Inhuman Swill : Medicine

Ella un-a-cyst-ed

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Ella in her Surgi Snuggli after cyst surgery
I've been so focused on my book for the past year or more that I can't even remember the last time I posted an Ella update here to the blog. I find that unconscionable, so I'm here to remedy that.

First off, Ella is doing just fine, despite the fact that she had surgery last month, the second time this year. Like many wheaten terriers, Ella is prone to developing big sebaceous cysts, which for the most part we have left alone. They're mostly only a problem if they start to grow. In that case they can cause intense discomfort, or they can even burst and get infected.

Normally we've handled Ella's cysts by having them drained with a needle when they get too big, but in February we finally had to send her under the knife for the first time to have four of them removed. One had burst, another was getting bigger, and we figured we would just take as many off as possible as long as she was under anesthesia anyway.

This is considered minor surgery, but it's still nerve-wracking, especially because of the anesthesia. But Ella came through the first surgery fine, which made us a little less wary about doing it again last month.

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This essay is excerpted from The Accidental Terrorist: Confessions of a Reluctant Missionary, available everywhere November 10, 2015.

WARNING: This essay contains graphic descriptions of primitive surgery that some readers may find disturbing.

In January 1994, when I was 26 years old, I sat down in my bare, cold room to write my first novel.

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Shock and jaw


A few months ago, my jaw popped out of place on the right side. Suddenly my molars no longer fit together on either side of my bite. A month or so later, my jaw went back into place for a few hours, but it didn't last. It's still out of place.

I went to my doctor early on, who sent me to my dentist. He told me my bite problem, with a left-to-right sliding displacement, was pretty rare in his experience. He sent me out to get a panorex and i-CAT 3D scan of my head so he could figure out what my options might be.

Upon reviewing the results of the scan, my dentist told me there was very little he could do to try to fix my bite short of making crowns for half my teeth. My best option, he said, was to consult an oral surgeon, who would take the scans and work out the best way to cut my jaw apart and reassemble it into something with a proper bite.

I suspect that my dentist wasn't really listening to me all the times when I told him that the problem had come on suddenly. I hope the oral surgeon I talk to is a better listener, and has a better solution than turning my skull into a jigsaw puzzle. I've never had many dental problems, and I find the idea of surgery both extreme and terrifying. I've never had to have surgery of any kind before.

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Hot bones

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So I headed down to St. Joseph Hospital yesterday morning for my abdominal CT scan. When I scheduled the appointment, I was told I'd have to show up two hours early to drink a nice barium milkshake. It turned out when I reached the radiology floor, though, that my urologist had merely ordered a scan with and without contrast. No barium required. This meant I was there two hours early.

That was okay, though. They squeezed me right in. Lying on the table being slid like a magician's assistant through the donut hole of the scanner, I was amused by the light-up pictographs that instructed me when to hold my breath and when to exhale. The fellow in the breath-holding pictograph looked like he had a huge wad of chewing tobacco stuffed into his cheek. Among the other icons on the scanner display were a heart, a pair of lungs, and something that at first looked to me like a bondage hood. It was actually supposed to be a radiation warning symbol with a camera aperture affixed to its underside.

I went through the scanner twice before a nurse stuck me with an IV line to flood my veins with a radiocontrast dye to help my urinary tract show up better in the images. She warned me that I would probably feel warm or flushed for a minute or so when the dye went in. The sensation was actually a whole lot weirder than that. It actually made me feel like I was being cooked from the inside out, like my bones were glowing red. It was like having the worst fever I'd ever experienced. And the sensation faded, as promised, after a minute or so.

(Does anyone know why it feels that way? I'm wondering if it's some kind of immunoresponse.)

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By the way, for those legions of you who've been on tenterhooks about my bladder, tomorrow I at last go in for my abdominal CT scan. (I had to reschedule it from last month because of a guest.) I have to be there two hours early to drink barium or something of the sort so my inner bits will be nice and glowy. I'll be sure to report.

Then next week I have my lovely cystoscopy at the urologist's office, when he have a look-see directly inside the ol' bladder. Can't wait for that. I've had one once before, and believe me, it's so much fun.

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The season of miracles

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Now that Christmas is over, let's talk about miracles.

Miracles have been on my mind since last week when I heard the story of Kateri Tekakwitha, a 17th century Mohawk-Algonquin woman whom the Vatican plans to canonize. The miracle that sealed her canonization was 5-year-old Jake Finkbonner's 2006 recovery from the flesh-eating bacterium Strep A. His chest, neck, face, and scalp were infected, but a Blessed Kateri relic and prayers to the long-dead woman supposedly halted the progress of the infection before it reached his eyes, brain, or heart.

Jake's recovery is wonderful, perhaps even remarkable, but is it a miracle? We tend to use the word miracle in two different senses without always making much of a distinction between them. Sometimes we mean an occurrence has come to pass that was simply quite unlikely. In this case, miracle is nothing more than a hyperbolic turn of phrase. But often we mean an occurrence that could only have come to pass through some kind of supernatural or divine intervention.

The miraculous waters are only muddied by the frequency with which the word gets tossed around in the news. A game-winning three-point shot from half-court at the buzzer and other impressive athletic feats get the same tag as the 10-year-old Dutch boy who survives a plane crash that kills all 103 other people on board.

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Rose bladder

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[Spoiler warning: Mildly squicky medical details within. The squeamish may not wish their appetites spoiled.]

I know you've all been waiting breathlessly to hear what's come of my possible kidney stone situation. I just saw my very booked-up urologist, and what he has to say boils down to: "We need to do more tests before we know what's going on."

He cautions me that there could be a myriad of reasons for hematuria (blood in the urine) and stinging urination. The blood (which, incidentally, I've only seen twice) could be coming from the kidneys, the bladder, the urethra, what have you. I need to start out by having an abdominal CT scan and a cystoscopy.

I've never had a CT scan, but I've had a cystoscopy one time before. It Is Not Fun. It involves having a camera shoved up your urethra and into your bladder. Yes, it's done with local anaesthesia, but you still feel it. The only good thing about it is, it couldn't be scheduled until January 18th.

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I can't help myself. I have to share a couple more tidbits on the topic of health care. First is Johann Hari of The Independent, who takes the American right wing to damning task in yesterday's "Republicans, Religion and the Triumph of Unreason." Here are two of the almost amusing bits from a not-really-very-amusing article:

These increasingly frenzied claims have become so detached from reality that they often seem like black comedy. The right-wing magazine US Investors' Daily claimed that if Stephen Hawking had been British, he would have been allowed to die at birth by its "socialist" healthcare system. Hawking responded with a polite cough that he is British, and "I wouldn't be here without the NHS"...

For many of the people at the top of the party, this is merely cynical manipulation. One of Bush's former advisers, David Kuo, has said the President and Karl Rove would mock evangelicals as "nuts" as soon as they left the Oval Office. But the ordinary Republican base believe this stuff. They are being tricked into opposing their own interests through false fears and invented demons. Last week, one of the Republicans sent to disrupt a healthcare town hall started a fight and was injured—and then complained he had no health insurance. I didn't laugh; I wanted to weep.  [full article]

And Diane Francis at The Huffington Post makes the case that "LBJ Created Canada's Superior Health Care System":

As the health care establishment appears to be once again able to block any reasonable changes to America's sick health care system, it's important to note that, ironically, the "father" of Canada's universal, single-payer health care system was late President Lyndon B. Johnson. In 1964, his plan caused Canadian Prime Minister Lester Pearson to rush the same health care scheme into existence so that Ottawa was not beaten by the Americans, as was the case in 1934 with Social Security. As things turned out, LBJ compromised with the Republicans and scaled back his plan to a co-payer insurance for senior citizens, or Medicare. So it's hardly surprising that, again, a popular President cannot win out against the nasty tactics and enormous wealth of the medical vested interests.
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Every time I hear someone on the radio going on about how there's nothing wrong with the American health care system, I get so mad I can't see straight. I always wonder out loud what that person would say if he lost his job and his health insurance, or if she suddenly couldn't get coverage for a life-threatening disease because of some innocuous "pre-existing condition."

I have pretty good health coverage, but that's only because my wife has a good job. I don't want to think about what would happen if she lost her job. COBRA coverage would be available for 18 months, of course, but it's as expensive as half a month's rent. And even with our coverage, it's a tremendous pain in the ass to negotiate the thicket of requirements you have to go through in order to consult a specialist, which both Laura and I are currently doing.

In fact, yesterday I had to cancel a long-standing appointment I was supposed to have this afternoon with the urologist I've been seeing (in a professional sense, not the sense of having an affair with, although he's cute in a reassuring-older-guy kinda way) this year. Why? Because Laura's insurance just changed to a new company, and my procedure would not be covered unless I could get a referral form from my primary-care physician, but that office wouldn't cough up the form because we haven't received our new insurance cards yet....

Fortunately it's not an urgent procedure, but if it had been I would be, to put it crudely, fucked. I can reschedule for a couple of months from now, but how much easier and more sensible would this all have been under a single-payer system? I don't know how anyone with serious health problems manages.

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"Retrogression" progression

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Retrogression progression
I'm not one to announce my daily word count, but I will say that progress is beginning to be made. Today it was made at a Starbucks on Greenview after I got my B12 shot at the doctor's office. Yes, it turns out I have quite a B12 deficiency, which might explain the tingling I sometimes feel in my back and legs, not to mention my frequent fatigue and general lack of energy. I think it's too early to chalk today's productivity up to the vitamin boost, though.

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