Medical Journal: 11/24/18

When Dr. Sulica said that my cough hadn’t been a result of the carcinoma and therefore might not go away, it occurred to me to ask him whether it might be worthwhile to try dextromethorphan. He said there was no reason not to, and that shutting down the cough temporarily might break the cycle of irritation-cough-irritation. Since the liquids taste foul and seem to induce coughing due to the coating they create on the lining of the throat, I ordered a bunch of gel-caps (of DXM hydrobromide)on line, and started taking one 15-mg capsule twice a day. (The bottle says two capsules every 6-8 hours, so I’m at the bottom of the dosage range.) Of course with the combination of healing-with-time and the placebo effect, it’s hard to judge, but the stuff seemsto be highly effective; I’m far less dependent on cough drops, and coughing far less often (really, not at all during the day, and much less at night, though I have been blowing my nose a lot).On the other hand, my physical stamina seems to have gone down, and my blood pressure up.

(BP just came in at 164/87; average since I started on the DXM has been something like 145/85. Hard to interpret because my pressure as measured in a medical office is consistently much lower than my pressure measured at home, but these readings are definitely higher than my home readings had been).

I have no idea how to think about the tradeoff; I think I’ll give it another couple of days and then cut back to one a day, unless Dr. Bomback (the nephrologist) says otherwise when I see him Tuesday.Losing the cough would be a big deal.

Heard from the kidney-transplant folks. They want a colonoscopy (yech!) unless I’ve had one within the last 10 years; I just checked, and my last one (which I swore would be the last one) was 12 years ago. They also want another cardiac work-up, and a letter from either Dr. Sulica or Dr. Sanfilippo that the carcinoma is gone. I also have to come in for additional bloodwork; apparently the question of whether the donor and I are really a match can’t be answered without some sort of test involving both my blood and hers.

Will also get a blood draw Monday in preparation for the appointment Tuesday; that will help guide the decision about how quickly to get the transplant. I’m inclined to push it as fast as the transplant folks are willing to move.

Author: Mark Kleiman

Professor of Public Policy at the NYU Marron Institute for Urban Management and editor of the Journal of Drug Policy Analysis. Teaches about the methods of policy analysis about drug abuse control and crime control policy, working out the implications of two principles: that swift and certain sanctions don't have to be severe to be effective, and that well-designed threats usually don't have to be carried out. Books: Drugs and Drug Policy: What Everyone Needs to Know (with Jonathan Caulkins and Angela Hawken) When Brute Force Fails: How to Have Less Crime and Less Punishment (Princeton, 2009; named one of the "books of the year" by The Economist Against Excess: Drug Policy for Results (Basic, 1993) Marijuana: Costs of Abuse, Costs of Control (Greenwood, 1989) UCLA Homepage Curriculum Vitae Contact: