satscout.com

Funny how a congenital abnormality can totally wreck your life. Seriously.

So the story begins with being born. Cliche, right? But what the story doesn’t say is I didn’t know until college that I was weird, and I didn’t know until age 25 that I wasn’t just weird, I was a freaking diagnostic unicorn.

I spent the first 17 years of my life with nightly enuresis. Put plainly, I wet the bed. Daily. Every single night. Not because I was “doing it on purpose”, as my parents continually accused me of. What sane person would choose to do that? It happened any time I fell asleep long enough to fall into deep sleep. So the real culprit was the deep sleep: it meant that my bladder simply overflowed because the normal mechanisms to keep it from happening simply did not exist. Not that I knew that yet.

Then came the fall of my senior year of high school and the prayer that would change my life forever. I prayed the most desperate prayer of my life to that time or ever after. I prayed “if you want me to be a functional adult, You need to fix this.” Functional, as in not wetting the bed every night. Functional, as in being able to have my own place. Functionl, as in being able to go to college and stay in a dormitory. Functional, as in eventually holding a job, or being allowed to learn to drive, or whatever.

You see, this point is where I lose medical professionals. They simply do not want to believe, whether it’s that my physical anomaly exists (even though it was documented in 1995 by a “real doctor”) or that praying a desperate prayer would change a functional deficit. But the truth is the truth, and I’m not going to pretend it’s different.

So I lost my ability to deep sleep, and with it lost my ability to self-repair. You see, the state of deep sleep is where most of the body’s self-healing ability kicks in. If you can’t deep sleep, you can’t do the normal repair work the body depends on to keep going. Even people who are sleep deprived will usually fall first into a state of deep sleep, then eventually come out of it into lighter stages and REM sleep before waking. Me? No matter how sleep deprived I get, deep sleep simply doesn’t happen – because if it were to happen, my bladder would overflow and I’d wake up with a wet bed again.

The signs of degeneration were subtle at first. During college, I convinced my parents that a job was a necessary evil – they did NOT want me to have an income or any degree of sufficiency that did not depend solely on their grace – but I argued that college textbooks were expensive, and working was a way to prevent that expense from falling squarely on their shoulders. So I worked as a cashier at a little-D “department” store called Bradlee’s. Believe it or not, their headquarters is (was?) in a town called Braintree. No lie. Sometimes we called it “Braindead”. Little-D department stores were the precursor to K-Mart and Walmart, the mass merchandisers. Chains like Bradlee’s, Ames, Jamesway, and Clover were where people went for cheap clothes, housewares, etc. They weren’t the high end Big-D Department stores like Sears or Macy’s (down here it’s Belk’s), but they provided jobs to people like me who needed money for college.

Yes, the signs of degeneration were subtle. I would come off a shift of being on my feet for anywhere from eight to ten hours (not counting the time to count out the drawer) with legs that looked like a melting candle bulging over my shoes. I chalked the gross edema up to simply dependency, and back then, if I were sick and in bed for a full day, the edema would disappear.

Even after surviving the first year at Temple and going to Bob Jones, I kept up with the pace; you can’t pull a full premed load of classes and work 20 to 24 hours a week on campus jobs otherwise. I graduated with my name on a backup list for MUSC in Charleston and more prayers, because the alternative was to move with my parents to Connecticut where I would be under their collective thumb permanently.

You see, my getting a driver license was not a priority. Ever. I spent through tenth grade at Lansdale Christian Academy, the tiny school associated with Immanuel Church of the Nazarene, where my brother graduated high school. Because I transferred to Calvary Baptist in eleventh grade, I did not get to do driver training like the rest of my class did (since I simply wasn’t there in tenth grade when they all did the driver education course). I was eventually alloewd to take the driver ed course in twelfth grade with the tenth graders, but it was far to late to take the driver training, and my parents were not interested in the slightest in me having that skill because it would mean a step toward independence, and that was the last thing they wanted for me.

All of a sudden when my sister turned 16, driving became a priority – for her, not me. While I had to beg to be permitted to work at age 18, she begged and got special permission to work at 14, scooping at a Baskin Robbins. They had to sign all kinds of paperwork and agree to strict rules about work on school days and such, but they gladly did so to give her what she wanted. Ant when she turned 16, they sent us for driver training. You see, they didn’t trust her alone with a driver trainer, so by sending us both, I acted as a de facto chaperone – not because they didn’t trust their little angel but because they didn’t trust a stranger. The driver instructor did not like the fact that I pointed out stuff (like the time he took us to a street that had once been two-way and had recently been declared one-way but still had a double yellow line down the middle, and I pointed out that the cars were parked in the same direction on both sides of the street – making my sister able to choose the correct lane to get into to make a left turn, much to the driver trainer’s anger/disgust). SHE got a certificate of completion. I got a letter. She got her license. I failed twice, the first time because my mother’s hazard lights didn’t work (it was “my fault” for not “checking” to make sure everything was “operational” before taking the test) and the second time because I didn’t look both ways in the enclosed driving test course when the left way had an actual “street” and the right way was… a grassy hill with no possible potential of any oncoming traffic (“there could have been Indians come down the hill”).

All the while, my health was going downhill and nobody noticed, or cared.

I got to med school – the headaches involved with being forced to move in August instead of July deserve a post all their own, and the subsequent trouble it caused – and pushed. And pushed. And studied. And continued to break down. At the end of second year, I was unable to take finals. I sat out six months and worked, a medical transcription job for the ER that I heard about from a friend. I went back and completed second semester of second year, passed the first part of the Boards (different name now of course), and started clinicals. Several complications later, I found myself out of school at the end of the year, and – again by the grace of God – found a medical transcription job at the employer where I stayed for nearly 16 years until I was laid off.

With insurance, I was finally able to establish medical care. I still see the internist I started with in 1995. I don’t know what I’m going to do when he retires eventually. I saw a urologist for the first time at age 25 and finally, finally got at least a partial answer to why everything had happened: My “urethra” exits in the left vaginal side wall. At least, he swore up, down, left, and right that the structure he was able to identify, catheterize, and demonstrate on fluoroscopy was my urethra. Additional “evidence” to this effect was the fact that I did not possess an external urethral meatus in the traditional location, just a little indentation a little smaller than my pinky finger where it should have been. We didn’t pursue further “treatment” for this congenital anomaly because I was still able to live what amounted to a “normal life”.

From menarche, I had always bled heavily. So no surprise that I was on medication to try to slow it down, and even on medication, I bled to the point of anemia every month. The first sign that my general condition was getting too much for my body to handle came in the form of high blood pressure, as in 160 to sometimes 180 systolic, and we kept switching up medications to try to bring it down. Because down is better, right? Unless the REASON the blood pressure is high is because the body is desperately trying to perfuse vital organs and the reason it can’t is because the blood vessels are in slow leak mode 24/7/365.

This meant I was on several medications early. I was diagnosed with asthma as a child also (the Vicks Vapor Rub story is probably somewhere else here) which meant trying to get my asthma controlled enough to be able to handle an exercise routine. We found out the hard way I can’t handle oral steroids. I got to the point where I was reacting to literally everything – allergens nobody knew could be allergens, soaps, detergents, shampoos, anything in the air, the green-and-growing things I already knew I was allergic to from years of symptoms that persisted in spite of allergy shots, and the most devastating and persistent of all even after the steroids were discontinued, the mint/menthol/synthetic cinnamon one.

Yes… lots of meds, changing meds, back then drug reps brought samples and knowing our situation he gave me samples to try to ease the drug costs. Drugs for depression – who wouldn’t be showing depressive symptoms with what I was going through? – drugs for blood pressure, drugs from my GYN for the bleeding, more and more drugs. I was diagnosed with sleep apnea and started on CPAP also.

And my body continued to deteriorate. Every time my body tried to work around all the things we were putting in it to try desperately to perfuse, it backfired and we added some other drug to prevent it from doing what it was designed to do… all because I couldn’t deep sleep, self-repair, and fix the continuing and growing problems. It got to the point where I started saying my primary pathology is that I leak – at the tissue level – things go where they are not supposed to go (like allergens) and don’t stay where they are supposed to stay (like fluid in my blood vessels).

In 2010, the corporate pencil pushers decided it wasn’t worth the money to pay for hospital staff to do medical transcription when they could have outsourcers do it cheaper. I ended up working for one of those outsourcers for five years until my own health got so bad I couldn’t do it anymore. My internist agreed to disability, and that was now nine years ago…

In 2014, December, just in time to miss the Christmas concert, I was hospitalized with a 105 degree fever and an infection in the edema of my left leg. Yes, it takes something as drastic as that to keep me out of a major performance. Just saying. My left leg and especially my left big and second toes are disfigured as a result. I was back in the hospital in 2017, February this time, with another infection. Wound Care made my disfigurement worse. I can still walk, but it’s not easy. I have walked with a cane anyway since 2002, so it’s not new.

I thought menopause would make things easier. No more bleeding! Whoopee! Except it didn’t last. And when the bleeding came back it came with vengeance. And enormous clots. As in fist size. Yes, measured in inches. I ended up with a gynecologist from my former GYN’s practice (she retired). Because my son tore my cervix on his way out at birth, I have scarring that made it impossible for her to do a proper D&C and get appropriate endometrial tissue for analysis. I was eventually sent to Gyn Onc, and HE couldn’t get a good sample either – it was basically cellular garbage. He recommended a hysterectomy…

Problem is that tricky little “urethra” that comes out in the left vaginal side wall. Yes, that one. The one demonstrated in 1995 by a “real doctor”. A real urologist who had unfortunately also since retired. And when I was referred to Urology to try to get pictures of where this “urethra” was so surgical planning could be done, I was faced with a traitor. She refused to believe what I told her. I could tell the minute she stopped trusting the veracity of my story: it was when I said that prayer meant no more bedwetting at age 17. She said she needed to do a procedure that would show if there were problems with my kidneys. Except it would need to be done under anesthesia. How convenient that I would not be able to object or voice questions.

She did indeed do a procedure. She carved a path up where she assumed the urethra “ought to be” – a space that had never until June 10, 2025, been breached by any kind of medical instrument, and a space urine had never flowed down. Urine still did not flow down that space even after the procedure. I had two days of vaginal burning as my system cleared the contrast she refluxed up my ureters into my kidneys. Her first version of the op note that I read on the night of the procedure contained no language whatsoever about my anomalous path to the left vaginal side wall – it read as if someone had normal anatomy and a normal, anteriorly placed urethra. I called her out on it the next day. I naively believed that once a report was signed, it could not be altered without some kind of digital footprint. Boy, was I wrong. I had a follow up visit with her on July 10. She refused outright to actually look in my vagina, in spite of my pleas. I went to print the report and found the read flag flipped to unread. This sent a chill down my spine. Accessing the report on July 10 found a completely different op note from the one I read on the night of surgery. She had somehow found a way to add a ton of language that made it sound as if she had done extensive searching for this anomaly and simply found no evidence of its existence. The truth is she didn’t even look, but this report – not the first one, the one with the extra added stuff in it – has poisoned all subsequent medical inquiry.

We tried a VUG at MUSC. The tech kept insisting that the tiny less than 2 mm “urethra” that she couldn’t even find without my verbal direction was “normal”, and that sensing fluid flow out of it HAD to “feel normal” even when I kept telling her it was not. She put a 7 French catheter up that passageway – 2 mm is 6 French, and 7 French is internal diameter, not external, so her catheter was not only occluding but stretching the “urethra” – and then refused to believe when it came time to void that I could not (not would not but could not) because the passage was solidly occluded. Even once both the catheter in the “urethra” Dr. James had created and the rectal catheter were removed, I had to push like I was delivering a baby AND push with both fists from either side to get any fluid to come out because the artificial path was so narrow. Shoving a catheter up it also meant fluid could not flow down its normal drainage pathway into the vaginal outlet, and I couldn’t make either the tech nor the subsequent resident, M-IV, and attending understand that we weren’t assessing the structure we were supposed to assess.

The attending said we’d probably need to do a VCUG down in Radiology for “better imaging”, but I knew that as long as they kept trying to access the bladder via the artificial and already closing pathway Dr. James created, it wouldn’t show what we were trying to get it to show, that is, the pathway down to the vaginal side wall everybody keeps trying to pretend is not there. Even trying to have a VCUG done at St. Francis under the order from my internist got me nowhere, as they were completely unwilling to acknowledge the vaginal structure as a legit “urethra” for access purposes. The best they were willing to offer was a CT IVP, where contrasted fluid/urine would be generated after IV administration, with a scan to take place immediately after voiding to hopefully get some contrast antegrade into the thing we’ve been trying to assess all along – the one thing nobody in 2025 is willing to JUST DAMN CATHETERIZE IT and move on. Funny how it was so easy to find that in 1995, a urologist found it immediately, and in 2000 when I was in labor, the GYN found it immediately too (I was cathed after she put the epidural in because she didn’t want urine in the birth canal, which is perfectly understandable).

Back to the present. I have a hysterectomy (TRH/BSO) that is on hold indefinitely until we get the anatomy sorted out. I have a congenital anomaly that nobody wants to admit even exists much less identify and locate so we can make sure I will still be able to pee after they take out my uterus. I have continued health problems that cannot and will not be solved because I cannot deep sleep because if I do I will involuntarily urinate once I reach that state. And I have an entire medical team that seems unwilling to look any of these problems – or my history including the desperate prayer in 1986 – in the face and accept the truth that I have had to live with for what it is.

Welcome to my world.

The cruelest, vilest, most horrific form of psychological abuse and gaslighting is to tell someone that an involuntary state is voluntary.

When someone has something wrong that they have no control over whatsoever, something that makes life difficult or even tortuous, the accusation that they are doing it on purpose hurts the most. What sane person would choose whatever condition they are in? But so many think it is perfectly fine to accuse someone of “being dramatic” or seeking attention for something they have no choice in.

Best case scenario – bad enough – is to say that if the person would “just choose not to do it” or be it, whatever the “it” is, that the problem would go away. Worse still is to punish for conditions the person has no control over and cannot change. Even worse is for the issue or issues to be medical, and dismissed as a psychiatric problem to be “treated” like anxiety, depression, delusions, or hallucinations instead. The underlying medical or congenital issue never being dealt with means the problem and its sequelae remain and often worsen with time.

But the worst of all is that the accuser ends up “vindicated” no matter what the outcome: If the condition changes (again, without input or control by the sufferer), the accuser simply says “see, I told you it would go away if you simply chose to stop”. If it doesn’t, or if it worsens, the accuser dismisses it, continues the accusations, and perhaps even gets a complicit psychiatrist or psychologist to affirm their “diagnosis” of attention-seeking, dramatic behavior. Either way, the accuser wins and the sufferer loses. There is no case in which the sufferer wins.

The only vindication a sufferer might someday see is if an outside force confronts the issue and proves that the suffering was involuntary – and for many this never happens.

My what a difference a few weeks makes.

Did I mention last time the only way I knew she hadn’t really looked was because I read her op note? The one that propagated to the patient portal?

First and most important: The TRH/BSO will have to be rescheduled. On followup on July 10, she dug in her heels and insisted that my urethra is normal and I have no aberrant pathway/fistula. I have since set an appointment with a second opinion urologist, who by coincidence happens to be in the same practice my original urologist, long since retired, belonged to. I intend to try to get him to examine me and pin a reality anchor in the aberration before I tell him the full story, as I think that telling urologist #1 the truth was part of the problem.

I read the original op note either night of or day after the procedure and saw no reference whatsoever to checking for what we were calling an ectopic urethra (because that’s what it got called in 1995). I went to print it for future reference and to show the second opinion urologist and read it in shock.

My first hint something was very, very wrong was when I went to the portal and saw the op note marked as “unread”. This put up an enormous red flag, as I had read the op note nearly immediately after the procedure and got my information from it. I clicked through to the op note and printed it and was aghast at what I found: There were several references that did not exist in the original to her checking and not finding an ectopic passage. She evidently checked while scoping the bladder from within and at the end checked the vagina to look from without and concluded that the “ectopic urethra” did not exist.

What makes this particularly concerning is the fact that the op note was signed day of, and it should have been impossible to either 1) propagate to the portal unverified, where I could have read it before alterations were made, or 2) get amended after the fact without it showing exactly when it was done. Quibbles to some, but to a medical records veteran these are extremely important points. It is clear on reading that the note was generated by voice recognition as certain discernable errors persist that would have been corrected had the document passed through the tender loving care of an MT/MLS in order to train the algorithm. It was signed, according to the document, day of in the afternoon just a couple hours after the procedure was complete.

So why does this terrify me?

I have this bad fortune of being able to sometimes see when reality changes around me. For example, one time I was talking to a doctor and I literally saw the color of his shirt change from pink to blue. I didn’t even blink. It was just one, and then the other, just like that. To him, it was probably “I put on a pink shirt this morning” and then after “but I put on a blue shirt this morning”, but for me it was a sudden change.

And then there was the time my son’s doctor wrote three physical scripts for his C-II medication (before they changed the rules to allow/force them to do it electronically). He brought the scripts in fresh off the printer and signed them in front of me and my son. The fourth witness to the signatures was the pharmacy tech who received them from me through the drive-through. An hour or so later I got a call from the pharmacy saying I had left them scripts with no signatures. I guess four witnesses wasn’t enough of a reality pin. I told her it was no problem, I would just pick them up and take them to him to be signed again. She got very upset with me, pretending I was accusing her of having altered them. I said no, just let me get him to sign them again and everything will be fine… He was surprised when I came back with the now unsigned scripts and asked for him to sign them again, as he also remembered signing them in front of us.

It’s one thing when the reality shifts are fixable things. It’s another thing entirely when I have spent the last month believing in a version of the op note that suddenly changed with added lines that were not in the original – but I could never in a million years prove it because according to the official record those lines were always there and were signed in officially on the day of the procedure. Saying those statements did not exist when they now do puts me in the position of being a liar. Again.

I have spent decades trying to live with the ramifications of both gaslighting and reality shifting and being called a liar when things are suddenly not what I said they were. This issue of the aberrant anatomy and its surgical implications is too important to have mucked up by something that will destroy my credibility as a historian.

The Mandela effect is a term that came about because millions of people witnessed either the funeral or the news coverage of the funeral of Nelson Mandela that was staged while he was imprisoned. When he was later released and subsequently proven to be alive, it was assumed that those millions of people who “knew” they saw the funeral and coverage of it were suffering from a mass delusion. Most if not all evidence of the funeral was scrubbed from the records after he was proven to be alive, so people trying to “prove” they saw it found no backup for their story. They were “shown to be liars”.

What needs to happen on the second opinion followup is I need him to stick a bloody catheter up the aberrance (at this point I don’t care what people call it, ectopic urethra, fistula, whatever) before I tell him the story. We need a reality anchor to establish that what the urologist found in 1995 was and is real. Then maybe, while the catheter is still in place, the rest of the story will be believable. My mistake was telling the truth before present day urologist #1 looked. She got the firm idea in her head that I was delusional and saw what she wanted to see accordingly. Even to the point of putting it in an official set of medical records. Possibly even to the point of making certain the op note changed from a bland note that did not mention looking to one that made certain to look. I can’t prove anything.

July 23 will be a very important day.

And I remain terrified. Because someone or something is now upping the ante. It isn’t just insignificant changes I see happen and shrug. It is credibility-destroying changes that could have catastrophic surgical consequences. And I am powerless to stop it. This isn’t some psychological thriller novel that will just resolve eventually when a bad guy is identified and the phenomena explained. How I wish that were so. This has been going on for my lifetime. And even talking about it makes me look crazy. It’s as bad as when people publicly declare “I am not suicidal” when they feel their life is under threat and it is possible it will be made to look like a suicide… the “Epstein effect”, I guess. I am NOT crazy. I do NOT lie. And I will do everything I can to keep anchored in reality, even when it changes.

If someone reads this, please pray. I need all the intercession I can get.

If I remember correctly, last time I posted I was about to begin a new medication… metformin. Its purpose is/was to reduce blood sugar in my vasculature – the very blood sugar my body was pushing out to try to attract fluid back into circulation. Well, the effects haven’t been pleasant. I have lost my ability to tolerate carbs nearly completely. Just the smell of anything sweet provokes severe nausea. Stuff I used to eat with relative impunity – toast, sandwiches, noodles, basic stuff – now gives me severe stomach upset or diarrhea. The most “carbs” I can handle are whatever sugar content resides in classic/regular Coca-Cola – I am told there is a lot of sugar, but the stuff does not taste sweet at all and helps settle my stomach, so I drink it regularly – and perhaps high other-to-carb ratio things like wraps, in moderation. I’ve always tended to be a meat-and-veggies kind of eater when left to my own devices, so it’s not that much of a “change”. Just now I can’t have potatoes if it comes from “real” potatoes. No fries. No bread. No toast with jelly. Or even toast to mop up egg yolks bursting on the plate. No noodles – that hurts a bit since I like things like ramen, soba, and udon. Kinda makes going to places like a Chinese buffet not viable since most of the stuff I would want to eat I can’t tolerate anymore. You get the picture.

Frankly, I don’t remember how much drama I’ve put here in the past and I’m not going to go back and read to figure it out. So I’ll try to summarize briefly. I have a congenital abnormality where my urinary outlet goes from bladder directly to the left side wall of my vagina. This meant, in practical terms, that from birth to age 17 – the fall of my senior year of high school – I had a wet bed every day. As in as soon as I was sufficiently unconscious, urine leaked out involuntarily. This was not a choice. This was not something I could “stop if I chose to”, as my parents vociferously demanded repeatedly. This was a biologic reality that was never assessed by a medical practitioner because my parents would not allow me to be left alone with one, ever, even a school nurse, lest I reveal the “family shameful secret”. Not that I could have brought myself to say anything in any case because I was so firmly conditioned. So I prayed desperately and asked the Lord to give me a dry bed, if He wanted me to become a functional adult. Yes, those were the words I used – “functional adult”. His way of solving the problem was to make it so I never entered a deep enough sleep for my bladder to overflow. This of course meant permanent sleep deprivation and no ability for regenerative healing that typically occurs during deep sleep.

Fast forward to age 25. I went to college, went to med school, had to leave med school because my health was failing, got a job, and finally had my own private employer insurance. I established medical care with an internist (who I love dearly and has been a stalwart for 30 years on my behalf now) and got seen by people I needed to see, including GYN, Pulmonary, and Urology. When I was assessed by Urology in 1995, I finally learned what my anatomic problem was: I had what he called a urethra that passed from the bladder to the left vaginal side wall. He demonstrated the catheter on live fluoro from my vagina to my bladder. He also demonstrated that where my urethra is “supposed to be” was only a blind sac with no functional connection to my bladder. One of the things they did was insert the kind of catheter with a balloon on the end to prevent backflow, and they gradually filled my bladder with fluid, partly to assess capacity, partly to assess sensory levels. Up and up the content went, with the pressure increasing until it was nearly too much to bear and they had pushed as much fluid as they could in – no more would enter. There was no leakage whatsoever, no passage whatsoever, from the “urethra”. Only from the “urethra” he said was exiting in my left side wall.

I’ve explained before the primary pathology of “I leak”. This has, over time, resulted in continual degeneration, massive menorrhagia, a single successful pregnancy, a complicated menopause, and now continual variable bleeding from an endometrium that just doesn’t know when to quit. I was referred from GYN to GYN/Onc, and he wants to do a hysterectomy. Problem is, we had to re-consult Urology after 30 years to establish the aberrant “urethra” and its location for surgical planning.

Enter stubborn recalcitrance. On June 10 – after the first attempt was aborted due to a potassium that just wouldn’t stay above 3 – we finally did a fluoro under anesthesia for anatomical mapping. Except she didn’t do it. She forced a passageway through the “normal” urethral “opening”, mapped out the ureters and kidneys and found them relatively normal, and concluded my only problem was some cysts in the bladder. She made zero attempt to locate or utilize the existing urinary outlet and insisted in her op note that everything was normal including the “urethra” she breached.

Well, I still pee through that vaginal outlet. I am willing to call it what it likely is, a vesicovaginal fistula, instead of the “urethra” title the urologist called it in 1995. But unless I can make her acknowledge the existence and location of said fistula, I am in danger of losing my ability to pee completely since the currently scheduled robotic total hystectomy with bilateral salpingo-oophorectomy (read: they’re taking it all out) will likely lead to a vaginal cuff with a closed fistula that will leave me no functional urinary outlet. The entire damn point of the fluoro was supposed to be to establish the position of the fistula/”urethra” so that surgical planning could be done to either preserve it or do something about the nonfunctional anatomically correct “urethra” to make it amenable to urine passage once the other is gone. She simply didn’t do it, and on the phone afterward insisted that my urethra was normal (it clearly is not). She refused to even acknowledge that the other passage exists.

The only functional solution to this, if the hysterectomy is to still go ahead on July 25, is to have her stick a balloon catheter up the vaginal pathway, inflate the balloon to prevent backflow, and then start filling the bladder up. If some actually exits through the new passageway she carved (I still can’t decide which verb I like best here – carved, bored, created, or something else), then we have some degree of hope that post procedure I will still be able to urinate. But if what I suspect happens, and filling the bladder results in no natural outflow from the “urethra” she insists is “normal”, then we have our answer. Preserve the fistula, or do something about the aberrant “urethra” that has never seen urine flow in my entire 55 years, no matter what she says.

So there is the dilemma as of Summer Solstice, or Litha, or Midsummer Night (yes, that’s where Shakespeare got it from), or whatever you want to call the night of June 20 going into June 21. If I can somehow make her test the theory, we may still be able to do the hysterectomy as planned. If not – I will have to find a urologist who will acknowledge reality before we can safely attempt closing off that fistula for good. You can’t pee through a closed vaginal cuff, after all.

I doubt anyone will ever see this, but if they do, all prayer is appreciated. God is able to soften hearts and open minds where facts and logic don’t work because of preexisting biases.

Basic text. Black on white.

Sometimes things are that simple. Sometimes they aren’t.

I’ve complained here before about medical stuff. The summary: I leak, at the tissue level.

My lungs leak: I mean here respiratory mucosa generally and lungs specifically. Allergens enter that shouldn’t be able to. My lungs are so sticky, I have never been able to breathe through a face covering, and they are so sticky, when I got my third lifetime CPAP machine last year (note: I use them until they die, and was first diagnosed with sleep apnea in the late 1990s), I had to bump the pressure up to 17 cmH2O until I could breathe, and when I put it that high and laid down, I actually felt my right lung reinflate. It was the weirdest sensation ever.

My gut leaks: I have gotten increasingly intolerant to some foods. It’s like the gut lining is supposed to be wall to wall post offices, that package nutrients and send them off for processing. But with the leaking, stuff gets tossed unpackaged into alleys between the post offices, which is then inspected by the immune system and sometimes declared hostile. And while at first the immune police see, say, bright blue boots, and attack when you eat them until you stop, maybe next it’s pink pillows. Then you stop eating “that” and then the “police” attack yellow canaries. And so on until your diet is limited to what you can eat safely without your immune system reminding you how much doesn’t make it into the “system” packaged and processed properly.

My endometrium: Menometrorrhagia wasn’t fun. Postmenopausal bleeding and oozing isn’t fun either, and if I survive the next days, we’re already talking about hysterectomy. Problem is my alternate anatomy, my ectopic urethra coming out the left vaginal side wall, and my overall poor condition because… I leak. It didn’t help that 25 years ago when my son was born (happy birthday, love), my cervix tore, which means it’s mostly scarred over now, and when they tried to do a D&C and get the endometrium out to examine, they couldn’t. They could barely sample it.

Which brings us to vascular leaking.

Oh, the tales I could tell. Dependent edema from a young age, legs looking like melted candles after shifts on register (Bradlees department store, summers when I was in college, only allowed because I argued I needed to earn money for books). Sudden drastic increase in the left leg in November 1998, which led to me being taken off all my medications including the hormone pills that kept the menorrhagia in check for fear of blood clots. Pregnancy in the summer of 1999, childbirth in 2000. Increasing problems with edema until the hospitalization in December 2014 with cellulitis in the left leg, with hospitalization again in February 2017 for the same damn thing. Wound Care screwing me up further. I still say had they left the toes alone instead of removing the naturally formed hard compressing caps, my first and second toes on the left wouldn’t look so grotesque. But maybe that was a blessing because those toes and the scarring on the leg helped my disability case in 2016.

But suspiciously, even before that, when I was in med school. The bouts of dizziness, the fatigue, the cloudy mind that led to the Neuro residents clinic doing a thorough workup including a head MRI so normal that a radiologist who never ever used the word “normal” used it for mine (a surprise since I have known inner ear damage from childhood infections that still affects my balance – another evidence of things leaking where they shouldn’t have been able to go, even when I was very young). The problems even when I was still working in house at the hospital because blood and fluid would pool and my head never seemed to get enough… something. Oxygen? Flow? Getting up and walking around wasn’t ever quite enough to clear my head. Walking to Outpatient Surgery with H&Ps for the next day – back in the days before Y2K when we did stuff manually – and still feeling (and probably looking) like a zombie.

My body tried. It really did. I got diagnosed with high blood pressure early and put on medications. And more medications. Because my body tried so very hard to keep fluid in the vessels, and the first thing it tried was clamping down. But medicine stopped that. Then it tried the renin-angiotensin signaling system, and another hypertension med shut that down too. I was already dealing with pain from arthritis and the disaster that happened when we tried to put me on steroids for asthma. We discovered that the steroids may have told the “local police” in the immune system to stop being so sensitive and triggering, but that just meant the “armed forces” and the “nuclear weapons” were brought into play, and I was having allergic reactions to just about everything, even though we had PAs saying it was “impossible”…

How many meds am I on at this point? Three for blood pressure alone, tackling three different systems. Two for pain, one an opioid and one that helps keep the opioid in my system longer because I metabolize things far too quickly. Side effect of being a redhead, likely – we have the genes for it, unfortunately. One for my gut, because when unmedicated I have bad esophageal reflux. One mild antiinflammatory to try to calm my joints down since I can’t tolerate most of the “really good ones”. That was seven. The eighth was a high dose progesterone to try to tell my postmenopausal endometrium to cut it out and get its act together, which only worked somewhat (measured from 19 mm down to 12 mm when postmenopausal endometrial stripe is supposed to be only a few millimeters thick at most).

It’s the ninth one likely to kill me.

So where were we? Trying to keep intravascular volume with a body determined to try every trick in the stinking book to do it while medicines stop it.

There is an important concept here: Oncotic pressure. If you have a vessel and put water in both sides, put a semipermeable membrane in it to divide it into two compartments, and then add “stuff” to one side, water will flow from the side with less “stuff” to the side with more “stuff” to equal out the “pressure” exerted by the presence of the “stuff”. Like, say, add some salt – the salt side will eventually equilibrate with more total fluid in it than the non-salt side.

So what does a desperate body do to try to pull fluid volume back into a leaking intravascular space? Increase oncotic pressure. Keep in mind here that I don’t have lymph return – I have potential spaces where lymph vessels ought to be. It’s part of the reason why the edema never really resolves. So you have all this leaked fluid that has zero motivation to return to the intravascular space for recirculation, and the body tries to make the intravascular space an oncotically desirable place to be. First it tried messing with the cholesterol/triglyceride system. I never got medicated for that, but as my desire for food has lessened over the years, my lipids have sort of evened out in a place where they don’t deem it necessary to intervene. But pushing more “stuff” into the vessels that way wasn’t sufficient to bring fluid in/back.

As an aside, regarding diet: I only eat two meals a day, breakfast and dinner. Breakfast happens at the end of my “day” in the morning before I go to bed, and when my husband is here, consists of three scrambled eggs with shredded cheddar cheese and cut up lunchmeat ham, plus three strips of bacon. I’m on team bendy, not team crispy, by the way. Suppers vary but are from a more or less range of “safe” things like spaghetti with meat sauce, burgers, sauteed vegetables, alfredo, and a weekend two-day meal that varies from broccoli/cheese/tomato/ham casserole, some kind of beef or pork roast, tenderloin, whatever is cheap at the supermarket that week usually, and a veggie side. I’m not much of a starch person, so I don’t go for potatoes usually unless it’s mashed potatoes from the box (because most of the allergenic stuff that upsets my gut is removed in the processing process). I will sometimes have a snack in the midpoint of the night when I’m awake – lately it’s been my doctor-ordered “piece of fruit” which I interpret to be at least a serving big enough to rival an apple or banana, but has been either sugar-free cup fruit or cut fruit from the produce section. Plus a Little Debbie Fancy Cakes pair, because it’s a peace treaty with my gut flora: I give it something and in return I don’t stay nauseous 24/7. That and drinking classic/regular Coke keeps me from throwing up all the time.

Ah, yes. My body trying to push more “stuff” into the vessels. The potassium leaving is either following the fluid leaving or encouraging it to leave, but that’s a chicken and egg question at this point. Just know that my potassium tends chronically borderline to low, and boosting it temporarily before procedures does nothing to stop the main process going on, i.e. the leaking.

Then my body has tried making more and smaller blood cells. This phenomenon is common in dehydration and is sometimes actually called anemia of dehydration. Yes, dehydration – despite how fluid-overloaded I am, I am also technically clinically dehydrated because my intravascular volume is chronically low, because I leak. Always comes back to that. I leak.

In even greater desperation, running out of tricks to pull out of its metaphorical bag, my body has resorted to releasing glucose in an attempt to attract fluid back into my blood vessels and regain/ensure perfusion of vital organs. You can see where this is going, I bet – yeeeeep, I’ve now earned a diagnosis of non-insulin dependent diabetes on top of everything else. Last A1C was over 8, which under normal circumstances would definitely meet one criterion…

…except, Houston, we have a problem.

A note about pathophysiology is important here. The normal person with diabetes has as lock and key problem: Cellular locks require hormonal keys, in this case insulin, to unlock and allow passage, in this case of glucose into the cells. In type 1/”juvenile onset” (though there ARE adults who get this also) diabetes, there is a loss of “key manufacture”. The islets of Langerhans in the pancreas produce insulin, but if the factories shut down, you need exogenous insulin to go in and do the job. In the meanwhile, glucose “backs up” in the system, and (more importantly) begins to “sugar coat” things that shouldn’t be sugar-coated, in the process ruining their function. The answer is to give the system more cellular “keys”.

In type 2/”adult onset”/non-insulin dependent diabetes, there is a key-lock mismatch. The keys aren’t formed correctly, or the locks warp, and it becomes more difficult for the cells to intake glucose. It’s as if there were a 100-unit apartment building, and suddenly one by one the tenants’ keys stopped letting them in to their units, and they’re all sitting outside with their groceries, unable to put them away. Then the perishables start melting and spoiling, and soon the environs around the building are drawing pests and bugs and animals because the groceries aren’t making it into the units because the tenants can’t unlock their doors, and there aren’t enough locksmiths to keep replacing the locks with ones that work. By the time you get to most of the tenants’s keys failing, you need exogenous skeleton keys (aka insulin) to force entry.

Either way, type 1 or type 2, common symptoms are the same: Excessive hunger, as the body’s cells shout out for either the tenants or Uber Eats or just Emergency Services to bring-them-some-glucose-NOW; excessive thirst, as normal people’s vessels being flooded with sugar makes them pseudo-dehydrated, and the thirst centers are triggered; sluggish feeling and foggy mind, as things start “sugar-coating” that shouldn’t; excessive urination, as the kidneys desperately try to offload the extra “stuff” that shouldn’t be there in the circulation, including spilling sugar and ketones in the urine; and a higher risk of infection as invaders see the extra nutrition just lying around for “anyone” to take as being too much to pass up.

Except I don’t have most of those. If anything I eat even less now than before, I only experience moderate thirst because I’m so fluid-overloaded, and if anything I urinate less than most people because what is coming to the kidneys is so “dehydrated”, the kidneys would stop peeing anything at all if I didn’t have the hydrochlorothiazide explicitly demanding them to in order to offload waste. The foggy brain from low perfusion of my central nervous system long predates the misguided attempt to offload sugar into the circulation, and so does the infection in the edema fluid.

Which brings us to why I’m making this summary post to begin with.

I was prescribed metformin. Now, there are lots of classes of antidiabetic meds with different mechanisms of action, and while my doctor wanted to try Farxiga, one that works by giving the kidneys standing marching orders to offload the sugar in the system, it’s a second line med, which means insurance won’t cover it unless you “fail” a first line med first. Metformin works by telling the liver to stop sending sugar into the bloodstream…

A note about how the liver works. Remember those packages that get sent from the gut post offices through the circulation? The liver is a big factory that not only makes bile and some of the enzymes required to digest food (the pancreas is a big contributor to most of those btw), it also takes “big” molecules like starch and breaks them down into “little” molecules like glucose. That’s part of why when you eat “high glycemic foods” you get a sugar boost/high, because they require little to no processing to make the energy available, while when you eat “low glycemic foods” you get a more sustained energy level, because the liver is working hard to take those “big” molecules and break them down and repackage them to be sent out as energy supply to the rest of the body.

Another aside: Go check out the manga/anime “Cells At Work” if you haven’t. It’s good. They depict this transport of oxygen and nutrients by the blood as the humanoid “cells” carrying oxygen canisters (which they actually do via hemoglobin) and baskets of food (which the red cells really don’t do directly, but hey let’s go with the imagery) to cells stationed in the rest of the body.

Back to the liver. The liver is both a factory and a storehouse. The factory side is processing what you eat into smaller units the cells can actually directly use. The storehouse part keeps sugar in holding, so that when you are between meals your blood sugar doesn’t drop too far. Glucagon is insulin’s sister hormone, that tells the liver to let some sugar out of the storehouse when needed. Simplified, I know, but bear with me here. Other organs and storage spaces are involved with other molecule types, like fat in adipose tissue etc.

Metformin is acting like a security guard telling the liver he’s not going to open the truck gate and let them out. It tells the factory to stop processing so much, and it tells the storehouses they aren’t supposed to let the supply out so fast, no matter what the rest of the body is shouting for it to do.

This would be a sensible thing to try if the locks and keys aren’t matching, and it takes a lot longer for the supplies to get inside the end cells – you don’t want trucks backing up everywhere, spilling their sugar loads all over the place while they wait.

Problem is, that’s not what’s happening here. The sugar trucks are being released in an attempt to encourage the osmotic transfer of fluid from the surrounding edematous tissues into the intravascular space – after most of the other attempts to preserve intravascular fluid have failed spectacularly over the last three decades of medical intervention.

I have plenty of keys for my locks. If anything, the cells are plenty full and don’t need more nutrients flooding their way. The cells pretty much plan on ignoring both the sugar trucks beyond their needs and the spilling of said sugar trucks. They don’t really care. There is so much extracellular excess fluid, it doesn’t matter to them anymore.

The reason I titled this “maybe the last” is because once I take the first metformin doses, it is only a matter of time before I experience catastrophic vascular collapse. It may be the first dose that does it. It may be the first week. I don’t know. But telling my liver to stop putting sugar trucks out into the system, and telling my liver to stop “making sugar” to store, when my liver is already under distress from the perfusion situation and my kidneys are slowly losing function because of the lack of perfusion, can only lead to disaster.

I don’t know if anyone will ever read this. Maybe it doesn’t matter. I just wanted to document what is happening and “what happened” if it is read after I die.

I know. Everyone dies. But it’s different when it’s pretty imminent.

I want to go on record as saying the ones I love most are Jesus, my husband and son, my family (yes, including my father’s new wife that he married after my mother passed away in 2021 from stage IV metastatic breast cancer), and my church family. Music ministry for the win. Choir light side and instrumental dark side both. Even the ding-a-lingers (yes, I was once a handbell player so I get to say that).

Jesus knows. He loves. He loved so much that He chose the only way to deal with the sin situation that separates us from Him. Sin required death, and only an innocent person can die for a guilty one (aka all of us). So He came, died, rose from the grave, conquered death, and went back to heaven all so He could make a way for us to be with Him in eternity. All it takes is us putting down our pride and repenting – agreeing with Him about sin and how guilty we are and how offensive it is to His holiness – and believing that His sacrifice is the only answer to solve that problem. Because the alternative is eternal separation from Him in hell, and nobody sane wants that. I certainly don’t want that for anyone reading this.

Okay, time to finish up. Didn’t expect it to take this long to “summarize” a lifetime of medical woes. Oh well.

I am “Satscout” – “Saturn’s scout” – it’s a Sailor Moon reference combining my favorite senshi with the North American ’90s dub name for them, “Sailor Scouts”, compressed into eight characters because Bellsouth had an eight character limit for usernames back then. Yes, I’ve been Satscout for over 30 years. I also adopted a catchphrase back then, “just a shadow passing through”. I admit stealing the line from a Clay Aiken song. Busted. But it’s apt. I like being in the background, just a shadow passing through. And life is so ephemeral, it seems justified that way too. Especially as I near what is likely the end of it. Hopefully someone will fill in the gaps once I’m gone. Probably.

Goodbye.

WordPress obviously doesn’t think I should be able to just post text without making things difficult. Like today. Okay, “yesterday” morning.

I’m putting this here as a reminder that sometimes I need a good kick to remember that, and why, I do not belong.

So we’re doing renovation of the audiovisual systems at church this summer. It’s a big project, a needed project. And the powers that be decided to have combined services in alternating venues, one week the Worship Center and the other the sanctuary, through July. It’s the first week in July, and we had services in the Worship Center.

It didn’t go well, for me at least.

You see, there is no worship guide printed for the contemporary services that take place in the Worship Center. At least in the sanctuary, we have something written down. In words. Black (or some other color) on white. As in something you can have light reflect off of, and read from. With no worship guide, one becomes dependent on words on screens. And so comes problem #1: The screens display the words in white text on a dark background. This renders them illegible. If they were dark text on a light background, they would be readily and easily legible. Light text on a dark background? A series of blobs because every. single. letter. has a huge halo around it, rendering it unable to be discerned.

Years ago when they switched from the old display system to the new one, they went with light text on a dark background. I brought up my concerns then and was readily dismissed. You see, apparently they think people prefer this. I tried to tell them many people, especially older people, would have a problem with this arrangement, and I begged to no avail to have them go back to dark text on a light background. Of course my pleas went unheard, and it usually isn’t an issue unless they don’t have the words to the songs on a piece of paper I can read.

Problem #2 stems from the fact that they don’t tell the choir ahead of time what songs are in the service unless we have 1) a rehearsal the prior Wednesday at which 2) we have available the next Sunday’s worship guide. Zero for zero since we’re only having rehearsals on the second and fourth Wednesdays in June and July. The only music we had print for was the packet of three prayer songs we are introducing in July and August, the first of which we debuted today. This meant flying blind in both senses: I was not told until the morning of what songs we were singing, and I had no way to get the words to them in a form I could read. It’s not enough to just tell me five minutes beforehand what songs we’re singing because I don’t have the entire repertoire of modern music memorized and at my fingertips. Being “able to sing” a particular song is useless if you don’t remember the words.

So… I spent most of the music part of the service in the old choir loft, carefully watching the orchestra director when he sometimes mouthed the words for my cues as to what was being sung. I probably looked like a lunatic. I certainly felt like one. As for the one song we had music for? The loft was dark while the “stage” area was lit “normally” as it would be for the worship band, with the worship band and orchestra having plenty of light and the choir loft… not so much. I had my music tilted in an effort to get enough light on it to read the new song.

After kind of making it through the music, I assumed the choir would leave the loft. Wrong – they all sat down. Yeah, I know it was crowded on the floor because of the combined services, but nobody said anything about staying in the loft, and I needed to get back to the choir room to be with my husband and son. So I left out the other side door and rode the elevator up to the second floor, went behind the balcony (at least they don’t hold Sunday school classes back there anymore now that they are set up as classrooms for the school) and to the choir room. We listened on the old system, where they have a dial to adjust Worship Center volume in the choir room.

Then came after. One of the things I do is organize the music breakfast. Today we had donuts – I think it may have been Krispy Kreme but I don’t remember for sure. They were plain glazed, three dozen. Somebody brought a casserole that categorized as sweet, the people who brought the donuts also brought a tray of pigs-in-a-blanket, and later someone else brought bagels and a quiche. I got everything mostly opened so they could be completely opened quickly at the end of the sermon to optimize throughput of people eating before second service. After the prayer, I got a bagel half with some cream cheese and a piece of the quiche. Then things went bad fast.

Did I mention that I had closed the blinds in the choir room to keep that nasty sunlight out so I could safely be in there? Well, I did. And it was fine until people came in. Two orchestra members immediately went to the windows, and over my protests, opened the blinds wide, claiming they were “cold” and that somehow justified streaming sunlight into what was previously a safe place. I retreated immediately, trying not to drop anything in my pain. I took my half-eaten bagel out to the hall and finished it, and one of the two who was opening the blinds followed me out into the hall, demanding that I give her a medical diagnosis to justify my asking them to keep the blinds closed. By then I was shaking, having been humiliated enough in the service and now after the service as well. I tried to tell her that I shouldn’t have to come up with some formal diagnosis I will never have to try to keep from the pain and danger involved with sunlight exposure, especially indoors where sunlight isn’t supposed to be. She turned and stalked off. I finished the bagel half, ducked back in long enough to throw away my plate and grab my jacket and bag, then went in search of my son. When he got out of the men’s room, we went home.

Further proof that the world would be better off with me not in it.

I should be dead.

I wish I were dead.

If I hadn’t promised I wouldn’t kill myself, I’d be trying.

But if someone else tried to kill me, I would not resist dying. I would welcome it.

But I’m not a person. I’m a thing. I don’t get to have desires.

As of this writing, we are a few days away from the November 2020 election. We shall see.

Masks are still a heavily debated topic. I can’t understand why. There is so much compelling data available about the dangers of extended mask use, I have no idea why people can’t see that continuing to advocate them is dangerous.

What’s worse, you have people who see it as a moral imperative. If you don’t wear a mask, you are somehow immoral. And if you can’t wear a mask, you have no excuse in their eyes and are somehow endangering them.

Nobody said logic has anything to do with any of this panic porn.

The condensed version of the dangers falls under a few categories:

1. Airflow: Wearing a mask for an extended period of time restricts airflow, making it harder to get oxygen IN and carbon dioxide OUT. Think what happens at high altitudes, squared.
2. Microbes:
   1. First, the corona is too small to be effectively stopped from entering you through anything but a mask specifically designed to prevent viruses. Normal “face coverings” of plain cloth give as much resistance as a chain link fence to a mosquito. Second, the moisture the virus rides on gets stuck to that chain link fence, resulting in you breathing in past the virus caught there (increasing YOUR load) and breathing out past that same virus caught there (increasing the load you send to OTHERS). Think breathing through a furnace filter that’s been in for three months. Yuck. So you aren’t impeding the virus’ passage, but the ones that stick to your mask are more easily transmitted and in higher concentrations. IF the virus is there to begin with, not to mention other bacteria/fungi/etc. that also ride the moisture, get caught in your mask, and have the same dynamics as above.
   2. When people actually get sick from the corona, the mortality usually isn’t due to corona but to things like bacterial pneumonia overlaid on someone whose immune system is already worn out from fighting a viral infection… the corona is the shock troops, and when your troops are out of ammo and supplies, the enemies’ allies come in and wipe you out.
3. Particulates: The masks aren’t invincible. If you wear a cloth covering, it WILL eventually fray, and those microparticulate fibers go guess where? Right, your lungs. And what happens when you breathe in particulate matter? Your body can’t remove it because it’s in dead end alveoli. Same problem smokers have with gunk, or asbestos workers had, or the “brown lung” and “Monday morning” sickness miners used to get before we realized how bad particulates were for breathing. So… wear masks day in and day out for months at a time, and not just health care workers but now EVERYBODY is ripe for particulates in their lungs, further impeding oxygen/carbon dioxide exchange and microbe trapping since your busy little immune cells are trying to wall off the foreign matter and invaders.
4. Improper use: Most people continually touch their face coverings, leave them only covering the mouth but not the nose “so they can breathe”, or do other behaviors that render the mask’s purported protective function useless.

It’s more complicated than just these concerns, of course.

But somehow the mask worshipers see the moral mandate of “just wear the damn mask already” as more important than protecting themselves and others from the documented mask dangers.

And don’t get me started on how the Powers That Be throttle information transmission about the same. You couldn’t post anything about hydroxychloroquine as a treatment (has to be in combination with zinc and an antibiotic) without getting your account taken down on social media, and articles about mask dangers get labelled “false” by the almighty leftist Fact Checkers who have set themselves up to be the arbiters of truth in a world where truth is what the PTB say it is and nothing else.

Welcome to Orwell’s 1984. The Double Plus Ungood Think is alive and well.

I am used to living in an insane world.

It is June 2020, and the world is going through a pandemic scare. Mass media peddle panic porn at an alarming rate, by design. Our city has come up with a mask mandate. For 60 days, you aren’t allowed to go out in public without wearing a face mask.

Of course this puts me in a damned if you do, damned if you don’t situation. Don’t wear a mask, and risk fines/citations from some Karen snitching. Do, and pass out and/or die because I can’t pull air through a mask or any other face covering. Of course, dying would be the better option for ME, but that would strand my son (if we were out together) and make their lives quite inconvenient.

But I am used to this.

For example…

Growing up, I was usually in a similar double bind quandary. If someone else were to take and use or destroy something explicitly mine, it was “tough luck” and “fair use”. This included things like homework, unfortunately. But if I looked at something – not even consuming it, just looking at it – it was stealing and a punishable offense. Even and including if someone else decided to lay claim to an otherwise unassigned or unclaimed thing.

Tough luck, indeed. RIP me.

We shall see what further dumpster fire July 2020 brings.

Ah… I leave the site alone for a while and the whole world changes around me.

First – I get this notice that good old Chrome is forcing everybody to make https the standard and so we have to implement SSL or people will get nasty red alerts on their browsers saying to stay away from the site because it isn’t secure. Sigh. So someone offers free SSL and all you have to do is say yes, right?

Wrong.

It turns out it is very easy to screw up your site settings if you don’t know EXACTLY what you’re doing. At least my host was able to give me access back 🙂

So I won’t be adding SSL unless I have someone on the phone or chat walking me through it OR have them do the setting remotely so I don’t screw it up again.

Second – I find that things that bothered me sometimes bother me more the older I get.

Take manipulation for example. Anyone bothering to read this will have figured out by now that I believe the Bible and worship Jesus. I am a Christ-follower, a “Christian” in the same sense as they were first called.

So when someone tells me that my attempts to bring an issue to light so it can be discussed and cleared represent “a root of bitterness” that I personally need to forget and forgive them over instead of an offense that other person has committed that needs to be addressed… that’s manipulation. It’s basically saying I’m wrong, they’re right, go hang. And it totally shuts down communication. It is the other person saying they have absolutely no intention of setting things right, and my responsibility is to shut up and take whatever they choose to dish out. Oh, and if I even try to call them on it, my wrong has multiplied and I need to repent.

I have been dealing with people doing this to me for decades. Literally. First my family, then my husband. I can’t even reference something that happened in the past as an object lesson for avoiding present and future misery without being told that I need to get rid of bitterness. I’m not bitter. I’m practical. I don’t want to fall into a pit a second time when I don’t need to.

That’s actually the sentiment that prompted me to come back to the site and post… when I found out how bad I screwed up the SSL issue. So irritation can be a good thing sometimes 🙂

“Her smiles, her frowns, her ups, her downs
Are second nature to me now,
Like breathing out and breathing in…”

Henry Higgins (Rex Harrison), My Fair Lady

Except when breathing out and breathing in is NOT second nature. Like when you have asthma.

I was about 12 when I had my first severe asthma attack. We discovered just how allergic I am to menthol.

I was sick with something or other, and my “loving” parents thought they were doing me a favor by smearing Vicks Vapor Rub on me. This in spite of me screaming in pain, wheezing, coughing, and having to be held down spread eagled with one of each of them (mother/father/older brother/younger sister) holding down a limb. You would think they would get a clue. I don’t remember what happened, except I passed out, unable to breathe, and woke up several hours later with the windows to my room open and the nasty toxic stuff finally scraped off my chest.

Since then, I have had allergic-triggered and exercise-triggered asthma which I largely avoid by avoiding allergens and being not stupid about exercise.

I am allergic to a lot of things. I am allergic to bee stings, for example. One notable sting happened in the early Pennsylvania years when we were visiting someone with a grape arbor in the backyard. It swelled up to the size of an orange before I passed out. My left arm, I was told, looked like it had a grapefruit on it when the swelling reached its maximum. I have no memory of what happened after that. I only know that for years afterward I carried an EpiPen, particularly during my year at Temple Ambler, home of the Horticulture department and ergo home of the entire bee population of Southeastern Pennsylvania, or so it seemed.

We tried to treat my asthma with steroids early on after I had a job (and my own insurance). We discovered I don’t do well with steroids. I became hyperreactive to all the things I was normally reactive to, including what I term “everything green and growing” since just about every type of pollen and all cut plants cause some level of allergic reaction (yeah, mowing the lawn when I was a teenager was a real problem; I had to do only a quarter of the lawn at a time and cut over four days because I could handle neither the allergic exposure nor taking a red hot gas cap off the lawnmower to refill it). Unfortunately, the residual effect of that time with the steroids, which are supposed to be antiinflammatory but in my case obviously were aiding and abetting the inflammatory response, is that I can no longer tolerate any exposure to mint, menthol (which chemically is basically purified mint), or synthetic cinnamon. Think gum, toothpaste, hard candies, “red hots”, Altoids, just about anything with the Halls brand name on it since their #1 active ingredient is menthol, etc. Even less common things like cherry cough drops set me off. I itch, wheeze, and generally scare people. I’ve had enough allergic reactions over the years that my entire upper singing range is gone. I went from alto to second tenor, where I currently have about an octave and a half good left.

What more could one body have to go wrong? Stay tuned…

No discussion of my varied pathologies would be complete without covering arthritis.

Some years ago, my doctor gave it a bunch of adjectives, mainly because we don’t know what it is, where it came from, or what to do about it. He called it early onset familial degenerative osteoarthritis – osteo because I’m not rheumatoid factor positive, degenerative because I have worn down places where bone meets bone, familial because every female in my family has some form of arthritis, and early onset because the discussion where this name was come to happened when I was in my early 20’s.

I clack. I crunch. Back in the day, I would try to negotiate a stairwell – echo-y places, stairwells – and the sounds my joints would make would surprise people.

So I had arm pain recently and in late January 2017 saw an orthopod about it. He took pictures and surprise, surprise (not), there was joint narrowing. Of course there was joint narrowing. 25+ years of arthritis will do that to a person. He gave me a joint injection which did nothing; it was the subsequent admission to the hospital for something completely different that helped the pain by forcing IV fluid through places that had sealed down in crazy ways. But that’s another post.

I was already marginalized when I was young. I didn’t think much about it except it made it difficult to figure out what I was expected to do at any given time and then do it.

It takes three systems working in concert for a person to have good balance. Your inner ear semicircular canals, your sense of proprioception – being able to feel where you are in space, and visual clues all work together to help you find out where you are and determine where you need to go.

I remember when I was little, I would walk on a low curb as if it were a balance beam. If I made it all the way around one of those little “islands”, I felt good about myself. Kid type things, you know?

I have been walking with a cane for nearly 15 years now. I got the cane when I was forced to come to grips with the fact that I could no longer balance.

When I was little, I had a series of “earaches”, as my mother called them. Some were severe enough that I would scream in pain, but I could not hear myself screaming. They left me with damaged inner ears, as far as could be determined by what little medical examination I was allowed. Remember, I was never allowed to be alone with a medical professional, so I couldn’t elucidate my symptoms (not that I had the words to articulate them well at that point anyway).

It wasn’t until later that I began noticing that I would sometimes “aim and miss” when I tried to walk or reach for things. I had to be looking carefully at what I was aiming for, then use that information to judge how far or not to move items. This encompassed as simple as not bringing a glass up far enough for it to make it to my mouth (or a fork or spoon for that matter) or as complex as missing a step on the stairs because my foot simply didn’t go far enough or went too far.

What finally drove me to the cane was an incident on Easter weekend in 2002. I sing in the choir at church – back then I was an alto (further discussion of this when I post about allergies). We sang in the Good Friday service that weekend. What happened next makes no sense unless you understand the configuration of the building. I had gone from the choir room (second floor) down to the choir loft with no significant trouble; I was only holding my folder and nothing else. I had gone from the loft back up to the choir room after the service, again without significant trouble.

The building is configured in such a way that there is a room behind the balcony on the second floor, then a set of double doors to lead to the portion of the second floor on the right hand side of the building. So you envision – from the point of view of the second floor level, with the balcony of the main worship center being the “middle” – to the left on the second floor is a hallway leading to the music suite, including the choir room, “library”, and offices for the music ministry staff. The room behind the balcony leads to a hallway, then a set of double doors. Through those double doors lies the second floor rooms and the elevator.

Except the maintenance staff had already locked said double doors. And I had no way to get to the elevator. I couldn’t manage the stairs with my arms full, and I ended up butt-bumping down the staircase, crying the whole way. I was frustrated and embarrassed, and grateful nobody was watching me suffer.

The next day at Walmart, I got an adjustable cane. It took some trying (and advice from a PT friend on proper length) to get it usable. That first cane disappeared one time when I was at the store and I went to finish unloading the shopping cart to the trunk of my car… when I went to retrieve the cane from the cart, it had vanished. The second cane is the one I still have. It’s the exact same thing, just the replacement for the one that disappeared.

I still sing in the choir, although now I’m a second tenor. Allergic reactions have destroyed my upper range.

And walking has gotten more difficult with time because I now have lymphedema in my legs, left worse than right. That will get a post all its own eventually.

But balance has been and continues to be a significant issue, affecting almost everything I try to do.

Part of why I wanted evaluation for the urologic history is because I was having trouble sleeping.

I didn’t know when I prayed for God to resolve my enuresis that He would do so at the cost of being able to sleep soundly. You see, in order to wake up enough to go to the bathroom when the bladder filled – before triggering the automatic release – I would have to sleep very lightly. As in very lightly.

I have always been a night person. I function better at night. Heck, I’m writing this at almost 2:30 in the morning. My mind is clearest at night. I get very sleepy when I’m in the sun – and that indeed will be the subject of another post, as it relates to my medical history.

Even when I was small, I would lie awake for hours after being “put to bed”, staring at the walls, or the night light, or the books on my shelf that I wasn’t allowed to read after lights out.

I’ve worn glasses since I was in first grade, again about six years old. One of the things they would do to punish me if I did something they didn’t like was take my glasses away so I couldn’t read.

I land somewhere between biblioholic and hyperlexic, and I am indeed using the term hyperlexia properly. Most people know “biblioholics” love books. Fewer people know that hyperlexics have a compelling, undeniable, undefeatable urge to read which is actually a need to “decode”. I would get so desperate for the written word (I learned to read when I was three or four and never looked back) that if I didn’t have access to real books, I would devour fine print in magazines. I would read those tiny ads they used to run in the back of women’s general magazines. I would read publisher information in size 4 type. I would read just to be reading because it scratched the itch. I think that qualifies as hyperlexia.

But at night, after lights out, I wasn’t allowed to read. So I would stay awake until I finally drifted off to sleep, when my body would then proceed to betray me.

And once day broke, I would deal with the consequences.

One of the things I hated most about growing up was getting punished for going to the bathroom. Let me explain.

Anyone else who wanted to sleep in on a Saturday could do so without any problem. But if I tried to go to the bathroom then go back to bed – and get sleep while the sun was up, and it was easier – then I would get pounced on and they would say “You’re awake! Now you have to stay up.” I wasn’t allowed to go back to bed, and I was perpetually exhausted. So I would try to find ways to pee if I had to while staying in my room – a wastebasket lined with a plastic bag, which I would then dump out a window… or a large Ziploc, again dumped out a window… or who knows. Just anything to stay in my room with the door shut so I wouldn’t be pounced upon and made to stay awake when I was so very tired.

It didn’t matter of course that I was trying to contain urine because I was already wet at that point. But I didn’t want them to be able to say I was ever doing it consciously, ever.

All in all, it was very difficult growing up in that kind of situation.

When I was evaluated as an adult, after much trial, I was eventually evaluated for and diagnosed with sleep apnea via polysomnogram. I also underwent a multiple sleep latency test to evaluate for narcolepsy since I spent every day exhausted. I didn’t have narcolepsy, but I did indeed have apnea, so I was issued a CPAP (continuous positive airway pressure) machine, which I still use.

Of course, apnea was never the main or original problem, but it became the most treatable problem.

Most people with sleep apnea are assumed to have as their main pathology an airway that closes while they try to sleep. They then wake in microbursts just enough to resume breathing, then fall asleep again. This disruption of sleep causes the exhaustion untreated sleep apnea patients experience. This intermittent airway closure also often causes snoring. Many sleep apnea patients get evaluated because their spouses or partners get tired of the snoring and insist they be seen.

I just wanted to be able to sleep.

It didn’t help that at that time, transcription at the hospital level was a “during the business day” kind of job and not the 24 hour industry it is now. I began working at East Cooper in 1994. Back then, many of our systems were either local – we typed documents in WordPerfect and saved them to a database – or self contained, such as our radiology, which had its own hardwired interface. I had to be at the job during the day in order to complete dictated reports during the day when they were needed.

Then I got pregnant – definitely another post, because there was a whole medical saga leading up to that – and in 2000, with all the Y2K computer compliance stuff, suddenly transcription became internet-based, and I became able to work from home, which was necessary with a newborn. My son and his medical issues are another story, which I may or may not reference here as it applies.

But sleep never got easier for me. I currently run my CPAP at over 15 cm H2O (the standard pressure measurement for CPAP is in centimeters of water, a unit many are unfamiliar with, even if they have heard of millimeters of mercury or mm Hg). Yes, that’s a high pressure. But it means when I lie down, I can breathe. And whenever I lie down, even if it isn’t for very long, I put on the CPAP because, well, I kind of like breathing. It’s compatible with life, and not breathing, isn’t.

I have spent the last 30 years wishing to sleep and not being able to.

That’s a very long time.

Might as well start with the big one.

If I’m going to catalogue medical problems, I’d better start with the stuff that was present in childhood and either continued on, or affected things greatly.

The elephant in the room. The thing that’s there, and “everyone” knows it, but you just don’t talk about it.

My existence for the first decade and a half plus of my life was the family embarrassment. I put a damper on anything they wanted to do. I have parents, an older brother, and a younger sister. I cramped their style.

You see, from as long as I could remember until the fall of my senior year of high school, I experienced nightly enuresis. In common parlance, I wet the bed. Consistently, every night.

I had zero control over this phenomenon, but was told on a regular basis that I was doing it consciously and I had to simply decide not to do it anymore.

By now anyone reading this should begin to understand the kind of damage that sort of talk was doing.

I still carry a lot of baggage from my childhood, stuff I will probably never really come to peace with. One of the biggest is the fact that I was always cast as a liar. It didn’t matter what kind of proof I could present to verify anything I said. It was assumed I was lying until someone else independently proved beyond a shadow of a doubt that I was not.

I was very scrupulous not to lie when I was growing up. My existence was too confusing. You see, in order to effectively lie, you have to be able to have a clear image of the truth in your mind, then formulate a clear image of something “not” that truth, then consciously choose to present that “not truth” as truth.

I can’t do any of that.

I had enough trouble just trying to figure out what was real and what was not. I didn’t have any brain cells left over to consciously lie.

That didn’t stop folks from accusing though, particularly my sister. Thank God she grew up. She’s okay now that we’re adults. But when we were little, she was a momma’s girl and a total brat. Anything she said was taken as gospel, whether it was true or not. She got away with anything she did, and all she had to do to get sympathy was accuse me of something. It didn’t matter what, though the bigger the accusation and the more trouble I got in, the more she could get away with.

But that’s another post.

I was six when I first learned to do laundry. That was because I was told that if I was going to choose to wet the bed, I was going to clean up after it. So every day, I took my sheets, my blanket, my bedclothes, and any clothes I had worn the day before, and put them all in the washer – or with help at first because I was too short. Eventually I did it all on my own. I was then responsible for getting it all in the dryer – again with help at first until I was tall enough – and getting it out of the dryer, then getting my bed made, every day. You see, I was much older before I discovered that when other people said “making the bed”, they were really talking about straightening out the sheets on a bed already made. To me, “making the bed” literally meant starting from the fitted sheet and going on up. I had to “make my bed” every single day.

I was forbidden to discuss this “family secret” with anyone outside the family. From the time I was old enough to suspect something might be medically wrong, I tried to ask a health care professional about the matter, but I was kept under strict guard. I was never left alone with a medical professional, not even a school nurse, long enough to ask the question, even as a hypothetical one.

You see, it was embarrassing. For them. Not as much for me – I myself didn’t matter – but they didn’t want word getting out that I was experiencing this, because it would embarrass the family.

So it wasn’t until I was grown and working my first job (after leaving graduate school, again another post) that I eventually had medical evaluation.

But first, someone is probably wondering, if you are a functional adult now, then how and when did it stop?

I mentioned before that I am a devout Christian. I got saved – accepted Jesus Christ as my personal Savior – when I was in fifth grade. I prayed a long time about God curing this problem, but it wasn’t until I got to be a high school senior that I got desperate.

I had the opportunity to go with a group from my high school down from Pennsylvania, where we were living at the time, to South Carolina to visit Bob Jones University for a high school fine arts competition and preaching conference. Several of my classmates were going, and I wanted to go – but could not, as long as my problem persisted. So I prayed. And prayed. And God was gracious and relented, and at first I had no idea the price I would pay for exchanging daily enuresis.

I did indeed get to go to BJU for the festival. When I graduated high school, I had been awarded a scholarship to Temple University (I graduated as valedictorian of the class of 1987). So my parents and I fought. I knew God wanted me at BJU. I knew just as well that we didn’t have the resources for me to go there. So I put up with Temple for a year. It was the worst decision I have ever made. It’s not a good idea to fight God. And it screwed me up royally academically.

After a series of events (again, perhaps a future post), I did finally end up at BJU, and graduated in 1991 with a B.S. in premedicine with a chemistry emphasis. I moved to Charleston to begin graduate school at the Medical University of South Carolina College of Medicine, as my dream had always been to become a family doctor and go find a small town to set up a shingle in.

Of course, God had other plans.

In 1994 I left school and started work as a medical transcriptionist at (then) East Cooper Community Hospital. When I finally had insurance and access to competent doctors… I could gauge many of them by the way they dictated their reports… I was finally, for the first time in my life, evaluated by a urologist. This should have happened back when I was a child, but never did.

One of the things we discovered is that I have aberrant anatomy. This should have been a warning sign, but I didn’t see it at the time.

*Warning, medically explicit/graphic comments ahead, read at your own risk*

Most females have a urethra (the tube that leads from the bladder to the outside world) that comes out somewhere in the region of the base of the clitoris, which is a structure analogous to the male penis. In the male, the urethra travels the length of the penis before it comes out at the tip. In the female, it comes out in the general region of the clitoris for most people.

Of course, mine is different…

We found that my urethra comes out in the left vaginal side wall. This is pretty important to know, so I can warn anyone trying to catheterize me in future that they aren’t going to find the opening where it “should” be.

It also means that most of the sphincter and supporting muscle structure that should surround it, doesn’t.

Which means, that no matter what they said when I was little, it really wasn’t my fault, nor was it my choice. When I fell asleep and the pelvic musculature relaxed, there was nothing preventing the bladder from emptying whenever it got full, whether I was conscious of it or not.

And this could have been discovered when I was just a little kid, had they only taken me for even a cursory examination by a physician. Even a competent general physician would have been able to tell my urethra was anatomically in the wrong place.

But with the lack of enuresis came a steep price, one I was to discover would be quite difficult to pay.

These posts begin in the context of the present. Today is March 3, 2017. I was admitted to the hospital February 9 with a high fever and severe pain in my hips and back to the point where I just wanted to die rather than continue with the level of pain. Given my history, my medications, and my rather high pain tolerance level, this is significant.

The next day, it was discovered that I had cellulitis in my left leg. Again. You see, this is the second time I have had cellulitis in that leg, the first being December 2014. Yeah, almost a year after my previous post, the one I put up in response to a friend’s comments stemming from ultra-Judaistic “Christianity”. The New Testament was necessary to complete an “imperfect” i.e. incomplete Old Testament whose purpose was to point humanity to Jesus.

Oh yes. I should mention for anyone reading this in the future for the first time, I am a Christian and have been for many years. I’m probably not nearly as mature as I should be. Or hope to be.

God created the human body. He created something so marvelous that to study it should at times evoke a sense of worship – not of the creation but the Creator.

But with sin in the world, things go wrong with the human body. Illness, disease (two different things, that), malfunction, dysfunction (again, two different things)… after a while you just get tired of it all.

I have had many many things go wrong with my body, and I’ve spent countless hours trying to puzzle them out, to make some little sense of it all.

There is a maxim in medicine they call Occam’s Razor. It means, the explanation that covers the most known facts/details about a case is the most likely true one. When you have multiple things going wrong, if there exists an explanation that covers most or all of them, it is the most likely correct one over several explanations that only cover parts but not the whole.

I’ve been hoping for and failing to find my Occam’s Razor, my explanation to fit my facts, not just mine but that of family history as well.

So now begins the sorting of information, laying out what I know piece by piece, to see what can be derived from what we know.

Once upon a time, the internet was young.

You had dot com, dot net, and dot org to choose from if you wanted a domain name – unless you were dot gov, dot mil, or dot edu.

I once held satscout dot com, dot net, and dot org, but gave up two of them because I didn’t have the money to keep them. Pity.

As far as I know, I’m the only Satscout out here in the wild, wild west internet.

That aside, I’ve held onto this little corner of the web for a while now and done little with it.

So I decided, in light of recent events, to document some of my medical history here. I doubt many if any will ever read it, but if I put it out here, maybe someday someone will solve the “mystery that is me”.

And without further adieu… let us begin.

I have a brother in Christ whom I care for and respect. We recently got into a discussion about the nature of the Old Testament; his position is that it is perfect and sufficient in an of itself – mine that without the New Testament, the Old Testament is incomplete and imperfect. As we are both believers, this isn’t a question of whether one of us is in error and needs to repent and be saved. It is, I think, a question of semantics: We are seeing the truth from different angles, and those angles can and should be clarified and reconciled.

The first step, therefore, is to define our terms. I had said in one of my followup posts that there were different ways of using the word “perfect”, and that the Old Testament is “perfect” in some definitions but not in others. The definitions (copied from dictionary.reference.com) by which the Old Testament is most assuredly perfect include

• conforming absolutely to the description or definition of an ideal type
• exactly fitting the need in a certain situation or for a certain purpose
• entirely without any flaws, defects, or shortcomings
• accurate, exact, or correct in every detail
• pure or unmixed
• expert; accomplished; proficient

The definitions by which the Old Testament – from the temporal perspective of our side of the Cross and Jesus’ sacrificial atonement for sin – cannot be said to be “perfect”, are these:

• excellent or complete beyond practical or theoretical improvement
• thorough; complete; utter
• unqualified; absolute

In grammar, there is an interesting way of seeing the word “perfect”: noting an action or state brought to a close prior to some temporal point of reference, in contrast to imperfect or incomplete action. The important qualifier here, and the crux of the disagreement, in my opinion, is the temporal point of reference.

Similarly, there is the concept of being “complete”. The Old Testament is to a degree complete:

• finished; ended; concluded
• having all the required or customary characteristics, skills, or the like; consummate; perfect in kind or quality

But it is at the same time not “complete” from the perspective of this side of the Cross:

• having all parts or elements; lacking nothing; whole; entire; full
• thorough; entire; total; undivided, uncompromised, or unmodified

Or again from a grammar perspective: having all modifying or complementary elements included.

I made two additional complementary statements: first, that the Old Testament saints were aware that the Old Testament was “incomplete”, and second, that the promised Messiah would bring and be the completion that was missing.

God made the original covenants. God chose when and where to make a new covenant that replaced the old. Some covenants, like the one with Abraham, were unconditional – He promised that the whole world would be blessed through his offspring (Gen. 22:18). Some were conditional; much of the blessing promised to the nation of Israel within the Mosaic Covenant was only available if they obeyed. In every case, God was the mediator, and He was the one who set the terms.

Deuteronomy 18:15-19 reads “The LORD your God will raise up for you a prophet like me from among you, from your fellow Israelites. You must listen to him. For this is what you asked of the LORD your God at Horeb on the day of the assembly when you said ‘Let us not hear the voice of the LORD our God nor see this great fire anymore, or we will die.’ The LORD said to me, ‘What they say is good. I will raise up for them a prophet like you from among their fellow Israelites, and I will put my words in his mouth. He will tell them everything I command him. I myself will call to account anyone who does not listen to my words that the prophet speaks in my name.’” Moses himself recognized that one would come whose words would supersede his. In Acts 3, Peter identifies this future prophet as being Jesus.

Jesus really got on the nerves of the Jewish religious leaders. He was pretty equal opportunity about offending them – Pharisees, Sadducees, priests, you name it, at one point or another, Jesus called them out for being all about the show and not about the substance. That was the crux of the need for a new covenant. Because the people God entrusted with His Law were in large part not obeying it, He called for something new. The old was a shadow of the things to come.

The book of Hebrews goes into a lot of detail about the old covenant being a shadow of the new. Chapter 8 quotes Jeremiah 31 by saying “The days are coming, declares the Lord, when I will make a new covenant with the people of Israel and with the people of Judah. It will not be like the covenant I made with their ancestors when I took them by the hand to lead them out of Egypt, because they did not remain faithful to my covenant, and I turned away from them, declares the Lord. This is the covenant I will establish with the people of Israel after that time, declares the Lord. I will put my laws in their minds and write them on their hearts. I will be their God, and they will be my people. No longer will they teach their neighbor, or say to one another, ‘Know the Lord,’ because they will all know me, from the least of them to the greatest. For I will forgive their wickedness and will remember their sins no more.” (vs. 31-34). Hebrews 8 identifies Jesus as the high priest of the new covenant, and while verse 6 says that the new covenant is superior, verse 13 says “By calling this covenant ‘new’, he has made the first one obsolete; and what is outdated and obsolete will soon disappear.”

Chapter 9 goes on to describe Jesus’ sacrifice as being the once for all atonement for our sin – to seal the deal, as it were, by “purifying” the realities in heaven of which the old covenant trappings were but copies and shadows. Chapter 10 goes on to say that the law is the shadow, not the reality, and that Jesus’ sacrifice cleanses sin once and for all. The latter part of chapter 10 is a warning – that those who are the recipients of the grace of God for salvation need to cling to it and not reject it. One who turns back from grace to the bondage of the law has “trampled the Son of God underfoot [and] treated as an unholy thing the blood of the covenant that sanctified them, and who has insulted the Spirit of grace” (verse 29). The call to perseverance in chapter 10 is followed by the “roll call of faith” in Hebrews 11 – all of whom were “still living in faith when they died. They did not receive the things promised; they only saw them and welcomed them from a distance, admitting that they were foreigners and strangers on earth” (verse 13).

Jesus himself said that He had come not to abolish the law but to fulfill it (Matthew 5:17). He even did things like get baptized (to the offense and annoyance of the Jewish leaders) in order to “fulfill all righteousness” (Matthew 3:15). When Jesus declared “It is finished!” on the cross, He was saying that the old covenant had been perfectly fulfilled and He had mediated the new one.

At the Jerusalem Council in Acts 15, James quotes Amos 9:11-12, using it as a proof text that the Gentiles would become believers in God. But when they come, they weren’t becoming Jews. They were still Gentiles, not bound by Jewish customs. The fact that the Moses was being preached in the synagogues meant that these Gentile believers would be trying to get along with Jewish believers who still held to the customs including the vows, the sabbath, etc. In an attempt to foster peace between the groups, and to stop the ones who said the Gentiles would have to follow the Mosaic Law, they came up with the four rules of thumb that would make them minimally more acceptable: don’t get tangled up with idols by eating meat that has been sacrificed to them; don’t eat meat with blood in it; don’t eat meat from strangled animals; and keep away from sexual immorality. The Pauline letters go into far greater detail as to how these details and others were to be worked out in the churches. Nowhere do they say that the old covenant was a requirement for the Gentiles. And even the Jews who became believers were free to stop following the Jewish customs. The first and most glaring example was Peter, who would associate with Gentiles even though Jewish custom said they were not allowed to because Gentiles were “unclean”. When he started shying away from the Gentiles because he was trying not to offend the Jews (not necessarily Jewish believers), Paul called him out on it.

I deliberately kept Paul out of much of this discussion because I didn’t want to base my reasoning solely on his interpretations, as good as they are. Even Peter acknowledged that Paul’s letters counted as scripture (2 Peter 3:15-16) and that Paul wrote with “the wisdom God gave him”. There is ample evidence, however, outside of what Paul wrote to support the idea that God used the new covenant to supersede the old, and that He made it known even before the Messiah came that it would happen that way.