Tuesday, Feb. 17, 2004 - 5:35 p.m.

Mad Nex: Beyond Tacoma Dome

Last week I went up to Tacoma for a screening to see if I qualify for the drug study I’m applying for. I arrived at the bus station, just one block from the Tacoma Dome station. The dome as viewed from the highway looks like a nice dome as domes go, but it sadly wasn’t visible from the station. From there, I took the light rail, which was free to ride, to other parts of that foggy city. The light rail was way futuristic looking (I’m pleased to see that now that I’m in The Future that’s been hyped for decades, at least some things actually look as they ought) made the same otherworldly sound as 17-year cicadas.

The research clinic was very clean, and the staff were very nice and patient. They had me read a million disclaimers and give them a bucket of blood and a carafe of urine. They’re also testing my DNA to see how fast I metabolize stuff. I suppose they’re also cloning me, so later when I start writing entries about how much I love the War on Terror, you’ll know what happened.

I spent the remainder of the day in a McDonald’s, eating chicken instead of beef to avoid Mad Cow Disease, and looking out the window upon the Department of Corrections and the home security store adjoining it, while reading the latest issue of Green Anarchy. I spied city busses going by that had “Clean Machine” emblazoned in huge letters across the tops. I grew hopeful that those words meant that the busses were fueled by hydrogen, but upon closer inspection they turned out to be burning natural gas, which means that though the emissions are significantly cleaner, they’re still pumping fossil carbon into the atmosphere, and they’re no less dependent on the global petroleum dictatorship. If the busses had been running on hydrogen that would have meant potential energy independence if the hydrogen could have been made using renewable energy sources, no CO2, and it would have cleaned ambient pollution out of the air. Sigh.

For a while I was really happy about the upcoming drug study, and looking forward to what I hoped would be a lucrative vacation: I hoped to socialize, do a lot of reading and writing, and meditate for 4 hours each day. But then I read that the drug I’d be taking occasionally causes brain hemorages that are fatal at least half the time. That really rained on my parade.

I did a google search on warfarin and intracranial bleeding, and found information that I didn't come across in my initial research. What I'm trying to ascertain is: do these studies indicate a risk to me in my particular study? The people studied are aimed at a higher target INR (2.0-4.0) than I would be on (1.5-1.8). But the febuxostat could conceivably raise my INR into the 2.0-4.0 range. The risk of intracranial bleeding goes up with age, and I'm still pretty young, but I shouldn't presume the risk to be zero. Most people on warfarin have an INR taken monthly, but I would have one taken daily for part of the study, and every other day during another part. I think the risk is low enough that if I needed those drugs, I would definately try them, but since I don't need those drugs, I need to think about it.

The risks I was willing to take were a 3% chance of temporary headache, nausea, dizziness, stomach pain, and diarrhea from the febuxostat, and if my INR went up, a possible nosebleed or bruising, after which they'd immediately take me off the warfarin. Now, I have to evaluate not only if I think the study is safe, but even if I thought it was safe enough to go there, do I think it's safe enough that I could relax and not worry while I'm there. It's not worth it if I would spend those 38 days in fear.

Right now I'm leaning toward not going, based on the intracranial bleeding risk and also one line I read, "It just makes sense that adverse or even deadly effects of drugs might not show up in trials, especially if the risk is relatively small." which would apply to the Febuxostat, the other drug I’d be taking, which at this point in its Phase 3 of the FDA approval process would only have been tested on hundreds of people. If it kills one in a thousand people and I’m that one, then I’m screwed.

Black to the bone, my home is your home…

But welcome to Tacoma Dome.

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