Thursday, May 29, 2008
Where to start?
The bulk of this will be much more personal and much less medical than my normal postings, but, that should be okay...I hope! I suppose to wrap up the medical stuff, ER ended with out any really resuscitations that I got to run, so, as you might expect, I was really unhappy about that. The month was much busier with general patients, but they were mostly aches and pains and a couple of heart attacks thrown in there for good measure. My attending interactions were a little different this go'round, but good over all. I did have a spat with one of the senior ER residents but that was because he was being a total douche! I probably wrote about that already...I'll have to reread the blog to see if I did write about it already.
I have been trying to juggle a handful of things including signing up for step 3, which is the last general medical board exam I have to take. Don't get too excited, I have to take three more radiology boards, at least! And, one of them is an oral examination...not fun.
On a more personal note, I have found out that there is a bad gene floating around my family tree with a defect in BRCA1. It is one of the genes that has been implicated in increased risk of breast cancer and it was found because my uncle was diagnosed with breast cancer a few years ago. Now he is fighting metastatic disease and was finally tested for the genes associated with the cancer.
What does this mean to me? Well, that is not exactly clear. The parent of mine that is likely a carrier has made it into the 70’s without any issues. My afflicted uncle was 70-ish before there was a problem. There is very little research on men, but what there is reports there is a 5.8% risk of male breast cancer by age 56. One can interpret that to be about 1.1% risk per decade of life. That is still about 1/2 the risk for a normal woman. There is also some increase in melanoma, prostate cancer, colorectal cancer, pancreatic cancer and stomach cancer, although I cannot find where any of these have been quantified. The only thing I can find in print is that there is a slight increase in risk. Women with a defect in this gene has a 80% chance of having breast cancer by age 70 and up to 40% chance of ovarian cancer by around that age. (I think I’m quoting the results of the female studies correctly.)
Here’s the dilemma for me: this gene is responsible for repairing DNA damage after ionizing radiation. If you assume that the increased risk of breast cancer is from normal background radiation, which is known, then you can calculate the risk per unit of radiation dose. At the root of the dilemma is the fact that I am planning on going into the field of radiology, which is, in part, the science of the bodies interaction with ionizing radiation.
With the above assumption in hand, and assuming that the increase in risk for cancer is linear with respect to small dose increases, I was able to calculate that my increased risk from my radiology residency (about 120 days of excess exposure above background radiation) was about 0.1% by age 70 if I were a gene carrier. Provided everything goes perfectly. (That’s a BIG assumption!) Right now, there is a 25% chance I’m a carrier and, if my parent tests positive then there is a 50% chance I will test positive.
Although my assumptions may not be perfect, I think they’re pretty good so it would seem that I’m not altering my risk tremendously if I were a carrier, even if I am an order of magnitude off in my calculations.
Next dilemma: Do I get tested? Once you know, it changes things. And, although there are law to protect people that test positively with respect to health insurance, there is no such protections for disability, life or long-term care insurances.
Housing: Since I’ve decided to continue to pursue my Radiology residency, ML and I have been trying to secure housing in B’more. Upon which, we are STILL working! We found two houses and one semi-traditional rental that we liked. The first house was just a few doors down from the house we almost purchased. Thus, we obviously love the neighborhood and street, but the house is only 9.5 feet wide! It’s deep, but it’s not terribly large house and if we kept our king size bed, we would have to launch in and out from the end of the bed to get in and out.
The next place we found was a converted high school into “luxury” apartment. The units are nice and they’re big and you can tell you’re in a high school, but the environment is very sterile. On the last day that we were looking, around 5p when we were just crapping out and getting ready to call it quits, we get a phone call from this unassuming man who was returning a call made on a Craigslist advertisement. We walked in the house and it was breathtakingly beautiful. He starts to tell us how he and his wife still live there and it was the first house that he renovated. Since, he has renovated about a dozen houses in the neighborhood. Looking around, everything is perfect! I’ve seen plenty of renovated homes in the area, but none have been this good. He tells us how he likes to do houses in themes and, in fact, the house down the street from my friend’s brother’s house (that we were originally hoping to rent) he had renovated in a Tuscan style. While we’re walking through this 3 bed room 3.5 bath house and listening to his stories about all of the mistakes in the house, which I finally had to inquire about because I could not find them, I finally asked him how much he was asking for rent. By this point he had told us that there were two other properties that we on the market, too. When he said, “$2650 per month,” I said very politely, “this is a beautiful house and we’d love to live here, but it must have been one of the other houses that we were calling about.”
One of the other properties was a few doors down and was the house of an Italian friend of his who passed away. He bought the house and was planning on renovating it in a Tuscan style as well, but has not done anything yet. Thus, the house was in original condition. Not terrible, but just average.
We finally saw the house that we’re currently trying to lock in which is a 2 bed 2.5 bath house. It is also stunning although not in any particular style other than nice. It’s got a parking spot, which is huge in B’more, it’s beautiful inside, and the entire roof functions as a roof-deck with a room containing a full size refrigerator, sink and microwave. Views of the city, the water and the Domino’s sugar sign are plentiful. The worst part is the house really outclasses our furniture and we’re not going to have enough extra money to quickly upgrade.
Next, there’s packing and moving. ML has packed so much that our living room here is packed full with boxes. I’ve packed a little, but I have much more to do to get ready to move. So, why am I writing this? Just don’t tell ML how long this post is. J
What other stressors are going on? Oh, well, we loaded up the Subaru to drive to B’more and before we got out of the Family housing, the check engine light came on! We drove to the dealer to see if they could tell us what was going on, but they were closed. So we drove home and took the Sebring. Good news was we got to have the top down for most of the trip!
There are a few more things going on, but that’s enough bitching for now.
