Being black is bad for your health

Black Man in a White Coat: A Doctor's Reflections on Race and Medicine by Damon Tweedy
My rating: 5 of 5 stars

This was a book club selection for one of my Book Clubs. I would call it an outstanding book to read. When Damon Tweedy entered medical school at Duke University, he expected a promising career which would give him the opportunity to serve the community. What he learned repeatedly is, "Being black is bad for your health." His professors highlighted the instances of poor blacks with no health insurance who can't afford the treatments they need, as well as the lack of health services for blacks in the rural South. In addition, the southern diet of over-salted fried foods, and the lack of exercise, cause hypertension, and heart disease.

Tweedy chronicles how during his internship, he met people waiting for hours for appointments in rural clinics, where patients often can't afford the medications prescribed, and doctors have to resort to samples to help their patients with limited income. While Tweedy had expected a career in cardiology, he actually transitioned to a practice in psychiatry, where he was able to provide talk therapy as well as prescription treatment for patients.

This was an impressive book, covering matters of health and race, as well as discrimination in the practice of medicine.



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Two broken toes, two busted suitcases, and the recurring dog dream

 

It's been two weeks since we returned from our Alaska adventure, a land tour followed by a cruise of the inside passage.  It was more fun ten years ago when we did the same trip for our honeymoon.

I broke my toes a month before the trip, and we had booked the trip last year, so we couldn't cancel.  The doctor OK'ed me to go and advised me to keep my foot elevated as much as possible.  I expected the biggest challenge would be making our flight changes on the three legs of the trip to get from Raleigh to Anchorage.  So Tinker arranged for wheelchair assists for me for the three airports.  The concourse change in Seattle was convoluted enough that we might have missed our flight if I had had two good feet walking without the assist.

By the time we reached our hotel in Anchorage, my foot had started to swell but I was prepared with an ice pack which we filled from the ice machine in every hotel stop for the whole land tour.  We traveled as a group on three motorcoaches and by glass-domed traincar on the Wilderness Express® to Talkeetna, Denali, and back to Alyeska and Seward. In Denali National Park we had an all-day Tundra Wilderness Tour deep into the park where we expected to see wildlife.  We had seen bears and moose from the train, but all the sightings in the park required binoculars.  We had enough space on the train for me to prop my foot up, but the days on the bus ended with a swollen foot.  I was happy to finally reach Seward where we boarded the cruise ship.

Since we had done a similar cruise before, we did not plan any excursions this time.  We had seen salmon hatcheries, and plenty bald eagle sightings, and there were enough whale sightings from the ship that a side trip wasn't necessary.  By the third day, my foot was down enough that I could wear sneakers on both feet, and walk a few blocks in our port stops.  Tinker did more exploring without me along with our friends who came on the trip with us.  I was content to be back in the cabin, catching up on my reading.  Our cabin steward kept the ice bucket filled so I could ice my foot.  We had several at-sea days which included getting closeup to the Hubbard Glacier and a separate day in the Inside Passage.

The trip home was two long flights, Vancouver to Toronto, Toronto to Raleigh.  I assessed my foot and Tinker assessed the luggage when we got home.  I didn't want to think about deep vein thrombosis, but my foot and leg were swollen up to my knee.  I massaged both feet and legs and packed the right one with ice when I finally went to bed.

The luggage fared worse than I did.  We do travel a lot, maybe three cruises and two other trips per year.  Our luggage was handled a lot more this trip than any I remember.  One large wheelie had a gash in the bottom, a second large wheelie had a busted wheel and the handle refused to slide out.  We had to decommission them both.

Now for the recurring dog dream.  It all started about six years ago, when number one son and his first wife came to visit from New York with a dog.  Tinker and I love dogs, but we don't currently own one.  We always say we'll get one when we finish traveling so much.  Son asked if they could bring the dog.  I said no, but his wife brought him anyway...a rather large puppy "Denzel" who was used to living in a small NY apartment, and going outside on a leash.  When they let him outside in the backyard, he went wild, found a space to escape under the fence and took off down the street.  They were able to chase him down in a few minutes and brought him back inside, where he continued to be rambunctious.  By the time they all went back to New York, Denzel had made a big impression.

For two nights after they left, I dreamed about the dog, and woke up thinking I had to drive him back home.  The dream was so vivid as to fill my half-waking moments with an urgency to get up and get the dog ready to go, I was in the bathroom starting my shower before I realized it was a dream.

Since that first episode, every time we return from a trip and I am overtired, as I was when we returned from Alaska I have that dog dream.  I still wake up thinking I have to take the dog back, but now I come to my senses before I get out of bed.

Will you still love me...

OK, Baby Boomers, we wrote the songs.

Will you still love me tomorrow?



Will you still need me when I'm 64?



And then there's the one that hasn't been written yet:

Will you still love me when I don't know who you are?

Tinker decided one of my bookcases was falling down from overload. After he repaired it, he said I needed to get rid of some of the books to make space for the photo albums. We have photos from every vacation, cruise, roadtrip, family occasion we have had since we got married in 2002. After we went digital, we took hundreds of pictures of everything and shared them with our friends on the internet. Then we printed about 15% of them using one of the online photo services like KodakGallery or Shutterfly...whichever one is having a sale when we need one.

After I got all the albums labeled and shelved, I started wondering what we would ever do with all those prints. They're nice to have when friends come over and ask about our travels...better to look at the prints than have them go with us up to our office and look at the computer screen.

Then I thought about my dear sister Laverne. LaVerne is 85 years old and has dementia. I hesitate to use the A-word as it seems like a sentence for my future health as well.

Anyway, LaVerne and her husband Goody traveled all over the world when they were able, and now they have a collection of photo albums. When I visited with LaVerne on one of those days when she didn't remember that Goody was her husband, I pulled out one of her photo albums and she started remembering events from those trips. Then she asked, "Why is it that every time I turned around, Goody was there too?" She turned the page and said, "There he is again."

Sometimes you just have to laugh to keep from crying.

Me and the Machine

It all started in February 2011 when I attended a Red Dress Affair sponsored by Duke Raleigh Hospital. The event featured a health fair, heart-healthy cooking demonstrations provided by Kroger, free advance lipid profile test provided by LipoScience, screenings by Duke Heart Center, healthy lunch, and presentations from Duke experts.

As the youngest of seven siblings who have various forms of cardio-vascular disease, I thought I knew it all. I manage my hypertension with medication, keep my weight down, eat healthy meals, and exercise regularly. I was just going for the fellowship with 20-some women from church, and free lunch.

Then, as I was finishing up my lunch of grilled salmon and green salad, a doctor started his presentation on sleep. He said, "I bet every time you go to the doctor you don't have any problem talking about your blood pressure, your blood sugar, your weight, and if anything hurts you talk about that too. But do you ever talk about how well you sleep?"

He asked five questions about sleep, from a slide that I didn't copy down. He said if you answered yes to any of these five questions, maybe you need to talk to your doctor about sleep apnea. I had answered yes to all five questions. I snore; I fall asleep when somebody else is driving; I have trouble staying awake when I'm driving; I fall asleep in the movies!! I fell asleep on Transformers, even with all that action and crashing and banging of machines.

My next 6-month checkup, I discussed it with my doctor. He didn't seem convinced that I have a problem, but he referred me to a neurologist for a sleep study. When I started talking to online friends about having a sleep study, over twenty people volunteered their own experiences, and it seemed that half the world has a CPAP machine. I don't have trouble falling asleep; my trouble is staying asleep. The study determined that I have mild sleep apnea...enough to benefit from having a CPAP (continuous positive airway pressure) machine.

I named him Argoyle. We've been together for two weeks now. I can't say that I get any more sleep than before, but I am getting better sleep. It's quiet enough, and the mask is unobtrusive enough that I forget I'm wearing it. I still wake up at four or five AM, but I feel refreshed.

I'll be taking Argoyle with me on a trip next week. Medicare won't pay for him unless I'm compliant, using it at least four hours per night for 30 days. Argoyle has a memory card to record my usage. So he and I will have fun going through airport security. I hope we don't make the news.

Oral Galvanic Effect

I had two fillings replaced in my teeth last week. My dentist took great care in making sure my upper and lower teeth came together correctly. I did the bite on the carbon paper thing several times until I felt comfortable.

On the way home, the Novocaine wore off. I bit my teeth together, and it was like an electric shock in my mouth. But if I bit firmly, there was no shock. I had other errands to run, and didn't have time to go right back to the dentist. Besides, I thought maybe the trauma in my mouth needed to settle down, and I would feel better.

When I ate dinner later, I had no pain from biting or chewing food. It was just from those bare teeth with fillings coming into place. Lucky for me that I wear a mouth guard at night so my teeth won't clench, or I would never have gotten to sleep.

I gave it a few more days before I called my dentist. No, my tooth doesn't hurt. Gums don't hurt. Not sensitive to hot or cold. It's just that electric shock thing. He told me to come in and he would adjust my bite again.

When I went in, he had me bite on that carbon paper stuff again, and I didn't get a shock with the paper between my teeth. Conclusion: Galvanic Effect. It was the metal touching metal that was sending a jolt through my mouth. It took my dentist about five minutes to grind down a couple of spots, so my mouth was fine again.

Something new every day!!!

Bucket list item: Figure out Medicare

This is my year to go on Medicare. You would think that since I'm the youngest of seven siblings, I might benefit from my older siblings' knowledge of Medicare, but no. Something changes every year, and each of my siblings has had a different set of circumstances going in. Some Federal employees, some veterans, various combinations of health or prescription requirements. I'm having to figure out mine on my own.

The thing that is somewhat distressing is having to make decisions that will impact my health for years to come, at a point in my life when it is increasingly difficult to sort out all the "Parts" of Medicare. Fortunately, North Carolina and many States have agencies whose sole purpose in life is to help Seniors sort through the alphabet soup of Medicare. In NC it's called SHIIP, Seniors' Helath Insurance Information Program. www.ncshiip.com They were the first ones I called. I told them that I retired from the State Government, and they told me Medicare would pay 80% of my health claims, and then the State would kick in. My coverage with the State would be 80% of the remainder. Then they reminded me that I would have to pay the State deductible first....currently $600 per year, plus co-insurance if applicable....HUH?

So I started digging through my handy "Official Government Handbook" on Medicare. They really ought to get some 70-year-olds to review the language in that thing. There's Part A, that many people get "Premium free," unless you're one of the people who has to pay for it. (What?)

"If you choose to buy Part A, you must also have Part B and pay monthly premiums for both." (Didn't I hear a bunch of tea party folks complaining being forced to pay for health insurance under the Obama plan?) I started wondering if you could opt out of Medicare...maybe if you're healthy you could wait until you get older and have more health costs. Nope, Nope, Nope.

"If you don't buy Part A when you're first eligible, your monthly premium may go up 10%. You will have to pay the higher premium for twice the number of years you could have had Part A but didn't join." GEEZ!! Why didn't my hubby tell me all this when he signed up. Well, hubby is a Federal retiree who came along during the Reagan years when Federal employees were not under Social Security. He wasn't even sure if he would be covered by Medicare. He is, and he is also covered by the same health plan he had when he worked. He had to change providers when he moved to North Carolina, but he still has the same coverage. He doesn't have to get into the alphabet soup.

So anyway, I started digging into the handbook to see if I could get some relief from that $600 deductible and co-insurance, and read about Parts A through D. I'm still trying to figure out if the Medicare Advantage Plan (Part C) will help me. The good people at SHIIP told me that my State Insurance would continue to cover my prescription drugs, so I don't need Part D. (The only good thing so far) I tried calling AARP, since they sent me their brochure of Medicare supplement plans. Plans A through D (not to be confused with Parts A through D) and plans E through J. The AARP person said I could not get a supplement since I already have the State plan as a supplement; that would make me over-insured. I could drop the State plan, but then I would lose the prescription drug coverage (no premium) and would have to get a Part D.

OH LAWD!! I'm going to have to call somebody to talk me through Medicare Advantage. Meanwhile the vultures are calling. The list of people turning 65 must be on a hot bulletin board somewhere. I have an appointment with my State Farm guy tomorrow to talk about home and car coverage. He'll probably bring out the Medicare kit.

Getting old sucks!!

"I have this one body, this one life"...

...So said Sally Field in her advertisement for Boniva. Now I'm saying the same thing in rejecting my current osteoporosis treatment.

I blogged about my comparative analysis of osteo drugs in August 2008 after my second bone scan showed that I had osteopenia. I jokingly called it Oscar de la Peña. It's no joking matter anymore. I didn't choose Fosamax because of reflux concerns. Now we know that long-term use of Fosamax has caused bone breakage in a significant number of women.

In doing my comparative analysis back then, I made a spreadsheet to line up all the side effects. Then I chose to go with Evista, which is not in the same class of drug with Fosomax. And then I forgot all the side effects of Evista...until Fosomax made the evening and morning news for several days in a row. That news made me go digging again into the small print side-effects for Evista.

The Good News:

• Evista lowers the risk of breast cancer.
• It lowers total cholesterol and LDL ("bad") cholesterol. It does not affect HDL ("good") cholesterol or triglyceride levels. (And I thought my good numbers were due to my use of Benecol)

The Bad News:

• Signs of a blood clot in the leg, such as pain in the calf, leg cramps, and leg or foot swelling
• Signs of a blood clot in the lung, such as shortness of breath, sharp chest pain, or coughing up blood
• Signs of a stroke, such as vision or speech changes, weakness or numbness in an arm or leg, and a severe headache
• Sudden loss of vision or vision changes, which can be a sign of a blood clot in the eye

Then I remembered that I talked to my primary physician about the risk since my family has a history of heart disease, including peripheral artery disease. He pointed out that deep-vein thrombosis is not the same as PAD. What we didn't talk about was the risk of stroke. And since I didn't know of any blood relative who had had a stroke, I didn't worry about that side effect, and started taking Evista.

The New News:

• I now have a primary relative who has had mini-strokes.
• I have experienced some vision changes, flashing floaters that lasted for a few hours.

I have for a long time used my sister to fortell my future. It's like a flash-forward to see myself dealing with the effects of mini-stroke. My sister has had no incidence of bone breakage, and she doesn't take an osteoporosis drug.

I have decided to take the natural route. I have quit my Evista, without consulting my doctor. I have boosted my Calcium intake...again.

More Good News:

I'm physically stronger. For the last year I have kept to a routine of strength training. Thanks to the crew at Rex Wellness, my arms, legs, core are all stronger. Thanks Deb, Sue, Marci, and Tricia. (And my role model, Michelle Obama)

I'll do another bone scan this year after a few months off Evista, to see if I can stay on track.

DNR

The doctor showed them the big yellow sign, meant to stop the staff in their tracks. This one said "Do Not Resuscitate." She asked my sister and brother-in-law if that was their desire. I thought they already had a "Living Will" but it turns out the attorney back home said to wait until they get to North Carolina, since the legalese would be different. But they responded, "Yes, that's what we want."

The thought of it cut me like knife. I needed clarification, just to be sure. "You mean, if they find you with your heart stopped, you don't want them to use those paddles to get you going again?" "That's right."

I told the doctor, we needed to discuss this further. I discussed it with their daughter who is snow-bound up north. She said to ask him separately what he would want for her Mom. She would abide by their decision.

I told someone yesterday that I would go ski-diving on my 80th birthday. While I don't want to be kept alive by extraordinary means (I'm saying this today at age 64), as long as there is some joy left, I want to hang in there. Maybe I'll see things differently if and when I reach 80 years. I hope not.

What feels like appendicitis, but isn't?

It's been over three weeks since my surgery, and the pain in my right side is gone. The ovarian cyst on the left was not the cause, but the laparoscopy to remove the cyst provided a view of the problem on the left. The picture below is fuzzy because it was a stealth photo of a photo. Adding the legend made it more fuzzy. My daughter had suspected that I had adhesions that caused the pain. When my gynecologist saw it, she called it a "tether." One quick snip, and I'm pain free.


I still can't play the piano. And I'm three days behind on my NaNoWriMo.

Will I be able to play the piano?

When my doctor came to see me Post-op, that was the first thing I said when I woke up. It was like I had been waiting all my life to make that dumb joke, and I finally had the opportunity. She was serious, "If you could play before." "How about playing tennis?"

Two of my greatest regrets. I quit the piano when I was four years old. Or it was really my mother who couldn't stand my banging and crying anymore. I couldn't stand to practice. I wanted to get it right the first time, so I would bang and cry. Some things I will never be able to do no matter how hard I work at it. I will always suck at tennis.

My surgery was a success. My left ovary and cyst along with the fallopian tube, were bagged up and pulled out through my belly button. Now I have three small bandages, one on each side, and one for the belly button. My gut feels like a small bulldozer went through it, but otherwise I'm feeling well.

My daughter said I probably had Propofol for a sedative. That would explain my loopy conversation. I feel like I understand Michael Jackson a little better now.

It's My Birthday

I had my Pre-OP meeting today. They do it by telephone. Rather strange, but it certainly was convenient. I've accompanied my brother for his last three pre-op appointments, so I knew what to expect. I had my shoe-box of meds all ready to tell them what I take. With my changing assortment of blood pressure medications, there was no way I would remember my dosage and the names of Benicar, Diltiazem, and Terazosin. Those are the three I'll have to take the morning of my procedure.

I had to confirm that I was having a left Oophorectomy...her word, not mine. A laparoscopy, and I'll stay overnight. My pain level is only two today. Any kitchen activity takes it up to a six (for-real!!) I went to muscle class last week, and that took it up to a seven.

I'll be glad to have this thing over.

Today is my birthday! The count-down starts to Medicare...LOL The insurance companies have already started bugging me to select a Medicare supplement plan. Gonna sit on my throne the rest of the day.

“No News” Sucks!

Whoever said, “No News is good news,” must have had their head buried in the sand. Some things I want to know, and I want to know NOW. I have been silent on this blog for a few weeks now, waiting for resolution of a health issue. Waiting Sucks!

When I started writing this blog, I called it “Aspiring Writer.” For about a year, I wrote mostly about the book I was writing and hoping to publish. But with everything else going on in my life, writing was just one of many things on my list of things to do, to see, to accomplish. I changed the title to “Checking off the Bucket List.” Aside from self-publishing my book in 2008, I became involved in the Obama campaign and the witnessing of the election of the first black President of the United States.

I have since gone in many directions with my Bucket List, writing about the things that give me pleasure and the things that keep me awake at night. Everything from that pesky “Check Engine Light,” to figuring out my new digital camera, to travel around the world.

My life has been blessed. At 63 years of age (I'll be 64 on October 7...don't tell), the youngest of seven siblings, I have out-lived my mother who died at age 54, my first husband who died at age 58, and one sister who died at age 58. I often said that I was living in the gravy. I have been reasonably healthy, an active Senior Citizen. My blood pressure is under control thanks to four daily meds, and I stay up-to-date with the commonly prescribed cancer screenings. If I have a pain I can’t explain, I nag my doctor until I have reason for it.

That brings me to the subject of this entry. I have experienced some non-specific abdominal discomfort for some time now. At first it was a stitch in my side that I had had for most of my life but became more intense in the last few months. I told my doctor and he suggested exercise to strengthen my core muscles. I did that and strengthened my core, and added what seemed to be muscle fatigue. I was never in enough discomfort to take pain killers, although my doctor had prescribed pain patches that I used a few times over the last few months. I became more concerned when I just could not manage an exercise ball. I didn’t have the balance to stay on it very well in a sitting position. I could do crunches from a lying position on the ball, but any pressure on my abdomen made me nauseous enough to quit the ball.

I continued to nag my doctor, until he ordered a CT scan. My insurance denied that request; they wanted me to have ultra-sound first. This is when the waiting started. The radiologists wouldn’t tell me anything specific, but the first ultra-sound showed a cyst on my left ovary. She said it wouldn’t be a concern if it weren’t for MY AGE. So they got approval for a pelvic scan and the CT that the doctor wanted in the first place.

Four business days after the first procedure, I had no word from my doctor, so I called and left a voicemail message. It’s impossible to talk to a human directly in that office. Day five, and still no word, I leave a panicky message. “I need someone to tell me I don’t have cancer.” Day six, I hear from my Doctor’s nurse. They have the 2 ultra-sounds. My doctor wants to send the ovary to my OB-GYN, and the nurse asks for that name and number. They still haven’t seen the CT. Day eight, I call my gyno. The receptionist says I should get a card in the mail. I have to explain that it is more urgent than that. So she leaves a note for the gyno. Gyno calls that evening. Describes what she sees on the ultrasound. I had my annual exam just 2 months ago, and considering the size of the cyst, she would have felt it. She doesn’t say it, but I hear, “it must be growing fast.” She wants to order blood tests.

I go in the morning of day nine, get blood drawn for a CA125 and a CEA test. I had done my homework. I knew what a CA125 was, and I was getting nervous. By day 11 the waiting is getting on my nerves. I finally hear from my primary physician’s nurse, the CT scan was normal. (He thinks I’m a hypochondriac.) Day 12 I call my gyno. She’s with a patient, but conveys the message that my numbers are OK, not to worry. She calls me after office hours. We talk about the procedure. I’m a good candidate for laparoscopy. Might have to stay overnight. She’ll hand it over to her office manager to get insurance approval, and schedule the procedure.

Today is day fifteen. That’s 15 business days. So we’re talking three weeks since I had the first ultra-sound. Still no news. I called this afternoon and the office manager is out until tomorrow.

Looming in the background is my dear husband who booked us last year on a cruise leaving from Barcelona on November 6. Ports of call are Athens, Malta, Rhodes, Cyprus, Sicily and the biggie....ALEXANDRIA, EGYPT.

Waiting sucks!!

Strengthening my core

I didn't even know I had a core until a few months ago when I started taking muscle classes. I found out right away that stuff was hurting that had never hurt before. Even my eyebrows hurt, and I complained about "That woman" who was hurting me.

All I really wanted was arms like Michelle Obama. I got a whole lot more than I bargained for. I still can't do a decent plank, but "Brunhilda" has made me stop doing wall pushes for situps. She says I'm stronger now....HAH!

But I have lost a few pounds, allover inches, and people are noticing.

Now for the part that is only for us girls. Core muscles include the pelvic floor. You know those muscles that start to atrophy after childbirth and with age. Fifty Kegels is no match for a 30 second plank! Hammercy!!

Here's a slide-show from the Mayo Clinic if you haven't mastered the plank.

Click here

Shopping for Meds

I know I'm a Senior Citizen around here. My friends call me Ms Sarah, Mama Sarah, Mother Confessor. I don't mind.

I probably take more prescription meds than most of you, so you may think this blog doesn't apply to you. But you may have a parent, grandparent, sibling, neighbor, or someone who is struggling with the cost of prescription medication and could use some relief.

I take seven prescription medications every day, along with a handful of vitamins, minerals, herbal supplements, and assorted other stuff. It takes a lot to keep a sister alive these days.

As a retired employee of the State of NC, my health care premium is free for life, or until they change something. Due to the current economic downturn the State Health Plan has made some changes to keep the plan solvent. Co-pays are increasing, as well as premiums for family members. Tinker has his own retirement, so that's not an issue. But for a lot of State employees the increase means they can't afford to insure their families. It was a short-sighted move on the part of the State, since it's the young people who don't have major medical expenses, who keep the plan afloat for us old folks.

I used to think a $30 co-pay for a 90-day supply of a generic medication was a good deal, until I realized that those same meds on the open market cost less than $30 for a 90-day supply. The preferred pharmacy for State insurance, Medco has been making money off of us. The open-market players have gotten into the pharmacy business and are selling that same 90-day supply for $10.

I've been a little slow in getting into the game, but this week I jumped in. Wal-mart, Target, and all the local grocery chains are in the game. In addition they offer incentives for bringing your new prescription, or transferring one from your old pharmacy. When I picked up my three generics yesterday that previously cost $90 total, I paid $30. It would have been $50 because I take 2 pills per day of two of those prescriptions, but I had earned two $20 incentives for two prescriptions I filled for a family member the day before. I can only cash in one at a time. Not a bad deal.

This is something I've been planning to do for months, but when a new Harris-Teeter opened across the street from my health club, I knew I had to do it.

If you can't take advantage of this kind of discount, check with mama, grandma, auntie, and 'nem. I bet somebody you know can.

Anatomy of the Arms

The photo above was taken aboard the Freedom of the Seas in November 2006. Not bad arms for an old broad who had just celebrated her 61st birthday. But there's a story behind the arms.

The trouble started in 2004 when I had a colonoscopy. That was a good thing to do, and I won't have to do that again until 2014. But in the process of moving myself into position on that metal table, I pulled something in my left shoulder. I noticed it at the time and thought it was something that would resolve itself in a few days. Within a few days I realized I couldn't lift my arm above shoulder height, and couldn't reach behind my back without pain for simple dressing tasks, like zipping or hooking stuff.

When I told my regular doctor, he said it sounded like a bone spur in my shoulder. Great, how did I get a spur and how do I get rid of it? So now I'm at the age when the doctor begins too many sentences with "At your age..." Thanks, doc. So he sent me to an orthopedist who specializes in shoulders. I didn't know there was such a specialty. The orthopede gave me a pulley contraption to do shoulder exercises that were supposed to build up my shoulder muscles and correct the pain problem. After a few months of the pulley and cortisone shots, I still couldn't fasten my bra without turning it around to the front. (Tinker thought that was cute.)

The next step was Aqua Therapy. Wonderful stuff. I recommend it highly for everybody. I did shoulder exercises in a warm pool with resistance devices to build up my shoulders. The warm water helped to alleviate the pain, and eventually I was doing lifts outside the pool and at home.

I was even carrying the 3 pound weights with me when we traveled. On one trip, the baggage handling totally tore up one suitcase with that undistributed weight. By early 2005, the shoulder was felling pretty good, except I couldn't sleep on my left side without pain. I tried sleeping on the right side, but I always prefer my left side, and would roll over to the left side in my sleep, only to be awaken by the pain. The therapists suggested sleeping with a teddy bear under that left arm. "A Teddy Bear?" It turns out that the teddy bear is just the right size to fit under the arm. So by our cruise in April 2005, the bear was going with me everywhere.



I stayed faithful to my weight lifting and slept with that bear until I had foot surgery in 2006. Since I was on crutches for several weeks, I was exerting that shoulder in another way. The last pain in the shoulder stopped, and I didn't need the bear anymore.



So there I was on that slippery slope, falling off the wagon.

My friends know the rest of the story. I've been inspired by "My First Lady" to get my arms back in shape, and I have a target date to see some progress. I'll be wearing something sleeveless Memorial Day Weekend, and I want my friends to congratulate me on my arms.

Implants anyone? (If you're sqeamish about teeth, don't read this)

Keeping a healthy mouth is a full-time job for me. I have suffered with bruxism for as long as I have had teeth. When I was two years old, my sister complained that my teeth grinding kept her awake at night. I don't know what kind of stress I had at two, but I'm still doing it.

The grinding led to TMJ - temporomandibular joint problems. About 25 years ago, my face hurt so bad from my dislocated jaw, that I needed braces. And I had beat up my front teeth so bad that it took bone grafts to save them. I continue to see a periodontist 3 times a year, and I wear night guards (retainers) to protect my teeth from the continued grinding.

Retainers don't last forever. I replaced the lower one about five years ago, and the upper one in August. The fitting process took several visits. But I'm still grinding away at night, and the teeth did some moving to adjust to the new retainer.

At my last regular periodontist visit, I told the technician that I noticed a few days earlier that my bridge seemed to be loose. The X-ray above confirmed the problem...not a loose bridge, but a cracked tooth. (Don't you love digital technology. No more developing of X-rays in a dark room. You can see them immediately on the screen of the laptop, even magnify that sucker.)

That was December 19. The Periodontist started drooling at the mouth and suggested two implants. He could do it before Christmas!! I wasn't ready to do anything so drastic without a second opinion, especially considering the cost. He hadn't told me what the cost would be, but I was imagining having to take out a second mortgage. I left there feeling the need for a good cry. We went to see "Seven Pounds" and that didn't help any.

I called my dentist that afternoon, and left a message. He doesn't work on Friday. I didn't find out until the next week that he was taking off until January 5.

I finally saw him this morning. We talked about options. The cracked tooth was also decayed, and I didn't feel any pain with it because it had a root canal. It would have to come out. He said the implants would cost about $3,600 per tooth (two teeth)!! If I were 20 years younger, and still working, I might have gone with that. But we decided on the cheaper route. In any case, I'm nursing a swollen jaw, and mourning the loss of another tooth.

Back to the Issues

There is nothing like a meltdown in the financial sector to get people thinking straight again. Maybe the Palin bump is over.

But I promised to talk about healthcare, at least my take on it. McSame thinks health care is a non-issue because sick people can always go to the emergency room and be treated there. That shows he's never had to go to an emergency room and be treated by a doctor who doesn't know or care who he is. Band-Aid treatment, besides being very expensive, never provides a cure, and never provides preventive treatment. Even if the patient doesn't foot the bill, somebody does. And you'll never get a PSA test, or a mammogram in the emergency room.

But who else has an issue with healthcare besides the emergency-room walk-in? Right now, I'm reasonably healthy, and I'm covered by my former employer's plan. As a retiree of the State of North Carolina, I don't even have to pay a monthly premium. When I reach 65, Medicare will be my primary coverage, and the State plan will pick up from there.

What I do worry about is my children, mainly #2 son. He has worked in sales for about eight years, on commission, no benefits. Paying for a private plan is out of reach so he's gambling with his health. He has had two major health incidents in the last eight years, so guess who took up the slack. When he was too sick to work, he even tried applying for disability, but it was not a chronic or permanent illness, so he was on his own.

Then there are people who have health coverage, or thought they did, until a major illness in the family exhausted the limits of the plan. They end up mortgaging their house or giving up everything, and going on welfare to keep their sick child alive.

I've traveled in third-world countries that do better by their citizenry than we do when it comes to health care.

I hear people arguing about the differences between Obama's proposal and Clinton's proposal for healthcare. My guess is that whatever comes out of the Congress will be something that resembles parts of those two proposals, but not exactly either one. That will be the time for discussion of the fine points, and calling our representatives about what we want.

What we need now is President who understands why this is an issue.

Oscar de la Peña

He's back!! I blogged about him a couple of years ago. I was diagnosed with Osteopenia, not exactly Osteoporosis, but bad enough to get your attention.

I had a two-year follow-up bone scan to see if there were any changes. I have been taking my calciium tablets faithfully every day. The bone scan shows that my spine has improved, but my hips got worse. My doctor recommends treatment. We talked about it, and I told her anything that "Can cause" digestive issues, usually "does cause" problems for me. So she left it to me to decide. The four leading treatments are Fosomax, Actonel, Boniva and Evista. The first 3 are similar in that they have to be taken with a full glass of water 30 mins(or 60 minutes for Boniva) before eating, and patient should not lie down during that waiting period. The big caution is the risk of upper gastrointestinal disorders such as dysphagia, esophagitis, and esophageal or gastric ulcers. If you have chest pain, new or worsening heartburn, or have trouble or pain when you swallow, stop taking the medication. They have different regimens of daily/weekly/monthly.

Those three scare me. I had an incidence of LPRD (Laryngopharyngeal Reflux Disease) a few years ago. I didn't have chest pain or heartburn, and didn't know I was having reflux unitl I lost my voice every morning.

The fourth treatment option is Evista. The big caution there is immobility while taking Evista can cause deep venous thrombosis, pulmonary embolism, and retinal vein thrombosis. Don't you just love the advertising for medication that tells you all the bad news. I should tell you that my siblings have a history of cardio-vascular disease including Peripheral Artery Disease.

So, I considered my options, and wondered if I should risk becoming Tinker's twin with the titanium hip somewhere down the road, or try something else.

What would you do?