Wednesday, March 05, 2008

What's new, what's old


Hello, again. I've been on hiatus for a while because over the last five months or so, I've either not really had anything interesting to say (often) or I've been too wrapped up in the business at hand to step away from it and blog (much less often).

It won't really take that long to catch up. Since last October, I stopped smoking pot and started baking and eating pot brownies, my dog developed Addison's disease and almost died, we broke a record for total snowfall in a season, and my mother-in-law was diagnosed with, and had surgery for, breast cancer.

What brought me back was this morning's visit to the urologist. Over the last couple years, my bladder symptoms (urgency + frequency) have gotten worse, although it's happened so slowly that it almost hadn't registered. Today, though, the urologist told me that he's pretty much used every pharmaceutical trick in his bag and doesn't have any new drug options for me. Instead, he said he thinks I'm a good candidate for getting a gizmo called Interstim (a.k.a. "the bladder pacemaker") implanted.

Interstim delivers a contant, mild electric charge to nerves near the base of the spine. What good will that do? The urologist explained that Insterstim fixes bladder function similar to the way a good hard smack fixes an old TV: it's not clear why it works, but it does. Here's how the process goes: First, they would implant the wires in a procedure during which I'd be sedated but awake. There are 4 wires, and they go in near some nerves at the base of the spine. After that, I'd go thru a two-week trial period during which the wires would be connected to a pager-sized control gizmo. The control gizmo can turn each of the four wires on and off independently and, I think, change the polarity of the charge sent to each wire. For two weeks, working with someone at the hospital, I'd go through different settings on the gizmo while keeping a pee-pee diary. After two weeks, they look at the results. If I've gotten at least a 50%benefit from the gizmo, they replace the pager-gizmo with a device that would be permanently implanted under the skin just north of my behind. If I haven't gotten a 50% benefit, the wires come out and I go back to my non-bionic bladder.

Cool, huh? There's a waiting list right now, so I wouldn't be able to get hooked up until July, but I told them to put my name on the list. The urologist says there's about an 80% chance that I'll see a dramatic improvement and a 20% chance that it won't do a thing for me. There's slightly larger than an Oreo under my skin, but not nearly as much as the Botox injection. And supposedly, my HMO will pay for it with minimal fussing (we'll just see about that).

So now we're all caught up. That wasn't so bad.

2 comments:

Kim said...

Hey! Good to see you back! So... how do you find the pot? Is it helping any MS symptoms for you? You kinda just slipped that news into your posting and curious minds wanna know ;)

Doug Lee-Knowles said...

Pot seems more effective at relieving the neuropathic pain in my legs than anything else I've tried (which includes carbamazepine, neurontin, lyrica, amitryptyline, nortriptyline, imipramine, zonegran and intravenous lidocaine). Actually, in the interest of full medical disclosure, I mentioned to my neurologist at the pain clinic that I was regularly using pot. He offered to write me for Nabilone, a synthetic cannabinoid, but said that I couldn't do both Nabilone and old-fashioned pot. I decided to stick with pot mainly because I wasn't crazy about the idea of always being under the influence of THC and also because my insurer wouldn't pay for Nabilone.

Shortly after that, a study was published suggesting that MS patients that smoke pot had decreased cognitive functioning compared to those that didn't use pot. And while it was a tiny little study, it gave me pause. I don't think anyone who's been a regular pot smoker would deny that it affects their cognition, but I started thinking about how I could reduce whatever risks posed by smoking. I looked into vaporizers, because there was some research suggesting that eliminiting the actual combustion, you greatly reduce your exposure to known nasties. But a good vape is expensive, and I'm not real flush just now. So I tried a brownie recipe I got off the web.

I think brownie therapy is a good fit for me. It's a gentler high, comes on quite gradually, and seems to linger as a pleasant little buzz for hours. Usually, I'll just have a little brownie before bed, so I'm not actually high while I'm awake. It's nice not to be filling the house with stinky smoke. I still take the cymbalta/amitriptylene combination for the pain, but I'd say the brownie therapy has taken my peak pain levels in the afternoon at work from a 7 or 8 down to a 4 or 5.