feuervogel | Entries tagged with life: medical

I got an Ink + Volt planner for this year (which mocks me every day with its reminders to check my monthly and yearly goals), and it has a X-day challenge every month. I've done German every day (twice), PT or stretching every day, and that sort of thing, so this month, I'm going to write an entry here every day. I miss longer-form social media and being able to interact with people, in this day of more ephemeral sites like twitter and tumblr.

Today I actually had an interesting experience. When I got up to Maryland, I signed up for health insurance through Kaiser Permanente. A few days later, I got a call from the allergy clinic, asking whether I wanted to take part in their program to see if I'm still allergic to penicillin. They got some money to run this protocol on new patients who listed a penicillin allergy in their charts. I said sure, why not, and my appointment was this afternoon.

The procedure is as follows: 1) a scratch test on the forearm with histamine (positive control), saline (negative control), pre-pen, and pen G. If that is negative, you advance to step 2: a repeat of the above, but intradermal injection instead. A negative result on that gets you to step 3: an oral challenge of 250 mg amoxicillin. If step 1 or 2 is positive, the protocol stops there. It takes 2 hours, because they watch you for an hour after the oral challenge to make sure you don't react.

So, as it turns out, I'm not allergic to penicillin anymore. According to the doc, the literature doesn't suggest any future resensitization following use of penicillins, so the likelihood of redeveloping an allergy is very low.

Current Mood: satisfied

I was cutting carrots yesterday afternoon, and one of them rolled, resulting in (eventually) 3 stitches and a tetanus shot. About 2 hours after it happened, I drove myself to the closest urgent care (after getting the bleeding to stop enough to put a bandaid on, then waiting until I was sure I wasn't going to pass out and also drinking sugary tea; I also ascertained that the trip was covered by my NC insurance).

If I'd been home, I'd have yelled for Ben (or called him, if he had a job) to drive me to urgent care while I held a paper towel on my finger. I don't really know anyone here yet, but maybe I could have gotten one of the apartment people to drive me, but they probably wouldn't have wanted to wait.

I'm not super worried about future events, but I'm trying to decide which of the department staff to tell "ok, here are things that could happen; probably won't, but if they do, here's what to do."

I'll update more about my apartment and life here later. I'm so sick of driving across town for things at Target, though >:[ I've been here not quite 5 days, and I've gone to Target 3 times. This Target's layout is a fucking mess, too, so good luck finding anything.

We lost Claire a few weeks ago. It hurt too much to write about, so I didn't. It was very sudden; she had a blood clot, and there was nothing we could do.

My GP agrees with me that I have Raynaud's and probably some form of Ehlers-Danlos (hypermobility type).

I should be hearing back about grad school soon. Russian class is going well.

I went to the doctor yesterday for these weird pink bumps on my toes that hurt and itch sometimes. Chilblains. Caused by excessive vasoconstriction in the capillaries at the extremities. Not much you can do about it other than wear multiple pairs of socks and wait for the weather to get warmer. Can be related to Raynaud's, which I've suspected I have for a while now.

Since I've been feeling a bit off and have had more migraines recently, I brought that up, as well as this feeling of swelling on the front of my neck. She said if it's still bothering me next week, I should call & she'll refer me for an ultrasound. She also had me give some blood for a thyroid test, since my last one was 10 months ago.

(I haven't been feeling up for exercising, which I don't like. I like exercising. I felt too fatigued this morning to do my lifting, and I wasn't happy.)

I've got 3 stories on submission (20, 7, and 1 days) right now, and a fourth I intend to get out soon, once I remember where the next place I wanted to send it was. (I also want to give it a read-over in a few days to see if the revisions I just made work or are clunky.)

I finished the last exam in my certificate course, which means I should be getting my certificate in the next month or so. I don't know if I need to do anything else, like say "hi, I finished everything, do I need to do anything else?" I read the syllabus-like thing, and it didn't really help.

I've almost finished reading this book about Berlin 1961, and, somewhat annoyingly, it's given me ideas that would make my novel better but require more extensive rewriting than I did during NaNo. -_- But now that I've finished the course, I can spend several hours every day reworking it. (And I also have a white board where I can make notes and outline things that happen off screen.)

This weekend should involve hanging out with people I haven't seen in entirely too long, games, pizza, beer, and cupcakes, so I'm pretty excited about that. (There was a red velvet cupcake mix at the store, which I couldn't pass up. It included a frosting packet! Not that cream cheese frosting is particularly difficult, mind you.)

I think for my next baking trick I'm going to make chocolate chip cookies with dark chocolate M&Ms instead. Though I might hunt down an oatmeal chip recipe for that for texture purposes...

Um, still teaching & planning to apply to grad school, which means I need to revise the paper I wrote in Marburg and contact people about writing LORs and prepare for the GRE ugh.

Current Mood: sleepy

I got another rejection on a story. This makes 0 for 7, but the second personal rejection. With feedback that would really have been useful before I exhausted all the pro SF markets. *sigh*

I revised the castle story and sent it out to another anthology. I think it fits the criteria marvelously, but I have no idea what the editor will think.

I not only have a German 1 class starting in October, but I also have a private lesson starting Monday. And no textbook (it's on order and hasn't arrived yet).

I made an appointment with my GP tomorrow morning to talk about my knee grinding when I go down stairs and the persistent tingling. (Sciatica? Something else?) I don't know whether I need to go to an orthopedist or if going back to PT will help. The PT I saw was fairly dismissive of my statements that my right hip didn't move as well as my left. ("Your left hip is just really loose, and you're comparing the two." Yes, I do have loose joints, but that doesn't preclude my right hip from having a problem.) So IDK, if I get a dispensation from an orthopod, maybe the PT will listen. Or a different PT.

I don't want to give up running, because I like it. I don't have money to join a gym (and the Y is more expensive than the gym ffs, fucking Chapel Hill), and my elliptical makes a distressing metallic grinding sound when I use it. I'd take up swimming, but the gym is too expensive. Unless I want to drive 20+ minutes each way to use a pool. (Spoiler: I don't.)

Blargh.

Current Mood: blah

+360, 25445.

Finished the scene I started yesterday, and I'm going to go finish sewing a thing I started this morning. I took 15 mcg of T3 today, and I feel SO much better.

I made a to-do list last night because I feel like my ability to mentally organize things is gone. I keep meaning to do things and then either forgetting them or falling into the hole of facebook flash games.

I was feeling consistently awful and low-level migrainey for a few days a couple weeks ago, so I went into my doctor's office, and they took thyroid levels. They said I needed to go down on my T3 because my TSH is too low. So I've been taking 10 mcg instead of 15 for about 2 weeks now, and I don't feel all that great. No migraines or anything, just lack of motivation, dry eyes, mouth, and skin, and low energy. I can't focus worth a damn, either. (And because of my neurologist's verbot on caffeine, I can't just make some black tea and make some focus, either.)

It could be that 15 mcg is too much, but 10 isn't enough. Unfortunately, the medication comes in 5 mcg unscored tablets. Though it also comes in 25s, and 12.5 might work out. Except for reasons completely unknown to me, because I've never had 90-day supplies called in before, the nurse authorized 90 days with 3 refills on my last T3 rx, while doing 30 days with 3 refills on the Synthroid, because I don't even fucking know. Maybe she goofed and read the #90 as 90 days, but #90 and #270 are a lot different.

So I have a metric shit ton of 5 mcg liothyronine tablets (at 2 a day, they will last me 135 days, or approximately 4.5 months), and I refuse to pay for a new prescription when I already paid 3 months' copays for the bottle I have. So if my doctor agrees at my physical next Thursday, I'll see about either taking 2.5 every day or adding a third in the afternoon. Or going to an endocrinologist, maybe.

I have this writing idea that I've been letting float around in my mind for a while, and I finally had some insight into it last night. So I made some rough notes around which the idea can coalesce while I work on other things.

I'm going up to DC next weekend (via Amtrak) to see the US and German men's soccer teams play at RFK stadium. I am excite. I'm staying with my sister Fri & Sat, then going to the game and staying with Ben's brother Sunday, then coming home Monday.

I need to write a letter (in German) to a language school and ask if I can do a practicum there and if they meet the criteria set forth in my course description. I don't really want to do it, but I need to. Ideally, I'd do the practicum in winter when airfare is cheapest, but I don't know ... well, there are a lot of things I don't know, like whether they'll even accept non-native speakers as praktikanten or whether they'll have openings in winter or how far in advance I even need to make arrangements. Argh. (I am fairly certain that there are no practica that meet the course criteria in the US unless you are majoring in education and doing your student teaching. There is an alternative to the practicum, which is 120 hours of teaching experience, which would take me far too long to acquire, if I could even get a job without a certificate and experience.)

Anyway. Stuff. I need to get started on my to-do list before I lost the entire morning to faffing about. This has already taken over half an hour to write, in part because I got distracted and wandered away for a few minutes several times.

Current Mood: busy

I spoke with the supervisor, who actually listened to my explanation of what happened and why I shouldn't owe any money. She talked to my doctor and called me back. My doctor is going to cancel out her charge from March 1 (making that the no-charge visit), meaning I won't owe them anything.

Finally.

On March 1, I was supposed to have my IUD removed and replaced. This is usually done in a single office visit for a single office-visit copay. With my plan, the specialist copay is $30.

For reasons involving my apparently extremely abnormal anatomy, only the IUD removal actually occurred on March 1. The nurse walked me out and was going to get my copay refunded, since I'd have to come back again in a week to try again, except the person who handled that was gone for the day.

I went back March 7, checked in, and didn't pay--they didn't ask me to pay, because it was to be a no-charge visit. So I went up to the room with all the fancy equipment in it and had my cervix prodded for over an hour until the damned IUD finally made it in. Yay.

In July, I received a bill for $30 for date of service March 1. At the time, I misread it as for March 7, the no-charge visit. I called the clinic, they assured me it would be taken care of.

Apparently it wasn't, because I received another bill in November for $30. And a robo-call, which put me on hold for the next available representative. Normally I'd hang up on that, but it pissed me off so much that I stayed on the line. I told them I'd already paid it back in March.

So I got another bill for $23.84, and another robo-call.

I spent half an hour on the phone with billing today, while a representative traced the path of my $30 copay. It was applied to March 7. According to her, I had to call the clinic to get them to adjust the charges. So I called the clinic guy.

He says, snippily, that he can't do anything because they billed insurance something something and I had to pay extra for the IUD itself? I don't know, I was a little too pissed off to follow the bullshit logic.

I have his supervisor's number and will be calling her in the morning.

I left a message with my doctor's nurse line, saying that I have been having a billing issue since July where they're charging me for the no-charge visit and saying I owe the copay I already paid, can you please do something to fix it, I'm about ready to quit this practice and go somewhere else. (Which is sad, because I like my actual doctor, and it's not her fault billing is full of incompetent assholes.)

So. Anyone who thinks the American free-market health care "system" is more efficient than a single payer with a single fee schedule is either living in Libertarian Utopiaville or has never had to deal with the health care system.

Current Mood: pissed off

+548, 14740/90000.

I got some writing in before lunch. Not the word quota I need to make Scrivener happy (660), but more than the 0 I was expecting.

I officially am the hardest IUD insertion my doctor has ever done. Apparently my cervix goes down before it goes up. But we have notes for next time in my chart, so hopefully it won't be as much of an ordeal.

Current Mood: sore

Today I was supposed to get my old Mirena removed and a new one put in. We got the first part done, but the second didn't work out so well. Again. My doctor tried using ultrasound to deal with my uterus (which is about 90 degrees anteflexed rather than a more typical 60 degrees) and get it in a better position, but my cervix just wasn't having any of that. Lucky me, I got to be the first patient she ever completely failed to insert an IUD in!

But she has a plan. I'm going back next week, and she's going to try it with ultrasound and a hysteroscope, and bring over a set of flexible dilators (because she couldn't get the rigid metal ones to go in at all, and the flexible one available at the clinic isn't big enough). I shouldn't have a copay on any of it (because they're refunding mine from today), but the online check-in thing wanted me to pay 2 co-pays (they had to schedule it as 2 appointments: 1 for the u/s, one for the gyn). So I told it to pay later. I have more problems with Duke and my insurance...

So anyway, hopefully after all this, there'll either be notes in my chart about how to deal with my anatomy or there'll be notes saying to schedule the extra rigamarole in the first place. Though I didn't schedule this appointment; the scheduling people did and sent me a letter.

At least this only happens every five years. I wish they'd come out with a 10-year Mirena... If they did in the next 5 years, I could get one and it'd last me until menopause! I don't relish the thought of trying to get one in Germany and explaining to the German doctor all my weird anatomical crap, even with notes from my doctor here...

I had a 3-month recheck of my levels earlier this month. My TSH is still too low, from my having been on way too high a T3 dose for a month or two, so my doc said to drop from 4x5mcg T3 per day to 3x5mcg. Starting about a week after decreasing the dose, I started to get more migraine-like symptoms and tinnitus. I got to a point where I couldn't stand it anymore, so I took 4x5 mcg one day. Unsurprisingly, I felt much better that day. (I've been tracking symptoms in the "mini diary" tool on my phone.)

Yesterday I did that again, and felt great. Today, there's massive sinus pressure and tinnitus making me want to stab my eardrums out.

I'd like to see my TSH in the normal range, but I hate feeling like this.

My T4 is borderline low, though, so maybe I could go up on my Synthroid and stay on 15 mcg of the T3. I should call my doctor's office, I guess. She wanted me to do another recheck in 8 weeks (so, the first week of October), but I'm not sure I can make it that long.

Current Mood: annoyed

As I may (or may not) have mentioned, I started physical therapy last week. I'd talked about it with my doctor at my previous physical, before I went off to Europe for 6 weeks last year, and she said she'd refer me if I found one that took my insurance. Then after I got back, there was The Nausea, which sort of took over my health focus for six months. Fun. Anyway, I just had my physical this year, and I got a prescription and went to Duke Sports Medicine.

What we're going to focus on is increasing balance in muscle strength. I have quads of doom, but my hamstrings and inner thighs are very weak, and the PT says addressing that should help with a lot of my issues. So I have to do this exercise to isolate and strengthen the hamstring and inner thigh 2-3 times a day. I fear I may be doing it wrong, even though I'm doing it the same way as before, because I get this cramp in my lower ribcage partway into the sequence. It's the same cramp I've gotten before when I bend down and get up wrong, so idk, maybe it's a sign that the muscles are adjusting. It only lasts as long as I'm doing the exercise. My lower back didn't hurt as much when I accidentally fell asleep on my back, or when I was lying on my stomach for a shoulder rub. Progress!

The PT said to call if it hurt, but they're closed today (for the holiday), so maybe tomorrow if it's still doing that. I'm still working out the exact position I need to be in, since I don't have the same equipment they do (and am improvising with the box my toaster oven came in, a phone book, a towel, and another box to get the 90-degree angles in my hips and knees).

So, I called Duke Sports Medicine today and got an appointment for next Thursday. Fine.

I get the online checkin email and go to the site to go through it. Insurance is right, agree to pay for shit, hit the second to last page and find a box filled with $250 that I'm expected to pay, rather than the $30 copay that's in my benefits booklet.

Oh, it's a HOSPITAL-based service, and subject to my deductible before anything else. It had better fucking NOT be $250 each fucking time. Hospitals can choose whether to have outpatient clinics, and they can choose whether to bill insurance as facility-based (and get the patient's full deductible) or as a free-standing clinic and just get their copay. Of course they'll choose the higher bill. Profit über alles.

And the BCBS-NC website has no option to find a physical therapist in their "find a doctor" area. It's not an option on its own, and it's not under specialties, so I can't "shop around" as free market fellaters would have me do to find one that isn't hospital-based and thus only subject to my $30 copay.

Update: I called the clinic back to see if that would be an every-time thing or just this once, and the guy who answered didn't think that sounded quite right (like it hadn't been billed to insurance yet, which they do the day before the appointment), so he transferred me to the person who handles insurance, who was either away from her desk or on another line. I left a slightly rambly voicemail asking whether I'd be paying the deductible or a copay or if it'd be $250 every time or what.

Update 2: The person who handles insurance called back. I met my hospital deductible already (that sinus CT back in October, which was clean and bought me the neurologist referral), and I'll have to pay nothing for it (until fall, if I'm still going in, when I pay the $250 again). Because it's hospital-based, not clinic-based, I don't even have to pay the $30 copay. Which is better, I suppose, but still unexpected to see "yes, you will owe $250 for your appointment. Please pay $100 in advance, and you'll be responsible for the balance upon arrival." (There's an option to skip payment, which I did, because it sounded entirely wrong, and I figured I'd pay it when I got to the appointment if I had to.)

ObProSinglePayer: Because clearly, the government couldn't be any LESS efficient than having an entire department that deals with the ins and outs of the dozens of insurance providers and their dozens of plans.

Current Mood: anxious

Today: +157, 83,795, 45 days left.

A snippet (and the end of a chapter):
That didn’t answer who the people who said they were judo students and teachers really were. There were other companies than the Sons of Mars, but Azar hardly knew anything about them beyond their names. The Hessians came from CEF space, she thought. Sahar had talked about them when Azar was a child, said they were the most honest mercenary company in the galaxy, but still mercenaries.

They were people whose loyalty could be bought and sold for the right price. And they were Seven’s best hope for freedom.

Doctor stuff:

Got renewals on my prescriptions for my thyroid meds, and we're trying 4x5 mg of T3 a day instead of alternating half and whole tablets. Got a prescription for physical therapy (2x/wk for 6-8 wks) for my low back and hip pain and the extreme laxity in my right ankle (I can almost touch it to the floor thanks to a nasty sprain when I was 13 without any follow-up afterwards, just "here's an ace bandage and some crutches, stay off it for a few days." We had no insurance. My doctor's eyes went a little wide when she tested it in the office.)

Since my PT copay is going to be $30, I may be dropping my Pilates class for a bit. As much as I enjoy it, $90/wk (for PT, Pilates, and tai chi) is fucking expensive for an unemployed person on her husband's income. Though there's a deal for $50 off the one-month unlimited pass (usually $150), which works out to 7 classes to be worth it, or two a week. I was thinking of getting it for June (since I'm going out of town for a week in July), but August may be better, depending on when I get into the PT clinic. I'll be calling them in the morning. Duke Sports Medicine has two locations, and I think the one NOT at Southpoint is going to be better (it's on 751 near Duke Hospital, but with actual parking).

Looks like I'm going to start being vaguely busy in the near future, yuck. That means much less faffing about on twitter and Farmville so I can get in PT, tai chi, and novel edits in the same amount of time.

I've been alternating a whole and a half Cytomel 25 mcg tablet for the last few weeks, and it's been going better. I think I'll ask about getting a prescription for 4x5 mcg tablets a day at my appointment in a couple weeks, because the half-tablet days are noticeably more symptomatic. Like right now, my ears are ringing, and they were fine yesterday, and I've got the slightest headache.

Cytomel has a 2.5-day half-life, which is fairly short. You reach steady state fairly quickly (2 weeks), but you also have more fluctuations in the levels throughout the dosing interval. So taking the same dose every day would be beneficial.

I go for fasting lab work on Friday. Cholesterol, blood chemistry, CBC, and thyroid levels. Yay. My white count may be a bit elevated, since I've had a cold for about a week. It's much better, and I feel mostly fine, except I have a stuffy nose and a productive cough. I've stopped sounding like a 90-year-old smoker, at least, though my voice isn't completely back to normal.

I get to see my doctor tomorrow morning to talk about my thyroid blah. Apparently they prefer you to speak to someone if you're having problems, rather than just getting bloodwork. Which means another $20 copay tomorrow, plus the one for my exam in a month.

I'd say 3 migraines in 10 days when I'd had one or two in the previous 4 months is kind of significant, yeah. Never mind the tinnitus, eyebrows thinning, tiredness, or mucosal dryness.

I'm not sure how we're going to manage my dose, because a whole tablet is too much, and half isn't enough. I'm willing to play some of the tricks we play with warfarin, with a varying daily dose, if that'll help. Alternating half and whole will get me 19 mcg/day avg, while taking 4 halves and 3 wholes a week would be 18 mcg/day avg. I'll see what the labs show, I guess, and what the doctor suggests from there.

That's what it sounds like in my ears.

While I was on 50 mcg of liothyronine (T3), the tinnitus had abated and I felt pretty good overall. Then I started feeling off, saw my doctor, and the T3 blood levels came back high enough that my TSH was undetectable, so I went to half-tablets.

T3 has a 2.5-day half-life, which means it's gone from the system in about 2 weeks (5 half-lives), and that it takes 2 weeks to reach a new steady state concentration. Toward the middle of the 2 weeks after changing my dose, I felt better, and the tinnitus wasn't so bad. Since the two weeks have been up (about 4/7), I've felt worse, and the tinnitus is driving me NUTS. Also, my eyes are dry again, and my nose is bleeding. I wasn't having that problem on the higher dose of T3.

I've also noticed that my eyebrows are bleaching/falling out, which happened last summer when I had The Nausea, then got better with added T3. Wikipedia just told me that's an actual sign of hypothyroidism. Huh. I'm going to look through our vacation pictures from last summer.

So, my medico-scientific curiosity was piqued, and I decided to look up if there's any known link between hypothyroidism and tinnitus. Google turned up a bunch of less-than-reputable and woo-based sites, so I turned to PubMed, where I had it search for hypothyroidism AND tinnitus. It turned up 8 articles. This one is a case study of a woman who presented with both typical and atypical symptoms, and they mention tinnitus in the abstract. The full text does not appear to be online.

A very old article in an ENT journal found that the incidence of hearing/inner ear issues was correlated with severity of hypothyroidism. That one's full text *is* available online, but not for free, so I can't access it.

I'm also feeling more and more off as time progresses on this lower dose. More migrainish symptoms (facial tingling) and the actual migraine I had last week, for example. I can't concentrate on anything. I don't want to call my doctor's office today, because she doesn't work Wednesdays, and I'll end up having to speak to someone who doesn't have the full history again and get unsatisfactory answers (like "you should get your levels checked again 8 weeks after changing the dose." Well, I'm symptomatic, can we check my levels SOONER? But last week I wasn't convinced of being symptomatic; this week I am. So maybe I'll call again tomorrow. Eight weeks is still a month from now, though I have a pre-physical labs appointment 5/6, and if I don't go in soon, I'll ask to include T3, T4, and TSH in that panel.)

I don't want to be one of those patients, but this is having a very negative effect on both my quality of life and my ability to work.

So today, the ringing in my ears, which I'd thought a biweekly bolus of caffeine was keeping at bay, decided to come back. I don't know if any of you are afflicted with this, but it's really hard to concentrate when there's this high-pitched whine inside your ears.

I managed to get some editing in, though. +167 to 76,906.

I found a comment I'd left on the next scene I'm doing, and it asks if I included what I'm referring to in this draft. I didn't. I guess I should consider putting it back in, eh? There's a few hundred more words for you! To go back and do it now, or to soldier on? I think I'll do it now. Well, tomorrow, or maybe tonight after tai chi, if I'm feeling ambitious.

In the meantime, imagine there's a constant 9000 Hz playing in your ears. That's my life. Thanks, migraines!

Current Mood: busy

1. Saturday, a few friends and I went on the Big Boss Brewery's tour for my birthday. It was extremely popular, but the weather was nice - 70 degrees or so - so after it was over, there was a big open-air festival almost in their parking lot. There were two food trucks (OnlyBurger (the veggie burger was pretty good, but the fries were meh) and KoKyuBBQ (Ben enjoyed the duck bratwurst sandwich and tater tots fried in duck fat)).

I tried their new Dunkelweizen, D'Icer, and it was pretty good. It wasn't Weihenstephaner or anything, but it was drinkable. (Speaking of Dunkelweizen, I tried New Belgium's in their Lips of Faith series; it was black as Coke and about half as sweet.)

After digesting the beers and food, Ben and I went out to Sage for dinner, where I boringly got the fesen joon. The jokey waiter must have cut his hair since New Year's, because I didn't recognize him until he started talking.

2. I haven't gotten anything productive done on my writing in a while. I fixed the plot issue I think; I still need to propagate some of the changes, but I can do that while I'm doing the hardest part of the revision process: getting into the characters' heads and adding descriptions. What do they see/hear/smell/feel/etc? What can I say other than "he narrowed his eyes" (eg)?

3. SCHEISST EUCH IN DIE HOSEN, WIR STEHEN GANZ AM OBEN, UND WIR STEIGEN WIEDER AUF. HIER KOMMT HERTHA! Yesterday's match pitted the best offense (us) against the best defense (Fürth), and we got a 2:0 win out of it, extending our lead over our next competitor to 4 points. Unless we lose the rest of our matches (which is, of course, technically possible, but not terribly likely), we'll get promoted back to the first league. HA HO HE!

4. I got the results from my bloodwork last week. I'm currently overmedicated for my thyroid, so I get to take half the Cytomel for a while and see what happens. (My TSH was undetectable, and my T3 was above normal limits, but T4 was fine.) Hopefully this won't lead to a return of The Nausea. Inability to concentrate is one of the symptoms of hyperthyroidism, so that helps explain #2.

5. Reading one of the free books I got, Darkship Thieves. I'm not very far into it yet, but so far, our heroine has ripped her nightshirt in half to stop the men attempting to abduct her in their tracks and commented on how she knows the man whose spaceship she ends up in is a "real man" (I paraphrase) because he responds to the sight of her breasts. Said real man (who's got cat's eyes, which is actually kind of nifty tech) is from an anarcho-individualist culture (barf), and on p 87, there's this bit about "those wacky 21st century folks, thinking there aren't really gender differences in brains" which made me want to hurl the book across the room.

Frustratingly, Persecution of the Other (and the people the cat-guy is descended from are basically bioengineered to be smarter/faster/stronger/fit better in X situation and were, of course, persecuted and wiped out on Earth, except those who fled) is very frequently a liberal/progressive motif, where The Other stands in for queers or racial/ethnic minorities or other real-life disprivileged groups. I don't get the impression Ms Hoyt has any truck with that librul pansy nonsense.

At least I didn't pay money for it. (I did buy Mark Van Name's omnibus Jump Gate Twist, and I feel OK about that, because Mark admits to being Baen's token liberal. Also, it features a beefcake/emo shot of Jon on the cover.)

6. Still taking tai chi. I'm taking a break from weapons to go back to Dr Jay's 9th Street Dance Chen class for the current session. I can't take both, because they meet at the same time. I may go back to weapons over summer, because it doesn't look like he's teaching Chen over summer. (I could be wrong; it happens on occasion.) I'm also taking Nina's Tuesday evening class, which may ALSO be going on hiatus over summer.

So I'm going to have to self-motivate if I want to get my yellow sash this year. I'm awful at that.

7. Cats are evil.

So, my neurologist told me back in November that there's a possibility some of my migraine symptoms are related to caffeine. (That would be the facial/sinus pressure.) I tried two months with no caffeine or once a week, and I can't say I noticed any difference in symptoms. So I decided to go back to whenever I felt like it, though not every day. I averaged every 2 days or so.

But now I'm noticing the sinus pressure again, so maybe there's something to it. Or it could be caffeine withdrawal. My goal is not to have any again until Saturday to test the hypothesis. Though maybe I could have a cup of tea now (2.5 days) and not again until Saturday (4.5 days). This is getting annoying.

I'm also not sure if the tinnitus is linked. It was louder and more annoying over the weekend.

After 10 years of my dentist wanting me to get one, and 4 denied authorizations from Blue Cross, the note from my neurologist recommending a bite guard got the fuckers to do their job.

They wanted evidence one time that I grind my teeth. The broken teeth weren't enough? The fact that I have 4 crowns (which cost, each, twice as much as a bite guard) isn't enough? The visible wearing down of the points of my teeth isn't enough?

Free-market health insurance sure works great and manages costs effectively, doesn't it? Good to know that BCBSNC's logic goes like $650 < 4x$1300, so let's deny the $650 thing. Because that's sure cost-effective.

Current Mood: pleased

All the hormone panels he ordered were normal, except reverse T3 was high, so he's giving me Cytomel (T3), because my thyroid isn't using the T4 like it should. I get to recheck RT3, T4, and TSH in 5 weeks (I'll call my GP and see if I can do it through her office, because driving to a lab is a pain) and follow up with him in 6.

If taking T3 fixes my migraines, I'll be so happy. In theory, it should fix other stuff that's been an issue for a while, so fingers crossed.

Now to start cooking.

As I suspected: severe menstrual migraine with abdominal involvement. The neuro said I'm a "very interesting young woman," because my symptoms aren't necessarily bizarre, just ... an unusual constellation, I suppose. I wonder if it's "case report in JNeuro or Cephalalgia" interesting...

He's given me muscle relaxants for the massive tension from neck to hip (finally!) and he wants me to take a triptan daily for the time leading up to my period. He wrote for Frova, but Blue Cross wants prior auth for that (they prefer sumatriptan, Maxalt, or Relpax). So I left a message at their office saying unless there's a medical reason to use Frova (there might be; I recall it having a longer half-life or something), I'd prefer one of their preferred, so I can have a lower copay.

He sent me for a fuckton of labs -- by which I mean LabCorp just billed BCBS $2700. He's checking my estrogen level, sedimentation rates, some fancier thyroid function tests (T3, to see whether I need to add Cytomel to my Synthroid because I'm not converting T4 to T3 properly), uh... I forget, but they took 3 tiger-tops, 2 orange-tops, and a lavender. At least one of the tubes had to be frozen.

And he said I have to stop drinking daily caffeine, or at least try it and see if it makes my headaches stop (though the withdrawal headache will suck). Apparently, the type of neck tension I have can be related to and worsened by a caffeine habit. But I can still have it 2 days a week, so my Saturday morning Cup a Joe is not threatened. (At least I like herbal teas?)

I have a follow-up visit on 11/24. Ben, dear, what time do your parents get in?

Again.

My ears were delightfully ring-free until very recently. So far it's just a quiet, background ringing, rather than the HELLO HIGH PITCHED NOISE NO YOU DIDN'T WANT TO CONCENTRATE ON ANYTHING WHAT DO YOU MEAN? that persisted the previous 3 days.

The left side of my face is tingly, and has been since before lunch. I'm getting a bit of a headache in the back of my head and in my frontal sinuses, though part of that could be the large volume of Urine-Off I poured where some cat peed on the rug earlier.

I have plans to go to a reading & signing tonight in Durham, but I don't feel confident enough to drive right now. Ben may be able to pick me up; I'm not sure whether he's going to or not.

I think I'll see if caffeine is the solution to my headache. I tried Sudafed for the sinus/facial thing, and it seems to have reduced the feeling like my eye was being squeezed, but the rest is still there.

I'm tracking my symptoms on a calendar, and I'm going to take it to the headache clinic on Tuesday. Thank god it's next week.

I hope my brain cooperates for the rally this weekend. I'll be taking my Zofran and Phenergan with me.

Ugh, Urine-Off smells so nasty.

Current Mood: drained

First, a question: what sort of posts do y'all like reading? I don't get many comments, even to posts that I think might generate some controversy, or at least thoughtful discussion. I'm not trolling for comments, here; just wondering if I'm boring everyone to death.

Idea
I have an idea for a post based on something A said months ago, about the difference between liberals and libertarians. It's sort of the synthesis of his comment, some comments

leora made on facebook, and months of my brain working on the whole thing. The words "monstrous" and "inhuman" may be involved.

Illness update
Tinnitus persists. Cognitive issues, like difficulty finding words, are also there. It's sort of like trying to think with a migraine, except without the icepick in the skull. I've slept poorly the last two nights. The eye doctor saw nothing in my eyes, so no eyestrain or vision changes or other signs of disease that are visible in the eye. I may have found a cyclical pattern that maps to my menstrual cycle, joy. Appointment with the headache clinic is in about a week. Should also be about a week till my period starts again.

Football
Hertha beat SpVgg Greuther Fürth 2:0 on Friday, making them the only undefeated team in the pro Bundesliga (1st and 2nd), and putting them nicely on the top of the league table with 23 points (7x3 wins, 1x2 draws). Only 25 matches to go this season, and if they keep this up, they'll be back in the 1st league next September. Unfortunately two of our top players were injured in the match. Nikita Rukavytsya strained a thigh muscle and is out for two weeks, and captain Andre Mijatovic will be out for six with a knee ligament injury (outer ligament, Außenband). They join usual goalie Maikel Aerts (ACL, at least four more weeks) on the injured bench. Coach Markus Babbel can put 17-year-old Nico Schulz in for Ruka, which he did a few weeks ago when he banned Ruka for coming late to practice, and he's got another option or two for Mijatovic. The other GK, Marco Sejna, has done well the last two matches, except for one spectacular fumble Friday that came dangerously close to a goal for Fürth. He's kept a clean sheet so far, and the Hertha defense has only conceded 5 goals in 9 matches, which, actually, is the lowest number of conceded goals in the entire pro Bundesliga.

Wolfsburg, on the other hand, lost to Nürnberg 1:2 on Saturday. After 9 matches, they have 10 points (3-1-5) and are in 13th place. The defense has conceded 16 goals, on par with 15th place Schalke, and better than Bremen (18 goals, 8th place), Stuttgart (17, 14th), K'lautern (17, 15th), Gladbach (27!, 17th), Köln (17, 18th). Apparently, last year's Wolves had some issues with their defense, so Dieter Hoeneß (Uli of FC Bayern's brother) went out and bought some defensive players, including young Danish international Simon Kjaer and German international Arne Friedrich. Unfortunately, Arne hasn't been able to play this season thanks to a back injury, but he hopes to be back for the second half of the season. Adding to the defensive woes is the injury of goalkeeper Diego Benaglio (Swiss international). The team doesn't seem to have gelled yet, especially the defense. After the match, striker/captain Edin Dzeko expressed his frustration, stating that "we're not playing as a team." I get that sense from watching them on the field, myself.

Writing
I'm still in chapter 1 on revisions. It's been difficult to concentrate at times, and the ringing in my ears doesn't help. I'm going to use November's NaNoWriMo as motivation. I'm not participating, but I'll be using the framework to motivate myself to finish these revisions. I need deadlines to get things done.

To be addressed in a separate post
Sanity/Fear rally plans!

Current Mood: busy

I wonder if my medical bills this year will be enough to itemize on our taxes.

BCBS sent my Explanation of Benefits ("This is not a bill") for the CT. Apparently, the CT (and likely the MRI) at the radiology place counts as a hospital for billing purposes, so they'll get to bill me for the $250 deductible.

In addition to the $250 for my admission in August, the $150 for the ER visit, dozens of $20 and $30 copays for office visits, my regular prescription, and the many tried-and-failed medications. And Ben's fillings.

Then there are Isis' $3000+ vet bills this year, which obviously can't be counted.

I really need to be able to get back to work before the entire buffer in my account is gone.

Current Mood: discontent

Nausea's back. Breakfast this morning was 8 mg ondansetron, my Synthroid, my omeprazole, and a can of ginger ale.

I haven't decided which doctor to call first: my GP, my GI, or pestering the neuro people to see if they have any info on me at all.

I'm feeling somewhat better than an hour and a half ago, but the idea of food makes me want to gag.

I plan to go to Pilates class, but I won't decide until 8:45 (class is at 9). If I go to class, I'll call a doctor when I get back. If I don't go because I feel ill, I'll call a doctor then.

Current Mood: annoyed

Since late June, I have:

- had a gallbladder ultrasound (negative for stones)
- been tested for food allergies, celiac disease, parasites, C. diff (all negative)
- had an upper endoscopy (normal)
- been on two rounds of antibiotics for presumptive sinus infection
- had a rhinoscopy (normal)
- had a sinus CT (normal - no sign of recent infection, either)
- been to the dentist to evaluate upper jaw/gum pain (just a torus)

I'm still having this weird, annoying pain and tingling around my left eye (which usually starts around 1 pm), and my ears are ringing.

The ENT is referring me to the headache center, a group of neurologists, because she thinks I may have a variant migraine. Considering that I have a history of migraines (which hit their peak of awfulness in 2005/06 while I was in Oregon, when I would have 2-3 migraines during my menstrual period and none the rest of the month) going back to at least 1999, I consider this a reasonable suggestion. (I've also been describing this facial pressure as "half a migraine," or "like my prodrome or aura, but without the part where my head goes in the vice at the end.")

I'm not sure it explains the whole nausea and vomiting thing, though. I don't know how long it'll be until I can get in to the neuro people.

Dr. Bishop pére took x-rays of my upper gums and didn't see anything. He poked around my tooth and had me bite down, and it didn't hurt. He did notice that the metal filling isn't in the best shape in the world, so if Tuesday's CT doesn't show anything wrong with my sinuses, I should call them back and they'll take the old filling out and look around to see if there are any cracks or the root is damaged, and if not, they'll put a resin filling in. He'd rather avoid doing a root canal if it isn't necessary, and he thinks sinuses is more likely.

The red, painful spot on my gum is a torus, or a bone spur on the gums. I have them on the lower jaw, so it makes sense. Apparently they're related to grinding your teeth, according to one dentistry website that turned up on the internets.

(Oh, yeah, this morning I got a call from the ENT's office with my CT appointment, Tuesday morning. I guess they showed enough evidence to BCBS to get them to authorize it.)

Current Mood: frustrated

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