After the family farce disaster that my previous post caused, I've been very hesitant to post another update without an actual diagnosis. But it's been three months and four specialists since this started, and still no one has any idea what's causing stupid neck syndrome*.

Dr. Oncologist ran out of ideas for which to test. Dr. EarNeckAndThroat ran a similarly thorough series of imaging and blood tests and came up empty. Dr. Lymphodema did a whole body lymphoscintigraphy and made the shocking discovery that my upper left arm has lymphodema. Considering the amount of surgery in that general area, it's actually doing rather well. But she doesn't want to subject me to any treatments stronger than a compression sleeve until the neck issue is straightened out.

About two weeks ago Dr. Rheumatologist received her invitation to the party. After her initial consultation, she prescribed naproxen to help alleviate the pain. Unlike Dr. ENT's steroids, the naproxen actually significantly helped with pain and didn't make me go crazy! I can turn my head to the right! My emotions are no longer limited to cranky and bitchy!

Sounds wonderful, right? Well, not quite. I can't just keep taking naproxen forever, so the actual cause of stupid neck syndrome must still be determined. With that in mind, Dr. Rheumatologist ordered me exsanguinated to the tune of seven vials.

Note to vampires: I do not have possession of these tasty, tasty carafes.

The results of whatever esoteric tests are being run this time are supposed to be in two days from now, on Friday. I won't hold my breath.

* Stupid neck syndrome is characterized by the elongated lymph nodes and the extended and hardened jugular on the right side of my neck, despite both my lymphatic and cardiovascular systems running smoothly.

After years of trying to explain an obscure Captain Beefheart reference, I finally gave up and took my orange claw hammer to both the name and layout that have grown so ugly in my eyes. I must admit, however, it took far too much time to redesign, what with Matt doing all the work and me supervising. But that is now over, and aside from some minor details that you will tactfully ignore, this is the day it finally goes live! Well, without further ado, I'm glad to announce "A Failure of Natural Selection!"

According to all my computer science training, the clear spot for the '!' would be outside of the quotes, as it is not part of the title string. Ergo, despite having succumbed to proper grammatical protocols, I have to ensure there is no confusion in such circumstances.

I volunteered for take your child to work day because I had nothing else to do on a Thursday afternoon. Why just the afternoon? My morning was already booked with happy fun time shot of Lupron. Therefore, aside from the obvious problems associated with putting me in front of a bunch of impressionable youths, there were no other reasons for the organizers to be worried. So I fainted.

I was informed afterwards that I was out for about 10 seconds and my eyes rolled back into my head. And yet somehow I convinced everyone not to call an ambulance, since the person who just lost consciousness is clearly the person who should be making medical decisions. More than one doctor made me promise not to do that again. Yes, the next time my brain completely misfires, I swear I will be more rational.

My brain continued to misfire for the next few weeks. Massive headaches, severe balance issues, and lots of nearly fainting. To top it all off, I managed to get TWO periods because why not. So instead of going to work, I spent lots of quality time in cold exam rooms under the tutelage of various doctors.

After thousands of dollars worth of nearly every medical test possible, not one doctor could satisfactorily explain what went wrong. The only thing they agreed upon was that things went awry.  Useful.

Time for another stab in the butt! This time things went more according to plan. The hot flashes came back and the brain problems stayed away for an entire month. At my next pre-stabby-time conference with Dr. Oncologist, she became suspicious. Completely unheard of side effects randomly appearing mere hours after administration that disappeared equally mystifyingly the next month? Sounds like a bad batch.

A quick look through my dismayingly large file revealed that the lot number on the malfeasant dose was different from all of the others. While rare, bad batches* do occasionally occur, so she was going to look into it.

Then things got really weird. Blood tests revealed that my hormone levels were correct for someone on Lupron. Clearly the drug was working, and yet Aunt Flo continued her monthly visits. Dr. Gynecologist and Dr. Oncologist asked colleagues for second, third, and twenty-seventh opinions, but no one could explain it. They concluded that it had to be some sort of fluke and that it wouldn't happen again next month.

Was anyone surprised when they turned out to be wrong? Nope! An ultrasound revealed that the cyst on my left ovary was back, and Dr. Gynecologist dove in for a closer look. She took a sample of uterine lining straight from the source, which was merely uncomfortable. The biopsy, on the other hand, was absolutely horrible.

Using the external ultrasound, Dr. Gynecologist attacked with a ten inch needle via the internal route. She stabbed her way into the normal looking cyst on my left ovary and grabbed a piece of tissue. Even worse, it took ten excruciatingly long seconds. "One one thousand. Two one thousand..."

The assisting nurse wiped away my tears, while complementing me on my lack of screaming. I think it's safe to assume that will never happen again. Then came the bad news - I have two ovaries. Time for round two, despite the right side never having any cysts.

I patiently waited a full week for the results. There was absolutely no random panicking or needless fretting. I certainly didn't check my phone for missed calls every three seconds. And yet the phone eventually rang! Everything was normal, for whatever version of normal applies to my entrails.

Still completely unable to explain what was happening, the doctor brigade decided to continue with the Lupron shots. Any further weirdness would trigger a new round of intricate tests of my intimate parts, but there was nothing left unturned for now.

I assume my ovaries were waiting to hear that. "We've experienced every possible test, so let's behave for awhile and see if something new happens!" "Great idea!" Miraculously they did just that - August came and went without a period. I can only hope September is similarly uneventful, but I'm not holding my breath.

* Unscrupulous douche canoes sell watered down or completely fake medicine to idiots who don't stop to think "huh, this brand new supplier is disturbingly cheap." Dr. Oncologist assured me that this was not the case here. If it was a bad batch, it was a legitimately manufactured bad batch. Yay?

The sole benefit of being stabbed in the butt by a Lupron-wielding nurse is not getting a monthly period. Well, that and the whole cancer prevention thing. But anyway, when I managed to get a period despite the Lupron, I did the only rational thing - "MATT! HELP!"

Oddly enough, he didn't have any useful advice, so I fell back to my usual plan of panicking and calling Dr. Oncologist. Of course she wasn't on call that weekend, forcing me to explain all the gory details of my lady bits to an unknown male. At least he was more knowledgable about the subject than Matt, and he assured me that while rare, it was not unheard of for a system to empty out any lingering material. Panicking could wait until after more than 48 of bleeding.

Gee, want to guess what happened next? If you said a Monday morning visit to Dr. Gynecologist, you win! I, on the other hand, did not win, though I received a thorough poking for my troubles. And the phlebotomist withdrew enough blood to run every possible test and feed two hungry vampires. And the radiologist got a good look at my uterus from every ultrasound angle. EVERY angle.

Once all of the test results were in, the standard doctor conference call ensued. The official result? I have mighty ovaries! For some, 3.75mg is just not enough to block estrogen production, and they "break through." Time to double my dose! Oh, and I was the proud owner of a 5cm cyst on my left ovary.

If I was normal, the cyst would also be normal. Apparently they come and go without causing alarm. But I'm not normal, so while more panicking wasn't called for, it was something to keep an eye on. Thankfully, further scans showed it shrinking, and within three weeks, it was gone.

After previous surgeries, I was still able to use my right arm. This time righty was subjected to the knife, so I had exactly zero useful arms. Matt had to help me with everything. Everything. To make matters worse, he refused to make airplane noises and pretend the fork was coming in for a landing when feeding me! With such subpar hospice care, it's a miracle I heeled at all.

Having long since grown sick of being stuck at home, I quickly grew restless. I needed something to occupy my drugged out mind. Clearly there was only one solution: Lego video games! By the time I returned to work, I managed to not only beat, but get every achievement on Batman 2, Harry Potter: Years 5-7, and Lord of the Rings. A worthwhile pursuit, if I do say so myself.

Alas, even with the drugs, mindless video games weren't enough to overcome the ennui associated with never leaving the house. This resulted in me deciding that we needed to buy lots of tiny drawers to better organize things RIGHT NOW, which is how I found myself at The Container Store less than two weeks after surgery.

I stumbled through the aisles, completely amused by nearly everything, such as a two foot tall metal filing cabinet with oodles of thin drawers. The best part? It was orange! Imagine the fun I could have opening and closing the drawers if only it wasn't on the very top shelf!

Matt valiantly attempted to get down the new object of my affections. What he failed to notice was a three inch clear piece of plastic at the edge of the shelf. The bottom of the cabinet caught and all the pointy metal shelves tumbled out. I instinctively reached up to save Matt's head from imminent peril. If that wasn't bad enough, I managed to deflect the impudent drawer into my left boob, pointy side first.

"AHHHHHHHHHHHHHHHH!"

The employee a few yards away helpfully chastised us with, "The plastic is there so you don't take things down off the top shelf. It's clearly labeled." Then he calmly strolled away, under the guise of getting help. He never came back.

Eventually I stopped screaming, if only because I needed to inhale. Meanwhile, Matt surveyed the shelves looming over head. Sure enough, some of the plastic "guards" were labeled, just not the one in question. Hmmm... lawsuit?

The overwhelming desire to evict the evil expander counteracted most of my fear, making my time in pre-op less horrific than previous visits. However, not even Lupron-induced hot flashes could counteract the sub-Arctic temperatures common to every hospital. Luckily for me, this hospital uses Bair Paws, which provided me with both amusement and warmth at the same time!

My temporary residence in bay 4, prior to operating room 4.

It is a well-known fact that I am a klutz. And even though I haven't gotten around to posting about my most recent adventures in surgery land, it is also a well-known fact that I have a fairly useless left arm. I'm sure you can guess where this is going.

Two days ago I decided to make myself a nice cup of tea at work. I merrily skipped over to the microkitchen and stretched as far as I could to get down a paper hot cup. I squeezed in a generous dollop of honey from the bear-shaped dispenser, plopped in the tea bag, and centered the cup under the instant hot beverage machine. Hot water, large, and start! Hmmm, there seems to be distinct lack of fullness in my cup. Hot water, small, and start! One perfectly filled cup of searingly hot liquid. I'll just pick this up and SPLURSH EVERYWHERE!

Somehow my left had escaped unscathed, while my innocent right hand was delicately charred. A combination of cold water and ice saved me from years of skin grafts, but nothing could hide the sticky, hot mess covering everything. I manned up, found a janitor, and apologized profusely.

Well, that was thoroughly embarrassing. Not willing to let such a challenge go unanswered, I managed to one up myself today.

The first Friday of every month is brunch day. Some people complain about not having two distinct giant buffets from which to get their meals, but I love having waffles for lunch.

I very carefully used my right hand to hold a cup underneath the batter dispenser so as not to risk a second failure of strength. With my emaciated left hand, I started to push on the nozzle. WOOOOSSSHHHH! THE ENTIRE NOZZLE FELL OFF!

The batter instantly overwhelmed my tiny, one serving cup.

"SOMEBODY HELP ME! THE WAFFLES ARE ESCAPING!"

Well, that got everybody's attention. A nearby coworker grabbed two large bowls and sprinted to the rescue. In the five seconds it took to fill both bowls, two members of the kitchen staff arrived on the scene with the proper tools to curtail the flood. But first they had to finish laughing at me.
One of them knew the secrets of the batter dispenser and removed the tank, but, alas, it was already empty.

Ten minutes later I was mostly debattered and order had been restored to the waffle station. I gingerly tempted fate by daring to try again. If ever I earned a waffle, that was it. And it was delicious.

That is how creating an epic mess became known as pulling a <me>.

After nearly a year with the horrible expander, I was actually looking forward to having it replaced with a nice, comfy silicone-gel implant. Just the thought of being able to sleep on my stomach made me giddy. Not giddy enough to merrily skip into the operating room, but enough to ward off most of my normal pre-surgery fears.*

As the operation date loomed near, I had the standard rounds of doctor appointments. What was not so standard was being handed a binder full of Playboy models and being told to pick out my ideal breast shape. I was even given post-its to note particularly good features. Having never been a teenage boy, I never realized that there are so many different considerations.

While I carefully compared 1959 boobs to 2006 boobs, Matt very carefully ignored me in favor of his phone. "What do you think of these?" "Umm..." "Do you think these are too big?" "Err..." "JUST GET OVER HERE AND HELP ME LOOK AT BOOBS!"

Ultimately, I gave Miss December 1963 best overall, though a few 1970s centerfolds made very good showings. Matt agreed.

With that out of the way, what size would I like? Honestly, I never had any real desire for bigger boobs. Alas, it would be impossible to make them reasonably symmetrical without increasing the right side at least a bit. Considering how highly I value symmetry, I decided that a slight increase was something I could live with.

A weighty matter hangs in the balance.

Dr. PlasticSurgeon explained that she wouldn't know exactly how much of an increase I would receive until she took out the expander. If I was lucky, the right side would only have a vertical scar extending downward from the areola. By pinching the skin underneath, the top would be perkier and a closer match to the entirely fake boob on the other side. If I wasn't lucky, I'd wake up with a lollipop scar, with the top part encircling the areola. Admittedly, when I stopped giggling, I was okay with either option.

I asked the doctor if I could have the expander after removal. I had grand plans involving a rifle and YouTube. She understood the sentiment, but deemed the lab techs to have a higher priority. I suppose being slowly dissected for biopsy is a crueler fate than instant destruction, so I acquiesced.

With all of the formalities taken care of, I managed to maintain my eager anticipation until the day prior to surgery. The real miracle, however, was that I didn't change my mind about my choice of new boobs.

*It's really not a good thing that I have a well-established baseline for "normal" surgery apprehension.

I have Obsessive Compulsive Disorder, though apparently I forgot to tell the internet since there isn't an existing label for it. While I now freely admit that my functionality highly correlates to the number of milligrams of Paxil I took the night before, I used to be quite embarrassed about the whole situation. And with tidbit out of the way, we may now begin our story.

Normal people whose tumors with estrogen receptors have been thoroughly eradicated are prescribed five years of Tamoxifen. Assuming the patient doesn't ingest the entire supply at once, it prevents new tumors from growing. If things go as planned, the Tamoxifen gets to the receptors before any estrogen, making the cancerous cells too sad to multiply. It is the standard treatment for pre-menopausal women and slightly super important.

Why did I bother mentioning the OCD? Because combining Paxil and Tamoxifen is equivalent to combining matter and antimatter, so taking both is a laborious way of doing absolutely nothing useful. But wait! Oddly enough, it's common for cancer patients to be on anti-depressants such as Paxil, so there is a standard solution: Effexor for everybody!

The faster I switched to Effexor, the faster I could start preventing future tumors. Doctor Oncologist and Doctor Psychiatrist talked about me behind my back, and Doctor Psychiatrist prescribed an agressive titration from Paxil to Effexor.

To say that the Effexor didn't work would be an understatement. It anti-worked. It was such a fail boat that I missed work. Doctor Psychiatrist made the executive decision that not having me committed to a mental hospital was a higher priority then preventing theoretical future problems. An even more agressive titration back to Paxil was prescribed.

My brain had enough and went on sabbatical. Massive headaches prevailed. It ended up taking nearly three weeks to fully switch back to Paxil, and I ended up on a higher dose than when this mess started. But I was functional human being again! Hooray for the little things!

Doctor Psychiatrist declared her job done and sent me back to Doctor Oncologist. She clearly couldn't give me newfangled Tamoxifen, but she could use good old-fashioned estrogen prevention drugs. A monthly shot of Lupron makes my butt sad and prevents estrogen production in my ovaries. A daily Letrozole pill prevents estrogen production in my brain. While usually reserved for post-menopausal women, this regimen has a slightly better long-term outcome. If there's absolutely no estrogen production, none can elude the Tamoxifen and bind to a receptor.

Of course, Doctor Oncologist wants to do this for ten years. Only 120 shots in the butt with a three inch needle. But on the bright side, I get an equal number of skipped periods. I can think I can live with that.