me feel better, and I'm glad to say that as my eyes are aging along  with the rest of my body, I'm glad to finally have an ophthalmologic that I feel good about seeing

Now I would like to have my health plan quit regaling me with health recommendations that I feel are derivative to my health.

Contemplation

Dr. Edwin Leap, who writes at a blog that bears his name asked his readers what they would like to see him write about. I have read his blog almost since it started, and I decided to answer his request. The most revealing thing was that while I was telling him my opinion, I realized that three fingers were pointing back at me. What I said to him was that medical bloggers tend to use their blogs to vent steam and it makes us neglect to write about   the good things in our lives, the things that inspire us. So today, since I write so much about the frustration that I feel so often when I go into doctor appointments, I have decided to write about a very good appointment. The bonus is that I actually had one this morning.

I went to my regular blood work appointment with Dr. R. I have an appointment with him every three months to check my blood work for liver function and glucose. He usually decides to keep up with other things, which is OK with me. Whatever he feels he needs. The cool thing about Dr. R, like Dr T. is that if I have a recent set of results (like within a month) he is willing to accept that and only add whatever else he needs. He is from Ukraine, and I think that they are culturally more frugal than most Americans. His nurse, Laura, was on vacation. So Dr. R came in and did the vitals himself. I wonder if he will be doing that all week. Well, at least it is a short week and it's half over. I actually went in to this appointment very confident because I had just gotten the results from my 5 week old blood work for Dr. B. It was astonishingly good. My A1c was rockin' and my triglycerides had gone into half of normal level. To add ice cream to the pie, my hdl was 85!!! I am hoping that Dr. R will consider taking away the overly expensive Trilipix medication. If I can do this without eating carbs, carbs aren't that worth it to me. I can gladly give them up. We talked during the appointment and the only thing that he was concerned about was that I have been having frequent palpitations. I am looking forward to the phone call where we discuss the results. I am expecting him to be impressed. The phlebotimost  in that office is awesome. She hits a difficult vein the first time every time. I hope Dr. R understands her worth.

The only strange thing was that Dr. R asked me about my medical oncologist. I told him that it was Dr. S and he told me that he had just sent over a patient to me. I just kind of said that Dr. S was a hard hitter and the patient was in good hands. That his patient would be in good hands. I couldn't figure out if he was looking for assurance.  I feel like I should have said something else, more revealing. But the truth is that I wouldn't be here if it wasn't for Dr. S and Dr. St. They pulled me out of the fire. I have a love love relationship with them even if I get frustrated with their office staff. They are still the best in my opinion. And that opinion is echoed by many medical professionals that I know. I'm glad that Dr. R has decided to align with them. It makes me feel better.

So from now on, I will try to report the good as much as my frustration.