Tuesday, June 10, 2008

Physician & Pharmaceutical Phun

Calories eaten yesterday: 1398
Fat: 29g (19%)
Carbs: 109g (31%)
Protein: 178g (50%)
Weight this morning: 132 (One week ago: 132.4)
Calories burned in exercise today: 0

This one is going to be long.

Where do I start? My alarm went off at 6:45 a.m. I got up, weighed myself, and got dressed. Brad was there shortly after 7 with a black Venti coffee for me and we were out the door about 7:30. I left the cats extra food since I didn't know if I would make it home before work.

Brad and I were at the clinic in Castro Valley well before 9 a.m. I made out a bunch of paperwork. They said they needed a urine sample so I did that. Later they asked for two days' worth of stool samples and sent me off with a kit that I am to complete and mail off.

They took me to an exam room and the doctor's assistant took my vitals. My blood pressure was low (about 90/60 I believe), and my temperature was 97.6 or some such (about 1 degree below normal).

They performed an EKG on me with about 10 electrodes attached to various parts of my body. I laid on the exam table and the lady said just to relax.

The assistant then took three vials of blood for testing - liver, glucose, cholesterol, thyroid, and something else I don't remember. She had to stab me twice because I moved my head and turned away when she stabbed me the first time and she said my vein moved. The second stab didn't hurt as much at least.

After the blood tests they gave me a NutriGrain bar and a juice box. I took the box, but turned down the bar since I had a Snickers with me.

Then they took me to the back for chest x-rays from the back and side.

Dr. Turns seemed nice. Since the clinic in Alameda refused to send me records without my written consent in person, I brought in my prescription bottles. He agreed to keep me on the Celexa and Xanax. They want to see me back for a PAP smear. I asked the doctor for a couple of Darvon (a prescription painkiller) since I am a virgin and even the junior forceps hurt like hell. He readily agreed. I eventually walked out with a prescription for 100 Celexa pills (3 refills), 100 Xanax pills (the full 1mg type!) (1 refill), and 10 Darvon (no refill of course).

After the doctor we went to McDonald's where I had a Big Mac (light sauce), a medium fries (split with Brad), and a sugar-free vanilla iced coffee. After that we drove back to Oakland and went to Jack in the Box where I has a sourdough grilled steak sandwich, curly fries (split with Brad again) and the new Kona coffee shake.

Then we drove to my old doctor and filled out the paperwork for a transfer of my records to the new doctor. Thank God that is over!

Then we went to Safeway and I got one donut, and then onto Applebee's for a Mochatini and the hot fudge dessert shooter (a small dessert). The dessert shooter has vanilla ice cream and I told the bartender to put lots of chocolate on top. She mentioned Lourd's ice cream around the corner (how could I forget?!) so we went there next and I got a junior sundae with Rocky Road ice cream.

Then Brad and I went to Costco to get my prescriptions filled. I called Canada and they said they could fill the Xanax, but only if I mailed in the prescription (no faxing allowed), and that seemed too much of a hastle.

Costco turned out to be hecka cheap. 100 tablets (1mg each) of generic Xanax was only $12.56, and 10 tablets of Darvon was $7.41. I didn't think they would be cheapest for my Celexa, but I asked then to check anyway. They do have a generic for it and 100 tablets (40mg each - my normal dose) is just $10.24!!! WTF?!? I pay about $75 for that amount in Canada! How it is so cheap here? Anyway, I got all my prescriptions for about $30.

They said it would take about 35 minutes to fill all the prescriptions. I had a hot dog and Diet Coke while we waited.

After all this Brad drove me to work and I was only a little late. I asked him to get me three cookies at Subway. Yum-my! I went back later and got three more cookies and a 6-inch ham sub (they were out of turkey and chicken).

Whew! What a day! Needless to say, I will not be going to the gym tomorrow. I'm sleeping in and recovering from today. Also, I seem to have hurt my right upper thigh either during my workout yesterday or from some way I slept last night. It hurts to walk so running is out of the question. However, I think it's minor and should resolve itself fairly quickly. I'll "walk it off" until it feels better.

No exercise today. Since I didn't come in on BART I didn't even get my 30 minute walk in.


Okay, the next part is me "thinking out loud" about how much Darvon/Tylenol to take before my Pap.

The Darvon (Darvocet) (100mg) is paired with acetaminophen (Tylenol, actual name paracetamol) (650mg) to prevent abuse as Tylenol will make you really sick and kill you if you take too much. So I have been researching how much Tylenol is too much so I can take the max dose for pain without doing any serious damage. So far it's looking like 4000mg of Tylenol could do serious damage, and possible 3250mg (the amount in five Darvon). Four Darvon would be 2600mg, quite safe.

Wikipedia says:
The toxic dose of paracetamol is highly variable. In individuals over 6 years of age, single doses above 200 mg/kg consumed over a single 24-hour period have a reasonable likelihood of causing toxicity. If an individual has consumed large quantities of paracetamol over a 48 hour period, a dose of above 6 grams or 150 mg/kg in the subsequent 24 hour period may cause toxicity. Toxicity can also occur when multiple smaller doses within 24 hours exceeds these levels, or even with chronic ingestion of doses as low as 4 g/day, and death with as little as 6 g/day. Consumption of alcohol has been tied to a smaller dose toxicity.

So running the numbers I am about 130 lbs. at my lowest weight of the week. That's 59 kilograms. So 200mg/kg is 59x200 which equals 11,800, or about 12g of Tylenol. According to the article above, it would take 4000mg of chronic ingestion to kill, or 6000mg all at once.

(Lest anyone think to kill yourself with Tylenol, trust me, don't! Death by Tylenol is slow and painful and takes several days.)

But I am still unclear about what one dose (only ONE time) of 3250mg would do to me. All that is clear is that I don't want to take 4000mg or more all at once. The pharmacist at Costco said to take it about 30+ minutes before my procedure as that is when the drug "peaks." I'll take 4-5 tablets.

I have no wish to hurt or kill myself so I am researching carefully to make the procedure as painless as possible without hurting myself.

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