I say “Utah,” you say . . .

Mormons, right? Well most people would. I’ve been to Utah three or four times now and on every visit I’ve found Utahns to be friendly, polite, and happy people. Now, I don’t have an ounce of religiosity in me, but if that’s what Mormonism does for you then more power to ‘em. I was back in Utah this summer and had another great time. Man, I love this place.

I suspect Utah is overlooked when people list their favorite places in the western United States for one of three reasons:

1) Mormons scare them (this is nuts, people in Utah are wonderful, religion notwithstanding);
2) no ocean (OK, I’ll give you this one, you’re probably not going swimming in the Great Salt Lake. On the other hand though, there are more mountains than you can climb.);
3) wacky drinking laws (the drinking law stated you had to be a member of the bar, restaurant, club, whatever, to drink alcohol. It cost 3 to 5 dollars to get in a bar just to have a beer. That was crazy. Just this year (2009), joy of joys, the Utah powers finally got wise and decided this might be affecting tourism. Drinking in Utah is now the same as the rest of the world).

Utah has a lot to offer the outdoorsy type. We began with a couple of nights in Solitude, a ski resort in the Wasatch Mountains just east of Salt Lake City. I imagine Solitude is a busy place in the winter — Utah boasts “The Greatest Snow on Earth” — but it’s calm, peaceful, sunny, and cool in the mountains in the summer months. In fact, it’s 10 to 20 degrees cooler at the eight thousand feet altitude of Solitude than it is at the bottom of the mountain in Salt Lake City.

Last year, we took our little rental car north and east of Salt Lake, touching on Idaho, Montana, and ending up traveling through Yellowstone National Park in Wyoming down past the Grand Tetons and eventually back to Salt Lake City. A photographers dream.

This year, after some relaxation in Solitude, we drove south towards Moab, Arches National Park and Canyonlands National Park. You probably don’t want to visit Moab in July and August when it’s over 100 degrees but in September — well, it was still 85 to 90 — but, as tourists relentlessly say, it is a dry heat. Dry heat or no, water (and sunglasses) take on a surprising importance down here. This is the desert so when you go out for a walk you take water with you. The signs on park trails often recommended you take a gallon.

Arches National Park has, believe it or not, arches. The park is just north of Moab and has natural red rock formations and buttes galore making it the stuff of cowboy movies.  Here are some more photos.

Canyonlands has . . . what? Can you guess? This is not the Grand Canyon, that’s a hundred miles or so down the road but Canyonlands is a bunch of smaller versions and picturesque regardless.

While downstate this far, we had to go to Four Corners, the only place in the U.S. where four states meet at one point: Arizona, Colorado, New Mexico and Utah. Ok, it’s not the most exciting place in the world and it took a long drive to get there but hey, check, it’s off the list.

Yeah, Sure You Will

I’ve been ignoring the blog for a long time because I thought I’d said everything I had to say about medical stuff that might be of some help to other people in similar situations. Plus, sometime after my last post, I discovered Twitter and — taking the easy way out of course — decided it was considerably easier coming up with a sentence or two (complete with abbreviations and emoticons (LMAO )) rather than a coherent paragraph  or two.

But after a month or two of reflection on this blog thing — plus reading other blogs that often had extremely short entries and, more often than not, were not even slightly entertaining — I thought I’d try to get back in the game and continue the ol’ life story.

We’ll see. My life is often so desperately routine and dull I bore myself into inertia trying to write it down. But for those two visitors a day to my blog  (on average), I’ll try to contribute a little more often.

Go for Mohs

I have that northern European combination of blue eyes, blond hair (well, it was blond when it was there), and skin cancer galore. The skin cancer, of course, would never have happened if I’d stayed in the cold, dreary, miserable, damp climate I was familiar with in England. But no, I’m in the U.S. and loving the sunshine and the tan. At least I was until the second fifty years kicked in. The doctor has just finished the third cancer digging expedition into the depths of my head and this one wasn’t pleasant. I say, “this one,” because the three experiences have been quite different from each other.

The first time, I had something called the Mohs surgery which was great in that you would never be able to find where it was on my face — no scars or marks remain. They sent me home with a big bandage wrapped around my head held in place by a rather fetching black sweatband. OK, that was the only bad bit about the Mohs procedure.

The second time a “general surgeon,” whatever that is, dug into my scalp, left a few stitches in for a week and I believe there is nothing visible today.

Today, though, the bad spot was about an inch from the mole where the Mohs occurred. Today’s doc was talking about how I’m going to have a scar and, “it’s going to be bigger than I would expect!” Bigger than I expect? I wasn’t expecting a scar at all.  So I asked him why I wasn’t getting the Mohs and he told me it depends on what the dermatologist recommends. If it’s going to affect my looks (and therefore, my psyche, I guess) then Mohs is used. Today’s cancer was determined to be on my forehead rather than my temple so it’s scar time. I have a huge forehead — more of a fivehead really — so I certainly think I should have been consulted on the spot where my temple ends and my forehead begins. My little psyche is already upset.

I’m left with a big indentation where the doc dug deep into my head and a lump on either side of the dent. It looks like a miniature skateboard run. Plus  it hurts.

My kind of Monday

March 2, 2009 in D.C.

Snow in DC this Monday morning– about 3 inches  — or that’s what it looks like through the window, I’m not going out to check because it’s 25 degrees and a 25 mph wind is blowing. The forecasters suggested somewhere between 4 and 8 inches but in DC that’s all they can do — suggest.

We often sit on the cusp of weather fronts here in the nation’s capital, this is where the stuff from the south meets the stuff from the north — or not.  When they do meet in winter it can mean a couple of feet of snow but so often a small burp inthe wind and Maryland gets dumped on while we get all worked up over nothing. Such is life on the cusp.

Anyway, a day off work. The photo is how the day looked from my balcony.

The We Are One Concert

People with issues

Along with, give or take, 400,000 like-minded people, I attended the concert for Barack Obama on the Mall yesterday. It featured lots of celebrities from the worlds of movies and music: Bruce Springsteen, U2, James Taylor, Jamie Foxx, Forrest Whitaker, Beyonce, Usher, Stevie Wonder, Tom Hanks, and lots more. The musicians did one or two songs each and the acts moved along smoothly and with surprising speed — it was being aired live on HBO so I guess that explains why.

I arrived on the Mall about 10 minutes before the first act appeared, and considering people were there six hours prior to that, I was surprised they left room for me.

I was nowhere near the action which was on the steps of the Lincoln Memorial, in fact I was closer to the Washington Monument but I had a pretty decent spot in front of a Jumbotron. You don’t go to see the stars in person you know, you go for the event. Or so I’m told.

The walk from the Farragut North Metro to the Mall contained more street sellers than I’d ever seen before. I would never have imagined there was so much Obama stuff out there for sale. Obama buttons three for a buck! Obama earrings, five dollars! More T-shirts than you can count, five bucks on the way to the concert, three on the way out. Hotties to keep your hands warm! And your toes! Five bucks for two. You know how professional activists move from one demonstration to the next wherever it may be? Well, I suspect many of the sellers were professional hawkers, I’ve certainly never seen many of them before. Anyway, if you didn’t get your Obama trading cards on the way in, they were still waiting for you on the way out. There were also professional preachers from Los Angeles who have issues with much of society it seems, at least according to their placards. (see picture)

An important and popular place.

I think a good time was had by most, if not all, at the concert. Certainly the people around me had a good time, some young ladies in front of me even got a pretty successful wave going. I’ve just thought of some more people on stage: Garth Brooks had a lively set, Mellencamp did his Little Pink Houses, Herbie Hancock, Mary J. Blige sang Lean On Me, and opera singer Renee Fleming did a great rendition of You’ll Never Walk Alone. Joe Biden kept his speech short.

The getting in and out was smooth for me and, I heard later, was a success for most. The Metro seemed to keep running — probably better than it does on a regular work day– so this bodes well for the inauguration tomorrow.

Sharks 1, Jets 0

I saw a performance of West Side Story at the National Theater in Washington, D.C. this weekend. About ten minutes into the show, the leading man, Tony, ran out on the stage, let out a moan, and dropped to all fours. The audience, of course, sat quietly not thinking anything was amiss. I have no idea why I say that, I had no clue what “the audience” was thinking, and my mind, as best I remember, was a total blank. The blankness was because my idea of a good time does not usually involve the words “West Side Story” or even “National Theater,” I was there because of a convoluted Christmas gift exchange.

Anyway, Tony went down, a person ran on stage from each side to check on him, and the curtain came down. The audience let out a belated “ooh,” and for the first time in my life I heard the words, “Is there a doctor in the house?” The calm, BBC-like voice from the heavens added, “If there is, please go to the back of the theater.” It seemed like much of the audience stood and started hurrying towards the back of the room. I don’t think any more people would have stood if he’d said, “Is there a government worker in the house?”

A man and woman directly in front of me got up and headed to the back. The woman’s parents were also there and the Mom told me the couple was man and wife and both were doctors, one an internist and the other a gastroenterologist. The two quickly returned saying they couldn’t get near the actor because of the crush of doctors. Maybe that’s what a group of doctors is called: a crush.

While we were waiting to find out what was going happen in Tony’s absence, I mentioned to my wife that as we had a couple of doctors sitting in front of us it would be a shame to waste an opportunity and did she have anything she wanted to ask them? While my wife cringed in embarrassment, I said, “It hurts when I do this!” The lady doctor, bless her, said, without even turning around, “Don’t do that!” The husband doctor merely glared at me.

That ended the interesting part of the proceedings although I should mention, the understudy did a wonderful job as the replacement Tony. The voice from the heavens also told us that Tony had been taken to the hospital and he was going to be OK.

One turtleneck too many?

This Christmas thing has got to stop. No, not yours, mine. For years now, my family has come together a week or so before Christmas to eat, drink, and exchange gifts at my sister-in-law’s house. When I say “my family” I mean my wife’s family. Mine is either dead or dropped off the planet. The cast of characters attending these events is as follows: my father-in-law and his wife (this is his second wife so I guess that makes her my step-mother-in-law, if there is such a thing); my brother-in-law and sister-in-law (the owners of the house and the wealthiest of the group); their two kids (my niece and nephew) ages 15 and 14; another brother-in-law; my two kids ages 30 and 26 and my wife. Over the years I suppose the average number of gifts given to each person is about five. Eleven people times five gifts each equals a lot of excitement, wrapping paper, and the inevitable disappointment at once again not getting anything useful. Talk about an embarrassment of riches.

When the kids were small it seemed a lot more appropriate for this extravaganza than it does today. I mentioned a couple of years ago that we’re all adults now (except for the 15 and 14 year olds) and there isn’t one of us that really needs anything. I was shouted down. Even my 80 year old father-in-law said, “I want my gifts!” He accumulated everything he could ever possibly need many years ago and since then it has been a huge problem deciding what to get him year after year.

My wife added to the mayhem by announcing that my kids should not be just taking gifts, they should also be buying for everyone. For them, receiving was waaay better than giving despite what you may have heard to the contrary, and so we have a rebellion on our hands. My kids are now willing to call it quits on the whole gift exchange idea. My wife, who has never worn a turtleneck and never will wear a turtleneck got two more turtlenecks from her relatives this year. I’m sensing things are starting to turn in my favor.

My alternative plan is for each of the couples to give money to charity and forego the gift exchange except for those under 18 years of age. Nothing is yet decided but I think next year, finally, the plan has a chance. Now all we have to figure out which charities are most deserving.

If this happens I might even look forward to seeing the relatives next December.

Happy Solstice

Enough of the sickness stuff. I could probably keep up a sickness blog until the day I kick off (infected tennis elbow anyone?) but I really don’t want to write it and I’m pretty sure you don’t want to read it. As I said earlier, my adventures in neurosurgeonville are on this forum in case someone gets a similar diagnosis and would like to find out how I got through it.

It’s now December 22, 2008 and much of my world is caught up in the heavy anticipation and excitement that is Christmas. Everyone, that is, except your resident atheistic, grumpy, bah humbugging blogger. I saw a movie many years ago of which I have little memory — something like a Christmastime detective mystery story. Or something. Anyway, a couple of detectives knocked on a woman’s door to ask her some questions. She squeaked about it’s Christmas Eve and how dare they disturb her, blah, blah, blah. The detective shut her up by saying, “It may be Christmas Eve to you lady, but to us it’s just Tuesday!” Right on.

I did, however, have a great winter solstice. How about you?

Tumor, one year on

I went to see the neurosurgeon today, December 1, 2008, CD in hand. I was of course, greeted by the inevitable paperwork screw up. It seems that I can never, NEVER I say, see the neurosurgeon without a referral from my doctor. This is pretty much how the receptionist greeted me, along with the news that she would allow me to see the guy regardless, but first I have to sign here and here and here which had me agreeing to assume the bill for this visit if I didn’t get a referral to them within the next 48 hours.

Knowing full well that this doctor charges about the same for a 20 minute visit as the GNP for a third world country, I raced home and e-mailed my doctor pleading for her to send the referral. A couple of hours after that, my doctor wrote to tell me she had faxed the document. I called the neuro place to confirm they had received it, and no, of course they hadn’t. Geez. These people are starting to make the National Health Service look good.

Anyway, back to the neurosurgeon that performed the gamma-knife radiation. He was happy with the MRI pictures. He showed me the tumor and pointed out the “necrosis” (dead part killed by the radiation) in the middle area. I congratulated him on his good aim. He also measured it and the size was unchanged from a year earlier — another good sign.

Also on the CD was the MRA to show the aneurysm although that doctor wasn’t present. The tumor doctor said from what he could tell the image looked as good as a partially unprotected brain aneurysm could look. He promised to send the CD to the aneurysm guy for his perusal. I’m to go back in another 12 months for another MRI to see if anything has changed in the tumor.

In the tube for an MRI

I had an MRI and an MRA yesterday, killing two proverbial birds with one proverbial stone. The MRI was for the tumor and the MRA for the aneurysm. There’s no obvious difference between the two scans — at least to the patient — except, of course, that it takes at least twice as long to have both.

An MRI is nothing to be scared of, there’s no pain involved, any problems are, quite literally in my case, in your own head. If you’ve never had an MRI before but someone tells you that it involves lying on a platform and being rolled back into a tube-like machine where your nose clears the ceiling of the tube by a good half an inch, then it’s understandable if you’re a little concerned. But, as it turns out, it’s one of those situations where the anticipation is worse than the event.

When making the appointment, the receptionist (or whatever that person on the other end of the phone is called) asks two questions of every potential MRI patient. Can you guess what they are? Remember, you’re going into a very confining tube.

The questions are, 1) Are you claustrophobic? You knew that one didn’t you? Here’s the one you didn’t get: 2) How much do you weigh? The tube is only so wide so I guess if you’re 400 pounds you’re going to have to go to plan B. I don’t know for sure, but I believe if you are claustrophobic or you are overweight then you have a more open MRI. Why we all can’t have a “more open” MRI I don’t know.

The procedure is something that can be improved, and I hope it is before I have too many more of those things. You lay down on the platform after removing all metal objects (really, you should plan on removing all clothes) and putting on a gown and being wrapped in a blanket. A circular frame-like structure is moved into place over your head — not touching you, but very, very close — and the platform, with you on it, is slid into the tube. The technician disappears into another room (I think he does, I couldn’t see anything) and it’s just a few seconds before the banging begins. Did I mention ear plugs? The technician gives you ear plugs before rolling you into the tube — this is a good thing.

The banging — I imagined magnets flying around my head — along with a little vibrating (that’s the resonance part, I guess (MRI = magnetic resonance imaging)) sequence varied. I don’t know how long each sequence lasted — a sense of time is absent inside the tube — but the type of banging would change periodically, let’s say every three or four minutes. It would go from BANGBANGBANGBANG and suddenly stop. The quiet was surprising. Then it would start again after one, two, three, seconds, but this time it would be DRRRRRRRRRRRR. Please feel free to explain what’s happening at this point if you know.

Part way through, I think I actually went to sleep for a few seconds. No matter how disconcerting the noise is when it starts, you adapt, you get used to it. Once or twice I must have adapted so well I passed out. The sudden noise cessation though, is enough to wake anyone. Strange to think of being woken up by the absence of noise but there it is. I tried mightily to go to the beach in my mind, or at least try to think of something other than being confined and having my ear drums assaulted, but it’s not easy. Still, just trying to think of something concrete is a help — if you have a “happy place,” this is where it would come in useful.

I had an MRI in Fairfax County, Virginia once, and they had a little mirror inside the tube that allowed you to see your feet. This turned out to be surprisingly satisfying — not because I have such great feet, but because it gives you something to focus on. Yesterday’s machine was in D.C. and not even in a building, it was in a trailer.

The technician had given me a squeezy bulb-type contraption to press if I needed help during the scan. As I was being rolled into the tube I had two quick questions for him: What happens if I sneeze? This was something I’d been consumed with over the previous 48 hours and I needed an answer. The guy said, “A sneeze is an act of nature.” Not a lot of help. I said, “Do I squeeze the bulb if I feel a sneeze coming on?” He replied, “No, no, no.” My second question — and I was close to disappearing from view at this point, was, “Is there a mirror in there?” Desperation was settling in. He said, “Sure, sure, sure,” as he continued to push me all the way out of his sight.

There was no mirror. I kept my eyes closed for the entire hour I was in there. I never did squeeze the bulb thing, I’m not even convinced it was connected to anything. I ended up not sneezing though I did get an awfully itchy ear that I couldn’t scratch.

Despite the stress of anticipation and the drama of actually being in the tube, it’s surprising how fast the memory of it all fades. A couple of hours after getting home I was back in the old routine, none the worse for wear. The MRI people gave me a CD of the images so up next is a visit to the neurosurgeon to let him see the results.