Take a look...

It's been ages since I've posted - lost of personal stuff I can't really talk about here.  However, I wanted to take a moment to share this.



At the time of this writing, it's actually at $1,996,595USD raised of $2,100,000 goal, 95% and 5 days left.  They are so close to raising the funding to tell the story the media has ignored.  Even pro-choicers should be clamouring to put an end to stuff like this (and Gosnell is by no means an outlier) and get this story told, if they truly believe in women's health and safety.

My budget is tight, but I just made a second $25 donation today, but donations as small as $1 can be made.  Every penny counts!  Please click on the graphic above and donate whatever you can afford.


Thank you.

6.5 million People and 30 years; Traditional Marriage is Still Tops

NOMblog: New Danish Study of 6.5 Million: Health Benefits of Marriage are Unique to Male-Female Unions

During 2000 to 2011, Danish male-female married couples were the healthiest and least likely to die at various ages compared with individuals who were unmarried, divorced or widowed. In contrast, same-sex married men in Denmark were no healthier than unmarried men. Same-sex married women had much higher mortality rates than other women, including the ones who were unmarried, divorced or widowed. There was no apparent marriage “benefit” in terms of better health or longer life for these same-sex married women.

I find it curious that, in so many studies, outcomes are so much worse for lesbian couples than any other group, except possibly single mothers.

A Response to Why are Feminists So Angry?

or You just don't get it, do you?

Someone I know shared a link to a column on a website I've never heard of before.  Why Are Feminists So Angry is a transcript of the embedded video by Jessica Valenti . 

Here is my response to various points in the piece.

She begins by addressing the contents of a protester's sign; a comment I've seen fairly often, in one variation or another.  It reads "I can not believe I still have to protest this shit." 

By "this shit," the protester is apparently shocked that there are still people who have problems with this issue of abortion.  My answer to that would be, "I still cannot believe that, with all the evidence of medical technology, people still pretend that abortion is anything other than the killing of a human being."  It could also be, "I still cannot believe that, after 4 decades, we commit infanticide on a massive scale."  I could come up with quite a few other responses, but I'll leave it at that, for now.

She then goes on to talk about getting an email asking her, "why are feminists so angry?"  She begins with, "It’s not that I’m angry. I’m exhausted. The war on reproductive health and autonomy feels absolutely never-ending."

 Let me explain something to you, Ms. Valenti. 

There is no war on reproductive health and autonomy.

This may be difficult for you and other activists to understand, but that's because you've framed the narrative as being about things like "choice" and "reproductive rights" and other such claptrap.  Let me say this again.

There is no war on reproductive health and autonomy.

There is, however, a war against so-called feminists that are just activists who claim to speak on behalf of all women.  There is a war against the campaign of misinformation, indoctrination and destruction against women.  Yes, Ms. Valenti.  You see, more and more women are recognising that, hidden behind such euphemisms as "choice", thousands of women are having their reproductive health damaged, sometimes permanently.  More and more women are recognising that, when it comes to "pro-choice" activists such as yourself, women are being denied the information they need to give informed consent to an invasive, damaging and dangerous surgical procedure.

How ironic that Ms. Valenti laments that states are trying to implement laws requiring women get "transvaginal ultrasounds for women seeking abortions."  Now, I don't know that these proposed laws specify transvaginal ultrasounds, or just ultrasounds in general.  I think activists just as Ms. Valenti just love the idea of waving around (metaphorically or otherwise) a rather large wand to show just how invasive such a procedure is.  I happen to know exactly how invasive such an ultrasound it.  I've had one.  It was done to try and find the cause of the pain that sent me to the emergency room.  In the end, it didn't do that job - the giant cyst that decided to do the twist with my innards was found using external ultrasound. 

In other words, ultrasounds, transvaginal or otherwise, are a normal tool in health care.  When it comes to abortions, ultrasounds are used to guide the abortionist to the fetus, so that when he (or she, but female abortionists seem to be in the minority) inserts the vacuum, he can watch on the screen as he suctions the bits and pieces out.

What self-identifying feminists like Ms. Valenti neglect to mention is that abortion itself is an extremely invasive procedure, and ultrasounds are already used to do them.  What Ms. Valenti and her fellows are objecting to is the patient - the mother - seeing the images.  She wants to prevent women from being informed as to what is actually in their uterus before they expunge it. 

She wants to deny women the information needed to give truly informed consent.

Yet Ms. Valenti and her peers claim it is those who are proposing these laws that are somehow against reproductive health.

Ms. Valenti then says, "I’m exhausted thinking about the fact that I’m still fighting a battle that my mother marched for."

To which I find myself wondering; if Ms. Valenti's mother had access to the information we now have about the grown and development of the human conceptum, would she still have marched for its destruction?

Lucky for Ms. Valenti, her mother didn't take advantage of her "rights" while pregnant with her.

Ms. Valenti goes on to say, "One provision in Arizona allows doctors to withhold medical information from a woman about her pregnancy if they think it might compel her to get an abortion. So if your pregnancy is in danger, if your fetus has an abnormality—a doctor could keep you in the dark and that would be absolutely legal."

How curious that, right ofter claiming her shock that doctors might have to provide women with information gained from an ultrasound, she's how shocked that doctors might withhold information?  One again, Ms. Valenti neglect to inform, herself. 

Just what medical information is there that a doctor might withhold in the belief that, given that information, "it might compel her to get an abortion."  Certainly not information that would actually endanger her life.  Do you know, Ms. Valenti, what sort of information that might be?  I can think of one in particular: gender.  Sex selective abortion is on the rise, with perfectly healthy and normally developing fetuses are aborted because of their gender.  Take a guess which gender is most likely to get aborted?  Why, female ones, it turns out.  There is, in fact, a rising gendercide happening around the world, with increasing numbers in Canada and the US.  How does a self-proclaimed feminist get around the fact that being female is a such a death sentence? 

As for "an abnormality," this is another issue entirely.  Eugenics.  Pro-choice advocates seem to be claiming some sort of moral high ground when they promote aborting fetuses that are "abnormal."  Downs Syndrome babies are the ones at greatest risk, but all developing children who are less than perfect are at risk.  Do "feminists" such as Ms. Valenti truly believe that the disabled are unworthy of life?  How do these pro-choices feel about cases where parents have chosen to abort children over such minor deformities such as club feet or, in one Canadian case involving a late-term abortion (and IVF pregnancy, no less) due to a cleft palate?  Do these feminists truly believe that only perfect babies should be allowed to be born?  Considering the attacks on Sarah Palin for not aborting her son with Downs Syndrome, just as one prominent example, it seems to me that the answer is yes.

What else shocks Ms. Valenti?  How about this.  "I’m shocked that when Ohio tried to pass their anti-choice heartbeat bill that would outlaw abortions as early as six weeks, they had a fetus “testify” by giving pregnant woman an ultrasound in front of the House. The pregnant woman didn’t speak, appropriately enough—only her fetus was allowed to make an appearance."

Yes, heaven forbid we use actual science and medical technology to make such a monumental decision.  How else is a fetus to "testify" as to its humanity?  And in mentioning that the mother didn't speak, does Ms. Valenti think that she was somehow forced to be there, against her will?  Did it not occur to Ms. Valenti that the mother was there precisely because she *wanted* her child to be given that voice activists such as Ms. Valenti would deny it?

Curious that Ms. Valenti frames this bill as being "anti-choice," while apparently wanting to deny the courts the "choice" of using medical technology to make a decision, or the mother the "choice" of allowing her child to "testify" in court.

What else shocks Ms. Valenti?  This.  "I’m shocked that in one county in North Carolina, the county board of commissioners unanimously voted to turn down a state grant that would cover birth control."

Is it really necessary to point out the no one is preventing women from getting birth control?  They voted to not pay for it with a state grant.  There is no reason for the state to be using taxpayer dollars to pay for something that is not medically necessary.  Is it really necessary, for someone who claims to support reproductive health, to point out that hormonal birth control actually harms women's health (not to mention the environment)?   Hormonal birth control takes a healthy, fertile body and chemically induces infertility.  That is the opposite of health care.  If a women still wants to do it, she can pay for it herself, or she can avail herself of the many places out there that will provide it for free.  For someone who claims to be all about "choice," Ms. Valenti would have choice taken away from taxpayers, many of whom would rather not have to pay for someone else's birth control.  It seems that self-proclaims feminists want to have choices, but want others to be responsible for the costs or consequences.

Ms. Valenti is not just shocked.  She's also sad.  "Sad knowing that the people these laws will affect the most are the ones that need care the most—they’re the most marginalized among us: young people, women of color, low-income women, those that can’t afford to travel across the state or to take days off of work to access care."

No, Ms. Valenti.  They are not being denied access to care. Access to abortion or birth control is not synonymous with medical care. This may come as a surprise to you, but there are a great many clinics out there that will provide women with crisis pregnancies in the US with medical care for free.  They continue to help women who need it after their babies are born, too.  And no, these are not "fake" clinics that "lure" women, as their opponents so shrilly claim.

What else saddens Ms. Valenti? "I’m sad that women’s health and lives have become secondary to their ability to conceive."

Here, Ms. Valenti is once again framing the narrative in a dishonest way.  No, their health and lives are NOT secondary to their ability to conceive.  Pregnancy is not a disease, and our ability to conceive is not a burden.  Self-proclaimed feminists would have women believe that becoming pregnant is the worst thing that can happen to them; that it's a life-destroying event, and that having a child when they're not "ready" is a tragedy.

This particular view is actually quite offensive and degrading.  It basically says that women are physically weak and fragile, and psychologically incapable of raising a child until some magical line is crossed and they are suddenly "ready" to have a child.  It's demeaning and infantilizing.

Ms. Valenti then goes off with some extreme examples and bombastic claims, as if they were at all the norm, making it seem as if the only reason women get abortions at all is for medical need, when the reality is the opposite.  She's sad, she's angry, she's furious. 

The then asks her email writer, "—the real question is not why am I angry; the real question is, why aren’t you?"  Then, after defending the abortion mill, Planned Parenthood, she has the gall to say, "It’s about affirming our basic humanity."

Because, Ms. Valenti, we don't agree with you.  We think you and your fellow "feminists" are the ones who don't get it.  You claim that you do what you do out of love and compassion.  We don't believe you. 

The problem, Ms. Valenti, is that you are denying someone else their basic humanity.  You are denying someone else their body autonomy.  You are denying a developing child it's very life.  The word fetus is not a word used to describe a tumor or a clump of cells.  It's not a word that describes some part of a woman's body.  It's a word the describes a developmental stage of a human being. 

Planned Parenthood, in particular, is not the bastion of kindness and compassion you paint it out to be.  It is an unethical organisation that is responsible for incredible harm to women.  They claim to be about women's health, but are nothing more than an abortion mill. 

Ms. Valenti, you express your exhaustion, shock, sadness and anger that you and other self-proclaimed feminists are still fighting the battle you thought you'd won 40 years ago with Roe vs Wade.  Would it surprise you to know that Roe vs Wade was based on a lie?  That "Roe", Norma McCorvey, was coerced into lying that she was raped?  That she never had an abortion and is now fighting to have the ruling that bears her name overturned?

Ms. Valenti, your cause is based on lie upon lie; that this issue is about "choice."  That it's about "reproductive health."  That it's about "women's rights."

What you and other "feminists" don't seem to get is that people are starting to learn the truth.  They are beginning to realize that the fetus is not irrelevant.  That a woman's "private choice" has very public consequences.  That there is another person involved; a person who has been denied their very humanity in the name of "choice."

Modern medical technology has made it impossible to deny that a human fetus is an individual, separate yet dependant upon its mother.  It is a living being with its own brain waves and its own heart beating its own blood through its own veins.  It reacts to stimuli.  It feels pain. 


Where is your love and compassion, Ms. Valenti, for that other human that's involved when it comes to "choice"? 

At the beginning, you talk about how you can't believe you're still fighting this battle after all these years.

What you're not getting is that you are fighting a battle that's built on illusion.  To frame the battle as being about "reproductive health" and so on is your deception.  The curtain is being pulled back and the truth is being revealed.  The truth of millions of lives, with all their potential, snuffed out.  The truth of millions of women irrevocably harmed by the lie of "choice." 

To be honest, I don't expect you and your type of "feminist" to get it.  You have too much invested in your illusion.  Part of that illusion is that your "side" is the one that's got the best interests of women at heart; that your position is the one that's compassionate and loving, even as it destroys the lives of thousands upon thousands of women. 

Meanwhile, more and more people are getting it.  They are recognising that the real war against women is the one that demeans their intelligence, denies them information, lies to them about the consequences of "choice" and tears into their bodies, their minds and their souls. 

The real war against women is the one you are waging.

So what's the accomplishment?

 I've seen the video at the following link shared by a lot of people on facebook.  Take a moment to watch it at the Do You Even site, then pop back here.

Heart Touching Inspirational Transformation

 Pretty awesome, right?

Except...

*sigh*

Okay.  Let's look at this story for a moment.  Here we have a Gulf War veteran; a former paratrooper with injuries to his back and knees, no longer able to walk unassisted.  He started doing yoga, regains his mobility, and now he can not only walk, but run, again.  That's pretty friggin' amazing!

Oh, wait.  That's not the story we actually got.  Not really.  What we really got was ZOMG!!!1! he got SO FAT!!!!!!!!!!!!!!! and he can't walk anymore.  His stomach was OUT TO HERE!!!!  But he LOST 140lbs in a year and LOOK AT HIM NOW!  He's skinny again!  What an amazing transformation!

(oh, and btw, he can walk and run now)

I realize this is a year's worth of clips put together and necessarily edited, but whoever put the video together had the choice of what to focus on.  There was an incredible story to share.  To go from having to wear back and knees braces, and having to walk with two canes, if walking was possible at all, to being able to throw those away and regain full mobility, thanks to a year of doing yoga, is pretty darn mind boggling.  Only a year!  That's just all kinds of amazing!

So why the focus on his weight?  It's almost as the weight itself was what caused his mobility problem and, thanks to the magic of weight loss, suddenly he's cured!  Even the brief clip of the yoga instructor was curious.  He describes seeing the back brace, the knee braces, the canes, but OH WOW!  He weighed 297 lbs and had a big belly!!!  I have to help this guy!

Wait.  What?

Even when the video does mention the "most important thing", just before showing him walking, then running, towards the camera, it comes across as a side note.  Just a minor benefit of what he REALLY managed to accomplish, which was to get skinny.

Look.  I can completely understand the challenges this man faced.  My own husband has been struggling with a back injury for many years.  (He's due to see a spine specialist in just a few days, where he will be assessed for surgery.)  Among the old injuries that have come back to haunt him are a knee injury in one leg and an ankle injury in the other.  He's in massive amounts of pain, controlled only so far through painkillers and muscle relaxants.  Last year, he actually had fewer days that he made it into the office then the sick days and holiday time he took because he was in too much pain to come in (though some of those days, he was still able to work from home).  Thankfully, he's good at his job and still managed to keep up with his work, and beyond, and his current employers are pretty amazing about accommodating his health problems.
 
And yes, he's gained a lot of weight as well.

Also, he does yoga and/or Tai Chi. Pain prevents him from doing it all the time, but he does try to keep it up as he definitely notices that it helps.  We also got him an exercise machine that he can use without further injuring his back or knees, plus we got him some free weights.  We recently picked up a home gym (small, cheap, but adequate for the job), so more weights have been added to the mix.

It helps.

Most of the time.

Other times, things go south, and he's near immobile for days.  Either his knee gives out or the pain in his back gets out of control.  Sadly, weather plays a big part in this, with sudden temperature changes making things incredibly painful for him.  Temperature changes such as the last few weeks, where we've gone from -44C for weeks to the +3C we're having now.  Such temperature extremes are the norm for winters where we live, and it wreaks havoc on his body.

But he keeps on going.

We know he's a good candidate for a surgical fix on part of his back problems - a herniated disc - and we're hoping the spine clinic will be able to give him more tools to deal with the other issues that are contributing to his pain.

Thankfully, no one has given up on my husband, nor has he given up on himself.

And thankfully, while his weight is brought up as a contributing issue, so far no one has tried to tell him that if he just lost weight, all his problems would go away.  Pretty much everyone has been on top of the fact that the weight he gained has been a consequence of his pain and immobility, not a cause. 

I'm really impressed with what the guy in the video accomplished.  To regain quality of life so dramatically is incredible!

Yet I can't help but shaking my head over the video.  Instead of focusing on the astounding results he got in regaining mobility in just one year by doing yoga, it focuses on how much weight he lost, how quickly he lost it, and how thin he got.

Gaining weight was a side effect of his loss of mobility.  Losing weight was another side effect of his regaining his mobility.

Here's a man whose injuries completely destroyed his quality of life.  Through yoga, he was able to recover that quality of life.

That's an amazing story!

So why did they make something that looked like a weight loss ad?

Court may force disabled Catholic woman to abort her child | LifeSiteNews.com

Court may force disabled Catholic woman to abort her child | LifeSiteNews.com

Todd Akin and Manufactured Controversies

There are two things about the Todd Akin controversy that amazes me.  1) that it happened at all (especially considering the complete lack of controversy over Biden's recent bout of foot-in-mouth-disease) and 2) that it's still going on.

When I first saw the headlines after Akin's interview, I could see right away that there was a case of how not to report the news going on again.  The headlines made it obvious.  Virtually every headline had the words "legitimate rape" in it, in quotes, followed by claims that Akin said women who've been rapes "don't", "won't" or "can't" get pregnant.  A few had some variant of how women can somehow "shut down" their bodies if they're raped to prevent pregnancy.

Of course, with headlines like that, people were in full freakout mode.  I expected that from the political left, of course.  They'll freak out over the most minor of gaffes by those on the political right, while pretending the most heinous comments from their own side never happened, or simply brush them off as irrelevant.  What amazed me is the vicious attacks from those on the political right.  From what I've seen (and I admit, I've missed a lot of it) the attacks on Akin from his fellow conservatives has far exceeded the attacks from his liberal opponents.

The problem is, everyone seems to be freaking out over what they think he said, or some projection of what he apparently meant when he said it.

What was it that he actually said?  Well, see for yourself.



Here's the transcript of his actual words.

Well, you know, people always want to try and make that as one of those things... "Well, how do you slice this particularly tough sort of ethical question?"
It seems to me, first of all, from what I understand from doctors that's really rare. If it's a legitimate rape the female body has ways to try to shut that whole thing down. Let's assume that maybe that didn't work or something. You know, I think there should be some punishment. But the punishment ought to be on the rapist and not attacking the child.

And then all hell broke loose.  But why?  What did he say that was really so wrong or terrible?  Let's look at the key phrases everyone is blowing a gasket over one part at a time.

"...from what I understand from doctors that's really rare."

Okay.  So what's controversial about that?  Pregnancy from rape is rare.  He's not saying it doesn't happen, as so many headlines and commentators have claimed.  He just said that doctors have told him it's rare.  How rare?  Well, that's difficult to say, since rape statistics are understandably questionable in the first place (more on that below).  What percentage of rapes result in pregnancy?  There have been many claims that the pregnancy rate in rape cases is the same as for consensual sex, but I'm not seeing any legitimate data to back those claims up.  Then there's this example.

Pregnancy is rare after a single act of forcible rape. In a prospective study of 4000 rapes in Minnesota, there were no pregnancies. In a retrospective study covering nine years in Chicago, there were no pregnancies. In a prospective study of 117 rapes there were no pregnancies among either the 17 victims who received DES or the 100 who did not.

Eugene F. Diamond, MD

Professor of Pediatrics and Past Chairman of the Department of Pediatrics at Loyola University Stritch School of Medicine

April 11, 1985 issue of the New England Journal of Medicine

Now, that's old data in just one area, but I don't know that women in Minnesota are any more or less fertile then women in other parts of the US, and while the number of reported rapes may have changed, I have not seen anything to suggest the percentage of pregnancies as a result of rape has increased since then.

So basically, then, his first statement - that pregnancy due to rape is rare - is true.  He didn't say it doesn't happen, or that he doesn't believe raped women get pregnant.  Obviously, he knows it happens, and that is reflected in the interview.  Yet if you read only the headlines, you'd think he said that rape due to pregnancy doesn't happen, which is clearly false.

What's the next part?  Ah, yes.  This one.

"If it's a legitimate rape..."

People are just losing their heads over the use of the word "legitimate."  There are all sorts of accusations that he was somehow implying that there's rape, and then there's rape-rape.  Kinda like Whoopi Goldberg.



Now if only people had flipped out over Whoopi's comments the way they are now over Akin's comments, because hers were far more condescending and insulting to rape victims!

What confuses me is how anyone could have any confusion about the use of the word "legitimate."  To be honest, I think Akin's detractors know full well what he was talking about, but it's far more satisfying to get all offended and pretend he was saying something else.  It fits into the "Republican War on Women" narrative so much better.

For those who still refuse to see the obvious, he's talking about ... well, legitimate cases of rape vs things like false accusations or false claims of rape. 

Here is where things get muddy.  Rape statistics are unclear at the best of times.  Part of the problem is that there is an unknown number of women who never report their rapes, or report them years after the event.  It's said that 1 in 4 women will be sexually assaulted (all types of sexual assault, not only rape) in their life time, which is meaningless, since it's a prediction.  Then there's the problem of false rape reports.  Again, it's hard to know how many false rape claims there are.  On one end of the spectrum, it's claimed that only 2 percent of reported rapes are false (which is higher then the percentage of abortions due to rape).  Yet a US Dept of Justice report from 1996 found that about 25-26% of rape cases were proven to be false!

So here we have a problem of there being an unknown number of unreported rape cases, coupled with what may be as much as 25% of reported rapes being proven false (some have claimed that number is actually as high as 51%, but I don't find it reliable).  It's entirely possible the unreported vs false accusations cancel each other out, but there's no way to know.

To further mess up the numbers, there's also statutory rape, which can include consensual sex as well as forcible or coercive rape.

In other words, when it comes to rape statistics, we really do need to know what is, or isn't, "legitimate" rape!

In context of the interview, this sort of thing was obviously what he was referring to.  The headlines would have us believe he was somehow claiming that rape victims weren't really raped, or somehow making light of the seriousness of the crime committed against rape victims.  Personally, I think that's a stretch.  It does make me wonder, though.  Just how could he have been more clear?  Some have suggested that he should have just said "rape" without any qualifiers, but in context of the interview, that would have actually made his statement worse.  So what would be a more appropriate word to us?  Real?  Authentic?  True?  Actual?  I can think of a lot of potential adjectives, but they all end up making his statement sound worse, too.

Which leaves us back with the word "legitimate."  Personally, I can't think of a better, less offensive, way to differentiate between actual rape events and false claims. 

Which leads us now to the next part that has people's heads spinning.

"... the female body has ways to try to shut that whole thing down."

Wow, have the responses been over the top to this part!  Akin is accused of all sorts of things, from being stupid, unscientific, and crazy, to associating him with Nazi experiments and linking him to some bizarre claim from the past that "spastic tubes" somehow prevent pregnancy.

First, let's make it very clear what he ISN'T saying.  He is NOT saying women who have been raped do not, cannot or will not get pregnant.  That's what's in the headlines and in the interpretations.  That's not what he said.  He is also not suggesting that women have some magical ability to voluntarily make their bodies prevent pregnancy during rape.  Again, that is something others are claiming is meant, but it's not what he actually said.

Is there any truth to the statement?

Actually, yes, and it's been known for ages.  Long before we knew about the chemicals our bodies produce, and the roles hormones play in reproduction in particular, it was known that trauma and high levels of stress can affect a woman's ability to conceive and/or prevent miscarriage.  Such things affect male fertility, too, but when it comes to women, our bodies actually do have ways to prevent pregnancy when conditions are not optimal for conception.

First, there are the effects of stress on the reproductive system.  This can be long term stress, of it can be stress from a single traumatic event. 

The female body is, from a purely biological point of view, a baby making machine.  We are awash with chemicals and hormones that are there to ensure optimal fertility.  That may not be true as individuals but, as a general statement for healthy women, that's how our bodies work.  Aside from stress, a number of things can trigger our bodies into becoming hostile to conception.  Nutritional deprivation is one such example.  When we're starving, women are less likely to conceive, and if we do conceive, we're more likely to miscarry.  Likewise, if we have too much or too little of specific nutrients, it can prevent pregnancy.  I remember seeing an interview, several decades ago, with a doctor from a Toronto fertility clinic.  He talked about how most of his patients didn't need extreme interventions such as IVF; most needed to only make minor lifestyle changes.  He described two cases to illustrate.  One couple he treated lived an extremely "healthy" lifestyle.  They were both marathon runners, and were in peak physical condition, yet they could not conceive.  In the end, it turned out the wife did not have enough body fat.  They relaxed their marathon training regimen, gained some body fat, and promptly got pregnant.  Another woman he described was also a "healthy" eater.  He talked about how one of the first things he did was look at the palms.  When he saw this woman's palms, he noted a distinct orange cast to them.  As he talked to her, he learned that she had read a lot about antioxidants and had been supplementing with beta carotene.  For some reason, she was taking very high amounts of it, which is why her palms started to turn orange.  She stopped taking the excessive supplements and was soon pregnant.

Calorie restriction can also affect fertility.  Our bodies can't tell the difference between starvation due to famine or starvation due to dieting.  It can tell when we are not getting enough nutrition to support a pregnancy, causing changes in our chemical balance that make it more difficult to conceive.

These are just a few examples of ways our bodies create conditions to prevent pregnancy by shutting down our reproductive system.  In the context of Akin's interview, it is the stress related responses of our bodies that kick in, creating conditions hostile to conception.  Such conditions also cause miscarriages and prevent lactation.  This is old news.

Do women still get pregnant, even in non-optimal conditions?  Obviously we do, and he never claimed we didn't.  He just said that our bodies "try to shut that whole thing down."  Which is accurate.  Sometimes, it fails.  The idea that he was suggesting women can somehow control whether or not they can become pregnant is ludicrous, but that doesn't stop people from making that assumption.

Now, I have no idea who Akin is and, frankly, I don't care all that much.  What I do care about is accuracy and truthfulness.  I've seen his interview and compared it to the many headlines and column inches dedicated to tearing him apart, and it bothers the heck out of me.  The attacks against him are inaccurate, in that they claim he said things he didn't, and dishonest in how they extrapolate meanings to what he said that are, at best, pure conjecture or, at worst, deliberate misrepresentation for the purpose of destroying him both personally and politically. 

Was what he said clumsy, "misspoken" and or insensitive?  Perhaps, perhaps not.  I think the "shut things down" part of what he said was clumsy and unclear, but only to those who don't know anything about the effects of stress on the reproductive system. 

Was what he said false?  No.  Though he was repeating what he says he was told by doctors, and he was in no position to expand on the claims during the interview, his actual statements were correct.

Of course, you won't know that by the headlines. 

With all the focus on one sentence of what he said, people are completely forgetting about the closing sentence.

You know, I think there should be some punishment. But the punishment ought to be on the rapist and not attacking the child.

People are completely ignoring what he's pointing out here, which is that it is the rapist that did something wrong and should be punished for it.  This brings up the obvious question for pro-abortionists using the rape and incest argument: Why should any child conceived in rape be killed because of what the father did?




 

Just you wait! Your turn is coming! (updated)

Things are still pretty hectic and my writing time is still sporadic, but I wanted to get this down before too much time passed and I forgot too many details.  So here is a continuation of our new doctor medical practitioner saga. 

Dh had his triple appointment last week.  I made a mistake in my last post; I thought we would get to see the actual doctor, but nope, not at all.  That appointment turned out to be with someone to help with chronic pain, but still another nurse.

When we came in for his appointment, he went to the receptionist.  She looked him up and noted that he was due to see the dietician first, then the diabetes nurse, then the NP.  Dh asked, "what about the chronic pain specialist?"  The receptionist checked again and corrected herself.  The second person was the chronic conditions specialist, who usually sees patients about diabetes, so she had assumed he was there to talk to her about his diabetes.  She apologized for the assumption.

Shortly after, we got called in to see the dietician.

It did not go well.

First off, after the introductions, she asked us why Dh was there to see her.  It turns out that, while she had been able to look at his file, there was nothing specific about why an appointment was made with her.  We just sort of hemmed and hawed a bit, then said we guessed it was because of Dh's diabetes.  He's been having difficulties controlling his sugars, especially when the pain gets really bad (as it has been recently).  He can't get enough exercise because of the pain, the meds don't seem to be doing very much, so we figured he was there to talk about dietary possibilities.

The rest of the meeting was very disjointed, uncomfortable and... weird.  One of the things we found weird was a mannerism; she talked as if we were 5 yr olds.  I wasn't sure what to make of it, but I'll assume she is used to talking to patients who don't research their own conditions very much - or anything else, for that matter.  Who knows?

We were booked for a 1 hour meeting with her and went over time by about 10 minutes.  In all that time, we basically came away with:

- eat more vegetables.
- and lentils.  (looking things up since then, lentils are on the off list, along with several other foods she mentioned, though plenty of sites promote lentils as some sort of miracle blood sugar controller)
- Dh doesn't have to avoid fruit (even though we told her fruit makes his sugars spike badly)
- margerine is better then butter
- butter and margerine both have 45 calories per teaspoon, and that has something to do with why there's no difference in bioavailability between butter and margerine.
- he should eat yogurt and cheese (yes, we did mention he's lactose intolerant, which is why milk isn't on the list, but he should just take lactase and eat them anyways)
- she thinks Dh, who is 6'1", should only eat 1800 calories a day (that was the level of starvation for men in the Ancel Keyes starvation study during WWII)
 
Now, Dh's diet sucks.  We know that, and it's a point of contention between us.  He'll go on about how he needs to eat healthier, but when it comes time to actually sit down for a meal, he eats little or none of the foods he's said he should be eating.  When it comes right down to it, though, we already know that the diet that best meets his needs for controlling blood sugar is basically an Atkins or paleo type diet - high protien,  plenty of fats, very little carbs.  The problem with this is it's friggin' expensive.  The price of groceries has been increasing quite a bit over the past couple of years and, though we've increased our grocery budget, (it's looking like I'm going to have to find some way to increase it again soon),  it's still not affordable for us to be buying that much meat (and no, vegetable substitutes are not adequate to the job.  They may be for others, but not for him).  When it comes to stretching the food budget, there's little that can beat the cheapness of high carb foods.  They are also a lot easier to work with and work out better as lunches for him at work.  For someone who's struggling just to bring his numbers into the single digits (in the Canadian system), that isn't going to work for him.  Even whole wheat pasta (which he finds disgusting) causes his sugars to spike, so all pastas would have to be out, along with all breads, potatoes and rice, along with fruit. 

Anyhow.

So that meeting wasn't particularly useful, and I found myseld dreading the idea of seeing her myself.  Especially since I have even less reason to see her then Dh did, and his appointment seemed to confuse her enough as it was.

Our next appointment was with the chronic care nurse, and I will say right now, she was AWESOME!  To begin with, she had a great attitude, which always makes things easier.  However, she asked us a lot of questions about his injury (the pain of which was the reason we needed to get a new doctor so urgently in the first place) and his history with it.  We also talked about his blood sugars, but it was in relation to everything else.  We learned a few new things from her.  For example, no one had ever mentioned the need to wash your hands with plain soap and water before using a glucometer to us before.  It turns out that just basic sweat on your hands can lead to false high readings.  Scented and fancy soaps can also cause false high readings, as can those anti-bacterial hand sanitizers and wipes.  "Milking" your pricked finger to get a drop of blood out can also lead to false readings, so it's a good idea to vigorously rub the hands together before using the lancet.

You know what else can lead to elevated blood sugar readings?

Pain.

Of course, Dh has noticed his readings getting wildly higher when he's in a lot of pain, but this is the first time anyone actually said outright that the pain itself has anything to do with it.  With every other person, his diabetes was viewed in isolation from his back injury, and since he's started seeing the NP at this new clinic, the focus has been entirely on his diabetes, with almost no discussion about the injury.  As I mentioned in my last post, stress is something else that can cause high readings, and he's got plenty of that completely aside from his pain, too.

While we saw her, she took his blood pressure.  His BP was normal, though one reading was ever so slightly on the high side of normal compared to the other.  His heart rate was really high, so she checked it again.  It was still high.  No surprise, really.  Aside from "white coat syndrome" (his BP readings are always higher in the doctor's office then when taken elsewhere, though they don't usually cross over into the high range), he was in massive amounts of pain at the time - he needed a cane to walk, and was breaking into a sweat from the pain, just sitting there.  Or should I say squirming, not sitting, as he constantly had to adjust his position to try and alleviate the pain.

Oh, there was something else that stood out.  During the meeting with the dietician, she had asked if we knew what Dh's A1C was.  She didn't see one on his file.  The last one Dh could remember, it was 9.  The chronic care nurse, on the other hand, had no problem finding it in his file.  It was 7.   That is still higher then recommended, but it is a HUGE improvement from where it had been some time ago.  He's cut his A1C to about 1/3rd what it was at one point.  She was pleased by that progress.

In the end, there wasn't much she could do for him.  He's got his MRI in about 2 weeks.  She did say that a major part of controlling his blood sugars is going to be controlling his pain - we're not going to get much progress with his sugars as long as he's having so much trouble with his back.  Until she gets the results from the MRI, though, she wasn't going to suggest anything beyond what we're already doing.


Even so, we came out of that meeting pretty happy.  She was really refreshing, and we felt confident that she was interested in all of his issues, not just his diabetes.  We look forward to seeing her again.

Then there was the appointment with the NP.

*sigh*

Now, the last time he saw her, she'd added 2 more prescriptions to his collection - baby asperin and a low dose blood pressure medication.  Note that he does not have high blood pressure, but the combination is to help protect his kidneys from all the other meds he's taking.  At least that's what we were told back then.

That's right.  Because he's on so many meds, they may be over taxing his kidneys, and the solution is to prescribe more meds.

No, there's no actual evidence that his kidneys are having a problem.

This time, she went over his numbers and latched onto his BP reading.  You know, the one that was normal, but had one number on the slightly high side of normal.  Both of which were slightly lower then the last time he saw her, so even though the low dose blood pressure medication was prescribed to him as being part of protecting his kidneys, she attributed the slightly lower reading this time to the prescription (because apparently any fluction can only be because of meds).  She wanted that second reading to be more in line with the first reading - or at least that was her reasoning - so she doubled the dosage on the BP prescription for him.  She also added two new prescriptions.  One is a cholesterol medication.  Does he have high cholesterol?  Of course not.  However, his HDL reading was lower then she wanted it to be, so more pills!  The other was a low dose anti-depressant.  This was the first one that was actually about his pain; it seems that low dose anti-depressants have been found to help with chronic pain.  At least that's what she said then; at this rate, I wouldn't be surprised if she says something else the next time he sees her.  The first brand of anti-depressant she named was one he'd been put on many years ago and reacted badly to, so she wrote him up for another one we've never heard of before.

As she was writing him up for all these prescriptions, I made a comment about "more pills" for him to take.  That's when she looked at me and said,

"Just you wait!  Your turn is coming!"

Then, before I had a chance to react, she started talking about when my appointment with her was.  It had originally been booked for the afternoon of the same day as Dh's triple appointment, but I hadn't had a chance to take the blood test, so I had rescheduled it to the end of this week.  I'm not sure what to make of her reaction, but her promise - threat? - was clear.  She already intended to put me on prescriptions, even though she had yet to see any new test results.

I was not impressed.

We finished up the appointment with getting Dh written up for medical leave for a week, on top of the days he'd already missed from the week before because of the pain.  By then, he was pretty wasted, so I took him home so he could lay down for a while.

That evening, I took the new prescriptions to the pharmacy.  There's one pharmacist I've been dealing with regularly, and he's quite familiar with Dh's file by now.  He's also given us a lot of advice and information, and we're quite comfortable asking him questions.  I had plenty of them when I gave him the new prescriptions.

I talked to him about the BP medication that got doubled, even though Dh's BP was normal.  He was rather taken aback by that.  He was also taken aback when I mentioned that Dh had just gotten 2 new prescriptions so recently, and now there was 2 more.  On looking at the list, he asked if Dh was having sleep problems.  One of the new meds - the anti-depressant - is often prescribed to people as a sleep aid.  This rather alarmed me because of Dh's severe obstructive sleep apnea.  When I mentioned that, the pharmacist was yet again taken aback that she would prescribe something like this to someone with sleep apnea.  That one was to be taken just before going to bed, but the other new one was to be taken in the morning, about half an hour before eating.  Dh is already taking something at that time, which I mentioned.  The pharmacist did yet another double take and checked the file.  It turns out the two meds are contra-indicated!  So he changed the instructions so that the old one is still taken half an hour before eating, while the new one can be taken with food.

Then the pharmacist noted the NP's name on the prescriptions and realization seemed to dawn on him.  It turns out he's had problems with this NP before - and he's never met or talked to her.  He knows her by her prescriptions.  Which is pretty interesting, considering this clinic is so new, and she's been there only a couple of months.

Dh is still going to take the new medications, though we have serious reservations about it.  He now has 11 different meds that he's on, including an injection, with two of them needing to be taken 3 times a day.  Of all those, only the 2 meds related to his back injury are taken as needed, rather then at set times.

There's something very wrong with this.

I've been really unhappy with all this.  We called this place looking for a new doctor, and we have yet to see one.  The doctor at this clinic we'd originally asked to see comes highly recommended by our pharmacist, I've heard positive comments about her elsewhere, and even Eldest has heard good things about her from someplace else.  Instead, we're seeing an NP seems to be a pill pusher and seems to make her decisions not based on actual readings, but her own idea of what things should be - and she's already got me labelled and is eager to put me on prescriptions, too!

So what do we do?

Today, I called and cancelled my appointments with the dietician and the NP and asked for an appointment with this doctor.  It turns out I still need to book a meet-and-greet appointment, and the earliest that can be done is in September.  That works for me, but Dh can't wait that long.  He's stuck seeing the NP for at least a few more times, as we have another follow up appointment before his MRI, then a follow up for the MRI results.

I still have to book an ultrasound for myself - my reason for seeing a doctor is still about the discomfort in my side - but I'm not going to take the fasting glucose test again.  When I see the doctor in September, I want to ask for an oral glucose tolerance test instead.  Meanwhile, I'm still using Dh's glucometer to test myself, and my non-fasting blood sugar levels are well within the expected ranges for non-diabetics, even based on the printout the dietician gave Dh.

I don't know if I dare hope too much that when I finally see the doctor, it will work out.  For all I know, she might be much like the NP.  Or she could be more like the chronic care nurse.  I don't know.  As I've been looking more into the implications of the change in diagnosis for diabetes, the more disturbed I am about it.  Will the doctor be just as eager to hang a Sword of Damocles over her patients as the NP?

Before the diagnosis change, 4.0 - 6.9 was considered the "normal" range for blood sugars.  7.0 and up was considered high.  Readings below 4 can be dangerous and, for someone with diabetes, readings of 4.5 or lower can be equally dangerous, as their blood sugars can drop so quickly, leading to coma and possibly death.  Still, there was a decent range of "normal."

Then the "pre-diabetes" notion showed up, and readings in the 6 range were considered something to worry about, but was still in the normal range. Readings of 4.9 or lower just don't seem to be discussed much anywhere.  Now, with a diagnosis of diabetes being made with only a single reading of 6.0 or greater, the range of "normal" is so small, it's almost impossible to not be diagnosed diabetic!  It also means that anything under 6 is now "pre-diabetic."  So basically, we're all either low blood sugar, "pre-diabetic" or diabetic.  How does that even make sense??

So if you're reading this and think you don't have to worry about being diagnosed as a diabetic, just you wait!  Your turn is probably coming, too.

update: June 28

Since writing this, I've had a chance dig around some more, and I'm even more pissed with the NP then before.  First off, I'm not finding anything, anywhere, that the threshold to diagnose diabetes has changed from => 7.0 to => 6.0  Going through the Canadian Diabetes Association website, not only does it still say 7.0 and higher for a fasting blood glucose, but it also says that no matter what type of test was used, a second test should ALWAYS done before diagnosis. 

I noticed something else.  For the fasting blood test, everywhere I looked said to fast at least 8 hours.  I was told to fast at least 12 hours.  As we go without food, our livers begin to release glucose to prevent our cells from starving, so even without eating, our blood sugar levels can go up the longer we go without food.  The sites I read also all said that only water is to be ingested during the fasting period.  I was told I could only drink a small amount of water in the morning.  Lo and behold, there is some sort of relationship between water and blood sugar levels, though the why and how of it is not completely understood.  Lack of water can lead to a high blood sugar reading.  More importantly for me, lack of water in general also leads to high blood sugar levels.  I don't drink much water, as I don't enjoy the taste.  Yes, I know, water isn't supposed to have a taste, but ours does.  I don't like bottled water, either, as I find they have an unpleasant taste, too (I find Dasani quite salty, for example).  Though I do drink things like tea, Coke Zero or iced tea, depending on what we happen to have in the house, I don't drink much of anything overall.  I have been recording my food and drink along with my blood sugar readings for the past while.  I also been recording all fluids *except* water in my records, though it's still on my mind as I document it all.  In the process, I've come to realize that not only am I not eating much, but I'm drinking even less, to the point that dehydration is probably a concern. So here I have yet another possible cause for my one anomalously high fasting blood sugar test. 

Not only is my increased level of stress lately a contributing factor; not only is my borderline dehydration another possible contributing factor, but the parameters I was given for my fast were practically a recipe for a higher reading.

And this woman's specialty is diabetes.  I find myself thinking of the old saying, that when your only tool is a hammer, everything starts to look like nails.

Really?

It's been a while since I've posted - life has been hectic, and there's no sign of things slowing down.  We're actually heading into the busiest time of our year, so I don't expect to be posting regularly for a while.

It's probably silly of me to be starting a post now, when it's past 1:30am, but I feel the need for a rant.

First, a bit of background.

We lost our family doctor.

We're not sure what happened to him, other then he went on medical leave and hasn't come back.  I had been expecting to hear back about the ultrasound I had done to try and figure out why I'm having pains in my lower left side, near where I had a large cyst removed over a year ago.  Though the discomfort is usually mild - it feels like I pulled a muscle or something, except it doesn't go away - it sometimes becomes uncomfortable to the point that I can't sit up straight.  Every now and then, there are sharp, shooting pains as well.  I figured it would be a good idea to get it checked out, rather then just put up with it, like I normally do with such things.

When I didn't hear from our doctor's office, I figured it was one of those "no news is good news," things; they had no reason to have me come in.  Then Dh needed to see the doctor and called to make an appointment.  There was an automated message saying the doctor was on leave for medical reasons (which has happened before) and giving the name of a doctor at another clinic that was willing to take our doctor's patients, if needed.  We were willing to wait for our own doctor, so never called the other one.  Eventually, though, Dh needed to get updated prescriptions and called again.

The number was no longer working.  Not even our pharmacist had a working number to get an updated prescription.  We ended up having to pay an extra fee for the pharmacy to able to get a 1 month prescription renewal for him.

Dh ended up calling the College of Physicians and Surgeons and, while they didn't know what happened with our doctor, they were able to see that all his files were sent to a holding company in Ottawa!

Long story short, we found ourselves in need of a new family doctor for the 4 of us and, based on a recommendation from our pharmacist, we found one almost immediately at a new health centre just up the block from our pharmacy.

Sort of.

 Dh ended up needing to see a doctor quickly, and they were able to get him in on the same day.  I made appointments for me and the girls for a meet and greet at the same time.

Except we never actually saw a doctor.  Nurse Practitioners (NP) do the majority of the visits with patients now, including being able to prescribe most medications.  We all ended up with the same NP.  Dh had his visit, got written up for a new and very thorough set of blood tests.  The girls and I came back a few days later for our meet and greet appointments, which we were able to do together, saving a whole lot of time.

Before my appointment, they were able to look up the results of the ultrasound for me.  The only thing that was found was a 6mm benign cyst on my left kidney - not something that could be causing the discomfort I'm feeling, nor anything of any concern.  Also, my liver is slightly larger then expected - a "fatty liver" - but I knew that already from an MRI I had done a few years back.  It's also not a health concern.  Everything showed healthy.  I got written up for a very thorough series of blood tests as well, and that was that.

At this point, I was feeling cautiously optimistic about the situation.  Sure, we weren't actually seeing a doctor, but if an NP can do the job, I'm good with that. 

Then I came back for a follow up visit.

The results of my blood tests were pretty much as expected.  My thyroid is working fine, my cholesterol is fine, my liver had one slightly elevated reading, but that was expected and is not a health concern, etc.  There was one reading however, that was off.

My blood sugar was at 8.2  This, apparently, is now considered very high.

Now, I've been pretty aware of my blood sugar levels.  When Dh was first (mis)diagnosed as diabetic (the high reading was before he got his CPAP, and it normalized after his sleep apnea was treated) we charted both his and my blood sugars several times a day for a week for comparison.  Both were well within normal ranges, though mine were on the low side of normal.  Years later, he was re-diagnosed, and this time his blood sugars really were consistently and extremely high.  We still tested my blood sugars every now and then, just to compare.  'cause we're like that.  Mine continued to test normal.

In all these years, my blood sugars have been well within the normal range, and no sign even of "pre-diabetes."  The most recent series of blood tests were about a year ago, and there was nothing odd about them.  My blood work has consistently tested right where it was supposed to be.

But with this one reading, she was ready to pronounce me a diabetic.

Now, if this had been my old doctor, I would not have been suspicious or concerned.  With the NP, however, there were a few things she said that made me increasingly bothered.

First, there were the comments in regards to diabetes itself.  She had some pages printed out from a medical website she referred to as her "Bible." (It turns out diabetes is a specialty of hers.)  I can only half remember the name, and in searching for medical websites, I can't find anything even close to what I'm half remembering.

Anyhow, she started reading off about diabetes to me from this printout, including the part that mentioned that the percentage of people with diabetes is 75%.  I did a double take, but didn't say anything, as she kept on talking, but this sounded really off.  I've looked it up since then, and the Canadian Diabetes Association says that there are 9 million diabetics and pre-diabetics in Canada.  Hardly 75%.  Did she actually believe that 3 out of 4 people were diabetic, whether they knew it or not?  Did I missunderstand what she was saying?  Unfortunately, I can't find anything that could clear that up.

The other thing she mentioned was the change in diagnosis.  It used to be that a blood sugar reading from 4-6.9 was considered normal, while 7 and up was considered high.  Now, anything 6 and up is considered high.  Way to make sure lots more people get diagnosed diabetic.  (It reminds me of how the range of "normal" weight on the BMI was dropped, rendering millions of people "overweight" in an instant.)  It also used to be that it took more then one test to determine if a high reading was not an anomaly, but it hasn't been done that way in a long time.  Now, all it takes is a single high fasting blood sugar reading, and that's it.  No matter how normal your blood sugars might be after that, you're still considered a diabetic, since diabetes is a chronic condition with no cure.

When I mentioned that this reading was a surprise and an anomaly, she said she was willing to give me "the benefit of the doubt."  She wouldn't diagnose me as a diabetic just yet (NPs can now render diagnosis without a doctor, apparently), and wrote me up for another blood test, this one for just fasting blood sugars.

As we were talking, we went back and forth with the other test results as well.  When she went back to my liver test, with it's one slightly elevated but not a concern reading, she mentioned treating it with weight loss.  ??  If something is not a health concern, why does it need to be treated?

The kicker was when she mentioned the normal thyroid results again, saying that we'd tested my thyroid to rule it out as the cause of my weight.

What?  When she wrote me up for blood tests, my weight was never mentioned at any point.  She certainly never mentioned anything in particular about testing my thyroid, since she was checking me off for a whole bunch of things that tend not to get tested for very often.  She had said she wanted to get a thorough blood work, and that's what I got.  The only thing that was mentioned in any other context was when she saw that I had some testing done on my liver in the past - some 5 or 6 years ago - because I'd been put on a prescription that had liver damage as one of the possible side effects.  I wasn't on that prescription long, so it was never an issue again.  That was partly why testing my liver was thrown on the list, too.

One of the things that she said was that, based on the 8.2 reading, she would put me on metformin.  She wasn't going to because of my saying this was an anomalous reading, so she'd wait for a second test to confirm that I'm diabetic.  She clearly already thought of me as such.

Because Dh has a series of follow up appointments coming up, she had me book a follow up appointment with her to go over the new test results, plus a dietitian, on the same day as Dh.  Hopefully, even at the same times, in that he'd be seeing the dietitian while I was seeing her, then he'd be seeing her while I saw the dietitian.  He also has an appointment with the actual doctor, whom we've yet to meet.  In the end, they were only able to book me in the afternoon.

Well, I didn't get a chance to take the test, so I've rescheduled my appointments.  I have to admit, though, I'm not happy with this.

Now, don't get me wrong.  It's entirely possible that I have suddenly become diabetic.  That's not how diabetes works, but it's possible.  I'm over 40 and fat, so my risk factor is a bit higher, however T2 diabetes has a strong hereditary factor, and both my parents are fat, and there is no diabetes in my family.

What gets me is that, if she really believes that 3 out of 4 patients she sees are diabetic, then she'd have decided I was diabetic right from the start, and before I was tested, simply because... I'm a fat, middle aged woman?  Granted, so is she, if not as large as I am, but still...

She also made no attempt to learn more about me.  No attempt to figure out why I went from normal health to diabetic within a year.  She did ask if I'd gained any weight, and I have - it was something I'd intended to bring up, because it's so unusual.  I've gained between 15 and 20 pounds in the space of a few months.  Curiously, I have not changed clothing sizes at the same time.

Oh, and we did also discuss the reason I wanted to see a doctor in the first place - the pain in my side.  I've been written up for another ultrasound.  The previous one was abdominal.  This one will be pelvic.  Beyond that, she really didn't know what to make of it.  It might be because of scarring from my surgery, but that's about all she could think of.  Hopefully, the new ultrasound with tell us more.

So I go to see a doctor (or not see one, as the case may be) about a pain in my side, and end up being told I'm fat and most likely diabetic.

From an NP reading off of online printouts with information I can't find anywhere else.

Since the appointment, I've found myself becoming increasingly angry about this.  Not because of her diagnosis - if I'm diabetic, then I'm diabetic - but because of the circumstances surrounding it.

Oh, and there was one more thing she said that has perplexed me from the start.  Near the end of the appointment, printouts for tests in hand, talking about the follow up appointment with her at the same time as the dietitian (because... I'm fat?  She is convinced I'm diabetic?), she gave me this sort of slyly humorous look and said, "you don't have to be diabetic if you don't want to be."

Really?

What does that even mean??  Is she saying that I can just ignore it and pretend I'm not a diabetic?  Or is she saying that I can physically choose to not be diabetic?  And if that's what she meant, how would I go about doing that?  Was it like with the liver test, in that I could "treat" it with weight loss?

I recall when Dh got re-diagnosed diabetic, and he picked up a new glucometer and other stuff the doctor prescribed for him, among the things he got was a booklet about the facts and myths of diabetes.  I'd skimmed through it.  Among the things the booklet said was, to paraphrase, "it's not your fault that you are diabetic; you did not do anything to cause it," and "if you are overweight, your weight did not cause your diabetes.  If you change your diet and exercise to control your blood sugar, you may lose some weight, but you might not, either.  Losing weight is not the goal; controlling your blood sugars is."  It also stated things like, "no, eating sugar does not cause diabetes, either."

Though I haven't had time to get the blood test done yet, or even make an appointment for an ultrasound, there are a few things I've managed to do.  I've borrowed Dh's glucometer, and I've been testing my blood sugars while keeping track of what I eat or drink.

I've also looked up information on diabetes.  Here's a list of symptoms for T2 diabetes, and my comments about whether or not I've got them.

Unusual thirst - no


Frequent urination - no


Weight change (gain or loss) - most sites just mention weight LOSS, not weight gain.  During the appointment, the NP said that my weight gain was probably a symptom, then mentioned weight loss as something that happens after many years. 


Extreme fatigue or lack of energy - no.   The only time I feel extreme fatigue is when I haven't slept.


Blurred vision - no, except when I haven't slept


Frequent or recurring infections - no


Cuts and bruises that are slow to heal - no


Tingling or numbness in the hands or feet - no


Trouble getting or maintaining an erection - n/a


Granted, diabetes can also be asymptomatic, so not having symptoms does not mean no diabetes.  What about risk factors?  Here's another list, with my comments added.


Being:
A member of a high-risk group (Aboriginal, Hispanic, Asian, South Asian or African descent) - no
Overweight (especially if you carry most of your weight around your middle) - yes

Having:
A parent, brother or sister with diabetes - no
Health complications that are associated with diabetes - no
Given birth to a baby that weighed more than 4 kg (9 lb) - one was 9 lbs 6 ozs, and there was nothing the least bit unusual suggested because of it; quite the opposite.  She's about to turn 16, so I think if that was a contributing factor, it would have shown up a lot earlier.
Had gestational diabetes (diabetes during pregnancy) - no
Impaired glucose tolerance or impaired fasting glucose - no
High blood pressure - no
High cholesterol or other fats in the blood - no
Been diagnosed with polycystic ovary syndrome, acanthosis nigricans (darkened patches of skin), or schizophrenia - no


The thing that made me most curious is why I would suddenly have a high blood sugar reading after all these years of testing normal.  It turns out that there are a few things that cause blood sugars to right in non-diabetics.  One is simply eating lots of carbs.  Not usually an issue with me.  Another is liver function.  Since our bodies always need glucose, our livers store it for later release when we're sleeping, which is why our blood sugars can be elevated in the morning, before we've eaten anything.  Other possibilities are illness and medication related, which doesn't apply to me, unless I count the discomfort in my side as an illness.

Then there was stress.  At first thought, I dismissed it, as I don't really think of my life as being stressful.  Then I thought about it and realized that, yeah, life has been VERY stressful lately!  In fact, once I started thinking about things, the list of stressers in my life right now is pretty friggin' long!  Some of them have been going on for quite a while now, with no respite.  So, yeah, stress could very well have something to do with that high fasting reading.

And what about the non-fasting readings I've been taking?

When talking to the NP about the diagnosis change in what's considered a high reading while fasting (from 7 to 6), I mentioned testing my blood to compare with Dh's, and that my numbers tended to the low side, not the high side.  She casually mentioned that 11 was normal for non-fasting numbers.

After keeping track for a few days (none of my numbers hit the 11 mark she mentioned, though I did get one that eeked above 10 after a restaurant meal), I went digging around for a chart of what normal, non-fasting readings throughout the day should be.  It was hard to find anything to say what's normal for non-diabetics (or any with the scale used in Canada), but from what I have found, my readings fall into the good to excellent range - and that's a very small range according to the charts and sites I looked at!  That 11 she mentioned, by the way, was considered high in all the charts I found, so again, I don't know what she was talking about.

As you can imagine, my confidence in the NP has faded dramatically.  I don't want to go back to her.  I plan to get that second test done, but I don't want to go back to her to go over the results. I sure as heck don't want to talk to a dietitian.  Somehow, I don't think that is going to go ever well.  You see, I discovered something else I was not aware of while keeping these records.  Or should I say, not aware of how bad it was.

I'm not eating anywhere near enough!

I don't obsess with eating or calorie counting, but I do have a problem when I start feeling hungry.  The hungrier I am, the less appetite I have, and the longer I tend to delay eating.  Even so, with my blood sugars normally tending to be low, I have long known I need to eat regularly to prevent them from dropping too much.  I try to, but things tend to get in the way and, before I know it, it's 2 or 3 in the afternoon, and I haven't had breakfast yet.  Some days, I've barely managed to eat a single meal.  I've been doing that far too often.  I hadn't realized how bad I had gotten. 

Somehow, I don't think a dietitian is going see me and my big round belly and bodacious butt and believe that I hardly eat.  I could be wrong and I don't want to prejudge someone I haven't met yet, but I'm already discouraged by what's going on with the NP.
 
I miss my doctor.

How not to do (and publish) science; metabolic syndrome

I've got another post I've been working on in draft that is taking me forever to finish, but I just had to post about what I encountered in today's health news.

This was the first article I encountered.  One in 5 Canadian adults has 'metabolic syndrome": study

A very brief article, short on details, but at least clear that "Metabolic syndrome isn't a disease in and of itself."  Rather, it's a group of symptoms that increase the risks of increasing the risks of getting "real" diseases.

Seriously.  That's what it comes down to.

No link to the study.

Then I found this one.  Metabolic syndrome now affects 1 in 5 Canadians.  So what is it?


This one, at least, links to the study.  More on that later.  First to the article, which starts with...

If I were to ask you what my most important tool as a doctor was, I bet you would say it is my stethoscope! Wrong. It is a tape measure.

Seriously??  This doctor considers a tape measure her most important tool?  Over a stethoscope?  Over her blood pressure cuff?  Over any number of tools available to her, she chooses a tape measure?

I'm glad she's not my doctor!!

So what is metabolic syndrome?  Well, you have to have at least 3 of these 5 symptoms.

Abdominal obesity
high triglycerides
low HDL cholesterol ( the good cholesterol)
high blood pressure
impaired glucose tolerance

For full disclosure, I have only one of these symptoms - abdominal obesity (more on what that turns out to be later).    My husband has two.

So of these 5 symptoms, abdominal obesity is the most common at... wait for it... 35%.  In other words, while it was the most common of the five, 65% of people don't have it.   They have three of the other 4 symptoms.  Meanwhile, the most common combination of factors was abdominal obesity, high triglycerides and low HDL (note that high cholesterol, the long time scare, isn't even mentioned - they are specifically sticking with low "good" cholesterol).  The article doesn't say how many that group represents.

Now, what are the predictors of having metabolic syndrome?  Is it the usual stuff I hear of lazy fatties stuffing their faces with junk food and too stupid to know better?

Nope.

These predictors that increased the risk were: education and income level. Higher levels of education and income predicted a lower likelihood of metabolic syndrome.

In other words, the more you know and the more money you have, the less likely you are to have metabolic syndrome.  Which could be considered good news, since 80% of Canadians do NOT have metabolic syndrome.  So solving this "problem" should just be a matter of helping people become more educated, and improving income.  Right?







Nope.

The implications of these findings are truly important. Among younger adults particularly, it is critical to address poor lifestyle habits.

Wait.  What?  Where did that come from?  Didn't she just write that education and income were...


*facepalm*

And in conclusion...

Cardiovascular disease increases with age and if we don't address abdominal obesity, and the other symptoms of metabolic syndrome the burden of chronic disease will continue to soar. What is more critical is that each if the components of metabolic syndrome can be addressed by lifestyle changes.

 So we have a study that, according to this article, shows that low income and education levels are the most common predictors of metabolic syndrome, and that 65% of the people with metabolic syndrome in this study did NOT have abdominal obesity as their  minimum 3 of 5 symptoms (note that some people in the study would have had 4 or 5 of 5 of these symptoms, too), and the cure for this is lifestyle changes.

Well, I suppose if lifestyle changes includes improving our education and increasing income, I could go with that. 

So what does the original report say?  The abstract is here. 

Notice something?

Yup.  This report is based on a survey.  In the pdf, you learn this survey was done in 2007-2009.

The abstract doesn't even end with a conclusion, but an interpretation (good to see that, for a change, but that doesn't seem to stop the media from reporting is as fact).

Interpretation: About one in five Canadian adults had metabolic syndrome. People at increased risk were those in households with lower education and income levels. The burden of abdominal obesity, low HDL (high-density lipoprotein) cholesterol and hypertriglyceridemia among young people was especially of concern, because the risk of cardiovascular disease increases with age.

 Which tells us... what?  Poor people with a lack of education are at higher risk for poor health than everyone else?  This is news?  Cardiovascular disease increases with age, also not news, but how does this address the problem of young people with metabolic syndrome?  Young people tend to have less education than older people, and less money than older people, anyhow.  It takes time to increase income and continue education.  What is the news here?

Also not addressed; the headlines reads that metabolic syndrome "now effects" 1 in 5 Canadians.  So what was the rate of metabolic syndrome before?  No idea.  As far as I can tell, this is the first time anyone has actually tried to measure it before.  We have data for 2007-2009.  That's it. 

Now then.  What does the report tell us?

Oh, dear.

First, they describe the methods.  Not only is this survey data by Statistics Canada (granted, data taken only from those that had actual blood test information available), but there is a whole bunch of number crunching for weight by

multiplying the weight for the collection site by the selection weights for household, and adjusted for non response. The weights for collection site and households were based on the 2006 census. The household weights were then converted to individual weights and further adjusted for nonresponse.

In other words, it's a data dredge.  They never actually studied anyone, weighed anyone, measured anyone, or took blood tests from anyone.  They used Statistics Canada information.

So let's look at the criteria.  First, let's look at what it means to be "abdominally obese."

waist circumference ≥ 102 cm for men and ≥ 88 cm for women

To translate into Imperial, that means men with waists equal to or greater than 40 inches, and women with waists equal to or greater than 34 1/2 inches, are "abdominal obese."

In other words, unless you are quite thin at the waist, regardless of anything else about your body, you are "abdominal obese." 

No wonder that most people in the survey were "abdominal obese."  It would be almost impossible not to be!

And on it goes.

You can go ahead and read the rest of the report yourself.

It's a whole bunch of data, but what does it actually say?  And what does it recommend?

Well, it takes a bunch of symptoms and, if people have enough of them, they are labelled as having "metabolic syndrome."  It doesn't mean anything more than having a combination of medical readings.

Having that combination of medical readings increases your risks of increasing your risk of actual diseases.  Nothing about causes, of course.  Just correlation.

It shows that there is an increased risk of having metabolic syndrome (the increased risk of increasing your risks) if you lack education an income.

Then we're told in various articles that we can reduce our risk of metabolic syndrome by reducing our abdominal obesity through lifestyle changes, even though 65% of the people described as having metabolic syndrome do not have abdominal obesity.

What questions aren't answered? 

Well, I would wonder what role lack of education and income plays.  Education (and I do not mean "schooling" necessarily, though I imagine formal schooling is how Stats Can defines it) and income are tightly connected.  There are plenty of studies this connection.  No surprise that people's health would be compromised if they don't have enough money to buy nutritionally adequate food.  No surprise, also, that young people are the hardest hit when it comes to low income and less education. 

Instead, writers leap to the idea that, if we just loose our abdominal fat, we'd solve all our problems.

Critical thinking?  What's that?

A Bit Better

Well, the adventure continued today, but at least we were able to get the mistake at the doctor's fixed up.

Unfortunately, Dh isn't doing any better.  For him, it started very painfully.  It took him a full 11 minutes just to get out of bed and to the washroom, which is just on the other side of the bedroom wall.  It was an excrutiating morning for him.

After yesterday's mix up, we headed straight for the clinic to wait for the doors to open.  We left a bit too early, getting there 15 minutes before the doors opened.  There was already someone else waiting, though that turned out to be for the pharmacy that shares the same main entrance as our dr's clinic.  That mean 15 minutes of slowly pacing back and forth along one side of the building, which did help loosen up Dh's back a bit.  He did take at T3 before we left, but 45 minutes later, it still didn't feel like it had kicked in.

By the time the doors opened, there were quite a few people waiting.  Dh went straight to the counter, gave back the print outs we got yesterday and basically told them, "this isn't me."  The receptionist immediately knew who Dh was.  It turns out our Dr. saw the guy who's file he'd actually had instead of Dh right after we left, and the mix up was caught then.  We were told that the request for an MRI got sent out properly, she was all ready to get a new chit for medical leave written up, and handed over a print out for prescription refills, which was something that got brought up during our visit yesterday.  Along with his refills, there was a new prescription for T3s for when what we have at home runs out.  Plus there was...

... hold on.  What are those doing there??

There were two new meds on the prescription list, and we didn't know why they were there.  One I recognized the name of.  It was an anti-depressant Dh had been prescribed before - 8 years ago and in another province! One of a number of possible side effects of this particular brand of anti-depressants was suicidal ideation, and sure enough, that was one of several side effects that he got out of them.  Not something he would be taking again!  I recognised the name of the other one, but couldn't remember what it was for.  After talking to the receptionist about it, she asked if we were able to wait around a bit so that we could talk directly to our doctor, who wasn't in yet but expected soon.  We decided to wait, though there was no way Dh could sit on those waiting room chairs for any length of time, so whe headed back outside, where he had more room to pace.  With his handy-dandy Blackberry, he looked up the other prescription that was on the list, and it turned out to be a painkiller that is often used topically.  I'm not sure why I recognize the name.

When the dr. arrived and he saw Dh he was very quick to apologize for the mix up.  It seems that the mistake was completely his, having called up the next patient's file instead of Dh's.  He saw us first, even though there were quite a lot of people waiting.  We even ended up in the same examination room as before. *L*  As we were waiting a couple of minutes for the Dr. to join us, Dh was sitting in one of those waiting room chairs, rocking gently from side to side, adjusting for the pain.  At one point, he just kept leeeeaaaannnniiinngggg over to one side until he head was almost on the counter beside him.  Thankfully, it didn't take long for the dr. to join us.

Again, he apologised and we found out more about what happened.  We asked about the new prescriptions on the list, and it turns out that they should have been on the other guy's file, not Dh's.  That got fixed right quick!  This had the potential to be a lot worse than it was!!  It's a good thing it got caught as quickly as it did. 

We chatted some more about Dh's situation.  A new medical leave chit was printed out, along with the proper test results from Dh's Xrays for the physiotherapist.  We got a chuckle over the coincidence that he'd have another patient with such similar problems as Dh - those his back damage is far less than what Dh's is.

So that was all fixed up and settled, much to everyone's relief.  Dh got his new print outs, and this time they both double checked that they were the right ones. *L*

After that, we sung through a fast food place for food, since neither of us had had breakfast.  It was a nice surprise for the kids, too.  When we got back, Youngest was up and very happy to see us. Somehow, she missed out on all our conversations yesterday and had no idea why we were gone or where!

Dh ended up spending most of his day tilted back in the computer chair.  The walking from earlier helped quite a bit.  Though every movement was painful, he had more range of motion than before, and the pain wasn't quite as acute.

Sleeping is getting to be a problem.  As long as he doesn't have to move or roll over, he's fine, but he can't stay in one position all the time, or that just brings in a new set of pain.  We're thinking of finding some way to elevate the top of his mattress to see if that would help, but we can't figure out how.  Sleeping in an incline might make things a lot more comfortable for him, though.  It's looking like we need to get one of those beds that are like a hospital bed, where you can adjuste the angle to whatever you want.  Not that we could afford something like.  :-P

Tonight, Dh is trying a double dose of the T3's (the maximum he's supposed to do) to see if that will make things easier for him in the morning.

I sure hope so, even if it just takes a bit of the edge off.

We shall see.

Not Good

Okay, it's well past midnight, and I really shouldn't start writing so late, but I wanted to record this while still fresh in my memory.

If you've been following my blog for a while, you know we've been dealing with some ongoing health issues with my husband.  Some of this includes old injuries coming back to haunt him, and the worst of these is his back.  He tore out the muscles on one side of his lower back twice - the first time while in the military some 20 years ago, the second time during martial arts training almost 15 years ago.  That second time never really went away, and it's gotten increasingly worse in the last few years.  Despite numerous doctors visits, Xrays, and other examinations, it was only last year that we found out that he also has spina bifida occulta, and that a couple of his vertebra aren't attached properly.  Basically, he's in pain pretty much all the time, though the severity of it comes and goes.

Last night, however, took it to a whole new level.  We don't even know what triggered it. 

For the past while, he's been missing a fair bit of work and he's often called me to give him a ride home from work early.  He usually walks to work, which is supposed to be good for his back, but it hasn't seemed to be helping at all lately.  He'd missed Friday last week because he could barely move, tried to go to work on Monday but called for a ride a couple of hours early.  He was walking with a cane again, and had difficulties just getting into the van.  He has his muscle relaxants, which help but make him sleepy.  Loopy, too, if he has to take more than one, so he doesn't take them while at work. 

For some reason, however, the area started spasming far worse than he's ever had before.  I had got up at about 5 am, having given up on sleeping by then, and was in the kitchen making breakfast when I started hearing him moving around.  He was clearly having troubles, from the sounds I was hearing, and I was really startled by some rather loud sounds I couldn't figure out.  It turned out that he was simply trying to get out of bed to go to the washroom.  It hurt so much to move, he had difficulty getting just rolling over, never mind crawling out of bed and having to crawl around to find something he could use to pull himself upright.  Then when he tried to use the washroom, the loud noise I heard was him falling onto the toilet (not off, thankfully).  When he came downstairs, I could hear him struggling with every step he took.  Rather alarmed, I asked what was happening with his back and he told me that the only thing keeping him from screaming in pain was the fact that the kids were asleep. 

He spent the next while pacing from one end of the house to the other, trying to work out the spasm.  Walking is one of the few things that helps.  He took a double dose of his muscle relaxants, but he wasn't sure if they were any help at all this time.  He would only keep walking for so long before he had to sit for a while, but the act of sitting down was incredibly painful.  I'd set up an electric heating pad for him to use, but he kept having to shift around from the pain, I don't know that it even had a chance to be any help.  He'd then have to get up and walk some more, with getting up being just as painful as trying to sit down.  We even debated whether or not to take him to the emergency, but decided against it.  Instead, we decided to get him in to see our regular doctor as soon as possible. 

We both finally tried to go back to bed for a couple of hours before the clinic opened.  Well, couch for me, as the hard mattress he needs for his back is too hard for me to sleep on.  We got a bit of sleep, at least, but even with the muscle relaxants and painkillers, his back wasn't any better.  It got to the point that he dreaded any kind of movement.  I understand only too well, from when we were living in Richmond and my osteoarthritis let me know it was there.  I still remember being almost in tears just thinking of how much pain I would be in when I stood up, yet not having a choice.  Knowing that moving around would actually help reduce the pain a bit didn't make that initial pain from getting up any easier to deal with.  At least I could sit up on the side of the bed before I had to deal with the pain.  For him, it starts with the very first movement.

He called the clinic shortly after it opened, and they were able to make an appointment for him at 11:30.  He spent much of that time in our computer chair, which has the most lumbar support, and also allows him to recline if necessary.  It's also much easier to get in an out of than any other chair we've got.  Even so, he was constantly squirming around, and would have to get up and pace every now and then.

When it was time to leave, I brought the van around so he wouldn't have to walk as far.  Getting into the van was a challenge.  He would get one leg in and be sitting down, but had to make several attempts to get his other leg in.  Even closing the door and buckling up had him struggling.  At the clinic, I was able to drop him off pretty much at the door (though 2 cars were parked in the loading zone, so it wasn't as close as it should have been).  I was able to find a parking spot fairly quickly, so it was only a couple of minutes before I could join him.  I remember glancing at the clock and seeing we were 10 minutes early.  At pretty much the same time, I could hear the receptionist telling someone that they could take Dh into an examination room.  Dh's name was then called by a young man I'd never seen there before.  Dh mentioned hearing that he was the son of one of the receptionists, so I don't know if he even actually worked there, or was just volunteering to help out. 

We followed him down the hall and he showed us to a room.  He seemed a bit hesitant about it, pushing the door open to see if anyone was inside, or at least so it seemed to me.  He carried no file, though.  The last time I saw our doctor, they were just moving back into this building.  The building the medical files had been stored in during the move had flood damage, and they were slowly going through all the folders to transfer them to electronic files.  This was a problem with some of the more badly damaged files, but ours were not among those.  At the time, the Dr. was still having to do everything on paper and by hand, but not anymore.

We didn't have to wait long before the Dr. came in.  He's seen Dh often enough to remember most of his issues off hand.  It was while he was describing the spasms to the doctor that I found out just how much worse than usual it was.  Normally, the injury area itself spasms, which also affects the surrounding area, but still mostly just his lower back.  This time, the spasms were shooting down through most of his leg as well. 

As we were talking, the Dr. glanced at the computer screen and noted that Dh hadn't had any Xrays done.  Dh mentioned that he had, and that was when we'd discovered the other problems with his spine. It reminded us to ask for the release the physiotherapist had asked for, so he could see the test results before attempting any more treatments.  It kept getting forgotten, so Dh hasn't been back for physio since then.  The Dr. scrolled up and found the test results and printed the page off.  He also wrote up a chit for medical leave for Dh.  He was willing to write him up for a couple of weeks or more, but Dh has lost a job over extended medical leave in the past, and he didn't want to risk that again, so he got written up for just this week.  The Dr. printed that off, too.  He also wrote Dh up for an MRI to check for nerve damage and see if there's anything that can be surgically repaired (which was ruled out a year or so ago, but it worth looking into again).  A bit more discussion of treatment and pain medication (the T3's I never used from my own surgery are now going to see some use), and we were done.  On the way out, the Dr. grabbed the printouts for Dh, who just folded them up with barely a glance. 

Yes, that detail is pertinent.

As soon as we got home, Dh scanned the note for medical leave and emailed it in to work.  Once he was safely ensconced in the computer chair, Youngest and I headed out for some errands.  Dh was in bed when we finally got back, but he got up soon after.  Once he was up, he took the computer chair again and checked his email.

Oh, oh.

There was a problem with his medical leave.  It turns out there was someone else's name on it.

???

The sheet was still in the scanner, so Dh took it and looked.  Everything was exactly as it should have been - a brief description of the problem, the length of time off, the Dr's info at the top and...

Who's name was that on the other side? 

Thinking it might just be a problem with the medical leave, I checked the printout of his test results.  Sure enough, there was this other person's name.  Reading the results, though, it looked right.  The specific vertebra that were damaged listed and... hold on.  It doesn't say spina bifida occulta.  It names a different type of spinal damage.  What the heck?

Some how, instead of Dh's file on the computer, the Dr. had someone else's file, and this someone else has problems just close enough to Dh's that the Dr. didn't notice.  We couldn't see the name on the screen and when Dh got the printout, it never occurred to him to double check for his own name.

Which means that this other person now has new notes on his file that should actually be on Dh's file, has been written up for a week of medical leave, and has a request for an MRI sent out.

Not sure what Dh has been written up for that was meant for the other guy.

In talking it over, the only thing we can think of is that the person who lead us to the examination room took us to the wrong room.  The Dr. likely sees far too many patients to remember all their names off hand, and would have had no reason to think that the file on his computer was for someone else.  That there would be another patient there at the same time with similar enough problems, and who *also* had testing on his back done about a year ago, would have been pure chance. 

Which means we need to get back to the clinic first thing tomorrow and get this fixed.  It's a relatively minor problem for us, but potentially a huge problem for them.

Not good.

Which also means I need to get to bed and try and get at least a few hours sleep. Tomorrow as the makings of another very long day.