Category Archives: Health Issues

Asthma, Holidailies

Wheezing and Whining

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As both of my regular readers probably know at this point, I have asthma, and I have it fairly bad. Not life-threateningly bad, and I don’t go to the emergency room on a regular basis (it’s been about three years since that’s been necessary), but I do get a nasty flareup every couple of months or so. Usually what triggers it is a minor cold or other bronchial infection. I seem to be prone to those. I’ve written about my asthma (and how it affects my political opinions) before, so I won’t go into detail here.

Anyway. Today I started taking the Prednisone again. Prednisone is an annoying medication. It works well and usually clears up a flareup in a few days, but I always hesitate to take it because of the side effects. For one thing, it really impacts my mood, and not in a good way. When Jennifer had to take Prednisone, it had euphoric side effects and she was full of energy. I know other people who are affected in this way. But no, not for me. Instead, Prednisone makes me cranky and irritable and depressed. My mood plummets, and I’m just not good company for the duration of the time that I’m taking it.

But the most annoying side effect of the Prednisone is that it makes me hungry. Or, rather, it interferes with that mechanism that tells me when I’m hungry and when I’m full, so that it reports to me that I’m never full. This is going to interfere with my weight loss efforts because I won’t be able to tell when I’m actually hungry or not.

So I’m going to attempt go go by visual cues this time. Instead of relying on my body to tell me when I’m hungry and when I’m not, I’m going to bear in mind that the human stomach is approximately the size of a clenched fist, and eat that much at my meals. And drinking water. Drinking lots of water. This will hopefully take the edge off the hunger. And perhaps bringing veggies to work with me. If I can’t control the amount I take in, at least I can control exactly what foods I take in. I hope.

Got ideas for how to deal with this? Anyone? Bueller? Bueller?

 

‘Tis the season for (wheezy) Holidailies

Asthma, Beer, NaNoWriMo 2013

WheezeNoWortMo: A Three-Part Miscellaney

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“I thought you were going to be done with the stinky part by the time I got home,” she says as she enters the house.

“Well…,” I reply, “I thought I was too.”

The house currently smells like wort. I think the smell of boiling malt and hops is heavenly, partially because it brings me back to my twenties, brewing beer with my friends Mike and Dylan (both of whom I’ve lost touch with over the years, which saddens me). Jennifer, though, doesn’t approve of the smell at all. “It doesn’t even smell like beer,” she says. “It just smells like wrong.”

I’m not sure what I can do about the smell, though, because it only occurred to me halfway through the boil to turn on the fan above the stove. I offered to open the windows and turn on the fans, but Jennifer says she can live with it. For now.

Currently the wort is cooling in an ice bath in the kitchen sink. I did a fine job, if I do say so myself, of keeping the kitchen clean while doing this. The cans of extract I placed on a paper towel in case they leaked. The hops were contained to their little bags. The sanitizing solution (because brewing is, according to the book I’m reading, 75% about cleaning) sitting in a big plastic bucket on the floor with a lid on to keep out curious cats. The boiling pot was cleaned and sanitized. So was the lid. And everything that went into the pot at any point is being cleaned and sanitized. Maybe I’m going a little overboard, but better to be over-clean than have skunky beer, right?

The intention with this beer is to make a nice vanilla stout. I’m not sure how I’m going to go about adding the vanilla flavoring. Jennifer has some vanilla beans that she’s willing to let me use. All the recipes say I’m supposed to soak them in bourbon for a few days, then add them at the second ferment. It’s that “second ferment” part that worries me. I have a secondary fermenter, but I’m worried about transferring the wort. Because that’s what I do. I worry. More on that some other time.

I’ll keep you in the loop on the details of the brew, because I’m sure you’re fascinated.

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Meanwhile, this stupid upper respiratory infection can go away any time now. It knocked me out for two days before Thanksgiving, then went away, then decided to take another whack at my lungs last Thursday. Jennifer’s been stuck with the same cold for that entire time (though now she’s just coughing instead of dealing with all the other symptoms). During those few days where I was feeling fine, Jennifer once said, “I can’t believe this cold didn’t stick in your lungs for a month this time.” Me, too. She was also kind of jealous that while she was coughing and hacking, I was breathing clear. That’s usually the opposite of what happens in our household.

Wheeze, wheeze. That’s what I’m doing now. My grandpa used to call me Julius Wheezer, and I have one friend who calls me “Wheezer!” whenever she and I get together. Better than “Geezer”, I suppose.

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Did you know that I participate in National Novel Writing Month every year? I know, it’s like I never talk about it at all! This year, I wrote Love in the Time of Cthulhu and put the entire thing online as I was writing it. You can find it here and read it all if you like. I know, I haven’t mentioned this before. My activities during November are a closed book, aren’t they?

Yesterday was the Thank God It’s Over (TGIO) party for the region, our traditional post-NaNoWriMo get-together where we commiserate, eat, talk about writing, eat, socialize, and eat some more (though I was actually eating very little because, well, I wasn’t hungry — I worked on that resistance muscle, so to speak). About fifteen people showed up, and we all had a good time. Some of us even got up the nerve to read portions of their novels out loud to the group. I did not, because I was afraid of my lungs conking out on me halfway through.

It’s funny that we can get together with these people, the other regional participants of National Novel Writing Month, hang out with them, chat, write, socialize, and call them friends for a month, then not see them at all again for the rest of the year.

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Here, have a picture of two of our cats, Rupert and Sherman. Jennifer took this picture yesterday, and I think it says more about them than I could in words. Click to emcatenate.

RupertSherman

What about you? What have you done with your weekend?

‘Tis the season for (stinky) Holidailies

Health Issues, Weight Loss

Re: That Gut

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Warning: No holiday content within.

For the past month or so I’ve been trying this radical new diet plan, where I eat only when I’m hungry and stop eating when I’m full (and avoiding refined sugar). You won’t find this plan in any book in any bookstore because the profit margin is way too low, though I have been following some of the advice that Judith Beck (no relation to Glenn Beck, thank God) gives in her book, The Beck Diet Solution.

Turns out I don’t actually have much of an appetite, compared to what I thought I had. When I really pay attention to my stomach’s signals — and I mean, REALLY pay attention — I end up eating a lot less. Of course, this means I have to seriously and constantly ask myself questions such as, “Am I really that hungry? Or am I simply bored/stressed/angry/upset/happy/just not paying attention/etc.?” Like a lot of people, I tend to eat my emotions. There are some people who simply can’t bring themselves to eat when they’re stressed out; I am not one of those people. When I get stressed out, my first reaction is to go for the food. I’m training myself out of that habit, but it’s taking longer than I would like.

Of course, then means resisting a lot of foods. The conversation inside my head goes something like this:

ME: Am I really hungry?

ME: No, I’m not.

ME: But I really want that double bacon cheeseburger and large fries from Jack in the Box.

ME: Too bad, because I’m not actually hungry.

Beck, in her book, talks about building up the “resistance” muscle vs. the “giving in” muscle. When you resist certain temptations, you build up your resistance muscle. Likewise, when you give in to certain temptations, you build up your giving in muscle. She uses this language to avoid using the word “cheating”, though I don’t see much difference, psychologically. In almost all the dieting literature I’ve read, you’re supposed to feel good, accomplished, excited, etc., when you resist a temptation. The dialog is supposed to look like this:

ME: Am I really hungry?

ME: No, I’m not.

ME: But I really want that whole pumpkin pie.

ME: Too bad, because I’m not actually hungry.

ME: YAY! I RESISTED A TEMPTATION! GO ME! ETC.!

Instead, though, what I get at the end is…

ME: GODDAMMIT, I REALLY WANTED THAT STUPID PIE! STOP BEING SUCH A SPOILSPORT, SELF!

And, two hours later…

ME: I’M STILL STRESSED OUT, AND I WOULD BE FEELING BETTER NOW IF I’D HAD THAT PIE.

ME: Sorry, still not hungry.

ME: GODDAMMIT.

I honestly didn’t expect that the whole process would be full of such self-resentment.

I’m pushing through, though, and sometimes when I resist that temptation, I do feel a sense of accomplishment and pride. Maybe it’s just a matter of practice, or training, or something like that. But I hadn’t expected that the whole process of simply eating when I’m hungry and stopping when I’m full would be full of such resentment.

But it might be working. Since early November, I’ve lost thirteen pounds; however, for the past two weeks my weight has held steady at about 260.  There should be some days when I expect that because in spite of my determination there have been a couple of days when I’ve overeaten, but not often. I’d like to see a continuing downward trend. It’s not there. I tell myself that I’ve just reached a temporary plateau, but that only helps a little. Honestly, I’d prefer to be all honey badger about this, and not give a s— about the numbers, but that’s pretty difficult to pull off.

Then again, I’ve struggled with my weight for most of my life. I didn’t get to where I was overnight, and it won’t come off overnight either.

Anyone have any suggestions for improving my mood/thinking about this? I’m all ears.

 

‘This the season for (grumpy) Holidailies

2nd Life, I Should Have Been a Firefighter, Just a Day in My Life, Lungs, NaNoWriMo 2007

Time Sinks

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…Being evidence that my blog can indeed consist of more than just Twitter updates.

It’s November, which is always a month full of time sinks for me.  I mean, everyone’s busy during November what with the holidays and Thanksgiving (well, everyone in America who celebrates Thanksgiving at least).   But for about 100,000 people around the world, November is also, of course, National Novel Writing Month, and the pressure of churning out 50,000 words in a single month can get to some people.  I passed the 50K mark yesterday, with 50,007 words total (according to the official NaNoWriMo word count verifier), so technically I’m done with that, even though the story itself is still incomplete.  It’s part two of the novel that I wrote last year, and I realize there’s at least one more part to come.  I’m really hoping, actually, that I can get this third part written in a very short span of time (maybe December through January), so that I can leave Deacon Dread and the Lord of Nightmares behind and get back to work on The Solitude of the Tentacled Space Monster, which has been languishing since late October.  I have ideas for other novels I want to work on in future NaNoWriMo’s, too.

I also chose to be a Municipal Liaison for our area in NaNoWriMo this year, meaning that in addition to writing my own novel I was helping to plan events and gatherings to help other people in Sacramento who are participating get their own novels written as well.  I had a helper in this, which was great, but the point is that NaNoWriMo kept me even busier this November than it usually does.

There’s that whole Thanksgiving thing, too, and I love Thanksgiving.  But since we don’t host Thanksgiving at our house, and since everything I bake always ends up tasting like soap, no matter how closely I stick to the recipe, my role in planning Thanksgiving is calling my parents (if it’s a year at my parents’ house) and asking them what time we should arrive.  That’s pretty much it.  So while I love going to the family for Thanksgiving, it just isn’t that big a time sink for me.  More on Thanksgiving in general in a future entry.

Another big time sink for me this past month has been, I confess, Second Life.  I signed up for an account just before the start of November, just to see what it was like, and was kind of hooked right away.  I decided to create a female avatar for myself for several reasons.  First, I know that even though I enjoy writing about female protagonists, they tend to be pretty passive, which frankly irks me, so I thought that maybe having a female avatar in Second Life would be the closest thing I’d get to having a female me in First Life that I could experiment with (no, not like that, you morally turpitudinous leches!).  I don’t know how accurate the experience has been, though I’m assured that even stating pretty obviously in your profile that you’re married (sort of the Second Life version of wearing a wedding ring) and that you’re not interested in sex of any sort, cyber or otherwise, is no deterrence to the guys who will come up and say something like, "Hey baby, nice breasts, wanna get it on?"  Of course, their language is usually not quite so refined.

Second Life has surprised me, though.  The brand new residents and the ones who are mostly interested in sex and guns mostly hang out in the newbie areas, and I’ve learned to avoid those.  Once you get past those areas you can find some truly remarkable simulations that have been built up by very dedicated people.  I’ve found a recreation of the city of Dublin; a couple of really amazing garden sims (my favorite is the SL Botanical Gardens, which was built by some botanists who wanted to recreate as many real world plants in SL as they could); some impressive music venues; a sim called "October Country" that’s dedicated to Halloween and the works of Ray Bradbury and other horror writers (Lovecraft’s Cthulhu makes a regular appearance); a recreation of the Globe Theater from Shakespeare’s days; and tons more.

Another reason I chose to have a female avatar in Second Life was that I originally thought my chances of meeting people who weren’t interested in just sex and guns would be increased if I made it clear that I wasn’t as well, and my impression was that simply having a male avatar in Second Life was an implicit announcement that you were after such things, no matter how many times you said you weren’t.  I’ve since learned that this isn’t automatically true, but my avatar’s gender had already been assigned, and even though I could change it simply by clicking a radio button in my "Edit Appearance" screen, her name — Zoe Compton — isn’t very unisex.  Besides, I’ve gotten used to her.  Plus, there are a lot more ways to customize your avatar’s appearance and dress it up if it’s female than if it’s male; if your avatar is male, your choices are pretty much limited to looking like a soldier with lots of guns, or a beefed up muscle man, or a hip hop gangster, or a super powerful corporate executive.  And besides, I’m a straight, non-transgendered, non-transvestite guy who enjoys watching "What Not to Wear"; how else am I going to express that side of me that desperately needs to shop for nice clothes?

It should come as no surprise that there are a number of men that play women in Second Life.  A lot of these men are gay (though I don’t see why they don’t just play gay male avatars); a lot of them are transgendered individuals who have no medical options for various reasons in real life, so this is their only way to express it; a sizable number of them are in it for the lesbian sex scenes because they now have a little porn star that they can control themselves on the screen; and, believe it or not, there are quite a few like me who are just in it for the heck of it.

So Second Life really has been a time sink.  In fact, I was falling behind in NaNoWriMo because of Second Life until I discovered that there is a surprisingly large contingent of NaNoWriMo participants who also participate in Second Life.  Hanging out with them, exchanging encouragement and participating in word wars really helped push me, which is why I was able to actually reach 50,000 words.

In case you’re interested, I’ve set up an in-character blog for Zoe.  You can find at it Zoe in Second Life.  I’ve run each entry through the Gender Genie to try to make them sound more genuinely female than male, and I’ve done a pretty decent job of at least fooling that website, though sometimes I end up with sentence constructions and word choices that don’t really make a whole lot of sense and that definitely don’t sound like me.  I’ve gotten several favorable emails about the entry called "Second Life: Not Just About Detachable Penises".

Another big time sink has been my lungs.  I seem to be fighting a permanent upper respiratory infection, and while I don’t focus on my lungs to the point of exclusion even when I’m sucking down on my nebulizer for the fifth time in a day, it sure feels like I have been.  Right now I’m on horse pill antibiotics and more steroids than I’ve taken in years, which means that my biochemicals are all screwed up.  I have not, strangely, gotten that magical side effect from Prednisone where everything in the world sucks including you, but I’m definitely getting the voracious and insatiable appetite which gets very consuming when I sit down to eat, crowding out any thoughts of "Hey, I shouldn’t have this huge hamburger" until, unfortunately, after I’ve alr
eady eaten.

Some day I hope to get my lungs under control.  They told me I would grow out of my asthma.  They lied.  And my doctor and I were discussing airway remodeling last week, a process where a long term asthmatic develops so much scar tissue in their lungs that the airways actually get altered and moved around.  This can show up in X-rays as blotches or white areas around the lungs, particularly near the heart, and it has freaked out at least one emergency room doctor who thought I might have some horrible heart condition until I mentioned the airway remodeling to her.  Of course, the airway remodeling has also left little pockets in my lungs which don’t get a lot of airflow, but do get some, and thus prove wonderful incubators for some of these infections once they show up.  This is why a cold which gives you a sore throat and a cough for a couple of days turns into a Cecil B. DeMille production for me lasting for weeks at a time.  My doctor tells me that I’m doing as much as I can, using top of the line drugs, for my asthma and there isn’t much more we can do without getting into areas of treatment that would simply be too risky and that my insurance probably wouldn’t cover anyway.

And, finally, there’s work.  I still love my job, but I feel like I’m reaching the top end of my skill set.  We’ve spent two years customizing Moodle to work with our department’s business model (because we’re a University governed by traditions of bureaucracy that go back to roughly 1100 BC, changing the software is a lot less painful and complicated than changing our business model), and we recently decided to rebuild our site using a newer version of Moodle.  Unfortunately for me, the internals of Moodle have changed so much since we first started working with it that it’s like learning the product all over again and has proven much more difficult than I had first anticipated.  This is the first time since my first few months with this job that I’ve come across a challenge at work that has really made me question my programming abilities.  It’s a new feeling, and one that I don’t particularly enjoy.  I’ve always been able to hack my way through any challenge at work, and in pretty short order; but this one is just grinding me down.  I know that I will get through it and that I’ll succeed, there’s little doubt in my mind about that; unfortunately, I’m just not going to succeed as soon as I would like to.

So, anyway, that’s where I’ve been this month.  Writing, Second Life, lung joy, and work.  See, I do, indeed, do more than just post to Twitter.

Fitness, Lungs, The Solitude of the Tentacled Space Monster

State of the Underpope

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The Underpope’s Physical State:  First off, Jennifer and I went and re-upped for Weight Watchers.  Losing weight has always been a challenge for me (as opposed to the cakewalk that it is for everyone else in the world, I’m sure), and I’ve never had much success using rewards to act as incentives for myself; I’d always end up buying the toy I wanted for myself anyway, long before I reached the goal weight I’d set.

This time I decided to go a simpler route, using something that I know would really get me going: books.  Every five pounds, I get a new book.  For my first five-pound loss, I promised myself The Complete Stephen King Universe; and for my first ten-pound loss, Soon I Will Be Invincible, because everyone needs a novel about supervillains and their difficult lives.  As of last week, I’d lost 4.8 pounds; not enough for that first five-pound reward.  This week, I lost six pounds, for a total of ten, so I ended up rewarding myself with both the first two books.  Woo hoo!  Of course, I’ve got a huge pile of shame, and I won’t be able to get to these books for awhile, but what the heck.  Next will be either The Chinatown Death Cloud Peril by Paul Malmont (I’ve been wanting this one for awhile), or Interworld, by Neil Gaiman, because, hell, it’s Neil Gaiman.  But it isn’t published yet, and may not be published by the time I lose another five pounds.

Of course, there’s the video iPod that I get when I break 200 pounds; and the motorcycle I get when I reach my goal weight (whatever that ends up being).

My jeans are getting baggy again, which they hadn’t been for a few weeks, and this is good but also annoying and a setback on my road toward a more polished, professional image.  Even my new slacks (flat-front and not pleated, thanks to all who chimed in on that point) are drooping in the seat a little now.  Honestly, I didn’t expect to lose this much weight this quickly.  I suspect that the process will slow down quite a bit in weeks to come so that it’s not so much a financial burden.

My lungs continue to give me grief.  My pulmonologist gave me samples of Prevacid, on the theory that somtimes gastric reflux can trigger asthma (I wouldn’t have thought so, but it’s common enough so that my doctor has a box full of samples of the stuff, just in case).  I think it might be helping, now that I’ve been taking it for a couple of weeks.

My headaches have returned.  I thought I was done with them years ago.  I need to go back and start reviewing what I did under the neurologist’s guidance: guided mediations, that sort of thing.  I think it’s an allergy thing.

The Underpope’s Creative State.  I am still stalled on The Solitude of the Tentacled Space Monster, partially because I think I’m overwhelmed by the sheer size of the manuscript and how much work needs to be done on it.  My goal is to reach 91,200 words by August 31.  It was going to be 90,000 words, but I miscalculated.  To that end, I set up a public Google spreadsheet to track my progress; you’re welcome to take a look at it, and call me on my progress if I don’t make it.

I used to have four short stories on my site: "Little Fluffy Wiggletoes", "LTM", "writing down some", and "Joe’s Salvation".  I took them down because I’m no longer thrilled with their quality and I’m not sure I want them representing my writing ability.  Well, "Little Fluffy Wiggletoes" was pretty good.  Plus, the stories were getting very little traffic, according to SiteMeter; except for "Little Fluffy Wiggletoes", which was getting hits from Google searches for young girls and sex.  I’m not comfortable with visitors like that visiting my site.  I may put it back up; I’m not sure.

Two recent rejections, which means only one sale this year.  At the moment, I only have three active submissions.  Tomorrow or the day after I’ll put out a couple more, to reach my goal of five active submissions at all times, but at the moment Daikaijuzine needs to take precedence; it’s just about time for my quarterly "Oh crap, the next issue’s supposed to be up in two days!!!" panic.  Fortunately we’re still a two-bit webzine.  I have dreams for Daikaijuzine, though, involving a print version and maybe even a publishing house way in the future, but such projects would require a touch more discipline.

Hm.  And that’s it for today.

Lungs, Moving

In, out, in, out…

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Today we’re cleaning up the house, getting it ready to show to prospective buyers.  Our office has been purged of about six years’ worth of detritus, and all my cool toys have been packed away as well as about nine linear feet of bookshelf space and eleven or so linear feet of books.

It just doesn’t feel like home anymore.  It’s too… clean.

Moved lots of stuff to the garage, which is going to be our staging area for the move, of course.  At some point we’ll fill up our garage to the point where we can no longer park both cars in it, but that’s okay.  My car’s pretty trashed anyway.  It can live outside.

So, getting a lot of stuff moved out of the office and computer room and library, ready to move in to a new house (here’s hoping).

In the meantime, in spite of all the moving around and the lifting and the shifting and all the resultant dust and airborne debris, you know what I haven’t had to use?  Neither my nebulizer nor my inhaler.  That’s what.  Air’s moving in and out pretty freely today.  There’s a very slight twinge and tickle deep in my bronchial tubes when I inhale very deeply, but nothing that’s threatening to turn into a wheeze or a hacking cough.

This is a weird feeling.

Lungs, Moving

Oh, in other news

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We made an offer on the house that we fell in love with in Sacramento.  We’ve spoken with our realtor and with a financial guy we know through church, both of whom have outstanding reputations in our community, and we don’t think this is premature.  So, let’s hope that this all gets done quickly.

Also, it appears that the most recent round of steroids and antibiotics are actually starting to have an effect on my lungs.  I woke up this morning with a strange feeling; it took a few moments to realize that it was the feeling of air moving in and out of my lungs with scarcely a sound.  No wheezing.  And while I’m still short of breath, having walked all the way from my car to my desk (less than a hundred yards at best — is that not pathetic?), I’m not coughing up my entire respiratory system, and my lungs don’t hurt nearly as much as they have been. Spiffy!

Lungs

I got a new drug

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Today, in the epic battle to bring my asthma under control, I started treatment with Xolair, which I mentioned in my last blog entry.  I had originally thought that the Xolair would kick in immediately and I’d be able to go jogging through a pollen-rich cornfield shouting out, “Come and get me, allergens!” this afternoon, but alas, that is not to be.  Instead, it takes about a month, according to my immunologist, to reduce the bloodstream levels of IgE measurably, and another month or so after that before the asthmatic symptoms noticeably reduce.

Something else I was confused about: apparently there is an increased risk of malignant cancers in people taking Xolair — 0.5% incidence in people taking the treatment, vs. 0.2% in the placebo group.  There’s a part of me which can’t help but worry over the increased odds (because that’s how I am), but intellectually I know that 0.5% chance of getting malignant cancer is still 99.5% chance of not (and anyone who knows more about statistics than I do who knows otherwise, please let me live in my delusion).  And, of course, Xolair is just a couple of shots; nothing at all exciting about it.

So, I guess we’ll find out in a few months whether this is going to work out or not.

Stay tuned.

Lungs

Worn Out Lungs

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Just about every asthmatic I’ve spoken to over the past couple of months agrees that this past year has been one of the worst.  My pulmonologist/immunologist corroborates that, and says that he’s seen far more urgent flareups this year than normal.

In a way, this is reassuring, because it means that I’m not alone in what appears to be this permanent flareup I’ve had since June.  On the other hand, it really doesn’t alleviate my symptoms.  I haven’t had a good strong breath for weeks, and I’m constantly coughing and wheezing.  I’m pretty fed up with it.  At least I can work from home so I haven’t had to use any sick time.

My doctor’s frustrated as well, because at this point I’m pretty much maxed out on therapeutic drugs.  I’ve got the maximum strength of Advair, I’m taking Singulair, plenty of Albuterol, and Aciphex (a drug used to treat GERD, because sometimes mild GERD can, even if no symptoms are reported, cause an asthmatic flareup).  And yet I’m continuing to wheeze.

There’s one more option on the horizon: Xolair, a relatively new drug developed by Genentech.  Xolair operates by going in and neutralizing Immunoglobulin-E (IGE), a protein which is associated with allergies.  IGE is almost always found in high levels in people suffering from allergies (though the presence of high levels of IGE does not necessarily mean you have severe allergies), and people with low levels of bloodstream IGE very rarely suffer from allergic symptoms (again, a high correlation, not a guarantee).  Despite plenty of research, no real purpose has been found for IGE in the immune system.  Early research indicated that IGE might be important in the body’s immunological response to parasitic infection, or in the early detection of certain kinds of cancer, but more recent research seems to contradict these results (in brief, people with allergies don’t have any lower incidence of cancer or parasitic infections than people without allergies).  My pulmonologist already has about a dozen people on Xolair, and it’s provided substantial improvement without any adverse side effects.  Said improvement is usually very quick, too.

The downside is that because it’s a new therapy, Xolair isn’t covered by many health insurance companies, is extremely expensive (about $15,000/year), and has to be delivered by subcutaneous injection.  Fortunately, my health insurance plan will cover it, provided that the patient has a sufficiently high level of IGE in the bloodstream (and my bloodtest shows a much, much higher level than most people; mine was about 350, while most people have less than 10 — and I’m afraid I have no idea what the unit of measurement is).  And I’m so used to shots that this won’t bother me at all (my mom sometimes jokes that I’ve had so many IV’s due to asthma that I’ve got track marks).

The manufacturer has already approved my taking the drug, so all that has to be done is for my doctor to send the necessary paperwork to my health insurance company.  If all goes well, approval should come within the next couple of days.

Here’s hoping that the Xolair really works.  I’m sick of being unable to breathe.  And I’m seriously worried that my asthma will prevent me from being able to go to Dragon*Con (or at least from having a good time while I’m there).

Costal Chondritis

A pain in the side

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Edited 19 July 2006: It seems that this particular page on my site gets four or five hits a day from people looking for information about costal chondritis (or variants thereof). I’m quite glad to be getting the attention, of course, but it’s kind of funny because I put so much effort into the rest of my site. Well, at least some good is coming out of this.

I understand the frustration of looking for information about this condition. I found nothing at WebMD, which is my personal favorite medical site, nor at WikiPedia, which is my favorite reference site (a search there for “costal chondritis” brings up “Tietze’s Syndrome”, which I’m not sure is the same thing). I guess that the best I can say is, talk to your doctor. Ice, heat, and non-steroidal anti-inflammatories seem to work for me (but please don’t think this is medical advice), though my doctor now recommends against stretching the affected area.

And six months after I wrote this original entry, I still suffer from costal chondritis. I think it’s primarily because I haven’t been free of asthmatic symptoms long enough during that period of time to really give the muscles and cartilege a chance to recover. On the plus side, since the pain’s been there, at a constant level, for so long, I can now be positive that it isn’t anything more serious.

Today I decided to go back to the doctor for this pain in my side which has been bugging me since August. In early December, the doctor who looked at it — not my regular doctor, who’s currently on maternity leave, but a good one by all accounts anyway — said it was probably something called costal chondritis. Back then I had a chest X-ray done, and the results were clear (well, as clear as a life-long asthmatic’s can be, when there’s airway remodeling and permanent scarring on the lung tissue). But despite the icing and the stretching and the Ibuprofin, the pain has not gone away. In fact, over the past few days, it’s gotten significantly worse.

I saw the same doctor today, and he looked at the results of the X-ray, listened to my symptoms, and did a couple of quick prods on my rib cage — “Does it hurt when I press down on your rib cage with 8,000 psi of pressure?” — and so on. And said Yep, very likely costal chondritis. But just to be sure, I get to go in for a bone scan this week, just to make sure there’s nothing there.

Because I am what I am, I naturally brought up the notion of cancer.

The doctor scoffed and told me that the odds of this being cancer are practically nil.

Anyway. So he explained costal chondritis more thoroughly this time, and I paid more attention. The “costal” part of the term refers to the ribs; you know, the bones that protect your heart and lungs and such. The ribs have cartilage between them to make sure they don’t rub together and damage each other. Between the bone and the rib is a joint; and it’s this joint which is out of whack. So, the cartilage is actually slipping because of the inflammation. Because this is happening, the smooth muscles surrounding the ribs — the intercostal muscles, a term I remember from the physiology classes I took in college — end up working harder to keep everything in place. But because this is not the sort of work the intercostal muscles are supposed to be doing, they wear out quickly and start to spasm. Pain ensues.

So, costal chondritis not only involves the inflammation along the costal/chondral joints, it also involves spasms of the intercostal muscles. The affected area could be just the bottom of your rib cage, or could extend all the way down the intercostal muscles and their associated muscles; from the collarbone, in other words, to just about the small of your back. That’s the affected area for me, though mostly it hurts at the bottom of my rib cage on my left flank.

The doctor believes this may have all started when I pulled a muscle in my back last August, and been exacerbated by a series of upper respiratory infections. This last cold, with all the coughing and the sneezing I had, probably just brought about the huge flareup I’m having now. There isn’t much I can do about it, though; take big doses of Iburprofin for a couple of weeks and see how it goes (in addition to the icing and the stretching), and if that doesn’t work, take a more aggressive approach. The doctor doesn’t like people to take anti-inflammatories if they can help it, but agrees that it’s time for that approach for me.

What it all boils down to, he explained, is normal wear and tear on the body, and it’s all probably exacerbated by the lifetime of asthma that I’ve had. Fortunately, I still have my pain management techniques that the neurologist taught me almost two years ago when I was dealing with my headaches, so I’ll break out that CD and see if I can get going on that again.

In other words: ouch. Frikkin’ ouch.

But other stuff is looking up. I’ve read through about four chapters of Fred Again and taken a lot of notes (including the huge, glaring, painful chronology issue right in chapter 2). And because I got a telescope for my birthday I’ve been listening to a lot of astronomy related podcasts, which are giving me ideas for the novel. 70% of the matter in the universe is dark matter, and no one knows what dark matter is. Except, of course, you and I know that it’s really just the ill will of Nyarlathotep and Azathoth that keep the universe together, right?