esrosedotblog

I got my annual flu shot today.

They say that old people are the most vulnerable so that is one thing. Another is that I do not want to get the flu. I have always taken the shot.

This is only important in that no one had a second thought about this until the last couple of years.

The anti-vaccers have landed.

These are the no-nothings that accompany other outbreaks of no-nothingness.

Witness Donald Trump. Would that there would be a vaccine for tiresome blowhards. But there is not.

But I digress.

I have never, ever second guessed my doctors. Not until I sought an alternative opinion and then went with that. Informed judgement.

This is why we have kept a traditional general practitioner who knows us and knows our history. Who applies his medicine to us personally and not out of some file. He says who and how we use specialists.

Someday, Doctor Jim will retire and we will have to make a decision if he does not transfer his practice, whole, to a younger man. He says that he is in for the duration.

He has done what he had to to make his energy be sufficient. For example, he does not give the shots anymore. No problem. I go to my regular pharmacy who also knows me intimately. It is a small outlet that belongs to the Walgreen special network. Designed, in this case, for gay men. It is named "Community".

I suppose that some day medicine will be a mass industry. But for now, not. I hope I will be dead when that happens.

Oh. Did you get your flu shot yet?

Labels: doctor, medicine

John and I drove to Indio this morning. He needed some diagnostic imaging.

Very sophisticated it would seem. Early results say that everything is OK. Details later.

I had to take him because he would not be in any shape to drive after his local anesthetic.

So I let him out and went to have coffee at a Starbucks. A muffin. Sit in the sun.

I enjoyed it all. Not that I would do it again or, rather, not that it would top my priorities for hanging out.

The muffin was half size. WTF! And the coffee mediocre.

But I did sit out in the sun next to this large family. Latin american. Mom, Pop, older daughters (3 I think) and a son,18 or so.Two beautiful babies.

How nice to be next to them. I didn't eavesdrop at all but it was apparent that they do this regularly enough to have the space comfortably and to exchange mild family banter, some news and most of all bask in the baby-ness of it all.

It has been a while since I have been around grand babies or any other kind. Or families. Gentle, loving and sweet.

The thing about outdoor tables is that people will tolerate less intimacy somehow.

I didn't stare but they knew I was a willing audience. An appreciative one.

I didn't eavesdrop really. It was mostly about the babies and family life as far as I can tell.

Very nice.

I went to pick up John and somehow got lost. I forgot about a turn I had made going to the imaging place. I had to call and be directed. That was fine with me.

Home then, where part of my own family was settled in for the morning. Two sons. More family-ness. But mine.

I still fail to see the attraction of Starbucks but the family compensated for that quite nicely.

Labels: family, health, medicine

I had a physical checkup over the last week.

I have reached the age where they will pay for an every four month cycle so, as much as I squirm about it, that is what my doctor has me on.

The lab report came back today. I passed it all with flying colors. The trouble I had last year with urinary stuff is gone. Back to normal. All OK. The creatinine. Down below what it is supposed to be.

But he is not going to relent on the frequency.

I do not really mind going. I like him, I like the routine and I like knowing what is going on. And, medically, I just figure that I am beyond the age of consent. What I want or think I need is not really up to me. I have to turn it all over.

I have to admit that catching things in time is a good thing. The spell I had last year with the nephrologist and the urologist was enough to tell me that early detection about anything is best. It is not a sell point for the medicos.

I have not had any cancer except for years ago with my prostate. They gave me radiation for that and it worked. I am 20 years, maybe more, free and clear. I did find out that they want ten years now and not the five they used to talk about.

But no other cancer anywhere now. It did not spread.

Heart? Nothing. Well, not nothing. There is a beat but it is fine. I take some little pills for an elevated blood pressure but everyone my age takes those. And I have a history of irritable bowel syndrome. Donnatal. Atropine/Hyoscyamine/Pb/Scopolamine. It is a barbiturate so I must be careful. I probably do not need it any more so I have dropped it to one a day. Sometimes I forget about it and nothing happens. He doesn't want me to go off it. So I won't. Doctors orders.

Boring, huh. Medical conditions. But some people read this who care about this kind of thing so, there it is. If you are still reading you are a better person than I. I hate hearing people go on about their medical "issues".

Labels: health, medicine

THE LONG AND THE SHORT OF IT

Today was a double header.

First, my annual checkup which happens twice a year actually. Only in October there is the EKG and maybe a few other things that I am not aware of.

It all went well. I have lost almost 20 pounds and he is happy about that although somewhat quiet with his praise. It is for me after all, not him.

Hence the blood pressure is well within range of acceptable but too early to decide to reduce the medication.

No other items were found.

We laughed a lot. Dr. Jim is a great guy. I hope we can hold on to him forever. If not, I can move on but I don't want to.

Everyone is getting old. Not a complaint. Just being realistic.

The second excursion was to the barber where we, for the first time, cut the long long hair I have been growing. Combed back sometimes by hand, no part.

I as astonished at the amount of hair he took out of it to shape things up. Last time he did nothing.

But it looks like nothing has been done. Well, almost nothing.

I don't much like going to the hair guy or the doctor but I have the best I can get. The barber is an award winner, the best of PS in some magazine. And he is fun to be with too.

If they can't be fun, I don't want any part of it. Unless I have to. Get a load of the accent on this doctor!

Labels: hair, health, medicine

SUNDAY

Not a normal day. We are going to a tea party this afternoon. Someone's wedding meeting-up anniversary.

I am not keen on tea or parties but I have been asked/told to attend, so that is that.

There seems to be an upsurge of tea which is not on my list but I will get by somehow.

Today is the first day of the drops for the left eye which gets operated on Wednesday. Instilling they call it. I still am working on using up all the drops for the right eye. Drops.

I am getting the long distance view, the same as the right, so that I will have binocular vision. The world seems flat with one eye.

The option was to get one eye done for close work, reading. Use the other one for distance.

I have been able to operate one eye-dly but it doesn't feel right to me. So, glasses for up front work it is.

I was a bit romanced by the eye-dea of no glasses at all but the gain is not there for me in the monocular.

I want stereo.

I am not good at putting the drops in. I waste a lot.

I go through spots where there seems to be not a lot to say or it is the same stuff so that even eye I a bit tired of hearing about it.

Also I have had other things to think about.

I am renovating my Netflix Queue.

Up until recently, I have been queuing up everything that scores a 70% critics' response on Movie Review Intelligence, a review compilation site that pretty much matches my taste, but then I would take the films off the queue when they got close to playing. The other thing is that I have accumulated a sizable "see it again" list and it is swamping the new ones. Given a choice, I want to re-see.

So. I am taking the less interesting ones off the queue. I just cannot see everything. I was putting more than the 4-5 a week I do watch and like all things that have more intake than out flow, the list was getting fat.

Chopping. Culling. Curating my own list.

Labels: cataract surgery, eyes, medicine, tea party

NOT MUCH TODAY

I went and got the eye drops I will need for the right eye cataract procedure. Or is it an operation? Or is their some other name.

They were reputed to be very expensive but not too bad. 45 copay for two of them and 5 copay for the other (prednisone generic).

I got obsessive with the pharmacist over whether I could overdo it or not. She told me that the ingredients were not dangerous in any way. The clerk who was a lot smarter and knew her customer told me to get over it and not worry about too much, not enough and so on.

I could see I was doing my boring in thing and quit. It is just fear getting a workout. "They are not dangerous".

I had a couple of meetings and loafed. There are some days I can do that, huh?

So much loafing there was no time for a movie.

I am doing OK with the election so far and do not feel the need to talk over the obvious disparity between solid Democrat proposals and GOP air balls.

I think that they have Romney nailed with the Swiss bank account thing. Whether nefarious or not. There is nothing ambiguous about it. The reason people have money in Switzerland is tax avoidance. Period. That is what I believe along with a lot of other people. Whether it is true or not is beside the point.

Thought for the day.

Hot turkey sandwiches for dinner. Yo ho.

Mine will have 9 grain bread, oven warmed turkey not the wave, nice jelly cranberry sauce and fake gravy. But the idea is the same.

Oh, I wouldn't have the mash either, raw vegetables instead.

Labels: cooking, health, medicine, Re-election of Barack Obama, Romney

THE EYES HAVE IT CONT'D.

I went for my cataract removal pre-op today.

Not many surprises.

They measured my eyes. The lens that replaces the cataract laden lens will be made for my eye and "wipes the slate clean" as far as prescriptions and all that are concerned.

I will be getting both eyes set for farsightedness. I will get OTC glasses for any close up needs. There was talk of one lens close and another far but they decided I am not a candidate for that. OK with me. The thought made me dizzy.

I won't go through the details of the operation but I will be in the place for two hours max. They will use a "twilight" drug to anesthetize me. I may be conscious for the whole thing. I just won't give a shit or feel any pain.

There are no stitches unless there are complications.

John will have to go with me to take me home and to go for the day after checkup the next morning. I will have a patch but I will take it off after four hours and will wear it during sleep for a week. They want my eye to be working and trying to see as much and as soon as possible.

The whole thing is very methodical. These people have always seemed to me to be sober and focused to a fault. There is no joking around. Their office is extremely quiet.

I had an elevated blood pressure coming in. Nervous. A considerable drop going out.

Hey. I have never ever had surgery before.

That is about it. Here is a picture of the whole thing. Cut, flush out old lens, put new one in. I love the music!

Labels: cataract surgery, health, medicine

AGELESS

Here we go again. The over and mis-treatment of old people. An American industry.

How Medicare Fails the Elderly

This is the scariest part of getting old.

I don't want any of it.

The useless and painful treatments that are foisted onto sick elderly are worse than the sickness itself.

HEY! Are my kids reading this?

I don't want any of this shit to happen to me. I don't want to live through it and I do not want to spend the money on it.

We have long term care insurance which is a help. But what the fuck? Hanging on to a thread of life is not living.

We have a good doc right now. Not bent on treatment at all cost.

I could use a medication for a mild problem that I have with "dribbling". But everyone of them cause debilitating (to me) side effects.

So, I will not use it. He agrees. He wouldn't do it himself. The ultimate Doctor Jim resolution.

The trick is to have enough brain cells to do yourself a favor and fade out. He says stop eating. That is what my mother did. The ultimate treatment will arise soon enough.

Labels: life, medicine

MINIMUM MAINTENANCE

I was glad to see this article this morning.

How to Steer Toward the Path of Least Treatment

THE RIGHT QUESTIONS Patients often want to know whether a test or procedure is covered by insurance, but other questions are more important, said Dr. Steven Woloshin, co-director of the outcomes group at the Vermont V.A. hospital and an author of several studies on overtreatment.

“A patient should ask, ‘Why do I need this test? What do I get out of it? What’s my chance of something bad happening if I don’t get the test, or if I do get the test?’ ” Dr. Woloshin said.

Make sure you know about all of the different treatment options available, and the pros and cons of each. Remember that medication may be as effective as more invasive treatments.

SCREENING ALTERNATIVES Balance the risks of any test or procedure against the potential benefit, given your medical history. Less-invasive, low-tech screenings with a lower risk of complications — a fecal occult blood test, for instance, instead of a colonoscopy — may be appropriate for some patients.

If a CT scan is recommended, ask about an alternative that might result in less radiation exposure.

TOO MANY MEDICATIONS If you take medications on a regular basis, have your doctor review your drug regimen periodically. Ask whether you may be able to wean yourself off a drug like a proton pump inhibitor if you make diet or lifestyle changes.

Drugs that have been on the market longer often are better understood and have better safety records than newer drugs, whose adverse effects may not come to light until they have been available for some time.

Fortunately, I have a doctor who agrees with my own assessment.

Labels: health, medicine

W.W.W.WRONG

I don't believe everything that I read on the internet so I check stuff. I should have seen that the "infection" article of yesterday was way way out of line.

Hospital Infections Revisited

The fact that I was so willing to believe this data is indicative, at least, of my fears about getting sick from going to the hospital.

But it was wrong and so was I in putting it in here. And I will still wash my hands thoroughly whenever I visit. And I still don't want to go to the hospital for something wrong with me but I will be less fearful about the infection thing.

Actually, 4.5 % still seems like a high number to me.

Labels: health, medicine

GO TO THE HOSPITAL AND DIE

Shocking. True. I have known this for a long time.

Graphic of the Day: Hospital Infections

Now, pay attention. The 1 in 7 is of the people actually infected. Not one out of seven admitted. But think about it.

I know way more than 7 people who have gotten infected while they were at the hospital. Way way more.

I am very paranoid about this. No one wants to go to a hospital. But I totally don't want to. I am afraid of medical facilities and I really, really, am not a paranoid person.

A friend had a knee replaced. She was not, frankly, in very good health to start with.

The site of the replacement went bad. Infected. They had to take the appliance out. She got a secondary infection which involved going back in and cleaning it out.

She has been in a rehab/nursing home for weeks, months, awaiting this thing to abate. Then they will open it up again, clean it out and put in a new knee. If she makes it and if there is not more infection.

She is not dead but, hell, it is too close a shave for my bet. And another quality of life thing.

Blah blah.

And we have the best medical system in the world. Didn't they say that? Those GOopers who didn't want any federal plan?

Labels: medicine

COUNT ME OUT

I just finished reading The Emperor of all Maladies by Siddhartha Mukherjee. It won the Pulitzer Prize last year.

I am amazed that I finished it. It is a great book.

From that experience, I came away with one abiding notion. In the field of cancer treatment in all of history, the most radical practices were maintained for years, decades, centuries, with the naive cooperation of patients who believed that what was being done for them would help them.

In actuality, almost all of it was experimental and often wrong. Even today, doctors will perform lethal procedures for the benefit of research and for a few short days, weeks or months of a miserable life.

Look at this. The author describes the conflict between the best treatment and the most radical new approaches.

The Annals of Extreme Surgery

Now it is hot chemo. What next?

Count me out.

First of all, I am a cancer survivor. A designation that I don't much like but there it is.

I was presented with several options for prostate cancer treatment. I took radiation.

It presented the least invasive procedure and it was meted out over a long period of time with lots of room for checking the results and making adjustments, if necessary. I could even stop it if I wanted.

I bought the services of an old lion of oncology who looked at my slides and ruminated about my options. He told me that if I was "surgery averse" I should never take that option unless it was life or death and, maybe, not even then.

Not only was it the most radical of all the approaches, it was frequently wrongly done and there was no path of return. Once your prostate or anything else is cut out, along with a lot of other useful stuff, there is no going back.

I think it is a scandal, what they are doing.

The politics of cancer within the medical fraternity is astoundingly self centered.

Yadda yadda yadda.

Count me out.

Labels: life, medicine

OR GONE

I mentioned my cataracts to a few friends.

One came to me later and handed me some paper. A description of a treatment method for a wide variety of ills.

I raised my back a bit but took the paper. It wasn't until I read it back home that I realized this "new" method was a late version of the Orgone Box, Willhelm Reich's discredited healing device from the 30s and 40s. Reich ended up discredited as well. And a little nuts.

The old version was that the foil lined box, you sit in it, collected a different energy from the universe. A sort of combination of electro magnetics and a belief that the Gods still sit on Olympus.

Look here.

It can have many variations. This one has something like a proton tube. Waves.

If you ever see a reference to "tin hat" people this is what they are talking about. There is still a church in the high desert that uses an upside down metal pyramid. You stand under it. I went to a meditation class (they were renting the space) there once.

This kind of thing happens in every decade one way or another. I am not surprised.

It is a little embarrassing though. I don't know, really, what to say to my friend. Not a close buddy but a nice guy.

I think, actually, that if you believe in this kind of thing it can have some positive effect. Good vibes in the mind would suffice for some ailments. Not cataracts.

When they start playing around with serious stuff it goes off the rails.

Since I am not a believer and these are my eyes I have no intention of getting close to it.

Maybe I can just say that.

I have found that people who are into this kind of thing are not easily thrown off the chase. They believe so hard that they don't get the subtle or even direct statements that say "no thanks".

I will try the "say nothing" approach for awhile.

Orgones.

Labels: medicine, whack

REVIEWING AN OLD DECISION

I hate the term but, the truth is, I am a cancer survivor. It sounds so breathless. Or something.

I was diagnosed with PC in 1996 when I was 59 and opted for treatment. First decision. Then, because I could and because I am surgery averse, I chose radiation treatment. Second decision.

I have been cancer free for 15 years. Five is considered enough.

Whatever they tell you, the aftermath of a cancer treatment does not end with the removal of the cancer no matter how happy that might make us feel.

There are problems with both potency and bladder control that, for some people, are severe. I missed "severe" but I am not without collateral damage. All manageable.

So the decision to get treatment is one which is very important.

One's age has always been a consideration for PC. Older men who have it will most likely not die of it. It is a very slow moving cancer.

On the other hand, younger men who get it need to be treated immediately if not sooner as the cancer is very fast moving. Think Frank Zappa.

The problem with prostate cancer is that it will spread to all the parts you see in the diagram. It must be eradicated in time before it moves.

Since my treatment I have thought about the decision I made. I have never doubted that it was the right one but, at the same time, one looks for verification and it has been hard to find.

I was part of a study of after effects. They are slow to evolve with radiation. People who get the surgery have real trouble immediately and then, sometimes, improve. People who get radiation have a slow onset of scarring "down there" and collateral problems.

Now, a new study tells me that I probably did the right thing.

When to Treat Prostate Cancer".

Makes a lot of sense to me. Before 65? Do it. After, think it through. There is no life expectancy advantage.

That is pretty clear, huh?

I am lucky. The damage is moderate. The life appears to be going along pretty well. I am otherwise very healthy.

I still go to the doc for tests. The PSA and the digital. That will probably go on until the end. A study tells about averages it doesn't cover the outliers. But so far, so good.

Incidentally, don't fool around with this. Get the tests done regularly. When you are 65 you can back off if you haven't had it yet.

Labels: health, medicine

ZINC AND THE COMMON COLD

I read this morning that research "proves" that zinc, long a pop-pharmaceutical for colds, actually works.

Somehow. They aren't sure.

And it is not clear about the best delivery system. Some counter the effects. More research is needed.

I have tried zinc lozenges for sore throats and echinacea capsules for colds.

I don't think either of them does much.

If I take them, I get over the cold in seven days. If I do not use them, it takes a week. (An old joke from Dr. Furlong our first family physician when I was a kid).

I will say that the zinc is pretty bad medicine whether it works or not. The lozenges are vile and they try to cover it with nasty cherry sweet flavor.

I gave up.

I still keep the echinacea around. I look at the bottle and treat it as a totem. Sit with it. Shake the bottle, listen to the caps rattle. Then I decide not to take it.

You know, most of these remedies have never been tested. Now, apparently zinc has been studied. But no one has checked out the side effects. Zinc poisoning. Zinc dementia. Zinc impotence.

Kevin Drum has a similar reaction.

Zinc, Glorious Zinc

I like the "suitable for vegetarians" on the bottle. I guess somewhere there is a meat flavored zinc. And no salt or starch. Wow.

Labels: medicine

FALLING FOR US

We got a letter from Anthem Blue Cross yesterday. I have hardly recovered from the results on my nervous system.

The letter announced a cut in our Medicare Supplemental medical insurance.

Thet harumphed and took credit and all, but the fact is that this reduction is a direct result of passage of the Affordable Care Act.

I knew that it was coming, or should come, but I was prepared for some kind of trick result. But, not.

We will pay a small percentage less this year, about 0.2% less. Considering that it was getting bumped one or two percent up each year this is a nice trend starter.

I don't know why people oppose this act, although more and more are approving of it. There is money in the pocket and better care. Less hassle. And no pre-existing conditions. To say nothing of the fact that other people will benefit from this.

And the act is not a job killer as predicted by the liars on the other side. It will make new jobs. And lessen the deficit.

I know that you already know this but I am repeating it to amplify the fact that OUR MEDICAL INSURANCE PREMIUMS HAVE GONE DOWN!!!

Labels: Administration Obama, health, medicine

A+

I got my test results back this morning from my Doctor. Doctor Jim.

He calls in early, this morning at 545 AM. He knows that I am up.

Not only up but back from the gym and having breakfast.

Good news.

Everything is excellent.

He went down the list. It is a long one. This is the annual and Jim is good at winkling out all the possible tests one can have under Medicare.

One that surprised me. He tested for the gout!

Jeez. The gout.

Well, I know that I don't want it. It is a real pain. Crystals of uric acid.

I guess that is what they test for.

But there were the usual suspects as well. And the PSA. Still checking even after 13 years in remission. Good idea. It can come back, prostate cancer.

Good news.

Labels: health, medicine

PHYSICAL

Today's feature was the semi annual visit to Doctor Jim.

This is the light one. Just a check on the prostate and a rundown of the other quality control points. No EKG. No knee taps. All that.

The primary purpose is the prostate. Followup on the cancer twelve years ago. I am well past the remission stage but he keeps up with the digital and the PSA test. I used to go every four months. Now, I have graduated to six.

I had no issues.

I am over my plantar fasciitis, there is a mild increase in my ongoing eczema spots (20 years now) but I have ointment for that. Nothing else.

He found nothing of interest. All pretty good for a 73 year old man.

I reported on the loss of ten pounds but he didn't make a big fuss over me about it. He is hard to impress with shit.

I will take the blood tests tomorrow and here the news about them next week.

Did I mention that our doctor is always on time and that you can even get into the room early if he is done with the previous?

We are badly spoiled.

Labels: health, medicine

BROUGHT LOW

There has been a sort of landmark case going on out here in the continuing war between the bicycles and the automobiles.

An emergency room doc did one of those pass, swerve and slam on the brakes things in front of two cyclists.

He said "to teach them a lesson".

They hit the car with major injuries.

He is heard on his 911 call telling the guys to get their bikes off the road. And telling the 911 people that they can send an EMT but the cyclists will claim more injuries than are actually the case.

The guy seemed and seems to be a real dick.

The trial was long and contentious but left little doubt that the doc lied and also had malicious intent.

During the trial he seemed to have no remorse and to feel aggrieved that his valuable time was being taken up with this case. He didn't seem to get that he was in trouble, could be found wrong.

I guess that the verdict was a shocker for him. He went directly to jail and did not pass go. Yesterday the sentencing. Worse.

Los Angeles doctor gets 5 years for injuring cyclists

As he read his plea for mercy he seemed, still, to be unclear that he had really done anything wrong.

I don't like to see anyone get time but, in this case, it has the happy effect of breaking this guy's balls and sending a message to other drivers that "close call" games with bikes are not a good idea.

I have had my own experiences with this kind of, out of the blue, hostile behavior. Come up behind very close then pass even closer then swerve almosts 90 degrees in front of the bike and hit the brakes.

I never ran into anyone but only because I had a fast reaction and learned to be ready for this kind of thing all the time.

For some drivers, a bike is a target. An outlet for caged rage. Or something.

So a lot of cyclists are going to be happy this morning.

I did not realize that this guy had been reported but not arrested for doing this before.

So much for Hippocrates' "doing no harm".

Labels: bicycle, medicine

GETTING A FLU SHOT WORKS TWICE

We got ours. See below. And if you have any doubts about getting a swine flu shot for yourself, read this.

The Official Word to All, Get a Swine Flu Vaccination Now

Because it is going to come back. And it has not really shown its full power yet.

The other thing is if you don't get the flu you won't pass it on to 6 other people. You can stop the pandemic at your doorstep.

It is the social consciousness thing to do. Thus twice worked. You then others.

Labels: health, medicine