And the latest medical stuff…

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.

The easy way we are amused (and some medical stuff because I’m me)

Here I am, looking less exhausted and beaten. My scabs were flaking off and healing nicely but some of them cracked today (vigorous chewing? It happened at lunch time) and started bleeding. I’m still impressed at how quickly the body can heal, but these stitches feel like flies on my face.

I left the house early today to visit Koch 33 Collision. In early February, a work colleague’s car happened to give mine a love bite on the entrance ramp of 22– this was early on in the days of my unknown cardiac troubles when the symptoms were starting to show. I remember not because my heart had anything to do with that situation but because I joked about minor car accidents just adding more stress to my life. The estimate will cost less than $1500, hopefully the insurance companies can agree to that.

When I came home, I made myself my first cup of coffee for the day. I have slowly been changing my morning coffee habit into a morning water habit, unless my blood pressure is low, then I go ahead and make the coffee (which my occupational therapist at hand rehab thought was hysterical).

“What?” I said. “This is my first week on this medication and my blood pressure has been low when I have to take it. They don’t know what caused my a-fib, so I can’t skip the dose, but I also can’t take a beta blocker with a blood pressure of 97/56.”

Today my blood pressure was perfect so no coffee.

The neurologist’s office called and moved my appointment up a week from 4/4 to 3/30. I mentioned the report from the physical therapist should be in my chart, and that the news looked good, and that my body had adjusted to the beta blocker so my blood pressure and my blood sugar seemed to be stabilizing.

Gayle had promised me a new graphic every week I made it without a fall. Unfortunately, I was on day seven when the last fall occurred so I never earned it. But today is day eight. So I definitely made it seven days. And I display my new badge proudly.

I worked on Larry Sceurman’s short story “The Vanity Demon” for his upcoming anthology, Coffee in the Morning. I’ve reached the point in the editing schedule where I should edit one story a day to kick back to Larry for final tweaks before sending to Gayle for layout.

Speaking of stories and Larry Sceurman, Gayle, Nan and I spoke to the Apex Writers Group last night on Zoom, about 21 people attended our presentation. The participants seemed most interested in book construction, so Larry’s book, The Death of Big Butch, allowed us to show how we used text and book design to reinforce the nostalgic feel of the 1970s.

I also received my latest copy of the Greater Lehigh Valley Writers Group newsletter, which included my first official “Podcasts for Writers” column. If you’d like to read all of it, it appears here. More of these lists will be printed and organized in my paid Substack archives.

The Teenager came home from work and we had to run some errands. Somehow, we ended up at my hand rehab appointment more than an hour early. We visited Josh Early Candies, which killed some time. But with our meager budgets we could not afford fancy chocolates.

We ended up at Grocery Outlet, but not our local store, one on the other end of the Lehigh Valley. And we hadn’t made it 20 feet into the store when I spotted Silk Very Vanilla Soy Milk in juice boxes. Now this is The Teenager’s favorite milk for drinking.

She almost bought a pop-top can of artichoke hearts to eat in the car but proclaimed that would be a new low, even by her standards. I bought myself a pack of Maple Donuts because it was time for my afternoon snack, and I seem to do better if I save a carb-y item for around 2 p.m.

The Teenager then made a noise and I wasn’t sure what was wrong and she said it was sad how happy we were wandering around a discount grocery store. I lamented that it was a shame Nan could not be with us. And I didn’t know if that would be a good time to also mention that Gayle and I had exchanged emails with a ridiculous amount of excitement about customized packing tape from Sticker Mule.

Gayle had said she had to check out the template because it was something the business should do when we had more money and I quickly said that despite the fact that we recently printed a new book, this was something we obviously needed. And then she totally outdid herself on the design, so if Sticker Mule delivers a good products, it’s going to be so amazing that you will have to order books just so you can receive a package from us. I pack a good looking parcel to start with, so this will up our game.

When I showed Gayle’s proposed design to The Teenager, the Teenager also got excited and I bet her father would, too, because he did spent most of her life to date as a shipper-receiver so our whole family has an acute appreciation and enthusiasm for packing tape.

But this is taking up way to much space– The Saga of Angel and Gayle and their Polka Dot Packing Tape.

The Teenager and I sat in the parking lot eating Maple Donuts. Maple Donuts are always delicious, but they are not maple flavored. These donuts had a sell by date of March 27 and it’s only March 21 so I knew they would be melt-in-your-mouth soft. And they had cinnamon sugar. I LOVE A GOOD CINNAMON DOUGHNUT.

I ate two cinnamon. They glided down my gullet and I couldn’t help myself from also having a plain cake doughnut. I have no self-control.

The Teenager whipped out a Silk soy milk.

“Are you going to drink that warm?” I asked.

“Room temperature,” she answered. “Do you think I ever drank these cold? How do you think they came out of my lunch box?”

,

Hearing her reminisce about having these in her lunch box reminded me of how many times I worked hard to find sales and coupons and deals to buy them for her because I knew she loved them– and other than that she only got Juicy Juice or Adam and Eve juices because I was very strict on what I fed her and Silk in juice boxes was so expensive compared to the half gallons. And sometimes I worked hard to save money on all the other groceries so I had the $10 extra to buy her favorite milk for her lunch.

And they are delicious.

The half gallons supposedly are only sold at Dollar General these days but we still haven’t found one in our area that sells them.

Once we headed to The Institute for Hand and Upper Extremity Rehabilitation, we had our cravings satisfied.

The Hand Report

When I arrived at therapy, they wrapped my hand in a moist heated pack for twenty minutes and it’s the best twenty minutes of my life. My therapist heard my tale of falling down the stairs and landing in the hospital in the hours after my previous visit, and he said I win for the most interesting story of the day.

Then, he proceeded to talk with me about things I could do at home to prevent future falls and make my life safer– because he is, at the end of the day, at occupational therapist. It was a great talk. It was an even better conversation because he gave me a hand massage during it.

My mobility has improved greatly, and even though it is still swollen, I can make a fist! I did several exercises there. My therapist mentioned that next time we will focus on strength, because he believes he can trust my previous experiences to make sure I follow through with a home rehab plan, he wants to be sure I have full hand strength so that I can fully grip the banister.

“Not that I’m picking on you,” he added.

I did four sets of exercises. First I picked up handfuls of these six-sided dice and dropped them all so that the six was facing up. Then I held the big ball in my hand and drew the alphabet in the air with only my hand and my wrist, not my arm. Then I squeezed the red ball. For the final exercise, I had two balls the size of a golf ball but a tad lighter. I rolled them across my fingers and then tried to reverse the order on the way back.

11 weeks in with mallet finger: Discharged from hand rehab

This week marked my 11th week in treatment for my mallet finger. Almost three months caring for this injury. 9 weeks in a cast. About 9 days in a splint 24/7. One week in a splint most of the day, taking it off 5X a day for an hour.

This morning was my third had rehab appointment since the cast came off. They also did the casting so I had two previous visits with them.

Typically, I go in, they make me bend my fingers and they measure everything, tell me the following week’s directions and send me on my way.

Today I went in, the had me heat my hand for 15 minutes and then I got a finger massage. The therapist measured my finger and made me a new night-time splint and told me I no longer need to wear the splint during the day.

Because I do so much work with my hands, if it starts to droop or just bothers me, I can splint it here and there for an hour.

I have another appointment with my hand surgeon July 27, so although the general guidelines say I only have to splint at night for 2 more weeks, it is recommended that I wear it until I see my specialist.

Other wisdom from my therapist as we chatted today:

  • Completely immobilizing a mallet finger for six weeks is the minimum in his opinion.
  • The finger can continue healing for an additional six months after splinting is complete. He recommends using individual judgment and awareness of the finger to decide how long to splint at night.
  • Massage the finger, especially the joints for five minutes several times a day.
  • Understand that the finger may never resume its former shape/posture/movement but that the end of the finger itself doesn’t have that big of a role in hand function.
  • Keep bending the fingers several times a day, gradually working into a fist.