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?
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