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.

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.

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.

The Origins of Hemochromatosis

There are many uncertainties in the universe, but there is one thing that you can count on: when there are two months between phlebotomies, something like that which follows is bound to happen.

“Why me?” This is a cry heard around the world, uttered by one out of every 250 people. “Why is my duodenum extracting every molecule of iron out of my beef burrito and stuffing it into my liver, pancreas, heart, and brain?” Well, as it happens, I have an answer. Actually I have two answers; in matters of such import, a plethora of explanations cannot help but illuminate. Both of these theories have currency. They are at the heart of the meaning of life, the universe, and everything, about which your humble correspondent has some expertise.

The first theory as to why there is iron overloading at all is called "The Big Iron Bang Theory". Approximately 13 billion years ago (you know, when I was a kid going to school, my teachers told me that this event took place 3 billion years ago; time flies when you are having fun), the universe did not exist. There were no stars and planets, no galaxies of any shape or size. In fact, there were no elements as we know them today, just an enormous number of sub-atomic particles living together in an extremely small condominium. Again, about 13 billion years ago, some sort of accident took place; the condo was condemned and all of the sub-atomic particles fled the inner-city to the suburbs. This shift in demographics fundamentally changed all of the sub-atomic particles. Some became hydrogen; in fact most of them became hydrogen. According to Carl Sagan, for every atom of any other element, there are “billions upon billions” of hydrogen atoms. In honor of the great astronomer, this ratio of “billions upon billions to one” is affectionately referred to as a “Sagan” (pronounced with emphasis, it becomes a "Shy-Sagan"). So, as a result, helium is hard to come by, as is oxygen, nitrogen, and argon. Seaborgium and Ununbrium are difficult to pick up at Wal-Mart as well. Iron, as it turns out, is a rare earth metal when compared to the amount of hydrogen bouncing around the universe. Why, then, do I end up with so much of it?

I was watching PBS yesterday and I found out why. It all has to do with the life of a star. In the beginning, a star is formed by the aggregation of an immense number of Bok globules, several Shy-Sagan-Sagan’s worth....... At this point, astronomers want to talk about hydrostatic equilibrium, Herbig-Haro objects, and proto-planetary disks. This, however, would be a digression from our main theme, so we will push on.....

When a star first flares into existence, its business is the fusing of hydrogen atoms together into helium atoms. The more helium there is at the core of the star, the brighter the star becomes. This continues for about 90% of the star’s life. As the star ages, it suffers what Sagan and his boys call “metallicity”, the dreaded creation of elements other than helium. At first, the process merely fuses helium into such innocuous particles like oxygen and carbon, but the malady continues with the specter of the “carbon-burning process”; the “neon-“ , “oxygen-“, and “silicon-burning” processes quickly follow. As might be expected, there is a point of diminishing returns, and that point is when iron is produced by fusion and the star cannot get rid of it. So, you guessed it, the star stuffs the iron into its own liver, pancreas, heart, and brain. Eventually, the inert iron core becomes so massive (about 1.4 times the mass of our own sun) that it collapses under its own weight and a supernova occurs, splattering all of the iron and all of the other elements all over the place, to be used in the formation of planets and all of the life on them. What no one has figured out before, but which I am sharing with you now, is that there are some stars that produce and store three times the amount of iron as regular stars. These are hemochomatosis stars.

Joni Mitchell, a famous songwriter and erstwhile astronomer, wrote a song in 1969 called “Woodstock” in which she explains why it is that we are all the way we are, why it is that I, my sister, and one out of every 250 people on this planet have hemochromatosis. The tag of the song, the chorus if you will, is as follows:

We are stardust
We are golden

And we’ve got to get ourselves

Back to the garden

So there you have it. The disturbing thing about all of this is that no matter what I do, I am gaining more weight. I play racquetball with Jenny for six weeks and I put on six pounds. I resort to eating nothing but heads of lettuce for lunch and I can’t fit into my suit pants. I fear that I am no longer in the hydrogen-fusing stage of my existence. I am a “red-giant” ready to collapse into a “white dwarf”. All I need is just another solar mass of iron before my heavy metals can be blasted all over the earth. It’s time to defrost the tri-tips.

The other theory explaining the existence of hemochromatosis is called the “Intelligent Wrought-Iron Design Theory”, but at present we can only talk about that in the state of Texas.

The Iron Mean

Yesterday I went to visit with the good “Doc Holliday” to find out what kind of condition my condition was in. To everyone’s delight, my ferritin had dropped to 223, 170 points down from January and 600 points down from last August (I say “to everyone’s delight”, only because Trillium and Judie had not, as yet, seen the numbers; they want me to be completely de-magnetized). We spent an hour together poking and prodding each other; he physically, I informationally. All of my organs appear to be in good working order (he thumped and poked a couple of these). Therefore, the hemochromatosis prognosis is good. I am supposed to go to the Infusion Center for a phlebotomy once every two months (bad news for the boys and girls in that institution). Since I dropped fifty points doing that from November to January, I am not opposed to the treatment.

After reviewing all of the blood work, “Doc” thought that my triglycerides were high (248; the high end of normal being 149). My HDL was one point below normal (39 instead of somewhere between 40 and 60). My LDL was 30+ points higher than the extreme (130 instead of between 0 and 99). Some of this could be explained by the fact that I was not fasting at the time the blood was drawn. That’s my story anyway. The truth probably has to do with the number of maple bars and “wheat dogs” that I have eaten during the last couple of weeks…. along with the potato chips, the salt water taffy, and the leftover Chocolate Christmas Oranges that I have been compelled to eat (by compelled, I mean that they were left out in plain sight). He said that I need to exercise (“Ooooohhhhhh! Nooooooooo!”) and change my eating habits (dirt instead of food).

I asked “Doc Holliday” what would happen if I did not pay attention to these numbers, if I just went on my merry way, content that I was not part of the static electricity generating machinery of the planet. He said, “Well, there is a .5 percent chance that you could have a heart attack or a stroke in the next five years.” I then asked what would happen if I went on this regimen that he was suggesting, a procedure that would mean that every time I ate something it would seem like I was grubbing for truffles in the back yard. He replied with a smile, “Well, your risk would be reduced to a .25 percent change of a heart attack or a stroke.”

“So,” I said, “What you are saying to me is that the odds of my not having a stroke or heart attack are 99.5 to 1 if I keep on eating what I am eating, but if I switch to daily doses from my compost pile I can improve my odds to 99.75 to 1.”

“That’s essentially it. Isn’t medicine wonderful? Aren’t you glad you came to seek my advice about all of this? Welcome to the club, brother; we are all going to be miserable together!” I went home with mixed emotions, which I quickly unmixed by having a handful of sour cream and onion potato chips, followed by a pork loin sandwich.

This morning I thought better of all of this and decided that I needed to be a little more rational. During my slumbers I had the phrase “the Golden Mean” pass through my mind several times, together with the phrase “the Iron Mean”. Not wanting to ignore communications from my “space pillow”, I came down early this morning to flesh out this entry by Googling the two phrases. Needless to say, I have enough material now for about six 5000-word essays.

There are four major “Golden Mean” entries to be found on the web. The first is an epistolary novel by Nick Bartoch, the third in the “Griffin and Sabine” trilogy. It sounds boring and since Bartoch lives in British Columbia, it probably is; the book is no doubt beautiful, but boring none the less, kind of like Vancouver.

The second entry has to do with mathematics. I read several articles on the “Golden Triangle”, the “Golden Rectangle”, and the special relationship between a man’s belly button and his nose. The conclusion that I came to was that Johannes Kepler and his fellow mathematicians all had a thing for maple bars and pork loin sandwiches and did not beat the odds. The best thing that can be said about all of their number crunching is that the whole universe may be reduced to the square root of the number 5 divided by 2. These guys may also have been suffering from undetected hemochromatosis with ferritin counts in excess of 1,618,033, all of the iron having been deposited in their brains. I was not impressed.

The third is an Aristotelian concept, suggesting that the relationship between truth and beauty may be mathematically quantified. All the numbers aside, however, the simplest redaction of his ideas may be stated thusly: “Both beauty and truth have symmetry, proportion, and harmony”. I had noted this already in the perfect dimensions of the “Maple Rectangle”.

The fourth articulation of the “Golden Mean” was conjured up by Confucius in the sixth century BC. It is sometimes called the “Unwobbling Pivot”, or the “chung yung”. In this philosophy the mind is to be in a state of constant equilibrium (a kind of intellectual mugwumpism that does not include maple bars or pork loin sandwiches; no extremes of any kind). The advocate of the “Golden Mean” never leaves the path of duty (he does exactly what his doctor, his wife, and his sister tell him). The man that observes the “Golden Mean” is a gentle teacher and never has contempt for his inferiors (which leaves out sarcasm, broad humor, and just about anything that makes me laugh, including this blog). And finally, a man of the “Golden Mean” always behaves himself according to his status in the world (What in the world does that mean?).

I have concluded that I am not fit for any of the preceding definitions of the "Golden Mean" and have decided that I should be an advocate for the “Iron Mean”. I Googled that phrase later this morning and found that there was actually such a thing as the “Iron Mean”. Here is the mathematical formula for the "Iron Mean":

“The percentage of time I love you now far exceeds the moments when I want to brain you with a skillet”.

Iron reduction, truth, and beauty are all interrelated! This is the key to Einstein’s Unified Field Theory! I need another maple bar to see if I am right!

On Tenderhooks

(Yes, yes, I know. “Tenderhooks” should be spelled “Tenterhooks” but I always wanted to start an essay with a parenthetical statement.)

I cannot recall the first time that I heard the phrase “being on tenterhooks”, but I was certain that I heard “tenderhooks”. I knew what it meant simply by understanding what “hooks” were and regardless of what the other two syllables sounded like, if one were on a “hook” it could not be a good thing. I now know precisely what the derivation of the word is and I can assure you that whether you are literally or metaphorically on “tenterhooks,” it is not a good thing.

I went to the Infusion Center yesterday and had a pint drawn. It was a memorably nostalgic experience (Yes, yes, I know, “memorably nostalgic” is a kind of double negative or a semantic reduplication, but I really mean what the words say.) None of the lady nurses would have anything to do with me this time around. They sent “Gory” and his little UVU side-kick “Nickel” to work me over. The first thing that “Gory” said to me when he arrived with his basket of medieval instruments was, “Hi! My name is ‘Gory” and this is my little UVU side-kick ‘Nickel’” (This, of course, constitutes meta-fictional redundancy because I already told you that in the previous sentence.) “Would you mind if ‘Nickel’ does the phlebotomy? She is a nursing student and is only here today during her clinical. She wants to be party to as much blood-spla….., er…, as many medical procedures as possible.”

“Sure,” I replied. “I haven’t long to live anyhow. You might as well move things along.”

“Thanks!” He then turned to the little nursing student, who looked like she was twelve, and began giving her instructions. It was then that I had the memorably nostalgic experience. I was taken back sixty years to the banks of the Middle Fork of the San Joaquin River. My family was camped at Red’s Meadows, then a primitive camping site near Devil’s Postpile in central California. My Dad was taking me fishing for the first time and was teaching me how to bait a hook. Gory’s voice echoed every word my father said to me.

“First you have to find a big juicy one…. Try that one there…. Right…. Now take the point and push it right into the center… Ooops! That went just a little too far. Back it up…. Move it to the left a little…. Now push it in as far as it will go…. Ooooohhh, sorry about that! That’s okay; I have another one over here.”

Then “Gory” turned to me. “You seem a little tense, Dr. Beeblebrox. And clammy! My, you are moist! Dr. Beeblebrox? Dr. Beeblebrox? Zaphod? Are you alright?” Everything went mercifully black for a while. That constituted my literal "tenterhook" episode of the week.

Now I have to wait two weeks in order to have my blood drawn for a check of ferritin levels. I am really curious about this because my last evaluation was in January when my ferritin count had dropped to under four hundred points. Remember that I had started this whole thing with a count of 826, but with each monthly phlebotomy the count dropped an average of 120 points. When I did not have a phlebotomy in December, my ferritin only dropped 50 points or so over the two months. It was then I determined to have a pint drawn in both February and March prior to my annual physical with “Doc Holliday”. If the previous regimen is any indication, I should drop another 240 points of ferritin putting me at about 150 or so. But I will not know for certain until another three weeks have passed. The metaphorical “tenterhook” aspect in all of this is the wait; I want to know now if all that has been going on since the first of the year has been productive, particularly since I am the one who inserted the extra phlebotomy into the calendar. I would really like to know if I have played the fool in this matter. I am, however, as optimistic as ever.

Now for those of you who have been on "tenterhooks" (either literal or metaphorical), wanting and waiting to know the linguistic origins of the word “tenterhook” I submit the following: A “tenter” is a rack or frame upon which woolen or other cloths have been “stretched” after having been washed or dyed. Etymologically, “tenter” derives from the Latin past participle of “tendere” meaning “to stretch”. (Note the “d” in the Latin word; I always seem to intuitively know the right spelling.) Some scholars have also suggested that the word has been influenced by the Middle French word “teindre”, a word meaning “to dye” (But can you trust anyone who likes to eat frogs’ legs?) The tenterhooks were curved nails driven through the frames of the “tenter” which were used to stretch the cloth so that it might retain its intended shape and size. “Tenters” were set out in “tenterfields” to dry. For those of you who are as compulsive as I am about these sorts of linguistic issues, the edges of the cloth that are placed on the “tenterhooks” are called “selvages”, the coarse woven border that usually is discarded when the cloth is finally cut to pattern. This is kind of like the pint of blood that “Gory” and “Nickel” threw away yesterday after dinking around with my veins.

An Open Letter to Ironoverload.info

I began this blog about eight months ago with a desire to accomplish two things. First, I wanted to face my affliction by finding out as much as I could about it and, second, attempt to do so in a humorous way. I find that dealing with problems, even serious medical problems, with a degree of jocularity makes me feel better about the whole thing. This is not everyone’s cup of tea (see below), but it is mine. During these seven months, more than 1900 people have looked at my entries, spending an average of 14 minutes per visit reading the stuff I have been cranking out. I would like to think that it is because I have a deft hand at providing information while inserting a little broad humor along the way (hmmm... maybe it is the reverse).

I have made unblushing fun of myself, my little paranoias and other personality quirks. I have made unblushing fun of my family members and friends, medical personnel and administrators, and even my internet service provider. Everyone has been fair game. I have even provided what I think is pretty good music, even though I know that many of my readers turn the volume down so they can more effectively wade through my rhetoric.

I have enjoyed most of the comments that I have received, though I must admit that the vast majority of them have been from people that I know and love. What a surprise to receive a note from the head of the Hemochromatosis Society in Canada, encouraging me in my attempts to get the American Red Cross to relent in their prohibition of hereditary hemochromatosis sufferers from donating blood on a regular basis! I don’t think that I have been very effective, hardly at all, but I was flattered in any event.

Another fellow, “W.Pat” he signs himself, has also left comments from time to time. His, however, have not been personal comments, but rather little information bombshells dropped in his own inimitable “cut-and-paste” technique. I suppose that I would not take umbrage with his entries except for two things: first, he copies the same thing over and over again, and second, he isn’t funny. What’s up with that? So, having someone walk up to the mouth of my verbal cannon, sticking himself headfirst down the hole, and shouting “Fire”, I feel obliged to respond in the only way I know how. Hold on to your bootstraps “W.Pat”!!!!

I am including below “W.Pat”’s latest comments, conveniently divided up into numbered paragraphs. His text is in italics; my piffle is in normal type. I realize that is counterintuitive, but, hey, this is my story!

1. Learn more about hemochromatosis at my blog than your doctor even knows. Preventing cancer of the liver is crucial. Medications should only be used when absolutely necessary. Hemochromatosis sufferers that test with elevated liver enzymes, must avoid acetemetaphen altogether and alcohol should be avoided.

Well, W.Pat, as it turns out my physician, “Doc Holiday”, knows quite a bit about hemochromatosis because I have been as instructive off-computer as I have been on-computer. As it turns out, he too is a technocrat and knows how to “google” just about anything, and I know that he has been diligent about it because I see his cyperprints everywhere I go. As to “medications”, I assume that you are talking about medications to control hemochromatosis, even though there are no such medicines. The only known effective treatment for hemochromatosis is blood-letting, an ancient yet proven method for dealing with my hereditary disease. Acetemetaphen is harder to avoid than both alcohol and liver since hardly anyone has taken the time to find out what that mouthful means. With any luck at all, it will turn out to be another B-vitamin. With regard to avoiding alcohol, every person on the planet would benefit from avoiding alcohol, not just those of us who have livers at risk because of excess iron

2. Foods containing calcium such as cottage cheese, yogurt, carrots, etc are great for slowing down iron absorbtion.

If by “absorbtion” you mean “absorption” I whole-heartedly concur. It would seem reasonable that if you are hammering down vast quantities of dairy products and vegetables there is not going to be a whole lot of room left for red meat. Calcium should be on the menu anyway for old geezers like ourselves. We wouldn’t want to die of “SpoungeBob” disease before some hereditary infirmity carried us off to an open-pit iron mine in northern Minnesota.

3. Too much iron in the liver is worsened with booze.

As it turns out the reverse to also true; too much iron in the booze brings a whole new meaning to “hard liquor”. I have not consumed any alcohol of any kind in fifty years. That is one of the reasons that hereditary hemochromatosis has not had its way with me.

4. Drinks that have tannins work very well also. Black tea and my favorite, green tea are very helpful. Most herb teas do not contain tannins.

Well, “Dr. W.Pat”, as it turns out there are problems with the tannins and their kin that appear in black and green teas. For all of the benefits that might come with regard to inhibiting iron absorption, there are serious liabilities such that I would never recommend the drinking of these teas that you suggest. Why compound your health issues?

5. Vitamin C enhances the absorption of iron. It is wise only to consume a moderate amount and not take Vitamin C tablets. Vitamin C has been known to precipitate heart palpitations in those with hemochromatosis.

I agree. This is a precept that I have been pounding into the heads of my readers for months. Hopefully, your “coffin-nail” comment will cause them to swear off this malignant vitamin and we can all enjoy a good dose of scurvy.

6. The ingestion of black tea has been shown to decrease the absorption of iron. African tea which is becoming popular may contain iron so too much should not be consumed.Patients with hemochromatosis should not take supplements unless there are documented deficiencies.

There appears to be an echo in this rhetoric. See paragraph #4. With regard to African tea, EVERYTHING CONTAINS IRON AND SO TOO MUCH SHOULD NOT BE CONSUMED! If everyone would follow that advice, we would have less obesity in this country.

7. In severe HH the disorder manifests as potentially life threatening conditions such as septicemia, cirrhosis of the liver, liver cancer, diabetes, heart failure and heart arrhythmias.

All of these conditions are side-effects and no one need worry about any of them if their ferritin levels have been brought under control in time. I have none of these ancillary disorders because my sister bugged the daylights out of me to have the blood work done and because my physician, who is as well-informed on my condition as anyone on the planet (see paragraph #1), has put me on a course of phlebotomies that has effectively brought my ferritin levels down to a moderately safe level, notwithstanding all of the fun I have been poking at him along the way. I started out with my ferritin at 826 or so and a couple of months ago, my ferritin stood at 392. My guess is that my ferritin level will be below 100 when I see him next. These intervening phlebotomies will do the trick. That and the fact that I have cut back my “wheat-dog” consumption to only six per week.

8. Hemochromatosis sufferers should drink lots of water every day to keep the blood thin for easier phlebotomies and to keep the kidneys nice and flushed out.

I drink vast amounts of water because I don’t drink vast amounts of booze. I have a Barq’s Root Beer from time to time and although it sounds like I am swilling down alcohol and caffine, it is not the case. I live in Utah, after all, and Barq’s has to tone their stuff down for us. A flushed out kidney is nice, as fresh as a spring morning.

9. For people who are diagnosed and treated early, normal life spans are possible. If left untreated, HH will lead to critical organ damage and most likely death.

Anyone who knows me is aware that there is nothing normal about me. I am the personification of abnormality, notwithstanding the diagnosis and the treatment of my genetic condition. My paternal grandfather lived into his mid-90s; my maternal grandmother lived to be 101. I don’t think that I am going anywhere soon unless I am taken out by some booze-soaked, red-meat-eating barbarian from California who decides to cross the median on I-15 while I am on my way to the store to pick up an extra gallon of fish oil. As to the death benefit, as far as I can tell, that eventuality is going to transpire no matter what we do. Embrace the fact!

10. You can find lots of real life tips from Pat at his blog:

No doubt, but what you will not find is my kind of humor. The only kind of “real life tips” that I might provide will be cooking on the barbeque as soon as the snow melts. Come on up, “W.Pat”, my tri-tip steaks are to die for…. literally.

11. Http://ironoverload.info

There is the web-site. Go in peace.