DrPH News

On Wednesday, I officially got news that my application for the DrPH programme for which I had applied was rejected. I think it was nice of them to let me know a full 34 days before classes were to have started. But the chair of the programme did handwrite a note of the bottom of the form rejection letter that reads "please call me if you'd like to discuss," and a neighbour of mine who's a professor told me this is a VERY encouraging sign.

Thank you to those of you who supported me through the roller-coaster of emotions this summer while I waited.

And now that I know that I won't be attending school, I'll start the job search in earnest. I had been hesitant to do so because I didn't want to start a job only to tell them that I had to leave because I found out that I was beginning school. And then, a few years later, have a bad reputation in the public health community for having shafted XYZ organisation.

So, now that my days are unscheduled for the next however long, I have contacted Michael Waltrip Racing (you may remember that I won a RaceDay Experience when I was in North Carolina) to claim tickets to the Dover race. Mom is going to fly out here, and we will go to that race together. Then we will fly to Kansas City together to attend the Kansas race together (those races are back-to-back weekends.

It's been a banner year: I lost a job, lost Oscar, got rejected from a school, and for those of you especially close to me, you know about The Big Drama going on this week that I won't be blogging about for matters of personal security.

Bidding Adieu to Kristi

In 2001, I went to an event at the Asian Arts Initiative. At this event, I met a woman whose name I no longer remember. One thing led to another, and this woman eventually asked me if I might be interested in being interviewed by this woman doing her dissertation on Korean-American adoptees and transnational/transractial adoption issues. Sure, why not.

That researcher was Kristi. She called me, we set up an interview. She was nice and interesting. It wasn't one of those "add water, instant friendship" kind of things. But over time, we forged a friendship. I became more involved in her research - sitting through mind-numbing adoption meetings with her, watching videos, and reading adoption propaganda. I went to her dissertation defence. She came to my thesis defence.

She told me just how wrong a certain guy was for me. I avoided her for awhile after that because nobody asked her. And, of course, she was right. I'm comfortable spilling my business on my blog, but not hers, so I'll just say that throughout the years we've talked a LOT about relationships, parenting, politics, careers, feminism, and the intersections of all of those.

Today, we met for about an hour a few hours before she had to be at the airport. Her older daughter Nina was with her, but her younger daughter Iris was getting in some time with her friend. (Kristi's partner Tom is already in Charleston in their new house.) While Kristi and I talked, I let Nina play games on my BlackBerry. "Min, can I play THIS one? How about THIS one? These all CAME on your phone????" Kristi looked at me and said, "See, THIS is why girls need more than one mom in their lives - for the games on their phones."

I'll miss Kristi. She's one of those people who will tell you what you need to hear, whether it's what you WANT to hear. If I'm ever fortunate enough to be a parent, she's the kind of parent I'd want to be - a very "it takes a village" kind of mentality. Her relationship with her partner is one I greatly admire. They take time for themselves, even though they have two daughters who are both active with extra-curriculars. They don't really have "his" friends and "her" friends. They know they don't have a perfect relationship, and they don't pretend to. So they - gasp - communicate with each other about issues.

It's easy to say these days that you'll still keep in touch - email, IM, text, Skype, etc. But she starts her new job (she's a professor) next week, and she'll be getting Nina and Iris settled in their school, helping them meet new friends, hell - she'll need new friends, too! And all of that just isn't the same as dropping in to see the new artwork that the girls have hung on the walls of their art studio, going to their School of Rock concerts, or guest speaking at Kristi's classes.

I didn't take my camera with me today, but here's a picture of Kristi and me from a few years ago, on the day I graduated from Drexel with my MPH. Good luck in Charleston, Kristi!

ETA: Original pic deleted when blog was moved.  But here's a pic of Kristi from several years ago.

State of the Min

The Summer of 2010 has been, well, interesting.

I want to thank everyone for being so supportive while I was mourning the loss of The Ocs. Every once in awhile, at the most unexpected times, I get hit with grief. Like when Med Student (who some of you know as Rachel) and I were eating at the local Vietnamese restaurant and she mentioned that she wished she had been able to have gone to free Goo Goo Dolls concert as part of Philadelphia's Welcome America (Fourth of July) celebration. I burst in tears, and she was like, "What happened? What's going on? What just happened?" When I finally stopped crying, I explained that I had also wanted to go, but that was Oscar's last night with us. And we just sat there, in the middle of the restaurant, holding hands for awhile.

Or the other day when I was talking to Ria and I mentioned my cats. And then I realised that I don't have cats, plural, anymore. And then I called my mom and cried.

I believe I emailed everyone who left a message for me on the blog who also left their email address, and I received a lot of messages on Ravelry that I believe I've also returned, as well. When I started modding the Free Pattern Testers group, I never realised that I'd meet such caring people with so many of their own stories to share, too!

I've also got another really frustrating situation going on right now which has my life in extreme limbo. Some of you know about it, especially local friends. But when I have definitive answers and know the implications of what's going on, I'll spill all.

In other news, I had my regular three-month check-in with my doctor last week. I'm still low in Vitamin D, so she switched me from 3,000 IUs a day to 50,000 IUs a week. And since I've been having very minor right upper-quadrant pain again (very similar to what I was having two years ago when the gall-bladder in-and-out of the hospital fiasco began), she did a bunch of blood tests and gave me an ultrasound order in case the pain gets worse, and I can decide whether I want to go in for the test. If the pain continues, I can make an appointment with my GI specialist, and I'll have the baseline pancreatic enzyme levels and U/S results for him to see.

She's also sending me to an orthopaedic specialist for my torn hip cartilage to get a second opinion since neither of us are particularly pleased with the progress I've been making with the PM&R guy I've been seeing. But first I need to see him one more time to get my MRI results back, my records, etc. And of course, he's on vacation for the next two weeks. Yay.

And the latest (which I made some vague references to on Twitter): Those of you who have ever tried to hang out with me in the summer know I'm terrified of hanging out outdoors. It's not that I'm not an outdoors person - it's that I'm allergic to pretty much every bug ever. If a bug looks at me, I'll get a huge-ass welt that will itch until forever. This past Saturday afternoon, I had what I thought was a bug bite kind of between my breast and my underarm. So I did the usual - took an Allegra (an oral antihistamine) and treated topically with Benadryl cream (also an antihistamine). But still I itched... and itched... and itched.

Until Saturday night around 11:00 p.m. when I called Mom pretty freaked out. My entire underarm area, going up to part of my triceps area was covered in what looked like tiny bug bites. Now, usually if I've just scratched a single bug bite a lot, I'll break out in hives, but my hives will be really large, and I know what they look like. And when I take an Allegra and slather on the Benadryl, it'll take the hives. But I'd been doing that all night, to no avail. So I was pretty freaked out. Mom and I went through all the usual suspects - no new foods, no new clothes, I had gone tromping through the woods, etc.

Sunday morning, when I woke up, the area hadn't spread, but it now looked like one huge rash (and when I say huge, I mean it - but I'll get to that in a minute). Instead of tiny bites, it looked as if my cat Felix had taken a fire engine red paint can and spilled it on me overnight. I blame Ria. She's the only person I know who has regular access to paint cans.

To make a long story short (or is it too late?), I spent the weekend not sleeping from the discomfort. I was very tempted to go to the ER - not because I thought my life was in danger, but I was simply that uncomfortable and unable to sleep. But my ER copay is $75 and a doctor visit only costs $10. And it being the weekend, I knew I'd have to sit for hours to see someone in the ER when they'd do the same thing the doctor would do. So I continued with the Allegra, Benadryl, and I threw in an ice pack every once in awhile (but since I only have one ice pack, that only worked every few hours).

I finally saw a doctor Monday afternoon. He measured the rash for my chart, and it was an impressive 6" x 8" (told you it was huge). He gave me a steroid taper, which I'm VERY familiar with, as someone with moderate-level asthma. He also told me to switch to hydrocortisone cream instead of Benadryl (or to alternate) since the Benadryl wasn't being effective for me. And to continue with the ice pack. I told him the biggest problem was just that I was "very uncomfortable," and he laughed a bit wryly and said, "I would imagine, from how red and how large that is, that would be the understatement of the year, my dear."

It's getting a little better every day, but that could just be because Fe got some paint eraser from Ria. I'm not sure. Mostly I'm happy that I can read and knit again. Not being able to use my right arm at all for those few days was a killer. While I'm ambidextrous and could use my left hand to eat and write, not being able to use my arm was interesting. (I had to keep it still because if I held it down, the affected upper arm area rubbed against the underarm area, which hurt. And if I held it out even a little, the skin pulled and stretched, which also hurt.)

So... that's my summer so far. Yay!

In the words of Daria, "Is it fall yet?"

In Memoriam: Oscar

19 February 1996 - 05 July 2010

Last Tuesday, Oscar and I went to the vet, got some steroids, and hoped that he'd start doing better. On Wednesday, we heard that his thyroid levels were too low, adjusted his meds accordingly, and hoped for the best. But he was already doing better, despite refusing the meds. Having been a social worker for "the aging" (aka: old people), I was aware that sometimes sick people (and animals) perk up for a bit right before they die. So even though Ocs started to ambulate better and even though he joined me for a shower, I was afraid to hope. But by Saturday night when he full-out JUMPED onto the love seat, my heart soared. I hugged him tight to my chest, told him I'd missed him, and welcomed him back. Little did I know.

When he woke up Sunday, he stumbled all the way down the hall, ending his trek by falling in the living room. Throughout the day, he got progressively worse. He had a bad fall in the litter box, in which he managed to flip himself over and ended up doing a face-plant in the litter. By the end of the day, he would only eat if I spoon-fed him baby food, and he would drink only if I brought a water bowl to him, and then he drank by putting the right half of his face in the bowl and drank sideways out of his mouth. He was non-responsive to pets or his name being called, and he was unable to walk or even stand by nighttime.

I called Dr. Kurpel first thing Monday morning, and described my boy's personality and symptoms. She said if I felt like it was time to say good-bye, bring him on in, and if she agreed, we could either do it today when I brought him in, or I could take him home to prepare myself and bring him back when I was ready. She then offered to transfer me back to the front desk to make the appointment, or said I could call back when I was ready. I decided I was ready to make the appointment then. I made the appointment for 3:40 p.m. Then I called Naomi and it was decided that she and Anju would accompany me to the vet's office. I asked Naomi to call the vet and get permission for me to bring Ocs in wrapped in his favourite blanket (a NASCAR blanket I won at Kansas Speedway two years ago). First, he couldn't stand or walk, so he wasn't going anywhere. Second, I couldn't bear the thought of leaving with an empty cat crate. They said it was fine.

Jill came over and got some pictures of Oscar. As Jill said, they probably won't capture the spirti of the Ocs, but at least I'll some more pics. We put him on his window perch, and hoped for the best. If any of them come out decent, I'll share them. Then Fe decided he needed to ham it up for the camera, so Jill got some pretty good pics of him, too. I tried to get some food into Ocs, but he refused food all day. Later, when Oscar and I left, I asked Felix if he wanted to tell Oscar good-bye, and I swear to God (and Naomi can verify this), Felix ran over to Oscar and they rubbed noses. No one will EVER be able to convince me that didn't mean something.

When we got to the vet's office, I made eye contact with Zoe (the ever-so-wonderful front desk woman), and I burst into tears. Zoe immediately grabbed a waiting room chair and said, "C'mon, let's get you into an exam room where you can sit down and be with him." Anju and Naomi came in with me, and I let Ocs lie on the exam table on his blanket. Dr. Kurpel saw him, and didn't even bother with all of the normal vitals. She saw him lying there, only his tail flicking back and forth occasionally, and I told her how the last 36 hours had been. She noted that when he comes in, he's usually pretty relaxed, but he was way beyond that. I replied that the only movement from him had been the tail. She said that, unlike with dogs, when cats flick their tails, it's a sign of UNhappiness - in Oscar's case, most likely pain or discomfort. Oh. Why did I feel instantly guilty?

A couple of times, while we were discussing some minor doubts that I had (He was like this last Monday, then he had five good days. What if we don't do this today and he's scheduled for another week of good days?), he tried to lift his head and just couldn't. At one point, he let out a strangled howl. She later told me that cats really only do that when it's their time to go. Their voice changes and gets deep, and it's a voice you only hear when they're about to go. And she said it was when she heard that that she knew it was his time.


She said that if I was still feeling like it was time to say good-bye to him, she completely supported that decision. I said I did feel that way, and I wanted to go ahead and do it today. She explained the procedure, and asked if I wanted to be with him for it. I told her that Oscar had been with me for everything, and I wasn't leaving him now. She asked me if I wanted some more time alone with him before she started, and I said it was okay - I'd been preparing since last week, really. Although she had explained the procedure before, she thoughtfully explained every step again as she did it. After a few minutes, she came back and gave Oscar the first shot to sedate him. She said she'd be back in a few minutes to check on him. At this point, I asked Naomi and Anju to say their good-byes to Oscar, as I wanted to be alone with him in his final moments.

Dr. Kurpel came back in after a few minutes, and started to insert the IV in Oscar's leg, but he wasn't sedated enough. So she gave him another shot, and we waited another few minutes. Finally, it was time. She gave him the IV drugs, and as soon as it was injected, she used her stethoscope to check his heart, nodded, looked at me, and whispered, "He's gone." She said I could stay in the room as long as I wanted to, she could bring my friends back if I wanted to, she gave me some materials on pet bereavement, and she told me I could call her anytime to talk if I needed to.

Then Dr. Kurpel and I had an impromptu little eulogy-esque type of thing for the Ocs. She said that cats sometimes put on a persona when they come in, but she could tell that Oscar was just Oscar - that he was really sweet and charismatic. And she always told him how handsome he was. I told her about the time that Oscar "buried" a dead bird under Mom's couch, and we only found it after we went looking for the thing that had made the house smell REALLY bad for three days. And how he planted his nose right in my ear at night so all I heard was his rather loud purr. And how he takes showers with me, and now showers will never be the same without him.

Before I left, I talked to Dr. Kurpel about Felix. See, Fe and Ocs were best buds. The very first night they were introduced, they were playing together. They actually woke me up that first night, and I thought they were fighting, but they were playing. And they've been pretty inseparable since; they groom each other, they play together, and they sleep together. So I'm worried about how Felix will react to not having his buddy around. She told me to watch his appetite and make sure he's eating. See if he starts hiding out. Monitor changes in behaviour. She said sometimes the surviving cat will take on the traits of the cat who passed. But, either way, just pay a little extra attention to him in the coming days, and call her if I have questions or concerns about the little guy.

We also talked a little bit about how confused I was about how Oscar went downhill so fast, then made this recovery for five days, then took a VERY sudden turn for the worse. She said that cats are especially good at masking pain and discomfort. But seeing at how quickly and aggressively this thing attacked Oscar, her best guess is that he had either a tumour or a cancer of some kind - that it went WAY beyond the thyroid issue, and anything I could have picked up on just from observing him at home. I just shook my head and sighed. Then she repeated her offer to call her anytime to talk to her if I needed to.

Once again, thank you for all of the support I've received throughout the last few weeks. Thank you for sharing your stories with me. Thank you for making me laugh, for the hugs, and most of all... for just listening to me cry on the phone (you know who you are).

Oscar's Vet Visit

As you know, Oscar and I had an appointment with Dr. Kurpel this morning. Last night, I had tucked Ocs in next to me, growing increasingly worried at his glassy, half-closed eyes. He was showing no interest in food or water, and I was pretty sure I knew how the conversation with Dr. Kurpel was going to go. I woke up nearly every hour, and I finally woke up just a few minutes before my alarm was set to go off, and started about my day.

To my surprise, Oscar joined me in the bathroom as I was getting ready to go. He had gotten off the bed by himself and walked down the hall into the bathroom. Now, as background, he almost always comes into the bathroom whenever I'm in there (typical cat - he must know what's going on at all times), but for the past couple of weeks, he's had no interest in anything going on. So this was two good signs - ambulating on his own accord and showing interest in old "hobbies." Then he wandered into the kitchen for some water. Then the trouble started. He tripped over the bathroom scale in the hallway. He stumbled in the living room. After he drank some water, he couldn't turn around (whether from sheer exhaustion or inability to manoeuvre, I don't know), so he just laid down in front of the water (which had the bonus of pissing Felix off). But his eyes were no longer glassy - they were wide and alert. He was holding his head up better (although it was still shaky), and he seemed generally perked up.

So, to the vet we went. And, this is when I want to sing the praises (not literally, because that would offensive to your ears) of Naomi who graciously put her day on hold to accompany Ocs and me to the vet today.

Dr. Kurpel checked out his vitals and checked his leg reflexes. She also watched him walk a little bit. He still stumbles when he walks, and he often splays his hind legs out, as if he can't hold them under him properly. She also noticed the same thing that I had with regard to his front leg also starting to get a little wonky. His right front leg is showing some weakness (but I'm wondering if that's because he's using his front legs to compensate for his hind legs), and he's been crossing his front legs when he walks. We discussed next steps. The options she laid out were to go see a neurologist, who she said probably wouldn't be able to tell a whole lot without doing testing such as MRIs, CAT scans, etc., which would involve sedation (read: much expense). And, of course, that would lead to findings, which would lead to, "So, here's what we can do about that." Which leads to more decisions, more procedures, etc. So, basically, it's a whole path I'd be taking Ocs down.

I told her that I'd given it a LOT of thought last night, discussed it with Wise Women (read: Mom and Ria) and decided that it just didn't make sense for a 14-year-old cat who has lived a long, full life and already has chronic health issues (thyroid disease and suspected arthritis). Plus, as Naomi mentioned, with an older cat, the anaesthesia alone is already an increased risk. And, as we all know, with an animal, you can't just explain to them that they're being poked and prodded for a reason and it's all to make them feel better. So, with all of that in mind, I felt pretty strongly against the neuro option.

She said she thought that actually made a lot of sense, and that she would make the same decision for her cat at home, given the circumstances. I felt SO relieved. I said, "Oh good! I was so worried I would leave and you'd talk about me to the other people here, like 'Man, I thought she was worried about her cat!'" She said, "Uh, you've MET me, right?" She said that she'd just told me about the neurologists at Penn because it's her responsibility to tell me about all of my options and let me make an informed decision. So, on to Option #2.

So said Ocs might have some kind of inflammation that could be causing all of this, so we could try a oral steroids. We discussed what the possible side effects of the steroids are, what could happen if we just do nothing, if the goal here is that the steroids help him or just make him not get worse (we're hoping for the former, but we'll settle for the latter), etc. If the steroids work, this will be another medication that he'll be on chronically. If not, we'll need to figure out what to do next.

She and I discussed quality of life indicators. Today, things for him are good. But yesterday and Sunday, they definitely weren't. (Oh, and I learned that purring doesn't equate contentedness. Sometimes, a purr can be a "pain purr.") The plan for now is that I will check in with Dr. Kurpel on Saturday, but sooner than that if Oscar takes a bad turn again.

Once again, I can't thank everyone enough for all the hugs, prayers, and thoughts you've sent our way. It means so much to me that you've been supporting Oscar, Felix, and me through all of this.

Oscar Update, Part II

I just called the vet and spoke to her because despite what seemed like some good signs yesterday, Oscar was showing some not-so-good signs today. First the good news: I did NOT have to make A Big Decision today.

Now, the rest of the update:

Yesterday, we walked through the house (largely unprompted) - still swaying and stumbling, but not as much - and then used the litter box all by himself. This seemed encouraging as I had been having to helping in and out of the box.

Then, this morning, he fell getting into his box. And he stayed in his splayed out position until I ran across the room to help him. After that, he has pretty much refused to try to walk at all. At one point, I got him off the of bed and put him on the floor to try to get him to drink some water, and he wouldn't even try to stand up; he just immediately laid down. I picked him up again, and, again, he made no effort to try to find his footing. The third time, he tried and stood for a few seconds until his legs started to give, then laid back down. Okay, fine, message delivered. I brought the water bowl to him.

I also noticed today that one of his front legs seems like it is also starting to act a little gimpy, which is troublesome. This is what prompted the phone call to Dr. Kurpel. I don't like new symptoms! When she called, she asked how I was, I said I was fine; I asked how she was, and she said she was good. Then she asked how Oscar was doing, which is when I just burst into tears. I said, "I actually don't know, which is why I'm calling you." I explained that it seemed like he was doing worse, then better, and now worse again.

We talked about his symptoms, including his ever-increasing lethargy, and she suggested that I see a neurologist at Penn's Vet School, if I thought he was stable. If not, I should take him to the ER. A third option was that I could bring him back there and she could do a regular exam to make sure that everything that she could check was fine, as far as heart rate, lungs, blood pressure, temperature, etc. If anything there was funky, that would at least save me a trip to a specialist. I decided to do that first thing in the morning, and we'll discuss options from there.

I'm hesitant about going the specialist route since - honestly (and not to be mean, but...) I don't have a lot of money. I'm unemployed right now, and we're talking about a 14-year-old cat. A 14-year-old cat who I love dearly, but who already has thyroid disease. So I also want to talk to Dr. Kurpel about what kinds of things, in her non-specialist opinion, does she think we could be talking about.

I also want to thank everyone who has been really supportive to Oscar, Felix, and me throughout the past several days.

Oscar Update

Those of you who follow me on Twitter know that Oscar has been ill again.

We went to see the wonderfully awesome Dr. Kurpel on Wednesday because I noticed several days ago that Oscar was having some problems ambulating - he wasn't able to jump up onto the love seat, and was actually having to crawl onto it. I had also taken note that Ocs had missed the last several showers with me, which is not at all like him. In fact, when I can't find him, I'll just start the shower water running, and he'll come running (it's a handy trick). He seemed generally lethargic, but I had written that off to the hot weather; I mean, I wasn't really going out of my way to run up and down the hallway, either, you know? But when he started stumbling around my apartment like a drunken sailor, it was time to call the vet.

And they said, "Bring him in TODAY." Okey doke.

I took him in later that afternoon and Dr. Kurpel said she didn't think it was a stroke (because I didn't report Ocs seeming disoriented or tilting his head a lot), but she did suspect a vascular event of some sort. She said it can be a side effect of the thyroid medication that Oscar is on for blood clots to form, and if he has a blood clot, it could be making its way through his spinal cord. And if it is a blood clot, it should make its way through his system and clear up. She said that has seen cats before brought in with complete hind leg paralysis due to the thyroid meds, and she said that once it gets to that point, that only thing that can be done is to put the cats to sleep. I asked her what kinds of warning signs to look for, and she said not to worry, because if that was going to happen to Oscar, it would have already happened. Whew.

HOWEVER, if Oscar isn't ambulating well in the next few days, pretty much the only other thing to do would be MRIs and CAT scans to look for brain lesions and spinal cord lesions, which would run over a thousand dollars. She thoughtfully remembered that I was unemployed the last time we met and asked if I was working yet. I told her no. She was very honest in telling me that even if we did those tests and found something, there's only so much that could be done and even THEN, there would have to be discussions about the likelihood of success of those surgeries, quality of life after, etc.

While we were there, we did his routine thyroid blood draw, which includes kidney and liver function tests. She also checked his blood pressure and did a blood sugar test to check for diabetes. Sugars and blood pressure were great. She called me the next day to let me know that everything with his kidneys and liver looked great, and his white cell count was SLIGHTLY elevated, but it was so slight that she wasn't worried about it. However, his thyroid level is now too low (he's been too high all this time). She said she's seen it happen before in one cat that she treated where the hind legs get locked up due to hypothyroidism, so that could also be contributing to the problem. So we adjusted the meds that day. I'm to call her early next week (which is now in just a few days), and let her know if Ocs is doing any better. From there, we'll make any decisions we need to make. *gulp*

Yesterday... was not good. Oscar was unable to sit properly to eat or drink. After he ate a little, he tried to walk about five feet and fell over. I burst into tears and went over to pet him, only to find that he was purring away - at least one of us was happy. Last night, I moved the food and water into my bedroom (where the litter boxes are) so Ocs wouldn't have to leave.

Mostly, I'm spending a lot of time this weekend holding and petting Oscar - hoping for the best, steeling myself for the worst.

In the meantime, enjoy this picture Oscar making himself comfortable with my friend Rachel (who Ria knows better as Med Student):