Osteoporosis

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In the middle of this February, my Smart Phone made a funny sound, alerting me to check on a new voice message.  I listened to the message.  It was from the nurse of my Primary Care Physician (PCP), the doctor whose mission is to find everything medical that is wrong with me. I thought, Now what? Our next consult is scheduled in March.  What does he want from me this early?

I found out soon enough.  The Orthopedic Surgeon (OS) who is attending to my broken left shoulder that resulted from the recent car/pedestrian collision accident, had given his report to PCP.  OS wanted PCP to get me a bone density test. The bone density test result would be a factor in determining the speed of my recovery from the accident in case the attorneys specialized in compensation for pain and suffering ask him.

I told PCP, At your insistence I subjected my bones to a density test very recently.  Why not give OS those results? He answered, That’s different.  The bone density test needed by OS is one taken after your traffic accident.  And I also need a new one to see how the medicine I prescribed to you has affected your osteoporosis.  What medicine? I asked,  beady brown eyes widened.  My reaction took him by surprise.  You didn’t get the pills?  I want to prescribe the latest good drug for your osteoporosis after I prove to your insurance company that the pills I prescribed to you did not work.  Instead of arguing,  I declared the snafu was his fault and we agreed his prescription for osteoporosis fell in the cracks because of all his referrals to the podiatrist, ophthalmologist, gastroenterologist, etc, plus orders for flu shot, pneumonia shot, shingles shot etc.  He gave me a prescription again.

I visited my colleague Dr Google and asked him about osteoporosis.  He said it is a medical condition in which the bones become brittle from loss of tissue, typically as a result of hormonal changes, or deficiency of calcium or vitamin D.

I wondered what kind of osteoporosis I have, if in fact the diagnosis is correct.  I remember the Grand Marquis car in the December 26th vehicle-pedestrian collision accident smacked  my left shoulder from the back, tossed me, and drove my face down on another paved lane.  I thought the impact of the moving car followed by the impact of the rigid pavement were enough to reduce my poor decrepit little body to a small heap of broken bones.  But no.  I shimmied out of the accident scene with a hairline fracture on the slightly dislocated left shoulder requiring no surgery.  What about the brittle bones?  My son thinks years of yoga practice have made me pliable.  I think the fish heads and rice in my diet get the credit.

Okay, whatev.  I’ll add Osteoporosis to the long list of maladies and medical terms that I have researched since turning 65.  It joins the ranks of adenocarcinoma, bunions, cancer, cataracts, colonoscopy, pneumonia, Varicella-Zoster, etc.  Love that last one in the series.  It sounds impressive but it means shingles.  Having experienced all of them and then some, I can proudly crow: Getting old is not for amateurs!

My left shoulder has loosened up and physical therapy continues until my left arm regains its full range of motion.  Then I’ll be able to tie the strings of my bikini swimsuits by myself again.  Meanwhile, I have the retirement resort’s limo pick me up and take me to a scenic area where I walk uphill then downhill then to my favorite sushi place.  This brings back memories of my days in Albuquerque city hall when I was an employed young woman engineer shunned by the exclusive world of male engineers, long before it dawned on them how awesome I was.  The draftsmen and I would eat our sack lunches in the drafting room. For dessert, we’d have Fig Newtons.  At the end of the main course, usually a home-made sandwich, I’d raise my hand with the dessert and exult: “High standard of living!” and we’d all crack up.  My happiness has always come from within.

I’d love to hear what you think.

Dusting Myself Again

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The Author Won’t be Competing in a Speed-Typing Event Anytime Soon

If you’ve been wondering why I hadn’t updated this blog sooner, here is a clue: I’m dusting myself all over again.

What happened was, on the evening of the day after Christmas 2017, I was involved in a traffic accident in a busy Southern Orange County road.  It was a car-versus-pedestrian kind of collision. Yup. I was the pedestrian in that conflict.

I was cautiously crossing the major road, the green light in my favor, when suddenly a formidable object, which turned out to be a Grand Marquis, swiped my back left shoulder and tossed me like a rag doll.  Hey, I’m only a svelte 112-pound senior babe.  I thought, OMG I have been hit!  Next thing I knew I was in a cobra yoga position, raising my bloody face from the hard asphalt pavement, determined to get the culprit’s license plate number in case the accident was a hit-and-run situation.  It happens when the blogger has seen too many True Crime TV stories.  And then it dawned on me:  This is absolutely amazing, quite incredible, and super fortunate.  I have my wits! I live to tell the tale!  I was shocked.

An ambulance ride ensued.  Later the sheriff interviewed the driver, who did not hit and run, a witness, and me.  It became abundantly clear that the accident was a liability issue against the driver.  According to my research later, the insured driver is a US doctor of Middle East origin.  Why can’t I stay away from doctors?

I’d like to tell the story in excruciating detail but it is best to keep my mouth shut while lawyers from both sides are hashing things out.

Thank you for your interest.  I’ll keep you posted.

 

 

CT Scans After 11 Months on Tagrisso

Okay, no photos for this post, just milestone dates:

December 8, 2017  CT Scans day

May 5, 2017  Last previous CT Scan day

January 15, 2017   Swallowed first 80mg Tagrisso pill

Whoa.  That’s seven (7) months between scans! Was I apprehensive on December 8, 2017? Nope.  I was more concerned that my cabbie might not show up in time or at all. I don’t believe taxi drivers will show up until they show up.

Non-emergency medical cab rides are subsidized by my city in California.  I like it.  The $45 round-trip costs me $8 plus a small tip dictated by my mood and the driver’s attitude.  The subsidy has nothing to do with the resident’s financial status.  The city simply loves its adorable seniors.  Had I known about the subsidy sooner, I would have not gotten lost looking for doctor’s offices using the public transportation system. It always happens to the new kid in town.  But hey! I learned something new in each of those bad-hair sweaty days plus they provided fodder for my blog.  Always looking at the bright side!

My one-man-band Onc, Dr Smiley, does things differently from the Oncs in teaching hospitals.  First he orders the blood tests then we do a face-to-face talk to discuss the results.  This time, he said all the readings were fine except my liver enzymes were high.  What could that be, I asked.  It could be an infection, it could be cancer, he said.  What! I’ve had those high liver enzymes before and they were caused by neither infection nor cancer.  I remember returning to my alma mater Google University to find out more about AST’s and ALT’s and I came up with all things that were music to my ears. I wanted to tell him that but I didn’t.  I simply smiled to match the built-in smile on his face.  Then he scheduled my chest and abdomen CT Scans at a hospital with which his practice connects.

This hospital does things differently too.  They had me drink this chalky barium concoction over a two-hour period prior to the CT Scans. Then came the CT Scan motions.

The scans took place on a Friday.  The following Monday morning a message from Dr Smiley lit my smart phone, which is always on Mute so that I’ll miss all calls and appear important.  The results must be in, I presumed.  The phone also indicated there was a text message from my son.  I checked that one first.  Priorities.  In response to my text, he said he had used two kinds of sauces on the fried tofu that he served me in his house the day before Thanksgiving.  I fought the feeling of perpetuating the culinary arts conversation.  I had to move on to listen to Dr Smiley’s voice message.

The message actually came through the female secretary’s voice.  Everything is fine, she said. The chest is good, the abdomen is good.  The tiny nodules too many to count still showed up in both lungs but they are stable.  If you have any questions, give me a call.  I thought, here we go again.  The nameless dots in my lungs aren’t going nowhere.  In my mind I declared them scar tissues.

Here’s another thing that the good doctor does differently: No face-to-face meeting to discuss good scans results.  I find that strange, but holy guacamole, good news is good news which ever way it is shared.

 

 

 

The Colonoscopy

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The Colon: Everybody Has One

In a span of six months I saw two gastroenterologists (GE).  Nothing was wrong with me.  I had no symptoms.  It was just that my doctors kept referring me to other doctors and I did not argue because I’m retired.  I need to supplement my recreational activities with educational ones.

My oncologist (Onc) referred me to the first GE, whom I never met.  His registered nurse interviewed me and concluded that nothing should be done to me but her boss the GE always made the final decision on the matter.  Sure enough he said nothing should be done to me.  Onc was happy but my Primary Care Physician (PCP) was not. He referred me to the second GE and told me for the nth time me I should get a colonoscopy because of my cancer history.  I finally caved in and agreed.

So off to GE#2 I shuffled.  My insurance company gladly notified me of their approval of PCP’s request: a 30-minute face-to-face interview between GE#2 and me.

GE#2 is another one of those young, suntanned and handsome Southern Orange County physicians to whom I’ve grown accustomed.  He definitely descended from one of the failed Hollywood star wannabes of Bugsy’s era.

He had 30 minutes so he went straight to business and asked me what symptoms I had that brought me to him. I told the truth: no symptoms. He gave me two options. Option number 1 screening, which is usually given to people with no symptoms. It would require checking of the stool by PCP through lab test results. Option number 2 diagnostic colonoscopy entails him sending a camera through the rear-end orifice and analyzing every nook and cranny of my large intestine, also called the colon. A camera? I asked, with feigned terror in my eyes. How big is this camera you’re talking about? He chuckled and clarified: It’s tiny and you’ll be under anesthesia.  You will not know what’s happening and it will take only about 45 minutes. I’ll look for polyps or cancer signs. If I see polyps, I’ll remove them there and then. I said, I have no symptoms, I’ll take Option 1. What happens next? His response: Your PCP will just keep telling you to have Colonoscopy.

I decided to cut out the PCP agony and go for the colonoscopy experience or Option 2.

GE#2’s battery of assistants went to work.  The tech scheduled a date for my colonoscopy procedure to be performed as an outpatient in a facility where mostly elderly men and women allow the gastroenterologist surgeon  to insert this tiny camera in the rear end for a scenic tour of the large intestine.  It would be like a small train entering a dark tunnel that has 4 bends, each one almost 90 degrees, forming an open square. The camera takes photographs at points chosen by GE. But first, the patient’s large intestine must go through a thorough cleansing to get rid of any caca that might block the camera and a clear view of whatever adorns the innards.

The nurse gave me a page long of must-do things: buy 32-oz bottle of gatorade and a bottle of a laxative; mix the two fluids; take three laxative tablets two different times; drink the gatorade mixture along with a liquid diet at certain times all day before the day of the procedure and hours just before the actual colonoscopy.

All told, I dedicated 3 days of my leisurely life for the project.  Day 1 for shopping, Day 2 for cleansing, Day 3 for the colonoscopy.  Retirement is awesome.  It allows time for this kind of experience.  I was not even thinking of results, bad or good.

Day 2 was the toughest, definitely not a time to visit Disneyland. I had to stay home, prepared to plant myself on the commode at all times.  Laxative overload owned me!

Day 3 proved to be anti-climactic.  I was told to lie down sideways on the gurney and relax.  A nurse installed an Intra-Vein line in front of my elbow and inserted an oxygen thingy in my nose.  Next thing I knew I was waking up.  Okay!  Chop, chop.  I joyfully exclaimed.  Are we ever going to start the colonoscopy?  The head nurse responded, All done.  You’ve been asleep for 2-1/2 hours.  I was stunned.  I had no pain anywhere, no bleeding, no discomfort, nothing.  Whoa! I could have dropped dead and entered the pearly gates without any knowledge of colonoscopy.  I missed out on the event totally.

Everything went well, the handsome devil Dr GE#2 assured me and handed me a sheet of photographs of certain scenic spots inside my large intestine.  I studied each ghastly image with mixed disgust and curiosity.  They looked kind of gross, really, but the pictures of the inside of my colon brought good news: no polyps, no cancer signs.

The clinic’s post-colonoscopy written instructions were pretty serious: No walking home, no bus, no taxi.  Someone must drive the patient home and the driver must be physically presented during the check in otherwise the procedure will be cancelled.  Good for them but I had my own agenda.  I convinced a male friend to accompany me and pretend to be my driver.  I wanted to go home by myself.

After an hour of my coming to, the staff noticed that no one with car keys had arrived  for me.  They became suspicious.  They wheeled me to a corner of the recovery room and held me hostage.  No car, no release.   While buying time for the anesthesia to wear off,  I stared at the door and the exit sign.  They beckoned me.  But the nurses could read the glitter of excitement of escape in my eyes.  They took turns talking to me, still hoping someone would show up with car keys.  Finally, they gave up.  The head nurse instructed a young man to drive me home and walk me to the door of my manor.

Don’t we just love happy endings?  Happy dance, senior string-bikini babe!

 

 

 

 

 

 

 

The Podiatrist

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The Podiatrist’s Domain: Feet and Ankles

I was scheduled to meet with Dr Paa, the podiatrist to whom my Primary Care Physician (PCP) referred me concerning my bunion problem, therefore I thought I should know more about a podiatrist.  The notion reminded me of an old friend of mine who had contracted polio when she was a little girl.  All her life she walked with a limp and saw a podiatrist a lot.  She told me the foot reigned supreme at her podiatrist’s office. The door mat design featured a pair of feet. Footstep silhouettes led her to the consultation room where pictures of feet and diagrams of  the foot skeleton hung on the walls. Thus the relationship between feet and podiatrist stick in my head.  But for this post, I wanted an accurate definition of podiatrist, so off to my alma mater Google University I shuffled.

According to my colleague Dr Google, a podiatrist is also known as podiatric physician. He or she is a medical professional devoted to the study and medical treatment of disorders of the foot, ankle, and lower extremity. Lower extremity as in toes?  What about the knee, I asked.  Is that too high for the good doctor? Dr G replied, Knee pain can be examined by PCP. If it requires surgery, he could refer the patient to an Orthopedic Surgeon.  For knee pain due to arthritis, gout, inflammation, a Rheumatologist is the doctor. OMG! My head spun with information overload.  All I wanted was a yes or a no.

According to unfounded rumors and my undoubtedly unreliable sources, 60% of podiatrists are foot fetishists. Foot fetishism is foot worship or podophilia and is more prevalent in men than in women. Just in case there is a scintilla of truth in the statistics, I scrubbed my toes immaculately before the trip to the podiatrist’s office.

Travelling by bus to Dr Paa’s office for the first time presented obstacles – like getting in the wrong bus and estimating wrong travel time – that caused me to miss the first appointment. Fortunately, I made the re-scheduled appointment in plenty of time and avoided being banned for life in that podiatrist’s office.

From the foot of a small hill, I could see above Dr Paa’s big office sign “Podiatry.” So near yet so far. The problem was the site layout had been designed for vehicle traffic.  The busy uphill driveway had no sidewalk.  I went to the block’s intersecting driveway and still saw no sidewalk.  What were those engineers, planners, and architects thinking? Did they not consider that I might move to California one day for bunion consultation?  I didn’t feel like walking to the other side of the commercial block to find a sidewalk so I did what any red-blooded fearless warrior would do: I slogged across the sloped landscaped embankment straight to Dr Paa’s Podiatry office.  Fortunately no pyracanthas or other thorny bushes got in the way of my trek.  No problemo.

It was a morning appointment. A wheelchair and an assortment of walkers and canes and as many number of people of various ages and sizes already filled the reception room when I arrived. No one cracked a smile for me.  I kept my peace.

At the appointed moment, a 20-something sparkle-dust podiatry technician, the only happy face in the place so far, tried to lead me to the examination room.  I liked her. She was game. Follow me, she instructed me smiling. I did not follow her.  Instead I walked in front of her and said, Follow me, walk this way and I did my hippy-hippy shake sashay. She unloaded a bombastic contagious laugh. The fun began.

Sparkledust took my weight and asked me my height.  I gave her feet and inches an inch taller than me.  How would she know? If it really mattered, she would have measured my height herself.  She walked out and Dr Paa strode in.

Dr Paa’s fictitious name means feet in the Philippine national language.  A Caucasian of eastern European descent, his real surname contains so many letters and is hard to spell. Tall and bulky with a slight beer belly – my kind of guy – he went straight to the point: How long have you had this bunion problem?  His fingers caressed my bunion gently. I wondered if my foot fetish fact source might be reliable this time. I replied, Thirteen years. He asked, And you were in pain all these years?  I answered:  No, I only had pain when I tried on tight shoes, which I eventually did not wear.

The rest of the exchange went like this:

He: What brought you here then?

Me: My PCP pressured me to complain about what could be wrong with me during my annual physical and my bunion came to mind. The bunion gives me no pain but it is not pretty.  He gladly referred me to you.  I thought maybe you know some new technology that deals with bunions.

He:  Unfortunately there is no magic. But I can do something for you.

The foot fetish rumor launched my mind on overdrive.

From a drawer he took out what looked like an electric eraser and used it to file my bunion-induced callouses.

Me:  I bought a pumice stone and did the same thing you’re doing.

He:  Pumice works but you should not scrape too much. These callouses will return.  The wider the bunion gets, the more the callouses build up.

In less than half a minute Dr Paa was done.

He:  Here’s what I can do for you.  Next time the callouses grow back, don’t remove them yourself.  I’ll do it for you.

Me: Really!

The foot fetish rumor tickled my imagination again.  My beady eyes widened.

He:  And you don’t have to come here.  Every Wednesday and Friday I hold office in your PCP’s office.

Me:  Ah..You guys are in cahoots!

Dr Paa apparently appreciated irreverence. He chortled.

He:  And you don’t have to worry about anything.  Medicare pays for it.

Me:  I like it!  No bus travel and the price is right.

We laughed.

Dr Paa left and Sparkledust entered the room with the oxygen-measuring gadget.  She clipped it around my left big toe, then the right big toe, then the left index finger, and finally the right index finger.

She:  Circulation is good.

Me:  Awesome.

With that, the podiatry session ended.  The secretary gave me a future morning appointment and sent me on my way.

I schlepped my bunion down the landscaped embankment, silly smile plastered across my face.  Contrary to PCP’s belief, there’d be no need to change my shoes or my foot.  And that’s good.

Do you have a podiatry story? Let’s hear it.

 

 

The Opthalmologist

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The Eyes Have It Today

This post brought back memories of my early days in America, soon after falling off the boat as a bright-eyed and bushy-tailed  young legal immigrant.

Tom, a Caucasian man who would become my husband and much later make me a widow the first time, drove himself and me to Visalia, CA and introduced me to my future sister-law, Trish.  A beautiful woman inside and out, mid-to-late 20’s like me, she was married and had two adorable toddlers. The two-year-old girl had blond curls and inquisitive exquisite big blue eyes that kept staring at me.  Noticing cutie pie’s behavior, mother admonished daughter. Tamara, it’s not polite to stare at people. Then Trish turned to me and apologized, Tammy has never seen an Asian person before.  But the toddler disobeyed the order.  She followed me around the house,  her eyes intensely focused on mine, irritating the heck out of me. Don’t get me wrong. I like kids. In their own room.

Evening came and everybody hit the sack.  At crack of dawn, tiny blondie made a mad dash to our bedroom.  Again she drilled her blue eyes on my face.  Finally she exclaimed with disappointment, Your eyes still look tired! Tom and I laughed. A good night’s sleep couldn’t fix my hooded eyes!

Now to the ophthalmologist to whom my primary care physician referred me.  But first, I consulted Dr Google.  He confirmed that an opthalmologist is a doctor in the branch of medicine concerned with the study and treatment of disorders and diseases of the eye.  Actually the appointment was for my annual check up.

I arrived at the clinic at 2:30pm filled with trepidation because for nearly three years, the ill-fated CO-1686 clinical trial had handed me drug-induced diabetes while fighting my lung cancer.  During my research, I read that diabetes can wreak havoc in every cell of the body, which definitely includes the eyes. Of course immediately after bailing from the trial, the diabetes disappeared.  Poof! just like that. In the two weeks prior to my opthalmologist appointment, my eyes had been feeling weird, a perfect reason to blame. cancer and diabetes.

A 40ish bubbly woman eye-care tech ushered me to a seat in front of a machine.  I heard clicking sounds as if she was taking pictures of my eyes.  Then she led me to the reading examination room.  Put your chin here, your forehead here.  I obeyed. She asked me to read the row of smallest letters that I could read. I read the bottom row flawlessly. Hmm..20/20, she muttered.  I responded, The cataract surgery results at work. After squirting pressure drops in my eyeballs, she suggested I walk to the reception room and wait for the ophthalmologist’s call.

After half an hour, a male voice called my name.  It was the good doctor.  A Caucasian man in his 50’s with a long last name that ended in “ggold” he had this air of being extremely busy.  No smile, no friendly banter, guard up, his eyes focused on my charts. This was one eye doctor who avoided eye contact.  I kept trying to intercept his line of sight but to no avail. The experience reminded me of an advice given to me on how to prevent a friendly dog from jumping on my lap: no eye contact.  Dr Personality (Dr P) must have feared I’d strike a long drawn-out conversation with him, push back the next patient and delay his going home. He certainly did not appear to be the beer-and-nachos kind of dude.

Then Dr P brandished what looked like a magnifying glass/flashlight and directed it to my eyes. He instructed me to rotate my eyeballs 360 degrees: to the left straight, to the left high, to the ceiling, to the right straight, etc. Sometimes my eyes got confused which way was right or left so he repeated the instruction a tad irritated. He asked me when I first noticed the stye-like bump on my lower right eyelid. I answered, Before grade school and my mother convinced me it was a beauty mark. As I grew bigger and older, it also grew bigger and older and every eye doctor suggested removing it. So much for beauty mark.  My tale of woe failed to get a rise out of Dr P.  He quickly followed up with a question, Do you feel like blinking  eyes often because  they felt weird?  And I thought, Oh no, here’s the disease caused by the drug-induced diabetes! I answered Yes, I’ve been doing that lately.  Dry eyes, he declared with authority. Take fish oil. It’s good for the eyes. I argued: I eat a lot of fish.  I was hoping he’d give me some static. But no. He quickly agreed that lots of fish in the diet would suffice.  He declared there was nothing wrong with my eyes.   His subsequent demeanor indicated in no uncertain terms it was time for me to skedaddle.

In light of the foregoing, I resolve that next time I’ll only take morning appointment when the doctor is still enjoying his work.  I’m not complaining.  Good news is good.

Would you agree that morning doctor appointments are better?

Revisiting Tarceva Divas & Dudes

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Looking Back
What a difference 3.5 years make for Tarceva users! I was cataloguing my blog posts, carefully reading each of them, and searching for timeless information beneficial to new Tarceva users when one particular post stood out.  It’s in the Tarceva Divas and Dudes blog.  The update post title was Tarceva Divas and Dudes 03/28/2014 (The Update).

The Update stood out because:

(a) It reflected the evolution of Tarceva users. I noticed that in 3.5 years, many users have moved on to other treatments, some have abandoned Tarceva in favor of clinical trials or approved clinical trial drugs, and a few moved on for good.  Moving on for good is  something all of us – with or without cancer – will do sooner or later, preferably later, because that’s what we finite beings do.

(b) It generated 125 comments, making the thread 7 pages long. A few comments even took on lives of their own.

(c) It was chock full of relevant information, including a first-hand blow-by-blow account of a biopsy and answers to often-asked questions like Why go on a clinical trial, What time do you take your Tarceva?

(d) It reflected the history of the Tarceva Divas and Dudes blog.

(e) It shows how the author evolved into an awesome amazing woman.  Ooops, sorry!  I just had this crying need to throw that in the mix.

And now to the If’s:

  1. If you want to walk down memory lane, or learn something new, or just want to have a chuckle for whatever reason, here is the link:https://www.inspire.com/groups/american-lung-association-lung-cancer-survivors/discussion/tarceva-divas-and-dudes-03-28-2014/
  2. If the link doesn’t work, and you are really into it, please cut and paste the link on your browser.  Or if you are a member of Inspire.com, search Tarceva Divas and Dudes 03-28-2014 on the site.
  3. If you make it to the site and you recognize yourself, please tell us where you and/or your loved one are in your cancer journey.  Only if you want!

Okidoke? Thank you.