Mike Salsbury’s Blog

On Tuesday, I took a “tracer” dose of radioactive iodine.  On Wednesday, I took another.  Thursday I underwent two scans to see where the tracer doses went.  As expected and hoped, the scans showed that the radiation was pretty much confined to my remaining thyroid tissue.

Based on the result of those scans, the doctor set my “big” dose of radioactive iodine to 75 millicuries.  In terms of the range of potential doses used to treat thyroid cancer, it’s in the lowest range of doses.

On Friday morning, I took a 76 millicurie dose of radioactive iodine.  Apparently, I also contracted a cold and cough.  Since the radiation, lack of thyroid hormone (part of the treatment), and restrictive diet most likely reduced the overall effectiveness of my immune system, I now have a sinus and chest cold on top of the symptoms of hypothyroidism and radiation treatment.  I’m sneezing and coughing on a pretty regular basis, and feeling exhausted and tired much of the rest of the time.

I know this is nothing compared to what other cancer patients like my mother (who died earlier this year from melanoma) have gone through, and I am both respectful of that and grateful that my situation isn’t worse than it is.  Still, it’s not an exaggeration to say that I feel worse than I can remember feeling in a long, long time… if not the worst ever.  While I will probably never understand what my mother went through in her final days, I think I have a greater appreciation of it than I ever did before.

Tomorrow morning, I look forward to being off the low-iodine diet.  That means I can have things with dairy (like my morning coffee with milk), sandwiches with cheese, and pizza again.  I can have sushi, Chinese food, Indian food, and more.  Perhaps even better than that, I’ll once again be back on the synthetic thyroid hormone. That should be the end of the severely dry skin, muscle weakness, unexplained muscle cramps, shortness of breath, and other symptoms I’ve had to endure since before Thanksgiving.

This coming Friday (12/26) is another set of scans for radiation, to determine where the last “big” dose went. Friday’s scan is supposed to be “more revealing” in some way than the one I had last Thursday.

After that, I’ll be working with the endocrinologist to regulate the dose of synthroid I’ll be taking from now on to give me a “normal” level of thyroid hormone in my blood.  I guess you could say that the end is in sight, at least as much as there is an end to this.  I’ll be having tests each year from now to confirm that the cancer hasn’t returned, so in a sense it will never be truly “behind me” and will always be somewhere out there in the distance.

admin Life hypothyroidism, low iodine diet, papillary carcinoma, radioactive iodine, radioiodine, thyroid cancer

I’m almost through my first full week of the low-iodine diet.  All things considered, it’s not that bad, but it’s certainly not fun.  I pretty much can’t eat in restaurants.  I can’t have anything with salt, because it might be iodized salt.  I can’t have anything with seafood or sea-based products (such as sea salt, seaweed, or seaweed extracts).  I can’t have dairy products. I can’t have soy products, such as soy sauce.  No egg yolks or anything containing them.  No bread products that contain iodized salt or iodine based dough conditioners (whatever those are).  There are lots more restrictions. 

Pretty much, my diet this week has consisted of: unsalted walnuts, unsalted sunflower seeds, oranges, apples, bananas, celery, home-cooked chicken, home-cooked pot roast, veggies, a special bread from a bakery that doesn’t use iodized salt, homemade popcorn with unsalted margarine and non-iodized salt, rice, and pasta.

Unfortunately, since I’m off the thyroid medication, too, I don’t think I’ve actually lost any weight on this diet.  Being off the thyroid medication is the worst part of this by far.  I get horrendous muscle cramps for virtually no reason. For example, one day this week at work I moved my arm slightly (not rapidly, not holding anything, etc.) and suddenly the muscles under my arm and on my rib cage under my armpit absolutely throbbed in pain.  I don’t think I’ve had that much pain in years, and it took the better part of an hour to go away.

Another added “benefit” to being off the synthetic hormone is that I’m really sensitive to cold temperatures, which is just great in December in Ohio.  What makes it more fun is that I’m in a recently-renovated area of our office complex at work.  This new area has a heating system that the engineers are still working the bugs out of.  This afternoon, a co-worker measured the temperature and humidity in our area, which was 70 degrees with 24% humidity.  He said the calculations say that feels like 64-65 degrees.  Everyone in the area, none of whom are hypothyroid, is complaining about the cold.  My hands and toes have been so cold the last couple of weeks that at times I can’t even feel them.

When I got in the car, I was so cold I started shivering.  That shivering activity set the muscles in my chest off with yet-another cramping spasm.  The pain continued at a decreasing level until we got home.

While making dinner, one of our cats was lying on the floor nearby, hoping for a handout. I stepped on his tail and he let out a screech. I reacted instantly to lift my foot and get off him.  That caused my leg muscles to spasm, which made me double over in pain.  Doubling over caused my shoulder, the muscles under my arm, and muscles under my armpit to all cramp in extreme pain.  By the time the pain subsided, my dinner had pretty much gone cold.

As if the muscle cramps weren’t enough, I get short of breath often, my leg muscles feel really weak, I’ve had memory lapses, headaches, dry skin, and have to be careful not to be “short” (mean/rude/impolite) to others.

The diet will continue until 12/22, when I’ll revert to a normal diet again and start taking the replacement thyroid hormone again.  I’m looking forward to that.

On Tuesday and Wednesday next week, I’ll be taking small doses of radioactive iodine.  Thursday I’ll undergo a radiation scan to see where the iodine went.  Friday (12/19), I’ll take the “full-size” dose of radioactive iodine.  That will begin a six-day period of keeping at least 6 feet from other people and pets.  Fortunately, that period will end on 12/25, so I’ll be able to spend time with the family then, be back to a normal diet, and taking replacement thyroid hormone once again. I ought to feel a lot better then than I do right now.

admin Life low iodine diet, radioactive iodine, thyroid cancer, thyroidectomy

At the office, we’ve been investigating an issue where (for reasons as yet undiagnosed) a number of  Windows PCs that are configured via Active Directory Group Policy to automatically lock their screens after 5 minutes of inactivity aren’t doing that.  In the process, I’ve started writing some scripts to gather data during off-hours times (e.g., 2am when few people should be working) to see whose machines aren’t locked and capture information about system resources, running processes, and the like.  Not enough data is available yet to reach any conclusions, but I have run into a few interesting tidbits that might be of use to other Windows administrators and support personnel.  I’ve decided to compile those tidbits here so that you’ll be able to make use of them in your own environment if you so choose.

The key that determines if a screen saver is password protected is:

This key has a value of 0 if it’s not password protected, and 1 if it is.

The key that tells Windows if a screen saver has been selected for activation or not is:

This key has a value of 0 if no screen saver has been selected, and 1 if a screen saver has been selected.

To set how long the “idle time” has to be before the screen saver kicks in, check this key:

This contains the “idle time” in milliseconds before the selected screen saver activates.

The key governing which screen saver is to be used is this one:

The value of this key is the path to the selected screen saver, such as “C:\WINDOWS\System32\logon.scr”.

The “normal” or “default” screen savers that ship with Windows (along with most user-installed screen savers) can be found in:

Where “Windows” is the name of the directory into which Windows is installed on your PC (i.e., if you’ve changed that to a different directory, adjust the “C:\Windows” part accordingly.

There’s nothing that requires screen savers to be stored in this particular directory, however, so you could find screen savers in other directories on the PC.

If you want to look for the screen savers on your particular PC, do a Windows search for files whose names end in “.scr” as those are (more likely than not) screen saver modules.

To start a screen saver from the command line on the PC you’re using, bring up a command line and enter the command:

Where “C:\Windows” is the directory where Windows is installed on your PC, and “logon.scr” is the name of the screen saver you want to start running.  The “/s” tells Windows to start the screen saver running.  Optionally, you could leave off the “/s” (or use “/c”) to see any options you can set for that screen saver (or get an error if there are none).  You can also use “/p <HWND>” to invoke the screen saver as a “child of the
window referred to the window <HWND>” (I’ve not used that particular function so I can’t tell you much  about it).

Note that even though your screen saver might be set to require a password when it comes back, my testing indicates that invoking the screen saver as above does not cause this to happen. You’re better off,  if you’re concerned about security, issuing a command to force the system locked.

It’s possible to lock your system from the command line.  To do this, bring up a command line and enter the following command exactly as written:

This will almost immediately lock the screen/system.

There may be times you want to lock a system that’s somewhere else on the network.  That can be done pretty easily by first downloading the  “psexec” tool from SysInternals (now a part of Microsoft).  Using psexec, you could remotely lock the screen of a PC on your network named “PC123″ by issing the following command from the command line:

(The above command should all be on one line. It’s not two separate commands.)

You can also invoke a screen saver remotely (with the caveat that it doesn’t actually lock the system) by using psexec to issue the following command:

(Again, the above command should all be typed together on one line.)

Since “normal” screen saver modules are all executables with the extension “.scr” in their name, identifying whether a screen saver is running on a remote PC can be determined by creating a single VBScript to connect to the Windows Management Instrumentation (WMI) service on the remote PC and query the list of processes to find one with “.scr” in the name.  If you find one, then more likely than not there’s a screen saver active on that machine.  The following VBScript code will tell you for the computer named in  “strComputer” whether a screen saver is running or not.

The above script connects to the specified machine’s WMI provider, retrieves a collection object representing the processes running on the system, scans through the collection looking for any with “.scr” in the name. If one is found, the variable “ssActive” is set to true.  It then checks the value of that variable to see if it found a screen saver running and reports that.  The above script assumes that the user running it has administrator permission on the remote machine.  If not, it will fail.

Note that I’ve intentionally left all error-checking out of the above script code to keep it short for publication. If you plan to use this in any kind of production mode you’ll want to build in checks to identify if the PC in question can be reached, if there is a problem retrieving the list of processes, etc.

If you don’t want to use VBScript but would still like to know if a remote system is locked, and you have administrator permissions on that machine, the “pslist” utility from SysInternals (now Microsoft) can make that fairly easy.  Just download pslist from the Microsoft web site, bring up a command line, and enter a command line like the following:

You’ll get back a response like this if the specified screen saver (logon.scr) is running:

This will tell you if the “logon.scr” process is running on that PC and how long it has been running.  If you’re not sure what screen saver the user might have active, just run pslist without specifying a process name.  You’ll get a much longer list, but anything in that list with “.scr” in the name indicates which screen saver module (if any) is running.

Note that while the above information is based on Windows XP Pro and has been tested with XP, in theory it should also work with Windows 2000 and possibly Windows Vista, but I have not tested it with those.

admin Windows Administration lock screen, lock workstation, Registry, screen saver, VBScript, Windows Administration, Windows XP

I was told to stop taking my thyroid hormone the day before Thanksgiving.  It began to take a toll on me pretty early on, and it’s only gotten worse.  According to endocrineweb.com, low thyroid hormone (also called hypothyroidism) carries with it a lovely list of symptoms:

• Fatigue
  Boy, have I noticed this one. Yesterday I walked a distance I used to walk every day without breathing hard, and wasn’t sure I would make it to the end between feeling worn out and in pain.
• Weakness
  I’ve experienced this one as well.  I don’t have the strength or endurance I had just a few weeks ago.
• Weight gain or increased difficulty losing weight
  This started even before the surgeon removed my thyroid, and I’ve been keeping a close eye on it. I don’t think I’ve gained anything in the last couple of weeks, and may have even lost a pound or two.
• Coarse, dry hair
  So far, I haven’t noticed this problem.
• Dry, rough pale skin
  The skin on my hands definitely mirrors this.  It’s much drier than it’s ever been, even to the point of almost cracking in places.
• Hair loss
  Fortunately, I haven’t see any of this yet.
• Cold intolerance (can’t tolerate the cold like those around you)
  Got this one in spades.  Doesn’t help that my office is in a renovated part of the building where the techs haven’t got the heating working just right yet, and that it’s now December. There was a long part of today where I couldn’t feel my feet and my hands were almost numb with the cold.  I’m the guy who could go outside in short sleeves for 10-15 minutes in the dead of winter, and now I can barely stand my indoor, heated office.
• Muscle cramps and frequent muscle aches
  This was the first thing I noticed, and it’s been getting worse.  Tuesday, I gently set my laptop bag on the floor in the den and really irritated the muscles and joint in my shoulder.  It caused intense pain for several minutes.  Other muscles and joints got in on the act later, to the point that I took two prescription pain killers and a muscle relaxer to try to counteract it.  It helped some.  Wednesday, my back decided to flare up and cause trouble.  Most every morning I’ve woken up with cramps in my hands that are so severe I can’t hold much of anything in them.  Even sitting here typing, my shoulders and arms are hurting.  I’m looking forward to the weekend when I can relax and move a minimal amount.  It’s not an exaggeration to say that stretching, twisting, or exerting any muscle scares me.  Most of the time, those actions cause pain comparable to a “charley horse” that lingers around for a while afterward.
• Constipation
  So far, so good on this one.
• Depression
  How anyone could have any of the above symptoms, combined with the knowledge that they have cancer, combined with the recent death of a parent, and not have some level of depression is beyond me.
• Irritability
  I hadn’t noticed, but apparently I do have this.  I said something I thought was slightly humorous but supportive, but dropped the jaws of everyone in the room because it was apparently “out of character” and mean.  I accidentally said something rude to a co-worker, too, in response to a comment she made… and I didn’t mean to be rude then, either. So while I may not be FEELING irritable, I must be based on the way others are reacting to me.
• Memory loss
  Yesterday, I would have said “no” to this one.  It started to be a problem today.  I’ve forgotten several things, sometimes very basic things like words I use often, and just couldn’t recall them.  I’m starting to understand what Denny Crane (William Shatner) on Boston Legal experiences with his Alzheimer’s.
• Abnormal menstrual cycles
  If this starts being a problem for me, it’ll be time to call the Guinness Book of World Records and maybe The National Enquirer…
  
  
• Decreased libido
  My wife probably wishes this was true.  I don’t think my libido has changed, but my desire to act on it has certainly diminished based on the cramps, aches, pains, and weakness I feel.

In addition to the above, I’ve noticed my voice having trouble today.  It sounds very weak and crackly to me. I can only imagine what it sounds like to others.  According to Wikipedia, that’s a symptom, too.  In fact, their list is a bit longer and indicates that I’m probably in the “late symptoms” category now. Oh, goody.

Monday I start the low-iodine diet.  This will probably take care of any potential weight gain because it eliminates nearly everything I can and do eat.  Fortunately, it does allow for an occasional beer and (homemade) popcorn.  On the serious side, it eliminates dairy products, seafood and sea-based foods, anything with iodized salt, anything with red dye #3, virtually all baked goods (due to iodine based dough conditioners in use), certain beans, more than 6 ounces of meat a day, and lots of other stuff.  What’s left is mostly raw fruits and vegetables, small amounts of home cooked meats without salt, popcorn, unsalted nuts, and homemade foods that you’re positive don’t include iodized salt or red dye #3.

Later in the week, I go in for blood work.

The week after that, I go in for a small dose of radioactive iodine. The next day, a scan. The next day, more tests (I think). That Friday, the “big dose” of radioactive iodine intended to kill any remaining thyroid cells or cancer cells.  For 6 days after that, I’m supposed to keep at least a 5-6 foot distance from others to avoid exposing them to radiation.  Thanks to the two surgeries and my mother’s illness earlier this year, I have no sick time left and barely any vacation days, so I’ll have to work at least one day while I’m in this “radioactive” state.  I’ll try to find a place away from my colleagues and as far as possible from others.  In a company of 1200 people that may not be easy.

On the 22nd, the worst of it should be over, as I’ll start taking the permanent thyroid hormone replacement and eating my normal diet again.  By Christmas, I’ll no longer be (dangerously) radioactive so I won’t be excluded from the festivities.

That’s all for this round. I’ll share more once the diet starts.

admin Life low iodine diet, radioactive iodine, radioiodine, thyroid cancer

I admit that I’m one of the millions of Americans who doesn’t know much about, think much about, or really care much about international politics.  I don’t often watch the news, and rarely enjoy it when I do.  Nevertheless, I saw this movie as an inexpensive download from Amazon.com for my TiVo and decided to give it a look.

While the story it tells leans to the right politically, I think it does a compelling job of explaining both points of view and gives some justification as to why we have a military presence in these places.  It has little to do with oil and more with promoting freedom and stability in those foreign governments.  I found it interesting and educational.  It’s clear from the comments on Amazon.com that there are other ways to look at this film and I intend to keep an open mind when I hear those arguments as well. 

If you have an open mind, or think you do, it’s worth taking a look at this film if you get the chance.

The World Without US – With Niall Ferguson

admin Movies world without us