THE WOMAN WITH ROSY CHEEKS AND ITCHY EYES

Not long ago I visited my eye doctor. I like him much better than the one who preceded him, though that doctor had a reputation as a miracle worker when it came to cataract surgery. I complained to that doc and also to the present one about my eyes being bloodshot, itchy, and “tired.” I thought it was from being on the computer so much. Last summer my eyes were such a bother that I went back on an emergency basis. That time the farmers were burning fields and I decided that was the problem.

I worried that I might have damage from my diabetes, because I slip off my compliance regime sometimes. I’m having increasing trouble with forgetfulness and bad temper. It’s a symptom of age. I’m 76. But also I’m reading about atrial fibrillation — arrhythmia of the heart and how it can make the blood turbulent enough to throw off tiny clots. The clots could mimic transient ischemic attacks, or maybe they ARE transient ischemic attacks, which are little pinches in brain function. I had interpreted my diaphragm as fluttering. This has nothing direct to do with my eyes, but if I’m too forgetful to take my pills in spite of sticky notes here and there, then the eyes suffer. It’s the beginning of the final unraveling.

Prince Harry of England -- Rosecea?

The anger comes from impatience but also from losing my temper over the doctor situation, even with my well-liked eye doc. More and more a visit means some teenager goes down a checklist and not much more. Then at the end of the last examination, the Doc asked if the pink cheeks and scaliness in one spot might be rosacea. Sure, it is. I know the diagnosis because a few years ago the GF Clinic’s one-time dermatologist diagnosed it, but he didn’t explain or prescribe.  Never mentioned eyes.  He was a very weird bald guy who left in months because patients complained. I’m beginning to suspect that Montana is a dumping ground or refuge for docs who’ve been in trouble. Rosacea is so obvious that even a teenager could see it.

My cousin also has pink cheeks — we’re Scots and it’s hereditary in part, though no one really understands rosacea. In all the checkups I’ve had, including the one that was double-teamed Physician Assistants, billed as a “free” Medicare checkup (which it wasn’t because I had to pay for lab tests — not announced in advance), neither really looked at my face. They just looked at the lab printouts, which they didn’t have during the physical exam. They never met my eyes.

The treatment for ocular rosacea is hot washcloth compresses with baby shampoo washing immediately afterwards. But the docs have always acted like tap water would kill me. I’m allergic to one of the eye exam chemicals and keep my eyes from swelling shut by splashing them with tap water, but they insist on using squeeze bottles of sterile saline — and billing me, no doubt. (There’s also an over-the-counter equivalent for rosacea washes.) It never quite does the job, but instead of arguing, I just go down the hall afterwards and wash my eyes in the bathroom. (It’s Unisex, incidentally, and so is the one in the supermarket.) But what do street people do?

Anyway, I didn’t know that rosacea affects eyes until the doc told me and he simply pressed me to try the new dermatologist at the clinic. He didn’t explain in detail. Thinking it was like the brilliant idea of selling glasses in spite of the new cheap internet competition from China, and also because my insurance now requires a co-pay of $45 which would buy three cases of cat food, I put off the idea of making an appointment. Even with low cost gas, it’s a long drive to Great Falls and the ancient pickup makes funny noises.

It's got Clinton by the nose.

Yesterday I was trying to restore order around here and realized I should learn more about rosacea, so I googled. Holy catfish. This is serious. In the advanced stages it’s like Bob Scriver’s herpes keratitis in 1962 that just about blinded him and pulled us into a close relationship very quickly because he really needed help. The treatment for ocular rosacea is very simple in the beginning: using a warm compress to loosen whatever is crusted on the eyes and then using baby shampoo to wash the outsides thoroughly. Artificial tears up to four times a day. As things get worse, the tear ducts might be blocked to divert the tears across the eyeball. The same meds that miraculously saved Bob’s eyes is used for advanced rosacea and the often accompanying eyelid inflammation: dioxiuridine.

If the rosacea increases and maybe leads to the inflammation of the eyelids (called blepharitis — I knew “itis” means inflammation but not that my eyelids were “blephs”), then things get more serious. Around here eyes suffer already because of bright prairie light with a high ultraviolet component and the wind carrying particles. Maybe we should all wear goggles. The Blackfeet at one time early in the 20th century had a terrible plague of trachoma, which is a chlamydia infection of the eyelids, rather easily cured if you know what it is and what to do. But people did NOT know what to do and there was a lot of blindness. Other tribes called them the “one-eyed people.”

It was the notorious Doug Gold who had an eye doc friend back in Pennsylvania and brought him to the rez. The doc diagnosed the problem, taught the Golds and a few other responsible men how to diagnose and treat it, and resolved the epidemic. What would they have done about ocular rosacea or were they genetically immune? Do trading posts carry baby shampoo?

Folks love villains and manipulate information in order to control the public reputation of their competitors so that everyone agrees with them. A person with the prominence and control of a doctor is always vulnerable to rumour and accusation. In the early days Doug himself was considered absent-minded, the proverbial professor, but his father James Gold, the Presbyterian missionary in Browning in those days, struggled hard with depression and finally had to be sent to Warm Springs.

So far, attacking Doug, who started the school system in Browning, is based on his mistaking culture for intelligence and drawing the conclusion that tribal people were genetically dumb, accepted wisdom in those times. If one culture accrues information and then tests another culture on their knowledge of it, naturally the second culture (which has its own information and world view) will not score well. Yet people cannot get it through their heads that an IQ test only measures how well one does on IQ tests, all about things valued by people who design IQ tests. They are PRINT culture, never ORAL culture. The more assimilated the Blackfeet become, the better they do on the tests.

If a doc is a little overambitious, a little careless, a little pressed for time, the consequences might be pretty serious. But it begins to look as though the culture of many doctors has left idealism behind and gone to greed. How do we pick our way through the problem? Since public perception always has a political element and is rarely self-correcting, any dynamic of suspicion and resentment can be exploited. Reputation counts large. GF Clinic needs to think about theirs. By withdrawing proper support staff from their doctors and adding boutique profit-makers, they are diminishing their professional standards.

I AM print cultured. I’m also hip to journalistic sensationalism about greedy doctors and the rather scandalous manner in which they have delegated their management and ethical self-policing to managers expected only to increase profit. I can defend myself in part through this mechanism of the internet, but also I’m old enough to remember doctors who used to take my hands, look into my face, and try to get a sense of who I am. It’s not impossible, even now. I recently saw a vid of a doc gently interviewing a squirming pre-adolescent boy who had been living on the street, doing sexwork. It was quiet, respectful, and revealing — even healing. That man was a true doctor.

THE MACHINIFICATION OF EVERYTHING

By the time I got past my eye doctor’s appointment and looked in the down-the-hall washroom mirror, I saw a face like a big red tomato, dripping wet.  This was because the doc’s file on me did NOT say “eyes allergic to lidocaine, wash out immediately” as I have made him write in repeatedly.  I don’t know whether the page fell out or they made a new file or what.  It’s a new office, very nice.  Hung with fine art by a man who is the most striking colorist since a certain artist discovered Merlin Enabnit.  (Private nasty joke.  Enabnit's book on color sold in hobby shops.)  My face gets red when it’s sun-burned, wind-burned, very cold, or when my butt is chapped. 

If my eyes are not washed out at once, they will swell shut so I can’t drive home (80 miles) and, as I’ve told the doc only half-jokingly, I will have to stay at his house overnight.  He doesn’t laugh.  I had to grab his arm once to make sure he heard me before he put the drops in.  He doesn’t listen.   The sober quiet girls who used to do the washout are replaced by a young man who did not put in enough saline drops to wash out my eyes -- too little, too gentle.

The doc forgot to order certain glaucoma tests and says there was not time to do them, but the last two times I also had to return for them -- I don’t think he forgets.  I think it makes two appointments out of one.  (My glaucoma scores, each eye, are 19.  That’s below the alarm point which is 22.  I have no loss of peripheral vision.)  It costs $30 per drive to GF.  This time I used my Christmas money.  The doc is part of the “creme de la creme” of arty GF society, which revolves around Charlie Russell.  For them $30 is a lunch tab.

My friend has just had two cataract operations that went wrong, leaving him in pain and blind.  This doc does thousands of operations, so I asked him what might have gone wrong.  I said, hoping to make him stop his scribbling and look at me,  “I want to ask you a question.”   

“Of course,” he said, not looking up and still scribbling.  When I asked, his first reaction was alarm that he might have done the operation or be blamed for it.  Then he settled down and gave me a bullshit ratatat med school exam answer that boiled down to “not in my practice.”  Then he came to the conclusion that I was afraid to have a cataract operation but thought I ought to.  You know,  “I have a friend who. . .” when you really want to know for yourself.  This is the guy who sent me to the incompetent diabetes doc, simply because she was female and he assumed I would prefer a lady doc.

Great Falls is touting “medicine” as their primary “industry.”  Billboards proclaim “top ten percent of total joint replacement doctors” and “industry award winner among hospitals.”  I want you to know that my blog is among the top ten percent of blogs in Valier, or would be if there were any other blogs in Valier.   (Since there are no others, I also occupy the bottom ten percent.)  It used to be that doctors who advertised were openly considered quacks.  And before the sole existing hospital swallowed all the rest, there used to be two hospitals, operated by nuns.   There are two keys to this little gold mine:  one is an aging population that has lived hard, mostly outdoors, and the other is insurance, big ranch-financed personal insurance, plus some Medicare for the lesser folks.

While I was in GF, I stopped by the fabric store to pick up two yards to cover an ottoman.  It took 45 minutes to get waited on.  The management had decided it was a quiet day and had sent two clerks home to save their wages.  The remaining clerks were slowed way down by having to use little hand-held zappers to shoot the codes on the fabric bolts, and then having to double-check with pencil and paper because the machines got it wrong about every fourth time.  One of the sets of tests on the eye doc’s machine had to be done over because the machine didn’t register the first set.  “Shall I hit it hard alongside its head?” I asked the ranch girl giving the test.  “Please,” she said.

I hadn’t been up the main Central Ave of GF for a long time, partly because it’s a narrow street with diagonal parking which people are always backing out of without being able to see, so I puttered along at 25 mph.  (The posted limit was 30, which I think is high.)  Two different motorists behind me became enraged that I was so slow: honking, gesturing, hollering out the window, and finally pulling into the on-coming lane (double yellow no-passing line) in order to get around me.   At the next two red lights I pulled up right behind them, so I don’t know what they gained.

Dave Lull sent me a link to http://www.bryanappleyard.com/rage-against-the-machines/  It’s a review of two books about the increasingly robotic and machine-dependent society we’re creating.  But I live in Montana.  Despite ice on the road in the morning and high winds the rest of the day, the land saves me.  The drive home -- even with stiff red eyes -- was a series of grand baroque panoramas of sky, all purple gauze and glowing amber edges.  The fields are dull and dun, too dry and too often chemical fallow, but the sky show went on demonstrating what the billowing smoke would look like if the Rocky Mountains were on fire or became volcanoes.  I passed a bald eagle on a fence post, way out of his habitat.  If he was looking for road kill, he’ll be hungry.  They’ve poisoned out most ground squirrels and rabbits.  The law just changed to allow citizens to "harvest" the big stuff like deer.  He’d better stick to fish.

The best moment of the day was stopping out at Bundi’s nursery where I generally visit in June when the frosts are finally past.  The winter greenhouse was already June inside.  There was a gorgeous lemon tree with both lemons and blooms and a fabulous huge clivia in a tub.  I bought an amaryllis, which I normally do at Christmas, but somehow missed this year.  We had a nice talk about Agapanthus Africanus. (below)  These last three kinds of plants are bulbs from South Africa.  The cash register was not electronic.  The sound system was blasting Johnny Cash, but the young woman who waited on me (this town is swarming with pretty girls cheerfully doing low pay jobs) was listening on earbuds to “alternative music.”   She told me the name but I forgot.

My friend despairs at the cynicism and machinery of the world, so I am wanting to assure him that it’s not quite too late, that mixed in with the death and greasy steel there are still corners of the world where the sky is grand (no shrieking F15’s today) and gardeners still tend blossoms.   But I wish I could have gotten some good advice for his eyes.

EMERGENCY RESPONDER BLOGS

The original idea of the “web blog,” from which the term “blog” evolved as a contraction, was to keep a record of websites one visited. In a sort of cross between bookmarking and reviewing, one used the new ability to use a pre-formatted website (free!) to suggest other places to visit. Since then there has been an explosion of these new “blogs,” all commenting on each other. It was a can of worms -- in a good way. So keeping a log with url bookmarks was a way of sorting worms and recommending them to your “fishing” friends.

This is a blog in the classic mode: a list of blogs that I like to visit, though lately I’ve been so busy turning out print for its own sake that I’ve not been visiting these “places” as much as I once did. And I’ve bookmarked so many url’s that I’ve rather lost track of what’s what. Still, I had a few categories that I kept better maintained, mostly because I visited them often. Below is the bookmark list from my category of emergency responders.

Working as an animal control officer put me right up against the whole issue of damage to mammals, including humans. The first question you get at 911 is “are there any injuries?” In Montana that includes livestock. To humans, suffering flesh is the ultimate emergency and we respond to calls for help as quickly as we can. Which sort of answers part of the question about why there is pain -- it’s because people will respond to it with help.

Law enforcement is the main emergency responder, with the fire department a close second. In my childhood there were no EMT’s because the doctor lived a few blocks away and he just came over with his black bag. But by the time my mother died in 1999 there were two different EMT companies standing at the front door fighting over who got to take the call. Animal control officers grew out of sheriff’s departments, a rural entity, and have run headlong into humane society investigators, an urban entity. Very awkward.

I’m sure the Superman/Clark Kent model of hero came out of emergency response. Most of the time the responder is Clark Kent, a desk jockey trying to keep order through bureaucracies like traffic monitoring, licenses, inspections, and so on. But now and then the responder must become Superman, able to outwit murderers, bank robbers, and all kinds of violence. Death itself. This combination of demands is pretty hard on most humans, who have a hard time switching from one mode to the other.

The list below is certainly not definitive, or even indicative, but they are writers I really enjoy reading. I’ve never found an animal control blog nor have I picked up any veterinarians nor have I looked for fire departments. After all, I’m hard-pressed to keep up with my own self-imposed blog goals and it would be easy to wander off into these real life narratives and opinions.

I think I enjoy the ones that are quite different in politics and culture from myself more than the ones who might be like me, but the truth is that not so many people like me go into emergency responder jobs. It was only an accident that I did. It’s just that there ARE some people well-suited for these jobs who, thankfully, are willing to reflect on what happens to them, what strategies worked, what it told them about human beings. At the very least there are a zillion stories here.

In the end these blogs are more interesting and useful than J.G. Ballard’s poeticizing and philosophizing of violence in a book like “Crash.” His experience of the reality was, after all, just one war and a few car accidents. For most of these bloggers, the war and the accidents never end.

http://thelawdogfiles.blogspot.com/
This is a down-south lawman who loves his gun and is waaaaay to the right politically. He’s full of piss ‘n vinegar, opinions and cop jargon. I love him.

http://medicscribe.blogspot.com/
Here’s a member of a community of EMT’s who respond to life-threatening emergencies and occasionally accidentally kill someone, which really pisses this guy off. He lists a lot of the books by EMT’s. How come ACO’s (Animal Control Officers) aren’t turning out the books? All we ever get is bleeding heart humane society stuff -- which sells exceedingly well.


http://phillydan.spaces.live.com/PersonalSpace.aspx?_c02_owner=1
A big part of the fascination of this EMT stuff is the gizmos. This guys knows all about gizmos and gives lots of recommends.

http://aflightmedicsjournal.blogspot.com/
Closed to intruders. The other fascination about emergency responders is the sense of a tight community that doesn’t let just anyone in.

http://shrinkette.blogspot.com/2005/07/grand-rounds-42.html
Written by a female psychiatrist who stopped posting years ago, but it’s still intriguing to see behind the curtain.

http://www.defrance.org/
Big commercial aggregator. Yawn.

http://www.crustyambulancedriver.blogspot.com/
This guy has a mordant sense of humor and a bigger heart than he gives himself credit for.

http://gruntdoc.com/
Short and snappy -- a Texas former military guy.

http://randomreality.blogware.com/blog
A sophisticated English version, remarkably similar to Yanks.

http://scienceblogs.com/pharyngula/
Quite sophisticated biology blog. You’ll find out what a pharyngula is.

http://blog.vitummedicinus.com/
Brisk and thoughtful doctor at war with gadgets and homeopaths.

http://injectingsense.blogspot.com/
About Autism Spectrum Disorders. Not medical -- just discussion.

http://www.kevinmd.com/blog/
This appears to be to be a medical columnist giving overviews. You can sign up to get emails.

http://blueridgemedic.blogspot.com/
A mellow guy who lives in a gorgeous place and is just beginning to teach EMT stuff.

http://www.rockymountainmedic.blogspot.com/
A Denver EMT who writes “purple” but intriguingly. He’s evidently stopped.

http://surgeonsblog.blogspot.com/
I actually know someone who knows this guy, who’s in Seattle. He’s stopped posting here, but there’s a link to his new blog. This old one really suits me and I don’t even mind rereading old posts. What does it feel like to put your hand into someone’s guts? He’ll tell you.

http://ambulancedriverfiles.blogspot.com/
This guy’s life is part sit-com, part stand-up comic, and often quite a lot of romantic tragedy. But he HAS lost a lot of weight.

http://urbanparamedic.blogspot.com/
Here’s a Boston liberal military guy. How many of THOSE can there be?

http://distractible.org/
The kind of thoughtful guy I’d love to have for a doc.

A BITTER STUDY OF DIABETES 2

In the last few days there has been something akin to panic in the Diabetes 2 community. A study by the National Institute of Health called ACCORD was meant to prove that if people diagnosed with Diabetes 2 were given drugs for high blood sugar, high blood pressure and high lipids, they would be healthier. The opposite turned out to be true. Fifty-some more people died in the group with the “best” (lowest) scores for these factors. YIKES!

None of the subjects were controlling their “Diabetes 2” with diet and exercise. They were on American Diabetes Association diets which despise low-carb strategies that depend on high meat and fat and pitch processed foods for diabetics.

In this last year or so, reading a lot of blogs by and about diabetics, I have formed the strong opinion that Diabetes 2 is NOT diabetes at all, but only framed that way because it is usually discovered through blood glucose tests given with the intention of detecting diabetes. THEN they find out you have high blood pressure and a high lipid count, which somehow leads them to the assumption that the low blood glucose has caused the other problems. There is a huge industry based on the treatment of diabetes and providing special foods and things like special shoes for feet in trouble. Because high glucose is countered by insulin, the idea has been to administer more insulin and more insulin -- without ever testing to see what levels of insulin there are in the blood, existing right alongside the high glucose.

Few people have tried to look at all this from a deeper, cell-level, metabolic approach. The pharma people like traveling down the tracks they’ve already established: more insulin, different kinds of insulin, new delivery systems for insulin -- though some had begun to protest that insulin, esp. at high blood levels, is damaging to organs. When pharma got off their insulin obsession, they went to lipid obsession: first cholesterol and then trans-fat. The magic bullet was supposed to be statins. The more the better, until people in some of the statin trials died. No one wants to talk about an earlier obsession with estrogen -- I had to fight hard to prevent doctors from putting me on estrogen and at one period I DID take estrogen with not-very-nice results. Some of the side effects of these drugs are mood and thought-altering, so naturally anti-depressants, etc., are also prescribed.

“17 million Americans have diagnosed diabetes and more than 90% of them have type 2 diabetes.” The doctors do what they are supposed to do for diabetes, it doesn’t work, the doctors ascribe it to failure to stay on diets and take meds (which they call “lifestyle changes”) and get mad at their patients -- shutting them out of discussion. Doctors these days must hew to the prescriptions of the insurance companies, the state, and whatever institutions employ them -- few have independent offices. Mostly they depend upon prescriptions: get a diagnosis, run your finger down and across to the proper med, and then the only concern is titrating the dose. Insulin levels, vitamin D levels, or any other variables not on the list are not addressed.

Meanwhile people have begun experimenting on themselves and discussing with friends. Some researchers have begun to strongly suspect that Diabetes 2 should be called “metabolic dysfunction” and are labeling their work that way, so that Googling the latter might get you better information than “Diabetes 2.” These researchers find a high correlation between metabolic dysfunction and blood levels of pthalates, dioxin, and other organophosphates used in manufacturing and agriculture. One study found this correlation in sea turtles, which never come to land except to lay eggs. Fewer than ten per cent of the creatures on this planet have undetectable levels of these chemicals. They are in the breast milk of Inuit women.

While global warming is attracting a lot of attention, our constant molecular meddling is seeding all living creatures with subtle poisons that derange the delicate balances that control our inner workings. The Vietnam vets and Vietnamese peasants who were exposed to Agent Orange found this out in very unpleasant ways. The rest of us will soon learn a lot more. In regard to Diabetes 2/Metabolic Dysfunction, we are about where AIDS was a couple of decades ago. But you can’t evade this by using a condom. This is in the water, the air, our bottles and dishes, our furniture and carpets, our food, and our pills. The Chinese contaminations of food and paint are only exaggerations of what is true everywhere.

So what can we do? How much of this constant warning and doom-saying can we stand without running screaming over the horizon? Not much, if you ask me, unless there is a redirection of funding towards positive ends: first, to understand the molecular interference in our blood and cells, and second, to greatly diminish the amounts of these substances in the world. We DID save the raptors, remember? We DID bring the robins back after a silent spring or two.

If we leave the problem as it is, simply wailing and wringing our hands, it will solve itself by diminishing the population. Eventually, there will be only the tough and adaptive left to continue with what we call “civilization.”

At the moment there is a movement -- evidently driven by insurance and government bureaucracy -- to discover who costs the most over a lifetime. The assumption had been that fat people are more expensive in terms of health care and pressure on welfare, emergency rooms, and nursing care. The impulse was to just get rid of fat people -- put them in some kind of concentration camp where they would be FORCED to lose weight. But now another reversal research study reveals it is THIN people who live on and on and on in nursing homes, demented but vigorous. So maybe there will be a movement towards force-feeding them at MacDonalds. Underlying this is the hope that one group (one’s own) will be genetically privileged for survival and that others can defined in some mathematical and objective way as “unthriving” meaning “unworthy.” Then you can at the least keep your children from marrying them and at the most perhaps shut them out of society altogether so they’ll just disappear. What if it turns out that only hunchbacks or blind people can live in this chemical soup we’ve created?

In the meantime, all these social and psychological forces aside, perhaps each of us had better keep track of the best evidence we can find and make our own decisions about our strategies. Doctors can just get used to it.

WHAT IT FEELS LIKE TO LOSE WEIGHT

About 1990 I went to a gynecologist who turned out to be a misogynist. This is more common that anyone would hope. He told me I was overweight (not a surprise) and that I simply needed to push myself away from the table. Fat is simply a surplus of calories-in. Change the balance with calories-out and I would lose weight.

Half a dozen excursions through Weight Watchers had taught me differently. I had bought a book about research on fat and I gave it to this guy for the sake of his future patients. Now I wish I hadn’t, though I can probably recapture the information via the Internet. It was about the molecular nature of sugars, proteins, lipids (fats) and how they were processed through human bodies, both between cells and within cells. There was research about ion pumps to take molecules through cell walls and how the molecules were stored inside the cells. Quite a bit had to do with water management both within and without the cells. This was a whole ecology of substances, their interaction and balances. It was not at all like my understanding of fat, which mostly was based on observations of bacon or tallow: that fat was a sort of goo that got smeared on one’s body under the skin.

More recently the town handyman, faced with a big life-changing move when his sons left school, decided to lose his formidable pot-belly. A methodical sort, he made a list of all the foods he ate, looked up their calorie counts, and crossed the five highest in calories off his list. He would not eat them. He lost fifty pounds in very little time. Lucky he wore bib-overalls or his pants would have fallen off!

So when I was diagnosed with diabetes 2 (because my retinas hemorrhaged), I knew I HAD to lose weight. This time I had the Internet. I decided to go with a combination health-food and low-glycemic sort of principle. I stopped eating anything with white sugar, white flour, corn syrup, or processed ingredients -- even (or maybe especially) if it was supposed to be for diabetics. I didn’t put imitation sugar or cream in my coffee -- I simply drank it black. If things were bitter or sour or aromatic, I learned to like them that way. Turned out not to be hard. And I lost fifty pounds quickly.

What I’ve reflected on since is what it felt like to lose the weight this time: it was like working a poison out of my system. This time the weight came off according to gravity, which one might expect though it certainly didn’t do that when I lost weight when I was in college. In those days it came off my waist and belly. Now it came off my face, my bosom (which conveniently folded down out of the way), my arms and legs and my hands and feet. I was fascinated that my fingers got long and slender. I could wear my wedding ring, if I wanted to, but I haven't since being divorced in 1970. I still have a pot belly, though it’s also somewhat “folded.”

I had several of what doctors identified as “lipomas” which is to say, “fat lumps,” an opinion they were so sure of that they refused to do biopsies or x-rays. (I was sure it was cancer -- I’m always sure EVERYTHING is cancer and since weight-loss is a cancer symptom, it takes a certain amount of fatalism for me to be brave enough to lose weight.) One lipoma was right above my knee in the back of my right thigh. Doctors hated to even feel it because they thought a fat middle-aged woman must be wanting a cheap thrill by getting the doctor to feel her lumps. (At least that’s the impression I got.) Gradually, it left.

But what I noticed was that in a streak going towards my body was a kind of almost-pain which I interpreted as being a sort of inflammation or varicosity of the big vein that returns blood from the feet. My fantasy is that the fat was being “shipped out” up that vein, which irritated it. That got me thinking about what it means to convert stored cellular fat into something that can travel out of the cell and be used somehow. Would it be glucose? I had read about people who had stored molecules of fat-soluble substances in cells, then lost weight which released the captured substances back into the blood. Some were contaminating substances -- maybe pesticides or heavy metals -- and sometimes it was hallucinogens, like LSD which brought on ghosts. I’ve never taken recreational drugs, but working in the foundry exposed me to strange things.

I wasn’t hungry on my invented diet, partly because I felt free to eat peanuts. They didn’t make my blood sugar go up, for some reason. I took a bare minimum of drugs -- one metformin in the morning -- though my original doctor had prescribed a handful of strong stuff which scared the bejeezuz out of me when my blood sugar plunged. I discovered cheese made my blood sugar go up steeply -- also potatoes -- but sometimes I craved cheese. What was it that my body wanted? (I’ve always believed in that idea that bodies “know” what they want.) When I take fish oil capsules and vitamin D, the craving diminishes. Aha!

My head is one hat-size smaller. My face has a jaw and cheekbones, which read as “good-looking” in our culture. My thick-facial-hair/thinning-head-hair syndrome (Inherited from my father’s side: an aunt and a great-aunt ended up bald. Shirley Maclaine has it but she can afford excellent wigs.) is probably increased. This is NOT read as “good-looking” and raises suspicions of high male hormones, which turns out to be true. This syndrome, the research suggests, arises in part when the gestating mother is afraid and full of adrenaline. My own mother was alone in the city for the first time -- my dad was on the road -- and had little community for support. She kept a .45 in the nightstand. In short, I’m becoming movie-star material because my mom was scared in 1939. My ear wax came back. What the heck does THAT mean??

But what strikes me -- to use an electronic screen analogy -- is that it’s as though someone adjusted my “screen” so that it’s high brightness, high contrast, and faster computation. I’m thinking fast, willing to get out and do stuff, better able to multi-task, and not so inclined to depression or just lassitude. I had thought I was aging quickly and would not be able to maintain this house much longer. Now I don’t feel that way. (All I need is money!) Who knew that this could be achieved NOT through medicine, NOT through buying beauty aids, but simply by NOT eating some things. This is not an insight about diabetes so much as it is an insight about how we are poisoning ourselves with polluted, over-refined and “fortified” food. Some folks have been telling us this for a long time.

My fantasy is little floating bits of molecular lipids leaving cells on blood and lymph streams, then being burned or exhaled or excreted. Sometimes I think I can almost feel it. My arm skin is loose and crepey. My formerly rock-like thigh muscles are soft, manipulable. My neck went from being a double-chin to being pleated. None of this has been as bad as I expected. I’ve been losing weight for two years now with resting platforms in terms of weight-loss and then more loss. It seems very much tied into tissue-water management (I tend to be dehydrated). My best indicator that my glucose level is too high or low is that my retinas get thick with water and my eyesight blurs. The shallow curves of ebb and flow left in my reproductive cycle clearly participate.

This kind of self-examination is not always very comfortable but a writer should not draw back. Reality is what we want. One would think that doctors would feel even more so that way if they weren’t drugged fat by money and the pharm industry.