Author: Katie

I wonder if anyone else with chronic illness has this problem.  I am so frustrated with the way I look.  This is nothing new with me.  I have had body image issues and eating disorder issues for most of my life.  I was just sort of hoping at this point I could let some of it go. After all, I should be glad for the days when I can actually get up and move, much the less worry about my weight or my lack of muscle tone.

But I do.

I always, always, feel I am doing something wrong.

Right now I am taking a tiny dose of prednisone every day just to keep going.  I think it is playing havoc with my appetite. I want OFF the prednisone but without it the fatigue and pain make it tough to function at all.  Is there a compromise here?  I don’t know.  Until I get my infusions back, I don’t know what to do.

I need to follow my eating plan.

I need to go to the gym.

I feel a failure.

I am sabotaging myself in so many ways and yet I cannot seem to forgive myself.

Does anyone out there have this problem or is it just me?

This is just a quick note as I am about to leave and go haul kids around all afternoon.

I seem to be having a flare.  ” What is a flare?” you ask.  A flare is when my body starts attacking itself.  My autoimmune system starts going wacky. One of the biggest signs is that I have incredible itching.  My itching is usually confined to my arms.  Last night it was so bad that I could not sleep.  I took enough benedryl to kill a horse but it did not help at all.  The only relief I got was from wet rags draped over my arms.  Cortisone creams (prescription strength) are also ineffective.

The only thing that helps keep me from going entirely crazy is the knowledge that I am not alone.  All of the sites I read where there are others like me; with Mixed Connective Tissue Disease, everyone talks about ‘the itchies.’  The itchies are a bit different for each of us but they are always incurable it seems and they come and go.  I have noticed they are at their worst when some other part of me is not working too well.

For instance, I am having indigestion from HELL.  When I try to take my vitamins and other medications, it hurts.  The pain in my chest and back is excruciating.  Also, the fatigue and the aches are back.

My personal opinion is that all of this stuff is back in full force because I cannot take my igg infusion right now.  In other words, IT IS ALL RELATED.

I am praying that the dr. I plan to see in Houston in June will really ‘get’ the inter relationships of it all and can help me put more puzzle pieces together.

I desperately need that help.

Ok, onward through the fog….

Nurses:

Fall of 2012

Let me begin with the obvious here: nurses are people. They are varied and variable and they all have good days and bad.  But, as a general rule, they are unbelievably competent, patient and caring people.  I admire them.  I am a fangrl.

First, some very special nurses: my infusion ladies. For most of the last eight years I have been getting infused at one of the local hospitals in their outpatient infusion room:  It isn’t a scary place.  It has lots of recliners and a television and plenty of blankets and pillows.  There are even curtains for privacy when you need it. The nurses who work there are like dear friends who know my innermost secrets: they hold my life in their hands once a month. They watch out for any changes in my blood pressure and do whatever they can to make what is a difficult process for me, go smoothly.

I really cannot say enough what these ladies mean to me.  I look forward to seeing them and know I will be okay, no matter what happens, as long as they are there.

ER nurses are another category I have come to know well.  They have a tough job.  They need to be everywhere at once.  Patients have no patience when they are in the ER.  Everyone is having an emergency, after all.  But, each one has to be prioritized and sometimes it is impossible to please anyone.  I don’t know how they do it.  Sometimes they get pretty hardened.  Sometimes they are there without you even asking. I have come to know the signs of an ER nurse.  If he/she is overwhelmed/tired they won’t bother to hand you the call button and sort of leave hoping you won’t ask for much.  If they are fresh on duty or the E.R. is slow, they may just stop in to check on you.  But that almost never happens.  I just try to remember they are people, at work, and that I am not the only patient. It’s hard when you feel like you are falling apart but I don’t know any other way.  I say ‘thank you’ a lot and I mean it.

Floor nurses in the hospital juggle a ton of information.  Doctors are only there for a brief time once a day—if that—per patient.  They rest of it has to be done at the computer station and through pharmacy.  Interaction with the patient is every two hours for the nurse every one hour for the aide. They take your vitals and check in on you.  Usually medications, like pain meds, are every four hours. The nurse has to record everything in the computer in your room.  Each time she gives you a medication, she gets the bar code off of your hospital bracelet and then the vial before she can fill the syringe.  There is a lot of paper work involved.

Usually these nurses are so competent that nothing can ruffle them.  If something does upset them, you know it is bad.  Every once in a while you get one who is just tired of being there. You can tell.  You are just annoying no matter what you say or ask for.

There is nothing you can do about that.

Keep your eyes and ears open, some of these nurses work back to back shifts of crazy hours and start to make mistakes.  They are human and I don’t blame them.

I do blame a system that lets them or makes them work those hours.  It is not ok.

Nurses are the heart and soul of medical care. Without them, there would be nothing.  They should be the highest paid and respected parts in the whole system.

Post Script: May 10, 2013

 

I no longer go the hospital for infusion days.  I have/had switched to home infusions that are done sub q (subcutaneously) and can be done safely at home.

Unfortunately, I have spent more time in the hospital.  Everything I wrote above is true.  Nurses are heroes and heroines. They should be allowed to wear capes and shiny, reflective tights.

Last week I was in the hospital for four nights and for all that time I had only one mediocre nurse.  I think that is pretty outstanding.

This is just a quickie to say hello.  I don’t have the energy or the brains to write coherently.   I am in the hospital with a suspected case of Aseptic Meningitis.  In other words, my body did not take well to my home igg infusion of the subcutaneous medicine. This is the infusion I have been so proud I am able to take because the IV versions were making me too sick:(

I have had many reactions ever since I have tried to take igg (immunoglobulin) replacement therapy . The nasty part is that I desperately need the stuff.  My body does not produce enough iggs  and in some cases my body doesn’t produce it at all.  This problem, called Primary Immune Dysfunction or Hypogammaglobulemia, is at the root of all my health problems.Different people have deficiencies across the spectrum.  According to the textbook, my problem is an easy one.  However,  I have begun to believe that this a stack of cards and that once one fell with me the momentum just increased and   Or at least that is what I have come to understand and believe.

My body is missing some of its natural immune system and has literally turned on itself looking for answers.  The plasma product I infuse (Igg or IVIG) replaces my crappy immunoglobulins with those of healthy people.  In fact, it takes 25 thousand people to make up a batch of the medication I infuse.  It is very complicated.  When I have a reaction, one of several things can go wrong: 1. My body recognized the new, healthy cells (?) getting pumped in and says, “Yo, bitch! These aren’t ours!  Get them out of here! Attack!”  2.Or, It could be,the suspension the product is mixed with is causing me to react (possible but not probable since it seems to happen with all of the brands after a while).  3. I am a space alien and human blood products are just not compatible with my alien blood.

Personally, I am voting for number 3.

In any case, this happened to me in early December and now here I am again.  The doctor wants to take away my goodies (infusions) all together.  I can see that from his perspective that would seem logical.  But, he seems to be wearing spectacles that give him a very different view from mine.  I know that without the medication at all, I feel weak, painful and half dead.  I get all kinds of infections and feel like I will die pretty quickly.

So, what to do?

I am going to go get another opinion.  That’s all I know to do.  If the next doc says to get off of the med and stay off then maybe I will.  I don’t know.  I cannot face that thought right now.  I am doing good just to write this and think it through.

Perhaps I should start trying to find my space ship and ‘phone home.’  I can’t just sit here eating Reese’s Pieces. I need to get to a place where I fit in and my body isn’t constantly in rebellion and making me miserable.  Hey, I could turn myself in at Area 51 (that is the alien one, right?).

Maybe they have enough specimens of my race to fix me there.

Okay, I am devolving really rapidly here.  I think I will have mercy on anyone crazy enough to read this and stop.

E.T. PHONE HOME.

I have hit a  Bump in the road.  This week the pain and the fatigue caught me up and hunted me down.  Like a frightened animal, I tried to hide. It did no good.  The pain and the bone crushing fatigue that is often its dance partner,  came to find me.

I realized that no matter how much control I try to exert over my illness(es), I will never, ever win.  It seems I have to learn this lesson over and over and each time I am deeply disappointed; each time I am frightened that the good or better days won’t come back again.

I suppose it is a little like going on a ride on a small plane.  Everything is smooth and the terror of being so close to falling out of the sky is mediated for a while.  You can almost touch the clouds; there is a sense of exhilaration and “I think I can do this.”

And then, just as you settle back, Bump!  You hit an air pocket.  Your pilot, or physician, is unperturbed, “no problem” she will say.  But really, it is a problem.  Because suddenly the ground is much too close.

This how I felt this week.  I felt myself slipping closer and closer to crashing into the ground.  Finally, I succumbed and went to the ER to try and get some pain relief.  My pain was in the same place it has been for over a year; the upper right quadrant of my abdomen.  I have been trying to do acupuncture, diet, exercise and whatever else I can think of to help that pain but sometimes it just eats me alive.

I saw my rheumatologist  and she suggested I not give up on all gastroenterologists.  In fact, she wants me to return to the pancreas guy in San Antonio.  So, I called for an appointment.  I dare not build up hope for a cure.  Besides, they can’t see me for five weeks.  It is just the same old thing as it has been.

My Mayo records have not arrived yet.  It is as though I never went there for two weeks.

Truly, I got screwed over at Mayo this time.  I am angry and sad about that whole thing.  My rheumatologist is going to ask around for other pancreatic specialists in the area and help me with this so for that I am most grateful.  In the meantime, I am signed up to see a nutritional counselor that specializes in food allergies.  Also, I am trying to decide whether to come off of or stay on prednisone.  If I am off, I swell up because my body is no longer working properly without them.  If I take them, I have a constant case of thrush.

But, this is all background noise.  I just want to get from one day to the next and take care of my family.  I can do that as long as I don’t get wiped out by the pain and fatigue.  Those two partners in crime are the ones that literally take me down.

So, what to do.

Fight the good Fight.

Keep posting from the Immune System Wars.

I need to keep writing.  I have been slacking of late.  I have been editing my essays but have not written anything new.  I don’t even know if this blog is helpful at all.  I don’t think I am making the best use of it.

But it is a weapon and I must use all the weapons I have.

So, “onward through the fog” and all that.

“Chin up and all that” too.

 

 

NOTE: I suck at blogging.  I have not been going in any sort of chronological order.  I have also not been explaining things very well.  Yesterday I wrote about an ‘a ha’ moment I had when my ob/gyn spoke about chronic pain as a fire alarm going off where there is no fire.  I liked the metaphor.  What I didn’t say was that I have both chronic pain and the other kind: actual inflammation.  They are very, very hard to tease apart. In fact, I really cannot tell the difference.  So, let me explain:

As I understand it,I have fibromyalgia syndrome and a connective tissue overlap disease in addition  to my primary immune disorder.  All of this means my neurons are morons and do not fire correctly. There is also something going on with my cytokines.  I don’t really understand that yet, but I am learning.

When the connective tissue disease or MCTD (Mixed Connective Tissue Disease) was diagnosed at Mayo in 2011,  I was put on a medicine called Plaquenil. This med helps dampen the immune system so it quits attacking itself and making my tissues swell on the inside. Once that took effect, a lot of my pain subsided.

In addition, when I do my igg infusions, my pain decreases.  So, I know my pain is partially due to disease.

However, a lot of joint pain and just everyday pain remained and I was told it would be with me for life.

Thus begin a journey down the chronic pain rabbit hole. I was told to find a ‘pain doctor.’   Well, I wish I had been given some sort of guidelines.  I have written a couple of essays about these experiences but let me summarize:

First guy: sent me home with multiple narcotics and suggested I take them all at once and go on about my day.  I nearly died in a car accident.

Second guy: Seemed brilliant and gave me stuff that worked but I never saw him after first two visits.  I was shunted to his P.A. or even a Medical Assistant.  The wait times in his office were one to two hours past an appointment.  They kept increasing the medications then yelling at me for being an addict.  It was very confusing and created a sense of shame and loathing that  felt  awful.  I didn’t know what to do.

I went to Mayo again in spring of ’12 and the doctors there told me a good pain clinic works at pain relief from several angles and never just hands out pills.  So, I fired the guy I had been seeing and found someone who has a more balanced approach.

At this point, I am off of over half of the narcotics and am once again turning to acupuncture as well as trying to help myself through diet and very moderate exercise in the pool.

However, the nature of the beast is that if I push too hard, it comes back and bites me in the butt.  Sunday I felt good and the water felt wonderful.  I got excited.  It felt like my old body was back.  I jogged in the water for twenty five minutes or so.

That was a big mistake.  It caused my body to react against itself and swell on the inside.

No one seems to understand how this works exactly but somehow we trigger a response that brings on the pain and the fatigue when we ‘over do.’ The disgusting thing is, you never know when you have over done it!

I find this hard to live with.

So, in a nutshell, that is me and chronic pain.  We are not friends.

Wow. That entry from Saturday is awful!  What a whinger I am.  So, I know you are all sitting there on the edge of your seats waiting to hear the latest.  Guess what?  I learned something valuable today.  I love it when that happens.

The first half of the week has been fairly bleak.  I have been in really ouchy pain and it felt like cramps. I have also been very, very tired.  I convinced myself it was endometriosis.  I hate hypochondriacs;I sure as hell don’t want to be one.  I don’t think I am.  After all, I have several, really nasty diseases that have to be treated on a daily or weekly basis.  (For instance, I am infusing right now.)

However, that doesn’t mean I don’t want to find a reason for my chronic pain. This gets especially tricky when it moves around. The pain has been in my pelvic region this week.  It hurt from my hips back to my lower back, especially on the right side. I have felt nauseated too.

So, today I had my ultrasound scheduled at the ob/gyn’s office.  When I got there, I told them I was in pain and wanted to see the doctor if possible.  I went ahead with the ultrasound (NOT FUN) and waited another hour to see my doctor.

This doctor is one of my all time favorites.  She got me through a tough pregnancy with my son and has always been there for me.  I love her.  So, when she came in I was groaning away and spread out on the table like a lump of fat tissue.  She said, “I don’t think your problem is gynecological. We have checked out your blood work from last week and other labs, plus the ultrasound, and I just don’t see much of anything. You are NOT in menopause and I am going to put you on progesterone ten days a month to regulate your cycle for a while.”

I sort of bitched and moaned and asked some questions.  She said, “you have chronic pain issues, right?”

“Yes,” I said. “I have chronic inflammation issues.”

“Right. That means your neurons are all screwed up.  They signal a fire alarm where there is no fire.  If I go in there and dig around for something I don’t think is there, like endometriosis, I could make it all worse.”

“Oh.” I said.  Fire alarm.  Neurons.  This was starting to make sense.  Then she said,

“Did you do anything in the last few days that could have exacerbated that area?” Then it hit me like a ton of bricks.

“Oh my God! I am an idiot!  I swam on Sunday and I went twice as long and twice as hard as I have been.  I thought I was doing well.”

“You’re not an idiot, but you did set possibly set something off.”  So, now I know.

Fire! Fire! Fire! I have a strained muscle and where some people might hurt a bit, my body tells me my hip is broken.  Why?  I don’t know.  Can it ever be fixed?  I’m working on it. I went back to acupuncture this week and I( heh, heh, )started swimming more.  (Oh well.)

I think I have a long way to go.  I also remember that my right hip has been gamey since my mid twenties when I fell skiing in Switzerland.  And, that is not nearly as romantic as it sounds, really.

So, I have to remember: the fire alarm is broken.  It is good to look for fire or sniff for smoke, but I need to remember that most of the time, there is no fire: just a hare trigger.

So, lesson learned and respected today.

Let’s see if I can remember it tomorrow:)

 

 

 

 

How is it that a perfectly decent week, one where I begin to think I am sort of in control,  go all to   hell so quickly?

I had been thinking that through diet and exercise and generally great virtue, I could conquer the beast that is my chronic upper right quadrant pain.  Then, I got the MEGA MENSES. Sorry to be graphic here, but I have not had a period in about 10 months.  At 47, I thought that I had gotten lucky and was going through menopause.  I had seen my ob/gyn last year and had all my equipment checked out.  It all looked fine then. So, I didn’t really think that could be the issue.

Well, low and behold, I found out this week, my female anatomy is: a. not in menopause–just screwed up. and b. I may have endometriosis or something worse so I have to get it all checked out again.

To be honest, if it were something fixable, that would be awesome.  But, I know better than to get my hopes up.

But here it is, Saturday morning, and my pain is back in full force. During the night it was bad enough to keep me awake.  So, I sinned against G..d and the Universe as a whole and took an extra pain pill.  (This is fool hardy in several ways.)  Guess what?  It ain’t workin!

So, today the conversation with myself goes: “how much of this can I take?”

“ER will not fix me.  It will just cost me $100 and a lot of heart ache to get pain relief.”

I need to hunker down and try and gut it out and all that jazz.  I hate the fact that my mind even turns to the possibility of getting pain relief at the ER.  I should know better by now.  I have been there enough these last few years.  As long as I don’t barf or anything, I should’t go.  Pain is relative. At least that is what I tell myself.  It is an unwelcome relative who wants to live with me.

No one in my family understands this.  My husband knows I am hurting so I can feel him pulling away from me. He has not a bone of empathy in his entire body.  So, on top of everything else. I have to consider his feelings and his dysfunction as part of the mix.  The kids get very stressed if I show how much pain I am in. So, it is up to me to grin and bear it as much as I can.

I guess all of the above is why I think of this whole thing as a war.  It comes complete with weapons and battles and enemies and hostages and innocent bystanders or civilians.  No one chose to be in this war: we were all drafted by my faulty immune system.

There is no way to desert and go AWOL either.  At least not for me.

I guess that is what my husband does: he goes AWOL when he knows he can’t fix me.

Hmmm. Well, I am off to the day.  I will grin and bear it and trudge through.  There is no other way to conquer the territory ahead of me.  I have run for it.  Duck and cover isn’t going to work today.

Well, I have been back in my own reality for almost a week now.  I must say it has been good to hit re-entry and realize that I am needed here.  My family was pretty shell-shocked when I got back.  Both kids were a mess and my husband was doing the automaton shuffle.  I cannot leave them like that; and have no results.

NO USE CRYING OVER SPILLED MILK.

(But Damn! I can cry over a broken dishwasher and a van without air conditioning because I spent it all at the effing Mayo!  WAAAAAHHHHH….)

So, I am the proud owner of a new thrush infection.  That seems to be the price I pay for any sort of steroid relief.  It sucks but I have to have a bit of steroid if I am ever going to get off of the pain pills, I think,

I have also found that diet, rest and staying relatively calm seem to help my side ache.  Today is the first day it has been bad since I returned and I am hoping yet to bring it to heel.  I am pretty sure it is bad because yesterday was Easter and I ate some dairy and some candy.  I also ate a little bit of ham, which was so salty I could almost not handle it.  It was bad/good.

I am trying to be extra clean in my diet with: no gluten exposure, very little dairy, no processed foods, and lower amounts of sugar, only a little meat and no coffee or sodas.

It seems to help. Basically, I can’t eat much.  My body cannot handle it.

I have been doing some reading about alternative pain control methods that I plan to discuss with my pain specialist tomorrow.  One of them is low dose naltrexone.  It is supposed to be an anti  opioid that can help the body deal with pain caused by autoimmune inflammation.  I have scanned several articles about it and spoken online to a lady whose doctor is prescribing the treatment.  I am hoping it is a way to get off of the pain meds I am taking now.  I believe they are squarely to blame for a lot of my gastric symptoms.

Basically, I was in pain so I was prescribed pain pills, which led to more pain, which have now led to damage.  It is a really bitter circle and it never ends but I mean to end it somehow.  I don’t think I have much of a choice.

I am interested in going back to acupuncture as well.  I have been in the past and have a wonderful  Chinese doctor who I trust implicitly.  My pain specialist is also trained in acupuncture so I will question him about this tomorrow as well.

The other thing I plan on is getting back to the pool.  I have to exercise.  Walking is fine but I need a bit more and the pool is the one place I like to go.  I have a gym membership and I plan to use it.  I guess I will pack my bag in the morning and go there straight from the doctor!

Well, we shall see where all these plans take me!

I will let you know)

 

This goes down as my longest trip to Mayo, Florida. When I fly home on Wednesday, I will have been here for two weeks and a day. It has been frustrating in the extreme and I have dealt with the nastiest doctor I have ever had here.

In the past two years when I have been out here, my experiences have been very good in the sense that I felt I was being treated as an intelligent being and that my doctors were working with me for a solution to whatever was going on. I guess you cannot expect a winner every time.

This all started so much better than my previous trips because my sweet, lovely, best friend and cousin, Kay, drove out here to meet me. I had her by my side for a whole week. Unfortunately, it was a week of nothingness. All that happened was a big deal, ninety minute MRI with a dye that made me react. (Yeah me , something new for the old allergy card!)

Basically, the doctor has been hostile in both of our meetings. And so far the meetings were a week a part. I was told by his staff that he only had office hours once a week and I just had to wait. However, he told me he was out for four days of the week I came in and that he has office hours every day. There was a ball dropped in several places there. I also learned I could have switched doctors; which would have been the best option all around. So, that first week, nothing got done but an MRI, some blood work and two trips to ER.

After my second meeting with the doctor last Wednesday, Kay had to leave to go home and care for her family. I got a menu full of tests, much like I would have expected when I first arrived. It really feels as though a week was just blown. I mean, I loved spending time with Kay, but it wasn’t the way we had planned.

The news from the MRI is that my pancreas is atrophied. But, as Mr. A-hole Dr. screamed at us, “I don’t know what your pancreas looked like before!” I understood that he wanted previous records but I was at a loss of how to get them. After making a few calls, I called his staff and they told me they would handle it. If I had known that a week before…. again… why the wait?

So here I am, it is Sunday again and I have come through several really bad days. Thursday I had an upper endoscopy and the anesthesiologist knocked me out really big time. I slept the whole day after the procedure and then through the night. I barely made it to barium swallow testing on Friday. Also, unusual for Mayo, the instructions were wrong for the testing. I assumed I needed to fast but it was not on the instructions: I was correct.

Yesterday, Saturday, dawned early and painful. I had been in horrible pain all night. My arms, my back, my hands, my wrists, my fingers, and yes, my damned upper right quadrant that sent me out here: all of it was hurting and I could not take it anymore. I was depressed and in pain and dirty. I had not bathed since Thursday morning. I am never gross like that.

I walked to the ER and they got me in pretty quickly. The lady doctor came in and I could tell right away what she thought: I was there for a high. Really? Who flies across the country to get high? I was in the middle of a Mayo clinic work-up; I had walked in from the Mayo Inn. What a dip! The nurse was an older male and seemed to be pulling for me but then I did the wrong thing: I had a full blown panic attack. All of a sudden he was not my friend and started talking to me like I was dumb. Oh My God, my daughter has anxiety disorder and suffers from panic attacks and I know how crappy it is. Being on the other side of the fence makes me physically hurt for her. I was given a Xanax under the tongue and told to go. I was not even offered a wheelchair.

So, what do you do when you are sick and far from home and having a panic attack? You take another Xanax and you pull yourself together.

I read my book and pulled myself together and got a plan. No more visits to ER. Today I cleaned up and got a ride to Target where I got my pain ‘script refilled. Then, I came back and booked my flight home for Wednesday. The last of my testing will take place tomorrow/Monday. On Tuesday I will try to see Dr. A Hole. He had asked me to see him on Thursday but I cannot spend more days doing nothing here. I have to go home. In any case I will get a complete work up and diagnosis packet from him in the mail. I would prefer to discuss it in person but we’ll see. I had to make an end date.

The people here do not realize that not everyone is from Florida. I don’t know why but that seems to be the case.

I guess a lot of the patients here are regional.

So, I have a plan, which makes me feel a little more in control. I am still hurting and my appetite has left the building. I have been a sweaty, weakened mess today. But, the only thing I can do is look forward.

This is Holy Week for Christians and Passover for Jews. I plan to celebrate Passover this year. The symbolism of slavery and the forty years spent wandering in the desert are not lost on me. Passover has been celebrated for over five thousand years and is really a ritual way of affirming G..d’s Covenant with His chosen people. He will not leave us in the desert. Eventually, against all the odds, we will be given the Ten Commandments at Mt. Sinai and we will make it to the Holy Land.

For Christians, inclusion in that covenant is made at Golgotha and completed at the empty tomb. The message is essentially the same: G…d comes back for His own: Even the stragglers.

That is a message I really need to hear just now. I am on shaky ground with my spiritual self these days. I am fighting my way back from a deep chasm of unbelief. But, all I can say is, I need that message. I need to know that the time I have spent and the money I have spent here have not been all for naught. I can’t handle that thought. Please, Lord, let there be some guidance and some light in my struggle. I want to be healthy as I possibly can be. I need to know what’s next for me. Do I have only pain to look forward to for the rest of my days? Or will I get better and have a period of remission? How can I take better care of myself?

How do I know when a doctor is looking out for my better good or when I need to move on? What is the balance between knowing too little and knowing so much that it is crippling?

There are so many questions. Perhaps that is one of the attractions of Judaism for me just now: the existential Why?

Well, this essay started with a title of May-HO. I did that because it was funny but also because that is what I feel like. I have whored myself out to Mayo once again and left myself open to suggestion. I have no control over answers; only hope and more questions.

I beg and plead that the Lord will let the doctors see and me understand some new direction for healing.