The devil is in the details

So Thursday's pancreatic function test went off without any complications (or so I'm told since they put me under for the procedure). Results should be available in a few days. Until then, I'm busying myself with (what else?) thesis work and keeping a close eye on what I can and cannot eat for the rest of this trip.

The problem is that the restrictions change from day to day. For the next test, which is in progress at the moment, Dr. Specialist is having me eat as much fat as possible (aiming for 100 grams per day) so he can measure how much of it isn't getting absorbed. Hence the last few nights of dis-figuring dining: burgers topped with blue cheese, spring rolls from scratch, and butter-drenched shrimp scampi (see below). Goodbye, waist; hello, tasty, tasty stuff. With gut-wrenching side effects.

Photo courtesy Almost Dr. Sis. This is actually a shot of the dish when she
prepared it three weeks ago -- last week's has been demolished.

On Wednesday, I'll be switching over to this diet to prepare for Thursday's test, which measures levels of GI-tract bacteria:

• white bread (no fiber, no whole grain)
• eggs (hard/soft boiled)
• grilled or broiled chicken (seasoned with salt and pepper only)
• white rice (seasoned with salt and pepper only, no butter or margarine)
• tuna fish, baked or broiled white fish seasoned with salt and pepper only
• turkey or chicken lunch meat
• plain water (not flavored)
• coffee or plain tea (no dairy, sugar, or artificial sweeteners)
• clear chicken or beef broth

Talk about drastic changes!

After that, I get 24 hours of more-or-less normal eating, then I start removing all whole-grain foods, salad greens, and dairy, progressing (regressing?) to nothing but clear liquids and a tasty little prep solution on Sunday to prepare for Monday's colonoscopy.

Yeah, the procedure my parents had last year, the one recommended for people once they hit age 50. I am so not close to 50.

But I sort of saw this coming after the last appointment with my GI doctor in Seattle. And fortunately, growing up in my family meant automatically developing a commodious sense of humor, so Almost Dr. Sis and I have been cracking poop jokes for a week to keep things light around here. I mean, why pass on such a bottomless can of laughs? (You can groan all you like.)

But in all seriousness, I cannot wait to have that colonoscopy -- if only so I don't have to refer to my Google calendar to see what the day's menu requirements are.

On faith

It's still January, but our tulips are coming up. WTF?

I went out to mail something at the beginning of the week and right by the front door, there they were, these happy little green leaves poking their way up, fully confident that winter had ended. I hope they don't get disappointed by a sudden cold snap before spring really arrives. I know, it's not too far off -- everything greens up fairly early here. But there isn't exactly a way for these guys to retract or change course now that they've committed to putting themselves out there.

I kind of wish I could be that confident.

Monday, I went to my GI doctor for follow-up. I finally had that long-awaited blood draw last week, so the plan was for me to get my results from him and talk about the plan going forward after the developments from December.

Well, the results were so-so. One of the liver function tests actually came back with results in the normal range, which is great. The other one, however, was still outside of normal. It did come down, but not far enough. So we'll recheck those in three months.

This isn't what's making me feel a want for mettle, though.

Back in December, when Troubadour Dad decided to push for a consult from a specialist at Almost Dr. Sis's medical school, it wasn't just a "why don't you get a second opinion?" sort of conversation. Troubadour Dad is very opinionated, shall we say. My responses to his questions about what I'd had done so far in my workup were all met with some kind of editorial comment. "Those GI guys just like to do procedures," he said with a knowing nod when he found out I'd had the endoscopy. "That's all they're interested in."

"He did find some erosions in my stomach lining," I said meekly. "I mean, that's good that he caught those early --"

"Yeah, sure," Troubadour Dad said. "That's his way of justifying doing that procedure so you'll feel like it was worth it. That's where they make their money, you know."*

I didn't say anything more at that point. But the damage was done.

On Monday, my GI doctor said that the symptoms I'd been getting since December were still not indicative of something specific. "Basically, you're still an unknown," he said. "We can either let it hang for now, or if you're not totally, totally happy, my next step would be a colonoscopy."

Well, I can't say I want one of those, but before that conversation with Troubadour Dad, I wouldn't have questioned that treatment plan. Instead, I've got this little voice in my head now that keeps whispering my father's words over and over. Talk about crazy-making. Add to this my worries that my GI guy knows I've had my records sent to the other specialist -- and therefore has reason to believe I don't trust him -- and I start to wonder if he's suggesting we "let it hang" because he doesn't see a point in putting further effort into a diagnosis if someone else is going to do it.

Okay, that last idea was probably a bit nutty, but I do know that doctors aren't immune to their own egos. Troubadour Dad's a prime example of that. What intensifies that problem is the father-knows-best mentality he brings out whenever he doctors his own kids. This is why I don't talk about my health with him if I can avoid it. Unfortunately, I couldn't really give him any other explanation but the truth when I wasn't drinking over the holidays. He knows me too well to think I'd just stop because I felt like it.

Anyway, about confidence. I just want to feel that it's okay to trust whom I've chosen to trust while we're figuring out what in the world is wrong with me. It's no help at all to doubt those people. But that voice, my father's voice. It's dogged me since I was a child, has told me I'm not wise enough -- will never be wise enough -- to know what's best for me, in my health, my career, my life. Most days, I work pretty hard to ignore it. But during times like these, I just can't seem to shut it up.

* GI doctors, please don't take what Troubadour Dad says personally; he's not out to insult you alone. He's got plenty more to say about folks in other specialties that are also not his own.