Thursday May 7, 2009 11:33 PM

Jim went back to Dr. New Guy’s office a couple of weeks ago. His implants had now healed long enough for them to start to make his new teeth. They called him that morning and asked if he could come in early because they had a cancellation, so they wound up cramming what they would have normally done in two visits into one. I didn’t go with him so I didn’t see what they did, but Jim was impressed when he got home. They were very, very thorough and meticulous in the way they took these impressions. They put this contraption on his head like a metal frame…Jim tried to describe it but the only picture I’m getting in my mind is this:



And Jim says it looked more like this:



But in reality, it was something like this:



…and they put the tray in with the goop, measured, took the tray out, more goop went in, back into the mouth, measured again…Jim was there for over an hour. He said that when Vanni took the impressions it was just one shot in with the tray and that was that- no crazy looking contraptions of any kind. These guys were absolutely meticulous. When Jim got home, they called and asked if he had time to come back in because they were ready to do the next phase. Of course he ran right over. He just went back for another visit yesterday and they did some try-ons…with the finished teeth on the bottom screwed into the implants, and the wax model on the top. Jim said the lower teeth felt fabulous, which would seem natural since they’re screwed right into the jaw. His uppers will be a regular denture, and Jim said he couldn’t really judge if the model felt better than Vanni’s did because they’re not held in place with anything. Once they had the paraphernalia stuffed into his mouth a crew of Dr. New Guy’s cronies all came in and were looking him over. One of them said something to the effect of “Well, if it were me, I’d move that up a millimeter…let’s adjust the seventh mandibular…blah blah blah blah…(more dentist talk).” No way did that kind of perfection go into anything Vanni did. Let’s keep our fingers crossed everything looks and feels and works good.

Now onto a monumentous occasion…..trumpets please….Jim ate his first sandwich since his surgery two years ago, and he didn’t choke on it or cough it back up afterwards. Now, I don’t think he could eat ANY sandwich, but this was a Subway tuna sub which has soft bread and mushy tuna. A long time ago Jim had said that he really missed tuna from Subway. Here he is with his sammich:



I really never thought we'd be two years down the line and this was his first sandwich, but Jim's learned to adjust his expectations. Maybe it's that or the Lexapro.

Next week he goes back to Dr. New Guy.

Sunday April 5, 2009 11:00 a.m.

Went to see Dr. Marshall about two weeks ago. The weight has been starting to creep back up, but it's still lower than when I started out. Dr. Marshall didn't like that I was still having mud-butt, so he switched me to extended-release Metformin, and three times a day instead of two. He also said my TSH is still too low, so he downed my synthroid dose again.

About a week after I took the lower synthroid dose, my ass was starting to drag. I mean, really DRAG. I couldn't even sit down and watch t.v. without falling asleep. I never agreed with the idea of Marshall lowering my synthroid. I had just started feeling better with the higher dose, and now he's lowering me based on my TSH figures. That started me wondering...can metformin do anything to your TSH levels? So I ran into an article from one of the endocrinology journals which came to the conclusion that metformin can cause your labs to register an artificially low TSH level without it really being low, but more study is needed. Now, you have to watch some of these articles on the web....many are written by crackpots who think you can cure cancer with vitamins...not something I'd ever try if I had cancer...but this was from a real medical journal...so I called Marshall's office. Marshall congratulated me on finding the article...said he knows one of the guys who wrote it, but it doesn't apply to me because of my T4 readings or some such crap. He suggested adding T3 along with my T4 that I'm already taking. He says some people need to have both. He asked me if I had ever felt o.k. on the Armour thyroid I used to take, because that has T4 and T3, and I told him, no...I never felt o.k. on the Armour. But we're going to try the T3 anyway. The only problem is, it takes four to six weeks for you to notice any difference. Well, I've been fat and feeling crappy for over a year now...what's another four to six weeks? I'll try anything. Marshall said if I started to have a lot of nervous energy to call him. Ha! I am SO far away from having nervous energy, I doubt that will happen.

Then Walgreens gave me grief about filling the prescription. Marshall faxed it in on a Monday. Walgreens never filled it. Finally on Thursday I saw that it was listed on my on-line prescription file on Walgreen's website, so I thought I could pick it up. I go there and they tell me that they don't have it ready because they have a call in to the doctor to "verify" the prescription. What's THAT bullshit about? Dr. Marshall's receptionist called me on Thursday afternoon to tell me the story about how Walgreens was so weird over this T3. They couldn't understand why Marshall would prescribe T3 and T4, and wanted to know if Marshall would recall my existing T4 prescription. They told Walgreens no, I need to take BOTH. Now, it's not like this was some controlled substance...it's thyroid hormone, for Christ sake! And it's not typical for people to take both, but not unheard of either, so what the hell is the big deal? Finally on Thursday night I was able to pick it up. We'll see what happens. Oh, and the extended release metformin was supposed to stop the mud-butt, but it hasn't. I still have it. But I don't care....bring it on! I can take it.

Jim goes back to Dr. New Teeth Guy the third week of the month. I got the letter I requested from Dr. New Guy describing what's wrong with Jim's existing dentures that Vanni made, but Dr. New Guy didn't go quite far enough for me to file a small claims case. He says in the letter that the lower dentures were all wrong to be used with a bar to connect to implants, but he didn't mention how the top dentures were "out" and didn't fit properly. I've got to get him to write another letter. In the meantime, I'm going through my records to tally up exactly how much we paid to Vanni over the last two years so I know what our damages are.

Saturday February 21, 2009 1:32 PM

As of this morning, I'm down eight pounds. I don't see it yet....I still have meatloaf on my waist and I don't think my clothes are fitting any differently, but the number on the scale is the number on the scale. So Dr. Marshall was right....my problem must be insulin resistance. Now here's my bitch for the day: If you Google "insulin resistance", everything out there will talk about how being fat makes you insulin resistant, and to avoid insulin resistance you should just "lose weight and exercise". Well people, that's bullshit. Insulin resistance is what MAKES you fat to begin with, and you CAN'T lose weight. If a thousand-calorie-a-day diet didn't do it for me, then NOTHING was going to do it for me except metformin. It boils down to a widespread prejudice against fat people. They are seen as second-class citizens. Never mind discrimination against race or sex or economic status or smokers or people who still wear mullets...I think discrimination against fat people is the most rampant kind of discrimination. Why don't we organize the million-fat-people march? Are some people fat because they pack away too much McDonalds? Sure. But I don't think all fat people are fat because of what they eat.

As for Jim, he's going to Dr. New Guy on Wednesday to have two more small implants put in his lower jaw. The implants he has now are all clustered in the front. Dr. New Guy wants to have a better anchor for the teeth on the bottom by adding two further out...one on the left and one on the right. After that, Jim's got to heal three to four months before any more work can be done.

Sunday February 15, 2009 9:50 PM

Jim went to see the new dentist a couple of weeks ago, and we had our eyes opened for us. The final verdict? The teeth that Vanni did are not right, and everything needs to be done over again. The cost? Another ten grand, and that's for the cheap teeth. Jim brought the dentures that Vanni made along with him, and Dr. New Guy kept looking at them saying...."I don't understand what he was doing here....you can't put a bar into these...this is not the way to do them...." I asked him to please write me a letter detailing exactly what's wrong with them, because I've got to somehow fight to get our money back. I don't know how I'm going to do it yet, because I'm tired right now....too damn tired...but I'll find a way. I'd also really like Jim to be able to have the better teeth....the ones where they aren't removable and are permanently attached. Those will be twenty grand....well, 18.5K to be exact. I have a plan.

On top of that, Vanni's office had the nerve to send us a nasty letter demanding we pay the $2500 bill or he'll put us in collections. Jim is pissed. Jim doesn't get pissed too often...I usually have the market cornered on pissed, but Jim wants to call there first thing on Tuesday. I think we're better off writing a letter...telling him not only do we have no intentions of paying him any more money, we also are notifying him of our intention to sue for what we've already paid. I may have to do small claims court, which will only get me part of the money, but part is better than nothing. I need the letter from Dr. New Guy before we can proceed. You'll notice that I am not mentioning the name of Dr. New Guy because I can't take a chance that Vanni find out who he is. I wonder what bullshit story Vanni will tell us about what his intentions were with Jim's dentures now. It's always a bullshit story with Vanni. Remember the incident with no implants on top? Dr. New Guy pretty much said that sounded like bullshit too.

As for my experience with metformin, the diarhea stopped for about a week, so I thought it was over, but then it came back, and now I basically have battery acid coming out of my butt on a daily basis. But I don't care that I have battery acid coming out of my butt on a daily basis....battery acid out of the butt is great for weight loss. I am supposed to tell Dr. Marshall if the side effects go away and come back, because there's a risk the drug could cause something called lactic acidosis, which can be fatal, but I doubt that I have lactic acidosis. I will just continue to put up with the diarrhea. I did discover that the metformin seems to have a bad reaction with my daily B complex vitamin, so I dropped the vitamin. I'd rather lose weight than have energy. So far I dropped five pounds and kept it off, but I've had to do a round of steroids for bronchitis, so I'm not making any weight loss progress at the moment. We'll see what happens when I taper off the prednisone. At least I'm not putting on any MORE weight, so I'm hopeful.

Valentine's Day was the two-year anniversary of Jim getting his tumor removed. Why did Dr. Jewell have to pick that date? It has forever changed Valentine's Day for us. Now it's Happy Tumor Removal Day. So in honor of such a day, I decided to make Jim a cake shaped like a tumor, and filled with red cake and red pudding so when we hack into it it bleeds. We brought it to the in-laws yesterday for the Happy Tumor Day festivities. Last year Jim wouldn't have been able to get it down. Here's some shots of the tumor cake....the carotid artery is made of marzipan:




BLEED TIMMY, BLEED!

Sunday February 1, 2008 11:56 AM

I started taking the metformin on Wednesday. Before I did it, I called my ex, who has type 2 diabetes, and asked if he had ever taken the drug. As soon as I said I was on it, he says, "So you have diabetes, then?" No, not yet. If I had untreated diabetes I'd be losing weight. I'm not that lucky. So he's on the drug, too, and said, "yeah...you'll get diarrhea, but it will eventually go away." At the first dose I had a little snap, crackle, pop going on my gut, and about once a day now I have what feels like battery acid coming out of my butt, but I can handle it. It's nowhere near the level of what I went through with inflammatory bowel disease. I'm down four pounds so far, but I think that's just from the diarrhea. If I can keep it off after the diarrhea stops, that will be the real test. At least if I can keep from putting on any MORE weight and my body actually responds to dieting, then I'll be somewhat pleased. I'll be even MORE pleased if I can shed these twenty pounds, but I think I might even be happy with ten. Time will tell.

I called Dr. Vanni's office the other day, and MAN....they were so NASTY to me on the phone. I talked with one chick who barked at me..."We called you and left a message in November that your husband's work wouldn't be covered." I said, "You didn't call ME in November..." and she said, "We called you in November of 2007." I said, "This is 2009! We have different insurance now. All I'm asking you to do is do a predetermination of benefits!" She sniped, "The implants aren't covered." I said, "He already HAS the implants. They've been in for fourteen months. We're waiting for the bar to be put in the lower dentures so he can wear them." She said, "That's usually not covered." I said, "Usually not covered is not the same thing as not covered, now is it?" She said, "We'll put it through and call you back when it's done" and hung up on me. What a nasty little twit! So I decided to check out another prosthlodontic specialist. I mean, if we're going to hemorrhage money, can't it at least be with someone who's NICE to us? So Jim has an consultation scheduled for next Thursday with a guy right here in Voorhees. We'll see how it goes. If Jim likes him, I can't WAIT to call Vanni's office and tell them to go f--- themselves.

Monday January 26, 2008 10:58 PM

Yay! Yay! Yay! If you could see me, you'd know that I'm doing the happy dance right now. No, I didn't win the lottery, but even better. I finally got Dr. Marshall to do something about my waist meatloaf that came to visit but won't leave.

He dialed down my thyroid meds last visit, and after almost a week I packed another three pounds on in two days. At that point I had HAD it. I'm DONE. I need him to do something NOW, not in March, so I called his office on Friday. I told him what was happening and asked him nicely if there was anyway he could "play with my insulin levels" now instead of waiting until March, because by then I could be ANOTHER twenty pounds heavier and I can't take it anymore. He was out of the office and didn't have my file in front of him but promised to call on Monday. So he called me late in the day today and said he was going to call in a prescription for metformin, which is really a drug for type 2 diabetes. I don't have diabetes....yet....but I have insulin resistance, so this should help my body use the insulin it's making. Basically how it works is, you eat, your body makes insulin. If you're insulin resistant the body says...."I can't use this insulin...make more insulin", so the body makes more, and then the body says..."I still can't use this insulin....make more insulin...." and in the end, what you eat plants itself around your waist. His theory makes sense to me. Everyone on my father's side of the family has type 2 diabetes, so I probably drew the short straw when it comes to genetics. Dr. Marshall warned me about the side effects of the drug...diarrhea is the most common for the first few days until you get used to the meds, so he told me when I start taking it, don't make any plans for any long bus trips to Atlantic City. Mom said to me tonight...."Diarrhea? You probably wouldn't even notice it." Meaning I've been suffering with that on and off for years, so who cares. If I could cope with inflammatory bowel disease I can handle it. And I lived through c-diff for Christ sake. If my head winds up hanging in the toilet non-stop, I don't know about that one. Could be a deal-breaker for me, but we'll cross that bridge when we come to it. Dr. Marshall says if this Plan A doesn't work, he's got a Plan B and a Plan C up his sleeve.

The script wasn't called in tonight so I couldn't pick it up. I'm raving at Jim...."I need my skinny meds! I need my skinny meds! Don't you understand? I need them NOW, husband!" He just laughs at me.

As for Jim's $2500 dental bill.....I called Vanni's office last Friday and asked them if this bill was for future work that Vanni's planning on doing, or is it for work already done? They said it was for future work. Well, why haven't you put it through insurance then? We don't get much of a dental benefit....2K per year, which doesn't go very far....but it's still 2K, right? They were supposed to call me back today. Never heard anything. I'll have to hunt them down tomorrow.

Sunday January 18, 2008 9:45 PM

I went back to Dr. Marshall in White Plains this week. It took me three and a half hours to get there because it snowed that morning. We're not talking about a lot of snow, because if that was the case I would have rescheduled, but just a dusting. However, people can't drive in any kind of bad weather, so what should have been a twenty-minute trip to get to the NJ Turnpike turned into an hour and fifteen minutes. The worst road hazard on the rest of the trip was the massive amount of salt on the roads. Literally every couple of miles I had to wash the windshield because of all the salty mist spraying onto my car, and I was praying I'd make it to White Plains before running out of washer fluid.

Dr. Marshall asked how I was feeling and I said, "I'm still fat." My shrink had told me to quit the 1000 calorie a day fast, which wasn't working anyway, and just eat normally. Luckily I haven't gained any MORE weight, but I'm not losing either. Dr. Marshall chuckled at me and said, "You're not FAT. I'm sure your husband thinks you look good...." and I said, "Sure he does, and then I call him a liar! I own a mirror!" Dr. Marshall gets a kick out of me. I tell him I almost wish I could have some of my inflammatory bowel disease back, which was good for some major weight loss. Then I start throwing my skinny jokes out....if I get too close to the pencil sharpener I might fall in...stand behind the flagpole and the teacher marks you absent....go outside and dogs try to bury you....Now I'm so wide that I go outside on a sunny day and kids pay me to stand in my shade.....

Dr. Marshall looks at my latest bloodwork and says that he has to adjust my synthroid a little because now I'm slightly hyPERthyroid. Now, being hyperthyroid should have been good for a couple of pounds off, by noooooooooo. My tachycardia is also coming back....my heart rate was 100 bpm in his office. He dialed my dose down a small notch but now is going to try and figure out why I gained so much weight in such a short period of time without benefit of cheesecake. He explains to me that there's a small subset of people (why am I always in the small subset of people?) who even though their thyroid is properly treated, their metabolism tanks. Dr. Marshall didn't use the word "tanks", but I'm paraphrasing here. That small subset of people, though, are typically obese. I told him that if something isn't done to get this under control I will BECOME obese, and pretty damn quickly too. He said the standard treatment for this small subset of people is basically amphetamines, which are a no-no for me with my tachycardia. I go back in eight weeks and if the thyroid is in the normal range by then he's probably going to start to play around with my insulin levels. I'll do anything. I don't care what it is. Even though I've seen the hell that Jim went through having a feeding tube, if Dr. Marshall said my only option was to do that I'd be running to the hospital right now yelling, "Sign me up!" I am a desperate, desperate woman. I would even do the speed if Dr. Marshall let me. Since I'm not going to be buying drugs on the streets of Camden I guess that's not an option.

Friday night I think God punished me for wishing for inflammatory bowel disease. I got hit with what sure seemed like my old friend at about 11 o'clock, and I was feeling like I was going to pass out on the toilet. I started thinking, is this my c-diff again? But no, c-diff has that very distinct toxic smell. Then I thought, do I have a stomach bug? So I did the french fry test....if someone gave me a McDonalds french fry right now, would I eat it? If the answer is yes, then I'm not sick. Nauseous people don't want greasy french fries. The answer was yes, so I couldn't be sick. I could have treated this gastric explosion because I keep a supply of Cipro that I keep in case of the bowel disease coming back, but I just let it run...literally. I figured it should be good for a pound or so down. Then I started thinking....could I live with this every day if it came back for real? Yeah....I think I could.

And no, Jim doesn't have his bottom teeth yet. He was supposed to see Vanni before Christmas but had to cancel because he had a guy quit at work and another one was on vacation. He hasn't rescheduled yet, but probably will be able to soon because he got a new guy hired. We have long stopped trying to rush this process. I don't know about Jim, but I'm just too tired to worry much about it anymore.