Archive for Medix

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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Lifestyle Change - Diet in Particular

Chicken over Cauliflower Rice

Ever since Damsel retired about 20 years ago, we have enjoyed preparing delicious meals on the weekends. She runs the kitchen while I run the smoker and grill. Occasionally, I help in the kitchen (sous chef role) with meat cutting and grinding or with shredding cheese and other kitchen helper labors of love. Thus far, we have been able to prepare just about anything we see in a recipe or on the TV cooking and food channels or on internet social media.

A few weeks ago, Damsel went for her regular annual session with the family doctor. He checked her over and pronounced all the vitals to be within limits - however, he wanted her to get some routine blood work done. Her initial report was that triglycerides were a bit too high and the doctor prescribed another more specific blood test. The results from that test indicated a marginally high blood glucose level, also known as pre-diabetes.

The doctor’s advice was to change her diet to cut down on carbohydrate intake. Well, damn! just about all of our favorite foods are laden with carbs. We did some research on low-carb diets and actually found some literature on understanding the pre-diabetic condition and preparing meals with low carbohydrate counts. We also found other sites with recipes and information, one of which had the photo above of a “Garlic Butter Chicken with Parmesan Cauliflower Rice” recipe. It looks pretty good, no?

So, we’re both going on a low-carb diet. No more potatoes (and most other starchy root veggies), pasta ( :( ), bread, pastries. fruit and a host of other goodies with high carbohydrate content. The only good news is that un-prepared meats of all kinds have zero carbs. Her diet will be to reduce blood sugar and mine will be to lose the 15-20 lbs that the doc has suggested.

Between a couple of low-carb cookbooks and websites like the one linked above, we should be able to prepare delicious food for our diets. In any event, we will not be denied wholesome, tasty meals just because of reduced carbs.

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Classic 50-ish Dodge Pickup Truck

50-ish Dodge Pickup

In what might be a prelude to the 24th Wickenburg Annual Classic Car Show and Fly-In, this clean 50-ish Dodge Pickup passed us this morning while we were on our way to the clinic for lab work. Damsel took several shots of the truck through the windshield as it approached us. This was the best one - Click on the image to enlarge.

We’re planning on attending the Car Show/Fly-in event on Saturday. Will try and get some pix posted then of both cars and aircraft.

The lab work was routine blood tests for both of us. We try and keep a regular check up which is prudent at my age and beginning to be for Damsel who qualifies for Medicare this winter.

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