Non Ferritous Sequitur

I have been experiencing a dry spell of sorts. I am between phlebotomies and am two or three days away from another blood withdrawal to check my ferritin count, and thus a week away from having any kind of a report from “Doc Holliday”. I thought, “Well, maybe it is time to find out a few more things. Maybe it is Google-time at the Beeblebrox household”. So this morning I went on line to find out just how much iron I am losing per day through my skin, my hair, and my fingernails. The answer is simple.

According to those who actually spent time investigating this sort of medical information for a living, normal human beings shed about one milligram of iron per day. I wondered if a person with serious iron-overloading actually sheds more. It seems reasonable that it would be so. A German outfit located in Germany (that seems right), says that normal people have about 65 (+ or – 25) mu-mols of iron for every 100 grams of dry weight skin. I have a question. Where did these German scientists get 100 grams of dry weight human skin? Think of this. A normal human being sheds his or her skin (about 22 square feet) every other day, at a rate of 7 million skin flakes per minute. I am told that if you gathered up all of the skin flakes shed in a week from every person on the earth you would have a pile of dead cells three stories high. Apparently there is no want of experimental materials.

Given that there are plenty of dead skin cells to work with, the little German project at least is plausible. The report goes on to say, however, that those people with hemochromatosis have significantly more iron in their skin. Now this seems intuitively correct, but has this been scientifically proven? I mean, when our little Herr Professor Doctors were ferreting about in their thirty foot pile of dead skin cells, how did they know which ones belonged to the iron overloaded class? Did they use magnets (my favorite technique)? Did they wait for the 1 cell in 250 to migrate toward the north? What? How? This is a puzzling conclusion and one that requires further research. Don’t expect any results any time soon.

Now, is this the sort of stuff that inspires my family or anyone else to rise up and take notice of my carefully crafted prose? No! It is what follows, the stuff that has absolutely nothing to do with my affliction, except in the most ancillary of ways. While I was trying to find out how much the entire skin of a normal human being weighs (9 to 10 pounds, but I don’t think that is dry weight), I happened upon a website called “The Analyst”, a digital naturopathic “.com” that was filled with all sorts of informative and really repulsive data. The article on Hemochromatosis (Iron Overloading) seemed to be fairly accurate. I recommend it.

http://www.digitalnaturopath.com/cond/C517593.html

What I found particularly interesting, however, ensconced between the elaborate charts and the rather erudite Glossary, was this little story.

When Jacob was finally given an exit visa by the Russians and allowed to immigrate to Israel, he was told he could only take what he could put into one suitcase. At Moscow airport, he was stopped by customs and an official shouted, "Open your case at once."

Jacob did what he was told. The official searched through his case and pulled out something wrapped in newspaper. He unwrapped it and saw it was a bust of Stalin.

"What is that?" he shouted at Jacob.

Jacob replied, "You shouldn't ask 'What is that?' - you should ask 'Who is that?' That is our glorious leader Stalin. I'm taking it to remind me of the wonderful things he did for me and the marvellous life that I am leaving behind."

The official sneered. "I always knew you Jews were mad. Go, and take the bust with you."

When Jacob arrived at Ben Gurion airport, a customs officer said, "Shalom, welcome to Israel, open your case, please!"

Jacob's case was once again searched and not surprisingly the bust was found. "What is that?” asked the officer.

Jacob replied, "You shouldn't ask 'What is that?' - you should ask 'Who is that?' That is Stalin the rat. I want to spit on it every day to remind me of all the suffering and misery he caused me."

The official laughed, "I always knew you Russians were mad. Go, and take the bust with you."

When Jacob arrived at his new home, his young nephew watched him as he unpacked. Jacob carefully unwrapped the bust of Stalin and put it on the table. "Who is that?" asked his nephew.

Jacob replied, "You shouldn't ask 'Who is that?' - you should ask 'What is that?' That is five kilos of gold."

Now that is my kind of blog.

Ken Youse Hold .... on to Your Wallet?

Given the nature of my little affliction, there is bound to be some repetition in the events recorded in this blog. I have attempted to keep things interesting, perhaps somewhat entertaining, as the weeks and months have rolled along. I have contemplated how in the world I was going to obtain enough material to make a weekly entry. How many times can I go to the Infusion Center to have a pint taken before the rhetorical well runs dry? It's hard to say. Thus far, the boys and girls over there have been quite accommodating, providing me with vast amounts of anecdotal tidbits with which to regale my readers. How many times can I take "Doc Holliday's" name in vain before the "Cease and Desist" order arrives at my front door? Its hard to say. I have been circumspect, choosing to rename everyone cleverly (or, as it is in one person's case, I have chosen to name her "Nameless", and so she shall remain).

In terms of my experiences with the staff at the three major major institutions with which I have to deal, these, too, have proven to be a rich source of grist for my verbal mill. I have hopes that I can continue on without droning excessively about my condition. In the present moment, however, I do need to follow up just a bit on an item that was left hanging a posting or so ago. That this has to do with the staff of two of the three major institutions with which I usually deal is merely coincidental. What follows below has only a faint resemblance to what has gone on before, but I suspect that it does so because of the smoke and mirrors in operation by the various parties concerned.

You will recall (if you can't, there is a place where you can go to review) that I had been to the Infusion Center twice before they finally billed DMBA and Medicare for the cost of hauling my blood out of me, and then out of the door. DMBA, however, was not as forthcoming with the payments as the Infusion Center had hoped, leaving then with the indelicate option of having to deal with me directly about the $70.22 shortfall. Before they actually sent me the bill, however, they thought to try alternative methods of recouping their losses. There was at least one attempt to make the whole process a more lucrative enterprise, but that ended in failure when the town fathers of Spanish Fork discovered that there were clandestine operatives salting an old, played-out, iron mine near Thistle, with my blood. They probably would have gotten away with it had not the rats in the mine begun to hum James Taylor songs in the middle of the night.

When the notice to "pay or else" arrived in the mail from the Infusion Center, you will remember that I called DMBA to find out exactly why I was having to pay $35.11 each time I had my blood taken, inasmuch as it was in their financial best interests to have it done. My contact at that time was a young man who introduced himself as "Gernrnnantily". After explaining what I thought was an exorbitant co-pay for the procedure, the fellow sent me off into the netherworlds of "Will You Hold Please" while he consorted with his supervisor. When he returned, he apologized for some sort of mal-function that had taken place in the "data entry palace" of the mystical land of DMBA. I asked him what I should expect. He said, "In no time at all your bill with the Infusion Center will be satisfactorily dealt with. These topographical errors are easy to resolve." Not only did I worry about the nature of the "topographical errors", but also what "in no time at all" actually meant.

Being the trusting, non-cynical soul that I am, I let the whole thing pass, anticipating that I would never have to have a verbal exchange with Big G again. This past week, however, I learned for myself once again that the truth of Lily Tomlin's aphorism, "No matter how cynical you become, it is never enough", had not become passe. Wednesday, I received a dunning notice from the Patient Services Department of the hospital suggesting that if I did not pay the $70.22 due them, I might find additional reasons to take advantage of Medicare's services, that my personal topography might have to be rearranged by someone with a very large magnet (the threat was specifically aimed at my medical condition; think of that!). I decided that my best course of action was to call DMBA again and find out what was up.

A new fellow, "Firmenansy", answered the phone. I began to explain all that I had originally communicated to "Gernrnnantily" about the billing. After a minute or two of listening to my prattle, he asked me if I could hold; he needed to talk with his supervisor. I told him I would wait. I do not know whether the length of time on hold is indicative of anything at all, but I am beginning to think that it requires some effort to come up with a fabricated tale that will momentarily satisfy the patient on line. "Firmenansy" was equal to the task.

"Well, Mr. Beeblebrox, the problem here is that the hospital has been billing us using a code that is reserved for "Out-Patient Medical Pfijmleyt" instead of using the code for "Lab Tbnllkonr Kndfdjkoeu". All you have to do is communicate that to your health provider and that should solve any and all topographical problems you may be suffering".

I was beginning to wonder if my time was worth $35.11 a pop, if I had to go through this sort of thing every time I went to the mine-salters. But, having been retired for nearly five years and having little or nothing else to do with my time, I decided that I should continue my efforts, notwithstanding the accumulating billable hours. So, taking "Firmenansy's" recommendation, I proceeded to call the Patient Services Department to provide the appropriate information that would keep everyone happy.

"Wad jouse want?" said a voice that sounded like it would be wielding the afore-mentioned magnet.

"I'm calling about my bill.... "

"Pay up or die!"

"But I don't think that I owe what you say I do. You see... "

"We don haf ta need to 'see' nuttin' here, but the color of yer dough. Pay up or die!"

"But DMBA said that the bill was not submitted corr...... "

"We ain't da billin' d'partmn'. We do da collect'n. But I kin translate ya..."

"What? Translate?"

"No... dats not it... translate..., transpose..., transfigure..., transmogrify.... "

"Transfer?"

"Ya! Dats it! Ken youse hold?"

I held... on for dear life. Finally, the voice of the unflappable "Queenie" (not her real name, but close enough as to make no never-mind) came on the line.

"Yes, Mr. Beeblebrox, what can I do for you?"

I explained everything that I had discussed with Big G, Big F, and BIG-BIG, again trying to make sense out of what had happened in the billing. I commented on the various billing codes and what DMBA had said about them. I then asked if there was anything she could do for me as far as the Patient Services Department was concerned.

"Oh yes. I am just now taking that account away from BIG-BIG. You won't be hearing from him again unless you say something unflattering about me in your next blog." (Note that I have been the quintessence of decorum in this matter.) She continued, "You wouldn't mind if I had a chat with DMBA myself, just to be sure that I have all of the right information?"

"No, not at all. Please do!"

I hung up the phone hoping for the best. About thirty minutes later, I received a return phone call from "Queenie" informing me that I would not have to pay the $35.11 per phlebotomy; that had been a problem with DMBA's computer, a problem that apparently BIG-BIG was able to help them with in some way.

"Now, Zaphod, you owe me one."

"Yes, I do. What do you recommend?"

"Could you cut down on the Barq's a little? Say, down to only eight or nine cans each time you come?"

"I think that I could maybe attempt to try to convince myself that perhaps or maybe that Sprite would do."

"No, Beeblebrox! Eight or nine cans period. And only ten or twelve packages of Lorna Doones. You're killing us over here. Its either that or you are going to have to cough up the $35.11."

It is clear that I am going to have to stop at Carl's Jr. on my way home next month.

The Angel of Mercy

I made my way down to the Infusion Center last Friday to have another pint of my preternaturally ironized blood drawn ("clink, clank, clunk"). I was greeted by a new crew. I supposed that I had worn Nurse Chappell and her buddies out. The head nurse was wearing a red smock; I had never seen one of these before. I quipped, "What does the red smock mean? Is there some sort of medical significance to the color code around here?"

"It's Friday," the Lady in Red replied. "Didn't you get the memo?"

"No, as a matter of fact I didn't, and apparently no one else in the office did either," I answered, looking around the entire complex at all of the powder blue, pastel green, beige, and other warm earth tones decorating the staff.

"Well, it is Friday and we are having a special celebration that demands that I wear a red smock today."

"Oh! What might that be?"

"Today we have a new Registered Nurse on the floor and she has never drawn blood from a patient before. You are her first."

"And the significance of the red smock?"

"It is difficult getting blood splatters out of our uniforms. I figured since I was to be the tutor of the new RN I ought to be prepared for any eventuality."

"And why am I being graced with a Newbie?" I asked with a quivering lip.

"Because if she screws up and douses the planet with your iron-rich plasma, nobody loses anything. We have to throw the stuff away anyway," she answered with a sweet smile.

"What colored smock is she wearing?"

"She is the one in the powder-blue smock. She is far more optimistic than I am."

So what happened to the pure white dresses that the nurses always used to wear when I was younger? The attire of the Candy-Stripers, I could understand; any errors on their part could be explained as Art Nouveau decorations. When I asked Trillium to marry me 42 years ago, she was dressed in white on the way to work at the hospital in Duluth, Minnesota. LPN's in Minnesota in those days wore white uniforms, and clearly had enormous confidence in their skills. It was the doctors who wore pastels. "Danger, Will Robinson!"

As I was waiting for the troops to show up with the various sized needles, tubes, bags, rubber webbing, the rubber ball, and the mop bucket, I thought about Lord Nelson's great ship of the line, "Victory", and his practice of painting the decks with red paint in order to minimize the psychological effects of having body parts and such scattered everywhere in the heat of battle. This may have made for effective warfare, but it seemed to me that the practice of wearing a red smock to a blood-letting bespeaks of a frame of mind that does not lower the blood pressure of the patient.

Speaking of sea-faring stories and such, one of my favorite songs by James Taylor is called "The Frozen Man". James wrote the song as a whimsical response to a tabloid headline that he had read several years ago about a sailor who had been found in a chunk of ice and whom the medical ghouls were contemplating resuscitating. The lyrics follow:

The Frozen Man

Last thing I remember is the freezing cold
Water reaching up just to swallow me whole
Ice in the rigging and howling wind
Shock to my body as we tumbled in
Then my brothers and the others are lost at sea
I alone am returned to tell thee
Hidden in ice for a century
To walk the world again
Lord have mercy on the frozen man

Next words that were spoken to me
Nurse asked me what my name might be
She was all in white at the foot of my bed
I said angel of mercy I'm alive or am I dead
My name is William James McPhee
I was born in 1843
Raised in Liverpool by the sea
But that ain't who I am
Lord have mercy on the frozen man

It took a lot of money to start my heart
To peg my leg and to buy my eye
The newspapers call me the state of the art
And the children, when they see me, cry

I thought it would be nice just to visit my grave
See what kind of tombstone I might have
I saw my wife and my daughter and it seemed so strange
Both of them dead and gone from extreme old age
See here, when I die make sure I'm gone
Don't leave 'em nothing to work on
You can raise your arm, you can wiggle your hand(unlike myself)
And you can wave goodbye to the frozen man

I know what it means to freeze to death
To lose a little life with every breath
To say goodbye to life on earth
To come around again
Lord have mercy on the frozen man
Lord have mercy on the frozen man

That little song went through my mind as I sat there waiting with Trillium for the The Lady in Red and her cohort, the Girl in Glacier Blue, to show up to do the messy deed. Why wasn't I going to get an "Angel of Mercy," dressed all in white? Even William James McPhee got one of those and he was almost dead. LR and GGB showed up after about 15 minutes full of enthusiasm and thinly veiled anticipation. I could tell that LR had put a fresh coat of ScotchGuard on her smock. What happened next almost defies description.

Never have I been treated as kindly as the "Angel of Mercy" treated me during the next half hour. She freely admitted that this was her first time doing a phlebotomy, but she had been a nurse for more than fifteen years. She explained things cheerfully as she went along, answering my jocular, but nervous questions about what was going on. When it came time for the first injection, the one that would numb the area around the vein that she was going to poke, I made my little half-joke about my phobia about needles, even the 20 gauge one she was about to use.

She said with a wonderful smile, "Oh, this is not that big; you should not even feel the needle going in. It is a needle that we use on infants so as to not hurt them. It's about a 28 or 30 gauge, if not smaller."

"So this is not going to hurt?"

"Yes it is going to sting a bit, but it won't be the needle. It will be the local anesthetic. That juice smarts when it goes in."

No one had ever told me that before; I had always assumed that it was the needle. I began to wonder if some of my other bad moments with needles were of a similar nature.

As she was getting ready to put the 14-gauge "doo-dah" in my arm, I joked about the "Bad Needle Technique" (still abbreviated BNT) that I had received a couple of months back and how I feared for any tuna hooked like that.

"Well," she said, "I haven't ever done a phlebotomy before, but I am really experienced in performing IVs. We shouldn't have any BeNT problems today!"

I waited for the jab, the pinch, the sting, the flickering lights. They never came. Apparently "AoM" put the anesthetic exactly where it was supposed to go, unlike others I could mention. In one fell swoop, "AoM" had swept away about half of my agonies about having my blood drawn.

What a day! I felt so good afterward that I took my first and only Angel of Mercy, together with T-ma, to Carrabbas for dinner. Grilled chicken with garlic mashed potatoes, together with a Caesar salad. Not much digestible iron there, and if there was, I didn't care. I had a friend in the needle business.

Blood-iron Reducing Techniques

Go to any other web site dedicated to this topic and you will find suggestions far less painful than the ones I am going to articulate here. Most will talk about diet, the sorts of things one should or should not eat, which supplements one should or should not ingest, and what sort of remedial activities actually will cause a loss of ferritin. Most of these are innocuous and generally affect nothing but your whole way of living your life. My modest proposals will be as effective as those proposed by the pantywaists at other websites, but far more memorable.

I personally recommend bike-riding. Barnacle Raff and I do that from time to time and as counter-intuitive as it sounds, free wheeling can bring about a sharp drop in ferritin. The first two forays that Raff and I took involved hardly more than getting into his truck, with our bikes loaded up, and managing to avoid mid-morning traffic on our way to the Riverwood Shopping Center. I have to say that the potential for a cost-effective blood-letting had been on the street both times we made the trip. Unfortunately, Raff's driving skill are prodigious and I neither went through the windshield nor was I ejected from our vehicle at impact. I did over-hear some blood-curdling screams from various parties along the way, but I have not discovered whether curdling one's blood actually affects the ferritin count. The trips from Riverwood to Vivian Park were not exactly fraught with danger, except for the occasional "mountain trail" that Raff likes to take. I saw several boulders with my name potentially written all over them in my own blood; rich iron deposits those.

The trip from the BYU Motion Picture Studios down to Utah Lake, however, was far more promising and productive. Last Thursday (not yesterday, but a week ago), Raff picked me up and because the weather was just a little nippy, he decided that we ought to do a longer, flatter, but warmer excursion. Hence, the Lake Effect. The ride began well, but there were far more travelers on the path than what I was used to. Raff decided that we needed to go about 10:00 so that we would avoid the ice on the path. There was only about a two-mile stretch that had any ice on it. What he had not foreseen, however, was the three-inch pile of leaves that made the path a bit slimy in places. Out of the 14 miles we biked, only 13.99 miles had this problem. Hence, when we came upon the two skateboard enthusiasts with their dogs on their forty-foot leashes pulling them down the trail, the opportunity for ferritin iron reduction was realized.

The usual practice for the patrons of the trail is that those traveling on foot are supposed to hunker to the right while we on bikes pass by them on the left. This practice can vary according to those who are walking and those who are riding and who really thinks that they own the walkway. In other words, anyone traveling along the Provo River Walkway probably ought to anticipate some sort of major injury about every third trip.

The boys on the boards were coming toward us about the same speed we were going towards them. They were engaged in activities other than watching out for Raff and me. I suspect that they were texting each other. In any event, one fellow was on the right side of the path with his dog checking out everything within forty feet on the left. The other fellow was doing the same, but with the orientation reversed. The dogs, of course, had minds of their own (perhaps the four travelers only had one mind between them) and were wandering around to see what the other had discovered. Raff and I shouted at the two boys that we were coming through. It was then that it became clear that the fellows had earbuds inserted as well, listening to KDAVOLA. It was then that things went awry.

Raff slammed on his brakes. As it turned out, he had tried to stop on the .01 mile of the trail that had neither ice nor leaves on it. I, however, was still on frozen tundra. I began to slide and fully expected to hit my 77 year old friend in the back with all of the iron-overloading that still could be measured. I did the only thing that I thought that I could do: I laid my bike down, and did a magnificent "tuck-and-roll" off the path and into the bushes next to the river. On the way down my left knee struck the asphalt. When I got up from my tumble, the two boys and Raff were very solicitous, hoping that I was not seriously injured. When it became apparent that there were no grounds for a personal injury suit, the four-some scampered off to continue their reign of terror elsewhere.

Raff said, "Are you really okay? Do you want to head back?"

"No," I replied, "I think I only scraped my knee a bit." I pulled up my left pant leg and discovered that I had a about a four square inch patch of missing skin on my kneecap that was quietly weeping ferritin.

"Wow! Are you sure you can go on like that!"

"Sure," I replied. "This is all part of my regular iron-overloading therapy. It is facing the Krrrakin that I am worried about." I went to the Krrrakin cave this morning and I was happy to discover that my graceful descent from my bike into the undergrowth had done no damage to my bonal arrangement. So, for those of you looking for new ways to eliminate ferritin from your system, find a place to go bike riding that has lots of sharp protrusions along the trail and a bevy of mindless teenagers multitasking. In no time you should be able to remember exactly what things the other websites have to say on this matter.

If this has been helpful, I may add blogs on cutting fingernails with a lawnmower (I have done this very thing) and giving one's self a haircut with a chain saw (I have come close on several occasions). Remember, it is in the loss of skin, blood, fingernails and hair that the body sheds its iron.

In an hour I go to the Infusion Center to have Nurse Chappell take another pint. I may be less ouchy about the process today.

Iron-Walled

Trillium and I have been somewhat concerned about the security of our computers. We have a wireless router with Comcast which has been effectively isolated to a few computers in the house and a few specific visiting laptops when they show up in the possession of our relatives whom we trust explicitly. In doing so, I am certain that we have taken away some hangers-on in the neighborhood who could tap into our extremely strong signal. Interestingly enough, even though we have six people on our block who could have regularly picked up on my router signal, Trillium has some problem getting the signal in the "Dungeon" where she has her workroom.

Safely ensconced in our little world of cyberspace, we have not been overly concerned about anyone attempting to hack in either. Both the Comcast box and the router have "firewalls", devices so spectacularly safe that it is supposedly impossible for anyone to secretly invade our personal computers from the outside. Additionally, we have spyware, adware, and virus detectors that are updated at least once a day. We are safe.

I assumed that much the same could be said of our various accounts on the web, like this blogspot, for example. Chris and Trillium, however, have had various encounters with unwelcomed guests on their sites. Chris decided to go "private" which effectively eliminates anyone whom he does not specifically invite. It is a pain to log in every time, but I understand his concern. Trillium, being deeply concerned about pictures and such, decided to put a tracker on her site just to see where her hits were coming from. It has taken her a little while to recognize that some of the odd cities were actually our regulars whom the tracker hasn't quite figured out yet. A little disconcerting at first. Some of the hits floored her, however. Who does she know in Quebec? Who is the guy in Clearwater, Florida, who is checking out my little bouquet of forest flowers? Trillium decided that she might want to go private too and encourage the others on our lists to do so as well.

I have decided not to go private, however. I figured that what I had to say about Hemochromatosis was for the entire world and not just for those who are close to me. Might I get hacked? Probably, but as Trillium pointed out to me this morning, no one is prepared to read everything I have written, much less comment on it. In other words, I am "Iron-walled". My prattlings on my genetic disease put the reader in a comatose state after the first four sentences. I doubt that there will be more than six people who will get to this point in my diatribe today, much less comment on it.

What a gift! To be able to compose such a heavy prose that nothing can break through it! I ruminated in another posting, wondering if my blood were musical. Some of my kindly correspondents thought that I was born with music in my blood. But the truth of the matter is that my blood is in my writing. Mason Williams wrote a song years ago about the poet Dylan Thomas, sung to the tune of "London Bridge is Falling Down":

Dylan Thomas is dead and gone
Dead and gone
Dead and gone
Dylan Thomas is dead and gone
His blood turned to words.

This is me. The Man with the Iron Prose.

Just for the record, I have had visitors from Germany, Australia, and a slough of cities I have never even heard of, much less had contact with. Who are these people? I have no idea, but they probably ought be concerned about the effect of my Iron Prose on their internet connection. Some day all of this stuff is going to reach a critical mass all around the world and "Wham": rust everywhere.