medicine

The Snip, Part 1

I’d like to start with a joke:

Is there a difference between men and women?

Yes! There’s a vas deferens.

What’s no joke, though, is the human population explosion. There’re just too damn many of us, as I explained last year. That’s the primary reason behind my decision, held for pretty-much the entirety of my adult life, to choose not to breed.

World population for the last 12,000 years.

I’m fully aware that the conscious decision to not-breed by a single individual – especially in the developed world – makes virtually no difference to the global fate of humanity. I’m under no illusion that my efforts as a vegetarian are saving the world either. But just like the voter who casts a ballot for their party – even though they know it won’t make a difference to the outcome of the election – I understand that doing the right thing doesn’t necessarily have to have a directly quantifiable benefit.

That’s why I’m finally taking the next obvious step. Next month, after literally years of talking about it, I’m finally going to put my genitals where my mouth is (hmm… maybe that wasn’t the best choice of words)! Next week, I’m getting a vasectomy.

I first asked a doctor about the possibility of vasectomy about a decade ago. He remarked upon my age, and said – almost jokingly – “Come back in ten years if you still feel the same way!” I almost wish that I still had the same GP now, so that I could do exactly that. Instead, I spoke about a year ago to my (old) GP here in Oxford, who misled me into thinking that I would not be able to get the surgery on the NHS, and would have to have it done privately. Finally, a second doctor agreed to sign off their part of the consent form, and I was good to go. The secret, it seems, is persistence.

I suppose I'll be eligible for a Golden Snip Award. Click through for more information. — I suppose I’ll be eligible for a Golden Snip Award. Click through for more information.

I’m sure that this is a decision that won’t be without it’s controversies. And believe me: over the course of the most-of-my-life-so-far that I’ve hinted at or talked about doing this, I’m pretty sure I’ve heard all of the arguments. Still: I feel like I ought to pick up on some of the things I’ve heard most-often –

What if you change your mind?

Even despite medical advances in recent decades in vasectomy reversal, vasectomy should still be considered a “one way trip”. Especially when I was younger, people seemed concerned that I would someday change my mind, and then regret my decision not to spawn children.

I suppose that it’s conceivable – unlike my otherwise potential offspring – but it’s quite a stretch, to believe that I might someday regret not having children (at least not biologically: I have no problem with adopting, co-parenting, fostering, or any number of other options for being involved in the upbringing of kids). I honestly can’t see how that’d come about. But even if we do take that far-fetched idea: isn’t it equally possible that somebody might ultimately regret having children. We take risks in our lives with any choice that we make – maybe I’ll someday regret not having taken my degree in Law or Chemistry or Rural Studies. Well then: c’est la vie.

Do you just not like children?

Children are great, and I’d love to get the chance to be involved in raising some. However, I don’t define myself by that wish: if I never have the opportunity to look after any kids, ever, then that wouldn’t be the worst thing in the world: I’d just spend my years writing code in a house full of cats. I have no doubt that raising children is great (for many people), but just like there are plenty of people for whom it’s not great, there are also plenty of people – like me – who could be happy either way. No biggie!

There are those who have said that this laid-back “take it or leave it” approach, especially when coupled with the more-recent act of rendering myself infertile, will make me less attractive to women. Leaving aside the implicit sexism in that claim, wouldn’t a fair retort be to point out that a woman who is looking for monogamous breeding probably isn’t my “type” to begin with!

But you should be breeding?

This argument’s usually based on the idea that I’m somehow genetically superior and that my children wouldn’t be such a strain on the world as somebody else’s, or that mine would have a significantly better-than-average chance of curing cancer, solving world hunger, or something.

The explosion of planet Earth. — Only sterilisation can prevent the detonation of the planet. Maybe.

And let’s face it, any child of mine would be just as likely to be the one to build a really big bomb. Or create a super-virus. Or just engineer the collapse the world’s economies into a prehistoric barter economy in a technophobic future anarchy. Attaboy.

In any case, I’m pretty sure that my personal contribution to the betterment of the world ought not to be a genetic one. I’d like to make a difference for the people who are around right now, rather than hypothetical people of the future, and I’d far rather leave ideas in my wake than a handful of genes. I’m sure that’s not the case for everybody, but then – it doesn’t have to be.

Or are there some arguments that I’ve missed? If you’re among the folks who feel really strongly about this, then you’ve got about seven days to make them, and then it’s off to the clinic for me! Just remember: what’s right for me isn’t necessarily what’s right for you, and vice-versa. Just because I use Emacs doesn’t mean that some other, inferior text editor might not be the right choice for you.

I wonder what my surgeon might say to the possibility of me live-tweeting the process? Would anybody be interested? (I promise not to include any photos.)

(with thanks to Nina Paley for permission to use the comics)

The Tampon Gun

This picture’s been floating around the Internet lately. I’m sure that the guy in the picture thinks he’s original, but we totally beat him to it. Back in about 2003.

The difference is, though, that when some friends and I were messing around with about a thousand applicator tampons that had reached their use-by date, we went one step further. We sellotaped laser pointers to the barrels of our guns, and had a laser-guided tampon battle in the car park.

It turns out that laser sights don’t actually improve the accuracy of tampon blowguns. As a weapon, they’re worse than useless, of course – tampons have actually been used to save people from blood loss after a bullet wound. But still, it made for a more fun – if sillier – afternoon than would have been had by just throwing the damn things away, even if we did then have to spend quite a lot of time picking them all up and binning them anyway.

Ouch

Recently, I’ve been diagnosed with cluster headaches. I could tell you more about them, but I’d rather just point you at the Wikipedia article and say “that’s pretty much spot on.”

This picture, from Wikipedia, covers it pretty nicely, actually.

So that’s pretty shit.

It’s been several months now – long enough that, to begin with, I suspected that these new, severe headaches were something to do with the concussion I suffered while moving house. I’m still not convinced that they’re not: it just seems a little too much like a coincidence that that’d happen just weeks before they started.

Since then, they’ve come and gone. Attacks will come on every couple of days – usually at about 3am, but sometimes in the afternoon – for about two weeks, and then will be gone for several weeks. And then they come back again.

The pain is… incredible. I can’t even begin to describe it nor compare it to anything else. Painkillers don’t seem to touch it at all. The only success I’ve had with painkillers has been when I’ve taken so much codeine that I’ve had an “opium high”. The pain doesn’t go away, but at least then I don’t care so much. Then within a couple of (long, long) hours, it’s gone, leaving me drained and exhausted. Sometimes it leaves me with a headache – just a “normal” one, the kind that you can wince and ignore, or treat with asprin – for about a day afterwards, but usually it just disappears as quickly as it came on.

Those things on the left that are shaped like space rockets? They go up my fucking nose, would you believe it. They're supposed to be for migraines, and they seem to work for me - at best - about one time in three.

I’ve been working my way through a variety of medications, with limited success. Basically, the doctors are guessing. In sheer desperation, I’ve even been caught using mild-to-moderately ridiculous alternative treatment, like chiropractic. It didn’t work – it just left me with a new variety of back pain: temporary, I hope – but I think it goes some way to expressing how crippling it is when I of all people will go to a “spine wizard”. Needless to say, I’m still a long way from desparate enough to try the really stupid alternative medicines: it’s still got to at least sound like it might work before you’ll get me to try it – after all, it’s not like any of these therapies are without risks.

There’s next to no build-up, and no warning, and no relief: they just start and go away their own accord. That’s a terrifying feeling of powerlessness. It’s genuinely scary, going to bed during one of their episodic periods, and not knowing if you’re going to wake up in agony a few hours later.

We’re getting somewhere, though, hopefully. I’ve been assigned to a specialist (to whom I’m sure I’ll be as much a research subject as a patient: I suppose it’s pretty ideal – if you have a rare, barely-understood disease and you’re at the point of being willing to try anything, you probably make a great research subject), and in the meantime there are plenty more medications left to “try”. And I’ve been reading some of the thoughts of other sufferers via an online support group, some of whom have shared some of their relief/coping strategies (some of which I’ve tried already; others of which I’ll try in the future). So there’s still plenty of opportunity for a “fix”.

I didn’t blog about this before now because I was hoping to get to a point where I’d be looking back on it and laughing, first. I quite liked the idea of putting up a blog post – perhaps with some photos of my MRI scans, or something – and saying “Hey; look what happened to me! It’s medication-controlled, now, and the only side-effect is that I can shoot frickin’ laser beams out of my eyes! Muhahahaha!” But I guess that point might still be a way away, and I didn’t want to keep you all in the dark.

Anyway: there’s that, then. If you were hoping for a clean, concise blog post with some closure at the end, you’ll be left hanging. But hey: if I have to suffer, I might as well spread a little bit of suffering to you, too.

Content Freeze

Isn’t memory strange?

Last week, we updated to the latest version of the CMS that powers the Bodleian‘s web site. During the process of installing and testing the new version, we initiated a “content freeze”, disallowing the 100+ regular content editors access to the administration sections: any changes they’d have made wouldn’t have been replicated in the new version, and we didn’t want a discrepancy in content while we were testing that the change had taken! We still had back-end access, of course, and a few minor “emergency” changes were made (on both the old and the new version), but in general, the site was in a read-only mode for several days.

A similar thing happened to my head during this weekend’s house move.

While running a van-load of stuff from Old Earth to New Earth, Ruth, JTA and I stopped off at Argos to buy a few bits and pieces for our new home. We parked in one of the few remaining parking spaces capable of accommodating our extended wheel-base van. Unfortunately this brushed us up very close to an unfortunately-placed tree, whose branches reached in through the door as I clambered out. I spent a while trying to reposition them so as not to slam them in the door while Ruth and JTA walked ahead, towards Argos, and so when I was done they were quite a way ahead. I turned and ran to catch up with them…

BAM! Something struck me on the top of my head. We’re still not all in agreement as to whether it was a branch or the wing mirror of the van, but it hurt like hell. My knees buckled up and I collapsed into a heap.

Before long I was on my feet, but as I began to feel dizzy and nauseous, we started to worry that I might be concussed, and Ruth took me to the hospital. By then, I was unable to keep my eyes open without feeling like the world was spinning and I was going to throw up, and I kept feeling like I was moments away from falling asleep.

By the time I’d seen a doctor, about three hours later, I was starting to feel a little better. We took a leaflet of “things to watch out for after a concussion”, which advised that I shouldn’t lift any heavy things (“But I’m moving house today!”) nor use a computer or drink alcohol (“This is my life you’re talking about!”), all of which I ignored to some degree or another.

I napped on and off for a lot of Sunday and some of Monday, but it was on Monday that the amount of damage I’d done became most apparent. I got out of bed and staggered downstairs to find that Ruth and JTA had at some point bought a shoe rack. They weren’t around, but neither was the van, and I reasoned that they must have been out collecting more boxes, but I thought I might as well make myself useful by assembling this shoe rack they’d gotten. It was of the variety that hangs on the back of a door, so I spent some time deciphering the instructions and putting it together… only to find that it wouldn’t actually fit onto any of the (quite thick) doors in our new house.

That’s when Ruth & JTA arrived. “I saw you’d bought a shoe rack,” I said.

“Yes,” they replied, “We bought it yesterday. We told you about it.”

“Oh. I don’t remember that. Anyway, I built it, but it turns out that it won’t fit any of our doors.”

“Yes, we know: we told you that too. We were about to take it back to the shop.”

I have no recollection whatsoever of that conversation. Or several other conversations, it seems. In the hospital, I remember that Ruth talked to me for an hour or more (I wasn’t capable of conversation myself, some of the time, but it was nice to hear a familiar voice), and I still can’t remember any of it except for snippets (something about her father’s new house?).

For much of Sunday, my brain went into “content freeze”, too. A read-only mode where my memories worked fine, except that I couldn’t construct any new ones: everything just went in one ear and out the other. Maybe this is to be expected: a quick look at some maps of brains and an examination of the bump on my head indicates that the blow came to a point squarely in the centre of the middle frontal gyrus (the dorsolateral prefrontal cortex) of the right hemisphere of my brain: an area associated with emotional self-control, social judgement, lateral thinking, and the transfer of working memory.

Still: it was certainly a strange experience to be told about events from only a day earlier that I simply can’t remember. It also made Tuesday interesting: long weekends are confusing at the best of times, but parts of my memory made it feel like I’d had only a two-day weekend (as parts of Sunday are simply missing from my memory), and so it was even harder than usual to shake the feeling that it was Monday when I arrived at work on Tuesday. That’ll be a pleasant surprise on Friday, anyway, when the weekend “comes early”: maybe I should bang my head every time there’s a long weekend.

The Doctor That DOESN’T Just Tell You What You Want To Hear

I went to the doctor this morning to discuss the side-effects of the lariam tablets. I’d made the appointment just a week ago, when I was still having weird mood swings and not being able to sleep, like, at all. Since my last tablet, though, last Tuesday, I’ve been pretty much fine: nothing worse than the weird dreams, which I can cope with. I kept the appointment anyway.

“What I really want to know is,” I told the doctor, “Are the bad side effects – the ones I had in the first week – likely to come back? Is lariam one of those things that, if you get your body attuned to it, it’ll be fine from then on… or is it somewhat more random and unpredictable?”

“All I can say,” replied the doctor, and here’s the best line in the entire dialogue, “Is that if it were me, I wouldn’t be taking lariam.”

Lovely. Thanks, doc.

In any case, he’s agreed to write a prescription for a more expensive but less-controversial drug, which I can collect later in the week if my third pill (tomorrow) makes me go weird again. He seemed quite keen to switch me to it immediately, but I’ve opted to give lariam a go for a little longer yet.