Wednesday, January 30, 2008

You Patient Readers!

I have no idea what possessed me to post not one but two enormously long passages about old health adventures. Yet you folks waded through them like soldiers, never complaining once. I salute you.

And will I reward your patience with some nice happy flower pix? I was gonna. I really was.

I will, too. Of course.

But first? Well...I got another bad boo-boo, and where best to indulge myself talking about it but here?

The point of this story isn't so much about the burn, but about the egg whites.

Last Saturday night, after working in the yard much of the day, I treated myself to some Lotus Chinese Kitchen. Since I like my food literally boiling hot - I can eat it that way without burning the inside of my mouth, but not touch it without burning my fingers - I nuked the won ton soup before bringing it to my perennial perch in the home office. When I'm not gardening or going to Sam's, I spend my waking hours here. I sit here to eat, too, with feet elevated as usual on their special chair, and a big pillow on my lap to hold my dinner.

Well, just as I'd settled in with my boiling soup...I dropped it. It hit my upper chest and ran down between my breasts and over the top of my belly.

With (for me) extreme speed, I got up and shed the rest of the soup off me, ran into the shower for a cold water rinse, then ran into the kitchen and separated three eggs. Pretty Lady and the egg white cure was thrumming in my mind. The burned patch is large, around 8" x 6". I grabbed a paper towel to sop up the egg whites, then lay it over the burn.

This was obviously a bad burn. I was clearly in shock, trembling, palpitations, surely low BP, all the classic symptoms. I had to consider the ER, but of course that's to be avoided if possible.

And what the egg whites did to keep me out of the ER was phenomenal.

It was the only thing that stopped the pain. Ice didn't do it. All my drugs didn't do it - and that's certainly saying something, there.

Knowing it was a second-degree burn and that I needed to monitor the shock, I stayed up until around 6 the next morning, when the shakes and palpitations finally quieted. I told Walter so he'd know. He scolded me, but he did understand this one came not from carelessness (like not wearing the mask), but innocent-enough clumsiness.

I sat in my chair as usual, feet propped high like you'd do anyway for shock, drinking lots of fluids like always, some salty food, Lotus with extra soy sauce...The shockiness didn't fade for many hours. I kept the paper towel soaked in egg whites on the burn, anchoring it down with an ice pack I usually use in my cooler.

The ice pack was nice. But I tell you this: the difference the egg whites made in that burn is extraordinary. By 6 am, I could leave the soaked paper towels off for several minutes and feel no pain at all. The redness was much less than it should have been. The loss of skin was too.

Just amazing. Really stunning, to me. I have some experience with bad burns. One came from pouring boiling oil over the back of my left hand when I was around 13, miscalculating while pulling the stopper out of the sink. That burn was so bad that the tendons in that hand are slightly but permanently damaged as a result. Over the years, a good dose of cooking burns, and one from melting old paint to strip it, followed.

MRSA adores two things: burns, and a channel. Walter's seen what happens when I get burned, how the MRSA sets in within minutes and grows rapidfire. So any burn is a source of horror for him.

Being able to tell him what the egg whites were doing probably kept him able to continue driving that night. He told me it was a treatment he'd heard of as a child in the old country, and because they didn't have refrigeration, he thought it wasn't simply because the egg whites were cold. I agree, completely, although of course the initial cold was soothing.

Now the blisters are breaking and the skin's coming off in large patches. MRSA has gotten into part of it, but only a small area so far. I have very good reason to believe that without the egg whites, this would be far more serious than it is.

Waiting for it to heal, trying to stay out of the yard and Sam's and therefore out of trouble, I've been sleeping and sleeping. Unanswered comments and emails are littering my trail, and all I'm good for is sleep...

Monday, January 28, 2008

Aliens from Outer Space, Part 2

Here's *Aliens Part 1,* the post below. (Actually, it really began with this post. If you like to be sure to go in order, and all.)

* * * * *

In 1994, living in Florida now, I'd been referred to a wonderful elderly allergist in Boca Raton. His name was Dr. Neil Henderson. He'd worked for 25 years as a New York pediatrician, moved to Florida, and spent the next 25 years as an allergist. I found out later he'd even had a cable TV show dealing with allergies.

One of his offices had an enormous stuffed gorilla sitting in a corner holding a cat. That HAD to be Koko and All Ball, her beloved pet tailless kitten that was hit by a car and killed one day. Koko, you see, is the first famous ASL (sign language) speaking gorilla. I never found out why the stuffed gorilla was there, or even confirmed it was Koko and All Ball. I asked an associate doc, and he didn't know.

Dr. Henderson was completely patient with his patients. Kind and gentle and compassionate. On my first appointment, he read all the answers I'd given to the allergy/health symptom questionnaire new patients filled out - and he said it was the most extensive reply he'd ever read. He knew it meant life could be very hard. He asked what he could do to help me. He said when a constant *total allergy* condition got that severe, what he could do - short of long term high-dose steroids, which I refused - was limited, but he would do whatever he could.

He gave me some of the best practical advice on allergen avoidance I've ever heard. Like how to read newspapers (printer's ink and paper allergies): your friend or spouse could open them up and spread them all out in an unused area, or a covered porch, and if you aired them for a day or two you could finally read them, all by yourself, even without a mask and gloves.

Sometimes, in the background, we could hear him hollering at one of the other docs on his staff. He did, apparently, have a temper. But judging from what I overheard, the only thing that set it off was if a staff doc did something wrong with a patient: missed a symptom, acted dismissive or unhelpful, did something not quite competent enough.

Dr. Henderson took the time to help me with my Social Security Disability application. That involves a fair amount of unpaid work on the doctor's part, but he never made me feel like I was wasting his time, or the time of his office staff. Quite the opposite - he was eager to help. That application was one of the most emotionally distressful things I've ever done in my life. His attitude made a huge difference to me; he helped me be strong.

Unfortunately, he was in poor health himself, and getting ready to retire. His patients would be turned over to his associates for treatment; some to existing docs on staff, but most to another young doc, newly hired. Toward the end, Dr. Henderson still came to the office sometimes to see a couple of his favorite patients, ones who didn't want to leave his care. I was one of them.

But, finally, he had to go. I was assigned to the new guy. Dr. Neil G.

The identical first name was foolishly comforting to me.

The way things came to pass, I had all of one or two appointments with that doc. I hung on by my fingernails to get my meds refilled.

The waiting room was down a long hall from his office, where he sat behind an imposing wooden desk to meet with patients.

In the distant waiting room, with two patients ahead of me and a few after me, we sat and talked about our beloved Dr. Henderson and wondered what the new guy was like. An elderly lady got up to take her turn with him.

A few minutes later, we listened with surprise as we suddenly heard his voice. It had to be raised pretty loud for us to hear him so far away.

He was yelling at the patient.

She was another one who loved Dr. Henderson like I did, and who found great relief following Dr. Henderson's treatment plan.

Dr. Neil G was screaming at her: --I don't CARE what Dr. Henderson did! You're MY patient now and you're going to do what *I* say!!!

She finally came down the hall to the waiting room and left without making eye contact or saying a word to any of us. There were tears running down her wrinkled old face.

Another elderly lady went in. He yelled at her, too, the same way.

Then it was my turn.

I'd figured out it was pretty important not to breathe a word about Dr. Henderson. Or to argue or disagree with anything this guy said. I just needed some prescription refills to keep me going until I could find another allergist.

As we went over my file, I noticed he tended to jump around a lot. He'd ask me a question, then not wait for the answer. He'd be talking about dealing with asthma, then interrupt his own self and bounce to discussing food allergies.

He disrespected and dismissed most of what I was doing. Without even reading them, he pooh-poohed years of diagnoses and thousands of test results; he said most food allergy tests were false positives. He was talking about skin tests; I mentioned I had RAST tests done too, which he carefully pretended not to hear. (whups, no no, quiet, k! now is not the time) He asked what my food allergy symptoms were, but again, never heard the answer, and actually got impatient with me when I tried to continue answering him, telling him what happened when I ate something I'm allergic to. I shut up, and quick.

I mentally filed away what I'd change about my treatment after his Words of Wisdom. Absolutely nothing. But I smiled and pretended to respect him.

He started puffing up with manly pride. Excellent. Okay, almost out of there in one piece...

He showed me how to use a steroid inhaler without getting the Very Dangerous Stuff!!! in one's mouth, by using a plastic chamber. Such a fascinating invention! I'd never seen one before, that's a great idea! Oh, you can give me one for free?!? Thank you so much. (For a person with miniature hands, jaw, and mouth, it was way too big and cumbersome to use, but he didn't need to know that.)

I was almost done and out of there safely. Please understand, I only undertake these deceptive tactics in dire situations. Needing my meds, and not knowing where else to go yet, made this an emergency.

He asked what meds I was on, and I told him. I emphasized that my first approach to treatment was the best - and the standard - one: allergen avoidance. For example, since pollen is a chief culprit, I use a lot of air-cleaning techniques; and when it gets too bad, I stay inside in my filtered air until the pollen count goes back down. That's not easy for me, since I'm an outdoors person who loves both to garden and to travel around, but when I'm that allergic I don't have much interest in being outdoors anyway. Just opening the front door feels like getting punched in the face, and breathing polleny air feels like I'm breathing chloroform. Knocks me down and puts me to sleep.

Then...then, Dr. Neil G asked me a certain question. A perfectly human one, but a silly one coming from a doctor, when you think about it. I get asked this pretty often and I have a standard response to it, dictated by my odd sense of humor. So far, in replying to that question, it had made every single listener smile along with me.

The question is this: --So how'd you get to be this way, anyway? How'd you get this extreme totally allergy syndrome?

I answer: --You know those aliens from outer space, the ones that come down and steal your body and do these medical experiments on you? Then when they bring you back, you're never the same. I think when you borrow something, you should bring it back in as good a shape as you borrowed it in. Or better. But them? No. Nothing works quite right any more. I'm not even sure it's the original model. Either they broke the bits they were messing around with, and didn't fix them right, or maybe they just substituted a bad copy of it. I mean, the old version was small and very strong and worked pretty good. Certainly, this isn't like the original at all.--

He became very nervous, shuffled papers around on his desk, said --Okay, I think we covered everything, goodbye...

I went home. The next day I got an odd call from my primary's office. THAT doc had THE best staff, bar none. Very hardworking, efficient, knew their stuff. Got referrals done fast, solved difficult insurance issues in two minutes flat, and were friendly helpful down-to-earth people.

Beth called and said she got this weird message from that new allergist. She'd heard strange things about him from other patients too. Was there something wrong with that guy?

--Well, yeah. But why do you ask?

--Because he faxed us this letter saying you were a head case, you need psychiatric evaluation immediately, you might be delusional and were agoraphobic.

WHAT?!? Delusional? Me, who loves reality? AGORAPHOBIC??? Me, who has trouble staying inside and not traveling around, even when I really should stay in? I mean, certainly I have my issues, but I'm the textbook opposite of agoraphobic! The last thing I am is someone who's afraid to leave the house!

Luckily, Beth knows me pretty well. She said, --Well, that's what I thought too. You had an appointment with him yesterday, right? What the hell happened?

--Oh. (dead silence) Uh, you know that little joke I tell about how the aliens from outer space came and took me away for medical experiments, and brought me back all Out of Order? And that's why I'm so sick?


--Well...maybe Dr. Neil G doesn't have much of a sense of humor?

--(dead silence) k. You told that one to someone you'd never met before?

--Uh, yeah.

--Okay, mystery solved. Don't worry, I'll shitcan the letter. Guy's a weirdo anyway. You know something? I'm going to stop referring patients to him. This is the last straw, you know? He's got a problem, I don't want to send anyone else there.

But do me a favor? Don't go telling that story to people you don't know, okay?

--Okay. Thanks, Beth.

--De nada, bye.

Dodged a bullet.

But just think: What if he'd sent that letter to some other doc, someone who didn't know me? I can't imagine how awful that would have been. It could've messed up my medical care for years. Destroyed my reputation.

All because a doc with obvious emotional problems decided to make a diagnosis outside his field, based on a few minutes' conversation, half of it in jest. No way did he know anything of substance about psychology, or he never would have said that about the agoraphobia. And why react that way in the first place to a standard practice among severe allergics? Surely I wasn't the first patient who'd had to resort to staying inside when the pollen's bad. Hell, I have handfuls of pamphlets from the AAAI and CDC and others, advising us to do exactly that.

Wow. The more I thought about the implications of what he'd just done, the more my blood ran cold.

My primary's office agreed to refill my allergy meds until I found a new doc. I was determined never to see this whacko again. And not long after, I saw him on the local TV news, being interviewed about some medical issue. Something else he was all scornful about, though I can't remember exactly what. He was working somewhere else, at an outfit in Coral Springs that's locally famous for misdiagnosing kids with meningitis, telling them it's just the flu, go home, buck up, take some tylenol and sleep it off - and next day, the kid dies.

I guess Dr. Neil G didn't last at Dr. Henderson's. So much for screaming at innocent little old ladies, making them cry for the sin of loving and trusting Dr. Henderson. The jackass landed up where he belonged: an incompetent place that got all dismissive with patients' illnesses, and let children die rather than *bothering* to listen and respect and test and think and do their job.

Fast forward to the present. It's the end of 2007, and I'm on a search for a doc who will do IgG booster treatments, and the insurance will only pay for it if it's done by an allergist/immunologist.

Unfortunately, few local docs will even do IgG boosters. One is the same Dr. C I saw in 1993 and had to leave. I tried another one around Thanksgiving, and he objected because my idiot primary sent an incomplete referral - meaning he'd not get paid! - and no file copy, no history of my condition, not even a copy of the test showing the low IgG. His staff was so terrified of my MRSA they went ahead of me opening doorknobs with paper towels. They never returned my insurance card and driver's license, probably scared to touch them. That one just didn't work out.

I had one last doc on my insurance list that I could try. The practice was a large one, the docs looked qualified, nice website. And I recognized some of the names.

I called. They said who their best IgG doc was, and we made an appointment with him for Christmas Eve day.

Huh. His name sounded a little familiar, although I wasn't sure what from - one way or another, I've heard many local doctor's names by now.

On appointment day, scootering in, the office staff were very good. I met the doc, and despite informing them in advance about the CA MRSA, I had to explain I don't shake hands any more, and why. He looked familiar. Odd. I have a very poor memory for both faces and names.

I told him about the low IgG, and he started reading my medical history, this paper I carry around and hand out to my docs. It has all my medical info, history, list of meds, list of other docs, insurance info, all that.

Instead of talking about the IgG, he immediately got on my case about food allergies. Those skin tests are often false positives, what were my symptoms? Well, I do have positive RAST tests too; anyway, here's what happens when I eat an allergenic food...Immediately interrupting my answer, he asked about my last allergist. She's a triple board-certified scientist down at Jackson, and also works with CFIDS, which I'm quite sure I do NOT have. But as I told this guy, I put *CFIDS* by her name on my med history list, simply because she works on it. Same way I put down *MD* or *DO.*

He began to dispute CFIDS, and I tried politely to explain I saw her for allergies not CFIDS; she'd tested me for CFIDS under some experimental program but we both thought I didn't have it.

He said, --Oh, she's an allergist now? --Uh, board certified, yes, if I remember right.

--Oh, so she finally got certified then? I didn't know that. (snark snark)

If you want me as a patient, folks, cutting down my other docs is not a good approach. I may well respect them, and for good reason. Most docs reading my doctor list are blown away at the extremely high quality of my medical care. It took me years and years to build that list up with really good docs. I fire the jerks and replace them with someone good, but that takes time.

Now, *I* can run a doc down to another one. That's different. It's my prerogative as a consumer. And I only do it if I have a really bad experience with a doc, when they do something they clearly shouldn't.

--So what other allergists have you seen?

--Oh, way back in 1993, Dr. C. She had a little issue with my husband for some reason, she'd make fun of him and put him down. Not a good idea. Call him Walter the Superhusband, all sarcastic because he'd come to appointments with me and be supportive. I think she was having marital issues at the time. So it just didn't work out with her. Then I saw Dr. Henderson, before he retired.

--Up in Boca?

--Yes, you knew him? I loved that doc. I wonder how he's doing.

--He died a few years ago. (Very curt and matter of fact.)

--Oh, no! I'm so sorry! I am really sorry to hear that, he was a wonderful man. He truly helped me when I thought there was not much that could be done for me any more. Did you know him?

(no response, head down shuffling my papers and muttering to himself)

Dr. Neil G's back on my allergy treatment: --Okay, we need to work on this and that and...

I told him, --Look. I do need a current allergist, and I will get to it. But right now, my one and only concern is to get this IgG treatment going. I'm immunocompromised while I carry three bad germs, including CA MRSA. That's really dangerous. I'm getting all these odd respiratory infections too, landed in the hospital for three days last year with one. So if we can attend to the IgG first, then I can move on to thinking about my allergy regimen afterwards, okay?


--I really want this IgG treatment. I really think it could do me a lot of good.

--Okay, well I can't run around ordering IgG treatments just because some patient comes in here and tells me what to do, okay? First, do no harm.

Warning bells warning bells! I shut up. Quick. I remembered what happened 14 years ago when I spoke openly with an asshole control-freak allergist. I'm here to get the IgG shots, don't blow it.

The doc explained this: IgG is a human product, not artificial, so even though it's much cleaner than other blood products, there's always a risk of infection. Considering that, if someone's IgG is still in the 500's, they usually don't do boosters. The exception is, if we test their immune response and they aren't making good antibodies. Otherwise, we only do boosters if they're in the 300's or maybe the 400's. We'll keep testing every year or so, and when it gets that low, we can just go ahead and do the treatment.

I am so disappointed. So badly disappointed. I can taste the bitterness of denial in my mouth, like a little kid who opened the very last birthday present and suddenly realized that the only thing they actually wanted, they didn't get.

--Well, how does that antibody test work?

--We take a bunch of titers - that measures your antibody count. Then we give a couple of vaccinations - for you, tetanus and pneumococcus - and run the titers again. If the antibody count goes up in response to the vaccinations, then we know your immune system is at least producing those antibodies, which is good. If not, then we can administer the IgG shots. See, first, do no harm, right?

I've paraphrased what he said, because he didn't present it in such an orderly fashion at all. Jumped around, kept messing with papers, looking at them, shuffling them around instead of paying attention to the topic at hand. He'd repeated *first, do no harm* several times. He talked about *FDA protocols* and *standard medical approach* several times too.

Based on my own personal experience - which includes some close familiarity with lawsuits in conjunction with my old profession - he was talking like someone who'd been sued. Someone who'd been lectured hard on how to talk, both by his own lawyers, and his bosses.

Hmmm. Not good.

The whole thing was making me uneasy. Something was nagging at my mind. Why did this guy seem familiar to me? Me, who can't remember names or faces very well?

We set up the first round of blood tests. I got in and out of Quest the same day, and fast, because there weren't many patients lined up on Christmas Eve day.

Dr. Neil G wanted me to call back in a couple weeks, once my blood tests were back. Hmmm. Seemed a little backward; the test results go to them, shouldn't they call me to let me know they were ready for Step 2? Whatever. I'd call.

But this guy kept nagging at me. Suddenly I couldn't rest until I found out who he really was.

After calling the insurance company and consulting the phone book, then examining his practice's web site, I knew the answer. It was the very same Dr. Neil G who made the old lady cry, the one who took over from Dr. Henderson.

SHIT. I HATE that man. You don't scream at old ladies and make them cry and expect me to have any respect or liking for you EVER, I don't care WHO you are.

Go back to that creep? NO. WAY.

I told Walter who he was. He said --NO. WAY. You should have reported him back then. Remember what he did to you? He could have really hurt you with that letter.

--True. Don't worry, I have no intention of returning. I can't. I know full well by now that it would only hurt my medical care, going to someone like that. I finally learned.

Soon I saw my ID doc, the good Dr. C. I told her about the creep, explained about him screaming at the little old lady. Dr C was startled. I said I couldn't continue to see a doc like that, it wasn't worth it. He was the last one on my plan, but I'd figure something out.

I also told her how he said FDA protocols meant I couldn't have boosters until my IgG dropped really really low, unless these sensitivity tests showed substandard antibody production. She said, --No. That's not correct, the FDA doesn't say that. There is some caution, but only because in the past this was abused, overused by doctors.

--OH! So maybe it's protocol for me to get them after all?

--Perhaps. We'll see. You must find an IgG doctor, we will go from there.

This is what happens when you visit a doc who makes decisions based on emotion rather than logic. In this case, his relevant emotions are fear and control. Anyone who uses emotion, instead of fact, to come to *reasoned* conclusions will go astray. Think with your head, feel with your heart; they each will inform the other, but make sure you know which one is really doing the job at hand. Make sure it's the right job too: the heart for feelings, the head for logical conclusions and decision-making.

Say a doc is a jerk in other ways, like screaming illogically at innocent patients, dissing your other docs, jumping around in a disorganized fashion about your medical issues, talking about issues that are not on the table, being dismissive of medical diagnoses made by other docs; thinking that a patient who wants IgG treatment, who was specifically referred for IgG evaluation by four other superb docs, is *telling him what to do,* displaying excessive concern about *first do no harm* and *follow protocols* - Say a doc is displaying all these questionable actions and statements.

Your care, in his hands, might not be the very best care. It might be compromised, because his emotional problems are overriding his logical judgement. Your own logical judgement should tell you that, even though emotionally you may want to trust him, because he is a doctor, after all, and you do need his care.

Next I saw my great pain doc, Dr. E. He's not just a Pain Management doc, but a surgical anesthesiologist. He's very well versed in general medicine, and extremely helpful with things like my MRSA issues. He's truly compassionate and not afraid to show it. I have great respect and affection for this man.

Dr. C (Infectious Disease), Dr. K (Rheumatology), Dr. S (Pulmonology) and Dr. E (Pain Management) are all quite gung-ho about the IgG. Just like me.

I told Dr. E about the asshole. I told him about it being a risky human product, too.

He said, --Wow. Unfortunately there are some nasty people in my profession. Control freaks and medicine, sometimes they go together. As for the risk? The risk to you of infection because your IgG is low is far greater than the risk of catching something from the IgG shot itself.

Ah! See what I mean? Smart doc. And note this: Dr. Neil G never considered the infection risk in that light.

I told Dr. E I couldn't go back to Dr. Neil G.

He said, --Hold on. You can't change people like that. They're like teenagers.

--Hmmm...You have kids, right? are they teenagers now? (grin)

--Oh yes! he laughed. --They're TERRIBLE.

--But listen: You don't have to see him for allergies or anything else. If he's the only IgG doc left on your insurance, just see him for that. Go through the sensitivity tests, maybe you'll qualify and get your boosters. You only have to look at his face a few times.

--(quiet...thinking...) Okay. I will. Crap. I hope he hasn't figured out who I am. That could be a real problem.

--Yeah-- he grins. --We'll see.

It was Dr. E asking me to go back to the creep, and for a logical reason. I'd do just about anything Dr. E asked me to. So. I decided I'd bite my lip and go back.

That took place on my late December appointment. I see Dr. E, by law, every 30 days. Last Thursday, January 24, was my next visit. For *busy work* during waiting times, I'd brought a stack of unopened mail. I got partway through it before I saw Dr. E.

Getting into the car to leave, I finished the stack...wherein I found a letter from Dr. Neil G.


Here, I'll reproduce it:

January 4, 2008

[k... name and address both misspelled]

Dear [k],

We regret to inform you that [...] Associates of Florida hereby terminates any doctor-patient relationship with you. We will provide you emergency medical care within our specialty for the next thirty (30) days to allow you to establish a relationship with another allergist or related specialist. We will also provide records, physician notes and test results to the physician of your choice upon your written request.

Please direct any request for those records directly to me at the Kendall office. Thank you.



So. I guess the jackass figured out who I was after all.

Saturday, January 26, 2008

Aliens from Outer Space, Part 1

After nearly dying from an anaphylactic reaction to penicillin in 1980, I stayed allergic.

I was allergic to everything I encountered.

The ER episode was on a Saturday or Sunday night. On Monday, I was sent to a Chicago clinic run by the allergy department at Northwestern, a highly regarded medical school. The professors running the clinic were considered a bit radical at the time.

When I got to the clinic, I was told the doctor was very busy and seeing another patient. I knew it was a teaching facility that saw people like me a lot - ones who couldn't pay, but had something interesting for the docs to treat. There were always a good five or six high-grade post graduate medical associates there. Full doctors learning a specialty.

After waiting for quite some time - and unaccustomed still to my new status as poor and insignificant and expected to wait uncomplaining - I started walking around looking. I found Dr. Zimmerman, identified by his name tag, sitting in a little corner somewhere, resting and having a cup of coffee.

--Hi. I'm your next patient, been waiting a long time. Interesting *patient* you've got there.

In a heavy German accent he replied, --Vell, efen busy doctors haf to haf some rest and coffee sometimes, no?

--Sure. In fact that's so important, it should be scheduled into your day. But not at the same time a patient is scheduled to see you.

I got my exam room assignment, and soon Dr. Z came in, followed by a troop of eager-looking students. Their faces wore such a hopeful, interested, vulnerable look, and I felt so much like a long-waiting bug under a microscope, I - well, I just couldn't help myself there - I said a bit sarcastically, --Ah! Here to "practice" our medicine today, are we?

As a younger woman, I must confess, I had a big mouth sometimes. In my defense, I really did keep it shut almost all the time.


Their poor little happy faces fell and I was sorry. Still, I hadn't figured on the price I'd have to pay for that crack later on.

Just as he was when I caught him on his coffee break, Dr. Z was totally unfazed. He began talking in his heavy accent. The students were startled by his voice, but then looked back at all the things he was pointing out on me. He was quite excited by my display of allergic rashes, so many different kinds all at once, very unusual, we're lucky to see this today. Nearly rubbing his hands in glee.

Fife disstinct rrashes - and can you describe vut is different in each, and vy? Vut's de name of dis one? Dat one?

Vy de brrilliant red patches in de palms and elsevere, you read about dis from de ER report, traces still remain. Is it purpura? No, purpura iss darker and defelops differently, can be palpable too. Dis is an indication dat de blood vesssels had veakened and vere no lonker containing de plasma and other blood constituents; and vut is de name and mekanism for dat, pleasse? De palmss ve can expect, yess? But vy to see dem elsevere only on dose joints vere de patient hass rrhematoid arthrritis?

He was clearly a very good teacher. I had some questions of my own, but I saved them for later. Not wanting to interrupt, you see.

At the age of 22, I looked much different than I do today. I was smack dab in that phase of our lives I call *Youthful Gorgeousness,* as opposed to my *Old Crone* status of today. The rashes and lingering signs of angioedema (huge blue-white cone-shaped hives) and erythema (the brilliant blood red patches on my palms and joints) were strikingly noticeable.

Dr. Z went over the angioedema, erythema, itching - I was still covered head to toe in tiny scratches from my fingernails - and the chest pain and throat pain. The finger that had started to split apart, swollen beyond containment from an angioedema hive. He discussed why my tryptase was normal, even though I displayed classic hallmarks of full anaphylaxis. (Tryptase tests to identify anaphylaxis are no longer used much, these days, apparently being inaccurate too often.)

The docs explained to me then and in later exams that sometimes, after anaphylaxis, a patient continues to be allergic to most everything they come in contact with. They didn't know why this happens. There was no official name for it yet. They themselves sometimes called it "idiopathic allergy syndrome," but not everyone called it that. They told me that I'd need to get an Ana-kit and stay on antihistamines (Benadryl and Atarax) for as long as this continued.

Because it might not be a permanent condition, I was instructed on how to test to see if I was recovering from it. If, in my daily life, I seemed less reactive, then after time I could try to decrease my doses of antihistamine. Very slowly and carefully please! If the symptoms reappeared, if I saw hives, rashes, itching, breathing problems, then I must immediately return to the original dose. Go to the ER if it didn't get better right away.

To be told that a patient could not only take part in diagnosing the severity of a condition, but actually even watch for symptoms and adjust meds accordingly, was absolutely radical at the time. Patients were NEVER directly involved in their treatment like this. Almost universally, they were considered by the medical community to be ignorant, emotional, illogical, impulsive, histrionic hicks that had no business participating in their own medical treatment in any way, shape or form except for taking meds. All else was the doctor's job, and his alone.

The reasoning went like this: If patients learned anything about diseases or symptoms, then they'd be hypochondriacs and think they had every illness described to them. And how did docs know this was true? Because they'd done the same thing themselves in medical school. So they had A Responsibility to prevent this from happening to the foolish unwashed masses they saw.

Back then, even asking the doctor a simple question usually got a shocked and hostile reaction. If they deigned to answer, the reply would often come in baby-talk or dumbed-down words, and dismissive in the extreme. A doctor was God, and the little lamb did not question Him.

Old school. Little did I know that medical treatment would take such a turn over the next fifteen years, that having patients ask questions and learn something about their medical care would be considered desirable and beneficial - and very much within the patient's rights.

The visit then turned to Patient Question time. Dr. Z had already introduced the student docs, who were all men; and one of them had proved it by politely leering at me, --The good news is, you don't LOOK that bad!, accompanied by a standard-issue playground bully wolfish grin. As an attractive young woman, the only woman present, sitting half-naked in a roomful of men, this was more an unsafe feeling than a friendly one.

Dr. Z wanted to know if I had any questions. Yes. How long might I be sick? He said he had no idea. For some, it was lifelong. For others, it went away in a few months or a couple of years. Even at that, it might return after being in remission.

The best way to get better was to avoid common allergens. I would remain in a state of constant allergic reaction for some period of time. The underlying condition was fairly static that way. However, certain allergens might increase the reaction quite noticeably - the more changeable or dynamic half of the equation. Avoid those substances! Learn about common allergens and avoid them too - shellfish, peanuts, etc. Watch yourself and learn what specific items you react more to than others.

My last question was about the red patches on my palms and joints. How did that work? I was just curious, could they explain it, please, in terms I might understand?

Probably not - it required highly detailed medical terminology, that one.

Try, please?

By then we'd gotten up and were all going through a doorway.

And one student doc, one who had not smiled at all when I'd said, --practicing our medicine?-- took up the challenge. Putting his face up close to mine and staring hard into my eyes, he began an A to Z rundown on how this worked, using twenty ten-dollar medical words in each sentence. After a minute or two his face began turning red. His fellow students started tugging gently on his sleeve, muttering hey, guy, that's enough; and Dr. Z, motionless and seemingly unaware, was actually watching him carefully. The other students noticed Dr. Z and upped their efforts to shut up their buddy. By then he was literally spitting with fury into my face, spewing angry medical words at me like they were pointed darts.

They gave up being unobtrusive and pulled him away, back through the door we'd just walked through. I heard him saying, --It's the fucking tail wagging the dog, why the hell am I supposed to take that shit from a --

Dr. Z turned back to me, his face now a mask of gentleness and kindness. He wanted to know if I needed anything else he could help me with. No thank you. He set up my next appointment, loaded me with scripts, and I went home, alone, to learn to deal with my radically changed existence.

Fast forward twenty-three years later, to 1993. Seeing Dr. C, an allergist in Ft. Lauderdale, I told her about my anaphylaxis experience in Chicago. As it happened, she knew a Dr. Zimmerman! A fabulous, brilliant, world-class allergist by now. Was it really the same doctor? We talked about him, and yes, it had to be the same one. Oh, she regretted not having him in medical school, she knew him from seminars and things she'd attended...

But, she wondered - why the German accent? He didn't have an accent. He was born and raised in America and sounded like any one of us.

Now, Dr. C and I had our differences, and her complete lack of a sense of humor didn't help. I use it and I need it, and a person without one can have difficulty communicating with people like me.

She said even putting on an accent for fun wasn't something she'd ever expect of Dr. Z. Did he only do it on that first appointment, where I'd been So Rude?, rude and demanding with this great respectable renowned allergist? --No, he talked that way every visit after that too.

She shook her head. I had a feeling she didn't quite believe me. A great doc does not do something silly like that, a childish little private joke. No matter how funny it is.

Dr. C and I, we didn't last. Just too incompatible. We saw things in life very differently from each other. In the long run it couldn't work out, and it didn't.

But I'd see Dr. Z again. In a heartbeat.

I'd tell him I found out about him, too. And grin.

Wednesday, January 23, 2008

January: Done.

The January 1, 2008 mortgage payment is now paid.


Monday, January 21, 2008

erk...respiratory infection

Well, it's nobody's fault but mine.

I was so intent on trimming the ficus last week, I sort of...forgot, to put on a face mask.

Lots of particulates in there. Sawdust, the dead leaves and stuff I brushed off the ficus branches, the old plant pots behind them - the ones I kept emptying out and generally cleaning up...

Basically, I was mucking around in a huge pile of natural compost. Stirring it all up with my hands and feet and chainsaw and loppers. Molds. Gazillions of microbes. Particulates.

I was trying not to get my face too close to stuff like that, but still - it was thick in the air, there was no avoiding it. There are plenty of particulate masks around the house. That job didn't even need the big sweaty half-face respirator, just a little cloth-type particulate mask.

I know that perfectly well.

That's exactly what got me in the hospital last spring, messing around with my compost without a face mask. And I was rewarded with an abnormal lung infection - the kind you get when your IgG is low, which is why the Great Lung Doc ran that particular test in the first place. A textbook case, I was.

Did I learn my lesson? Did I wear a face mask last week?


Fool me once, shame on you. Fool me twice, shame on ME.

So now I'm paying the price. I finished the four-day trimming job last Wednesday night. By Friday I had a full-blown raging respiratory infection, upper and lower. Bad. Fever and chills, weak and dizzy. I'm on permanent antibiotics, okay? But I still got this respiratory infection, one that looks bacterial to me - horrid huge amounts of yellow gunk coming out of my lungs and sinuses.


Last night I got ready to go to the Icky Place. The plan was this: Call the lung doc today, maybe the ID doc; they'd want to see me; they might very well put me in the Icky Place. That would be Broward General this time, where the Great Lung Doc is on staff and can do a blasted bronchoscopy right there, not send me HOME for it like stupid Holy Cross Inpatient did last spring, the dumb urps.

Miss Nancy cracks me up: she said to be sure to have a proper kit - books, all that - and make sure they don't feed me constant starch like dumb Holy Cross...And something to make the hospital food taste better? Lemon? An herbal seasoning mix to sprinkle over their so-called Food?

A nice jar of peanut butter too!

Then she kindly *listened* to the entire story of Poor Mr. Foot getting his surgery in my hospital bed in 2004. I felt so much better after that, I knew I could handle any Icky Place business I might have to deal with today.

But this morning when I woke up, it looked like I'd turned the corner. The fevers are down some, I'm not as shaky, and my lungs aren't nearly as rattly. That's all good. Very good.

Walter says the CPAP surely helps. I believe he's right.

So I'm out of bed for a little while now, and wanted to say Hello everyone! still alive here, pretty much...

The desktop is virtually dead, disconnected; the laptop screen is on the fritz, so I can't take it to bed with me. It's hooked up to a regular monitor just now, in the home office where the desktop was.


Oh! I know! If I can't take the laptop to bed, I'll bring the CPAP to the office!

And it worked out JUST right.

Wednesday, January 16, 2008

More Backyard Wildlife: Knight's Anole

I've been working up a storm out in the yard.

And what led me to set aside the Great Paper Chase for a few days?

Well. The physical inactivity made my blood sugar skyrocket.

Not to mention...I got some new pain pills. Lyrica, to deal with the neuropathy and fibromyalgia.

All of a sudden, I've been SOOOOO busy out there! '-)

I believe this guy is a Knight's Anole. They're Not From Here. They're from Cuba. Pretty, but a bit invasive.

Can you see him yet? He's sitting on the downed branch, a bit northeast from the center of the pic.

I've seen this guy hanging out in my ficus for a year or so. He's a bit grumpy with me: --Hey. Watchoo doin'? I'm not looking at you. If I don't look you'll probably go away.

--Sorry, guy. It doesn't work that way with me. --Okay. I'll look.

We had a little talk while I was up there taking down his habitat. He wasn't too happy with me, but he knows the score.

He's busy deciding whether to stay, in the severely curtailed ficus vegetation, or move on. But in the meanwhile, he gets out of the way.
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Hey, Baby...

These birds on the telephone line - I don't know who they are. At a distance, I was hoping it was a pair of American kestrels I saw the other day. I'm lucky enough to see these beautiful small falcons most winters, and I'm pretty sure we have more than one breeding pair in the neighborhood.

They were flying around in the air together just before dusk. Calling and calling back and forth in their high-pitched hawklike scream, swooping around each other, making a large circle over several houses on my block.

I don't know what they were doing this for: maybe playing, maybe courting. Hopefully, not looking for babies robbed from their nest.

It was a beautiful display, like they were dancing together in the air. Calling and calling, talking, clearly focused on each other with a startling intensity.

These birds? Not kestrels. But I do think they're winter visitors of some sort.

--Heyyyyy, baby! Lookin' good!

--HUH. Do I know you?

Okay, sugar. Be that way. Two can play that game.

Well...I don't want to be rude...Who'd you say you were?

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Sunday, January 13, 2008

An Egret Eats Its Snake Snack

Click click! It makes the pix much more clear.

Driving through the neighborhood, I saw this great white egret. If you've never seen one, that's quite a big bird.

It had a snake in its beak. Or maybe a glass snake. If you've never seen one, that's a legless lizard that you'd swear was a snake. Until it blinks.

The snake was about twice as long as its neck. If you've never seen one, that's quite a long neck.

Unfortunately, by the time I backed up the car, got the camera out and turned it on, said snake had mostly disappeared down that long long gullet. I did get a nice shot of a *GULP.*

Sometimes when your dinner squirms a lot, it can put a crick in your neck.
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Friday, January 11, 2008

i DID it!!! All by mySELF!!!

So now - please excuse. I'm going to leave some comments and emails unanswered for a while, and not finish my fine big post with pix of the Jury Duty day. Nope. Not yet. I'm gonna decompress in the garden first. (All day, that usually means.)

My gmail went down last night. Right in the middle of an interesting IM with Nancy.

Oh my lord. HORRORS. Can you IMAGINE?!? On top of everything else, gmail's where I write all my posts. Keep my To Do list. Drafts and notes and emails involving the Great Paper Chase. The very long list of medical folks we owe like $7000 to for the bypass and such (provider name, dollar amount, phone #, account #, dated notes on previous conversations...).

And Walter was asleep. Finally, after harrowing days driving on ice and so forth, he was asleep.


I am a MAJOR technophobe PLUS techno-lame-o. I know this stuff is child's play for so many of you.

But me? Oh Lord.

Okay. Deep breath. I sucked it up. Yes. I tried this, that, and the other, poking around, trying to get far enough into gmail to see what went wrong. I finally googled gmail. After several tries I clicked on one that let me into Gmail just far enough to get a Help menu. At the time, gmail thought I was accessing them from a telephone, okay? !!!

I tried what they said about finding cookie preferences under my security stuff. It wasn't there.

I thought. Before, people have walked me through this thing were you clear your cache of temporary files and cookies and stuff. Maybe that would help.

And I called up various mysterious Control Panels and thingies, and prodded here and there again, and somehow or other managed to delete that temporary stuff everyone seems to want to throw away when the computer gets gunked up.

I have NO IDEA which it was that helped, or even how to find the place again.

But I did it. ALL BY MYSELF!!! Walter is STILL asleep and I have my gmail again!!! So I could write this post!!!

OH, I was a GOOD GIRL!!!

Wednesday, January 09, 2008

Jury Duty

All my life, I've wanted to sit on a jury.

And every time I got called up for it, my employers nixed the idea.

Often this employer was the Federal Government. So much for promoting civic responsibilities in its employees, huh?

Then, several years ago, I got called again. But it was a bad time of year, allergy-wise. I talked with the administrator and we tried to work out some disability arrangements, but it just never came together.

But now?

It's January. I'm in reasonably good health. I think maybe I can make it. It's probably only for one day.

So I'm going.

*Don't Be Late!* They seem pretty concerned about that part of it. Perhaps they know how I'm just burning to answer those delightful comments in the last post...and the fact that I'm a person who would be late to their own funeral.

I want to be on time for this one. So I must set aside my bloggy desires, and be off.

Yours in Citizenship...


Monday, January 07, 2008

I Have Denuded the Orchid Tree

Well. I guess it still looks fairly full.

Or not! But if it doesn't? It will again, and soon.

This is the planting area I'm working on now. I took out a big plumeria and the remaining trunk of a palm tree that didn't make it. I'd swiped that palm tree from elsewhere, and after I'd dug it up, I couldn't bring it back home as soon as I wanted to. It was pretty big and heavy, and lugging it all the way to the chain-link fence, tossing it over, going back to the Saturn, and sneaking behind the big restaurant to tie this ten-foot palm tree up on the scooter carrier took some effort. I had to wait for the right moment.

Unfortunately, the right moment came along a bit too late, and that tree didn't survive. Oh well. Hopefully, it was better than getting bulldozed and chipped, what happened to all its siblings.

Same planting area - I just walked across the front to get a pic from this corner. I love that piece of wood. Next to it are some new snapdragons I just planted. (Thank you, Pops!)

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Sunday, January 06, 2008

Yesterday I Got NO Mail


That NEVER happens.

I was out in the yard, weeding the driveway close to the street, and the mail carrier walked by me. So I said, --You don't have to walk up to the mailbox, I'll take it.--

And she gave me a big sweet grin and said, --Got nothing FOR you today, sugar.

The way my jaw dropped must have tickled her funny bone, because she saw my face and burst out in giggles.

It was true.

You know you're getting your stuff straightened out when the volume of mail actually hits zero.


More yard work now. I just got up an hour ago at 1 pm, so I'm off to only half a day of sunlight. Time to go grab it while I can.

The agenda? I'm almost done pruning the orchid tree. Yes, I've hacked it within an inch of its life. I do it every year around this time.

Don't cry! It's good for it. It'll look all naked in the next pix I post. But as you saw from the big orchid tree post, it comes back with new growth so fast it'll make your head spin.

And I'm doing all the general cleanup the yard's been asking me for, too. One of the front planting areas will get a revision. I think - I do believe - Walter loves the idea - I've decided to move the lignum vitae tree from the side yard to the front.

I'm so excited I can't stand it!

hee hee! Yeah. I know.

I'm easily amused.

Pix to follow! Tune in tonight!

Friday, January 04, 2008

Still Sleeping it Off

I didn't meet my goal of sending out HAPPY NEW YEAR!'s to everyone by midnight. But I gave it a good shot.

At first I tried to just run in, post the *Happy,* and hit the next blog. Do all the East Coast bloggers first, then midwest, then west. Playing the time zone difference, see?

It didn't last though. Looking at the blogroll, going walkabout. Australia was already a lost cause, timeliness-wise. Those folks are WAY ahead of us.

Do you have any idea how hard it is to NOT read the most recent posts and all the comments on blogs you like, and worse yet, have been missing because you've been so intent on being a Good Paper Chase person? Yikes!

Then I started falling asleep in my nice comfy office chair, computer on, wireless keyboard on my lap. I do that sometimes.

When I woke up again I'd do a few more HAPPY NEW YEARS's/try not to visit too long so you can catch the next one on the blogroll...fall asleep again...

All in all, it was great schmoozy fun. I staggered off to my actual bed and CPAP machine somewhere around 9:30 am.

And slept, and slept, and slept...around 18 hours more, if I remember right.

I think I may have missed a couple of you. If so, please accept my apologies. It wasn't because I don't care!

Now, in various travels to the store or the doc's on Wednesday and Thursday, the 2nd and 3rd, I see everyone here is intent upon getting back to business. Busy busy busy! Phones are ringing off the wall, staff looks a bit harried but intent on their tasks. That lackadaisical holiday feeling is so gone, it's as if it were a distant memory. New Year's? What New Year's?! That is SO last year!

So I, too, will get BUSY BUSY BUSY here, and morph into Git 'er Done mode once again.

Just as soon as my cold-numbed hands and feet will let me.