Sometimes the doctor does know best

This morning, I had my planned 6-month review with Dr. Foie Gras. I had seen the doctor last month when he performed my annual upper scope, when I get to experience the glory of sedation. Since I slept through that visit, it wasn’t a great time for us to catch up.

Today I was fully alert, and I was blessed with both the doctor and a wonderful student (fellow? resident? I don’t know for sure, but we’ll call him Dr. F.G. Wannabe) who was calm and self-assured. His questions were spot on and he inspired confidence. J. liked him because he looked to her for her input.

We addressed a number of issues, including the fact that Dr. F.G.’s young son will soon be crawling. Oh yes, and my recent liver unhappiness, which seems to be resolving without intervention and causes him no concern. I pointed out the significant weight loss since the last appointment, a good reminder that no one else scrutinizes my weight as much as I do.

We also spoke of the findings of his recent scope, which were largely unremarkable. Nonetheless, he decided there was a need for a follow up next month. Over the past several years, each scope has revealed a pancreatic rest. Let me tell you my layperson’s understanding of what this is, in case you don’t know. Some wayward cells from my pancreas have taken up residence in my stomach, where they’ve been resting for some time now, and although their appearance is unchanged, the doctor wants an internal ultrasound and biopsy done “just to be sure”. My low level of platelets will necessitate a platelet transfusion immediately prior to the procedure, so I don’t bleed excessively from the little snip snip. If you have any platelets to spare, I could use them January 24. I lost a few nights’ sleep over this procedure when I first booked it, but Dr. F.G.’s explanation has reassured me.

At some point in the visit, Dr. Wannabe completed a manual exam, which included his fondling my one-of-a-kind spleen. The doctor was poking around, trying to figure out how my organs were doing that day, and I started whining. “Ouch, that hurts!” I said. He responded, “It shouldn’t hurt there.”

What could be more patronizing? A doctor I’ve never met before tells me that my tender abdomen shouldn’t hurt? It’s not his body; how would he know? But then I thought about it for a minute. My abdomen wasn’t the only thing that was hurting; the rest of my body was sore too.

Then I had an insight. I had forgotten, as the doctor was manipulating my belly, that I’d attended a killer Pilates class the day prior. Every week, I undergo 60 minutes of torture. I never know which body parts are going to hurt the next day. The teacher, who has a striking likeness to Mr. Rogers, except for the sadistic streak, upped the ante yesterday because the gym will be closed next week. Maybe he was preemptively preparing us for our overindulgence over the holiday.

Turns out the wise doctor was right: my pain had nothing to do with his manual exam. Needless to say, I skipped my planned workout today. God forbid I should strain my abdomen any more than I already have.

Pilates movement outline--abdominal crunch


A true Israeli breakfast of champions

Israeli breakfast buffet, eggs, olives, etc.

Lest I leave you with the impression that if you go to Israel, you’ll come back with a high bilirubin count, let’s talk about the food. It’s incredible, every single morsel.

Because Israel is surrounded by countries that are, at best, ambivalent about her existence, Israeli food is largely produced within its borders. In our travels we passed olive trees, date trees, banana trees, grape vines, and pomegranate trees dripping with fruit. The bananas were so tasty, J. refuses to eat another Chiquita.

(By the way, I don’t recommend eating an olive straight from the tree–it’s not a pleasant experience. Squeeze it and watch the oil ooze out, but cure your olives before you take a bite. I learned this lesson the hard way.)

Then there are the milk products, the yogurt and labneh and white cheese, which is a loose facsimile for our cream cheese but smoother and much tastier. Because so many restaurants and hotels in Israel have kosher kitchens to accommodate the religious Israeli residents and the tourists, many kitchens exclude meat from their menus. There isn’t enough space in this small country to produce a lot of meat. Rather, there is a very large sea known as the Mediterranean that is bursting with fish, and since fish can go either way–it can be eaten with milk products or with meat–the fish is aplenty.

Now imagine that all of this food finds its way into the buffets of the typical Israeli breakfast at hotels. This meal is often included in the cost of the hotel. We call it “Israeli breakfast” while Israelis call it “breakfast”. Whatever you call it, it is a perpetual exercise in self-restraint.

Imagine a variety of yogurt and cheeses, granola, dried fruits, and preserves. There’s smoked fish and tuna salad alongside a variety of breads and rolls. Add in eggs in various preparations, perhaps in spicy tomato sauce, or as an omelette to order. Of course there are sliced tomatoes, olives, and a mishmash of salads, including Israeli salad (which Israelis call “salad”). It’s finely chopped tomatoes, cucumbers, and onions. Then there’s the stuffed pastry with savoury fillings like mushrooms or cheese.

Finally, there’s breakfast dessert, usually consisting of babka, i.e., chocolate- or cinnamon-swirled heaven, and halvah. Halvah is tahini and sugar, with added flavourings like cocoa powder or pistachios or whatever you can imagine, pressed it into a block. For immediate sugar shock, shave some halvah onto your babka.

If Israelis ate breakfast like this every day, they’d all be morbidly obese. The full Israeli breakfast is purely a tourist phenomenon, not that I’m complaining.

You won’t be surprised to learn I gained 10 lbs over the course of 14 days. But you may be surprised when I tell you that J. gained 0 lbs eating as much or more than me. Then we came home, and within one week on my strict low-sodium diet, I was back to my fighting weight.

I’ll admit it feels crummy to gain 10 lbs in 14 days, but losing 10 lbs in a week more than makes up for it. Best diet ever. You’ll come back with your bilirubin level intact, but if you gain weight, it’s all on you.


If I’m yellow, must I be mellow too?

Picture of Alberta premier and delegates breaking ground on new cancer centre

Did I mention they’ve broken ground on the new Calgary Cancer Centre? If I can stay alive for 6 more years, I’ll be in the front row at the ribbon-cutting ceremony. I’m looking forward to more space, more windows, a more upbeat, patient-friendly environment, and better sound proofing.

The clinic rooms at the old centre have padded doors, either to protect patients who want to fling themselves around when they hear bad news, or to provide soundproofing between the patients and clinic staff. The soundproofing doesn’t work, though, as I was reminded yesterday when I overheard the nurse unexpectedly scheduling me for an urgent abdominal ultrasound. Turns out that little fever I’d spiked the previous week had wreaked havoc on my body.

Dr. Blood Lite was so alarmed by my blood test results, including a spike in my liver enzymes, and a dramatic dip in my platelets, that he initiated further assessment. And just like that, our day went up in smoke.

I knew my liver was unhappy. I’d lost my appetite, I’d felt so crummy I’d skipped yoga, and I noticed a few other changes that involve the colour yellow. But I was slowly starting to feel better, i.e., less yellow, so I didn’t think much of it.

Off I traipsed to the lab to repeat my blood work, followed by the ultrasound clinic for a wee peek inside. Unfortunately, I was assigned the almost-graduate ultrasonographer, when I needed the 20-year expert.

I am not easy to scan. My internal organs are displaced by my ginormous spleen, rendering some hard to see altogether–where art thou, oh pancreas?–so it took Ms. Trainee some time to sort out my innards. She spent a very long time examining one spot over and over.

Eventually Ms. Trainee brought in her supervisor, who said, “I know you’ve been here a while. Do you mind if I take a look?” It was a rhetorical question. How would you have answered her? There are many ways I could have responded. I could have said, “I’m really exhausted and sore from all this poking and prodding after a very long day. Can I go home instead?” Or, “Ms. Trainee, if you were having trouble sorting me out, could you not have dragged your supervisor in 45 minutes sooner?” Or, perhaps, “No!”

Ever the compliant patient, I failed this assertiveness test and said, “Fine.” If I hadn’t let her continue, would she have had adequate results for the doctor, or would I have had to endure more poking and prodding another day? We’d been at the Cancer Centre for hours already, and I wanted to go home, but even more I didn’t want to have to return. I was ready to put this little yellow blip behind me. Thus I endured another half hour–longest abdominal ultrasound ever–while J. worried I’d died during the examination. Eventually, I stumbled back out to the waiting room.

I hope I’d handle a situation like this more effectively were it to arise again. I’d ask more questions and express my needs, both of which I failed to do yesterday. Maybe then the experts could move their magic wand a little faster. I can only hope.

My head may be in the sand but I can still hear you

Many people on a beach with their heads in the sand

While everyone else was back-to-school shopping, I was back-to-size-8 shopping. I wanted a few clothes that fit my new body, however temporary, so I scoured every sale rack I could find. I didn’t buy much since this petiter me may be fleeting, but I was tired of looking schlumpy while my body sorted itself out.

No, I haven’t gained all that weight back. Rather, I’ve lost another kilo in recent weeks. No wonder I was nervous about yesterday’s appointment with Dr. Blood Lite. “I have been eating more,” I told him, “but not enough to gain weight.” Although I feared his wrath, he is too kind to be angry.

After discussed my leukemia, which seems to be stable, he asked whether I’d ever reviewed the progression of my liver disease with Dr. Foie Gras. Where did that question come from? I told Dr. BL that, no, Dr. Fois Gras and I had not discussed my liver’s prognosis, but likely because I had never asked.

As much as I want all the information I need about my various ailments, I don’t want it before I need it. I may not ask the questions but I still know what the potential outcomes are. I told Dr. BL, as I’ve told you, my faithful readers, that I can only think of one of my illnesses at a time or my anxiety overwhelms me. Mostly I pretend I only have leukemia and forget about all that other potentially deadly stuff.

For many years, I have been low on my liver doctors’ totem poles; the patients they focus are often in acute liver failure or have more aggressive liver diseases. They need liver transplants or they are dying. I was one of them once, about five years ago to be exact, but I’m not right now. I only think of myself as someone with liver disease when my liver is malfunctioning. I know what a failing liver looks like, but I choose not to ask for details.

I see Dr. Fois Gras every six months or so, he takes a closer look inside me once a year, and he reviews my blood work quarterly. My blood test results have never garnered a telephone call from his office. No news is supposed to be good news, right?

Usually my denially approach works, but it failed last night between 12:30 and 3:30 a.m. when I stared at my ceiling, listening to both J. and the dog snoring, and wondered if something was terribly wrong with my body and no one was telling me. Maybe Dr. BL was afraid to share his concerns after I’d put on my blinders in front of him. Or maybe he was being thorough since he didn’t know me all that well. It must be the latter.

If he were that concerned, he would have told us to cancel a trip we’ve planned, but he didn’t. He encouraged us to go even though it’s very far away. He even mentioned that our destination country is known for many well-respected hematologists.

You might wonder where we’re going, but that will have to wait for another post. First, I need a good nap.

Introducing Dr. Blood Lite

This one’s for you, Janet.

You may wonder who this Dr. Blood Lite is, and how I named him without consulting you first, my dear readers. This time I didn’t need your help, thanks to a comment on a previous doctor-naming post. In that comment, a beloved beer connoisseur, who would never imbibe the beer of the masses, came up with this perfect name.

If you haven’t yet put one and one together, Dr. Blood Lite is Dr. Blood’s locum for her sabbatical. He is a lovely young doctor and, since he’s been trained by Dr. Blood, I know he’s learned from the best. Dr. Blood had told us she had considered her replacement carefully, and she hit the jackpot. Dr. B.L. seems calm and kind and he even introduced himself using his first name. You know how I like to be on a first-name basis with my physicians. It gives me a false sense of collegiality.

Although I did not recognize the newbie, we had met once before when I was an inpatient on the hospital’s palliative unit. Do you recall that hospital stay, the one where the hematology unit was full so I ended up lodging with the dying people? I could not remember him but J. clearly recalled Dr. B.L.’s Edmonton Oilers lanyard. In fact, I envision her hijacking my future appointments to talk about McJesus. That Dr. B.L. could remember our brief encounter is a miracle on par with McJesus’s MVP performance last year.

Back to my health for a moment. Dr. B.L. told me that, if my blood work is to be believed, I am holding steady on all fronts. This is good news. There are no significant changes since last visit, which means I will stay on my current treatment plan.

My blood work did not explain my appetite loss, which was a relief. I had pretended I wasn’t worried about my disinterest in food, but I was lying, as you probably suspected. I may have a perfectly reasonable medication-related explanation for the pounds melting off me, but as a graduate of the School of Something Could Always Be Seriously Wrong, I’ve still wondered whether my liver might be tanking. As of today, I worry no more. My liver is a-okay.

Despite my apparent well-being, Dr. B.L. was alarmed by my rapid weight loss. So alarmed, in fact, that he said something that no doctor has ever said to me before: he told me to start eating more. He forbid me from losing any more weight and said he expects me to pack on a few pounds by the next time I see him. He even suggested ways I might increase my caloric intake.

My inside voice could not help but giggle in response to Dr. B.L.’s concern. I wanted to say, “Do you realize who you are talking to? I am a glutton! Cookie Monster is my doppelganger. Or is it Miss Piggy? Whatever, you’ve got me all wrong, doc.” Instead, I listened respectfully and told the doctor I would take his concerns under advisement. Yes, I used those words. And he smiled, just a little. I think we’re going to get along.

Now I must force feed myself some dinner. Doctor’s orders.

arm reaching table full of appetizers

Ah, ha, ha, ha, stayin’ alive


Did you miss National Cancer Survivors Day yesterday? Not to worry, so did I. I scored nary an invite to any of the festivities. I’m not even sure I am a cancer survivor; all I know is that my cancer hasn’t killed me yet.

Turns out I’ve got a good cancer, if there is such a thing, one that people can live with for many years. And since most of the time I’m in complete denial about my co-existing conditions (my impaired liver and my polycythemia–Happy 17th Polycythemaversary, by the way), I can pretend I too will be one of these people who will live a long life.

One of the main reasons I don’t feel like a true survivor is that I still take daily medications to keep my leukemia at bay. Oh, and my regular visits to the Cancer Centre. There’s nothing like hanging out amongst my cancerous peers to remind me I’ve still got the big C.

Unlike many other cancerous folk, I have very few leukemia cells now, according to most recent testing. So few that, in a CML patient booklet I just read, I am considered in remission. No one has used the R word with me before; in fact, when I was first diagnosed, I was told people with CML don’t go into remission. I was as surprised as you may be. If I’ve misled you, I did it unintentionally.

I also learned from that informative booklet that, with the advances in treatment of CML, many of us are living to a ripe old age. The focus of intervention has shifted from treatment to our quality of life. That part I get, now that I have reached Day 7 of The Wrath of the Gouty Finger. The leukemia isn’t so bad; it’s the symptoms and medication side effects that I find challenging.

So I’d like to suggest a new day of celebration more appropriate to those of us with CML. Let’s call it National Cancer-Symptoms Survivors Day. We’d be celebrating maintaining our quality of life while living with the threat of a potentially terminal illness hanging over our heads. We gatherers could compare notes on our various medication side effects and how we have survived them. We could share information about the interventions we’ve added on to manage those side effects.

I can think of many ways such a get together could benefit me. I’m sure there’s a CML survivor out there who would know how to manage yoga postures that require my lying on my belly. “Do you also have to rearrange the position of your football-sized spleen when you lie down?” I’d ask. Or how about our unrelenting fatigue? “Do you too fall asleep during matinees? How do you keep yourself from snoring?” Then there are the challenges of taking all those drugs. “How do you manage to time your medications to minimize all drug and food interactions?” The possibilities are endless!

We’ll plan our special day to coincide with the National Cancer Survivors Day. Then those of us who feel left out will have somewhere to go where we feel a sense of belonging. We all need to feel we belong somewhere.

Cut out figures holding hands

Fatigue is a many-splendoured thing

I’ve been struggling with more fatigue than usual of late. I should be napping daily, and on the days that I don’t, despite my best efforts, I spend part of the day in a fog. Last Monday, I napped before my volunteer shift so I’d be able to serve soup safely.

Despite my fatigue, I dragged myself out of bed this morning so I could write this post. If I let myself, I could return to bed and sleep for another few hours. My self-denial does not allow for the stimulating effects of caffeine. I am hoping writing will get my brain cells firing.

I try not to belabour you with stories of my fatigue day in and day out. I’d hate for your reading to put you to sleep. And I don’t want you to view me as a whiner. But since people often ask me why I’m tired, I thought I might list the known reasons here.

  1. Medical factors:
    1. Leukemia (I expect you to know that one)
    2. Polycythemia (maybe less obvious)
    3. Liver disease (yes, my sick liver makes me tired)
    4. Related to C, pharmaceutically-induced low blood pressure
    5. Several other medications with those little warning stickers on the bottle, “Do not operate heavy machinery….”
  2. Environmental factors:
    1. Bedroom is too hot/too cold/not just right
    2. Pesky songbirds that awaken early in these parts
    3. Pesky dog who takes her cues from the pesky songbirds
    4. Stanley Cup playoffs

Let’s focus on 2D, since the playoffs, however transitory, are currently compounding the chronic fatigue caused by medical factors (1A through 1E). Now that Calgary is out, I am rooting for the Edmonton Oilers under duress. They are making a notable run for the Stanley Cup. Now in the second round, they continue to play brilliantly, despite last night’s loss.

The Oilers’ performance should be of no matter except (and this is a big “except”) their games have been taking place late in the evening. Because I am a devoted hockey pool member with players selected by my beloved (my love for hockey only goes so far), I am invested in how well all teams are performing.

(For the benefit of those who do not know what a hockey pool is [primarily my family], I choose the well-performing players from teams I believe will have success in the playoffs. [Liar. J. chose my players.] Players are eliminated as their corresponding teams are. By retaining the most players through the final round, I have the best chance of winning the title.)

So I’ve been staying up late watching hockey and counting my points. Thanks to J.’s wise selections, Annie’s Agitators is currently second, neck and neck with Jesse’s Water Wings. J. lags well behind, having chosen an inferior team for herself. (I take credit for my success, despite J.’s doing all the heavy lifting.)

But, let’s not forget the compounding role of factor 2C: Jelly, never an avid hockey fan, sleeps through long evenings of our rooting for the underdogs. She startled awake once to J.’s raucous cheering after a goal, but the rest of the time she has slept soundly through our deriding the referees. Jelly would never manage to awaken with the birds if she stayed up with us to watch. Perhaps I should follow her lead?

Basset hound Jelly sleeping in awkward twisted position

A simple recipe for poisoning your loved one

Picture of pasta with cheese and pepper

Two years ago, J. celebrated her birthday in the ER, where I had gone to seek urgent medical attention. I made the one day of the year that’s supposed to be all about J. all about me. After spending several hours ignoring my symptoms, I could no longer deny their seriousness.

I’ve since succeeded in avoiding hospital visits on J.’s birthday. Last year I left my cancer at home and celebrated J’s birthday in her favourite London pub. This year, staying healthy was a piece of (birthday) cake, for me at least. I have been the picture of health for a chronically ill person.

J.’s birthday this past Saturday started out like any other day. I had carefully planned a special meal for her. I chose not to tell J. what was on the menu so she wouldn’t try to simplify the offerings.

I then carefully gathered my provisions. On Friday, I made sausage and bean soup because soup always tastes better on the second day. I planned to make the pasta and dessert on Saturday.

At dinner, J. enjoyed the soup and the pasta so much that she even took seconds. Then she had her first bite of the Portuguese custard tarts I’d laboured over that afternoon. She left the rest of her tart untouched while I scarfed mine done. She became increasingly quiet, and then she abruptly fled the dinner table.

J.’s using the facilities during a meal is not unusual. Her kidneys are so healthy that she pees hourly. I found it odd when she did not returning promptly to the table, however. I waited and waited, and then I went in search of her, only to discover she had spent the last 20 minutes ridding herself of my carefully cooked dinner. She was so sick that night that she couldn’t even watch her beloved Oilers clinch Round 1.

Ever the catastrophizer, I was sure my special meal had poisoned her. I reviewed the meal ad nauseum. I was sure I’d cooked the sausage meat properly. Yes, I’d adequately heated and then cooled the soup. I’d baked the custard tarts, with their six egg yolks, long enough. And then I considered the fresh pasta. Was there salmonella instead of semolina in the flour mix? (Recalled flour is all the rage lately, but E. coli are the offending bacteria.)

The cheese did have a bit of mold on it, which I cut off before grating, but did I miss a spot? How dangerous is moldy cheese anyway? Turns out some molds are fine–Brie cheese is made with mold, for example–but others molds can make you sick. Then I learned that some molds have a toxin that is precursor to liver cancer. Oh great, I gave J. cancer on her birthday.

Before you throw out all your cheese like I did, consider this: people don’t react to food poisoning as quickly as J. did, according to my wise neuroscientist friend. And despite my questionable immune functioning, I didn’t get sick. Perhaps it wasn’t my cooking after all.

Once I’d determined I hadn’t killed J., J. told me that she’d been feeling off all day. Sorry to hear that, honey, and please excuse my huge sigh of relief.


P.S. Turf that green cottage cheese pronto.



Crisis chez Dr. Liverpaté

Did I mention that, with a little cajoling, I scored myself an appointment with Dr. Foie Gras (who my dear friend insists on calling Dr. Liverpaté, which does have a certain ring to it)? So off J. and I went this week to visit the dear doctor, seeking help for my progressing lumpy gout.

Dr. LP well tolerated our barrage of intrusive personal questions. At our last visit, he disclosed he had married and bought a house. This time, we learned he and his wife recently had their first child, a baby boy. Dr. LP happened to have a newborn picture or two on his phone, which he showed us readily. We oohed and ahhed appropriately.

The doctor’s recent sleep deprivation did not seem to interfere with his clinical acumen. But before we give this esteemed physician too much credit, let’s consider his job: gastrointestinal specialists train intensively for years in order to be able to ask people about their poop. Yes, all such doctors have a morbid interest in their patients’ potty habits, and they make a whack of cash investigating such habits. Can you imagine talking to each and every patient about their No. 2? I certainly cannot, and I am grateful that my clinical interviews cover a broader range of subjects.

And so, after I addressed my concerns, including whether my gouty bumps would continue to grow until they became grossly disfiguring and burst through my skin (we’ll address his response to my catastrophizing some other day), Dr. LP circled back to the No. 2 (not his but mine). But because even a poop specialist prefers visuals to words during a discussion of this type, Dr. LP began looking frantically around his assessment room for the hanging poop chart, a.k.a., the Bristol Poop Stool Scale. Lo and behold, there was none.

With any other patient, this would have been a true GI crisis. Dr. LP knew that I, a longstanding clinic patient, familiar with poop-preoccupied physicians, would know not only about the existence of this chart but also have the chart memorized. I didn’t need the visual reminder; the verbal cuing would suffice. So we had a quick discussion, after which I expect Dr. LP made a note to hang a copy of this chart forthwith so other less experienced patients would not have to endure such an awkward conversation.

Before we left, Dr. LP, who is by nature a serious fellow, displayed an uncharacteristic playfulness, possibly prompted by his recent sleep deprivation. We had been discussing a certain over-the-counter medication, and Dr. LP was distracted by its absurd advertising, which he tried to locate for us. He explained that this medication’s packaging has always been an emasculating pink, so the company had recently come out with a blue-bottled version for macho men. The contents of the pink and blue bottles are absolutely identical; only the colours of the labels differs.

What, then, would I like you to take from today’s post? With any GI specialist, you can expect the poop talk. Hopefully there will be a poster to help you through it. Also, not only do men have babies, they are babies.


Blue bottle of Lax-a-Day for men

Dangers lurk everywhere, and other trite updates

Before we get into my bad behaviour on Saturday night, let’s start this week with a few important updates. I’m not ready yet to acknowledge my stupidity so let’s ease into this true confession, okay?

Alfalfa sprouts picture with red RECALL written over itFirst off, I removed the alfalfa sprouts topping my eggs benny yesterday, but proceeded to eat the potentially deadly soft-poached eggs. Sprouts can kill. Does ridding my meal of one potential germ carrier counterbalance not ridding it of another? I didn’t really think so either.

Second, my taxes are ready to be dropped at the accountant’s office later today. I too am in shock.

Several pieces of sugarless gum strewn on a blue tableThird, every time I pop a piece of sugarless gum in my mouth, which is rare these days, I remind myself that I cannot go swimming because my urine will be traceable in the pool. Not that I pee in the pool. Not that I even swim in public pools anymore, although I used to at one time. Sometimes I start thinking of how much pool water I probably swallowed over the years and I get a little queasy. I doubt I’ll ever set foot in a pool again, so perhaps I can stop fretting about my sugarless-gum consumption.

Fourth, and with acknowledgement of my idiocy, I was feeling especially froggy on the weekend. My gout-related bumps (tophi) are slowly growing. I am developing one on the end of a finger, the first to cause me some discomfort. What if my painful lump interferes with my ability to type my blog? Only Saddy truly understands how upsetting this would be.

Instead of dealing with this problem by calling Dr. Foie Gras, my go-to doctor for such issues, I performed an internet search. I wondered what would happen if my body continued to overproduce uric acid, collections of which cause these little lumps. A uric-acid-reducing medication may have contributed to my near-fatal liver failure four years ago, so I’ve been forbidden from taking any since. I’m hoping there are other options.

Scared person looking at computerLet’s not even talk about what I learned on those highly reputable internet health sites. I don’t want to upset you or to haunt you since, for all I know, you too may cross bridges before they’re even built. What I read was not nearly as upsetting as the accompanying photographs. I happened upon a photo of a gruesome tophi-ridden hand likely belonging to the Wicked Witch of the West. It was truly grotesque. (I will spare you by not reproducing that image here. You needn’t be traumatized like I was.)

So not only did I look on the internet for health information, I did it right before bed when I was absolutely pooped. What was I thinking? I needn’t solicit material to inspire nightmares right before bed. Needless to say, my fifth update of note is that my long-vanquished insomnia returned that night. Better not to sleep than to risk a nightmare, I say.

Today, I will be contacting Dr. Foie Gras’s office to see if I might schedule a visit. Hopefully his administrative assistant, who is prone to ignoring my desperate pleas for help, will contact me promptly with an appointment time. If not, I will follow up by sending a copy of that photograph to her. That’ll light a fire under her, for sure.