Cap'n Bob & the Damsel

Medix

The Big “O”

The old and tired saying comes to mind: If I knew I was going to live this long, I’d have taken better care of myself. However, despite our reckless self-deprecation in our earlier years, we have managed to turn all the bad habits into less-worse habits and persevered this far down the road to eternity. We remain in good health and visit the specialists of the few ailments (now in remission) who monitor those functions and all gauges are in the green.

Our festivities for the day will consist of Steaks on the Barbie with a nice salad provided by the Damsel. There might even be a couple of adult beverages consumed as the day goes on.

We may get some rain and a possible Thunderstorm later today. As I look back on the years, I can remember quite a few times we had lightning shows in mid to late July. That would be nice if we have some of that today – we could use the cooler weather, but not so much the inevitable humidity that comes with it.

Here’s to another trip around Old Sol.

22 Jul 2023 by Medix Notions Retirement

Mid-Spring News —
Busy Week Upcoming

Image above — A Curve-Billed Thrasher was perched atop our big Saguaro Cactus singing its spring songs this morning. I took this shot this morning with my Canon EOS Rebel SL1 and a 250mm lens. Click on the image to enlarge.

Other than celebrating holidays and preparing the feasts associated therewith, we have had a relatively calm early spring with no outstanding chores nor appointments. As of this week, however, that will change as it seems that we made a lot of appointments all in the same week.

Tomorrow, Monday 4/24/23, we’re going to have to get the dogs to the Vet for their annual immunizations; the licenses are due in May and the County Animal Control Bureaucrats will be requiring current Rabies vaccinations for both dogs.

On Tuesday 4/25/23, I have an appointment with the Ophthalmologist for a regular follow-up exam. Both eyes received cataract lens replacements in 2020 and the Doctor wants to admire his work, I guess. Or maybe he wants to check up on things like eye pressure, floaters, retina etc.

On Wednesday 4/26/23, we have our standing appointment at the Pet Groomer for both dogs. Tucker, our little Long-Haired Chihuahua mix pup will be getting a trim which we think will make him more comfortable in the desert heat this summer. He really is a fluffy little guy and won’t need that fur coat when the indoor thermostat is set to 80° and the outside temperatures will be in the low 100° range.

On Thursday 4/27/23, I have a Dermatology appointment. Last visit, the Doctor removed a suspected basal cell lesion from the back of my neck and will probably want to do a follow-up procedure for it by applying Liquid Nitrogen to kill off any remaining basal cells. Plus, I have a couple of other suspicious spots he needs to examine. Wear your sunscreen, kids!

Finally, on Friday 4/28/23, our landscape crew will be reporting to tend to some needed yard work including tree and shrub trimming, weed control and renewing the courtyard quarter minus ground covering. I don’t expect that I will need to help them do their job, but I know some things will come up that we may not have anticipated and we need to be there to authorize additional work.

But wait! There’s More! On Monday May 1st, I have to report to the clinic for blood work as a precursor to my Nephrology appointment in May and on Tuesday, I need a haircut.

This retirement business can be less restful than one might think.

Getting old is not for sissies.

23 Apr 2023 by Arizona Critters Medix Retirement

Dermatology — An Ongoing Thing

Virtually, every year since I have turned 50 years of age, I have had to visit one dermatologist or another to deal with epidermis problems. Even prior to that, I had minor things like cysts and moles that the doctors dealt with back then.

Since coming to Arizona and even a couple of years before that, Dermatologists have treated me by removing skin lesions such as basal cell and squamous cell carcinoma. A lifetime of sun-exposure in the deserts of the west have come back to haunt me. Damsel says that skin remembers the UV exposure long after we forget about it.

Today, I had yet another appointment with the dermatologist who removed a lesion from my upper right chest a month ago. He had some interesting news for me; the dermopathology report indicated that the latest biopsy was, indeed, a keratoacanthoma which is a more aggressive form of skin cancer than those before this. The follow-up treatment in this case is like the other follow-ups in that the doctor freezes the tissue with liquid nitrogen directly on the lesion site and the area around it. This method, according to the treating physician, will usually prevent a recurrence 88 to 92 percent of the time.

I did some research on-line about keratoacanthoma which answered a couple of questions one might have:

Who Gets keratoacanthoma?

Keratoacanthoma is most common in fair-skinned older males with a history of chronic sun exposure. Most patients are over 60 years of age and it is twice as common in males than in females.

What causes Keratoacanthoma?

  • Exposure to ultraviolet light
  • Chemical carcinogens (e.g. cigarette smoking, industrial workers exposed to tar, pitch, and mineral oils)
  • Cutaneous trauma (e.g. surgery, radiation)
  • Human papillomavirus infection.

What is the outcome for keratoacanthoma?

Keratoacanthoma is regarded as benign and thus has an excellent prognosis following surgical excision.

I’m guessing UV caused my problem, although I was a smoker many years ago. I like the odds given for a full recovery.

15 Sep 2022 by Medix Retirement

Healthcare Update

caduceus.pngAs I mentioned in the Labor Day post, we elected to have hernia surgery sooner than later which seemed like a good choice given complications that usually develop with an untreated hernia. The surgery took place this morning at our local hospital. The surgeon (featured at the link) indicated that everything went well and I am at home now in the office comfortably posting this item.

I read the statistics on my type of hernia (Inguinal) and it turns out that about one-fourth of the adult male population will develop this condition sooner or later. Thank God that the radiology department during an unrelated CT scan discovered the problem and brought it to our attention a couple of months ago. The urologist that ordered the CT scan read the report to me and recommended that I consult a general surgeon, which (obviously) I did.

The pre-surgical procedures were the usual: surgical gown, hair net, vital sign monitor hookups, IV tube, etc. The one difference I can account for being that the anesthesiologist brought in an ultrasound system and probed my right side while inserting a syringe to anesthetize a major nerve under the muscle in order to provide a level of comfort post surgically. I have to say that it’s working inasmuch as the only sensation from the surgery site is minor pressure and not pain. This may wear off by tomorrow, I have been advised, so I am prepared to deal with whatever discomfort that may occur.

As always, Damsel was there to get me to and from the hospital and to provide post-operative care when needed. I am in continual thanks to God Almighty for the love and care given by my wife.

It should be getting easier every day as I heal up.

15 Sep 2021 by Medix Retirement

Cataract Surgery Report

Lens ImplantIn August and then again in October, I had eye surgeries to replace aging lens elements 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!

21 Nov 2020 by Medix Notions Retirement Science

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!

18 Aug 2020 by Medix Notions

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.

10 Mar 2020 by Medix Notions Retirement

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