EXACERBATE — NOT THE SAME AS EXASPERATE – Marilyn Armstrong

Daily Word Prompt – Exacerbate – 06/18/19

A long time ago, when Garry and I still lived in Boston and both of us were working, we used to get both Boston newspapers delivered daily to our townhouse in Roxbury. I mostly scanned them and read Doonesbury, but Garry pretty much read both papers cover to cover, but always from the back to the front because the sports and entertainment were in the back. He was dedicated to the news in a professional way, but he was personally dedicated to sports and entertainment. So he started with the fun stuff and moved frontwards.

Happy kidneys

I was doing what I did for a living which was writing or editing manuals — or doing both — depending on the size of the project and how each job was defined. I was in “auto-correct” mode and often found myself unconsciously correcting errors in the newspapers. Usually, these were typos, misprints, incorrect tenses, or clumsy writing. I forgave most of it because people who write for the news — any news service be it TV, radio, or press — are under constant deadline pressure. They have to get it right and on time.

So there I was, reading the Boston Herald. Not my favorite newspaper, but it had better comics and a bigger sports section, which made Garry happy. The Boston Globe had better writers. Or, perhaps, they were encouraged to be better writers at the Globe, while the Herald prided itself on being “down to earth.”

There had been an unfortunate event. I think it happened during a police training camp for upcoming recruits. The weather was very hot and the training instructor refused to let anyone stop for a drink of water, even in nearly 100-degree heat.

One of the recruits had a kidney problem, unbeknownst to the drill sergeant and the heat and lack of water caused him to die of kidney failure. It was quite a scandal and it ultimately changed the way recruits are trained.

In the Boston Herald, they wrote: ” … and with the weather so hot, the young man’s kidneys, which were already damaged, became exasperated causing the recruit to die.”

Unhappy kidneys

I know it was a tragedy. Truly, it was. And I realized that this was probably an autocorret error. Autocorrect had decided the writer couldn’t possibly mean “exacerbated” and must have meant “exasperated.”

I had a sudden weird mental image of his kidneys throwing up their hands or whatever kidneys throw into the air and saying, “That’s it. I’ve HAD it. I’m outta here.”

The poor young man suffered from exasperated kidneys.

I’m not sure what the moral of the story is except if you are writing for the news, you should probably turn off autocorrect.

FANDANGO’S PROVOCATIVE QUESTION #27 – Marilyn Armstrong

Fandango’s Provocative Question #27

The question this week is exactly the kind of question I do not ever want to answer. It might be a question nobody wants to answer unless they are a medical researcher with skin in the game, so to speak.


“If you could choose one — and only one — particular malady, condition, or disease for which a safe and effective treatment was available, what one condition would you choose to treat and why is that your choice?”


As someone with more maladies than I care to list, some likely to kill me, others just likely to be a serious pain in my back, exactly how would I pick?

I have absolutely no idea what I should pick. Cancer? It has managed to kill about three-quarters of my closest family. Heart disease took the rest — and I’ve already had both, big time. Or maybe I should vote for arthritis? Unlikely to kill me, but very likely to make living increasingly unpleasant.

I’m pretty sure they are doing significant research on all of these diseases. Cure them? Who knows? But they have come a very long way in treating both cancer and heart disease. Arthritis lags behind, likely for a couple of obvious reasons the first being that almost everyone gets it.

It probably is not preventable unless old age is preventable. Also, it isn’t lethal, which means it doesn’t generate the money for “cures” that more fatal diseases garner.

I’ve got it! Let’s cure aging!

I don’t mind going gray or wrinkly. But let’s dump arthritis, exhaustion, bad hips, worn-out knees, loss of memory, and insomnia. While we are at it, cure dementia and Alzheimer’s. Add a little zip to our steps so we can be old, wise, and energetic. So we can still be who we have always been — right up until that last breath.

Photo: Garry Armstrong

And please, while you are at this curing business, make sure everyone has full access to medical care, no matter what is wrong with them.

AND STILL ALIVE – Marilyn Armstrong

In 2010, I discovered I had cancer in both breasts. Two tumors, unrelated to each other. Just twice lucky. They removed the tumors and the associated breasts and gave me very attractive fake replacements. Much perkier than the old ones in an artificial implant sort of way. I have a little ID card for both breasts as if they each have their own identity.

Maybe they do. Thus, a little more than 8-1/2-years after the siege began, I’m officially a survivor. Almost but not quite.

My mother died of metastasized breast cancer. My brother died of pancreatic cancer more than 10 years ago, having never gotten as old as I now am. This is not a reassuring family history.

All chronic illnesses make you paranoid. The thing that’s so insidious about cancer is its absence of symptoms. The possibility that it is growing somewhere in your body and you won’t know it’s there until it’s too late, is about as scary as a disease gets. Nor is it a baseless fear.

I had no idea I had cancer — much less in both breasts — until it was diagnosed twice during a two-week period. One diagnosis of cancer is hard to handle. A second diagnosis a week later is like getting whacked over the head with a bat. It leaves you stunned, scrambling to find someplace to stand where the earth isn’t falling out from under you.

I don’t think most of us are afraid of dying per se. We are afraid of the journey we will have taken to get there. We’re afraid of pain, suffering, the humiliation of dependence and gradual loss of control of our own bodies. After having one or more close encounters with the dark angel, no one is eager to feel the brush of those wings again.

We are called survivors, which means that we aren’t dead yet. The term is meaningless.

Put into perspective, we are all survivors. Anyone could be felled by a heart attack or run over by a beer truck today, tomorrow, in five minutes. The end of the road is identical for all living creatures. It’s only a matter of when it will be and what cause will be assigned. Everyone is in the same boat.

If you’ve been very sick, you are more aware of your mortality than those who’ve been blessed with uneventful health, but no one gets a free pass. The odds of death are 100% for everyone.

Recovering from serious illness is a bumpy road. Each of us has a particular “thing” we find especially bothersome. For me, it’s dealing with well-wishers who ask “How are you?”

If they wanted an answer, it might not be so aggravating, but they don’t want to hear about my health or my feelings about my health — which are often more the issue than anything physical.

They are being polite. So, I give them what they want. I smile brightly and say “Just fine thank you.”

I have no idea how I am. All I know — all I can possibly know — is that for the time being, I am here. To the best of my knowledge, nothing is growing anywhere it’s not supposed to be.  Eight-and-a-half years after a double mastectomy, I am in remission. That’s as good as it gets.

The real answer for those of us who have had cancer, heart attacks, and other potentially lethal and chronic ailments is “So far, so good.”

That is not what anyone wants to hear.

We are supposed to be positive. Upbeat. You are not supposed to suffer from emotional discomfort. Why not?

Because if you aren’t fine, maybe they aren’t, either. They have a bizarre and annoying need for you to be bright-eyed and bushy-tailed no matter how you actually feel. It’s their version of a vaccine. If you are fine, maybe so are they.

Since cancer, I’ve gone through major heart surgery and having survived that, I figure I’m good to go for a while. None of us are forever, but I’m alive. Presumably, I’ll continue to stay that way.

Welcome to surviving. It’s imperfect, but it beats the hell out of the alternative.

KILLING PAIN – OUR LUDICROUS LAWS STRIKE AGAIN – Marilyn Armstrong

FOWC with Fandango — Ludicrous

It’s ludicrous. I do not get up at 6 in the morning. But we did today. Why? Because the medication I need is only made by a single manufacturer and none of our local pharmacies have any left. There is a full dose at the pharmacy at UMass, so first we have to go to the doctor to pick up the prescription, then dash off to UMass to get the pills — and hope they saved them as requested AND hope traffic isn’t too horrible.

NSAIDs

Demerol is an old medication, around for at least 40 years, maybe longer. It’s milder than most of what they make today and more importantly, it doesn’t make me sick, which most narcotics do.

So we’re on the run. Again.

Tomorrow we’re heading down to Tom and Ellin’s and I hope the weather is decent! It’s going to be another nutsy week for the retired people.

The problem with NSAIDs

I was pretty sure when this country decided to get rid of opioids, they were going to forget that there are people who actually need them because they can’t take anything else. I can’t take any NSAIDS (Nonsteroidal anti-inflammatory drugs) including ibuprofen in all its many forms, aspirin (in its many forms), Celebrex, Vioxx … or any combination of these packaged in combination a different drug. I can take Tylenol (generic or not), but only 6 per day lest I overload my kidneys. That doesn’t leave me much wiggle room for a lot of pain from this, that, or the other thing.

They have actually improved the glue so they stay on!

I have invested in a lot of 4% lidocaine patches and liquids and surprisingly, it helps. It’s not addictive, either. The prescription strength is 5% and is so insanely expensive, it’s out of my range. I bought it once. It was for me out-of-pocket $488.

If the 4% patches are $20 for 15, how can 30 — on a script — run nearly $500? That doesn’t make any sense. If you want to stop excessive opioid use, how about making other stuff priced so regular people can afford it?

On social security, you only get a certain amount you can spend on drugs. I’m lucky that I’m on a Blue Cross plan that requires no payment for blood pressure medication, which is the vast majority of what I need to survive. But everything else is on my dime and it’s a very little skinny dime. The Demerol —  being a generic — is not expensive. It’s also not available most times and getting less so every day. I can easily foresee a day in the not very distant future when no one will make it and I’ll either have to switch to something stronger and more addictive — or suffer. I’m not very enthusiastic about either possibility.

America is an overkill kind of country. We either give out opioids to everyone by the handful, or we decide no one needs them.

And this works too, but the patches last longer. On the other hand, you can use this in places the patches don’t fit.

People like me get slammed between the pages of their current standards. Which I’m sure will be changed soon enough because there are a lot of people in pain that need help. Pain is actually the second largest subject with which medicine deals. Chronic from a wide variety of causes including men back from battle, people who have fallen off ladders, police officers … and people like me who can’t take what everyone else takes.

It is ironic because regular over-the-counter Excedrin (or equivalent) works better than Demerol. So do most muscle relaxants — but I can only take them a few times a week because I have a long history of ulcers.

The frustration is crazy. I can’t take a lot of things because of the replaced heart valves and the pacemaker, other things because of the ulcers, and many more things because of allergies or sensitivities.

I know I’m hardly alone in this. And I’m sure it will get worked out, but whether it will get worked out fast enough for me is another big question.

And yet I’m not terribly worried because in the end, if this becomes unavailable, we’ll find something else. I just wish it wouldn’t be so damned complicated. Or expensive!

AND AFTER ALL THE TESTS … Marilyn Armstrong

After Garry and I left our car with the valet at UMass Memorial, I looked at Garry and commented: “I should have just gone to an eye doctor.”

Considering all the testing and checkups, you’d think I’d have a diagnosis. Nope. I know just what I knew when this round of medical visits began. This was one of the times when two things happened at the same time. I wrongly assumed the two events were connected.

Back again

It’s a natural reaction. I had my little seizure, or what seemed like one and my vision went all funky at the same time. One plus one is expected to equal two, except when it remains one and one and they don’t add up.

Seizures? Not exactly.

I have narcolepsy. It’s one of the many reasons I don’t want to drive. One time, a few years ago I fell asleep while driving. The next thing I knew, I had an incident with a tree. I don’t know how far I drove (asleep) before I hit the oak. I also knocked off my rearview mirror somewhere en route to the big tree and no one ever found it.

It’s possible I drove for a mile or two (there was no traffic) before I drifted to the side of the road and conjoined with nature.

It turns out that narcolepsy can produce those weird sort of seizures I had and one of the ways you can tell it was not a real seizure is that it leaves nothing behind. You aren’t groggy or muddle-brained. It’s literally as if nothing happened. I remember once in the middle of a home barbecue, I collapsed in the hallway. On further checking, I had fallen asleep and just fell in a heap on the stairwell. Everyone thought it was funny. I didn’t think it was all that funny, but I didn’t know I had narcolepsy.

It can be a difficult problem to diagnose. My shrink finally nailed it.

Ever since I hit that tree, I’ve been wary of driving. It’s why I always have a stash of amphetamines with me. It’s no big deal if I fall asleep at home — as long as I don’t hit my head or face on something on my way down. Which I have also done. In that case, I was walking, said I felt funny, but apparently kept walking (but not awake) into a door frame. That time I also woke up screaming but with good reason. I split my face open. It required some interesting stitching of nose and lips … and a missed interview for a job I wanted.

I also was a serious sleepwalker for many years. I don’t think I still sleepwalk because it’s too hard to get out of bed … but when things go really missing and I eventually find them in some strange place, I suspect I did it while asleep. My granddaughter also sleepwalks. Is it genetic?

It never crossed my mind that all of these events were part of the things narcolepsy does, but that’s what they’re telling me.

The narcolepsy is not new. I have spent many hours sleeping in my car by the side of the road because I knew I was going under, only to be woken up by the cops telling me it’s illegal to sleep by the side of the road.

I would point out that this is exactly what they tell you to do if you feel you cannot continue to drive. It’s in all the books on safe driving. Nonetheless, they immediately tell me I have to move along. Have they missed the part where I say I was too tired to keep driving and had to stop or I was going to have an accident?

Stupid is as stupid does.

So that’s the story of the seizures. They aren’t seizures. They are my narcolepsy acting up, usually on a day when I not taken amphetamines. They don’t make the problem go away, but for at least four or five hours, they keep me reasonably alert.

Finally, the strangest part of narcolepsy is that you may have symptoms of its approach (intense sleepiness), or you may be hit by waves of dizziness. Or a sudden upset stomach. Or you are fine and fall over. Asleep.

It’s not a disease, though it is a condition and while the amphetamines help for short periods when I absolutely must be awake, it doesn’t cure anything.

Nothing cures it probably because they aren’t entirely sure what causes it. They have theories, most of which seem to involve sleep apnea except I don’t have sleep apnea. I do have exactly the right kind of insomnia, though. The kind where I fall asleep directly into a dream, then wake up every two hours until finally, a nightmare makes me decide sleeping isn’t a good idea and anyway, the dogs are barking.

What about my eyes?

It’s probably (drumroll) … cataracts. My right eye is relatively clear, but my left eye is cloudy.

I’m 72. Garry was treated for cataracts when he was barely 60 and my father had cataracts years before me. Actually, everyone gets cataracts sooner or later. Dogs, cats, and horses, too. I’m just a bit late, but by age 75, everyone either has cataracts or has had the surgery. It is THE most widely performed surgery in the world. They expect to perform around 30 million cataract surgeries next year. That’s a lot of surgeries.

You get old? You get cataracts. You can also get cataracts without getting old. Some babies are born with them.

There are no eyedrops of any other form of correction for cataracts other than surgery. You get them repaired or you don’t. If you don’t, eventually you can’t see.

So my next doctor is the ophthalmologist. It would appear that I may not need new glasses. I may need new eyes. Which sounds like a good idea. Garry and Tom both have had the surgery and they LOVE their new eyes. Finally — NO glasses.

Wrapping Up: Coincidence is not a sign from the Universe

Just because two things happen at the same time doesn’t mean they have anything to do with each other. We all read too many mystery novels where everything is a clue. This is particularly important when you are dealing with physical symptoms. Simultaneous doesn’t mean causative.

And this is also what’s wrong with having so many specialists who only look at your wrists or fingers or hips, but not your spine, brain, or eyes. I think most of us need someone who will look at all the stuff going on who can then tweeze the pieces apart and figure out what is really wrong.

Dr. House, come back! I need you!

HOW GO YOUR YEARS? – Marilyn Armstrong

When I was in college, two of the women with whom I became friends were suicides. Neither of them was happy, but I would never have guessed either of them was suicidal.

One of them was just 19 when she killed herself. The other was 21.

For this reason, I have never assumed “everything is fine” for anyone. Even when you ask, you will only know what you are told and that is rarely the entire truth. People are secretive about their deepest fears and thoughts.

“How are you?”

“Everything is fine.”

“You don’t sound fine.”

“No, really. I’m fine.”

How many times can you ask before you realize you aren’t going to discover more? When people mention that aging makes them “think about mortality” I realize I began thinking about mortality when Karin died and then again when Anna jumped. Also when a young couple, just married, crashed their car into a truck and died on the highway.

Yet again, when my first husband got kidney cancer at 34 and lived, but still died young of heart disease and medical errors. Then my brother died of pancreatic cancer at 61. One of Garry’s colleagues — in her early 40s — died while waiting for a bus in Cambridge. When my first husband’s father died of his second heart attack at 52, I was pregnant and sorry he never met his grandson. For that matter, Jeff died at 53 and never met his granddaughter.

I knew a young person who died of a heart attack before age 21. Another internet friend, Rosa, died last year of a heart attack. I only found out when her mother called to tell me. She wasn’t yet 35.

And of course, there are all the friends our age who are battling cancer, dementia, heart conditions, not to mention the ones who have “beaten” cancer, but of course, you never really beat cancer. You are remitted and that will have to do.

When people complain about not being as active as they were when they were many years younger, I think they are missing the point. Age or disease can do you in at any point in your life. You don’t have to get old. You can be 21, an athlete, and collapse on the court.

The Dark Lord will have his way. When and how it hits you is partly how you used your body and your DNA. Depending on your constitution, your ability to walk, run, ride, or whatever you do may be compromised. Even eliminated.

Then again, are you breathing on your own? Do you get out of bed in the morning, even if it is a struggle? Do you find joy in your life? Do you laugh? Are there people you love who also love you? Is life interesting? Are you still curious to know what’s going to happen?

If any of these things are true, yay for you. You are alive.

Mortality is always with us, whether we are old or young. We may not be paying attention to it, or we may be under some delusion that we are exempt from “the end” because we exercise and eat right. But there will be an end.

Maybe, as Jeff used it say, it’ll be a runaway beer truck. Or something unexpectedly medical. It may be tomorrow or in 60 years. Whatever time you have, be gracious and grateful. Many people don’t get a life full of years. Others get the years and manage to be miserable anyway.

Enjoy your years, however many you have. And while you are at it, be nice to the people you know and especially those who love you and who you love. Kindness is the least expensive and most valuable gift we have to give.

FACTORING IN THE TEST RESULTS – Marilyn Armstrong

FOWC with Fandango — Factor

So my test results came back. After I did a full translation of virtually every word in the report — I’m pretty good with medicalese, but this was way above my pay grade — I discovered that considering my age and stage of life, I’ve got functional, but not perfect arteries. If you want to factor in all the tests that were run initially during my first visit to the neurologist — and then this new set of tests — we know that I’m getting on in years.

Which is exactly what we knew before. We do not know if what the tests found to have anything to do with the visual symptoms. They could be connected, but they could also be entirely separate with no connecting thread. And worse, there’s actually no clear way to address the matter. It’s not like there’s a book which gives answers because what’s bothering me aren’t the symptoms for any known disease or condition or illness.

Thus I know what I knew when I started this process. I was afraid this would be the result and why I didn’t want to begin the process. It’s “non-result.”

A lot of information has been collected,  but are any of these results related to the symptoms? I’m not even sure why I started this process in the first place except that I felt I had some kind of obligation to find out if it meant something — or not.

“Or not,” seems to be the answer.

I’m just as worried (but more confused) than I was at the start. I’m overloaded with information that doesn’t mean anything to me. I suppose — or at least I hope — that this will make more sense after I see the doctor next week.

With all the advances we’ve made in medicine, in the end, a lot of it is more like art than science. Maybe someday it’ll be just like “Bones” on the Enterprise. Just use that little tricorder and poof! Diagnosis, cure, and life renewed.

I’m waiting. Aren’t we all?