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Friday, December 11, 2009

T-shirt Must Remain On

I write today with a shred of good news: a doctor examined me and did not declare my situation completely hopeless.

More specifically, I had a follow-up appointment with the Ear Nose & Throat (ENT) surgeon—a terrific man—who also happens to be my next door neighbor. I had a host of questions for him about my ears ringing, my tingly scalp, my bloody nasal discharges, etc., but all I was able to walk away with was the confirmation that none of my current issues ORIGINATE from problems in the ears, nose, or throat. I suspected this, but it was necessary to have this intermediate step before the big appointment next week with the brain surgeon.

If my head were a giant nut, the ENT surgeon is like the nutcracker and the neurosurgeon is like that metal stick near a bowl of holiday nuts for poking and prying the meat out of walnuts and pecans. So today I ruled out problems with the "shell" and next week the brain surgeon will get to the "meat," probably with another MRI.

The other key thing I heard today was my extremely unusual PAPILLARY CRANIOPHARYNGIOMA (and its recurrence) was nothing more than "bad luck." Nothing in my lifestyle, eating / drinking habits, allergies, oboe playing, fondness for the Detroit Lions, fondness for the Stockhausen Klavierst├╝cke, or anything I can possibly control led to the tumor. A few unlucky ones get it. Most don't.

In the meantime, I have begun to manually replace hormones my pituitary, hypothalamus and thyroid glands will not provide for me anymore. When I wake up first thing, I take a thyroid pill with plenty of water. Then for my diabetes insipidus I do one squirt of a nasal spray which keeps me from urinating up to 24,000 ml per day (and drinking water frantically to keep up with the dehydration). One little squirt stops all that. Amazing.

Then I shower and—literally—it is time to "man up."

As I dry myself—the water droplets on my tanned pectoral muscles glistening in the morning sunlight—I open the top drawer and retrieve a foil packet of AndroGel. Pure testosterone.

I put on gamma-shielding sunglasses and rip the packet open. A burst of laser light blazes from the open foil, bouncing off the mirrors, and a chorus of angels sings high above me. I smear the gel evenly over my shoulders and upper arms, then wipe the excess over my abdominal muscles which protrude like a six-pack of steel. I wash my hands thoroughly and wait for the gel to dry before sliding into a loose T-shirt. I must keep the T-shirt on always—A.L.W.A.Y.S.—and suffice it to say the instructions leave no stone unturned when spelling out circumstances that arise between spouses where the T-shirt MUST REMAIN ON.

My endocrinologist—the straight talker—was clear about this too. He said, "Apply it to your shoulders and stomach. Keep a T-shirt on and make sure you don't . . . uh . . . get it all over your wife."

Got it.

This encouraged me to read more of the printed instructions for AndroGel because they were starting out so darned good. I was not disappointed. I also read, for example, it is not a good idea to apply AndroGel "directly to the scrotum." I was not going to do this, and I must say the thought never occurred to me. But I assume the determination of some patients to get back on track knows no bounds.

Also (I read with increasing interest) AndroGel is flammable. Staying away from open flames is "recommended." Reading back to the earlier paragraph about where NOT to apply the gel, I wonder if some unfortunate soul did the unthinkable once and—in a bedroom full of romantically lit candles—he ironically made Jerry Lee Lewis's biggest hit ("G. B. of F.!") very relevant all of a sudden.

I have been though enough rehabs (knee surgery, two hernia repairs and now two brain surgeries) to know the value of a slow, measured approach to putting oneself back together, both physically and emotionally -- Do it slowly, do it once, do it right, do it carefully, don't rush it . . . and don't do something stupid like self-immolate.

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