Archive for Medix

Cataract Surgery Report

Lens ImplantIn August and then again in October, I had eye surgeries to replace aging lens element in my eyes with artificial implants designed to eliminate cataracts and to correct visual acuity.

Image: Lens Implant similar to those now in my eyes. Alcon© AcrySof™ Click to enlarge.

My guess is that millions have had their cataracts replaced but this is my story and observations. The surgery is quick and painless with perhaps a small amount of discomfort that quickly abates afterward.

In my case, as I grew older, I became nearsighted and had to wear glasses to fly, drive and do anything that required distance acuity. I removed the glasses to read and work with things close-up. Kind of a pain in the ass without bifocals, and I hated bifocals so I did without. This was before progressive lenses were available.

After a while I wore a contact lens in one eye only so I could see distance, but the uncorrected eye was perfect for reading and working on the computer at home and work. No glasses other than shades were involved. This technique is called “monovision” with one eye corrected for distance and the other used for close work.

Then, about 23 years ago, I had Lasik® surgery to fix my right eye only in order to eliminate the need for a contact lens. Still monovision, but now independent of corrective lenses. I had glasses made for driving where the correction fixed the nearsighted eye and corrected for astigmatism in both eyes. I eventually added progressive corrections so I could seamlessly switch between the distance view and the instrument panel or GPS. That was the status quo up to the surgeries this year.

The left eye surgery was a standard lens replacement while the right eye was a bit more complex, which I will describe below. After the left eye was fixed, one of the first things I noticed was a rather pronounced difference in color perception between the fixed eye and the unfixed eye. With the left eye, white looked white and with the right eye, white looked yellow-ish. Blues were vivid in the left eye and dull with the right eye. I guess I underestimated how big an effect that cataracts have on your vision.

I mentioned that the replacement surgery in the right eye was more complex. When I had Lasik® in that eye I had no idea that it would affect the cataract surgery in that the cornea became distorted. To correct the cornea problem, a second procedure was needed. Before the lens replacement process, they put me under a machine that made contact with the cornea and fired several laser blasts to reshape it. Immediately after that the lens replacement took place with an additional measurement to determine which lens power to use. The surgeon then selected the proper power and completed the surgery.

All the follow up appointments with the ophthalmologist went well. I was now seeing 20/20 with the right eye and the left eye was suitable for close work and reading. This month, I ordered two pairs of prescription glasses - one pair of shades with progressive lenses for driving and daytime outdoor use and another single-vision clear pair for watching TV and other night time use.

Damsel and I were out the last couple of evenings watching the ISS fly over. As a bonus, the crescent Moon, Jupiter and Saturn were gathering together in the southwestern sky in a gorgeous asterism. And Stars! So many Stars all now brightly focused and brilliant. I can SEE!

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Retirement Life Events

Yesterday, we had the second surgery to correct the cataract in the right eye. This was a bit more complicated than the first surgery (which was a simple lens replacement) in that there were additional measurements and a second laser process involved to fix the astigmatism in the right eye cornea. There was yet another measurement made during the surgery to determine which of four possible lens implants would be selected. I regret to say that the cause of all the additional processes could have been circumvented had I not had LASIK surgery on the right eye 22 years ago.

I went to the day-after follow-up this morning and the results pleased the surgeon (who kept patting himself on the back) as well as they pleased me since he had me reading the fine print on the eye chart even though the dilation in the eye was still set at F 0.6 or so (wide open). The eye will be considered completely healed and functional in a few days although the eye drop regimen will persist for about three weeks. I thank the Lord that all this is behind me and seems to have worked out.

A few weeks ago, I upgraded Damsel’s AR-15 with a forward vertical grip. I watched a video on the ‘Tube where some dude installed a vertical grip on the standard hand guard by using a rail section and a compatible grip. I did the modification to her rifle by following the advice I saw and when it was complete, I was not satisfied. The grip still had some wobble even though it seemed to be securely fastened. It was a workable kluge.

I previously reported on the hand guard upgrade on my rifle with a quad rail and a vertical grip. That worked out very well and I am still happy with it. I was going to apply that same upgrade to Damsel’s rifle but we got distracted a bit since she indicated that she wanted to get pink furniture for her gun. So, we abandoned the quad rail upgrade. Now, the pink furniture seems to be sold out everywhere. I am on waiting lists but nobody can seem to say when they will be back in stock.

Well, I didn’t want to wait to get her gun fixed and get rid of the foregrip wobble, so I ordered a Magpul MOE Hand Guard (which is the same manufacturer of the pink stuff) as an interim solution while waiting for the ultimate pinkness to show up.

Today, the hand guard arrived and I completed the mod to her rifle. The before and after pictures are below. The kluged verical grip on the standard hand guard (left) and the Magpul hand guard and vertical grip (right). Click on either image to enlarge.

Standard Kluge Magpul MOE hand guard and grip

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Tales of the Caduceus

caduceus.pngThe purpose of this post is not to elicit sympathy, but rather to share some of my recent healthcare-related experiences. There are several things going on with the old meat-frame, none of which, at this point in time, are too serious or life-threatening.

Eight years ago, I found out that I had a malignant neoplasm in the bladder which was transurethrally resected and my most recent checkup showed no signs of recurrence. There were some complications that needed correction after the initial surgery, but those are in the past save for some minor atrophy of my right kidney.

I’m seeing a nephrologist for the kidney function which is now diagnosed at stage 2 (of 5 stages) failure, but no special procedures indicated at this point. No dialysis is required at this time and probably never if I follow the prescribed diet and medications.

I’m scheduled for cataract surgery on the left eye next Monday. Prior to that, the hospital wants me to be tested for COVID-19. That test is scheduled for Friday. The surgery, I’m told by others that have had the procedure, is quick and painless and generally a big success.

I have been going to several dermatologists over the past 30 years, or so. I have a good one here in town who I see regularly. I’ve lost count of the minor excisions of skin cancers and other lesions on my epidermis. Squamous, Basal Cell, Common Warts and Nevi have been victims to his various cutting implements. Some of them just get frozen with several dabs of liquid nitrogen. I’m sure there will be more in the future.

It’s been five years since my last colonoscopy, so I’m due. It would be a longer interval except the proctologist removed several polyps last time, so I’m a bigger risk to have more. I have yet to set up the session, although anytime prior to December 2020 would probably be OK.

Last month, I had my 77th Birthday. Just prior to that, I had chest pressure (can’t really say pain) but went to the ER anyway. They did a chest X-ray, an EKG and blood work and found nothing out of sorts. As a follow-up, I got a CT scan of the upper torso. The radiologist found nothing to address the pressure I had, but did notice some small irregularities in my lungs. I have an appointment with a pulmonologist to further examine the radiology. I assume they will tell me my options once they have looked at the the scans. The local radiologist who wrote the report recommended another CT scan in six months to see if anything changed.

After the chest pressure incident, the family doctor ordered an Echocardiogram. The results of that test were quite normal.

I may update this post over the next couple of days when we figure out what’s to be done next with regard to the lungs. I may also update with a report on the cataract surgery.

UPDATE: OK here’s the first addition to this post - I visited the Pulmonologist (lung specialist) today who reviewed the suspicious CT scans and pronounced them “no big deal.” He wants to test me for Valley Fever (a common ailment in the southwestern US) but other than that he says to come back in a year to see if the little nodules in my lungs are doing anything like growing. Praise God!

UPDATE 2: It’s been over a couple of weeks since the cataract lens replacement in my left eye. I’m happy to say that it went well and the new lens is functioning perfectly. I am still using eye drops per the ophthalmologist’s direction for another week. The second surgery is scheduled for mid-October. There are complications in the right eye that I will post about later. Thank God again for a good outcome!

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Medicare Wellness Checkups

medicare.pngThis is the first year that The Damsel and I have signed up for a Medicare-approved (and 100% covered) “WELLNESS” check up with our local healthcare clinic. Damsel has just become eligible for this procedure and I, after several years of non-compliance, decided we should do it together. Since it is covered, it might be interesting to see what this senior health checkup is all about.

We made our appointments for the checkup for both of us at the same time with our healthcare provider. When we arrived for the appointment we were escorted to a treatment room in the clinic. Our provider was a Nurse Practitioner who greeted us and then started through her checklist of things to discuss. There would be no examinations other than verbal today. She referred us to our Regular Family Physician if we had specific health issues that may require physical examination and/or treatment.

The following topics were discussed for each of us starting with me and the with the Damsel:

  • Wellness Discussion - History of chronic or other past and current health issues
  • Advance Directives - what to do regarding our healthcare desires if we become unable to communicate them
  • Substance abuse screening
  • Depression screening
  • Nutrition discussion
  • Exercise discussion
  • Preventative health and fall risk discussion
  • Immunization record and possible additional immunization needs discussion
  • Adult depression screening
  • Cognitive exam (verbal memory and confusion testing)

We were advised that our response to the latter cognitive exams showed no signs of confusion or memory loss (eat your heart out JOE BIDEN). We were given a detailed printed record of the discussions and exam highlights and it looks like we’re pretty much normal with our petty arthritis and joint pain. Our dental and vision care is up to par and other than a couple of potential immunizations (tetanus, shingles, pneumonia) we’re OK.

The one thing we were short on was advanced directives; we both need to get our health treatment desires in writing via a “Living Will.” Pursuant to that, I prepared a Healthcare Directive and Medical Power of Attorney document for each of us; we will be having them notarized this week and will file them with the Arizona Department of State, the latter which will issue a wallet card for us to direct first responders how to act upon our wishes should we become comatose or otherwise unable to communicate.

The directives are only a start upon our last wishes documentation. We have a bunch of details that need to be ironed out before crossing over the bridge to Paradise. Those will be getting resolved over the next few months.

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It’s Not A Diet - It’s A Lifestyle

keto.pngLast year, we both had our annual check-up with the family physician. After our exams, he ordered some lab work, mainly phlebotomy (blood work). Within a few days, Damsel got a call from their office advising that her tests had come back showing her to be in pre-diabetes (type 2) with high triglycerides. My results weren’t all that too hot either, with the usual (for me) high cholesterol and other chronic problems showing up (kidney, hypertension, etc.). The doctor recommended a low-sugar (i.e. low carbohydrate) diet for her.

The pre-diabetes condition was something that immediately needed attention. We searched for and found a volume on KETO pre-diabetic recipes that went a step further than food prep and described how a body typically could reverse the diabetic trend by eliminating most high-in-carbohydrates foods. After reading up on some of the science behind the recovery process, we both decided to adapt our food preparation and consumption habits. Damsel to try and slow down the diabetes potential and me to try and lose some of the fifteen or so extra pounds.

The first step was to purge from the pantry any and all items that were on an IMMENSE list of high carb no-nos. After filling up four good sized cardboard boxes of goodies headed out to the local food bank, we dutifully delivered them never to see the likes of those items in our pantry again. The list included rice, pasta, legumes, peas, corn, carrots, wheat flour, cornbread mix, pancake mix and so forth, most of which would regularly be included in our home-prepared meals.

We quickly adapted to the change and found many delicious recipes for low carb meals. There is plenty of on-line help on the food topic out there including Diet Doctor, plus there are cookbooks galore including many by TV Chef George Stella whose variety and clever substitutions for hi-carb goodies is a very good thing.

Early this year, after being on the new feeding arrangement for a few months, we saw the family doctor again. He prescribed follow-up testing to see how we were doing. When the test results came back, Damsel showed a definite drop in the triglycerides and other lipids that were now essentially normal. I did not see her A1C number, but the verbal report indicated it was now normal.

Damsel has lost a few pounds since the onset of the low-carb regimen, but more importantly, she is now in the green arc.

Me, on the other hand, I am now back to my high-school weight, having lost about 25 pounds. My weight is now stable and is normal for my height and build. I have now backed off of my blood pressure meds to about ⅓ of the previous dosage. I visited the kidney specialist and was advised that my marginal function had improved from 60 percent efficient to 80, which is fairly normal for my age (just turned 76 this week). My lipid numbers are all normal except for a high HDL cholesterol reading (a GOOD thing) and a low risk for cardio-vascular problems (a VERY GOOD thing).

The following excerpt* from one of our several books on the topic describes how we are neither starving nor craving these days:

MAINTAINING A LOW-CARB, HIGH-FAT DIET is beneficial for weight loss. Most importantly, according to an increasing number of studies, it helps reduce risk factors for diabetes, heart diseases, stroke, Alzheimer’s, epilepsy, and more. The keto diet promotes fresh whole foods like meat, fish, veggies, and healthy fats and oils, and greatly reduces processed, chemically treated foods. It’s a diet that you can sustain long-term and enjoy. What’s not to enjoy about a diet that encourages eating bacon and eggs for breakfast!

Studies consistently show that a keto diet helps people lose more weight, improve energy levels throughout the day, and stay satiated longer. The increased satiety and improved energy levels are attributed to most of the calories coming from fat, which is very slow to digest and calorically dense. As a result, keto dieters commonly consume fewer calories because they’re satiated longer and don’t feel the need to eat as much or as often.

* Ramos, Amy. The Complete Ketogenic Diet for Beginners: Your Essential Guide to Living the Keto Lifestyle (p. 13). Rockridge Press. Kindle Edition.

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Happy New Year!

happy-2019.png

We had a pretty good day today. It started out with a little light snow, some of which stuck. Snow is unusual for us here and, coincidentally, it snowed here on New Year’s Eve in 2014, but today’s snowfall was nothing compared to that event. After it warmed up a bit, some gentle rainfall slushed all the snow away this afternoon.

2018 was good to us. Even though we had some surgery on the thyroid last march, there have been no health issues other than the usual arthritis and other aging things. We started a diet a couple of months ago and it has been working. I lost over 10 pounds so far and a couple of notches on the belt. Damsel is doing as well.

In the coming year, we have springtime plans to head to Colorado. This year, we had a marker placed on an ancestor’s grave in Montrose, CO and we are planning to go view the work and to place a wreath or three. We also will be visiting in Pueblo, CO to place more wreaths and perhaps meet up with some long lost cousins.

For 2019, we wish everyone a wonderful, prosperous and happy new year!

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Cowboy Classic Ford Pickup

Cowboy Classic

Earlier today, Damsel and I were at the clinic where I had a follow up appointment for a blood test I took earlier this month. On the way out of the parking lot, Damsel took this photo of a classic mid-50’s Ford stepside pickup truck all decked out cowboy style with saddle and rope. Wickenburg is big into rodeo, especially the team roping event and this cowboy’s rigs suggest he is one of ‘em.

The appointment at the clinic was with my nephrologist (kidney doc). We actually saw the doctor’s Nurse Practitioner who analyzed my lab results which show that the kidney functions are currently “good enough.” That’s good to know that I won’t be needing dialysis or a Kidney transplant anytime soon. She forecast that with my numbers the probability is that I wouldn’t be needing any of that until I’m 120 years old.

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