heart Archives - Ramblin' with Roger

My month (or so) of medicine

Echo

My month (or so) of medicine explores why September, leading to October, seemed so darn complicated this year. It doesn’t USUALLY land so many events in such a narrow timeframe.

ITEM: I received a telephone call from CVS, a real, live person(!), asking me if I wanted a flu shot. Sure! The next day, I got an electronic message. Do I want the COVID shot too? Why not?

On September 2, I went to my nearest store. Oh, they haven’t RECEIVED the shipment for the COVID shot yet. It wouldn’t arrive until Labor Day. (This was true; my daughter got both shots that day.) Then the text I received indicated that I had DECLINED the COVID shot! What? Anyway, I got one on September 16.

ITEM: I went to my podiatrist on September 11. The office recently switched to a new computer system, so paying the $8.66 balance I owed required going back into the old system, which the new receptionist didn’t know how to access. It took a while. So it goes.

ITEM: I had been seeing someone to remove excessive earwax every three months; yeah, I could PROBABLY try to do it myself, but whatever. The problem is that I was supposed to see my person in July, but their system said they weren’t available until late September. Then I got these tantalizing texts saying there was an earlier opening, always at a time I couldn’t make. Finally, I got in on September 14, and the impaction, which wouldn’t have taken place if I’d been treated on schedule, had created an irritation that required prescription eardrops. I didn’t get them because they cost $170.

I gotta have heart!

ITEM: I was supposed to get a tooth implant, but I couldn’t remember the date. September 21 at 9:30 a.m. Fine.

Then I got a message from St. Peter’s Hospital portal saying my procedure would be fully covered. What procedure? It turned out to be my TRANSTHORACIC ECHOCARDIOGRAM (TTE) W/COLOR FLOW & DOPPLER (CONTRAST/BUBBLE/3D PRN). And this one was scheduled for the morning of September 21. They didn’t ask me; they just informed me. At least Medicare fully covers it.

So, I had to reschedule the tooth implant to mid-October.

I’m guessing my cardiologist’s office will contact me to set up an appointment to interpret my echo results.

ITEM: Teeth cleaning in late September; no issue.

ITEM: I had a follow-up for my cataract surgery from two years ago. But the doctor had to reschedule until later in the month. C’est la vie.

ITEM: The annual physical is in early October. My Primary Care Physician is retiring at the end of the year; I am sad. I was her patient when she worked in a two-doctor office. Her practice, like so many others, was taken over by St. Peter’s/Trinity Health. I have followed her to several locations; the current one is the most inconvenient. If I don’t get a ride from my wife, I have to take a bus to the Rensselaer train station, then an Uber.

But she’s been a great doc to me for over two decades: direct, opinionated, thorough, occasionally quite funny. I’m not looking forward to breaking in a new PCP.

I need to do stuff

moderate dilation of the ascending aorta

I need to do stuff. Specifically, I need to clean my office to work on some reimbursements for my health care expenses. In the midst of starting to clean, I put things on top of other things, and it has become even more challenging to do what I was trying to do in the first place.

I started this process two months ago and have made no real progress. Not only is it irritating to me, but it’s probably a physical hazard. My wife came in here and almost tripped over the garbage can, which is the greater motivation. Her hand is still healing.

The only way I will clean this room and put away the recently played compact discs is if I don’t have to write a substantial blog post.

I wanted to say that I’m OK. I find art in my house every sunny day. Above is what the hallway looks like going upstairs, and below is a shrunken image. I’m not sure which one I like better, though I don’t think either picture really represents how cool it looks, but I can cope with that. It’s still discovered art, and multiple rainbows to boot.

Ticker

The one thing I can tell you is that I went to my cardiologist in late September. I like my cardiologist; he’s amusing. As I mentioned at some point, I have a “moderate dilation of the ascending aorta.” If the “maximum diameter of the enlarged segment” reaches 5.5 cm, I will need to have heart surgery. It was 5.1 last year, and it’s 5.1 this year, so no open heart surgery for me in 2025! Yay, me.

So, to the question: “How are you doing ?” I answer, “Well, I’m not having open heart surgery this year, which means I’m just fine!” Or fine enough for the nonce.

The EOY health report for 2023

The benefits of root canal

Here’s the EOY health report for 2023:

Vision: I went for my eye exam on December 7. My doctor noted that, eventually, I’m going to need cataract surgery for both eyes, especially the left one. I’m going to get a diabetic eye exam in six months. Why not at the time of my last visit? Because my eye insurance paid for one service, and my medical insurance will cover the other, I couldn’t do both simultaneously.

Meanwhile, I recognize I need more illumination. I couldn’t read the name of the third movie playing at the Madison Theatre from the Mobil station, which was far away. But it was after 4 pm, and the sun was on its descent.

Likewise, I was ordering a watch for my wife for Christmas because her extant timepiece ceased working. I could read the word TIMEX on her current item but not Indiglo below it. Well, not until morning, when the natural light from outdoors aided me.

My wife told me that the last time she ordered glasses for our daughter at the same optometrist’s office, the spectacles were ready that day. Mine didn’t even start to be processed until the 13th, and it wasn’t ready on the 22nd when I called. I did not get them until after Christmas.

Heart: that thing is okay for another six months. No open-heart surgery THIS year. Yay.

No children were harmed.

Knees: My always achy left knee has been particularly aggravating me. At church a couple of weeks ago, I was heading towards the loo when some small human unexpectedly zigzagged toward me. It was all I could do to avoid falling on top of said small human. That would have a headline: “Fat old man falls, crushes small child in front of church bathroom.” But not falling, I pulled something, not only in my knee but my left ankle.

I actively avoid falls. My insane cat, Midnight, runs in front of me into the kitchen two hours before he is scheduled to be fed. I don’t want a dead feline on my conscience, either.

Last week, my neighbors allowed a garbage can to be filled with water. Then they tipped it over, with some water puddling in front of our house, and then freezing. Fortunately, my wife put down rock salt.

I’ve avoided getting a cortisone shot, determining that it only masks pain rather than truly treating it. But masking the pain may be the way to go if the discomfort continues into the new year.

Teeth: I had a cavity filled in November. When I went to the appointment, I misremembered it and thought it was just for a cleaning. The oddly comforting thing is that it didn’t hurt much after having a root canal in the area a few years ago.

Thus endeth the report.

Health report: damn knee

walking stick

On Saturday, March 4, Albany received enough wet snow that several tree branches came down throughout the city. One was in my yard. Unfortunately, it was also totally across the sidewalk. It needed to be moved.

Ultimately, I needed to walk into the few inches of snow. Unfortunately, atop the snow was a sheet of ice, which made me turn my ankle. It was uncomfortable, but I figured it’d pass. The next day, it seemed fine.

Monday morning – more the middle of the night – I awoke to extreme pain on the left side of my left knee. I could not bear to put any weight on it. Getting out of the office chair took ten minutes.

So I spent the better part of Monday and Tuesday, my 70th birthday, sitting on the sofa, my damn knee elevated, watching news programs (60 Minutes et al.), and reading magazines. I couldn’t focus on much more than that.

Eventually, I felt less pain with a knee brace and a walking stick. I first damaged my knee in 1994, as I wrote here. I’m working on getting an ortho appointment.

You gotta have heart

Meanwhile, I went to see my original cardiologist on March 9. Even after a few scans over the past three years, it is “unclear whether the patient’s bicuspid valve is congenital or acquired due to heavy calcification.” I have a “moderate dilation of the ascending aorta. The maximum diameter of the enlarged segment is 5.1 cm.”

If it gets to 5.5 cm, I get to have heart surgery. Oh, joy! I’d be lying if I said it didn’t make me a little anxious when I think about it, which is about twice a year when I get the scans and see the heart doc.

I need to lose more weight, as I’ve lost none since the beginning of the year. The good news is that I haven’t gained any either, and it’s stayed in a five-pound range.

Two hospital visits on the same day

transthoracic echocardiogram

How I had two hospital visits on the same day. Well, of a sort.

Monday, October 10: Leslie and I return to Albany, stopping to pick up a lot of Italian food. My wife also wanted us to pick up her prescription pain medication, but it wasn’t there. Her doctor’s office had failed to send the info either that day or the following morning. She increasingly needed pain relief, particularly from the inflammation of her left foot. Finally, it was filled, and I retrieved it.

Moreover, in addition to the infection of her ankle, a blister developed on her left shin. When I think of a blister, I think of a tiny, though irritated, area. This was considerably larger. As my wife later suggested, it was also appropriate for the holiday season because it like as though it was from a zombie.

Leslie and I saw my daughter before she left the next morning with about a third of the food, which was fine.

Tuesday, October 11: We were going to go to a timeshare in the Berkshires, but my wife couldn’t stand the pain of being in the car for an hour. Plan B: After we put the one cat in the basement, Leslie came over and washed the dishes while I attempted to straighten up the house and tend to my wife.

Wednesday, October 12: Leslie and I went to the rental car place to return the vehicle. She Ubered to the airport, and I took the bus home. I certainly didn’t mind taking care of my wife, but it ate into most of my time for food prep and just helping her to get from one point to another.

The day without end

Thursday, October 13: My wife and I had separate medical visits. I went to the cardio section of St. Peter’s Hospital to get a transthoracic echocardiogram (TTE). What is THAT? It is “a test that uses ultrasound (sound waves) to create images of your heart. TTE can determine how well your heart is functioning and identify causes of cardiac-related symptoms.”

I’m getting this test because of this. I used to get one annually, but then my cardiologist retired, and no one in the office followed up. So I had to get my primary care physician (PCP) to contact another practice in Schenectady, who I had seen a couple of weeks earlier. BTW, the Ellis Hospital main phone line sucks. I was in phone hell for ten minutes before abandoning it, Googling the directish number I needed, and calling that.

Part 2

So after the test, I went home, ate lunch, and watched a recorded episode of JEOPARDY. But before I could finish it, my wife called and said that HER PCP was displeased with the progress of her leg. The antibiotics should have done more. She should go to the emergency room and be admitted. I was to meet there, at St. Peter’s, where I had just come from.

We both arrived around 2:30 p.m.; she’d gotten a ride from the church friend who had taken her to the doctor. After two hours, she was called to the triage office, which involved her using her crutches to hobble there. Yes, the nurse there said my wife should be admitted. She finally got a wheelchair.

Around 6, I went home to take the trash to the curb, feed the cats, and, most importantly, make my wife a sandwich. The selection of graham crackers, saltine crackers, and Lorna Doones has dissipated over time. The bottled water is gone, with just some ginger ale cans.

Finally, my wife gets to go to a bed attached to the ER. I go in about a half hour later as it becomes obvious that she won’t see anyone for a while. At about 11 pm, I go home.

Admitted

Friday, October 14: She tells me that several medical folks saw her overnight, some of which involved doctors waking her in the middle of the night. Around noon, she’s on the fifth floor. But she doesn’t have a room yet. And she hasn’t eaten or even drunk water since 8 pm the night before because the vascular surgeon was supposed to see her.

I arrive on the 5th floor at about 1:45 pm and find my wife, who doesn’t yet have a room. She’s on the floor, with some partitions providing a modicum of privacy. Then I got a call maybe 10 minutes after I arrived. It was my MIL wanting to know how her daughter was doing; I hadn’t spoken to her since we were still in the ER.

Finally, at about 2 pm, my wife gets a room. More importantly, since it was established that the vascular guy WOULDN’T see her that day, she got some food!

I was very distressed by all of this. It was my impression that her PCP could call the hospital and bypass the hours of waiting. I figured it would be like my last ER visit in August. Of course, that was a perceived heart thing in a less busy hospital. One of the medical professionals we spoke with subsequently said that’s just how health care is, especially in the last three years.