June: “Don’t Spoil a Good Dream”

“Don’t Spoil a Good Dream,” illustration by Frank Mack, calendar, South Pacific Base Command headquarters, US Army, 1945. (In the public domain.)

Swollen Bear Is Swollen

My keratocystic odontogenic tumor was finally cut out of me earlier this week, and now I have a large gap where it used to be that needs to slowly fill with the appropriate tissues. The procedure was carried out by three surgeons and was rather intense, including carefully separating my exposed inferior alveolar nerve from tumor tissue, but they put me back together so well that my jaw did not need to be wired and I can even speak fairly well. I am now recovering quite comfortably thanks to good medication. I am on a liquid diet for a few days but will be on a soft diet before the week is over. Also of note: At no point in time did anyone at the hospital ask me which three oral surgeons I find the sexiest in the whole clinic, yet those were coincidentally the very three who did the job.

The illustration

“Mr. Bear Came Down with the Mumps,” illustration by L. J. Bridgman for “The Strange Story of Mr. Dog and Mr. Bear—The Christmas Tree,” by Mabel Fuller Blodgett, St. Nicholas, Dec. 1915, 185. (In the public domain.) (Internet Archive) (Flickr)

My Surgery Is Nigh

The time has finally come when the keratocystic odontogenic tumor (KCOT) about which I have been complaining for more than a year will be cut out of me. A few facts about my procedure:

— The tumor extends from my left wisdom tooth down my jawline to the further (right) side of my chin. Over the course of my long treatment, it was hoped the tumor would shrink. Although it has indeed shrunk, it got flatter and narrower but not significantly shorter. This means I still need quite a long incision for it to be excised, which I estimate from a tape measure held to my face to be at least six inches.

— Because this type of tumor is particularly aggressive, every last little bit of it needs to be scraped out, which necessitates removal of bone tissue at least a millimeter deep from parts of my mandible that are in contact with it. I will also need annual visits to an oral surgeon for the rest of my life to ensure the tumor doesn’t recur.

— There will be direct manipulation of my inferior alveolar nerve by my surgeons. Such intimate interaction with the nerves may leave me with some paresthesia on my face, possibly for the rest of my life. I admit I am concerned about whether my verbal articulation will be affected, and if so, how much.

— My jaw may be immobilized after surgery, and I will eat only a soft diet for a time. In preparation, I have stocked my apartment with soup, sauce, baby food, ḥummuṣ, yoqurt, butter, sour cream, cottage cheese etc.

I have great confidence in my surgeons’ abilities so I find I am not fearful. I will write about the recovery in the upcoming days as I expect to have more time to be online than ever before. See you later.

The drawing

Fig. 88, “Patient with dentigerous cyst,” uncredited illustration in Injuries and Diseases of the Jaws: The Jacksonian Prize Essay of the Royal College of Surgeons of England, 1867, 3rd ed., by Christopher Heath, Philadelphia: P. Blakiston, Son & Co., 1884, 192. (In the public domain.) (Internet Archive) (Flickr)

After some of my friends requested information on my health and others expressed some confusion over it, I offer this health update.

• As you may remember, the x‐ray I had in August for sciatica incidentally revealed evidence of kidney stones, which led in October to a visit with a urologist who ordered another x‐ray and a CT scan so he could properly diagnose me. Much of November and December was spent correcting multiple billing, scheduling and authorization errors made by the health providers’ offices and by the insurance company, but I finally received the x‐ray and CT scan on different days earlier this month. When I was again seen by the urologist, the test results showed, not surprisingly, that I do indeed have kidney stones, and they are large enough that he recommended laser lithotripsy. Because I am in no pain and because I am facing significant oral surgery in the near future, we postponed my next urology visit until springtime.

• The last time I was seen by the oral surgeon in October, x‐ray and CT scan results showed that I had good bone tissue regrowth, but that the tumor itself hadn’t shrunk significantly. The aforementioned billing, scheduling and authorization errors, as well as the snowstorm, delayed the following visit, but it will be tomorrow (Wednesday), and based on our telephone conversations, the removal of the tumor on my jawbone is imminent, possibly within the next two weeks.

Good news and bad news

So the sciatic pain about which I complained in August is gone, at least for the time being. However, the routine x‐ray of my lower back incidentally revealed what look like calculi in my kidney, so now I have an appointment with a urologist too. If it’s not one thing, it’s another. 🙂

🖻 Uncredited frontispiece in De ischiade nervosa commentarius, by Domenico Cotugno, Vienna: Apud Rudolphum Gräffer, 1770. (In the public domain.)

Previously

• “Sciatica I have,” 21 Aug. 2015.

• “Sciatica ideographs,” 25 Aug. 2015.

• “It seems a warm shower…,” 26 Aug. 2015.

Sciatica ideographs

These are the ideographs (three emoji characters and an Egyptian hieroglyph) that I used in my sciatica post, arranged like a comic strip to be read from left to right and lightheartedly portraying how my walking was affected by sciatic pain.

🚶 PEDESTRIAN

💥 COLLISION SYMBOL (here representing the sudden onset of pain)

😧 ANGUISHED FACE

𓀗 EGYPTIAN HIEROGLYPH A019 (“bent man with cane,” “be infirm; old …”)

Graphic by Elyaqim Mosheh Adam.
• The glyphs for the first three characters (🚶, 💥, 😧) are from the Twitter Emoji set, developed by Twitter with the Iconfactory, under a Creative Commons license.

• The glyph for the final character (𓀗) is from the open‐source Noto Sans Egyptian Hieroglyphs font, commissioned by Google, under the Apache License.

Sciatica I have.

I regret to say that I’ve been diagnosed with another ailment. For the past two weeks, I have had pains in my hip and thigh that led to occasional difficulty walking. I also have some numbness and weakness of the muscles in that leg that led to my knee giving out and my falling into a sitting position on two occasions (on the 13^th and 15^th, both times while socializing in community organizations).

Sunday night and Monday morning, the pain was at its worst, almost unbearable. It had largely subsided by ten o’clock so I walked to the doctor’s office and was diagnosed with sciatica. My primary care physician’s associate told me how nerve pain is very persistent and how physical therapy doesn’t work for everyone and how they would talk to me about pain management if physical therapy didn’t work for me. Then I went home and looked at Wikipedia—not the most reliable source, I acknowledge—which gave a very different story: “Often all that is required is time and in about 90% of people the problem goes away in less than six weeks.”

Wednesday morning, I limped to the nearby radiology building for a spinal x‐ray, but that night and Thursday morning, I was nearly pain‐free and was able to socialize. I’ll be starting physical therapy next week, but I’m feeling pretty well as I write this; today, only a little pain has returned and it’s intermittent. I’ll keep folks informed should they be interested.

🚶 💥 😧 𓀗

23 March–19 April 2015 microblogging

Microblog posts of mine that only made it to Twitter and not to Google or Tumblr.

Just another visit with my oral surgeon. —23 Mar.

A consultation with the surgeons. —25 Mar.

I’m still getting over a gastrointestinal bug I first noticed Wednesday when I preferred to stand in the hospital waiting room than sit. 🏥😷 —27 Mar.

Ensalada con pollo. —27 Mar.

House of Cards ≠ “Oscar’s Farts,” a rarely seen episode of The Odd Couple. 📺 —1 Apr.

Chef salad. —2 Apr.

With participants from the gay men’s discussion group. —3 Apr.

Una otra ensalada con pollo. —9 Apr.

At the Persian Parade. —19 Apr.

At the festival after the Persian Parade. —19 Apr.

With five participants (plus the facilitator), the gay men’s discussion group Friday was quite well attended compared to how it’s been recently. The introductions and preliminary talk about ourselves led into an organic discussion about addiction. As it turns out, I was the only one without an addictive personality; everyone else present has had true addictions to alcohol or to recreational drugs or to sex or to overeating. Gripping a discussion as it was, I had difficulty relating to it for that reason, but also for one other: Multiple participants were happy to attribute their strengths to God and take credit for their accomplishments away from themselves in order to hand it over to a Deity. Even those who saw the benefit of praising and recognizing merit in human accomplishment still tempered it with God talk. (God gave me the tools the overcome my addiction but I had to use them.) The facilitator even attributed human ethics to God, saying that he truly believed that our internal voice that knows right from wrong (to which we do not always listen) is God. Another participant compared God to the sun and humans to the planets which revolve around it. Nevertheless, this was an exceptional discussion in which I learned about their strategies for overcoming their issues and I got to briefly discuss the adjustment disorder I feel I had in the early Aughts.

It was the first night of Passover and I had no seder to attend, but I went out to eat with the men’s group participants to a local diner and had a Passover meal of chicken cordon bleu, a garden salad and side vegetables (no bread).

16–22 March 2015 microblogging

Microblog posts of mine that only made it to Twitter and not to Google or Tumblr.

I felt sorry for the ḥalal truck guy because he looked so cold. I wanted to cuddle with him to keep him warm. 🌡 😈 —16 Mar.

The crazy song mash‐up in my head: “Sweet, Fast Hooker Blues,” “Rock This Town” and “Polythene Pam.” 🎵 —16 Mar.

The @KeyFood “Louisiana style” hot sauce I get from Global Supermarket is quite bland; my food sooner tastes too vinegary than pungent. 🌶 —16 Mar.

Each day for breakfast, I have a makeshift nargesi: scrambled egg, spinach, mushroom, garlic powder, black pepper and hot sauce. 🍳 𓆇 🍄 —16 Mar.

No one phoned me all day. Within five minutes of my stepping into the shower, the phone rang. 🚿 ⚞☎ 😣 —16 Mar.

Thinking to mix tuna salad with a garden salad. —16 Mar.

I had to convince and push myself to begin my daily constitutional today but returned with a spring in my step, bounding up the stairs. 🚶→🙋 —16 Mar.

❝ “Building your dream has to start now. / There’s no other road to take.” —⁠John Farrar, “Magic,” 1980. 🖊 —18 Mar.

🌬 34°F, wind 13 m.p.h., feels like 25°. So much for my “daily” constitutional. Novruz and the equinox are on their way. Right? 🚷 —18 Mar.

Rubbing elbows with important persons after the film festival. —19 Mar.

Every discussion group participant (other than the facilitators) is here with me! —20 Mar.

Having keys duplicated. —21 Mar.

⚕ Regarding my health: I got some good news from my oral surgeon yesterday. Although I have tremendous bone loss in my mandible from the keratocystic odontogenic tumor, the panoramic x‐ray taken yesterday showed the first signs of slow but significant bone tissue regrowth compared to the image from three months ago. At that rate, he estimated another six months to a year before the final surgery to cut out the tumor. (The bad news is that he’s moving on to another institution and I’ll be assigned another surgeon in the new year.)

👅 Regarding language: Two other surgeons, both Jewish, were also looking at the radiographs, and the older one used a Yiddish expression that the handsome younger one, bedecked in a kippa, did not understand. (Unfortunately, I missed the expression itself, only paying attention once I heard them discussing the Yiddish language.)

Also, I don’t associate the neighborhood with Semitic languages but rather with Indo‐European and Sino‐Tibetan ones; however, another attractive Semitic man was talking emphatically in Arabic into his mobile telephone on 82^nd Street and then a couple sitting next to me in the hospital waiting room were talking in Arabic as well.

My Sleep Study

➡ I had a sleep study 6–7 October but am only now telling the story.

◦ Although I had been told that if I didn’t show up for the test or if I canceled it too late I’d be charged two hundred dollars, I had been told little else about the sleep study in advance. For example, I had not been informed ahead of time that I’d have a private room in which I’d be able to change clothing, so I wore loose clothing in which I intended to sleep.

◦ The technician attached a tremendous number of polysomnography wires to me, mostly to my head, some of which were fed down my shirt or my trousers leading into a box that looked like a telephone switchboard.

◦ I had been assigned a room soon after I’d arrived, but after all the wires were attached, I was instructed to sit and watch television for a number of hours before the test would begin. (I watched Antiques Roadshow.) Although I had access to a toilet and to drinking water, I was expected to be at the clinic many hours without having access to any food.

◦ When the time for the test finally came, I got in bed and the technician spoke to me from another room, apparently testing the connections: “Look to the left. Now look to the right. Now move your left leg. Now grind your teeth. Now slower.” We went through the same routine in the second part of the test and I didn’t understand why grinding my teeth was the only thing I needed to do at two different speeds until I realized she had not said “Now slower” but had instead said with an accent “Now snore.”

◦ I wasn’t allowed to sleep on my belly, the position that allows me to breathe most easily when horizontal, but only on my side or back, so I had some difficulty falling asleep. Eventually, I got into some pretty good dreaming but the technician abruptly walked in to begin part two of the test.

◦ She fitted me with a CPAP mask and left the room again. I was on my back the rest of the time, so I had to strive to keep my mandible forward in order to breathe properly, and I actually felt myself stop breathing a few times before finally falling asleep. Needless to say, because I was in a position in which I have some difficulty breathing even when awake, and because I only had about half the night remaining, I didn’t sleep very much. At the setting used, the CPAP machine seemed to have at most a negligible positive effect. I thought the technician might occasionally enter the room and alter the CPAP pressure but she did not.

◦ After barely sleeping the entire night, I was awakened in the morning, given a survey form to fill out and then discharged. Despite the conductive gel still in my hair, one of my first priorities when back in my home neighborhood (after running into a number of friends) was to eat.

The Importance of Protein in Evolution.

I was thinking about how human actions affected our evolution. Persons born with beneficial mutations or adaptations were more likely to survive and pass on those genes to successive generations. If it is in fact of genetic origin, a preference for the taste of cooked food seems to have protected certain humans from deadly microbes and hence led to the possession of those genes by a larger segment of the population.

Consequently, could a liking of the taste of meat have impacted human evolution irrevocably, whether positively or negatively? A little research seems to have borne out that eating meat has indeed had a dramatic effect on our evolution, although whether the taste itself contributed to it still eluded me. The increased amounts of protein had a beneficial effect on our brains, and our bodies also increased their ability to digest fats and cholesterol. This may seem like an endorsement of eating meat in modern times, but it is rather a recognition of the importance of diets that are high in protein and presumably low in sugar. While an omnivorous diet would meet those criteria, modern‐day vegetarians can consume large amounts of légumes, nuts and seeds as protein sources.

• Bernard Campbell, Human Evolution: An Introduction to Man’s Adaptations, 4^th ed. (Piscataway: Aldine Transaction, 1998), 277. “Meat is a concentrated form of food comparable to seeds, which have been exploited by the rodents and are no doubt a contributory factor to their great success. Meat contains a high percentage of protein and, when digested, will release a whole range of amino acids necessary for the synthesis of body tissues. … Meat also contains vitamins (particularly in the liver) that are not readily available in a vegetable diet. There is little doubt that the final stage in human evolution was correlated with the exploitation of the large terrestrial mammals. … Our immensely successful evolutionary radiation must be associated, then,…with an important change in emphasis from a diet that was mainly vegetarian to one that was increasingly omnivorous.”

• Anna Gosline, “Taste for Meat Made Humans Early Weaners,” New Scientist, 29 January 2005. “[T]he nutritional benefit of eating meat at a younger age would have helped children’s brains to grow and develop more quickly. Human brains grow three times quicker than those of chimpanzees.” The article also states however that eating meat may have made human lives shorter: “[A] branch of hominids began to eat animal carcasses—a risky activity that would have brought them into contact with other predators and significantly raised mortality rates for the hunters. This would have created a selection pressure to wean infants earlier and earlier, since those no longer dependent on breast milk would have been more likely to survive their mother’s death….”

• Hillary Mayell, “‘Evolving to Eat Mush’: How Meat Changed Our Bodies,” National Geographic News, 18 February 2005, 2. “When humans switched to meat-eating, they triggered a genetic change that enabled better processing of fats…. [A]s a species we are relatively immune to the harmful effects of fat and cholesterol. Compared to the great apes, we can handle a diet that’s high in fat and cholesterol, and the great apes cannot.”

Photo credit: Matt Lewkowicz (Horsefeathered).

A version of this article is reproduced at webcitation.org/5kYw1atS3.