Archive for the ‘Health’ Category

Disease of the month

June 7th, 2015

When I was a tot and lad (I’m a Boomer), Reader’s Digest terrorized the nation. Within a week of the delivery of the latest monthly issue, GPs knew their regular patients would complain of identical symptoms.

The RDs had predictable ToC’s. There’d be an inspirational tale of overcoming seemingly insurmountable cirumstances. There’s be a damning example of government waste and overreach. There’d be that disease. There’d likely be a terrifying research snippet as well.

We’d learn from our grannies that virtually everything was fatal and caused cancer. I remember green beans and cranberries in the 50s. If you tunneled down into the findings, you found that you’d need to consume bushels of this or that to have the same effect as what the lab animals got, but never mind. The point was that string beans and cranberries each caused cancer.

We are so fortunate that the internet now delivers terror so much quicker and more efficiently.

greendragon1Today I walked about six miles from home down to the Fowl Meadow in neighboring Canton. There I braved the fatality of ticks and more on the overgrown nature trail.

Sure enough, I returned from a couple of hours of hiking and wading through the underbrush to play paranoid. I did go to the backyard to water the beds and pots to check, check, check.

I removed my shoes, socks and trousers. While I had left the house with both sunscreen and bug juice, I looked for ticks. Then, I put my clothes in the wash. Then I showered and scrubbed my body with the soapy brush. Finally, I washed my clothes.

Yes, it was silly. I did not see any ticks or other bugs, but as we simple-minded and literal sorts are prone to drone, “Better safe than sorry.”

Is it?


Christie, Ever a Jock

January 17th, 2014

Online big, braying heads from left and right, from pretending to be real news (Fox) to pretending to be pretend news (Stewart), one phrase in NJ Gov. Christ Christie’s saga of a news conference got chuckles and guffaws all around. In his pretense that he knew nothing of the GW Bridge mess before it happened, he started with, “I was done with my workout yesterday morning and got a call from my communications director at about 8:50, 8:55, informing me of this story that had just broken on the Bergen Record website.”

[If you’re nitpicky or masochistic enough, you can get the transcript at the WaPo here. ]

The risibility trigger was the single word workout. The underlying justification is that because is visually is such a porker, he can’t really work out, can’t be anything like a jock.

I have no doubt that in his Christie brain, he remains as much an athlete as he was in school. He may weigh twice as much and jiggle like a twerker (except on top) when he moves, but his mind and body remember. He’ll always be a jock to himself.

In fact, he reinforced that in answering a question in the conference about his HS chum David Wildstein, who seems to have done the bridge dirty deed. In trying to distance himself from his until-that-day great buddy, Christie said he didn’t know him much in school, that they ran in different circles, that “You know, I was the class president and athlete.”

Here again, he surely was the only person in the room who considered himself an athlete, but he thinks, says and acts it.

christorsoWe can get into how he might be strong and even quick, despite his rotundity. In his gymnasium (don’t think of the origin of that word as running naked), he could well lift more and run longer at a faster pace on a treadmill than younger, scrawnier sorts. Fat does not preclude fit.

The important aspect is that his being still is that of a jock. His pubescent identity remains and defines him. He has the poise and confidence of a competitor who has been successful an strutted his stuff in front of thousands, in his case as varsity catcher on the baseball team — not bad training for being a politician, confidence, arrogance, accomplishment, control of the situation.

As a disclaimer, I was also an athlete in high school and into college (until a gruesome auto wreck cut that short in the sophomore year). I identify with the benefits of team sports and understand how you don’t outgrow that anymore than you would if you were a cheerleader or even a U.S. Marine.

To worry the cheer leader example a bit (and putting aside that G.W. Bush was one), cheerleaders keep key attributes they had or picked up in the process. The former cheerleaders I know are, well, cheery. They have that people-person persona. They push those around them to succeed…with them. In other words, they make good real-estate agents, PR or marketing types, and other best-food-forward optimists. They smile a lot and many have kept their version of blonde hair. They are still cheerleaders at 40, 50 and beyond.

We all supposed are who our parents were, what we eat, what we wear, and many other nature and nurture background factors. I remain convince though that what we’ve done, particularly in high school and college push its way out of our insides our whole lives.

Much is made of the nerds in high school, the bookworm introverts and such who stay that way. That is even more true for the jocks and cheerleaders. In Gov. Christie’s case, I suspect his crouched glories as catcher have defined him immutably.

As this bridge scandal inevitably expands and splatters him, let’ s see how many times he alludes to athleticism and his former glories. Jon Stewart may snort, but there is a jock inside the massive pol who won’t be denied.


Man, Woman, Life, Death, Infinity

October 9th, 2013

caseyA real plus for watching House was the deadly disorder or disease of the week. In a simpler time, half a century ago, medical TV shows were far less sophisticated and demanding.zorba

Specifically for one example, Ben Casey seemed to have a single diagnosis — subdural hematoma. We’d just get to identify or sympathize with the suffering patient, when the internal head blood clot diagnosis accounted for all the dreadful symptoms. After all, the doc was a surgeon and like a cabinet maker or auto mechanic, he had a shot at seeing and fixing the problem that way.

Viewers had to be pretty dull not to notice that week after week, for 153 shows, the somatic villain was almost inevitably the same.

I had a flashback reading yesterday’s paper about Argentina President Cristina Fernandez’ Ben Casey moment. She has, ta da, a subdural hematoma. Unlike the best case in which the body resorbs (dissolves and eats up) the clot, her clot has come with pressure, headaches and lately upper-arm numbness. Those did not improve and her docs decided it was time to go in.

The US is still way down the list in longevity and medicine has not in the main made us that much healthier with drugs. Yet fortunately, in a few areas, like surgery, advances have been solid. In Ben Casey, popping the lid to remove a subdural hematoma was a big deal and might well have meant death on the table.

Here’s for President Fernandez’  unremarkable operation and cure…and thanks for the memories.


Young, youngish, still too young corpses

September 5th, 2013

Noticing the box with half my mother’s ashes, I thought again of three good folk I knew who died unnaturally young — or maybe naturally if you consider invidious, insidious disease to be our shared fate. Certainly going before 60 doesn’t seem right to me.

Today would have been my mother’s 89th birthday. She was outside the too-young range. She died 9 years ago.

nycchumsAt 33, Paula Delancey went first. We went to high school together, dated, and in our early 20s ended up becoming really close friends. She went to the CIA (as in chef’s school up the Hudson) and spent weekends in my West Village apartment. Hyde Park NY was not theater central nor where her friends lived and played.

“Her ambition is to be happy,” was beside her HS-yearbook pic.She was terrifically bright and well read. I couldn’t believe what a vapid, inane thing to write. Now of course, the older I get, the wiser that aim is.

She was a lot of fun, constantly laughing and joking, even ridiculing her own blunders and shortcomings.She looked forward to being a fabulous old lady.

The pic is, right to left, Paula, Isabel Wolfe (now Frischman) and I in Isabel’s NYC apartment.

She never got there. After being the first woman ever to graduate at the head of her class at the CIA, she worked in several NYC restaurants and then was head chef at a couple of others. She ended up making great money, taking her mother on an extended luxury trip to Paris and heading toward those two goals of being a grande dame and staying happy. Then she got cancer of the spine.

Apparently there’s little to do. She gave NYU Medical its best shot at chemo, radiation and surgery. She faded, continuing to sicken, go bald and suffer. She died in 1981. That was my first eulogy, delivered to a chapel in Brick Township NJ filled with a few of her friends and many of her aged parents’.


At 40 , Neil Passariello was also far too young and far too vital to have died. This month he will have been dead 23 years.

He was the long-term partner of my friend from college, Jasper Lawson. He died of effects related to AIDS. He was finishing his doctorate in clinical psychology (Jasper already that one).  There is a regular colloquium in his honor.

I like to think I gave him a last bit of earthly pleasure. When he was in the bed where he died, I bought a bouquet of coriander I picked from my garden. He loved the herb and would say every meal needed a dish with cilantro and of course a pasta course. He no longer opened his eyes when we visited that last time, but he definitely smiled as I held the coriander close to him.

Surely all of his family and friends remember him as funny, dramatic, loud and passionate. An Italian-American, he referred to his heritage as he spoke intensely of food, of sex, of music. He could and did literally break out into song, generally an aria from an Italian opera.

His death did not seem right or timely or fair. He made others’ lives better and more fun, both personally and professionally.

Jasper and I have laughed more than once about how Neil made Jasper seem so WASPy, mannered and tame in contrast.

Jasper’s husband, Jay Landers, is remarkably patient when friends accidentally refer to him as Neil. On occasion, I make that faux pas. Supposedly that is expected with first “spouses,” although Neil died before same-sex marriage was legal. His intensity brings him to mind, quite understandably.

rehfieldAt 57.  John Rehfield still fits in the too-young category. He was remarkable in many ways. I can say for certain he was one of my two favorite managers (I married the other one).

John was a trade-magazine anomaly in being a civil engineer who was a good, no, a superb writer. He won every possible award in construction and trade journalism. He hired me to write for Construction Equipment knowing my only building experience was on carpentry crews during college summers. The day he hired me he said he could teach me anything I needed to know about construction but he couldn’t teach his engineers how to write.

He was very tall and light bulb shaped (his head at the screw end) and even laughed at his odd physique. He was an incessant punster. He came to work at dawn and completed his own before the rest of us arrived. He spent his day dealing with company matters and forever being there to help his writers, editors and art director. Oh, and he always wore a Mickey Mouse watch; he explained that he bought his children Disney stock when they were born, largely for the cartoon characters around the border of the certificates. They became surprisingly wealthy as the stock split repeatedly. He figured the watch was the least loyalty he could show.

He did wonderful motivational deeds too. Every so often and not related to the scheduled reviews, he’d come around to mention he was giving me a raise, just because I was doing a good job and writing good articles. I overheard him yelling at the publisher, telling him to keep his sales reps away from me; I ran the national directory of equipment and they all wanted favors for their customers.

Alas, Conover-Mast, across from the Daily News building in the literally heart of Manhattan, fell prey to Boston-based Cahners. The new parent sent the kids to Boston or Chicago. Moving to lower-tier towns was too much for those of us young and single. Most of us didn’t go.

Within 7 years, John died of cancer. Even though my sister and her kids were in Chicago, I would have felt stranded had I followed him there. I prefer to recall him as healthy and funny.

In fact, I remember each of these three for their virtue and joy they took in life.

Hipster Skins

September 2nd, 2012

OK, I shouldn’t be surprised. Yet I am. Biking out through Dedham, Wellesley, Newton and back into Boston neighborhoods, I did not see a single one of the hundred or so cyclists who did not have a pricey jersey.

I felt like such an old hippie and I guess I am. I buy my tires, tubes, tools and gear from the biking monster Nashbar/Performance/Bikes Direct. I know those designer jerseys are $100 to $150 per, replete with the logo of the beer or such you are pandering to advertise. I own a few of those, because they were two-thirds or three-quarters off. My favorite in the drawer is Mickey Mouse; it is garish and gives me an advantage cycling with inattentive drivers.

Today though, I rolled out in an orange tee-shirt with a skeleton on a cycle. It was a memento from a Tour de Graves in Boston when Ray Flynn way mayor and before he became a drunken conservative ambassador to the Vatican. I was an old guy with a T instead of a stylish fashion statement.

I know in my heart of hearts and on the occasional radar machines on the roadside that I can skunk the 20, 30, 40 and 50 somethings in their high-end jerseys and multi-thousand-dollar bikes. Instead, I find myself glad to see so many cyclists out of Labor Day weekend. In Wellesley in particular, many dozens of deuces and quartets plied their Spandex-contracted flab on public byways. Bless their hearts.

Worthy and workman-like they are. I can’t begrudge them their need for attention. Let us allow they are exceptional, privileged folk who might otherwise stress a lawn chair and instead are trying to be simultaneously fit and pretty.

That’s OK to us journeyman cyclists. The pretty pretenders server their purpose. The more humans on cycles the better. Motorists slowly, every so slowly register, “Bicycles. Must share road.”

Sorry, hipsters and fogies, though. The really scrawny and big-bellied in their high-end jerseys are laughable. If you’d been a jock in your teens and gotten the hormones coursing, you wouldn’t be a flab bowl or a skinny-jeans joke now.

Let’s all ride every weekend…hell, every day.

Medical Sigh Science

July 16th, 2012

My comminuted (multiple breaks and pieces) collarbone got the latest treatment or non-treatment. As an example of how medicine changes and maybe or maybe not advances, conventional orthopedic wisdom has again shifted.

Pic note: Click for a somewhat larger view.

Where a badly broken clavicle used to require holding the big pieces together with a plate and screws (pins, in surgeon lingo), recent trends favor non-surgical benign neglect. This surgical info page describes the options.

Previously, the idea and ideal were to stabilize the whole bone and keep the pieces together to promote faster, stronger bonding healing. Now, according to both my ortho surgeon and physical therapist, the new wisdom is that outcomes are no better with plates/screws than letting the components find each other and form enough bone to made a renewed clavicle.

I’ve only had surgery once in my life, three-plus years ago for a badly broken leg. I shall permanently wear a titanium rod inside my left tibia from my knee to ankle. I’m not eager for more cutting, drilling, pounding, and other internal carpentry.  Yet, I already have a tangerine-sized lump above my left pec. Chums who had broken their collarbones as teens or 20-somethings have insisted I feel their residual bumps, which are much smaller. They said they had simple, single breaks, which may account for the difference.

Several other folk with related knowledge, including Uncle whose daughter is in the PT/rehab biz, concur on the shift from plates/screws. While plain old logic suggests that bones that fuse into their original alignment will be much stronger than those that lump up more randomly, the surgeons say their studies don’t support that. Hard to believe, but in my case it’s a bit late to speculate.

What’s amusing to me, even being an non-controlling participant in this current treatment scheme, is knowing that the science in medical science is mostly not linear. Unlike the concept we grew up hearing, treatments don’t inch or leap ahead to better and better outcomes. Instead, they mostly seem to move in and out like the tides.

I recall my first awareness of that when I was in elementary to middle schools. My mother ran Red Cross chapters, which included planning for and overseeing such courses as first aid and home nursing. She was really annoyed to have to replace those texts and see her instructors were tweaked as the AMA and similar bodies changed their minds with new research truths. I think of covering wounds, particularly burns. Yes bandage; no, open air; no, salve; and on and on, somethings changing with each new major study more than once a year.

Truth be told, docs and medial societies can be incredible faddists. Studies can contradict each other, despite following precise and detailed methods and even being replicated by others. The science can be approximate or fungible, which leads to funky doc punditry. It’s the now-we-know syndrome that comes with the fad of the latest findings. Generally no one dies from the sudden shifts, but I long ago lost faith in the concept of inexorable medical advances.

Certainly even worse than shifts in perceived surgical best practices is drug pushing. So many adults end up with one to a dozen or even more prescriptions. I think of my late in-laws who’d each fill a window sill with their daily meds when they visited. My wife remarked to her mother that those were a lot of different drugs. Her mother agreed and said she asked her doctor if they were all necessary. She reported that he asked her which she’d like to stop, and when she picked one said if she stopped taking it, she’d die.

More commonly, docs find it far easier to treat symptoms with drugs than actually to diagnose the cause of the symptom and, to think back to the ideal of the profession, cure the patient with the like of nutrition, behavior modification and such. So, the docs are more likely to say that taking this or that drug will add two or five or more years to the patients’ lives.

These pharmaceutical company promises may or may not have validity per patient, but we can be sure the benefits don’t compound. That is if you have six prescriptions for drugs your doc says will add those years to your life, you can’t expect the benefits to add up. If it did, we might all expect to live to 150 or longer.

I hark back to childhood when I was never seriously sick, but a pediatrician seemed magic. Swollen tonsils got a single penicillin shot in the butt and cleared up quickly. Nowadays, I”m aware people past their 20s or 30s tend to end up with chronic conditions or ambiguous symptoms. Very much unlike the mystery disease article in the Sunday New York Times Magazine or an episode of House,  we don’t get a team of dedicated, resource (including time) rich doctors who do what is necessary to diagnose and cure us. In fact, we can be pretty sure, our nurses and doctors won’t have the time and inclination to listen to our symptoms and consider our self-diagnosis.

Back to my increasingly lumpy formerly unified collarbone, I didn’t have a lot of options. In the ER and next week followup, the orthopedic surgeons said the muscles would likely keep the bones close enough. I could have insisted on a plate at the time or when I saw the big gap at five weeks, could have pushed to the then big deal of opening me up, re-breaking the bones as needed and then using the plate. So, really, no choice by that time.

Now if I don’t have another trauma to that collarbone and if normal activity including free weights doesn’t snap the new version, the outcome will be acceptable. I won’t project or anticipate. I’ll just go with the idea that the current treatment trend is OK.

Phat and Fat: Down For The Count

July 14th, 2012

After some healing, I’m still limited athletically but got the OK yesterday from a physical therapist to go back to elliptical machines…provided I do not use the arms. Apparently my broken ribs are merely painful and my multi-fractured clavicle is half fused. Towering, grinning Jeff in Beantown physio agreed with the surgeons that I needed to be very careful about weight bearing and muscle straining for another six weeks.

And this is prime bicycling season. It grieves me.

I’d done the boring stationary bike, while being specifically forbidden from real cycling. Yet, I’ve had passionate, sweaty, prolonged encounters with the West Roxbury Y’s Cybex Arc Trainers and was pleased to do some real exercise after a month and a half walking and that stationary bike-like object.

I was intellectually but not emotionally prepared for the predictable side effect of having lost a substantial amount of weight. The machine measures energy expended and reports the calories. It starts with you setting the type of program, the time, the exertion level and your poundage.

This time, I weighed about 14% less than the last I used an Arc Trainer. Sure enough, despite soaking my shirt and shorts, I saw about 250 fewer calories used in the hour.

I was mildly disappointed, but this is what is supposed to happen. By the diet cliché, when you lose weight, you use fewer calories when you exercise. You simply aren’t lifting and moving the same amount around.

Of course there are numerous wild cards here. For one, despite the medical/nutrition chant of calories-in/calories-out, the basal metabolism rate for a given rate is ONLY AN ESTIMATE…yours almost certainly will vary. Research on this that looks good to me (Volek and Phinney) finds that at least three-quarters of us don’t fit that highly oversimplified formula.

For another, metabolic rates do change. Age, illness, activity change, and dozens of other factors can up or depress rates. Then there’s also the somatotype, with extremes of ectomorphic and endomorphic bodies not at all following the formula.

Then as I dutifully recorded today’s machine report on my sweaty hour, I briefly mused, why do I bother? I have carefully recorded caloric intake and expenditure for years. I have found poor correlation for the amount of aerobic exercise I do (a typical day would have me losing between 0.39 and .75 pounds — absurd and it doesn’t happen). My niece and my mother before us similarly kept records. We measured and weight, as well as used the package nutrition figures and the diet software’s figures. Despite the fantasies of doctors and nutritionists that if the calories-in/calories-out calculations don’t work, the answer is not that the patient is delusional, dishonest or inaccurate. Alas, I have good software, keep damned accurate counts and measures, and have to conclude that my metabolism is too efficient.

I do have factors that slow metabolism. I’ve lost more than 10% of my body weight…several times. I am older. Those with a few other factors account for some of the difference. I believe after years of records and a frightening amount of reading and experimentation, that I have to accept that my metabolism does not follow the basal estimate.

As a side note, I think programmers would have a hit with an heuristic nutrition program. Imagine a program that takes several months of calorie input and exercise output, links them to weight and body fat measurements (I do those two once a week), and then adjusts your calculated basal metabolic rate to reality. It would regularly fine-tune the rate, learning as you report your poundage and fat. Then when you saw 0.15 loss for a given day, you’d have some faith in its accuracy. There’s money to be made from us many million dieters!

Back to my question, this is like the other measurements I take. I do keep records. I do learn from them. They confirm or contradict my hypotheses. I personally adapt to the fantasies and failures of doctors and nutritionists. To do that, I need a baseline and data to reference.

After finally accepting that the food pyramid was junk science for me and ending up after my nutrition research with lower carb/higher protein and fat, the daily recording and weekly measurements are more important that ever. I can’t trust my doctor or nutritionist to customize my diet for fat loss and weight maintenance. I have to do that.

Following my bike crash, I feared backsliding and gaining weight/fat. I haven’t, even with dramatically less aerobics. Apparently part of the body healing broken bones is increased metabolism for the healing period. Ah.

Before the wreck, I had begun slowly adding grams of carbs to the diet weekly. The idea in the carb-based diet books is to see what your set point is for carbohydrates. The theory is that the FDA’s estimate of 300 grams per day is wacky and way too high, but there’s some level above the initial low-carb standard of 25 grams per day that will work, and some level that will make you start regaining weight and fat.

So, you are your own scientist and you are the universe of one in the lab. Slowly add carbs and see the effect. Ease off if you have to and if things go real sour, drop back down to that initial 25 grams for a week or two to reset.

I’ll note that I am aware that a scale weight may vary from 1 to 4 pounds naturally and temporarily. You may have a water-weight gain, perhaps from alcohol use. You may be constipated and loaded up. The causes go on and on, but the lesson is not to flip out from a single divergence.

I also believe in weighing weekly. Many people, my wife included, are daily sorts. That strikes me as a bit obsessive and likely meaningless. If I need to adjust, I think a week is a good touchstone.

So, there we (or I) have it. I record daily and measure weekly, knowing that the software reports on the results are inaccurate. Having the reference is important to me. Seeing the graphs of weight and body fat measures are key. In fact, as a mesomorphic sort, I think the body fat number is much more important than pounds. When I lift free weights, I actually get a little heavier, my metabolic rate seems to increase, and my body fat percentage goes down. Weight up and fat down; that’s OK.

This series includes:

Call it Lifestyle on the intellectual and emotional commitment to low-carb
Watching the Struggle on my grandmothers diet woes
Wrestling with Fat on overcoming fear of dietary fats
Hunger? do you starve on a low-carb diet?
Low-Carb Eats on what’s on the menu in the regimen
How Much of What Food on calories-in/calories-out cliché
Dr. Cadaver on mindless trust in group averages
Who’s Counting on body fast v. weight
Part 1 on pants don’t lie


Blue Bloods Birthing Babies

June 17th, 2012

Amusement and satisfaction coexist in a big shot’s indicator in today’s NYTmidwives are becoming must-have status symbols for rich ladies.  Reminiscent of the FT‘s splendidly absurd How to Spend It insert magazines, we learn that the likes of supermodels in NYC and Boston use “the best” midwives now instead of OBs to deliver their princelings and princesses.

Having long been big on midwives, I see this as a likely advance, one that will percolate into the populace. First will be the celebrity imitators, who can do more than copy the pretentiously unusual baby names. The birth method may well open up, increasing demand for more midwives and birthing facilities.

This is personal with us. Our three were all born with midwives, beginning in 1979. I know from both experience and reading that prenatal care is vastly superior with midwives over OBs/nurses and that outcomes are superior, in no small part because of preparation and monitoring. Moreover, numerous moms beyond my wife have spoken of how much better the births went without being strapped down and rushed and drugged and cut open and such. Having a couple of women with you throughout (not even including the serving hubby or beau or equivalent) is an order of magnitude better than the standard hospital routine.

We had to work to get access to midwifery services. Actually the easiest was the first, at the Maternity Center in Manhattan’s Yorktown. They’d been delivering babies and training midwives (and fighting jealous OB groups) since the Depression. They were in a gorgeous, commodious former mansion, to which we made a weekly pilgrimage (always followed with a pregnant-lady satisfying meal at a local restaurant).

There were lots of measurements, stringent rules for nutrition and exercise, and correcting or preventing problems that would preclude a non-hospital delivery. The OBs who worked with the center were of course midwife friendly. They were wont to say on the rare times we saw one to listen to the midwives, to rely on their estimates of delivery date, and to practice the breathing and other techniques we’d use in delivery.

One morning, I awoke to see my wife in the rocking chair saying, “It’s time.” When the contractions were close enough together, we took a taxi from the Village and were off to the arena, or at least the birthing room in the basement. The first one made it some work, as in back labor. He needed to go from sideways to head down, which took the better part of a day. He was healthy with a high Apgar score. My only shocks came at how slick he was when I caught him and at the official New York moment of birth, which was when I cut the umbilical cord. That was one tough tube.

A few hours later, we were in a cab headed to our apartment with our son, following the requisite OB visit to certify his health. It was great to nest with the baby the same day.

Two and three were born around here, although we had to chase the midwives.  What was then the Harvard Community Health Plan only offered a midwife center for Eastern Massachusetts on the grounds of the Beverly Hospital. That’s a haul from Boston’s Jamaica Plain. We took our mandated birthing refreshers more locally but drove to the North Shore for the birth. We got there but didn’t have a lot of time to spare.

We were both more relaxed for the second act and the labor was considerably shorter.  I caught son two too. As with the first, we headed home the same day and were a family, now of four, at home.

The third fell afoul of bureaucracy and because-we-can behavior of a teaching hospital, but still produced a healthy son. By this time, the HCHP shunted us to a midwife area at Beth Israel Hospital. That was fortunate geographically, as this labor was under an hour. We managed to drive there from a few miles away and toss the keys to the valet. I was well aware of the fast progress, but the midwives and nurse didn’t seem to get it. In the room, I immediately washed up and put on gloves. While the trio was across the room chatting, I caught son number three without them.

Unfortunately, BI being a teaching hospital, the OB on call insisted that our son’s heart rate was too slow. He also didn’t get the usual squeezing workout of delivery, so he was a bit purple. The doc had him put in a neonatal ICU. We were not pleased and this two brothers were concerned when they visited and put on yellow scrubs to see him under Plexiglas with tubes. When our own pediatrician was available nearly two days later, he came by, checked him over, pronounced him very healthy and with a heart like a future athlete and sent us all home.

I can go on about the glories of midwife preparation and delivery. I have been known to do just that. If it takes the status-seeking super-rich to spread this gospel, that’s OK by me.

The Power of an Earring

June 10th, 2012

I put a post earring in my left lobe this morning. It’s a silver, smiling sun, symbolic of our youngest graduating high school today.

Big, fat, hairy detail as Garfield thinks. Well, to the incapacitated, it’s noteworthy.

Healing from broken ribs and clavicle, these small and normal tasks are remarkable. Moving the left hand to the lobe and manipulating the earring back onto the post was moderately painful. Of course, in context, completing the wee task was still a minor accomplishment.

And there it is…for those inconvenienced or worse by accident or disease, the wee range from impossible to requiring effort to delighting with the relative ease of completion.

I recall nearly 30 years ago, I broke my right wrist in a fall on roller skates. I like to think of that as a noble sacrifice instead of clumsiness. Our young firstborn had fallen right in front of me. Having no out, I could have plowed into him or taken a tumble. An amusing aspect is that two resident docs from Mass General were running along the Esplanade beside us and heard the crack. They said they were so happy after treating so many broken bones to see and hear it actually happen. Whee.

The doc who set the cast on the wrist asked the obvious question — are you right handed? Well, I was, or so I thought.

As it turns out, I apparently had been ambidextrous all along. I just had accepted the training I’d had at school and home. I’ve heard from other boomers that they too were told righthandedness is the norm, ergo you are righthanded. Yet, with a bad wrist break and a hand immobilized for a month or so, I had a single choice, be helpless or see what I could do.

My writing with the left hand was not quite as good, but plenty legible. After never having had the muscle memory, I found it refined quickly. I learned that I had no problem with other tasks — shaving, cooking, dressing myself and on and on. I found as the cast came off too, that I could use both hands as needed separately, such as stirring a pot and a frying pan with different motions simultaneously. I just had never tried.

It makes me wonder how many of us are really ambi unaware.

The harder part was doing two-handed tasked with just one. The extreme example was tying shoelaces. The docs told me it was impossible ad that I had to go with slip-on or Velcro closure shoes. That was a direct challenge, which I accepted. It is tough, but not at all undoable. It too falls in that class of the normal made impossible then mastered.

I recall too many years before that in my volunteer work at VA hospitals, being with vets who relearned basic tasks. They tended to have a sly, infectious joy at re-adding each task to their repertoire.

I relate.


Little Pink Pill

June 5th, 2012

Magazines, websites and I hear even the T and V drown in drug ads. Most of those intend to convince Boomers they’ll sicken and die if they don’t accept the capsule, tablet or pill that treats symptoms they didn’t know they had. Vanity, fear of mortality, peer pressure…who knows what makes these is-the-purple-pill-right-for-you attack work.

On the other hand, in my tiny universe of one, in the past four years, I’ve found an effective diet regimen — opiates.

Probably like other blogs that write on common physical issues, this one gets a fair number of hits related to various aspects of my broken legs. That makes perfect sense, both in seeing how someone else dealt with your condition and in filling in the huge gaps that docs often leave. I look at the info sheets the ER provided me for my broken clavicle and ribs, thinking these are as bad as a Microsoft Office Help system. There’s not enough useful there, and no effort to address common and likely problems.

In that context, I’ll note that I had been losing weight and fat, using a self-customized low-carb/moderate protein and fat nutrition plan. Then coming up on 11 days ago, my big boom threw me to the pavement from my road bike at speed at 20-some MPH, with those fractures, cracks and such. Being unable to exercise in the slightest, I have feared what had been my weekly weigh-in. I still record all I eat, but only two days have had the slightest exercise, and that’s been just over a mile walk up and down this hill. While the amble was slow, halting, painful and demanding, it’s far, far from my normal daily fitness attacks.

Mirabile dictu! After not weighing for the past two Mondays, I dared today, knowing I just had to record the damage and push ahead. By the scale, I was down nearly 10 pounds. I suspect I had been holding some water, as I was at a plateau and that some of that recent drop was soggy tissue giving it up. Nevertheless, to a banged up old guy,not gaining would have been plenty of good tidings.

On the way to the weigh-in, I was on oxycodone, an opiate. Likewise, following my leg surgery and much, much worse pain levels, I had hydromorphone, a synthetic morphine replacing the actual opiate given me in the hospital. In both post-trauma situations:

  • I was not hungry when I had the drug in my system
  • There was real, substantial weight loss
  • My typical nervous response did not turn to food
  • I was (almost surely irrationally) terrified

I have known drug addicts in many situations. During my college and professional years working newspapers, I would meet them both on the job and socially. I have never known a plump one. However, I am at a disadvantage (for which I am grateful) in not coming from a family with drug addiction in it.

Still, I fear opiates and other highly addictive drugs. I think at various times in my life, I would have been healthier and more productive if I drank less of an evening. More to the point, I smoked for a decade from my late teens. I was truly addicted to cigarettes and nicotine. Kicking was no fun and took several tries. It was the idea that we’d create a baby that inspired the victory. So, I know I can exhibit addictive behavior.

For both pain drugs, I disdained the doctors and nurses, nurses in particular, who chanted, “Stay ahead of the pain!” They actively encourage what looks like drug abuse to me. At least, they’d have you take the script dosage and stay drugged up all day and night. The idea is that you heal better. The reality is that you would bug them less if you were out of it.

I recalled how they pushed antacids and laxatives and such in hospital. I had no symptom indicating any of the several allegedly preventative drugs and adamantly, repeatedly refused multiple nurses and docs. Likewise, I demanded the minimal morphine dosage over their objections.

Post-hospital and recently post-ER, I weaned myself from the opiates quickly, preferring a higher level of pain to a possible dependency. That’s not for everyone. I know many who get emotionally wrapped up in pain issues and who take analgesics daily and more for any cause. Coffee is a drug for me, as is a drink. Thank you very much.

Alas, the current opiate was to help me sleep at night and manage during the day. Turns out, that wasn’t true in my case. The first full day after the bike wreck, I went with three of the scripted four pink pills. During the day, taking one made me almost pass out and become a dozing drooler. Not cool. At night, one at bedtime kicked in at a half hour, give or take, but only provided two or so hours of rest before the agony of scapula and ribs, that is their related muscles and nerves, had me teary and too, too awake. The cycle repeated if I waited the six hours from the previous pill and dosed again.

I discovered I was better off grimacing and groaning my way into a seated position on a living room couch. That minimized pressure on the torso and chest, allowing more exhausted sleep than the drugs did.

With all the upper body damage, breathing was very painful, coughing almost unbearable, climbing our many stairs (four stories with the basement where my computers are) was very bad down and much worse up. I have reasons to think of pain relief.

I confess on those first few nights of agony, I could understand how junkies and the pain-fleers would double or triple on the dose. I felt the urge. Yet, I went from two pills a day to one to none.

When I can drive again, I’ll swing by the pharmacy where my wife got the pink pills and drop the container off for disposal, as I did with the hydromophone. I’m not quite sure why I am so wary of addictive prescription drugs, but there are many worse compulsions and areas of paranoia.

So to those stuck in acute pain cycles, I advise a bit of self-science. Step back, Newton like, and observe. Do behavior and as in my current case, posture offer relief drugs don’t? Is being shoved into stupor awful to you? Can you manage your pain with fewer doses than the bottle calls for?

I think of a former minister who was on the other end. She said she hated pain and give her anything and everything necessary to take it away. She and I differ.