August 29, 2008
Fear itself
You know I'm scared to die, right?
Obviously. I come back to that theme in one way or another about every six weeks, unless somebody I know has just died, than I dwell on it for daily for six weeks.
I hear that awareness of our own mortality is what separates humans from the rest of the animal world.
With Paul dying last month, then the notion that I might just be walking around with (let's whisper it like they did back in the day) cancer, the dying thing has been up at the front of my mind.
I have a book: No Death, No Fear, by a Buddhist monk named Thich Nhat Hanh. He wrote
Our greatest fear is that when we die we will become nothing. Many of us believe that our entire existence is only a life span beginning the moment we are born or conceived and ending the moment we die. We believe that we are born from nothing and that when we die we become nothing. And so, we are filled with fear of annihilation.The Buddha has a very different understanding of our existence. It is the understanding that birth and death are notions. They are not real. The fact that we think they are true makes a powerful illusion that causes all our suffering. The Buddha taught there is no birth, there is no death; there is no coming, there is no going; there is no same, there is no different; there is no permanent self, there is no annihilation. We only think there is. When we understand that we cannot be destroyed, we are liberated from fear. It is a great relief. We can enjoy life and appreciate it in a new way.
I've had this book for several years and I have read it many times, but when I'm at a funeral, it's impossible for me to think of death as an illusion.
But also at a funeral, I'm feeling sorry for myself. I wanted to show Paul some pictures I took. I wanted to go the baseball game with him. I wanted to hear what he thought about Olie Kolzig going to Tampa...I missed my friend.
That's why I'm scared of other people dying: I'll miss them. Why am I scared to die?
To contrast scholarly Buddhist monks, I give you humor columnist Gene Weingarten. He has a regular chat on the Washington Post web site, where this exchange occurred earlier this summer:
...I would like to be more settled about mortality--as I don't want to spend time/energy worrying about the inevitable.How would you suggest overcoming this problem?
Gene Weingarten: Do what I did. Get a fatal disease and recover from it. Everything changes. You don't worry as much because you feel you're living gift time, anyway.
If THAT'S out of the question, remember what my father told me when I was about ten or so and asked what it was like to be dead.
He said, "Well, what was it like for you in 1918?"
Uh...
"Well, that's what it's like to be dead."
Not so scary, right?
Put that way, it really isn't. Now, if you believe you might be roast on a spit for eternity for the bad things you've done, or if you think you could be reincarnated as a bug, that's scary, but non-existence really isn't.
I was rolling this over in my mind for much of the night last night.
When I was a little kid, I never wanted to go to bed. I would go downstairs to the dark living room, listening through the screen door to my parents and the neighbors sitting on the patio talking. I'd linger in the hallway, peaking around the corner to watch McMillan & Wife. Conversation that went over my head, tv crime drama, whatever was going on after bedtime, I didn't want to miss it.
I guess that is why I don't want to die. It's not really that I am afraid of what comes after, I just don't want to miss what will be going on here.
And then in terms of what is wrong with me...the thyroid, I mean, not all my other problems...it is statistically improbable that I am suffering from anything fatal, anyway. If I had to put down money, I'd place the bet on benign follicular adenoma. And I'm afraid of surgery, but that is because I spend a good portion of my day reading about drug reactions gone bad. Realistically, it's probably more dangerous for me to drive around suburban Washington on a rainy Friday with people distracted by the holiday weekend than it is to undergo this common surgery.
So there it is. Nothing to be afraid of. Let's see how this gets me through til Tuesday, 2:30 p.m.
August 26, 2008
Distractions
Ted had some ideas for how to distract myself. Good old real life has stepped in with some less amusing ideas, for instance: the rats have mites! So everybody needs to be medicated, and the cage and all the houses scrubbed, and loads of laundry washed. Yippee.
(Your ideas were good too, Ted. Interestingly enough, we had e-mail today proclaiming that Friday is Hawaiian shirt day. I'm not sure if the big boss who sent it has ever even heard of Office Space.)
August 24, 2008
Obsessing
About ten years ago, I was doing "watchful waiting" for a lump in my left breast. It turned out to be nothing, just a cyst that never came back. I don't remember being consumed by fear over it, but then I was also juggling getting divorced and laid off. It was a busy time.
In contrast, I'm having a hard time keeping my mind off the thyroid thing. I have a bad PubMed habit, and I've found a few papers that suggest the malignancy rate of solid nodules greater than 3 or 4 cm is in the 24-26% range. That still means the chance of this nodule being benign is 3 in 4.
Probably, I'll get a cool scar, a week off work, and perhaps a need to take thyroid hormone for the rest of my life. It's a cheap generic drug; big deal.
I went by my parents' house on Saturday to pick up some tomatoes, and filled them in on what I know (and what I'm speculating based on what I read in abstracts of medical journal articles). My father said "Are you nervous?"
I said "I'm scared shitless." What's the use in bravado?
Now if everything turns out fine, I'll look silly for being such a basket case, while if I were putting up a brave front, I could look all cool and I-told-you-so when the pathology comes back that I have a harmless adenoma.
Normally on Sunday night, I'm dreading going back to work. Tonight, I'm hoping I have a busy week. I'm hoping my phone rings off the hook and every annoying problem touches off four more issues that demand addressing. I ciuld use the distraction.
August 23, 2008
No surprise here
Your result for The Hockey Role Test...
(is in the extended entry, because it screwed up my format)
The Stay-At-Home Defenseman
40% Playmaker, 10% Goal-scorer, 50% Stay-at-home, 0% Rusher and 40% Goalie!
Shaone Morrisonn is a prime example of a young stay-at-home defenseman.
August 20, 2008
Oh yeah...
Whether I should be this nervous or not, whether I am crazy or not...the stress is having an effect on me. They took my blood pressure this morning and it was 140/80.
"It isn't normally that high," I said. "I've had it down below 120/80. It was 120/80 just a week and a half ago."
The nurse looked at me a little suspiciously.
"I think it's because I'm nervous," I said.
She took my pulse: 80 bpm.
My resting pulse is 72, maybe 75 when I've been lazy about working out. It isn't 80.
I have lost three pounds, at least.
241.0*
Well, I saw the endocrinologist. Apparently I have a 4-cm mass on my thyroid.
Ok, no, I got a little more out of the visit than that. Mostly, the endocrinologist thinks we should skip the biopsy and go straight to surgery. I can follow his logic: the mass is so big that there is an increased chance of a false negative, so why bother?
I see the surgeon on September 2. Since most surgeons like to do surgery, I expect the surgeon will concur on the surgery idea. I'm not so wild about it, but that's because I'm a giant wuss. (I'm not wild about the mass in my throat either. Am I a whiner or what?)
I really had to press the doctor about the ultrasound. Every time I asked, he just went back to the limitations of biopsies. I finally said "I do realize that pathology is the only definitive way to diagnosis this, but was there anything at all that you could tell from the films?"
So I got:
The mass is big.
The mass is solitary.
The mass is solid.
The mass has a regular border.
The mass doesn't show areas of calcification.
Those last two are good, but the first three might knock my great 95% odds back a bit. From what I've read (and doesn't a week of constant Googling make me an expert?), you want your thyroid nodules to be small, fluid-filled cysts that show up in little clusters.
So.
So.
So, how about those Nats, huh?
*That's the ICD-9-CM code for what I have.
August 19, 2008
Statistics
Usually, I'm glad that I have a huge medical library at my disposal. This past week, I'd probably have been better off in blissful ignorance.
Statistically, 95% of the growths on thyroids are not cancer, and of the five percent that are, something like 85% are easy to treat and have excellent rates of survival.
So you can guess what I keep reading about...the rare but horrible ones, of course. That's what keeps coming up in my literature searches. Of course, medical journals publish papers about rare and horrible things, because really, no one is interested in reading about the routine treatment of (yawn) benign conditions.
After the radiologist declined my doctor's CT scan request (the shellfish allergy scared them off), the doctor decided to add a referral to an endocrinologist, who I'll see tomorrow. It gives me something to do while I wait for the appointment with the surgeon.
I am way more freaked out than I have a right to be. Ninety-five percent, for goodness sake.
The worst type of thyroid cancer, there are only 300 new cases diagnosed a year in this country. That's one in a million. I have a lot of quirks, but I'm not one in a million.
I hope.
August 15, 2008
To ponder
I'm spending more time than usual in medical offices lately, and I'm curious...do they preferentially hire for front desk staff who are snotty, bitchy, rude, sullen, unhelpful, churlish, sarcastic, and surly, or does that attitude develop from dealing with the patients?
August 13, 2008
Worry beads
Before I left on vacation I was kind of down in the dumps about some things at work. Then my friend Paul died just before we left, and considering the tailspin I go into when a rat dies, imagine my tailspin for the unexpected death of a guy who had been like an uncle to me for 25 years.
I didn't do much at the beach but make necklaces. I've never made jewelry before (I don't wear it often), but for some reason I had picked up a kit at a craft store, and it was sort of mind numbing (in a useful way) to count and string beads.
I got home and work was just as bad as it was when I left, and the air conditioner broke, and my car broke, and rats are wheezing, and I finally made the appointment to have a human doctor look at the lump in my throat that has been nagging me since March.
I figured they'd send me to a gastroentorologist, diagnose me with GERD, and put me on Prilosec.
I did not expect them to send me to a radiologist, find a 4-cm mass on my thyroid, and give me something else to worry about for the next three weeks until I see the surgeon.
Would anyone like a necklace? Or a bracelet? Earrings?
August 10, 2008
Sunday dinner
I have never formally participated in an Eat Local challenge, but the idea of eating locally appeals to me. (Within reason, of course. I live in Maryland, where avocado does not grow, but I am not giving up guacamole.)
As I put dinner on the table tonight, I realized this was probably one of our most local meals yet.
The chicken came from Groff's Content; and Victor made it beer-can style with Summer Rye from the brewpub down the street. The vegetables (those are blue potatoes, not a trick of the flash) are from the farmer's market* this morning.
And dessert:
Blackberries (which are around later than usual, I guess thanks to the cool weather and the rain) and peaches, also from the farmer's market, topped with yogurt from an Amish dairy in Lancaster and that granola to which I am addicted.
It would have been better if I had grown some of it myself, but my tomatoes are still green, and this dinner didn't call for basil.
(I did have homemade pesto for lunch, though.)
*I can narrow it down more: potatoes from Comus, green beans from Thurmont, fruit from Sibillasville.
Fixed the brewpub link.
August 09, 2008
Why you don't stick your hand in a pile of sticks
Found a beaver lodge on our hike today:
Look closer:
I'm pretty sure it is just a harmless Northern Water Snake, and not a very big one at that. Still, I wasn't going to get any closer.
August 07, 2008
August 03, 2008
Quote of the day
Or quote of yesterday, really. I was watching the football Hall of Fame induction last night (Art Monk!) and there were times I wondered if it was on the Christian Broadcasting Network rather than ESPN. Not complaining, mind you, it was just an observation.
But I laughed and laughed at this part of Gary Zimmerman's speech:
I chose Oregon over other schools because it was the only college that would sign me as a middle linebacker. While dressing down for the first practice, I thought how strange it was that I was No. 75. After practice the coaches pulled me aside and explained that my future might be on the offensive line. The Dalai Lama once said that not getting what you want is sometimes a wonderful stroke of luck. The point I'm trying to make here is that nobody starts out wanting to play the offensive line position; it's just where we end up.
The Dalai Lama? I love it.
