Medical Mysteries

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Everybody likes a mystery right? Especially a medical mystery – whether it’s a crime show based on forensics, like Bones or CSI, or a doctor show with an irascible but brilliant main character like House, medical mysteries are great fun for all involved.

Well, except the patient. Or corpse. And if you are the patient, it’s no fun at all.

Recently, I’ve been feeling tired. A lot. My doctor suggested I drank too much wine (and I have dutifully reduced my consumption by a quarter – though it is still a lot) but also ordered a lot of blood tests. There was a lot of good news – almost everything was normal, including, by the way, liver function. My glycerides were high but that’s fixable by cutting out some carbs. My bad cholesterol, to quote the doctor, “looks like it would if I were taking drugs to control it.” Which I am not – so go me.

My B12 is low – low enough that diet won’t fix it, so it’s a daily supplement from here on in and a re-test in a couple of months. Low B-12 can lead to fatigue and may also cause a certain amount of poor moods. And I thought that was being caused by work.

Usually, low B12 is also a sign of anemia. But, mysteriously, my iron levels are abnormally high; high enough that the doctor will consult with a blood specialist. Because, right now, there is no explanation for this result – and it’s not one prone to false positives. Nothing in my diet explains it, I don’t take iron supplements (I actually take almost nothing on a daily basis) and I haven’t recently been blood doping. Not since my days as an Olympic sprinter. So low B12 and high iron is a bit of a mystery.

Big deal, you might think, high iron can’t be a bad thing right. Iron helps oxygenate your body and high iron should give you a real energy boost. Actually, according to my other physician, Dr. Google, high iron is just as bad as low iron when it comes to energy – so it might be contributing to my fatigue. And, when really high (I’m not – I don’t think) it can cause liver damage (or cancer), heart disease and, not surprisingly, premature death. More horrifying, it can even cause impotence! Fortunately, I’m like Donald Trump that way – no problem in that department. No, seriously. I wouldn’t kid you about something like that.

Strangely, the cure for high iron is quite simple – though somewhat medieval. There are no drugs or dietary changes that will help. The solution is to give blood every six weeks or so and, if for some reason you can’t give blood, that’s okay they’ll just take it. It has a fancy name – phlebotomy – but really it’s bloodletting. Like in the Middle Ages. With leeches or vampires or something.

I’m sure all this will work out fine. In the meantime, I’ll keep analyzing the clues and stay away from large magnets.

And that’s ten minutes.

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Expensive Urine

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One of my favorite moments in all of The Big Bang Theory is when Sheldon describes taking a lot of health supplements as a recipe for very expensive urine. He is absolutely right. Most of the vitamins and other supplements people take are not only useless, some may actually do considerable harm. Excessive doses of beta-carotene (Vitamin A) can increase the risk of smokers of getting lung cancer. The ultimate risk-taker might be someone who chain smokes while popping Vitamin A tablets and skis down a hill blindfold.

Yet the supplement industry continues to grow at an amazing rate (roughly at the speed of the Brazilian economy – 6 % a year) and has now reached $34 billion in the United States alone. People who routinely decry Big Pharma see no problem in spending huge amounts of money in so called ‘natural health’ stores. They take vitamins and minerals and various pernicious weeds and not only claim their miraculous benefits but deny that it could ever do any harm. It’s a grassroots business they claim – connected directly to Mother Earth. Grassroots? $34 billion? I’m experiencing a cognitive dissonance. As I’ve said before, if alternative medicine can be proven to work, it is medicine. Otherwise it is bunk (though it might produce placebo effects).

I have no problem with people spending their money any way they like. But it is phenomenally annoying when they adopt a holier than thou attitude about it. You don’t see smokers and drinkers do that, do you? How often have you heard me tell someone with a cold, they should drink bourbon? A lot less than I get told I should take XYZ ‘magical remedy.’ To tell you the truth, alternative medicine fanatics sometimes display the same proselytizing zeal as annoying and blank-eyed folks who come to your door on Saturday morning asking if you’ve found Jesus yet.

Still, it is a concern when the same people who peddle this snake-oil to gullible, though apparently well-educated, individuals begin to make pronouncements about vaccines – pushing useless nosodes while claiming vaccines are poisonous. Personally I think they should be held accountable for measles outbreaks but, hey, live and let live, right? Well, except for the kids they kill.

It’s not that some supplements aren’t required for people who have specific medical conditions. B-12 is an important treatment of pernicious anemia, for example. But in all those cases, there is sound scientific evidence proving their effectiveness.

All the rest is just people trying to make money.

And that’s ten minutes. From my sick bed.

Thrombosis

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Ten minutes of words are running a bit late today as I had to get up and out of the house early to go to the Ottawa Hospital Thrombosis clinic. Say what?

Let’s step back a bit. About a month ago I tore the meniscus in my left knee. Nothing dramatic, it just decided to pop. I did a few rounds with the doctor before deciding on a mild course of treatment involving physio and pain killers. All was going well and I was well on the road to full recovery when, while in Alberta I climbed over a fence and twisted my knee once again. Sigh.

Back to physio last week. During the exam, the therapist noticed a little swelling around my knee – water on the knee as they used to call it. No worries. The treatment proceeded and while my knee was still pretty sore, I felt I was on the road to recovery.

Then on Saturday, I was a Prose at the Park – lugging books around and sitting a lot at a table to sell them. It was a fun day but by the end of it, I was pretty sore. When I got home I noticed that the swelling had increased.

On Sunday morning my entire lower leg from knee to ankle was swollen to an ’impressive’ degree according to a couple of doctors and nurses. The calf was sore to the touch and painful to walk on. The swelling persisted and on Tuesday I went to my doctor to have it checked out.

By three o’clock I was told that I might have a blood clot in my leg – deep vein thrombosis is the medical term. I was sent to find injectable blood thinner that I was to, well, inject myself with before going to the hospital the next morning bright and early.

Strangely, the seven pharmacies I tried couldn’t fill the prescription but since I just assumed they were taking precautions I didn’t worry. I certainly didn’t intend to spend my night in emergency to get a little needle.

So I go to the clinic and get checked in. A doctor does the examination and says – yeah, it’s a high probability that you have blood clots.

A blood test specifically designed to test for clots gives me a score of 1250 (anything above 500 is considered risky). So it off to imaging I go for a full ultrasound scan of my left leg. The techs make suitable soothing noises combined with expressions of concern.

I am sent to wait some more. Then the doctor returns and tells me that I’m clean as a whistle – no sign of clots at all and no indication that I need to be re-tested anytime soon. Life, as he said, will ‘return to normal.’ Three hours in and out and, for my US friends, it was all covered by the government.

The explanation: a ruptured fluid sack in guess where? That’s right, my knee. Turns out it was that after all.

So, despite my initial expectations, I won’t be on rat poison for the next six months. That may disappoint a few people but it has put a fresh spring in my step. Which is too bad, because my knee still hurts.

And that’s ten minutes.

The Will to Live

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Animals may struggle to survive but they have no will to live. Driven by their selfish genes who want nothing more than one more chance to reproduce themselves, animals will run and hide and fight but in the end they surrender to the inevitable. The rabbit relaxes in the eagle’s claws, the deer falls to the lion’s jaws and even predators slink away to die when the time comes. Animals live in the present, sentient, yes, able to distinguish between good things and bad, good moments and fatal ones. But they have no concept of tomorrow. Lucky them.

Only humans — and perhaps a few other species — have the capacity to contemplate their own death. They can know that present joy may still lead to sorrow and that present pain may have future relief. They can weigh the merits of holding on versus letting go.

So why do some let go so easily while others cling to the sweetness that is life?

I had a friend, Frank, who was diagnosed with a very aggressive form of prostate cancer. He was given six months to a year, perhaps two with treatment. Many people would have slumped their shoulders and accepted their fate. Not Frank. He eagerly took the treatment offered and then the next one; he volunteered for experimental drugs, changed his diet and his lifestyle. He held on for nearly a decade.

But he didn’t merely hold on; he embraced life — travelled and explored, tried new foods and new things, did things that scared him like skydiving and through it all laughed and met every new challenge with grace. Even at the end, when he could no longer eat, he would come to dinner and drink clear soup while the rest of us feasted. He would laugh and sing and enjoy the company of friends. I never knew a more graceful approach to death — or, rather, to life.

My mother-in-law, Dorothy, was widowed some years ago after a lifetime with the same man, an Anglican priest. Even in their last days together they were clearly in love. Dorothy grieved and wondered what was left to her, other than heaven. Until she was told that her heart was literally broken and that she might not have much more to life. She decided then and there that she wasn’t ready, in her words ‘to leave the party.’ She took the promise of a year or two and following every instruction of her doctors to the letter has now stretched it to more than a decade. Last week she broke her hip. At 89 and with a heart condition, they discussed the issue of resuscitation during surgery. It might break your ribs; there could be a lot of pain. Her answer: absolutely bring me back if you can. I still have flowers to grow and berries to eat and yes, a little wine to drink and great grand children to visit with and oh so many books to read. I’m not ready to leave yet.

The surgery went well — no extreme measures needed — and Dorothy looks forward to returning home.

There are days when the grind of bad knees and gradual slowing of every part of my body makes me wonder what I will do when it gets to be too much. Will I slip away like an old dog and find someplace to die or will I cling to the party until the last dog is hung? What will you do? Merely struggle to survive or will you struggle to live. Because that’s what separates us all — not the will to live but the joie de vivre that makes living worthwhile.

But that’s ten minutes.

Haggard

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I spent the weekend at Ad Astra science fiction convention in Toronto. I’m a veteran of the SF Con world, having attended my first one in 1979 when, if I remember correctly, Theodore Sturgeon was the guest of honour. In 1983 I went to my first World Con — in Baltimore — where I met Isaac Asimov, if only briefly. So yeah, I’m old. Which people kindly kept reminding me of all weekend which comments of: you look tired. And my, but you’re haggard.

Well, it’s been a busy winter and it was a busy Ad Astra too. I saw lots of old friends and made a few new ones. As usual these days I spent my time moving between the panels I’d been asked to participate on and the dealer’s room where I was selling books in my role as publisher of Bundoran Press. I managed to attend a couple of readings and made brief appearances at parties on both Friday and Saturday night. In bed by midnight both nights — which may well be the first time that has happened. So maybe I am tired. Or haggard.

Another sign that I may have become an ‘éminense grise‘ was that they put me on a panel on the relevance of classic SF, presumably because I was old enough to have read it on its original stone tablets. Still, I was sitting beside a young writer, Andrew Barton, who was reading classic SF because it gave him insights into identifying the prejudices and blind spots in his own writing. Made me think I might have a few blind spots, too.

I also got to talk about the emergence of James Bond into public domain (in Canada at least) 50 years after the death of Ian Fleming. I suspect I was the only panelist alive when Fleming was still writing. Do I start to detect a theme?

At least I wasn’t completely left behind — I did get to talk about emergent artificial intelligences and the future of the car — which makes me think that it could lead to a reboot of the classic TV show, My Mother the Car. You do remember that don’t you? It was on in the 60s. I think.

Hmm. Well maybe that does make me think it’s time to start on my spring rejuvenation program. I did come across a diet book the other day called: Lose 10 pounds and 10 years. Though given how haggard I feel — I may have to double down.

But that’s ten minutes.

Walking Away

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One the hardest things in life is to simply walk away. Try it sometimes when you are in an argument. The person you are fighting with will be enraged. They will scream at you to come back, call you a coward, gloat that you have given up and they have won. Walk out the door and you will have to hear about it for weeks or years. Yet walking away is sometimes the best thing you can do.

Violence is often averted and friendships and relationships saved by the simple act of walking away. As long as you come back, of course.

Much harder than walking away from a fight is walking away from your own life, your own stated values. It often requires a complete gestalt shift — a conversion of some kind — so you don’t see yourself as walking away from something but walking toward it. People who leave their families for another person have to be convinced that they are not so much leaving as being driven away or that the person they are leaving for is somehow a higher goal, a better love, a safer or healthier choice. Is it true? Sometimes, but it always will begin to feel true — never more so than if you feel the pangs of guilt.

Relationships are hard but we actually are wired to form new ones. It was essential for the survival of the species. Too many women died in childbirth; too many men died in war or while struggling with nature. If we couldn’t make new attachments where would we be?

Maybe the hardest thing to walk away from is yourself. We all have an image of who we are. We make commitments to others but especially to our own consciences. Deals with the universe if you like. No one, even killers, think of themselves as the ‘bad’ guy even when they embrace their own wickedness. They are locked into their own code of conduct and community — hence there is nothing worse than a snitch.

So where does that leave people who honestly think they are ‘good’ guys or gals? They believe in honesty but find themselves lying; they believe in strength but find themselves weakening in the face of adversity. How do you sleep at night when you feel you are about to break faith with yourself or someone else?

Mostly you don’t, I suppose. You lie awake trying to rationalize the things you know you have to do. Because sometimes it is not a matter of choice. Sometimes, things just get the better of you and walking away isn’t a positive thing but a necessary one.

Most of us only face these things once or thrice in our lives and the good thing about being older is that you learn that as long as you stay on your feet you can get to the other side.

And that’s ten minutes.

Newfoundland Sorrow

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I’ve been to Newfoundland (really just St. John’s) four times — twice during my art education phase and once on Senate business, studying the oil industry. But it is the first visit — the one a week after my wife was diagnosed with breast cancer — that colours them all.

It was December 1995. Lynne had discovered a lump while showering on the day of her thesis defence. She said nothing to me — or to anyone else — but went to the defence, kicked ass and came home with her Master’s degree. It was Friday, so we had a party. On Monday, she went to her doctor and that night told me that she was scheduled for a biopsy the following Monday.

Given her age (41) and the rapidity of the lump’s growth (it hadn’t been there three months before during her exam), the biopsy was done in the morning and the results were delivered that afternoon. Stage 2 but aggressive.

They offered to do the surgery that week but we had a trip planned to Newfoundland to visit Lynne’s closest friends before going on to Nova Scotia to spend Christmas with my family. We had put a lot of resources — time and money — into the trip and she refused to give it up. The doctors agreed that there was no harm waiting a few weeks (it actually was optimal because it would then occur in the middle of her menstrual cycle — maximizing chances of success) so a few days later we were off to St. John’s.

Lynne was determined that the trip would be fun and focussed on our friends who were in Newfoundland teaching at Memorial on a term assignment. They weren’t all that happy and she didn’t want to make them unhappier.

So we didn’t say a word for four days. We visited museums and shops, climbed Signal Hill in the fog, ate and drank and listened to music at their house — a beautiful old place on the waterfront — or at the many bars and restaurants scattered through downtown.

Winter often comes late to St. John’s and so it was that year. It was mild — I doubt if it ever is warm there, at least not based on subsequent trips — with a couple of beautiful clear days, the sun shining like gems on the harbour, plus some real low overcast days with the banks of fog moving in and out with the tide. It was, in a word, perfectly beautiful. It was Newfoundland.

But sun or cloud it was all coloured with a deep shade of blue and the weight of impending doom.

On our final night there we broke the news. There was wine mixed with the tears but as the night progressed there was also love and laughter. That colours my memory, too.

Lynne was lucky. Her cancer was effectively treated and she is still well to this day, though we are no longer together. But I can never think of Newfoundland without thinking of that first visit and her toughness and tenderness. And the sorrow — not for her, but for those who weren’t so lucky.

And that’s ten minutes.