I had floater issues yesterday, off and on throughout most of the day, especially when at the computer. Not a single large floater, but a variety of smaller sized ones--the usual black blob, the illusion that a gnat was flying by, an empty watch-stem configuration, but most ominous was that bug that seems suspended just to the upper right, as if caught in my hair. I saw floaters when I woke up, so I called and got an appointment with Dr. Salgado. I went through a series of tests with 2 different assistants, both male, before I saw Dr. S. She said, in essence, there was no visible damage, but advised watching it closely, because of the presence of "lattice." If any changes, call at once, weekend, or holiday. She wanted to schedule a return visit with Dr. Sax. I told of my other plans for next week, and she said to tell the doctor there to contact Dr. Sax if need. But in the end, she found that Dr. Sax had a cancellation for Monday at 9: a.m., so I was lucky, she said. We'll see about that.
Dr. Salg. said the IOP in my right eye today was 12. and checking my chart said Dr. Weiner is wanting it to be 11. So I'm almost there. I've have had no treatment in that eye, I told her, the SLT only in my left, which did not have a pressure check today. I don't see the value in having an SLT to lower eye pressure only a single point, but as he said last visit, everything changes from time to time.
(I can picture myself, lying in a hospital bed with my knee in a sling while having a laser procedure to my retina. All I'd need is to have a kidney stone episode. If I weren't so old, I'd laugh and laugh and ...
So obviously "trained" in dealing with the elderly, she tries to explain the situation in terms that I can understand. I had asked a question, which signaled to her that I knew nothing. She used the analogy of a cold to show that sometimes the onset of a scratchy throat signals that you are catching a cold and sometimes the scratchiness goes away without a cold developing. So it goes with floaters: sometimes they can mean that a significant problem is developing, and at other times they are insignificant. (Just like sometimes a cigar is just a cigar, goes through my mind, but of course I don't say that.) She then stresses that it is critical that I be on guard to note any change and immediately call to report such. I point out that was why I was there; she confirms that I did the right thing. Ever since the first day of this month, everything seems just plain stupid, and I don't exempt myself from the equation. Any progress seems to be subsumed in a circular pattern, like in those websites that keep bringing you back to the entry page, and blocking you from moving ahead.
I had asked a question, about a possible association between one of the myriad of eye conditions and another. She responds by saying that in all her years of practicing ophthalmology, she has never heard of such a thing. And then she ices the generational cake: "And I have been in practice for 10 years." (Again, I don't point out what goes through my mind, that half of the underwear I have on is older than that.)
I get the sense that she is deferring to her elders to some degree though. She schedules a follow-up appointment with the esteemed Dr. Sax. She says she doesn't want anything to be overlooked. Remember that toy tin train set, the Honeymoon Express or whatever it was called, with the little train that went perpetually in a circle?
Friday, July 4, 2014
July 4, 2014
"It's just another day." That's what old people used to say about some holiday or momentous occasion that was so earthshakingly fascinating to us. How could anyone say such a thing! Christmas is coming, with all its secrets, Halloween with scariness and thrills, birthdays with cake and love, and, probably most anticipated of all, the opening of the Great Schaghticoke Fair. Speculating and hoping and dreaming all rolled into one remarkable life experience. "Same old thing," said the old people. We, unable to comprehend, vowed never to feel that way; why would anyone want to? In the ignorance of our youth, surrounded always by those who held similar values, the failure to be enthralled by life seemed to be a deliberate choice, a choice way beyond our ken.
Life, if you live long enough, has a way of getting even, of making you humble, though too late to be of any value or consolation to those long-gone old people. Isolation and loss levels the playing field, eventually, to a plane where the days all seem as one. Minus the camaraderie of others who share the joy of expectation, life's color turns to gray.
After childhood, a portion of our remaining time is spent in trying to recapture what we had for the next generation. So much anticipation, preparation, and sharing of thoughts and ideas, almost, but not quite, as magical as the first time around. After that cycle has run its course, and life's magic begins to be handed down yet again, comes the sameness of the days. The old people have lost a critical connection. There is no joy in looking forward to that which can only diminish.
It is raining today, on the Fourth of July. It's just another day, though a rainy one, which alters nothing. I have anticipated nothing---no parade, nothing to decorate, no patriotic outfits to coordinate, no festivities to organize or attend, certainly no fireworks-------just another day.
Life, if you live long enough, has a way of getting even, of making you humble, though too late to be of any value or consolation to those long-gone old people. Isolation and loss levels the playing field, eventually, to a plane where the days all seem as one. Minus the camaraderie of others who share the joy of expectation, life's color turns to gray.
After childhood, a portion of our remaining time is spent in trying to recapture what we had for the next generation. So much anticipation, preparation, and sharing of thoughts and ideas, almost, but not quite, as magical as the first time around. After that cycle has run its course, and life's magic begins to be handed down yet again, comes the sameness of the days. The old people have lost a critical connection. There is no joy in looking forward to that which can only diminish.
It is raining today, on the Fourth of July. It's just another day, though a rainy one, which alters nothing. I have anticipated nothing---no parade, nothing to decorate, no patriotic outfits to coordinate, no festivities to organize or attend, certainly no fireworks-------just another day.
Wednesday, July 2, 2014
Portentous
Neuropathy is an insidious condition, one requiring adaptations, at least on a temporary basis. So we assessed what help may be available, and found, first, the Rensselaer County TRIP program, which provides assistance on a labor-free basis. A telephone call and then an email went unanswered for several weeks. I do understand that they have a very limited number of employees, but we wanted help as soon as possible so as to prevent any of the dreaded bathtub accidents that are so common. So we found that there is similar help provided through the VA, free to veterans who have applied, no service-related disability needed. A call to them informed us that all that was needed was a script from his VA assigned doctor confirming the condition. A call to that doctor said help would be forthcoming.
Today was the day. Both offices responded. Good news and bad news. The Rehabilitation Specialist from the Rens. Co. Home Access program arrived first. What is chilling is what he mapped out as a plan for accessibility. All that was asked for was the installation of grab bars for the tub and shower, to ease entry and exit and to avoid slipping and falling. He presented a plan to widen the front step and install a ramp from the doorway to the driveway. He said that was his job, to survey the scope of future needs. It is good to know, but sickening to confront. In the meantime, he said that installing grab bars should be no problem, and would be handled through contact with the Mini Home Repair specialist. He left an application.
Shortly after he left, a representative from the VA called and said they were shipping a set of 3 grab bars to us. No charge, all we need to do is have them installed. Coincidentally, the Rens. Co. specialist said the bars would be about $40 each, but installation would be free.
Moreover, the larger scale accessibility modifications, up to $25,000 are very affordable in that there is a 5-year recapture with payment deferred and being reduced at 20% each year, as long as we live in the house. If the house is sold before the 5 year mark, then whatever percentage of the loan is left would be due. He said he doesn't read obituaries. So we would pay nothing and the loan would decrease by 20% each year. If we're both gone in 3 years, for example, only 40% would be owed, but not unless the house is sold, and the deed filed.
So it's a lot of important and helpful information, and all involved could not have been any nicer, making it a smooth process, but it is one of the saddest days in a long time.
Today was the day. Both offices responded. Good news and bad news. The Rehabilitation Specialist from the Rens. Co. Home Access program arrived first. What is chilling is what he mapped out as a plan for accessibility. All that was asked for was the installation of grab bars for the tub and shower, to ease entry and exit and to avoid slipping and falling. He presented a plan to widen the front step and install a ramp from the doorway to the driveway. He said that was his job, to survey the scope of future needs. It is good to know, but sickening to confront. In the meantime, he said that installing grab bars should be no problem, and would be handled through contact with the Mini Home Repair specialist. He left an application.
Shortly after he left, a representative from the VA called and said they were shipping a set of 3 grab bars to us. No charge, all we need to do is have them installed. Coincidentally, the Rens. Co. specialist said the bars would be about $40 each, but installation would be free.
Moreover, the larger scale accessibility modifications, up to $25,000 are very affordable in that there is a 5-year recapture with payment deferred and being reduced at 20% each year, as long as we live in the house. If the house is sold before the 5 year mark, then whatever percentage of the loan is left would be due. He said he doesn't read obituaries. So we would pay nothing and the loan would decrease by 20% each year. If we're both gone in 3 years, for example, only 40% would be owed, but not unless the house is sold, and the deed filed.
So it's a lot of important and helpful information, and all involved could not have been any nicer, making it a smooth process, but it is one of the saddest days in a long time.
Tuesday, July 1, 2014
Parking at St. Peter's
Another plus for Samaritan
I encountered the banana-eating office rep by chance in the Down elevator. She was showing a couple to some venue, and seemed delighted to be able to "point the way" to Valet Parking Access, as she had previously promised. She is, as self-proclaimed, more tactile than cerebral. I took this opportunity to try to clarify the parking situation. Things have changed: the first lot is for (I have to say I have now forgotten. Visitors?) Patients are to take the new, second turn, which leads right into the hospital with no need to cross the road. You can get your parking ticket validated and not have to pay the fee. I ask what is the fee for visitors and she says $5.00. Valet parking is free for patients, but $6.00 for visitors. I told her I had parked in the first lot/garage, and she said that was fine; it happens all the time.
When I got home and said if anyone wants to visit, they'll have to shell out at least 5 bucks, he said he could be a patient......
I encountered the banana-eating office rep by chance in the Down elevator. She was showing a couple to some venue, and seemed delighted to be able to "point the way" to Valet Parking Access, as she had previously promised. She is, as self-proclaimed, more tactile than cerebral. I took this opportunity to try to clarify the parking situation. Things have changed: the first lot is for (I have to say I have now forgotten. Visitors?) Patients are to take the new, second turn, which leads right into the hospital with no need to cross the road. You can get your parking ticket validated and not have to pay the fee. I ask what is the fee for visitors and she says $5.00. Valet parking is free for patients, but $6.00 for visitors. I told her I had parked in the first lot/garage, and she said that was fine; it happens all the time.
When I got home and said if anyone wants to visit, they'll have to shell out at least 5 bucks, he said he could be a patient......
Journal of Knee, July 1, 2014
June is gone, again, and July brings me to St. Peter's for what is blithely called Pre Admission Testing, PAT for short. I feel rather disgruntled because I don't feel like being a patient at an Albany hospital, so I'm biased to start with and that puts me in a mood where everything seems stupid. I've already gone through the telephone interview, have received instructions in the mail, so why I have to traipse all the way down there seems unnecessary to me. I had to have clearance from my primary doctor and cardiologist, and unless they plan to run any tests other than those already ordered, it's a wasted trip. Besides they could have sent a script, which I could have taken to a closer lab.
But compliance and I are one, so off I go to my 10:30 appointment. I know there is a shorter route, probably shorter by at least 5 miles or more, but I choose to go my established way, which is to take the Northway to the end, turn left on Western Ave, guided by the blue H signs until I turn right onto S. Manning. That street name is very familiar to me from all the years I went to school and then worked in Albany, but now it has a negative connotation, due to one of the heirs to the name. He who spent his whole life capitalizing on that name. But I dismiss the thought, driving straight through the intersection, and make the left turn into the St. Peter's parking garage, as I have done for years for my mammogram. The woman in the entrance booth, looking to be about 88 years old, asks where I'm going and I say to the hospital. She says where in the hospital and I tell her. She says I'm in the wrong parking area, and tells me I'll have to go out and around. I ask where am I to go, and she gives up and says ok, go ahead and park. We don't know what each other is talking about. I have to drive up several levels, though end up on what is labeled Level2, and right next to the elevator.
I remember too late that in my telephone interview, the nurse told me I could use Valet Parking. Oh, well. I take the elevator to the ground floor, and cross the roadway into the hospital. The makeover has left it looking very attractive, I do say, and the ground floor is full of the smells of the coffee shop located there. I take the elevator up one floor, and locate the PAT section. Everything is well marked, and there are plenty of information booths as well as helpful attendants circling the premises. Everything has gone fairly smoothly, and I am right on time. The entire floor is suffused with the smell of pizza, from the new food court pizza place, a good odor if you're ready for lunch, not so much if it's still morning and you are on an empty stomach pending blood testing. I wait behind the privacy line for only a minute or so before the woman behind the counter calls me over, saying she would have called me sooner but she had a banana in her mouth and couldn't talk. TMI, I think, but I remain civil while she registers that I am indeed present. Any questions? I try to clear up the parking snafu, and ask her where to access the Valet Parking. She says she can't answer because she doesn't have a good sense of direction, but that she will show me later on. OK. I go into the bloodletting room, and the nurse there called me sweetheart at least 3 times, and I could have punched her out. Even before she had difficulty drawing my blood and said it was because I had a lot of scar tissue. No one has ever told me that before, and I think she was just finding a reason for her difficulty.
I then had to wait, for too long a time, all by myself for the interview with the nurse consultant. After a while, Nurse Nancy, for that was her name, called me in for the assessment. Same old, same old---health history, meds, abuse situation questions----could have been done on the phone if you ask me. She did comment that I was very honest, because my weight was exactly the same as was registered on the 2 scales. She said most people understate their weight. I'd love to weigh less or at least have people think I weigh less, but I sure don't want to throw off the formula for anesthesia which I believe to be based on body weight.
Nancy was professional and pleasant; I learned she was menopausal though, could have skipped over that. During the part of the interview that dealt with anesthesia, I thought to ask a question which has been on my mind: How is it possible to be "awake and responsive" during surgery, but have no memory of it when you are fully awake? She said doctors consider a patient under general anesthesia to be totally unconscious, but if a regional or epidural anesthesia is used, the patient's body can respond but the mind is not awake. I've always felt that it's not possible for a patient to have been aware during the procedure and than have no memory of it later. She confirmed my belief, or so I think.
But compliance and I are one, so off I go to my 10:30 appointment. I know there is a shorter route, probably shorter by at least 5 miles or more, but I choose to go my established way, which is to take the Northway to the end, turn left on Western Ave, guided by the blue H signs until I turn right onto S. Manning. That street name is very familiar to me from all the years I went to school and then worked in Albany, but now it has a negative connotation, due to one of the heirs to the name. He who spent his whole life capitalizing on that name. But I dismiss the thought, driving straight through the intersection, and make the left turn into the St. Peter's parking garage, as I have done for years for my mammogram. The woman in the entrance booth, looking to be about 88 years old, asks where I'm going and I say to the hospital. She says where in the hospital and I tell her. She says I'm in the wrong parking area, and tells me I'll have to go out and around. I ask where am I to go, and she gives up and says ok, go ahead and park. We don't know what each other is talking about. I have to drive up several levels, though end up on what is labeled Level2, and right next to the elevator.
I remember too late that in my telephone interview, the nurse told me I could use Valet Parking. Oh, well. I take the elevator to the ground floor, and cross the roadway into the hospital. The makeover has left it looking very attractive, I do say, and the ground floor is full of the smells of the coffee shop located there. I take the elevator up one floor, and locate the PAT section. Everything is well marked, and there are plenty of information booths as well as helpful attendants circling the premises. Everything has gone fairly smoothly, and I am right on time. The entire floor is suffused with the smell of pizza, from the new food court pizza place, a good odor if you're ready for lunch, not so much if it's still morning and you are on an empty stomach pending blood testing. I wait behind the privacy line for only a minute or so before the woman behind the counter calls me over, saying she would have called me sooner but she had a banana in her mouth and couldn't talk. TMI, I think, but I remain civil while she registers that I am indeed present. Any questions? I try to clear up the parking snafu, and ask her where to access the Valet Parking. She says she can't answer because she doesn't have a good sense of direction, but that she will show me later on. OK. I go into the bloodletting room, and the nurse there called me sweetheart at least 3 times, and I could have punched her out. Even before she had difficulty drawing my blood and said it was because I had a lot of scar tissue. No one has ever told me that before, and I think she was just finding a reason for her difficulty.
I then had to wait, for too long a time, all by myself for the interview with the nurse consultant. After a while, Nurse Nancy, for that was her name, called me in for the assessment. Same old, same old---health history, meds, abuse situation questions----could have been done on the phone if you ask me. She did comment that I was very honest, because my weight was exactly the same as was registered on the 2 scales. She said most people understate their weight. I'd love to weigh less or at least have people think I weigh less, but I sure don't want to throw off the formula for anesthesia which I believe to be based on body weight.
Nancy was professional and pleasant; I learned she was menopausal though, could have skipped over that. During the part of the interview that dealt with anesthesia, I thought to ask a question which has been on my mind: How is it possible to be "awake and responsive" during surgery, but have no memory of it when you are fully awake? She said doctors consider a patient under general anesthesia to be totally unconscious, but if a regional or epidural anesthesia is used, the patient's body can respond but the mind is not awake. I've always felt that it's not possible for a patient to have been aware during the procedure and than have no memory of it later. She confirmed my belief, or so I think.
"Moral Principles"
"What moral principles and guidelines need to be considered in developing a health care policy?"
Adapted from material provided by Catholic Health Association, Sacred Heart Medical Center, NYS:
"...it is necessary for us to accept death as part of the human condition. Death need not be avoided at all costs."
"When the risks and burdens of treatment are disproportionate to the benefits to be gained, there is no obligation to undergo treatment." Examples...include "excessive suffering for the patient, EXCESSIVE EXPENSE FOR THE FAMILY OR COMMUNITY*, investment in medical technology and personnel disproportionate to the expected results, and inequitable resource allocation."
I have no idea what the resource allocation is or how equitable it should be, but it can't be a good thing, can it?
What would Jesus do?
*That must be why Kasey Kassem was spirited away.
Adapted from material provided by Catholic Health Association, Sacred Heart Medical Center, NYS:
"...it is necessary for us to accept death as part of the human condition. Death need not be avoided at all costs."
"When the risks and burdens of treatment are disproportionate to the benefits to be gained, there is no obligation to undergo treatment." Examples...include "excessive suffering for the patient, EXCESSIVE EXPENSE FOR THE FAMILY OR COMMUNITY*, investment in medical technology and personnel disproportionate to the expected results, and inequitable resource allocation."
I have no idea what the resource allocation is or how equitable it should be, but it can't be a good thing, can it?
What would Jesus do?
*That must be why Kasey Kassem was spirited away.
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