Friday, July 12, 2019

Watchman Device

Just got back from the cardiologist to verify whether my pacemaker was doing exactly what it should be. It is. Then the conversation changed to getting me off Warfarin.

There is a way. It's 94+ % successful, and it's permanent. It's an implanted device called a Watchman. In techno-speak, it's described as a left atrial appendage and closure device. In addition to its existence, I learned why A-fib can cause strokes from blood clots. Nobody ever really told me, beyond the fact that it can happen.

There is a pouch, known as LAA or left atrial appendage, in the muscle wall of the left atrium. It's shaped like an ear. Blood can pool in there and not get expelled properly during A-fib. That's where the possible clot forms, and it can exit once the heart is back doing its merry thing properly and lodge elsewhere. If the lung, it's a pulmonary embolism. If the brain, a stroke. Preventing it is helped by blood thinners, Warafrin being one. Blood thinners carry their own risks, bleeding from injury, even a brain bleed - the other kind of stroke.

With risks either way, an alternative has been developed, used in EU and China, now here with FDA approval. The Watchman is inserted via a tube through the groin and fed up into that pouch in the atrium. Once inside, it expands into a ball shape, and lodges in place. Overnight in the hospital, avoidance of pool and shower for a bit, then normal. Well, as normal as I ever am. Within a few weeks the body encases it, blocking the pouch from being able to pool blood which can clot. Once closure is confirmed, blood thinners can be discontinued.

For the curious, or those confuddled by my description, there are videos online. I got to see one before leaving the cardiologist's office. I'd never heard of this, and I'm guessing some of you will be new to it also.

Since Steve and I are still trying to get north before fall, and both need to be back in early October, any activity on this will be postponed till then. Warfarin is still my go-to for now. Even without this, I'm feeling 100%, energy wise, breathing wise, emotion wise. I'm good.

Now we finish fixing Steve.

Monday, July 8, 2019

If This Were YELP About AZ Pain Clinic

Another week, another screw-up by AZ Pain Clinic. Yep, I'm naming them now. I'm also advising anyone at all contemplating using them - perhaps because your insurance think's it's a good idea - think twice and go elsewhere.

When it started out as performing a procedure that not only wasn't helpful but created new levels of constant pain, it was possible to shrug it off as one of cases where one particular body didn't react exactly the same as others do. It happens. Unfortunate squared, but c'est la vie.

But add in extremely rude staff when you inquire when results not coming in a few hours as touted, first telling you you needed more patience, try back in three days, repeated after those 3 to be another week, and then outright yell at you for being so impatient with them. Oh, and would you like another treatment yet? Only another set of three $175 co-pays, after several others "needed" before the procedure.

Then they cancel an appointment without informing you, nevermind the bumpy ride to their not-so-close office also aggravates your back pain, and claim after you arrive that they "lost" your phone number.  Uh huh, sure. Of course they did. Cynical? Me? Actually, considering stuff that came later, they might have been that incompetent.

Steve heard about another procedure which worked for a cousin. Yep, they do that at AZ Pain. First he needed an appointment with a shrink. (Say what?) As that appointment rolled around, suddenly the news came through of another cancelled appointment, since that Doc didn't work there anymore, but we could reschedule for later at a location about as far away across the extended metro area as it's possible to go. Another pair of painful rides. Lonnnnng ones. So, done. Passed. Go back for the procedure.

You think it's that simple? First they gave him an appointment which we thought was for the preliminary work by the surgeon, but turned out to be a "medication evaluation" to see if he needed more narcotics. Not what we asked for. Another co-pay, of course. The one good thing we thought came out of this visit was her informing us he was fully approved for the procedure. Just go home and wait for the scheduler to call.

And wait. And wait. Finally impatience won. After a long round of voicemail maze, he was finally connected. He'd never heard of Steve. He was waiting for approval to come through.

Wait, what? Callback to the person Steve saw who told him it was a done deal. Oh shucks, she's no longer working here. So, OK, who in the office would have access to those records so we could see just where in the process we were stuck. Apparently the three monkeys work there. Nobody knew anything, nobody had a clue who might know the answer, nobody was willing to check, and we were referred back to the scheduler for the information he said he didn't have.

Holiday mess. Weekend mess. Monday morning Steve makes two calls. Scheduler still hasn't heard anything. Insurance company searches Steve's records and find absolutely no indication anybody has called, emailed, faxed, sent smoke signals or drummed any kind of request for their approval.

Steve, Rich and I had been working to make plans based on whatever contingencies came out of the morning's calls. Part of this process was my questioning whether this change would put us further behind than sticking to the original mess. I decided to check out YELP, for the first time in my life. Yep, they did medical reviews. Yep, AZ Pain was in there.  Lots of entries. Let's see, out of 5 possible stars, their rating was ... Whoa! ... Just over 1??? Time to read some of those reviews.  Several comments wished there were a lower level to rate them. Time to read on. Yep, I recognized that problem... and that one ... and that... and that.... Oh, and look at this: they named Steve's Doc doing the procedures specifically. I was now convinced the change was the way to go.

Armed with the current information, Steve first called the the insurance company for other approved clinics, contacted them for information, picked one, called his Primary for the proper referral, had me drive him to the old clinic for the paperwork - signed on-spot - for voluntary cessation of their services, and put in his request for his medical records.

Steve had found out the new clinic could fit him in as quickly as 3 days later, provided everything was ready in time. Naturally, as we expected by now, AZ Pain put a stall on his records. I reminded them (I was getting into the middle of this now) that all the records are electronic, all that's needed is call up his file, insert a disc, and press a button. They agreed, but claimed that would still take 5 days. Not good enough. OK, maybe put a STAT on it and it might, just possibly, be ready in three. Could they mail his records out to us?

HELL NO! Not another  few days of delay, not acceptable. I'll come pick them up as soon as they're ready.

I'm holding my breath, doncha know?

Thursday, July 4, 2019

Lovin' That Paint Smell

After the last posting, I suppose I should clarify that this time I'm talking real paint. Latex, in fact. Interior paint.

We've done such a good job recently of clearing out, sorting through, and organizing all the stuff crammed into the third bedroom - aka library - closet, most of which has been sitting there since it was moved in way back in October of 2012. Several trips to Goodwill have found much of it new homes. Reorganizing the shelves has made homes for other stuff. A bunch will be transported up north if/when we manage to clear out of here. And some we keep there.

The "we" of course means Rich and myself. Steve is in no way up to moving his back around in all the contortions that would take. Rich is making good on his offer to help up out once he came down here. And now that my health is basically normal again, I've lots of energy combined with a strong itch to put this place into the order we actually want to live in.

Part of that is the wish to turn that closet in the library to a computer office. Now not everything will come out of that closet. Some space is still needed to some of what was in there.  But that itch pushed for something not so inconvenient as what had been. Besides three walls of bookshelves, we have a table holding my old laptop and printer. I had to replace the laptop when it decided it wasn't going to connect to the wifi anymore. It still worked otherwise, and turned out to be the only thing which still coordinated with my old faithful Hewlett Packard 1200 printer. My computer skills have increased to the point where I can convert (most) files into PDFs, pop them onto a thumb drive, pop that in the old laptop, and print away. Oh, and all the cleaning and sorting revealed the existence of nearly three reams of paper for it.

So in principal it all worked. The drawback is that the table they sit on is always in the wrong place, blocking access to two columns of shelves no matter how it was laid out. It probably got relocated every couple of months. Clearing out the closet revealed there was going to be more work needed than just rearranging the furniture. While we had taken off the broken closet doors when we moved in, the bottom track they slid across had not been removed. There just was not enough time to get everything done while we had the family crew down here. It was ignored while everything got stacked up behind it.

After the recent sorting out, I decided that the closet could still hold its smaller amount of stuff and still allow the back legs of the table to recess into it a small amount, enough to make it convenient for use and not disrupt the flow of the rest of the room. It's light enough to be moved if something behind it needs to be accessed. I should know! But for now it had to be completely cleared...
       And painted...
       With wall holes spackled first...
       And illogical wood braces (we think) removed...
       And those strips holding long-removed carpet in place with all their nails pointing up removed also...
       And the occasional nail driven into the concrete floor which still remained with a bit of carpet attached pulled out as well.

Now everything could be cleaned and prepped for painting. Another coat over the concrete floor would cover the white paint drips from the shelves being painted back when they were installed, custom made by my other son, Paul. Of course, his short visit didn't leave time for simple repainting, and we hadn't made any ourselves.

Now, however, I'm loving the smell of the paint drying. White inside the closet captures the light and tosses it back into the room. The grey is simply practical, and I was kicked out before any of it went down. I'm still banned. It may be a few days before the rug I just picked up goes down to add its touch to the mood and we can start putting everything back in that's supposed to go in.

So while we all wait for the paint to dry, I'm loving that smell. It's the smell of making a house our home. If I need something else to do, I can still wonder what on earth happened to that box which contained all those wind chimes we've been waiting to put back up out over the patio.

Monday, July 1, 2019

Painting Water

Now that I'm back in the pool, I'm finding some things to be different. There are more often people there I know to talk to. More of us seem... uh, less slim than in former years. More tattoos show, though that can fool you: what I was sure was a leaf and ferns pattern over a shoulder blade became, on closer look, a bruise. I'm guessing there is a story there, probably one all too common in a population acquainted with falls and blood thinners.

The fact that we're here in the summer, when our typical pool hours are still in daylight, creates difference as well. At first it used to be just that we were out seeing whatever sunsets the desert skies were producing. Some are still blah, but if it's spectacular we're not busy indoors. But today was something extraordinary. Sunday means the pool closes earlier, so we were in the water while the sun was still about an hour from setting. It made all the difference.

It's all in how the pool is constructed. The sky is open, but it has two-story walls of the community center on two sides, with short walls with decorative iron bar railings offering views out the other two sides. It's more open north and west, more surrounded east and south. Taking advantage of southwest traditions, all the exterior walls are stucco, and in this case a bit more brownish than what's common. That made what happened possible.

As the sun was setting, its light climbed up the two stories of the eastern side. It hinted at turning it golden, but when the eye is used to seeing brown either nighttime-dark or daytime-light, color changes are easily dismissed. It's much like taking a photo of snow in both sun and shade, and finding out later that shaded snow is blue. The eye says it's just a less bright white, but still white. The photo says otherwise.

 Water does interesting things with colors too.

The surface of the pool catching reflections was adding it's magic,  turning lighter brown into a blindingly bright marigold. What really set it off were the other two colors it picked up, the intense blue reflected from the late day cloudless sky directly above, and the aqua of the pool from below squeezing between reflections.  The currents in the water and disturbances of passing pool walkers separated the colors into dancing ovals or shimmers in endless motion, tossing colors around wildly, never blending them into each other but just moving them dizzyingly, soothingly, hypnotically.

I needed my pool walking exercise, and while hating to lose that color feast, it did prompt me to follow the path around until its curves brought me to the next spot where the angles lined up to repeat the display. And again. And again. In all it lasted for over 20 minutes, the quantity of gold slowly diminishing as the shade crept its inevitable way up the side of the building until the sun finally set. With that, the deep blue also changed, giving way to nondescript lighter and darker shapes more likely attributable to lights coming on, with the aqua now the preeminent color.

I'd had plenty of time to observe my fellow walkers. Nobody seemed to notice this great gift. Conversations about kids, neighbors, coyote sightings, health and home states went on without a falter. I was the only one to stop occasionally in the right spot to soak it all in. How could they not see it?

What a night it would have been to have brought along a camera!

Thursday, June 27, 2019

A Day At The Club

Thursday is my day where my responsibilities as an officer (secretary) including opening up, filling in for any other members who didn't show up, and kind of overseeing everything. Usually that actually means sitting around chatting or working on the project du jour. Today was more than just a little different. I sent off an email to the other officers, some scattered as far as Yellowstone and Florida, just to keep them in touch. For info, a red card is a repair request listing what's wrong and warning not to use, Bell is another rec center whose members are invited to our club while their jewelry club is closed for the summer, Earl is the guy who runs the supply room, the only position that was filled today and he had to leave early. Last names are deleted for this posting.  It read as follows:

"Interesting" day today. Decided to do some lapidary. One saw wouldn't turn on, no red card. Didn't  inspect further. One next to it worked, but nobody has put gem lube in it for a bit. Glad instructions for mixing it were available, because I quickly found out why they hadn't and it's been a couple years since I'd done it. Situation fixed.

Grinder with 45 degree plate (first of those inside door) got plugged with water, but Carol (one of our Bell additions) used some pressure by repeatedly pushing with her finger to "plunger" it through. Bell actually has that tool. Might consider getting one,  or just letting us all know where an existing one already is.

After Earl left, everybody wanted to buy supplies. Got lots of practice hunting for stuff, ringing up sales without standing immediately in front of the cash drawer (the second, third, fourth times).

One of those center employees with the pretty shirts stopped by to get his wife a birthday present. $200.+ later he took home, all in sterling and turquoise, earrings, a ring, cuff, and necklace. He got to use the polishing cloth on them while I rang him up and found him a box. Of course I couldn't remember exactly where the cards go after the sale, but I called Vic and told him where I left them.

Susan B. brought in a whole bunch of jewelry to put in the silver vibrators before doing the cards to submit for the store. When she went to remove them, what she found was black sludge and silver looking 50 years old. From both vibrators!!! We spent about an hour rinsing them out, rinsing them out, rinsing them out, and once we finally thought the shot was ready to put back in the vibrators, rinsing it out more. With new chemicals she ran stuff again, and some of it improved. Not great, just improved. There is a nice piece of wrapped larimar with black spots on the back. She plans to return when she again has time to continue the process. There was one bell cap found with the shot, of some undetermined metal definitely not silver, but we have no clue what else could have been run through the vibrators with no followup cleaning, or by whom. One can only hope  their stuff turned out the same way.

At end of day, those three of us remaining worked together to complete the monitoring list. Nice cooperation.

Hope you are all enjoying YOUR Thursday!

Wednesday, June 26, 2019


Well, not everything's the same, of course.

I'm recovering and becoming more active - until I'm not - until I am again. The house is not only getting cleaner with Rich's help, but things packed up way back in 2011 are getting unpacked, organized, put out or away properly, or facing the age old question, "What on earth was I thinking when I packed ____?" Fortunately, there is an abundance of thrift stores in the area, mostly raising funds for charities, which welcome donations. We can see properly out several windows now, can enjoy stained glass pictures hanging in front of them, and admire long-hidden art up on the walls. Part of seeing them is the replacement of long-dead ceiling-high light bulbs.

(No, we still can't find what passes for studs in these walls, but picture hangers work on glue and velcro now.)

And... we're packing stuff up for the return to Minnesota. Just don't hold your breath, folks. We'd all be moldy and cobwebby if we were to do that. Because, you see, there's still no good information on when Steve can get his back procedures, first the trial on the pain interrupter, and - hopefully - the installation of a permanent one much like they do a pacemaker. Not to mention requirements for follow-ups.

There is progress, or what a sleepy snail might consider as such. The required psych evaluation has been passed. Of course, it wasn't smooth. Not the test - that was fine. The scheduling was another matter. (Yep: S.S.D.D.) The first appointment was cancelled. The doc doing it moved out of the local office and it was rescheduled for later and relocated to Chandler, AZ. If you need a map to prove to yourself, rather than take my word for that being a long drive, particularly for somebody who reacts to every excruciating little bump, go for it. Don't forget to count the mileage for the return trip. For an area of the country with no frost heave, some of these freeways have a lot of bumps.

Today's trip was back to the local office. There were "preliminaries" needed before scheduling the test of the external interrupter. It seems like the preliminaries involved a blood pressure check, reading the labels on his pain meds and evaluating the number of pills remaining for a determination of his possible next prescription, and listening to me gripe about how long this was taking.

Yep, he let me accompany him into the exam room to play "bad cop." I did. They were polite. There was the reassurance that the procedure had been approved. There was also some blah blah blah about somebody named Steve who was looking for an opening in the schedule to fit us in, but no specifications, and we'd never heard anything from/about this person regarding any inkling of hope for anything happening besides an infinite set of planetary rotations around its axis.

In other words, S.S.D.D.

With another co-pay.

Sunday, June 9, 2019

Post Paced

Deep breath.
Alrighty then, I'm back.

So, the drugs are wearing off, especially the part where the fentanyl quit and I'm beginning to find out what's actually ... uhhh... "uncomfortable" in doctor speak. But first another nap.

With some time to reflect, I realize that the anesthesiologist was right when he said I wouldn't be completely under,  just doped to the point of not giving a sh... uh, he was more polite than that, so, darn. I was remotely aware during the procedure of hearing background conversation, and of being somewhat reassured that the topic seemed to be the procedure and not, say, athletic scores. Plus, nobody panicked. I don't remember a word, of course.

I'm home, the pacemaker's in, and recovery is about to rule my life for for the next few weeks. It's turning out to be different from the way it's described online. For example, when wearing this sling which cements my left arm tight to my torso, I quickly find out that my PJ pants hang up on my left hip when I most desperately need then to quickly slide down. Ahem. I mean, sure, there is a spare clean pair in a drawer, but how many could I go through in the three days before I can start removing the sling for brief periods?

Turns out the three days with the sling bit just isn't happening. I was allowed to remove the big bandage after 24 hours. Yes, I actually counted them. Of course, the expected happened. My skin bubbled under the adhesive edge and decided to abandon me for the glue. Hello red marks and scabs. Yep, gross. The worst spot is where the sling was over it, and rubbing and pressure really aggravated my allergic reaction. So, no more sling wearing. I sleep with my elbows down and tucked in anyway, so no motion issues due to being unconscious. There is a drawer in the bedroom that's stuffed a little fuller now. I'm saving the sling for possible future use.

Second day, I can drive again. Good thing because Steve had a doctor appointment. I'm already noticing I can breathe better, though I think that's an illusion and what's really happening is the blood is getting around to where it should much better. Sweet!

Saturday and I am comfortable enough to drive to the bus depot next to Sky Harbor airport and pick up Rich. He's volunteered to come down for the duration of medical recovery for both of us until we can head north. The plan is still flying Steve up north and me driving. Only this time I will have a companion, "in case." That doesn't seem as urgent now as it did before the pacemaker, but he'll still be good company.

Our first stop before home was joining the group demonstration for peace. Being even more political than I am - saying a lot - he was happy to join us and plans to continue as long as we're here. He's also helping with things around the house. Some are the simple things which would have required me to raise my left arm over my shoulder. Others include tackling long-postponed chores which were neglected due to our medical issues.

I'm out walking now, with Rich accompanying me. I started in Walmart, requiring a sit-down or two, but back to pushing a cart rather than riding a scooter cart. I overheard him telling Steve when I was supposedly out of earshot how proud of me he was over the changes in activity level. We try to get out twice a day, working up to 3 blocks each time. With the triple digit temperatures finally arriving, alternatives must be found. Up and down halls in medical buildings, the community center, shopping WalMart again, all work.

The one-week shower: HEAVEN!

The two week+ visit to the doctor brings the adjustment to the pacemaker. Imagine a round hand-held magnifying glass about 5" across, with no glass in the middle but with a cord sticking out the end of the handle connecting to a suitcase piece of electronic equipment over on the counter. The open part of the loop hangs over my shoulder and is placed around the pacemaker. The technician fiddles with his settings and I start to feel woozy off and on. After I double check that he's causing it, I tolerate the discomfort until he finishes. I'm fine!

The Doc takes off the steri-trips covering the incision and checks it out. I'm healed well except for one spot. This adhesive must be better than the big patch was, because my skin doesn't begin to bubble until later that night, meaning I still have it in place. Still itches, though. So does the pacemaker. That's supposed to be a good sign. He'll see me in another four weeks, forgetting that is when he's on vacation, so I get to wait another week. Not a real biggie, as I presume Steve will be dealing with his back even longer than that. Oh, but no swimming for another four weeks. Dang!

Back in the pool again!!!!! No, it's not been the four weeks. Then again, no, I'm not dunking my upper chest in the water. Our community center has a walking pool, two interconnecting loops at two different depths. I can walk through the 3'6" part and keep the incision area dry, providing nobody is roughhousing and splashing. But hey, we're geezers here, plus a few guests. There occasionally is a wheelchair parked on pool edge, folks with different mobility issues, and no horseplay. A lot of folks just stand around in the deeper water and chat. I can even practice getting in and out using the steps instead of the ramp, so, including cooling off, the pool has triple benefits. Plus, Rich gets to swim as well. Even waiting till the sun is down, there's a couple hours available before it closes. We come home wonderfully cooled down and tired.

Time for another nap. Then, let's see... organize my pictures. I can ditch a couple thousand and have room on the thumb drive to back up my library. I even bet the old computer where the wi-fi failed, the one I still keep because it connects to my old printer, still has my Alaska pics on it and another thumb drive can hold all of those without culling!