Tuesday, December 29, 2015
Saturday, December 19, 2015
Diagnosis X
The doctor said, and this is an exact quote, "I don't want to make anything up." He has referred patient, and any potential diagnosis, to an esteemed specialist and evidently doesn't want to venture any further out on the proverbial limb.
Sunday, December 13, 2015
In Dreams...
In last night's dream, he was playing golf with his brother, and the swing was good and the ball was going as directed, and his comment was that only yesterday, he could hardly move at all.
Tuesday, December 1, 2015
Lack of Vision
Or, "I think they don't care."
October 8--- Double appointment set for (1) Field-of-Vision Exam and (2) Office Visit with the esteemed Dr. Weiner
October 7, Received call at 4:00 p.M. saying Dr. W. would be "unavailable" and Manager would call me back to reschedule. Will need the 2 appts.
November 10--No call from office after more than a month, so I called to check my patient status. They had been busy, I'm told. They rescheduled, in 2 parts, for Nov. 23 and Dec. 1.
November 23--Drove to Clifton Park for the intensive Field-of -Vision test. The machine was broken, awaiting repair. Rep promised to call me back that day, or even night, to apprise me of situation, important because of my pending appointment with the inimitable Dr. W. on December 1.
Nov. 23, 24, 25----Did not receive the promised call. I'm so hurt.
November 25, evening---Received recorded call confirming my Dec 1 appt. But that's not to happen until after the Vision Exam
November 27---I called to say what the heck, but the office was closed til Mon.
November 30---I was going to ignore my scheduled visit, which was to be in Troy office, but decided to give them a courtesy call. I explained, and I mean I had to explain, the situation that I was not to see Dr. W. until after the F of V test. She had to leave to check my story. She came back to tell me that yes, she'd called the Clifton Park office and the machine was being worked on right now. She left again to check with Dr. W. and returned to tell me that I could have the Field of Vision test tomorrow morning, Dec. 1 at 9:30 on the repaired machine in C.P., and then keep my 3:40 appt. with Dr. W. in Troy
I told her that, since I'd received no call, I'd assumed the Dec. 1 Follow-Up appt. would not happen, and I had made other plans, which was true.
She said she'd cancel then. That was it.
I'd been previously informed that Dr. W. will be out of the country for about 9 weeks or so, and would not be available for any appointments until his return, sometime in February of 2016 or so.
I guess they don't need my business, and I hope I don't need theirs.
October 8--- Double appointment set for (1) Field-of-Vision Exam and (2) Office Visit with the esteemed Dr. Weiner
October 7, Received call at 4:00 p.M. saying Dr. W. would be "unavailable" and Manager would call me back to reschedule. Will need the 2 appts.
November 10--No call from office after more than a month, so I called to check my patient status. They had been busy, I'm told. They rescheduled, in 2 parts, for Nov. 23 and Dec. 1.
November 23--Drove to Clifton Park for the intensive Field-of -Vision test. The machine was broken, awaiting repair. Rep promised to call me back that day, or even night, to apprise me of situation, important because of my pending appointment with the inimitable Dr. W. on December 1.
Nov. 23, 24, 25----Did not receive the promised call. I'm so hurt.
November 25, evening---Received recorded call confirming my Dec 1 appt. But that's not to happen until after the Vision Exam
November 27---I called to say what the heck, but the office was closed til Mon.
November 30---I was going to ignore my scheduled visit, which was to be in Troy office, but decided to give them a courtesy call. I explained, and I mean I had to explain, the situation that I was not to see Dr. W. until after the F of V test. She had to leave to check my story. She came back to tell me that yes, she'd called the Clifton Park office and the machine was being worked on right now. She left again to check with Dr. W. and returned to tell me that I could have the Field of Vision test tomorrow morning, Dec. 1 at 9:30 on the repaired machine in C.P., and then keep my 3:40 appt. with Dr. W. in Troy
I told her that, since I'd received no call, I'd assumed the Dec. 1 Follow-Up appt. would not happen, and I had made other plans, which was true.
She said she'd cancel then. That was it.
I'd been previously informed that Dr. W. will be out of the country for about 9 weeks or so, and would not be available for any appointments until his return, sometime in February of 2016 or so.
I guess they don't need my business, and I hope I don't need theirs.
Monday, November 30, 2015
Stroke Scale
NIH Stroke Scale Response Value
Level of Consciousness----Alert?
LOC Questions-------------Answer 2
LOC Commands-----------Obey 2
Best Gaze--------------------Normal?
Visual------------------------Any visual loss?
Facial palsy------------------Normal?
Left Motor Arm Drift------Any drift?
Right Motor Arm Drift------Any?
Left Motor Leg Drift-------Any?
Right Motor Leg Drift------Any?
Limb Ataxia------------------------Absent?
Sensory----------------------Normal?
Best Language-------------Normal?
Dysarthria------------------Any Aphasia?
(Motor Speech Disorder)
Extinction-/ Inattention-----------------
If score is 0 no stroke
1-4 minor stroke
5-15 moderate stroke
15-20 moderate / severe stroke
21-42 severe stroke
For score greater than 4, tPA is usually administered: Tissue Plasminogen Activator
Level of Consciousness----Alert?
LOC Questions-------------Answer 2
LOC Commands-----------Obey 2
Best Gaze--------------------Normal?
Visual------------------------Any visual loss?
Facial palsy------------------Normal?
Left Motor Arm Drift------Any drift?
Right Motor Arm Drift------Any?
Left Motor Leg Drift-------Any?
Right Motor Leg Drift------Any?
Limb Ataxia------------------------Absent?
Sensory----------------------Normal?
Best Language-------------Normal?
Dysarthria------------------Any Aphasia?
(Motor Speech Disorder)
Extinction-/ Inattention-----------------
If score is 0 no stroke
1-4 minor stroke
5-15 moderate stroke
15-20 moderate / severe stroke
21-42 severe stroke
For score greater than 4, tPA is usually administered: Tissue Plasminogen Activator
Sunday, November 29, 2015
Thursday, November 26, 2015
Stealing Dream
My sister and I were trying to take something from a house that we sneaked into. She needed some papers that were in there and I was helping her. I drove her to the place near where she lived in the city. It was daylight and the back porch was unlocked and nobody was home, so we went in and she was looking for a specific folder she wanted to get. Everything around seemed to be white though not new: the walls, the furniture, the entire back porch where she was searching. She seemed fairly calm but I was nervous, afraid of our getting caught. I had gone inside the main part of the house, left my pocketbook in there, retrieved it, and told her I thought we might get caught, as I had seen a couple of neighbor ladies drive by and they seemed to look in our direction. My concerns were affecting her and we left, in my car, the same one I drive now. The fear of being found out was so strong that every single thing seemed ominous. When we stopped at a traffic light, I told her that it probably had a camera that snapped a picture of our license plate. She thought so too and we tried to come up with a valid excuse as to why we might have been in that neighborhood. We could say we were going to her house, but it was not in line with her address. We could say we were lost, but we were too close to her house. We could say we were shopping , but the neighborhood was residential. If we said we were just driving around, we would seem guilty. We drove away, nervous and afraid, of exactly the same mind, as if we were one person, totally united in our distress.
Wednesday, November 25, 2015
Ask the dog, Dammit.
I read this week that an elderly, emaciated, tumor-afflicted dog that had been abandoned in South Carolina has been transported all the way up here to receive medical treatment and surgery in hopes that the poor thing can eventually be adopted into the home of a loving family who will care for him in the time he has left. The dog's age is estimated at 10 -13 years, and the surgery to remove and treat his tumor, and the procedures to treat his skeleton-like frame will be intensive and certain to provide only a brief increase in his life span at an enormous financial cost.
One of the first questions hospital patients are asked, at least those patients of a certain age, is whether they have a DNR. A valid option, it would seem, as long as it's not misinterpreted.
But why should it be deemed acceptable that the elderly be questioned about end of life choices with the implication being that there is a right time to die when all-out efforts are made to save an ailing old dog . The dog was abandoned, we read, so public outrage is directed at whoever allowed that to happen, and the cry is for someone to pay for this atrocity. Maybe a hard-hearted owner cast the dog out after 10 years or so. Or it could be that the dog, sick and unable to eat, went away to die: its own decision that it had suffered enough and knew the time had come to let go.
Dogs, not being human, do not have access to a DNR. It may be that they are smart enough to do the right thing without the need to consult an outside source.
One of the first questions hospital patients are asked, at least those patients of a certain age, is whether they have a DNR. A valid option, it would seem, as long as it's not misinterpreted.
But why should it be deemed acceptable that the elderly be questioned about end of life choices with the implication being that there is a right time to die when all-out efforts are made to save an ailing old dog . The dog was abandoned, we read, so public outrage is directed at whoever allowed that to happen, and the cry is for someone to pay for this atrocity. Maybe a hard-hearted owner cast the dog out after 10 years or so. Or it could be that the dog, sick and unable to eat, went away to die: its own decision that it had suffered enough and knew the time had come to let go.
Dogs, not being human, do not have access to a DNR. It may be that they are smart enough to do the right thing without the need to consult an outside source.
Saturday, November 14, 2015
Rescue Me
But not without cost. Just received our Health Statement which contains the use of the Hoosic Valley Rescue Squad conveyance on June 17. They, the Provider, submitted 2 charges, one for $1,050 and the other $272, totaling $1, 322. One trip but billing for separate services, evidently. Medicare approved the entire amount, but paid only $401.29. Our other insurance, BC/BS paid $102.37. Since we had already met our Deductibles and Out-of-Pocket Maximum for the year, we paid 0.
That expense has to be a real hardship for those without adequate insurance. Some must refuse ambulance services if they know the cost. A few days after our emergency service, we received a call asking, on behalf of the Hoosic Valley Rescue Squad, if we were planning to sue the business where the incident had occurred. I learned the call did not originate from the Squad, but from a central volunteer emergency services billing agency. The caller seemed surprised when she heard we had no plans to file a lawsuit. She said she'd bill our insurance then.
That expense has to be a real hardship for those without adequate insurance. Some must refuse ambulance services if they know the cost. A few days after our emergency service, we received a call asking, on behalf of the Hoosic Valley Rescue Squad, if we were planning to sue the business where the incident had occurred. I learned the call did not originate from the Squad, but from a central volunteer emergency services billing agency. The caller seemed surprised when she heard we had no plans to file a lawsuit. She said she'd bill our insurance then.
Saturday, November 7, 2015
Not Really Naked, But Afraid
I was in this place, and I needed to get something to eat, for myself and others, those who were with me, and depending on me to do so. I went to all the different areas that were selling food, but no one paid any attention. I tried to flag down the staff members, servers who were delivering food to others, but couldn't be heard.
I tried to assess the situation, coming up with this theory: "Maybe," I said to those who were waiting, "it's because I've got this comforter wrapped around me and I'm mistaken for a patient,"
So I went to get something to wear. I had a store of clothing, new and unworn. I selected what looked like a dress, but it was a gown with a princess embellishment on the front. I knew it was too youthful, so thought of giving it to a grandchild. I looked at the tag and it was Size 14, so I knew that wouldn't work---I'd be gone before she got to that age.
I pulled on one sweater, and then another. They were too small. I couldn't even comfortably fit my arm in the sleeve.
I woke up hungry.
**The next night was different. I was in much the same type of place, with many people around, and, for some now unknown reason, I changed the radio to another station. After I found out, or failed to find out, what I needed to know, I left. The man in charge switched the dial back, glowering as he did so. Later Danny told me it was because he was listening to the latest sensation in broadcasting, Ed Cenci, the podiatrist with the white Afro. I felt embarrassed: I hadn't known. (I later saw him boating with my daughter, but I remained out of view, beneath a stairwell.)
I tried to assess the situation, coming up with this theory: "Maybe," I said to those who were waiting, "it's because I've got this comforter wrapped around me and I'm mistaken for a patient,"
So I went to get something to wear. I had a store of clothing, new and unworn. I selected what looked like a dress, but it was a gown with a princess embellishment on the front. I knew it was too youthful, so thought of giving it to a grandchild. I looked at the tag and it was Size 14, so I knew that wouldn't work---I'd be gone before she got to that age.
I pulled on one sweater, and then another. They were too small. I couldn't even comfortably fit my arm in the sleeve.
I woke up hungry.
**The next night was different. I was in much the same type of place, with many people around, and, for some now unknown reason, I changed the radio to another station. After I found out, or failed to find out, what I needed to know, I left. The man in charge switched the dial back, glowering as he did so. Later Danny told me it was because he was listening to the latest sensation in broadcasting, Ed Cenci, the podiatrist with the white Afro. I felt embarrassed: I hadn't known. (I later saw him boating with my daughter, but I remained out of view, beneath a stairwell.)
Friday, October 30, 2015
Journal Entries----Elementary, My Dear
Evidently mandated: Journal Entry Assignment: Things I Never Knew Until Now
Sept. 22, 1980---Today I was warned not to get my white pants dirty, but someone in this class pushed me, namely S.
Sept. 25, 1980--Today I signed up for trumpet.
Sept. 26, 1980--Today was boring. Nothing really happened,except that I played kickball.
Sept. 29, 1980--Nothing happened today so I'm going to write about Saturday and Sunday. I went to the Red Coach that made me sick. Oh! Today I was goalie.
Sept. 30, 1980--Today I woke up at 7:00 a.m. and watched "Dr. Who." Besides that nothing really happened.
Wed., Oct. 1, 1980--Well, today I decided to go grasshopper hunting for Mr. Scerbo, but played soccer after I found out you had to squish their heads. But I played a good game of soccer. I was goalie, they scored one and we scored two.
Thurs. Oct.2, 1980--I really don't believe it. Tomorrow is my birthday. Well, gotta go.
Fri. Oct.3, 1980--Today at 5:00 a.m. I WAS ten. Out on the playground I played soccer and I got massacred. Not in soccer, though. Anthony saw my journal and man did I get it.
Mon. Oct.6, 1980--Today, nothing happened, so I'm writing about Saturday and Sunday. I got a lot of presents. One of them is Empire Strikes Back figures. And a bike, a digital radio, shirts, and a huge silver coin collection.
Tues., Oct.7, 1980--Well, nothing really happened. Oh, I forgot today we had silent lunch, but I didn't really care. I sort of liked it.
Wed. Oct. 8, 1980--Today was boring. Nothing really happened except Mr. Jones came in and said, "There is to be no talking for fifteen minutes."
Thurs, Oct.9, 1980--Today nothing really happened.
Fri., Oct.10, 1980--Today I found out that there will be no contact activities. I don't know about soccer, But I hate Mr. Jones's rule anyway.
Wed. Oct. 16, 1980--Today in lunch Mr. Jones came in and said that there will be no talking until five of. And made Michele B. stay in his office for a week. But it was a serious crime, coming back from the lunchline.
Oct. 20, 1980--Today nothing really only that we fought out on the playground. Oh, today I'm going to run a mile. You see I've been running a half mile, now I'm going a mile.
Thur., Oct. 23, 1980----Today in lunch (well., I'll just use a couple of names) someone crumpled a "Scooter Pie" and passed it down and somewhere along the line it was thrown. It was thrown about 15 minutes until as I hear Greg threw it on my food, and I was so mad I threw it on the table as hard as I could. Oh, and before that Sheeran threw the Scooter Pie away. But Gary took one of his and threw his. After that Mrs. Simpson came over and made me stand up on stage after the whole class was throwing it. Most everyone stuck up for me but it didn't help.
Thurs. Oct. 27, 1980--Today nothing happened except we had silent lunch.
Wed. Oct. 29, 1980--Today was a normal day nothing very exciting happened just the same old thing.
Fri. Oct. 31, 1980--Today is Halloween and I'm going to be an electronic game, and out on the playground Scott and Gordon were fighting with their fists. I wasn't.
11/3/80--Today there was a "big" fight scheduled with Gordon and Strope but Gordon didn't come out.
11/5/80--Today was a normal day except I missed the bus and my father drove me to school. Oh, I almost forgot yesterday was the election and Reagan won but I wished Carter was elected for president.
11/7/80--Today while we were fooling around I saw Gordon smoking and Greg told.
11/10/80--Today, man it was cold. I was just wearing a jacket and my hands were freezing about ready to fall off. In lunch the mustard was spilled all over the table.
11/2/80--Today was normal. Dickie got whopped in the head by Mike.
11/17/80--Today was normal. Nothing really happened, just that we were supposed to have silent lunch but we didn't.
11/20/80--Today Mr. Scerbo took us out in the snow. We made snowballs about 100 pounds. I got soaking wet because of the snow. I kept on sliding into the little snowballs so they wouldn't be competing with ours.
11/12/80---Today was normal only that we went out in the snow.
12/1/80--A lot of things happened during Thanksgiving vacation. I had a wonderful time. I just don't know where to start.
12/2/80--Today we played smear the ***. Nothing else really happened. You could say it was a normal one. Oh, today Mr. Estramonte was in.
12/3/80--Today I got another point in SS, so that means I'm tied with Mark S. And also two work periods. Oh, today we didn't have recess. We had a work period.
12/4/80---Thank God it's Friday. This week was really long. Lots of homework and a cold. But today wasn't that bad. I played checkers and Bermuda Triangle.
Mon. 12/8/80--Today we didn't go out but we had a play period. It wasn't much fun but it was a time to play.
Tues.12/9/80--Today we went out and Anthony and Mark got hurt.
1/13/81--This is my first entry in 1981. Can you believe we haven't written in over a month. We didn't write about Christmas or even New Year's.
1/16/81--Today nothing much really happened, just that it's 1981. Now I gotta go.
1/29/81--Today we saw a movie on TV in school.
I think it was called the Great Train Robbery. It was by Walt Disney.
3/6/81--Today we went outside. It was
3/31/81--Yesterday President Reagan was shot. The man who shot him was John Warnock Hinckley. He also shot 8 other persons. One was James Brady, the Press Secretary, a D.C. officer and a Secret Service man. Luckily a rib stopped a bullet that saved President Reagan.
4/1/81--This is a new month besides that it was usual.
4/3/81--Today was o.k. except we went out.
4/9/81--Today we went out. Man, were kids hurt. I think Sheeren broke his nose and I got my thumb jammed.
5/5/81--Today I got about 30 sec. of play because I had to do homework.
6/12/81--This is the last day before there's only 1 week left.
Sept. 22, 1980---Today I was warned not to get my white pants dirty, but someone in this class pushed me, namely S.
Sept. 25, 1980--Today I signed up for trumpet.
Sept. 26, 1980--Today was boring. Nothing really happened,except that I played kickball.
Sept. 29, 1980--Nothing happened today so I'm going to write about Saturday and Sunday. I went to the Red Coach that made me sick. Oh! Today I was goalie.
Sept. 30, 1980--Today I woke up at 7:00 a.m. and watched "Dr. Who." Besides that nothing really happened.
Wed., Oct. 1, 1980--Well, today I decided to go grasshopper hunting for Mr. Scerbo, but played soccer after I found out you had to squish their heads. But I played a good game of soccer. I was goalie, they scored one and we scored two.
Thurs. Oct.2, 1980--I really don't believe it. Tomorrow is my birthday. Well, gotta go.
Fri. Oct.3, 1980--Today at 5:00 a.m. I WAS ten. Out on the playground I played soccer and I got massacred. Not in soccer, though. Anthony saw my journal and man did I get it.
Mon. Oct.6, 1980--Today, nothing happened, so I'm writing about Saturday and Sunday. I got a lot of presents. One of them is Empire Strikes Back figures. And a bike, a digital radio, shirts, and a huge silver coin collection.
Tues., Oct.7, 1980--Well, nothing really happened. Oh, I forgot today we had silent lunch, but I didn't really care. I sort of liked it.
Wed. Oct. 8, 1980--Today was boring. Nothing really happened except Mr. Jones came in and said, "There is to be no talking for fifteen minutes."
Thurs, Oct.9, 1980--Today nothing really happened.
Fri., Oct.10, 1980--Today I found out that there will be no contact activities. I don't know about soccer, But I hate Mr. Jones's rule anyway.
Wed. Oct. 16, 1980--Today in lunch Mr. Jones came in and said that there will be no talking until five of. And made Michele B. stay in his office for a week. But it was a serious crime, coming back from the lunchline.
Oct. 20, 1980--Today nothing really only that we fought out on the playground. Oh, today I'm going to run a mile. You see I've been running a half mile, now I'm going a mile.
Thur., Oct. 23, 1980----Today in lunch (well., I'll just use a couple of names) someone crumpled a "Scooter Pie" and passed it down and somewhere along the line it was thrown. It was thrown about 15 minutes until as I hear Greg threw it on my food, and I was so mad I threw it on the table as hard as I could. Oh, and before that Sheeran threw the Scooter Pie away. But Gary took one of his and threw his. After that Mrs. Simpson came over and made me stand up on stage after the whole class was throwing it. Most everyone stuck up for me but it didn't help.
Thurs. Oct. 27, 1980--Today nothing happened except we had silent lunch.
Wed. Oct. 29, 1980--Today was a normal day nothing very exciting happened just the same old thing.
Fri. Oct. 31, 1980--Today is Halloween and I'm going to be an electronic game, and out on the playground Scott and Gordon were fighting with their fists. I wasn't.
11/3/80--Today there was a "big" fight scheduled with Gordon and Strope but Gordon didn't come out.
11/5/80--Today was a normal day except I missed the bus and my father drove me to school. Oh, I almost forgot yesterday was the election and Reagan won but I wished Carter was elected for president.
11/7/80--Today while we were fooling around I saw Gordon smoking and Greg told.
11/10/80--Today, man it was cold. I was just wearing a jacket and my hands were freezing about ready to fall off. In lunch the mustard was spilled all over the table.
11/2/80--Today was normal. Dickie got whopped in the head by Mike.
11/17/80--Today was normal. Nothing really happened, just that we were supposed to have silent lunch but we didn't.
11/20/80--Today Mr. Scerbo took us out in the snow. We made snowballs about 100 pounds. I got soaking wet because of the snow. I kept on sliding into the little snowballs so they wouldn't be competing with ours.
11/12/80---Today was normal only that we went out in the snow.
12/1/80--A lot of things happened during Thanksgiving vacation. I had a wonderful time. I just don't know where to start.
12/2/80--Today we played smear the ***. Nothing else really happened. You could say it was a normal one. Oh, today Mr. Estramonte was in.
12/3/80--Today I got another point in SS, so that means I'm tied with Mark S. And also two work periods. Oh, today we didn't have recess. We had a work period.
12/4/80---Thank God it's Friday. This week was really long. Lots of homework and a cold. But today wasn't that bad. I played checkers and Bermuda Triangle.
Mon. 12/8/80--Today we didn't go out but we had a play period. It wasn't much fun but it was a time to play.
Tues.12/9/80--Today we went out and Anthony and Mark got hurt.
1/13/81--This is my first entry in 1981. Can you believe we haven't written in over a month. We didn't write about Christmas or even New Year's.
1/16/81--Today nothing much really happened, just that it's 1981. Now I gotta go.
1/29/81--Today we saw a movie on TV in school.
I think it was called the Great Train Robbery. It was by Walt Disney.
3/6/81--Today we went outside. It was
3/31/81--Yesterday President Reagan was shot. The man who shot him was John Warnock Hinckley. He also shot 8 other persons. One was James Brady, the Press Secretary, a D.C. officer and a Secret Service man. Luckily a rib stopped a bullet that saved President Reagan.
4/1/81--This is a new month besides that it was usual.
4/3/81--Today was o.k. except we went out.
4/9/81--Today we went out. Man, were kids hurt. I think Sheeren broke his nose and I got my thumb jammed.
5/5/81--Today I got about 30 sec. of play because I had to do homework.
6/12/81--This is the last day before there's only 1 week left.
Monday, October 26, 2015
Departure
When my son was five years old, he was a patient at Child's Hospital to have his tonsils removed. The hospital was named after a person, not limited to caring for children, but we were in the pediatric unit.
During our stay, there was a total of about six to ten babies who'd had surgery to correct cleft palates. They were all about one year old, the age when they could best tolerate the surgery. It was usual to see nurses and other attendants put them in wheeled highchairs and take them along on their rounds. The reason was to avoid the babies' being isolated in their cribs for long periods of time. The reason for the babies being isolated was the absence of their parents, most of them anyway. The rule in the ward for that type of surgery, dealing with the palate and lips, was that parents were not to visit unless they could stay the entire recovery period. For when the parents would leave, the babies would cry, and thus jeopardize their healing.
We were in the hospital three or four days, and amidst all those babies, I don't recall hearing any of them cry. Perched in their highchairs in the doorways of the other patient's rooms, they mostly sat and observed in silence, with solemn expressions.
Missing the parental attachment might have been crushing to them, but not as devastating as saying good-bye.
During our stay, there was a total of about six to ten babies who'd had surgery to correct cleft palates. They were all about one year old, the age when they could best tolerate the surgery. It was usual to see nurses and other attendants put them in wheeled highchairs and take them along on their rounds. The reason was to avoid the babies' being isolated in their cribs for long periods of time. The reason for the babies being isolated was the absence of their parents, most of them anyway. The rule in the ward for that type of surgery, dealing with the palate and lips, was that parents were not to visit unless they could stay the entire recovery period. For when the parents would leave, the babies would cry, and thus jeopardize their healing.
We were in the hospital three or four days, and amidst all those babies, I don't recall hearing any of them cry. Perched in their highchairs in the doorways of the other patient's rooms, they mostly sat and observed in silence, with solemn expressions.
Missing the parental attachment might have been crushing to them, but not as devastating as saying good-bye.
Sunday, October 25, 2015
Loss
When her last surviving sister died, Helen was left alone, the last member of her generation. Two generations were gone; she had no one left: parents, aunts and uncles, cousins, brothers and sisters, all gone before her. All the important people in her life had left her, and she took her latest loss hard. Call it grief, or mourning, or by whatever name, but she called it "that all-gone feeling."
Saturday, October 24, 2015
Ooph-thalmology + Hello From the Other Side, Nov. 23, and 26
The inimitable Dr. Sax told Dave that he doesn't need to see him again for 2 years, though he scheduled a follow up appointment with his associate one year from now. He advised him that everything looked good, except for the Red Sox stickers on his cane.
Since I was in the office, I asked at the desk if Dr. Weiner was still seeing patients there. "Yes, every Tuesday," was the answer. Several weeks ago, on the eve of my appointment, the office cancelled my visit with him, due to his not being available. The rep said a manager would call me back to reschedule, which has not happened. Could I have been un-patiented? Talk about rejection.
UPDATE----Nov. 23
After a month had passed, I decided to call to learn my status as a patient. Sorry, they said, the reason no one had called me was that they'd been very busy. My reschedule must be in 2 parts. I need the more intensive, thus lengthier, field-of-vision test, and then an appointment wit Dr. Weiner. The first visit was scheduled for 10:40 on Nov. 23, in the Clifton Park office. I arrived at 10:30, and after a short wait, a rep came out and said she had to talk to me. She apologized and said that the machine was broken, and she hadn't had time to call me before I left my house. They have a call in to repair and hope for an answer this afternoon, so if I wanted to go out for lunch, then I could return and find out if the machine is fixed. No, I said, too iffy, and I have other things to do--true story there. She told me again how sorry she was and she promised to call me back this afternoon or that night to let me know if the repair had been made, or if I would need to reschedule. "I'll call either way," she emphasized. That was 3 days ago, and no call. My appointment with the inimitable Dr. W. is scheduled for next Tuesday, shortly before he leaves the country for a 9 week or so stay. I wonder if I'll get a call to confirm or cancel. The ball is in their hands because there is no way they're going to hear from me.
UPDATE---Nov. 26
I received a recorded message confirming my appointment on Dec.1 with Dr. Weiner. Since the field of vision test which was the basis for my visit did not happen due to a broken machine, and since no one contacted me to notify me of its repair and to reschedule,as promised, there is no point in a visit with Dr. Weiner. That was made clear to me when they cancelled my October 3 visit due to his "unavailability." I said they were not going to hear from me, but because the vision test was in the Clifton Park office and the Dr. W. visit in Troy, I waited until Friday to call, but learned the office is closed until Monday. So be it.
Since I was in the office, I asked at the desk if Dr. Weiner was still seeing patients there. "Yes, every Tuesday," was the answer. Several weeks ago, on the eve of my appointment, the office cancelled my visit with him, due to his not being available. The rep said a manager would call me back to reschedule, which has not happened. Could I have been un-patiented? Talk about rejection.
UPDATE----Nov. 23
After a month had passed, I decided to call to learn my status as a patient. Sorry, they said, the reason no one had called me was that they'd been very busy. My reschedule must be in 2 parts. I need the more intensive, thus lengthier, field-of-vision test, and then an appointment wit Dr. Weiner. The first visit was scheduled for 10:40 on Nov. 23, in the Clifton Park office. I arrived at 10:30, and after a short wait, a rep came out and said she had to talk to me. She apologized and said that the machine was broken, and she hadn't had time to call me before I left my house. They have a call in to repair and hope for an answer this afternoon, so if I wanted to go out for lunch, then I could return and find out if the machine is fixed. No, I said, too iffy, and I have other things to do--true story there. She told me again how sorry she was and she promised to call me back this afternoon or that night to let me know if the repair had been made, or if I would need to reschedule. "I'll call either way," she emphasized. That was 3 days ago, and no call. My appointment with the inimitable Dr. W. is scheduled for next Tuesday, shortly before he leaves the country for a 9 week or so stay. I wonder if I'll get a call to confirm or cancel. The ball is in their hands because there is no way they're going to hear from me.
UPDATE---Nov. 26
I received a recorded message confirming my appointment on Dec.1 with Dr. Weiner. Since the field of vision test which was the basis for my visit did not happen due to a broken machine, and since no one contacted me to notify me of its repair and to reschedule,as promised, there is no point in a visit with Dr. Weiner. That was made clear to me when they cancelled my October 3 visit due to his "unavailability." I said they were not going to hear from me, but because the vision test was in the Clifton Park office and the Dr. W. visit in Troy, I waited until Friday to call, but learned the office is closed until Monday. So be it.
Thursday, October 22, 2015
Avoid the Pain
When my firstborn had a potential orthopedic condition, Dr. Grattan, pediatrician and most respected of all doctors, referred her to an orthopedist, Dr. Paish. He seemed a little edgy in a way, but I went by the recommendation and all turned out well.
A few years later, the father of this child twisted his knee in the driveway while playing hide and seek with the kids around the parked car on a snowy day. He had to crawl back into the house, unable to bend his leg to any degree at all. Since he was almost totally unfamiliar with medical procedures of any kind, he wanted to see a chiropractor, probably recommended by someone he worked with. I remember driving through wintry weather to some place in Albany to see a Dr. Harbinger. He left the office quickly, as the chiropractor couldn't bend the leg even slightly.
So we consulted Dr. Paish, who diagnosed a torn meniscus, and advised immediate surgery. He scheduled the surgery for early morning the next day; in those days you had to spend the night before in the hospital. That evening was very snowy, and slippery, so Don offered to drive us there, accompanied by Barbara, as I recall. We entered the waiting room, the four of us, and just as he was preparing to sign in, Dave had a change of heart. He wanted to get another opinion, or wait for it to get better. I can't quite recollect all his reasoning, or non-reasoning. So home we drove, through the cold and darkness, ice and falling snow.
Early the next day, Dr. Paish called, looking for his would-be surgical patient. In essence, the conversation was "Where the Hell are you? And if you don't reschedule before 24 hours are up, I won't operate. And you'll have ruined any chances of saving the use of your knee."
The surgery was scheduled for a Monday, the first medical visits for any of us except for pediatric issues. It was a tough surgery in those days, and recovery even tougher. When Dr. Paish made his post-surgical visit on that Monday, I can still hear his words. "I'll stop in to see you on Wednesday. Not tomorrow; tomorrow you'll be in a lot of pain and I don't like to see my patients in pain. See you Wednesday."
And so it goes.
A few years later, the father of this child twisted his knee in the driveway while playing hide and seek with the kids around the parked car on a snowy day. He had to crawl back into the house, unable to bend his leg to any degree at all. Since he was almost totally unfamiliar with medical procedures of any kind, he wanted to see a chiropractor, probably recommended by someone he worked with. I remember driving through wintry weather to some place in Albany to see a Dr. Harbinger. He left the office quickly, as the chiropractor couldn't bend the leg even slightly.
So we consulted Dr. Paish, who diagnosed a torn meniscus, and advised immediate surgery. He scheduled the surgery for early morning the next day; in those days you had to spend the night before in the hospital. That evening was very snowy, and slippery, so Don offered to drive us there, accompanied by Barbara, as I recall. We entered the waiting room, the four of us, and just as he was preparing to sign in, Dave had a change of heart. He wanted to get another opinion, or wait for it to get better. I can't quite recollect all his reasoning, or non-reasoning. So home we drove, through the cold and darkness, ice and falling snow.
Early the next day, Dr. Paish called, looking for his would-be surgical patient. In essence, the conversation was "Where the Hell are you? And if you don't reschedule before 24 hours are up, I won't operate. And you'll have ruined any chances of saving the use of your knee."
The surgery was scheduled for a Monday, the first medical visits for any of us except for pediatric issues. It was a tough surgery in those days, and recovery even tougher. When Dr. Paish made his post-surgical visit on that Monday, I can still hear his words. "I'll stop in to see you on Wednesday. Not tomorrow; tomorrow you'll be in a lot of pain and I don't like to see my patients in pain. See you Wednesday."
And so it goes.
Friday, October 16, 2015
Pain Unto Death
" I am at grips with the worst, the most sudden, the most painful, the most mortal, and the most irremediable of all diseases. I have already experienced five or six very long and painful attacks of it. And yet I flatter myself, or there are even in this state means of standing fast for a man whose soul is free from the fear of death and unburdened of the menaces, conclusions, and consequences with which the doctors stuff our heads. But the actual pain itself is not such a harsh and piercing sharpness as to drive a well-balanced man to rage and despair. I have at least this advantage from my stone: that it will achieve what I had not hitherto been able to bring about in myself in order to become wholly reconciled and acquainted with death for the more it oppresses and troubles me, the less fearful will death be to me. I had already attained the point of only being attached to life for the sake of life, but my pain will dissolve even this understanding; and God grant that in the end, if its sharpness happens to exceed my strength, it may not drive me to the other no less wicked extreme of longing and wishing to die."
Michel de Montaigne 1533-1592
Michel de Montaigne 1533-1592
Tuesday, September 29, 2015
"Death Investigated' circa 1945
In my attempts to put my house in order, I came across a yellowed newspaper clipping, undated, but since I remember being quite young when I heard the contents, I suppose the date would be 1945 or so. (I suppose we could look it up.) The paper was likely The Troy Record:
"VALLEY FALLS MAN'S DEATH INVESTIGATED
Find Body of Walter Madigan in Troy House
Authorities early today were investigating the mysterious death of Walter V. Madigan 45, of Valley Falls, found dead in a lodging house at 1535 Fifth Avenue about 9:45 p.m. yesterday.
The body was lying face downward. The man's left eye was discolored and bruises were found on both knees and elbows.
Madigan did not reside there and Charles Gilboy, who operates the lodging house, told police he had never before seen the man. Gilboy discovered the body on the first floor in the rear room. He promptly notified police.
Death Due to Shock
Coroner Charles J. Cote said that Madigan had died of a cerebral hemmorhage., apparently due to severe shock. Whether the shock resulted from the fall or was induced by a blow, the authorities have not learned.
Dist. Atty. Earl J. Wiley joined Chief Detective Lynch and Capt. Joseph P. Shields of Central Police Station in the investigation. Plainsclothesman Michael J. Kane and Patrolmen Frank Dippo and Thomas Maguire of the radio patrol started an immediate backup in an effort to trace Madigan's movements yesterday.
Madigan was employed by the Allegheny Ludlum Steel Corp. He had been on vacation and was due to report back to work at 4;00 p.m. yesterday, but did not appear at the plant. Madigan, police were told, went to the plant Sunday night but was informed he was working another shift.
Madigan's lunch box and his coat were found in the lodging house. His hat bore his identification working-badge and papers in his pocket revealed his identity.
Autopsy Report
An autopsy performed at the Fred J. Lowe Funeral Home in Fifth Avenue by Drs. Irving Strosberg and and Stewart H. Jones showed Madigan had not eaten in about 12 hours. No traces of alcohol were found, the coroner said. The man's organs had been in perfect condition. He had suffered no fractures.
A teletype message was sent to Schenectady police requesting them to inform Madigan's sister, Mrs. James Fitzpatrick of 381 Western Avenue, that city, of his death. Police also learned he has a brother, Charles Madigan, residing at Valley Falls.
Gilboy told investigators that he does not lock the doors of the lodging house at times. He also resides there. Madigan had been dead at least four hours when his body was discovered, Cote said."
"VALLEY FALLS MAN'S DEATH INVESTIGATED
Find Body of Walter Madigan in Troy House
Authorities early today were investigating the mysterious death of Walter V. Madigan 45, of Valley Falls, found dead in a lodging house at 1535 Fifth Avenue about 9:45 p.m. yesterday.
The body was lying face downward. The man's left eye was discolored and bruises were found on both knees and elbows.
Madigan did not reside there and Charles Gilboy, who operates the lodging house, told police he had never before seen the man. Gilboy discovered the body on the first floor in the rear room. He promptly notified police.
Death Due to Shock
Coroner Charles J. Cote said that Madigan had died of a cerebral hemmorhage., apparently due to severe shock. Whether the shock resulted from the fall or was induced by a blow, the authorities have not learned.
Dist. Atty. Earl J. Wiley joined Chief Detective Lynch and Capt. Joseph P. Shields of Central Police Station in the investigation. Plainsclothesman Michael J. Kane and Patrolmen Frank Dippo and Thomas Maguire of the radio patrol started an immediate backup in an effort to trace Madigan's movements yesterday.
Madigan was employed by the Allegheny Ludlum Steel Corp. He had been on vacation and was due to report back to work at 4;00 p.m. yesterday, but did not appear at the plant. Madigan, police were told, went to the plant Sunday night but was informed he was working another shift.
Madigan's lunch box and his coat were found in the lodging house. His hat bore his identification working-badge and papers in his pocket revealed his identity.
Autopsy Report
An autopsy performed at the Fred J. Lowe Funeral Home in Fifth Avenue by Drs. Irving Strosberg and and Stewart H. Jones showed Madigan had not eaten in about 12 hours. No traces of alcohol were found, the coroner said. The man's organs had been in perfect condition. He had suffered no fractures.
A teletype message was sent to Schenectady police requesting them to inform Madigan's sister, Mrs. James Fitzpatrick of 381 Western Avenue, that city, of his death. Police also learned he has a brother, Charles Madigan, residing at Valley Falls.
Gilboy told investigators that he does not lock the doors of the lodging house at times. He also resides there. Madigan had been dead at least four hours when his body was discovered, Cote said."
Saturday, September 26, 2015
Stained Glass
For some reason, I've never cared for stained glass. I know it's considered beautiful by many, an art form in itself, and indeed I know adults who have spent considerable time, effort and money learning how to create it. Probably my first association with stained glass was in church. Our Lady of Good Counsel had a wealth of stained glass, in the side windows and above the altar. The windows were for ventilation. The men who served as ushers would open and close the windows using a long pole with a hook on the end which somehow fit into the selected window panel. In those years of living with imperfection, several of the glass insets had been broken, and replaced with clear glass. That disturbed me in some way; I'm not sure why, maybe because it made it seem as if the original installation was not that important. But more unsettling was the large stained glass panel looking down on us from the center of the church right behind the altar, impossible to ignore. The detailed composition featured monstrous-looking images, similar in my child's mind to gargoyles. If I had ever asked what the scene represented, perhaps the answer would have made me feel better about it, but of course I never raised the question.
Some of the old houses in the village, as well as other places, had stained glass at their entrances, usually in the front door, or set in the wall next to the door. I remember going with my parents to a judge's house for some reason, and waiting on the porch and looking at the stained glass in the door; it seemed old and carried with it a sense of foreboding.
I was diagnosed with the flu once in my life, at the end of a full year of rigorous programs of treatment. On the night before Christmas Eve, I felt really tired and weak and when I looked into the bathroom mirror, I saw not my reflection, but a sickening and dizzying array of stained glass, in mostly blue. tones. While that may sound like a beautiful sight, it was in reality horrific and terrifying, and totally obliterated everything else.
I'm left with the thought that maybe the word "stained" doesn't belong in a positive description of anything.
Some of the old houses in the village, as well as other places, had stained glass at their entrances, usually in the front door, or set in the wall next to the door. I remember going with my parents to a judge's house for some reason, and waiting on the porch and looking at the stained glass in the door; it seemed old and carried with it a sense of foreboding.
I was diagnosed with the flu once in my life, at the end of a full year of rigorous programs of treatment. On the night before Christmas Eve, I felt really tired and weak and when I looked into the bathroom mirror, I saw not my reflection, but a sickening and dizzying array of stained glass, in mostly blue. tones. While that may sound like a beautiful sight, it was in reality horrific and terrifying, and totally obliterated everything else.
I'm left with the thought that maybe the word "stained" doesn't belong in a positive description of anything.
Making A difference
A few days ago, I made a return trip to The Office, cardiology office that is, to pick up test results. Last time I was there, in conversation with the representative, I mentioned, in addition to another issue, the "Stand in Line" sign, and its unfortunate area of obscured visibility. She'd blamed it on the architects and their construction of a very large pillar; she said they were working on the problem of signage. Lo and Behold! Progress! The sign, fairly small and attached to a movable pedestal, had been moved, from behind the large pillar to a position more to the front and alongside of it. Who says nobody listens?
Tuesday, September 22, 2015
I Dare You!
I'm ready for it: if anybody messes with me, the charge will be elder abuse, a crime carrying additional penalties than if committed against a non-elder person. That is only fair, after all that we've endured these many years. Hate crime charges rule!
Thursday, September 17, 2015
NPH (non speed-related)
As per Dr. Khan, Normal Pressure Hydrocephalus occurs when excess fluid accumulates in the venrtricles of the brain. It is called "normal pressure" because though excess, the cerebrospinal fluid pressure is often normal. But if the fluid causes the brain ventricles to enlarge, the nearby brain tissue can be damaged. NPH can cause certain symptoms, including difficulty walking and decline in thinking skills and later on, loss of bladder control. It affects primarily people in their 60's and 70's. The symptoms may overlap with other age-related conditions. So of course it's difficult to diagnose. A spinal tap may help identify those mostly likely to benefit from a shunt. In most cases, I read, people do not benefit following the removal of the fluid, but the symptom most likely to improve after the insertion of a shunt is difficulty in walking.
I think, when dealing with the elderly, there is not much credibility attached to a lot of the treatments due to lack of sufficient time or interest in follow-up research or investigation. Creatures like guinea pigs, who have a much shorter lifespan, are much better indicators of whether a procedure or treatment will be effective. If you are a guinea pig and have health insurance, there is hope for you.
The Voice
In the mist of memories that flit across the mind from time to time, I recall a man's voice, so compelling that the sound of it instantly caught my attention. I was leaving a medical office in Saratoga, for reasons I can't remember, the office on the corner across from the hospital. It must have been about a dozen years ago, in the time when age wasn't so all-encompassing. I'd checked out and was in the process of leaving when I heard a voice, coming from the area behind the check-out station, or so it seemed. In conversation with the personnel behind the desk, he sounded so friendly and confident I assumed he was a professional, a representative of some kind, but no, he was also leaving the building, just behind me, and I saw he was in a wheelchair, unaccompanied but mobile.
I think he might have asked me to hold the door,or maybe I did it on my own. I know we had a brief conversation, and as he propelled himself out of the parking lot, and down along the lengthy sidewalk, I remembered that he had said, as he thanked me for my help, "It wasn't that long ago that I was walking around just like everybody else." The sound of his voice lingered, and as he wheeled himself away, I'd wished
I think he might have asked me to hold the door,or maybe I did it on my own. I know we had a brief conversation, and as he propelled himself out of the parking lot, and down along the lengthy sidewalk, I remembered that he had said, as he thanked me for my help, "It wasn't that long ago that I was walking around just like everybody else." The sound of his voice lingered, and as he wheeled himself away, I'd wished
Monday, August 24, 2015
Ed O'Brien
I used to watch him on the early news every morning. Saw him once at a wedding in Saratoga, where he sat with the rest of the Channel 6 crew. Even this year, he couldn't wait for 2 things--to get back to work and for Opening Day at Saratoga.
Thursday, August 20, 2015
Diagnosis Bleak
It seems so unreal to me, that once cancer has spread to the brain, the afflicted person can still be in control and speak in rational terms, with that something gnawing away at what defines their very being. But at least, and it is still a very slim "least," Jimmy Carter's cancer seems to be treatable.
At another time, in another place, I still hear the doctor's voice, as he drew a rough diagram: one slightly smaller circle inside another. "If the cancer were a ball," and he paused to pencil in a small round blob on his sketch, "we could treat it with radiation. But it's not. It's here," and he used the pencil to darken the area between the two circles, "in the fluid surrounding the brain, so there is no way to treat it."
Time is an elusive quality, and sometimes you can buy a little of it, and other times there is no negotiating at all.
At another time, in another place, I still hear the doctor's voice, as he drew a rough diagram: one slightly smaller circle inside another. "If the cancer were a ball," and he paused to pencil in a small round blob on his sketch, "we could treat it with radiation. But it's not. It's here," and he used the pencil to darken the area between the two circles, "in the fluid surrounding the brain, so there is no way to treat it."
Time is an elusive quality, and sometimes you can buy a little of it, and other times there is no negotiating at all.
The Talk(s)
My appointment today consisted of X-Ray and Ultrasound to track the progress or location or existence of kidney stones, a routine I undergo every six or nine months or so.
The woman at the check-in window of the X-Ray Department asked me if I had parked in the newly opened Parking Garage. I said I tried to avoid them because of their association with too many crime shows where bad things happened there. She laughed in agreement, and assured me that this garage was very nice, beautiful I think she said. The other woman behind the window, having overheard the remarks, told me that there was a new scam, that drivers were finding a piece of paper on their rear windows as they went to leave the parking garage, and when they got out of their car to retrieve the paper, the perpetrator would get in, and steal the car, and usually the women's purses that they would have left on the seat. The first woman handed me a leaflet extolling the merits of the new parking garage. The other woman said the scam had not happened there.
The X-Ray technician showed up to call me in for my procedure, a single and simple X-ray. A convivial fellow, he asked me where I was from, and when he heard Valley Falls he said he used to have a job as a vendor to the businesses there, but hadn't been to the area in many years. I asked if the company was Desormeau. I used to accept deliveries for them in my childhood clerking days. I didn't mention that though, being fairly certain that at the time, he would have been yet to be born. Yes, he said, though the name had been changed to Tri-City Vending Company. I remembered that too, though I didn't say so. What was the name, he asked of the big white building with the wide front porch, and the place that used to sell pizza, and some place called Keyes in Schaghticoke. I told him most of those places had burned down.
As it happened, there was a delay. He had to change the battery in the X-ray machine, and while he was doing so, he told me that his brother was about 3 inches taller than his own apparent 6 feet 2 or so, and weighed 50 pounds more, and had suffered a kidney stone which broke him down into tears of agony. He himself placed never having a kidney stone high on his bucket list. He viewed my film, and said "nothing jumped out" at him.
On to a brief wait before the session with the Ultra-Sound technician. She was young and looked fit, but she had to work around her ailing shoulder. Because of the constant position of her arm that her job called for, she had torn her rotator cuff. She'd gone through physical therapy, which helped somewhat. She said if they had told her about this occupational hazard, she would have trained for another position.
In a certain way, I find it almost gratifying that people I don't know seem willing to engage in conversation with apparent disregard of age, and without semblance of patronizing. The "conversation" is pretty much one-sided, but I don't mind.
The woman at the check-in window of the X-Ray Department asked me if I had parked in the newly opened Parking Garage. I said I tried to avoid them because of their association with too many crime shows where bad things happened there. She laughed in agreement, and assured me that this garage was very nice, beautiful I think she said. The other woman behind the window, having overheard the remarks, told me that there was a new scam, that drivers were finding a piece of paper on their rear windows as they went to leave the parking garage, and when they got out of their car to retrieve the paper, the perpetrator would get in, and steal the car, and usually the women's purses that they would have left on the seat. The first woman handed me a leaflet extolling the merits of the new parking garage. The other woman said the scam had not happened there.
The X-Ray technician showed up to call me in for my procedure, a single and simple X-ray. A convivial fellow, he asked me where I was from, and when he heard Valley Falls he said he used to have a job as a vendor to the businesses there, but hadn't been to the area in many years. I asked if the company was Desormeau. I used to accept deliveries for them in my childhood clerking days. I didn't mention that though, being fairly certain that at the time, he would have been yet to be born. Yes, he said, though the name had been changed to Tri-City Vending Company. I remembered that too, though I didn't say so. What was the name, he asked of the big white building with the wide front porch, and the place that used to sell pizza, and some place called Keyes in Schaghticoke. I told him most of those places had burned down.
As it happened, there was a delay. He had to change the battery in the X-ray machine, and while he was doing so, he told me that his brother was about 3 inches taller than his own apparent 6 feet 2 or so, and weighed 50 pounds more, and had suffered a kidney stone which broke him down into tears of agony. He himself placed never having a kidney stone high on his bucket list. He viewed my film, and said "nothing jumped out" at him.
On to a brief wait before the session with the Ultra-Sound technician. She was young and looked fit, but she had to work around her ailing shoulder. Because of the constant position of her arm that her job called for, she had torn her rotator cuff. She'd gone through physical therapy, which helped somewhat. She said if they had told her about this occupational hazard, she would have trained for another position.
In a certain way, I find it almost gratifying that people I don't know seem willing to engage in conversation with apparent disregard of age, and without semblance of patronizing. The "conversation" is pretty much one-sided, but I don't mind.
Sunday, August 16, 2015
Down town with E. A. R.
"So on we worked, and waited for the light,
And went without the meat, and cursed the bread.
And Richard Cory, one calm summer night,
Went home and put a bullet through his head."
And went without the meat, and cursed the bread.
And Richard Cory, one calm summer night,
Went home and put a bullet through his head."
Friday, August 14, 2015
Part 7: The Finale
The supervisor comes to the window to see what the issue is. I told her about the delayed appointment time, and she apologized. The results of the testing will be available if I call the office, though I may have to come in and pick them up. No problem there. (I hope they're normal. that I won't indeed receive a call, but I'm inured by now to all surprises.)
She asked if there was anything else, so I took this opportunity to share with her some of the observed issues mentioned above. She agreed that the sign was unfortunate, that they're attempting to get new signage installed. The problem was with the architects, she said, that they had placed a very large thick pillar in the middle of the room in front of the bay of windows. She said people didn't pay attention to the signs anyway. She, Meredith, I think her name was, seemed personable enough and I didn't want to be rude, but Sheesh, the reason people don't pay attention to the sign is that it is not visible except from a limited area. I didn't tell her that and neither did I say that I could walk right over, pick up the sign on its post and set it back to where more people could see it. Nor did I tell her that a few similar signs could be made and placed on the front and sides of the monstrous pillar, vastly increasing the visibility. The present sign is no more than a piece of posterboard atop a post. I left it alone; they're working on it, so she says. I didn't even point out that the sign is the same as when I was there several months ago, and in that same time period, the recently started construction of the parking garage has been completed.
Since we were on the subject, I could not refrain from saying the concept of having one line for both check in and check out was unwieldy and inefficient, and rather humiliating, when those who got it wrong were reproved for jumping the line. I said that in their old office, there were separate venues for those leaving their appointments, and it seemed a lot better. She said the CEO wanted there to be just one line. Then she said that she didn't know of any office that didn't have the problem of people having to stand in line. I suggested that taking a number would reduce the time that people would have to stand there, a rather important consideration especially in a cardiologist's office, wouldn't you say?
She asked if there was anything else, so I took this opportunity to share with her some of the observed issues mentioned above. She agreed that the sign was unfortunate, that they're attempting to get new signage installed. The problem was with the architects, she said, that they had placed a very large thick pillar in the middle of the room in front of the bay of windows. She said people didn't pay attention to the signs anyway. She, Meredith, I think her name was, seemed personable enough and I didn't want to be rude, but Sheesh, the reason people don't pay attention to the sign is that it is not visible except from a limited area. I didn't tell her that and neither did I say that I could walk right over, pick up the sign on its post and set it back to where more people could see it. Nor did I tell her that a few similar signs could be made and placed on the front and sides of the monstrous pillar, vastly increasing the visibility. The present sign is no more than a piece of posterboard atop a post. I left it alone; they're working on it, so she says. I didn't even point out that the sign is the same as when I was there several months ago, and in that same time period, the recently started construction of the parking garage has been completed.
Since we were on the subject, I could not refrain from saying the concept of having one line for both check in and check out was unwieldy and inefficient, and rather humiliating, when those who got it wrong were reproved for jumping the line. I said that in their old office, there were separate venues for those leaving their appointments, and it seemed a lot better. She said the CEO wanted there to be just one line. Then she said that she didn't know of any office that didn't have the problem of people having to stand in line. I suggested that taking a number would reduce the time that people would have to stand there, a rather important consideration especially in a cardiologist's office, wouldn't you say?
Part 6: Outlet
I don't think the technician who asked if I'd been late for my appointment believed me when I said I had arrived early and had waited 45 minutes because he excused himself and left the room to visit the desk. When he returned, he said he knew I hadn't arrived late, that it was a problem at the front desk which had caused him to take the 10:00 appointment ahead of mine. He was OK about it, and so was I, and the procedure went smoothly, taking only 10 minutes or so. Then I left to return to the line so I could check out. I know the drill by now, and the location of the sign.
I'm still ready to just leave for home, but when I asked the woman at checkout when I could get the results of the test, she said the policy is that I would be contacted only if the results are not as expected. I already knew that because there it is, plain as day, printed on each appointment card: "We will notify you of any test results that are other than what your doctor expected." These folks don't deal in unnecessary interactions. Now the problem is: I don't know really what the doctor expected. My next scheduled appointment is not until July of 2016. And since the office has botched up my paperwork for today, how can I be sure that today's report finds its way into the proper hands: what channel does it go through before or if it reaches the doctor?
I asked if a patient portal was available, and was told it's in the works but is not yet working. No surprise there. When I mentioned the above, that my appointment time had been somehow mishandled, she asked if I would like to talk to a supervisor about it because all she herself can do is handle check ins and outs. At first I said no, but when she said the supervisor is right there, I agreed. That's what supervisors are for, right?
I'm still ready to just leave for home, but when I asked the woman at checkout when I could get the results of the test, she said the policy is that I would be contacted only if the results are not as expected. I already knew that because there it is, plain as day, printed on each appointment card: "We will notify you of any test results that are other than what your doctor expected." These folks don't deal in unnecessary interactions. Now the problem is: I don't know really what the doctor expected. My next scheduled appointment is not until July of 2016. And since the office has botched up my paperwork for today, how can I be sure that today's report finds its way into the proper hands: what channel does it go through before or if it reaches the doctor?
I asked if a patient portal was available, and was told it's in the works but is not yet working. No surprise there. When I mentioned the above, that my appointment time had been somehow mishandled, she asked if I would like to talk to a supervisor about it because all she herself can do is handle check ins and outs. At first I said no, but when she said the supervisor is right there, I agreed. That's what supervisors are for, right?
Part 5; Tea-colored Tedium
The voice at the end of the line had told me I might have to wait ten minutes or so, but it's now more than 30 minutes. The woman sitting next to me has grown restless waiting for her ultrasound. She is complaining, quietly enough, to her companion, and on her cell phone, threatening to leave if she's not called soon. Her appointment was scheduled for 9:00 and it's now past 9:30. She tells me that I'll be waiting longer than 10 minutes past my appointment time too. She can't understand why a procedure of this type would run late. They're all by appointment, aren't they.
She evidently has some place else that she needs to be, and I don't, so I'm not really bothered by the delay, just bored enough, now that I'm done with my newspaper, so that my attention turns to the decor of the room, the carpeting first because I'm mostly staring at the floor. The office has been completely renovated within the last year, so the carpeting has to be new. But it doesn't appear so. The color is kind of a sepia toned weak-tea shade, and the pattern looks like vintage brocade drapes, but with a random trail of some kind of wandering design. There is a large stain, or maybe it's only a temporary spot, over near the row of windows. I hope it's just spilled water.
Tired of gazing downward, I look around and see that the walls are also the same dreary shade of pale tan, and note further that the upholstery of the chairs is the same hue. It could be that someone somewhere decided this shade of brown is the most restful for cardiac patients, but it reminds me of the color that the late writer Kurt Vonnegut identified as "babyshit brown."
She evidently has some place else that she needs to be, and I don't, so I'm not really bothered by the delay, just bored enough, now that I'm done with my newspaper, so that my attention turns to the decor of the room, the carpeting first because I'm mostly staring at the floor. The office has been completely renovated within the last year, so the carpeting has to be new. But it doesn't appear so. The color is kind of a sepia toned weak-tea shade, and the pattern looks like vintage brocade drapes, but with a random trail of some kind of wandering design. There is a large stain, or maybe it's only a temporary spot, over near the row of windows. I hope it's just spilled water.
Tired of gazing downward, I look around and see that the walls are also the same dreary shade of pale tan, and note further that the upholstery of the chairs is the same hue. It could be that someone somewhere decided this shade of brown is the most restful for cardiac patients, but it reminds me of the color that the late writer Kurt Vonnegut identified as "babyshit brown."
The Sign, Part 4
The sign, the one behind the pillar, is about the size of a standard cookie sheet, maybe a little smaller. It is held up by what looks like a portable shaft of some sort, stuck in a slot across the top. It reads, "PLEASE WAIT HERE TO BE CALLED BY A RECEPTIONIST, TO CHECK IN AND TO CHECK OUT.
More later, about the sign.....
More later, about the sign.....
Biding time, Part III
After duly standing in the single line before being called up to one of the 6 windows, I sat down in one of the more centrally positioned rows of seats in the vast waiting room of the cardiology office. Well, there are about 30 doctors associated with the practice so lots of patients wait lots of time. People were sitting, waiting, along both sides of the room as well. A man came out of the examining room with his checkout paper in hand and started to present it to the woman at the first window on his left. "Oh, no," he was told, "You have to stand in line, the one over there, behind the post." He quickly rectified his position and took his place behind the 5 or 6 people standing in the line. The line concealed behind the post.
A while later, a man entered the office and obediently walked up and joined the line, to check in. A woman in a walker appeared behind him, and in a strident voice, said, "Sir, you took my place in line. I was here before you." He turned, surprised, and told her as he stepped back out of line, "Help yourself." Then, mumbling, "I didn't see you, didn't know you were in line." She ignored his mutterings, and him altogether; she just wanted her place in the all-important, one only, line. I assume that since she was using a walker, she had taken a seat along the side of the room, but still wanted to reserve her space. Sometimes cardiac patients become fatigued. Because by this time, I had finished both the Jumble and Crossword, I was bored enough to notice that his face had turned red, with embarrassment probably, and maybe a little anger. I would hope that his discomfort would have been directed not at the woman's aggression, but at whoever is responsible for the hellish situation of the facility, but he said nothing, nothing I was aware of anyway.
A while later, a man entered the office and obediently walked up and joined the line, to check in. A woman in a walker appeared behind him, and in a strident voice, said, "Sir, you took my place in line. I was here before you." He turned, surprised, and told her as he stepped back out of line, "Help yourself." Then, mumbling, "I didn't see you, didn't know you were in line." She ignored his mutterings, and him altogether; she just wanted her place in the all-important, one only, line. I assume that since she was using a walker, she had taken a seat along the side of the room, but still wanted to reserve her space. Sometimes cardiac patients become fatigued. Because by this time, I had finished both the Jumble and Crossword, I was bored enough to notice that his face had turned red, with embarrassment probably, and maybe a little anger. I would hope that his discomfort would have been directed not at the woman's aggression, but at whoever is responsible for the hellish situation of the facility, but he said nothing, nothing I was aware of anyway.
Waiting Room, Part II
He is so out of place in the cardiologist's waiting room. First of all, he is young, so that makes him stand out, but not as noticeably as the way he is dressed. He is wearing a suit, a well-fitting one at that. And real shoes, the only pair of leather-shod feet in the waiting room. Moreover, he has a haircut, the kind that, while fairly long on top, shows undeniable signs of having been razor-cut in areas. His appearance screams "Pharmaceutical Rep." He may as well have been wearing a sign. He sits, waiting, for a while, but not for too long. A female staff member appears to tell him that unfortunately, Dr. P. will not be able to see him today, as the doctor is "swamped" with appointments. Another office tech appears, trying to offer another option. The two women continue to fawn over him, kind of competing with each other to see who can be most helpful, one advising the other that "we don't want to keep him waiting too long." (The waiting room is lined with waiting patients, who presumably are not being paid for their time.) Finally, it is decided that the man should return another time, that the doctor he was hoping to see would be so informed. As he prepares to leave, he hands the staff member a packet containing a dozen or so packages of samples of some kind. The staff member exclaims, "Oh, are you giving these to me?"
Thursday, August 13, 2015
The Hell That Is A Medical Office
All else aside, for now anyway, this is the story for today: My appointment, for a routine ultrasound, was scheduled at my last visit about a month ago for 9:30 this morning. I arrived 15 minutes early, stood in the line of humiliation, and checked in. The rep at the window said there would be a wait; they had a lot of ultrasounds scheduled for today. I told her I knew I was early, that my appointment was for 9:30. She said I may have to wait until 20 of 10:00. I didn't mind, sat and did the Jumble and the Crossword, and time went by. At 10 o'clock, I decided I would leave if the wait went over one hour. I was called in at exactly 10:15, and the first thing the tech said to me was:
"Were you late for your appointment?" No, I told him, and said that I'd been waiting 45 minutes. He left the room, and returned, saying "they" hadn't sent the order and that he'd taken his 10:00 o'clock patient ahead of me.
When I went to check out, I asked when the results would be ready. She seemed surprised, said I would be notified if the results were not as expected. I asked if there was a patient portal and she said they were still working on setting it up; it wasn't available yet. I said, considering what had evidently happened to my paperwork today, that I wanted the results myself. My next appointment isn't until next July. Who knows what could happen to another piece of paper by then.
More later----I like to remember these things, so life seems better without them.
"Were you late for your appointment?" No, I told him, and said that I'd been waiting 45 minutes. He left the room, and returned, saying "they" hadn't sent the order and that he'd taken his 10:00 o'clock patient ahead of me.
When I went to check out, I asked when the results would be ready. She seemed surprised, said I would be notified if the results were not as expected. I asked if there was a patient portal and she said they were still working on setting it up; it wasn't available yet. I said, considering what had evidently happened to my paperwork today, that I wanted the results myself. My next appointment isn't until next July. Who knows what could happen to another piece of paper by then.
More later----I like to remember these things, so life seems better without them.
Wednesday, July 22, 2015
P.T. and H.W.
P.T. stands for physical therapy and H.W. for housework.
For one of the physical therapy exercises, the therapist handed me a piece of flannel cloth, positioned me in front of a wall, and instructed me to hold the cloth against the wall, and make 10 circular clockwise motions and then change to counterclockwise motions, as if I were washing the wall. Really? Part of the reason I was at physical therapy was because it was painful to do something that involved scrubbing anything. Is there no upside to having a torn rotator cuff? Not even an excuse to avoid housework?
For one of the physical therapy exercises, the therapist handed me a piece of flannel cloth, positioned me in front of a wall, and instructed me to hold the cloth against the wall, and make 10 circular clockwise motions and then change to counterclockwise motions, as if I were washing the wall. Really? Part of the reason I was at physical therapy was because it was painful to do something that involved scrubbing anything. Is there no upside to having a torn rotator cuff? Not even an excuse to avoid housework?
Sunday, July 19, 2015
The Arrogance of Physicians
June 23 was the date of my annual cardiology appointment. After the office electrocardiogram, Dr. C. said everything appeared to be in order, and gave me a script for a routine blood test. When I was at the checkout (not really) window, I asked the rep if the test results would be posted on the patient portal. She wasn't sure, but said if any of the results were not as expected, I would be contacted. Indeed, a sign posted nearby said the same. She asked if I wanted to have the blood test then and there. I said no, I would do it later. I hadn't fasted, though they don't seem to care about that.
July 14, after the 8 hour fasting period indicated on the script, I drove to the lab on Hoosick Street for the bloodwork. It was a Tuesday, and by Saturday of that week, I had the complete test results.
In the doctor-knows-best world of that cardiology practice, I would not have received the results until June of 2016, at my next appointment. The doctor would not have contacted me as none of the results were out of the ordinary. That is a good thing, but think about the downside of that protocol: I might have spent time worrying about whether the results were abnormal, without any clue as to how much time should elapse before I felt secure that no call was forthcoming. Or the test results may have gotten lost or gone astray. I have sat in an office where the doctor was unable to access any results. I have been told that a lab had dropped and broken my blood sample. I don't know exactly how test results are put into the office system. Who would decide whether to file them in my patient folder, or alert the doctor that something appears to be abnormal enough to warrant notification? I do know, in any medical office I have been to in recent years, the doctor looks over any medical reports in the office just before he speaks to you. In this instance, should I have waited until about May of 2016 before having the blood drawn? They were prepared to do it then, so the results would be a year old before my next visit.
Common sense should dictate that any blood work the doctor deems relevant could be done a week or so before the office visit so that the doctor would have the recent results in front of him at your appointment. As my old science teacher, Mr. McMorris, used to say, " There is no such thing as common sense. It should be called simple sense. What is called common sense is really not very common at all."
July 14, after the 8 hour fasting period indicated on the script, I drove to the lab on Hoosick Street for the bloodwork. It was a Tuesday, and by Saturday of that week, I had the complete test results.
In the doctor-knows-best world of that cardiology practice, I would not have received the results until June of 2016, at my next appointment. The doctor would not have contacted me as none of the results were out of the ordinary. That is a good thing, but think about the downside of that protocol: I might have spent time worrying about whether the results were abnormal, without any clue as to how much time should elapse before I felt secure that no call was forthcoming. Or the test results may have gotten lost or gone astray. I have sat in an office where the doctor was unable to access any results. I have been told that a lab had dropped and broken my blood sample. I don't know exactly how test results are put into the office system. Who would decide whether to file them in my patient folder, or alert the doctor that something appears to be abnormal enough to warrant notification? I do know, in any medical office I have been to in recent years, the doctor looks over any medical reports in the office just before he speaks to you. In this instance, should I have waited until about May of 2016 before having the blood drawn? They were prepared to do it then, so the results would be a year old before my next visit.
Common sense should dictate that any blood work the doctor deems relevant could be done a week or so before the office visit so that the doctor would have the recent results in front of him at your appointment. As my old science teacher, Mr. McMorris, used to say, " There is no such thing as common sense. It should be called simple sense. What is called common sense is really not very common at all."
Thursday, July 9, 2015
Hoosick Street Crash
A Troy Police car collided today with a car turning into the Massry Pavillion. I don't know all the details, but on my numerous trips there, I adjusted my route to go through the Frear Park circle, turn right on Hoosick and then another right into the Massry Pavillion. I would rather not be stopped on the Hoosick Street Hill waiting to make a left turn. I wasn't so much concerned about police cars, but rather the tractor trailers streaming down the hill, at least as they do in the morning hours.
P.T.Finale
Assessment today at 8:A.M. with Maureen. Exercises and re-assessment form for me to fill out, a duplicate of the form from the first day which rates difficulty and discomfort levels for a number of activities on a scale of no difficulty to impossible to perform. I think I marked some improvement in most areas; why not? They do their best. And I was given some exercise bands which slip over the door. Maureen demonstrated how to use them; you knot them and put the knot across the top of the door, and then close the door, securing the knotted band so you can use it to exercise the shoulder. It worked fine, there, on the substantial door. I suspect there's a good chance that the doors in my home may prove to be iffy. Any part of the structure, the door or the frame, could give way and compromise not only my shoulder but other body parts as well. Anyway, I finished the entire course of physical therapy, third consecutive year.
Maureen also handed me a form to rate the facility itself, including the staff. I gave excellent rating to all except the outer office staff. They are efficient enough, but almost all of them robotic to where the rating "friendly" could not possibly apply. There are several of those patient-take-notice postings in the office, the chief one advising patients to not use perfumed products out of consideration for the therapists as well as other patients, and of course the usual warning as to what befalls those who don't pay whatever is due. But at least the wording as to approaching the window says to stand back only if there is someone ahead of you. You are free to approach either of the windows if no one is ahead of you. ( Unlike the cardiologists' office!) But there is a notice on the window that says do not knock on the glass; someone will be with you soon.
I've never seen anyone rap on the glass, or try to eavesdrop on the person in front of them either, and of course I have no idea if anyone ever tries to skip out without paying their deductible or co-pay. So one might conclude that (1) all those negative and patient-unfriendly posted notices are effective, or (2) they're totally unnecessary.
P.S. Now that I am done with paid professionals being concerned with my progress, or lack thereof, I am on my own. Nothing is more stultifying than that subject.
Maureen also handed me a form to rate the facility itself, including the staff. I gave excellent rating to all except the outer office staff. They are efficient enough, but almost all of them robotic to where the rating "friendly" could not possibly apply. There are several of those patient-take-notice postings in the office, the chief one advising patients to not use perfumed products out of consideration for the therapists as well as other patients, and of course the usual warning as to what befalls those who don't pay whatever is due. But at least the wording as to approaching the window says to stand back only if there is someone ahead of you. You are free to approach either of the windows if no one is ahead of you. ( Unlike the cardiologists' office!) But there is a notice on the window that says do not knock on the glass; someone will be with you soon.
I've never seen anyone rap on the glass, or try to eavesdrop on the person in front of them either, and of course I have no idea if anyone ever tries to skip out without paying their deductible or co-pay. So one might conclude that (1) all those negative and patient-unfriendly posted notices are effective, or (2) they're totally unnecessary.
P.S. Now that I am done with paid professionals being concerned with my progress, or lack thereof, I am on my own. Nothing is more stultifying than that subject.
Wednesday, July 8, 2015
Ortho Uno Anniversary.
X-rays of both knees, as surveillance. Dr. C. said they were "perfect." Not sure if he meant the films or the knees, suppose he meant both. He said he is glad I'm doing so well. He asked which knee I liked better. I waffled and said both, but probably the second which has had no pain at all. I still have some numbness in the bottom of my heel. which he said is "unusual," but it's not really bothersome. Checking flexion, he said the left knee is really good, and the right knee is better than the left. He asked if I can climb stairs,cycle, etc. All good there. I'm to return in one year unless there is a problem, as sometimes the bone attacks the plastic and deteriorates it or something like that. I wasn't really listening; I just asked how I would know, and he said there'd be pain. The usual instruction as to take an antibiotic before dental cleanings. He said the risk of infection traveling to the knee is very low, but really bad if it does happen. And so it went.
My appointment was at 10:00 A.M. and I was home before 11:30. It occurred to me on the way home that I enjoyed the drive, through the city of Troy, over much of the same route as when I drove to graduate classes at SUNY Albany, or to work at the Education Department in Albany. As I drove past HVCC, their sign reminded of registration for fall classes starting August 21. And so that also will come, and go.
My appointment was at 10:00 A.M. and I was home before 11:30. It occurred to me on the way home that I enjoyed the drive, through the city of Troy, over much of the same route as when I drove to graduate classes at SUNY Albany, or to work at the Education Department in Albany. As I drove past HVCC, their sign reminded of registration for fall classes starting August 21. And so that also will come, and go.
July 7--#9
Cory and the usual exercises, a lot of work with the bands, elastic not musical. Some are uncomfortable, but not really difficult. Ho hum. I stopped at DD's on the way home. Clerk was youngster who was trying to solicit donations for the Muscular Dystrophy Association, but couldn't pronounce it. The women tried to help him, decided he could say MDA. Kind of funny...
Wednesday, July 1, 2015
PT Days 7,8
Monday, June 29, Had to leave early for my 9:30 appt., to take Dave to his Dermatology appt., which is just across the parking lot. A Police Car was parked at the Massry Pavillion with 2 officers overseeing therapy on the arm of an unhappy-looking man. I saw Maureen today, and underwent the usual exercises.
Wednesday, July, 9:30 appt. with Cory. She is from Cohoes, and has twin teenaged sons,one of whom just returned from field trip to Wash. D.C. Turns out she knows the McKay family, some of them anyway. Joanne's daughter, Amy, and Cory have children of the same age. Oddly, she looks a lot like Joanne who was a Jannicelli before she married Roger, and Cory's name was Dushane, of French derivation. I'd encountered ELO and son as we were checking in, and saw him as I was leaving. He was working Sudoku puzzles as he waited, but wanted to talk. He seemed interested in getting people to attend the Albany Light Opera in September. I said I'd think about it , but it would depend on how light the opera is.
I have one week of PT left, next week being week 5. I'd been prescribed 6 weeks, but I'm not questioning it. I think my shoulder has improved. Time or treatment, who knows?
Wednesday, July, 9:30 appt. with Cory. She is from Cohoes, and has twin teenaged sons,one of whom just returned from field trip to Wash. D.C. Turns out she knows the McKay family, some of them anyway. Joanne's daughter, Amy, and Cory have children of the same age. Oddly, she looks a lot like Joanne who was a Jannicelli before she married Roger, and Cory's name was Dushane, of French derivation. I'd encountered ELO and son as we were checking in, and saw him as I was leaving. He was working Sudoku puzzles as he waited, but wanted to talk. He seemed interested in getting people to attend the Albany Light Opera in September. I said I'd think about it , but it would depend on how light the opera is.
I have one week of PT left, next week being week 5. I'd been prescribed 6 weeks, but I'm not questioning it. I think my shoulder has improved. Time or treatment, who knows?
Thursday, June 25, 2015
PT Day 6 + Post script-Dave's Procedure*
8;30 a.m. Saw Maureen today, Cory probably on vacation. I didn't ask. Accepted the pre-workout heat treatment, so everything did seem easier. Usual exercises, though 20 reps for most now instead of 10. No pain, but surprisingly tiring. The TV is on the wall, usually news at that hour, so we have a running discussion as to when the Prison Escape will be on Lifetime, et al. Cory sees Kathy Bates as Tillie. I suspect they'll cast someone a little hotter, maybe Charleze Theron. She's played a believable murderess, is beautiful but can play ugly,so would fit right into the part. I suppose we'll have to wait until the escapees are captured until the movie though.
Later in the day, I drove Dave to his primary care doctor in Cambridge. Kathy, a nurse there, was a student of mine when I taught at Cambridge Central. She was a delight then in tenth grade, and still is. She calls me Miss Madigan. So sweet. She said her class just celebrated their 44th Class Reunion. Seems like made-up story somehow. She had a twin brother, Kerry, also a nice kid and a good student. I saw him some years ago at one of the Troy hospitals, a nurse or aide. I can see Kathy sitting in first seat, middle row of my classroom, Room 203. I have a vivid memory of testing them on "The King and I" and playing the sound track in the back of the classroom. She hummed to herself as she wrote her essay. The memory is clear, but who we were then is a surreal blur. Anyway, the doctor, assessing the input from other doctors, thinks that Dave should have one of the tests mentioned by the neurologist. So it's scheduled for next week at Samaritan Hospital. For all the good that comes from the barrage of tests, he may just as well be tested on "The King and I."
* Dave saw neurologist, Dr. Verdini on July 26, for follow-up on the thoracic MRI which he had ordered. He was told results were normal. When Dave said he had seen his primary, told him that he (Verdini) had mentioned the possibility of a Video Swallow test, the primary said it might be a good idea. The test was scheduled at Samaritan. Dr. Verdini said he thought the test was not indicated. Dave cancelled the procedure.
Later in the day, I drove Dave to his primary care doctor in Cambridge. Kathy, a nurse there, was a student of mine when I taught at Cambridge Central. She was a delight then in tenth grade, and still is. She calls me Miss Madigan. So sweet. She said her class just celebrated their 44th Class Reunion. Seems like made-up story somehow. She had a twin brother, Kerry, also a nice kid and a good student. I saw him some years ago at one of the Troy hospitals, a nurse or aide. I can see Kathy sitting in first seat, middle row of my classroom, Room 203. I have a vivid memory of testing them on "The King and I" and playing the sound track in the back of the classroom. She hummed to herself as she wrote her essay. The memory is clear, but who we were then is a surreal blur. Anyway, the doctor, assessing the input from other doctors, thinks that Dave should have one of the tests mentioned by the neurologist. So it's scheduled for next week at Samaritan Hospital. For all the good that comes from the barrage of tests, he may just as well be tested on "The King and I."
* Dave saw neurologist, Dr. Verdini on July 26, for follow-up on the thoracic MRI which he had ordered. He was told results were normal. When Dave said he had seen his primary, told him that he (Verdini) had mentioned the possibility of a Video Swallow test, the primary said it might be a good idea. The test was scheduled at Samaritan. Dr. Verdini said he thought the test was not indicated. Dave cancelled the procedure.
Wednesday, June 24, 2015
Tuesday, June 23 PT
8;30 a,m. seems a little early for any exercise, at least to me. But I do it anyway, having scheduled early sessions so the rest of the day would be free. Free to do what is the question, but if anything comes along I'll be ready. I dismissed the heat pad option today, but I think I'll reconsider next time. On a rainy day like this, everything seems to stiffen up a little, and besides the more time that's available, the more exercises there are: stretching, pulleys, elastic bands, wall washing and, yes, ball pushing. The exercises may seem a little dorky, but it's possible they're helping. The shoulder is no worse, and seems to be less troublesome. I could be wrong though; maybe I'm just getting used to it, because torn tendons can't repair themselves, as far as I can figure out. And so says the Ortho doc, who also said that Physical Therapy "could possibly help." Kind of a lukewarm referral, but he is a surgeon, and all they really want to do is cut into something.
Today was a double header in that I had my annual cardiology appointment later in the day. With a few hours to kill, I thought I'd hang out in downtown Troy, maybe even go to the library, but the day was rainy and the parking problematic, so I thought better of it and drove over Oakwood Ave to Dunkin' Donuts for a Coffeecake Muffin. I can't understand why the heavy traffic flow in the city, but the streets are usually jammed, on weekdays anyway.
The day went smoothly nonetheless. Then I arrived at Capital Cardiology Associates. I can't say there was a problem, but my annoyance threshold was activated as soon as I got there. Before, actually, because the parking is horrendous. Except for a handful of spaces in the building's tiny parking lot which is doubly frustrating because if you happen to drive in, it's a dead end and a challenge to back out of. The regular parking lot is closed to patients, though there is Valet Parking offered. I chose not to involve myself in that, and drove around to the opposite side of the building and found a parking spot near the end. In order to avoid the construction activity, I walked through the building, to the North Corridor, by the Emergency Room, went out that exit, crossed the driveways and entered the Medical Building. I'm still in an okay mood, didn't get hung up in the parking lot, don't really mind the hike, and then I enter the Cardiology Office. It's the first time I've been there since it was overhauled and refurbished, but, Alas, it is no more user-friendly than before, perhaps even less so.
The waiting room is large; there are, I think, 29 doctors in the practice. A bank of 6 stations or desks or counters, or whatever they're called lines the entire front wall. Most of them are occupied by people---clerks, reps, receptionists, whatever they are called. Of all the medical offices I've been in lately, and it's way too big a number, those who work here score among the highest for coldness and aloofness. Or so it seems to me. I don't really care, don't want their friendship, but I suspect they're trained to be that way. I say this because of the way other things are run.
There are several other patients there when I arrive; they move quickly because they are called in to one of the many exam rooms. Now anyone who watches TV knows that competing advertisers delight in ridiculing the "Get in line" practice used by banks and motor vehicle departments. And it seems that most facilities have gotten away from that module that treats the customers like sheep.
But not here! There is a sign, in front of the line of receptionists' windows, that instructs patients to "Form a line here. " In their old office, at least there was seating at checkout to wait for the person ahead of you. In this new "modern" office, the sign is in front center of the vast waiting room, with no seating nearby. And in an office for CARDIOLOGY.
I undergo an annual EKG. The tech is complaining about the cold and apologizing for her cold hands. I don't mind, I tell her, but suggest she wear thermals so she won't be freezing. She can't she says because she's sometimes in the other part of the building where it's boiling hot. That's the sunny side. I say I would have thought that would have been addressed with the new construction. She finishes the EKG, looks concerned, shows me the printout and says something is wrong, as my left side shows no activity. After she ascertains that the fault is with the electrode, and not my body failure, she re-attaches the electrode and tries again, and then again after replacing the electrode. It seems her fingers are numb from the cold.
She leaves with the final printout in hand, and a short time later, Dr. C. comes in. He takes my blood pressure, as he always does, pronounces it acceptable, and asks, as he always does, the same question; "Do I have any interesting events coming up this year?" I mumble something about family visits and new grandchildren, tempted to say I've signed up for a lunar landing or to try my hand at zookeeping because I know he's not paying attention. He says I won't need a stress test, that it's been 15 years since I wore the Holter Monitor, doesn't see any need for a repeat, won't need most labs as he's received reports from other doctor, so will order only a Cholesterol Test, and oh, yes, a cardiac ultra-sound. Any questions? I have had a very elevated CRP* reading for at least several years, at one time was prescribed a statin for it by my then primary doctor. He says he isn't worried about that -- nothing ever came of those tests. Come back in one year, he says. Take these papers to Check-Out.
I'm still fairly complacent, and I leave. I'm in an office off the left side of the waiting room, and stop at the window nearest the doorway I just left. There is one other patient about 3 windows over, and another man approaches soon after. The woman behind the window announces, "You need to get in line. There are other people ahead of you." Another rep adds, "The line is over there, behind the sign." The people, 2 of them, behind the sign, were checking in, and I was checking out. The sign is invisible, being behind a large pillar, and faces the incoming traffic. Their old office, as do most offices I've been in, had separate windows for people checking in and checking out. The new office has 6 windows, most of them open, but all of the reps work from a single line of coronary patients. I also have avoided shopping at JCP's because of the horrible queue of a check-out lane. And aren't they filing for bankruptcy?
, *CRP-----Cardiac Reactive Protein, a measure of inflammation. A blood test highly touted a few years ago, but evidently now disregarded by some. Or so I'm told. While a lot of information has become available through the Jupiter Study, about the risks of inflammation and its connection to life-threatening conditions, it has yet to be definitively determined what to do with the information so gleaned. So with lack of any profit motivation, the studies are largely ignored.
Today was a double header in that I had my annual cardiology appointment later in the day. With a few hours to kill, I thought I'd hang out in downtown Troy, maybe even go to the library, but the day was rainy and the parking problematic, so I thought better of it and drove over Oakwood Ave to Dunkin' Donuts for a Coffeecake Muffin. I can't understand why the heavy traffic flow in the city, but the streets are usually jammed, on weekdays anyway.
The day went smoothly nonetheless. Then I arrived at Capital Cardiology Associates. I can't say there was a problem, but my annoyance threshold was activated as soon as I got there. Before, actually, because the parking is horrendous. Except for a handful of spaces in the building's tiny parking lot which is doubly frustrating because if you happen to drive in, it's a dead end and a challenge to back out of. The regular parking lot is closed to patients, though there is Valet Parking offered. I chose not to involve myself in that, and drove around to the opposite side of the building and found a parking spot near the end. In order to avoid the construction activity, I walked through the building, to the North Corridor, by the Emergency Room, went out that exit, crossed the driveways and entered the Medical Building. I'm still in an okay mood, didn't get hung up in the parking lot, don't really mind the hike, and then I enter the Cardiology Office. It's the first time I've been there since it was overhauled and refurbished, but, Alas, it is no more user-friendly than before, perhaps even less so.
The waiting room is large; there are, I think, 29 doctors in the practice. A bank of 6 stations or desks or counters, or whatever they're called lines the entire front wall. Most of them are occupied by people---clerks, reps, receptionists, whatever they are called. Of all the medical offices I've been in lately, and it's way too big a number, those who work here score among the highest for coldness and aloofness. Or so it seems to me. I don't really care, don't want their friendship, but I suspect they're trained to be that way. I say this because of the way other things are run.
There are several other patients there when I arrive; they move quickly because they are called in to one of the many exam rooms. Now anyone who watches TV knows that competing advertisers delight in ridiculing the "Get in line" practice used by banks and motor vehicle departments. And it seems that most facilities have gotten away from that module that treats the customers like sheep.
But not here! There is a sign, in front of the line of receptionists' windows, that instructs patients to "Form a line here. " In their old office, at least there was seating at checkout to wait for the person ahead of you. In this new "modern" office, the sign is in front center of the vast waiting room, with no seating nearby. And in an office for CARDIOLOGY.
I undergo an annual EKG. The tech is complaining about the cold and apologizing for her cold hands. I don't mind, I tell her, but suggest she wear thermals so she won't be freezing. She can't she says because she's sometimes in the other part of the building where it's boiling hot. That's the sunny side. I say I would have thought that would have been addressed with the new construction. She finishes the EKG, looks concerned, shows me the printout and says something is wrong, as my left side shows no activity. After she ascertains that the fault is with the electrode, and not my body failure, she re-attaches the electrode and tries again, and then again after replacing the electrode. It seems her fingers are numb from the cold.
She leaves with the final printout in hand, and a short time later, Dr. C. comes in. He takes my blood pressure, as he always does, pronounces it acceptable, and asks, as he always does, the same question; "Do I have any interesting events coming up this year?" I mumble something about family visits and new grandchildren, tempted to say I've signed up for a lunar landing or to try my hand at zookeeping because I know he's not paying attention. He says I won't need a stress test, that it's been 15 years since I wore the Holter Monitor, doesn't see any need for a repeat, won't need most labs as he's received reports from other doctor, so will order only a Cholesterol Test, and oh, yes, a cardiac ultra-sound. Any questions? I have had a very elevated CRP* reading for at least several years, at one time was prescribed a statin for it by my then primary doctor. He says he isn't worried about that -- nothing ever came of those tests. Come back in one year, he says. Take these papers to Check-Out.
I'm still fairly complacent, and I leave. I'm in an office off the left side of the waiting room, and stop at the window nearest the doorway I just left. There is one other patient about 3 windows over, and another man approaches soon after. The woman behind the window announces, "You need to get in line. There are other people ahead of you." Another rep adds, "The line is over there, behind the sign." The people, 2 of them, behind the sign, were checking in, and I was checking out. The sign is invisible, being behind a large pillar, and faces the incoming traffic. Their old office, as do most offices I've been in, had separate windows for people checking in and checking out. The new office has 6 windows, most of them open, but all of the reps work from a single line of coronary patients. I also have avoided shopping at JCP's because of the horrible queue of a check-out lane. And aren't they filing for bankruptcy?
, *CRP-----Cardiac Reactive Protein, a measure of inflammation. A blood test highly touted a few years ago, but evidently now disregarded by some. Or so I'm told. While a lot of information has become available through the Jupiter Study, about the risks of inflammation and its connection to life-threatening conditions, it has yet to be definitively determined what to do with the information so gleaned. So with lack of any profit motivation, the studies are largely ignored.
Friday, June 19, 2015
PT 6/18/15
Pretty much more of the same. It just occurred to me: what if the remaining tendons tear? I mean, they are being stretched.
Since the routine was altered as of yesterday, the eldest, done with school for the year, shouldered responsibility for getting the brothers off to school. I stopped in on the way home, bringing Dunkin's donuts, and we both went to VF to check on Papa, then to Strawberry Acres. They've reopened after being closed for a time after the death of the owner. His widow, and their son, are running it now. She said it has not been a great year for strawberries, with not enough warmth and then too much rain. Berries were $5.00 a quart or $3.00 if you picked your own. That proposition was not in our wheelhouse, so we bought a couple of baskets. The berries were rather small, which I don't object to, but many on the bottom had too many heavily seeded areas on the bottom, which I had to amputate along with the hulls. They were tasty, but kind of a pain to deal with.
Since we were in the area, we stopped at Daisy's house, where a young Mexican woman holding a baby who evidently lived in the other apartment indicated the family was gone. She was friendly, but did not speak English though, and either may not have understood or else was following the custom of being a non-informant. The chickens were still there...
Since the routine was altered as of yesterday, the eldest, done with school for the year, shouldered responsibility for getting the brothers off to school. I stopped in on the way home, bringing Dunkin's donuts, and we both went to VF to check on Papa, then to Strawberry Acres. They've reopened after being closed for a time after the death of the owner. His widow, and their son, are running it now. She said it has not been a great year for strawberries, with not enough warmth and then too much rain. Berries were $5.00 a quart or $3.00 if you picked your own. That proposition was not in our wheelhouse, so we bought a couple of baskets. The berries were rather small, which I don't object to, but many on the bottom had too many heavily seeded areas on the bottom, which I had to amputate along with the hulls. They were tasty, but kind of a pain to deal with.
Since we were in the area, we stopped at Daisy's house, where a young Mexican woman holding a baby who evidently lived in the other apartment indicated the family was gone. She was friendly, but did not speak English though, and either may not have understood or else was following the custom of being a non-informant. The chickens were still there...
Tuesday, June 16, 2015
PT3
Appointment today at 8:30 a.m. with Cory. Stretching, pressing, swinging, the pulleys. Rather painful, but I say nothing. Hoping muscles are being strengthened to compensate in some way for lack of tendon. Afterwards, drove to the Eddy Heritage, just past St. Mary's Cemetery. The last time, perhaps the only time, I was there was a bizarre graveside service.
Thursday, June 11, 2015
Poignant
I was waiting at Seton Rehab for my appointment when a man walked in. He was elderly but spry and jovial. He greeted the woman at the desk,She recognized him and called him by name, Jeremiah. They exchanged greetings and he continued to stand by the door to the rehab room, chatting with everyone around. They all seemed to know him. The door opened and someone said to another man, "Tim, you can go in now." "What about me?" asked Jeremiah. "Well, you can go in for one minute," he was told. "For only a minute?" he asked. "I just want to say hello to everyone, to see how they're doing." He did go in, and came back out in just about one minute. He walked over to where a woman was sitting on a bench, and began talking to her, seemingly recognizing her. I was called in to my appointment and don't know what else happened. I picture a scenario where he was a patient there, and was made to feel important during his rehab, and thought they would be pleased to see him and welcome him back. So mistaken, and so sad.
P.T. #2
Thursday, June 11, 2015
My appointment today was at 9:30 a.m. The therapist was Cory, who I also remember seeing, but I don't say so. We started the session with moist heat, which felt rather good even though the day was fairly warm..Some stretching exercises, some work moving a stick,or cane, back and forth, pressing my shoulder against a ball placed in different places against a wall, and an exercise where you use a cloth to make circular movements as in washing a wall. Clockwise motions were tolerable, but the counterclockwise movements difficult. The last exercise was the pulleys. A little taxing but my favorite----Id compare it to the use of the exercise bike during knee rehab. I turned down the offer to have my shoulder iced after the exercises. I do so hate to be cold.
My appointment today was at 9:30 a.m. The therapist was Cory, who I also remember seeing, but I don't say so. We started the session with moist heat, which felt rather good even though the day was fairly warm..Some stretching exercises, some work moving a stick,or cane, back and forth, pressing my shoulder against a ball placed in different places against a wall, and an exercise where you use a cloth to make circular movements as in washing a wall. Clockwise motions were tolerable, but the counterclockwise movements difficult. The last exercise was the pulleys. A little taxing but my favorite----Id compare it to the use of the exercise bike during knee rehab. I turned down the offer to have my shoulder iced after the exercises. I do so hate to be cold.
PT Shoulder Journal Tuesday, June 9
Seton Health Physical Rehabilitation Assessment
For the third consecutive year, I'm engaged in physical therapy. In 2013 and 2104, the therapy sessions were post-surgery so there was a definite protocol, endorsed by the surgeon, it would seem, aimed at bringing the operated site back to some semblance of normalcy.
The present prescription from the orthopedist is geared toward retaining or maintaining mobility in the shoulder with the torn rotator cuff, and also keeping the unaffected shoulder from becoming strained. Or that's my understanding anyway. I've been told a torn tendon is like a broken rubber band; it can not heal itself because the ends are not together--the only way that can happen is through surgery, which would sew the ends together I guess. It's said that the tendon, once torn, retracts the way a snapped rubber band does. In my mind, though, I don't see it quite like that. Yes, if a new rubber band is snapped, it shortens back up. But if the rubber band is old and stretched out, the ends don't retract; they just lay there, flaccid and limp. I can imagine a stretched-out broken tendon just hanging listlessly in my shoulder, ready to twist around some other piece of nearby mechanism. Actually, that's what it feel like sometimes, that something is there, and needs to move away.
The therapist assigned to assess my shoulder is named Maureen; I remember seeing her from before. I had asked if the therapist I'd had before was available, but the woman at the desk is not detail-oriented and pushes ahead at her own pace. Who is available all depends on what time frame you want and how each therapist is scheduled. I wanted to schedule morning sessions, to be done with it; I chose 8:a.m. for most.
The assessment, about an hour long, consists of taking a history and then moving the affected arm into a number of positions, almost exactly the same routine the orthopedist uses. Maureen has a copy of my MRI report which details the injuries, and she comments that I seem to be doing better than the report would indicate. That sounded familiar as they said the same about my knees. They suggest I may have a high threshold of pain, but I'm certain I do not. I just want to get any unpleasantness over with as soon as possible. I can make myself do everything that is presented, even when pain is present. She does not ask me to put a dish on a high shelf, push the vacuum cleaner with my right hand, hook my bra, or throw a ball overhand, all things which are hard to do.
For the third consecutive year, I'm engaged in physical therapy. In 2013 and 2104, the therapy sessions were post-surgery so there was a definite protocol, endorsed by the surgeon, it would seem, aimed at bringing the operated site back to some semblance of normalcy.
The present prescription from the orthopedist is geared toward retaining or maintaining mobility in the shoulder with the torn rotator cuff, and also keeping the unaffected shoulder from becoming strained. Or that's my understanding anyway. I've been told a torn tendon is like a broken rubber band; it can not heal itself because the ends are not together--the only way that can happen is through surgery, which would sew the ends together I guess. It's said that the tendon, once torn, retracts the way a snapped rubber band does. In my mind, though, I don't see it quite like that. Yes, if a new rubber band is snapped, it shortens back up. But if the rubber band is old and stretched out, the ends don't retract; they just lay there, flaccid and limp. I can imagine a stretched-out broken tendon just hanging listlessly in my shoulder, ready to twist around some other piece of nearby mechanism. Actually, that's what it feel like sometimes, that something is there, and needs to move away.
The therapist assigned to assess my shoulder is named Maureen; I remember seeing her from before. I had asked if the therapist I'd had before was available, but the woman at the desk is not detail-oriented and pushes ahead at her own pace. Who is available all depends on what time frame you want and how each therapist is scheduled. I wanted to schedule morning sessions, to be done with it; I chose 8:a.m. for most.
The assessment, about an hour long, consists of taking a history and then moving the affected arm into a number of positions, almost exactly the same routine the orthopedist uses. Maureen has a copy of my MRI report which details the injuries, and she comments that I seem to be doing better than the report would indicate. That sounded familiar as they said the same about my knees. They suggest I may have a high threshold of pain, but I'm certain I do not. I just want to get any unpleasantness over with as soon as possible. I can make myself do everything that is presented, even when pain is present. She does not ask me to put a dish on a high shelf, push the vacuum cleaner with my right hand, hook my bra, or throw a ball overhand, all things which are hard to do.
Friday, June 5, 2015
Amtrak
I like to travel by train, or at least I think I do. I have basic requirements, though; I want to be able to sit down, in a seat, and the temperature should not be freezing or boiling hot. I have boarded a train with a reservation for seating, and had to sit on my suitcase. The temperature on some trips has been really cold; other times, the air conditioning did not seem to exist, as on one trip I took alone to Rochester and the temperature had to be at least ninety degrees. On a trip to Florida, the train stopped in its overnight journey and the sleeping car I shared with my three-year-old son seemed to fill with exhaust fumes, and I had a panic attack, feeling like I couldn't breathe.
Over the years, I've learned to accommodate to railroad conditions. I bring a jacket, I carry a water bottle, and I pre-arrange for seating. Age helps in that respect. I refuse to think of terrorists on the train, and I don't want to picture the train leaving the tracks. So, yes, I like to travel by train.
On my latest trip by rail, it was easy to forget about security issues. The only security measure I perceived was the conductor's warning not to fall into the gap between the platform and the train. We witnessed that once; a woman, getting off the train, fell right down into the space below. They got her out, can't remember her condition.
Some areas served by Amtrak appear to be sorely in need of funding. The Framingham station, for example, has been abandoned, and passengers board directly from the area along the tracks. Moreover, you have to go up and over the tracks to get on. There is an elevator, but it was broken, maybe hadn't worked in years. I was hand-in-hand with a small child so we counted the steps as we walked to my train, 42 steps up and 42 steps down. I think the only saving grace was that I've been climbing 100 steps a day as rehabilitation for my knee. That, combined with adapting to a child's pace, made it not too strenuous. It also helped that my son carried my luggage.
Over the years, I've learned to accommodate to railroad conditions. I bring a jacket, I carry a water bottle, and I pre-arrange for seating. Age helps in that respect. I refuse to think of terrorists on the train, and I don't want to picture the train leaving the tracks. So, yes, I like to travel by train.
On my latest trip by rail, it was easy to forget about security issues. The only security measure I perceived was the conductor's warning not to fall into the gap between the platform and the train. We witnessed that once; a woman, getting off the train, fell right down into the space below. They got her out, can't remember her condition.
Some areas served by Amtrak appear to be sorely in need of funding. The Framingham station, for example, has been abandoned, and passengers board directly from the area along the tracks. Moreover, you have to go up and over the tracks to get on. There is an elevator, but it was broken, maybe hadn't worked in years. I was hand-in-hand with a small child so we counted the steps as we walked to my train, 42 steps up and 42 steps down. I think the only saving grace was that I've been climbing 100 steps a day as rehabilitation for my knee. That, combined with adapting to a child's pace, made it not too strenuous. It also helped that my son carried my luggage.
Rate your Doc
Too much time on my hands, so I searched Health Net to see how the doctors I know stack up against their patient ratings. Some doctors have no ratings submitted. The highest number of ratings I found was 32, and that doctor, a gastroenterologist, had the lowest rating of all, only a 2+ out of 32 people who submitted ratings. Patients rate the office environment and staff also, so even though those ratings are separate from the doctor's, those conditions may influence the entire survey. Or else, people with gastric conditions are a pretty unhappy lot. In contrast, both orthopedic surgeons I've visited have perfect ratings, "5's" out of 6 and 11 ratings. Orthopedic patients may be healthier, therefore happier, than most, but considering the number of patients they see, 5 and 11 ratings are probably insignificant, though representative of something. My primary care doctor, who I rarely see, has a perfect rating too, though only from one person, probably his mother.
Tuesday, May 26, 2015
Rotation
It was last November the 14th, one of the first days that you could feel the winter season approaching, a cold and blustery day. I had an appointment at the medical complex in East Greenbush, and decided to wear a warm winter coat, a leather one. As I was getting ready to leave the building, I slipped the strap of my pocketbook up on my shoulder at the same time as I pushed the door open. A gust of wind forced its resistance against the door, and I felt pain in my right shoulder, in the arm I used to open the door. After I got to my car, I sat there a while, flexing my arm to alleviate the pain, and tried to rub the ache away. I assumed I'd strained a muscle; I think something like that has happened in the past and had resolved in time.
The shoulder continued to bother me, though, making it so uncomfortable to put dishes away on a higher shelf that I began to use my left arm instead. It didn't hurt to hold my toothbrush in my right hand, but brushing, or combing, my hair was a different story. Raising my right arm to the side was difficult, and painful. But more disconcerting was that I would be awakened during the night with a rather sharp, localized pain centered across the top of my shoulder.
The pain and restriction still had not dissipated three months later, so I contacted Ortho NY and made an appointment with Dr. Lee Kaback, an orthopedic specialist in shoulder repair. My appointment with him was March 11, at which time my shoulder was x-rayed before the consult with the doctor. The exam consisted of raising my arm in different positions, and resisting while he applied pressure on the arm. I could put my arm in any position requested, though in some with discomfort and or pain. Given my circumstances (meaning my age of course) I am stronger than most would suspect, and my arm didn't fall down when he pressed on it. I have since read that if the rotator cuff tear is complete, the arm will drop instantly, with no tendons to support it. I was not in that category. If he had asked me to put my arm behind my back and then try to push it straight out, I would not have been successful, but he didn't ask that.
Dr.K. said I probably was suffering from arthritis; he knew the history of my knees. The pain is probably like that, he said, but I said no, it was much more localized. He seemed to think a Cortisone shot would be a good idea, there and then, but I wasn't prepared for that at the time. He asked if I would like to have an MRI to assess any possible damage, and I agreed. I was not so concerned with the pain, though I'd like it to be gone, but more concerned that whatever damage was there could progress, and impede the use of my right arm.
On March 15, I had an MRI at ImageCare in Latham, and on April 8, a follow-up appointment with Dr. K. for the results. The first words he spoke after the requisite greeting were to say that I had "a very large tear in the rotator cuff," and that was where the pain was coming from. And my options: he loves to operate, he says, and he would do so right now, but there are issues. Older tendons don't heal as well, and the recovery period is 5 months or so. He again mentioned a cortisone shot for the pain, which he said could be effective by reducing the inflammation. He said I could try Physical Therapy. I asked if the tear would improve on its own and he said he didn't think so. I asked if the physical therapy would be helpful and he said it might be. I opted for the P.T. and he wrote me a script. I'm still thinking about pursuing that course.
4/17/2015
At my F.U. visit, Dr. K. said I had "a very large tear" in the rotator cuff tendon, and offered the above options. He didn't go into detail as he knows patients are uninformed and he doesn't have the time to educate them. After all, he had to spend much time and a great amount of money to gain his knowledge. That's why he's the doctor: I'm just the damaged piece of clay that he can mold into some semblance of normalcy, or not. He had seemed to think my problem was arthritis, but I didn't think it was. The pain was too localized. Anyway, I wanted to know more than what he told me, mainly because I want to be informed of my condition before I begin physical therapy. I plan to delay the start of P.T. until after the baby is born. I know that once the course of PT is started, it must run its course without interruption. Medicare is very fussy about any alteration to the start and finish date. So to clarify my condition, I requested a copy of the MRI report, which is a very simple thing to do, and to me, somewhat satisfying. Following is a synopsis of the 3/19/15 report:
The clinical indication was to evaluate for arthritis versus cuff tear. Finding were that while the other tendons in the shoulder, the subscapularis and teres minor, were pretty much normal, the same was not true for the supraspinatus and the infraspinatus. Now I'm not a doctor, but besides seeing them played on TV, my three years of high school Latin lets me know that the supra part is where my pain and loss of mobility is. And the report reads:
"Full thickness retracted tear of entire supraspinatus." That has to run right across the top of the shoulder because that's where the pain is.
"Tear extends posteriorly to involve the infraspinatus, with full-thickness tear of the anterior 10 mm of the infraspinatus. Posterior to this, tear extends another 10 mm posteriorly as an articular sided tear that delaminates into an interstitial tear extending to the myotendinous junction."
This taxes my cache of Latin, but helps me understand why the doctor would say only a very large tear. It seems as if the supraspinatus ran amok and took everything nearby down with it. I suppose retracted means what it sounds like----the same way a snapped rubber band behaves, turning in on itself.
Adjectives pertaining to other structures are "mild, minimal, and moderate." Somewhat jarring to see the report addresses "Bone Marrow" status. Who knew that would be on the table, but fortunately the finding was: "No evidence of fracture or pathologic marrow infiltration." Phew!
IMPRESSION:
"Full-thickness retracted tear of supraspinatus and anterior fibers of infraspinatus. Further posterior extension of tear as articular surface and interstitial tear of the more posterior fibers of infraspinatus. Probable full-thickness retracted tear of long head of biceps tendon."
It reminds me of a night last summer when I was at the computer and heard a rushing and then crashing sound, as if a train had derailed at top speed. A tall tree had suddenly snapped its trunk and its fall had impacted and thereby damaged all the structures in its vicinity. As far as I know, though, nothing retracted. I think I'll call on Monday* to check if it will be acceptable to wait until June to start therapy. I do look forward to holding a little baby in my arms.
* I never did get around to calling, so when I went to Seton and presented my script I found that it would need to be renewed. A call to the Ortho office would do it, I was told. It happens very frequently. In the meantime, they will do the assessment today. They seemed confident it will work out.
The shoulder continued to bother me, though, making it so uncomfortable to put dishes away on a higher shelf that I began to use my left arm instead. It didn't hurt to hold my toothbrush in my right hand, but brushing, or combing, my hair was a different story. Raising my right arm to the side was difficult, and painful. But more disconcerting was that I would be awakened during the night with a rather sharp, localized pain centered across the top of my shoulder.
The pain and restriction still had not dissipated three months later, so I contacted Ortho NY and made an appointment with Dr. Lee Kaback, an orthopedic specialist in shoulder repair. My appointment with him was March 11, at which time my shoulder was x-rayed before the consult with the doctor. The exam consisted of raising my arm in different positions, and resisting while he applied pressure on the arm. I could put my arm in any position requested, though in some with discomfort and or pain. Given my circumstances (meaning my age of course) I am stronger than most would suspect, and my arm didn't fall down when he pressed on it. I have since read that if the rotator cuff tear is complete, the arm will drop instantly, with no tendons to support it. I was not in that category. If he had asked me to put my arm behind my back and then try to push it straight out, I would not have been successful, but he didn't ask that.
Dr.K. said I probably was suffering from arthritis; he knew the history of my knees. The pain is probably like that, he said, but I said no, it was much more localized. He seemed to think a Cortisone shot would be a good idea, there and then, but I wasn't prepared for that at the time. He asked if I would like to have an MRI to assess any possible damage, and I agreed. I was not so concerned with the pain, though I'd like it to be gone, but more concerned that whatever damage was there could progress, and impede the use of my right arm.
On March 15, I had an MRI at ImageCare in Latham, and on April 8, a follow-up appointment with Dr. K. for the results. The first words he spoke after the requisite greeting were to say that I had "a very large tear in the rotator cuff," and that was where the pain was coming from. And my options: he loves to operate, he says, and he would do so right now, but there are issues. Older tendons don't heal as well, and the recovery period is 5 months or so. He again mentioned a cortisone shot for the pain, which he said could be effective by reducing the inflammation. He said I could try Physical Therapy. I asked if the tear would improve on its own and he said he didn't think so. I asked if the physical therapy would be helpful and he said it might be. I opted for the P.T. and he wrote me a script. I'm still thinking about pursuing that course.
4/17/2015
At my F.U. visit, Dr. K. said I had "a very large tear" in the rotator cuff tendon, and offered the above options. He didn't go into detail as he knows patients are uninformed and he doesn't have the time to educate them. After all, he had to spend much time and a great amount of money to gain his knowledge. That's why he's the doctor: I'm just the damaged piece of clay that he can mold into some semblance of normalcy, or not. He had seemed to think my problem was arthritis, but I didn't think it was. The pain was too localized. Anyway, I wanted to know more than what he told me, mainly because I want to be informed of my condition before I begin physical therapy. I plan to delay the start of P.T. until after the baby is born. I know that once the course of PT is started, it must run its course without interruption. Medicare is very fussy about any alteration to the start and finish date. So to clarify my condition, I requested a copy of the MRI report, which is a very simple thing to do, and to me, somewhat satisfying. Following is a synopsis of the 3/19/15 report:
The clinical indication was to evaluate for arthritis versus cuff tear. Finding were that while the other tendons in the shoulder, the subscapularis and teres minor, were pretty much normal, the same was not true for the supraspinatus and the infraspinatus. Now I'm not a doctor, but besides seeing them played on TV, my three years of high school Latin lets me know that the supra part is where my pain and loss of mobility is. And the report reads:
"Full thickness retracted tear of entire supraspinatus." That has to run right across the top of the shoulder because that's where the pain is.
"Tear extends posteriorly to involve the infraspinatus, with full-thickness tear of the anterior 10 mm of the infraspinatus. Posterior to this, tear extends another 10 mm posteriorly as an articular sided tear that delaminates into an interstitial tear extending to the myotendinous junction."
This taxes my cache of Latin, but helps me understand why the doctor would say only a very large tear. It seems as if the supraspinatus ran amok and took everything nearby down with it. I suppose retracted means what it sounds like----the same way a snapped rubber band behaves, turning in on itself.
Adjectives pertaining to other structures are "mild, minimal, and moderate." Somewhat jarring to see the report addresses "Bone Marrow" status. Who knew that would be on the table, but fortunately the finding was: "No evidence of fracture or pathologic marrow infiltration." Phew!
IMPRESSION:
"Full-thickness retracted tear of supraspinatus and anterior fibers of infraspinatus. Further posterior extension of tear as articular surface and interstitial tear of the more posterior fibers of infraspinatus. Probable full-thickness retracted tear of long head of biceps tendon."
It reminds me of a night last summer when I was at the computer and heard a rushing and then crashing sound, as if a train had derailed at top speed. A tall tree had suddenly snapped its trunk and its fall had impacted and thereby damaged all the structures in its vicinity. As far as I know, though, nothing retracted. I think I'll call on Monday* to check if it will be acceptable to wait until June to start therapy. I do look forward to holding a little baby in my arms.
* I never did get around to calling, so when I went to Seton and presented my script I found that it would need to be renewed. A call to the Ortho office would do it, I was told. It happens very frequently. In the meantime, they will do the assessment today. They seemed confident it will work out.
Tuesday, May 12, 2015
Lewis Lent Redux
What we didn't know until later, or had not connected to murder:
He was staying at the rectory of the church on Old Rte 146. He helped out by doing some custodial work there.
He frequented movie theaters; one was a short walking distance away from the theater in the mall.
A local family, who attended the Clifton Park church where Lent was staying, befriended him and he was a frequent guest in their home, where he played board games with the three younger sisters of my son's classmate.
At one time, after Lent was in custody, investigators knew he had lived nearby and searched the area near Exit 9 of the Northway for clues to, or a buried body, of the missing girl.
None of the above information was known or cared about until after he was captured. I think the family involved did not want to disclose that, out of religious compassion, they had allowed a murderer to be in contact with their 4 young children. As I remember, the oldest, a boy, revealed it as something he wasn't to talk about.
On a warm summer day, during the "U2, Rattle and Hum" afternoon showing, my son, my nephew, and I came into contact with him. Of course we didn't know the extent of danger at the time, but even the youngest knew something was amiss.
He entered part way through the movie. We three had been the only audience that beautiful day. I was sitting in the back because of the amplified concert music, while the boys, 10 and 11 or so, were closer to the front, in the center section of seats. He entered and at first sat in the left tier. Then he moved across to the center aisle, closer to the boys. One of the boys, influenced probably by the musical tastes of older siblings, was attentive to the movie. . The younger, bored after a while, engaged in flipping a quarter down the center aisle, and then retrieving it. Since the theater had been empty save for us, it caused no disturbance, and he was fairly low-key about it, and would return to his seat sporadically. The man then moved to directly behind the boys. At this move, the older boy came up to my seat,and said he thought something was wrong. Both boys then moved a few rows in front of me; it was near the end of the movie.
I kind of regret my next move, though remember times were different back in 1988 or so. We weren't nearly as aware of sexual offenders or sexual predators on children. I only knew about "perverts" who exposed themselves in theaters. So when the man left first, by the entrance to the left, I told the boys to stay seated in the back of the theater, and I walked out the same exit area the man had. It is a curved archway to the theater exit, but the man was standing there, with his back against the wall, waiting---for what? I almost said something to him, but for some reason did not. I just circled back to where the boys were, and faced the wrath of my son-----"How could you.....?
I remember telling the boys, "You've met you first pervert." As we left the theater, we spotted the man going into the men's room.
On a usual day, most likely the boys would have used the restroom before going to the McDonald's that was then in the mall.
That day, we drove to the McDonald's in Mechanicville, kind of joking about what had just occurred.
I wonder about what would have happened if the boys had decided to go to the restroom during the movie. I'm sure I would have let them go together. Old enough to be responsible, a summer afternoon, Clifton Park, not many people around. When Lent was captured, after the girl he tried to kidnap right off the street succeeded in slipping out of his grasp, he was found to have rope and tape in his vehicle. On a later trip to the theater, my son checked and said there was an exit from the men's bathroom to outside the theater.
I don't know what would have happened if I'd spoken to him. I guess I didn't because I didn't know what to say. "Why did you move your seat 3 times? Why are you standing here now?" I had passed within inches of him, and could see his face for the first time. He looked benign enough, kind of like a school teacher, I'd thought. He was wearing a short-sleeved button-up shirt, and army green khaki type pants.
He was staying at the rectory of the church on Old Rte 146. He helped out by doing some custodial work there.
He frequented movie theaters; one was a short walking distance away from the theater in the mall.
A local family, who attended the Clifton Park church where Lent was staying, befriended him and he was a frequent guest in their home, where he played board games with the three younger sisters of my son's classmate.
At one time, after Lent was in custody, investigators knew he had lived nearby and searched the area near Exit 9 of the Northway for clues to, or a buried body, of the missing girl.
None of the above information was known or cared about until after he was captured. I think the family involved did not want to disclose that, out of religious compassion, they had allowed a murderer to be in contact with their 4 young children. As I remember, the oldest, a boy, revealed it as something he wasn't to talk about.
On a warm summer day, during the "U2, Rattle and Hum" afternoon showing, my son, my nephew, and I came into contact with him. Of course we didn't know the extent of danger at the time, but even the youngest knew something was amiss.
He entered part way through the movie. We three had been the only audience that beautiful day. I was sitting in the back because of the amplified concert music, while the boys, 10 and 11 or so, were closer to the front, in the center section of seats. He entered and at first sat in the left tier. Then he moved across to the center aisle, closer to the boys. One of the boys, influenced probably by the musical tastes of older siblings, was attentive to the movie. . The younger, bored after a while, engaged in flipping a quarter down the center aisle, and then retrieving it. Since the theater had been empty save for us, it caused no disturbance, and he was fairly low-key about it, and would return to his seat sporadically. The man then moved to directly behind the boys. At this move, the older boy came up to my seat,and said he thought something was wrong. Both boys then moved a few rows in front of me; it was near the end of the movie.
I kind of regret my next move, though remember times were different back in 1988 or so. We weren't nearly as aware of sexual offenders or sexual predators on children. I only knew about "perverts" who exposed themselves in theaters. So when the man left first, by the entrance to the left, I told the boys to stay seated in the back of the theater, and I walked out the same exit area the man had. It is a curved archway to the theater exit, but the man was standing there, with his back against the wall, waiting---for what? I almost said something to him, but for some reason did not. I just circled back to where the boys were, and faced the wrath of my son-----"How could you.....?
I remember telling the boys, "You've met you first pervert." As we left the theater, we spotted the man going into the men's room.
On a usual day, most likely the boys would have used the restroom before going to the McDonald's that was then in the mall.
That day, we drove to the McDonald's in Mechanicville, kind of joking about what had just occurred.
I wonder about what would have happened if the boys had decided to go to the restroom during the movie. I'm sure I would have let them go together. Old enough to be responsible, a summer afternoon, Clifton Park, not many people around. When Lent was captured, after the girl he tried to kidnap right off the street succeeded in slipping out of his grasp, he was found to have rope and tape in his vehicle. On a later trip to the theater, my son checked and said there was an exit from the men's bathroom to outside the theater.
I don't know what would have happened if I'd spoken to him. I guess I didn't because I didn't know what to say. "Why did you move your seat 3 times? Why are you standing here now?" I had passed within inches of him, and could see his face for the first time. He looked benign enough, kind of like a school teacher, I'd thought. He was wearing a short-sleeved button-up shirt, and army green khaki type pants.
Saturday, May 9, 2015
The 100 Steps
With all the exercise addicts out there, I hesitate to reveal my daily regimen, but I can justify it by saying that I am old. Anything is better than nothing; at least I hope so. Since I finished physical therapy last fall, my daily "workout" has consisted of riding my exercise bike for about half an hour, usually while watching Jeopardy. I had moved the bike into the bedroom because it was so cold in the outside room that I had to bundle up in coat, hat and gloves. I don't set the tension on the pedals very high, and I convince myself that I am exercising, though it never makes me tired or out of breath. I stop because it is rather boring.
So with the return of nice weather, I returned to my step therapy--outside, on the steps leading to the pool. 100 steps. That doesn't take very long, but I find it much more taxing than riding a bike. My legs have to heft all that poundage up and then down 5 steps about 20 times. At first, I stopped to gasp for air at 50 steps, then 60, and 70. Today was the first time I managed to do 100 steps without stopping to breathe. I trust that no passing motorist would notice and think I had gone batty; the speed at which cars go by my house prevents anyone from seeing more than a single climb. Or at least I think so.
When I get to the top of the stairs, I stand on the deck and practice my other exercise--this one for balance. I stand on each foot for as many Hail Mary's as I can recite. Sometime I can get as far as three.
What the heck, I'm no Kelly Ripa.
So with the return of nice weather, I returned to my step therapy--outside, on the steps leading to the pool. 100 steps. That doesn't take very long, but I find it much more taxing than riding a bike. My legs have to heft all that poundage up and then down 5 steps about 20 times. At first, I stopped to gasp for air at 50 steps, then 60, and 70. Today was the first time I managed to do 100 steps without stopping to breathe. I trust that no passing motorist would notice and think I had gone batty; the speed at which cars go by my house prevents anyone from seeing more than a single climb. Or at least I think so.
When I get to the top of the stairs, I stand on the deck and practice my other exercise--this one for balance. I stand on each foot for as many Hail Mary's as I can recite. Sometime I can get as far as three.
What the heck, I'm no Kelly Ripa.
Friday, May 8, 2015
Diagnosis X
The neurologist said he had suspected a serious neurological disorder. Though he didn't specify at the time, he most likely thought it might be ALS. But the progression of symptoms and lab tests did not bear this out. Fortunately. Obviously a motor neuron disorder, but not that one.
Based on my research, which of course is googled, I would suspect PLS.
Primary lateral sclerosis "affects the upper motor neurons of the arms, legs, and face. It occurs when specific nerve cells in the motor regions of the cerebral cortex gradually degenerate, causing the movements to be slow and effortful. The disorder often affects the legs first....When affected, the legs and arms become stiff, clumsy, slow and weak, leading to an inability to walk or carry out tasks requiring fine hand coordination. Difficulty with balance may lead to falls....Affected individuals commonly experience ...an overactive startle response. The cause is unknown. The symptoms progress gradually over years...PLS is sometimes considered a variant of ALS, but the major difference is the sparing of lower motor neurons, the slow rate of disease progression, and normal lifespan. Most neurologists follow the affected individual's clinical course for at least 3 to 4 years before making a diagnosis of PLS. The disorder is not fatal but may affect quality of life."
The second sentence above may be why none of the many doctors and specialists have come forth with a diagnosis, other than to agree that neuropathy is present.
Of the hundreds of causes of neuropathy and the many forms of neuron motor diseases, PLS may be one of the most benign, but it's no picnic.
Based on my research, which of course is googled, I would suspect PLS.
Primary lateral sclerosis "affects the upper motor neurons of the arms, legs, and face. It occurs when specific nerve cells in the motor regions of the cerebral cortex gradually degenerate, causing the movements to be slow and effortful. The disorder often affects the legs first....When affected, the legs and arms become stiff, clumsy, slow and weak, leading to an inability to walk or carry out tasks requiring fine hand coordination. Difficulty with balance may lead to falls....Affected individuals commonly experience ...an overactive startle response. The cause is unknown. The symptoms progress gradually over years...PLS is sometimes considered a variant of ALS, but the major difference is the sparing of lower motor neurons, the slow rate of disease progression, and normal lifespan. Most neurologists follow the affected individual's clinical course for at least 3 to 4 years before making a diagnosis of PLS. The disorder is not fatal but may affect quality of life."
The second sentence above may be why none of the many doctors and specialists have come forth with a diagnosis, other than to agree that neuropathy is present.
Of the hundreds of causes of neuropathy and the many forms of neuron motor diseases, PLS may be one of the most benign, but it's no picnic.
Monday, May 4, 2015
The Great Outdoors
I couldn't wait for the nice weather to get here, and evidently neither could the ticks. I have personally encountered 3 ticks in 4 days. More than in my entire previous lifetime. I have taped all 3 of them to a Post-It Pad. The little arachnids have lost a few of their legs, but otherwise appear intact.
Vocabulary Word To Die For
Dermatochalasis----If you're over 50, don't look it up unless you want to kill yourself, because chances are you have it.
Tuesday, April 14, 2015
Truth To Tell
I don't know when it began, all that hugging on TV. Used to be that the Hollywood air-kissing style was the subject of humor and ridicule, but currently every celebrity guest introduced on a TV program hugs the hosts and anyone else in the general area. Because I no longer travel in fashionable circles, I can't say whether the hugging trend has carried over into real-time life. I can say that the only hug I've received in recent months, from anyone over the age of 3, was from a 73-year-old physician whose first language is Hindi.
Monday, April 13, 2015
Friday, April 10, 2015
The Nicene Creed
"I confess one baptism for the forgiveness of sins, and look for the resurrection of the dead and the life of the world to come."
I know it's a sign of our blind shortcomings, but we live with so many unanswered questions. When I was a child, I wondered if my dog would be in Heaven. Now I wonder the same about my original knees.
I know it's a sign of our blind shortcomings, but we live with so many unanswered questions. When I was a child, I wondered if my dog would be in Heaven. Now I wonder the same about my original knees.
Sunday, February 8, 2015
Stoned
Before my routine FU visit to check the status of actual or potential kidney stones, the urologist prescribed both a KUB ultrasound and X-ray. The 2 tests should complement each other and narrow the status of any stones. However, the doctor appeared a little nonplussed about the findings, which were several small stones, left side oriented. One test indicated the presence of uric acid stones and the doctor said he was prepared to prescribe something for them. But the other test, (and I forget which was which) indicated the stones were calcium oxalate, for which there is no prescription except dietary restrictions. And who eats rhubarb anyway? The stones are "non-obstructive" and as long as they remain so pose no problem. I do have twinges from time to time, and I told the doc that if they became obstructive, I could definitely tell and would let him know.
The office was fairly busy, but the good doctor seemed in no hurry. Even though my intake report indicated no new procedures since my last visit, he looked further back in my records and asked how my knee surgery went. Since that's the first time since last July anyone has mentioned it, I was a little surprised by his question. It has been 6 months. He seemed kindly interested and I wondered if he or someone in his family was considering knee surgery. Somewhere else in the conversation, he told me that when he recently underwent a routine colonoscopy he was concerned about a burning in his chest area down to his stomach, tracing the path of the burning pain. He thought it might have been because he mixed the cleansing solution with Gatorade. He than re-traced the path of his discomfort. I said Gatorade is made up of a lot of citric acid and other chemicals so I hope he was somewhat reassured. I do my best.
The office was fairly busy, but the good doctor seemed in no hurry. Even though my intake report indicated no new procedures since my last visit, he looked further back in my records and asked how my knee surgery went. Since that's the first time since last July anyone has mentioned it, I was a little surprised by his question. It has been 6 months. He seemed kindly interested and I wondered if he or someone in his family was considering knee surgery. Somewhere else in the conversation, he told me that when he recently underwent a routine colonoscopy he was concerned about a burning in his chest area down to his stomach, tracing the path of the burning pain. He thought it might have been because he mixed the cleansing solution with Gatorade. He than re-traced the path of his discomfort. I said Gatorade is made up of a lot of citric acid and other chemicals so I hope he was somewhat reassured. I do my best.
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