Remembering three items; drawing a clock face

Next year, I’m told, the test at my doctor’s office will be tougher.

three thingsA couple weeks ago, I went for my annual physical at my primary physician’s new venue. The Physician’s Assistant, who was previously unknown to me, asked me to put the numbers on an analog clock face. Then I was to indicate ten minutes after eleven on said drawing. I succeeded!

We agreed that, a generation from now, this might not be a very useful exercise. Maybe sooner.

There were three words I was given to remember. Even that evening, retelling this to my wife, I couldn’t recall the first word. It may have started with S. It surely WASN’T Tequila because the second word was Sunrise.

The third word I feigned forgetting, lightly pounding the arm of the chair I was sitting in. Finally, I gave the correct answer: Chair.

I’m not sure how much this proves; I’m notoriously bad at remembering names. But good at numbers; I was asked to recall my weight, which I did. But that also had the visual cue.

Having to have this test administered really ticks off my primary care physician. It’s apparently a mandate of some sort for those who are eligible for Medicare; I do have Part A.

If the test HAD shown some developmental loss, it might well be at a point when it’s far too late to be of any use.

Of course, the “rule of three” is “a writing principle that suggests that things that come in threes are inherently funnier, more satisfying, or more effective than other numbers or things. The reader or audience of this form of text is also more likely to consume information.”

That’s SO true. When my wife asks me to remember three items to pick up at the store, I’m good. Add a fourth item, and out comes the pencil and paper. Some are even worse off: Fred Allen said: “I always have trouble remembering three things: faces, names, and – I can’t remember what the third thing is.”

Next year, I’m told, the test at my doctor’s office will be tougher. I’d start studying now but I don’t know what’s going to be on the quiz.

Family health report, July 2017: hammer toes

You start to feel better and you inevitably overdo.

The big story this summer is that the wife had surgery on the three middle toes on July 5. She had hammer toes. She didn’t have to do it now, but eventually, without being corrected, it might impact her mobility as she gets older.

The surgery was very successful. Her response, in terms of limited swelling, et al, was very good, her doctor told her at every followup visit.

One of the things we have both discovered, with my hernia surgery a couple years ago and her recent surgery, is that the cycle of pain is quite fascinating. Right after the surgery, when you get home, you feel really great. The anesthetic has not yet worn off.

Then the pain starts to creep in, and you better start taking that opiod right way, because if you decide to tough it out, it will take longer to get relief. But the prescription lasts only a couple days. It’s less than what you want, and you start taking the over-the-counter stuff, and for longer that you think, hopefully without ruining your liver.

You start to feel better and you inevitably overdo. The Wife is even worse in this regard than I. When she walked too much, and didn’t put her foot up, she is surprised how much it still hurts three or four weeks on.

Meanwhile, I chipped a tooth, for which I’m getting a filling on August 13. More significantly, both in terms of time, pain, and money, I’m getting a crown on September 13.

The Daughter noticed a mark in the whites of my right eye at the end of the month. It was a vertical red line that looks as though someone had drawn it with a Sharpie. The very next day, I went to my ophthalmologist, who said it was a broken blood vessel, and that it would resolve itself. It looked much worse than it felt.

I is for iatrogenic

Unlike an adverse event, an iatrogenic effect is not always harmful.

iatrogenicSomeone sent me this piece from an obituary: “…His demise was probably iatrogenic.” Iatrogenic was not a word I knew.

It means: “induced inadvertently by a physician or surgeon or by medical treatment or diagnostic procedures: an iatrogenic rash.”

The origin of the word comes from the Greek, iatros, meaning physician, plus the English suffix -genic. The word’s first known use was in 1924.

Some of the causes of iatrogenesis include side effects of a treatment and drug interactions, which may have been unanticipatable.

Also, “unlike an adverse event, an iatrogenic effect is not always harmful. For example, a scar created by surgery is said to be iatrogenic even though it does not represent improper care and may not be troublesome.”

Still, iatrogenic disease is the 3rd most fatal “disease” in the USA, with avoidable errors such as infection, and medication errors as leading causes of mortality.

Related: the dictum “first do no harm” doesn’t exactly come from the Hippocratic Oath, but it does come from the Hippocratic Corpus, at least in essence.
***
Sam Simon has died at the age of 59; it was not iatrogenic. He was the co-creator of the hit animated show, The Simpsons. There’s a lovely article about him in Vanity Fair.

ABC Wednesday – Round 16

Colonoscopy preparation day!

If I’m a little slow visiting your websites, you will know why!

Preparing for my second colonoscopy

I’m having a colonoscopy tomorrow. Oh boy! The preparation starts today. Actually, it started a week ago, when I purchased the laxatives and the clear liquids to take today. Then a couple of days ago, start a low-fiber diet, avoiding nuts, seeds, popcorn, and corn. Yesterday, drink at least 8 glasses of water or other clear liquid while maintaining a low-fiber diet.

Today, low residue breakfast: eggs (not fried), bananas, apple sauce, juice without pulp. Clear liquids for the remainder of the day. At 3 pm, start the laxative/clear liquid regimen, finishing up tomorrow morning, which of course will keep me…busy. The actual procedure will be around 12:30 pm tomorrow, and my wife will bring me home.

So if I’m a little slow visiting your websites, you will know why!

Here’s what humor writer Dave Barry said about HIS colonoscopy back in 2008: “Which brings us to you, Mr. or Mrs. or Miss or Ms. Over-50-And-Hasn’t-Had-a-Colonoscopy. Here’s the deal: You either have colo-rectal cancer, or you don’t. If you do, a colonoscopy will enable doctors to find it and do something about it. And if you don’t have cancer, believe me, it’s very reassuring to know you don’t. There is no sane reason for you not to have it done.”

I did this before, a decade ago. It was no big whoop; I don’t believe that I watched the procedure on the monitor. My wife gets one every five years – her brother John died of colon cancer at the age of 42 in 2002 – and she likes to watch.
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Colonoscopies Explain Why U.S. Leads the World in Health Expenditures: “The high price paid for colonoscopies mostly results not from top-notch patient care…, but from business plans seeking to maximize revenue; haggling between hospitals and insurers that have no relation to the actual costs of performing the procedure; and lobbying, marketing and turf battles among specialists that increase patient fees.”

Here’s my favorite piece of recent spam, verbatim: “The ρost offerѕ рroven necеsѕary to myѕelf.
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Symptoms of Adult ADHD/ADD

If I have a big project, I’ll often attack it with great enthusiasm, but lose passion for it; it even says that is true of me in an extensive horoscope I got in the late 1970s.

I get these e-mails from this “natural health” doctor, and he had this chart of what to look for to see if one has ADHD (attention-deficit/hyperactivity disorder) or its cousin, ADD (attention deficit disorder without hyperactivity, “which is more common in grown-ups”).

Time to self-diagnose:

*Trouble concentrating, especially when reading
That can happen, especially when I’m thinking of something else I want/need to do.

*Being easily distracted
Definitely true. Sometimes, I’m working on one thing, and the next thing is more interesting. Then I have to peel back to get back to task #1. Although sometimes, at work, task #2 pops up and it’s more important than task #1. Then task #3 might become the priority.

*Disorganization and procrastination
Disorganization has ALWAYS been true. My mother, in particular, dubbed me the “Absent-Minded Professor”, a description my sisters gleefully seized upon.
Now, I have systems. My bike lock key, when I’ve locked my bike, is always in the same slot in my backpack; ditto the bus pass. My glasses go on the same part of the dresser so I can find them in the dark.
When the routine is altered, I forget. I don’t ride my bike one day because the weather is miserable. I will; take my bike lock out of my backpack because it’s terribly heavy to carry for no purpose. I ride my bike to work the next day, and only halfway there, when it’s too late, I realize I have no bike lock. (I end up sneaking it up to my office via the freight elevator because the security folks get REALLY nasty if I take it up the passenger elevator.)

I used to procrastinate over things I hate. But I’m better, after having taken a jc’s recovery treatment; I tend to do them first, just to get them over with, on the theory that fretting about them took up too much psychic energy.

*Addictive behavior (e.g., drugs, drinking, gambling, overeating, excessive shopping)
Drugs, no. I remember my father giving me a sleeping pill – I was 25 at the time, and I felt SO good that I KNEW I should avoid THAT. Also, being associated with Legacy Healing Coral Springs has allowed me to see that it can be dangerous to your health.  Drinking, maybe for a brief period in my 20s. Gambling, no. I’m bored by gambling and particularly hate casinos. I might buy a lottery ticket when the pot is high enough that an office pool is formed.
Overeating, for sure, especially when I’m feeling melancholy.
Shopping, when I first got credit cards, I spent too much. Largely curbed, and now I hate it when I can’t pay off my bills in the current month. (The root canal, not covered by my insurance, is going to take two or three months.)

*Restlessness
Definitely true. I should do yoga.

*Anxiety, depression, mood swings
Anxiety and mood swings, not so much.
Depression can be inexplicably subject to that.

*Impulsive and risky behavior, including reckless driving
Actually, I’m usually quite risk-averse. It’s not that I can’t be impulsive; I’ve had whole romantic relationships based on that in the past.

*Low self-esteem
Actually, no. I’m rather wonderful.

*Inability to finish projects, lacking motivation
This has long been true. Do you know how complicated projects need intermediate goals? DEFINITELY true, because if I have a big project, I’ll often attack it with great enthusiasm, but lose passion for it; it even says that is true of me in an extensive horoscope I got in the late 1970s. Blogging is great because it’s 365 discrete (but not always discreet) pieces. But writing a book? Can’t imagine.

*Forgetfulness, chronic lateness
I used to forget a lot. That’s why I need the systems. And I’ve long tended to be late, though so does my wife; the difference is that she fails to recognize it. But I HATE being late to an airport or train station, and desire to be early if I’m in control of the situation.

Here’s a classic morning at home recently. My daughter is upstairs, wants a particular outfit. It’s in the dryer in the basement, so I go downstairs to the first floor but realize I need to go to the bathroom, and I do, reading something; I use up the last of the toilet paper. Then I start going back upstairs before I remember that I need to go down to the basement. Now I need to take a shower quickly at the point the daughter needs to go to the bathroom. “Go downstairs,” I say. So she does, but, of course, there’s no toilet paper in the downstairs bathroom, because I used the last of it, so I have to go bring some downstairs before I shower.
Now is that ADHD, or is that just morning?

*Being short-tempered, inability to tolerate frustration
I used to be quite short-tempered, especially in my 20s. I figure it was a reaction to not being able to fully express my anger in my childhood. I get frustrated much less than I used to.

At some point soon, I’ll write about preventing adult ADHD.