Wishful thinking

I bit down on my tongue. Hard. Held my breath, fixed both eyes on a spot on the carpet by the bed, told myself don't cry. I'd managed to get from Seattle to the panhandle of Texas despite surgery, despite infection, without letting on to anyone how I was feeling. My doctor had cleared me to fly, and I needed to go home. For my research, I'd told myself -- to look firsthand at the photos and old letters from my parents' early years together, before I was born, to begin untangling their story for my thesis. That's what I'd finally realized this project was about.

Don't cry, I thought harder. Don't cry don't cry don't cry. But my mother had her arm around me.

"You've been so good," she said. "It's okay, you don't have to be strong anymore today."

Don't have to be strong? Since when did she ever use words like that? The spot on the carpet dissolved into a uniform blur and I buried my head in her shoulder, bewildered but relieved.

"You're so warm," she said after a few minutes.

I lifted my head. "It's fine," I said. I reached for a tissue and glanced toward the door, hoping my father, who usually spent the evening watching TV on the couch just outside the room, couldn't hear us. "This fever's not as bad as the first."

My mother frowned but said nothing, a hand still holding tightly to my shoulder as she surveyed the suitcase on the floor, the airline ticket stubs on the nightstand. "You've had a long day. Now you should just rest."

I pulled the robe she'd lent me closer, leaned my head against hers, and closed my eyes.

*

I remember getting sick as a kid -- flu, strep, bronchitis, the usual. All of which meant long mornings at the pediatrician's office that smelled like old vinyl seats, worn-edged board books, and that nose-wrinkling soap you found only where there were doctors. We never said it aloud, but I don't think my mother or I particularly liked that place.

My mother tended to look worried during those visits, but not because of me. My father would be irritated when he got home. While he doctored the sick every day at the hospital, giving his all to an endless string of cardiac patients, he didn't tolerate illness in his own house. Most of the time, he'd just ignore the problem, leaving my mother to handle all the nursing duties -- administering medication and fluids, keeping track of symptoms, cleaning up vomit. On occasion, he'd pop his head into the bedroom doorway to assess the situation, but he never crossed the threshold.

He did, however, expect my mother to keep the rest of the house running as usual. A hot meal ready to serve, the newspaper waiting by the couch, bills paid, phone calls made, my younger sisters bathed and fed. If things weren't as he felt they ought to be, he'd whine -- at me ("Are you still throwing up?") and at her ("How much longer before dinner? It's getting late."). My mother couldn't help growing annoyed in turn. She never said anything directly to me, but the look on her face when she was caught between my needs and his said plenty: he wouldn't cut her any slack. Couldn't I?

Hers was obviously wishful thinking, but I felt guilty all the same. So I learned to downplay how I was feeling, even if I was miserable. It was better than feeling like a nuisance, even if I wished deep down that it didn't have to be that way.

*

My body remembered this as I leaned against my mother, so many years later, in the dimly lit guestroom of my parents' new house. The mattress on the bed was old, but the comforter was brand-new to match the pillow shams my mother had sewn. "To update things," she'd said a few weeks earlier on the phone, telling me how much she couldn't wait for me to see what she'd put together. She'd wanted to work on the room sooner, but in my parents' nearly four years in Panhandle, she hadn't gotten around to it until then. It didn't matter to me -- being with her, no matter what kind of bed I slept in, was what made home feel like home. Though I did like what she'd chosen, knowing that I would be the one to curl up there.

And how I wanted to do just that. But I didn't want to move while she sat next to me, holding me close. How I'd wanted this too, in those moments when she'd been forced to choose between me and my father. Even early that evening, he'd only grunted, when my mother mentioned I'd been ill, and then complained about what had taken her so long at the grocery store, where she'd gone to get the fresh fish he'd wanted for dinner. Nothing seemed to have changed.

But my mother's arm stayed around me as I glanced toward the door, listening for sounds of the TV, long after the meal had ended. "He's gone to bed," she said. "Don't worry about him."

I dabbed at my eyes, not sure what to say. But for once, she seemed to understand how much I needed her, even more than I'd realized.

Things I am grateful for, or an epistle to the powers that be

Dear Life:

You and I have had our ups and downs this year. Mostly downs, by any measure, but let's not quibble over the finer points therein. Suffice it to say that in general, 2010 has been unmatched in this Troubadour's experience of "rough patches," "tough spots," "suboptimal circumstances," or any other euphemistic label you'd like to slap on it -- despite multiple appeals for relief. To which I have to ask, at the risk of sounding repetitive: WTF?

I have not, in the past, been a big bright-side seeker. I lost my innocence a little too early on to develop the habit. But I'm willing to try almost anything at this point, given the November you've served up so far. And as tomorrow is Thanksgiving, I figure now is as good a time as any to start. So whatever you are -- an entity indifferent to the human plight or one whose intentions for me have yet to make any sense -- listen up.

In the last week, I was grateful for the following:

• Getting to see one of my dearest friends from college, who happened to be interviewing in Seattle for a medical residency at the UW and needed a place to stay. Never mind the kidney infection you decided to make apparent to me with a raging fever and teeth-rattling chills, about the time her flight was going to arrive. The ER was on the same route as the airport, so it was convenient for D to drop me off and continue on to pick her up. A reunion in one of those skimpy hospital gowns was not what I'd envisioned, but I have never been happier to have company. The laughter that came from behind the curtain in my ER bay for the hours we were stuck there should be proof enough of that.


• Having my white cell count remain oddly normal in the ER, despite the fact that the infection had already spilled into my bloodstream by the time the poor nurse assigned to me found a usable vein to get the IV antibiotics going. (Is laughter, indeed, the better medicine?) The delayed immune response fooled the hospital into discharging me on the same night rather than admitting me for what was actually a much more serious condition (bacteremia, with the potential to turn into straight-up sepsis). It was nice to get to spend a few extra hours with my friend outside the hospital, which we used not wisely but very well. We took the conversation home and didn’t end it till nearly 3 a.m.


• Having the blood cultures come back soon enough the next day to get word to my urologist, who promptly called in the extra antibiotics I would need to make sure the infection was properly treated (the ER doctor prescribed only 7 days' worth; turns out I needed 14). Without them, I would have been short on meds for the length of my research trip. Which brings me to ...


• Getting to go on said research trip, despite the severity of the aforementioned infection. I know the party line, per the infectious disease consult ordered by the urologist, was to cancel my plans, but she and I decided that the calculated risk of getting on a plane for a few hours to spend a week essentially under my parents' care (the arrangement was for me to stay with them while doing the research) was reasonable to take. Yes, you made me pay for it by giving me more chills and fever while I was somewhere over Utah, but I was armed this time with enough antipyretics to kill a buffalo. So I'm still glad I went. Recovering in Panhandle, Texas, is essentially no different from recovering in Seattle. And Mom's chicken soup beats any I could make.


• Being lucky enough to have scheduled my return flight between that arctic front's passage over Seattle and its subsequent arrival in Panhandle. For a few days before the anticipated snowy cold snap, we were concerned that I might get stuck in Texas for the holiday, leaving D on his own for Thanksgiving. But I'm home now, thanks to a little mercy from the travel gods, and we will have turkey together tomorrow. Given the last month's health ridiculousness, we will not be throwing the usual fete we love to put on nor will we be traveling to share the holiday's bounty with the numerous folks from out of town who have invited us. But we are glad that I'm on the mend (for real this time, we hope) and look forward to the long weekend, if only just to rest.

So. Here's to a happy Thanksgiving. May what remains of 2010 offer much to be grateful for. (I wouldn't mind, though, if the things to be happy about were packaged with fewer associated challenges ...)

Sincerely,
C. Troubadour

Warning: rant ahead, or a peek into the mind of a food-anxious freak

What follows is an account of one day in my battle with disordered eating. I have fought this problem since before I was old enough to drive a car. It is one of the reasons I finally sought professional counseling through a dietitian this summer, though I didn't know it at the time.

In the months since my work began with the dietitian, I've made many gains. But under the right (wrong?) circumstances -- such as the recent weeks of stress -- backsliding happens. I'm writing about that for the first time here, now, because it's better than keeping silent.

I should have paid attention to the sinking feeling this morning.

It's the kind you get when you haven't eaten in a few hours and your blood sugar dips. Your stomach is growly and your head gets thick and it is all you can do to remember where you were supposed to go next -- much less what you were supposed to do once you got there -- on that list of errands you'd set for yourself.

It was another early morning. And you didn't count on things taking so long. Take a snack, your brain was saying as you headed for the car, wishing you could just stay home. But you were tired and you didn't want to have to have that snack. In the fuzzy logic -- or plain mule-headedness -- of on-the-way-out-the-door thought, you told yourself a doctor's appointment, a haircut, and an in-and-out trip to the grocery store should not take more than three hours. You'll be home right on time for your next meal,* you said. Screw the snack. It's extra calories you don't need. You've lost a little weight in the last month -- don't you want to keep things the way they are?

So you get through your appointment. When you get to the salon -- the bargain-basement walk-in one that also happened to put out a coupon that you needed to use this week if you wanted the additional savings -- you find two other people ahead of you in line. Okay, no problem. You flip through the look books since you haven't had a trim in six months -- better find a picture of what you're supposed to look like so whoever on the rotating staff is assigned to you will do the job right.

And you wait.

And you wait.

And you wait some more. No reason things are slow except that there are only two people working. By the time the woman with the scissors is ready for you, you're regretting that snack you told your brain to forget. The stylist does a good job, a thorough one. So thorough you're wondering if she's cutting each hair individually. And this is just a trim? The morning you thought you'd still have, after finishing these errands, slowly begins to slide out of reach. But, oh good, the stylist is finally done.

This, if you weren't going to take that snack, is where you should have gone home right away instead of trying to stick things out.

After leaving the salon, you head over to the grocery store. What did you need? It takes effort to remember, even though it's just two items. One of them -- salad greens -- wouldn't even be necessary if the greens you bought last Thursday, with an expiration date of November 10th, hadn't already decomposed by the 7th. But you need those greens. What the hell else are you supposed to fill up on if bread and crackers and cereal and all the rest of the food you've ever loved can only be eaten in portions that would make a mouse cry?**

At last, you do get home. You make that salad -- a quarter of an apple, an ounce of goat cheese, not quite a tablespoon of olive oil and balsamic vinegar, tossed with the greens -- and slap some turkey with mustard on low-carb bread. It's a good lunch, a filling one. But you've eaten the same damn lunch for five days straight*** because you've been on autopilot with everything else going on. And now you want what you know you can't have: anything with more than 15 grams of carbs per serving. In any quantity you like.

You wait out the cravings. You're supposed to get on with the rest of the day anyway -- so the morning's gone, and you haven't showered yet, and the workout that you've been hating lately but that you cling to because it means your body still functions and your weight is still under your control needs to be done. But then the phone rings. And you're so lonely that you will totally blow another two hours talking when you know you'll be mad at yourself for shoving off more of the afternoon. Your resistance is waning.

When you hang up, you head for the kitchen. You need fuel for the workout, or that sinking feeling will get you halfway through. So you allow yourself some carbs.

But you've got no willpower left. Between the sugar lows and the lost morning and the loneliness and the sheer sense of defiance you have against all that the universe has thrown at you this year and the last with no rhyme or reason, you've HAD it. Before you can stop yourself, you've inhaled enough from the pantry to horrify your (former) endocrinologist and alarm your dietitian, the latter of whom you should call and 'fess up to right now so she can help you.

And I will.

Tomorrow.

* Eating meals at regular intervals is helpful in maintaining optimal blood-sugar levels and preventing binges.

** Obviously, this is a bit hyperbolic, but when your brain has no fuel, it doesn't process thought very logically or reasonably.

*** Creating variety, even only slightly, in what you eat can be helpful in preventing boredom, which can otherwise trigger binges.

Foggy

My writing brain is sluggish tonight. Yesterday morning started early for me; I had to beat traffic going downtown to have some labs drawn. And even though I slept in today, I'm dragging now. Thank goodness for the end to Daylight Savings Time. The day we "fall back" is one of my most favorite in the year.

When I got to the doctor's office, things were pretty quiet, unlike Wednesday afternoon, when I was there for follow-up with the new internist. The lab techs were just getting started with their preparations for the day -- filling syringes with flu vaccine, restocking vials for blood -- and I didn't have to wait to be called in. The woman with my lab orders waved me over right away and started tying a tourniquet around my arm.

"You fasting?" she asked.

I nodded. I hadn't been sure if the tests required it, but it seemed better to err on the side of caution than to have to reschedule the draw -- one of the tests could only be done first thing in the morning.

I glanced at the labels the woman had printed out for each vial of blood and noticed the number was remarkably short for what I'd seen on the day of my follow-up appointment. (The tech who had originally printed them that afternoon had advised me to wait, given the morning-only test, and have all the blood taken at the same time to save me an extra needle stick.) So -- "We're doing cortisol, anti-TPO, vitamin B-12, and vitamin D today?" I asked, just to be sure.

"Hmm? No, no, I've just got lipids and a hemoglobin A1c," the woman said. "Wait, what's your name again?" She fumbled around with her order sheet for a moment as I gave her my information. "Oh yes, I remember! The other girl said you were going to come back today to get everything done and she taped your other labels to the fridge -- "

We both turned to look at the refrigerator, whose doors were bare.

"Shoot," the woman said, untying the tourniquet. "Wait right here."

I've learned not to be surprised when snafus like this occur. Even as recently as Wednesday, there were some near-mistakes that happened -- the physician ordered the wrong test and only realized it when I asked her why she'd chosen it over an alternative that was purportedly more accurate; then the lab tech handling a urine test gave me the wrong label for the specimen cup and only realized it when I pointed out that it was for the second of two urine tests my doctor had ordered, which could only be done while I was symptomatic (I wasn't that day).

Is it just me, or does it seem like I'm having to double-check what shouldn't be mine to check in the first place?

The woman taking my blood Friday morning eventually found the labels she needed -- in a garbage can. Lucky for me; apparently, once those labels are printed, the request records leave the lab computer and go to a completely different facility where specimens are received (that way, the folks handling that step in the process know exactly what to look for). I don't know whether we would have ended up having to call the receiving facility to figure out what testing needed to be done or if anyone was even at said facility at that time of day. Either way, it wasn't going to be a simple fix.

So. I'm grateful that everything worked out in the end. I just hope the incidence of error drops in future visits. For the next set of tests, scheduled for Wednesday of the coming week, I'll be sedated -- and there's no way I can look out for myself like that!

Two-faced

Halloween was a low-key affair this year. Last week, we again attended the annual pumpkin carving party one of D's friends likes to host, but we didn't go in with a plan as we did the first time. Just a gourd of a ghoulish hue and a vague idea of what we might put on it. Here's the end result:


A pair of eyes apiece -- the ones on the right are mine (adapted from a template) and the others belong to D (carved freehand).



I'm amused that the creepy gaze I thought I was creating ended up looking more concerned than anything else. I guess having another face emerging from the side of one's head would be a good reason ...

Halloween night in question was busy, and not just because we got about 200 trick-or-treaters (fairly standard in our neighborhood). We had a last-minute guest, one of our friends from Portland, who was supposed to be on vacation in Venice but had had his passport turned down the day before at the Portland airport. Too beaten up, the gate agents told him. His only option, if he still wanted to make the trip, was to get a new document issued from the nearest emergency processing center -- which was in Seattle.

"I'm going to be fairly rotten company," he warned me ahead of time. Which was completely understandable. But I paused before telling him that I might not be much fun either. Even though we've known each other for more than a decade, I still hesitated to say anything about what's been going on in the last few weeks. On the outside, there are no obvious signs that mark me -- perhaps I look more tired than usual and my clothes are a little looser, but no scars, no broken bones. Still, I've had my resources tapped repeatedly, dealing with unpredictable pain, diverting whatever energy I have into finding a doctor who will listen, waiting for a diagnostic plan to take shape.

As I hinted here, these aren't things I like to tell people in real life, not even my family, because pain, both physical and emotional, is so intimate. To admit to someone that you hurt is to take a risk -- that the other person will respond insensitively, that he or she will downplay your experience, that you will feel worse for having said something in the first place. So I've learned not to talk about pain out loud if I can get away with it; I do it in this space instead.

But with someone I've known so long, it also feels dishonest to pretend all is well. And I'd been run down enough in the last few weeks that the act of pretending was going to be too much in person, especially because the physical pain is so unpredictable; it can flare up at any time. So I told my friend in brief that I wasn't in the best shape. The result was an awkward few seconds on the phone -- he acknowledged what I'd said but didn't seem to know what else to offer. Then someone came to his door and he said he had to go.

So I'm still turning one face to the outside world and letting the other exist here. I wish there were a way to integrate them more. But for now, this is the best I can do.

Them's fightin' words

I knew getting a dietitian was the first step toward some important changes, but apparently it's starting a small revolution.

I think I'm firing my endocrinologist.

It's not a straightforward story, but the short version is that on my visit to said endocrinologist's office last week to follow up on that pesky kidney stone, I updated him on the diet adjustments I've been making with the help of my dietitian. And he wasn't happy -- the caloric allowances she'd laid out for me didn't jive with what he thought I should be aiming for (he was advocating a much tighter budget). Not one to sit helpless when given conflicting information, I asked him to speak with the dietitian so that we could determine where the disagreements were in their assessments of my needs. His response: "Tell her that I have a subspecialty degree in metabolic disease" -- or some such field, I can't remember his exact words -- "and if she still has questions after that, she can call me."

Huh. Did he really think she (or I) was going to accept credential-waving as an adequate reason to follow his plan?

Sensing I was getting the brush-off, I e-mailed the dietitian after I got home, explaining the discrepancies between the recommendations, and expressed my concern. She immediately got back to me, promising to contact my doctor so that we could get the diet guideline questions resolved.

Apparently, he wouldn't talk to her.

Instead, he left a message for her with his nurse -- one that wasn't far off from what he'd told me to relay, from what I've gathered. And he's still refusing to take the dietitian's calls.

Is it ego? Insecurity? A control issue? All of the above? I'm done speculating. I need a care team, one in which the various members work together. If someone's refusing to communicate, much less collaborate, there's no way this is going to work out in my best interest. So I'm removing myself from his responsibility.

This has been a long time coming -- over the last few months, this guy has said and done other things that left me feeling unsupported and unheard. It's not worth going into detail, but each incident eroded my trust in him just a little bit more. I'm glad to be able to leave his service, knowing without question that the problems with him aren't "just in my head."

But finding that next person. I can't say I've got a lot of confidence in the current remaining team members (with the exception of the dietitian) -- they communicate minimally, by faxed lab results at best. This endocrinologist was kind of the only person who at least went through the motions of examining the bigger picture (he made the referrals to other specialists, so he got their letters back interpreting the results of their tests). I need someone willing to take the time to look closely, to pursue answers.

I happened to read Big Little Wolf's commentary on the doctor-patient relationship as all this was going on, and that, among other things, has reinforced what I've known for a while: that my search isn't going to be an easy one. But I'm looking because I have to. This mess -- or message service -- masquerading as coordinated care has gone on too long.

And I will totally sic all seven pounds of my attack kitty on the next M.D. who tells me his degree is what makes his plan (or lack thereof) superior to anyone else's.

Every kidney has a silver lining, the sequel

Yep, this little nuisance again.

You'd think I'd recognize a kidney stone after the first one, but no, this one presented itself quite differently. Referred pain? You got it (rather, I did).

So a good part of Friday found me waiting here (the hospital's walk-in imaging clinic):


Not exactly my first choice for where to spend all that time. But when the ultrasound didn't reveal anything amiss in my gallbladder (a good thing!), the GI folks had to refer me to somebody else (with a practice in the same medical facility, but an entirely separate registration/appointment process). That doctor, whom I got to see only on the luck of some other patient's cancellation, sent me back to the clinic for an x-ray, which revealed the real cause of all the trouble.

The doctor was very kind and hung around after his office had closed, just so he could interpret the x-ray for me (it was late in the day when he ordered the test, so there was no way the radiologist would have the official report to him in a timely fashion). He could have gone home and told me to wait for the results, to be delivered by phone after the long weekend, with orders to go to the ER if things got worse before then. But he didn't, and I'm thankful. Because of his kindness, I was able to go home with an answer and greater peace of mind. I'm still under orders to go to the ER if anything untoward occurs, but given the size and location of the stone, that's very unlikely.

Who knew I'd be glad to have a kidney stone instead of the alternative?

(Don't get me wrong; it still hurts. But given the choice, while alone, I'd rather deal with a problem I can treat from home as opposed to something that requires hospitalization, no matter how routine. Who would feed the kitty?)

I just hope I'm not in for a repeat of this in the future. Especially since it occurs without warning and in such misleading ways! Worst fear: that it happens while I'm on a plane. If I'd gone with D on Thursday instead of staying behind to work on my thesis, I'd have been somewhere over Texas during the nastier part of that afternoon. I suppose I should thank my writing obligations for preventing that ... ?

Tuesday

... was hard.

Well, for that matter, Monday was too. I had my follow-up appointment with my local GI doctor to talk about the plan going forward after what he lightly referred to as the Million-Dollar Workup.

I was glad he wasn't put off that I'd gone to someone else for all the testing. I'd planned to be forthright about discussing the findings, no matter how he seemed (I did have all the new data sent to him). But it was a relief all the same that we didn't have any awkwardness about it.

The good news he had for me: my liver enzymes are completely back in the normal range. Which means I can drink again -- at last! -- with continued monitoring every few months.

The bad news I had for him: this little problem called depression is not going away.

It is not the fault of any single thing. But we were supposed to start trying to have a baby this month. That was, in essence, the plan D and I framed up last summer, which was why we were so intent on getting my health issues fixed -- or at least properly examined to see what kinds of risks and other concerns we needed to take into account before trying to get me pregnant. We went to a reproductive endocrinologist, who ran the usual blood tests to get baseline readings, which revealed the abnormal liver numbers (you know the rest of that story). He also discussed the things I ought to consider to get my body in the best shape for this new adventure -- including tapering off the antidepressants I'd been taking since mid-2008. Commuter marriage? Not good for someone who's been dealing with chronic blues for a long time. But D and I were done with that, and I was working through family stress in my writing. I felt ready to move forward.

So I timed the step-down very carefully, waiting till after the holiday season to attempt it. The process seemed to go well; by the first week of February, I was done.

But the combination of things that was the rest of that month -- I didn't anticipate how they would affect me. I thought I was in a better place; really, I did.

No.

Of course, it's not just February I'm trying to work through. February was just a month of triggers. But, given their effects, it's clear that there are underlying griefs I haven't found a way to manage completely. And knowing that, knowing I haven't yet achieved that goal is what kills me now. Because I wanted to be ready for motherhood (at least, as ready as one can hope to be). The reality is that there's no way I can look myself in the eye and say, "Sure. You can handle it." I know at least that much about where I am, even if I don't know much else.

And yet. No matter how wise that decision, for me and for the little life that will be utterly dependent on me, it is still heartbreaking -- because of the delay, because of the reasons for the delay, because there is no clear mark on the horizon to tell me when the delay will be over. And the irony of it all: the antidepressants were quite likely the source of the liver damage.

I know I shouldn't be hard on myself about this as it certainly won't help. If there's anyone who needs to be in my corner with me, it's me. "You've got a lot going on," the GI doctor said sympathetically as I confessed to him that I'd relapsed (with not just the GI problems but also depression) and what that meant for our plans for a family. He urged me to take care of myself first.

I spent much of Tuesday trying to write this post, but it was still too hard to put everything into words, so I gave up and cuddled our foster kitties for a while. They seemed to know I needed their company and stayed close. Today, to my relief, felt better -- even though what I've described isn't a fraction of the way it all feels, at least some of that was writable, which means I'm working through it. I am taking care of myself here.

I just wish I didn't have to.

$%!#

I hadn't been blogging about the outcome of all the testing for a lot of reasons.

For one, I needed a break from thinking about it. And I certainly didn't want this space to become all medical, all the time. Then the diagnosis, while a diagnosis, was still preliminary, so I didn't want to jinx it by talking about it -- I figured I'd get my prescriptions filled (a combination of antibiotics and probiotics), start treatment, and await the results before mentioning anything here. Things were looking good too! No nasty GI symptoms for a week and a half. I was stoked.

But this morning, I woke up to a gastrointestinal mutiny.

What the hell happened??? Of course my brain shifted into analytical mode and started counting off possible causes. Last night's leftovers? (Not likely, barely two days old, quite properly refrigerated, and without effect on D.) Side effects of the antibiotics? (Doesn't make sense -- wouldn't they have made themselves known early on?) How about the shellfish from two weekends back. (Again, doubtful, given the time lag.) That leaves -- uh oh.

Did I mention we picked up two foster kitties on Friday? And that one of them recently tested positive for giardia? I had no idea until after I'd gotten them home and had time to read their medical files thoroughly. Kitty's been treated, but still. Gulp.

I've always been very, very careful about handwashing after handling any of our fosters. These parasites, however, are especially tenacious -- you have to boil them to death. Unfortunately, as much as I'd like to, I cannot plunge my hands into boiling water every time I finish grooming our furry guests or scooping their litter.

Please, after these last nine months of GI evil, let me not have gotten giardia.

The problem is that its symptoms, from what I've read, are essentially indistinguishable from malabsorption resulting from other causes (the issue I had to begin with). In my case, Dr. Specialist was guessing I had a bacterial imbalance in my small intestine. And a significant reduction in symptoms after this course of antibiotics would mean he was probably right.

But now, now there's this new variable. Possibly throwing off this test, as it were. Does it mean further months of not knowing for sure what's wrong? Are we going to be playing the watch and wait game all over again? And which doctor am I supposed to call -- Dr. Specialist, who is nearly impossible to get hold of because of the system he works within, or my local GI guy, who seems to be a bit more conservative (read: in no rush to get an answer) in his diagnostic approach?

I know, I'll call both -- Dr. Specialist first thing tomorrow and as many times as is reasonable (it's too late in the day to reach him now). If no answer after a day or so, I'm moving on to local GI guy. That's the best I can do. I just wish I could do something more in the here and now to help me feel less frustrated.

Well, in a way, I suppose I already have. I bought myself some potted gerbera daisies last week because they caught my eye at the grocery store. Took them directly to our bathroom, our makeshift spa for plants. They're hanging out at the edge of the tub, the first thing I see whenever I walk in there.

In hindsight (yep, back to the poop humor again), flowers were a great idea.

Because this never happens

... I had to take a picture. Yep, those are my (rather foreshortened) legs stretched across all three seats on the plane from Chicago to Seattle on Tuesday. Thank you to the two passengers who decided they wanted upgrades or standby seats on an earlier flight. You made those four hours so much better than they might have been.

It looks like all the testing is over for at least a month. And several of the tests came back with results we can actually work with, so it was very much worth all the trouble. Many thanks to Dr. Specialist for the very thorough work-up and for helping me retain some sense of dignity through what were some fairly dignity-robbing circumstances. Many more thanks to Almost Dr. Sis for getting me where I needed to be for all those appointments -- I know it couldn't have been easy with the tough stuff you were dealing with in your own life. The gods of timing, eh? How they mock us sometimes.

I'm happy to say I've recovered from the last round of sedation (Versed + Demerol = one very groggy Troubadour, even more so than after general anesthesia! WTF?). That said, it's taking me longer to bounce back from these last two weeks than I thought it would, for a lot of reasons, some unexpected.

Fortunately, D and I have a long weekend planned just for us at a local bed-and-breakfast. So I'm looking forward to that. Maybe when we get back, some more trip-related news. And if not, then definitely one more curlicue-related story.

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.

Good news!

Avoiding this stuff is paying off.

I went to see my endocrinologist today, and he says my blood work looks terrific. The cholesterol (LDL) levels are continuing to come down (87 now, with the goal of 70 or under) and my oxalates are finally within spitting range of normal (34 now, with the goal of 30 or under). So in his book, I'm in fine shape. "Don't change a thing!" he said at the end of my appointment. "This is exactly where I want you to be."

It is so nice to hear that I'm doing things right. It may not mean that I get my pancreas back to its normal function, but I'm maintaining the status quo, and that means no drugs. Just diet and exercise as usual.

The picture above is from my trip to visit Almost Dr. Sis -- this is like her version of Pike Place Market, and it had so many tempting tasty things at each stand. We steered clear of the bad-for-you items and got some fresh salmon, which Almost Dr. Sis grilled up for dinner. Amazing stuff, especially with fresh asparagus and Mom's recipe for wild rice pilaf and stir-fried mushrooms:


Speaking of which, it's time to start dinner. I'm turning in early after that -- the endoscopy is tomorrow at 7 a.m. Looking forward to having that over with! If all goes well, I'm treating myself to sugar-free molten chocolate cake for dessert afterward.