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.
Thursday, June 25, 2015
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.
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