(The anticipated conversation with my physician during the annual physical I should schedule soon. Pokings and proddings are omitted for the comfort of the reader.)
There were several things, actually. First of all, I wanted to see the new facility. I didn't get an invitation to the open house when you moved.
I understand that medicine is your specialty, not clinical tourism. I was just hoping that you'd recommend a blood test so that I could see the new lab area. My primary medical concern is making sure that I am still healthy enough for 65-mile bike trips.
Last summer I took a couple of 68-mile trips, but I found that pushed my over the line. So I'm only planning to travel up to 65 miles at a time this year. Of course, last year I only planned 60-mile trips. I went over because of unforeseen things like road construction and closed restaurants. So maybe you should tell me if I'm not healthy enough for 68-mile bike trips.
I have been having some GI symptoms that would probably be more worrisome if they were happening in isolation. Things like continuing indigestion, reflux, alternating hard and soft stool. Nothing exciting, but it has been continuing for quite a few weeks. Months. But the rash means that I discount most of that. Also, I found myself self-medicating with Mountain Dew® for a few months. Besides that, I'm convinced that I have cysts of Toxoplasma gondii in the brain. (They make the smell of my cat seem less threatening.) And HERV. I have HERV.
I have this chronic itchy rash on my ankles. Of course, it goes away when I visit the doctor, but it can get fairly annoying some days.
Yes. You see, the rash is psychosomatic. I've had it on and off for years, always tied to times of high stress. The first time I went to Todd Gallion about it after home treatment didn't do anything after several weeks. He couldn't even see it. I didn't realize that the rash was psychosomatic until it vanished when I made the appointment.
Oh, yes. On and off for several months. Same time period as the GI symptoms.
Yes, and that brings me to the other subject that I wanted to discuss. My mother's final illness happened just a year ago, which was just 9 months after my dad died, and I'm recapitulating a lot of the emotion from that time. The other topic I wanted to discuss is family history.
I know that some people drink a lot of caffeine, but if I have more than one Mountain Dew® or Faygo Moon Mist® in a day, or more than 3 in a week, I figure I'm self-medicating. It really started when the company I worked for was sold out to a very large, very corporate, and rather out of date company – the people who send you large quantities of medication alerts (which I suspect you recycle). Anyway, my consumption of mutant dews increased significantly during my mom's illness last year and I'm at about that same level again now. I find that caffeine helps me sleep, for example, and sometimes it calms the digestive tract, too.
Yes, but the more usual experience is using the drug when no drug is called for. My case, I think, could be better compared to the focus that stimulants give to patients with ADHD.
I think that I mostly just want to talk through the things that happened to my parents to make sure there isn't anything potentially hereditary that we should be considering in terms of my health. My mom, for example, had diabetes for 30 years and it never did kill her, plus arthritis and cancer.
Carcinomatosis. But she had cancer 3 separate times – I think it was 3 distinct cancers – before one of them finally got her. And then she was a 91-year-old widow, almost 92, and you'd expect that something would probably get her.
Yes. First she had breast cancer, in 2000. The next year she had colon cancer; the surgery was the day before 9/11. Last year they found metastisizing tumors in the abdomen when she had severe tendonitis in a major leg tendon. (I forget the name of the tendon.) We don't know for sure whether that was left from the breast cancer; she wouldn't let them biopsy the tumors. What would be the point? My own opinion is that it was de novo. But I have no evidence, either.
I don't think that there is anything like a colonoscopy. The one I had was clear, but Dr. Christian recommended another in 7 years because of the family history. So that would be due either this year or next.
He was diagnosed with mitral valve degeneration that would, according to Dr. Gapinski, eventually kill him, but after 20 years, it still hadn't. He gradually developed some sort of dementia. We don't know exactly what kind it was; certainly he didn't present classic symptoms of Altzheimer's, for example. I myself suspect something that affected neural conductance, maybe a myelin degeneration. The reason I say that is that I saw degeneration of his balance and fine muscle control develop in parallel with the memory deficits, and because the memory deficits presented mainly in associative memory recall for all time periods rather than failures to create new memories. He did have episodes when he couldn't form memories, but those seemed to be TIAs or similar events. For example, he fell and couldn't recall the fall, or the visit to Dr. Fenster, or most of the time in the nursing home before they moved to assisted living. But he could remember other falls that happened later. On the other hand, one time he couldn't remember that he had worked for the Corps of Engineers, even though he did remember that the work was related to flood control and was in Arkansas. He couldn't reason out the answer, but he recognized the right answer when I supplied it. Also, he lost the ability to retrieve memories about the deaths of my sister and brother, which you have to think would be pretty deeply etched in his mind.
Bulbar poliomyelitis, 10 days apart in 1955. Nothing genetic in that.
He was shot in the face in January, 1960. There is nothing genetic in that, either, I hope, but it might be relevant that there were some parallels with associational deficits, especially in his speech. After he was shot, he had a lot of trouble finding words. The problems in his dementia seemed to be analogous. He also became quite deaf; I don't know whether his hearing had been affected either by the shooting or by his short stint with the Army artillery, or whether there was any genetic component involved.
Only when people are arguing with me.
Oh … is there anything we could do about my big toe?
Yeah, but sodium hypochlorite is a wonderful treatment. The other big toe was blighted, too, but I smashed the right toe on my bike in the middle of the infection (when the nail wasn't doing very much to protect my toe). Now I just can't seem to get it to grow out clean.