Peeking into the rock

In light of the new guidelines for statin use, and the fact that more people have muscle damage from taking statins than previously thought, it seems like there ought to be better information about preventing, monitoring, and responding to statin-caused muscle damage.

I want to stop right here and acknowledge that statins are good drugs in general. The incidence of side effects, even given that it is much higher than we can really know because of people like me who don't put together their muscle symptoms and statin use, is pretty low compared to the health and longevity effects. They're cheap for what they do, too. I was really reluctant to consider the statin connection when I was figuring out my leg pains. Which probably means that I had years more pain and possibly more permanent damage than necessary. But I'd say to a person who is taking a statin now, that if you develop leg pain that doesn't go away, be suspicious. Do a trial of stopping the medicine. Since the medicine is a long-term, cumulative preventive therapy, you can afford to stop it for a couple-few months and see what happens.

Meanwhile, I have finally found one article that is neither a hysterical, credulous hatchet job nor a dismissive, sweep-it-under-the-rug condescension. It's a little old - 2005 - but it is aimed at physical therapists and it is measured, intelligent, and informative. Here it is.

Unfortunately, what I have not found is an assessment of what happens to people who do get longer-lasting effects, and what is the best strategy for retraining the muscles.

One interesting thing in the article that I thought could have been better explained was the advice to tell patients not to use pain relievers for this type of pain. Since no pain reliever seems to have any effect whatever on my leg pain, I don't take any of them anyway, but I wonder why we're not supposed to. It was in a way almost as much of a relief to give up on pain relievers as it was frustrating, because I already take so many medications (a risk factor for muscle damage with statins, as it turns out: my only other one is being female). Although, these days, most of my medications are actually nutrients. Which sounds good until you think about it.

On a related front, the dog also seems to need anti-inflammatories. Ah well.

Not quite before breakfast, but I ate while I wrote. Only 1329 words on the new chapter (34!). Stopped because I need to think about what happens next. What happened here was a report about a coal miners' strike in the lands owned by Yanek's biological brothers. What happens later in the chapter is a general strike by the workers in the city where Yanek is now. What happens in between is a complicated puzzle piece. And somehow all of this has to actually be about Yanek's ultimate relationship to a wild sow earth spirit.  And he still needs to get his soldier's discharge pay and buy a new drum, and yes the drum needs to be gotten before the strike happens, so maybe that's next.

You know those books where there's like three characters and all the action takes place within twenty-four hours and on the premises of one particular building?

Thios book is the opposite of that.

on another front: due to a miscommunication with an office worker at the doctor's office, instead of ordering my knee xrays I appear to have gotten a huge slice of my written medical records. It's pretty interesting, to me: the interesting part is that it would look really boring to an outsider. Considering all the conditions I'm diagnosed with, and the medications and behaviors I've undertaken to address them, I am a healthy, boring person. My latest labs are sterling -- middle of the middle, totally unremarkable. Except the colitis, which is mild. Oh, and my lumbar MRI reveals "moderately severe" stenosis of different kinds at several different vertebrae, but we all know that means nothing (really, people with horrible MRIs can be limber and painfree, while people with nothing showing at all can be crippled and suffering). Even the surgeon who proposed to replace my knee joints couldn't really make that strong a case for it now that I've read her notes.

All the notes, by the way, every single one of them, say "looks well and is not in distress." Which means, I guess, that it is a formula, since that's three doctors and a physical therapist.

Another note: the surgeon said the right knee was worse and proposed to operate on that one firstbut it doesn't hurt at all these days: it's only the left that hurts ever, now.

The next thing I do will be to work in the garden and talk to Bonnie, then I'll run errands, go dancing, and write a little before bed, probably on one of the other little projects.

Nick Mamatas is right, we can't escape irony is our lives.

Today, my personal one is
( you really don't want to know )

Yesterday I was working on the downstairs bedroom so I don't have to live in a dump for the next year and so I will eventually be able to clean up the living room too.

So I wrote one sentence.

Today I brought the word count to 1.7K+, which is better.  I'm sort of speeding throguh drummer's training camp.  Tomorrow I'll get him chosen by hsi first unit, and the next day maybe have his first battle, and probably on one of thiose two days the conversation with the older drummer about how they're already dead, so they may as well see if they can save their comrades, and by the way, we fuck around a little too.

I was looking for more about military drummers, but there's not a lot more to be found, so I'm making up a lot of stuff whole cloth, and hoping that it makes sense.

I've been poking at Frank's old laptop but it's probably a paperweight. I have some time before the surgeries anyway: I've moved back the first one to May, so I have more time to work out the finances and strengthen my legs before hand.  There's no reason not to, I'm not in much pain at all and I really am getting stronger.  Yesterday Kevin the physical therapist decided I was ready for a new set of exercises which are as he says "efficient" -- meaning they are difficult, painful, and tiring. I should be proud, but I'm sore. I mean muscle sore, not emotion sore.

Also, that cracked tooth finally shed the cracked bit off, and now I have three teeth with chunks out of them.  At my age, my mother had three teeth, though, so that's an improvement.

Also: tomato sandwiches.

Yesterday I dragged my factotum (actually fac-quasi-totum) Phillip to San Francisco to have after-Thanksgiving with my brother's family and my stepmother. She is pretty weary: unable to sleep since the latest round of cancer tests began. But it was good to be there.

Driving there and back was hell on my knee though.

But you know what? Everything is hell on my knee. It feels okay now and then in certain positions for a while and the arnica-marijuana rub my stepmother had felt okay for a while and acetaminophen (paracetamol) sometimes makes it feel okay for a while, after a while, and icing seems to make it feel less hellish, but any position is hellish after a while, and so is walking, and so is not walking, and the worst of all is the wee hours of the morning. Last night I took an acetaminophen tablet to bed an I took it when he pain woke me up and it was still two hours before I could go back to sleep.

And I'm supposed to move furniture today and it was a project I initiated and it's taken months and months to line it up so it could happen.

No, not healthcare related things at the moment.
( TMI to follow: trying an lj-cut in rich text editor because I fail at it in html )

1) My doctor's office called me today to tell me that the FDA has cut the recommended dose for Simvastatin in half, because the old dose was causing muscle deterioration.  I've been on the standard dose for years and years and years. I asked "how would you know if you were getting this muscle deterioration?"

Muscle pain and weakness, she said.

So, I had thought that I was experiencing the various weird muscle cramps and not being as strong as I used to be because of sedentary habits and possibly insufficient potassium (being on diuretics raises your need for potassium).  Of course, I actually still could be, and honestly I've had less of the pain since I started making sure I get more high-potassium foods, and I have had less of the pain since I have been making sure I walk the dogs and work in the garden and stuff.  But, well, it could be part of the picture.  So I'm cutting my pills in half.  The bonus is that I just filled my prescription, so a month's supply of simvastatin will actually be two months' supply this time.  Too bad I can't keep getting the 80s -- next time I buy the drug it will be a 40.

2) Yesterday I had a coughing relapse.  At first I thought it was another wave of the bad cold I had last week.  It probably was, partly, because my nose has never stopped being weird. But I realized part way through the day that I was also having especially bad coughinf fits soon after I ate, and I've been aware that I had drifted into eating way more starchy food and sweets and dairy than I ought to but I was just too lazy to work out what to eat instead (that's why the irreproducible recipes posts last week).  So I figured that at least some of the relapse is due to bad diet.
Then this morning I discovered that (a) I had forgotten and left accessible food on the counter overnight for the first time in a long time and (b) the rat that I thought had left because there was no obvious sign of its presence had not gone, and in fact had gnawed a hole a bit bigger than a ping-pong ball in the hunk of parmesan cheese.  As the day progressed I became convinced that part of my relapse is in fact due to the fact that I have had a rat for two months and I am intensely allergic to rats (and no other thing, though I have some non-allergy sensitivities, obviously).  And I don't know if it's the power of suggestion but my skin is prickling like it always used to when we had pet rats and I keep getting that horrible unsatisfying cough that goes on and on and doesn't dislodge the thickness back there.

Why have I had a rat for two months?  Because I am a wuss.  First I tried to sic the dog and the extra dog on the rat.  Unfortunately, both of them lived in households with pet rodents in their youth, and while Truffle will in fact kill a couple of gophers, voles or wild rats in the field every spring, they both seem to think that a rodent in the house is a scary authority figure they dare not even bark at.  Then I had to go all the way to Capitola to buy a rat trap because where do you buy one in Santa Cruz? (I just thought of a place I will go to tomorrow)  Then I had to work up my courage to set up the rat trap.  And it was even harder because Zack said to put it into a paper bag so I wouldn't have to touch the rat.  And then I got desperate and I finally tried to set the trap and it sprung immediately and then wouldn't reset again for drugs or money.  So no rat trap anymore.

Tomorrow I buy several rat traps of different designs (all in the spring type: no bait, no glue: I want the thing to die as quickly and painlessly as possible.  No catch and release because what would that accomplish?  We're talking about a serious threat to my health here) and I will set them carefully with no extra flourishes but just yummy bait, one at a time.

This condition threatens more than my daily health.  I can't do anything really vigorous while it's in sway because the slightest movement causes a coughing fit and urinary disaster (no, dears, kegels have kept this manageable when I'm not having overwhelming coughing fits, but they don't cure it, and nothing seems to help when I am having these coughing fits except to sit on many layers of folded towels and do lots of laundry).  I can make it through a day of work by spending a lot of time in the bathroom and taking a wide variety of drugs (antihistamine, antacid for the acid reflux component which is there even with the right diet and acid-reducing drugs during the periods when coughing fits are likely to happen, and demulcent/menthol cough drops -- Hall's or Luden's or Ricola, like that).  But I can't dance or run or be embarrassed (yes, dogdamn it, being embarrassed or otherwise emotionally stressed overpowers both my cough control and my bladder when I am in this kind of cycle).

The good thing about this noise is that there appears to be some reason to think I can get back on track, health and activity wise.

(tell me if I managed to get an lj-cut to work?  I had given up on using them because they never seemed to work)

I've told this a few times. But it's time to say it again. My personal experience has taught me one thing about abortions:

universal access to abortions, no questions asked, is the only acceptable condition.

I have had two abortions. I used to think I wouldn't have an abortion "just for timing," but it turns out I will, and that timing isn't such a light reason.

My children have never been homeless, have never gone hungry, have never had to wait long for a pair of shoes -- though Frank had to wait over a year for a tonsillectomy before we got medical insurance that would cover it. But there were times in our lives -- notice the no medical insurance -- when we were cutting pretty close to the wire. And there was another thing, which is that I was an elevated-risk mother: not exactly high-risk, but elevated. How elevated? 10% of women experience preeclampsia, but 20% of women who've had it once have it again: and that amount is elevated still further in women with high blood pressure (mine came down to "borderline" a couple of years after my first was born). None of the restrictive abortion rules that have been proposed allow for a woman to choose not to carry a pregnancy for elevated risk: only imminent death, or maybe, sometimes, imminent risk of permanent invalidism.

My first abortion took place when my son was about to turn four, and I was working irregularly. I was temping in factories and subbing in a preschool. We had no medical insurance. I couldn't find a doctor who was willing to try for a normal birth, and I started dreaming about being on a production line to death. The image was from the freezer plant where I used to work: a continuous belt of thick white plastic, rolling into darkness punctuated by glaring lights. I didn't like the gynecologist I picked out (she had seemed reasonable in the hospital when I was recovering from Frank's birth).

I didn't really like having an abortion. I didn't like having a procedure to prevent having another kid -- I did want another kid some time. But I felt so much better afterwards. I was going to live, most likely, and raise my child.

My second abortion took place when my son was ten and my daughter was two. I was looking for work as a teacher, having just got my credential. The baby would have been born in October, a month and a half after school started. Financially, the situation was even more impossible than before. I had student loans to pay off, and two children to help raise, and frankly, my risk level had not improved, even though I'd managed to pull off a healthy-enough pregnancy (with lightly elevated blood pressure this time, and gestational diabetes again) and safe vaginal birth -- I was now over thirty-five, and my blood pressure was still hovering just below the action level. I had no second thoughts. I mattered to my family, and I wasn't going to take unecessary risks to have a third child we'd never planned on. The thought of leaving the nice fellow with a newborn, a toddler, and a pre-adolescent, and all the medical bills and only his wages, was just horrifying.

I've been told a few times that we could have found someone who wanted to adopt the child who would pay all my medical bills while I gestated that baby for her. Yeah, right.

Women who are afraid of pregnancy are generally portrayed as neurotics. However. Worldwide, the chance of perinatal death is 1 in 74. Yes. More than 1% of all women worldwide die in pregnancy, labor, or the immediate aftermath. In developed regions, that drops to 1 in 2800. That's a big difference: some of it is due to better nutrition, some due to cleaner conditions for giving birth in, and some is due to the presence of magnesium sulfate (the drug of choice for preventing convulsions and stroke in preeclamptic mothers). Worldwide, 12% of maternal deaths are attributed to preeclampsia: in the US, 18% (I think the higher number is due to fewer mothers dying of sepsis, hemorrhage, starvation, etc).

When abortion is restricted, what is being said is: your life is worth less than the life of the hypothetical person. This is simply unacceptable. When we say it's about choice, anti-abortionists think we're talking about something frivolous: something like a preference for Birkenstocks or high heels. But that's not the choice. The choice is your whole life: sometimes this means the quality or shape of your life, and sometimes it means whether you will live at all. And nobody has the right to tell you when it's appropriate to take that risk and when it is not.

It's not just cheesy that the soft media like to showcase women who choose to bear children in spite of life-threatening conditions which are exacerbated by pregnancy. It's heavily ideological. It's meant to impart the message that real women, good women, will willingly accept their own death in order to procreate. There have been stories about women who did that explicitly, literally: women who could live if they didn't carry through with a pregnancy, but who specifically doomed themselves by doing so -- women with treatable cancers whose treatment is incompatible with pregnancy, women with heart or circulatory conditions which simply could not survive the perfusion of pregnancy, let alone the stresses of labor. Of course it follows from my argument about that these women hav the right to do this. But it's nnot the right thing to do, any more than it is the right thing for a sixty-five year-old woman to marshall the expensive medical resources necessary to conceive and carry a baby. In both cases the woman is guaranteeing that her child will be an orphan: she is building tragedy into the primary conditions of her child's early life. (the sixty-five year-old may actually live to see her child graduate from college, but she's unlikely to get much further)But these women are made out to be heroes, and women who have abortions are made out to be selfish, even though they generally do it to preserve their ability to take care of children they already have.

I still haven't mailed the envelopes. I forget what happened on Monday -- first I was cleaning, then I was trying to figure out the math of how to get to the demonstration either before or after the washing machine repairman, then I was cleaning some more while the washing machine repairman was here, then I was trying to figure out if the demonstration would still be there if I left right now, then I was talking to the nice fellow and Frank about the demonstration, and then -- I didn't get to the post office. Or the demonstration, which was huge, but Frank got there. The nice fellow tried. Tuesday I had oral surgery. Wednesday I was with Gloria. Today is Thursday.

I have made a character grid for the paranormal romance. All my notes for it are on my jump drive, and so is the entirety of Afterwar. I love my jump drive. There are hours at a time at Gloria's where I can write if I have my work with me, and I do write -- yesterday I wrote most of a review for The Silver Bough by Lisa Tuttle, whose pub date was April 25 (short version: read it). It only needs de-gushing and a little intellect enhancement and then it's ready to go. And I didn't even have my jump drive because Frank needed to borrow it. Which makes me feel stupid: of course that's what I should have given him for his birthday.

Anyway, now that everything's on the jump drive I can finish Afterwar at Gloria's, and then start the romance.

I'll try to get the envelopes mailed from Watsonville today.

The sleep study was ambiguous -- I have an extremely mild apnea, not apparently enough to account for the blood pressure problem (which appears to have been solved anyway) but they want to treat me anyway because of my "daytime sleepiness" which I do not have (but I did have thirty years ago which they seem to have mistaken for a current problem). So I don't think I'll make that appointment -- insurance doesn't cover CPAP, and the nice fellow actually does have a problem, which will be expensive enough to pay for. And I think once I get him on the machine I'll sleep much better.

I think I sleep better if I go to bed first, anyway -- so I'm pretty well in sleep zone before he starts snoring and choking and stuff.