Friday, September 30, 2005

sabotaged by the spell-checker

Howard Fineman has a thoughtful piece (via VodkaPundit) up over on MSNBC.com on why the Democrats aren't doing as well as they theoretically could be. He makes a lot of good points, but I am so juvenile I was distracted by a typo. Here's Fineman discussing LBJ's trip to New Orleans in the immediate aftermath of a hurricane there during his administration:
I thought it was an instructive contrast to Bush’s too-little, too-late personal response to Katrina. But the anecdote contains a lesson for Democrats, too: LBJ stood for a big idea—the healing power of government. He was in the mist of his Great Society presidency.

I'm pretty sure that's not what Fineman meant to say, but I love it. The Great Society was responsible for a lot of murky public policy goals, and most people who continue to advocate the Great Society are walking around in a fog.

October column: Chocolate Banana Bundt Cake

Updating an old favorite, in the newest issue of the Low Carb Luxury Online Magazine.

This really was a delicious cake -- even the kids, who usually only eat the frosting and skip the cake itself, liked it. Enough to have more than one piece! (Typical scenario when trying something new: Do you like it? yeah... Will you ever eat it again? No! [heh])

If you would like to try the regular lower-carb banana bread recipe, it's here.

The bananas are really a spectacular ingredient for improving texture. Many low carb baked goods suffer from being too dry, too leaden, or too spongey. I often bake with added fruits (like bananas or apples) or vegetables (like shredded zuchini or stewed pumpkin) because they are such versatile ingredients, improving taste, texture, and nutritional content as well. It seems so obvious to me that I wonder why no one ever complains that many of my recipes are so similar. I suppose if you packed them all into a book, it would be more noticeable, but since these folks only get one a month, it's harder to see the pattern. Then again, I haven't written up every fruit-or-veggie inspired creation I make at home, either. (yet)

This column's tag mentioned the regular banana bread and encouraged people to email me if they wanted the recipe, and so far I've had six requests. This was, by far, my favorite: Since I have tried your recipes before and loved them - I'd like to request a copy of your "lower carb" banana bread. (emphasis in original)

Nothing like a little ego boost first thing in the morning.

Thursday, September 29, 2005

well, I never

I really did not think that if I worked out regularly, I would get fit. I had a defeatist attitude underneath it all -- something was going to happen, it just wasn't going to work.

I don't mind saying it: I was wrong.

I feel scads better. I have more energy and fewer aches. I did my seven laps again today, but on the last lap I had enough energy to do an all-out, fast-as-I-can freestyle lap. Minimal rests at either end in between pool lengths, too -- I think next week I'll start doing straight 50s instead of 25s.

I do still need a new swim cap, though. My hair's getting soaked. At least it's not being yanked out of my scalp by the latex cap, because I put the lycra one on first. But I need to find a silicone swim cap that's big enough to hold in all my hair!

Also, my yoga class is really great. The instructor (who is also named Joan) is awesome. She changes up the class every time, so even though we always stretch out everything, we do it in different ways. Certain moves become familiar, but that's OK. I love it, and I'm really going to miss it when I'm in Houston.

One reason I don't want to need surgery is I don't want to give this up. It feels good to be getting into shape, after all these years of inactivity.

Tuesday, September 27, 2005

easy seven

Today was, as DS2 says, "a Y day." I did seven laps, and could have easily done more but I didn't want to be late for yoga. It was good, but also kind of weird. I think this is week 4? Perhaps week 5. But still, it hasn't been all that long, and today I just felt like I could keep going. I'm not sure I really could, mind you, but at least I wasn't sucking air like I'd just been come in from deep space.

I think it helped that I alternated: freestyle, back stroke, breast stroke, back stroke, etc. Front, back, front, back.

I read up online and discovered a nifty bathing cap trick: wearing the lycra cap under the silicone (or, in my case today, latex) one to keep the hair dry without it being pulled every-which-way while you're putting the cap on. I tried it today and it mostly worked. I just have too much hair, and have to keep experimenting with ways to distribute it more evenly under the cap. Or I can just resign myself to the idea that the ponytail will get wet, and deal with it. Maybe 2 ponytails would work better.

If I can keep up with this, maybe that master swim team won't seem so impossible when I get back from Houston.

breast cancer: good news, bad news, other news

The good news on the breast cancer front is that my annual mammogram came back normal, so that's a huge sigh of relief. I wasn't anticipating any problems, and it's sure nice to know there weren't any.

The bad news is that the risk of developing pre-menopausal breast cancer is 2.4 times higher for left-handed women.

Guess who's left-handed?

In other news, being hypothyroid seems to be protective against breast cancer, with a 61% reduced risk. However, for white, pre-menopausal women who have been diagnosed with thyroid cancer (guess who, again), there is a significant increase in the risk of developing breast cancer.

Even more incentive for me to be diligent about monthly self-examinations. You can bet I'll never miss an annual mammogram, either.

Monday, September 26, 2005

an egregious omission

I first read about Boston.com's list of Top 50 SciFi TV shows this morning while reading over on Cathy Young's new blog. It bothered me (the list, not Cathy's blog, which is great). Then this evening, I saw that over on the M.A.W.B. Squad, Sandy blogged about it as well. Even though I left comments in both places, that just doesn't seem like enough of a response. The seriousness of the error that is propagated by this list is too grave to let it pass with just a few comments on other people's blogs. So, here we go.

First off, you should know that this list is presented in the most awkward manner imaginable. You have to click through every. single. show. Granted, each show has its own page with a good-size photo and a blurb-ish description of why the show made the list, so they are nice to look at. You still have to click forty-nine times to make it through the whole list -- and that's not the worst of it.

No, the worst thing is that Farscape isn't even mentioned in passing. Deep Space Nine was snubbed, but at least the list's creators acknowledged its existence in the Voyager blurb. Matt Roush of TV Guide said back in 2003 that Farscape "set the bar for this kind of series," but it didn't even merit a fly-by on Boston.com's list.

**sigh**

So, what did make the list? Since I'm in the mood, I'll do the click-work for you. Here ya go:

50. Earth - Final Conflict
49. The Wild, Wild West
48. 3rd Rock from the Sun
47. Buck Rogers in the 25th Century
46. That Was Then
45. Greatest American Hero
44. Lois & Clark: The New Adventures of Superman
43. Nowhere Man
42. Science Fiction Theatre (1955-57)
41. Futurama
40. The Thunderbirds
39. The Man from U.N.C.L.E.
38. Batman
37. Space 1999
36. The Bionic Woman
35. Battlestar Galactica (Original)
34. The Avengers
33. Lost in Space
32. My Favorite Martian
31. Alien Nation
30. Voyage to the Bottom of the Sea
29. The Six Million Dollar Man
28. Adventures of Superman
27. Buffy the Vampire Slayer
26. Stargate Atlantis
25. The Jetsons
24. Wonder Woman
23. Tales from the Crypt
22. Andromeda
21. Quantum Leap
20. The Hitchhiker
19. Dark Angel
18. V
17. Firefly
16. Flash Gordon
15. Logan's Run
14. Star Trek Voyager
13. The Outer Limits
12. Xena: Warrior Princess
11. Lost
10. Sliders
9. Mystery Science Theater 3000
8. Dr. Who
7. The Twilight Zone
6. Stargate SG-1
5. Bablyon 5
4. The X-Files
3. Star Trek: The Next Generation
2. Battlestar Galactica (New)
1. Star Trek (original)

While this list contains some happy surprises -- The Wild, Wild West being one of them, it also contains a lot of outright crap, and a few shows that have rightly fallen into the memory hole and shouldn't be retrieved. Nowhere Man? Earth - Final Conflict? Some choices are just plain odd: Voyager, but not Deep Space Nine? I don't get it. And short-lived costume idiocies like Logan's Run, which had one plot they recycled for every episode? Buffy at number 27, but Xena at number 12?

Who made this list, and what have they been smoking?

I found it very interesting that Firefly made the list, when Farscape did not, especially as Firefly was perceived as derivative of Farscape when it hit the scene -- although the similarities were certainly coincidental. But the fact that Farscape had four full seasons and then a very successful mini-series to wrap up the major story arc was apparently not enough for it to get a mention here. Then again, Farscape wasn't directed by Joss Whedon and doesn't have a pending major motion picture. (Hello, Serenity.)

When I watch the new Battlestar Galactica, I find it evocative of Farscape in many ways: the pacing, the immediacy, the grime. Trek existed in a genteel, leisurely universe by comparison (although Deep Space 9 approached gritty from time to time). But all the things that make the new BSG so great came first in Farscape.

Farscape had it flaws, and many of them ("trying too hard" came up often). But its omission from this list is nothing short of egregious.

If you've never heard of Farscape before and would like a fairly detailed, one-page intro to the program, here's one I wrote way back in May 2000: Where No Series Has Gone Before, originally published in Bob Furnell's Jigsaw Magazine, by and for fans of science fiction television.

In case you were wondering: the best thing about this list? That Farscape's legacy continues, even if it is uncredited, in shows like Battlestar Galactica.

the joys of being immune comprised

In case you didn't catch it, the title above is fine example of sarcasm.

Here's the latest: I have a spot on my tongue. It has been there for at least three weeks. It feels, and has felt this whole time, as if I burned my tongue, but only in that spot. I also have this annoying filmy/fuzzy feeling in the rest of my mouth, no matter how often I brush my teeth.

I had thought it was just another random radiation side-effect, and have been waiting for it to go away. But since I didn't, I did a search and found this helpful reference.

Since my symptoms match those described for erythematous candidiasis exactly, I went in to see my primary care doc this morning. By some miracle, they had an opening at 10:15AM, so I didn't have any offspring in tow. Dr. T agreed with Dr. Hoffman's diagnosis above, and prescribed me a 10-day course of Nystatin to swish-and-swallow.

It's not bad, taste-wise, but the side effects could be horrid, including the usual tummy nasties nausea and diarrhea (I have those every day anyway...) and even vomitting. Whee! But I supposedly will get over those after the first couple of days, and should be just about cured by the end of the week. Here's hoping. Of course I still have to swish-and-swill the stuff 4x/day until it's gone, but at least the filminess from the Nystatin wears off after a while.

Dr. T ordered a blood draw, too, because he wants to check my white blood cell count. You don't normally see this kind of infection in someone with a well-functioning immune system. One well-documented side effect of radiation treatments, including RAI, is decreased WBCs, so it will be interesting to see where mine is, nearly four months post-treatment.

I find it rather ironic that my health is being attacked this way, especially when I feel pretty good overall. It's always something, but I keep reminding myself: it could be a lot worse.

Sunday, September 25, 2005

The Corpse Bride

I went to see Tim Burton's latest with the two peewees today; DS1 declined because (he said) he thought it would be too scary. This, from the kid who reads 2 or 3 Goosebumps books a week -- I don't get it. So we left him home with DH and went off to a matinee.

The movie theater was only about a third full, but that's typical for a Sunday afternoon. One thing I was looking forward to was the new Goblet of Fire trailer, which did not disappoint -- I hope they get it right, and from the previews, it seems as if they at least got the look of it, and the attitudes. But as we've all discovered to our dismay, trailers can divurge wildly from their source material. Still, I'm hoping.

I'll also mention that there was a completely obnoxious and inappropriate-for-a-kids'-movie preview for the new Jennifer Anniston movie, Rumor Has It. Shirley MacLaine is in it also, and the basic premise of the movie is that the family was the inspiration for the Dustin Hoffman movie, The Graduate. In thinking about it, it doesn't make much sense, unless he did not end up marrying the girl he stole from her own wedding... but anyway, it was obnoxious. The Keira Knightley Pride and Prejudice preview I didn't mind, the kids were oblivious, but that Anniston flick thing was annoying.

Now, the film: a very slight thing, nearly weightless in all aspects, which is saying a lot because the musical stop-motion-animation genre tends to be leaden. The story was minimal, the design was superb, the characters not much more than mere wisps but well-defined nonetheless, and it all moved along at a great clip. Of all the voices, Christopher Lee's was the best, and provoked the best laugh line as he was trying to shoo The Dead out, and one of them piped up with, "Could you keep it down? We're in a church!"

There's one huge continuity gaffe* but if you ignore it, everything works out just fine. So there was humor, love, sacrifice, one really scary scene that lasted about 10 seconds (when The Corpse Bride first appears), some cute little tunes and a very nice piano duet. Very well put together, and I pretty much agree with all the critics that say there's not much substance to it, but it's very well done, if you like this sort of thing.

Which I do, very much so, and I'm glad I went.

*That continuity gaffe: after Victor is first brought "downstairs", the only way he can get back is via a spell. But when Victor decides to re-marry his Corpse Bride for real, they invite everyone "upstairs" to join them for the ceremony, but no special arrangements are needed to take them all topside. You'd think, since they made such a big deal about Victor being trapped before, that they would've at least mentioned the process by which everyone got back to the world of the Living, but they didn't. Weird, and unlike Burton to overlook such a detail.

Wednesday, September 21, 2005

locked and loaded

Got the call today from MDA -- first appointment is bright and early at 7:30AM on October 17, but I have to be there at 6:30 to register. Yikes!

Mom's coming out a few days before. I feel as if I spent the afternoon playing travel agent, but in reality it probably all took less than an hour. That's pretty amazing. I'm staying in the hotel that's connected to MDA so I won't have to worry about renting a car. Now I'll just be on pins and needles until I actually get there and see the doctor and they do the tests.

I have to arrange to get my films and scans. I'm glad I don't have to worry about getting the slides, since the folks at MDA arrange for them to be sent directly. Theoretically there is plenty of time to do what needs to be done before I leave, but I'm sure I'll be running around like a crazy person anyway.

"stuck on stupid"

Everyone and his little sister is blogging about General Honore's press conference. I found it via VodkaPundit, but I think I may have seen it on Instapundit earlier.

There's a reason, of course. It's such a brilliant, brutal put-down, and it was wisely used, first as a caution -- "Don't be stuck on stupid," and then as an accusation: "You are stuck on stupid," when the reporter wouldn't give up on trying to dig up some dirt on why things are going well for Rita but didn't for Katrina.

It's just so refreshing to see someone tell it like it is, and actually accuse the media, face-to-face, of obscuring facts and muddying an important story because they feel their own agenda is more important than the public good.

It's true, the media does not like to be used by the government, and Gen. Honore was basically telling them, "You'll report what we tell you and that's it," which of course makes them chafe at the bit. But too bad. This wasn't a normal press conference, this was disaster management and communications.

I predict gross over-use and misuse of the catchphrase. I can already envision scenarios in which I can use it on my kids, like when they are too stubborn to realize they've already lost whatever battle they still think they're fighting. But I think I'll try to use it as a warning -- "You don't want to get stuck on stupid," rather than an insult. Because saying "you're stuck on stupid" is quite a slap: you're too dense to realize just how clueless you are. Because if you knew, you wouldn't be stuck there, would you?

hazardous duty

This afternoon, I was doing one lap of backstroke (out of five total laps), and as I finished the first pool length, I smacked my right wrist on the pool wall. Ouch.

Back at the other end, I whacked my left forearm, and before I could stop myself, I bumped my head. I felt like one of those cartoon characters with the little birds twittering around my throbbing skull.

But that could've been the new latex swim cap, which did keep my hair dry but was also snug. Very snug. Perhaps a bit too snug? It didn't seem too bad until I bumped my head. Anyway, I appreciated not having to wash my hair out when I got out of the pool.

So begins week 3 of the new workout. Didn't do anything over the weekend, but today wasn't too bad anyway. I managed the five laps OK. Yoga was tough because we used the stability balls and the teacher really works us. She's great in how she varies the routine from class to class.

I have the sense that if I keep this up I will actually get fitter, but I'm also skeptical. I think if I actually expect to improve I will only disappoint myself. On the other hand, staving off further deterioration is a really good thing. What I really want is to swim with these guys. We'll see what the docs in Houston say. If they give me the greenlight, I'm signing up.

Monday, September 19, 2005

back on the rollercoaster

Up and down, up and down...

MD Anderson called today. The surgeon wants to see me, do a CT scan, and get a consult with an endocrinologist.

That all sounds fine, and we're working out when all that is going to happen.

However, I had just about managed to convince myself that I wasn't going to have to go, you know, at all, and now that psuedo-calm has just been completely blown.

Plus it makes me very nervous to go see a surgeon. Surgeons generally recommend course of action involving...surgery.

it's worse than I thought

DD was invited to a fancy dress-up birthday party by one of her classmates, at Mrs. Pott's Tea Party in Mesa. It's the kind of party where the girls get to pick a dress from a huge selection, and they get their hair and make-up done, too. They also get to pick out bracelets, clip-on earrings, necklaces, all that stuff, and short or long gloves.

After doing the whole dress-up thing, they had a tea party, including an etiquette lesson, and got to eat things like sandwiches with no crust on them. They didn't drink real tea, they just pretended their fruit punch or lemonade was tea, and enjoyed very much being little ladies, with the staff dressed as English maids. The interior dining room walls were faux-painted to look like a castle, and teacups were everywhere, even the chandeliers were teacups! Both the setting and the staff were lovely, and the birthday cake was especially delicious. It was really a lovely party.

So, what's worse than I thought? DD's girlie-girl thing. Examples:

1. The girls were asked to wear dressy shoes. DD has some cute black Mary Jane-type shoes, and I expected her to wear them. But no, she came downstairs in her sparkly shoes that must be at least a whole size too small. I quizzed her: are they hurting your feet? No, Mom. Are your toes squished? No, Mom. Of course when we were leaving the party I noticed she was walking as if her feet were killing her, so I had her take the shoes off in the car on the way home. For the record: yes, she was willing to wear shoes that were much too small, just because they looked a certain way.

2. She chose big, square fake sapphire earrings, with a border of rhinestones, and a matching multi-strand pearl necklace with fake sapphire and rhinestone clasp. At one point she pointed to an earring and said, "These hurt," she paused for a moment, "but I don't care, because they're pretty."

3. Final, and most conclusive evidence. All the other little girl chose dresses that were pastel and cute. Take a look at DD in the dress she chose. To get the full effect, you might need to appreciate this view.

Now do you see what I mean, it's worse than I thought?

Saturday, September 17, 2005

on combined T4/T3 therapy, or feeling better on thyroid meds

Important Disclaimer: I am not a doctor. I am a thyroid cancer patient. None of what follows is intended to provide medical advice, only food for thought, and perhaps some useful information for other thyroid patients to bring to the attention of their own doctors.

Nearly all hypothyorid and thyroid cancer patients are treated with T4 hormone replacement alone, almost always the name-branded Synthroid, sometimes Levoxyl. There is, however, another hormone produced by the thyroid gland, T3; a synthetic version of T3 called Cytomel is readily available. Yet by far the vast majority of thyroid hormone replacement users have never been treated with T3. Why not? The subject comes up two or three times a month over on the Yahoo! Thyroid Cancer Support Group, and it usually goes something like this: My endo says my levels are fine, but I still feel crummy. Has anyone tried combined T4/T3 therapy?

Every time I see that reliably controversial topic raised, I get annoyed. Not at the poor innocent who has posted the question, but at the endocrinology industry that continues to screw around with hapless hypothyroids and thyroid cancer patients, year after year. So if you're searching for answers on combined T4/T3 therapy, you may find some here.

Endocrinologists avoid prescribing T3 as if it were pathological, completely ignoring the fact that normal functioning thyroids do indeed produce it. They usually cite three issues with T3, as follows:
1) it's not necessary, since all cells in the body can convert T4 into T3 as needed; 2) it's dangerous, since overdose can produce thyrotoxicosis, with symptoms including palpitations and high blood pressure; and
3) it's not as effective, since its half-life is so short (one day, as opposed to 7 days for synthetic T4.)

To these issues, I offer these common sense rebuttals:
1) If it weren't necessary at all, why would normal healthy thyroids make it in the first place? Also, the fact that people can survive without it is not dispositive of the supposition that they could do better with it. This is, at heart, a quality of life issue.
2) It is true that overdose can produce very serious problems, but these same problems can be caused by overdose of T4. Saying "it's too dangerous!" is just silly. If we were to follow that logic, no one would ever get thyroid hormone replacement treatment, and I'd be dead right now. Pharamacists hand over deadly medications to patients millions of times a day, and yet no one questions the practice -- because doctors write appropriate prescriptions for their patients. I really think endocrinologists should give themselves more credit.
3) Ah, the half-life issue. T3 is more rapidly metabolized, and so it is harder to get a nice, even supply of T3 into the bloodstream if the patient wishes to take a single dose once a day. The solution is, of course, time-released T3, which can be easily prepared by a compounding pharmacy. Some patients have no difficulty in splitting their T3 doses over the course of a day to maintain an even keel, so to speak. But some combined T4/T3 patients (like me) have no problems whatsoever taking all their meds at one time each day -- the T4, with its longer half-life, helps keep the overall level of thyroid hormone stable.

In spite of these counter-arguments, the established endocrinology community continues to spurn combined T4/T3 therapy. For an example of those holding the prevailing opinion, take Dr. Kenneth B. Ain, author of the generally superb and only somewhat condescending The Complete Thyroid Book. I "know" Dr. Ain from his frequent contributions to the above-mentioned online support group, and let me tell you: he has apparently infinite patience for repetitive questions but not much for stupidity, and he'll come right out and tell you if what you're talking about makes no sense whatsoever. I appreciate having a straight-shooting professional out there making sure the group doesn't wander too far afield, and I recognize that Dr. Ain's contributions to the group are invaluable. He has many years of thyroid and thyroid cancer treatment experience, and there's no one else in the group who comes close to having his level of authority because of it.

But along with that authority there often comes a kind of arrogance. And so it is with Dr. Ain, at least with respect to the combined T4/T3 question. Here we find him completely dismissing the possibility of combined therapy's use for thyroid cancer patients:
The only role of T3 for people with thyroid cancer is for the temporary preparation and recovery from hypothryodism for radioiodine treatment, thyroglobulin tests, and scans. (Complete Thyroid Book, p 152)
And here we find him repeating the Standard Line Against T3 as I described above:
The only small study suggesting T3 supplemention of levothyroxine therapy for hypothyroidism was flawed and could not be verified or replicated by several larger studies done thereafter. T3 can make you thyrotoxic, which can be dangerous, as we discuss in Chapter 4. Since all hypothyroid people on T4 will make T3 because of the laws of biology and biochemistry, adding T3 is not helpful and could be harmful. [...] [P]hysicians cannot ethically recommend a therapy that could be potentially harmful when there is no perceived benefit. (p. 244)
These two brief quotes more than adequately summarize Dr. Ain's feelings about the use of T3. There is no benefit to hypothyroid people in its use, he says, and in fact it could be harmful. Happily, there's a considerable amount of professional, medical disagreement with Dr. Ain's position, but it's all rather "below the surface" -- rarely published in the journals. Dr. John Lowe and the Dr. Richard Shames have both discussed their problems with the newer studies which refute the contention that adding T3 to a hypothyroid patient's therapy was beneficial. I'm not a doctor but I am extremely familiar with the kinds of study bias, bad design, and selective reporting of facts that Lowe and the Shames are describing here, and I still think that combined T4/T3 therapy is a good idea.

But what about Dr. Ain's assertion regarding all that research? I think that while Dr. Ain's opinon is supported by whatever research is out there, that doesn't mean that the research itself was properly or even honestly done -- that is, without a pre-set agenda to prove or a sponsor to please. Recent reports on the inaccuracy of scientific research would seem to support my position.

But what I really don't understand about Dr. Ain's opinion (which is, remember, exactly the same thing as the mainstream opinion) is that even he readily recognizes that:
The thyroid gland usually releases around 80 percent of its thyroid hormone as T4 and 20 percent as T3.(p 9)(emphasis added)
You would think that if the normally functioning gland produces not just T4, but T3 as well in a non-insignificant amount, that fact alone would argue for combined T4/T3 therapy -- but not so.

This issue eerily parallels the cheerful pronouncements of mid-20th century doctors who declared that evaporated milk and early baby formulas were just as good as mother's milk, and as a result, nursing became stygmatized as "low class" or "poor". Yet now as each year goes by, formulas are newly fortified with yet-another essential nutrient that has been identified in mother's milk. So, when is the medical establishment going to learn that natural human phsyiology should be the model on which treatment is based?

Combined T4/T3 may not be required for good health, but if a patient isn't feeling well on his current therapy, why not give it a try? Some people may fare better on straight T4 therapy, and if they feel well, there is no reason to change. But for the many hypothyroid or thyroid cancer patients who continue to feel less than optimal, combined therapy could help them feel better.

So what if you want to try it?
There are a number of practitioners who do "believe in" combined T4/T3 therapy, if only because they believe the evidence of their own eyes: patients who report to fewer symptoms and more well-being when on the therapy than not. In addition to the above-mentioned Drs. Lowe and Shames, one proponent of combined therapy is Dr. Larrian Gillespie, The Hormone Diva. In her book, You're Not Crazy, It's Your Hormones, Dr. Gillespie says:
Now, remember the body "naturally" produces a ratio of 90% T4 to 10% T3 by weight...(You're Not Crazy, p27)(emphasis added)
Dr. Gillespie says 10% by weight, whereas Dr. Ain says 20% of the hormones produced. Are they saying the same thing in different ways? I suspect so, because T4 is a larger molecule and so will take up a greater proportion of the whole by weight. Since Dr. Gillespie has had success in her practice using her dosage formula, you could use it as a starting point if you wish to bring this subject up with your own endocrinologist. You'll want approximately 10% of your total dosage to be delivered via T3, but since one microgram of T3 has the equivalent "strength" of 4 micrograms of T4, it's not as simple as splitting a 150mcg dose of T4 into 15 mcg of T3 and 135 mcg of T4! Dr. Gillespie offers this simpler formula for converting a straight T4 dosage into combined T4/T3 doses:
[D]ivide your T4 dose by 13. This will give you the amount of T3 for proper balance. Multiply the value by 9 for the [new] T4 level.(p. 29)
Sounds easy enough, right?

Now you'll just have to convince your endo to let you try it. You'll also have to pay more, because Cytomel is never a covered drug on medical insurance in my experience. But you just might feel better.

A bit on Thyroid Hormone Intolerance
When I was first diagnosed hypothyroid,I was put on a straight T4 therapy. I felt so horrible, I literally told my doctor, "I don't want to live this way." It is true that there is no such thing as "thyroid hormone intolerance." You can't be intolerant to thyroid hormones, we all need them to live. But what can happen is a kind of systemic attack (for lack of a better word) if you have an underlying condition that leads to problems when you start supplementing with thyroid hormones. Symptoms include: insomnia, headaches up to and including migraines, palpitations, and muscle and joint aches. Two conditions that can cause these symptoms when thyroid hormone supplementation is introduced are anemia and adrenal fatigue. The T4 prescribing information warns about these two conditions, but doctors never test before writing out the scrips. Seriously, they don't, so you'll have to look out for yourself.

On the anemia, it's iron stores that are most important here; Dr. Gillespie advises targetting serum ferritin around 100.

Unfortunately, most endos brush off the idea of adrenal fatigue-- if you don't have Addison's Disease or Cushings Syndrome, those adrenals must be fine! Why is there no middle ground with these docs? They'll readily treat a thyroid that's only limping along at half-capacity, or give progesterone or testosterone when those are testing out low. There's just huge skepticism over the idea that adrenal function could be sorta-OK, but not exactly right. So adrenal fatigue can be hard to diagnose, and it's controversial to treat, too. But unless your adrenals are OK, thyroid hormones are going to make you feel horrible. Check out the "adrenal fatigue" link above if those symptoms sound familiar.

So you can see there a number of reasons you can feel crummy while on thyroid hormone replacement. Look into these two conditions first, and once you know you're OK, if you're still not feeling your best, give the combined T4/T3 therapy a try.

Additional Resources
Mary Shomon's indispensible site, Thyroid Disease on the About.com network.

Mary's book, Living Well with Hypothyroidism

Richard L. Shames and Karilee Halo Shames, Thryoid Power Ten Steps to Total Health

Friday, September 16, 2005

so-called lives, revived

Acting lives, that is.

I mean, there has to be some coincidence, right? Claire Danes reappeared out of nowhere to co-star in Terminator 3 a few years ago and I thought, "Huh, I guess she's still in the business."

But then, Jared Leto popped up in the heavily promoted, big budget flop Alexander. Whoa. I mean, both have been working, but completely under my radar, I guess. Just another couple of TV actors who tried to make the leap to the big screen and for whatever reason, didn't.

But now? Jared's back again co-starring as Nic Cage's little bro in Lord of War, and Claire has her own upcoming opener, as the titular Shopgirl.

I just watched the trailer for this last, and if Jared Leto had been cast in the Jason Schwartman role, it would have been My So-Called Life for the big screen, little Angela all grown-up and still innocently beautiful and confused about whom she should fall in love with.

For the record: Claire Danes still has gorgeous porcelain skin and amazing hair. And Jared Leto unlike some guys, never outgrew his Jordan Catalano phase: he's still a cutie, too.

Thursday, September 15, 2005

it's all good

I talked to the scheduler first thing this morning to clear up this referred-to-a-surgeon business. She assured me that it's more like a central clearing station, and that they would review my records and decide where to send me. OK. She also said it would probably not be until next week that they get back to me.

While DS2 was in school, I popped over to volunteer as an aide for 3rd grade math. Unfortunately I was too late for DS1's class, but I was able to help for about an hour with one of the other classes. I did some manual labor for the teacher, putting packets of worksheets together, and in between times helped some of the kids figure out their problems. I liked it a lot. But then again, I got to leave after an hour. I wonder how I would last if I knew it was going to be from 8AM until 3PM? Ha!

After lunch, the point person from Houston called. You could've knocked me off my chair with a feather on that one. In typical fashion, the endo had only sent her letter and my records from my 9/2 appointment, nothing else! So I put together a history of my thyroid cancer experience and faxed it over along with the operating report, the pathology report, and the radiology report after my initial round of RAI. Ten pages, all of which should have been unnecessary - but at least now I know they have the whole story, and they'll figure out who I should see. I'm just letting that go for now, and figuring I'm OK until someone tells me otherwise.

It was another "Y day," and DS2 still loves going to the play center (as we call the child care center) there. I did five laps and then yoga and it is just soooo nice. I should have done this years ago.

I don't know whether I had a mild case of Minocyclin-flu or what, but my RA is finally calming down and I am not so horribly creaky. Even my digestion seems better today; I haven't taken any immodium, and lately I have been eating them like candy (not really, max 4 a day) -- but also having horrible ab pains. Who needs that? I stopped taking it today to see what would happen and no pains. Also no dire digestive emergencies, either. So far so good.

Just before supper, my middle sister called to say her new grandson was born this evening, all the way across the country in Massachusetts. By the time I get to see that baby, he'll be a year old. I had to laugh because she was so happy that the baby had finally arrived (he was quite late) that she didn't even ask about his name. There is plenty of time for all that, though. We are all happy that both mom and baby are healthy.

Wednesday, September 14, 2005

sell out!

Yes, I added Google Ads to the blog. They crack me up, sometimes offering up the most outrageous things only tenuously connected to the content of the page they appear on. They're here as a test-run, I want to see how they behave before I put them on my 'professional' (heh) sites.

I've made a few dollars here and there from my affiliate accounts, and it all goes towards defraying my hosting costs -- which, btw, have never been completely covered by any site-generated revenue. But every little bit helps.

a brief respite from cancer blogging

I am actually living my life while all this cancer idiocy is continuing in the background.

Yesterday morning I had my mammogram, and if there are any problems with it I may just have to crawl into bed for a week. Seriously. But I'm not anticipating any problems -- then again, who does? Let me enjoy my denial while I can, OK?

But then after the squeeze machine, I did my first stint volunteering as an aide in DD's first grade classroom. I was only there for a little over an hour, and I had an absolute blast.

Yes, there were times when five 6-year-olds were talking to me simultaneously and I thought my head was going to explode, but I was only there for an hour, and I got to leave, so it was fun! All but one of those kids belonged to someone else, they weren't my responsibility, I just was there to help out, and I know that I was helpful while I was there.

Then I picked up DS2 from his school, and we both lounged around like slugs until it was time to pick up DS1. Then it was off to the Y, where I swam five whole laps and did not suck air like a dying fish (much), and then the yoga class again (the teacher is fantastic), and then picked up DD, came home, made dinner, etc etc etc.

After the kids got to bed I was exhausted but happy. It was a really good day.

Today was an at-home day, but I did the whole cleaning thing again (DH was too polite to admit he was shocked, I'm a terrible housekeeper.) Didn't vaccuum, but did everything else and made up the beds this time. And I don't even feel like collapsing now.

Cancer can kiss my butt.

feeling a bit like Linda Blair...

You know, when she played the possessed girl in The Exorcist, and her head did that spinning around thing? (Fortunately, that's where the comparison stops!)

The reason I am suffering from psychic whiplash: I got a message today from my endo's office, with my referral information. I missed the call because I was upstairs doing whatever, and my cellphone was downstairs, and the scheduler called my cell instead of the home number. The message was quite brief, basically saying "We're referring you to Dr X, his number is..."

Dr X, I think. Why have I not heard this name before, since I've been chatting about MDA docs with the thycans for a week now? Being me, I immediately get onto the MDA website and plug in his name, and that's when my head started to spin: he is a surgeon in the Head and Neck Department.

I'm sure he's a fine doctor and most likely a brilliant surgeon, but: why am I being referred to a surgeon?

I put in a call to the scheduler, but it's lunch hour and I have to leave a message. By 4:15 I hadn't received a call back, so I called again, and got to talk to the lovely and competent Y, who always helps me out. (By chance, she was answering the phones this afternoon.) I explained the situation to Y, and she said, "Unless they know something we don't, that doesn't make any sense."

So, once again, I have no idea what's going on, other than that I most likely have already been referred to a surgeon -- for what? I'm no way going to have surgery without further testing. Usually you don't get referred to the surgeon until all the tests have been done and you're certain you need surgery.

Man, this is tedious in the extreme, and that first missed phone call was extremely unlucky, because the scheduler left early today. So I have an appointment at 9AM with my cellphone, and will try to get some answers then.

Kleenex required

This link was sent to me this morning by a fellow 'Thycan,' or thyroid cancer patient: Survivor (there's music, but no dialog)

That's how I feel on the good days. On the bad days, I'm consumed by self-pity or swallowed up in rage. There have been some bad days lately, but I think I'm over that, hopefully for a good long time, if not forever.

That's the thing -- I keep coming back to my Dad's wisdom: Nothing lasts forever. I will manage, somehow, to get through all this.

Tuesday, September 13, 2005

so that's all right, then?

I guess so.

After nearly 11 entire days of letting horrible treatment-related scenarios run through my mind, my endo called me today. The biopsy was negative, my Tg is only slightly elevated, TSH is fine, blah blah blah. Still wants me to go to Houston, though, and I am, as I have said several times already today in other venues, happy to go.

I don't feel "adequately managed" at this point, and so a referral to the best treatment center sounds just right to me.

To explain my disgruntlement, take the biopsy. It was not a good sample, and if the doctor had any interest in really following my case, she wouldn't be resting so easily on that "negative" result. Then there's the rise in my Tg, even though I am way suppressed (TSH at 0.05, yikes! I wonder, could we ease up a bit on the T3 and see if my digestion slows down? -- nevermind, I'll ask at MDA.)

Probably the thing that gets me the most, though, is that her demeanor is so solicitous and caring when I'm sitting in the room with her, but once I leave the premises, it's nearly impossible to get a hold of her. (That's probably -- almost assuredly -- not fair, but I'm talking about my feelings here, which may or may not be based on actual experiences.) So, when I saw her on the 2nd after the ultrasound, she actually took my hand in a comforting gesture before she told me that she wanted me to go to MDA, and then prepped me for the biopsy.

You know, when you have cancer and your doctor makes the point of holding your hand before telling you something, it gives you an impression of Very Bad News. So today's conversation, which was all la-di-da, confused me. How did we get from intensely concerned to casual? On the strength of that pathetic biopsy report? Please.

Anyway: one of the Thycans on the Yahoo support group told me it's common for Tg to elevate after a procedure, so that slight uptick might have been because of the FNA. Although the blood was drawn within 30 minutes of the two sticks for the FNA, so I don't know if it would have kicked in that quickly. But apparently I was wrong when I said there was no way to spin that increase in Tg! Learn something new everyday, thank God.

Monday, September 12, 2005

History Channel's Rome Week: the good, the heinous

Since I am thoroughly hooked on the new HBO series Rome, I TiVO'd all of the History Channel's tie-in shows during their Rome Week. DH and I have been watching them here and there, and finally came to the end of them last night.

The best by far was "Engineering an Empire," which explained how they did what they did. Never before have I understood how the aqueducts worked, and the answer is quite simple: gravity. They would sometimes only descend a fraction of inch over several miles, but gravity's funny, it doesn't matter how long that "downhill" slope is, as long as it is downhill. And every single aqueduct was downhill all the way to Rome. Amazing. Among other marvelous inventions -- running water, central heat, heated baths, fantastic roads, walls, and bridges -- is what perhaps seems the least consequential but is in fact probably the most important: concrete. So very cool.

But I come not to praise The History Channel, but to kick it's teeth in, for the simultaneously fascinating and insulting series, "Life and Death in Rome." (There are no links to this series, hence the link above to the HBO promo page. Sorry.)

There were six episodes, each covering a different aspect of the Empire's history. As is typical with History/Discovery/Learning Channel documentaries, there is a fair bit of repeated content, the usual talking heads, the skimpily-budgeted re-enactments. The episodes did a great job of conveying quite a lot of not-well-known information about Rome, and frequently quoted primary sources. One thing I really appreciated was that the primary sources were not always taken at face value, particularly in the episode featuring "Scriptus," who was essentially a tabloid journalist.

Another successful aspect of the series was the use of the technique I first noticed in the Walking with Dinosaurs series. Each episode contains a narrative thread, following a historical person or family. Bringing the history down to the personal level makes it much more compelling, and gives us a greater understanding of what it must have been like to live through those times. DH and I were amused to see the same actor playing a Dachian in one episode, a Roman in another, and a British Islander in a third -- but that didn't matter, especially as none of them had any dialog. It could have been anyone filling out the toga, and that chap was fine.

So what do I have to complain about, then? First, there is a tremendous amount of footage, and certain clips that get a lot of re-using, that approaches soft porn. We know that Romans had a very different standard of morality than we do, and we know their attitude towards sex could basically be summed up as "the more the better." But it became tedious seeing the same orgy and public bath scenes repeatedly, with the "naughty bits" blurred out. I'm not being a prude here -- there were some very attractive people in those scenes. I just didn't need to see them all 20 or 30 times. That's a problem with this type of documentary, where limited budgets lead to a lot of recycled footage. But the shock value of these scenes quickly wears off as we see them again and again.

The biggest problem with this series, however, had nothing to do with the inherent weaknesses of the documentary form. No, this problem stemmed from the politics of the writers and producers. They made the very odd decision to parallel ancient Rome, and certain events in and about Rome, to the modern-day United States. So Rome's military might, and the strength and speed with which they attack, are compared to the modern American army. All well and good, but when they started comparing some Roman empire-buildng excursion to Gulf War I, it did somewhat put my dander up. The United States is not and has never been (to the best of my knowledge) an empire, and our wars are not wars of aquisition.

But what really pissed me off was when they compared the sacking of Rome to the terrorist attacks on America of 9/11/2001. Let me just say, there should and can be no comparison. Rome was destroyed, and left in complete disarray. The Empire never recovered. The US was attacked, and roared back to smash the Taliban in Afghanistan and to oust Saddam in Iraq, where the democracy project is well underway.

I understand that the writers chose the modern-day parallel as a "hook" to grab the viewer and hopefully give them some greater understanding. Since television is a visual medium foremost, it's not surprising that images of the 9/11 attacks and the aftermath would be used. I still find it egregious that they chose to repeatedly show footage of the planes crashing into the Twin Towers on 9/11 in a kind of stutter-loop like we used to see on "Homicide." How dare they simultaneously exploit this horror and trivialize it like that? Perhaps the BBC producers didn't realize that to a nation full of Americans, that particular scene is not some meaningless piece of stock footage.

Even worse, the talking heads and the narrator all speak with this wistful tone about how America was shown to be vulnerable, and would it ever recover? It was quite a show of thinly-veiled anti-Americanism, and I watched with a kind of sick fascination, wondering how thin those veils would get. It was truly astonishing as pundit after pundit mused on how the destruction of Rome really did parallel 9/11, as if they can't wait for the inevitable crumbling of the US that should result.

Perhaps my sensitivity to these issues was heightened by actually watching the program on the anniversary of 9/11, but I don't think so. Here's what I know: The attacks on 9/11/2001 hurt us, and woke us up to a reality that many of us did not want to recognize (and there are still great swathes of society who are holding onto their 9/10/2001 mentaliy, God help them.) But we recovered both physically and economically from those attacks, and if we are not unified politically, at least a majority of us are strong in our resolve to protect this country and insure our future. Hurricane Katrina inflicted far more damage to our country than the 9/11 attacks did, and we're already repairing and re-building. We've seen an enormous outpouring from all across America to help those who were displaced by the hurricane. We are a strong people, fundamentally united underneath it all, by our love and respect for each other. We're a far cry from the disarray and dissolution of Rome in its waning days.

We're not going anywhere.

about those penguins...

We went to see The March of the Penguins over Labor Day weekend.

Nearly everyone, except Walter, seems to love this movie.

First, it must be said that the cinematography in this movie is extraordinary. There's no other word for it. I can't wait for the DVD because I'm so interested in seeing the "making of" feature that simply must accompany the feature film. One of the things that impressed me the most was that they managed to edit the footage so that no human artifact, or human, appeared on screen at all, until some outtake-like clips shown during credits.

The penguins themselves, as has been noted everywhere, are quite charming to look at. My favorite scene is when a penguin missteps and falls on the ice, then struggles to get up with a very human-sounding "Harumph!" noise. It was a very funny moment. The penguins are also exceptionally tough and survive some of the harshest conditions on the planet, all of which is meticulously shown to us.

I will balance my next remark by saying that Morgan Freeman is an excellent narrator. His voice is calm without droning, and he is a pleasure to listen to. But there is where my pleasure with the narration ends. If Morgan Freeman had been reading the phonebook aloud, the narration would have been better.

Because, unlike the 94% of critics who adored this movie, I am firmly in Walter's camp. The narration goes to great lenths to anthropomorphize the penguins, even to saying such completely absurd things like they endure the harsh conditions "for love."

It's completely ridiculous. They're not people. They don't have human emotions. They do not love, nor can they be "devastated" when they lose an egg or a chick. Later footage of the parents ignoring the chicks as they are attacked by a gull proves the point, as does the fact that once the chicks are able to fend for themselves, the parents take off and most likely never see them again. (The chicks will spend 5 years at sea until they are ready to reproduce themselves.)

I don't understand the choice of the filmmakers here. This movie was brilliantly shot and so expertly edited, it's breath-taking. Then they saddle it with this maudlin script! Why? Why should we be spoon-fed this dangerously unrealistic depiction of wildlife? Things like this lead to people thinking that the idea of re-introducting large predators in North America is a good idea.

No, thanks. I really don't see the point in us sharing our top spot in the food chain. And I don't understand why we can't just appreciate penguins in all their penguin-ish glory, without turning them into tiny tuxedo'd parental masochists, subjecting themselves to cruel winter months of depravation, all "for love."

site design/techie question

My copy of Namo WebEditor6 finally arrived a few days ago, and I spent some time over the weekend paging through the delightfully hefty User Manual. As someone who has written a fair amount of user documentation in her day, I really appreciate a good manual. The WebEditor manual is plagued by oddly fuzzy screen capture images, but otherwise is a model of efficiency, wisely dispensing with chumminess or cute gimmicks. It tells you what it's going to tell you, and then it does, with a nice organization.

I confess, I still haven't installed the product, but I'll get around to it, and am strangely optimistic that the UI for the product will be at least as nice as the documentation implies it is. They seem to have their heads screwed on straight, there.

I also confess that I got a bit jazzed looking through all this techie stuff. The last thing I taught myself was HTML, but I need to go further than that, now, which brings me to my question.

I am redesigning FarscapeWeekly. This will be a bottom-up re-do, keeping only the main logo ("FarscapeWeekly") and probably nothing else (although I have always liked that color scheme.) There are literally hundreds of documents out there, and I plan on having a template -- top and left frames remain the same, center panel contains the changeable content.

So, here's the question: should I just do it as one page with an inline frame, or use server-side includes, or do I need to get more complicated and make this a database-dependent site? I know that's how Webseed did it, but frankly I'm not sure I need to go that route. The only thing that's changing from page to page is the actual content, so there wouldn't be any real need for a database. On the other hand, that's exactly what database-driven sites are designed to handle... but it still seems like overkill.

I have no idea how to make this decision! (hee) I will spend some more time with the manual but if anyone would like to give me a general direction to go in, I'd really appreciate it.

bad news

I called the endo's office and was able to speak to Y to see how things are going. Dr. M, having been out of the office for 2 days last week, is swamped, and so I probably won't hear from her until much later today or tomorrow.

I did ask Y for my Tg (thyroglobulin) number, and it's up to 1.7 from 1.4.

That is bad news, and there is no way to spin it into something else. Tg is not supposed to rise while the patient is on a suppressive dose. I was so hoping that the lymph nodes were related to the sinus junk I've been enduring lately, but now that seems unlikely. Note that I completely chickened out and didn't ask about the FNA biopsy results... I literally didn't want to hear it.

This weekend, thinking about the possible courses my life will take in the immediate future, I felt gripped by a near-panic. I don't want any more surgery, ever. I have no way of saying this strongly enough: DO NOT COME NEAR ME WITH A BLADE. I have enough scars. I have enough musculo-skeletal problems resulting from previous surgeries. I'm on enough daily medication. I've had enough pain for a lifetime, thankyouverymuch, and I'm only 42.

This is developing into a phobia -- well, not really a phobia, because no rational person wants to be dissected -- and I have no idea how to calm down about it. So I find myself contemplating asking for a prescription for something Valium-like. I need to not freak out, that's not helpful. But I'm not sure I can keep myself from freaking out. Do they make a drug that will keep me from falling over the edge while still enabling me to drive?

blah

I have a couple of posts percolating but since they require looking up links and references, I don't have the energy to do them now.

Yesterday afternoon I took the kids over to the Y and did my laps (4, better) while they played (thank you, Y lifeguards.) Came home, got the little ones bathed, took my own shower (chlorine itches!), made dinner, did laundry, watched "Rome" off the TiVO... a good day.

This morning, I felt like my head was going to explode so I took ibuprofen, did not work. I've been taking Immodium with every meal and that isn't working all that well, either. So between the head and the stomach and everything else, just -- yech.

Of course I lie to everyone who asks "How are you?" Well, not too much of a lie, I thnk: I usually say "I'm hanging in there," which is non-specific enough but still doesn't invite too much inquiry. I don't want to deal with it.

Hoping to hear something today, but probably won't. Don't know whether to sigh or scream, and so will do neither.

Saturday, September 10, 2005

a few words to Richard Cohen

I came across references to Cohen's Sept 8 piece, Too Perfect to Know the People, earlier in the week on some of my regular reads. I finally had a chance to read the whole thing today, and it cries out for response.

There are a few issues I'd like to raise to Mr. Cohen. Let's start off with this quote: In retrospect, I learned more by failing than I ever would have by succeeding.

Here's the first point:
Just because you wish something were true doesn't make it so.

That is a mighty big assumption Cohen is making there. I'm sure he learned a lot through the experiences he did have, but how can he possibly know that he would have learned less had he stayed in college? I would not be willing to make such an assumption. In fact, having recently reviewed my own failures, I can quite clearly see the opportunities I missed. I know I learned less, I grew less, because I took an easier path. Why is Cohen so sure that the road he took is better than the one he couldn't follow because he couldn't overcome his boredom and distraction? The reality is, he can't know it, but he asserts it because he wants it to be true.

My second point:
Empathy does not require experience.
One of the greatest abilities we have as humans is to learn from other people's experiences.

Cohen decries Judge Roberts' lack of life experience, quickly recapping his professional resume. Then he segues into an anecdote about Theodore Sarbin, a psychologist who learned empathy for the underclasses by "riding the rails as a hobo." Sarbin gets full credit for this experience, but Cohen undercuts Roberts' own summers spent working in steel mills thus, He shared the work -- but not the plight.

Well. It's somewhat difficult to tell from the obituaries, but it would seem that Sarbin did the same thing. He got his PhD from Ohio State when he was only 30, after receiving a bachelor's degree from the same institution and a master's degree from Case Western. Sarbin, it appears, followed much the same path as Roberts: college, then advanced degrees, then well-respected professional work. Yet Sarbin gets credit for learning empathy, while Cohen assumes that Roberts' summers as a steelworker taught him nothing about the nature of hard work or blue collar workers. I supspect that Cohen feels comfortable lauding Sarbin while denigrating Roberts, because Sarbin's politics are more to Cohen's liking. Cohen seems incapable of considering that two intelligent, well-educated men could possess similar capacities for empathy.

Cohen's piece then takes an odd turn and rants about the "cold arrogance" of the New Orleans' evacuation plan, which made no provision for those unable to get themselves out of town. We've all seen and heard about the consequences of this spectacular failure, but Cohen goes right off the rails, here: The poor? It's as if the idiots up and down the line never heard of them. It's as if no one at the top of the Federal Emergency Management Agency or at the White House knew they existed. Check that. They knew, but it was theoretical: Oh, they'll manage.

Third and final point: It was the responsibility of the city and state to evacuate New Orleans, and to adequately prepare safe havens for those who remained.

Please note I am not holding the federal government blameless here. But blaming the White House for the plight of the poor who were abandoned in New Orleans is ridiculous, especially given the fact that it was George W. Bush who pleaded with the local authorities to evacuate the city. Even then, they only reluctantly agreed, and then failed to implement their own disaster plans. The snafus have been many, and the White House has bungled many aspects, but the evacuation of the city is one thing that can not be laid on the White House's doorstep. Anyone who has seen the famous photo of the flooded bus yards has to recognize that.

(It's all well and good to say "The Feds should have taken over when they realized the local government was incompetent!" But there are laws against that kind of thing, and whatever you may think of the President, he is not a dictator.)

Cohen brings it all together in closing, I would prefer that Roberts had had his moment of failure. He will lead one branch of the government. I wish he knew more about all of the people.

I wish Cohen knew more about all of the people, too. I wish he knew that empathy doesn't require experience, and that sometimes even those with direct experience, like Mayor Nagin and Governor Blanco, fail in their duties to protect those who elected them.

heart-stricken

On the way home from school, DD told us about one of her friend's mother helping out during recess today. I asked her, "Well, do you know where I'm going to be on Tuesday?"

DD happily said, "Here," meaning school, because Tuesday morning I start my classroom volunteer time.

At the same time, though, DS1 said, "Texas."

Oh! My poor babies... I wanted to hug them all together, then, but of course I couldn't because I was driving. So I had to just tell DS1 that I'm not leaving next week, but I probably would find out when I was leaving, next week.

I do hope he didn't really believe that I would announce a big trip like that is such a silly way. I don't think he really thought about it, because it wouldn't make sense for me to ask that question -- it just means that the whole "Mom's going to Houston because of her cancer," idea is front-and-center in his mind.

Both DS2 and DD wigged out this afternoon in ways that I was hoping they had outgrown. It was the end of the week, and the afternoon was stacked with disappointments (the cafe at Borders is closed for renovations! yikes!), but still, it was the worst regression we have seen lately. I know it's all tied up together, their acting out, my own stress about this situation, the end of a long busy week, all that. I'm trying to stay on as even a keel as possible but I know that sometimes I'm just too sensitive myself. Of course they pick up even the slightest change in the emotional tide, and since they're in it, too, they are going to react.

I wish I could spare them this, more than anything in the world. But the only thing we can do is endure it as best we can, until times are better.

held back

After dinner this evening I went to the parent orientation meeting at our church for DS2's Atrium class. I love the curriculum -- the Catechesis of the Good Shepherd -- and I enjoyed meeting all the staff and assistants that work in this ministry.

Overall the hour or so I spent there was peaceful, but at two sharply distinct moments I was filled with bitterness and despair.

Early in the evening, the head of the program was introducing all of the staff to us and listing off all of their accomplishments -- the degrees they held, the volunteer work they did, the boards they sat on. Hearing the accomplishments of woman after woman, I felt my own inadequacies stabbing me. There I sat, 42 years old, with what to show for it? Yes, I have a college degree, and I worked for 15 years. I have three beautiful children, but in all honesty, I've spent most of my adult life parked on my ass sitting in front of a computer. Was that really the best use of my time? I don't think so.

Later on, the same woman asked if anyone was interesting in becoming a teacher. I have been interesting in taking the formation (classes) for about two years now, but something always interferes. There is a new class this fall but it is Monday and Thursday nights, from 6:15 to 9:15. Of course Mondays DS1 and DD have RE from 5:15 to 6:30, and of course Thursday night is a swim practice night. Then also, there is the specter of my diagnosis/treatment at MD Anderson, which of course includes a trip to Houston -- and who knows how long a recovery.

It made me angry. I want to do this program, I need to do something to move myself forward. All of those accomplished women had pursued degrees or education that was relevant to what they were doing with their lives, and that's something I have never done. I have always, always taken the easy way out in school and in jobs. I have always believed that I'm lazy, because I usually only do what I have to do to get by -- but then again I can look at any number of things I have accomplished, that required real work, only because I wanted to do them.

So I realized I'm not lazy. I have been held back in my earlier life by other's perceptions of me, it's true, but also by my own short-sightedness. I lacked some fundamental confidence to even try many things because they seemed "too hard." I don't often stop to think that many of the things I do effortlessly seem difficult to other people!

Now the only thing that seems too hard is the pain I see my children experiencing as my cancer once again requires my attention. Everything else is cake, really. And since I don't know when (or if, really) I'm going to Houston, I'm going to just keep on as if I'm not, until I have to.

I have many regrets over decisions I've made over the course of my life, but if I give up now, and let this cancer continue to hold me back, then everything else I've done that I'm not so proud of will pale in comparison. Even if I can't accomplish what I attempt, even if I never finish, I have to at least show my own kids that the only thing that will ever hold them back is their own desires.

It is nearly always true that if you want something hard enough, you'll be able to do whatever it takes to achieve it. These years since DS2 was born have been a blur of depression and one physical failing after another. There doesn't seem to be any end in sight for the physical challenges, either, but I can't let that continue to keep me back. When the first problem struck I thought, "OK, let me just regroup and then I'll get on with things," but it has been literally one thing after another and the idea of stopping to regroup and recover before I tackle anything new is, at this point, laughable. I may never recover, and I'll just have to regroup while in motion.

ring ring ring

Every time the phone rang today I was filled with dread. I knew that the odds of the call being from the endo's office were close to zero, and yet still I am dreading that call.

Today's calls ran the usual gamut of no-ones and solicitations, but I also got a few calls from folks just checking in on me -- do I have any more news? how am I doing? do I need any help with anything?

Such calls are nearly overwhelming in their kindness. I feel guilty because I cannot give any more information than "I should know more on Monday, hopefully," and "I'll let you know as soon as I know more about what's going on."

The proper term is supportive. I really do feel as if some of the weight of the uncertainty is lessened by sharing it.

Friday, September 09, 2005

going toe-to-toe with Stephen

I'm not exactly sure why but last night, in a fit of mild insanity, I challenged the VodkaPundit on his sorta-hysterical rumination on what will happen if the US bans embryonic stem cell research. The fun continues in the comment thread this morning.

Summing up my opinions on the matter: there are so many sources of stem cells now that refusing to create nascent human life for the sole purpose of destroying it should be a no-brainer. I don't consider this opinion to be based solely on my religious beliefs.

In the course of writing my replies, I found all sorts of nifty papers and information over on the NIH Stem Cell site.

Stephen's post was inspired by the events on the President's Bioethics Council, with Leon Kass stepping down and Edmund Pellegrino stepping up. Pellegrino is opposed to all embryonic stem cell research, and supports a ban. Needless to say, this is causing much gnashing of teeth among those who share Stephen's views.

Via Instapundit, this discussion on Hit and Run is, I think, pretty typical. I give major props to commenter Dave W, though, who hits the nail on the head: The US has already had one Civil War over bioethical issues. In that war, as you will recall, the bioethics side beat the property side. Needless to say, countless people jump all over him for his interpretation, but in essence, he's right.

Thursday, September 08, 2005

thoughts on the new workout

Day 2 of swimming and yoga...

Tuesday and Wednesday were dead-on-my-feet days, but I did the workout on Tuesday anyway. The swimming was very hard, the yoga was challenging but not difficult -- does that make any sense?

The combination of intense aerobic activity followed by an hour of meditation and stretching is a very good one for me.

Today, I swam 4 laps with much less difficulty than on Tuesday. I realized I am not racing, so slowed down my strokes to work on form and keep my kicking steadier. I did much better this time, especially on the freestyle. My muscles don't give out so much as my lungs can't keep up. I start out taking a breath every 5 strokes, then every 3, then by the time I'm 2/3rds across the pool I have to just keep my face out of the water, because I'm gasping like a beached fish (ha). Still, it went much better this time.

Tuesday's yoga was on a stability ball, today's was on the mat, both were fine. I only completely failed one pose, but my thigh muscles were just beat -- perhaps if I had tried it before swimming it would have been different, but as it was, just couldn't do it. Everything else felt good.

Today's workout was made possible by the Aleve I took around 2PM. It didn't make me feel fantastic, but it did take a substantial edge off. I took some more at 8PM and am feeling creaky and tired but not destroyed, although my hands are killing me.

I hate to take medicines of any kind but I am a regular pill-popper. It's very annoying. It would be less annoying if the pills actually worked better.

I like this workout a lot. I hope I can keep it up. I'd like to build up my stamina in the pool to the point where I can do the Master's swim team. My breathing is so far behind my muscles at this point I think working up to what I want will be less painful than I anticipated. I do realize I've been in incredible pain since Tuesday, but the thing is, I'm not in pain while I'm swimming -- swimming feels good (except the gasping for air part, that sucks.)

I do need a swim cap that will keep my substantial mop of hair dry, though. I hate how it feels after being in the chlorinated pool. I rinse it out, of course, but I don't want to deal with the hassle of a real wash before I dash off to yoga. So, a different swim cap is in order, but other than that -- everything's OK.

Y to the rescue!

In my continuing effort to prove the old adage "the squeaky wheel gets the grease," I called my endo's office today, but with a slightly different strategy.

Instead of asking general nebulous questions about the status of my referral, I asked to speak to Y. Y was spectacularly competent in making sure I got my Thyrogen shots. I gave her a brief rundown of what happened at Friday's appointment, and asked her what I could expect from the process.

She surprised me by saying, "Let me take care of this for you. I'll pull everything together and get it to the doctor, and I'll get back to you." My endo, unfortunately, went home sick today and most likely won't be in tomorrow, either. But that's OK because the FNA results won't be back until tomorrow the earliest, anyway. So Y will leave a note for the doctor that she'll handle all this for me, and I should hear something on Monday.

That was a pleasant surprise. Now I am praying for Y that she doesn't come down with my endo's illness!

I reviewed my path report one more time to see what it said about psamomma bodies. Alas, "Psamomma bodies are conspicuous." That would seem to indicate I do have the diffuse sclerosing variant of papillary cancer, which is known to be more aggressive. Well, that would explain all the lymph node activity even while suppressed -- if indeed that's what's going on in those nodes. I'm having a lot of trouble swallowing and my throat is sore, but whether those things are cancer-related or just a sinus cold with post-nasal drip, I can't say.

spot report

The appointment with the dermatologist went very well. There's only one spot under surveillance for now, the doc thinks it's just a fibroma, and nothing to be concerned with, unless of course it changes.

So now I'm 2-for-3 in diagnostics, with only one more test, my mammogram, remaining.

It's hard to describe how profoundly relieved I am that I do not need any skin biopsies. They are not particularly painful and at this point, having had so many, I feel as if I take the stress involved in having stitches and waiting for the pathology report in stride -- but the reality is, it's still stressful. Even if it's only 2 stitches, it's still stressful. I hadn't realized how much I was worried about this appointment -- too many other, bigger worries were taking over. But I'm very happy now to have my clean slate.

did anyone get the license number of that truck?

Or maybe it was more than one. All day yesterday, continuing into this morning, I feel as if I have been run over. This is an extraordinary amount of pain, even for me. Ibuprofen is taking the edge off, but it's exhausting. I slept both in the afternoon yesterday and after the kids went to bed... just drifted off on the floor where I was stretching to try and relieve some of this misery, about 9 o'clock, and drifted in and out until about 10:30, when I made myself get up and do all my getting-ready-for-bed stuff.

Of course, when I dragged my creaky self to bed by 11, I couldn't sleep! I was debating getting an Ambien but did finally fall asleep before I could make myself get out of bed to get it. I find it irritating that we flipped the mattress last week and now the bed is more uncomfortable! Or maybe it's just me (likely).

Dermatologist appointment this morning. Whee!

Tuesday, September 06, 2005

the journey of a thousand miles

-- it's going to take a 100 years at this rate.

No, no, it's good, really. After lunch I had a nap.

Then I got up and packed my gym bag, DS1's gym bag, and made DS1's smoothie. Then picked him up at school and drove to the Y, and sent him off to his practice.

Then I checked DS2 into the childcare center there; he was reluctant to leave the house until I mentioned going to the Y. Then he perked right up, "Can I go to the play center?!" Yes, yes, he was a happy boy.

Then I put on my old suit and my new bathing cap (lycra = not waterproof! What was I thinking?) and my new goggles (awesome) and swam.

Well, I tried to swim. DS1 calls them "25s" and "50s". I did I think 6 25s, possibly 8 but definitely no more than that. I am incredibly out of shape for this kind of aerobic activity. I was exhausted usually before I reached the other side of the pool. Still, it felt very good to be in the water. I'll just have to keep working on it.

Got out of the pool feeling wobbly (all those muscles have no idea what's hit them), took a shower, got dressed, and went to the yoga class. Now that was perfect for my level of (non)fitness, but still difficult. We used a stability ball for a good part of the class and by the end of it, my muscles were doing the little spastic tremor dance again. Whee!

Doing it all again on Thursday, if I can move. Eventually I'll get better.

the jury duty experience

I got up at 6:07, the first time the snooze alarm went off. Got up, got dressed, made the kids' lunches, emptied the dishwasher, packed myself a breakfast of sorts: banana, half a tuna sandwich, some chocolate chip cookies, and a cup of coffee in a travel mug.

I brought my notebook and folder with some of my records in it, I'm not exactly sure why. The plan was to call the endo and see if there was any word on my referral, and to call the insurance company and see if Anderson is an in-network provider. I certainly didn't need to bring my records.

Left the house about 10 before 7AM, and got to the parking garage at just about 8AM. The traffic was horrific. I would not survive that trip as a daily commute. The slow drive does facilitate eating in the car, though. I couldn't eat until about ten past, since I needed to wait an hour after taking my meds. The eating part worked fine, but I dripped coffee down my white linen top. Lovely.

Other than that, the rest of the trip was uneventful. On the way down in the elevator in the parking garage, an (East) Indian in a lovely deep red sari chatted me up. She sounded exactly like my endocrinologist. We rode together in the shuttle bus to the courthouse. She was the first person to exhibit the general personality in evidence: annoyed at being there, but semi-cheerful about making the best of it. No one wants to get put on a long trial. We all just want to get back to our real lives.

After going through security, I checked in: handed in my paperwork, got a little badge that my juror number slip slid into. Then, a fair amount of waiting around. I took advantage of the lull to go to the women's room to blot the coffee out of my top. It wasn't perfect, but it was worlds better. Fortunately linen dries quickly. I went back to the waiting room, more sitting around with nothing to do.

I found the courtesy phone (no sense in wasting my cellphone battery) and called the insurance company. She gave me the rundown but couldn't tell me if Anderson is in-network, since they only deal with in-state claims. But she did tell me we've already met our deductible this year. I called the out-of-state number and turned into a spaz. They couldn't find Anderson in their listing; did I have an address? No, of course, I didn't have anything, and I couldn't get on the computer to look it up, either. She told me U of TX is in-network if that helps -- I didn't think it did and rang off, rather dejected.

Then I called the endo's office to see if there was anything I could do: I told the receptionist I was stuck and was just calling for the heck of it, but she couldn't help -- my endo's dictations from over the weekend weren't done yet, so the referral process hasn't even started yet. Nothing to do there, yet. (sigh)

Finally, something: they played a tape over the closed-circuit TVs, a PSA/training video about jury duty. No one seemed to be feeling any better about performing their civic duty, in spite of the rah-rah that the local TV personalities were putting out for us. I ignored the tape.

I ignored the nice woman's orientation spiel, too, because I was using a pay-per-use computer terminal. I looked up MD Anderson and happily saw that it is indeed part of U of TX. Sweet! I checked my mail and all my usual sites, and did some surfing off the blogroll over there. The terminal had the most annoyingly nonstandard UI ever. After a while, a twenty-something guy came over and said, "Excuse me, ma'am, are you going to be on there long?" He needed to check his mail. I said give me just a minute, and he said great, and then drifted off. I logged off, amazed that those nearly 42 minutes went by so quickly. I had surfed for 41 minutes and 38 seconds. My credit card will be charged something like $4.20 if I read the billing policy correctly. If I didn't, I'll end up with a $25 charge or something. I don't care.

After that I was just sitting around, bored, until finally something else happened. The orientation lady announced that they were seating a jury for a 6-week trial. She read off everyone's name: if you can do it, you say "yes," if you had a legit reason you couldn't, you say "no." I discussed the possibility of legit excuses with the three guys at the table with me. The ambulance driver thought being an ambulance driver is a good enough excuse: he'll do more good out on the streets. The guy with the new job said his high blood pressure should do it for him, but I told him my sad story of how the jury selection review board rejected my excuse request even though I had a doctor's note. He seemed non-plussed because in nearly any heirarchy of misery, cancer tops high blood pressure, and yet I still had to be there. The third guy just looked on rather amused by the spectacle, I think. Still, we all said "no" when our names were called.

The orientation lady segregated all the "Yes"'s into a side room, leaving the rest of us in the main area. Each "No" had to fill out a form with an excuse. My first excuse was the upcoming visit to MD Anderson for the thyca treatment and probable neck disection surgery. Yes, I used the terms cancer and neck disection, because 1) they are not hyperbole and 2) I really did not want to serve on a 6 week trial. My second excuse was the primary-care-giver to 3 young kids, no family in the area, etc etc. I never heard another peep about the 6 week trial after filling out that form.

After that relatively mild ordeal, they put a tape in the VCR: Fools Rush In, a truly dreadful movie with Selma Hayek and Mathew Perry. No chemistry at all between the two of them.

At that point I really regretted not paying attention to the orientation spiel, because I thought I heard something about a Starbucks nearby. I was too embarrassed to ask the staff about it, though. They looked busy.

I was being sucked into the vortex of the horrible movie when something unexpected happened: they were selecting a jury for a trial beginning today. They were reading off names, and they called me! Yay! I got to leave the depressing room full of 250 other prospective jurors perched on uncomfortable chairs and watching a really bad movie. (They really shouldn't do that to people, you know: neither the chairs, nor the movie.)

Our bailiff was a pleasant older zaftig woman who herded all 47 of us down an infinite corridor to an elevator bank. During the herding process I chatted with a woman who reminded me a lot of Goldie Hawn, only with red hair. She had a very good sense of humor. We went up to the 9th floor where we waited in the elevator lobby outside the courtroom until they were ready for us. While we were waiting, we got our juror numbers. I was 26; red-headed Goldie Hawn was 27. We traded stories about previous court rooms experiences. Red had unfortunately spent a lot of time in them as her ex is a deadbeat and never pays his child support. State of AZ does nothing to enforce, either. Lousy situation. My only time in a courtroom before today was to get my marriage license to DH -- who knew there was a 3-day waiting period? We didn't. The judge teased us, but gave us the necessary permission.

The bailiff gave us very detailed instructions on where we were to sit when we got into the court room. When we got in, the room was not big at all. I always expect huge courtrooms from those scenes on "Law & Order" with the enormously high ceilings and gorgeous bas reliefs on the walls. No such luck here, just wood panelling. I still could barely hear the judge even though she was quite articulate. She had probably the best diction of any non-actor-type person I've ever heard. Quite extraordinary.

We got to hear a brief overview of the case, which started today and would finish tomorrow. Have we been involved in a similar case? No. (Although later I realized I do know someone who was involved in a similar case, but it was moot at that point.) We were introduced to all the principal players. Did any of us know any of them? No, again.

Now, the important question: is there any other reason you can't serve on this jury? I held up my number, along with a half-dozen or so other people. The judge listened to us whine, in order. A few self-employed folks. Juror 19 was like me, primary transportation for 3 kids, only hers are older than mine. When it was my turn I said that: "Everything Juror 19 said goes for me, too, only my kids are younger." The judge quizzed me on how old they are. She questioned DS2 being in school, and I explained his preschool schedule. I told her that DH is self-employed and doesn't get paid if he doesn't work. No family local, etc. She made a few notes.

After everyone finished giving their excuses, she called a bunch of numbers -- including 26. We all stood up, and she dismissed us. We happily marched back to the elevator. There was a businessman that I teased, "I didn't think she was going to let you off." He had a conference to go to the next day. The judge zinged him with knowing about his jury duty at least 6 weeks in advance; he smoothly countered that he was planning on "one day" service. That's the rule here in AZ: one day/one trial -- either/or. Juror #19 and I commiserated about being chauffer-moms.

All of the dismissed folks went back to the jury selection room to get our "proof of service" paperwork. The room was empty. It was about 12:10PM by that time, and everyone had gone to lunch. The woman at the desk told us we could go home. We straggled out of the building and, not waiting for the shuttle, we trudged the 3 short blocks back to the garage. It was not a big deal, keeping to the shade. I ate my chocolate chip cookies on the way. We all piled into the elevator at the garage. Juror #19 and I were both just happy to be released in time to get a decent lunch.

I got home in about 35 minutes, inordinately thankful that I didn't have to deal with rush hour traffic on the way home, too.

-*-

Being a juror was a lot like being back in elementary school. Go here; sit here; do this; stand here; wait. Speak only when you're spoken to; be respectful. I did not see one person being mouthy or difficult. Everyone knew they were there for a reason, and it was just better to go along and get through it. People were generally pleasant: I can't count the number of rueful smiles and indulgent eye-rolls I saw today. In a weird way, it was nice. You hear so much about people being jerks, self-centered and rude, but the nearly 300 people I saw in the jury pool today were anything but. Everyone was polite, and the staff did their best to smooth the process out for the jurors. In particular the woman who did the orientation was very good at her job; she had just the right amount of humor in her approach -- and she certainly knew how to play to her audience.

So it was exhausting, but interesting. And ultimately, a glimpse of the good heart of the citizenry.

Monday, September 05, 2005

wallowing

Nearly the first thing I did this morning was burn the bacon into inedible bits of charcoal.

Not an auspicious start to the day.

I spent the whole day in pj's, websurfing or watching TV or generally lying around.

I've done some research. I may have the more aggressive diffuse sclerosing variant of papillary thyroid cancer. Since I'm only guessing half the time when I read medical references, I won't come right out and self-diagnose, but I will say that would explain why the cancer is not responding to suppression.

OTOH, I have a sore throat and maybe all those lymph nodes are showing up just because I have a cold... oh, how I wish I could believe that!

Swallowing is becoming a dicey proposition once again. I understand that some difficulty is to be expected when you're choking down horsepills, but seriously, no one should have to choke when taking a sip of water. I don't think my neck liked being poked on Friday, even if it was only 2 sticks.

So today was my day to feel kind of crummy and do nothing and be shell-shocked, but by tomorrow, I am officially over this wallowing business. It just gets to be boring after a while.

Sunday, September 04, 2005

huh...

I thought my little ol' blog was too insignificant to rate comment spam; I guess I was wrong.

Comment verification has been turned on -- hope it isn't too troublesome for the humans out there with something to say.

The Big Breakfast

My latest column is up over at LowCarbLuxury, The Big Breakfast.

I love it when I get fan mail: "This is definitely a keeper!"

Needless to say I agree; it's a low-carbed version of the Eggs Blackstone I had years and years ago at The Beach Plum Inn in Menemsha on Martha's Vineyard. What does it say about me that I can vividly remember a meal I had at least 15 years ago? I don't know, but I take my inspirations where I find them, and happily.