Looking for Iron in All the Wrong PLaces

The last three weeks have been boring. Boring! Boring! Boring! But boring can be good, as you are about to discover for yourself.

My usual cast of characters are in retirement, or at least in a state of grace. Barnacle Raff and I have not been biking for about three months. He says that it has something to do with the enormous snowfalls that we have had this winter. I think it has to do with the number of times he has had to carry my limp and unconscious body to the stoop. The Krrrrakin has told Medicare that all of my bones have been properly arranged and that I need not return, on pain of death. The boys and girls at the Infusion Center have boarded up the doors and windows of their office so that no one taller than five foot eleven can get into the place. That's okay, I really don't have to storm the castle for another three weeks. Doc Holliday said that if I showed up at his establishment before the 15th of April he would issue a restraining order. That is about the time I was planning on going there in any event, so no harm no foul. So the fodder for my verbal cannon is out of range, insofar as the medical industry is concerned. That has been the case for three weeks and will continue for another three weeks until I have another pint drawn.

My daily bouts with the computer have continued, however, and I am well along in my writing, finishing one book, starting another, and plowing through the second half of a third. For those of you who are interested in philately (in sixty-six years I have only met three people so afflicted), I have managed to mount more than 43,000 of my little pieces of colored paper, 41K in the last three weeks. I think that I have the materials for an obsession here. TG2 and I have continued to beat the daylights out of each other at the Rec Center. Yesterday Jen said that she had never seen me move as fast as I did playing. I think that I have become a little more agile with less iron.

Not having my ferritin levels checked for a while has made me a little nervous about what I eat. Trillium and I have only been to a restaurant two times in three weeks. We had lunch at Cafe Rio and, in the spirit of living dangerously, I had a chicken tostada. Later, we went to Subway and I plunged into the iron-acquisition mode by ordering a 6-inch Subway Club. The turkey and roast beef were cut "bridal-veil" thin so that with all of the rabbit food on the bun I suspect that not much in the way of hard iron really made it into my system. At home I indulged myself in a new culinary delight by having a tin of lemon-pepper kipper snacks. I am certain that there is a joke in this, but for the life of me I can't think of one.

As to our experience with Comcast, I should probably give you an up-date. After the first fellow came and complained bitterly about my splitters and all, he assured me that someone would be out to fix the problem on the pole. I waited three weeks for an improvement. None came. I called the service number provided and had a chat with "Jake" who said that he would put two of his specialists on it right away. Dispatch called a couple of hours later to tell me that I did not need two specialists, only one. I said that I had entertained two already, separately, one for the house and one for the pole, and there had been no improvement. She basically then called "Jake" a liar by saying that they never send two technicians at a time to the same house. I told her that I had a blog about this sort of thing that was being read by hundreds of people in over twenty nations and that she was fast entering into my range of verbal fire. The house technician showed up soon thereafter to discover what had been discovered three weeks earlier; the pole technician showed up the same day and did what he had failed to do three weeks earlier. The internet seems to be fine now. So..... on to sweating iron.

Apparently it is possible to sweat iron. I include below a clip taken from the Palo Alto Medical Foundation site which seems to be moderately well-informed.

Iron and your body

Iron is an essential mineral in the human body playing an important role in many different types of cells and proteins. The adult body contains 3-4 grams of iron. The majority of this, approximately 2.5 grams, is circulating in the blood as part of the oxygen-carrying protein hemoglobin which is present in red blood cells. One gram of iron is found in tissues as part of the iron storage protein ferritin; most of this extra iron is stored in the liver. Other iron-containing proteins and enzymes that use iron as part of chemical reactions in tissues account for approximately 400 mg of additional iron. A smaller amount of iron is circulating in blood plasma bound to an iron carrying protein known as transferrin. This protein combines with iron that has been absorbed from intestinal cells and carries it to the cells that need it. Cells signal their need for iron by placing receptors for transferrin receptors on their surface. Another protein called HFE is involved in regulating the amount of iron that is absorbed from the intestine and then distributed throughout the body. In hereditary hemochromatosis excess iron is absorbed for unclear reasons, and the most common genetic mutations leading to hereditary hemochromatosis are in this HFE gene.

Iron enters and leaves the body in several ways. The average western daily diet contains 15-25 milligrams of iron of which ten to twenty percent is absorbed. Additional iron may be obtained from vitamin supplements or blood transfusions. The primary location for the absorption of iron is the first part of the small intestine (duodenum). Iron is lost from the body slowly by several different mechanisms. Sweat carries a small amount of iron with it, and loss of aged cells from the skin, digestive tract and urinary tract account for about 1 mg of iron loss per day. Menstrual bleeding results in a small amount of continued blood loss in pre-menopausal women. Small amounts of iron may also be lost in blood from the digestive tract, for example from stomach irritation or colon polyps.

Now don't you feel learned? I discovered another article in the American Journal of Clinical Nutrition that proposed that sitting in a sauna for extended periods of time (about an hour or so) would bring about iron reduction through sweat, on average about 50 nano-grams per liter of sweat. I don't know about you, but I am concerned about the boys at AJCN. Who thought this study up? (To be fair, Doctors Brune, Magnussen, Perssen, and Halberg, Swedes all.) Where did they get the money? (Since the article was written in 1986 by a pack of Swedes, it is unlikely that we will be able to blame the Obama administration. Although.....) How did they convince 11 people to spend 60 minutes stewing in a Swedish bath? (My guess is that they simply invited seven of their friends over to the house.) Who did they persuade to shovel out all of the liquid iron from the sauna? (Probably a graduate assistant; been there, done that.) And what did they do with all of the results of their study? (It is probably in the same place that the German scholars stored their thirty-foot pile of dead human skin cells. See an earlier blog entry on this study. On second thought, don't see the earlier blog on this study. Once is enough).

Wasn't that worth the wait? Aren't you glad that my daughter asked that fateful question, "Dad, can you sweat iron?" I know that I am glad. Now I think I am going to mess with my music list.

Sweating Cannonballs

About twice a week TG2 and I go to the Orem Rec Center to play racquetball. Both of us are trying to lose weight and we think that by vigorously exercising for an hour or two a week we will be the Biggest Losers. To date I have gained three pounds. I have no idea where it is coming from. The up side is, however, that I may very well be dropping my ferritin level by playing.

On our way back home Monday TG2 asked, "Hey! Can you sweat iron?"

"What?"

"I said, 'Can you sweat iron?' Kind of like sweating bullets".

Being a clever sort, I replied, "Actually, bullets are typically made of lead and brass; not much iron in them. I suppose that I could sweat cannonballs, if it were possible to perspire the iron out of my body." Being a dutiful father, I decided to find out just what the relationship was between sweat and iron-overloading.

I went on-line this morning, or at least tried to. We have been having trouble with Comcast's feed to us. I called their service center last week and a fellow came out to check our system. He tried to tell me that it was because of the 437 splitters that I have on my house lines that my signal wasn't working properly. He also testified that the splitters I was using were not especially for the internet and therefore would not serve. I told him that I had put that system together over two years ago and did not begin having any problems until a few weeks ago. He became very quiet. He went about his business which took him out to our phone/cable box at the southeast corner of the house. From there he made his way through the snow to the box in my neighbor's yard and from there to the pole on the fence line that holds the main lines high in the sub-freezing winter winds of Utah Valley. After a few minutes the technician returned to inform me that the problem was probably due to some antiquated connectors on the pole and that in a day or two someone would come out to our place and change the divider out so our signal would be proper. He left and we have not heard from Comcast since. What does this mean?

What it means is that when I went on-line this morning to look up the connection between "sweat" and "iron", I discovered that there was no connection between me and the server. The net result in all of this is that I am going to have to make up something. My guess is that exuding iron molecules while playing racquetball is probably not possible. Would I not come back from the Rec Center looking like I had just rolled around in the dirt in St. George? What is true, is that I look like I should be put under the dirt when I come back from the Rec Center.

I have decided, however, that I did deplete some of my iron-overload last Monday as a product of TG2's mad racquetball skills. The first iron loss took place as the result of a rather magnificent volley early in the first game. TG2, mustering all of her strength, leaped for a fast ball that was sliding by my left side. She whacked me and the ball at the same time. She hit me on the thumb-knuckle of my left hand, scraping off three or four million skin cells with that singular blow. Iron loss! I also had immediate subcutaneous bleeding that eventually decorated my hand in various shades of puke-green and yellow. I would like to think that that event constituted a mini-phlebotomy, but alas it was not to be; the bruise was simply absorbed by my pancreas.

Mid-way through the second game (I was now playing with my right hand), TG2 made another one of her magnificent grand slams, accelerating the ball to a speed approaching Mach 4. The ball hit me in the middle of the back of my head, bounced off the ceiling, ricocheted off three walls and eventually came to rest in a corner where it lay smouldering. TG2 was laughing hysterically. I was trying to figure out what all of the skinny brown snow was drifting about the court. It was my hair! Another massive iron-depletion!

We finished the third game and began the trip home. This, as you will remember, was when she asked the question about sweating bullets. My left foot started to pain me some and by the time I reached Star Gazers Point I felt the need to pull off my shoe to see what was going on. By the look of things, I was again the victim of another of TG2's athletic skills. At some point she must have stepped on my foot, squashing the pinky toe. It was all red and the nail looked like it was ready to fall off. Hooray! More major iron loss!

For those of you hoping for something more insightful, I apologize. I had hoped to be more insightful, I really wanted to be more informative, but Comcast is the culprit. I know that out there somewhere is some hemochromatosis scholar who is on the cusp of discovering the connection between the second sweat gland behind everyone's right earlobe and iron overloading. Oh happy day! But not today.

Two Notable Iron Reductions

This week I had two major iron-reducing procedures. The first was my regular phlebotomy at the local Infusion Center. I was attended to by the "Pink Lady" who was jovial, to the point, and managed to analyze every joke I told. I persisted at my vain attempts at veiny humor because there was, in the three-sided cubical across from me, three or four people who looked like they needed cheering up. Some sort of procedure was going on over there and it wasn't a blood-letting. I don't think it was a blood-getting either. Given the rather grim countenances twenty feet away, I suspect that there was something rather serious transpiring, far more significant than the little iron-depleting exercise I was going through. The "Pink Lady", in her attempt to keep me cheerful during my soap opera with the 14-gauge needle, regaled me with the significance of all of the letters that were printed under her name on her tricked-out name tag. She had an RN degree, a Bachelor's of Nursing, and a credential of some kind that meant she was a master mechanic in all thing vascular. She told me that she needed all of that sort of book-learning in order to administer chemo-therapy, something that regularly happened at the Infusion Center. Suddenly I thought I knew what was happening across the way and why everyone was more than willing to be jollied up by my gasping humor.

While we were there, I asked the "Pink Lady" to let me know what my hemoglobin level was. Inasmuch as I was stepping outside my normal role as patient and doctoring myself by throwing in this extra phlebotomy, I thought that discretion was in order. (Actually, Trillium thought that discretion was in order, but if I gave her credit for everything I came up with, I would be truthful, but not worth very much as far as the public perception of my logical thinking skills is concerned.) My understanding is that 12-14 hemoglobin in an adult male is about right. As might be expected, my level a couple of days ago at the Center was 16 or so, high in almost anybody's book. Phlebotomies are not making me anemic.

Which brings me to micro- and macro-cytosis. My sister commented on a previous blog (and in numerous phone calls) that I might very well be afflicted with macrocytosis along with everything else (actually there isn't anything else except for the iron-overloading, but at the moment I wrote the sentence I was feeling a little sorry for myself). Again, as might be suspected, these two afflictions have to do with the size of one's blood cells, "macro-" being too big, and "micro- being too small.

I went to Wikipedia, my source for all things unknown and unknowable, and picked up the following: "Macrocytosis is the enlargement of red blood cells with near-constant haemoglobin concentration, and is defined by a mean corpuscular volume (MCV) of greater than 100 femtolitres (the precise criterion varies between laboratories)." I followed the definition for the first eight words and then blacked out until the parenthetical statement. I want to know what it all means, but I suspect that it is not worth the effort. But I did want to know in the worst way what a "femtolitre" is. Back to Wiki: "The femtolitre (US femtoliter) is the metric unit of volume equal to 10 to the power of -15 litre, or one quindecillionth (European) or one quadrillionth (American) litre. It is abbreviated fL or fl." I guess that it is kind of like a "nanosplatter", but with a less memorable name. I am now taken with the new and wonderful word "quindecillionth". Should not the federal government be thinking in these numerical terms rather than its opposite as far as the economy is concerned? But I digress...

The Mayo Clinic suggests that there are a number of reasons why a person may have contracted the condition known as macrocytosis. I will comment discretely as I present their findings.

1. Vitamin B-12 deficiency (I have no idea where I am here. I have enough trouble curtailing vitamin C and increasing my vitamin D. Besides, any vitamin having more than five varieties is too hard to keep track of.)

2. Folate deficiency (I suffer this only in the autumn when all of my leaves fall off.)

3. Liver diseases ("Doc Holliday" informs me that if my liver were any healthier I would be stalked by Hannibal Lector)

4. Alcoholism (This could have been a problem in my youth, but I switched to Vanilla Wafers made with artificial vanilla when I was 15).

5. A side effect of chemo-therapy drugs (I, thankfully, do not have to endure this, except in Trillium's van where there is a Cinnamon Air Freshener hanging from the rear-view mirror).

6. Increased blood cell regeneration (A-hah! This comes with blood-loss, whether deliberate or accidental; the bone marrow can't seem to differentiate between the two.)

The boys at the Salad-dressing Clinic have concluded that macrocytosis is not a disease, that it has no symptoms, and there is no known treatment. They will, however, take your money for.... um.... any reason at all. Isn't this fun! Now on to microcytosis!

Micro-psychosis... er .... micro-cytosis is a condition which usually shows up if you have one of the following:

1.Iron deficiency anemia (This... is.... not... my... problem;... clank!)

2. Sideroblastic anemia (I've seen this word before, somewhere, but concluded that I did not fit the profile... at least I don't think I did.)

3. lead poisoning (More heavy metals! The only lead poisoning that I can recall took place in seventh grade when Juanita Barcelona stabbed me in the back of my hand with her pencil. I probably had that coming.)

4. Peridoxine deficiency (This is the sweet name for vitamin B-6. I am no more comfortable with this than I was with vitamin B-12; B-12 is also called Cyanocobalamin for those of you with insatiable linguistic curiosity.)

Now the second iron-depleting procedure that I had this week was a hair cut. As the lovely girl from Richfield was going about her business, she said over and over "Man, you sure have a lot of hair!" I wondered if she meant that in the context of "... for a guy who is five times older than I am!". She wore out three pairs of scissors in the process. As I was leaving, the sweet young thing suggested "Perhaps, Dr. Beeblebrox, you should cut down on your B vitamins, particularly B-essemer." I looked that one up too. Bessemer vitamins are designed to reduce the amount of carbon in pig iron in order to make a higher quality steel. Apparently my follicles are taking over where Geneva Steel left off.

National Casting of Aspersions Week

This proved to be a tough week for me and I thought that a day-by-day recounting would be useful.

You remember (or not) that I had my phlebotomy a couple of weeks ago after a two-month respite from poking or prodding of any kind. The fact that I did not have a blood-letting during December disturbed me somewhat (or not) and I was left with a lot of time on my hands when I thought very little of anything else 'ceptin' eatin', which I did a lot of. Along with consuming a vast amount of iron-bearing foods, I compounded the problem by chasing every molecule down with phenomenal amounts of sugar and vitamin C, which without question facilitated absorption of any kind of iron floating about in the air. I began to fear for my life.

I decided last week, during our stay in St. George, Utah, that I would have my ferritin check on Monday the 19th. Now before anyone accuses me of a gross insensitivity, I have to say that since my retirement everyday is a holiday. I don't keep track of these sorts of things as a rule, because as a rule these national days of pause have little or no impact on my daily life. Trillium's birthday does and our anniversary does, but most everything else is just another day in paradise. When I called to make an appointment for my 30-second mini-extraction, no one answered at the clinic. "What is with these people?" I said into the mouthpiece of the phone. "Is everybody on vacation?" It was then that I looked at the calendar. I was so chagrined at not acknowledging Civil Rights Day, as it is called here in Utah, that when Friday came I did not take the trash out to the curb, expecting that Waste Management would come on Saturday, which is their practice when a holiday falls mid-week. Thursday night, after all of the evening events were over, Trillium said, "Aren't you going to take the trash out?"

I smugly replied "They won't come tomorrow; Monday was a national holiday."

"You better take it out; my calendar says that tomorrow is the big day, and it is a two-bucket day." I did so, in the rain, grumbling all the while about the farce that recycling is in our valley. I have a sneaking suspicion that even though two separate trucks come on Friday mornings, one each for the black and blue cans, they end up taking the refuse that we have diligently segregated to the same place for burial. Trillium is never wrong, however, and the trucks rolled about on their appointed rounds at their usual hour. Horror of horrors! Waste Management does not observe Martin Luther King Day!

Tuesday Joe Biden was sworn in as the 47th Vice-President of the United States, the man who assured me that paying more taxes was patriotic. I celebrated the occasion by spending an enormous amount of Medicare dollars by having my ferritin level checked. Now I have to decide whether I am un-American or simply a tax-and-spend Republican.

Tuesday I called my doctor's office early with the usual phone routine, and set up an appointment to have my blood drawn for the ferritin check shortly before the time that we were going to visit T-ma at the Shire. About 1:20, Trillium and I made our way to the University Health Care Center on University Parkway. For those of you who don't know, UHCC is named such because of the University of Utah, of which it is a part. University Parkway is named for BYU of which I am a part (an alumnus twice over, you know). I am always in a state of confliction when I go to visit with "Doc Holiday" who went to medical school at the University of Cincinnati (another outfit in dressed in red). Anyway.... "She-Who-Shall-Remain-Nameless" (SWSRN for short, pronounced "Shwooshrun") showed up at the front desk shortly after I checked in at 1:30 and waited there apparently doing nothing for over ten minutes while I cooled my heels beneath the television set carrying the broadcast of the Inauguration of the new President. I might have forgiven her if she had been watching the history-making event, but she simply stood at the far side of the desk with a blank look on her face. At 1:45 she invited me into her lab as if she had just noticed me, did her 30-second task and wished me well. She did, however, complement me on my veins. Was this sweet observation supposed to ameliorate the the fifteen minutes of heel-cooling, a rhetorical symbolism without substance? What a day!

On Wednesday, Tom Hanks, an actor whose work I have admired, declared that I was "un-American" simply because I hold political views that differ from his. This he did with a personal phone call. The phone rang. "Yes?" I replied.

"Zaphod! This is Tom. You're un-American and I wanted you to be the first to know that I am in the process of calling up all thirteen million of the rest of your people to let you know how I feel."

"Tom," I said, "How much is this going to cost you? Thirty or forty million dollars? Personal phone calls to thirteen million people world wide is going to be a little pricey. Why don't you just hold a press conference and tell us all off at once?" You all know the rest of the story.

I waited all day Thursday for "Doc Holliday" to call me with the results of my ferritin check. No joy! When the mail came yesterday there was a letter to me from the good doctor informing me that my ferritin level was at 345, some 52 points lower than the last level in November. To date I have lost almost 500 points of ferritin, this since August, about 100 points per phlebotomy. I have wondered what would have happened if I had had blood drawn in December and January. Prior to this last measurement I had dropped on average about 120 point per phlebotomy. Is is possible that I could have been as low as 160 by now if I had given it up twice instead of once? I am determined that I am going to give blood two more times, once in February and another in March, before my semi-annual visit with "Doc Holliday" in April. He will probably excoriate me for taking my life into my own hands, but I need to have good ratings on the internet, especially at "Trillium.com" and "Reallyaggressivesister.org".

Nothing else happened on Friday, the product of a four-day work week. Trillium and I went out to Chuck-A-Rama for dinner. Salads of all kinds, Cajun White Fish, a batch of batter-fried shrimp, and cobbler for desert. Oh, happy iron-free day!

Pig Iron, Part Deux

Sorry.....

During that last posting, the "wheatdog" was doing all of the talking.

Getting back to the iron in hotdogs, I have to say that the whole process of figuring out an appropriate amount of iron intake for a hemochromatosis patient is obfuscated by the fact that the USDA makes it almost impossible to understand their system. For example: the makers of Ballpark Hotdogs testify that one of their beef franks will provide a person with 4% of his (slightly less for her) daily requirement for iron. The United States Department of Agriculture says that a normal person needs about 10 milligrams (.010 grams) of iron to make it through a normal day. If you are an abnormal person or are having an abnormal day, you are on your own, mathematically speaking. Assuming normality, Ballpark is suggesting that if you wish to have all of your iron come from their wienies, you would have to eat 25 of them. Wow! As much as I love "wheatdogs", I can't hammer down a whole loaf bread in a day. Maybe there is more going on here than meets the eye.

Inasmuch as we hemochromatosis patients absorb three times as much iron from the food that we consume, should we conclude that one hotdog eaten by myself would provide 12% of my daily requirement for iron? That seems reasonable. Yet I have to ask myself, again, how much total iron is there in a hotdog? Resorting again to the math of the matter, if 4% represents a tenth of the total amount of iron in a hotdog (remember, 4% is the promised nutritional value, and normal people only digest 10% of the total available), then the total amount of iron that could be wrung from a Ballpark frank is 40% of the USDA's recommendation. The USDA says that 10 milligrams (.010 grams) is all that you need each day. If my mad math skills have not failed me, each Ballpark beef frank has a total of .004 grams of iron held within its plump little self. Now, hold on to your bootstraps! A Ballpark beef frank weighs 56 grams. What in the world constitutes the other 55.996 grams of material in that wienie? Don't think about this conundrum too long; "Calorie Count" gives Ballpark beef franks a nutritional grade of "F" and those guys have no clue about hemochromatosis. They also apparently have no clue about what constitutes a great tasting hotdog. The fact of the matter is, no matter what else is in a Ballpark beef frank, 53.5678 grams of it is pure "yummy". What I find interesting is that Trillium has intuitively selected the best possible venue for my personal addiction to "wheatdogs", and this long before "Doc Holliday" and I had our first set-to.

Here are Consumer Reports top six hotdogs, as of July 2007:

1. Hebrew National Kosher Beef Franks (weighs 49 grams and has 50% more iron than Ballpark; I have eaten loads of these behind Trillium's back))
2. Nathan's Famous Skinless Beef Franks (with roll, weighs 100 grams and has half of the iron of a Ballpark wienie; when is the next train to Coney Island?)
3. Boar's Head Skinless Beef Franks (weighs 45 grams and has the same iron as Ballpark; never heard of them, but can you get beef from a boar?)
4. Hebrew National Kosher Reduced-Fat Beef Franks (weighs 49 grams and has the same iron as Ballpark; non-fat sounds like you're concerned about your health. You can eat three of these in place of one Ballpark.)
5. Boar's Head Lite Skinless Beef Franks (weighs 45 grams and has the same iron as Ballpark; still suspecting the boar's head!)
6. Ball Park Beef Franks (weighs 56 grams and is the industry standard; 4% of USDA suggested iron intake)

Earlier in our married life, Trillium and I lived in Garden Grove, California. For poverty purposes we used to shop at a grocery store in Santa Ana called McCoy's. Everything was cheap! One day while shopping I cruised by the meat department and found hotdogs on sale for $.10 a pound. I had never seen them that cheap before, even at McCoy's. I began emptying the freezer case into my cart. Trillium came by with another cart and said, "Whatcha doin'?" She always uses that accent when I am doing something suspect.

"I'm a-pickin' up food!" I always use my Mortimer Snerd accent when I sense that I have been caught doing something stupid.

"Whatcha got?"

"Hottendoggies, yup, yup yup!"

"Whats inem?"

I looked at the "nutritional facts" label. "Beef lips and pork snouts," I stammered, somewhat aghast.

She gave me that look she always gives me on such occasions and said sweetly, "Too much cheap iron. Put them back. You'll thank me later".

Thank you! Thank you! Thank you!

Pig Iron

I went to the Infusion Center a couple of days ago and gave my bi-monthly pint. Prior to doing so, I called up the International Red Cross to see how their movement toward allowing hemochromatosis patients to give blood for public use. For those of you who have been following my adventures with this unexpectedly unrare disorder, I had called them once before about this matter because I thought that $107.00 per pop was just a little too much to pay in order to share my lovely B+ blood with the land fill. I called the local office; the Donor Acceptability Department. I was greeted by a somewhat familiar voice.

"Hello, Mr. Beeblebrox. What may I do for you?"

"How did you know it was me?" I asked.

"Caller I.D.. I find it is a lot more personal if I greet our patrons by their names. Is there something I can do for you."

"I was hoping that I could do something for you. I am wondering if you have changed your policy on the donation of iron-overloaded blood. I understood that the policy was supposed to change in this region after the first of the year."

"Oh! I don't know. This is just the Donor Acceptability Department. I will have to put you in touch with the Donor Acceptability Department in Boise, Idaho. Can you hold?"

Before I could ask the obvious question, I was put on hold. A few seconds later, another voice (I say another voice, but it sounded surprisingly the same as the one that I had just been speaking with, whom I thought hailed from Provo, Utah) picked up the line and sweetly said,"Hello, Mr. Beeblebrox. What may I do for you?"

I replied: "I was hoping that I could do something for you. I am wondering if you have changed your policy on the donation of iron-overloaded blood. I understood that the policy was supposed to change in this region after the first of the year." I have to do these repetitions frequently as I move up the information ladder. Someday I am doing to figure out a way to scissors-and-paste my voice.

"Hmmmm! I don't know. Let me check with my supervisor. Can you hold?"

At what point does anyone know anything about who qualifies as an acceptable donor of blood? Eventually, the girl came back on line. "Well, Zaphod (I began to wonder if I had called them more than once), it appears that the policy has not changed. You will still have to go to the Infusion Center to do your duty to yourself and your sister. Bye-bye now."

Somewhat dazed at the exchange, I found the number of the Infusion Center and asked to set up an appointment. The person at the other end of the line said, "Hello, Mr. Beeblebrox. What may I do for you?" I was certain that this was the third time I had spoken to the same person.

"I would like to come down as soon as possible and have a phlebotomy. I have a standing order from my doctor."

"Yes, yes, we know, but we are really busy this morning. There have been a goodly number of people who have fallen off the wagon over the holidays. Could you come sometime after 2:00 this afternoon?"

I said that I could and would. As it turned out, Trillium and I went up to see T-ma about 1:00 or so to see how she was getting along with the staff, and how many times she had hit any of the therapists there with it. All of this progressed, the drive to and fro, from home to The Shire, to the Infusion Center, and back home in one of the worst snow storms in Utah history. Our stay at The Shire was short, but we had time to play one game of Phase 10 before moseying off to Provo. I am a little dim about who won. I think that T-ma did; by one card. I faded fast once she began swinging her cane at me. (Now no hasty chastisement here; you all know that this scene was fabricated for artistic effect. My mother-in-law and I get along just fine.)

At the Infusion Center, I signed in once again in some detail. If one does not show up at their place more frequently than once a month, then all of the paperwork has to be done all over again. I was taken to a cubical, very similar to all of the others in which I had been previously ensconced. While I was sitting there waiting for someone to deflate me, a very large man raced by, his hand over his face, and blood streaming down his arm. I was naturally curious. While I waited there, the same man passed by the front of my cubical several more times in the same attitude and condition. When my paperwork arrived from Registration, Nurse Chappell flounced in and began preparing me for my blood-letting. I took the opportunity to ask Majel the burning question. "Who is the fellow with the bloody nose?"

"Him? Oh, just another phlebotomy guy. I'm not sure whether he asked for a second can of root beer [this she said looking at me with a knowing eye] or whether they just had trouble finding a good enough vein in his arm to draw from."

I am not vain about my veins, but I was happy that they seemed to be cooperating that afternoon. I can't help but wonder though, how long it would take to give a pint of blood through one's nose. I went went home rejoicing in the condition of my cardio-vascular system, even though the hole in my right arm was obscenely large.

Now in another vein.

I have tried to be at least a little bit conservative in my eating habits, but there appears to be one thing that I cannot seem to do without. At some point in my childhood, I happened upon a really hot hotdog and finding no other ready condiment, merely put butter on a piece of bread and wrapped the slice around the dog. It is sort of like a "corndog", but it is more like a "wheatdog" without the stick. I love these things. I can eat them for breakfast, lunch, or dinner and sense no shame whatsoever. I just had one a few minutes ago, even though Trillium fixed a lovely (and supremely healthy) meal for dinner. It is an addiction.

How much life-threatening, liver-destroying, pancreas-eroding, brain-frying, heart-stopping iron is there in a "wheatdog"? Who cares?
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(I need an attitude adjustment here!)

Lot's Soup

I have decided that the slings and arrows of life aimed at other people can have a direct effect on my own. Several weeks ago, T-ma fell in her room upstairs, breaking her hip, the femur, just below the ball joint. The medical team suggested that there were three possibilities: first, they could glue and staple the bone back together and wait six months for the bone to mend; second, they could perform a hip replacement, after which T-ma could be up and about within 48 hours; or third, they could stick her out in a nearby snowbank and let nature take its course. I love it when physicians make the choices that they want so clear to the people they are talking to. There is a kind of mental and emotional manipulation going on here that suits these fellows to a tee (or tea, depending on which side of the pond you are from). T-ma thought the snowbank sounded fine; Trillium suggested that the hip replacement had appeal; and I pretended to be mute.

Visiting people in the hospital has almost always given me the willies. I don't like the places in general, and the outfit wherein the operation on T-ma was performed didn't do much for me either. I am not convinced that hospitals are anything more than a vast repository of microbes and viruses waiting to descend upon and invade the bodies of anyone coming for services or those who are visiting those who have already been served. I mentally (and quite possibly physically) cringe every time I pass through the doors of a hospital.

After a few days of recovery, T-ma was sent off to The Shire, a local rehabilitation center where she could receive physical therapy on a daily basis, so that she could one day return to the Mount Kilimanjaro that is our house (we have nothing but stairs). Medicare volunteered to pay for twenty days in The Shire, figuring that in that time she would be fully healed. During the twenty calendar days that she has been there, six of them were weekends, meaning that she received no therapy on those days. This left 14 days of therapy in order to bring about total recovery. In the beginning there seemed to be some confusion as to whether or not there should be any stair-practice, a curious development inasmuch as that particular skill is absolutely vital on Mount Kilimanjaro. Eventually the doctors said that stair therapy should be part of the mix. One attempt at walking the stairs was made; great protestations were heard; and stair therapy became passe. One day I took the opportunity (as a good son-in-law) to chat with Tiny Tim, The Shire therapist. I found him in the tulip garden attempting to tip-toe around answering my questions directly.

"Well, she complained about about the stairs. There were too many of them [six]. There were just as many going up as there were going down [again six]. And when I suggested that she had to do this twice a day, she hit me with her walker."

"Well, Tiny Tim, she is 86..."

"At least that explains why she hit me with the walker that many times. Do you think she was trying to make a point?"

"No doubt." I then suggested that she might be ready to try again. She had said as much to me a few minutes before. Tiny Tim visibly winced, but promised that he would attempt another session with her that involved (gasp!) the The Shire Stairs. I don't think he has, as yet, broached the subject directly.

Other than the fact that I have usually attended Trillium in her daily jaunts to the hospital and The Shire, I have been affected in another way. For a couple of weeks we made it our practice to visit T-ma in the late afternoon, about four or so. Leaving The Shire about five-thirty meant that we would have to race home and quickly throw a meal together (when I say "we" I really mean "she"). I decided that I should be gallant and offer to take us out to eat somewhere. Trillium agreed. We have now visited every fast-food slinging establishment in the valley, along with a few other places that we had long ago dismissed as being the poster children for the County Health Department. I cannot imagine that this has been good for my ferritin count. I am actually beginning to lose the svelte lines of my youthful 66 year-old well-toned body and am starting to look like a spokesman for a Michelin Tire Commercial.

Christmas day we went up to The Shire to visit T-ma. We went around noon since none of our children could pull themselves away from their happy hearths to visit the tropical depression at Mount Kilimanjaro (that is a little unfair, since most of them showed up in the afternoon, notwithstanding the blizzard going on in Utah). We arrived just at lunch time as it turned out. Before we went into the dining room, T-ma regaled us with her adventures with The Shire cuisine during the previous four weeks. From her tone, I would have thought that the nutritionist (who shall remain Nameless) would be sporting about 86 lumps of one sort or another. One of the nurses said that since it was a light day, many of the inmates having been furloughed for Christmas, we could eat lunch with T-ma. I thought to myself, "Well, here we will find out the truth of the matter. I will know for myself, just how petulant my mother-in-law really is".

The main course was a chicken Caesar salad, the chicken was hot and redolent with lemon-pepper seasoning. I thought it a little strong to my taste and thought to chase it down with a glass of red punch that was on the table.... (eeeek!) .... (gaaasp!) ..... (I am at a loss for words). I believe that that concoction destroyed 9,345,294,567 of my brain cells in about 2.576 nano-seconds. I switched to water. The second course arrived shortly thereafter. Soup, a kind of green sludge with assorted colorful flakes floating about in it. A lady in back of me was served before we were and immediately broke in to a tearful fit about the soup, that it burned her mouth, that she needed baby food, and a dozen other such exclamations.

"She's such a whiner," T-ma said. "All day and all night. You'd think she was lying in a snowbank somewhere." About that same moment, our soup arrived. "Oh, my heck!" shouted T-ma as she took a spoonful, "This stuff is battery acid laced with salt. Here Zaphod; you can shovel this down," she said as she pushed the bowl in my direction.

"I have my own, T-ma. Thank you very much anyway," I sweetly replied, pushing the bowl back in her direction. I then demurely sipped my first spoonful from my own bowl and nearly gagged. I almost shouted out, "Oh, my heck! This stuff is battery acid laced with salt," but I did not care to validate my mother-in-law's assessment of the products of The Shire's lumpy chef. In order to be as supportive of the healing process as I possibly could, I consumed the entire bowl of soup with a bit of flourish, hoping that the salt would somehow ameliorate the torrent of iron consumption that had been going on in my life since T-ma had been incarcerated. I could not think of any other reason why I should slurp it down.

Salt causes iron to erode away. That is why we go to the car wash frequently here in Orem. It only seems natural that consumption of vast amounts of salt would cause a reduction of ferritin levels. After spending seconds on the internet, Googling the connection between hemochromatosis and high-sodium diets, I found nothing conclusive that would verify my hypothesis. There appears to be an open field here, one that suggests that someone with an entrepreneurial spirit could become independently wealthy in a few short weeks if they could only make that scientific connection between salt and iron. My ambitions are somewhat more modest. I asked the chef for the recipe for the soup. I have copyrighted that recipe as "Lot's Soup"; that's the ticket! When the break-through comes, I will be ready with the cure.

By the bye. When I have some sort of an injury or illness that might require a stay in the hospital or a rehab center, just stuff me in a snowbank somewhere. Everyone will be happier for it.