Doctors Doctoring

Now that I established I was old and fine with that in my last post, I will write a companion piece about being old. The companions are apparently doctors.

I did pretty well health-wise during my life, but lately the engine light is coming on more often. I have always avoided doctors and their ilk, and especially such nasties as blood tests, because they like to stick you with needles. I haven't been in a hospital since I was ten, except to visit some other unfortunate, but I don't like hospitals either, as a patient or visitor.

Oh, I've had my occasions with the medical professionals. When I was 22 or thereabouts I was sent home an hour early from work because the staff doctor could not detect any heartbeat. He didn't want me traveling in the rush hour. I guess he thought it was unwise to have the undead wandering about in the subway.

Between then and now I was fairly safe from doctors. I just didn't get sick much  and when I did I tended to ignore it as much a possible and keep on keeping on. Oh, now and again I visited a dermatologist because of my psoriasis, which I have written about before and probably will again because of its comic overtones, but not here.

I had a bad patch back in the early to mid-1990s that forced me into the clutches of several medical practitioners. I took my children swimming in our community pool one Saturday and standing in the water I was hit with a horribly painful muscle cramp. It wasn't in my legs where I usually experience such things. It was in my ribcage. I struggled out of the pool fearful I was having a heart attack until it went away. After that I began to have regular cramps hitting me everywhere, my legs, my arms, my chest and even my neck. It was quite annoying.

Then one day I walked out of my office at Wilmington Trust, did a little semi-circle and walked smack into the wall. How odd! I was also experiencing double vision. When I looked at TV I saw two sets, one slightly atop the other. I went to the eye doctor and he said my eyes were fine, but double vision could indicate some underlying problem elsewhere in the body.

I went to my doctor and was passed off to a nephrologist. That worried me because he was a kidney guy and I didn't want kidney failure. He had me take a bunch of tests and scans and thumpings and proddings and said, "You have hypothyroidism. Take this little pill every day and you'll be fine." (Do I hear Jefferson Airplane playing "White Rabbit" in the background?)

And indeed I was for about a year and then I kept waking up with what felt like sand in my eyes. It scratched and hurt, and worst when I walked outside into the sunlight the beams stabbed my eyes like knife thrusts. The pain was excruciating.  I was driving I-95 to work with one eye closed and my hand over the other, peeking between the fingers.

Back to the doctor, who ran blood tests and then called me up one evening and said, "You better come see me. Your blood tests make no sense." Just what you want to hear your doctor say. When I visited he showed me the tests and said he didn't know what the heck was going on. This led to more tests and finally to an Endocrinologist. (Gee, the titles are getting longer.) I had done a rare thing, flipped from hypo to hyperthyroidism. At any rate they eventually killed my thyroid, drove a stake through its heart, steroided me, radiated me, iodized me, and sent me home more or less cured.

And from 1995 until last year I was doing great. I was seldom ever sick, and never seriously so. I had off and on arthritis attacks, mainly in my feet, but I bore the pain and did what I was called upon to do at home or work. I got a lot of perfect attendance awards at Wilmington Trust. I felt invincible.

But age and Doctors caught up to me.

It started with the beginning of last year. Both my wife and I were sick that January 2012. I hadn't been

ill like that in a couple of decades. It held on, too. Happy New Year! The bug went away eventually, but before I was fully on my feet my leg was kicked out from under me. I guess it was bursitis. Whatever, my knee swelled up and appeared to have a grapefruit implanted within and boy, did it hurt. I could barely hobble or get in my car. Driving was a horror, because I couldn't bend my leg and the pain was extra sharp cramped between seat and pedals. Obviously my morning walks had disappeared throughout January and February.

By mid-March I was finally back walking and things were becoming normal, but when April came I was called up home because my mom had a stroke. Most of the remainder of 2012 was taken up with getting proper healthcare for my parents through to their deaths and then dealing with the funerals and the aftermath of settling the estate. I looked to 2013 to bring some relief.

But this year started much as 2012 did, with both my wife and I ill with something like the flu. This hung on, seemed to go away and returned again. Then in March I was hit with an especially vicious arthritis attack in my left wrist. I had never had an attack in my wrists before. It usually attacked my feet, specially my toes. Arthritis attacks normally lasted a few days, then went away for a while. This wrist attack would not let go. It went on for two weeks and the pain was intense enough that I began popping aspirin for relief. I am not big on medication. I always took as little as possible and I only took pain relievers when the pain got extremely unbearable.  After the two weeks the arthritis lessened, although to this day my wrist aches if I turn it too far in any direction.

Note that up until now I still avoided doctors. I was on some medications as it was, I didn't want more. I have to take a pill to replace my thyroid hormone. I also have been on two high blood pressure piles for a decade of so now. I take them in the evening. That's all I wanted.

But right after the wrist got better I felt I was getting sick again. I had a pain in my midsection. I feared it was a stomach flu, oh joy. It eased up and on the Thursday before Palm Sunday we went out to dinner at Dead Presidents in Wilmington.  When we got home I went to the bathroom to urinate and as I stood I felt woozy. I thought I would faint. I had to lie down on the bathroom floor for a bit. I attributed it to the drinks I had with dinner.

On Friday and Saturday I was okay, but after church on Sunday I felt very tired. I plopped down on the sofa and fell asleep. When I awoke I got up, but after a few steps had to sit down on something. I couldn't walk but a short distance without being faint. I assumed I did have the flu after all, but next morning I had to rush to the bathroom right after awakening, not to urinate as was usual, but the other. I had a ghastly bout of diarrhea (dratted flu). I stood up very wobbly and looked down and saw what was there was black.  I knew what that meant, something was bleeding inside somewhere and it could mean cancer.

Now the doctors were going to get there clutches upon me. My family physician examined me and ordered an emergency colonoscopy and stat blood work. If the blood work came back that afternoon showing my hemoglobin was low she was going to put me right in the hospital. Fortunately, though it was low, it wasn't that low and I was able to remain home and make the Easter Sunrise service that week. The next Thursday I was off to doctor number two (no pun intended) for the colonoscopy and an endoscopy.

I had a bleeding ulcer, but otherwise was clean, nothing cancerous threatening. At the end of the month on follow-up the gastrologist gave me the okay to eat whatever I wished. He had also done something that closed up that bleeding ulcer while he was in there. He did put me on another medication, Prilosec.

I was happy with this result, but three days after that meeting, as we entered the merry month of May, I was hit with another vicious arthritis assault. This time it was to the middle finger of my right hand. It was awful and as it entered the second week it spread into my index finger. I also noticed that my index finger had become rigid and this scared me. If this could happen here, it could happen anywhere to any joint. Back to my family physician, who sent me for blood work again and an X-ray of my right hand. Results of this was a visit to doctor number three, a Rheumatologist.

The doctors have me now. I have two more medications. One is very powerful with many frightening and dangers possible side-effects, like death. It is the same medication they give cancer suffers as chemotherapy. The second medication is Folic Acid because the other depletes that in your body and your cells need it to stay healthy. This medication also suppresses the immune system, so I am now more prey to infections and disease than ever.

Because this medication is also a threat to liver health I must have a blood test every four weeks. I visit the doctor every six weeks. The doctors have won, they have me for life!

My medications look like those decals on the rear windows of cars, you know, the ones that show daddy and mommy and each little tyke and maybe the family pets all lined across the glass.

Doctors, medications, blood tests, oh my, I'd rather face lions and tigers and bears.

So there I am with my good buddy, whose somewhat worse off than I, waiting in the doctors office this morning for my latest six week check in. My blood pressure was 120/72 and my blood test results were all fine, but my middle finger on my right hand has grown as paralyzed as the index finger recently, so he upped my medication dosage and I must go get another x-ray of my hand (actually both hands this time). Welcome to the side issues of age, Larry.

Maybe I should write about my visits to dermatologists again. At least that is humorous and involves nudity, always a popular subject.

On to That Final 20%.

I see we are not calling them Senior Centers anymore. Some are retitled "Center for Balanced Living."I don't know what that means? What is it? A retirement community for Wallendas? Some state is renaming every one "Active Adult Center". That sounds too much like a gym to me. If I walk in the door will somebody yell, "Give me ten!"What if I don't feel like being all that active?

Why can't we ever call anything what it is? I guess people can't face the truth. I'd be happy with Senescent Center, where the Geezers and Biddies play to they drop...dead.

Frankly I'm fine with being a senior citizen. By gum (old geezer slang word), I earned it. I will not be robbed of my right to be old. And don't give me that mishmash of 70 is the new 60 or 50 or perhaps they're calling it the new 20 by now. Seventy might be on the cusp, but 72 old, man.

They have this thing called life expectancy and it says for us dudes it is 76-77 years. That puts me four or five years away, so if I ain't old now I never will be. This life expectancy thing is a bit suspect to me. Some agency puts out list by countries and the United States ranks 51 on those lists. I think its just political. Got to watch anything put out there may be some manipulation for political reasons. Like they are back on this Global Warming kick again at the United nations, even though there hasn't been any increased warming for 17 years. they dismiss this as a "pause". If it's been seventeen years, i call it a trend.

But never mind, we're talking about life expectancy and those world types say 76-77 for us fellows. Yet, if I go to the Social Security Agency I am told I can expect to live another 13 years, which would make me 85. Furthermore, the CDC (Center for Disease Control) says I got 19 more years to go, which gets me to 91.

No matter how you cut it or who you believe, 72 makes me an old man, maybe on the young side of old age, but old nonetheless.  One way I figure is this. That 91 sounds like a reasonable number to me. Most my family lived up close to that. My mother died at 92 and my father at 94, so I got pretty good genes in the aging game. So if we round off at 90 and divide by 5 we get a pretty good breakdown of a life's divisions: childhood, young adult, career years, middle age into retirement and old age.

I worked until I was 70 and then full retirement kind of happened. That was a couple years ago so I'm now in stage 5, - old age.  I have arrived in my 73rd year and essentially the last 20% of my life.

(By the way, remember, when you celebrate your 72nd birthday it means you have finished up 72 years. The day after you birthday you are working through your 73rd years.)

This is not a complaint about being old. If there is any complaint it is about those who deny it, won't accept it, lie about it, flee from it or fear it. Get over it. Everybody gets old unless they die young, so celebrate and embrace it, you have survived.

I will tell you I don't feel much different in my brain. My mind's image of myself is basically the same as ever, so I guess your subconscious does lie. In my head I look like I'm maybe 25. I don't see an old man when I look on the mirror either, so mirrors must practice deception, too. I see a man with a white beard and bald pate, but he doesn't look grizzled and worn to me. Ah, but when I see photographs of me, then I wonder who is that old man and why do I have a picture of him?

It's my body that really let's me know I'm old. It sneaks up on you and you don't always realize what

the body is saying, but gradually you get the message. For example, I'm a walker. I have walked places all my life, often for just the pleasure of the walk. My friend, Ronald Tipton, and I used to walk up and about the hills around Downingtown as children and that exploring by foot has remained a lifelong habit for both of us. When I worked, I would walk away my lunch hours and take a long walk in the evening after I got home. And these days I go every morning to one of our local parks and traipse away four or five miles of varied terrain, up hill and down.

But then I was passing everyone who appeared before me and if walking with companions would need slow or stop occasionally to allow them to keep up. Now I notice everyone is passing me. I feel I am stepping out at a good pace, my same old pace, but apparently not. I also know I am walking the same distance in more time.

Ignoring some recent health issues, such as my half-paralyzed right hand, the two main fingers stiffened

by arthritis, there is another obvious indicator that I have moved into old age. Strength. I was never an Arnold Scwartznegger, but I had some amount of strength. I us to lift weights to keep toned and I could press 120 pounds straight over my head and I did arm curls with 35 pound dumbbells. Now I struggle to carry a forty pound bag of kitty litter into the house.

Don't take this little missive as morbid. It isn't focusing on death. Death isn't just around the corner. Remember, the CDC says I have 19 more years...at least. No, I am just being realistic and admitting that in many ways I am pass it. I'm content with that. I'm happy with that. Much of the fuss and feathers of life are over. I look forward to a simpler, perhaps more placid remaining 20% of it.

Also my big hope is I will return to regular entries in what have been becoming my long neglected blogs.

Fickle Finger of Fate Don't Bend So Much These Days or A High Five Might Bring Me Low

Okay, so where were we before being rudely interrupted by nostalgia? Oh, yeah, wobbling on the brink of old age and its requisite aches and pains. We'd just scooted to the doctor and been hustled off to an emergency colonoscopy, if you can call a week later hustling. It was a long week, too, because the "Big C" hovered about my brain like an angry wasp. Praise the Lord, and I don't say that flippantly, I mean it most sincerely, it wasn't that dire.

It was merely angioectasia in the cecum, a medium hiatal hernia, granularity and friability in the antrum and an ulcer in the distal bulb. The last was the bloody culprit, an ulcer (the only word I could recognize other than hernia in all that) in the duodenum (for those such as I who don't know where the distal bulb is). There is no sense to going to all those years of medical school and racking up all those student loads if you are going to talk in plain English. Just saying, "You got a bleeding hole in your gut," doesn't sound worth all that effort learning those sesquipedalian words. (I was an English minor in college so I should throw around words worth my effort too.)

We've rather dealt with my lower G.I. problems in past posts such as Glory Be, the Lord Must Know How Much I love Tomatoes. (By the way, once upon the time "potatoe' with the "e" was the correct spelling, and in fact was the preferred spelling within "The New York Times" until 1988. The Sun Valley Potatoe Growers still use that spelling. So you say "potato" and Dan Qualye said "potatoe, so lighten up you spelling elitist, by any such spelling it is still a starchy tuber. I know it is besides the point, but tomatoes reminded of that to-do over nothing.) Anyway, as I was staying, we've dealt with my intestinal perforations so let's move on to my other bodily ravages.

My gastroenterologist must have done something while poking about in there because my bleeding ulcer stopped seeping and he told me I could eat what I wished. Oh, I came out of that follow-up appointment clapping my hands, but three days later not so much. I couldn't clap. My right hand was swollen up, was red and hurt like a tank had run over it...twice. 

Yeah, I am use to these arthritis attacks. They put one in agony for  few days, ease up, go away and then after some nonspecific time period return to plague a different joint. Not so this time. Pain gripped me like grim death for a week, for two weeks and it spread from my middle finger to my index finger and back again, like it was playing tennis with my digits. Once again I was driven to another long-named doctor, a rheumatologist. 

I got some damage in that hand that I guess is permanent. My pinky finger has an unnatural bent to it and my pointing finger has no bend at all. It just pokes straight out there with a hook at the end. I must forever avoid fights for I can no longer make a fist. Still in all, the good doc put me on a steroid (Prednisone) for three weeks and the pain and swelling dissipated. You can't stay on that stuff long though or it turns you into the Hulk.

Now I am on an antimetabolite and antifolate substance called Methotrexate,  the same drug used in

 cancer chemotherapy. It comes with a long list of scary possible side effects (one of which is hair loss, but as you can see it is too late for that to worry me). 

The biggest threats to me are to my liver, thus I must go for blood tests every four weeks to assure that organ isn't fizzling out, and suppression of my immune system. This latter side effect has the somewhat positive effect of reducing my psoriasis. So if my liver goes and I die I will at least have pretty skin.

I find myself getting tired more these days, which is another possible side issue of this treatment. And so again I claim I now qualify as elderly. Oh, I also have to take a daily dose of Folic Acid. Remember that term for this stuff, antifolate? Yeah, it depletes your folic acid and you need a bit of that. If you don't have it you may have:  diarrhea, macrocytic anemia with weakness or shortness of breath, nerve damage with weakness and limb numbness, pregnancy complications (I doubt this!), mental confusion, forgetfulness or other cognitive declines, mental depression, sore or swollen tongue, peptic or mouth ulcers, headaches, heart palpitations, irritability, and behavioral disorders, impairment of DNA synthesis and repair, which could lead to cancer development.

Ain't we gots fun when we gets old?