ultrasound, microinfo

I had an ultrasound today and had more blood drawn for labs.
No info though. Guess I’ll have to wait till next week to hear anything from my doctor.
I asked for copies of the ultrasound images so I could see what my insides looked like, but the radiologist said no. Boo. Apparently I can request that my doctor request a copy of the images, if he agrees to it. Doen’t sound very HIPAA-compliant to me. >=(

Meanwhile, I’m in a sort of limbo… not really stricken, but not really well.
I have a more or less constant low-grade fever and headaches, abdominal soreness, and at night I wake up with abdominal pain, which isn’t super-severe, but enough that I can’t fall asleep without taking an oxycodone.

I’m worried that the doctors might not schedule any sort of treatment until after I get back from my trip to Washington, so I will be feverish the whole time and not able to fully enjoy it.

Especially since I don’t have enough oxycodone to last that long, which could mean a lot of sleepless nights up tossing and turning in pain (apparently that’s when Gall Bladders do their thing, most gall bladder pain happens to people at night).

I’ve been looking forward to the trip for a while now, it would suck to have it spoiled by my stupid insides.

Sigh

I was talking to someone at work today about what happened, and she said:

You had a burger, a slice of pizza, chips, and cake?
And then chicken pot pie the next day?
Of *course* your body couldn’t take it!
You’re old now, you can’t eat like you used to.

It didn’t seem *that* excessive to me at the time, most other people at the party had a lot more pizza and cake than me… but maybe she’s right, since obviously my body imploded from it.

Sigh.

I’m just amazingly depressed by the whole thing. I feel humiliated, like a failure, and like I can’t trust my body.

No answers yet

Had some blood drawn for lab work and an ultrasound scheduled for Friday.
I’ll get to find out the sex of the baby!
Just kidding.
I’ll get to find out if I need to have some of my insides lopped out.

Right now my guts don’t hurt too bad, but I have a bitch of a headache.

The day my insides went horribly wrong

Sunday started as a slightly off day. I could feel something, a not-quite-rightness about things.
I broke a container of chervil when making breakfast, shattering the small jar and covering the floor with the spice. I cleaned it up, and didn’t mention it to Sarah (she was taking a shower at the time).

After breakfast, we were going to Old Sturbridge Village, Sarah’s parents were in the area and would meet us there.

I had trouble getting ready – trips always slightly discombobulate me, but I felt extra helpless as I got ready go.

As we pulled up to Old Stubridge Village, I felt sort of grumpy and out of sorts. “I feel like every decision I make today will be the wrong one,” I said to Sarah.

We met up with Sarah’s parents, and wandered around OSV for a while. Sarah’s dad had bought a big bag of lemon cookies at the bakery there, Sarah and I split a cookie (a bad decision, a precursor to the upcoming really bad decision).

We saw pretty much everything there, some interesting stuff, some just reminded me of growing up in rural Maine. I saved Sarah from stepping in an enormous pile of horse manure, she had been tromping along reading a brochure, oblivious to the potential messy fate.

“Colonial times were really stinky,” she commented.

After we’d made the rounds, we decided to get something to eat. When we go to the tavern, though, it was closed. So we left OSV and went to a place Sarah’s parents had been 10 or so years before, the Publick House.

It’s an old-style upscale hotel/dining/event place, a massive structure with a rambling, maze-like interior.

We finally found the dining area (with some assistance from one of the staff) and perused the menu.

I settled on getting the Chicken Pot Pie, and a salad and a dessert. “Remember from the book ‘Eat this, not that’,” Sarah commented, “those are loaded with fat.”
“Yeah, but tasty,” I reply.

Little did I know then that my decision of dish would nearly destroy me.

The chicken pot pie was yummy, though I burned my tongue a little when eating it, blowing on each spoonful instead of waiting for the dish to cool.

For dessert I got Indian Pudding, which I don’t think I’ve had before. It was good, not too sweet, with a scoop of ice cream. I had some of Sarah’s Apple Pie, which compared to the Indian Pudding, was almost too sweet.

After dinner, we headed back to my car to drive home, and Sarah’s parents headed back to their hotel.

On the ride back, I could feel something wasn’t right.

“Oof,” I commented, “I feel stuffed.”

“Me too,” said Sarah.

[Warning: The remainder of this story falls into what most people consider the “too much information” category.]

But I felt more than stuffed, I felt over-stuffed, bursting at the seams.
I had been constipated for the past couple days, which worked out great for the bike ride, but now I was afraid I really *was* filled to bursting.

On the drive home, the pain got worse and worse.

A couple years ago, I felt a similar pain, and ended up going to the ER for it. The said it was constipation, and proscribed me some laxative.

I still had some of it left, so took some. I couldn’t remember how long it took to work, though.

The pain continued to escalate.

Sarah went out to get some different treatments to try.

In agony, I prayed for her return.
I tried meditation, which worked, but only for small periods of time. Then the pain would come bursting back into my awareness. I heard Sarah come in, and eagerly greeted her.

“Sorry,” she said, “every place was closed. But there is a 24-hour Walgreens on Park, I’m looking it up in google maps.”

She tried to print out directions, but couldn’t get the printer to work. I was in too much pain to help. She wrote down directions and headed out again.

I had noticed that lying on the cool tiled floor in the kitchen seemed to help a little, so I tried an ice pack. I’m not sure it helped at all, but it didn’t make the pain worse.

Sarah came back again, this time with supplies. She was concerned about me trying too many things on my body, but I was in so much pain, I was willing to try anything. Things that seemed disgusting and unthinkable at any other time were welcome. I tried an enema and a suppository, both of which had little to no effect. I forced myself to throw up, anything to try to decrease the pressure, but it did little but leave me with the taste of vomit in my mouth and throat.

Then I took a warm bath, which did help, but I have the smallest bath in the universe – I had to put my legs straight up on the wall to lie down in the tub, and even then the water didn’t cover my abdomen, where the pain was. So I gently splashed water over my stomach, which helped. Not only were my intestines crying out in pain, but my abdominal muscles were as tight as possible, as were my back muscles. The warm bath helped relax them a little.

At this point, Sarah was pretty exhausted, she had been tired earlier, and now it was past midnight. She fell asleep, and I went to the couch, so my pained thrashings wouldn’t wake her, and tried to get some sleep.

I realized after a while there was no way I was going to be able to sleep, there was simply too much pain.

I remembered my trip to the ER last time. It had been ridiculously expensive, but they had given me morphine, which made the pain go away. At that point, I was desperate to make the pain stop. There was a pair of scissors on the kitchen counter that I had to put away, because every time I walked by them, I would eye them and think about stabbing myself in the gut, anything to stop the horrible, horrible pressure and pain.

Finally I resigned myself. I knew it was an amazingly expensive rip-off, but the ER seemed like the only choice. My insurance would cover some of it, at least. The thing that gets me about ER visits is that what is expensive is not the doctors, or the medicine. The expensive thing is the time you spend in a bed. That’s right, the medicine and doctors only cost tens or hundreds of dollars, but time in the bed costs THOUSANDS. So they have an incentive to keep you in the bed as long as possible, since it’s like a taxi with the meter running. The most expensive taxi on earth.

I wake Sarah up. “I can’t take the pain anymore,” I say, “I’m a wuss. I need the ER and some sweet, sweet morphine.”

“Ok,” she says.

We get dressed and head over.

I check in and a nurse takes my vitals and gets some info about my condition.
Then we wait in the waiting area. I give Sarah my iPhone to play with, she plays Quordy (which a friend from college wrote) while I squirm around on a couch, trying to find some mythical comfortable position, but it’s a hopeless quest.

Finally I go up to the reception desk, I ask her if there’s a water fountain.
“You have abdominal pain, so we can’t give you any liquids,” she says.
“What about a bathroom?”
“You’re just going to go drink some water, aren’t you?”
“No, I… I’m feeling a little queasy (I was) and want to know, just in case.”
“I can give you a bucket if you need one,” she gestures to a pile of plastic bins.
“I just… I just want to know where the bathroom is.”

She is about to tell me, when a woman walks up, saying “I’m ready for him”.

I call to Sarah, and we head into the ER “pod”. I’m handed off to a nurse. “This way,” he says, and sets me up in a bed. He tells me to remove my shirt and put on a hospital gown. Oddly, he leaves the room. I’m removing my shirt, not my pants. I guess they treat men and women removing their shirts the same? I’m not sure if that’s progressive, or prudish… seems weird in a hospital, but I guess they want to make extra-sure no one sues them for sexual harassment…

A number of nurses and doctors examine me, all asking the same questions. I’m never able to get through the full recounting of my tale before they cut me off with another question. Seems inefficient, that they would get more out of letting me finish, or asking new questions, instead of each asking the same ones. Seems like that information isn’t getting passed from one person to the next – the very first nurse took notes, but doesn’t seem like these doctors and nurses were. I was pretty distracted by the pain, though, so perhaps they have some system I didn’t see.

They bring in an ultrasound, and scan my belly. I can’t see from where I am, but they say I have three gall stones. They also say I have an unusually large gall bladder, but don’t say what that means.

They take some blood to run some tests.

At some point, they finally offer me some pain relief. I’m not sure if they didn’t want it to mess up my lab data, or they just liked watching me squirm, but it seemed like a while before they finally got me some morphine.

Morphine is great. It didn’t completely eliminate the pain, though, just knocked it down a few notches. I felt almost like I could drift off to sleep.

After a while, though, the morphine begins to wear off. I’m not sure how long I’ve been in the bed. Hours?

A doctor comes in to talk to me, I forget exactly what he said, a lot of horrible stuff about possibly removing my gall bladder, how fever might be deadly or something, but I was distracted from what he was saying, because the pain was back.

He chastises me for trying chemicals to cure my constipation, said that I was dumb not to just use lots of prune juice. Well, excuse me for using the medicine that the same ER prescribed last time…

Finally, he says he’ll get me some more pain reliever, this time morphine and another one, which Sarah says is extra-strength ibuprofen.

A couple times, I ask for a copy of my medical records from the visit. One nurse blows me off, he tells me some bullshit about that not being allowed under HIPAA. In fact, HIPAA says the opposite, that unless there are special reasons, a patient is allowed copies of their records on request.

One of the doctors was better about my request, though she only gives me the lab results, not the other records (for example, the ultrasound scan had been recorded).
In my experience, doctors and hospitals are notoriously secretive about medical records. Even though they are obligated to release them if you ask, they will usually dodge and weave to give you as little as possible. I say “all”, they make their own interpretations, thinking to themselves “well, obviously he doesn’t want *all* the info, I’ll just give him this one report.”

When I say “all”, it’s what I mean. I swear, you’d have to be a lawyer or bring one with you to get them to ever comply fully with HIPAA.

So anyway, they release me, and give me a prescription for oxycodone and that extra-strength ibuprofen. It’s been about 4 or 5 hours total, which is pretty fast for an ER, though I imagine the bill will be several thousand bucks… we’ll see.

We get home around 5:30, and drop off to sleep, exhausted. Sarah doesn’t have to work Monday, or doesn’t have to work till later in the day, we don’t wake up till around, I dunno, 11am or 1pm or something.

Sarah has to head home to feed her cat and get ready for work the next morning, which is at early o’clock.

I head to Stop & Shop, and feel like an old man shambling through the store, buying my prune juice and milk of magnesia, getting my prescriptions filled. It occurs to me, I have white hair, age spots on my face, failing organs – I don’t just *feel* like an old man, I am one.

Which plunges me into despair. I mean, I’ve tried to live a fairly healthy life the last few years. Sure, I could exercise more, and I do eat the occasional slice of pizza or pasta dish, but by-and-large, I go for the healthy choices.

And what does it get me? Gall stones. Which, as a friend pointed out, are usually found in, as Wikipedia puts it: “the four F’s: Fat, Female, (nearing) Forty, Fertile.”

I’ve always fully expected to live to 100 or above, which seemed perfectly reasonable – I take care of myself, eat well, have a generally positive outlook.

But now I am told that if symptoms continue, I may need my gall bladder removed. At that moment, standing in the supermarket, I felt a complete failure. Anything I had done to try and stay healthy had been either too little, too late, or doomed to failure from the start.

The prune juice and milk of magnesia did the trick, got my insides cleaned out and working again.

However, I’ve been feverish today. Which I remember the doctor saying something about, something very bad, but I don’t remember it all. The long and short of it is probably just that I’m fucked.

I have an appointment to meet with my regular doctor tomorrow morning, where doubtless he will give me his own rendition of the “you’re fucked” tune.

I remember the good old days, back on Saturday, when I used to be healthy.

Sigh. Days long gone, I guess.

Professional Vampires

I gave blood today. I prepped for it this morning by eating two bowls of cereal and a belgian waffle covered in whipped cream and strawberries for breakfast, then drinking a liter of water.

I wrote a little blank vitals sheet on a business card ahead of time, so I wouldn’t get them scrawled messily on a scrap of paper like they usually do when I ask for my vitals.

My vitals:

My hemoglobin always seems to be on the low side.

It went MUCH smoother than last time. The woman doing it was very good, I barely felt the needle, she was quick and efficient. When it was done, she used a non-stick arm wrap instead of bandaids, so my arm hair didn’t get all ripped off painfully when I removed it.

Medical days

Note to self: be less vigorous playing Boom Blox on the Wii. This weekend I was all flailing around, pitching baseballs at block structures, and two days later, I’m walking to a meeting at work, and *ping*, I get a pinched nerve in my right shoulder. Probably not a coincidence. Still painful, hopefully it sorts itself out in a couple days, I’m going to a bowling birthday party this weekend (real bowling, not Wii).

Right now is “Open Enrollment” at Staples, which means it’s the two-week period where you can make any changes to your benefits, which you can’t change until this time next year.

It’s confusing, there are 4 different medical plans… last year I chose a not-so-good one, which ended up with me paying a lot out of pocket. So I switched to the next plan up, which is a little more expensive, but means less out of pocket if I use it.

They added a “non-smoker discount” this year, which is pretty cool for lil non-smoking me. Actually, it makes it about $30 a month cheaper… and then I switched to the more expensive plan, which was about $30 more a month… so the net result is I’m paying the same as before, but getting better coverage.

There was also an incentive to take a “Personal Health Assessment”, so I took that. I scored 98 out of a possible 100, the only suggestion was that I get more exercise, which I’m planning on. I’m going biking with Ben again on Thursday.

If you want an idea of what the personal assessment was like, there’s one called “Real Age” online… just make sure you opt out of all the email offers… they periodically interject the quiz with questions like “Do you want to improve your health? (this will send you emails)”…

On RealAge, I scored as 27 years old, 6.5 years younger than my actual age. Not too bad for a graying programmer…

First ride, first injury

I went for my first bike ride of the year today. This week is “bike to work week” so seemed like a good kickoff.

I met Ben at his house, and we biked from there to Staples, then after work biked back. It was a nice ride, though hilly, which showed me that while I thought I was in decent shape, I’m not when it comes to biking.

The ride went smoothly, but I had a mishap afterwards.

Last year I bought some bike shoes and bike pedals that clip together, but hadn’t been able to put the pedals on because the old pedals were on too tightly. Ben got the old ones off for me, using a vice to hold the crank steady while he used a wrench attached to a long piece of pipe to get the leverage to loosen the pedals.

Once the new pedals were on, and the clips were attached to the bike shoes, it was time for me to try them out.

I found them very, very difficult to use. Getting clipped in is a matter of exactly lining up the clips, and putting all my weight down on it until it snaps into place. And getting out… well, that’s where the mishap occurred.

I was leaning against Ben’s porch railing, practicing getting clipped in and out, and got clipped in, but couldn’t get unclipped. To unclip the pedal, you have to rotate your foot about 60° – which wouldn’t be too bad if it was a pivot from the toe, but the clip is in the middle of the foot.

Try it right now. Put your foot flat on the floor, and try to pivot it somewhere between 45° and 90°, using the arch of your foot as the center of rotation. It’s not easy.

Unable to unclip myself, I fell sideways, crashing into the steps with the bike on top of me. I held out my hand as I fell, so although my leg hurt, it was my hand that took damage.

Ben helped me unclip by grabbing my foot and rotating it. Once free, I noticed the ring finger on my right hand was bleeding, from a couple scrapes on the side, and also I had torn the skin off my fingertip, it hung as a flap.

I mentioned this to Ben, he made an “urk” sound and went to get some bandaids. For some reason Ben’s squeamishness around blood strikes me as out of place, because he’s very matter-of-fact and non-squeamish in all other matters. As a father of two kids, he must have to deal with blood and other bodily fluids all the time…

The mechanical advantage of using clips is pretty big, they make it so that you apply energy to the bike on the upstroke in addition to the downstroke, without a clip you are only applying energy on the downstroke. Clips also make it easier to stand up on the bike, for going up steep hills.

For those reasons, I’ll practice using the clips again until I get it, but right now, I’m not a big fan of them.

Amateur Vampires

I gave blood today. I was worried since last time I gave blood I nearly passed out, so this time I made sure to eat a big breakfast (which works out well with my trying-to-eat-a-big-breakfast experiment). Apparently it worked, I felt fine.

I was the guinea pig for the girl who took my blood, seemed like it was her first time, she had a woman guiding her through the procedure. The heavyset girl was nervous, flushed and sweating, and continuously getting flustered and either freezing up or doing things in the wrong order. Luckily the older woman was there to correct her, or probably something horrible would have happened to me, the girl seemed especially confused about what order to undo clamps.

Excerpt from the scene:

[Girl is standing there, frozen]

Woman: What is it?

Girl: …

Woman: What’s the problem?

Girl: um… [gestures downward, to what I assume is a puddle of my blood on the carpeted floor]

Woman: You must have clamped that tube in the wrong spot. [rubs blood into the carpet with her shoe] It’s ok, doesn’t look like you spilled too much.

Since she was a novice, setup took a lot longer, as did breakdown. Which is annoying when you’re waiting for them to take the needle out of your arm. The whole process took about an hour and 15 minutes. The last two times I gave blood, it was more like 40 minutes. I know people have to learn sometime, but there is a great deal to be said for efficiency.

It got me thinking about giving blood.

One issue I have is, they don’t give you much for it. Yes, they sometimes have swag, like a mug or whatever (this time they gave out a coupon for a free personal pizza at Unos, which is about the unhealthiest food you can buy – no wonder americans are so obese, when a *HEALTH* organization like the Red Cross is giving out coupons for 2400-calorie meals), but they *could* give you something much more valuable.

Like if they did a free cholesterol screening. I’ve seen the machines, they are about the size of the hemoglobin machines, I bet they could do a combined one that does both. THAT would be valuable.

I always ask for my vitals, but they are ill-prepared for that. This time, I got my vitals messily scrawled on a bandage wrapper. Not only that, but she only wrote blood pressure and heartrate, I had to ask again to get the hemoglobin number. She seemed annoyed that I was asking for information. And I saw her punch in about 6 or 7 values, and she only gave me 3 (4 if you count BP as two fields) so who knows what other data she had that she didn’t share?

Data, BTW: Pulse: 60, BP: 106/68, HGB: 14.5

Rendered with my chart-drawing script:

Now that I think about it, she took my temp, but didn’t give me that value…

Sigh, selfish medical people, never want to share data. Like gollum with the ring, they are… “Yessss, my precioussss data, preciousssss…”

But anyway, my point is that, how about they give you a free cholesterol test if you give blood?

And maybe also have a trained nutritionist on hand to give free advice while you are in the recovery area? Instead of walking out with a coupon for a free bucket of lard, maybe people could walk out with some useful data and advice…

Also, this time I gave blood, it was the Red Cross, the last two times it was a local hospital that came to Staples. The hospital had better giveaways (the steel-lined plastic mug I got last time is quite nice, I use it every day) and were friendlier. Maybe it was because the girl was so flustered, and the woman was busy helping the girl, but they barely spoke to me at all.

Another thing they could do while giving blood, and for medicine in general — one thing that works as a great pain/discomfort suppressor is distraction. I read an article recently about a doctor who decided, rather than sedate kids to calm them down, he gave them his iPhone with a video playing on it to look at. Seems simple, but apparently most places just drug kids to quiet them down.

It would have been nice if they’d had a TV with the news or something on it while people donated blood. They did have a really crappy boombox in the corner, crackling out some tunes, so that was better than nothing, but probably the more senses are distracted, the better.

Grr…

Another HPV story, these just make me mad – basically HPV has been identified as a major cancer-causing agent for a number of different types of cancer, but efforts have only focused on protecting women, not men. Women have screening tests and a vaccine. Men have… nothing.

According to the article, when asked about making a vaccine and test for men, makers of the vaccine said “cervical cancer is really the focus.” In other words, “we don’t really care about male health.”

What does the CDC have to say to men concerned about HPV? Here’s what they say on their website:
“There is currently no vaccine licensed to prevent HPV-related diseases in men.” and “There is also no approved screening test…” and “HPV is very common.” Ah, yes. Very helpful.

So basically what they are saying is there is a virus that causes cancer, and lots of people probably have it, but men have no way of telling if they have it, and only women should be protected from it anyway. Very nice. Very proactive. Fuckers!

They don’t even have important information about throat cancer (like HPV is a 10x greater risk than SMOKING!) on their site – apparently the CDC doesn’t have time to be current on, you know, Disease. Certainly not Control (the only advice they offer men is “not having sex is the only sure way to avoid HPV” — so clever of them, guess they can cancel skin cancer research and just tell people to live underground out of the sun). Maybe they should just be called “Center“.

Overall the CDC, drug companies, and medical industry’s response to HPV show that they learned NOTHING from the outbreak of AIDS. Imagine if they found a vaccine for AIDS, but decided to only test it and release it for women. Well, that’s what they’ve done with HPV.

Thing is, the current vaccine for women would *probably* work fine on men, too. But no one has bothered to do a study to find out. Because apparently no one cares.

Back in 2006, Bradley Monk, a professor at University of California-Irvine published an article in a medical journal where he recommended using the vaccine on men as well as women, saying: “To have a vaccine that prevents cancer and not use it would be one of the greatest tragedies.”

Guess no one listened to him. Two years later, still no work on testing it on men.

Sigh.