Ear Doctors, Braised Meats, Walterdale

We finally heard back from the hearing specialist (awkward wording, no pun intended!) via my surgeon's office, Dr. Williams. I will be calling in for clarification, but the message that Dianne left basically said that the specialist doesn't think that he needs to see me, that the results of the hearing test are enough to make a diagnosis, and the diagnosis is that I should get hearing aids. WHAT?!!! Uh, I would really like to sit in a small, closed room and have a conversation with the specialist who is looking at the test results produced by a pay-as-you-go clinic that sustains itself on the sales of hearing aids and have him look me in the eye, and say slowly, clearly, distinctly that I need some assistance with my hearing, and what he believes that the hearing aids will achieve. I want the academic lecture about perception of sounds and how losing the ability to hear a particular frequency range affects your brain's ability to interpret speech. I want him to tell me if I should expect to have further deterioration, and to talk me through some sort of timeline for what I should expect as a bi-product of the chemo, and what is natural aging, and whether the introduction of hearing aids into my environment will slow down any further deterioration. I want him to tell me that there are other mitigation strategies, or not, as the case may be. I want him to lay out the programming standards for the hearing aids, and to tell me which type of aid performing which assists are recommended for my particular situation. And I want him to write a prescription which I can shop around to different hearing aid providers until I find pricing, styles, brands and services that suit me!

Geez... and speaking of hearing issues, I got an earful of abuse this morning from a friend who says that I'm not putting enough of the juicy details into this blog... Now what he was really referring to was the dinner that he prepared for us over the Labour Day weekend that I had absolutely no problem eating. What he prepared for us was a couple of different braised meats... the emphasis is on the 'braised' part. And I do have to admit that not only was it very tasty (just about everything he cooks is!) but the braising made it very easy for me, dry-mouth-sufferer-and-difficulty-swallowing-challenged-guy to really enjoy the meat for the first time in a long time. I had been restricting my diet to fish and certain types of seafood until Labour Day. I don't want to give him too much credit, but after that dinner, I've been a bit more aggressive about finding meat dishes that are easier to chew and swallow.

What the heck is 'braising'? Here's part of the Wikipedia statement on the subject:

"Braising (from the French “braiser”) is a combination cooking method using both moist and dry heat; typically the food is first seared at a high temperature and then finished in a covered pot with a variable amount of liquid, resulting in a particular flavour.

Braising relies on heat, time, and moisture to successfully break down tough connective tissue and collagens in meat; making it an ideal way to cook tougher cuts. Many classic braised dishes such as Coq au Vin are highly-evolved methods of cooking tough and unpalatable foods. Swissing, stewing and pot-roasting are all braising types. Pressure cooking and slow cooking (e.g., crockpots) are forms of braising."

What Gord did was really quite wonderful... a bit of lamb and a bit of beef. And it wasn't just 'stewed', either... it was carefully, thoughtfully done, with a lovely sauce, complimentary veggies and garlic smashed potatoes. Its kinda too bad that we don't live on the coast near these folks. We miss the Sunday dinners with them... and I probably wouldn't be as challenged trying to put on weight! Gord is a bit of a gourmet cook... and I really think he misses have 'regulars' to cook for...

Last night we went to the Walterdale Theatre Associates 50th Anniversary. I don't know the real stats on this, but they seem to be one of the best organized, best funded, continuously performing and longest surviving community (used to be called 'little') theatres in the country, if not on the continent. Volunteerism is alive and well in Edmonton! We shared a table with city councillor Ben Henderson, and Alberta MLA Laurie Blakeman, professional actress Patricia (Bell) Casey, Lou, the volunteer barkeeper for Walterdale and Ruby, their volunteer Social Convener. Okay, the part about Ben and Laurie sounds pretty ostentatious, but it is a bit of a cheat... we've been friends for a long, long time, and because they know that we don't have any 'agendas' it is comfortable to share a table (and a bottle) with us... which is very cool 'cause we get to talk about their dogs, their cabin north of Athabasca and Ben's newly discovered fascination with red shoes. We don't spend enough time with them to waste what time we do get with them on politics...

At the dinner gala we met up with a lot of old friends and acquaintances... it was really quite lovely, and sometimes a bit embarrassing. I'm not sure that I really know how to accept people's well wishes gracefully... Laurie said that I was handling it quite well, but I still feel pretty awkward about it all. But they came from all over to be there last night. Gaye Lepage came in from Port Moody... Sheila Dodd came down from White Horse, or Yellowknife or someplace up there... Gerry and Vivian Streader came in from the Island... Frank and Mary Glenfield were there... and seemed quite surprised by how good I looked. I had seen them both at a small birthday celebration for Laurie Blakeman some months ago, and they admitted last night that they thought I looked quite dreadful then.... One of the local 'event' writers for the Edmonton Journal, Nick Lees, was even in attendance. I did notice a dearth of professional actors, directors and designers who got to practice their craft at Walterdale; where were they all? There isn't that much going on right now... And Chris Allen was his usual erudite self, starting the evening off with a presentation of Elizabethan era instructions on how to behave at dinner and then closing the performance with Puck's final lines from 'A Midsummer's Night Dream'. Chris had sent me some really wonderfully funny emails during my treatments. He writes so well! When we found him amongst the crowd earlier in the evening, before dinner, he gave me a hug! And I mean a rib-cage-crushing-hug-that-leaves-imprints-of-the-buttons-of-your-shirt-on-your-chest kinda hug after having looked me straight in the eyes and declaring, embarrassingly loud "You're my hero!"

Oh, its so nice to be getting out in the world again.

Unfortunately, we missed the show at the Citadel last night... G. is suffering from bronchitis and was not in any condition to spend 3 hours at a show and socializing... I am a bit disappointed. Surprisingly, it didn't take quite as much to psyche myself up for the return to that building than I first thought.

The other shoe finally dropped about J., the oldest of the two girls. The tests have come back indicating that it is NOT lymphoma, but active CMV (cytomegalovirus), instead. Its not as bad as what it could have been, and what else they were testing for. Another cancer diagnosis in the family would have devastated her mother. J. probably picked it up during her work as a obstetrics nurse... she will need to be monitored for the short term to make sure that the hepatitis-like component doesn't affect her liver.

I remain very disappointed with the three major political party leaders, and am furious with Mr. Harper for his discounting of the impact of the Arts. I was seriously thinking about voting Green Party even though I know that they can't carry this riding, as an endorsement of where they stand on building for the future. I've pretty much determined that I'm going to vote for the party most likely to dislodge the Conservatives in our riding. I suspect that it will be the Liberals; the local NDP candidate is an absolute wingnut...

Mid Week Update

Fall is upon us! The weather here began to turn over the weekend... cool early mornings, moderated temperatures at midday, cool evenings, and rain! This morning at 6 am the temperature was +2 degrees C. A frost had formed... And no, I didn't ride my motorcycle to work. In fact, I haven't ridden it any morning this week. Monday it was raining too much. Tuesday threatened rain, and I needed some extra reference material at work that wouldn't really fit on the bike safely. This morning I was running late, and the cold spooked me. Its currently lovely and bright, but chilly...

Its time to start seriously thinking about how I will be storing the motorcycle for the winter. G. has suggested that, if we move things around a bit, it could spend the winter in the garage. I'm not sure that that is such a great idea. An acquaintance at work has suggested that it could be 'tarped' and left out back by the deck and the hot tub. On one hand its not a bad idea, but on the other hand I'm really not sure what even that limited exposure will do to the bike. I'm thinking that I may look into a storage unit at one of the local storage facilities, but I'm not really sure about spending the money.

Things at work are starting to get busy... busy is good. If I let it, it could start to spill over into my personal time. We'll just have to avoid that, eh?

Monday night we saw Carol Burnett at the Winspear. Nice enough... but the ticket price was a bit much for what was delivered. I didn't pay for the tickets, but nevertheless, I seriously question the value proposition. Now, there were rabid fans in the audience (the place was sold out) who will undoubtedly take issue with my position. But I really believe that it would have been so much better to have been in a smaller, much more intimate venue. And for me, the question-and-answer format just didn't work...

Last night was at home... sort of.

Tonight we've got Spanish class, although G. has announced that she's not feeling well enough. I'm starting to worry that her bronchitis has slipped into pneumonia.

Tomorrow night is the opening of "Pride and Prejudice" at The Citadel... I haven't been in the Shoctor Theatre for nearly ten years. This could be very traumatic!

Friday Night is Colin James at the Arden in St. Albert.

Saturday Night is the 50th Anniversary Gala at Walterdale Theatre.

Busy week, eh?

My swallow has improved a wee bit, thanks to Irene's guidance (therapist at iRSM/Compru). But I am starting to believe that the real problem is with my tongue and dry mouth syndrome. I may be stuck with this problem forever... and the dry mouth issue is making me cautious at work. I do not speak as much as I used to, and when I do, I start fretting enough that I'm losing my train of thought. I'm really not sure that I will be able to do full day training/presentations any time soon. I need to develop a strategy for keeping my mouth wet... Drinking water every couple of minutes gets a bit tedious, and, when I'm on a roll, I forget and then find myself with a problem. There has got to be a better way to handle it!

Its too early to tell if the new strategy for my shoulder is working, or not...

10 Months on...

Busy Day...

Well, so far this morning I've been to work for a couple of hours, then jumped on my motorcycle and ran up to Anderson Hearing Clinic to get my hearing tested. After I'd parked my bike, and walked around the building towards the front door, I passed by dog that was tethered to one of those stand up ashtrays. Nice dog... After I got well beyond him, a wasp stung him, and he took off, pulling the ashtray over, and then with him... it terrified him! He ran out into the traffic, but was not hit... some guy in one of those monster 4 x 4 pick ups ran over and stopped on the ashtray, which effectively brought the hysterical dog to a halt. I stepped into a local restaurant and called for the owner, who did emerge to rescue his dog. You'd think that if someone could lift one of those ashtrays, they'd figure that their dog could move it too... sometimes I just shake my head.

The hearing test was very similar to the one used to take the baseline way back in November of 2007. The biggest difference was the use of words at varying volumes, and not just tones. What we did discover is that, in a controlled environment, I can hear and discern language nearly perfectly. Once we moved to the frequency test, we discovered that the high end frequencies are a bit of a problem... though not as bad as I first feared. The actual hearing loss is 'moderate' at worst. The challenge is that when the loss of acuity of the highs are combined with the tinnitus and background noise, I begin to lose the ability to distinguish certain chunks of language. The nice man suggested that it can be adjusted for with hearing aids... at about $1,400.00 per ear. Well, I guess that isn't too, too bad, given that it could be as much as $3,000.00 per ear! He is willing to let me have a pair of aids for six months to be sure that they are actually working... I did say that I want to have words with my Doctor before making any sort of decision... Vanity aside, I am not adverse to the aids. Its a little disconcerting to be sitting in a meeting and not being able to pick out specific conversations. I'm not entirely sure that aids will fix that, but I'm willing to give it a try if the good Doctor suggests aids as a viable option.

This afternoon I will be spending an hour with the ladies at COMPRU, now iRSM to see if we can't figure out what to do about my swallowing problems, and maybe even my speech issues. And, coincidentally, Irene sent along (via email) photos and mpegs of the last couple of times that I was in....

This first mpeg is the baseline done before the November surgery. Its a bit dark (exposure), but if you watch it a couple of times you'll be able to figure out what it is all about.

This next mpeg is one month AFTER the surgery. Its a much better framing of the shot, and an exposure level that works much better...

And next we have the six month view. This is the one that shows what the issue is... if you watch it carefully, you can see the material that I am swallowing get hung up on the flap that covers the windpipe. I end up coughing a little bit, for a little while, if I can't clear it quickly. Constantly drinking water while eating helps, but, well, constantly drinking water dilutes the taste of the food! And, of course, when I ask for water at a restaurant, it comes ICED, which further diminishes the taste experience.

But its all kinda cool to watch, isn't it?

Its kinda odd to note that the first mpg shows the need for a secondary swallow, the second mpg is nearly perfect in how the barium mass goes down slickly, and then the third one is taking way too much work to swallow. I'm not entirely sure why the second and third are so different. Yes, the tissue swelling has gone done. Healing is good. I thought that maybe they had mislabelled the mpegs and pre-op vs. one month post-op had been reversed, but I am able to see the indicator wire that was placed in my jaw to warn off the radiation team from the relocated saliva glands in mpegs two and three and not in mpeg one, so I know that we're looking at them in the correct sequence. Maybe we've got scar tissue that is inhibiting the process? I really don't know at this point...

Irene sent some photos, as well. I'll upload them in a separate posting...

End of the week...

Well, its the end of another week... and still not much to say.

I did write those two ITIL exams on Friday and found them more challenging than the previous three written two weeks ago. The format still makes me cringe a bit, and the wording, the UK-centric language, and the murky answers all contribute to a questionable value. The five exams are part of the testing, or piloting of the exam cycle... and if I want to teach any of the knowledge areas that the exams are centred on, I do need to pass the exams and get certification first. So, its a bit of a bonus to be able to write the pilot exams in an effort to get an early certification and therefore be in a better position for the company to offer training... hopefully we can be one of the first organizations out of the blocks with the proper offerings.

I spent the afternoon on Friday at a retreat for our Consulting group. It was held above the Ukrainian Bookstore at Fort Edmonton Park... a lovely reconstructed 'pioneer village museum' concept park in the river valley. The actual event was just 'okay'; no stunning revelations or new approaches. Even the guest speaker, although interesting (spoke about possible synergies between Consulting and Finance and Audit) there wasn't anything earth shattering, or even earth shaking in his talk. I was quite disappointed in the catering; there wasn't anything that I could eat beyond a couple of pieces of melon. For some reason, it never even occurred to me that I needed to remind the support staff that I can't do gluten... my fault, I know. They can't be expected to remember everything. Its a good thing that I've gotten into the habit of carrying a protein bar and an Ensure in my briefcase/backpack. Its just a wee bit embarrassing, however, to be sitting there, protein bar in hand, while everyone else is tucking into lasagna (vegetarian and regular), a Caesar salad with crumbled croutons and a dressing of questionable origins, and some pretty amazing looking (and smelling...mmmmmmm) dessert squares. Its not a pleasant thing to have to explain to the event organizers why you're not eating what was being offered, especially after other members of the team have made noises about making sure that I did eat to gain the much needed weight. Its just not worth discussing some things; my world is so full of contradictions at the moment. But I did get, by default, a nice bottle of white wine. It was one of the door prizes (incentives for showing up at these retreats!) won by a newer member of the team I'm working directly with, who just happens to be a practicing Muslim, and therefore does not drink. So he passed the bottle to me... I do feel a little bad for him; its Ramadan, and he's having a heck of time with the day time fasting. He caved, and ate lunch with everyone else.

One of the things that did stick with from the retreat was the thought that I have to get on with 'building eminence' within the company and the community, generally. Now that I'm back form the hiatus imposed by the cancer, and now that the first series of the new ITIL exams have been dealt with, I need to go to work on establishing myself in the ITIL consulting space, as a separate entity from, or within the team. Its true that a lot of the work flows to me, but people aren't thinking of me first. The work is redirected by other members of the core team. And there are certain opportunities that I am not being considered for. I worry that its because of the bout with cancer. The timeline may not have moved far enough for other members (and managers) of the Consulting group to be confident that I am a safe investment... That I find to be a depressing thought. So I need to figure out a way to build my eminence and profile really quickly, efficiently and effectively.

And now for a quick change of topic:
I had a quick look into the attic this morning. We've been having some challenges with heat this summer, and I got to wondering whether or not the attic insulation might have something to do with it. Rather obvious approach, isn't it? Ya, well... I'm not always that good at checking out the obvious first... So, anyway, I discovered that the attic is full of Weathershield branded blown insulation, and even found a certificate in the roof joists which says that there are nine inches of the stuff, giving an R-32 rating. And it does look like the right amount of insulation is there... with at least one low patch near an outside wall. I wasn't about to go crawling around in that stuff to verify depth throughout. I'm thinking that a call to an insulation company may be a good idea. Maybe an additional 3 inches of insulation might be a good idea? In any event, I'm starting to think that the heat problem may be a lack of insulation in the exterior walls... Again, though, I think I need a conversation with one of the experts.

Ramblings...

'Not a lot to say lately, but I thought I'd just scribble down some of the random thoughts and events that have been swirling around...

I'm very disappointed in Stephen Harper for calling the federal election... turns out he's just like every other self-serving politician, bending the laws he himself created when he finds they are not serving his best interest. His 'fixed election date' law was, or is, such a great idea, but it didn't take into account the 'non-confidence' aspect of the parliamentary system. If it was to really work, the concept of the non-confidence vote should be thrown out... then we'd really get to see democracy in action! The one question I do have is will we be back at the polls when that law says we should, in October of 2009 (or whenever)? Or will he ignore the law if things aren't just right for him?

I'm also very disappointed in Stephan Dion. To borrow a phrase from Bill Clinton; Its the Economy, Stupid. When will these guys learn that everything else follows.... if he can get 'on message' with the economy, the Green Shift plan will naturally fall into place IF it is properly aligned. I must say that I am pleased that Mr. Dion has asked the tv networks to include Ms. May and the Green Party in the televised debates. We'll just have to wait and see how that goes. She may be enough of a perceived threat to Harper's Conservatives that he will fight the move...

I've been spending some time with Facebook recently... and tracked down a few old high school friends and a couple of University friends. Its such an oddly fascinating communication tool. A disconcerting and yet satisfying experience.

I'm prepping to write more ITIL V3 exams on Friday. Those things are 'crazy'!

Protecting the saliva glands

I find myself quite tired these past couple of days. Hard living over the weekend? Weather changes? Post Labour Day blues? Not really sure what it is...

I promised someone (do you think I can remember who?) over the weekend that I would look up the name of the drug that has the potential to reduce radiation damage to saliva glands. It was something that I was NOT offered... and boy, does that piss me off. It is possible that it hasn't been approved for use in Canada, yet. But it has been in use in the USA for some time now... a bit annoying, really.

Amiphostine is the name of the drug. Anecdotal discussion says that it is injected before each radiation treatment and that it can get expensive. Hopefully who ever I was talking to/about has a good drug plan. Also sold under the brand names Ethyol® , Ethiofos , Gammaphos, WR-2721

From the MedlinePlus website:

"This medication is used to:
protect the kidneys against the harmful effects of the cancer-fighting drug cisplatin in patients with ovarian cancer or lung cancer
reduce the severe dry mouth caused by radiation treatment after surgery for head and neck cancer
Amifostine is in a class of drugs known as chemoprotectants; it protects against the harmful effects of cisplatin and radiation treatment. The length of treatment depends on the types of drugs you are taking, how well your body responds to them, and the type of cancer you have. "

I've been reading stuff from 2005 that says that the drug can be effective... its not a guarantee. Its interesting that it hasn't become part of the treatment protocol at the Cross Cancer Institute. There are side effects, almost as bad as the chemo... and maybe that's why?