I got on the bus this morning with the intention of riding to Starbucks at Crown Center to gather my thoughts on recent medical visits for this blog entry. I forgot that they were setting up Crown Center for Boulevardia’s new venue for that event. So . . . here I am at Messenger. Of course that gave me an excuse to have an Ibis pastry with my coffee!
Wednesday, June 15, was my second post-op visit to the cardiologist. He was not very talkative, but seemed pleased with my progress. I think that this cardiologist is more of an introverted person and perhaps more introspective, as well. He is the polar opposite of my previous cardiologist, who was quite gregarious. At my last appointment with her, she greeted me with a hug as soon as the PA had collected all my vitals. Anyway, back to Wednesday’s visit . . . blood was drawn for labs. There was nothing concerning from the lab results as far as my heart is concerned. The cite of the incision continues to heal as it should.
Endocrinology had ordered some tests as well. Unfortunately, my A1c went up three tenths of a point, so I guess knee surgery is not in the near future for me . . . again. Part of the rise of my blood sugar level was due to the surgery. As with my first knee replacement, my blood sugar rose and stayed up for awhile. The diabetes team is changing my meds in effort to bring my A1c down, so hopefully it will be regulated soon. I will be doubling my Ozempic dosage and will possibly stop taking the Glimepiride.
While I am writing about orthopedics, my right ankle is a bit painful. My noticing of this started after I stopped taking the NSAIDS because of my elevated creatinine level. Some of my fingers are experiencing arthritic pain. The increased awareness of this is probably because I’m no longer taking the NSAIDS (shortened to anti-inflammatories) so I will soon be calling the orthopedist about my ankle and for a referral regarding my hands. The physical therapy practice finally received the prescription for PT for my knee. They called while I was in my PCP’s office yesterday. I will return that call today. The PT facility is about a half miles from my apartment, so I will walk there and get in some exercise a couple of days per week. This will be a partial fulfillment of exercise that cardiologist, weight management team, and diabetes team are happy about. Unfortunately, the physical therapist who worked on my first knee is on vacation right now, so I will begin therapy on July 1.
In the weight management department, I have started losing weight again. I’ve been averaging 1 to 1.5 pounds per week, so I am on the right track.
As I wrote earlier, I was at my PCP’s office yesterday. I had an annual physical and will spare you details about that. He was a bit concerned about the diabetes team removing one of my diabetes meds from my daily regimen so I will discuss that with the endocrinology PA. I mentioned earlier that I have stopped taking the anti-inflammatories. Instead I am taking Tylenol and Turmeric. After seeing the doctor, I discovered that I am taking too low a dose to be effective. Hopefully, all the arthritic pains that seem to be creeping up on me will decrease with the adjustment of the dosages.
So . . . if you are coming to this blog from the link on Facebook, this about sums up my geriatric adventures since my entries in May. I guess even if you are not coming here from the Facebook link, it’s still a summary of those adventures/misadventures. It appears that I will be spending at least as much time in doctors’ offices as I have been. It has become apparent that retirement is necessary in order for one to have enough time to sit in the doctors' offices as one's body deteriorates!
—
I would be remiss not to mention that when I went for my first post-op check-up after my defibrillator surgery, I saw my dear friend, Paul Ingold. He and Roger were waiting in a family practice clinic waiting. I did not see them, but Paul called out, “There’s David Alonzo.”
I was on my way to my own medical appointment, so I only stopped for a very short period of time to say hello and be on my way. I had no idea that Paul was very sick at the time. A few days later, I found out he had been admitted to the ICU. He’d been diagnosed with cancer and other complications.
Paul and I both went to William Jewell College and were in the same residential house our senior year.
When I moved back to Kansas City in 1999, I visited Broadway Church and when I turned around in that pew, I saw Paul from 23 years ago! He had just moved to Kansas City for very similar reasons that I had and I believe it was his first time to visit the church since he moved to KC. We both eventually became members of that church and our friendship deepened. About 15 years later, I joined a different church and our encounters decreased, although we did always see each other at an annual William Jewell Homecoming gathering at the home of our mutual friends Mark Morris and Carolyn Cupp. The last time was for a bon voyage party for another Jewell friend who was retiring to New England.
Sadly, Paul succumbed to his illness on June 10. I will definitely miss his smile and pithy humor.
Friday, June 17, 2022
Monday, May 9, 2022
Adventures in the Geriatric Zone continue . . .
If you are a Facebook user, you might have seen my post of last Friday:
The light was flashing on the box, so I pushed the button to send data. Thinking it would just do its thing, I walked away from the box. An hour or so later, I came back into the bedroom and it was still flashing. I thought, maybe I didn’t press hard enough and tried again, this time staying with the box and hopefully seeing a signal that the data was sent.
No such luck!
So, as a patient with a fairly new ICD, I tried not to panic, but called the cardiologist’s office. I left a message that my magic little white box was not working. The nurse called me back and gave me the number of the help line of Boston Scientific, manufacturers of the ICD and the magic white monitor box. The customer support person stayed online with me to troubleshoot what was going on and finally she asked, “Do you have an Amazon Echo device near your device?”
I did not define on the side table on the opposite side of the bed as “near,” but apparently I was incorrect in not doing so. She asked me to unplug the Echo Show that was on the opposite end table and the data went through.
The Echo Show now resides just below the 55” TV screen in the living room.
And now I know that as, my friend David Hunker said, I had one “magic device interfering with another magic device.” Just another example of ain’t technology grand . . . except when it isn’t?
Fun fact: A remote heart monitor, if placed on the side table on the right side of a queen sized bed may interfere with the Amazon Echo Show on the left side.I found this out last Thursday when I pressed the button on the little white box that sends data to the cardiologist weekly from the defibrillator that has been implanted in my chest cavity!
The light was flashing on the box, so I pushed the button to send data. Thinking it would just do its thing, I walked away from the box. An hour or so later, I came back into the bedroom and it was still flashing. I thought, maybe I didn’t press hard enough and tried again, this time staying with the box and hopefully seeing a signal that the data was sent.
No such luck!
So, as a patient with a fairly new ICD, I tried not to panic, but called the cardiologist’s office. I left a message that my magic little white box was not working. The nurse called me back and gave me the number of the help line of Boston Scientific, manufacturers of the ICD and the magic white monitor box. The customer support person stayed online with me to troubleshoot what was going on and finally she asked, “Do you have an Amazon Echo device near your device?”
I did not define on the side table on the opposite side of the bed as “near,” but apparently I was incorrect in not doing so. She asked me to unplug the Echo Show that was on the opposite end table and the data went through.
The Echo Show now resides just below the 55” TV screen in the living room.
And now I know that as, my friend David Hunker said, I had one “magic device interfering with another magic device.” Just another example of ain’t technology grand . . . except when it isn’t?
Tuesday, May 3, 2022
May 2 - A Full Day at KUMC
Sorry to the folks who got teaser pictures from yesterday's visit to KUMC. I am not composing this post until Tuesday morning from the beautiful Starbucks at Brookside!
For those of you who are coming here from the Facebook album, you have the summary of the day. For those who are arriving here from elsewhere, here goes:I
On Sunday, May 1, I received an email saying that I was on a waitlist for orthopedics (regarding my unreplaced knee) and that an appointment had become available on Monday afternoon. I accepted the appointment with the knowledge that I would be at the Medical Center all day long. So I packed my messenger bag accordingly with iPad, cellphone, reading material - after all the appointments were five hours apart.
So I arrived at my cardiology appointment at 9:45 AM. The main purpose of this appointment was to make sure that the incisions were healing as they should.
They were. Great news, right? During the appointment I turned off my phone, which turned out to be a mistake.
I asked the cardiology nurse to direct me to the orthopedics office.
She checked all upcoming appointments and all she could find was an upcoming orthopedist appointment in June.
WHAT??
II
So I checked my patient portal and found the same information. I did find the text message that said I had an appointment at 3:00 PM. So armed with that, I found the orthopedics office and checked in by showing the text message. They asked me to be seated and the nurse would be out.
In the meantime, I checked my voicemail which had come in while I was in the cardiolgy office about the cancellation of the appointment. It was not a satisfactory explanation why I had a new appointment a month and a week after my original appointment or for that matter why the new appointment was being cancelled.
The orthopedics nurse came out about a half hour later (it was after all still four hours until the appointment) and explained that initial visits were not scheduled at 3:00 in the afternoon because the doctor takes longer with new patients in order to assess what is going on. Then she kindly asked, "Does that make sense?"
Of course, it did.
However, advocating for myself, I replied, "Yes, that makes sense. However, it doesn't really explain why the automated service offered me this new appointment time when I really did not fit within the parameters. May I speak to someone who is in charge of scheduling?"
I got a look like he doth protest too much and remained in my waiting room chair for someone to come out and help me. Finally about noon tne nurse came back out and apologized and said, we can see you this morning if you're OK with that.
I was. Even though it was noon when I got in. That was much better than waiting until June since I was already there!
Anyway, I now have new X-rays of my left knee. As I knew from my old X-rays, there is virtually no cartilege. And this winter there were many days of left knee pain. Also walking, especially on uneven surfaces, my left knee would feel like it would buckle, much like my right knee did before it was replaced.
[If you've been following my health reports, you know that the surgeon who replaced my right knee retired between the time of the replacement and the end of the Covid lockdown. This is why I'm establishing a relationship with a new orthopedist.]
Anyway, back to the findings of the orthopedist. Because of my diabetes, my blood sugars are still too high to consider a knee replacement. It is very close, however, my most recent A1c was 7.1 and orthopedics at KU will not consider knee replacements until A1c is under 7.0.
So . . . the doctor gave me an injection in the left knee. A knee brace guy came in to fit a knee brace. And the nurse sent a referral for physical therapy, which should start soon.
At this point, I'm not sure if I will have the PT at KU or where I had it after my right knee surgery. In either case, it will occur before decisions about surgeries or other possibilities rather than after.
I'm happy to explore other options than surgery, anyway. Several friends have suggested stem cell therapy. I don't know if this is covered by Medicare, but it doesn't hurt to inquire.
III
Three days before the surgery, [I let them know that I was having an earache. I asked them to check it out because I didn't want something like that to put a wrench into the surgical process.] They found nothing that impede the surgery, so I had the ICD inserted on April 22.
However, throughout the week after the surgery, I had recurring earaches and they have gone down to a sore throat. These have been fairly mild, but bothersome. So I decided to go to the urgent care center at KU before going home. (My PCP is on vacation this week.) They checked it out and found that I did have an ear infection. I was glad to find this out because it did feel very much like infections that I had forty or fifty years ago, commonly known as swimmer's ear.
The urgent care doctor prescribed a five day round of antibiotics. Normally, he would also have prescribed a decongestant, but thought the cardiologist might not be amenable to that since it sometimes causes higher blood pressure.
So this ends this post about my continuing adventures in the Geriatric Zone.
For those of you who are coming here from the Facebook album, you have the summary of the day. For those who are arriving here from elsewhere, here goes:
- Cardiology post-op visit
- Orthopedics initial visit
- Urgent Care visit,
So I arrived at my cardiology appointment at 9:45 AM. The main purpose of this appointment was to make sure that the incisions were healing as they should.
They were. Great news, right? During the appointment I turned off my phone, which turned out to be a mistake.
I asked the cardiology nurse to direct me to the orthopedics office.
She checked all upcoming appointments and all she could find was an upcoming orthopedist appointment in June.
WHAT??
So I checked my patient portal and found the same information. I did find the text message that said I had an appointment at 3:00 PM. So armed with that, I found the orthopedics office and checked in by showing the text message. They asked me to be seated and the nurse would be out.
In the meantime, I checked my voicemail which had come in while I was in the cardiolgy office about the cancellation of the appointment. It was not a satisfactory explanation why I had a new appointment a month and a week after my original appointment or for that matter why the new appointment was being cancelled.
The orthopedics nurse came out about a half hour later (it was after all still four hours until the appointment) and explained that initial visits were not scheduled at 3:00 in the afternoon because the doctor takes longer with new patients in order to assess what is going on. Then she kindly asked, "Does that make sense?"
Of course, it did.
However, advocating for myself, I replied, "Yes, that makes sense. However, it doesn't really explain why the automated service offered me this new appointment time when I really did not fit within the parameters. May I speak to someone who is in charge of scheduling?"
I got a look like he doth protest too much and remained in my waiting room chair for someone to come out and help me. Finally about noon tne nurse came back out and apologized and said, we can see you this morning if you're OK with that.
I was. Even though it was noon when I got in. That was much better than waiting until June since I was already there!
Anyway, I now have new X-rays of my left knee. As I knew from my old X-rays, there is virtually no cartilege. And this winter there were many days of left knee pain. Also walking, especially on uneven surfaces, my left knee would feel like it would buckle, much like my right knee did before it was replaced.
[If you've been following my health reports, you know that the surgeon who replaced my right knee retired between the time of the replacement and the end of the Covid lockdown. This is why I'm establishing a relationship with a new orthopedist.]
Anyway, back to the findings of the orthopedist. Because of my diabetes, my blood sugars are still too high to consider a knee replacement. It is very close, however, my most recent A1c was 7.1 and orthopedics at KU will not consider knee replacements until A1c is under 7.0.
So . . . the doctor gave me an injection in the left knee. A knee brace guy came in to fit a knee brace. And the nurse sent a referral for physical therapy, which should start soon.
At this point, I'm not sure if I will have the PT at KU or where I had it after my right knee surgery. In either case, it will occur before decisions about surgeries or other possibilities rather than after.
I'm happy to explore other options than surgery, anyway. Several friends have suggested stem cell therapy. I don't know if this is covered by Medicare, but it doesn't hurt to inquire.
However, throughout the week after the surgery, I had recurring earaches and they have gone down to a sore throat. These have been fairly mild, but bothersome. So I decided to go to the urgent care center at KU before going home. (My PCP is on vacation this week.) They checked it out and found that I did have an ear infection. I was glad to find this out because it did feel very much like infections that I had forty or fifty years ago, commonly known as swimmer's ear.
The urgent care doctor prescribed a five day round of antibiotics. Normally, he would also have prescribed a decongestant, but thought the cardiologist might not be amenable to that since it sometimes causes higher blood pressure.
So this ends this post about my continuing adventures in the Geriatric Zone.
Tuesday, April 26, 2022
First post-op report
Today is Tuesday, April 26, five days after the doctors inserted the subcutaneous implantable defibrillator and lead with defibrillation threshold evaluation/reprogramming into the left side of my chest, just below my left underarm. There is a much smaller incision at the center of my chest. Both areas have remained pretty sore, but today the pain is much more bearable.
Strangely, when my right knee joint was replaced two years ago, I felt almost no pain. Doctors and nurses seemed to be astounded whenever I said my pain level was about 0.5. I remember taking one of the hydrocodone/acetaminophen pills after the knee operation was completed, but this time I have been popping the pills every six hours like clockwork! The pain has stayed around 2.5 from the time I was in the hospital except for the time that I have been asleep. Today, actually, the pain has pretty much subsided and now it is going into the itchy stage, which I think means it is healing.
Saturday evening, I went to bed on my flat, non-hospital prop-your-head-up bed. I slept pretty soundly, but I had great difficulty getting out of bed. It may have been paranoia that I would pull apart the wound which was just held together by the Dermabond surgical glue and, of course, there was no nurse to help me to get out of the bed. There is no bandage. The surgical fellow who discharged me on Saturday morning assured me that there was no real need for the paranoia, but based on past experience with my appendectomy from nearly sixty years ago, I sort of felt like there should be something holding my innards in - like stitches and lots of gauze. But that no longer is the name of the game. Even my knee a couple of years ago didn't really have much of a dressing covering the wound. And like that wound, stitches are supposed to organically dissolve. (Actually, the knee had stalples rather than stitches and the chests incisions had only glue.)
Visually, the little defibrillator that is under my skin doesn't really protrude too much, however, since it is a new permanent fixture, even though it only sticks out a tiny bit, it seems like a foreign object that I'm sure I will eventually get used to.
Sunday night and Monday night, I slept in my recliner in the livingroom to avoid the fifteen minute ordeal that getting out of bed was on Sunday morning, but I think I will try to sleep in my bed again tonight because I did sleep much more soundly in my lovely queen size bed which allows for much more sprawling.
Thursday, the monitor box is supposed to flash and I'm supposed to press the button to send all the data from the little box inside of my body. It is my understanding that the monitor box will flash weekly on Thursdays to let me know that it is time to press the button. My CPAP monitors my nightly sleep pattern, but I don't have to press any buttons to submit data . . . it just sends the data every night. And I just take the little SD card to the pulmonologist and he extracts the data at my yearly appointments.
All of these new gadgets make me feel like I should be able to do outstanding feats of superhuman strength like Col. Steve Austin, the Six Million Dollar Man, but alas, despite the new body parts and/or enhancements, it just keeps my lungs breating and my heart beathing and my joints bending!
Interestingly, there there are no warnings against getting the incision wet. Normal hygiene is possible. However, I have been admonished to just pat dry.
I went to church Sunday morning for a special Earth Day outdoor service. Yesterday I took the bus to pick up some stuff I needed from the store. And right now I am at Starbucks using up their unsecure wi-fi to type up this blog entry. Things are more normal than they were in the first month of Covid lockdown. But I think that is how it is supposed to be.
Strangely, when my right knee joint was replaced two years ago, I felt almost no pain. Doctors and nurses seemed to be astounded whenever I said my pain level was about 0.5. I remember taking one of the hydrocodone/acetaminophen pills after the knee operation was completed, but this time I have been popping the pills every six hours like clockwork! The pain has stayed around 2.5 from the time I was in the hospital except for the time that I have been asleep. Today, actually, the pain has pretty much subsided and now it is going into the itchy stage, which I think means it is healing.
Saturday evening, I went to bed on my flat, non-hospital prop-your-head-up bed. I slept pretty soundly, but I had great difficulty getting out of bed. It may have been paranoia that I would pull apart the wound which was just held together by the Dermabond surgical glue and, of course, there was no nurse to help me to get out of the bed. There is no bandage. The surgical fellow who discharged me on Saturday morning assured me that there was no real need for the paranoia, but based on past experience with my appendectomy from nearly sixty years ago, I sort of felt like there should be something holding my innards in - like stitches and lots of gauze. But that no longer is the name of the game. Even my knee a couple of years ago didn't really have much of a dressing covering the wound. And like that wound, stitches are supposed to organically dissolve. (Actually, the knee had stalples rather than stitches and the chests incisions had only glue.)
Visually, the little defibrillator that is under my skin doesn't really protrude too much, however, since it is a new permanent fixture, even though it only sticks out a tiny bit, it seems like a foreign object that I'm sure I will eventually get used to.
Sunday night and Monday night, I slept in my recliner in the livingroom to avoid the fifteen minute ordeal that getting out of bed was on Sunday morning, but I think I will try to sleep in my bed again tonight because I did sleep much more soundly in my lovely queen size bed which allows for much more sprawling.
Thursday, the monitor box is supposed to flash and I'm supposed to press the button to send all the data from the little box inside of my body. It is my understanding that the monitor box will flash weekly on Thursdays to let me know that it is time to press the button. My CPAP monitors my nightly sleep pattern, but I don't have to press any buttons to submit data . . . it just sends the data every night. And I just take the little SD card to the pulmonologist and he extracts the data at my yearly appointments.
All of these new gadgets make me feel like I should be able to do outstanding feats of superhuman strength like Col. Steve Austin, the Six Million Dollar Man, but alas, despite the new body parts and/or enhancements, it just keeps my lungs breating and my heart beathing and my joints bending!
Interestingly, there there are no warnings against getting the incision wet. Normal hygiene is possible. However, I have been admonished to just pat dry.
I went to church Sunday morning for a special Earth Day outdoor service. Yesterday I took the bus to pick up some stuff I needed from the store. And right now I am at Starbucks using up their unsecure wi-fi to type up this blog entry. Things are more normal than they were in the first month of Covid lockdown. But I think that is how it is supposed to be.
Wednesday, April 20, 2022
Pre-operative assessment / cardiology nurse office visit
I am at KU for my hour and a half pre-anesthesia appointment for my upcoming procedure on Friday. This is to be followed by a half hour visit with the cardiology nurse.
The phrase "I’m going to have a defibrillator implanted" now glibly [is that the correct adverbial form of that word?] rolls off my tongue. Then I realize that before a year ago, I didn’t really know what that meant. I then further realize that it may sound more intimidating than it really hopefully will be. It is not open-heart surgery. It is however, implanted in one’s chest, so it definitely is surgery.
My friend, Mark McDonough, described it this way:
. . .
Now that the pre-operative assessment appointment is over, I understand why the appointment was for an hour and a half. It wasn’t just an appointment with the anesthesiologist’s PA.
Then I crossed the hall to cardiology. They took my vitals again. Went over my meds list again. Asked me my full name and birthdate again. And again, it wasn’t just the cardiology nurse.
The phrase "I’m going to have a defibrillator implanted" now glibly [is that the correct adverbial form of that word?] rolls off my tongue. Then I realize that before a year ago, I didn’t really know what that meant. I then further realize that it may sound more intimidating than it really hopefully will be. It is not open-heart surgery. It is however, implanted in one’s chest, so it definitely is surgery.
My friend, Mark McDonough, described it this way:
As I recall from EMT training, an internal defibrillator, like the the portable ones placed in many public buildings and some churches, provides an electric shock to the heart if heart goes into Afib (atrial fibrillation) or other arrhythmia). From what I’ve heard, it’s not terrible but you will know if it goes off.This, no doubt, is why I’ve heard it called a zapper. Another friend, Katy Nolen O'Dowd, said that her husband has one and that it has been a life saver on more than one occasion. I was first diagnosed with heart failure about eight years ago, but so far, I’ve not had a serious heart incident, so this is a very proactive move and I will have to break myself of the habit of popping my cellphone into my shirt pocket.
. . .
Now that the pre-operative assessment appointment is over, I understand why the appointment was for an hour and a half. It wasn’t just an appointment with the anesthesiologist’s PA.
- First I met with a pharmacist to establish what meds I am taking and which ones I should stop until Friday and which ones I should not take on the day of the procedure.
- This was followed by an appointment with a visit with a surgery nurse to collect an exhaustive medical history, followed by the collection of vials of my blood, just in case I need a transfusion and to test the blood for any bad juju that might be there.
- And then finally, I did meet with the anesthesiologist’s PA to let me know what I should do Friday morning, what would be happening to me so I don’t feel the incisions being made, etc. etc.
Then I crossed the hall to cardiology. They took my vitals again. Went over my meds list again. Asked me my full name and birthdate again. And again, it wasn’t just the cardiology nurse.
- After vitals were taken, I met with very nice gentleman who administered a vector test with Boston Sllcientific. This will help the surgeon know where to put the wires in the right place once the incisions are made.
- Then the cardiology nurse took over and let me ask questions and also gave answers about things I didn’t know I should question.
Saturday, April 16, 2022
Pandemic: Part 2 - 2021
As I said in a previous post, I started de-isolating myself after the Great Lockdown in the fall of 2020. I started seeing my primary care physician for office visits in October and December of 2020. After these visits, he referred me to the cardiologist at KU and also to the endocrinology department at KU for my diabetes. I also saw him in March, May, September and November for regular check-ups.
So . . . In February of 2021, I had my first office visit with a new cardiologist. This would result in an eleven visits directly related to heart problems during the year. On February 19, I had the first appointment with the cardiologist at KU. At this appointment, the cardiologist just went over my medical history.
I started having Telehealth visits with a physician’s assistant in the endocrinology department every few months starting in March 2021, with one visit in person to check for diabetic neuropathy in my feet. I also had my annual eye exam in August for vision and diabetic retinopathy. I also have cataracts that have remained small for five years, so they are not yet at the point that they need to be removed.
On March 22, I had an echocardiogram. It was at this point that there was some concern about my heart function. I had been concerned about being tired much of the time and becoming out of breath after walking just two or three blocks. Because of the low ejection fraction, the cardiologist ordered several other tests during the month of April. These included cardiac catheterization, MRI, nuclear stress test, and treadmill stress test. I had a visitation with one of the cardiology nurses after one of these visits in which she cross-examined me about my how I was feeling, how I was living, etc. I guess the cardiologist felt that she was a health sleuth that could probe me for answers better than he could. And that time, they decided to test some of the blood they had collected for anemia and for iron absorption. Not really sure which of the symptoms I described led them to prescribe those tests, but it was just a few days before my next visit with another cardiologist in the practice on June 4, who specialized in implanting defibrillators. He gave me all the lowdown. Then I asked, “Have you been informed that I’ve been diagnosed with iron deficiency and anemia? I just got those results yesterday.” He hadn’t. The conversation about defibrillator implantation came to a halt!
At this point, the cardiologist called in an order to endoscopy for a complete upper and lower GI. Lovely! I had had a colonoscopy five years earlier so, I get to have another five years early. I’d never had an upper GI before, however, so this would be a new experience. When I called endoscopy the next day, they had received the cardiologist’s order, but their next open appointment was in five months. So I spent the summer months wondering what might be causing the anemia and iron deficiency. In the meantime, I started taking iron supplements and Vitamin C at the suggestion of the cardiologist. I had check-ups with the cardiologist in July and October, at which point he was perturbed that endoscopy could not get me in any sooner than the end of November. He ordered another echocardiogram for November 1 and called to see if I could get my upper/lower GI any sooner.
The November echocardiogram proved hopeful because my ejection fraction was up to what it had been before the Great Lockdown. Actually, it pretty much stayed at that level ever since I was first diagnosed with heart failure ten or so years ago, except for the echocardiogram in March.
On November 11, I had a preliminary visit with the gastroenterologist about what would be happening with the Upper/Lower GI endoscopies. And on November 19, I had the procedure. Fortunately, the results were not entirely conclusive concerning internal bleeding, so I would need another procedure which involved swallowing a mini-camera, a capsule endoscopy. I’ve already posted in the blog about this in the entry for April 6, 2022.
However, because of the disparity between the two echocardiograms, the echocardiograms, the cardiologist ordered a MUGA Scan before the year was out.
Three days before Christmas I had the MUGA Scan. The short story here is that the hopeful news about my heart function from the November echocardiogram was not verified. And this is the reason that in one week I will be having a defibrillator implanted.
The cardiologist also wanted me to lose weight, so he referred me to the weight management clinic at KU. I had one initial visit with the doctor and several periodic visits with a physician’s assistant in the department every couple of months from May 2021 on.
I became concerned because of news that some CPAP machines had been recalled. I have been using a CPAP because of sleep apnea since the fall of 2001. Fortunately, my machine was not one of the ones that was recalled, but now I have established a relationship with a pulmonologist at KU as well as the myriad other specialists I have been seeing. Because of technology, my sleep patterns are monitored year-round and my sleep health seems to be pretty good. My very first CPAP machine in 2001 was much larger and it did not have an SD card to record my sleep patterns to send them to the pulmonologist. Unless something changes drastically, I will only have to see the pulmonologist once a year. I realize that this is not especially interesting reading and that it is full of medical terms which I may or may not have explained accurately, but it was to the best of my understanding. And now it is here in this blog so I don’t have to re-type it every time someone asks, “How are you doing?”
So . . . In February of 2021, I had my first office visit with a new cardiologist. This would result in an eleven visits directly related to heart problems during the year. On February 19, I had the first appointment with the cardiologist at KU. At this appointment, the cardiologist just went over my medical history.
I started having Telehealth visits with a physician’s assistant in the endocrinology department every few months starting in March 2021, with one visit in person to check for diabetic neuropathy in my feet. I also had my annual eye exam in August for vision and diabetic retinopathy. I also have cataracts that have remained small for five years, so they are not yet at the point that they need to be removed.
On March 22, I had an echocardiogram. It was at this point that there was some concern about my heart function. I had been concerned about being tired much of the time and becoming out of breath after walking just two or three blocks. Because of the low ejection fraction, the cardiologist ordered several other tests during the month of April. These included cardiac catheterization, MRI, nuclear stress test, and treadmill stress test. I had a visitation with one of the cardiology nurses after one of these visits in which she cross-examined me about my how I was feeling, how I was living, etc. I guess the cardiologist felt that she was a health sleuth that could probe me for answers better than he could. And that time, they decided to test some of the blood they had collected for anemia and for iron absorption. Not really sure which of the symptoms I described led them to prescribe those tests, but it was just a few days before my next visit with another cardiologist in the practice on June 4, who specialized in implanting defibrillators. He gave me all the lowdown. Then I asked, “Have you been informed that I’ve been diagnosed with iron deficiency and anemia? I just got those results yesterday.” He hadn’t. The conversation about defibrillator implantation came to a halt!
At this point, the cardiologist called in an order to endoscopy for a complete upper and lower GI. Lovely! I had had a colonoscopy five years earlier so, I get to have another five years early. I’d never had an upper GI before, however, so this would be a new experience. When I called endoscopy the next day, they had received the cardiologist’s order, but their next open appointment was in five months. So I spent the summer months wondering what might be causing the anemia and iron deficiency. In the meantime, I started taking iron supplements and Vitamin C at the suggestion of the cardiologist. I had check-ups with the cardiologist in July and October, at which point he was perturbed that endoscopy could not get me in any sooner than the end of November. He ordered another echocardiogram for November 1 and called to see if I could get my upper/lower GI any sooner.
The November echocardiogram proved hopeful because my ejection fraction was up to what it had been before the Great Lockdown. Actually, it pretty much stayed at that level ever since I was first diagnosed with heart failure ten or so years ago, except for the echocardiogram in March.
On November 11, I had a preliminary visit with the gastroenterologist about what would be happening with the Upper/Lower GI endoscopies. And on November 19, I had the procedure. Fortunately, the results were not entirely conclusive concerning internal bleeding, so I would need another procedure which involved swallowing a mini-camera, a capsule endoscopy. I’ve already posted in the blog about this in the entry for April 6, 2022.
However, because of the disparity between the two echocardiograms, the echocardiograms, the cardiologist ordered a MUGA Scan before the year was out.
Three days before Christmas I had the MUGA Scan. The short story here is that the hopeful news about my heart function from the November echocardiogram was not verified. And this is the reason that in one week I will be having a defibrillator implanted.
The cardiologist also wanted me to lose weight, so he referred me to the weight management clinic at KU. I had one initial visit with the doctor and several periodic visits with a physician’s assistant in the department every couple of months from May 2021 on.
I became concerned because of news that some CPAP machines had been recalled. I have been using a CPAP because of sleep apnea since the fall of 2001. Fortunately, my machine was not one of the ones that was recalled, but now I have established a relationship with a pulmonologist at KU as well as the myriad other specialists I have been seeing. Because of technology, my sleep patterns are monitored year-round and my sleep health seems to be pretty good. My very first CPAP machine in 2001 was much larger and it did not have an SD card to record my sleep patterns to send them to the pulmonologist. Unless something changes drastically, I will only have to see the pulmonologist once a year. I realize that this is not especially interesting reading and that it is full of medical terms which I may or may not have explained accurately, but it was to the best of my understanding. And now it is here in this blog so I don’t have to re-type it every time someone asks, “How are you doing?”
Tuesday, April 12, 2022
Pandemic: Part 1 - 2020
This is the first part of my Pandemic tale. It all started in March, 2020.
On March 12, 2020, I had a first date with someone. We had chatted on Facebook and decided to go for pizza at Minsky’s. Five hours later, the world completely closed for about nine months and it remains partially closed to this day. Thankfully, masks and vaccines have partially rescued the world from the dreaded lockdown.
By the way, there wasn’t a lot of chemistry with the person I dated, so eventually the direct messages slowed down until now and I am not sure my Facebook friends list even has that name any more.
As a person who tests consistently as INFP on the Myers-Briggs Personality Type Indicator, I thought the lockdown hadn’t really affected me much. I know that it didn’t have the psychological effect that many spoke about on TV.
I became very familiar with Netflix TV series:
So, you may be asking yourself, what effect did the lockdown have on David?
Well, here goes:
I started going to places other than the grocery store in October. The first thing was my great niece’s wedding; I went there because it was an outdoor event. I started calling doctors and making appointments. First my primary care physician. Then I called to make an appointment with my cardiologist for a yearly check-up that was three months overdue. (Here’s the rub.) My A1c had skyrocketed to 12.1. The cardiologist’s office said you’ll have to come in to see Dr. So and So; I had no idea why my cardiologist of about ten years wouldn’t see me. So, as one does, I Googled her. I found out she had died of a heart attack three months earlier in the latter part of the Lockdown. She was only 50 years old. In what year could that have happened other than 2020!
So eventually, I started a long series of doctor visits at KU Medical Center, where all my specialists are now, since KU is easily accessible by public transportation. (By the way, all buses here in Kansas City have been free since 2020.)
So the next blog posts will be a rundown of the battery of tests that went down during the year 2021 and that have led to a continuing regimen of doctor visits in the present year!
On March 12, 2020, I had a first date with someone. We had chatted on Facebook and decided to go for pizza at Minsky’s. Five hours later, the world completely closed for about nine months and it remains partially closed to this day. Thankfully, masks and vaccines have partially rescued the world from the dreaded lockdown.
By the way, there wasn’t a lot of chemistry with the person I dated, so eventually the direct messages slowed down until now and I am not sure my Facebook friends list even has that name any more.
As a person who tests consistently as INFP on the Myers-Briggs Personality Type Indicator, I thought the lockdown hadn’t really affected me much. I know that it didn’t have the psychological effect that many spoke about on TV.
I became very familiar with Netflix TV series:
- Queen’s Gambit
- Tiger King
- The Circle
- The Circle France
- The Circle Brazil
- ETC . . .
So, you may be asking yourself, what effect did the lockdown have on David?
Well, here goes:
I started going to places other than the grocery store in October. The first thing was my great niece’s wedding; I went there because it was an outdoor event. I started calling doctors and making appointments. First my primary care physician. Then I called to make an appointment with my cardiologist for a yearly check-up that was three months overdue. (Here’s the rub.) My A1c had skyrocketed to 12.1. The cardiologist’s office said you’ll have to come in to see Dr. So and So; I had no idea why my cardiologist of about ten years wouldn’t see me. So, as one does, I Googled her. I found out she had died of a heart attack three months earlier in the latter part of the Lockdown. She was only 50 years old. In what year could that have happened other than 2020!
So eventually, I started a long series of doctor visits at KU Medical Center, where all my specialists are now, since KU is easily accessible by public transportation. (By the way, all buses here in Kansas City have been free since 2020.)
So the next blog posts will be a rundown of the battery of tests that went down during the year 2021 and that have led to a continuing regimen of doctor visits in the present year!
Wednesday, April 6, 2022
April 6
As I said in yesterday’s post, updates on my health vanished into thin air when I downloaded the mobile app for Blogger. So I am going back to the old fashioned way, by updating the blog on a browser. While I intend to replace those posts mostly in chronological order, this one will be about the most recent occurrences since some friends have already read David’s Medical History 2021.
I got the untranslated results of the capsule endoscopy, on April 1. If they had sent me the results and had not scheduled a doctor’s appointment, it would have been a clever April Fools’ Day joke. However, my appointment with the gastroenterologist was on April 5. I wanted to make sure to hear what the doctor had to say before I shared them with the public.
It’s funny, as you are in the geriatric zone, the doctors look like they only recently graduated from high school. Then you realize that indeed they did graduate relatively recently!! So, the very young doctor patiently explained the results . . . rather like a grandchild teaching his grandpa to play an video game.
I had read the endoscopy report, as a homework assignment before the office visit. I interpreted it to mean they found nothing that would explain the iron deficiency or anemia. The doctor gave me an A on my translation. Pretty good for an old guy who never took that foreign language in high school or college!
So I asked, “Does that mean I’ll just be taking iron supplements and Vitamin C ad infinitum?” He seemed reluctant to answer in the affirmative. He decided that I should have blood drawn before I left the medical center. Thanks to the miracle of modern technology, my smartphone buzzed me to give me the results of the blood tests before I even arrived home from the office visit. However, my very young doctor sent me a message this morning that read:
Since the anemia is probably related to one of the myriad geriatric ailments that I have ... diabetes and heart disease among them ... maybe the defibrillator implantation coming up in a couple of weeks will help.
The weight management doctor at my last appointment noted two things. First, I hadn’t lost any more weight after the initial twenty or so pounds. And second that my creatinine level was high and suggested that I talk to my PCP about stopping Naproxen which I had been taking for arthritis pains. Naproxen is an NSAID and NSAIDs tend to mess with kidney function and an elevated creatinine level means that one's kidney function has been thrown out of kelter. I did. He agreed. He wrote:
I got the untranslated results of the capsule endoscopy, on April 1. If they had sent me the results and had not scheduled a doctor’s appointment, it would have been a clever April Fools’ Day joke. However, my appointment with the gastroenterologist was on April 5. I wanted to make sure to hear what the doctor had to say before I shared them with the public.
It’s funny, as you are in the geriatric zone, the doctors look like they only recently graduated from high school. Then you realize that indeed they did graduate relatively recently!! So, the very young doctor patiently explained the results . . . rather like a grandchild teaching his grandpa to play an video game.
I had read the endoscopy report, as a homework assignment before the office visit. I interpreted it to mean they found nothing that would explain the iron deficiency or anemia. The doctor gave me an A on my translation. Pretty good for an old guy who never took that foreign language in high school or college!
So I asked, “Does that mean I’ll just be taking iron supplements and Vitamin C ad infinitum?” He seemed reluctant to answer in the affirmative. He decided that I should have blood drawn before I left the medical center. Thanks to the miracle of modern technology, my smartphone buzzed me to give me the results of the blood tests before I even arrived home from the office visit. However, my very young doctor sent me a message this morning that read:
Iron deficiency has continued to improve. Your other vitamin levels were normal. You are still mildly anemic but I suspect that this is unrelated to iron and related to other medical problems. (Anemia of chronic disease) I would say stay on your current dose of iron for now.Since the iron has to be taken on an empty stomach and because it works better in an acidic environment, I wake up each morning and take a 65mg tablet of ferrous sulfate - that sounds much fancier than plain old iron tablet - and a 500mg tablet of ascorbic acid - that sounds more formidable and much more likely to induce pity in my readers – and then I wait for an hour before I take the rest of my morning medications and breakfast and proceed with my day.
Since the anemia is probably related to one of the myriad geriatric ailments that I have ... diabetes and heart disease among them ... maybe the defibrillator implantation coming up in a couple of weeks will help.
The weight management doctor at my last appointment noted two things. First, I hadn’t lost any more weight after the initial twenty or so pounds. And second that my creatinine level was high and suggested that I talk to my PCP about stopping Naproxen which I had been taking for arthritis pains. Naproxen is an NSAID and NSAIDs tend to mess with kidney function and an elevated creatinine level means that one's kidney function has been thrown out of kelter. I did. He agreed. He wrote:
You can safely take Tylenol up to 2 tablets 4 times a day as needed. Also, over the counter Turmeric supplements are also somewhat helpful as an anti-inflammatory that would not affect the kidney function.So now, I just await the implantation of the defibrillator on April 22. In addition, I also have made an appointment with an orthopedic doctor at KU because the surgeon from Research Medical Center who replaced my right knee in 2019 has retired during the Pandemic. My left knee is beginning to feel like the right one did before it was replaced.
Tuesday, April 5, 2022
Entering the Geriatric Zone
OK . . . so some of you saw my posts here about my health in 2022 and they have vanished! I downloaded the mobile blogger app that was supposed to miraculously make it easy to manage this blog. Apparently, it is not nearly as intuitive as they seemed to think it was. It didn't make managing blog posts easier. Instead, I accidentally erased all the posts since February 2022 and see no way to retrieve them. So I guess I will start again!
I saw an old friend the other day whom I'd not seen in many years. (We went to high school together to give you an idea.)
I said to her, "I am quietly and slowly entering into the geriatric zone."
She replied, "Oh, not me. I briskly slid right in."
I counterreplied, "Well, yes. I guess I'm just in denial."
So over the next week or so, I will re-collect my thoughts about what my health has been like since the great lockdown of 2020 due to the Covid Pandemic and I will post these recollections as well as any updates so that those friends of mine who care to read the musings of a senior citizen who is a mere two years shy of 70!
No one was ever so astute as Rod Serling when he said, "You are about to enter another dimension, a dimension not only of sight and sound but of mind. A journey into a wondrous land of imagination. Next stop, the Twilight Zone!" Or perhaps even moreso when he said, "A journey into a wondrous land of imagination.” Very similar things can be said about the geriatric zone. I’m not sure how wondrous this land of imagination is or whether I actually could have imagined how wondrous (or unwondrous) the land would be. In fact I am seeing and hearing the Zone, but I’m not sure I am really mindful of the zone at all. At times, I am quite sure that I am losing my mind, but here are some of my musings about health after age 65!
I saw an old friend the other day whom I'd not seen in many years. (We went to high school together to give you an idea.)
I said to her, "I am quietly and slowly entering into the geriatric zone."
She replied, "Oh, not me. I briskly slid right in."
I counterreplied, "Well, yes. I guess I'm just in denial."
So over the next week or so, I will re-collect my thoughts about what my health has been like since the great lockdown of 2020 due to the Covid Pandemic and I will post these recollections as well as any updates so that those friends of mine who care to read the musings of a senior citizen who is a mere two years shy of 70!
No one was ever so astute as Rod Serling when he said, "You are about to enter another dimension, a dimension not only of sight and sound but of mind. A journey into a wondrous land of imagination. Next stop, the Twilight Zone!" Or perhaps even moreso when he said, "A journey into a wondrous land of imagination.” Very similar things can be said about the geriatric zone. I’m not sure how wondrous this land of imagination is or whether I actually could have imagined how wondrous (or unwondrous) the land would be. In fact I am seeing and hearing the Zone, but I’m not sure I am really mindful of the zone at all. At times, I am quite sure that I am losing my mind, but here are some of my musings about health after age 65!
Wednesday, February 2, 2022
SEVEN YEARS LATER!
Now that Facebook does not have the app “Notes,” I have decided to use this blog account again. I don’t like to post things that would fill an 8 1/2 x 11 sheet of paper as a post to my newsfeed. I will, however, post a link for those friends who might be interested.
Some of you may have read updates from 2020 and 2021 that were posted to catch you up on my health journey. I will add a blog post summarizing those posts. Then I will add another blog post with more recent information.
So . . . if you are interested keep watching!
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