a blab by idle

Yesterday, after dinner, my nose bled for about 50 minutes.

Today, after I got home, my nose bled for an hour and half continuously and then intermittently for another hour (and it's still going).

This is starting to get old. This is starting to get annoying. Three times now I've had a few moments of wooziness and light-headedness during this time. In theory my secondary polycythemia should make me all but immune to the effects to the effects of hemoglobin loss due to a minor wound like a nosebleed. So I'm faced with the possibility that (a) I'm having psychosomatic effects or (b) I'm losing enough blood to actually cause a hypovolemic issue (which I really have a hard time believing).

I found a couple of references that seem to refer to vitamin C and cayenne as both powerful anti-epistaxis agents, including some vaguely on the fringe. Since I've been a little low on the C of late, that might be a factor. Also, I drank for the first time in a long time this week. Perhaps my platelet counts have been dropping even more than I previously realized and this was enough to push me over the edge?

I think I really need a new CBC with diff and CMP. So maybe next week I can start to get some answers.

Aster has, once again, found a li'l beaut and has blogged it for all to see.

Prepare, all ye unworthy: the Unitarian Jihad hath commenced!

Just enabled SETI@home on my two home computers — morel and polaris — as well as my two main work computers — reiki and ichabod — each of which thinks it's a dual-processor box (and, in the case of the Macintosh, really is). Of course, I want to do real work on these machines sometimes, so all the setiathome processes spawn with -nice 19, and of course there's the issue of "battery? what battery?" on the laptop, but I'll monitor that as it goes.

Why did I suddenly do all of this? For reasons that I'm far too tired to blog now but will definitely mention soon.

Ahh, HIPAA: all you have done for me so far is keep me away from my own lab work.

After days of browbeating my doctor's office for lab results, I finally get a call today: "Mr. Swanson? Your hemoglobin — that's your red blood cells — is a little high, as is what we call your hematocrit. Dr. [redacted] suggests you go see your GP."

I felt like Bruce Banner. All I could think of, after all the run-arounds and phone calls to nowhere, was "Don't make me angry. You wouldn't like me when I'm angry."

So I tried to stay calm and just say "Um, alright, can I have any abnormal data?"

She paused, almost stuttering. "You, uh, want the actual numbers?"

I lost it. "Yes, of course I want the numbers! What good is data without actual numbers? How can I make informed decisions without actual data?"

She was aghast, clearly. "Well, what do you want?"

"Anything abnormal."

"For all of it?"

"Well, yes, of course. Give me the results of the dig check and the BNP, plus anything out of range in the CMP and the CBC/diff — and I know the crit, hgb, and platelet will be off, so let's start with those."

She was stammering. "Um, uh, what ones did you want again?"

Sigh.

She gave me most of the abnormals, except on the CMP. She reverted back to infanti-care for that one: "And on the CMP, one of your liver indicators was slightly off."

Must… not… snarl… "Ah, let me guess, bilirubin, right?"

Again, I seem to be rocking the world of this poor nurse's aide: a LAY PERSON who is asking after the CROWN JEWELS of MEDICAL KNOWLEDGE! "Uh, um, yes, that's right."

Needless to say, she gave me the value.

After I got off the phone, I let loose with a short rant to the effect of "heaven forfend I want the read DATA with which to make INFORMED DECISIONS about my own HEALTH CARE!" Neal (who had been standing there waiting for me to finish) just smiled tightly and said, "That wouldn't be BITTER I heard just there, was it?"

I laughed ruefully — well, as best I could with this annoying little cold. "No, no. I'm not bitter."

Without missing a beat he simply responded, "Oh, that's right, I confuse that with homicidal rage all the time."

Then we went for Chinese food. But, hey; at least I got the abnormal values.

Now to fight with Medical Records to get full faxes of everything….

Although I am two days behind the times, some of you still might not know that MT 3.16 has been released (though at this point, with their plethora of postings and news links, I don't know if there's much reason for me to repost the info anymore).

They have a good ProNet post on it too (even if it's been buffed by a marketing pass).

I'll be upgrading soon, of course.

This is… subtly demoralizing, to say the least. I finally found the proceedings of the 32nd Bethesda Conference, which was on "Care of the Adult with Congenital Heart Disease". This occurred in October of 2000. Table 1 from the report of Task Force 2 is, perhaps, one of those most quietly depressing things I've seen in quite some time.

Also, today, someone forwarded me an article on those bent on "Reclaiming America for Christ" from Rolling Stone. It was a surprisingly insightful article on some people and organizations that make my blood run cold.

Finally, I've been trying to figure out just what's my damage on being able to keep things neat and organized. Why I don't seem to be able to deal well with any things domestic. And why people seem to think that even when I admit to a mistake, it's up to them to treat me like a child and make sure I don't ever make another one, again.

Yeah. I guess the word for the day is "demoralized."

It seems that I've noticed a potential trend — I've been getting really exhausted (as in bone-tired) every day at work. But I've just realized that it seems to be concomitant with the ingestion of my daily vitamins and medication (which I tend to do in one fell swoop).

I don't really see the buffered C as a culprit, but more likely one of the following:

1. some rogue agent in the massive multi-vitamin I take having a weird interaction with my system
2. the three diuretics slamming my metabolic system at once and overloading my body

I'll have to "lab rat" myself in the days to come to see if I can isolate one or two as the specific culprit(s).

The only test I wasn't familiar with from the appointment was the BNP. Turns out that it's a highly correlative marker for CHF.

So I finally have an (implied) diagnosis based on the result (199.9).

The thing that gets me is: in four years of living in Arizona and three years of interacting with medical professionals there, why did nobody ever order this for me? It's a simple test, part of a standard venipuncture series. I had blood drawn several times between 2000 and 2004. Once the puncture's been ordered, it's nearly trivial to draw a standard 5mL lavender tube off the same stick.

*sigh* The more I read about the bumblings of adult cardiologists in dealing with ACHD issues, the more I realize that the recommendations put forth from Task Force 4 at the 32nd Bethesda Conference may actually be important to consider implementing.