There’s no way to stop a ticking clock

Clock is ticking with sand timer

Remember when I used to joke about whether this was my last Hanukkah, or Passover, or Rosh Hashanah? I’ve stopped joking.

When Dr. Blood Lite told me I had one year to live, I forbid myself from becoming preoccupied with the clock ticking down my days. A few months have now passed since I received this news, and I’ve been trying to live in the moment rather than focusing on what’s down the road. I’m a realist, though, remember?

I realize no one knows exactly how long I will live. The doctor has given me his best estimate because that’s all he can do. Only time will tell. Maybe it won’t be 365 days, but 364 or 366, or 300 or 400. When I was first diagnosed with polycythemia, I thought I’d be dead within 10 years, and here I am 18 years later. My diagnosis with CML, although scary at the time, turned out to be a minor blip in the story of my health. I know I should be focussing on all the living I’ve done since I’ve been sick and all the living I have left to do, rather than the fact that my life may end sooner than I had hoped.

Then Passover came, followed closely by Easter. This year is supposed to be about creating memories, but last weekend all I could think about was whether I was celebrating these holidays for the last time. All my efforts at living in the moment failed miserably.

I gave myself permission to be sad, which I have to do sometimes. Sad that next year’s Seder would go on without me there to participate. Sad that I’d never again be able to hunt for Easter eggs like all the other preschoolers. I’ve heard of dying people celebrating Christmas early; I guess I could do the same for my favourite holidays as well, but I wouldn’t be fooled.

The thing about being told I have one year to live is that every milestone that passes in that year is potentially my last. Holidays, anniversaries, birthdays, even seasons–any of them could be my last. If my doctor’s prediction of my life span is accurate, I’ll probably live through my 55th birthday next October, but my 56th is unlikely. I should be around for our 6th anniversary this June, but likely not our 7th the following year.

Let’s return to the Seder. Although I was not the designated afikomen seeker–that’s assigned to the youngest person present–I bullied the rightful one into allowing me to conduct the search, figuring it would likely be my last chance to do so. Thankfully, others who were more observant than me guided me to the hidden stash using the red-light/green-light method. This method is effective with toddlers and spacey people like me. Even with this help, the young’un had to rescue me in the end, since, despite all her expert guidance, I still came up dry as a piece of matzah. It may have been my last chance to find the afikomen and I failed miserably.

I will try to create only happy memories in my final year, but some days, I’ll be mourning what’s potentially my last kick at whatever can I’m facing. I thank you in advance for being patient with me.

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Is it time to change my outdated blog title?

twisted cord with beginning and end untwisted, muddling in middle twisted

Dear Powers That Be:

In addition to the death sentence you handed me a few months back, you had the gall to give me a post-vacation cold? Do you really think I want to spend any of my remaining time blowing my nose and coughing through the night? I’ve accepted the deadly illness. Least you could do is give the cold to someone healthy.

With heartfelt irritation,

Annie

Now that that’s off my chest, we can return to the matter at hand. My blog was first published under its current name, Muddling Through Leukemia. The name came to me in a dream (not really) and it’s worked. I’ve had no desire to alter it in any way for four years. But times have changed, as you know.

I’m not really muddling through leukemia anymore. CML is the least of my worries. Nor am I muddling through polycythemia. In fact, what I’m dealing with is a rare bone marrow disorder known as myelofibrosis. Ever heard of that?

Myelofibrosis and polycythemia fall in the category of bone-marrow disorders known as myeloproliferative neoplasms. (Try saying that quickly three times.) Polycythemia may transform into myelofibrosis over time. Myeloproliferative disorders are a subtype of blood cancers treated by hematologists using the cancer-fighting arsenal. More internet research might help me better define this category of disorders for you, but you know how much I abhor internet health research, especially since everything I’d look up now would be dire. I do know that people with these disorders all have wonky bone marrow, so that’s enough for me.

I have described myelofibrosis to you previously; I simply neglected to name it. Remember that day I received my one-year notice, when Dr. Blood Lite confirmed the increase in fibrous tissue in my bone marrow? He was telling me that my polycythemia had transformed into myelofibrosis.

I must say that Muddling Through Myelofibrosis has a nice alliterative ring to it, and you know how I love my alliteration. Muddling Through Myeloproliferative Neoplasms almost rolls off the tongue, but no one would have any idea what I was talking about. Also, there are several disorders that fall in this category so it’s a bit broad.

I’ve decided, despite what I’m dealing with, that I’m too attached to my blog title to change it now. Muddling is what I’ve been doing for years, through life and anxiety and health crises and now even through dying. If I change the blog’s name, I’ll be abandoning all those people who search the blog by title. If they can’t locate me, they’ll think I’ve died already, and I’m not dead yet. Plus no one will have any idea what myelofibrosis is, except for you, my faithful readers, so who’d want to read about something they’d never heard of?

That’s why I’ve decided to stick with my inaccurate blog title for the duration, trusting you can make the leap to my current reality. Sadly, it’s also possible that my title will regain its accuracy some day, if I am one of the 12% of patients with myelofibrosis whose illness becomes Acute Myelogenous Leukemia (AML). I’m told AML is no party, so let’s not even go there yet. One step at a time.

You are not going to LIKE this post

thumbs down emoji

I created this blog as a way of sharing news about my health. When I first started writing, blogging seemed an effective way to keep people in the loop. Thanks to your diligent readership, the blog has helped me feel connected with you.

It can’t have been easy to read my posts sometimes. You have joined me on the ups and downs of my cancer roller coaster, sharing your wisdom and words of support. You’ve laughed at my jokes, which I realize are often funny only to me. You’ve stuck with me as I’ve muddled through both physically and emotionally. I couldn’t have asked for more from all of you.

You know my worries about my health have been rampant of late. I was hoping that my concerns about my recent bone marrow biopsy were unfounded, that my anxiety had gotten the better of me, that I was facing a challenge that was surmountable. Unfortunately, I was wrong. My story will not have a fairy tale ending today.

The results of the biopsy were not good. The fibrosis in my marrow has increased significantly since it was last assessed three years ago. The more scarring there is, the less space is left for healthy blood cells to be produced. This progression explains my recent anemia and my drop in platelets. Unfortunately, as the fibrosis continues to take over my marrow, my body will have increasing difficulty producing blood cells.

All is not lost, however. With the help of a red-blood-cell producing hormone and IV iron infusions, my red blood cell counts should improve in the immediate future. This will help me to feel less fatigued, thank goodness. I will also receive the occasional whole blood transfusion as needed. The doctor has reassured me that my low platelet count is manageable. We’ve agreed to my abstaining from tackle football and full-contact hockey for now.

Sadly, my health will continue to decline from here. At some point, there will be no more room in my bone marrow for the creation of blood cells. The methods I described of raising my red blood cell counts will no longer be effective. I will feel increasingly unwell, and yes, I will die.

The doctor asked if I wanted a time line. However anxious I am, I find not knowing much more stressful than knowing, so I said yes. He believes that I have a year or so left to live. This may not seem like much, but for me it is an eternity. I’ve had the fear of death hanging over me since I was first diagnosed with polycythemia 18 years ago, and I have outlived all predictions. Now I will be grateful for however long I have and will do my best to relish every moment. So will J.

There is so much more to tell you about what I’ve learned and what the next steps are, but I think this post has been heavy enough for one day. Furthermore, I rigidly adhere to my 500-word post limit no matter what. Thanks as always for reading. I’ll continue blogging for as long as I can, and hope you’ll stay on board. I could use your support now more than ever.

Resolutions are made to be broken

How are those resolutions going? Are you eating better? Are you down a size yet? Have you thrown out your money on that new gym membership? Well, if you’re struggling to maintain your commitment to yourself, you’re not alone.

My resolution to stop catastrophizing about my health lasted a total of 8 days. Then I went to the cancer centre for my regularly scheduled check in. I arrived with my resolution in tow, fully expecting an uneventful visit. I hadn’t noticed any new or different symptoms. Sure I’ve been napping most days, I’ve had the odd bruise, and I don’t quite feel myself, but that’s nothing new.

I knew I was in trouble when the lovely Dr. Blood Lite entered the room with an unusually grim look on his face. He pulled his chair in close to mine and asked how I’d been feeling. Then he said, “I’m worried that….” I can’t tell you how that sentence ended because, frankly, I was stunned by his lead in. A opening like “I’m worried that” is pretty high on the list of sentiments no cancer patient wants to hear.

It turns out my blood counts are dropping and the doctor is not sure why. I’m tired because I’m increasingly anemic and I’m bruising because my platelets continue to drop. Since my leukemia is well controlled, these changes likely reflect my wild card, polycythemia. I’ve had polycythemia for 18 years now, and in that time no brilliant medical researcher has devised a way to stop its advancing. The symptoms are manageable but the polycythemia train keeps moving, and I can’t jump off.

There are other possible explanations for my changing blood counts but this one needs to be investigated. The doctor suggested I reduce the nonessential chemotherapy that addresses my polycythemia symptoms since this drug could be responsible for my declining counts. No problem. If, after 6 weeks, reducing the meds is not the answer, the doctor will have to inspect my bone marrow for clues.

A long time ago, I wrote about the little minions who might one day start squatting in my marrow, building homes in the spaces needed to produce healthy blood cells. I’ve never invited them, but I have no means of kicking them out. Landlord-tenant bylaws do not apply. The only way to know whether the minions are squatting is to take a closer look.

J. knew that waiting six weeks to search for the minions would torture me. She asked whether I might have the bone marrow aspiration sooner so at least I’d know what I was–and we were–dealing with. For me, not knowing is much worse than knowing, even if the news is grim.

And so, dear readers, I blew my resolution completely yesterday. The doctor’s appropriately asking me about my advanced care plan didn’t help. (More on that another day.) I will now reinstate my resolution forthwith, knowing that in some situations, follow through can be challenging despite our best intentions. Next week, I will have no trouble following through since an Ativan will help me visit La La Land during the procedure.

I will keep you posted. I always do. If I can deal with this, so can you. And don’t forget, inside every anxious person is a brave person itching to get out.

Weiner dog in cape flying through air

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

Another year, another doctor’s appointment

Green-brown frog with lots of warts

We’ve had a bit of a hairy holiday, and when I say hairy, I mean hairy. We’ve been dog sitting left and right, three shedders followed by one non shedder. Jelly has enjoyed the company, although it appears that familiarity breeds boredom. As I write, Jelly and her bestie are sleeping soundly on their beds.

But time stops for no cancer patient, and so yesterday, when many workers and schoolchildren enjoyed a day off, I was visiting the only blood lab open in the vicinity. Then today, the first Tuesday of January, J. and I traipsed off to see Dr. Blood. The appointment was largely uneventful but even uneventful appointments are instructive.

Shall I review which blood tests were wonky and which were improved? I could but that would bore all of you. Also, the numbers are only a small piece of the puzzle. Lately Dr. Blood and her proteges have been stressing that how I feel is more telling than any lab test result.

But one wonky result is too intriguing to skip: yes, I have too much uric acid. I can’t tell you what uric acid is but I know that having too much of it, whether because of overproduction or underexcretion, can result in gout and kidney stones. Although gout used to visit me regularly, I have been surprisingly pain free for a very long time now. I have never had a kidney stone, although I hear they are not much fun.

Dr. Family suggested the uric acid testing when I showed her a few small painless bumps on my hands last month. I thought one bump might be a wart, but the ineffectiveness of the do-it-yourself wart remover told me otherwise. (A word from the experienced: Do not use wart remover to remove anything but a wart. That stuff burns like the devil.) Dr. Family reassured me I was not turning into a frog.

She diagnosed my bumps as tophi, not warts. Tophi are deposits of uric acid crystals that can develop over time if uric acid levels are elevated. My polycythemia and leukemia and other various medical anomalies may be to blame for my predicament.

Thankfully, Dr. Protege, or shall we call her Dr. Fellow, reviewed this finding with me and stressed that my high uric acid level is less important than how I am feeling. I told her I am feeling bumpy but goutless. She is not especially concerned, and made no mention of my morphing into an amphibian of any sort. Phew!

In the meantime, because the Great Sugar Revolution has so successfully lessened my fluid retention (in other words, it has deflated the water balloon that is my midsection), J. is encouraging me to ask Dr. Liver whether I can reduce my diuretics. These drugs deplete the body of fluid and can, in the process, elevate uric acid levels. If I lower my diuretic dosages, maybe that will slow down the development of those unseemly bumps. I may not be turning into a frog, but I still don’t want to look more and more like one.

 

What I get for the price of hospital parking

Line of cars awaiting parking

You may have been glued to the television or internet on Tuesday, but I didn’t have the time or energy for that. I must say it took considerable effort to avoid watching the U.S. election results. I had to resort to Chopped on Food Network for distraction. While you were fretting about the election, my Tuesday was a typical day in the life of a cancer patient.

I visited the Cancer Centre with J., where I attended my regularly scheduled appointment. We arrived early to secure parking and I trotted off to the lab for an up-to-the-minute blood-analysis (ca-ching). While we awaited my appointment, the volunteer Cookie Ladies appeared with their warm tea and snacks (ca-ching for that endless supply of cookies and drinks). Sipping on tea is the perfect antidote to the stress of a cancer-related appointment.

A lovely hematology nurse called me in and assessed me (ca-ching). Then I saw a knowledgable hematology fellow (ca-ching, ca-ching), who consulted with with Dr. Blood (ca-ching ca-ching) and sent me off for another two months. My body and my blood are stable, except for an odd mouth infection I developed after a trip to the dentist last week. My magic mouthwash–yes, that’s what it’s really called–seems to be helping. Finally, I stopped by the in-house pharmacy to pick up two months’ worth of free chemotherapy (ca-ching ca-ching ca-ching, although there could be more ca-chings; those drugs are expensive).

Have I ever mentioned that Dr. Blood had to seek special dispensation for the government to fund one of my chemotherapies because it is not normally used for polycythemia? I’ve often wondered how I’d pay for that medication out of pocket or, even worse, whether I could afford it at all. Would my functioning decline were I not taking it? Thankfully, I needn’t worry about those things.

Man vandalizing parking meterFor my excellent and timely care on Tuesday, we paid solely for the cost of gas and parking. I’d pay an arm and a leg for parking in order to receive such fantastic medical care. (As an aside, I saw this picture in the news recently: in it, a hospital-parking-fee protester vandalizes the parking meter. Mr. Destructive, who do you think will be paying to fix that machine? Perhaps you might consider another means of protest.)

All this has me thinking of J.’s decision, at age 53, to retire in 13 work days (not that anyone’s counting). She could not have fathomed doing so if we lived in the U.S. Our health care costs would have been daunting, and early retirement would have been impossible.

While that new president was being elected, our grand niece was admitted to the children’s hospital in need of delicate spinal surgery to remove a growth. Imagine any family having to bear the cost of neurosurgery. Thank goodness these parents don’t have to worry about paying for treatment and can focus on more important things.

The results of the U.S. election remind me of how lucky I am to be sick in Canada. 20 million people in the U.S. have benefitted from Obamacare, and I can’t imagine their fear that their new government may alter or eliminate their health-care benefits. If need be, moving to Canada is always an option.

Sometimes the bad news bearer has good news

I love my work, but, to be honest, being a psychologist is not all butterflies and rainbows. I have had to deal with many challenging people and difficult and emotional situations, Abuse is traumatic for the client and its disclosure can be traumatic for the therapist too. My clients have survived tremendous adversity.

Often, I’ve been the bearer of bad news. Parents can be devastated to find out their child is learning disabled, or has an autism spectrum disorder, or may not become an astrophysicist. For years, I informed parents I believed their children, whom Children’s Services had removed from their care, should not be returned to them. I lost a lot of sleep questioning my own judgement.

Years of this type of work are wearying even for a competent clinician. I don’t often consider the positive side of having cancer, but I can thank my leukemia for potentially preventing occupational burnout. My work doesn’t compare to that of a physician, however. I may have said things that affected the rest of my client’s lives, but I’ve rarely dealt with life-and-death situations.

I can’t imagine informing a patient that she has cancer. That’s what that smart hematologist-on-call told me four years ago. (Happy Cancerversary to me, by the way!) The ER doctor called Dr. Diagnosis for a consultation because of my blood disorder (polycythemia). Dr. D. reviewed my past blood work, spotted some anomalies, and suggested further testing.

I can remember exactly when she told me she thought I had leukemia. After spending a long day in the ER, I was transferred to a hospital bed, so J. had just gone home. I was alone, overwhelmed, and overtired when Dr. D. came in to give me the news. Needless to say, I was beside myself. What did she know? Had she consulted my hematologist, whose care I’d been under for 12 years? Somehow she kept calm in the midst of my meltdown.

J. and I talked with this know-it-all together the following day. J. was as perplexed as I was. We challenged her and confronted her and she stayed calm. In the midst of our uproar, she told us that the diagnosis was a good thing, that she caught the illness early, and that there were wonder drugs that could stop CML in its tracks. That was the good news, and eventually we stopped fighting with her.

By the end of the week, J. and I had realized this doc had probably saved my life. Then, even though we had just met and I had caused her a full week of confrontational grief, Dr. D. facilitated my transfer from my old hematologist, whom I no longer trusted, to Wonder Woman, a.k.a., Dr. Blood.

So I don’t envy these doctors, and I couldn’t do their job. How do they describe their day over dinner? “Saved a patient’s life today, honey.” How do they manage when a patient they’ve cared for and cared about dies? Do they ever fret, or lose sleep, over their decisions? They must. If they need to maintain professional distance to survive the emotional onslaught, so be it.

Thanks docs. I wouldn’t be here today without that level of care, and caring.

Sign saying

One potato, two potato, red potato, pink?

Basket of red potatoes tipped over

Spot the genetically modified potato!

Turns out my cancerversary will be long past by the time I see Dr. Blood and her fantastic team again. I have been given the summer off my patienting job so I can busy myself with other things, like deciding what to bake for my next celebratory Cancer Centre visit.

Barring counselling the odd client (by “odd” I mean “occasional” and not “unusual”), I will have a fair amount of free time this summer. Lukewarm coffee, anyone? I’m available days. As always, I will keep the home fires burning while J. is off earning our keep. Jelly and I will walk ’til we drop, I will keep us in groceries, and I will cook tempting meals and bake delectable wares.

Why just the other day I went to the mega-grocery store, list in hand, only to have an energy vampire sidle up to me at the red potato bin. This well-dressed older woman had nothing better to do than suck all the energy out of unsuspecting shoppers. You know the type, ready to pick a fight over the produce.

As I was choosing my red potatoes, the EV sidled over and said: “Those potatoes don’t look very red.” I nodded and smiled but did not engage her because I feared what might come next. (When anyone tries to engage me in a negative conversation, I put up my magic shield and deflect all incoming messages. Alternatively, say something nice or engaging or interesting and my shield magically vanishes.) Because she had not garnered the outrage she was hoping, she repeated herself: “Those potatoes aren’t very red.” Then she added: “They must be genetically modified.” That’s quite the judgement on those poor potatoes, isn’t it?

If I were an agronomist, perhaps I could have determined whether the potatoes were genetically modified. But, sadly, I’m an ignoramus. EV was implying through her tone of voice that genetically modified potatoes are evil. I don’t know enough about genetically modified food to care. I may nurture my gut bacteria with daily kefir, yet I wonder whether some genetic modifications are not so bad. If you can make my tomato last longer or pack a more nutritious punch, I’m in. That’s why I bought those pink potatoes despite EV’s protests. For all I know, they’re better for me.

After I laughed (just a bit), I said: “I certainly can’t tell by looking at them.” Then I left to check out the genetically ambiguous lettuce. Were I not wearing my ill-fitting socially appropriate hat that day, my inside voice would have said: “Why the heck are you shopping at the cheap mega-grocery if you have disdain for genetically modified produce? The farmer’s market beckons! There you will find God’s bounty. But don’t complain about the ugliness of the produce or the short shelf life.”

Perhaps my strong reaction stemmed from the fact that I too am genetically modified, albeit by God and not by science. Imagine my life without my genetic anomalies, i.e., my Philadelphia chromosome (a.k.a., CML) and my JAK-2 mutation (polycythemia). I’d kill for a scientist to manipulate my genes. Who knows? Maybe it could extend my shelf life.

The perils of drinking pineapple juice in the pub

You probably want to know how my appointment at the Cancer Centre went yesterday. I’ve been holding out on you long enough. Let’s not keep you waiting any longer.

We arrived early despite construction on the route to the hospital. That’s because we allowed one hour for our 15-minute journey. Remember J.’s motto: “If you aren’t early you’re late.” The appointment started and ended punctually, so we did not even reach the parking maximum. What’s the saying? 7 dollars saved is 7 dollars earned? That’s it.

What’s that? You wanted to know about the appointment itself?

The visit was lovely. The very kind nurse, whom we had not met before, beckoned us before J. had finished filling out my form. (As an aside, I forgot to confirm that J. had checked the “Itchiness” box, but I trust she did.) After we discussed how I’d been doing, the nice nurse asked me whether I’d been drinking. “Ha ha,” I responded.

Then we met with Dr. Blood, who had the most gorgeous shoes on. After discussing her footwear, she asked us all about our trip. Then we heard details about her upcoming vacation, which sounds fabulous.

Could I get to the point? But isn’t this the point?

Then, just like the nurse, Dr. Blood asked me whether I’d been drinking. Why was everyone asking about my alcohol consumption? Turns out my liver enzymes had inexplicably jumped since they were last tested. Elevated liver enzymes may indicate excessive happy hour participation.

My fair readers, you know I don’t drink. I never drink. Drinking is strongly contraindicated for those with a bum liver. So when Dr. Blood jokingly suggested I’d spent a little too much time in the pub, I chuckled again, whereupon J. raised her hand and said: “That would be me.” That gal of mine doesn’t miss a beat, does she?

Were you aware that over time women who live together end up cycling together? And by “cycling”, I don’t mean going for a bike ride, I mean visiting with Aunt Flo, having their time of the month, or menstruating, whichever terminology you prefer. This led me to wonder: since J. and I can no longer cycle together–I gave up cycling a while back now, poor balance and all–perhaps our bodies are finding other ways to commune. She drinks a few beers in the pub and my liver enzymes skyrocket, even though I’m sticking with pineapple juice and soda. It appears I am suffering the consequences of J.’s actions.

But there’s another reason Dr. Blood was asking about my boozing: I had told the nurse I was itchy. Intense, unrelenting itchiness can be a sign of a troubled liver, hence the “Itchiness” box on The Form. But I have itchiness à la polycythemia, i.e., my itchiness is short-lived and occurs only after a shower, as I explained to the doctor. “Oh,” Dr. Blood said, “that kind of itchiness.” And since everything else seems a-okay–if my liver were really in distress, I’d have no appetite, and there’s certainly no sign of that–Dr. Blood sent me for repeat blood work in a few weeks, and suggested a visit to Dr. Foie Gras if the numbers don’t improve.

As to my fear she might suggest lotion? Completely unfounded. She knows better than that.

Picture of woman drinking beer