Just spent time pawing through the weekend edition of the L.A.Times for food coupons.
I read recently that the recession is luring more consumers into becoming coupon-clippers. I wonder how many in the clipping community are clipping coupons for food even though they take meals through a G-tube, like me?
Most of the coupons I clipped today for soup, cream of wheat, instant mashed potatoes and Jell-O don't expire till the end of February, and maybe my G-tube days will be behind me by then.
The last calories that passed my lips were in a Jamba Juice Peanut Butter Moo'd smoothie. I had been having difficulty swallowing for some time, but for some reason I had no problems with the Peanut Butter Moo'd, and I would bolt out of the office daily to head to the Jamba Juice in the Beverly Connection. I kept a Post-It note in my wallet that read "P.B. Moo'd" to hold up to the girl behind the cash register.
I haven't been back to Jamba Juice since the first week of December, when I got my PICC line and then my G-tube. The staff there may be wondering what happened to the mute who got the Moo'd and never dropped anything in the tip jar.
A week from today, my nephew Philip is getting married in Fort Collins, Colo. I have a reservation to fly to Denver on Thursday but it's clear that I'm in no shape to travel.
Besides missing the wedding, I'm passing up an opportunity to see family members from Tennessee, New York, Massachusetts, Arizona, Iowa and California. But they all know what's going on, and I hope that they understand why I'm sitting out the celebration.
Saturday, January 10, 2009
Friday, January 9, 2009
Sicko
Not even a day has passed since I went to the hospital for a CT scan, but already Dr. Birusingh, the head and neck doctor at Kaiser, has reviewed the images and recommended the next step for me to take.
The doc wants to schedule a biopsy. After an exchange of e-mails, he and I agreed that I would see him in his office on Monday morning at 9, with an eye on performing the procedure on Tuesday or Wednesday.
The timing Dr. Birusingh proposed is twisting my gut. My body is sick, right? So getting this procedure done sooner rather than later makes sense. That means having the biopsy on Tuesday.
But my brain is a little green and moldy around the edges, too.
See, I have a ticket to see a program called "Juvenile Mindrot: Inappropriate and Disturbing Kids' Cartoons" at the Silent Movie Theatre on Fairfax on Tuesday night. I can't imagine I'd be in any condition to watch banned cartoons in a room full of other sickos like me after spending time under the knife in the Kaiser operating room.
Dr. Birusingh will likely scoop or scrape tissue from my mouth and tongue during the operation. Once I emerge from the fog of anesthesia, something tells me it would be a good idea to avoid the risk of splitting my stitches with a vigorous laugh or two.
I'll decide which day to have the procedure on Monday when I see Dr. Birusingh face-to-face. Maybe he'll offer insight into what he saw in my scans from last night and that will help me decide whether I should move forward as fast as possible, or just fast.
By the way, I dropped by Kaiser early this morning to have blood drawn, pick up a few prescriptions and have the IV I got for last night's CT scan removed from my arm.
I walked up to the counter of the basement imaging center, held up a note that read "Uh, I think I was supposed to leave this behind last night," and pointed to the IV in my arm. The waiting area was full but I was allowed to leapfrog ahead of the other patients and see a nurse right away.
As soon as the nurse saw me, his face brightened. He said that he and I were in the same marathon training group several years ago. I sort of remember him from the training group, which had a hundred members or more, but he clearly remembered me.
"So are you still running marathons?" the nurse asked, as he yanked the tube out of my vein.
I bobbed my head vaguely, which counts as a fib. I haven't run a marathon since 2002, and with a G-tube swinging from my stomach and a tongue swollen to the size of Orca the Killer Whale, I don't have any marathons on the horizon. I have done some nutty endurance stunts on my bicycle, however, including three AIDS/LifeCycles, and hopefully a fourth in May.
Before I left, I scribbled a perky note to the nurse saying that it was great to see him again even though I can't quite pinpoint seeing him before at all.
When I get my voice back, and my tongue regains its agility, I'll come back to the imaging center, track him down and tell him the truth. With all of the time that I spend at Kaiser, I need to protect my reputation.
The doc wants to schedule a biopsy. After an exchange of e-mails, he and I agreed that I would see him in his office on Monday morning at 9, with an eye on performing the procedure on Tuesday or Wednesday.
The timing Dr. Birusingh proposed is twisting my gut. My body is sick, right? So getting this procedure done sooner rather than later makes sense. That means having the biopsy on Tuesday.
But my brain is a little green and moldy around the edges, too.
See, I have a ticket to see a program called "Juvenile Mindrot: Inappropriate and Disturbing Kids' Cartoons" at the Silent Movie Theatre on Fairfax on Tuesday night. I can't imagine I'd be in any condition to watch banned cartoons in a room full of other sickos like me after spending time under the knife in the Kaiser operating room.
Dr. Birusingh will likely scoop or scrape tissue from my mouth and tongue during the operation. Once I emerge from the fog of anesthesia, something tells me it would be a good idea to avoid the risk of splitting my stitches with a vigorous laugh or two.
I'll decide which day to have the procedure on Monday when I see Dr. Birusingh face-to-face. Maybe he'll offer insight into what he saw in my scans from last night and that will help me decide whether I should move forward as fast as possible, or just fast.
By the way, I dropped by Kaiser early this morning to have blood drawn, pick up a few prescriptions and have the IV I got for last night's CT scan removed from my arm.
I walked up to the counter of the basement imaging center, held up a note that read "Uh, I think I was supposed to leave this behind last night," and pointed to the IV in my arm. The waiting area was full but I was allowed to leapfrog ahead of the other patients and see a nurse right away.
As soon as the nurse saw me, his face brightened. He said that he and I were in the same marathon training group several years ago. I sort of remember him from the training group, which had a hundred members or more, but he clearly remembered me.
"So are you still running marathons?" the nurse asked, as he yanked the tube out of my vein.
I bobbed my head vaguely, which counts as a fib. I haven't run a marathon since 2002, and with a G-tube swinging from my stomach and a tongue swollen to the size of Orca the Killer Whale, I don't have any marathons on the horizon. I have done some nutty endurance stunts on my bicycle, however, including three AIDS/LifeCycles, and hopefully a fourth in May.
Before I left, I scribbled a perky note to the nurse saying that it was great to see him again even though I can't quite pinpoint seeing him before at all.
When I get my voice back, and my tongue regains its agility, I'll come back to the imaging center, track him down and tell him the truth. With all of the time that I spend at Kaiser, I need to protect my reputation.
Thursday, January 8, 2009
Rattled
I was slouching on my sofa, raising a can of vanilla Isosource with one hand and holding my G-tube and syringe with the other, listening to Jimi's "Manic Depression" on KLOS-FM, when the walls of my apartment and the floor began to shake.
I thought, "Is this how it's all going to end for me? Sitting on my butt, tongue swollen beyond the capacity of my mouth, clutching a rubber tube connected to my stomach as the ceiling crashes down upon my head, with Hendrix fighting to be heard above the sound of breaking concrete?"
Well, that was 30 minutes ago or so.
I managed to not spill a single drop of Isosource during the quake, but I did briefly wonder if tonight's feeding was going to be my last meal. Luckily, I was able to fight off that bleak premonition. "Manic Depression" was followed by "New Kid in Town" and I put the quake out of mind, instead cursing Uncle Joe Benson for playing the Eagles at a moment when I had no hands free to use to turn the dial of my radio.
Supper's over now, and I can process the events of the day, which turned out to be another day of progress.
I asked a friend to call Kaiser to schedule a CT scan for me, and he was able to get me in at 5:30 tonight! Before reporting to the basement at Kaiser for that procedure, I stopped by the Head and Neck Clinic across the street and was able to see Dr. Birusingh face-to-face. He said he was delighted that I was able to get the CT scan so quickly, and he promised to phone me Friday morning to discuss the next steps with me. It's likely that I will be having a biopsy.
The CT scan was not uncomfortable. It was similar to the MRI but the CT machine was more like a donut than a cylinder used for the MRI, and it didn't emit weird, loud noises. At the beginning of the procedure, the nurse started an IV on my right arm, and toward the end, I was injected with contrast.
Before I left, I scribbled a note to the CT technician. Tomorrow morning, I have to have my HIV labs drawn for an appointment with Dr. Towner a week from today, and I wanted to be sure that the contrast would not interfere with getting a reading from my blood sample tomorrow. She assured me that it would not be a problem.
What is a problem, however, is that I left Kaiser without having my IV removed. I think that they simply forgot to remove it, but maybe it was my responsibility to tell someone that it was still in my arm.
Well, I'll see if they can use it for tomorrow's blood draw, and then remove it. The last thing I need is more plastic tubing sticking out of my body.
As I write this, Jim Ladd on KLOS-FM has been spinning tunes like "Shake It Up," "Shakin' All Over" and "Whole Lot of Shakin' Goin' On" but now he has segued into a series of Elvis recordings in observance of the King's birthday. Most people in Southern California have probably already forgotten that they thought they were going to be buried in rubble tonight. And I'm looking to the day when I can forget about my medical problems of the past several months.
I thought, "Is this how it's all going to end for me? Sitting on my butt, tongue swollen beyond the capacity of my mouth, clutching a rubber tube connected to my stomach as the ceiling crashes down upon my head, with Hendrix fighting to be heard above the sound of breaking concrete?"
Well, that was 30 minutes ago or so.
I managed to not spill a single drop of Isosource during the quake, but I did briefly wonder if tonight's feeding was going to be my last meal. Luckily, I was able to fight off that bleak premonition. "Manic Depression" was followed by "New Kid in Town" and I put the quake out of mind, instead cursing Uncle Joe Benson for playing the Eagles at a moment when I had no hands free to use to turn the dial of my radio.
Supper's over now, and I can process the events of the day, which turned out to be another day of progress.
I asked a friend to call Kaiser to schedule a CT scan for me, and he was able to get me in at 5:30 tonight! Before reporting to the basement at Kaiser for that procedure, I stopped by the Head and Neck Clinic across the street and was able to see Dr. Birusingh face-to-face. He said he was delighted that I was able to get the CT scan so quickly, and he promised to phone me Friday morning to discuss the next steps with me. It's likely that I will be having a biopsy.
The CT scan was not uncomfortable. It was similar to the MRI but the CT machine was more like a donut than a cylinder used for the MRI, and it didn't emit weird, loud noises. At the beginning of the procedure, the nurse started an IV on my right arm, and toward the end, I was injected with contrast.
Before I left, I scribbled a note to the CT technician. Tomorrow morning, I have to have my HIV labs drawn for an appointment with Dr. Towner a week from today, and I wanted to be sure that the contrast would not interfere with getting a reading from my blood sample tomorrow. She assured me that it would not be a problem.
What is a problem, however, is that I left Kaiser without having my IV removed. I think that they simply forgot to remove it, but maybe it was my responsibility to tell someone that it was still in my arm.
Well, I'll see if they can use it for tomorrow's blood draw, and then remove it. The last thing I need is more plastic tubing sticking out of my body.
As I write this, Jim Ladd on KLOS-FM has been spinning tunes like "Shake It Up," "Shakin' All Over" and "Whole Lot of Shakin' Goin' On" but now he has segued into a series of Elvis recordings in observance of the King's birthday. Most people in Southern California have probably already forgotten that they thought they were going to be buried in rubble tonight. And I'm looking to the day when I can forget about my medical problems of the past several months.
Wednesday, January 7, 2009
What's new, pussyCT?
Caught flatfooted today by an e-mail I received from Dr. Birusingh, the head and neck surgeon at Kaiser.
I had forecast that no news about my condition would emerge this week, since my MRI was just five days ago and I was told to expect to wait a week for results. I checked in with the doc by e-mail yesterday, and just 30 minutes ago, I saw his response in the Kaiser message center.
Dr. Birusingh says that the review of my MRI scan shows swelling of the tongue and upper neck, and he recommends a CT scan of the neck "to more fully evaluate that area."
He continues: "Based on the CT scan, it may be necessary to have a surgical procedure to take a biopsy of that area."
"Biopsy" is a scary word. But it's not the first scary term I've encountered in my quest to get to the bottom of what's wrong with me. I'm not going to get all bent out of shape about it; instead, I'm happy that the MRI didn't come back normal, like the test last month.
Right after e-mailing Dr. Birusingh to say I want to have my neck looked at as soon as possible, I headed over to Wikipedia to learn about CT scans. (In yesterday's Family Circus, Dolly called the procedure a "CAT scan" but I'm not about to mimick the medical vocabulary of fictitious four-year-old.)
"CT" stands for "Computed tomography." The original name was "the EMI scan," because it was developed at a research arm of that British music company.
So the fortune that EMI made off of the Beatles in the 1960s may have bankrolled the research that led to developing the EMI scan in the early '70s. Who knew that when I plunked down my allowance for the "I Want to Hold Your Hand/I Saw Her Standing There" 45 in 1964 that I was making an investment that would reap dividends for me 45 years later?
As far as I can see, the CT scan doesn't look as intimidating as an MRI. Heck, if "CAT scans" are referenced in Family Circus, how uncomfortable can they be?
So ground is being gained on my case. Goo goo gajoob!
I had forecast that no news about my condition would emerge this week, since my MRI was just five days ago and I was told to expect to wait a week for results. I checked in with the doc by e-mail yesterday, and just 30 minutes ago, I saw his response in the Kaiser message center.
Dr. Birusingh says that the review of my MRI scan shows swelling of the tongue and upper neck, and he recommends a CT scan of the neck "to more fully evaluate that area."
He continues: "Based on the CT scan, it may be necessary to have a surgical procedure to take a biopsy of that area."
"Biopsy" is a scary word. But it's not the first scary term I've encountered in my quest to get to the bottom of what's wrong with me. I'm not going to get all bent out of shape about it; instead, I'm happy that the MRI didn't come back normal, like the test last month.
Right after e-mailing Dr. Birusingh to say I want to have my neck looked at as soon as possible, I headed over to Wikipedia to learn about CT scans. (In yesterday's Family Circus, Dolly called the procedure a "CAT scan" but I'm not about to mimick the medical vocabulary of fictitious four-year-old.)
"CT" stands for "Computed tomography." The original name was "the EMI scan," because it was developed at a research arm of that British music company.
So the fortune that EMI made off of the Beatles in the 1960s may have bankrolled the research that led to developing the EMI scan in the early '70s. Who knew that when I plunked down my allowance for the "I Want to Hold Your Hand/I Saw Her Standing There" 45 in 1964 that I was making an investment that would reap dividends for me 45 years later?
As far as I can see, the CT scan doesn't look as intimidating as an MRI. Heck, if "CAT scans" are referenced in Family Circus, how uncomfortable can they be?
So ground is being gained on my case. Goo goo gajoob!
Tuesday, January 6, 2009
Holding pattern
Any breakthrough in resolving my medical problems is unlikely this week.
No encounters with the Kaiser doctors who have treated me so far are scheduled; my next medical appointment is not until a week from Thursday, and that is a routine visit with Dr. Towner, my HIV doctor. This Thursday, I'll get blood drawn so I'll have fresh HIV numbers for that appointment.
There is a remote chance that last week's MRI results will be known by the end of this week, but I'm not banking on that.
While at Kaiser getting my blood drawn, I'll stop at the pharmacy and pick up refills on my three HIV prescriptions that are not available in liquid formulations.
I miss the simplicity of my old HIV regimens, all of which simply required me to pop some pills. Among those regimens, Crixivan, an early protease inhibitor, was the most complicated medicine I ever had to take. I had to take doses of Crixivan exactly eight hours apart, and always on an empty stomach.
I guess I'll know next week if I'm administering my meds properly through the G-tube. I have a tiny syringe for liquid Norvir, a large syringe for liquid Epivir, and an even larger syringe for Truvada, Ziagen and Prezista, the three tablets that I grind into powder and then tap slowly into a syringe filled with water. There are many opportunities for things to go awry, and if precision matters, I may be missing the mark.
With luck, in time I will have only a scar above my belly button to remind me that I ever had a G-tube, and I'll be able to resume swallowing my meds. Everyone tells me that they see that outcome for me. I'd like to believe that they're right.
No encounters with the Kaiser doctors who have treated me so far are scheduled; my next medical appointment is not until a week from Thursday, and that is a routine visit with Dr. Towner, my HIV doctor. This Thursday, I'll get blood drawn so I'll have fresh HIV numbers for that appointment.
There is a remote chance that last week's MRI results will be known by the end of this week, but I'm not banking on that.
While at Kaiser getting my blood drawn, I'll stop at the pharmacy and pick up refills on my three HIV prescriptions that are not available in liquid formulations.
I miss the simplicity of my old HIV regimens, all of which simply required me to pop some pills. Among those regimens, Crixivan, an early protease inhibitor, was the most complicated medicine I ever had to take. I had to take doses of Crixivan exactly eight hours apart, and always on an empty stomach.
I guess I'll know next week if I'm administering my meds properly through the G-tube. I have a tiny syringe for liquid Norvir, a large syringe for liquid Epivir, and an even larger syringe for Truvada, Ziagen and Prezista, the three tablets that I grind into powder and then tap slowly into a syringe filled with water. There are many opportunities for things to go awry, and if precision matters, I may be missing the mark.
With luck, in time I will have only a scar above my belly button to remind me that I ever had a G-tube, and I'll be able to resume swallowing my meds. Everyone tells me that they see that outcome for me. I'd like to believe that they're right.
Sunday, January 4, 2009
Hello, Black Monday
For the first time in memory, I'll be sitting out Black Monday.
Black Monday is the name that I give to the first Monday following New Year's Day. It's the day when people who make a New Year's resolution to lose weight hit the gym to launch or restart an exercise routine. Their presence makes gyms more crowded, meaning that it takes longer for everyone to complete their workout.
Health clubs are feeling the brunt of the financial meltdown, so the invasion of the newly resolute may not be as severe tomorrow as it has been in the past. I won't be there to find out. I'll be asleep when the gym opens, instead of on my way there for a workout before heading to my job.
I haven't shown my face at the gym for one month and two days. On Dec. 3 I got a PICC line in my right arm for intravenous feedings, and two days later I got a G-tube for feedings directly into my stomach. Going to the gym hasn't been a priority, and I haven't gone running or ridden my bike since then, either.
I haven't been able to put weight back on with the formula that I pour into my G-tube; all I've been able to do is stop losing additional weight. I need those calories to get through a sedentary day, I don't want to burn them at a quicker rate by resuming my exercise routine.
And I also feel a little uncomfortable doing cardio with a foot-long rubber tube hanging from above my belly button. I could trip on it; it could get snared into the treadmill; it might get caught on something and rip my tummy right out of my torso.
So this is a good time to take a sabbatical from working out. And I can use the hours that have opened up in my day for other pursuits.
My brain is reaping the dividends of this sudden lifestyle change. Yesterday a friend who knows that I am sick dropped off a stack of DVDs. So instead of burning calories at the gym on Black Monday I can get up early and give my brain a workout by watching "You Don't Mess with the Zohan" or "Sex and the City."
I don't want to get too comfortable being a couch potato, though. AIDS/LifeCycle 8 is less than five months away. While I don't know when I will be able to resume training, I don't want to backpedal on my commitment to ride and raise $5,000.
Black Monday is the name that I give to the first Monday following New Year's Day. It's the day when people who make a New Year's resolution to lose weight hit the gym to launch or restart an exercise routine. Their presence makes gyms more crowded, meaning that it takes longer for everyone to complete their workout.
Health clubs are feeling the brunt of the financial meltdown, so the invasion of the newly resolute may not be as severe tomorrow as it has been in the past. I won't be there to find out. I'll be asleep when the gym opens, instead of on my way there for a workout before heading to my job.
I haven't shown my face at the gym for one month and two days. On Dec. 3 I got a PICC line in my right arm for intravenous feedings, and two days later I got a G-tube for feedings directly into my stomach. Going to the gym hasn't been a priority, and I haven't gone running or ridden my bike since then, either.
I haven't been able to put weight back on with the formula that I pour into my G-tube; all I've been able to do is stop losing additional weight. I need those calories to get through a sedentary day, I don't want to burn them at a quicker rate by resuming my exercise routine.
And I also feel a little uncomfortable doing cardio with a foot-long rubber tube hanging from above my belly button. I could trip on it; it could get snared into the treadmill; it might get caught on something and rip my tummy right out of my torso.
So this is a good time to take a sabbatical from working out. And I can use the hours that have opened up in my day for other pursuits.
My brain is reaping the dividends of this sudden lifestyle change. Yesterday a friend who knows that I am sick dropped off a stack of DVDs. So instead of burning calories at the gym on Black Monday I can get up early and give my brain a workout by watching "You Don't Mess with the Zohan" or "Sex and the City."
I don't want to get too comfortable being a couch potato, though. AIDS/LifeCycle 8 is less than five months away. While I don't know when I will be able to resume training, I don't want to backpedal on my commitment to ride and raise $5,000.
Friday, January 2, 2009
Another MRI
I've tried three times to struggle through the Wikipedia entry for Magnetic Resonance Imaging (MRI) and each time I want to run away screaming.
The first sentence, which explains that an MRI "is primarily a medical imaging technique most commonly used in radiology to visualize the structure and function of the body" is straighforward enough, and gives me courage to move on. The second sentence, which declares that an MRI "provides detailed images of the body in any plane" is also within grasp of my intellect. But I start to get wobbly when I try to follow the third sentence, and by the middle of the fourth sentence I get completely wigged out and I check the URL to make sure I haven't landed on Wackypedia by mistake.
Luckily you don't have to understand the MRI process in order to experience it. I had my second MRI in a few weeks early this morning. I trust that the radiologists at Kaiser understand what MRIs are all about and got satisfactory images of my head during the hour I laid flat on my back inside a cylinder about two feet in diameter.
This MRI was different in several ways from the first one that was performed last month. For one, it was in a different location: the basement of the main hospital at Kaiser Sunset, rather than a stand-alone building further north on Edgemont Street. With a duration of more than one hour, it was also longer than the previous procedure. Finally I was partially restrained from movement by a device that was placed on my head, and the technician kind of tucked me in before I slid inside the cylinder, which was a nice touch. I haven't been tucked in for a good 40 years.
I'm sure that the MRI technology is very state-of-the-art but to me the MRI machine looks like something out of Woody Allen's "Sleeper." I try to not look at it, frankly. As soon as I feel the bed moving into the enclosed area, I close my eyes and keep them shut until the procedure is over and I slide out.
It's the noises during the procedure that really strike me as bizarre. You could almost dance to an MRI, if you didn't know that dancing during an MRI would screw up the whole thing.
So I'll save my urge to dance for the day I get the results from today's procedure. With luck, today's MRI detected something going on in my head that will lead to an effective treatment. I'll know in about a week.
The first sentence, which explains that an MRI "is primarily a medical imaging technique most commonly used in radiology to visualize the structure and function of the body" is straighforward enough, and gives me courage to move on. The second sentence, which declares that an MRI "provides detailed images of the body in any plane" is also within grasp of my intellect. But I start to get wobbly when I try to follow the third sentence, and by the middle of the fourth sentence I get completely wigged out and I check the URL to make sure I haven't landed on Wackypedia by mistake.
Luckily you don't have to understand the MRI process in order to experience it. I had my second MRI in a few weeks early this morning. I trust that the radiologists at Kaiser understand what MRIs are all about and got satisfactory images of my head during the hour I laid flat on my back inside a cylinder about two feet in diameter.
This MRI was different in several ways from the first one that was performed last month. For one, it was in a different location: the basement of the main hospital at Kaiser Sunset, rather than a stand-alone building further north on Edgemont Street. With a duration of more than one hour, it was also longer than the previous procedure. Finally I was partially restrained from movement by a device that was placed on my head, and the technician kind of tucked me in before I slid inside the cylinder, which was a nice touch. I haven't been tucked in for a good 40 years.
I'm sure that the MRI technology is very state-of-the-art but to me the MRI machine looks like something out of Woody Allen's "Sleeper." I try to not look at it, frankly. As soon as I feel the bed moving into the enclosed area, I close my eyes and keep them shut until the procedure is over and I slide out.
It's the noises during the procedure that really strike me as bizarre. You could almost dance to an MRI, if you didn't know that dancing during an MRI would screw up the whole thing.
So I'll save my urge to dance for the day I get the results from today's procedure. With luck, today's MRI detected something going on in my head that will lead to an effective treatment. I'll know in about a week.
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