MEDICAL QUESTIONS – Marilyn Armstrong

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

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

“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

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!

SEEING DOUBLE – Marilyn Armstrong

FOWC with Fandango — Double

Among the final tests they did on me — after the fancy arterial testing, mental testing and a lot of stuff I barely remember, they ran an eye test. You know: holding up the card and asking you to read the letters? It turned out I saw it twice with my left eye, but only once with my right one.

“AHA,” they cried. “By George, I think we’ve got it!”

They peered into my eyes, but couldn’t see anything in the left one. It was murky.

“CATARACTS!” they exclaimed, looking and sounding relieved. By then, we were ALL relieved. The seizures weren’t seizures — they were narcolepsy which is in my records, but no one ever looks at your records. They do everything except check to see if you have by some odd chance another condition which could account for the current problem. Why do they bother to keep records since no one reads them anyway?

Remarkably, it is exactly like the folks in customer service who never look to see if someone left notes in your records. It’s probably part of the onrushing of stupid that makes the world such a dandy place for all of us.

Suddenly, all was (sorry for the pun) made clear. Double and/or fuzzy, depending on which way you looked at it, or more to the point, depending on which angle I am looking at it.

I only have double vision peripherally and only on the left. Looking straight ahead, it’s a single image but fuzzy. The left side of my right eye is also murky. Who said everything has to grow evenly?

Just for a statistical explanation for you number-minded folks, at age 75, you either have cataracts or have had cataract surgery. They expect to do more than 30 million such surgeries this coming year — worldwide (only about 3 million in the U.S.). There might be more because cataracts are inevitable. There would be even more except for poor countries which don’t have the facilities or doctors to perform the surgery.

Someone at some institute is working on eye-drops that will make cataracts disappear, but it hasn’t happened yet. This would be great because it might be a way for all the people worldwide who don’t have facilities for eye surgery to have their cataracts corrected. But drops would mean you won’t get those corrective lenses that give you perfect vision (for a few years, anyway). You probably haven’t seen that well since you were a toddler. I really want that perfect vision.

Warning: You will absolutely need reading glasses! But the good news? You can get the cheap ones from Target or Walmart.

What a great idea, to be able to open my eyes in the morning and see clearly! Without fumbling for my glasses. Totally cool!

So. This old lady has cataracts. How utterly normal.


Note for photographers of a certain age

If you are a photographer, one of the signs of cataracts is that the colors in your pictures seem dull. If you find you have to keep turning up the saturation and sharpness, you might have cataracts. You don’t need to be old, either. They can occur at any age, though more likely when you’ve passed 60.