Bleomycin Says "Suck It."

After dealing with this wart on my thumb for years, trying almost every therapeutic option available, I finally was able to get rid of it with 4 injections of the anti-cancer agent Bleomycin in one sitting. The injections were quite uncomfortable and the tip of my thumb turned purple and necrotic and looked like it was dying for about two weeks but the wart slowly flaked off and I was left with normal healthy skin.

I know this may not seem like a big deal to most people, but it was to the point where the lesion was affecting my job. I was very self conscious when touching people to do an exam, especially little kids with their parents watching every move I make. And after fighting with it for several years and failing I was beginning to think I was either going to have to live with it or amputate my thumb. So I am very happy now that I can approach people with my hands and not have to worry about what they are thinking about my thumb.

A picture of my thumb, post Moxa treatment. You can't see the actual lesion itself because the burn is covering it. You can see the distribution, however. It was quite large.




My thumb as it appears now, 6 weeks out from Bleomycin treatment.

Decisions

Being a physician puts you in situations where you have to make decisions. The first rule in making medical decisions, per the Hippocratic Oath, is do no harm. I think the second rule is to use your education, training, and experience to come to the best solution. The problem is that in medicine there are lots of gray areas and the best solution often isn't known. I'm pretty laid back in general and usually give my patients a few options and let them pick the one they prefer as long as I don't think it will be harmful. This allows the patient to be an active participant in their own health and takes some of the blame off me if things don't work as well as we had hoped.

I bring all of this up because last week I had to make a decision that didn't go over well with the patient's parents. I can't give much details due to HIPAA regulations. It had to due with a teenage girl and a potential overdose situation and the parents called requesting a refill of the same medication and I told them no. Obviously there are a lot of behind the scenes stuff going on that I can't mention but they thought she couldn't function without the medicine and were upset that I wouldn't refill it and yelled on the phone, etc. But I said no and didn't let them talk me out of it. I think this pretty clearly falls under rule one - do no harm.

This is just an example of some of the decisions that have to be made and things that go on on a day to day basis. Medicine itself is difficult, but when you throw in all of the other aspects that get involved, i.e. social needs, financial needs, insurance policies, and on and on, it makes for a rather challenging field at times. Suffice it to say I was a bit stressed at the end of the day after talking to the parents on the phone, wondering if I made the right decision.

Parking Violations Are Obnoxious

I'm probably going to go on a bit of a rant here so I'll apologize ahead of time. Last weekend I got a parking violation for parking in a "no parking" zone. I got the ticket while at a game at Hinkle Fieldhouse. For those of you who haven't been there, it is surrounded by residential buildings in the middle of Indianapolis. I saw one parking lot and it required a tag to park in it. Otherwise, there were no other places to park except the street. Some of the streets did have "No Parking" signs and I avoided parking on those streets. However, the street I parked on had no indication that you couldn't park there. No signs at all. And apparently none of the other 15 drivers who had parked on the street with me saw any signs either. They all got tickets too for parking in this "No Parking" zone. The ticket was bogus to begin with. If they didn't want people to park along that street, put up a sign. It's that simple.

The ticket cost $40 but if I paid within 7 days it would only cost me $20. So I went to the website and a disclaimer came up that said it could take up to 7 days for a ticket to show up on-line. How convenient that the ticket doesn't show up on the web until after the discount deadline. I checked the website for 5 days and nothing showed up so I gave up on that route of payment and tried to call. Of course it was a stupid computer menu that I was talking to. It kept asking me for a number that was on the ticket but wasn't labeled so I had no idea which number it wanted. And every time I pressed zero to be connected to a real person I got cut off. I tried 4 or 5 times and got cut off every time. At this point I gave up and decided that I was going to have to go downtown to pay off the ticket in person. So I drove out of my way to downtown, paid $5 to park for 10 minutes, got charged $1.50 processing fee to use my credit card, let the lady know what I thought of their terrible system, and went on with my day. It would have been great if they would have just labeled the street in the first place and I would have avoided the entire situation.

Super City Part 2

I went down to the Super Bowl village twice, once on Thursday with Sarah and once on Saturday with Craig. Let me first say that it is amazing to me how much fanfare goes into celebrating one game. I think it's safe to say that this event has more to do with celebrities and entertainment than an actual football game. The whole thing is a little over the top. With that being said, from what I could tell and from pretty much everything I read Indianapolis did a great job of hosting. Things were well organized, there was lots to do and see, and it was interesting to witness the hoopla in person. The wonderful weather we had here all week didn't hurt either.

Saturday was a bit of a different story. I've never seen downtown Indy so crowded. It looked like Times Square on New Year's eve. It was a bit much for me, honestly. We only stayed down there for a few hours before we bailed to a less crowded vicinity.

Overall I think the event went over well and for a few days the international spotlight was on Indianapolis for a good reason. I think our city looked really good on the big stage. It was neat to see and probably a once in a lifetime event for me unless the game returns in the future. A few pictures are posted on Sarah's site.

Super City

Indianapolis is no stranger to hosting large events. Look no further than the annual Indianapolis 500 mile race, which is the largest attended single day sporting event in the world. Despite the fact that the 500 is way past its prime in popularity, it still draws approximately 300,000 people each year. The Super Bowl crowds this year will be half as large. Yet hosting the Super Bowl is huge for our city for other reasons. Football is more popular in America than racing. Not only does the sporting world focus on the Super Bowl, but the entertainment and celebrity world does as well. Also, did I mention 100 million world wide viewers? The Super Bowl is a big, big deal for the city of Indianapolis and central Indiana.

I'm planning on heading downtown twice over the next week. I'll let you know how it goes in my next post. I'm a little nervous about it, to be honest. Part of me is thinking it will be just like every other trip downtown except twice the price and four times the hassle. The other part of me is excited. It will definitely be a ton of people having a good time, with the possibility of some celebrity sight seeing. Either way, make no doubt about it. Hosting the Super Bowl is a big victory for a small market Midwest city. I'll let you know how Super Bowl city is next week, hopefully with some pictures.

Taking A Stand!

I'm glad some of these big time web companies have the guts to stand up to the ridiculous bill proposal that is SOPA. Blatant pirating of movies and music is one thing, but when you have a set of laws that are so vague that anything could be called private property (see an example here, from WWTDD) it obviously threatens not only the Internet as we know it but free speech. In addition, the recent shut down of the MegaUpload site makes me question the necessity of the bill to begin with. Why do we need new laws so everything can be micromanaged when they already have the power to go after the big guys? Good for Wikipedia and Google and other companies for taking a stand and getting millions of people to sign a petition to prevent the bill from going through. I just hope that the Internet as we know it lives for ever. I fear that bills like SOPA will continue to come and the powers to be will slowly take away Internet freedoms until it is highly regulated. Only time will tell. For now, a small victory for us and hopefully a big win if and when the bill gets rejected.

Tilted Kilt

Tilted Kilt
Location: Downtown Indy
Price: $$
Rating: 4 Cheeseburgers


BoilerPip and I made a trip downtown this weekend to eat at the Tilted Kilt and watch some of the NFL playoffs. The Tilted Kilt is an Irish pub-themed sports bar. It has all of the essentials for a sports bar: beer, lots of TVs, good and affordable bar food with some Irish meals too, and pretty waitresses. If you mix Buffalo Wild Wings with Hooters and the Claddagh, the Tilted Kilt is what you'd get.

The Tilted Kilt is a chain of restaurants and the one in Indy just opened a few months ago. It's a fun place to go and catch a game. I'll likely hit it up again in the future, though a north side location would be great as I don't get downtown too often. If you're in Indy for a game I'd suggest checking it out for your pre-game festivities. You won't be disappointed.