Wednesday, June 24, 2009

In a city that knows how to keep its secrets

Spring never arrived, and summer blew in like a defective furnace that never shuts off. Last Friday when I left work, the temperature was 87ºF, and the humidity 96 percent. It's like the tropics, but without the charm of exotic birds and monkeys, unless you count Hyde Park's monk parakeets (which, by the way, I haven't seen in a while). Here by the lakefront, the temperature was lower and less likely to induce a coma, at least in me.

J. was visiting relatives in Oklahoma, but that didn't deter me from taking a cab to Ogilvie Transportation Center and a train to Braeside, then walking to Ravinia for A Prairie Home Companion with Garrison Keillor. Although Keillor hasn't slowed down that I've noticed, I didn't want to miss the opportunity as there's no way to know how much longer he'll want to travel and do live shows—or will be able to. Life presents us with many surprises, not all of them in the plus column.

I found a spot near the walk that looked like it would remain reasonably shaded for most of the afternoon (it did, except for one 10- to 20-minute lapse when the sun started to beat my brain and I moved a few feet over).

After getting comfortable and breaking out cheese and crackers, I noticed something I thought was new—video screens on both sides of the stage, like those I'd seen a Sting concert years ago in Grant Park. Ravinia has succumbed to the call of the YouTube video age, where you pay lots of money to go to a concert and watch it on TV. My blanket happened to be positioned so that I could see both screens, although at a distance. Is there not a little irony in going to listen to a live radio show and finding that even those who paid Pavilion prices are seeing it up close and personal, with a teeny Garrison and guests on stage and a giant Garrison and guests looming to the left and right?

It was a good show, although I found the increased visibility of security unsettling. Three to five security men were always in view in my little area, which made me nervous about inadvertently doing anything I didn't see anyone else doing. One of the men spoke to a woman because one foot of her chair was partly off the grass and onto the walkway. There's something about that kind of strict enforcement of "The Rules" that disturbs me.

The crowd struck me as a younger than I remember or expected. There seemed to be fewer elderly, more people with children, and more young couples. That there are people under 40 who listen to a radio show that's hardly cutting edge and only mildly cynical in this Age of Cyncism is amazing—people can and do turn off their computers and games and home theaters for a warm summer evening under the clear blue skies of June.

After standing in line a short time, I had to forego the post-show book signing because I didn't want to miss the 7:38 p.m. train that arrived closer to 7:52. J., who was home from the airport by then, offered to pick me up at Ogilvie—which proved to be tricky when he forgot his mobile phone. I had no way to tell him the train was late, and he had no way to tell me where he was. Fate can be kind as well as cruel or petty, so we found each other outside the station just as both of us were thinking of giving up.

Sunday I had an arranged outing to the zoo with JT. The skies and forecast were just iffy enough to deter the crowds. Many people were probably indulging in Father's Day activities (as a docent, I'd noticed that the zoo is a popular destination for Mother's Day, even when Mother is more than 80 years old and openly wants nothing more than to stop walking and to sit down for a long breather). Not surprisingly, a date at the zoo seems to be less popular for fathers than, say, an afternoon on a golf course or a few days in Argentina.

While many animals managed to elude us, including the red wolves and beavers at the Children's Zoo, others were less reclusive. We came upon 15-year-old African lion Adelor in the classic "hairball hurl" pose, compulsively licking his chops. Sure enough, after a few minutes he upchucked a yellow stream onto a rock not far from one of the females, who later moved away (wouldn't you?). Adelor wandered over to the northeast corner, assumed the classic "dump" position, did so, then headed to the middle, where he plopped, slung an enormous paw over a rock, and fell asleep. Give or take a few hundred pounds and shades of irritability, he's the very picture of your domestic tabby. Writ large.

At the bird house, the tawny frogmouths resembled wizened wise men in their sleep. I couldn't tell if the one on the higher perch were looking at me through his narrowed eyelids. Their soft, gray owlishness gives me a "peaceful, easy feeling."

I watched as one of three laughing kookaburra young dangled a dead mouse from its bill, perhaps confused as to why the kill had been so easy. After dispatching the mouse, it landed aggressively almost on top of its sibling, who protested. They dueled with their bills, both chortling quietly, as a disinterested parent maintained a dignified distance.

Three gray trumpeter cygnets dutifully followed their parents, the Caribbean flamingos displayed, a stork took a break from delivering babies to tend halfheartedly to a nest it hadn't started, a sand cat prowled its expanded domain, and a young François langur raced relentlessly after its tolerant family members. On the wild side, half-grown rabbits seemed to be everywhere. Right before we left, one rustled in the vegetation behind our bench, snipping it off efficiently with its teeth and seeming to inhale it.

Just as long as it stays away from the lions, tigers, and bears.

Sunday, June 21, 2009

Ignatius the tenacious

In this episode of General Hospital, on Tuesday the 16th, the day after my annual physical, I set off for Northwestern Memorial Hospital to consult Dr. M. about performing a laparoscopic myomectomy on the remains of Ignatius, the tenacious fibroid that, eight months after an 18 August 2008 uterine fibroid embolization (UFE), had shrunk no more than 1 centimeter. As you can see in the MRI image, Ignatius still takes up more space than some vital organs. My back and legs hurt, I feel bloated, and my bladder capacity seems to be less than a cup of coffee, let alone a mug. It has to go, and I was hoping that Dr. M. would be willing to take this project on, despite its size and mine.

I didn't complete any paperwork, so after introducing himself and sitting me down, Dr. M. asked the status and health questions you'd expect from a gynecologist, including the name of my current gynecologist ("Oh, she's very good."). One question threw me off, however: "Are you in a relationship? That seemed awfully personal. What happened to the traditional, tried-and-true "Are you single, married, divorced, or widowed?"? I supposed "partnered" (if awkward in construction) could be added to cover every base, but "Are you in a relationship?" sounded like something I'd expect from a therapist or
I answered with a simple "no." But the things I wanted to say . . .

He asked me the question every specialist who's new to me asks: "Why are you here?" I find this disconcerting because in most cases, including this one, they know why—they have a referral. Sometimes I feel like it's a test to see if I can describe my condition accurately enough to eliminate the possibility of hypochondria. I told him what I knew, about how long I'd known it, how the UFE had proven to be ineffective, and that I'd been told he may be able to perform a laparoscopic myomectomy. "I think you have the images." Indeed, he did. I thought so.

He'd asked me if I'd considered a hysterectomy, and I said "no" in a tone that I hoped conveyed resolve. He warned me that the myomectomy could turn into a hysterectomy (I'd received the same warning about the UFE), but quickly added, "But I've never had to do that." Later I noticed he'd written "NO hysterectomy" in his notes, too.

Dr. M. noted a couple of risk factors, neither of which, to my surprise, was my weight. The first was the long appendectomy scar on the right side of my abdomen that runs from a little below the level of my navel to the level of my pubic bone. The other is the degenerated nature of Ignatius, which is no longer solid muscle tissue but more of a cream cheese consistency, as he put it. It might take two hours, he said, then corrected himself to three, presumably because of its size and consistency. I brought up the size again, and he said that not many besides him would do this on me. I'm not sure I found that as reassuring as it was intended to be, but at least he said the uterine wall is in good shape.

On the way to the examining room, where he wanted to see my scar, I told him that my fibroid is named Ignatius. He asked if I call it "Iggie" or any other nickname, but I said we try to keep a more formal relationship (appropriate, I think, when one party has killed and is now trying to excise the other). He rattled off some of the other names he'd heard from other patients, although I don't remember them. When I mentioned that I would have liked to have had the pre-UFE Ignatius in a jar, he offered to take photos. I liked this in him—he allows a certain sense of humor and humanity to show, unlike many physicians. He didn't correct anything I said or explain anything that I already knew, so I felt like I was being treated like an intelligent and informed patient—whatever the actual case may be.

The appendectomy scar, it appears, is far enough over that it shouldn't be a factor. He marked the likely incision points (I've forgotten how many—six?), none of which is very close to the scar. They seemed to form a circle around my navel. This should look interesting afterward! He asked if the scar bothers me, and I said no (while it's a little more sensitive to touch and used to "pull" a little once in a while, for the most part I don't notice it except for its ghastly appearance). If it bothers me, he said, he could have a plastic surgeon take care of it. The offer was tempting, but my share of just the myomectomy is probably going to be enough to break my bank.

In the meantime, when he pressed on Ignatius, I told him that I could feel it in my bladder, which needed relief already.

The more I look at the MRI image, the more I am convinced that Ignatius is not only compressing my bladder, but my spine and nerves as well, causing lower backache and occasional searing leg pains and numbness. I will soon find out.

I've scheduled the surgery and the pre-operative appointments (one at 7:30 a.m. on my birthday!) and received instructions. Recovery from the myomectomy seems easier and less complicated than recovery from the UFE. Dr. M. didn't give me a definitive amount of time I'd need off (two weeks for the UFE), an there seems to be only one prescription (narcotic) painkiller and ibuprofen recommended, compared to the four prescription painkillers, antibiotics, and anti-inflammatory medications plus two nonprescription stool softeners for the UFE. I was told not to lift anything greater than 10 pounds after the UFE (Hodge fits into that category, which is part of why he took an extended vacation), but I see that I am "encouraged" not only to walk and engage in moderate exercise, but to lift up to 25 pounds. (Still, Hodge is due for another extended vacation, I think. Nothing like being chased by a fanged beast when you're recovering from surgery.)

This time, I feel less hesitant about the necessity. I'm used to how I feel, but as Dr. T. said, "That can't feel very good." It's like being 16 weeks pregnant—but for years. I want to walk without aching—and without having to be within earshot of civilization and plumbing. The 24 to 36 hours after the UFE were relentlessly painful, but I can look forward to that again if it means getting 95 percent (Dr. M.'s estimate of what he can do in this case, vs. 99 percent) of the invader's mass off my innards and spine. It's getting on my nerves. Literally.

Imagine—all this time, trouble, and expense began as a single muscle cell run amok.

Thirty-seven days and counting.

Addendum: J.'s reaction to the image: Is it the huge thing that reminds me of a steak because of the large white thing at the bottom (makes me think of fat on a steak)? [Note: The large white thing is my uterus.]

Thursday, June 18, 2009

John Adams on age

From John Adams by David McCullough, in a passage about a possible Adams candidacy for US president:
When [Abigail] reminded [John] that he was sixty years old, he replied, "If I were near I would soon convince you that I am not above forty."

Wednesday, June 17, 2009

Annual exam, 2009 version

Each year, a new element seems to be added to my annual medical exam. Last year, it was a test for Vitamin D level, which had by then become a hot topic. Mine showed that I was critically deficient—not surprising for a fair-skinned, obese Anglo-Saxon after a typically overcast midwestern winter.

The other new test for me was an EKG. Thanks to CPR training, I understand how important it is to have rhythm and that flat lines, unlike in made-for-TV medical dramas, are permanent.

In the 2009 edition on June 15, a breathing test was introduced. I look at these assessments in the same way I used to regard academic tests—as a challenge that I must not only pass, but excel at. Since my underlying belief is that I breathe poorly due to overcrowded lungs and and formative years spent breathing secondhand smoke in confined areas (including at my first job, before smokers were exiled to the great outdoors), I viewed this procedure with trepidation. It required a certain amount of coordination, that is, the ability to breathe in and out at the correct moments. The pressure!

The idea is to suck in as much air as you can hold, put an enormous tube attached to a computer in your mouth, and blow as forcefully as possible when cued. Your objective is to blow the leaves off a cartoon tree, among which monkeys are hidden. The tricky part for we the uncoordinated is that you're supposed to inhale again before removing the tube. I think.

All three times the device chastised me for doing something—not the same things—incorrectly. My first effort seemed respectable but weak, the second terrible all around. By the third I had almost gotten the hang of it, but it was too late as it was my final attempt—just I was getting a good look at the monkeys! Reviewing the results later, Dr. T. laughed at how I fared progressively from okay to poorly to best (the key being that the results were acceptable, of course).

Except for the critical lab tests (results as yet unknown and feared), my other results were good—EKG, blood pressure (100/80), urine, etc. She noted that my uterus is still huge, so I mentioned my anticipated consultation with Dr. M. She said that if he couldn't remove Ignatius the fibroid laparoscopically, perhaps he could recycle my appendectomy scar. Now there's a thought. She believes that I would have to feel better minus the squatter. I am beginning to agree. For example, 75 minutes elapsed from one bathroom visit to the next, I felt like I really had to go, and still I produced all of two ounces. Two ounces! My capacity must be at most four to six. Maybe eight. If I don’t cough or sneeze.

I celebrated my okay health by breaking my fast with a wrap and coffee at Argo Tea, then headed off to where the sun rarely shines. Does it shine anywhere these days, or is everything filled with direful doom and gloom?

Tuesday, June 16, 2009

Where's Ignatius? (or, find the fibroid)

Backache, anyone?
I'll post an update when I have time, energy, and energy and time, but for now enjoy this April 2009 MRI view of Ignatius, the persistent subserosal fibroid. Click the image for a larger version.

Wednesday, June 10, 2009

Dream: Love and fear in the magical forest

I was walking on the path along the woods at home, with the trees on my left and the field on my right. In an instant, I was transported into a dense fairy-tale forest, where among the trees were amiable people and interesting shops full of unusual wares. This secret place, which combined the beauties of nature and the comforts of civilization and art, was deeply mysterious and inaccessible. I had stumbled into a place that felt like home, but I knew that I did not belong there.

The people there knew it, too. I sensed that they were afraid for me but they could not warn me.

The deeper into this place I wandered, the more at home and the more fearful I felt—fearful that I could not stay and would have to leave. TJB was behind this. He did not wish to drive me away, but I had to go. It was he who was influencing the people, much as he have regretted having to do it.

Gradually I realized that I was dreaming, and I resisted waking up. I did not want to break the spell and the hold the forest had over my heart.

Writing at Bonjour

This is what I look like when I'm writing at Bonjour. Don't let it deter you from stopping in for a croissant or morning roll.

Monday, June 8, 2009

State of the art fair

Saturday J. and I went to the 57th Street Art Fair, arriving around 50 minutes before closing. I have a one-sided love-dislike relationship with art fairs:

On the love side:
  • They're outdoor community events, an ancient human tradition I adore. I love the idea of a crowd coming together under the open sky for an event that's important to individual participants and to the community. In this case, the community is not only geographic, but artistic: creators, patrons, buyers, browsers (like me).

  • At a good art fair, there are amazing varieties of materials, styles, techniques, themes, uses, and so forth. Someone selling conventional wall paintings may be parked next to an artist who crafts jaw-droppingly lovely inlaid wood bowls, and both may be near another artist whose etchings are whimsical and witty. We saw everything from knitted and crocheted pins to erotic statues of fat women (a personal favorite for some reason).

  • Sometimes I find something I love that I can both afford and use, for example, niobium earrings from Sozra at the Ann Arbor Street Art Fair. It was there I also found a three-dimensional clock for J., which I think featured a cat in a tiled kitchen and an evocative seascape seen in the background through a window.
In the dislike column:
  • Much of the art doesn't appeal to me. A couple of nicks in a keystone of polished wood. Colorful, childlike scrawls. Abstract anything. Garish colors. Urbanscapes. In some cases, it doesn't appeal to my eye or my taste; in others, it seems bland or unoriginal or uninspired; in others, it seems like a cynical cheat. Corollary: I have no cohesive taste or style, so I would not be able to choose art, decorative or fine, to create a beautifully designed interior space. I would end up with a hodgepodge of styles and colors, leaning toward the cool end of the spectrum.

  • I have no room. Being a pack rat junk collector, leaves little room for displaying art properly. Having a cat who likes to chew, bat, and knock things over is another factor.

  • I have no money. Let‘s say that I had control over my collection of miscellaneous 1970s kitsch, souvenirs, and other junk. Still, I can‘t afford much that I like, for example, whimsical etchings (three figures) and erotic sculptures (five figures)—and wouldn‘t they complement one another?
The weather forecast called for rain, but at least on Saturday the clouds held off. There weren‘t the crowds I remember from a hot, sunny day a few years ago. It may have been the threat of rain and the relative coolness of the air, the proximity to closing time, or the state of the economy, but there was a lack of people and energy, I felt.

J. and I have very different browsing styles, which can be challenging. And I didn‘t see anything that stopped me in my proverbial tracks. I should have gone with less of a hope of finding something because I was disappointed in my mission.

One thing made me smile, though, despite it being fundamentally a little sad. One artist was accompanied by a beautiful little dog with little or no use of its hind legs. When the man went for a walk, he strapped the dog‘s back legs onto a little car with wheels. While those legs dangled uselessly from their straps in the air, his good front legs pulled him and his wheels along. The dog, who otherwise spent his time lying on a blanket behind the display, seemed content enough with this arrangement, strange as it may at first look.

We went to 57th Street Books with its 20 percent sale for members, and such were my mood, purse, and space issues that I didn‘t buy anything. This has to be a first.

Not surprisingly, Medici on 57th was crowded, with a 15-minute wait, but the spinach and goat cheese pan pizza was worth it. It gave us the strength to start going through some of J.‘s papers. Even though they aren‘t mine, filling a bag with the nonessential ones and dropping it down the chute was satisfying and cathartic.

Dream: Miracle poles

A high school friend invited me and others to a concert featuring a female rock singer—someone who could fill a club or maybe an amphitheater, but not a stadium, a woman who’s more notable for influencing male rock stars than for her own performances. (And someone whose music I’ve never heard.) We sat near the front, where I held two vertical poles that could connect to one another through cross pieces.

We won a drawing and were invited backstage during the break. My friends disappeared, and I discovered that I would have to cross a gap high above the stage onto a crumbling concrete ledge full of holes. I hesitated, wondering why this sort of thing always happens to me, and swung over ungracefully by sitting.

While my friends were getting a conventional on the floor below—I could see them from the perspective of a third party through the cross section of wall, similar to how the inside of the Borg ship was sometimes shown on Star Trek: The Next Generation—I was taken backstage and questioned. I was asked to whom a reporter owes his loyalties from an ethics perspective. At first this seemed a simple question—the employer—but later I thought loyalty should be to the public and the public good. Feeling trapped, I suspected my answer was unsatisfactory and wondered what I was expected to prove. I knew they wanted my poles, which could help cure an ailing band member. That’s why we had “won” the tour.

It must have worked because I found myself in the band’s inner sanctum, the place they didn’t want anyone to know about. A series of grandmotherly women cried as they lined up to hug me. I thought that no one would believe any of this.

Strangely, in all this I had never met the singer herself. As I contemplated and questioned the positive review I would give the experience and thought about how moved I was by it, I passed her and one of her intimate friends. They were deep in conversation and ignored me. I was hurt and wondered what this snub meant after all that had happened. I felt bitter and guilty about it.