Friday, May 29, 2009

Packin’ Iron

I went to the Infusion center today and had a wave of nostalgia overwhelm me, and this time it was not the brandishing of needles that sent me back into my childhood. Nurse Chappell was limping about the establishment, carrying her odds and ends here and there. I became a little concerned because she usually is so spry. I thought that if she was hobbling about, bringing all of the paraphernalia associated with my phlebotomy, who was going to bring the Barq’s Root Beer and my package of Lorna Doones? My prospects even seemed more grim when the staff sat me down in a dark cubicle and did not turn the light on. From the corner a chorus of dwarvish voices softly chanted “We like the dark… dark for dark business”. Grim, but familiar.

Being in a reflective mood there in the twilight, I tried to imagine what I might do with the gimpy nurse in my next blog entry. My mind immediately went to the George Garabedian Players and their parody of “Gunsmoke”. In the television series which ran for twenty years, Matt Dillon was played by James Arness, Miss Kitty by Amanda Blake, and Chester Goode by Dennis Weaver. What is germane here is that Chester in “Gunsmoke” had a game leg, just like Nurse Chappell at the Infusion Center did today.

Mr. Grillon

[Kissing sounds, female giggles, male says, "mmm".]

[Fester, getting louder and louder:] Mr. Grillon, Mr. Grillon, Mr. Grillon, Mr. GRILLON!

[Kitty and Grillon continue laughing, smooching, billing and cooing and not paying attention throughout.]

[Grillon:] Hunh?

[Fester:] Mr. Grillon, it's Doc.

[Grillon:] Not now, doc, come back later.

[Fester:] No, I'm not doc, I'm Fester. Doc, he's lyin' in the street with an arrah' clean through his neck.

[Grillon:] Not now, Fester, come back later.

[Fester:] No, Mr. Grillon, now it's Doc, and he's hurt real bad there in the street. That's what he's doing.

[Grillon:] Who's there?

[Fester:] Oh, Mr. Grillon, now you just gotta come, now Doc, he's your friend.

[Grillon:] Hunh? Oh, yes, Doc. Uh, get Doc to take out your adenoids and see if that helps.

[Fester, under his breath:] I don't know about that.

[Fester:] You need some hot coffee. Now this thing is serious. Now Doc, he's been hit. He needs your help. Now what'dya figure on doin', Mr. Grillon?

[Grillon:] Oh, Fester, it is you. Can't-cha come back later? An', ah, get the Doc to look at that leg or something .

[Kitty, whispering:] Get rid of him.

[Fester:] The Doc has looked at my leg, Mr. Grillon, and there's nothin' he can do.

[Grillon:] Well, then show him the other one -- try to get a matching set.

[Fester, sighing:] Mr. Grillon, now, now, Doc, he's not gonna make it. Now, that arrah's clean through his neck and he's just lyin' there, right smack in the middle of the street, like. You're the Marshal and I've always looked up to you.

[Grillon:] Fester, you go back out there and make sure it's really Doc, an', ah, check him over real carefully, then let me know.

[Fester:] Well, yes sir. I'll do that checkin'.

[Sound of limping footsteps out, and then back in.]

[Fester:] It's Doc alright, with an arrah right through his neck.

[Grillon:] Which side?

[Fester:] Oh, I didn't check.

[Sound of limping footsteps out, and then back in.]

[Fester:] It's both sides, clear through.

[Grillon:] Through what?

[Sound of limping footsteps out.]

[Fester:] Through what!!

[Sound of limping footsteps back in.]

[Fester:] Wha... throug... ooo, Mist... Do... It's DOC!

[Grillon:] Oh, Doc, of course. Wait there a minute, Doc, I'll be right with you.

[Festus, speaking softly:] Oh, wait there a minute... Obvious... an arrah right through... on there... I do my best. I go back and forth... oh, oh...


[Festus breaks down mumbling and crying.]

I laughed myself silly the first time I heard this bit. I think that I have it on a 45 record somewhere in my collection. The other noteworthy quote from the “Gunsmoke” era is something that Trillium brought to my attention many years ago. During the opening credits of the show, the voice-over says of Matt Dillon’s role as Marshall of Dodge City, “It’s a lonely job, and a chancy!” That’s is exactly how I felt when I went to the Infusion Center alone today, without Trillium, for the first time in ten months.

After having “Gunsmoke” float through my mind, I conjured up another old western that I used to listen to on the radio and then later watched on our 9-inch television: “The Cisco Kid”. Duncan Renaldo played the Cisco Kid, an outlaw that was always in the market to help anyone in trouble, and never ever killed anyone. His side-kick, Pancho, was played by Leo Carrillo, one of my favorite actors of all time. One of the best lines ever attributed to “Pancho” has him saying in dire circumstances, “Let’s went, before we are dancing at the end of a rope,…. without music.” At the end of every episode, “Pancho” would make some sort of bad joke to which his partner would say “Oh! Pancho!", and Leo Carrillo would say, “Oh! Cisco!” and they would ride off into the sunset together. Now this afternoon, after I became a pound or two lighter, I was ready to crack a bad joke and have Trillium cry out, “Oh! Pancho” (I am still getting tubby) and I would then sweetly reply “Oh! Kisyou!” She, however, as I mentioned before, was unavailable for this exchange and I was not about to kiss myself.

I was reminded of my third television western after I got home. About the same time that “Gunsmoke” and the “Cisco Kid” were airing, I also listened to,

Out of the night, when the full moon is bright,
Comes the swordsman known as ‘Zorro’.
This bold renegade carves a ‘Z’ with his blade,
A “Z” that stands for ‘Zorro’

Guy Williams played the lead in “Zorro”. Guy Williams also was the actor who played John Robinson in “Lost in Space”. He would later grow up to look just like Anthony Hopkins. This whole series came to mind as I took the wrapping off my right arm where “Chester” had inserted the needle for my phlebotomy. There, over the hole where the needle had been, was a perfect little “Z” etched into my skin (Trillium will verify that fact). I think that someone has been taking liberties with my elbow when I was not looking. Now if Trillium had been with me, I am certain that the staff would not have been able to play their little joke on me. I can hear her now as they whip out their little tiny swords to do me in and as she pulls out her Colt 45, “Now, you are going to have to ask yourselves, ‘Do you feel lucky?’ Do you?” I pack iron simply because I am genetically predisposed to do so; Trillium packs iron because she has her own little mark on me and doesn’t allow anyone to mess with her man.

Tuesday, May 19, 2009

Two Snake or Not Two Snake; Is That a Question?

I guess that I have been in a dream cycle lately, pestered by my mind while the rest of my body is trying to catch a wink or two. I think that my brain was reacting to the fact that I haven’t had much source material of late regarding my erstwhile affliction. In another week I will go in for another phlebotomy; two weeks after that I will go for my ferritin check, and a week later I will have my regular visit with the good “Doc Holliday”. The last month or so have been a wasteland for my gift of sarcasm. The dream cycle has taken various forms, but the one that has bearing for this blog involved a snake, or two, depending on who you talk to.

I usually come up with the title for a posting before I actually write my piece. This past week I woke up with “Iron Serpent” on the brain. “Hmmmm,” I said to myself. “What can I make of that?” I thought about how snakes shed their skin frequently, apparently in an attempt to get rid of vast amounts of unwanted iron. I suspected that the fact that a snake has no hair at all and is devoid of fingernails and toenails, must have been for them the ultimate sacrifice in their battles with hemochromatosis…. As you can tell, I was not yet fully awake. Snakes don't sweat much, which serves as counter evidence to my dream-thought.

I wondered if my little dream image came from my intimate association with the medical profession, with “Doc Holliday” and “She Who Shall Remain Nameless” at the University of Utah Medical Center, or because of “Nurse Gory” and all of his fun playmates down at the Infusion Center. I did not have an immediate answer. As you well know, when I find myself in such a predicament, I resort to the Internet for something charming. Notwithstanding my efforts, I have failed at “something charming” so you are stuck with the remainder of this posting as it is.

Googling “Iron Serpent” proved to be a bust. There is an on-line RPG game by that name which did have some appeal because of all of the virtual blood-letting. I am doubtful, however, that cyber-phlebotomies are going to impress anyone in the medical profession. There was a picture of downtown Cairo, Egypt, entitled “The Iron Serpent”, but I really could not make a direct connection between the picture and our present topic except that a great deal of pig iron has been poured out upon the Egyptian sand recently as a result of the Swine Flu pandemic that has been sweeping the world (there is no shortage of stupidity in this country, by the way, when ordinarily intelligent people begin calling a virus that has killed one-tenth of one percent of the people killed by regular flu, a “menace to billions”). Wikipedia gave me “Steel Serpent”, the arch enemy of “Iron Fist”. I can hardly wait until these Marvel comic book characters make it into a major full-length movie.

I then returned to my first notion about the medical profession and discovered some really bizarre things about the symbols for medicine. Can anyone tell me the difference between the caduceus and the Rod of Asclepius? I thought not. The latter was originally the symbol for ancient Greek medicine. The symbol features a single serpent wrapped around a staff. The staff was to be understood as the symbol of godly authority. The snake has been identified as the rat snake, "Elaphe longissima", a slithering beast which the Romans thought was beneficial to health, but never bothered to explain why they felt that way. Other scholars, in an attempt to raise the gorge of everyone on the planet, have averred that the snake of Asclepius was really a parasitic worm, “dracunulus medicinses”, which had to be extracted from beneath the skin by wrapping it slowly around a stick. This explanation certainly has convinced me as to why I get the willies every time I walk into a hospital.

The “caduceus” or the sign of two serpents wrapped around a winged pole was the device that represented the Greek god Hermes (Mercury in the Roman pantheon). Hermes was the patron lord of gamblers, thieves, tricksters, and alchemists (Hmmm… I am beginning to see a pattern here). By the end of the 16th century, alchemy and medicine had become identified with one another (to say nothing of gamblers, tricksters, and thieves) resulting in the association of the caduceus with medicine. It was not until 1902, however, that the caduceus was adopted by the US Medical Corps. A fellow named Captain Reynolds duped the newly appointed Surgeon General, W.H.Forwood, into accepting the symbol for the Corps. By the time the silliness of the caduceus was realized, too many of the newly minted pins were in use and the US Army was stuck with them forever.

In 1992 a survey of medical organizations was taken regarding their use of the Rod of Asclepius or of the caduceus. Interestingly enough 62% of all professional medical groups in the United States used the Rod, while 76% of the commercial medical organizations touted the caduceus (Hmmmm… the pattern persists). What does iron have to so with all of this? As far as I can tell, absolutely nothing…. except metaphorically.

I believe that there is a little bit of irony involved in the use of the Rod and the caduceus here in Utah Valley. “Doc Holliday” has the caduceus plastered all over his office, and yet I have never felt tricked, robbed, or gambled with during any of my visits with him. The Infusion Center has no symbol as far as I can tell, but I have been just a little fanciful of late and I have concluded that they and their patrons would prefer the Rod of Asclepius. I reported that when I had my last phlebotomy, “Nurse Gory” and his sidekick “Nickle” worked me over in the same spirit that my father and I worked the worm over on the banks of the Middle Fork of the San Joaquin River when I was learning to fish. I am now beginning to suspect that they were after the “dracunulus medicinses” that has taken up residence in my left elbow; the chop stick that “Nurse Gory" had stuck behind his ear really makes sense now.

Friday, May 1, 2009

The Iron Pourri Pot

Yesterday was Thursday, today is Friday; let's have that perfectly clear.

Last night at dinner Trillium said out loud, "My goodness, it feels like Friday!"

I said, "That is because there were two Wednesdays this week".

T-ma said, "That's impossible!"

I said, "No, think about it. It really is Friday, but since there were two Wednesdays, it is only Thursday".

Trillium looked at me with those wonderful blue eyes and said "Are you trying to drive me crazy? It 'feels' like Friday; it isn't Friday".

"It is all part of the two-Wednesday illusion, Trillium, all you have to....."

T-ma said, "I got up late this morning so I am not really sure what day it is....."

********

When I first started this blog, I tried to mix in a little humor, just to keep myself a little amused. At some point Trillium noted in one of her comments, "You know, you really need to put a disclaimer on your entries. Someone is going to believe every word you say and do themselves irreparable damage".

I replied, "I deal in outrageous hyperbole; there is no need to explain every joke I tell. If a statement I make seems insane, it probably is. People shouldn't have any trouble at all discerning fact from fiction, the real statistics from the fraudulent ones. Anyone who tries to give themselves a self-inflicted phlebotomy by careening down a mountainside without handbrakes probably deserves a concussion".

I have since decided that there is always the possibility that one of my readers may be experiencing a two-Wednesday workweek and, thinking that it is Friday instead of Thursday, may not get my jokes. So I have decided to give you a key by which you can invariably tell when I am telling a whopper, my "tell" as it were. My students discovered many years ago that when I was embarking on a shaggy dog story, that the corners of my mouth would begin to tremble ever so slightly. Once they saw that, they would lean back and simply enjoy the joke. So, there you have it. When the edges of your monitor begin to tremble ever so slightly while you are reading one of my entries, you may know with certainty that I am trying to be funny.

******

Yesterday Trillium and I went to Costco for a few things. We both supplied ourselves with a cart and so we actually ended up with a lot of "few things". I was feeling peckish, inasmuch as I had not as yet had lunch. Everything looked edible. After I had picked up the water softener salt and a few other essential items for the microwave, I met Trillium at the milk cooler. As I was making my way down the aisle, I noticed huge stacks of Honey Bunches of Oats. "I really like those," I said to myself, "Why am I not eating them? There must be a reason." Then I remembered. It was because of the high iron content...... "What.......!!!" I internalized. "There is no animal matter in Honey Bunches of Oats; there is no heme iron in those!" Then I realized that I had made the observation about the iron content last August when I was really being paranoid about the iron content in my body. I had not yet really made a distinction between heme and non-heme iron. So, because of a two-Thursday workweek at the end of summer last year, I have made myself miserable with toast every morning for eight months. What made me think that two pieces of bread with loads of Smart Balance smeared all over them had less iron than a nice bowl of Honey Bunches of Oats? I have no idea.

I turned to Trillium and said, "Why are we not buying Honey Bunches of Oats.....?"

"Cholesterol," she answered sweetly.

*******

I have been doing a little research on cholesterol and hemochromatosis as aspects of one another. It has been hard work, and for that reason most scientists have ignored the field. I found out that Low Density Lipoprotein (as opposed to High Density Lipoprotein) has a tendency to form affectionate relationships with the walls of blood vessels creating what is generally called "plaque". Too much plaque and the vessel is blocked, causing a stroke, a heart attack, or a two-Monday workweek. Hence, LDL is often called "bad cholesterol". HDL, IDL, VLDL, and chylomicrons (I'll let you work these abbreviations out for yourself) apparently are a little more anti-social and can be called (at least HDL can be) "good cholesterol". Cholesterol of all kinds are actually necessary for life. Our bodies need the fat (lipo-) in the cholesterol and it can only be transported to the cells of the body through the water-based blood system. It is the "sticky" LDL that causes the problem......

You should be bored out of your mind at this point.....

I know I am.....

Learning that my cholesterol problems are directly associated with my hemochromatosis problems was a great relief to me and I hope to you as well. I have, as a result of my studies, come up with a recommendation or two.

First, when you go to have your phlebotomy, do not allow the nurses to take the blood from one of your veins in your arms. Make them take it from your waist somewhere. While they are digging around for a blood vessel they can at the same time do a little "lipo-suction" (did you see the "lipo-" part? That is the "bad fat"!) Reducing the body fat once a month will keep you and your doctor happy.

I was happy to discover that having a regular phlebotomy reduces the amount of LDL coursing through your veins, although I have to say that my source regularly has two-Tuesday workweeks and is not completely reliable. His nurse told him that the LDL count can be reduced by ten percent with each phlebotomy. Wow! The way I figure it, three more bloodlettings and I will be out of the "Woods of Angina". I now stand at 130 LDL; one phlebotomy would drop me to 117; a second would drop me to 106; the third would reduce it to 96, four points into high normal. What a deal! Another two-fer! The scary part is where my blood cholesterol must have been before I started my therapy. According to my mad math skills, my LDL would have stood at 251 in August and my blood vessels would have looked like gummy worms.

The "fly in the lipoprotein", however, is the fact that I know that a year ago, when I had my last complete blood work-up, that my various cholesterols were just about as they are now. "Doc Holliday" is concerned about where I am at, but my medical history does not justify any enthusiasm for the "phlebotomy-over-statins" technique of dealing with my weight or my hardening arteries. I only have one question now: What am I going to do with the ten-pound box of Honey Bunches of Oats that I bought yesterday?

*******

If you, by now, have not figured out the significance of the title of this entry, there are not enough days in the week to explain it to you.