World Enough and Time

I went to the doctor today - not my regular doctor, but the specialist she referred me to, who is looking into whether I really have Sjogren's Syndrome.

First I had to fill out a form with many questions on it; whether I'd ever had a stroke or liver disease, whether I smoked, that sort of thing. Then when I was in the office with this doctor, first consultation, she's asking me for the details regarding my answers. And she looks at my joints. She noticed that my right hand is bigger than my left - and in all of my life, I don't think anyone has ever mentioned that before. Often people notice how much smaller my left wrist is, but not the hand itself.

I explained that my left side in general is smaller than my right, from having had scleroderma as a kid. Scleroderma hadn't been on the 'tick-off' list. And she was right onto it, asking questions about when the onset had been and who my doctors back then had been, and what treatment they'd given me, and I was trying to remember, as best I can, because 'onset' occurred when I was four years old. A bit hard to remember, and at the time, I don't think the grown-ups told me everything. I remembered some of my doctors' names. I knew what the treatment was, no problem remembering that: none, because there is no treatment. They rubbed my skin with vitamin E. Maybe that did the trick.

She looked at my scars and said I had 'coup de sabra' scleroderma. She'd read about it in the case studies, but she'd never seen anyone who had it.

"That means sabre-cut," I said, and she agreed. That hit every romantic notion in my body. Swords! Pirates! Swashbuckling! Okay, okay, that's only a personal quirk and it's just a name for a disease, but hey... if I have to have a weird disease, I like having one named after slashing swordplay. It's so colourful it's poetic.

She asked me if I missed a lot of school as a kid because of being sick, and I confessed I did. And she described my symptoms, and asked if she was right, and she was. She asked me also if I'd had rashes, and I had to think a bit, but yes, I remember having horrible hives sometimes - not a memory I really want to dredge up. I never associated it with the scleroderma. I suspect it was before I got diagnosed.

This is the first time any doctor has paid any attention to the scleroderma since my scars stopped spreading, when I was about eight. I think it's because they don't know what to do about it, and so don't know what to say; and because they think it was a misdiagnosis, because I survived. I have the scars to prove I had it, scars aplenty, and no one has ever come up with a better suggestion as to the cause.

So now I have to get blood-work done (what else is new?) and I have another appointment next month.

Coup de sabra. Hot damn.

A satisfying day - a really satisfying day, the first in a long time. I seem to be calming down with the Sjogren's Syndrome - maybe because my pills are working, maybe because the symptoms are abating, maybe because I'm just getting used to the idea of this thing. Anyway: good day.

• Went to the medical lab at 8 a.m. for more blood work - I got a phone call from my doctor on Friday to say something else was wrong with my blood. She didn't say what, but the requisition slip that I picked up on Saturday said to check TSH (thryroid, right?) and vitamin B12, and CBC -
  "complete blood count", with maaseru tells me they always ask for.
  
  Once again, the lab was empty, much to the amazement of both staff and the few other patients who were there - they concluded it was because everyone was on holiday. It took a relay of two different nurses before they got any blood out of me.
  
  
• Then Lynne and I went for a walk along the canal. It was a beautiful morning, but rapidly getting hot. I think all the grass in the city has died.
  
  
• Brunched with maaseru at Zeller's, and went with her to various places for various tests on her car that have to do with renewing her license. The car is doing fine, which cheered her up no end.
  
  
• Went to my gym for my 60th workout since May 1.
  
  
• Helped maaseru at her place for a bit, and then did a large decluttering job on my bedroom, including getting rid of some furniture. Found a few old treasures - like my notes on the talk given by Dorothy Dunnett at the gathering in Edinburgh in 2000. While working on the room I listened to the audiobook of A Civil Campaign by Lois McMaster Bujold.
  
  
• Had supper at Pim's place: sushi. I was a little nervous about trying to eat the rice, and it was mildly difficult, but the supper was good. Her guinea pigs are adorable.
  
  
• Pim sent me the link to this item on hunky Olympic athletes, which also did a lot to cheer me up. Especially the fencers.
  
  
• Finally, got to sit back and read. Aaaah.
  
  
  

The event of the day was going to the General Hospital for my annual encounter with Dr. Pollock, who put my elbow together eighteen months ago. It was x-rayed again today, because, said the nurse, there was a 'fragment' a year ago and they wanted to check it. She was gone before I could ask: a fragment of what? Where?

My elbow looks like this:



The (other) nurse agreed that the scar was a work of art, and the Doctor was totally chuffed at its state. "I never thought you'd have that range of motion," he said. He took photos of me with my arms straight (well, as straight as the left one goes) and bent, and held out, palms up, and palms down, to go with his lectures on this type of arthroplasty. "You heal well," he said.

This made me feel a lot better. I'd had a niggling streak of guilt, thinking that maybe I'd be able to straighten my arm if only I'd put a little more time, effort, pain, whatever, into my physiotherapy. Knowing now that I have exceeded expectations, I think that probably isn't true. I did all I could.

Dr. Pollock says I will probably need surgery to replace the other part of my elbow in ten years. Or maybe not; this is uncharted territory. He said the same thing a year ago, so maybe I get an extension.

I went home. I studied French. I studied a lot of French, and did a lot of homework, and went to my class feeling tired but prepared. Well, sort of prepared. Then I wrote the exam.

Tired now.

I went to my doctor today, to see what she'd have to say about the infected cut on my hand, and to ask her why the incision from my gall bladder surgery suddenly started bleeding on Sunday.

It's like playing Doctor Roulette. My regular doctor, Dr. Griffiths, is on medical leave. Her replacement, Dr. Laughton, is on holiday. So I got Dr. O'Connor this time, whom I'd never met before, but whom I liked very much. She too used to faint a lot as a teenager. We commisserated and swapped "embarrassing times I have fainted in public" stories.

She looked at the mini-wound on my hand and said, "Are you sure that is a paper cut? It's the strangest paper cut I ever saw." I explained how the edge of the poster had scooped out a little half-sphere of skin. he lanced the abscess, said I probably don't need antibiotics - that's a relief, because I can't afford them right now. She examined my no-longer-bleeding incision and said it was fine, it's just that the scar tissue is still tender and I should scrub it gently when I shower. Okay. Fine by me.

Then I left the book I was reading behind in the waiting room. Luckily, it's not out of my way, to go back and get it tomorrow.

What should a person do for a gall bladder attack?

It started about 3 a.m., and it won't go away. I looked online and found a site suggesting drinking apple cider vinegar in apple juice, so I did. It didn't help. Tried acetamnaphen, and the pain's still there.

I was going to work today, and make money. Or, if not that, get things done at home. No dice. I can't bring myself to eat anything, either.

And the pain makes me grumpy.

I'll be goind for medical tests in August, but that doesn't help me now.

Any suggestions?

I had to go to the dentist today; broke a tooth last week, and I'd been procrastinating on going back even though I knew he wanted me to see him in the fall. He teased me for spending money on going to France rather than going to see him - but I think he understood why! We talked about France and Greece. He's been to Greece; I am envious. He said he never saw the men in Greece working, only the women.

After getting my teeth checked (I have an appointment to fix the broken one later on), I walked home, not sure how long it would take. It took about an hour - turns out to be just short of 5 km. I bought some groceries, betaed a story, and had a good visit with Lisa and Lynne. And my shin muscles felt tired and tingly. Still do.

Since I was printing my apazine on my beautiful new printer - so fast! so beautiful! - I quickly used up the starter cartridge they give you to start. The new toner cartridge was impressively quick and easy to install. I am very happy with this beautiful beast.

Had a terrifically busy day at work - I knew I would - with many emergencies. My stomach didn't stop hurting, and I simply did my best to ignore it, and not feel sorry for myself. After work, I had a brief visit with redmtl, then went home and slept.

And now I feel better. Better enough to have some mushroom soup for supper. Seems to be all right.

Now, off to French class.

My friend Lynne brought me this list of ways to live well and healthily, from a book called Younger Next Year for Women by Chris Crowley and Henry S. Lodge. A better list than most, and doable:

Harry's Rules

1
Exercise six days a week for the rest of your life.

2
Do serious aerobic exercises four days a week for the rest of your life.

3
Do serious strength training, with weights, two days a week for the rest of your life.

4
Spend less than you make.

5
Quit eating crap!

6
Care.

7
Connect and commit.

I had my last physiotherapy appointment today. Good-bye to Leslie the physiotherapist, who gave me a full assessment: I'm getting strength back in my left arm and shoulder faster than she expected, though from my point of view it's still weak as half a kitten. She said that when she first saw how badly damaged my arm was, she pretty much freaked, but I've worked hard and got most of my functionality back. I can't help wondering if I worked hard enough - the occasional day I blew off the exercises, did that make a difference? Well. I'll never know.

So now I still have to do arm exercises, and shoulder exercises, but on my own. She says I may get my arm to strengthen still more: it's at about 20-25 degrees, she considered 10 degrees her goal - might I get it to 15 degrees? Seems worth trying.

Today I had a follow-up appointment with Dr. Pollock at the General Hospital. I was a little worried about how to get there, but it turned out to be fairly straightforward (though time-consuming) to take the #101 from O'Connor and Isabella to Hurdman Station, then the #106 to the hospital. I'd left myself time to go to the cafeteria there for breakfast: bacon and eggs and toast and coffee. I even remembered to bring my coffee cup, since I dislike coffee in a paper cup.

Then there was the usual waiting for appointment, and waiting for the X-rays, and then seeing the intern, then seeing the surgeon. What a sweetheart he is. And though I felt nervous about the appointment, he was actually reassuring. I'd been afraid that I'd have distressing restrictions on the use of my arm, especially since I still can't straighten it. But it turned out to be more interesting than that.

Dr. Pollock said that with a normal elbow replacement, the usual restriction on weight to be lifted with that arm is five pounds. He'd told me ten pounds, in the hospital right before the surgery. But this time he explained that the surgery he did on me was quite unusual and fairly rare, so he didn't think the usual restrictions apply. He said that I should be careful with it, and not to lift heavy weights, but to judge by the levels of discomfort and not feel restricted. He warned against repetitive lifting of heavy objects, but otherwise to not worry about it excessively.

I wish I'd said, "What about yoga?", but I think I can figure that out with common sense. If I stay away from exercises where the arm is weight-bearing (like the Plank or the Crow, both of which I used to like) I should be all right. Downward-facing Dog is out too, alas. But no point fretting about there. There are plenty of yoga poses I can still do, and it would be good for me to be doing them.