equivocality — Jeff Ngan's collection of thoughts, experiences, and projects, inspired by pretty much everything
22 Jun 09

Feeling My Age

So cur­rently it’s:

7:00am — Two mesalamine pills for my col­i­tis and two snorts of cor­ti­cos­teroid for my hayfever
3:00am — Two mesalamine pills for my col­i­tis
7:00pm — Two snorts of cor­ti­cos­teroid for my hayfever
Dinner — One mul­ti­vi­t­a­min to make up for the foods I can’t eat due to col­i­tis
11:00pm — Two mesalamine pills for my col­i­tis and 20mg of cet­i­rizine hydrochlo­ride for my hayfever

I expect to be wear­ing adult dia­pers and using a walker any day now.

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30 Apr 09

Protected: Self Medication

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26 Apr 09

Conflicting Medical Advice

One of the drugs I’ve been pre­scribed for my col­i­tis, Asacol, is delay-released, which means it has a spe­cial coat­ing that makes it travel through the stom­ach, and absorbed only in the colon. This spe­cific brand is released in the left and end of the colon, which is where my col­i­tis is. I often get con­flict­ing advice about how to take the drug:

It’s gen­er­ally taken that the doctor’s advice takes prece­dence over any­thing else. But as a per­son who works in the med­ical indus­try, where doc­tors are fre­quently revealed to be incom­pe­tent, I know that not all of them know what they’re talk­ing about.

Scary, for an indus­try in which we put so much blind faith. Who am I sup­posed to believe?

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11 Mar 09

Being Strong For My Grandmother

The can­cer has spread to her bones and sev­eral major organs now. We asked the doc­tor not to tell her, but we can’t do any­thing against his moral oblig­a­tion to inform the patient. Either way, she doesn’t know how seri­ous it is, whether it’s from shock and denial, or mem­ory loss.

But she’s awake, and aware, and feel­ing no pain, which is good enough for me. The most we can do now is to try to make the rest of her life as enjoy­able as possible.

She thinks she’s going to be fine. Keeps telling me that she’ll take me to a nearby park when she’s bet­ter. As much as it hurts me to know this won’t be pos­si­ble any­more, it’s reliev­ing to know she’s so obliv­i­ous. We don’t let our­selves cry around her, for fear that she may real­ize how bad it is.

Her face is more sal­low, her fin­gers and legs ema­ci­ated, but she still has her thick, black hair1. Aside from a dis­tended stom­ach, it’s hard to tell that she has such a grim prognosis.

But by far the hard­est part is hav­ing to cod­dle her like a child to take her med­ica­tion. Telling her she’s a good girl if she swal­lows her pills and reward­ing her with ice-cream. That we’re only strict because we care about her. It tears me in half when she gives such a painful look of dis­taste with every pill we hand her, 18 a day.

She used to be so strong. Now we have to be strong for her.

  1. I used to have even more”, she tells me. []
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26 Feb 09

My First Colonoscopy

Warning: This may be a lit­tle too much infor­ma­tion for some. I find it funny that almost a year ago, Tiana crowned her­self the win­ner of our inad­ver­tent com­pe­ti­tion on gross-out bod­ily func­tion blog­ging, and specif­i­cally men­tioned that to top her period-blogging I would need to do a live blog­ging of a colonoscopy. I was too sedated to do a live blog­ging, so this is a night-of blogging.

Bishop takes rook-pawn, Tiana. Your move.

Before

The first (overnight) lax­a­tive is to clean out your colon of all solid wastes. It doesn’t kick in overnight, it starts work­ing in about an hour, which means you aren’t going to get much sleep.

The sec­ond lax­a­tive (mag­ne­sium cit­rate) makes your intes­tine absorb water through osmo­sis, so that you start pass­ing liq­uid for a more thor­ough clean­ing. The mag­ne­sium cit­rate wasn’t as bad tast­ing as I expected (sort of a chem­i­cally sour lemon­ade), but that, along with hav­ing to drink ten glasses of water to make it effec­tive, did make me slightly nauseous.

When liq­uid comes out of you from this end, it doesn’t make a nice con­tained splosh. No, it goes every­where. I lost track of how many times I went to the bath­room, and used almost two rolls of toi­let paper in two days. And when you wipe this many times, even three-ply, ultra-soft toi­let paper feels like it’s coated in dia­mond dust and dipped in acid.

I was able to get through a decent chunk of my novel, The Last Light of the Sun, and learned from GQ how to “Work That Tan”, why Shia LaBeouf is the upcom­ing bad boy of Hollywood, and that Rolex makes a $37,500 nau­ti­cal watch.

You really don’t feel like doing any­thing but lie around when going through this. As such, I was able to fin­ish God of War 2, and unlocked the awe­some Cod of War cos­tume, which still makes me laugh every time a Greek sol­dier addresses Kratos as “My lord!” when he’s wear­ing it.

During

Every per­son I spoke to who had a colonoscopy said that it was a breeze. Not so for me.

Pretty much as soon as they injected the seda­tive into my IV, I passed out, only to be awoken by bouts of agony. I’d say that for the entire pro­ce­dure I was only con­scious for about two min­utes in total, but those two min­utes were not fun. I don’t think I would have woken up if it wasn’t for the pain.

Part of the dis­com­fort is sup­posed to come from inject­ing air into the colon so they can bet­ter see the colon. I couldn’t tell if it was that, the instru­ment they used to do it, or the endo­scope itself snaking into my colon, but I felt a sharp pres­sure on both the anal cav­ity, and inside the colon.

I remem­ber scream­ing through grit­ted teeth, grab­bing the han­dles of the bed, swear­ing, and think­ing that I should have bet­ter man­ners before pass­ing out again.

At one point, some­one also had to hold me down, and uttered com­fort­ing words, but I couldn’t make out what he said.

After

Since the colon is inflated with air, I was warned that I’d be pass­ing gas for a while after the pro­ce­dure. This is true, and very invol­un­tary.

I have severe ulcer­i­tive col­i­tis, which is an inflam­ma­tory bowel dis­ease. The doc­tor showed me pic­tures of my colon; the right side is fine, but the left side is so inflamed that it’s black, red, and bleed­ing. All the infor­ma­tion is being sent to another spe­cial­ist, whom I’m very glad to be able to see soon.

I was pretty groggy for a while after, par­tially because I hadn’t eaten in two days, and par­tially because of the seda­tive. Every time I stood up, I felt like I was going to pass out.

Right now, I have to take 12 pills a day, one of them being pred­nisone, a steroid to sup­press the over­ac­tive immune sys­tem responses, the other being mesalamine, an anti-inflammitory drug to bring the swelling under con­trol. These drugs are scary. The side effects are pretty bad, but the doc­tor judged the ben­e­fits to out­weigh the poten­tial risks.

I may have to take pills (con­sid­ered “main­te­nance med­ica­tions” to pre­vent relapse) for the rest of my life. While I feel this low­ers my qual­ity of life, it’s much bet­ter than deal­ing with the flare-ups and side effects of col­i­tis. Aside from that, the only cure is to have part of my colon removed in surgery, which I really don’t want to do.

The diag­no­sis of hav­ing a chronic diges­tive dis­ease is not great, but I’m very relieved to have an expla­na­tion of the mys­tery pains, along with a treat­ment plan.

I hate, hate, hate being alone when I’m feel­ing sick. My stom­ach still feels very funny and unset­tled. So Julie came over last night to hang out a bit and to take my mind off every­thing, and watch some Robson Arms.

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24 Feb 09

A New Hope In Healthcare

The mind, know­ing some­thing painful or unpleas­ant is going to hap­pen to the body, can pre­pare for such sit­u­a­tions. Which is why I wasn’t ready for this. I didn’t wake up this morn­ing, and think, “At some point today, some­one will put a plas­tic tube in my ass, and shine a flash­light into it”.

Yet this is exactly what hap­pened. With a lack of for­mal­ity, after telling me to “Just relax”, the doc­tor inserts a specu­lum (in this case, the aptly named “anoscope”) in my anal cavity.

Unprepared for the sen­sa­tion, I brace myself and grab the edge of the bed. I wouldn’t say that the feel­ing was painful as much as…unsa­vory.

Just try to relax”, he repeats, with words added about an attempt. I thought he was already all the way in. I was wrong. With a thrust, he goes deeper.

I can’t stop laugh­ing. It’s half ner­vous, half hys­ter­i­cal. This doc­tor must think I’m enjoy­ing this.

But no doc­tor has ever done this before, or been so thor­ough in going over my symp­toms, and it’s a far cry from the health­care I’ve been get­ting before. So, after he lit­er­ally wipes of my ass of the excess lubri­ca­tion and I’m tuck­ing the tails of my dress shirt into my pants, I thank him.

Wait. I hope he doesn’t take that the wrong way.

Colonoscopy kit

He tells me I need a colonoscopy. As I’m book­ing my appoint­ment, the recep­tion­ist hands me a colonoscopy kit (at $25) which includes:

The lax­a­tives are to com­pletely clean out my sys­tem so they can see what’s going on inside my colon. The nau­sea tablets are to coun­ter­act the unpleas­ant taste of the mag­ne­sium cit­rate. I haven’t been able to eat any­thing with seeds three days prior, and noth­ing but clear liq­uids at two days until the pro­ce­dure. Unfortunately, I’m off for two days from work and a night of Tai Chi, as the first round of lax­a­tives has me run­ning to the bath­room at fre­quent inter­vals. Louise is dri­ving me to the clinic and back, as I’ll be given two seda­tives dur­ing the pro­ce­dure: one to relax me, and one to make me groggy. I’m just hop­ing that I’ll pass out, and wake up when it’s over.

Read the rest of this entry »

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16 Feb 09

Father-Son Bonding

I called my dad on his birth­day this week. After the divorce I would never call him, spe­cial occa­sion or not, sim­ply because I needed to dis­tance myself from the sit­u­a­tion. He did call me on mine last year though, which reestab­lishes a sort of prece­dence and rit­ual, and he actu­ally thanked me for the call.

We made the usual small talk, about work and home.

Mercedes Benz SLK 55 AMG 2006

He told me he bought a car: a 2006 Mercedes Benz SLK 55 AMG hard-top con­vert­ible with 18″ rims and 7-speed-automatic trans­mis­sion. He’s going to keep the Beemer for win­ter dri­ving. It filled my heart with quiet joy when he said I could drive it the next time I vis­ited him. Not so much because he was let­ting me (for I was always allowed to drive the Sportline 300CE while liv­ing at home), but because I could tell in his voice that he wanted me to try it.

I asked him if there’s any his­tory of col­orec­tal can­cer in the fam­ily, which the doc­tor wanted to know at my last appoint­ment, to which my dad answered, thank­fully, no. He shared with me his own health con­cerns, the med­ical terms of which he only knows in Chinese. These are things I avoid ask­ing about when I visit him, as he pops some pills from a bot­tle kept with the dishes in the kitchen, and I real­ize that I’m learn­ing more about my dad than ever. It’s not so much out of a need for pri­vacy or avoid­ance of embar­rass­ment, but sim­ply out of con­ve­nience, as these top­ics would never get brought up.

It’s strange to bond with him in this way, only after so many years of leav­ing home.

I remem­ber him try­ing to teach me pho­tog­ra­phy when I was younger, but he soon lost inter­est, in both pho­tog­ra­phy and me1. Maybe it’s the dis­tance that makes us appre­ci­ate each other more, and it wouldn’t be the same if we lived in the same city.

In a way, I’m glad to have the rela­tion­ship now, and I’m able to for­get that I’ve never had it for most of my life.

  1. As such, all my pho­tog­ra­phy is self-taught, aside from one trick used to zoom a lens towards the sub­ject so that the edges are blurred that he showed me at the Statue of Liberty. []
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06 Jul 08

On Isotretinoin

I recently started a course of Isotretinoin, a strong med­ica­tion used to cure severe acne by alter­ing DNA tran­scrip­tion. For some rea­son, my acne has really flared up in my late twen­ties. I would get huge cysts on my face that would last for weeks, not to men­tion the hyper-pigmentation that would last even longer after the cyst went away. Needless to say, it was mak­ing me very anti-social when I was talk­ing to peo­ple and felt like there was a huge dis­trac­tion on my face.

I was referred to a der­ma­tol­o­gist, who gave me a pre­scrip­tion for “full strength” (accord­ing to my body weight) to see if I could han­dle the side effects. The phar­ma­cist asked me if she made a mis­take because they don’t offer a dosage that strong, so now I take a com­bi­na­tion of two dosages.

Due to the potency of the med­ica­tion, there’s a huge list of side effects. The scari­est is the mood changes. I’m sup­posed to stop the dose if I start experiencing:

As a per­son who’s suf­fered from sui­ci­dal thoughts in the past, this was quite a fright­en­ing propo­si­tion. I asked my friends to be aware, just in case I don’t notice any changes in myself.

So far though, the only side effect has been extremely dry skin, espe­cially on the face. The lips have been the worst; I can’t eat or drink any­thing with­out apply­ing a thick layer of mois­tur­izer on them, oth­er­wise they peel like mad.

There’s also a dry­ing of mucous mem­branes. To relieve the chap­ping, I’ve started smear­ing Vaseline in my nose.

Prior to this, the only time I used Vaseline was as a sex­ual lubricant.

Now I get aroused every time I breathe in.

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04 Dec 07

The Weight Issue

With a tone of gen­uine con­cern, as if I was being con­sumed by some dis­ease, Abdallah told me he noticed I was get­ting thin­ner. Perhaps this is true. I was recov­er­ing from an episode of IBS, and con­trol­ling my food intake. Maybe its my sets of nar­row, flared pants I’ve been wear­ing lately on Julie’s sug­ges­tion1.

Louise tells peo­ple I don’t eat a lot, which is true only when we’re out 2, and is also the only time she’s seen me eat. It makes me even more ill at ease when I’m already feel­ing unat­trac­tive, as if it was my fault and I wasn’t doing enough about it. Others will com­ment about the size of my waist, or make a pass­ing remark about how they wish they had my metabolism.

I try to take it all in stride, but it’s not easy when the sub­ject is con­stantly brought up.

According to my doc­tor, I’m aver­age weight — the aver­age being a range, with me being near the bot­tom. I know this, but it doesn’t make it eas­ier. Bronwen once told me that I have a weight issue, and after think­ing about it for a while, I real­ized that it was true. Even though it’s some­thing I can joke about, it’s still a source of self-consciousness, lead­ing back to mem­o­ries of my par­ents telling me that no one will love me if I’m this size forever.

Sometimes I won­der if I’ll ever get over it.

  1. Her the­ory is that baggy pants do noth­ing to hide thin limbs and make skinny peo­ple look even skin­nier. []
  2. Usually because I don’t like to be too full when I’m out. []
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09 Aug 07

I Hate My Doctor

He doesn’t lis­ten to me. He’ll ask me a ques­tion, then cut me off. He triv­i­al­izes my symptoms.

Next thing I know, I’m rushed out of office.

He’s a nice guy, but nice doesn’t get you healthy.

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