Medical

WHEN BONES DON’T KNIT – Marilyn Armstrong

/ Marilyn Armstrong / 31 Comments

Yesterday morning, I dropped the mouse for the computer in the bedroom. I reached down to pick it up and a pain shot through my chest, down my arm and I yelped.

I had a lot of heart surgery more than five years ago. Most of it has healed well. The thing that hasn’t healed properly is my breastbone. Surgeons split it in half when they work on your heart. Normally, it will take between 2 and 6 months to knit into a single unit. Mine didn’t knit, so it’s still a two-piece breastbone. Healed, but not knitted and held together with steel wire. Apparently, no medical technology exists that can convince a bone to knit if it doesn’t want to.

Typically, this is a problem on joints that cannot be immobilized — ribs, breastbone, shoulders, spine. And, I should mention that when one of these is broken, you discover that every single other thing in your body is connected to it. So it has been for the past two days. Moving really hurts. But only at certain angles while using my right arm.

I’m a rightie. Of course.

It seems a little better today than yesterday, but it’s still crunching with each breath I take. I can hear it through my inner ear. Creepy.

Every doctor I talked to assured me — energetically — that it would heal in three months. When after three months, it hadn’t healed, they said “Definitely by six months.”

When more than a year had passed, they shrugged, pointed out that there’s nothing they know of that will make a bone knit if it doesn’t feel like knitting. Nope. No glue. The only thing they could do is open me up and rewire me. “Why, ” I asked, “Would that improve the quality of my life?”

My doctor — my personal physician — shrugged. “It wouldn’t. Personally, I wouldn’t do it.”

It’s more than five years later, heading rapidly into six years. My chest still crunches when I breathe and sometimes pops out of place when I lift something with my right arm. It sometimes makes breathing pretty unpleasant and my right shoulder doesn’t like me anymore.

Meanwhile, I’m held together by some pretty tough steel wire. Doctors always seem so sure what will happen after the surgery. Except in my experience and for a lot of other people, it doesn’t necessarily go that way. Nerves don’t “calm down.” Bones don’t knit. You are left with a lot of weird problems you were sure were going to be gone. If at least the major part of the surgery worked, then I suppose it’s better than where you were at the start. I always want to trust my doctors because they mean well, but they aren’t me. So these days, I understand just because they believed it when they said it doesn’t mean it will happen that way.

A BIT OF ADVICE ON SURVIVING YOUR MEDICAL SYSTEM – Marilyn Armstrong

/ Marilyn Armstrong / 11 Comments

I’m alive for two major reasons:

  1. Because I didn’t take a lot of advice I was given. I had been misdiagnosed and had some bad doctors.
  2. Having learned my lessons the hard way, I did my homework and sought out the best doctors for whatever needed to be done.

In earlier surgeries, I tried to make life easier for people to visit me, including a working husband. Now, I find the best, most respected surgeon … even if he or she is a long drive from home. It’s my life on the line.

Dealing with breast cancer in both breasts — two unrelated tumors — and ultimately getting Boston’s best surgeon and plastic (rebuilding) surgeon was complicated, but I found a doctor who was a friend of Garry’s brother (who lives in Minnesota, but the doctor lived in Boston). The “local” surgeon had 30 surgeries and told me what I was going to do. No choice. She believed she already knew what I needed.

I spent a month finding someone with hundreds of hours who was head of the women’s surgery unit in Boston. It was a very nerve-wracking month hoping cancer wouldn’t grow much while I sought the best doctors I could find.

There is a lot of advice I wish I had gotten but didn’t. Instead, I got some excellent advice from myself.

The most critical information I can give you is to make sure you are using the best doctors and hospitals. Local doctors may be able to set a broken leg, but for anything more complicated, they might kill you if you let them.

I took my own advice which is how come I’m here to tell the tale. I’m pretty sure if I hadn’t been my most powerful advocate, I’d be an ex-blogger.

This is my best advice. 

Life is unexpected. Shit happens. Cancer, heart issues, diabetes, arthritis. You name it, we get it. No matter how well you take care of yourself, you will at some point require medical care, maybe surgery, maybe other stuff.

Regardless of convenience, understanding the quality of the medical facilities within driving distance — even extended driving distance — are critical to surviving.

Do the research. Find out what available medical facilities and associated doctors and surgeons and support services are reachable. If you have to drive a considerable distance to obtain the best services and people, do it. Survival trumps convenience.

Your life is on the line. I’ve been there, done that, and lived to tell the story. It is absolutely worth it. You are worth it.

STUPID IS THE NEW NORMAL – Marilyn Armstrong

/ Marilyn Armstrong / 26 Comments
96-OneRuleToRuleThemAll

My motto and I really should remember it more often

For the past couple of days, I’ve been dealing with the customer service for the medical plan I was trying to join. I spent — LITERALLY, NOT KIDDING — four hours on the phone yesterday until the battery on my phone died. It has never died before. Ever. In like five years. It’s not a cell phone.

They couldn’t answer a simple question, they gave me wrong answers, transferred me to the wrong departments, but to be fair, they didn’t disconnect. A miracle indeed. At the end of the conversation, I said: “SEND ME BACK TO BLUE CROSS!”

And then and there, I switched back to my previous medical provider. Because if this was before the plan had even gone into effect, it was going to be like the year I spent with Fallon when I needed to see a medical oncologist and the person on the Customer Service line told me there were doctors listed, but not their specialties.

“So how do you list them? Alphabetically?”

My doctor’s (not this doctor, the doctor before the last doctor) dimwitted secretary sent me to a cancer surgeon and when I called her back and explained that I don’t need a surgeon, I need a medical oncologist because I had cancer and what I need NOW is a checkup. I went with that company for a year and never actually got the checked.

Then came Blue Cross and life got better. This plan would have saved me around $150 a month which is a good deal of money, but I was pretty sure it would also ruin my life. I can’t do it anymore. I cannot spend the rest of my life fighting with customer service to just answer a simple question. I’m too old, too tired, too beat up.

I’ll pay the money. Just let me have people who answer the phone and know what they are talking about. Please!

And for all the comments I haven’t answered and posts I haven’t read? I swear to you I have spent about 9 hours over the past two days straightening out my medical plan — well, OUR medical plans. I’m exhausted. And I’m running out of birdseed again.

AN AWFUL LOT OF POSTS BUT WHO REMEMBERS THEM? — Marilyn Armstrong

/ Marilyn Armstrong / 24 Comments

9,947 published posts. I know that’s not quite 10,000 but it’s close.

Now, the minuses:

Tom: 400
Ellin: 525
Rich: 1,000
Garry: 1.000

So of the 10,000 posts, about 3.000 were written by other authors and probably another few hundred were re-blogs, so call it 4,000 written by other authors or re-blogs. I’ve probably written about 6,000 posts of my own. That includes most memories of childhood that were not published in my book … or are parts of the book or rewrites of chapters of the book.

Today’s statistics

About half of my posts were photographs, though even there, I tend to include writing even when the majority of the post is made up of photographs. But not always. It depends on how tired I am when I put the post together. And how many pictures I have.

So let’s say between 4,000 and 5,000 posts were exclusively mine. Still a lot of writing. Strangely, I wrote a lot more than that during my professional writing life. News writing, advertising, and documentation included thousands of pages and a mountain of research. I don’t remember how many books I wrote or how many kinds of software I wrote about. Or for that matter, what subject matter was involved.

I do not know if this is related, but for the last few months, I’ve been terribly tired. Aches and pains in many or most of my joints. Even my fingers, arms, shoulders, and occasionally my neck. If I don’t take pain drugs, I can’t stand up. Actually, it’s my inability to stand that’s my clue that I haven’t taken my medicine. I try to stand up and I fall back down.

“Oh, right,” I think. “I guess it’s medication time.”

I recently had a major three-day checkup on my heart. All things considered, my heart is doing very well, especially in view of all the surgery it has undergone. The implanted valves are working. The ventricles are pumping enough to keep the correct number of red blood cells flowing through veins and arteries. Whatever is wrong, it’s not my heart. So, whatever is going on is probably not lethal … at least not yet.

The neurology department did a major checkup on my brain (such as it is) and proved that (1) I have a brain so it’s not just a rumor, and (2) it’s more or less normal, at least neurologically. I’m not demented. I don’t have Alzheimer’s, or any sign of a brain tumor.

In fact, having changed medication for my spine, my headaches have almost entirely gone away. Proving my point that they should stop looking at each little thing and start looking at my entire self. I’m pretty sure they might find more connections.

To quote a song, “Dem Bones“:

Dem bones, dem bones, dem dry bones,
Dem bones, dem bones, dem dry bones,
Dem bones, dem bones, dem dry bones,
Now shake dem skeleton bones!

The toe bone’s connected to the foot bone,
The foot bone’s connected to the ankle bone,
The ankle bone’s connected to the leg bone,
Now shake dem skeleton bones!

The leg bone’s connected to the knee bone,
The knee bone’s connected to the thigh bone,
The thigh bone’s connected to the hip bone,
Now shake dem skeleton bones!

Dem bones, dem bones, dem dry bones,
Dem bones, dem bones, dem dry bones,
Dem bones, dem bones, dem dry bones,
Now shake dem skeleton bones!

The hip bone’s connected to the backbone
The back bone’s connected to the neck bone,
The neck bone’s connected to the head bone,
Now shake dem skeleton bones!

The finger bone’s connected to the hand bone,
The hand bone’s connected to the arm bone,
The arm bone’s connected to the shoulder bone,
Now shake dem skeleton bones!

Dem bones, dem bones gonna walk around
Dem bones, dem bones, gonna walk around
Dem bones, dem bones, gonna walk around
Now shake dem skeleton bones!

This is especially relevant to me because my spine seems to be the source of most my problems, not counting my heart, my missing stomach, and ye olde cancer.  So my good doctor sent me directly to the lab. I went to the one at Dana-Farber because they are much faster than the hospital and there’s a guy there who can ALWAYS find a vein. In ONE shot.

Meanwhile, I should be figuring out what I’m going to write for tomorrow, but surprisingly, that was not what I was thinking about. I was wondering what, if anything, the test would find. If they found something, what might it be? If they don’t find something, there’s simply got to be a reason why I feel this way. I never want to do anything or go anywhere. I’m too achy and tired. I don’t even want to talk on the phone.  I felt less tired after major surgery than I do these days, so something has to be going on. I would hope this isn’t a preview of the rest of my life!

So I didn’t get new pictures of my newly opened Christmas Cactus flowers because by the time we got home from the doctor, laboratory, and grocery store, it was dark. I’ll take pictures tomorrow.

Note that there are any number of versions of the words to “Dem Bones.” In case you find another version and the words are not quite the same.

NCIS AND MY PACEMAKER – Marilyn Armstrong

/ Marilyn Armstrong / 27 Comments

EPISODE: Need to Know (2012)

Alan Katzenbach, a lawyer, waits for Gibbs with his client, a chief petty officer named Leland Wiley. Wiley was busted for drugs and wants to trade his info — which he says is about national security.

It concerns Agah Bayar, the arms dealer. Gibbs is interested. Wiley comes over to talk, but grabs his heart and drops to the ground.

ncis-need-to-know

Gibbs comes for the update from Ducky. Turns out, Wiley had top security clearance and his workstation is locked down. They haven’t been able to connect him to Bayar yet.

Abby calls Gibbs to the lab. She tells him Wiley’s pacemaker was linked into a computer to monitor it. Someone hacked in and jacked his heart rate up to 400 beats per minute.

“Somebody murdered Wiley by remote control,” she says.

What does this have to do with me?

Well, glad you asked. This episode so intrigued the heart surgery team at Beth Israel Deaconess in Boston (where I had all that heart surgery in March 2014), that they decided to find out if it really could be done. One of the people that performed the experiment was my surgeon.

They did it. My surgeon did point out as far as they could tell, to actually hack a pacemaker you had to be no more than a couple of feet from it. Nonetheless, they made the manufacturer change the programming.

In theory, nobody can hack my pacemaker.

I find this comforting. Garry finds it disturbing and I suppose I can see where he’s coming from. He doesn’t like thinking about the mechanical and electronic stuff that keeps me alive. It would creep me out too, but I’m a bit of a geek.

RBB-pacemaker

I find the technology sufficiently interesting to overcome its inherent creepiness. It is creepy. However, it doesn’t matter. No matter how I feel about it, I’ve got this thing in my chest. It keeps my heart beating. If my heart would beat on its own, I wouldn’t need a pacemaker.

In the beginning, they used to stop my heart will beat without it. My heart stops beating. Talk about creepy. It is a very unpleasant — and indescribable — sensation.

The blue tooth remote functions still work. They are (in theory) more secure than they were a couple of years ago before the NCIS episode aired and the guys got curious about it. Remote functionality is important. After all, I might need a tune-up. Blue tooth lets my doctor access my pacemaker from … how far? I don’t actually know. A considerable distance, whatever that is.

Garry — again — doesn’t want to know about it. I pointed out if someone murders me, this is potentially important evidence. He would still rather not think about it.

So there we are. Too creepy?

I can feel my pacemaker. It sits on my left shoulder. The outline is visible. I can feel the wires, the connections through my skin. I find it impossible to ignore. I might as well find it interesting. It’s part of me, after all.

And no matter what, I will always have that Pacemaker because, after all those tests, my heart absolutely will not beat without it.

WHAT’S THAT WORD? – Marilyn Armstrong

/ Marilyn Armstrong / 2 Comments

Words That Sound Right

Although this is subjective, some words sound like the thing they describe. Personal favorites are:

Puffin, Bulbous, Fidget, Prickly, Twitch, Bubbly.  
Puffin
Fidget Kit from © The Therapy Store (2015)
Bulbous flowers
Prickly (and then some!)
Welcome to Twitch (c)
Bubbly
Words Which DON’T Sound Like Their Meaning
Medical terminology is designed to take the sting — and sometimes the responsibility — out of troubling problems. PTSD – Post-Traumatic Stress Disorder is the latest entry in trying to find a way around admitting that war is bad for those who fight in them — and other living things.
The Thousand Yard Stare

It started during the Civil War when it was noticed by a lot of people that many former soldiers were not the people they used to be. They were scary or scared. They had delusions. They thought they were being followed or that the war had found them … again.

The first army in history to determine in which mental collapse was considered a direct consequence of the stress of war and was first regarded as a legitimate medical condition was the Russian Army of 1905. The Russians’ major contribution was their recognition of the principle of proximity, or forward treatment.

In actuality, fewer than 20% were able to return to the front.

The brutalities of WWI produced large numbers of the psychologically wounded. This time, they began by attributing the high psychiatric casualties to the new weapons of war; specifically, large artillery. It was believed the impact of the shells produced a concussion that disrupted the physiology of the brain; thus the term “shell shock” came into fashion.

Another diagnosis was neurasthenia: “The mental troubles are many and marked; on the emotional side, there is sadness, weariness, and pessimism; repugnance to effort, abnormal irritability; defective control of temper, tendency to weep on slight provocation; timidity (also: rage, violence, insomnia).On the intellectual side, lessened power of attention, defective memory and will power….” (1)

At least the early descriptors name the cause — war or battle. Artillery. But those who make war and send others to fight it don’t like taking the blame — or the responsibility  — for dealing with the outcome. Since no one is planning to end wars, they try to make its repercussions less threatening by never mentioning battle in any symptom relating to it.

Thus if you remove the word “war” from the illness, there’s no more war.

By the end of World War I, the United States had hundreds of psychiatrists overseas who were beginning to realize that psychiatric casualties were not suffering from “shell shock.” … Unfortunately, they continued to believe this collapse came about primarily in men who were weak in character.

During WWI, almost 2,000,000 men were sent overseas to fight in Europe. Deaths were put at 116,516, while 204,000 were wounded. During the same period, 159,000 soldiers were out of action for psychiatric problems, with 70,000 permanently discharged. (2)

Then came World War II. Everyone knows the story of General Patton slapping the soldier in the hospital and treating him as a coward. Generals cannot afford to believe that war is bad for soldiers, that it isn’t just a matter of mind over matter. Although Patton is certainly the most famous for expressing his feelings on the matter, I doubt he was unique in his opinions. He was just more outspoken than most.

It became clear it was not just the “weak” who broke down. This is reflected in the subtle change in terminology that took place near the end of World War II when “combat neurosis” began to give way to the term “combat exhaustion.”Author Paul Fussell says that term, as well as the expression “battle fatigue,” suggests “a little rest would be enough to restore to useful duty a soldier who would be more honestly designated as insane.” (3)

Gabriel writes in “No More Heroes,” a study of madness and psychiatry in war, that contrary to what (we see) in the movies and television, in the military, it is not only the weak and cowardly who break down in battle. Everyone is subject to breaking down in combat.”When all is said and done, all normal men are at risk in war.” (4)

Vietnam and subsequent wars have kept troops permanently under siege while the medical community has sanitized symptoms. PTSD lacks any obvious link to war and battle. It doesn’t change the problem and has not resulted in better treatment in Veteran’s Hospitals. Today’s ploy is to not even acknowledge that any such problem exists and deny treatment by ascribing soldiers’ symptoms to “something else.” Anything else. Anything else to avoid the military’s accepting responsibility to care for its own victims.

The cost of war exceeds our ability to cope with its fallout.

Apparently, no one considers not sending more soldiers into combat might be the better — best — solution.

Funny about that.

WE MADE IT – Marilyn Armstrong

/ Marilyn Armstrong / 5 Comments

The first thought I had this morning was “The phone is ringing. Answer the phone.”

Getting to the phone from bed is a stretch and a twist. I could make it easier if I moved my Disney “Someday my Prince will come” lamp. But this would also make it more difficult to turn the lamp on and off. Since I use my lamp more often than I answer my phone, the phone stays put.

Regardless, answering a ringing phone from a dead sleep is one of my more acrobatic moves. Most times, when it rings early in the day, it is either a telemarketer or a doctor’s office reminding me about an appointment. This time, it was a friend from whom I was glad to hear.

“Hey, Rob!” I said. You’ve got to love Caller ID.

“I’m alive,” he said. He sounded great. Considering he had just had two heart valves replaced during the previous week, that’s not such a small thing. I was amazed, delighted and impressed he sounded so perky and clear-headed.

Rob goes way back into the early teenage years of my life. We met at the college radio station. He was 13. I was 17. I felt very superior since I was obviously four years more mature than he was.

He always had a baby face, full of freckles. He still does, though the hair has become mixed with gray. Our lives have continued to intersect throughout the decades. When he was 14, he got cancer. He was treated. Went into remission. Decided to skip college because he figured he was going to die young.

Not.

He taught himself computer programming and morphed into a software developer. He learned to fly. Bought a small plane. I got to fly it too, even though it was a pretend flight as “co-pilot.”

It was fun, scary, and made me realize I love to fly. As a passenger. No piloting for me, unless I can grow my own wings.

He went to live in Brussels. I went to live in Jerusalem. Both of us came back and got married. My first husband — with whom we were all friends because he ran the college radio station where we met died following a mismanaged mitral valve replacement. I was married to Garry by then, having met Garry at that same radio station.

No exaggeration. Everything started there.

First dawn of spring 2017

So you can see why everyone in our crowd is more than normally nervous about heart valve replacements, even though Jeff’s death was at least partly his fault though I think more the result of an arrogant doctor who failed to take fundamental precautions during post-operative care.

Hearing from Rob was heartening. He had two valves replaced, the mitral and the aortic. He had previously, some years back, had a coronary bypass, so he was a little cranky this surgery. He takes exceptionally good care of himself — and his wife, Mira, would personally fight back death with her bare hands. I wouldn’t mess with her.

We had talked several times about surgeons, hospitals, mechanical versus tissue valves. I explained why I preferred tissue. No blood thinners and with all the other medical issues I’ve got, who needs to deal with potential bleeding issues too? Rob is not exactly free of other medical problems, either. He’s got his original cancer lurking. He will never run out of things to worry about.

Nonetheless, he sounded terrific. Alert. Alive. He had made it. If you live around here and you need serious heart surgery, I highly recommend Beth Israel. They are terrific. If there’s such a thing as a great hospital experience, you will have it there. I don’t say this lightly, having been resident in pretty much every one of Boston’s highly-regarded facilities.

It was deeply reassuring to not lose another friend. Given how small our “herd” has become, we try to grow closer. Because now, we really know time isn’t forever.

We are a strange herd of oddballs — musicians, writers, artists, mathematicians and more. Long may we live.

ONE THING I DID NOT WANT TO BE – Rich Paschall

/ Rich Paschall / 15 Comments

Old, by Rich Paschall

When you think of all the things you want to be when you grow up, “old” probably is not on the list.  You may think about being a doctor or nurse.  You may consider lawyer or politician.  Fireman or police officer may be on your list.  In fact, in your elementary school days you may have changed your mind many times. It is OK to dream about the future and fantasize about what you should do some day.

If superhero is on your list, you may have to give that one up rather quickly, unless you are Robert Downey, Jr.  He is still playing Iron Man past the ripe old age of 50.  I guess that is a commentary on keeping yourself in good shape.  Of course, he is just play acting, like we do as kids, and he certainly has a stunt double.  Your own life does not come with a stunt double, sorry.

If we give it any thought at all while we are young, of course we want to live a long life.  Therefore, we do want to get old.  If accident or disease does not rob us of life too soon, then we will indeed get old.  It is all the things that go with it that I am not too pleased about.

Contemplating the years

Contemplating the years as the sun sets.

I did notice the changes in my grandparents as they got older.  I am certain that I threaded needles for both my grandmothers at some point in time.  I knew they could not see as well as when they were younger, but I never thought about that being me some day.  Yes, I can still thread a needle, but I probably have to hold it at just the right distance in order to do so.  In fact, I really need trifocals, but I have settled for two pair of bifocals instead.  The bottom part is the same on each, but one pair is strictly for the computer.  The top part of the glasses are set to optimize the view from where the monitor should be, a little more than arm’s distance away.

This is not fooling anyone, of course, not even myself.  People can see I switch glasses in order to see.  I should have gotten the same style glasses so it would be less obvious.  When I am on Skype, and can see myself back on the screen, I really do not like the look but I am stuck with them for a while.  At least glasses have gotten better and these are not as thick or heavy as ones I wore years ago.

72-LensCrafters-Auburn-Mall_22

As my grandfather got older, I noticed he sometimes used a cane to help him get up, or walk around.  When he was in his 80’s, he never left the house without the cane.  He just might have too much trouble walking while he was away. Sometimes when I walk past a window or mirror, I think for just a moment the reflection I see is my father or grandfather.  My stepmother once said that I should take it as a complement that people see me as my father, since he was so handsome, but I began to think they saw me as they saw him later in life.  That is, old.

When you see pictures of me, you generally will not see the cane.  I set it down for the shot.  Years ago my doctor sent me to a sports medicine guy for a foot problem of still undetermined origin.  Maybe I was playing sports in the park long after a time when I should have moved on.  Maybe I suffered some trauma that came back to get me.  Maybe it was related to some disease I contracted.  In any case, I had it operated on, which did not help.  Years later I had another operation.  That did not help either.  I had many procedures in between.  Was it just an issue of getting older?  We will never know for sure.

I have heard it said that the aches and pains we feel as we get older are not a natural part of life and we should not just accept them.  Perhaps some accept them when they could feel better, but I have never accepted them.  I have spent a good deal of time getting to know my doctor and all that goes on in his business.  Yes, I might as well interview him a little, he interviews me a lot.  Together we have looked for solutions to my various problems.

The Gabapentin for the foot nerve pain does not seem to eliminate the problem, even if it lessens it.  The Lidocaine patch may numb the pain, but I cut the patch down because a completely numb foot is not a good thing for walking and creates a dull pain, which actually is not much better than a sharp pain.

My doctor does not like my diet or my cholesterol.  He seems to cast a skeptical eye at my insistence that I watch the cholesterol rating on the food I buy.  That does not include restaurant food, however.  Or what John cooks for dinner.  Statins did not work.  They created muscle and joint pain I could not stand.  The non-statin anti-cholesterol pills are not as effective, but hold less side effects, apparently.  Other problems and medications have come and gone. Parts wear out, you know.

Recently a high school class mate of mine wrote to say he had finally gotten in to a senior center he had applied for a while ago.  He had a variety of health issues in recent years and needed to get into such a community.  I wrote back that I could not imagine that any of us would be talking Senior Center, because it seemed like just a few years ago we were in high school together.

With any luck at all, old age will catch you some day.  You will probably feel it coming.

Related: Share If You Are Old Enough To Remember (humor)
To Not Grow Old Gracefully (Sunday Night Blog)

THE STRETCHY BITS – Marilyn Armstrong

/ Marilyn Armstrong / 15 Comments

“Oh,” said the doctor on television. “It’s just a strain. Nothing to worry about.”

I always laugh, without much mirth when I hear that and you hear it often. If a bone isn’t broken, if your head hasn’t been bashed in, no one had a heart attack or brain aneurysm, it’s “No big deal.” Most people break.

I do not break. I stretch. I have never broken a bone — not counting my big toe which I broke diving into the water with my toes pointed, something I only did once. Talk about stupid.

I’ve done a ton of damage by stretching, banging, bruising and generally disarranging parts in and around some kind of joint (knees, fingers, feet, ankles, chest, shoulder, wrist, etc.). You non-medical people might be surprised at how many joints we have, many of which are really tiny.

Nonetheless, it’s official. A sprain is no big deal because all the doctors on television said so. We nod like good viewers.

Strains, sprains, and pulls are harder to heal than breaks. Bones usually heal, but cartilage, tendons, ligaments, muscles may heal and then again,  maybe won’t. All those stretchy pieces are in places that can’t be conveniently set. Ribs. Chest walls. Joints. Knees, hips, backs, groins. Ankles, feet, hands. Spines.

You can’t wrap these human parts in plaster or whatever they are using these days because the parts to which they are attached have to move. You break a small bone in your foot — common among hikers, skaters, skiers, runners — and while you can put a boot on the foot or a brace on the knee, you can’t lock it in place. It has to move because there are attached things that need to move.

We are all connected with strings

Your chest needs to move because you need air. When I was just out of the hospital, I asked how long it would take my sternum to heal.

“Three months,” they said.

Five months later I asked, “Really, how long before my chest heals?”

“Six months,” they assured me.

Five years later, it has not healed. The truth is, you can’t make it heal. There’s no magical medical voodoo that will make anything heal. Bones usually heal — but not always. Those stretchy bits are even less cooperative.

Anatomy. Knee Joint Cross Section Showing the major pieces which make the knee joint. I had the meniscus removed years ago. That was nothing. A bandaid!

When I tore all the ligaments and tendons on my left knee — just about 50 years ago — they wrapped me in plaster from thigh to ankle. I was young and everything healed except the anterior Crucis ligament — which has remained torn. Only surgery will fix it and the surgery doesn’t always work. It was considered a 50-50 bet when I was in my 20s and I turned down the option.

Maybe they’ve improved how they do it now, but since they can’t make my chest heal, I’m betting it’s the same story now. They just work with different equipment. They won’t even try to fix the stretched ligaments in my right shoulder. Healing is slow at my age.

I don’t get repaired. Instead, I am told I have to be more careful.

Exactly how careful can I be beyond how careful I already am? All it takes is a shoe catching on a rug, a damp spot on the floor, a dog underfoot, or getting tangled in my own feet. Garry fell trying to put on his pants and all I did was hit a slightly damp patch on the linoleum floor. We weren’t trying to climb mountains or run the marathon.

Design of the shoulder (Garry had this surgery)

Strains may not kill you, but they sure can limit you. It took me years to remember to not fully extend my right arm or it would dislocate the shoulder. More years to remember to put my feet down carefully so my knee wouldn’t slide out from under me. One error, one little fall, and you are back where you were.

It is extremely frustrating, not to mention painful. But really, the pain is less of a problem than the aggravation. There nothing you can do but let that piece of you rest until it decides to feel better.

I’d like to point out that a strain is not less painful than a break or a sprain and is far less likely to heal properly. Strains are like taking the elastic in your pants and stretching it beyond its ability to come back to the correct size. So you either have to replace it (in a human being, that’s called surgery) or throw your luck into the strength of a safety pin.

I often believe we haven’t been strung together with sturdy enough materials. I know I could use a major restringing.

FAMILY MEDICAL HISTORY – Marilyn Armstrong

/ Marilyn Armstrong / 17 Comments

We do not know nearly enough about the health of our parents and grandparents. We don’t know enough because they didn’t care to tell us about them. The freedom we feel know to discuss our ailments and cures is relatively new. When I was a kid unless it was lethal or it directly affected our day-to-day lives — no one said much.

Sometimes we got “hints.” Clues. Listening to the grownups talk sometimes dropped information that we could later put together. We learned more as we got older, especially if we were nosy enough to ask, but mostly, people in general across races, ethnicities, and religions, people didn’t talk about their medical issues.

It simply wasn’t done.

I knew, for example, about my mother’s breast cancer because it was unavoidable. And also, because my mother talked to me about grownup things to a degree that was unusual in parent-child relationships at that time. Also, knew about her radiation therapy because she had to explain why she could not go into the sun at all. They don’t do radiation (or surgery) like that now, but back then — well, let’s just say they have come a long way since then. They may not be able to cure cancer, but they treat people who have the disease with considerably more kindness.

I also knew about my father’s bone disease that came from being dragged by a car when he was a child and because they didn’t yet have antibiotics, it got into his bone and was not healed until he was in his fifties.

I knew who needed eyeglasses. Who was near-sighted. Who was far-sighted. My mother’s far-sightedness was a bit amusing because as she got older, the books she needed to read needed to be farther and farther away. At one point, she could only read the phonebook when it was on the floor and she was standing up.

What I didn’t know was close to half my family had been born with club feet. I knew my then-husband had been born with club feet (it was hard to miss), but because I knew nothing about its presence in my DNA, I didn’t know that Owen had a pretty much 100% chance of coming up with the same problem. As did Kaitlin, too. It turns out — and no one told us — that club foot is a very common genetic ailment among children. Almost every family has traces of it in their DNA.

But no one mentioned it so I was genuinely surprised when Owen showed up with it.

I didn’t know my father’s heart problems were genetic or that I had the same problem because they are not typically tested for. I’m pretty sure my father didn’t know he had it. He was told he had “congestive heart failure” which is a bucket term the medical community uses to describe just about every kind of “old age” heart problems.  Except that they don’t just show up only in old age. Young athletes die on basketball courts and football fields because no one knew they had Hypertrophic Cardiomyopathy. It’s not something a family doctor can hear in a stethoscope. You need a specialist and unless someone knows it runs in the family, no one checks.

Garry knew about deafness. It was kind of obvious. But he didn’t know that both parents suffered from Glaucoma. Now he has tests coming up. Bad news? Yes, but not terrible news because treatments for it have come a very long way. Use your eyedrops, get regular exams and you are good to go.

But he didn’t know. Because people didn’t talk about it. He did vaguely remember his mother using eyedrops. When he called his brother later in the evening, he discovered both parents had it.

My thoughts? Tell your kids about your medical history. A lot of things are genetic and we don’t always know it. Some things are genetic and the link has yet to be discovered.

Discovering your newborn has something you had no idea ran in your family is a hard way to discover the truth.

MEDICAL QUESTIONS – Marilyn Armstrong

/ Marilyn Armstrong / 5 Comments

I got a questionnaire from some group associated with Blue Cross. They wanted to know if my problem — my trip to the doctor last April — was the result of a work-related injury. Considering that I’m 72-years-old and on Medicare, the odds don’t favor this being a work-related injury, but I’m always up for a laugh or two.

It was just basic “who are you” data until they got to when I started seeking assistance for this problem, listed as “Arthritis” which is very rarely a work-related injury, but I’m a good sport. So I listed August 1, 1965, as the original date I sought treatment since I know I had the surgery that August, but it’s hard to remember which day I went to the doctor. It has been a while.

Back in the day?

It wasn’t work-related then, either. Not only was I not yet employed at anything, but it was horse-related. Riding horses has never been part of any work I’ve ever done, though I wish it had been.

Now, I’m just waiting for them to call me back and ask for additional information. I know. I should be more respectful. Actually, maybe it was 1966?

STRAINS? NO BIG DEAL, RIGHT? – Marilyn Armstrong

/ Marilyn Armstrong / 9 Comments

RDP Tuesday: STRAIN

“Oh,” said the doctor on television. “It’s just a strain. Nothing to worry about.”

I always laugh, without much mirth when I hear that and you hear it often. If a bone isn’t broken, if a head hasn’t been bashed in and no one had a heart attack or a brain aneurysm, it’s “No big deal.”

It’s official. The doctor on television said so and we all nod like good little viewers.

Strains, sprains, and pulls are harder to heal than breaks. Bones usually heal, but cartilage, tendons, ligaments, muscles may heal and then again,  maybe not. All those stretchy pieces are in places that can’t be conveniently set. Ribs. Chest walls. Joints. Knees, hips, backs, groins. Ankles, feet, hands. Spines.

You can’t wrap these human parts in plaster or whatever they are using these days because the parts to which they are attached have to move. You break a small bone in your foot — common among hikers, skaters, skiers, runners — and while you can put a boot on the foot or a brace on the knee, you can’t lock it in place. It has to move because there are attached things that need to move.

We are all connected with strings

Your chest needs to move because you need air. When I was just out of the hospital, I asked how long it would take my sternum to heal.

“Three months,” they said.

Five months later I asked, “Really, how long before my chest heals?”

“Six months,” they assured me.

Five years later, it has not healed. The truth is, you can’t make it heal. There’s no magical medical voodoo that will make anything heal. Bones usually heal — but not always. Those stretchy bits are even less cooperative.

Anatomy. Knee Joint Cross Section Showing the major pieces which make the knee joint. I had the meniscus removed years ago. That was nothing. A bandaid!

When I tore all the ligaments and tendons on my left knee — just about 50 years ago — they wrapped me in plaster from thigh to ankle. I was young and everything healed except the anterior Crucis ligament — which has remained torn. Only surgery will fix it and the surgery doesn’t always work. It was considered a 50-50 bet when I was in my 20s and I turned down the option.

Maybe they’ve improved how they do it now, but since they can’t make my chest heal, I’m betting it’s the same story now. They just work with different equipment. They won’t fix the stretched ligaments in my right shoulder. Healing is slow at my age. So I don’t get repaired. I am told I have to be more careful.

Exactly how careful can I be beyond how careful I already am? All it takes is a shoe catching on a rug, a damp spot on the floor, a dog underfoot, or getting tangled in my own feet. Garry fell trying to put on his pants and all I did was hit a slightly damp patch on the linoleum floor. We weren’t trying to climb mountains or run the marathon.

Design of the shoulder (Garry had this surgery)

Strains may not kill you, but they sure can limit you. It took me years to remember to not fully extend my right arm or it would dislocate and more years to remember to put my feet down carefully so my knee wouldn’t slide out from under me. One error, one little fall, and you are back where you were. It is extremely frustrating, not to mention painful. But really, the pain is less of a problem than the aggravation. There nothing you can do but let that piece of you rest until it decides to feel better.

I often believe we haven’t been strung together with sturdy enough materials. I know I could use a major restringing!

TOO LATE LEGAL – Marilyn Armstrong

/ Marilyn Armstrong / 20 Comments

“Have you considered marijuana?” floated past me on the conversational breeze. It was my previous cardiologist speaking. Was I in the Twilight Zone? No, he was merely suggesting pot might be a good drug. For me. It would deal with a variety of issues. He wasn’t suggesting “medical marijuana” because though theoretically we have it, insurance won’t pay for it and almost no doctors are certified to prescribe it. But don’t worry, now we can buy it recreationally — and legally — at a local shop.

“Uh, yes,” I said. “The downside, other than the price tag, is coughing. Coughing hurts.”

“Take in more air when you inhale,” he said. “You’ll cough less.”

Right. Like I didn’t know that already. He forgets that mine is the generation that made it popular. The biggest users of legalized pot are —  you guessed it — senior citizens.

I grew up in a world where getting busted for having a couple of joints in your pocket could land you in jail for a long time. A world in which marijuana supposedly was the gateway drug to a life of dissipation and degradation which would end with you lying face down in a gutter in a part of town where the cops won’t go.

Now I live in a world where the cardiologist recommends smoking pot.

My mother was born in 1910 and passed in 1982. Growing up, horse-drawn carts were far more common than automobiles. She was a child during World War I, a married woman and a mother in World War II. She survived — somehow — the Great Depression and marched with friends and family in a spontaneous parade of celebration when the New Deal passed. Even though the Depression didn’t really end until World War 2 and brought employment to everyone who wasn’t fighting.

By the time she passed, there was cable television, home computers, and two cars in every driveway. One day (I was a kid) I shouted: “Oh look, a horse and cart!”

She looked bemused. “When I was your age,” she said, “We used to shout “Look, a motor car!”

And today, my cardiologist suggested pot. Okay. I think I see a motor car.

Our local cannabis shop is at the edge of town, close to the main road that goes to Rhode Island. Convenient. It also has a parking lot.

I was afraid they’d put the shop in the middle of town and we’d have a permanent traffic jam.

Massachusetts, in its infinite wisdom, has so heavily taxed cannabis that it’s more expensive to buy it legally than to get it from ye olde dealer. In fact, it’s a lot cheaper to buy it from the same guy you bought it from before they made it legal. Competition lowered his prices while the state upped theirs. Figures, doesn’t it?

As it turns out, pot has no particular medical advantages for me.  The cannabutter I made was so strong, I didn’t feel better. Mostly, I just passed out.

I wish it did work medicinally. I wish something would work. The company that made the medication that always worked for me stopped making it a few months ago. It was cheap to buy and it helped. But it wasn’t profitable. Now we are searching for something else that won’t make me sick, make my heart stop, or give me ulcers while reducing the pain enough to allow me to function.

Pity the pot didn’t do it.

FANDANGO’S PROVOCATIVE QUESTION #27 – Marilyn Armstrong

/ Marilyn Armstrong / 16 Comments

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

/ Marilyn Armstrong / 9 Comments

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

/ Marilyn Armstrong / 16 Comments

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!