So today Ed & Anne & Adam & I all went to the antique store...

...and I wish I could get Ed's video to download, because it is classic.

Back in the day, when I still had a husband, that husband had a toy. It was a clown.

It was not just any clown, though.

It was a vaguely threatening-looking, unhappy, weeble-y NORWEGIAN clown.

With a feather in his cap.

I had completely forgotten the existence of this horror (which I used to keep replacing in the storage room, because I couldn't bear the thought of it oh my God it's coming after me in the night holy shit) until today, when we walked into El Cutseo Antiquey Shoppe....

...and there it was. By the door, in the first display case. A little faded, but recognizable. Because, really, who else in Hometon would have a Nightmare Norwegian Clown?

We remarked on it, and Adam even played with it a bit, making it weeble back and forth, even though I reminded him that it would come after him in the night.

It was....memorable.

Cancer McCancersons post: This is NUTS.

I've been all about the numbers today:

Dollar amount I spent at Target today, buying things to last the next six weeks or so:

Almost three hundred.

Number of people who get polymorphous adenocarcinoma every year (generously):

400.

Number of people hit by lightning every year:

700.

Number of people killed by hippopotamuses/i every year:

More than 11,000, or about 33 a day.

Amount I've spent on this cancer so far that hasn't been covered by insurance:

Roughly six grand. (Thank God for a high credit limit. Please don't drop it, Citibank. I'll pay. I swear.) (And how the hell do you do this if you don't have insurance? Starve? It's not like you can get free prosthodontics at County General. This is crazy.) (I mean, I know a universal health care system can't cover everything, but for cryin' out loud: just doing the preliminary dental Xrays on this bastard cost me well over $300. I got one single stinking pano and a couple of side shots.) (That's scary. I really hope I don't lose my health insurance now. I would never get insured again, even with the new rules covering preexisting conditions. They'd find something.)

Number of people over the age of 65 hospitalized for a non-fatal fall in 2006 (US only):

400,000+.

Number of hip fractures resulting from falls in 2006:

More than a thousand A DAY.

Current population of the US:

307,000,000 (roughly).

Number of people who will get any sort of salivary gland cancer this year:

36,000 (roughly).

Number of horizontally-impacted wisdom teeth I will have to have removed during surgery:

One.

Amount of distress it caused my prosthodontist to discover that I was not, as he had thought, perfect:

Untold.

Number of pounds I've put on--on purpose--since diagnosis:

15.

Number of pounds I can expect to lose if I have radiation treatment:

40-60.

Number of inches a G-tube would have to be to go into my belleh and stay:

The minimum, about eight. Maybe nine.

Number of radiological tests I will get on Monday:

Two.

Number of lymph nodes they will biopsy then:

One. I hope.

Number of positive results I hope I get:

ZERO.

When a stroke's not a stroke.

When is a stroke not a stroke?

Well, when it's...not a stroke, Eisenstein.

One of the interesting things about the human brain and body is that, when you've had something go very wrong indeed in your head, that wrong thing can be reactivated by things going wrong in your body. It can even be made worse.

Let's take a typical case: your average Little Old Lady In No Acute Distress (LOLNAD) who had a stroke, say, ten years ago, that left her with a little residual left-sided weakness. Other than having to use a cane to keep from tipping over unexpectedly, she's dandy. She lives in one of those poncy-schwantzy apartments with a day nurse who comes in to help give her meds and an aide that stays overnight.

One morning, the aide notices that in addition to being more weak on the left side, Granny LOL is confused and can't talk very well. She's having difficulty following commands and seems really sleepy and irritable. The aide, being a bright person, calls 911.

The ambulance arrives and whisks Granny LOL to the nearest emergency department, where she has a thorough stroke workup: chemistries, urinalysis, a CT scan of her head to rule out a bleed, and a general exam. Everything's negative....except the urine. It's hot. She's got a UTI.

So she's given a dose of antibiotics and sent over to me at Sunnydale, where she gets an MRI to look for signs of new occlusive stroke. She also gets all the other tests and chicken-waving that are standard for our patients. At the end of the day, we discover...

...No stroke. Thank God. Just a UTI that's been allowed to grow (because most people can brew one without symptoms, and older folks are hit hard by them).

Why does this happen? Honestly, I don't know the technical explanation. I do know that in probably half the female patients I get who are over the age of 70, and about a third of the male patients that age, there's a urinary tract infection that's present. It's recognized that even a supposedly "asymptomatic" UTI can cause the sudden onset of confusion or a worsening of dementia. That same infection can cause what we call a reactivation of old stroke symptoms as well--sometimes to the point that the person's worse off than when they had the original stroke.

Moral of the story: If you have an elderly patient (or, for that matter, any patient) who suddenly manifests a worsening level of consciousness, do a UA while you're doing all the other stuff to rule out nastier things. It's a fair chance your person will have a positive dipstick, and antibiotics will vastly improve things.

Lists, lists, lists....

The Schaft asked a very good question down below, in the comments of the "Minions" post: Why on earth would I be asking for feedback on a tips jar now, rather than looking around at my local community and seeing what needs to be done there?

It's a question that deserves an answer. Here's the answer:

I donate my time, money, and rather a lot of food to local community groups and food banks. I give X amount every month to stinking pinko liberal commie causes, add extra to my gas bill to help keep the heat on for other people, add extra to my electricity bill ditto air conditioning, and give my time and expertise (such as it is) to places like my beloved Planned Parenthood. I do all this already.

What struck me when I was diagnosed with this cancer is this: you can get help for all the shit you need help with, except for what you need help with the most. I've been all over the Innerwebs, and the resources for people with orphan diseases--especially ones that are falsely linked in the public's mind with "lifestyle choices"--are slim to none. Try being a person with no risk factors who has a disease that, at best, 339 other people will be diagnosed with in this country this year. It's a freakin' desert.

If I were in danger of freezing, baking, starving, or having an abnormal Pap test, I could find help. But now? When I have questions about how radiation might affect my thyroid, or the surgery will affect my voice, or how an obdurator might affect my sex life (not that I have one now, but hope springs eternal)......nothing.

That's what's different. That's why I suddenly care about people who are diagnosed with such wierd, off-the-wall shit that, if they're not in my position (working for a research-driven institution; having a surgeon who's one of the few who's seen hundreds of these things), are screwed.

Not being able to find somebody like me sucks. I want there to be somebody like me out there the next time somebody like me goes looking.

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Having cancer is rather more complicated than you'd think at first. Thanks to Beloved Friend Pens, I have now--drum roll--ordered a TV set with a built-in DVD player, and have signed up for a month's worth of Netflix.

I was such a newbie that I typed it in as "netflicks" on my browser.

I've also, since I won't be able to talk, ordered a new phone with a better keyboard and unlimited texting.

And I've got a list of the things I need to buy a month's worth of: dog food, cat food, toilet paper, detergents of various sorts, painkillers, saline solution for contacts, you name it.

*** *** *** *** ***

I've got to make my own picture board. The ones at the hospital won't cut it: they have symbols for "pain medicine" but not a symbol for "bring me the good drugs, dammit!" or "get that asshole out of my room."

*** *** *** *** ***

Met with the speech therapy person and the physical terrorist today. They're both going to be looking for me after surgery. I also have nurses lined up and people reserving a room for me.

Too much to do. Too much time to do it in; not enough energy for any of it.

Prostodontist: new sort of dinosaur, or dude with his hands in my mouth?

Let me tell you, Peeps: If this little journal of schmancery adventures helps even one person, it'll be... ... ...exactly the same pain in the ass it is now, but it will have helped one person. I guess.

So: today I saw the DDS who will be making the prosthetic for my mouth. Or, rather, prosthetics, as there will be three: one for the immediate post-surgery period, one that I can wear about a month after that, and a third to be worn....at some point in the future, and forever (or as long as I want).

I asked; they do not come in different colors. Also, I won't be taking it out much. So sad: no rainbow-stripey palate with a unicorn shitting a rainbow on it.

Anyway: the widget will be a hard plastic thing that goes across the part of my hard palate that's missing. That's to start: it'll still be possible for me to snort stuff out my nose in the beginning, since they can't put anything over the soft palate tissue until it heals. Therefore, I'll have to have speech therapy to teach me to swallow safely and to speak intelligibly again.

Yeah. That took me aback a bit.

In addition, I'll have to do some very high-tech exercises starting immediately after surgery, whereby I shove as many stacked-up tongue depressors as I can into my mouth. Since the surgeons will be cutting my jaw hinge muscles, this'll keep the healing muscle from stiffening up. I found out--and you may make what you will of this--that I have a record-settingly large mouth opening: 55 millimeters. The average is ten millimeters smaller. I can put 32 stacked-up tongue depressors into my mouth at once.

Bask in awe. I'll give you a minute.

The second and third palatal obdurators will have what's called a "speech bulb" on them. This will apparently help me deal with the loss of a chunk of hard palate, but it's going to take some time to sculpt them properly so I don't sound like something out of a cartoon. That's fine; it's down the road a bit. I just won't answer the phone 'til then.

Tomorrow I'll work again, huzzah! You know it's getting tiresome when twelve hours with the differently-brained looks like a vacation.