One Sick Mother

Through The Looking Glass

I once had a boyfriend who elevated pointing out the obvious to a fine art. I mean really: If there was a Nobel prize on the subject, he would have won it over and over again. I don't quite know how he did it, either, because the obvious thing he would point out wouldn't be the most obvious thing from another's point of view. It wasn't the obvious obvious, if you know what I mean. It was even more obvious than that. Say you saw a red car on the street: He wouldn't say "there's a red car" He would say something like "That car is driving on the street". Like there would be somewhere else that car should be driving ...in Sydenham.

He was wasted as a programmer. He should have been a politician or a TV news reporter. They excel in pointing out the obvious. Although his specialty was transactional databases for retail, which involves counting the obvious, so maybe he was in the right place, after all.

People adapt.

That was the keenly insightful, unoriginal and totally obvious thought I was going to use to open this post. Like many unoriginal thoughts, it happens to be true. The adaptability of people is how we survived famines, floods, Ice ages and God-knows-what else to become the dominant force on this poor little struggling planet we call home. Mostly, adaptability is good. It allows us to adjust to the changes life throws at us: The car broke down? I'll take a train, I lost my job? I'll change careers. People can deal with amazing life changes: My right hand doesn't work so well? I'll use my left hand...

Stop.

That's where adaptability is bad. Because just because one can adapt, doesn't mean one always should.

When one is unwell, slipping into a state of permanent unwellness is an easy trap to fall into. Because let's face it: most of your friends and family fuck off and abandon you. They do. They either drop you immediately like a scalding poo or they slowly slip away. You spend a lot of time on the internet, connecting with other unwell people. New symptoms are easy to write off as part of the original problem. You continue to just use your left hand instead of yelling at the doctor that this right hand thing is unacfuckinceptable and he needs to find out what the problem is and fix it.

Now some people are probably confused at this point, because it is hard to understand what I mean, especially if you haven't lived it. I mean that reality can become skewed. " Normal " can change. That's what adaptability is all about -if you ask me. Creating a new “normal”. Two years ago, it was normal for me to follow a breakneck schedule: I rose at 5am, I was on the train at 6:07. I was at my desk at a Wall St institution eating breakfast shortly after 7. After work, I came home, picked up the kids, cooked two dinners (one for the kidlets, one for the adults). Then I did kid baths and bedtime, worked, maybe had a little metime at the telly or on the computer and tried to be in bed by midnight.

Yep. 5 hours sleep a night (if I was lucky). No wonder I got sick.

Now I sleep 8 or nine hours a night and I still have to nap most days. If I have a “good” day and overdo things. I am a mess for several days afterwards. For awhile I was accepting this 'new' normal. I had blackly hilarious stories about ER visits and hospitalizations. I expected to have fits and seizures. I was starting to think that they were part of my new life. I adapted. I was even starting to… Accept. Isn't that the final stage of grieving?

Then my good friend, Wynda -one of the few "normal" friends I have left (as normal as my friends ever got, anyway), interrupted me mid-blackly-hilarious-story and said in that gentle way she has: '"Sweetie. This is not OK"

She was right. She is right.

I e-mailed my doctor shortly after that and got in his face. That was when he pointed me towards #25 and we started getting somewhere.

But I still haven’t reached the point of this post. Sorry. Seven Hundred words in and I am nowhere near the point. This is why I don't make my living as a writer. The job usually pays by the word and I waffle too much (OK this and a few other things -like no-one wants to hire me).

I saw the Cardiologist last Friday and I mentioned the vitamin C problem to him. He suggested I see an MD who specializes in nutrition. Not a nutritionist, a physician. He said that he knows of one hospital in the area who has that kind of department: Sloane Kettering. That was when I felt I had stepped through the looking glass. I don’t quite know why. It just seemed like one hoop too many, you know? Go to a cancer hospital to find out why my body doesn’t absorb or process nutritents properly.

Yes. I guess it makes sense…. In The Twilight Zone!

So I’ve been putting it off. I’ve been telling myself I am too busy with the holidays etc, but really I have had time to make a few phone calls. I just haven’t done it. And then this weekend I got to thinking about adaptability, and how I will not accept this current state of being as normal and I really do need to step (farther) outside my comfort zone if I want to get well.

So I am going there. At this point I am not sure if “going there” means I will be stepping through the looking glass or stepping back. Either way, I’m going.

Cover me.

Forget Size. It's All About Position

...according to a study I just read.

Well, you could have knocked me down with a feather! I always thought bigger produced better results. That was certainly my perception in my own life. I laughed at people who said things like "size isn't important. It's how you use it" because I thought they were trying to make excuses for their own inadequacies.  I mean of COURSE size is important! Bigger, faster, stronger. Give me Steve Austin over Pee-wee Herman any day of the week. Actually, you can give Pee-wee Herman Steve Austin over me any day of the week too! Not that Steve Austin would have anything to say about it. He's fictitious.

I was quite surprised to read this paper -and it was something that I had learned previously, but I guess I hadn't processed it properly- that size is not the most important thing. What matters most is position.

...when performing an MRI of a weight-bearing joint. 

"What?" I hear you say?

Why? What did you think I was talking about? Get your mind out of the gutter (...Rob)!

The spine is a weight-bearing structure. it consists of a bunch of bones separated by sproingy discs of squishy stuff. Yep. Them's technical terms. The sproingy discs stop the bones rubbing against each other, allow for movement, and act as shock-absorbers.  They can change shape and look different depending on the forces exerted on them; gravitational, as well as lateral and multi-directional forces exerted by the muscles and other bits attached thereon.

So if you photograph these sproingy discs when a person is laying flat, you see them at their sproingiest; happy and at rest, -under no pressure at all- singing little songs to themselves. Sit that person up (the position which puts most load on the spine, apparently), and things can change considerably: The weight of the head (12lbs), shoulders and everything else exerts downwards and the little discs may change their happy tune. They will squish and may even change position relative to other structures in the spine, such as ...say ...the spinal cord. This is probably especially true of the connectively challenged: I.e. people with EDS, Marfans, and other connective tissue disorders.  But of course, this hasn't been studied. <sigh>

It is also true that other weight-bearing joints -especially damaged ones- can look quite different under load than at rest. If your ankle bothers you when you put weight on it, why bother to MRI it with while laying down?  If you think about it, it's perfect common sense. ...Once someone explains it to you. It took a brain surgeon to figure it out in my case, so don't feel bad if you didn't think of it yourself.

Position is important, too. They MRIed my neck with my head straight, then with my head tilted to either side, my chin down, and finally with my head tilted back. The discs didn't move around too much until I tilted me hread back, and I tell you that picture was scary! I often used to sleep with my neck in hyperextension (don't ask me why) and since seeing that picture, I have been training myself not to do it.

Now, I had lovely pictures of myself to post at this point, where I could show side-by-side images of my spine, taken minutes apart, one laying flat and the other sitting. You can clearly see where one of the herniated discs in my neck bulges out a lot more under the  pressure of gravity. But I can't find the feckin CD! Sorry. I will throw in pictures when it shows up -probably in the oven or my underwear drawer.

OK, you've sold me on position, but what has this all to do with size? I hear you ask? Well it has to do this: They have been making MRI machines more and more powerful recently. they have been throwing Gausses and Teslas and probably some other central European geniuses around like nobody's business trying to make the Steve Austin of MRI machines. They had Functional MRIs and diffusion ones and ones which combine MRI with SPECT... and all sort of interesting things which I don't understand, but I'm sure are terribly impressive.  All of these will take fancy pictures of one while laying flat and under no gravitational pressure. This is fine for cancer, MS and probably a gazillion other things for which one might be magnetically imaged.

It is not fine for anything structural, and certainly not for anything weightbearing or subject to gravitational pressure.

And for structural abnormalities, one doesn't need all that firepower. You only need 650,000 Germans (Gauss)  or slightly less than two-thirds of a Serbo-Croat (Tesla). So you don't have to worry about the iron oxide in your haircolour being sucked out by the gigantic magnet. I don't think that is possible BTW (I don't think there is iron oxide in haircolour), I just like the idea of it for some perverse reason. The only people in the world who make positional MRIs is a company called FONAR, and their machines are less powerful.

But that's OK. Because it's position that's important.

You'd Better Watch Out...

Santa Claus is coming to our house. Keep your nose clean and keep the cookies coming.

My kids are 7 and 9, so I was a little worried that this would be the year that Santa Claus was killed for at least one of them.  I know they are a little old to believe in Santa, but that is part of the magic of Christmas. And indeed, part of the magic of special needs kids.

My own belief in Santa was killed when I was seven. Of course, then I had Hard Evidence. I had found a hidden present, which later turned up under the tree with Santa's signature thereon.  I remember debating this with my Very Best Friend, "N" on the stairs of her parent's old house.

"Maybe it was a mistake"

"No. It was definitely the same doctor's set"

"Well, maybe your Dad got some extra presents and said that Santa sent them"

"The same paper? the same writing?"

"The same paper?"

"Yes"

"Oh."

So I killed Santa for her, too. Sorry, N. I wish I had more tact back then. Hey! I wish I had more tact now, but I guess I don't...

I remember that disillusionment to this day.  N. probably does, too. And it was like ...20 years ago (really). So now, even though my kids are relatively "big" to believe in Santa, I have worked hard to keep him alive for them. No Hard Evidence anywhere. Separate wrapping paper for Santa presents. Crumbs on the floor left by reindeer. OK maybe one of them will read this and I'll be screwed, but that's why God invented passwords.

I was concerned this year that my son, who is older and a clever little bugger for all his Autism, was going to test the Santa theory. He had refused to divulge to us his Santa Gift List. I figured he was holding back in the hope that Santa would somehow read his mind, and if not; theory proved: Santa didnt' exist. I have been trying to get information on what he wants out of him for weeks, but the best I managed was some Pokemon cards. Well, Himself managed to get a list out of him eventually. I have a feeling he is still holding something back, so I'm throwing an extra gift in there -just in case. (Maybe I'm overanalyzing this?)

But maybe my fears are in vain. Because the kids talk a really good game: Today at dinner I was talking to them about Santa, and they mentioned that the kid next door -we'll call him "Tommy"- doesn't believe in Santa. I asked my kids why they thought he would say that? -I have learned from experience that kids can often  come up with far better explanations for this stuff than I can- They did: "Maybe he doesn't believe in Santa the same way he doesn't believe in Halloween (good one!) "Maybe Santa won't come because Tommy doesn't believe in him anymore" (NICE!). And then my daughter said.

"Tommy said the parents get the gifts! I mean that's crrrrazy!"

"Yes it is." I said. "Where would I get money like that?"

"...and where would you go shopping in the middle of the night?" she asked, arms askew...

I had a hard time keeping my face straight at that one. I guess she can't figure that parents might plan in advance. Or maybe she knows me better than I thought.

But my son had the best theory:

"Maybe Tommy's on the naughty list" he said, knowingly and conspiratorially. 

You know, that would explain a lot...

A Full Night's Sleep

You know, the funny thing about improvements is that you don't always notice them rightaway. You usually notice if something gets worse straightaway. That you notice. But if there is an improvement, you tend to take it for granted, until one day you wake up after another full night's sleep and think Wow! I slept! ...and not for the first time this week!

Most healthy people don't realize how amazing and important a full night's sleep is until they become a parent. That's when you really start to miss something you had previously taken for granted.  But at least when you are a parent, you can usually fall straight back to sleep after the baby has been fed, burped, changed and settled.

Waking in pain is another matter. High-level pain is probably the easiest to manage, because you know to take the Strong Meds and then do whatever you need to do to combat it.

However if you wake with low-level pain, there is a dilemma: Do you try and tackle it with a Tylenol, which will rule out taking some of the Strong Meds later should the pain get worse? Or should you try and tough it out, hoping it will fade? (because most of us don't want to waste the Strong Meds on low-level pain). And sometimes you don't even fully realize the problem. I have tossed and turned for ages before I even noticed that pain was keeping me awake. Heck, I have been in labor and not known! But as we have established in the past:

I'm strange. Clinically so.

So pain. Yeah: Even when you take the meds they take awhile to kick in. So begins the whole business of trying to find a comfortable position in the meantime. Because pain -back pain in particular- is rarely static. it can change in nature and force depending on the forces of nature exerted upon it, especially gravity.  And back pain is rarely alone. It likes to take other pains along for company. So you get into a position where your back doesn't hurt (much) and after a little while, the shoulder pain starts. You change position to alleviate that, and the original back pain gets worse. So you change again, and neck pain starts. This can continue all night, until you are practically crying -not from pain- but from lack of sleep.

My main areas of back pain are in the lower back -right at the sacroiliac junction (which is made up almost entirely of connective tissue) and in my neck where I have three herniated discs. The lower back pain is the bugger that keeps me awake most. It is so constant I barely notice it sometimes.

So I think it was Thursday when I woke up and I realized that my back pain had not woken me in a night or two. I confirmed it on Friday and again today. My back has hurt very little (relatively speaking) in several days.

The vitamin C must be doing some good.  Except in the cold-fighting department, because I have had a horrible cold. But I will take a cold over back pain any day of the week.

OSM's Guide to Dealing With a Hypochondriac Friend, Part I

So you're best friend's a hypochondriac. She looks fine In fact, she looks better than most of your other friends the same age. She seems cope fine with everyday life. She manages all the everyday activities just fine (that you can see). However she is always complaining about her health. She stresses out about every little cough or mole. She is always trawling the Internet looking for new ailments with which to diagnose herself. She knows more medical terms than the Oxford Medical Dictionary and yet there is Nothing Wrong With Her.

You wish she would see that this is all in her head and she is fine. Because then she could move on and live her life: and more importantly, her "problems" wouldn't be sucking your time away from your own REAL problems: your  mom's increasing dependence on you since your dad's death and your son's struggles in school. If she could walk a few miles in your shoes she would see what real problems are and that would make her realize how lucky she is and shut her up. You are very frustrated with her behavior.

So you come to One Sick Mother (-not knowing my Secret Internet Identity) for advice:

Well, here is my advice to you:

Either you are her friend or you are not. Make a choice and stick with it.

If you are not going to be her friend; walk away and tell her why. Do not renege or ping-pong on this decision because that will be harder on you both. Really I mean this: If you are not going to support her and take her condition seriously: Walk away.

"But I can be her friend if she will only stop with all this hypochondria crap" I hear you cry"

The thing is: She can't. Her "hypochondria" is part of who she is. Friends are a package deal. They do not come a la carte. You cannot choose which parts of them you like and try to remove or change the parts you don't. This is also true of husbands. Or wives. So stick with the whole friend or walk away.

So let's say you decide to stick with your friend. What then?

"How do I deal with her hypochondria?" you ask. She is always looking to me for medical information and opinions. I don't want to encourage her in her mental illness. I can't be her enabler."

OK. So now who's spouting pseudo-psychological TV bullshit? "Enabler?"  Puleeease!

How do you know your friend is not actually sick and undiagnosed? Are you a doctor? How do you know she is "mentally ill"? Are you a psychiatrist? Oh you're not. I see. Well, was it because her doctor said so? Is he a psychiatrist? No? we then he cannot diagnose hypochondria. So maybe he's just incompetent and blaming her for his failures (ever thought of that?)? Ask yourself this: How would you feel if -after months or years, it turned out that she actually has a rare or little understood condition? Would you feel glad about all those roadblocks you have put in the way so as not to "enable" her in her very valid quest to find treatment? No. You'd probably be sorry. Or pissy and defensive.  Or all three.

So why not take the conservative approach and support her?

Because let's face it: although there are probably some real hypochondriacs out there, just as there are real people with Munchhausen's Syndrome; However, the vast majority of people who are labeled as "hypochondriacs" eventually end up with a valid medical diagnosis.

Or dead.

In that case, the diagnosis usually comes out on autopsy. "Oh! If only I'd known... " you might cry, But your friend knew. She tried to tell you, and you didn't bloody listen.  Because you didn't want to '"enable" her. So you ignored her and enabled her death. Pat yourself on the back. Job well done.

We all have a little voice inside ourselves which is our guiding force. Call it what you will: intuition, instinct, God, your gut. It is the thing that tells you when someone is lying or if a situation just doesn't feel right. It is the thing that made you argue with the doctor when your kid was sick and he said nothing was wrong. It is the reason you don't trust that guy in the bookstore -despite the fact that he has been nothing but nice to you. It is the one voice you always regret ignoring. Because if you spurn or ignore an instinct, you usually regret it (if you live).

You friend has that voice too. It is telling her that something is not right in her body, but the doctors cannot tell her what is wrong. Her symptoms may be too unspecific or intermittent. They don't fit into a neat pigeonhole. And guess what: she looks great! (she probably eats right and takes all her vitamins). So the fatigue must be depression. The doc writes a script for anti-depressants to get her out of his hair, and so the downward spiral begins.

Because your friend doesn't understand how she could be depressed when she doesn't feel depressed. She hasn't lost interest in the things she loves. She has lost the energy to do them. Of course if time continues and she still feels this bad, she will become depressed. It hasn't happened yet, but everyone seems to be willing it so. Putting the cart before the horse, so so speak. And she is stuck, facing down both barrels of a self-fulfilling prophecy, and unable to do a thing about it.   

Adding Insult to Irony

Here's the irony: I don't get sick much. 

I mean, I am *unwell* every day, but I don't catch that many bugs and viruses (or should that be viri?) that go around every season.  This has been true for a long time: I have two kids in school, so they catch colds and other stuff that goes around. Whenever a bug goes around the house, I usually catch it last and it seems to effect me the least and last fewer days in me relative to the other members of the family.

It was one of the things that made me wonder in the past if I might have an auto-immune disorder? Maybe my immune system was in hyperactive mode? However, I have been tested for most of them, and my immune system, although apparently vigilant, does not appear to have gotten so bored as to start gnawing on my joints or myelin. Remind me to buy it a chew-toy for Christmas -just in case.

Of course, it could be that the bugs effect me less because I am so used to being unwell all the time and toughing through it, that a little more unwellness on the pile makes little difference.

Vitamin C is supposed to ward off infection. So you'd think -given my scurvy status- that I would have been picking up every bug from SARS to MRSA to the flu. But that hasn't happened (I am happy about that! Not looking gift horse in the mouth here).

Any now that I am correcting the deficiency with huge amounts of Vitamin C, I should never worry about a cold ever again!        ....Right?

WRONG!  I woke up this morning with a sore throat and the sniffles.

Talk about an insult...

Not Many Would Brag about This One.

So I washed my hair today and hardly any of it fell out. 

Like I said, not many people brag about this.  I think most people are used to their hair staying fairly well put. If it doesn't, it usually has a good identifiable reason, such as male-pattern baldness or chemotherapy. But mine falls out in scads for no apparent reason. Sometimes it takes a break from falling out for a little while, but it always resumes the pattern eventually.  It is lucky I have a lot of hair, although in recent months, it has started to look very thin. 

I'm thinking maybe this pattern I have observed in the past has had to do with Vitamin C deficiency (or maybe other deficiencies). Since we found the Vitamin C deficiency last week, I have been very good about taking my daily 3+ grams of vitamin C, as well as eating blackberries, oranges  and pomegranate. 

However, I am not really feeling any better. Only yesterday, I bitched to my PCP in an e-mail about that. OK, I am not feeling better today either, but at least I am happy not to have sacrificed a wodge of hair for the sake of cleanliness.

Maybe vitamin C is like a Wall St firm: Maybe the benefits start at the top and filter down?  So let's imagine this:

So today less hair fell out. Tomorrow I might have sparkly eyes and maybe my teeth will stop hurting The skin on my face will be less discolored. On Wednesday my shoulders will crunch less and my hand pain and inflammation will start to subside.  By Thursday my spine and hip will be clickety-clacking less. On Friday my knees will stop hurting, and next Saturday, my ankles will subluxate less and my feet will hurt less.

Yeah, right!  But it was fun to imagine...

Vitamins, Vyte-amins (never schmitamins)

For some reason, this vitamin C thing has really thrown me for a loop. I woke up yesterday morning and my first thought was "I dreamt I had a vitamin C deficiency..."  Then I realized that it wasn’t a dream. I do actually have one. Smart of me to think I might have dreamt it because honestly: How can shit like this happen in 2007?

Apparently, quite easily:  Most doctors don't test for this stuff anymore. I think it is assumed by most doctors that most people have a balanced diet (and most do) and that they are taking their one-a-day (and many do). But how do you know that the vitamins you eat and supplement are actually being absorbed and used by your body? Unless the levels in your blood are actually tested: You don't.

It often does not become apparent that you have a vitamin deficiency until that deficiency has progressed quite a ways. Especially as nobody is looking at deficiencies as a possibility overmuch these days (because we all take our one-a-days and eat a balanced diet, right?).

So absorption: Yeah... I stopped taking my one-a-day several months ago. It seemed to me that on the days that I forgot to take it, I felt somewhat better the following day. I figured it was one or more of the 30-odd ingredients therein, but how could I tell which one? It wasn't like I could dissect that huge, foul-smelling green pill and pull out the ...Inositol (and WTF is Insosital anyway?). So I stopped taking it and I started taking individual supplements, concentrating on those ones which I had been told by doctors that I need; calcium, D, B12, B9 and I threw in C because it is good for hypoglycemics.

I confessed my discarding of the multi-vitamin to my rheumatologist (#20 for those keeping count) and I expected a total bollocking, because she is really big on the whole vitamin-and-nutrition thing. Instead she nodded and said "That's good. Most of a multi-vitamin is not absorbed by the body anyway".

Oh?

Yep. Apparently ...like 90% of a multivitamin pill passes right through the body without being absorbed. And some vitamins/minerals/drugs block absorption of other vitamins/minerals/drugs. So a lot of the "stuff" you take can be canceling out other "stuff" you take. “But I don’t take any prescription meds”, you think to yourself. How’s about OTC meds? Antacids? Ha! Nuff said.

All nutritional needs are not created equal, either: Take the RDAs, The Recommended Dietary Allowance for vitamins & minerals. This was developed in 1943 and last revised in 1974. It is in the process of revision again now, and will re-emerge as the RDI (Recommended ...Something Intake), but that is not official yet, so those labels we all read so carefully and those guidelines we try adhere to are older than a lot of us are. Hey! They are nearly as old as my best friend claims to be and I never take her advice either. Also the RDA/RDIs don’t include any recommendations for special cases; pregnant or nursing women, people with chronic pain or auto-immune diseases, people of different ancestry… I suppose doctors are supposed to take care of the special cases. Supposedly supposed to … Hmm… Reassuring. Let’s look at ...say B12 deficiency because I know most about that one:

A serious B12 deficiency will show up in a fairly bog standard blood test that most of us have done in our annual physicals (because we all do get checked anually, right?). It will show up because a B12 deficiency will eventually cause the red blood cells to become deformed i.e. megaloblastic anemia if you want me to get technical on you. (And I spelled it right first time! Not bad for a network engineer from Dublin. So the doc maybe tests you for intrinsic factor production (won’t go into that here) and if OK, will tell you to take B12 and all is well with the world, right? Wrong. Two problems with that methodology (which is the standard one, BTW):

Problem 1:
B12 is not only necessary for red blood cell production: it is essential for myelin production. Myelin is the stuff which helps protect the nerve cells and allows them to conduct signals properly. If you think you don’t need it, any person with Multiple Sclerosis (MS), syringomyelia (SM) or any other demylinating condition will set you straight pronto. Higher levels of B12 are needed to support myelin than to support red blood cell production, so by the time the red blood cells start coming out wrong, the myelin will have been suffering for far longer.

Messed up blood cells can be corrected pretty quickly with B12. Nerve cells: …not so much. Some correction can occur, but oftentimes B12 deficiency damage like peripheral neuropathy is irreversible."Oops! Sorry..." your doctor might say. But sorry doesn’t get the feeling and function back in your hands and feet.

Problem 2:
Folic Acid (AKA folate or B9) has been added to a lot of processed foods in recent years to cut down on neural tube defects in newborns. This is not a bad thing. Really. Most of us now are walking around with nice high Folic Acid levels. So if Grandma decides to become a surrogate, the baby will be unlikely to have Spina Bifida. Great! (Although I can’t make any promises on Baby not needing serious therapy)

So it's all fine except for one little thing: when it comes to blood cell production, Folic Acid can take over where B12 left off (to a large extent). So if you have high folate levels, you are far less likely to develop megaloblastic anemia. In other words the folate “helpfully” disguises the B12 deficiency, so it becomes virtually undetectable in a standard blood test until it is really, really WAY too late to do anything for the damaged nerves. Because clever and talented as it is, Folic Acid cannot help out with myelin production.

So the standard methodology for detecting low levels is flawed -for B12 anyway. I haven't looked at the other vitamins overmuch. Do I need to?

But B12 is in a balanced diet? Right? Absolutely: By far the the best source is liver –which most people don’t eat anymore. OK it’s in red meat. Oh. Most people don’t eat that on a regular basis, either. Well, it’s in egg yolks. Oops. Most people eat far less of *them* than they used to. I guess most people need to supplement their B12. Do most people know that?

My endocrinologist (#10) says he started testing B12 levels in his diabetes patients because one of the medications he was prescribing is known to deplete B12 (I think that’s why). He was astonished when the results started coming in and many of them were really low –too low to be explained by the medication. So he started testing all his patients as a matter of course. He said that the majority of his patients have low or clinically deficient B12 levels. And that’s only one practice. I think most people don't know to supplement.

So what's the freakin point? one might ask. “I’m screwed if I eat a balanced diet, unless I mess up me cholesterol and I screwed if I take a one-a-day and something is going to get me anyway, right?”

The point is that we patients -healthy people included here, should be taking more interest in our nutritional status, and we should be involving our doctors in this process. It shouldn’t be a big deal to have our vitamin levels assayed every year at our annual physical exam. The main ones anyway. Ask your doctor about it. Because preventative medicine is the best kind. Take it from a sick mother who knows.

This is new...

So I just had a bad attack of ..whatever attacks me. I don't think I have mentioned that my senses often get scrambled before during and after these attacks: vision disturbances and the ability to hear a flea fart and the usual ones.

So I was shuffling by the back door just now just now and I let the dog back inside because it is like 20 degrees and snowy. I got a whiff of the snowy fresh air and turned back to the kitchen to smell ...something foodily unidentifiable. 

Soup?  No. There is nothing on the stove. I look around confused and afraid that I have started to cook something and forgotten about it. it is close to lunchtime, after all. 

The microwave beeped and I remembered: I had put a cup of coffee in there to re-heat.

Coffee. That must have been the smell. How could I mistake that? But I could not have told you it was coffee had you offered me a million bucks.