In 2023, I had two falls close together (two bouts tumbling down the stairs in two weeks) and in general, I tend to fall more in winter (and not even outoor falls due to weather and ice). These two factors and my hospitalization with AFib after my falls in 2023 led me to go to the emergency room yesterday because of my fall at lunch time on Wednesday.
I just wanted to make sure that this fall didn’t lead to a sequence of falls.
In similar cautiousness, today I visited my old ortho practice from when I broke my ankle in 2016. That’s the infamous “I broke my ankle and went to the Chinese buffet before heading to urgent care for an x-ray” incident. Read more about that here.
I felt silly, because my injury is pretty minor compared to other orthopedic cases. The ER told me that if it didn’t feel better in two weeks to follow up with ortho.
But I know from past breaks that the first two weeks is when the healing really solidifies and if it heals wrong, I would have more problems. And I wanted better direction on how to splint it, a better splint, and confirmation it was broken.
It is. In two places in the knuckle.
This is my right hand. At this point only one finger of my right hand has not been screwed up in some capacity.
And the doctor seemed to agree with my fastidiousness. He gave me a better splint and some first aid tape and told me to come back in four weeks for a follow up and new x-rays. His assistant gave me some Coban tape and some buddy strips for the splint.
I have a high-deductible insurance plan and I do not have an HSA, so I know I will pay more than I want to for this, but it’s my dominant hand and I need it to work.
I visited my neurologist/physiatrist yesterday for my four-month follow-up. Four months ago she recommended I join the Thrive medical fitness program with the hospital network. I met with her in November to discuss how I could move forward with exercise and strength training; I was scared that I would hurt myself working out alone.
According to her records, I lost six pounds! She was very happy to hear about and see for herself the gains I’d made in my strength. She reminded me that I was still “young enough” to keep making gains, whereas at a certain point the aging process makes it so that all we can do is maintain our strength.
I told her about my bumpy February, complete with several unexplained falls. She has some concerns about this, concerns that are mitigated by my fall-free March. I told her my theory that the change of seasons and sinus “stuff” might impact my balance– referring to my serious falls of March 2023– and reporting that I had not resumed taking my allergy medicine after a winter hiatus.
There are some other signs, some dealing with episodic urge incontinence and a recent bout of constipation, the strange weakness and sensations in my fingers, and my typical hyperreflexia that could suggest an issue with my spinal cord in my neck. So if anything changes or becomes more persistent, I have to let her know immediately and not “downplay” it. She referred to me as one of those patients who is “a trooper” and just keeps going.
So she wrote in my after visit summary as my main instruction to “make good decisions.”
How many of us could curtail a lot of our health problems if we followed that advice?
My next steps will be to focus on working out and continuing my progress with strength training and weight loss, reduce caffeine intake, and improve my cardiofitness. My next appointment is scheduled for the day after my cardiologist appointment, so hopefully I will have some positive trends to report to both of them.
My neurologist also made me promise that when I get my service dog, she gets to meet him/her sooner rather than later.
Monday is my last session as part of the Thrive medical fitness program at St. Luke’s. Working with the trainers in the program has reminded me of some hard truths– and the part that’s hard is the reality of your own habits and thinking patterns.
The numbers show some nice progress. I lost four pounds of fat and gained one pound of muscle. (And had I eaten better imagine what those numbers could have been.) My blood pressure according to their records has stayed the same, but based on my home readings has gone down and requires less medication. The strength-based tests– well, I kicked butt.
I certainly feel better, and stronger, though I still have work to do on my cardiofitness. That won’t really improve until I commit to more cardiovascular exercise, even if it is just walks around the neighborhood. I would love to return to riding my bike again, but there’s a fear factor there. It’s an activity I don’t want to do alone, which is also true of walking.
But here are the lessons:
When my body hurts and locks up, strength-training stretches all those muscles and gets rid of the pain.
I can only lose about a pound a week if I eat well and exercise at least three times a week. Diet alone won’t do it. And my food choices don’t have to be perfect but they have to be solid.
Salt is my nemesis. Too little and I experience orthostatic hypotension and lightheadedness, too much and I end up with as much as five pounds water weight.
I must be choosy about my fast food. Domino’s or Little Caesars pizza will put me in a coma, and I will sleep so well, but the impact will show on my heart rate, blood pressure and weight. Wing Stop has no benefits, only the effects of the salt. I now keep various processed chicken products in the freezer because while they are not a wholesome choice, I can make my own sauces to replicate Wing Stop and save the truly detrimental health effects. Taco Bell in small doses can be tolerated, and I usually get a cheap box deal and make the items all vegetarian. It adds some extra fiber and vegetable matter to the mix.
And out of all the fast food chains– I can navigate the menu at Chick-Fil-A and not notice any real impact. Their fruit cup and kale crunch salad, especially when paired with grilled nuggets, are solid choices. They also have a chicken (or vegetarian) cool wrap, which, while it is calorie dense, is easy and quick to eat– with a good portion of lettuce and cabbage. (Yes, they also have amazing salads, but those big salads are realistically three portions. That’s a lot of salad and chicken. A lot.)
Do I have the discipline to not only continue but improve upon this progress? I don’t know. Honestly. IF I made a commitment to meal planning and cooking, I could. But with money and time always an issue, I don’t know. With stress leading me to seek comfort in my favorite foods– did you know they have Sour Patch Kid Jelly Beans? Eva says they flipped Sour Patch Kids inside out… With fatigue influencing my choices– caffeine and sugary carbohydrates, anyone?
Will I get up in the morning, drink a glass of water, and commit to some sort of exercise in my home gym?
My hope for the new year was to finish the book A People’s Guide to Publishing and use it as a guide for making goals for the publishing company for 2025 and to maybe, perhaps, finally finish my business plan.
With the ailment I inherited from the college student, I didn’t do nearly as much I had hoped over the holiday season, except for reading light fare like Blubber and binging old movies (Practical Magic, The Dream Team, A League of Their Own).
This year has been challenging– even with my attempts to get my act together– I am still where I was six months ago when I joined the Omada program.
But with my colonoscopy which happened December 30, and getting cleared for the Thrive Medical Fitness program at St. Luke’s Hospital Dec. 27, with my first workout scheduled for Jan. 1, I literally had a clean start.
A new year. A clean colon.
And then the dog ate a lot of the leftover Christmas cookies.
So now I won’t be tempted to eat them.
Back to the gym
Wednesday’s exercises
I did my first workout with Alex at the St. Luke’s Sports and Performance Center at the Anderson Campus on Wednesday morning at 8 a.m. That was the “push” workout. The exercises reminded me a lot of the workouts Andrew and I did together at Apex Training. When I told Andrew about it later, he remarked, “the basics always work.”
I survived the workout well, and the next day my chest muscles in the area of my shoulders and armpits reminded me that I had exercised the day before. Alex has me using the treadmill for 15 minutes, with the goal of getting my heart rate to 120-130. It’s embarrassing how challenging the treadmill can be for me, all that walking fast and making sure my feet do the right things. I so envy the people who don’t have to hold on for dear life.
Friday’s exercises
Today we did the “pull” workout. I even brought an earphone so I could listen to a podcast on my treadmill walk. The fifteen-minute walk allows me to cover a half-mile. I know that’s rather pitiful, but we all start somewhere. Alex is learning that I can handle a lot more weight than he suspects when it comes to upper body exercises, and like Andrew, he loves to make that sadistic little statement of “looks like that was too easy.”
Alex wanted to see me four times a week, but he’s only at the Anderson Campus one day next week. So, I asked, where he would be. And he said Phillipsburg. And if you know me, you know I know Phillipsburg.
He looked surprised if I could come to Phillipsburg and I asked if that were okay or if it were too stalkerish… I’m literally in the middle of the two facilities.
I’ll be seeing him in Phillipsbug on Tuesday and Thursday afternoon and then on Friday afternoon in Bethlehem Township. We scheduled all that when I saw him Wednesday, and today he said he was very excited to see me in Phillipsburg next week because that’s the gym he spends the most time in and it’s less cluttered.
When I left the hospital today, everything hurt. But I was proud.
Functional Fitness
My dear friend Thurston has been writing about what he calls “crisis conditioning” and functional aging as part of his Phulasso Living newsletter. (Read more about that in his own words here.) After a traumatic and severe leg break in Autumn 2023, he experienced his own fitness challenges. As an active guy, and a strong “in-shape” kind of guy, I think it surprised him how much energy and muscle power it took to have a mobility issue like his broken leg. He had to rely on mobility aids to get around his house (after weeks in bed) and I remember him commenting to me about how his strength did not guarantee that he had the upper body strength to support his own body weight.
The world suddenly looks very different when you face a flight of stairs with a pair of crutches or worse– a walker.
Thurston’s career has focused on safety and emergency preparedness. I think his accident may have changed his view on how much he can trust his own body, or perhaps how much he can take his body for granted, because in some ways, aging is a crisis event. Aging makes it harder to recover from injuries and from workouts. Aging makes it harder to maintain and even harder to build muscle.
But I have often viewed my own body as an unreliable partner. And something Thurston said in his newsletter hit the nail on the head.
After achieving a great deal of progress up until the spring and summer, I noticed something that really frustrated me. If I missed 3 or more days of exercise, I experienced stiffness and pain, and the number of repetitions and sets in my exercise routine would decrease! It was almost as if I hadn’t been doing much exercise at all.
–Thurston D. Gill, Jr.
I have been strength training on and off since college– which is 30 years now. I spent almost 10 years working at Target in a physically demanding job. As I approached 40, after a broken hand, I recommitted to my own fitness. And at 46-ish, I joined a private gym and hired a strength coach. I was a consistent client at Apex Training for three years, even when I had to scrape pennies together to pay for it, until my trainer had a family emergency that put a pause in our relationship and suddenly, I no longer had the money.
What Thurston describes is what I experience. That is what cerebral palsy does to me. My muscles in my legs and lower body never relax. They never get the message from the brain to relax. To facilitate better motion, I stretch and strength train and go to balance and gait physical therapy to show them rather than tell them what to do.
And the more I do it, the more that becomes their default.
And if I don’t do it, they forget.
I guess Thurston and I are both telling you not to take your body for granted, but to also realize that you need a plan to maintain your health and your strength because you never know what might happen. When I broke my hand, it was my dominant hand. That happened when I was in my late 30s.
Would it be more difficult now, a decade later, to do all those everyday tasks with my left hand?
What if I suddenly did have to use crutches?
If I fell, do I have enough upper body strength to pull myself across the floor? Into a chair?
Can I balance on one foot? For how long? Can I do it on each leg?
How do I carry items upstairs if I need one hand to hold the railing?
Can I navigate without relying on my eyesight?
Can I still walk a mile? Two? (If the car breaks down in the middle of nowhere…)
Yesterday I had a colonoscopy, which means that I went 36 hours without food and experienced my first bowel prep. As with many things, I approached it with the same curiosity I would other aspects of life. Like how long does it really take to clean one’s colon? How does it feel to fast for an extended period of time? Can I find a broth or a gelatin dessert I like?
I’m not a big meat eater, and was vegetarian for eight years before my daughter’s birth. So the clear liquids diet seemed abhorrent to me, and the fact that they asked you to avoid nuts, seeds, whole grains and vegetables and fruits with skin for five days also troubled me.
The directions for the prep said I needed a 64-ounce bottle of Gatorade, but not in red, orange or purple as those colors could look like blood in the colon. I didn’t know if blue were okay. I looked at all the flavors in ever store and it looked like yellow was the only color that was safe. Except Gatorade is gross. And it’s hard to find a 64-ounce bottle of Gatorade, so I had to hit the grocery stores. That’s a LOT of Gatorade.
I told myself– find a small bottle of a flavor that might work and taste test the Gatorade. But even then I could not do it.
I looked at this logically. The whole point of the Gatorade is to suspend the Miralax powder into a liquid and to offer the body electrolytes so you don’t end up horribly dehydrated. Gatorade is not the only electrolyte drink out there. There’s also Propel, G2 (okay so that’s just diet Gatorade), and high-end products like Liquid IV. I’ve been down this rabbit hole before with research when my primary care provider suggested I drink more electrolytes to treat my orthostatic hypotension. I already had a favorite.
I ordered myself some of my favorite electrolyte powder (Powder Vitamin Plus), in lemonade, unflavored and ginseng green tea. No colors.
As for clear liquid diet… I made chicken stock and froze it. But, I don’t like chicken broth and I could not convince myself to thaw it out and drink it. I found some gelatin that expired in 2022 from when I promised I would make Eva finger JellO, but I couldn’t find the JellO. Eva also brought home a bottle of Sprite.
I used the Sprite and a random can of Beetlejuice spiced apple soda from Fanta to make one batch of finger JellO but the color of the soda was bright green and I expected it to be golden. I also made a batch with white grape-strawberry juice (and that was diet).
Saturday morning I had a big salad, removing all the items from the “avoid list.” Then I had a decent dinner, and a few homemade Christmas cookies. Lately, if I have more than three Christmas cookies, the sugar makes my belly feel wonky and this night was no exception. I stopped eating at 6:30 Saturday night (and didn’t eat solid food again until 10 a.m. Monday).
On Sunday morning, I made some electrolyte water and a hot ginger drink. Midmorning I made black coffee and laced it with a little chocolate chip cookie dough Torani syrup. For lunch, I had a heap of finger JellO and a small cup of vegan soy ramen broth. In early afternoon, I drank a cherry Coke zero.
I took my first set of laxative pills at 2 p.m. and an hour later, well you can imagine the results. I already had no stool left in my colon, but as most of my intake had been brown liquid…
At that point, I filled a glass jug with 64 ounces water, and a scoop of lemonade electrolyte powder and a half scoop of the ginseng powder. I shook and started to add the miralax powder. Except it didn’t fit. Even with me stirring with a long spoon as I added it slowly.
I poured it all into the blender, which resulted in about 72 ounces of final mixture.
I put it into the fridge, with the overflow in a mason jar so that I could track how much I was drinking.
At 6 p.m., I started drinking. At first, it tasted good. The directions said to drink half. Now, at this point, it already looked like my colon was clean. And I was supposed to drink it in about an hour. A glass every ten to fifteen minutes. I managed the amount suggested in an hour and twenty minutes. By the end, I never wanted to see the mixture again.
The final set of laxatives were at 8 p.m. I went to bed about 8:45 p.m., but my lingering cough kept me up, and every time I coughed I had to use the bathroom. I finally dozed off at midnight, only to be scared awake by my alarm at 3:45 a.m.
My procedure was scheduled for 9 a.m. and the directions said to finish the prep mixture four hours before the procedure. I went downstairs and poured a glass, drinking while I watched the Apple TV program Trying. I made it through almost two glasses. Then the drink started to gag me. And I used the bathroom and saw that my waste was still as clear as my urine so I returned to bed.
Around 6:30 a.m. I woke again and took a shower. Checked my blood pressure and my weight. Blood pressure up, weight down by 3 pounds.
Eva took me to the hospital at 8. They had asked me to arrive by 8:15 a.m. Now, I schedule a lot of these procedures at St. Luke’s Easton Campus as it is about 600 steps from my house. It’s usually empty, and the doctors and medical professionals there always seem to take good care of me. I used the self-check-in kiosk and went up to the Lotus waiting room.
That waiting room is full of the chairs that I love. We had a teal chair that we called “the throne” that I bought myself when I found it on clearance. I loved that chair, but in its first few months of owning that chair, we got a puppy who ate the chair. We tried several times to fix it, but she repeatedly ate the chair until there was nothing left. For a while, we took the legs off and set it on the floor with a slipcover over it and just gave it to the dog, but eventually, we gave up and threw it away. Which broke my heart. Because she also ate holes in my couch.
When I ended up in the ER for stitches in March 2023, after the fall that left the scar under my lip, I noticed the Lotus waiting room was FULL of my chair. Half of them in the color I had purchased, half in St. Luke’s blue. I had been admitted to an upper floor, perhaps the third. I looked down upon the chairs as I headed for the door.
It’s an ugly waiting room with a collection of my chairs.
They took me back to the unit at 8:40. Eva had to leave to feed some clients breakfast and the nurse told her to come back to this waiting room. The unit looked the emergency room from every television medical drama made in the last thirty years. There was another person there getting prepped for something. And maintenance men changing the lights which technically put them at an angle where they could see through all the privacy curtains from above. Not that I care.
Two nurses started prepping me and the doctor and the anesthesiologist lined up for my consent and the consent of the person next to me. The whole process was a very efficient assembly line. I mentioned that during my prep all I could think about was saltines. And the staff laughed and said they could handle that. The nurses took one look at my tiny veins and I think they panicked. They got a third nurse specifically to start my IV.
That IV was beautiful.
She was like an IV angel.
Normally IVs are a tumultuous experience for me. When I had my tilt table test, the man who administered that IV dug around under my flesh for what felt like an eternity and left bruises all over my hand and arm from his failed attempts.
I have never had blood draws as smooth as what this nurse did yesterday. I included a picture: If you see the three dots on the top side of the frame in the middle of the edge of my hand and think of them as Orion’s belt (they are from an old cat scratch) and travel to the middle of my hand slightly to the left, you will see a tiny pin prick– and not the one between the two lines on my wrist– that’s where my IV was. There is no bruising. At all. I had an IV in this hand and there isn’t a single piece of evidence that it was there!
As the placed an oxygen mask over my face and told me to turn to my side, someone else gave me an extra pillow concerned for my comfort. My last thought as I watched the nurse or whomever finish pushing the plunger on my medicine was “Why do I need to be comfortable? I’ll be unconscious.”
It was 9:20 when I woke to a small bottle of water and a pile of saltines. I texted Eva and she was almost to the hospital. The doctor told me he did find and remove a polyp. And I was home by 10 a.m. And the saltines were delicious.
It is Saturday, December 28, around 8:30 a.m. when I start this. Do not expect much eloquence from me, as the gunk Eva passed on to me from her recent illness is still interfering with my ability to think and sleep. It has instead given me a lovely cough, which now after more than a week is getting “wet” and “productive.”
I FINALLY finished my medical intake at the St. Luke’s Medical Fitness program. Because of my paused membership, I’m not sure when my end date in the Thrive program is but let’s assume mid-February for now. This whole journey started in early November when I visited my neurologist-physiatrist to talk to her about my recent mobility issues and any concerns she had about me returning to an exercise program.
The older I get, the more I worry that my cerebral palsy will cause me to hurt myself because I tend not to notice when my body is doing the wrong things.
Eva has worked really hard on remodeling the garage and including a space for a home gym, so I need to pay some attention to myself in that regard. But I’m out of shape, and falling more than usual, so I’m scared.
My neurologist referred me to the medical fitness program, and I had my first medical intake appointment on November 11. My blood pressure spiked during that appointment, so they sent me home without doing the baseline exercise portion of the intake. I returned two days later, and they almost sent me to the ER because my blood pressure was still bad.
Two trips to the primary care doctor, two trips to the cardiologist, and two or three falls (depending how you count, one was a trip, but I still believe it happened because of balance issues which makes it a fall) later, my blood pressure seems under control again.
And of course, yesterday, when I turned up at the gym in the basement of the hospital, it was 130/90.
Since I’ve been fighting the gunk, I almost canceled the appointment, but I filled a water bottle with my electrolyte flavor, grabbed a scarf, forgot a mask, and hopped in the car. My fear was that if I canceled the appointment, the intake would have to wait until after my colonoscopy and I was worried that one thing would lead to another and I’d never get this done.
When I arrived, I forgot my water bottle in the car, still couldn’t find a mask, and realized I had no idea where my membership/gym tag was. In the back of my mind, I knew I had packed a gym bag at my last attempt and that the tag was in the gym bag. But where was the gym bag? And what bag did I use?
Lots of hand sanitizer and frequent hand washing and I refused to shake the young man’s hand. I also told him if I continued to cough and he had to send me home, I understood. But I reiterated that I had had many trials to get to this point and I would rather be sent home than continue the cycle of not trying.
Onto the fancy scale I went (168) and I know that body fat percentage was in the forties, wish I could remember what it was when I was super lean a decade ago. Turns out that information may only exist in paper journals in my attic.
39-year-old Angel … with something to prove before hitting 40
The Angel in the pictures is 45 pounds lighter than me, and I think those 45 pounds, age and stress have had a ridiculous impact on my blood pressure and my mobility. (And for the record– the sweatpants worn by Angel in the pictures were my favorite sweatpants ever.)
I have learned that my body reacts strongly to salt and sugar, and that I “do better” when I cook, and that I have no self-control with processed snack foods like potato chips and doritos.
The trainer I met with yesterday talked about maximum heart rate and how hearts slow down as we age. The highest my heart rate reached in 2024, according to my AppleWatch, was 186. 207 was the highest since I got the watch. The online calculators I have seen suggest that my maximum heart rate for my age is between 170 and 179.
The trainer, and maybe his name was Ryan but maybe I invented that, would like to see me four times a week. I still have the mental mindset to make this work, but my physical stamina and fortitude have worn me out to the point where I can talk myself out of my own efforts.
Maybe, someday, I will get my discipline under control and be one of those old ladies who powerlift. Screw the whole red hat/purple dress thing.
Meanwhile, Monday is my first colonoscopy. It was supposed to be the Monday after Thanksgiving but the doctor had a death in the family. Tomorrow I start my official bowel prep, and it scares me, because I get shaky without food, and low blood pressure without salt, and I already have a mobility disability. Then they will knock me out on Monday, and I tend to have a heavy reaction to medications and anesthesia. So none of this makes me comfortable. The actual colonoscopy, that doesn’t scare me. But everything else does.
So tomorrow, unless I experience miraculous healing today, I will be expelling mucus from my lungs and all the poop from my bum.
I started my new fitness journal Monday and have been making good choices, tracking my activity and walking the dog everyday.
Each day my number of steps increases by about 500 and today I made it up an extra bend of stairs before I was out of breath– Nan lives on the third floor and I always take the stairs instead of the elevator.
I’ve reduced my caffeine intake, resumed taking my beta blocker and have taken my baclofen regularly. Today was my second try to finish my intake for the Thrive Medical Fitness Program at St. Luke’s Hospital. I even arrived 15 minutes early, used the restroom and sat in the waiting room imagining petting my cat, Fog, and listening to his purr.
They wouldn’t let me finish the intake on Monday because of high blood pressure and heart rate and I was determined to do everything I could to come in on target.
Well.
My heart rate passed.
My blood pressure, despite several attempts by more than one person over a course of 20 minutes, did not. They asked several times if I had any symptoms– and I said no because I didn’t. They asked several times. And the last time my trainer emphasized if you have any symptoms at all I will accompany you to the E.R. right now. They let me go home with a promise that I would call my primary care physician and go talk to them tomorrow. And they instructed me to take my blood pressure as soon as I got home.
My numbers there were: 180/120, 180/117 and 160/110.
I came home and the numbers had fallen: 123/91, then 116/82, and finally 115/71.
I went to the bench outside the hospital and called my primary care physician from there. The office is on the way home from the hospital and it was only 4:30 p.m. so if they had concerns they could have me come immediately to the office or stay at the hospital.
I have an appointment for 8:45 a.m. tomorrow.
And the staff at the fitness center thanked me for being so flexible and understanding, acknowledging that the whole situation must be frustrating, but getting angry about it won’t help me– or my blood pressure.
Honestly, I think my body is just anxious about being in/near the hospital.
So we’ll see what my primary care physician’s office says tomorrow.
I had my intake for the Thrive medical fitness program at St. Luke’s Hospital. I did not finish all of the required testing because my heart rate and blood pressure were too high.
But let’s back up. Perhaps things aren’t as “all or nothing” as I feel right now– I feel like in many areas of my life I am “failing” or “losing” and the reality is that life is more complex than that.
I was soooo excited to join the Thrive Medical Fitness program, and I still am. The staff seems pleasant and supportive.
And I wanted to do stuff.
No doing stuff yet.
I had a 5:30 appointment for the intake, and I was 100% honest on the form about my habits and my medical conditions. After all, it’s a hospital-sponsored program so they have access to at least my medical history anyway. So I told the staff member about my fall history, about my bout of afib, about my orthostatic hypotension, my anemia, and my increase in spasticity.
And I quickly learned that due to all of these conditions, I will not be allowed to workout independently at the facility. I will have to make an appointment and work out with one of their trainers for every workout.
Now, to start, I can see this being prudent, and I hope I will prove I am not a danger to myself and be allowed to drop by and workout. But, if not, my new home gym is almost ready.
So, I accept this. I even try to see the nice staff person’s small gestures to my elbow as I step on and off the fancy scale as kindness. She does not know me, so she has to be cautious. But it would be a delicious story if I fell off a scale. And hurt myself. At the hospital.
Which reminds me of the time I fell down the stairs at the hospital, but that’s another story. You can read that story here.
Then, they took my heart rate and my blood pressure. Both were really high and would not come down.
Part of that might have been because I did not know they were in the basement, and even when I made it to the basement, they were tucked in a corner that had me walking around the whole building for a while. Then I got myself worked up when my anxiety was already doing overtime– I’m thinking a lot about how I’m going to heat the house this winter, what my next strategy will be for maintaining the publishing company’s income, and facing the holidays, a time of year when I typically feel the absence of my family.
So today I started taking my beta blocker again as I initiated my Clever Fox fitness journal. I filled out all the spaces regarding measurements, goals and trackers. Maybe it will force me to be introspective and keep track of my own behavior.
And meanwhile, I have taken Bean Dog for several walks this week. Our first was on last week, and it lasted less than five minutes. We walked halfway up our block and back, just to see how she behaved for me and if she would walk with me and leave Eva behind. The second walk was straight down our street almost 1.5 blocks and straight back, for a total of nine minutes.
Yesterday we walked around the whole block, which took 12 minutes, but about 8 minutes in, Bean spotted our neighbor’s pitty jumping at the fence literally within view of our house and I was afraid to try to get her home. In trying to grab her heel-level handle, I scraped my knuckles on the asphalt and decided to just sit there and wait for Eva to rescue us or for the dog to calm herself.
Today we walked two full blocks (15 minutes) after Eva trained me to use a hands-free leash with a bungee-style lead to absorb some of the force. Eva hooked it to the traditional leash so if she started to react badly I could brace my body weight and use more of my power to balance the dog, and then regain my control by taking the traditional leash back.
We have not had to do that, but it’s good practice and good exercise for both of us.
PS– I return to the medical fitness center tomorrow to resume my intake testing.
It was my first MRI, to monitor an aneurysm in my brain discovered last year during my random heart issues. Last year they did a CT scan with contrast as I did not know if tooth implants would count as metal. (It does not. They are non-ferrous. I learned this as a more-or-less universal fact from the radiology tech. And to think I made my poor dentist research the screw in my mouth.)
When I called to schedule a few weeks ago, they asked where I wanted to receive an MRI and I chose the hospital that is 600 steps away from my front door. They offered me an appointment at 7:15 a.m. on a Sunday. I agreed.
Roll out of bed, wander to the hospital, get an MRI, and be home while it’s still early for a cup of coffee.
And that is indeed how it played out, and I had my coffee in my hand before 8 a.m.
On the walk over, I noticed this Subura station wagon from Vermont with roses on the hood. Now, between the apartment building across the street and the hospital itself, one finds a lot of out-of-state cars and doctors-in-training. And while I did not linger long enough to read what was written on the windshield, it said something like “you and me forever” and someone had laid a wrapped bouquet of roses on the hood. A marriage proposal? A stalker? A farewell from a lover returning to a place far away as a promise to come back?
I surely hope they aren’t roses, because leaving roses on the hood of a car in the middle of the city in the rain, especially if it’s a marriage proposal is certainly both romantic and stupid.
I arrived at the hospital around 6:50, in part because I know they ask you to register at the front desk and then meander through the facility to reach the waiting room of your particular appointment where you start the registering process again. There are usually insurance card checks, and headshots taken to prevent fraud.
I walk in the front doors and there’s one person, in a hospital t-shirt, sitting right inside. Before I even have a chance to pause or plot a course, she greets me with, “Are you hear for an MRI?”
I say yes, and then she follows with, “Is your name Angel?”
I again say yes.
Now, I know this particular hospital doesn’t do much hospital-ing. They literally only have one floor of inpatient services, and I experienced that last year. I must say the renovations are looking gorgeous, again, nothing like the room I stayed in last year straight out of mid-twentieth-century Americana. At this early hour on Sunday morning, there is no one in the hospital but me and this employee, Rose. No one.
“As soon as I clock in, I’ll take you back,” Rose says. “But we have a few minutes. So have a seat.”
I sit behind Rose in the waiting area in front of the not-even-staffed-yet registration desk.
“That’s fine,” I say. “I’ll read my book.”
I have a lovely conversation about Rose, her retirement from one of the larger hospitals in the network, and how she has really enjoyed reading again since her retirement. She clocks in and escorts me upstairs and down the hall to the MRI suite where I sit in another waiting room and Rose greets the staff who are arriving with us for their shift.
I sit and read my book, and the techs come for me. For the first time ever, I am given hospital pants. I peel off my civilian layers and tie on my gown and pants.
Much to my relief they have a metal detector as the final phase of the pre-MRI adventure. I am pleased to report I am not magnetic.
So many of these tests come with so much hype, and I have to say, I think I prefer the MRI to the CT with contrast, because an MRI doesn’t make me feel like I’m about to or in the middle of urinating in my pants.
And they tell you to stay as still as you can– which always makes me super aware of every twitch in my body.
They warn you that the machine is loud and they give you ear protection. If I had to describe the experience I would say space rocket meets construction site. And so many different types of squealing, clanging and banging.
7:30 a.m., Wednesday, April 5: Yesterday I was discharged from hand rehab with John at The Institute for Hand and Upper Extremity Rehabilitation. My hand strength in my right hand is stronger than my left hand, so even though my pinky doesn’t quite have all the functionality it should, John thinks with proper use and exercise at home I can handle recovery.
As John said, implying that he could trust me to monitor and invest in my own hand health, “with everything you have on your plate, this is a mere flesh wound.”
Indeed.
With that, I had my last session of rolling and smashing silly putty and twirling balls in my hand. Really, hand therapy is not that far from children’s play. As an adult, there’s not enough activities that involve silly putty.
After a weekend of high blood pressure, my body suddenly feels low– and my blood pressure is on the low side, even after coffee, and I’m light-headed and feel as if my blood sugar could be low, despite snacking on a slice of fresh pizzeria pizza (I found that real pizza versus Dominoes or frozen varieties does not have the sodium and preservatives that impact my numbers) when I took my evening dose of Lopressor. I ate breakfast, and that helped some, but not enough. I also had an 8-ounce glass of water.
So, as my primary care doctor is signing off on me returning to work on Monday and we’re still waiting for my cardiologist’s report, I’m terrified that something might happen today. But I don’t want to manifest my own misfortune. It’s interesting to note that today was supposed to be my first day back to work, but I still have physical therapy during the day this week, and I felt better knowing my cardiologist should have the info he needs by then in case we need to make adjustments to my treatment plan.
The manufacturer of the Zio sent a push notification to my phone that they received my device and will have the data to my doctor soon.
My left hip, according to my physical therapist, was tight Monday, and now my right hip is giving me issues, the kind of issues it often has when compensating for the left hip.
I should have taken a shower last night, but I thought it would be nice to shower in the morning, but then I remembered I have physical therapy and the gym today… but I might have to take two showers today. I need to see if I can shake this feeling of brain fog and lightheadedness. By then, it will be 8 a.m. and I can call my doctor’s office. They are next door to physical therapy so maybe one of the medical assistants can take my blood pressure. Because my neurologist would be mad at me if I ignore this.
8:20 a.m. After a hot shower and exposure to The Teenager’s work drama– not being able to get into a client’s house to feed the dog– my blood pressure is now high. So I don’t know whether to call the doctor or not. I put on my sports bra inside out and my shirt backwards.
8:30 a.m.I called the doctor’s office. They won’t let a nurse or medical assistant take my blood pressure because they would like a doctor there because of my history. I have an 11:15 a.m. appointment, directly after my physical therapy, with one of the residents, I think, because it says my doctor’s name but that’s not what she told me. But it usually shows the resident’s names so we’ll see.
9 a.m. I decide to play with the Stitch Fix style algorithm before leaving as I only have a couple minutes. This will be important later… because brain fog. That was another symptom I’m struggling with– I put on my sports bra inside out and my shirt backwards.
Brief interlude while I am thinking of it. My hospital EOB came yesterday, as did updates as to some of my other medical visits. It’s obscene to see the battle between medical providers and private insurance companies. When did this become an acceptable model of business? The hospital charged my insurance company almost $18, 500 for one day of services. The insurance company pays a pre-negotiated rate of $2,500 and I get bill about $300.
In a similar fashion– the medical office billed the insurance company for the resident who so patiently spent 30 minutes removing three stitches from my face. It was itemized as “surgery” and the provider billed $66, of which the insurance company paid $13. And left $1.50 for me. So this poor resident, who worked her way through medical school and had to dig the stitches out of my scabby face, isn’t even worth $30/hour?
9:40 a.m. I arrived at Physical Therapy to sit and read my book until my appointment. Yesterday, I finished Susie Bright’s How to Read/Write an Erotic Story and I have every intention of finishing Suzanne Mattaboni’s Once in a Lifetime today.
10 a.m. or there-abouts: physical therapy with Jimmy, instead of Eric, because it’s Eric’s birthday, and his colleagues suggest that this might not be his first thirtieth birthday. I am also informed that the goal today is to poke fun at Eric as much as possible because he’s not there to defend himself.
Summary of Physical Therapy: I worked hard and found myself pushing and having good balance despite the issues with my quasi-lightheadedness. As usual, my left side is tighter than my left, but I notice as the day goes on my discomfort on the right seems to be correcting itself.
I also told my physical therapist about The Institute for Hand and Upper Extremity Rehabilitation and my mallet finger that I did last year, right before Easter. I explained how I ruptured the tendon pulling my socks off. He’s now afraid to take his socks off.
10:40 a.m. I stop at the car to update my notes and drink some water. This massive Audi SUV is parked next to me, requiring that I turned sideways to slip into my car. I take my blood pressure: 122/71.
10:50 a.m. I walk down to the primary care office, and finally put the facts together that between the physical therapy office and the family practice, there is a pediatrician. That’s why I always hear screaming children though the wall. I use the rest room and open my book.
11 a.m. My doctor’s assistant takes me back to the exam room, and confirms that I will be seeing my doctor. She’s the same person I correspond with through the portal, and who fills out all my paperwork with the patience of a saint. She doesn’t weigh me and this disappoints me because I think all this healthy eating has resulted in a smidge of weight loss.
If we’re honest, I feel silly. My head still doesn’t feel right, but I’m fine… I mean I’m going to be cautious but it could be so many things: blood sugar, blood pressure, the beta blocker, allergies or even the pollution from the major industrial fire a mile away yesterday or heck even stress… but the neurologist said… Everyone in the office, including the doctor, reassured me that I did the right thing since no one wants me to fall again.
My blood pressure was 120/77, which is pretty darn close to my car reading so that proves that my monitor is reading my blood pressure accurately and the presence of the doctors does not cause my blood pressure to increase.
Alpha Books J Journal
11:10 a.m. the assistant leaves and I open up the final pages of my book. And I finish it in five minutes.
11:30 a.m. the doctor arrives. He sees my Alpha Books J journal in my lap and starts asking questions. Then he asks why I am there– that my chart just says “high blood pressure.” I explain that no, it’s actually lightheadedness that started with low blood pressure but hasn’t abated since my blood pressure returned to normal levels, and that the neurologist made me promise not to ignore symptoms like lightheadedness.
I explain that I got out of bed a tad clumsier than usual, after ten minutes of trying to force myself up despite 9.5 hours sleep, and I just attributed it to stiff cerebral palsy legs. But as I went downstairs and turned the lights on, I realized I was a tad lightheaded.
I poured a glass of water, took my blood pressure and my meds, and made a cup of weak (for me) coffee and finished my water and had fruit and toast.
I pass the doctor my list of blood pressure readings and tell him my first of the day was 102/68, followed by 108/65 an hour later.
He peruses the list I gave him and asks, “do you have some fancy blood pressure device that takes your blood pressure every hour?”
“No,” I say. “I’m just neurotic.”
He chuckles. “It’s not bad,” he says. “It gives me data to work with. I have patients I can’t get to take their blood pressure once a day.”
“I know you’re going to ask me what happens in certain situations, so I just want to see if I can anticipate the questions so I have the answers. Like there’s definitely a difference when I eat pizza from the local pizzeria that uses real ingredients versus Dominoes.”
He mentions I should track my pulse. I told him I look at it when I take my blood pressure because the neurologist mentioned it but I haven’t written it down. I haven’t noticed anything. And I didn’t tell him about the symptom diary I started. But I did come home and add heart rate to my iPhone tracking info. I really need an Apple Watch. Okay, I want an Apple Watch, but I refuse to consider buying one until my business computer is paid off and I replenish my savings and pay off the credit card bills I ran up during this hiatus from work.
He performs some basic exams, and has the nurse take my blood pressure lying down, then sitting, then standing up. If the low pressure is caused by gravitational pull on my body, or something like that, my blood pressure will drop as I quickly force myself upright.
My blood pressure spiked (142/100) suggesting that I tensed, which I did, because the sudden movement made me feel like I was swaying. And I braced my muscles, afraid I might fall.
So, the next test in our journey through Angel’s recent career as a face-diving professional, is to half the dosage of my Lopressor. My doctor thinks he found a note made while I was in the hospital that the IV medication made me dizzy and that’s why they switched me to the oral tablets. I don’t recall this, but a lot happened that night… so I asked The Teen much later, and she said no, my memory is correct. I read the note the doctor found, and I believe, though I could be wrong, that the real problem is doctors have no skill at writing and this leads to misinterpretation. Ooooh, maybe I need to start a “Clearer Writing Styles for Doctors” workshop.
And since my echocardiogram was perfect, and he reviewed it there with me, but I’d already read it, he wondered if the beta blocker was necessary at all (ironic since he was trying to get me on blood pressure medication for the last two-plus years) and/or if the Afib was an isolated incident. I dispute this theory, because I had two unexplained, nearly identical falls within two weeks.
My doctor reduced my beta blocker in half, which meant I had to remember to go buy a pill splitter because I already have the tiniest pills I ever saw. And he also suggested taking some sort of hydration beverage into my bedroom– a G2 gatorade or a Propel– to drink before getting out of bed.
And he closed with something like, “these are the kind of things I have to tell my patients who are 70 or 80, but unlike them, you’ll listen.”
Then he asks, “when is your next appointment?”
Not until August, I reply. He looks to me in disbelief. “I want to see you before that.”
And he sends a note to the cardiologist that he reduced my beta blocker and asks him to review the data from the Zio patch. The same Zio patch that just returned to the manufacturer yesterday.
I mention I will see the cardiologist May 5, if that matters when scheduling our next rendez-vous.
“I want you to check in in the next couple days,” he directs me, “and I want to see you next week.”
“How about April 20?” I ask. “It’s in the middle of now and April 5 and I already have to take the day off for some CT scans at the hospital and physical therapy.”
I’m going back April 20, at 8:30 in the morning, to meet with one of the residents. I didn’t think to check which one.
12:10 p.m. I leave and head to my friend Maryann Ignatz’s house to bring her some books she ordered and visit.
2 p.m. CVS. The computers have gone insane. I don’t think this will impact me as I peruse the aisles. My list is simple: a better lotion for scar care, an electrolyte drink, a blood pressure monitor, and a pill splitter.
Now, I have a borrowed monitor and I’d rather have an Apple Watch connected to a wireless monitor cuff…
And the only thing on the list today I need right away is the pill splitter.
So I find one for $8.49 and I have a 40% off coupon that expires today. I also find Propel dry powder packets that go into a water bottle– I think $3.49 for ten packets. On Amazon, the already constituted Propel Water in the same flavor costs $8.38 for 12 bottles, which is 70 cents a bottle or twice the price. I even placed one of my reusable water bottles by my bed, and I picked one with a screw-on lid designed for my bike so it’s less likely to spill.
The blood pressure monitors start at $62, and the $62 one provide $10 in Extra Bucks, but I don’t want to spend that much now.
And the only lotions “better” than the ones I have at home start at $10 and the ones specifically for scars are $20.
And on top of all that, the system doesn’t really register my Extra Care card, so it says I was logged in, but it didn’t use my coupon.
I never pay full price at CVS.
And we’re not going to talk about the fact that they were sold out of jelly beans.
3:30 p.m. I make a run to the bank and take the dog for a trip to Dunkin’ for Munchkins. Oh, and the teen. I eat too many jelly munchkins, drink a cold brew and eat one of their salty processed sandwiches, their completely not-a-Grilled Cheese with their sun-dried tomatoes. Not worth the money I paid. My blood pressure does not change. I cancel the gym for tonight because I still don’t feel stable.
I come home and I cut a pill. The Teenager then insists she can do it better and that I’m sloppy.
vegan tofu salad with lime dressing and cucumbers
4 p.m. I spend some time with my cockatoo, and tend to some self-care details and start laundry.
6 p.m. The Teen and I make salads with tofu nuggets and romaine and cucumbers. The Teen devours heaps of romaine and cucumber. With a homemade fresh lime dressing.
I mention to the Teen that KFC has nuggets now.
“Really, Mom?” she protests. “You expect me to eat tofu after mentioning KFC?”
And then I proceed to drop the knife several times while chopping vegetables. I’m amazed I still have all my toes. Brain fog is so real.
6:45 p.m. I text the neurologist just to update her.
7 p.m. I place my last load of laundry into the dryer and find a half pill of my beta blocker on the table.
I call the teen’s name.
“Did I not take this with dinner? Did I miss my mouth?”
“I doubt you missed your mouth,” she reassures me. “It probably just slipped out of the bottle.”
“I could count them,” I say.
“And if there is an even number, you fucked up,” she says.
It was an odd number.
7:30 p.m. I finally retire to my room hoping to start a new book as part of my pre-bed, no screens ritual. I make the bed, feed the cats, put my Propel packets in my drawer and organize my lotion (for scar massage on my finger and my face) and my water bottle. But first I have to finish this blog entry. And I notice– to my chagrin– that somehow this morning I changed my next Fix from May 18 to April 18. Hopefully I can change it back before the stylist grabs it, because my charge card needs to take a little vacation from my wallet until I rebuild my rocky finances.
And that, friends, was my day. Louise the Tripod is snuggled against me, kicking me with her back feet and snoring. I still need to give the bird water, make my Propel, brush my teeth and massage my scars. So, if you think I’ve been over here partying during this short-term disability leave, I have not.
Angel Ackerman 