January 04, 2007

From yesterday's notebook

"I saw Dr IZ the gastroenterologist today and he was okay. He had me weigh myself in private in the examining room then tell him the number (this was after a ten minute discussion of the presenting problem in his office right next door). Then he did a brief exam, told me to dress and meet him back in his office. When I opened the door and rounded the corner to enter the open door of the office, I saw two strange men inside: one in a sweater, sitting at the desk, and the other standing, talking to him. I hesitated. The one seated said, Come in, come in. Or someone did. I didn't actually see either one say the words, I was too busy trying to figure out who they were and panicking about whether I was actually in the right place. One of them, the man seated at the desk, seemed to be Dr Israel, but I didn't recognize him. The absence of a minute or two, and the change of rooms, had made me uncertain that the same person who had done the exam was here now. I had looked at him, had made eye contact. But it seemed to me that this man wore a sweater, and the other did not, and I simply could not tell that the two were the same! I could recognize him from the sweater now, if he wore it. That I remember, a black shawl collar button down. But his face remains a blur, for now at least. It always takes several to many meetings with a person for me to consolidate some sort of memory of them that will withstand changes of place and clothing and remain with me permanently. And if the interactions are only casual, I might not recognize that person out of context ever. Some receptionists I've seen, or suspect I've been seeing for years I still don't recognize, except that I know their names when they introduce themselves on the phone. I wouldn't recognize my dentist anywhere, barely recognize him IN his office, though I've been going to him for at least 8 years. THe hygienist I used to see, who just left, I have no inkling as to who she was or what she looked like, and I never was sure if I saw the same one each time, though apparently I did. There is one polish assistant I recognize within the office, because she calls me inside each time, and talks with me before the dentist enters. But I would not recognize her out of context. I suspect this is the case for most people but would love to hear from you whether it is or is not. Can you recognize a face after you've seen it once, twice, ten times, or perhaps you never recognize a face...which is more common a phenomenon that you might think. It must run in families, this sort of ability or lack thereof, as I know that my father has a similar difficulty with recognizing faces and even warns new patients that if they see him later on in a different context and say hello, he won't recognize them, though he will of course remember them as patients. He has told me the pithy line in which he encapsulates all this, but I'll be damned if I can remember it now! :)

The same Dr IZ didn't like my weight and weight loss over the year past and went looking for reasons for it, even though I told him it was simply from a lack of appetite and forgetting to eat. He did a number of blood tests, for diseases that are obscure and wholly impossible for me to have, and I told him so and why. But he did them anyway, plus various enzyme deficiency tests etc -- all on two tubes of blood. I only hope it is not extremely expensive as it was totally unnecessary.

I forgot completely to suggest that the Abilify could be taking away my appetite, largely because we didn't discuss the meds at all, not even in the context of my abnormal liver function tests or LFTs, which was rather strange.
I know that the Lyme doc was concerned about my weight in March 2006, after I'd been on Abilify for two and a half months, and that when I started it in January I noticed that along with helping me write write write, it seemed to curb, even obliterate my appetite. But my appetite had been getting less and less anyway for months, so the Abilify just put the final cap on it.

(An aside: Odd the effect that different atypical anti-psychotic drugs have on me, when they work. Zyprexa, while the drug from hell in certain ways, lets me read with enormous pleasure, concentration and understanding, but only while actively taking the drug. Once I stop it, my ability to read diminishes gradually as the drug gradually disappears from my system. Nothing, not even Ritalin for my narcolepsy, has ever given me what Zyprexa did in terms of sustained interest and moptivation, memory, and enthusiasm for learning. With one 10 mg dose, or less, 2-5mg if on Luvox which magnifies the effect, it all becomes passing easy. I'll bet even a PRN dose of Zyprexa would work, and be effective, but I doubt anyone would prescribe such a powerful and dangerous drug PRN! Now on Abilify the writing is easy, but reading is a big problem, and much harder to do: I can put out written inforamtion but can't take it in very effectively, though I do force myself to slog through as much reading as I can. It's a pity that I must force myself though. Reading shouldn't be a labor, it should be a labor of love!)

Back to appetite: I don't find food particularly distasteful. I just don't feel any urge to eat it, or any need to. I don't feel any hunger pangs or any signals at all to remind me that I need to eat. Yesterday is a case in point: I had prepared a meal, small but nutritious and hot, for myself and put it on the table, then went back to the fridge for something to drink. I got a can of selzer and took it recliner and sat down, preparing to start writing emails, completely forgetting that I had just made myself supper and was supposed to eat. That's the sort of ridiculous thing I mean. I did remember when something made me turn to see the plate on the table, but it was a close call! So even when I remember it is meal time, I can forget to eat what I make myself.

I had the liver ultrasound today. The technician, when I asked if everything looked normal, said she was seeing "some things," which might have "been there a long time or not." She was taking pictures of them for the person who reads the sonograms. I dunno what she was talking about. She wouldn't explain any further either, not to say it was fat or that it might have been anything else. Probably fat, my guess is. Since that's what everyone seems to expect. What that means, I don't know. But my impression is that it's nothing to be upset or even worry about.

Joe's car is on its last legs, so he's thinking about getting a wheelchair accessible van. This is well before he needs it, while he is still able to drive but as he in the market for another car, it makes sense to buy it now than buy a car and have to buy a van in a year or two. It also makes sense because once he needs it, and is unable to drive or otherwise get around on his feet, he'll be housebound until his wheels are available, which could take months, depending on what he gets and what he needs to have done to it. It's not all that pleasant a thought, his getting a van, on the one hand, because of what it means. On the other hand, Joe has ALWAYS wanted to have a van, and now he finally has an excuse to get one.

Welp, enough of this for now, I forgot breakfast and only had a little yogurt for lunch, and though I had supper, it was not enough to make up for the deficit, so I'd better go find something to eat now, before I have to go to bed on too few calories yet again. Hope I haven't made too many typos as I haven't proof read this time.

Posted by pamwagg at January 4, 2007 08:13 PM


Pam, I am afraid that I don't recognize people either, not till I have seen them and talked with them several times. Once or twice is not enough, unless there is something very remarkable about their appearance. It's downright embarrassing, as people whom I do not recognize seem to have no difficulty whatever in recognizing me; I am forever being pleasantly and familiarly greeted by people whom I struggle to place. I have noticed--at least, I tell myself that this is true--that introverts seem to have more trouble with facial recognition than extroverts.


Posted by: Cynthia at January 5, 2007 09:40 PM

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