In Praise of Collagen

Until 6 months ago, I had not been much of a fan of supplements. That attitude goes back to my youth. The long and short: My family was homeless, eking out an existence in a bleak and dismal slum of Manila. Through sheer tenacity and grit, the family worked together to make my college engineering education possible and enabled me to start the family’s exodus from the slum hell hole.

In slums anywhere in the world, parents don’t think supplements. Thoughts of food occupy their heads – where to get food to feed the family so everybody survives. Nutrition does not come into play. All that’s needed is the basics for survival – shove the food in the mouth, the digestive system works it, and ejects the waste sooner or later, hopefully neither too soon nor too late so existence can go on.

Survival in the slums has benefits. The immunity system gets a rigid workout on a daily basis. I remember in grade school, my siblings and I were almost never absent from school for being sick unlike our classmates who came from well-to-do families.

Okay you get the drift. I grew up not taking one-a-day vitamin pills and other supplements. Even when I could afford them already in the US, I had zero motivation to take supplements. But, like some other subjects, supplements pick my interest and I read about them lest I’ve been missing something in my life. If something impresses me, I mention it to friends and family whose desperate health complaints seem to be a match for the supplement. I don’t give medical advice. No. No. I’m not a physician. My engineering background limits my medical knowledge to the human machine’s parts involved in the use of the sewer system.

When I was in business years ago, my architect, a Polish-born opera singer who turned to architecture after her vocal chords went kaput, gave me an earache with complaints of aching joints daily. So I mentioned to her the over-the-counter glucosamine, which, from what I read, was first developed for dogs with arthritis problems, and later found to work well with people. Perhaps desperate to remember how good it was to feel good, she bought a bottle of glucosamine and took a dosage of the pills that night. The following day, she came to work with spring in her steps, smile on her lips, her face aglow. No more pain! She said she had never felt better. She even bought me a sushi lunch! We were both delighted.

My colleague the renowned Dr Google and I keep each other entertained with the latest health trends on probiotics, prebiotics, Keto anything, state-of-the-art supplements, etc., but I never buy them. There is one exception. For the last 4 years, I have had no choice but to buy and take Folbee Vitamin B6 and B12 supplements prescribed by my primary care physician Dr PCP to prevent, he says, deficiency due to the lung cancer. At first I tried to get away with not taking them but he insists that I bring all my medicines during our visits. He had sensed a little mischief in this geriatric patient!

My resistance to over-the-counter supplements ended 6 months ago. Collagen made me do it. I’d heard about the benefits of collagen but never really took it to heart. But one evening at the retirement resort whirlpool, before the pandemic struck, I happened to sit near one of the regulars, a Hispanic woman, late 80’s, unhealthy chubby, walks with a walker, and the only one who wears red lipstick and cheek blush in the pool. She broke the silence between her and me by gushing about how collagen really works. Based on her appearance, I could not tell how collagen could have really worked. But perhaps her collagen had a different agenda. After listening some more, I found out it was her husband taking the collagen. She exclaimed, I see the tiny hairs growing on his forehead hairline. How old is he? I asked. 90, she replied. Collagen grows him hair at 90? I asked in disbelief. Yes! she replied. Wow, I acknowledged the magic.

I am not familiar with the circumstances that brought her husband to collagen but I know why her story excited me. In January 2019, I updated my blog with a post on Hair Loss when I was letting my ebony-dyed hair grow longer. I intended to stretch my face when I pulled the long hair into a small Asian bun. It happens when there’s too much time in the hands. The hair grew long but tresses started falling, gradually widening my forehead! The Hispanic woman’s unabashed declaration of faith in collagen gave me a glimmer of hope. After all, over a year had already passed and my wide forehead had not exhibited any signs of narrowing. I was getting tired of wearing biker’s skull caps and camo caps that match my half-dozen camo pants in an effort to look hip instead of needing a hair transplant. If the old boy can grow new hair at 90, by golly, this younger old chick should be able to do even better.

Before making a mad dash to buy my first jar of collagen, I did my research with the help of Dr Google. It’s great to have the good doctor at my beck and call. Here’s what I found out:

Collagen has a definition the long, short and layman of which is that it’s the most abundant protein in the human body, found in bones, muscles, skin, and tendons. It’s the substance that holds the body together, a scaffold to provide strength and structure. Collagen production declines with age and exposure to smoking, UV light, etc. Women experience a dramatic reduction in collagen production after menopause. By age 60, a considerable decline is normal. Oh dear….

Then the good doctor and I moved on to clinical studies.

Some studies show that taking collagen for several months significantly improved skin elasticity as well as signs of aging. Others have shown increased density in bones weakened with age and can improve joint, back, and knee pain.

How about hair? It’s my only interest in this collagen exercise. Collagen, being made up of amino acids that help the body make more keratin, which contributes to thick healthy hair. Getting warmer! The body may be able to use the amino acids in collagen to build hair proteins and strengthen the skin that contains the hair roots. Aha!

I read enough. I was convinced. Time to spring for a jar of collagen.

The only ingredient of the collagen supplement I bought is hydrolyzed bovine collagen peptides, processed cow’s skin in ordinary English. It comes with a measuring spoon equivalent to 2 tablespoons. Collagen peptides dissolve perfectly in my hot cafe au lait before it is topped with a 2-inch high mound of whipped cream.

I’ve been on six months of collagen supplements now and hair has grown on the vacant real estate on my forehead, which has been restored to its original width. I’ve been letting my hair go gray again after suspecting that the ebony dye chemicals prompted the hair loss. Now I notice, intermingled with gray roots, new growth of black hair has come through the scalp!

New hair growth on previously vacant space

I can’t vouch that collagen will be effective for Bro, the youngest only living brother of my first late husband. Bro’s we head became as smooth and shiny as a bowling ball by age 20, inherited baldness from his dad, according to my late drama-mama-in-law. I can’t imagine collagen coaxing hair follicles to rise from the dead after 50 years.

Since hair growth was my only baby in the collagen experiment, I was not keen on other collagen users’ glowing testimonials on its effect on their nails, skin, and joints. However, I can’t help but notice some changes in mine.

I have been trimming my fingernails and toenails more often. They grow faster. The fingernails used to be brittle, ridged, and crumbly – all signs of the aging process, I thought. Some readers suggested they are side effects of Tagrisso. They are no more, regardless of the reason. They are whiter, stronger, healthier – not crumbly.

The skin on my forearms seems taut.

Remember my painful left knee after I got carried away with the pedometer app on my smartphone? And the broken left shoulder from the car/pedestrian collision? Haven’t had joint pain. It could be the Boniva. Maybe both. Who knows? Who cares? No pain is no pain.

OMG! I sound like a snake oil salesman!

Do you have a supplement story to share? Let’s hear it.

Meanwhile, Happy Dance!



Coping with Covid-19 Hassles

The month of July brought all sorts of situations requiring the mind’s coping mechanisms to function well, otherwise, one would go nuts. Fortunately, being a self-proclaimed Life Coper Extraordinaire, I handled each aggravating event with aplomb. Of course it kind of helped that I’m retired and content, collecting moola from the Social Security Administration (SSA), drawing my fair share before the SSA funds dry up.

I had an appointment scheduled with my primary care physician Dr PCP on July 8th. As usual he required me to get fasting blood test panels from LabCorp one week ahead to allow time for processing, the results of which would help him determine all that’s wrong with me. While he says he would like to see perfect numbers for my ripe old age, I suspect a slightly amiss reading would also bother him, but not intensely, because it would present an opportunity for him to refer me to one of his specialist buddies. I know what happens between referrer and referee. They make each other happy.

July 2nd, Thursday. I rose early, ingested zero food and drinks. As usual, I moseyed on without an appointment to LabCorp, which is located 2 floors below Dr PCP’s offices in the same building. Lo and Behold! A sign on the door said “Due to Covid-19 prevention yada yada, this facility is closed permanently; please visit our offices at Mission Viejo and Irvine. I was aghast. How dare them not warn me in advance! I refused to spend $30 round trip in Lyft to either city and take the risk of being rejected because I had no appointment. I thought, Surely my insurance should accept more than one lab in town. I asked my buddy Dr Google, What say you, Doc? He gladly responded, Your insurance works with LabCorp and Quest Diagnostics. Right answer! I went upstairs and asked Dr PCP’s medical techie to Fax my blood test order to Quest, which is located in the building next block. Since it was getting late for the no-appointment fasting hours, I decided to go home. Hunger pangs were beginning to gnaw on my innards. I’d do the blood test the following day.

July 3rd, Friday. I rose early, ate and drank nothing and moseyed on without appointment to Quest. Lo and Behold! It was closed. A sign said, “This office is closed for Independence Day. Will return Monday July 6th.” Hungry and hacked off, I shuffled home. Fortunately, I fancy myself as Scarlett O’Hara of Gone with the Wind. Back at the manor, as I was doing my yoga routine, during the cobra pose, I sighed, Tomorrow is another day! I felt better already.

I browsed our retirement resort’s newsletter. It opened up with, Pursuant to the governor’s Covid-19 lock-down edict, the annual Independence Day fireworks is cancelled. Instead, I guess to placate the old folks, management planned in haste a parade of patriotically decorated golf carts. With so little to do during a lock-down, every little bit of entertainment was welcome.

July 4th Saturday. I dressed up for the parade-watching occasion: a white wide-brimmed hat, a red sleeveless silk top, and blue denim shorts. How patriotic is that? I didn’t want to overdo it. At the appointed hour, I got my cellphone camera ready and sat on a bus bench on the designated parade route. I observed the other parade watchers as they arrived: socially distanced masked old men and women on wheelchairs pushed by masked caregivers or on their own holding on to walkers or canes. Them Old Folks, a group I talk about as if I did not belong. Yes indeed, what’s not to love about that attitude?

I waited with great anticipation for the parade of colorfully decorated golf carts, my hands all eager to produce a thunderous clap. And I waited. And waited some more. I looked down momentarily and scribbled a paragraph to my blog update post in progress. When I looked up, Lo and Behold! I noticed everybody had left. All gone except me and my male Indonesian neighbor standing 10 feet away. We waved at each other. I stood up. I’m going home, I told him. So much for Covid-19 Independence Day 2020!

July 6th, Monday. I got up early, fasted again, and sashayed to the building, the 3rd floor of which contains the offices of Quest Diagnostics. A majestic 3-story structure resembling India’s Taj Mahal, it is named…..ta da….Taj Mahal! When the elevator door opened on the 3rd floor, I saw a long line of socially distanced masked people on the corridor. The line wrapped around a distant corner. I asked an elderly gentleman in the line, Is this for Quest? Only for those without appointment, he responded. I joined the line. Slowly but surely after nearly an hour, I reached the intake waiting room where 6 people could sit on chairs, 6 feet distance between them. All the other chairs were stacked high against the wall. I occupied a seat and waited.

Finally I heard my name called. I thought a phlebotomist, a medical technician who does nothing but draw blood from various people all day, was ready for me. Lo and Behold! She just wanted to inform me Quest no longer accepted my insurance. I quickly decided on another option. I said, Okay I’ll pay out of my pocket. How much is it? It felt liberating to sound like a loaded senior babe. Around $400, she answered. I was floored. That’s it. I’m out. I can use those bucks when the casino opens after all this Covid-19 issues are resolved. Dr PCP will just have to see me without blood test results. I took the 15-minute bus ride to Laguna Main Beach where the cool ocean breeze tenderly blew away the aggravations.

July 8th, Wednesday 10:30a.m. While waiting for the elevator that would take me to Dr PCP’s office, I noticed a sign: LabCorp is located on the 4th floor. By appointment only. On the same floor as Dr PCP’s office! Where were they when I needed them?

At Dr PCP’s office, the med tech did the intake motions. She weighed me, took my temperature and blood pressure, and instructed me to sit down and wait for Dr PCP. It turned out to be an unusually short wait, the best thing in these pandemic times. Maybe I was the only patient for the day. The exchange between Dr PCP and me went like this:

Dr PCP: How’s the bikini girl?

I responded with a hearty laugh.

Dr PCP: I knew you’d like that.

Me: I know. I’m easy.

And we laughed simultaneously. He opened the medical record filled out by the intake med tech.

Dr PCP: You’ve lost weight. Five pounds!

Me: It makes sense. I fasted all week last week trying to get my blood drawn. Still unable to get it done.

I figured a little exaggeration would impress the good doctor. But no! He let out a big fat yawn instead.

Dr PCP: I did not have a good night sleep. My head feels empty.

Me: That’s not reassuring. I’ve never been seen by a doctor who can’t think.

Dr PCP: It’s a good thing you have no blood test report. We have nothing to discuss. Let’s do this: Get the fasting blood test before the end of July. Weigh yourself once a week. I don’t want you to lose any more weight.

Me: The last weight measurement was in the winter. I had thicker clothes on me – jackets, mufflers, hats, falsies. The socks for my Z-coils weighed half a pound, the Z-coils 2 pounds.

I just had to have the last say. I must admit, Dr PCP and I have had an entertaining doctor/patient relationship since Day 1 four years ago. He’s the most fun PCP I’ve had in memory. Actually, until the day I signed up for Medicare, I never had a PCP. I did not like going to doctors unless I had to, which was seldom. The moment I signed up for Medicare, the insurance company required me to have a PCP. I chose a Nursing Practitioner, figuring, What does she know? She’d be perfect. She’d be less aggressive in finding what’s wrong with me. What did I know? My Stage 4 lung cancer diagnosis came under her watch!

As instructed, Dr PCP’s med tech handed me the fresh order for a fasting blood test before the end of the month. I assumed he had already plopped for a nap.

July 23rd, Thursday, at LabCorp. Another fasting morning for the blood test. Blood test scheduling will never be the same again. I had scheduled my appointment online. I liked it. I did not have to talk to a machine. Just press, press, done – date and time all fixed.

On the eve of the appointment date, LabCorp emailed me a reminder: Due to Covid-19, we’re limiting the number of people in the waiting room. Come on time but not too early. Sign in, wait in your car or somewhere, but not too far you can’t come quickly when you receive our text that it’s your turn. It thrilled me that LabCorp and I were on the same page! Having failed to get the blood test a few times three weeks ago, I had no plan to travel to Disneyland to wait for my turn.

I found an empty seat in the waiting room. When it was my turn for blood draw, Lo and Behold, I discovered I had forgotten to bring Dr PCP’s order! OMG another catastrophic day! Then it dawned on me Dr PCP’s office is just next door. I negotiated to keep my slot. I walked a few steps and got an order slip from Dr PCP. At long last, the Lo-and-Behold situations were over, the fasting blood test was behind me.

The following day, LabCorp’s Patient Portal notified me of the results. I reviewed them and found everything acceptable.

Well, well. All’s well that ends well. Happy ending, Happy dance!

Travel During COVID-19 Lockdown

A friend of mine once remarked, Why do you always have a story to tell? My answer: Because I’m a curious chick. I think out of the box. Checking things out excite me. When I do things out of the box, naturally wild unexpected stories happen.

Around Mother’s Day last May, word got around that powers-that-be were easing the 2-month COVID-19 lockdown. As I took my daily walk on the serpentine roads of the gated retirement resort, I noticed more masked residents had ventured outside their manors and were enjoying the warm Southern California sun. The light bulb on my head lit up: Enough of this imprisonment! It’s time for a road trip! It was something easier said than for me. I had given up driving 4 years back upon the demise of my last late husband who had done all the driving for me. The thought of me filling up the car, maintaining it, driving it, searching for a parking spot agitated me. The few times I had to drive in Albuquerque, I shunned freeways and left turns and took only straight scenic routes and right turns. At my age, in California, I was not about to learn how to get in and out of lanes of wide boulevards to weave in and out of 16-lane freeways. I returned the dearly departed’s car to the dealer and dedicated myself to travel by all means of transportation: taxi, uber, lyft, train, car rental, bus, golf cart and hooves. Travel prospects provided new source of excitement for the retired senior babe.

Not an ideal place for sauntering in a string bikini

My Plus One, BT, rented a spanking new Maxima for one month, same brand as my first personal company car more than a decade ago. We mapped out a road trip plan to drive leisurely eastward. Inspired by Glen Campbell’s song “By the Time I get to Phoenix,” BT would start from the west coast, through Tucson to see relatives and friends, then Albuquerque to visit my Son the Sculptor and his family for a few days, then to Dallas to meet my baby sister’s new husband who had ended her 17 years of widowhood. Wheels up!

My Son the Sculptor got wind about the proposed trip. He phoned me. He gently hemmed and hawed about Albuquerque’s coronavirus lockdown, his concern about my advancing age, my compromised immune system, my chances of picking up the COVID-19 from hotels and restaurants along the way, and my NEED to quarantine for 2 weeks after the trip. Oh dear, in other unspoken words, NO WAY! Concerned friends and relatives also expressed their rejection of my proposed drop-by in various tactful ways. I took the hint. I understood totally. I surmised fear in their hearts. After all they don’t have the advantage of having been diagnosed with Stage 4 lung cancer and sentenced to 8 months to live 8 years ago. Being on the receiving end of a terminal stage cancer diagnosis, I feel empowered. I consider all other maladies from A to Z in WebMD as ailments that cause slight temperature.

I confronted BT, Let’s talk. Why are we involving friends and relatives? Why mine? Why not yours? Which of your out-of-town relatives do we bother? They’re all dead, he said. I have an aunt still alive, the younger sister of my 92-year-old mother. She has Alzheimers and lives in an assisted living facility in New York. So much for BT’s contribution of ancestral persuasion to the proposed 30-day road trip.

We were now on Day 3 of the 30-day car rental and BT hadn’t steered Maxima a mile out of the gate. Finally, he and I agreed to go it alone, still eastward. He tried to make phone calls to reserve a hotel room and I hit the internet and tried to make a hotel online reservation for our first stop: Tucson. What a rude awakening! In every hotel’s website, the COVID-19 notice of closure except for essential travel blocked the web page. We couldn’t possibly make reservations. The government co-conspirators wouldn’t stand down.

BT and I regrouped, Let’s make the trip out of town within 100 miles of our retirement resort. Let’s go to our favorite mineral hot springs resort near Palm Springs, an hour and a half away. Agreed. My string bikini swimsuits in the suitcase and my mask dangling from one ear, we were ready. Wheels up!

Bentleys, Beemers, and other fancy cars with CA license plates spaced miles away from each other rushed on the freeway. It was extreme social distancing like nothing I had seen in the greater Los Angeles, CA area – not a good sign. When we reached our destination, we went straight to our favorite resort where hot mineral spring water is piped into swimming pools and jetted whirlpools. From the parking lot we could see on the hotel registration door a big foot-high red sign that screamed CLOSED. Undeterred we walked to the door and tested the knob. It was locked. I read a notice in fine print taped on the door “Open for essential travel only:” We’re covered! I told myself. I was ecstatic. I whispered to BT, Quickly, think of a reason that will qualify our hotel stay as essential. It did not take much to convince the hotel management that we were on essential business. They approved our stay. It would be safe to assume they could use the revenue. Then the hotel clerk informed us the pools were closed and restaurants all over town were closed. Bummer! Where would I get my steaming hot cafe au lait topped with whipped cream in the morning? Instead of registering, we drove back to our own resort where the 5 pools and hot spas were also closed. At least my refrigerator was stacked.

So much for the planned road trip. For the rest of the 30-day rental period, the car found its way to the long drive-up lines of In N Out Burgers, and Del Taco. Walmart, Home Depot and COSTCO made the short list of shopping destinations outside the golf cart limits of the retirement resort. One night we drove to San Juan Capistrano train station bar and listened to Chris Crame, a talented guitarist former high school classmate of BT. Chris has been singing for tips any top 10 hit song from any generation for 50 years in various SoCal Beach City venues. He had called himself The Human Jukebox until he was sued for copyright infringement. One would think nobody heard of the new coronavirus at the bar. Social distancing did not exist. Nobody wore a mask except BT and me.

In due time, BT returned the car but the dream of escaping from the COVID-19 lockdown persisted. The uncertainties of travel strangely provided the urge to seek the thrill.

Let’s fly! With destinations in mind, we checked out Southwest Airlines. Hawaii was out; outsiders were forbidden to fly in. Other preferred places with operational restrictions included Costa Rica, Mexico, and some US states. Aha! Dallas was open and my sister and her new husband egged us on to come visit.

Very early on a June gloom cool Thursday morning, BT and I sat in a Lyft cab on our way to John Wayne Airport after agreeing to wear face masks and allow the cab window to remain open during the drive. Thanks to my biker’s skull cap the wind failed to mess up my hair and my face mask warded off the bugs from my teeth.

At Southwest’s departure check in area, a masked uniformed employee sanitized the check-in kiosks after each use. At the security check-in area, everybody wore a mask and stood on socially distanced X-mark. At the flight gate waiting area, passengers sat 2, 3, or more seats away from each other sideways but I noticed something amiss. Directly behind my head was a man’s head with a cowboy hat. The airline companies need to remove and replace the seats to make them separated rows that face only one direction. Just saying.

The lines of passengers waiting to board in groups of A, B, and C no longer existed. They floated around socially distanced until called to board in groups of 10 socially-distanced people at a time.

In the cabin, the center seats were vacant. No soda, coffee, tea, or alcoholic drinks were served. Zero. The only beverage provided was a flip-top aluminum can of no-fizz Deja Blue tepid water accompanied by a paper-wrapped drinking straw. No chance of virus transmission there. We received sealed small pack of pretzels to chew on while pondering the new state of travel. In-flight magazines were nowhere in sight. Only a barf bag and a laminated sheet of emergency instructions occupied the seat pocket in front of passengers. I sorely missed the in-flight magazine crossword puzzle. To keep myself occupied, I studied the emergency instructions just for entertainment, I hoped.

At deplaning time, we the masked passengers stood up in a tight line on the aisle as we jostled while retrieving our luggage from the overhead compartment. So much for social distancing, I told the guy next to me.

Upon arrival at Dallas/Fort Worth airport, online news of Texas having a record new cases of COVID-19 cases and hospitalizations greeted my eyeballs. Fortunately everything is big in TX including hospitals. The guv assured the mostly Cowboy fans, No worries. We can handle this. He made an instant fan out of me.

Our hosts – my sister and her groom – live in The Colony, one of the many small towns and cities around Dallas. Everyday they took us on a tour of the neighboring attractions. Social distancing was evident everywhere. People wore masks inside buildings, but took them off in restaurants. It’s kind of challenging to feed the face through muzzled mouths.

Our first destination was the Pioneer Plaza in Dallas where sculptures of 84 bulls appear to stampede through a sloped rocky alley. Only in Texas: $8.4M privately funded project. Naturally my Son the Sculptor came to mind. He could have been a member of the team of sculptors who made $100,000 per bull! Unfortunately the Pioneer Plaza was dedicated in 1955 when my son was only 19 and still trying to wean himself from the skateboard.

The author shares a rear view in Pioneer Plaza

Stringtown, Oklahoma offered the next point of interest – a farm where fierce cocks that fight to the death are raised for the wealthy Filipino cockfighting aficionados in the Philippines. They are sold at $3,500+ per rooster including 2 hens – enough to start a community of two-legged intensely ferocious and aggressive feathered warriors. Imagine a Filipino senior babe assimilating all that precious knowledge. Just when I thought I’ve got everything already figured out!

We continued on to the Queen Wilhelmina Lodge in a National Park at the Arkansas Oklahoma border. There we gulped icy cold beer and loaded up on quesadillas after a punishing trek down and up a rocky path to a scenic view. Okay I confess. Only the newlyweds completed the trek. BT, a Type 1 diabetic and I, a Dr-Google-diagnosed Type 2, turned around halfway. Our glucose numbers were ebbing.

All told the van rolled in excess of 600 miles over 3 states in 4 days. No open casinos beckoned along the way. It was a good thing our hosts have a whirlpool hot tub for 4 in their backyard. It provided a great relaxing soak while we rehashed the exhilarating experience at day’s end.

That road trip happened 3 weeks ago. Having avoided other people upon arrival in the retirement resort, I beat my chest for successfully quarantining. Now I take stock of the state of my health. After the five days of climbing up and down the travel van, long periods of sitting, walking, and hiking, I had brought home a pain in the pinky toe of my right foot, the site of the big toe bunion. My esteemed colleague Dr Google gave me the name of the small toe problem: bunionette! I feel like doing somersaults to celebrate. But I can’t. A raw aching bunionette is not conducive to bouncing around. Then why the celebratory mood, you ask. My answer: It’s not COVID-19 I brought home from the trip!!

Home, safe, and sound. Happy dance is more like it!!!


My 8th Cancerversary

The number 8 seems to appear often in my cancer journey. I wish it would show up a lot more on the craps table when I’m betting on Hard 8 or just 8. Of course it is not showing up at all these days because casinos are closed. The Covid-19 pandemic social distancing order sure is a killjoy.

It was August, the 8th month in the year 2012 when a biopsy revealed the malignancy of a 3cm x 3cm x 2cm tumor at the bottom of my left lung. Based on the cancerous tumor and the too-many-to-count sub-centimeter nodules that lit both of my lungs like the Milky Way in the sky, the first oncologist gave me a prognosis of 8 months to live without treatment and may be 11 months to a year with treatment. The pronouncement brought tears to the eyes of my son, then 38, and Octo, 78, my husband at the time.

Whoa, Whoa, Whoa! That was August. This is June. Why 8th Cancerversary in June? Because this blogger marches to the beat of a far-out drum. I established my anniversary on the month of the activity that led to the diagnosis. Why? Because I could. And there are no rules. And no one really gives a fig.

In my 8 years of riding the cancer train, I took Tarceva for first-line treatment, followed by the CO-1686 drug (Rociletinib), then Tagrisso. The recent growth of one nodule was actually the first documented progression in 8 years.

The progression that caused the switch from Tarceva to Rociletinib was never documented beyond reasonable doubt. What happened was, Octo had made plans to live to be 100 and beyond. He had insisted that I live to be at least 92 so he and I could tiptoe through the tulips together hand in hand toward the sunset. While Tarceva was gobbling up most of my cancerous tumor, Octo was frantically researching upcoming clinical trials. We were living in Albuquerque, NM then. He was very determined to ensure I was on a cancer drug when Tarceva stopped working. He accompanied me to every appointment with my Onc, who also had Stage 4 lung cancer. A corporate executive before retirement, Octo exercised control. He insisted on speaking on my behalf and drove everybody in the doctor’s office crazy. Not me. I didn’t care. Somebody had to do it. My mind was abuzz with blogging ideas. At that point in time, I had declared it my mission to enlighten and entertain about lung cancer for as long as I could. After all, I had already exceeded my 8 months expiration date.

Octo nagged my Onc for the next clinical trial that might apply to my Adenocarcinoma Stage 4 EGFR deletion 19. He flat wore my Onc out. Exasperated, my Onc, who traveled to his own Onc in Denver for cancer treatment said, I will introduce you to my own Onc. Ask him. If he’s good enough for me, he should be good enough for you. Exact words. I was there. Henceforth I referred to the Denver Onc as my Onc’s Onc.

Onc’s Onc agreed to look into my case. He saw the too many tiny nodules to count in my lungs and the shrunken sole tumor at the bottom of my left lung. Since there was no CT scan report indicating progression, he patiently and methodically scoured the last 2 CT scan images and compared them. Finally he found 3 nodules on the last one that were not on the previous one and informed us. Octo and I visited Onc’s Onc in Denver. He showed us the 3 nodules, which he called “3 little fellas.” That could be progression, he said. Anxious to be in a clinical trial, Octo and I were delighted, Yes! Knowing what I know now, I realize no one – not a one – ever gets ecstatic over news of their cancer progression.

Onc’s Onc looked me in the eye: To qualify for the CO-1686, you must have the T790M mutation. Onc arranged for a biopsy at the University of New Mexico (UNM) hospital. Lo and behold, the biopsy result showed positive T790M. We’re in! Octo declared. Not so fast, warned the clinical trial honchos. We have to confirm your biopsy result with our own biopsy result. And they did do their own analysis. Their result: T790M negative. It was quite a spread from T790M+ to T790M- but they accepted me anyway. Amazingly my main tumor continued to be stable under the clinical trial for almost 3 years. Unlike Tarceva which produced horrible diarrhea, Rociletinib did not give me any adversarial side effects for the first 4 months. Then came the drug-induced diabetes type 1 – without need for insulin – as THE side effect for the rest of the trial days. Meanwhile the “3 little fellas” were never mentioned ever again in subsequent CT scan images. They probably either disappeared or simply joined the ranks of the other unknowns in the too-many-to-count platoon.

The CO-1686 clinical trial tanked. The Rociletinib manufacturer orphaned it after the Food and Drug Administration (FDA) refused to give it the accelerated approval. Being the self-proclaimed valedictorian of the trial, I even agreed to be flown to Maryland to implore the FDA to approve it, because having more cancer treatment drugs is better than having less cancer treatment drugs. My testimony fell on deaf ears like the couple of other helpful testimonies. That more people suffered from side effects than those who benefited from the drug proved to be insurmountable. Octo, my caregiver and fearless advocate for the clinical trial, fared worse. He wanted so bad to accompany me to the FDA hearing and root for me during my speech. Unfortunately leukemia got him and he passed unceremoniously.

The progression on Rociletinib that led to Tagrisso was even less established. My last CO-1686 CT scan result report informed my Onc, Dr Brevity, at University of California in Irvine (UCI) that a nodule was found on top of my adrenal. Perhaps anxious to close out the clinical trial, he deemed it metastasis and progression rather than wait for the next CT scan to see if it would grow or disappear. He gave me a prescription for Tagrisso and released me. The drug-induced diabetes disappeared within 2 days of stopping Rociletinib.

For the first time in 4 years I was out of the university scene, without a protective, aggressive caregiver/advocate and left to my own devices. I had no UNM, University of Colorado, UCLA, and UCI to lean on. My primary care physician Dr PCP referred me to one-man-band Onc Dr Smiley to whom I gave Dr Brevity’s Tagrisso prescription. Dr Smiley ordered a CT scan for me to establish his own baseline. Surprise! The resulting image report mentioned unremarkable adrenal, kidney. I asked Dr Smiley, Where is the nodule on the adrenal? His response: With cancer, we don’t go looking for things that were seen before. There was neither metastasis nor progression! Time had simply come to close the trial and for the senior babe to move on with Tagrisso. As of this writing I’ve been on Tagrisso for 3 years and 5 months.

So last March, for the first time in 8 years and a succession of 3 drugs, one nodule grew and was clearly documented in the CT scan report. Within a month of its discovery, Stereotactic Body Radiation Therapy (SBRT) whacked the nodule in 5 sessions. The treatment gave me zero side effects.

Optimism reigns supreme in the heart of my inner Mehitabel. Hopefully the SBRT worked. We’ll find out in the CT/Pet scan scheduled in July.

Meanwhile, 8th Cancerversary is a good occasion for Happy Dance.

I’d love to hear your story.

My SBRT Experience

I could hardly wait to experience my Stereotactic Body Radiation Therapy (SBRT)! Hell, I’ve been retired for 12 years after a successful 25-year run of my own engineering and environmental consulting company. It had been an epic struggle getting to the “I have arrived!” mode, overcoming hurdles deliberately thrown by males on the path of a young pioneering gung-ho engineer babe. Oh, but it was all worth it. After retirement, I have just been into filling my cup before my number’s up. Okay, I admit. This cancer thing gets in the way of cup-filling activities. Fortunately, positive attitude propels me to the good side of things: I see another fodder for my blog! So we’re talking savoring the moment here.

For my type of cancer – Non-Small Cell Lung Cancer (NSCLC) adenocarcinoma EGFR/T790M 1cm slow-growing nodule in the middle of the left lung – the SBRT treatment amounted to a total of 5 sessions, day after day except for Saturday and Sunday between Day 2 and Day 3. Everything started on Thursday, by Wednesday afternoon the following week, it was over, finished, done deal, “tapos,” “finito,” YEAH!

After 5 Sessions

Each SBRT session set up was very similar to the simulation session. That’s why the word “simulation.” Duh! The only difference was that the SBRT zapping timing varied depending on the imaging angle. The patient positioning was the same for each session. Naked from from the waist up but covered by the blue hospital gown, I was helped on the CT scan bed by two radiation technicians (rad techs). My back fitted in the bed’s groove from head to legs. The rad techs placed a plastic triangular wedge under my knees to make it easy on my back. They placed a small oval foam thingy on top of my tummy and told me to hang on to it. I said, A pretend steering wheel! Yes, they chorused. Don’t move.

Day 1

The first SBRT session happened on the day after the 2nd of 2 simulation days.

It started with getting checked in. A masked receptionist at the hospital took my temperature and asked if I had a cough, sore throat and muscles, diarrhea, etc. I asked, perplexed, What do those have to do with SBRT? Nothing, she answered. It’s about the pandemic social distancing. Light dawned. Oh yeah, I get it. It’s not always all about me. It’s the reason for my wearing a mask. What was I thinking?

Moving on.

Preparation/Setup

A 20ish male hospital aide in sky blue uniform met me at the general waiting room and led me to the SBRT preparation area. He showed me the restrooms, a wall of lockers with keys hanging, the dressing room, and the SBRT waiting area. He escorted me inside the dressing room and showed me clean blue hospital gowns that fasten at the back and new unused plastic bags to temporarily contain personal belongings, a containers for used gowns and a trash can for used plastic bags. He said, Put your belongings in one of the lockers or take them with you to the SBRT room. I took with me my backpack and the bag containing my belongings – blouse, bra, eyeglasses in their case, hearing aids in their case, mask, ponytail clip.

Two radiation technicians in their early 30’s – an Asian man and a White woman – helped me up the hard CT scan bed covered only by a sheet. The bed’s rigid surface rubbed against my bony elbows. Not a pleasant sensation. After positioning my body on the bed mold from head to legs, the duo started placing the mask/shield on me. I felt it tightening against my face over closed eyes. There was a little space between the mask space for the lips and my lips. I could still talk! I asked, Are you guys bolting me down? Yes, and they laughed, and continued bolting. I asked one more question while I could, So this is what you guys do, bolt people down all day? Just about, he answered, and tightened the last bolt. Now I could no longer talk but I could hear them giggling. They probably had never been asked that question or they lightened up over their chosen career path. Soon I heard sounds of something being turned on, something being released, footsteps going away from me, then the sound of a door closing.

Zapping Time!

So there I was all alone in the SBRT room, bolted down and muzzled. Extreme social distancing! I was thinking there better not be a fire anytime soon. A good thing my inner Houdini interrupted my train of thought and reassured me, Don’t worry. I got this, babe.

Faced with a situation I and only I could address, I asked myself, What should an irreverent senior babe do during 45 minutes of zapping while she is bound tight, can’t move, can’t see, can hear but can’t talk? I thought about reliving my entrepreneurial engineering days when meeting payroll and getting new projects occupied my head. Nah, that was so decades ago. I heard about people imagining beautiful scenes. Only images of drainage ditches and landfills showed up. Engineering snuffed out my artistic proclivities. Fortunately artiste extraordinaire, my Son the Sculptor, has compensated for my shortcomings. I tried to sleep but I couldn’t. Several thought ideas floated in and out of my mind. Soon I heard the door open and sounds of footsteps toward me. Great job! exclaimed the woman tech’s voice. I let out a big sigh of relief.

See? 45 minutes was not too bad, was it? She asked after releasing me from bondage. I complained, It was more like 45 hours. Come on guys. There must be something we can do to make this more like 45 seconds, more fun. She offered, How about music, you like music? Music, yes! I accepted. What kind of music do you like? 50’s and 60’s! I replied automatically then immediately thought, I’m a vain woman. Why did I give away my age? The names of rock stars Led Zeppelin and Eric Clapton would have definitely scooted my age at least a decade down. But I only know their names, not their music. Listening to their music would be like listening to a high-pitched Italian opera without seeing any action that clues in the lyrics. 45 minutes of torture. I looked at her eyes and repeated, 50’s and 60’s. Got it, she acknowledged.

All done, I gathered my stuff and moseyed on to the dressing room. There I stared at the mirror. A familiar face stared back at me. It was waffle face! The basket mask had left deep impressions on the skin. I took a picture and texted it to my son: First SBRT session done, 4 more to go!

Day 2

Same preparation/setup and zapping session except for the 50’s and 60’s music, which made a world of difference in passing the 45-minute zapping time. The music brought back memories of my youth when I used to play my favorite Latin gypsy music album “Sabor a Mi” by Eydie Gorme. I remembered that each song was anywhere from 2.5 minutes to 3 minutes long. During the zapping session, I listened to each song and counted them on my fingers on the pretend steering wheel. I figured 15 songs would approximate 45 minutes. Meanwhile I allowed a range of emotion for each selection while parsing the lyrics. There was a Frank Sinatra’s song about when chips are down, all sorts of bad things happen. His wife left him Monday, Tuesday he got fired. Sad. I appreciated my being retired. No tension with a pension. Neil Diamond’s “Sweet Caroline” brightened things up, created a problem. Being bolted down, I could not swing and sway and do my hippy hippy shake. I could not even move my lips to help the chorus of “Sweet Caroline Pah! Pah! Pah!’

Time went by uber fast. Sure enough, after the 15th song, the rad techs came to unbolt me. As soon as I could talk, I declared, Tomorrow we’ll play the Bee Gees! The Bee Gees, yay! The rad techs celebrated the choice of artists they could recognize.

Day 3

Same preparation and zapping session, except the rad techs forgot to leave me with music. I surmised they had been too occupied bolting people down ahead of me. So I spent 45 minutes thinking of what to think.

I saw Rad Onc because he had instructed the techs to send me to his office for a routine SBRT visit. He gave me a heads-up on what to expect within 2 weeks after the last SBRT session: red spot or spots on the skin on the radiated area, nothing to worry about. We’ll discuss side effects, if any, over the phone.

Day 4

Same preparation/setup and zapping session except the Bee Gees music filled the air. The 15 songs tided me over the 45 minutes. Stayin’ alive! Stayin’ alive! Before leaving the rad techs, I put in my order for the 5th and last day: Elvis Presley.

Day 5

Same preparation/setup and zapping session except Elvis Presley music entertained me. After the techs unbolted me and set my mouth free, I asked, What kind of entertainment center do you guys have here? The voices sounded like they were coming from a tin can. They did not sound like the artists either. Who are they? She replied, I don’t know who those people are. And we laughed. I continued, I wanted to complain about the sound system earlier but I fought the feeling. I was afraid you’d not appreciate my ungratefulness and turn it off to punish me. We laughed again. Then it dawned on me, Am I allowed to laugh here? I did not see anybody crack a smile all the 5 days. Of course masks make people inscrutable.

I rushed out of there, happy and relieved the SBRT was behind me already. I was almost at the dressing room when I heard Congratulations, Congratulations! I turned around and saw the male tech, one hand outstretched handing me my diploma, the other hand lugging my mask/mold, which I had requested early on to take home with me.

So there we have it. I could hardly wait to get there and could hardly wait to get out of there. The moral of the story: Going through the SBRT procedure is a breeze. Anybody can do it. “Nothing to fear but fear itself.” Whoever quoted that is my hero.

Happy dance.

I’d love to hear from SBRT vets and future vets.

The Happy Graduate Sans Waffle Face

The Preparations for SBRT

One positive thing arises from the slight progression of my Stage 4 adenocarcinoma non-small cell lung cancer. It gives me fodder for my blog! Of course I’d rather have stayed in the suspense mode, neither knowing if the damned cancer will be on remission for the rest of my life, nor one day rear its ugly head full monty and hurl me over the Pearly Gates so I can start grooving with Elvis and Liberace.

When I started this blog and researching for it 6 years ago, I read a lot about SBRT, short for stereotactic body radiation therapy. SBRT’s use for cancer treatment has been around for a while but I don’t recall reading any cancer blogger’s blow-by-blow account of the procedure. The novelty of being in a clinical trial consumed me. Now here I am eyeball to eyeball with Mr SBRT who’s in charge of arresting my cancer progression. The purpose of my blog is to share knowledge and perhaps, by chance, lighten up those who have the time and the inclination to crack a smile, therefore I dedicate this blog update to those who give a damn about what I have to say. The SBRT procedure I describe herein applies to my kind of lung cancer: a slow-growing 1-cm tumor in the middle of the left lung.

My proposed SBRT treatment started with a consultation with the Radiation Oncologist (Rad Onc), the latest professional in my cadre of medical specialists. He said he had pored over my medical record. After some exchange, he asked, Do you have a Pulmonologist? I answered, The first and last Pulmonologist I had was 8 years ago. He diagnosed my cancer after a biopsy and declared the tumor was in a beautiful location. Then without consulting an oncologist, he got together with a surgeon to carve the 3cm x 3cm x 2cm tumor out from the bottom of my left lung. During the operation, the surgeon felt other tiny nodules in the vicinity of the malignant tumor. So he discontinued the video-assisted thoracic surgery (VATS), closed me up, and left my pursuit of cancer survival to my own devices.

I noticed Rad Onc’s furrowed eyebrows. Probably all he wanted to hear was a simple yes or no. I love throwing doctors for a loop.

After recapturing his lost train of thought, Rad Onc resumed: I’ll refer you to Dr P, a Pulmonologist. The Pulmonologist will do a bronchoscopy on you. He’ll drop tiny gold stuff, called fiducials, in your upper left lung to pinpoint and mark the location of the malignant tumor that will be zapped.

The Bronchoscopy

On the day before Bronchoscopy Day, I received 2 identical text messages – one from Dr P’s office nurse and another from the surgical nurse at the hospital where the bronchoscopy would take place. Both said: No food or liquid after midnight. Go to the Emergency area, tell the security guard you have a scheduled procedure, then he will walk you to the operating waiting room.

The Day!

The head guard ordered the youngest guard to take me to the operating room area. The bright-eyed white kid who probably entertains the notion of one day becoming a brain surgeon, or at least a health technician, obeyed the order enthusiastically. He and I strode out to the sidewalk together. Then suddenly he took off speedily! He was at least 20 feet away when it occurred to him he was alone. He turned around, saw me, and walked back toward me. I’m so sorry, he apologized. You look good and I did not ask if you need a wheelchair. Don’t worry, I deadpanned. It’s not you. It’s me. I take tiny steps. One of my late husbands said it’s because I have rice paddy feet. The words “one of my late husbands” raised his eyebrows and sent furrows to his forehead. We walked to the surgical area together at my perfected saunter.

The Preparation Room intake nurse gave me a printed blue cotton gown that closes at the back. She told me to take off everything and put them in a bag. Including panties? I asked. The last lung work I took off only from the waste. She replied, Everything. When was the last time you had a drink of water? I answered, Last night before midnight. I lied. The procedure was scheduled at 9:00a.m. At 7:00a.m. I took Tagrisso with water to push the pill down my throat. But I couldn’t tell the truth. A sign on the wall above the water fountain in the waiting room said: Don’t drink or your procedure will be re-scheduled! She gave me forms to fill out and sign, statements to agree to and sign, questions to answer, like do you have end-of-life directive. Then I initialed one blank after another. I thought, This procedure’s got to be major serious. If things go awry, these folks would simply wrap the sheet tightly around my nude body, hang a numbered tag on my big toe, preferably the one without a bunion, and call it a day.

I was wheeled into an imaging room. A technician took a couple of X-ray pictures of my lungs.

After the lung picture taking I was wheeled into the Surgical Room where the procedure will happen. The nurse said the X-ray image will guide the Pulmonologist while he is dropping the fiducials and taking a tissue sample, if possible, for biopsy.

A team of vibrant 40-something registered nurses and doctors manned the Surgical Room. The professional camaraderie among these technology savvy medical hot shots was palpable. They were compassionate. They made me feel as comfortable as possible. I was comfortable enough to ask one RN, Why is drinking water not allowed after midnight? Her answer: During the procedure the patient might throw up, the water could get into the lungs, cause pneumonia, and on and on. I cringed a little, but I decided to get on with the program.

It was now 9:16a.m. The Pulmonologist arrived looking like a plumber – a bandana wrapped around his head and a black tool box in his hand. Same guy but so different from the person I met at his office a week ago. The Anesthesiologist, a white male, strode in, wearing a cross-body bag over his pajama-like operating outfit, head covered with surgical cap, face masked. He appeared like he just got out of bed. Two Registered Nurses (RN), both white females, hovered about.

The procedure began. The Anesthesiologist put his hand with something like a soft cup in front of my mouth and nose. Breathe, as if you are going to sleep, coaxed one of the RN’s. I obeyed.

Next thing I knew I was waking up to the soft voice of an RN: The procedure is over. You are in Recovery Room. The procedure took around 45 minutes. You were asleep all this time. It was past 11:00am.

Damn! I missed the whole thing again, just like the colonoscopy, gingivectomy, parathryroidectomy, hysterectomy, to name a few. Story of my life. Medical instruments have gotten in and out of my body orifices from all directions and I had no idea what happened. Fortunately, the Pulmonologist, a great guy unaffected by his god-like power, promised to give me the video of the procedure. Really proud of his work, he said, You should show it to your friends and family. I’ll put it on your Facebook account. I wholeheartedly agreed. We went through the Facebook motions, he friending me, me accepting him, the whole bit. Whether he follows through or not is another story, another day.

The RN’s helped me get dressed up for my exit. They lifted the sheet covering me. They saw a nude senior unlike what they had obviously expected – a body ravaged by over 7 decades of wear and tear from the earth’s elements. You look good! they chorused. Thank you, I humbly acknowledged their compliment. I still do rock a string bikini. And I laughed. But to me, that “you look good stuff” is getting old. I wish it’d be replaced with something more reassuring like “You look absolutely ravishing!” Wishful thinking warms the heart of a near-octogenarian babe.

Before leaving I asked the Pulmonologist, What about the biopsy? He answered, The nodule is too small, not enough tissue for the lab. I asked some more, What happens to the gold in my lung? Are you going through the procedure again to remove the bling? No, he replied. They stay there. Actually some people cough them out. I thought, Mmmm, I better watch for mineral products if or when I cough. One never has enough precious metals in her financial portfolio.

By noon, I was back home, alive and hot to tell the tale.

The Mask/Shield Molding Event

According to my buddy Dr Google, SBRT treatment for the body means that a specially designed coordinate system is used for the exact localization of the tumors in the body in order to treat it with limited but highly precise treatment fields. Pardon me, my friend, I said. That’s profound. Allow me to simplify it: The Rad Onc has a method of pinpointing exactly where the tumor is in the body so that he can zap that puppy with precision. Satisfied, Dr Google continued, For the patient’s protection, a mask/shield based on the lung image produced by the Pulmonologist is molded.

Rad Onc scheduled the molding event a week after the fiduciary dropping event. Rad Onc instructed the Radiation Technicians to make the special mask/shield to protect me from the top of my head down to my waist. The preparation of the mask/shield for me and only me proceeded in earnest inside a room called Simulation Control Room.

For the shield, I was told to strip from waist up and wear the standard hospital gown. Two Radiation Technicians then positioned me lying on my back on the CT scan bed. They told me, Stay very still, do not move. They moved the sheet under my torso as if I was a rag doll – a tad this way, a tad that way. It was a dry run for the SBRT event.

For the mask, one technician plopped on my face a very warm material, silicon or thermoplastic I don’t know which. It gave me a sensation of having a facial. I loved it! The material immediately adhered to and followed the contours of my face. I could breath but I could not see. Fortunately I am not claustrophobic.

After the techs deemed everything in place, they asked the doctor to inspect. He approved. The techs ran me through the CT scan. The simulation was over. I was prepared for the SBRT, which was to be scheduled another day.

I took a picture of the mask/shield (shown above) and texted it to my Son the Sculptor. He texted back, Oh wow! Looks like you’re going to be inside a basket!

Yes! The mask/shield basket is an exact replica of my profile. The chest could have been more voluptuous though, reminiscent of a bygone era.

So far I’ve had no adverse effects from the bronchoscopy or any of the procedures I went through.

I’d love to hear from readers who have experienced SBRT.

Meanwhile, happy dance!

Bone Mass Density & First Annual CT Scan Results

I blame the coronavirus pandemic. In compliance with our governor’s social distancing order, our retirement resort’s administration building was closed to all but necessary people. I can’t access my favorite computer. This blog update was generated in my smart phone.

The pandemic for sure cramps my style. Whenever I step out of my house, I wear a mask. All of a sudden my ears are carrying several gadgets – eyeglasses, hearing aids, earrings, mask. Shit! I’m a petite senior babe with petite outer ears. The head appliance overload sends my face dangling forward.

Okay…on with the report.

Boniva. After taking Boniva once a month for one year, the bone mass density scan image of my skeleton, compared to those of the last two years, showed stability. My poor aging bones’ osteopenia did not worsen into osteoporosis. By golly, Dr PCP is right. He insists, You did not lose. That means you are winning. Carry on with the Boniva. I don’t argue.

Tagrisso. Tagrisso has been great. I have been on it for 39 months. It has maintained the stability of the sole nodule at the bottom of my left lung, which started my non-small cell lung cancer journey 8 years ago. Onc Dr Smiley put me on 4-month scan, then 8-month, then, early March, after much confusion, as in Dr Smiley posting a glowing CT scan report before I’d had the CT scan, my first 12-month scan finally happened. I have remained asymptomatic – no cough, no fatigue, no loss of appetite, no pain, no lumps. Nothing. Nada. I feel great.

Having had no scans for a whole year, I noticed changes in the process. I had to make 2 trips to the hospital’s spanking new cancer building named after the wealthy couple who donated it. The first trip was the day before scan day to pick up the 2 bottles of chalky raspberry flavored barium drink. I was instructed to drink all but one fourth of the liquid at home. The following day – scan day – I drank the remaining liquid just before scan time. Another change: I was not given the intravenous liquid that gives the warm sensation and the feeling of wanting to go potty. So my body’s horizontal trip through the scanning machine tunnel was all there was to it – very quick and painless.

The CT scan result report in the patient portal started awesome. The innards were unremarkable. No lymph node issues. No metastases anywhere. Stable sole nodule at the bottom of the left lobe. Seen again was the Milky Way – the tons of tiny nodules too numerous to count but all under one centimeter the largest one being 6 mm, which is now 12mm. Clueless, I thought, That would be me, Celia the Gambler double or nothing. And then it hit me. Twelve millimeters! That’s 1.2 centimeters equal to 1/2 inch! If the nodule was solid and had clear margins it would resemble a green grape. At the end of the report, Dr Smiley added a recommendation: SBRT, short for stereotactic body radiation therapy. He wrote he had called Dr so-and-so (Dr SS, a Radiation Oncologist) but no answer. End of Report.

I assumed Dr Smiley would contact me after he got the return call from Dr SS but I did not hear from him again by phone or through the patient portal. Fortunately, I had an appointment with Dr PCP for our semi-annual what’s-wrong-with-Celia session. First thing he said to me was, Have you read your latest report from Dr Smiley? Are you not going to ask for a biopsy before SBRT?

I said, He will call me back.

Dr PCP was adamant. No, you call him. I will write a script for you to follow.

A script? I thanked him although I had my own script in my head. After all I’ve been researching and blogging about cancer treatments for 6 years. I accepted his handwritten script, which I had no intention of following word for word.

As soon as I got home, I sent Dr Smiley a message through the patient portal.

Me: Dr Smiley, I haven’t heard from you. Has Dr SS returned your call? Or can this wait until our next meeting in July? Don’t we need a biopsy?

Within a minute he responded with what seemed like a horrified reaction over my mention of July. Sure got his attention!

Him: NO! This has to be taken care of now, this month, March 2020. No need for a biopsy.

Me: Give me the phone number of Dr SS and I’ll ask for an appointment.

Him: For your information Dr PCP and I have been discussing you, my basis for no biopsy, Dr PCP’s justifications, Dr SS’s two cents, etc.

I did not argue with Dr Smiley. I was saving it for my one on one with Dr SS. After all the radiation oncologist would know more than the cupboard oncologist, who only deals with approved drugs like Tarceva, Afatinib, Tagrisso, etc.

Well! How about that? Suddenly 3 doctors are involved in my 12mm nodule. Why don’t I add a 4th one? And I did!

I contacted my buddy, my Onc’s Onc, the Lord of Lung Cansah in Denver. The last time we talked was 3 -1/2 years ago in Maryland where I was flown to implore the FDA to approve the CO-1686 trial drug, which was eventually orphaned.

Those who have followed this blog from day 1 will remember that my first onc in Albuquerque has cancer. He introduced me to his own onc in Denver for a clinical trial possibility in case Tarceva, the drug I was on at the time, lost its potency against my EGFR cancer mutation. Thus the moniker my Onc’s Onc.

I texted my Onc’s Onc. Within a couple of minutes, he responded! Here’s how the exchange went:

Me: Hello my Onc’s Onc! Just to say Hi and inquire big time. How’ve you been? It appears my run on Tagrisso has hit the skids. I was doing so good the last 3 years that my CA Onc decided to go to once-a-year scan. I had one last week. Everything is fine except one 6mm nodule in the left upper lung (LUL) doubled in size, now 12mm. I remain asymptomatic. Do you know of any post-Tagrisso clinical trials I might qualify for? Thanks, the Diva

Within minutes he replied.

Onc’s Onc: I’d wonder, if only one site is growing, if you can zap with SBRT and stay on drug. YOO (Your Onc’s Onc)

Me: Thank you for your super quick response. Really appreciate it. Just thinking ahead. SBRT was the immediate reaction here, too. Carry on!

Dr SS, the Radiation Oncologist

Dr SS, of Chinese ethnicity, marched into the examination room with the Kung Fu swagger of a warrior who has successfully conquered a battalion of nodules in his young mid-40’s existence.

Dr SS: I read your medical history. You look good!

I liked him instantly. I guess he was expecting to see a despondent wrinkly little old lady in tennis shoes.

Dr SS turned on the computer and showed me the CT scan image of the 12mm nodule in my LUL. Against the black background, the CT exaggerated picture of the nodule resembled a dandelion flower. It was the first time in my over 3 years outside of the university hospital scene that I’d seen a picture of my lungs. The Oncs in the one-man-band cupboard sector are not big on picture sharing.

Dr SS explained the SBRT procedure. Then he asked, Do you have a Pulmonologist? We will need one to prepare you.

Me: Whoa! Whoa! Before we start bombarding this body with radiation, I think we should investigate that nodule. It could be benign, it could be malignant. In the six years that I’ve been blogging, things have come – then mysteriously disappeared – in my lungs and other parts of my body.

Dr SS: We can do a biopsy but I’d suggest something safer: a CT/Pet scan. Have you had it already?

I couldn’t believe what I heard. He should have noticed it during his review of my medical history, which showed no record of a recent Pet scan.

We agreed on the CT/Pet scan as the next course of action.

And so I went through the CT/Pet scan, which can provide more information about the cancer like size and SUV that CT alone or Pet alone can’t do. SUV stands for Standardized Uptake Value, the rate of glucose absorption by the malignant tumor as compared to the rest of the neighboring non-cancer cells. Radiation oncologists look for a nodule of 8mm maximum in size and SUV of 2.5 before they get excited about doing SBRT.

The result: My nodule is 10mm in size and its SUV is 1.4. It’s big enough but its appetite is less than voracious. Dr SS and I decided to go for the SBRT. But first, he had to ask his favorite Pulmonologist to do the honor of giving me a Bronchoscopy – a procedure that involves shoving a small camera through my throat to enable him to examine my passage ways from north to south, take pictures and gather tissue samples if necessary. I’m pretty sure anesthesia would be involved, just like when I had colonoscopy where the small camera went cruising from south to north.

Dr P, the Pulmonologist

Dr P, and his sidekick a female nurse strode into the examination room where I was waiting. They were both wearing masks, like my plus one, BT, and I were.

I could tell Dr P is a tall handsome devil of a middle east persuasion, wearing a cloth head covering. He said he was not going to examine me because I look good. He explained his role. He would drop tiny gold stuff on the tumor area to guide Dr SS when working on the focusing of the SBRT equipment.

We scheduled the gold-dropping event on April 3rd.

So until then, I keep the energy level high, the stress level low.

And with the new knowledge about the tumor, we can make room for a little happy dance!



Boniva, First Annual CT Scans, Etc.

A few days after my entry into the world of retirement in 2008, a younger friend asked me, What’s the secret of looking like you have always been retired? As usual, I was tempted to claim I am a genius gifted with an amazing personality that just latches on to the wave and goes with the flow.  But I could not say that.  Truth is, I ran into a secret:  Set ONE and only ONE task each day and make sure to accomplish it.

One day last month, the only task on my calendar was an appointment with Dr PCP and his osteoporosis clinical trial group. The clinical trial technicians were going to measure my bone density. Twenty (20) minutes later, I’d meet with Dr PCP and we’d discuss the bone density results – whether my ingesting Boniva once a month for ten months has made my bone more youthful, less like honeycomb.

I so looked forward to the appointment. If the bone density test result would everything is fine, it would debunk my colleague’s assertion that the vehicle/pedestrian collision accident did not break any of my bones because I was only hit by the car’s rear-view mirror. I subscribe to the imaginative account that had me surviving after the car hit me and tossed me 80 feet up in the air.

I got dressed up early, anxious to execute the task. After completing all the primping motions to live up to the appearance of a gorgeous senior babe, I looked at my watch. I still had an hour to kill. Since Dr PCP’s clinic is only walking distance from my manor, I thought I might as well do some of the yoga poses that are good for my left knee. And I did and the poses relaxed me so much. Next thing I knew I was waking up from a nap! OMG! I’ve just risen from the dead! I looked at my smartphone, which is always on mute, and saw it was past my appointed hour. In addition, a transcribed voice message from Dr PCP’s medical tech greeted my eyeballs: “You had an appointment with us this morning and you called and you left a message you were coming blah blah blah.” I called back immediately and recited to her my alibi.

Me: I’m all dressed up. May I come now?

She: (pretending to sound stern) You had the opportunity. You lost your chance.

Me: (concern in my voice) Oh dear! Let’s re-schedule it then. Any day within the next two years will work for me.

We re-scheduled the bone density test March 8th this year.

That’s my Boniva story and I stand by it. The medical fact story will be for another day.

Fortunately, there are other developments I could write about. My first annual CT scan was up last month. On February 20th, I met with my oncologist Dr Smiley. He told me happily the result of the cancer blood test I had taken a week before: Carcinoembrionic Antigen (CEA) tumor marker level is stable. The he went through his physical activity of kneading my neck and belly, searching for suspicious lumps. He dictated to his medical flunky his findings: None. With the contagious built-in smile on his face, he told me to get my first annual CT scan. I smiled back and said, I have not had a CT scan in a year. Please run by me again the procedure. He responded, I will request approval from your insurance company. As soon as it’s approved, my staff will contact you and give you the telephone number of the imaging entity, which you will call to schedule your CT scan. Perfect, I acknowledged his clear instructions.

Day after day I waited. Of course I did other cup-filling activities. I played the slot machines at an Indian Casino in San Diego, shared a foodie lunch with a friend, sauntered in my bikini at the hot spa.

It was already February 27th – one whole week- and I still hadn’t heard from Dr Smiley’s staff. I checked the patient’s portal to see if I might have missed a message. There was none. Instead I saw his latest chronological assessment of my condition. What I read shocked me! On the 2/20/2020 entry, he discussed our visit. On 2/21/2020, he discussed a detailed CT scan report. There was already A CT SCAN REPORT! I read it with great enthusiasm. It was great! It would make a perfect cheating document. If I were running for president of the United States and my opponents demand full disclosure on my health, I’d flash that report! Then I thought, OMG! Whose lungs are these? Whose innards do these belong to? Someone out there likes me and impersonates me! Okay wishful thinking. But I had done enough sleuthing for the day. The important thing was to get on with the program.

I sent a message through the portal: Hi Doc! I haven’t heard from your office that your order for a CT scan for me at Mission Hospital has been approved and I should make my appointment for it. Please advise.

As soon as I pressed “SEND” a response came from Dr Smiley: Celia, didn’t you have your CT scan earlier this week already?

My response: No, not yet! But I did read your report in the portal. I liked it but it made me wonder!

His response: I will look into it with my staff and see what the hold up is.

Moments later, a message from him: Yes your order has been approved by the insurance, and the number is …

My response an hour later: I got your message. I made the appointment for March 2nd. FYI I was told your order was approved on February 21st.

So there’s another hanging story! Story about the results will be for another day.

But wait! There’s more. I want a complete story to cap this blog update. Here it goes:

The word PERFECT has eluded my list of personal attributes. When I was young I thought I’d be a perfect candidate for Miss Philippines. But No! My older sister said beauty is a prerequisite for such title. Later I thought I’d be a perfect candidate for City Engineer. But No! I was two decades ahead of my time. So I gave up on the PERFECT adjective.

One day three weeks ago I received an e-mail from a clinical research coordinator. It said: Celia, your urologist referred you to our office. She said you’d be a PERFECT candidate for a urinary Tract Infection (UTI) clinical trial. She said you have a “colonization of the lower urinary tract by E. Coli bacteria and you are over 18 years old.”

The email message moved me. The word PERFECT was clearly mentioned. In my twilight years, I finally had a match! A guinea pig babe in a UTI clinical trial!

I emailed back, Send me the trial material and I’ll be the judge if we are prefect for each other. And she did.

The material said there will be a screening for 21 days. Qualified candidates will get into the rest of 35-day trial, which is randomized and involving a placebo or an investigative drug while staying in one of 8 trial sites. There will be a top payment of $350 per day for 7 days stay in a facility. All other pays range from $30 to $100. I liked it! I said I’m in.

The candidate must have worn a catheter in the past or is currently using a catheter. A new catheter will be installed for the trial. There was one problem. I have never experienced a catheter and hope I never experience it. I informed the trial coordinator. She checked with the powers that be for exemption. She reported back: Nope, no exception.

I am still not perfect after all!

Now there’s a finished story.

That calls for a happy dance.

Oh the Aging Bones!

So the first part of the new year came and went like a ship that docked and sailed. Gone with the waves and the wind. Only memories linger now.  But the events in it were germane for events of months yet to come.  Am I waxing poetic or what!

January opened with a big swallow of the pill Boniva, a once-a-month drug prescribed by my primary care physician, Dr PCP. There’s a story behind Boniva. Yes, indeed, there’s always a story.

One day in In 2018 during my physical therapy sessions after having been smacked from behind by a full-size sedan, Dr PCP got this wild-hair notion to prescribe a drug for me to fight osteoporosis. Our conversation went like this:

Him: I’ll give you a prescription to combat osteoporosis. It’s the best and latest in the market. It’s called Prolia.

Me: But I don’t have osteoporosis. Remember a car hit me and hurled me 80 feet in the air, according to someone who never saw the accident, and I sashayed out of the scene with zero broken bones? I just got tossed around like a rag doll. That’s all. I was not reduced into a pile of broken bones even after bouncing on the street pavement twice.

Of course I did not tell him I was wearing a floor-length coat as thick as a sleeping bag during the accident.

Him: Your bone density test results showed you have osteopenia, which could lead to osteoporosis, if left unchecked.

Me: Okay. Tell me more about Prolia.

Him: You’ll get an injection only once every 6 months. And you will immediately see the improvement. The only problem is you can’t stop taking it.

Me: (inscrutable eyes widened) Why would I start taking something that I can’t stop taking?

Of course I did not launch into a discourse about my decisiveness in reducing dosages or stopping prescribed pills if they didn’t seem to do anything.

He had no answer but continued to try to talk me into taking Prolia. He failed and we parted with the osteoporosis prevention issue unresolved.

One evening Dr PCP phoned me at night at home. It took me by surprise. He is a busy doctor. He usually only sees me on appointed dates and times. When I had a rare problem between appointments, his assistant answered the phone, asked me several questions, discussed the answers with him, and got back to me. I wondered about the phone call at home at night. Is he really such an awesome doctor that he cares so much about me and/or my future osteoporosis? Does he own stock in Prolia? I found the answer on the new sign outside his office: “Senior Clinical Trials – The Osteoporosis Diagnosis Center!”

Him: I really want you to consider doing something about your osteopenia.

Me: Dr Google gave me the literature on Prolia. I am not qualified to take Prolia. The literature said it should only be taken by people who have thyroids. One of my 4 parathyroids was removed years ago when I had surgery for goiter.

Dr PCP surprised me again. He had a new pitch.

Him: Oh no, I’m not going to give you Prolia. I’ll give you Boniva. It’s a pill you take only once a month.

Me: Can quit Boniva any time unlike Prolia?

Him: Yes you can.

Me: Okay! That’s better. But I’m not going to start taking it until my accident lawsuit is settled. I don’t want to introduce new substance in the blood coursing through my veins that could complicate the settlement discussion.

He caved in.

In March 2019, the pain-and-suffering lawsuit was settled. On April 2, 2019, I started taking Boniva. What’s with April 2 and not April 1? April 2 does seem unusual. Well, it’s because I totally forgot about it on April 1. The first of the month is Inspire Branastasia’s Rabbit, Rabbit day and my blog update post day. Priorities!

This February will mark the moment of truth for Boniva. We’ll see if 10 months of the drug has improved my bone density. I did follow the strict instructions faithfully. I took the pill only with water. For one hour after taking Boniva, I ate no food, drank no beverage other than water, and stayed upright. Staying upright during that hour is extremely important. On the first swallow day, I became curious and wanted to check what would happen if I went horizontal? Would my bones snap and crackle? Should Boniva be a certain height from the floor for any reason otherwise it will get upset and cancel out the effect of Tagrisso? Then I thought I better not tempt the fates! I turned to my buddy. Please answer the question, Dr Google.

Dr Google and I should be on first-name basis already after all these years but he is so secretive about his first name.

Dr Google said Boniva can cause serious problems in the stomach or esophagus of the patient. That’s why anyone who can not be upright for at least one hour after taking Boniva should never take it.

In other words, I figured a person throwing up while on her back could drown in her own vomit. The instruction could have just said that and I would not have had to bother the good doctor.

Dr Google continued. Boniva works by slowing bone loss to help maintain strong bones and reduce risk of broken bones or fractures.

Talk about bones! The pain in my left knee returned. I finally asked Dr PCP to refer me again to the orthopedist Dr O, who attended to my left shoulder that had been hurt from its collision with the sedan. It was a moment of truth, a time for Dr PCP and me to let the real damaged-bone specialist do the diagnosis!

Time came for my meeting with Dr O. He told me to walk from point A to point B in his office. I did as told.

Dr O: You do have a limp.

Me: That’s why I’m here.

He told me to sit on the examination table. He poked here and there.

Dr O: (Looking me in the eye) Did you recently exercise more than you normally do?

I thought, wow! How could he be so dead on? Dr PCP and I were right after all.

He gave me a cortisone shot on the knee and prescribed an non-steroidal anti-inflammatory drug (NSAID).

Me: I already took NSAID.

Dr O: How long?

Me: Couple of days.

Dr O: You need to take NSAID one week on, one week off until the inflammation is gone which should not take long. And don’t be entering marathons anytime soon.

The conversation was a perfect example why I shouldn’t be stopping prescribed pills without doctor’s blessings – the perfect reason I don’t give medical advice here.

Between the cortisone shot and obeying doctor’s orders, my left knee has almost healed. Dr O also prescribed 8 hours of 15-minute insurance-covered physical therapy sessions. I don’t think they’re necessary because I can do somersaults now. But why not? I’m retired. I enjoy keeping busy and learning something new everyday.

Happy dance!

A New Ailment

Happy New Year!!!

Whoo Hoo! I discovered an unpleasant new health issue.  It’s new to me anyway, and I’m flaunting it like a new string bikini.  I’m sharing the story because it is a one-size-fits-all kind of thing.  It involves the mechanics of the human body, which is  a machine, the  mother of all machines. 

As I’ve written before, based on my observation, the normal human body is a perfectly designed machine.  Each and every part of it is located where it makes sense.  For example, the nose is on the face, not on top of the head.  Otherwise, we’d drown when it rains.  The arm bends at the elbow, the hand toward the mouth, so we don’t eat like pigs and other lower class mammals.  The leg bends at the knee, the foot toward the back so we can kick ourselves when we have knowingly allowed an opportunity to pass us by.  Maybe that’s just an expression.  I’m  tempted to cite more wowzy examples but I think you get the drift.

Now  to my earth-shattering discovery but first, I must confess, sometimes I’m always the last one to know.

I blame my Apple smartphone.

My smartphone is an integral part of my fingers.  It’s my go-to when I’m alone or waiting for my turn in line, for blood test for example.  I play Scrabble with my sister, sister-in-law, and one “random guest.”  One day I’ll try to figure out who that is.  I email, text, google, do online shopping, news reading, blogging, banking, some phoning, etc. etc..  One day I inadvertently hit something on the screen.  Suddenly out of nowhere appeared that day’s date, an ongoing count of steps, and miles covered by the steps.  There was even the number of flights of stairs climbed.  I thought OMG.  Siri follows my every move!  I know she occasionally injects herself into my life.  One time I burst into a karaoke song and she barged in, I did not understand what you said.

I closed the page on the phone and voila:  A step-counting app appeared!

Step counters had been all the rage but I refuse to buy apps or Fitbit.  I only do free apps.  Walmart.  Banks.  Amazon.  WordPress.  I noticed the app in front of my face is part of Apple’s smartphone package and therefore free.  Oh boy oh boy!  I showed it to my Plus-One, BT.  I told him, Now we can count our steps and keep up with the gang of old people who brag about their daily thousands of steps!  He got as excited as I was and responded, But I have Android in a cheap phone from Walmart.  I need my own step counter app.  No problem.  I downloaded a compatible free one in his smartphone.  I like to think I’m the tech-savvy one.

That was early September 2019.  Henceforth we established in the retirement resort a step-counting route, on which we walked religiously daily.  We raised the statistically normal person’s average of 4,000 steps to a minimum of 10,000 every day, no days off.  Sometimes we even made 20,000. We competed against each other.  When we went to separate destinations, we compared numbers at the end of the day.  If one did not have the minimum 10,000,  the laggard took off and walked some more to make up the deficit.  At the pool at night, we crowed about meeting our challenges to the other crowers.  Life is good in the retirement resort, where crowing about health habits – eating plant-based foods, gym routines –  is a favorite pastime.   

Two months later, in the beginning of November, BT and I traveled one way by train for a relaxing ride to Albuquerque to root for my Son the Sculptor at the dedication of his commissioned public art sculpture.  The train ride inside a first-class roomette was anything but relaxing.  After the art dedication, our bodies were not in a train-riding mode.  Fortunately we had a pre-arranged 900-mile road trip back from Albuquerque to South Orange County, CA, courtesy of my brother-in-law and his wife, Phoenix residents who had also attended the art event.  NO spring chickens, all four of us seniors who’ve convinced ourselves we can still do the limbo rock.  Okay, I just speak for myself.  But we all believe in step counting gadgets.  

During the trip, we drove for about 4 hours before taking a break for the first time to stretch our legs.  I noticed a pain on my left knee as I tried to stand up.  The pain showed up at each stretch break on the drive.  I blamed my sitting position.    

Upon arrival at the retirement resort, I took the blood test ordered by my primary care physician Dr PCP.  He would compare the result with the one I had a month ago.  He was monitoring my elevated liver enzyme count, which had fluctuated while I was on the CO-1686 clinical trial.  Maybe the high liver enzyme count was only caused by all the antibiotics I had taken during the seemingly endless urinary tract infections.  A couple of days later, my smart phone vibrated.  It showed an incoming call from Dr PCP’s office.  I thought, the blood test result must have alarmed him.  Maybe my liver enzyme count had doubled!  

I answered the phone.  

Celia, do you have any pains in your body?  The voice at the end of the line was that of PCP’s registered nurse, RN.  I answered, No, Why?  She responded, Your muscle enzyme count is elevated.  MUSCLE enzymes? I asked her.  What happened to LIVER enzymes?  Why does my body have more enzymes than the law allows?  She said if I did, Dr PCP would give me something to take.

After hanging up, I immediately consulted my colleague, Dr Google, who’s at my beck and call 24/7.  He said elevated muscle enzymes can be caused by trauma, arthritis, muscular dystrophy, Parkinson’s disease, heart attack, etc.  HEART ATTACK? 

I focused on trauma.  Trauma seemed more manageable and less scary.  I remembered the pain when I stood up after long periods of sitting.  I decided my left knee was traumatized by the awkward sitting position for hours.  I called RN and told her about the circumstances that traumatized knee.  She agreed it could elevate muscle enzyme count and passed the info on to Dr PCP.

Dr PCP is cool.  He was not automatically convinced.  He asked RN to mail me an order to repeat the blood test after a week.  I could imagine Dr PCP wanting to examine me again then refer me to a vascular specialist if my muscle enzyme count did not normalize.  I must hand it to Dr PCP.  He is a conscientious primary care physician.  He also loves the way referrers are made happy by the specialist doctors.  

I waited two weeks before I took the follow-up blood test.  The results came back and RN phoned me the news with a smile in her voice:  Your muscle enzymes back to normal!  She made no mention about the liver enzymes.  I was glad there was nothing to worry about. 

Days went by.  My left knee pain worsened.  Each time I stood up I felt like falling on my face.  Fortunately, it just so happened that I was scheduled to see Dr Paa, my podiatrist.  He does my big toe nails every three months.  The knee is part of the foot so I’d ask him. I was not optimistic because long ago when I asked Dr Google if the knees were too high for podiatrists, he responded:   orthopedic specialists for pain from diseases that affect the knee, physiotherapists, osteopathic or rehab physicians for pain from injuries, the list went  on and on.  OMG information overload!  All I wanted was a simple yes or no.  Sure enough, when I saw Dr Paa, he told me to see Dr PCP.  

Dr Paa and Dr PCP share offices.  I went to Dr PCP’s medical tech and tried to make an appointment.  Instead of making an appointment, she asked me all sorts of questions, with a view toward discussing my situation with Dr PCP and said she’d call me back. 

The following day, she phoned me.  She said, Dr PCP wants to know if the pain is in the back of the knee.  I answered, No why?  She responded, Dr PCP is thinking blood clot. I said, No way.  My blood flows continuously like the Niagara Falls.  It clots quickly but only when necessary like after a blood draw.  She said, Okay, then, Dr PCP said, take NSAID like Ibuprofen for one week and don’t exercise for one month.

After the phone conversation ended, it dawned on me:  I had bragged about my arterial blood.  When it comes to health, things can change rapidly.  No crowing be allowed about glowing health.  I remembered my late husband Octo, the second in the widowhood series.  He had enjoyed excellent health and one day laid out his plan to live to be a hundred.  Three weeks later his remains were cremated.  Leukemia got him.

So back to Dr Google I shuffled to ask about symptoms of blood clot in the leg.  He said, warmth and swelling on the affected area.  I looked.  Nope. None.  Another symptom: vomiting.  I had not vomited since my last post nasal drip.  Another symptom: Chest pain. None.  The last time I had chest pain was years ago when I became voluptuous and needed to move on to the next size bra.  And so with all the other symptoms.  Nada.  Blood clot was not the cause.   So back to sleuthing with the good doctor Dr Google.

Finally, we found the ailment that appeared to fit my symptoms.  It’s called patella femoral pain syndrome or PFPS for short.  Dr Google said, it is also called Moviegoer’s knee or Runner’s knee and is the most common cause of knee pain.  It comes from muscle overuse.  Obviously the daily 10,000+ steps for two straight months with zero break or rest were just too much for my aging legs and the knees took the brunt of the over exertion.  Sitting during the long drive exacerbated the problem.  The cure, among others listed, is RICE: Rest, Ice, Compression, and Elevation.  As always, here and now, I recite my disclaimer.  This post is not meant to give medical advice.  Check with your doctor.   I am not a doctor, a nurse, a therapist, or anything within miles of the medical profession.  I am a retired professional engineer, a civil engineer who delights in analyzing water puddles on the paved street after a rain and blaming the current young civil engineers for bad street design.

Dr PCP agreed with me. 

The new ailment is under control now.   My left knee hurts only when I stand up after sitting for a long time.  Once I start walking, everything is fine as long as I keep walking.  I can even do 10,000 steps no problem.  But what kind of a deal is that?  I need to rest sometime.  So the answer is moderation in sitting, standing, and exercising.  

I believe sauntering on the beach in my string bikini qualifies as moderate exercise.