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I am low-energy, distractable, lazy, diffident, tentative, and easily discouraged to begin with. I began 2016 thinking I would ride the energy and optimism from my lovely new knees to Get Things Done, Get In Shape, and Get A Job.

I was doing pretty good until February, when I got the cancer diagnosis.

seriously this is just a long organ recital and for my own records, so don't read it )
So anyway, 2016 was for me like many others mostly a loss. I haven't mentioned much about the big world because others have more, and more eloquent, things to say about tt. I'm still alive, of course, and I still have a house. Also I have a pile of writing I'm sort of working on for several days at a time before I collapse in on myself for a few days again.
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I am writing this month, but I can't do Nanowrimo for reasons. One: I don't seem able to focus on very large projects at this time. I'm just grateful I can write at all! Anything longer than a short tends to get lost in the underbrush of a no-longer-chemo-brain. So I'm writing shorts, cleaning up old stuff, submitting a bit. I decided that since it's really unlikely for me to make enough money to be thrown off of Medi-Cal in the near future, it's dumb not to submit. Actually--did I explain this?--being thrown off Medi-Cal is not the thing I fear. What I'm afraid of is getting put into the grey category where they don't throw you off Medi-Cal but they require you to pay several hundred dollars (for some people, thousands!) before they will pay for anything. It would be better to get thrown all the way off and pay the (newly) normal subsidized premiums and copays, but that doesn't happen immediately. Worse, I have no idea what would trigger which alternative. So, just as in the case of facing up to cancer, etc., I just have to live my life.

I already submitted two things--one at the end of last month, but I'm counting it in this month. That was a near-future sort-of fantasy about a woman who is being moved out of her inundated neighborhood to find that her new neighborhood is pretty watery itself. And also pretty strange. The other is "John Brown's Body," which is ten years old and looks it, but it's going to a reprint market and its datedness might be interesting in the light of how things are working out, politically, these days. I mean it's sort of the opposite to everything!

I wrote a flash piece but my first reader (you know who you are) said what I was feeling--that the story felt like the unshot gun on the mantle. So now it's turning into a novella. I think it's kind of a time paradox story, but maybe not: some mysteries are not to be understood by the author. An old lady returns to the mysterious coastal village she spent a summer in during her childhood, and finds things to be somewhat different from how she remembered them, but some things are entirely too similar. The best part is the setting, of course. I think, despite what I said about my brain not being able to handle longer projects, that this is not too much for me to handle. Again, there are parts of the story that can't decide whether they are near-future sf or fantasy.

During the summer I was working on two short novels, but due to chemotherapy I could only move them forward a bit. One was about girls who save the world by means of their special relationship with crows and pigeons respectively. Honestly, the hardest part of that one is working out a believable mechanism for them to save even a shred of the world. And yet, parts of the world do get saved on a regular basis.

The other is low-fantasy in that it is set in the same fantasy world--but a different corner of it--and it is unlikely that much of the fantasy elements will come to bear on the story. It's an enemies-to-lovers story happening in the interstices of a larger drama of bandit freedom fighters and also referencing the earliest days of the motion picture industry as experienced by eager innovators in other corners of the world. But not our world. Informed by the last years of the Ottoman empire but in no way an analog for it.

On other fronts: I am a third of the way through radiation therapy. The only bothersome effect is my own body's ridiculous response to any postural demand, which is to spasm painfully somewhere. I have to lie in a comfortable position on a well-constructed individualized support for less than half an hour a day, and my body's response to this is to develop stiff painful areas in my neck, back, and arm. Not the side being radiated. The other side. My radiated breast is a little red, and maybe a bit sensitive, but not so as I'd care, especially with this other crap going on.

Continuing with the health care theme, I've restarted physical therapy. I'd gotten de-conditioned and I'd gained weight during chemo, because I spent a lot of the day sleeping or lying in bed reading. Now my energy level is back to its normal (kind of low) levels, and I'm getting more exercise, but there's some damage to undo. Also, I've been using the BiPAP machine for two months and it is not creating as dramatic a difference as one might expect. However, the doctor has some suspicions about my oxygen uptake which we're going to measure next week & discuss next month.

AND last but not least in this theme, today I got cortisone shots in both thumbs to fight severe trigger finger. It's the second round. The first wore off two months ago but the PA's not willing to give me shots more often than every six months. So if this happens again we're looking at surgery. I'm not afraid of surgery. I'm afraid of being the little old lady who collects all the surgeries, and also the fact that I've been enjoying my surgical experiences feels a little perverse to me, so I drag my feet for that reason too.

It's time to go to radiation or I'd expound about Zluta and the state of my house, but that will have to wait for another day, because after radiation Zluta and I will take a walk and after that I will want to clean house a bit before time for dancing.
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Two weeks ago was my last chemotherapy infusion. I went one more than I thought I might because the week before was tolerable. But the next week was all "WARNING WARNING you're walking wobbly! your neuropathy is creeping up your legs! your hands and feet feel weird ALL THE TIME!" So we agreed it was time to stop. Supposedly I'm starting radiation real soon now.

So--neuropathy has subsided a little but if I walk for half an hour it gets worse in my feet and legs, so exercise takes some determination. I learned yesterday how to sidestep the need for determination. This is what you do:

1. Go to a network of trails that all loop back to the same place so you can't get truly lost.
2. Conveniently forget the "STEEP HILL" designation on the map posted at the other trailhead (it helps to choose the trailhead without the sign).
3. Blithely decide to walk a loop instead of going out a ways and turning back.
4. Blithely forget/downplay the length of the trail so you think you've gone more than halfway before you get to the "STEEP HILL." (which is actually in the moderately steep category, not the needs-walking-stick category) So when you get to the "STEEP HILL" there's no point in turning back.
5. Now you are stuck walking the rest of the trail, no matter how much you'd like to quit.

Actually this was the Red Trail behind Chaminade, which is only a mile and a quarter long, but it took forever (that means a bit over an hour, honestly) to walk it because Zluta had to sniff everything and hello, apparently I have breathing issues again after years without (damnit), so I had to take the upward part a little slower. It wasn't bad but it was dumb. I guess I should get an inhaler again, though I didn't need it yesterday, I just wasn't at peak performance. The good news! is that my knees continue to be excellent and I only even thought about them later and it was "huh, downhill, no problem!"

It was lovely though. Saw a huge cottontail and several brilliant scrub jays, and heard a woodpecker and some other bird which I guess I should call familiar-unknown, in that I've heard that bird a lot around here but I don't know which one it is. The trail goes through a pine flat, a meadow, and a redwood ravine, so most of it was shady. That's why we went there. It was only ten but it was already hot and I had enough self-preservation to avoid sunny exercise.

I already know I don't feel the heat reliably, so I have to hydrate & protect myself based on other information.

Other post-chemotherapy observations:

At some point where I didn't notice it, the rest of my eyelashes and most of the rest of my eyebrows fell out. This is still due to the adriamycin/cytoxan treatments which ended about three months ago, the taxol doesn't do that. Also my nails are still playing out their destiny. My thumbnails are loosening from the top down so they have these giant unreachable pockets that fill up with debris and I can only get them partly clean which is sufficiently gross. I keep experimenting with new methods, but they continue to look like they are bruised (honestly I did think it was bruising at first so my intense efforts to clean them started late). My toenails are working their way off altogether, but it's really slow and the new toenails are already completely formed before the old ones fall off. I've lost three so far, and there's another four or five looking like they'll come off in the foreseeable future, and a couple that look like maybe they'll just be weird forever.

My tastebuds are returning to normal but not as fast as my taste. That is, I want to eat some things that don't yet taste good, so I have some disappointments. My perception of salt which some people already thought was pretty odd is utterly hopeless now. I mean, most things taste to me like the salt got up and walked off the job in protest, but if there's enough salt for me to notice it's there it tastes poisonously oversalted. Normally I mostly don't salt food but enjoy the occasional pickle or pretzel. Now I want to eat some salty food but I'm disappointed every time. Otherwise, most food just tastes a little bland now, and the pervasive plastic taste that ruined everything is mostly gone. For a while water tasted really foul because of it, and I had to force it down to keep from being dehydrated.

You know how there's been a backlash against the hydration obsession fad? Articles everywhere telling you that you don't need eight glasses of water a day? Now I get people trying to tell me I in particular don't need to drink as much as I do (I drink between two and three liters, usually two and a half). They are wrong when they speak of me in particular, though. I know from years of natural experimentation (that is, days of not being able to drink as much as I need), that if I drop much below that level, especially if I do it more than one or two days, I will be terribly thirsty, get headaches, muscle cramps, and cognitive impairment. By the last I mean: if I haven't had enough water to drink, don't let me drive.

I had a kind of depressive episode the first week or so off chemotherapy. For months the infusion center has been the center of my life. Three times every two weeks, and then twice a week, I went there and chatted with the staff, got myself monitored, got myself cared for. I had no idea how attached I was until it ended. I'll be going back there from time to time for monitoring, but it's still an abrupt change. It got better as soon as I realized why I was wanting to sleep all day.

The other medical thing I'm doing is getting used to the BiPAP machine. I love the delicious air coming through the mask but I'm having trouble adjusting in some other ways. I have two masks. I thought I wanted the nose pillow because it was more comfortable than the nose mask the sleep tech offered me at the time of the study (at which it was revealed I was having 90 events an hour and desaturating to 83%). But my nose is a bit stuffy currently and so it is hard to breathe with my mouth closed, which with the nose pillow mask leads to a drowning sensation as the air goes the wrong way. And also the nose pillows kind of hurt my nose. I suspect the pressure on the machine is set too high too. When I use the full face mask the incoming air forces my lips open even if I'm trying quite hard to keep them closed. Even with the attached humidifier going I get pretty dried out too. And I'm having trouble with leaks. All of this will get worked out in time, but it's a lot of adjustment. Currently the longest I've kept the mask on is five hours, but I've also only had it for four days.

Of course I found an apnea forum. There's some true-believerism going on there, but the best thing is that somebody there wrote a nice piece of software to read the SD card from the machine so I can see the full record. Right now I'm finding that endlessly fascinating. I've learned that I do in fact have some possible central apnea going on as well as the obstructive kind, which was my belief from the beginning. It makes little difference in treatment, and the difference is already what the doctor prescribed. That is, he put me on the automatic bi-level machine, which adjusts the pressure so that the body is stimulated to exhale better. There are shenanigans to be done with carbon dioxide, but those aren't warranted unless the BiPAP machine doesn't work well enough. It looks like it will. But I think it will be a while before I am better rested and make more sense.
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If I was a fanfiction writer there is a thing I would do.

Last night I was high as a kite on dexamethasone (a steroid I take prior to taxol infusions so as to ward off the possibility of neuropathy) and I couldn't sleep at all. So having run in to the radio play of "Jacobowski and the Colonel," I listened to that. Being shorter than the Danny Kaye movie I imprinted on as a child, it didn't have all the bits, but it was good.

Today I'm thinking that if I were the fanfiction type, what I'd want to do would be an AU retelling in a science fiction landscape (because that's where I feel most comfy, no other reason), in which Jacobowski and the Colonel end up paired overtly, Marianne throws them both over for being two complicated to deal with and picks up with Szabuniewizc--this is almost canon, as the former two do leave together on the ship to London and Marianne and Szabuniewizc stay behind to wait for them in France--but also, along the way they lose the ridiculous macguffin of the idiot-ass plans and spend the plot development time breaking partisans and refugees out of capture and leading them to the Pyrenees-equivalents (as Jan Yoors was doing with the Roma family he adopted himself into)into the Spain-equivalent, so that the Colonel's bravery and ridiculous honor mentality and fatalism and Jacobowski's resourcefulness and flexibility and stoicism continually come into play in high-stakes action leading inevitably to an entirely different scene at the docks where it makes more sense for Jacobowski to be grandstanding with cyanide pills (which do not feature in the radio play unless I dozed off a bit there at the end).

Actually the thing to do would be to file the serial numbers off completely since the structure of the plot has now changed a lot in which case everybody can go back to having non-romantic relationships with a dollop of tenderness in there with the conflict. Also, Szabuniewizc gets to be much much more of a person! And maybe a woman.

On another front, my left hand feels funny right in the skin layer. I am noting this because I am watching for neuropathy because it terrifies me. I am thinking it is the amazingly dry skin I have there because of the taxol, and I am moisturizing a million times a day. But watching. And I told the nurse about it, though I said I didn't think it was neuropathy because of the area that feels funny, and because there is no numbness or clumsiness. I forgot to mention my wobbly legs after sitting too long on the toilet because I got lost in a phone game (Jewels Star Mineral, the only jewels game worth playing), but I don't think that's neuropathy either, I think it's pinching the sciatic nerve sitting like that in such a doofus fashion for so long. Recording it here so when I think about it again in the future I can find this date.

The hand-foot syndrome I previously recorded as being so very very mild has developed in a doofus way also. All the pain and disinclination to move went away pretty quick and then I thought I was getting away with nothing at all because the peeling took a long time to start. Now more than a month after the last adriamycin infusion the bottoms of my feet are quietly and painlessly--but grotesquely--peeling right off in great flapping sheets of parchment. I'm tearing off the easy bits so they can go into the garbage without getting all over the floor and into Zluta's greedy little mouth (yes, dogs are gross, so what else is new), and scrubbing with the brush after showers and sponge baths, slathering thick layers of cocoa butter on to them, and wearing socks all the time if I can bear it (sometimes it is too hot). My hands have a suede-like texture because the calluses are not so thick there and the peeling is very fine-grade, but as I said, I think it's making them feel odd. Not painful, not numb, not tingly per se, just kind of dry and prickly.

Other than a lot of missed sleep and incoveniently-placed make-up sleep and about two and a half days of delayed-onset excruciating abdominal pain last week my first taxol went uneventfully, and this week looks to be the same, though I hope for less pain since I did discover that tramadol helped a lot last time. I don't think of pain medication for sometimes quite a lot time, usually just planning to ride it out unless there are exercises for it. This is not always wise. If I had taken tramadol earlier last week I might not have needed to miss folk dancing again.

I just read that paragraph and it's not clear why I think last week was uneventful, especially noting that I didn't list the digestive upset. Maybe because the sleep disturbance and digestive upset are par for the course if you're injecting systemic poison into your carotid artery for a couple hours a week? And because it was clear they were self-limiting? And not really huge in the scale of things I'm concerned with at the moment?

Anyway, I'm not writing the Jacobowski and the Colonel rewrite fic, at least not now, but I'm pleased I can think of it.
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Friday I decided that, since my blood counts were so close to normal, I could probably stop cowering before my exhaustion. I could spend less time napping and lounging in bed, and try to work up my stamina gradually (of course, this may be obsolete as of the first taxol infusion on Wednesday, we'll see). So I decided to dance more than I had the Friday before (seven dances instead of four, oh well, it's still more). And also to walk more. Yesterday in the late morning I took Zluta to Antonelli Pond and we walked almost a mile, which is not much but I'd been turning around way before that and we both had more fun. Then in the evening we went on the old rehab route around the soccer field, which is also almost a mile. And this morning! We went to Pogonip, met up with a Bernese mountain dog and her nice man, and walked to the place where the spring runs over the Spring Trail. Round trip: 2.8 miles. And I am no more tired at this time of day than I have beem, though my calf muscles are trying to get me to agree that they have been mighty today and deserve a medal (to which I reply, no you have not been mighty, you have been normal, all you get is this nice bed we're sitting on).

So I think I was correct in my assessment that I had reached the point where more resting was counter-productive. It's always a question with tiredness or pain: "does this need rest or exercise or both? How much does it need?" The most common answer, I think, is "both." And I think also, that with exercise, if it's not making things worse, it's making things better.

Meanwhile Blue Shield and Sutter are up to shenanigans again. A year after my first knee surgery I get a bill from Sutter saying that Blue Shield has paid everything they're going to pay and now I owe 400 dollars. Of course I don't have 400 dollars. Even more to the point, last year I paid every bill I was given, and Blue Shield said I had hit the limit of what I had to pay in that year, so there's no reason for them to refuse to pay, and no reason for Sutter to expect me to poay instead. I've Twitter-shamed them both,because that worked before,  but since it's a weekend, they might not see it. So I may reply to my Twitter chain on Monday to make it new again.

Another nice effect of the morning's walk is that the Bernese mountain dog played with Zluta on the way and now Zluta is willing to crash. She coughed kind of a lot on the way back, which I attribute to dust on the trail.She's had this particular cough as long as I've known her. She doesn't cough often but when she does it's always the same kind of deep, honking cough that moves her whole body. She never seems to slow down after coughing like that. The vet thought when I first got ZLuta that the cough would be self-limiting and didn't indicate a bigger problem. I'll bring it up when we see her again, but I think it's functional, not easily treatable, and it doesn't seem to bother her except while she's actually coughing.

And now for some more writing!
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One of the more vivid images from the Phillipine "People Power Revolution" which brought down the dictator Marcos and was supposed to bring democracy, representation, peace, justice, and economic development to the Phillipines forever was Imelda Marcos' shoe closet which had an unimaginable number of bespoke shoes in it, all of them of course outrageous impractical fashion items with spike heels. It would be difficult to tell most of them apart, and they all cost ridiculous amounts of money. Of course the news out of the Phillipines is continously terrible, but you knew that would happen, didn't you? You can remove the dictator, but if you leave the colonial relationships in place you have not liberated the people.

But it's shoes I want to talk about. Lately my feet have been bruised around the edges. I've finally had to conclude that my once-perfectly fitting shoes have grown too small for me. Of course it is not the shoes that have changed size: they are not made of shrinkable fabric and I have not washed them in hot water and heat-dried them. Nope, my feet have grown again. Of course, ingeneral, adults do have size creep on their feet. They might get a bit wider or a bit longer or both over the years, so that they graduate high school a size 7B and in old age they're wearing a size 8C--I'm using US women's sizes here.

I graduated high school with a size 6EEEE. I'm going to go downtown and try to pick up an equivalent to a size 9D today. I say equivalent because lately only Keen shoes work for me, and they don't come in widths, but they do, somehow, go on my feet, which measure a D. In addition to having wide feet, I also have tall feet--high instep and low arch means a lot of foot. So I also have to buy shoes with removable insoles, and remove those insoles, before I can walk around in them. Fortunately I have strong feet that don't need arch supports at all (arch supports bother my feet, actually).

Shoes being rather expensive, my budget is usually one pair of any type per year. I think I've mentioned that I have one each pair of hiking sandals, hiking sneakers, hiking boots, hiking babydoll flats, and hiking velveteen slipons. By "hiking" I mean "has fancypants hiking soles of hard rubber or vibram." I don't prefer these soles: in an ideal world, I would have lighter shoes, though these are all very light considering. Also in an ideal world I would have knee boots in red suede with soft flat bottoms and maybe folkart embroidered flowers on them, for dancing. But nobody asked me when they drew up the standards for footwear.

What this brings me to is yet another cancer metaphor, only it starts out as a metaphor for social revolution. One of my favorite childhood books is called "The Land of Shvambrania" and it was written by Lev Kassil, who was a Soviet children's author (and probably, from my reading of one of his other books, the execrable Early Dawn, a terrible party hack, but this one book was really wonderful). I know I've talked about it before. It is a kind of memoir of the way he and his brother used their fantasy play to deal with their experiences before, during, and directly after the 1917 revolution. The first parts of the book are a bit comic, and sometimes they read like a portal fantasy (which was my first attraction to the book as a kid). Later, it gets more serious as the kids attempt to adjust to the radical changes in their lives. In one scene, tyheir family is visited by representatives of the local evolutionary council. They've lost a lot, not only from the privations of civil war, but they used to be comfortably middle-class and various of their comforts have been expropriated. The leader of the delegation is a shoemaker and he asks the kids' father how his shoes, which he made, are holding up, The dad praises the shoes, says one of them is squeaking a little, and the revolutionary says to bring them by and he'll fix them. The dad says those shoes work a lot better than the revolution. The leader says "that's because we can't make the revolution to fit you personally."

As a kid I was really impressed by this, because it gave me a context to understand how something that was clearly supposed to be so very good for everybody could be bad for particular people. We were always hearing about how this or that person who had had a good life before 1917 or before 1956 in Cuba had lost everything due to revolution (a lot of the Cuban stories didn't add up to me, because they featured people who seemed to be doing just fine in Miami, so I kept wondering, if this is what "lost everything" looks like, what does "kept everything" look like?), but on the other hand, there were these statistics about pre- and post-revolutionary measures of quality of life.

I am most definitely not angling for a human rights argument here, I am just talking about one particular thing in a story.

Anyway, how the shoemaker becomes a cancer metaphor--well, it's obvious, isn't it? But actually the personal fit of my cancer treatment has been pretty finely tuned. No ativan for nausea because it works too much like vallium which makes me stop breathing. On the other hand I can have the "dense" treatment of Adriamycin because I have a strong heart. I can have this particular drug treatment on the other end of chemotherapy and radiation because of the estrogen sensitivity of the cells in the tumor. And so on. But...

In the news today is an article in the Lancet, the abstract of which you can read here (if you have access to the Lancet, or you pay thirty dollars, you can read the whole thing). The rather ponderous title is "Economic downturns, universal health coverage, and cancer mortality in high-income and middle-income countries, 1990–2010: a longitudinal analysis" and its pricipal author is Mahiben Marathappu.  Spoiler alert: unemployment and cutbacks in health care and public health measures caused at least 40,000 extra cancer deaths in those twenty years.


Capitalism is murder.

on another front: Thank you Aaron! I had the kippers with guacamole and radishes yesterday and it was really really good.
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The oncologist said my hair "might fall out, maybe probably, but can't be predicted." The nurses said my hair would fall out and recommended getting it cut very short in advance of the time--which they predicted would be a couple of days to a week after the second infusion. Also, the printed materials suggested the same thing. And when I asked my friends and family, not if I should cut my hair short, but whether I ought to do it as soon as I could arrange it or closer to when I expected it to happen, the consensus was to do it earlier rather than later, and shorter rather than less short.

So that is what I did. My wonderful daughter Emma came over as soon as we could arrange it and buzzed my hair. With electric clippers! It was really amusing! She took before and after pictures of me and they are good ones. I looked pretty cute in them both! I think the short hair makes me look even more Jewish than ever. In my mind I think that is a neutral value. I mean, it's good enough to look Jewish, but it's also good enough to look like other things too. She also brought me some very nlce headscarves to borrow until my hair grows in again. So I have been practing with the headscarves now and then to get a feel for how I like them. Apparently simple heascarves are the best, for me. Just tied in the back, or the ends brought round, twisted & tied in front, or held on with a hair tie. They all work.

Since my hair was already thin on top ("female pattern baldness" but not as severe as that sounds) I started sunscreening my scalp when I remembered. I'm supposed to be more sensitive to sun rays now, so I have appropriated K's 30 spf sunscreen he used when he worked for the post office and doesn't use any more.

Anyway, this morning--two days after the second infusion--when I was rubbing on the sunscreen, my hands came away all fuzzy and my first thought was not how alarming it was but how cool it was. This is rather indicative of how things are going in general. I credit the extensive preparation that the cancer team has given me and also the word CURATIVE right on my papers and also the fact that my side effects have been so mild and manageable. It's turned the whole thing from a dark and frightening journey into an adventure, rife with inconvenience but also full of discovery and meeting new and interesting people. I think I'm a little disappointing to my friends and family who want to jump in and help me but the main thing I ever want from anybody is to go on a dogwalk with me. I mean, I think they feel in their heart of hearts I probably need more than this, but they're too polite to insist that I must be wrong about my self-assessment.

I got followed on twitter by a cancer quackery bot, so I blocked them and made a general tweet that I would do the same for any more quacks. Some actress showed up on NPR promoting her book about how she made her husband refuse "conventional" treatment for advanced bladder and prostate cancer and treated him herself with nutrion and stuff. I don't know how the thing came out because I was offended and I turned it off so I wouldn't be yelling at the radio.

Well, I was going to write a food post too, but now I have to pee and take a nap. Then I'm going to get the cardoons, the mignonette, the clematis, and the purple flower that Ellie gave me into the ground, or die trying. I've had them all too long.

Phenological observations: it is jam season now. I made strawberry jam from the giant berries that came in the grey bears bag last week. I prefer smaller strawberries with no white in the middle, but they are hard to come by these days because marketing decisions. My sister-in-law is making apricot jam this weekend because her tree recovered from the drought this year and produced a lot of fruit. The yellow plum tree around the corner has started dropping plums so as soon as I can get myself organized I'll make yellow plum jam. My coreopsis and love-in-a-mist and some other flowers I can't think of now are blooming freely. The sweet peas that were in too much sun are completely down, but Robin my co-mother-in-law brought me a bouquet of deep purple, very fragrantr sweet peas and orange Peruvian lilies, a very dramatic combination.

And now I have to go because I am totally falling asleep and in danger of pissing my pants.

One last thing: you needn't say "fuck cancer" on my behalf. It does nothing for me.
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I'm working on an extended metaphor for how I am experiencing cancer treatment. I do not feel like a warrior, not at all. I don't even feel like I'm fighting the cancer. If any fighting is going on, it's being done by the medical team. I'm doing something else.

It's not that I don't feel I'm contributing to the project at all. Although I should emphasize that my part in this collective effort is rather small. But there are so many people working on this, and so many jobs tro do, that I don't feel like there's something wrong with me having a small part to play. I do that part with all my best intentions and my best efforts, and I am grateful for all the other people who have all their jobs to do.

So the metaphor I'm working on is that it's like the stewardship of a nature reserve which is being threatened by an invasive species. I'm not in charge of the eradication efforts. That's the medical team's part. They've introduced chemical controls, but mainly they're trying to tweak the balance of the predators. They've brought in chemicals which are nearly as alive in my body as viruses or at least prions--please notice this is a metaphor and I don't believe the Adriamycin etc are organisms--but these are rather indiscriminate in their prey behavior and they go after the native species in my nature reserve as well as the invasive ones, and therefore the tweaking. They have a good idea nowadays of how these things affect the natural balance in my environment, so they have all these supportive measures to offer me, and here is where my part comes in.

I get to attempt to maintain the ecological equilibrium of this habitat. A big factor in how well this regine will work is in how well my body will tolerate it. So when my oncologist says "take this, this, and this for nausea, and this for analgesia," I do it. My usual response to discomfort is to attempt toughing it out first and then treating if necessary, but in this case, it's a more workmanlike response to jump in there and do the preventive measures and to treat small discomforts before they become big. Because small discomforts will get bigger as treatment progresses, so there's no point in waiting to see if it will be okay. Yes, I can live with low-level nausea, but if untreated low-level nausea can progress to the point where food and medicine won't stay in my body, then I'm treating the low-level stuff to prevent that (hopefully. It's also a known thing that some people's bodies don't tolerate the treatment no matter what the people do).

So, also, therefore, I attempt to have generally good nutrition, I get exercise, and I'm trying to sleep properly. Not because I am a Warrior who will Eat Myself Well, or Exercise Myself Well, or Sleep Myself Well. Because I understand that I can support the overall effort by taking good basic care of the habitat.  I'm working on having a good mood and all that not because I believe that's a magic bullet against cancer but because honestly what's the poiht in defending your life if you're not going to get something out of that life?

I have an impulse to be understanding of people who fall for quackery when they get cancer or some other life-threatening condition. How they want to believe that some fellow can give them apricot kernel extract and make it all go away. Or that if they boost their immune system with echinacea or turmeric, they will live. But I can't really see the moment when you decide "this person who has spent years studying the actual human body, specifically the behavior of real cancers in the actual human body: them and their whole team of researchers, practitioners, technicians, nurses, they can't possibly know as much about cancer as this fellow on the internet who read the Bible and a book about alchemical humors and set up shop with a pile of untested junk that's got no quality control either."

I kinow there's a certain contrarian set of mind where a person becomes sure that whatever is standard procedure must inherently be incorrect. I think part of the reasoning for that is that once in a while a scientific advance comes from someone questioning the underpinnings of former received wisdom. But when that is true, it's not true because someone gazed into their navel and decideed that everything was bunk. It's true when a person finds the right question to ask and asks it scientiifcally, carefully keeping records and actually being quite routine and boring.

I think also for some people they want to see their life in the hands of a superhero who can single-handedly dash the enemy to the ground and fly the patient to safety with the glorious cape fluttering around them. So they fall for charismatic quacks. Myself, I would rather be a routine patient in the hands of less colorful, competent people with flexible, multipathed protocols to hand and a variety of tools to fit different situations. I loved that my oncologist drew me a flow chart the first time I saw her. And I was entertained when she said "Now, I'm not so important in the process yet, but after the surgery, you'll be seeing more of me..." I liked the sense that there were plans in place already no matter what came up, and I also like the sense that my doctors and nurses were working as a team rather than grandstanding.

Anyway. That's me talking cancer philosophy. I'm not a Cancer Warrior Woman, I'm a Cancer Park Ranger--no, really, a Cancer Groundskeeper. I'm not fighting. I'm gardening.

And also

Apr. 15th, 2016 09:24 am
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My echocardiogram was entertaining and lovely (since I went to it fresh from the knowledge that I am NOT RIDDLED WITH CANCER and I can try for an actual CURE), and of course, as I knew, my heart is strong as an ox.

Yes, I knew it. But I also "knew" my biopsy was going to turn up scar tissue from the previous infections, so there you are.

Anyway, soonsoon I'll have lots to say that aren't "oops my health" or "at least my health isn't that bad."

Zluta continues to be a manic darling, and the garden is fantastic at the moment. I'm cooking up all the turnip greens over the next couple days because a friend of mine gave me a Black Krim plant so it's tomato planting time. I really want to find a couple Paul Robesons and maybe a Black fromTula. Detect the pattern? Black tomatoes from Russia do very well in my garden. And my old standbyes, the yellow plum and Roma, don't seem to do so well for me any more.

My kale from last year is starting to go flowers. I do have other batches of kale started so there will be little gap  between productive kale, which is important because both Zack and I depend on it. Right now I am eating the kale flowers, they are delicious, but eventually they'll come to the end and so it goes. My parsley is all bedraggled because most of it has decided to set seed also--also eating those bits to try to slow down the process, which worked for a while but a lot of the parsley is only putting out those weird "I'm going to seed now and you can't stop me" leaves-- there are two kinds, one is a tiny stunted version of the normal leaf and one is entirely different, with narrow leaflets in a fan shape. So I'm finding baby volunteer parsley and moving it to the parsley forest and I'm sowing seeds in the area too. I've been working on increasing the flower real estate in the yard, and that's finally paying off. And of course it's spring, so. I have yellow Louisiana iris and calla lilies for the dramatic, and volunteer(!) sweet peas, and coreopsis and freesias (not many) and roses and cuphea (sort of like fuschias, which are not flowering at the moment, oddly), and a couple kinds of salvias and a few quince blossoms and some pansies and cineraria and bleeding heart and of course the lemons are blooming and the apple tree just finished and the plums are the size of shooter marbles which is apparently my favorite size at which  to notice ripening things.

Manymany thanks to all the well-wishers and most especially to the horse people who answered my questions. Later I may ask you to read the thing over (it will be shortish, about 50K?) and see if I screwed it up. This is the story that gives me an excuse to listen to all the Southern European and Asia Minor music I want to all day long. Especially if the music is a bit ovfer 100 years old. Seriously, you can find that sometimes.

On a less brilliant note, "the computer" is still returning the false information that Blue Shield is my primary provider, so confusion still reigns. It means Central California Health Alliance denied coverage in the first round even though they have already told me on more than one occasion that they know they are my only provider. It will work out but why should everybody have to do everything over again so many times?

well, the 9:05 goose from the north has gone by, so back to work.
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Today or tomorrow, the surgeon said, we should get the pathology results from the surgery. I thought the oncologist said it would take longer than a week, but maybe she said it would take longer than a week to get started with the next phase of treatment.

Anyway. The way it goes is that there are two possibilities. Either the margins are good or they are not. If the margins are good, I don't need another surgery. If they are not, the surgeon needs to go in and take out more flesh. And beyond that there are two possibilities. Either the lymph nodes are free of cancer, or the lymph nodes have cancer in them. If the lymph nodes have cancer in them, I need chemotherapy before I have radiation. If the lymph nodes are free of cancer, there are two possibilities. Either the cancer cells from the breast have a high oncotype score, or they have a low oncotype score. If the oncotype score is high, I will have chemotherapy before I have radiation. If the lymph nodes are clear and the oncotype score is low, I will go directly to radiation and thence to taking hormone blockers for five to ten years depending on another string of possibilities.

The numbers are with me in each of these if/then situations--I mean, it's more likely than not that the margins are good, the lymph nodes are clear, the oncotype is good. If that is all the case, then I suppose I advance from "cancer patient" to "cancer survivor"--or do I do that at the end of radiation? I'm not sure. If any of those things are against me, I stay a "cancer patient" for that much longer.

I just want to open the box and see which I am, but it's not even 8:30 so I need to be patient.

Meanwhile, my brother-in-law is insisting on paying to paint my house  but the problem with that is that he's insisting on doing things his way, which means insulting the professionalism of the painters and insisting on breathing over their shoulders while they work. I almost fired him and started thinking about how to get the money for it myself, but then I used my cancer situation as a lever to get him to slow down instead. I'm going to use the time gained to figure out how to get him to trust the painters to do their job. He refused to consider Zack's painter, I believe because he doesn't trust Zack, and got three folks off of Yelp: the first two are kind of bros who started painting irregularly and independently but a long time ago so they're licensed and they have crews now. The third is a woman who got where she was by working for another painter for a long time and studying for various certifications before she took over the business.  Myself, I feel I have reason to trust any of the four of them (including Zack's painter), but if I'm choosing and I can't throw the business to Zack's guy, well, I think you can guess which one I want.

I have a bad head cold for the first time in years. I forgot how stupid and sleepy a cold can make me. I'm good for a few hours in the morning, when I do a bit of housework, take the dog out, and write a little. Then I doze and struggle to do anything at all for the rest of the day.

And now I am off to pick up my Grey Bears vegies and walk the dog and visit my friend Glen, which will take up the rest of the morning. I did poke a little at one of my projects this morning, but I am soooo slow and stupid that I made little progress. I did realize how little I know about horses (hence th previous post).
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Every bit of information I have gotten since that first partial pathology report has been boring. That's good. I do have a fairly rare and aggressive type of cancer, but it's not more aggressive than other more common cancers, it doesn't appear to be growing fast, it has given no evidence of having spread anywhere, and it has helpful receptors and it  doesn't have unhelpful ones. So therefore my treatment plan is really routine. I will have a wee bit of a lumpectomy and the lymph nodes connected to that part of the breast will be removed too. If all goes well, and there's no cancer in the lymph nodes and the piece of flesh that's removed looks like it has a good margin around the tumor, I'll get a course of radiation and five to ten years of a hormone-locking medication. If there's doubt about the margins, they might go in again and remove more tissue. If there's cancer in the lymph nodes, or if no cancer in the lymph nodes but there's dangerous looking genetics in the removed tissue, I will also get a course of chemotherapy.

Everybody seems to think this is walk-in-the-park level of treatment, by which I mean, i'm not expecting tremendous amounts of side effects--some, of the type we associate with these things, but not a lot. And no disability to speak of. Which is frustrating the hell out of friends and family who want to do things for me. All I need is three rides the day of the surgery and someone to walk the dog that day and the next. After that--I'm a boring normal person.

It's all a bit anticlimactic, but I'm not complaining.

On another front, doves sat on my skylight for half an hour yesterday, giving me a lovely view of their red red feet and their fuzzy feathery butts, but it sure drove Zluta nuts.
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The biopsy results are too normal for the visuals so I have to repeat it tomorrow. They think they missed it.
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I'm at the hospital now. I had my surgery at eightish and now it is almost five. Everything has been delightful so far. Something about the combination of my excitement over getting titanium parts to replace bone spurs as big as my thumbnail, the methods and attitudes of all of the numerous staff I've had to interact with, and the very clever anasthesia, has made this an enjoyable experience so far. The spinal hasn't completely worn off yet and the opnly exercises I'm doing so far are foot twirls and knee straightening and some upper body squiggles so I haven't had any challenges to face. It will most probably not be so much fun tomorrow! But if my  morale holds out it will probably not be hellish either.
The anasthesiologist said many reassuring things but he didn't name the medicine he used to put me under. He did say it was a different drug from a general anasthesia and actually put me into a more natural sleep. He said it was called a "deep consciousness" drug but he thought the name was inaccurate because I wouldn't be conscious. He actually deliberately woke me up somehow for a little while for some medical reason while there was still some kind of carpentry going on, so I heard some conversation and some hamering and sawing. This was not creepy though, a fact I attribute to the drugs I was on. I did get some swirly colors somewhere in the edges of consciousness, which was entertaining. They were sort of pale teal and yellow with clear dots and spiral cilia.
I expected to be foggy and non-functional this afternoon especially as I kept doing last minute prep things last night instead of getting a good sleep, but instead I'm chipper and a wee bit restless so I had Jason and Keith bring me my computer and help me get it set up. I am under orders from Jason to work out what's wrong with my Steam account so he can buy me Cities:Skyline to play. I'm not ready to walk anywhere until tomorrow, but I wouldn't know that as long as I just sit here.
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Last week I read Lisa Goldstein's Summer King, Winter Fool and Noriko Ogiwara's Dragon Sword and Wind Child. I attempted to read Microcosm by Norman Davies and Roger Moorhouse, supposedly a "portrait" of the Polish city Wrocław, and started Echoes in Time by Andre Norton and Sherwood Smith.

Both the books I finished were nice little amusements. They have stories in them that ought to seem biggish, involving the whims of gods and kings and queens, but because they were both sort of stylized and removed from actual life, they seemed small to me. Like pretty toys. I liked them both, though I got a little impatient partway through and wished they would drop the royalist crap. I mean I felt like they were wasting themselves on trivial gods-and-royals stories when all that beauty and passion could have been spoent on something I personally care about because doesn't the world revolve around my tastes and if not why not? But they were fun anyway. Goldstein's book is in a completely new world informed by late Eurpoean nedieval times, and Ogiwara's book is in a magic world not many steps removed from Japan.

Microcosm is unreadable. It's written like one of those breathless magazine survey articles of the sixties, jumbled up and oh god why don't they use any of the actual place names! What the hell! Some of the places names they translate into English and I don't mean those odd Anglicized place names, I mean stuff like "Giant Mountains" and "Snowy Head" and "Cats Hills." Also, "The River." Skipping ahead, I see that they eventually deign to use the names of at least cities and states but they've lost me already.

I was going to say that this was obviously a product of the postwar period because even though the book spans prehistory to modern times the first chapter is about World War Two and of course that would have made sense up to about 1989 because until Solidarnosc Americans thought history stopped in Eastern Europe in about 1950. But the book was first printed in 2002, so I don't understand why the book starts out like this. I recall nopeing out of another Polish history book by Davies too. Unfortunately Polish histories aren't very thick on the ground at my library. What there is--is almost exclusively this guy, and/or books about concentration camps. Which are necessary to tell Polish history but not sufficient. Maybe I'll try it again sometime when my disappointment has had a chance to settle down.

I don't have  much to say about the Norton/Smith yet, since I just started it.

I stalled out on the giant fantasy trilogy my brother-in-law lent me. I feel like I should keep trying because he was so enthusiastic about it. Also I haven't started the Kameron Hurley. But probably next is The Mystic Marriage by our own Heather Rose Jones, and anything that looks fun in the library, and another attempt at Eastern European history. I think I remember seeing some other city histories on the shelf.

cut for medical neepery, not gross but probably boring )
On still another front: I'm hungry and I think I am going to boil some cracked grains in milk. Yes, I get to do that. Because, that's why.
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I finished Longbourn.I liked it a lot, though I was kind of dissatisfied with the ending. But I often am. I know some of you people care deeply about spoilers, so suffice it to say that the ending felt a wee bit rushed and forced to me. But the main thing is that here is a richly detailed working class romance where the resolution isn't "take the porotagonist out of the working class." Also, it's a great antidote for the whole (in my opinion) corrupt Regency Romance thing. I think I understand why so many people love that genre, but my response is usually "I hate these people and I want someone to expropriate everything they own and distribute it to the workers," Not exactly conducive to enjoying a lighthearted read. Longbourn is not, by the way, lighthearted.

I also read a chapbook of Karen Joy Fowler's (The Science of Herself)and now I want to call her up. She lives in my town! She actually went to school with the nice fellow, and sweetgly contacted me after he died--she didn't know he lived her until she saw his obituary.

Right this minute, I have no reading agenda, I am editing a thing for submission and I want it done byu next week, so I can do the next thing, etc. I want to get these old things cleaned upo and ready to send away, and then clear the decks so I can go back to not-Poland after surgery.

I finally got a cost estimate on the surgery and it's a relief: I do not have to cancel after all. This is of course a terrible crime against men of property and Congress would like to put a stop to it.

The other good medical news is I rode my bike to physical therapy and back: maybe three miles altogether? I'm not sure. And it was fine, though I expect to wake up tonight with the screamies. I did walk my bike up the one substantial hill, but the physicfal therapist says with my knees, I really, really should. She approved of the venture in general, though.

Yesterday I was thinking it looked like I am in a period where I can have more function or less pain, but not both, and that I seem to have chosen more function for now. Today it looks like I can have somewhat less pain if I persist in  going for more function. That's also reassuring. That's how it was until about a year ago. More exercise relieved pain as well as providing more function, bu just not right away.

Oh, and on another front: aside from the rain giving up on us and retreating, we do seem to have entered early spring, by the particular flowers blooming (quince) and the busy behavior of the birds. Also, I can tell there is more light, and both dog and I are more ambitious. She and I went for a long walk at the Yacht Harbor yesterday. She had some trouble coming back up the stairs, barely enough to call trouble.
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Apparently nobody seems to think it is proper to warn a patient that a procedure will cost them over nine hundred dollars after insurance pays their bit.

No, not the knee surgery, the cardiac stress test I took to qualify for the surgery (of course I passed). I'm not paying it yet because ever since I signed up for insurance it takes several months for the actual cost of things to settle out. I keep getting bills and refunds for the same visits over and over. I mean I pay my copay when I walk in the door, and some months later I get a bill for the copay that I paid, and sometimes I get a refund for the copay that I paid (and which was a correct copay, I do not deserve a refund), and one time I got several hundred dollars of refunds for all the copays followed by a bill for the non-insured rate. I just never ever cash the refund checks and mildly protest the bills and stay put and eventually the correct history shows up.

And the thing that happened at tghe beginnijng of the year, where my old doctor thought he was grandfathered in to the new system but he wasn't because the Physician's Medical Group to which he belongs had pulled out, and I ended up owing them several hundred dollars? I've recently gotten a letter from the insurance company saying that was an error and I'll be getting a refund from my old doctor sometime down the line.

However, justg because this keeps happening doesn't mean that every unexpected cost is going to resolve. I have asked for estimates repeatedly for the surgery and now I might get one because I threatened to pull out over it.

When I also complained that I have been told nothing about the procedure despite having asked for information, the poor harrassed assistant said "Why have we scheduled you for surgery if you don't know these things?"

Why, indeed, but it turned out she meant that she thought I hadn't actually made an informed decision to have the surgery at all. That I have: exercise was giving me diminishing returns and it is stupid for it to be so difficult for me to walk down a goddamned hill.

Though my one friend who had her knees done still has a lot of trouble, she does say she thinks it was worth it.
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"Let's talk about death panels"

You keep saying that the ACA puts death panels in place to decide who's going to live and die.
The old system decided years ago that I should die young and in agony. I worked at low-wage jobs till I was fifty-nine. Now I have severe arthritis and I can't do it without knee surgery. I also have familial early onset of the diseases of age. Without medicine, I would die young like many members of my family. My husband died young too.
The ACA gave me insurance again. My medicine was costing me about a hundred and fifty dollars a month (after my pharmacist gave me an unofficial discount: otherwise it would have cost five hundred dollars a month) and there was no hope of paying for physical therapy or surgery. Now I pay a dollar a month for my insurance, I see a whole team of regular health professionals, and my medicine costs twenty-five dollars a month. I'm doing the preliminaries for surgery. So much for death panels -- the ACA has insured that I'll have a decent life.
Some Republican spokespeople have actually gone on record as saying that people like me should suffer and die young. Well, I'm going on record as saying that I don't agree. I have two beautiful children who deserve to have a mother to encourage them, and I contribute to my community as best I can (I volunteer, I give blood, I am an active citizen).
Every time one of you people spreads your lies about ACA death panels, you discourage more people like me from signing up for insurance and getting taken care of. Those people are at higher risk of increased disability and early death. Do you understand this makes you a murderer?

Oh lumbago

Sep. 25th, 2014 03:32 pm
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Not of general interest.
seriously, only read the next bit if you're interested in osteoarthritis and old lady health )
On another front, it rained and rained last night. On my laundry, but I note this more as a note of humor than a true complaint, because hey, it rained and rained! We love rain.
ritaxis: (hat)
I finished the second volume of the glass thorn series by Melanie Rawn. Now I have to wait for the library to get the third and fourth books. I never ever do this. And when I tried to tell Keith (my younger roommate)about why I liked this stuff, I couldn't describe it in a way that doesn't sound like bad books. But they are not bad books, they're fun. I've put the third one on request for when it comes in, but the fourth one, while published, is not even on order yet.

Now I'm reading Quantum Thief by Hannu Rajaniemi and oops it looks like it's part of a series too. I'm not sure I like it. I haven't thrown it against the wall yet. I won't, literally, of course. But it has a lot of elements I find annoying. All the post-singularity claptrap where whatever happens is because the author decided it would be cool, and the mechanics of the world allow for any damned thing whenever, that just irritates me. And I'm not into stories about "history's greatest thief" either. But in translation at least it's sort of amusing, even though I can't bring myself to much care about anybody, even the poor Quiets, who are paying for their longevity by taking turns being transformed into enormous hideous worker drones.

I'm also still slogging through The Coasts of Bohemia which is for some reason harder to get into than Prague in Black and Gold. I gather Derek Sayer, author of the first, is a decade or two younger than Peter Demetz, author of the second, and didn't leave during the Communist years like Demetz. I wish I could say that one or the other of them is more left- or right- wing, but I don't really have evidence as they both take a kind of Scheikian view of the Soviets as being just another of a long line of people who seem to have thought that Central Europe would fare better as clients of someone else. And also both of them are critical of Czech nationalism and clear-eyed about history's nuances. I would maybe say that Sayer is more bitter than Demetz, based on a few sentences here and there, but I don't even know if I can say that. I do feel like Sayer's point is "We Czechs (et cetera) are too much more important than anybody ever acknowledges, so there!" while Demetz's point is "these lands have always been diverse and polyglot, in fact the Germans and Hungarians got here a bit before the Czechs (etc, since apparently until Masaryk "Czech" really only referred to a certain tribe of Slavs in the region, and if you wanted to talk about all of them you said Slavs or Slavonians)." I may be being unfair the Sayer, I should be able to tell when I'm done with the book. It's not that Sayer doesn't address the issues of ethnic and linguistic diversity in Bohemia (etc), he does, and he addresses the question of "who the hell is Czech anyway?" which is a touchy one throughout much of the history fo the area. Because a lot of German speakers considered themselves Czechs and a lot of Czech speakers considered themselves German, or Austrian, or whatever the country was that was ruling them at the time.

On another front, my latest leg insult is not a blood clot. It may be something rather like sciatica. On a relatred front to that, I like the clinic arrangement. I like having these different assistants and other professionals to talk to, and I like the production-line fashion that they deal with admistrative things. I also like that when they ordered a doppler ultrasound on my leg, we didn't have to wait a week for the insurance to authorize. I didn't even have to take a paper. The PA asked me to make my appointment before I left the office because if it didn't work the first time she would pull strings. The doppler itself was amusing. The handheld device was set against my leg repeatedly and it made quiet little clicks each time until suddenly it went WOWOOSH which was the doppler we spoke of running through clear blood vessels. I couldn't stop laughing afterr that. Unfortunately, it doesn't make a nice tidy image for me to get a copy of.
ritaxis: (hat)
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.

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