Noting Differences, Not Just Swearing At Them...As Much

OK, more details. First shoulder surgery:  I'll start with the waking up part., smooth and easy, not a care in the world. The second time around I woke fighting, not just noting people were talking around and over me. I was convinced I wasn't breathing. I had to force my diaphragm to expand and contract, suck in air, expel the spent fumes. It didn't feel like I was doing it naturally, and worse, nobody was noticing. I tried to tell people I wasn't breathing but the person next bed over, on the other side of the curtain, needed attention. Nobody noticed me even when I managed to push a word out, to sound an alarm. I knew the anesthetic could affect my lungs, so I didn't dare let my attention lapse from controlling my own breathing. It  took several terrified minutes before I felt breathing would continue without my consciously working at it.

Not my idea of a good time. Nor of being looked after. Obviously I survived the experience, but I hope never to repeat it.

It's not the same as forgetting details. After all, who  could forget thinking they couldn't breathe? I forgot I had to wait 7 days post surgery before being able to remove a sticky dressing in order to get a complete shower. I had to call the doc's office and ask them when it was OK. 7 full days. I am so yearning to rinse a ton of stinging salt off me. Summer sweat is here! But the incision needs a full 7 days to seal completely, to fully keep germs out. Infection is their one big worry, the thing most likely to cause implant failure.  As the patient allergic to medical adhesive who once peeled adhesive tape away after surgery, and both watched and felt it peel my skin off with it, it's kind of a big deal for me. I insist that EKG stickers get an alcohol wipe before the staff forget where one was stuck. I may be the only person who isn't actually amused by looking like I just "enjoyed" carnal relations with an octopus. The one time I lost so much skin with the tape it took a week extra to heal, and alcohol swabs were required to prevent infection starting.

But Hurray! Tomorrow is full shower day!

Another difference is pain. I started in with Oxy the first time in the hospital because it was recommended, if that's what you call a hand holding one out to you along with some water. and it indeed did prevent pain successfully..... Or maybe..... I just took it third day in, everything else wore off and I needed it. So I'm doing a morning and evening dose now, knowing my body is starting to complain. Last time there were more tablets than in this bottle,  30 then, 20 now, so I'm waiting to see if I will need the previous dose, which seemed to wear off simultaneously with need. Mostly any pain this time is when the straps don't seem to be holding my shoulder high enough. It feels like it's pulling apart, and the mirror shows a strong low slant instead of level shoulders. While some straps dig painfully in, others are too loose. I pull what/where I can. No happy medium. Where they dig into my neck the hard plastic scratches. Same with shoulder blades. I hate this "sling" contraption worse than the previous one, but I figure mostly that's less skin protection from summer fabrics.  OK, I asked for that by waiting for a warmer season, but that was for ease in bathroom duty. Is any of this making sense? This may well be why I'm not legal to drive for a few days or weeks.

Today I put on very baggy shorts and didn't need all the assistance moving clothing. Steve seemed a bit disappointed by that, but I noticed he didn't seem to miss the constant waking out of a sound sleep! Or maybe he just likes turning it into our private game, like I do. Either way, he has thanked me for interrupting an unpleasant dream, so there's that, anyway.

There are still parts of the contraption which dig painfully into my arm, especially with any movement. Losing it will be a joy! The ultimate goal will be having enough pain meds to match pain supplied.

One benefit from past experience has been learning the value of grocery deliveries. Not just talking getting it to the yard, but up the porch stairs, or even inside the front door.  Especially with gas prices right now. Part of my OT before being allowed to leave the hospital was demonstrating getting groceries up the stairs. Safely! So... sideways or even backwards. AND THIS DOESN'T EVEN START WITH PLANS TO REPLACE THE NOW UNSAFE FRONT PORCH, A WHOLE 'NOTHER TOPIC SAVED FOR A DAY WHEN I CAN FIGURE OUT I'M DOING FULL CAPS BEFORE I HAVE TO DELETE / RETYPE!

Second Verse, (Not) Same As The First! !

First, expect typos and worse. I just deleted everything I just wrote - no clue how - and am trying to recall what I was writing. Shoulder #2 is fixed, healing in its contraption to prevent movement or comfort plus all illusions of competence, and from the moment the IV ports and nerve block went in, everything was different from last time except for the side, hospital, and surgeon.  My only comfort at times like this is having an excuse. Plus Steve doesn't tell my he's upset when I stare swearing at whatever latest thing is going wrong!

I just had to reinvent another paragraph! Arrrrggggghhhhhh!

Lesson one: all is different when you lose the strong side, and I'm very much a lefty, the side in the contraption now.

I am able to do some things, such as the aforementioned swearing. In fact, competence is growing! I made coffee, though only half a cup.The rest of breakfast was all finger food. Luckily I planned for that. Triscuits, banana chips, and chocolate chips. No scolding! There have to be a few benefits to this, right?

On the other hand I can wake up freezing because the house was very warm when I went to sleep in the middle of some show (???) and woke in the wee hours without blankets. Too groggy to remember I needed a bathroom assist with relocating pants to wake Steve first for his favorite part of being able to help me brought the predictable results. Luckily by then I got my brain in gear, did necessary things in necessary order with necessary assistance, and returned for necessary sleep with a much needed blanket. 

(You thought I was going to repeat "necessary" again, didn't you? Instead, after replacing ALL the "r"s with necessary "e"s I changed course.) In the meantime I got much more practice with swearing at stock reports and some weird kind of notifications which keep intruding on my screen from the right side. Note I never use those, don't give a flying fuck how stocks are doing, am not invested in them nor ever wished to be, and have no earthly idea why they keep popping out. Same with the bloody notifications. I have managed to figure out how to get rid of them - DANG IT AGAIN! - for a minute or so.

They have persuaded me to hang it up for now.  I'm fine... sort of.

Stages Of Waking

Dreams are funny things. By funny I don't mean laughing-funny, I mean weird-funny. I'm one of those people who often wakes out of a dream and thus remembers some of it for a very brief while. A few minutes later I'm aware of having had one but the details.... rarely recalled, just a feeling, an awareness I had been dreaming. More than that is unusual. Occasionally later in the day something will prompt that feeling to return, but totally without any context.

This morning is a good example, though bits of memory exist. The main part of the dream was about swimming across a wide river I identified as the St. Croix, somewhere around Stillwater. as judged by wideness and how populated it was, though all landmarks were missing It was just a flat, calm river, brownish water somehow clear, not dirty. The swim was totally enjoyable. There had been a point to swimming and who I was swimming with, something to accomplish, but already fading.

I was there with people I know. Who? No clue, just identified as people I knew and was talking with during the swim. Who expects logic in a dream? I don't, during the dream or in retrospect. But at some point we were done swimming and it was time to get out of the water. I needed to call my parents.

So I did, partly while still in the river, partly up on dry land. I complimented them on having such a nice river to swim in. It never occurred to me to question why this was their river of course, just something to say while I was checking in.

Around that time, the real world started to intrude. An actual thunderstorm was going on outside, welcomed in an awake state to water newly planted flowers in the gardens so I didn't have to haul a hose around later in the real day. It was expected and welcomed, as well as interrupting the dream. Rolling over kicked my bad shoulder into complaint, completing waking me up out of the dream, and the few steps to the bathroom progressed through a series of ideas as I finished shedding the dream. First, I was glad it was a nice call with my parents.  The sudden change in head position produced a bit of vertigo, where I bounced into the wall next to the door frame and had to cling for a couple seconds instead of falling, coupled with it occurring to me to recall my actual age and wonder if I'm this old, how old can my parents be? Now stable in balance and again walking normally toward my first morning goal, I realized  both of my parents had died over a decade earlier.  Our phone call hadn't happened.

Yep, there it was. I was now fully awake, back in the real world, aware of the needs of this particular day, and enjoying listening to rain on the roof. It was still in the one-o'clock hour though I'd never remember just where, my shoulder ached, it a was time I could take my thyroid pill but still had to wait for my Tylenol another hour to kill the ache if still needed, and wait for daylight to check the rain guage to see how much rain we'd have gotten by then. Since I was now fully aware, what was on the TV, recorded since I went to bed? I needed to change position to a sitting one, meaning the room with the television. Or maybe back to sleep?  Or maybe I should blog first, since I had a topic? If I went back to sleep it would have vanished in its entirety.

Hey, at least it wasn't one of those dreams where I couldn't find where the car was parked! Even while in bed during those, a part of me knew I wouldn't be able to walk that far in order to locate my car wherever it was, as these dreams happened before my knee replacements. Those themes were the usual way my brain was getting used to my retirement, taking away my car, my ability to identify streets and towns I needed to go to, nor could I read the labels on the packages so I could tell where to deliver them. I still recall one in a dream going to Appleton but nobody would tell me if it was the one in Minnesota or in Wisconsin, and I needed to hurry! And whatever building I happened to be inside of, there was never an acceptable bathroom to be used, lacking stall doors or anything more than an open hole on the floor, a broken pipe protruding a few inches. I just couldn't go there!  I decided, as the shock of waking from those dreams happened, that was a very good thing!

Oh No! Not Betty's Pies!

The news has been full of wildfires in northern MN these last few days. One is north of Brainerd, the other north of Two Harbors.  Since we love the North Shore, both for long day trips and camping occasionally, we frequently stop just north of Two Harbors. That news immediately caught our attention.

First thing I noticed about the area decades ago was a nice pullout shortly past Duluth from the highway along the shore with great photo opportunities of Lake Superior and land jutting out, tree topped rocky cliffs, wildflowers for foreground, and of course waves. Then there was the Stewart River dumping into the lake and the shots it enabled. Finally, after repeated stops and an urge to explore more, there was risking crossing the bridge over the Stewart River while hugging the low railing, making our way carefully down to the other side's shore, and discovering an abundance of Lake Superior Agates. 

Oops, now everybody knows where to find them! Then again, they get picked over soon after ice melt. It could take another big storm to bring more agates ashore. After road construction/"improvement" a couple years ago, crossing the highway in that spot can be extra risky since the former pullout is inaccessible by car, traffic is faster there, and the new bridge no longer has a safe raised margin along the railing for crossing the river. One has to cross the busy hiway on foot, or take a steep path along the river bank under the bridge, or start from a different pullout, the only one left. 

That's also the large parking lot for all the customers for Betty's Pies, or as our favorite metro news station puts it, "The Iconic Betty's Pies". The road improvements have made it safer for vehicle traffic, getting in and out, but not so much for pedestrians with old bones and joints trying to reach the shore. Parking has expanded, porta potties are lined up for the people waiting to get in or to hike. One can even hike upriver to a falls, I'm told. Since it's a 9 mile round trip, I don't plan to do so. The place has really grown over the years.

Because Betty's Pies is iconic. We stop there every trip, either to have a single slice each, with or without an order of a full meal,  or order multiple pies to go in a prepared cooler over ice. Sometimes all of the above. Note those pies aren't just for us. When we know we're going up there, we take orders from people who can't get there themselves. We'll pay up front, they pay before they get their pie(s). We arranged to do so for our planned two day trip to Duluth last fall, which turned into swapping vacation plans for 4 days in the hospital. On the plus side, once health returned, we did manage lunch and picked up pies for the trip home. The boat trip didn't happen. Agate hunting didn't happen.

And now, Betty's Pies might not be open again this summer when we plan to head north again. That one fire damaged part of the restaurant, and as I write this, still is not under control though planes are scooping up water from Superior to drop on it. The staff has said they will be back in business as soon as they can. Since we plan to head back up with better luck to take advantage of the boat trip we paid for last summer, we hope to time it out for when they are open again.

Best of luck, folks! We'll be waiting!

Anybody want to put in an order for pies again?

$$$$$ The Real Medical Bill

 It only took four months to get here. That's how long since my first shoulder replacement surgery with one night in the hospital, until seeing an actual itemized hard copy of the hospital bill. It has helped me make a decision.

I've been on Medicare since the day I turned 65, which was a good bit of planning ahead since - unknowing while I made the arrangements over the phone ahead of time - that was the same day my heart landed me in the hospital, the beginning of a long series of hospitalizations for various procedures. Since that time I've gotten 2-page quarterly mailings, listing my medial charges, how much of those Medicare actually allowed me to be charged for, how much they cover of that, and what the balance is. Within a year I signed up for Supplement F, a second plan which covers all the rest of the costs for what happens. It's not cheap, and I've watched its monthly cost creep up, but I was promised a deal, since I signed up so early, of a total cap on the price tag. It is nicknamed "Cadillac insurance", both because it covers pretty much everything else, and it's a bit high priced. It's also no longer offered to new retirees, in lieu of other supplemental plans which cover less, but remains available to those of us who signed up for it years back, so long as we pay the premiums and continue breathing. We're "grandfathered in" if we so choose.

Medical service providers, for those who don't know, get a carrot and a stick if they agree to take patients on Medicare. There is a limit to what can be charged per procedure. But they get paid reliably and promptly. The upside is lots of patients for whom they get paid promptly. Other insurance plans are notorious for fighting charges, and IF finally approved, paying really late. Even after that, the Docs have to wait for further payment from the patients themselves. It can be a long slow trickle, taking up lots of staff hours pursuing payment, and can even include legal costs. Most accept Medicare patients because overall it is to their financial benefit.

Lately I have been wondering if it was worth keeping my supplement F coverage. Was the monthly bill still worth it? The heart's all fixed except for replacing a pacemaker battery, estimated in three more years. The knees were replaced and doing well. The Type 2 Diabetes is well controlled by diet alone. As I put it to others, all the bad spare parts have been removed and the needed ones replaced. Of course, I said that before finding out what shape my shoulders were in while simultaneously finding out just how necessary to quality of life they were. Or discovering what living on NSAIDS for several decades can do to a pancreas.

The bill/report came in a packet of individual pages so thick that I somehow thought I had been sent one of those booklets detailing what is covered and not, like one gets after the annual insurance sign up reminding you of rules and coverage and how to access benefits. Usually that's a full magazine! Steve's annual new insurance plans come like that. My quarterly statements tend to be two or three pages, including one listing all the languages this could be sent to you in, many of which I'd never heard of until those statements. Nearly all the time I pay nothing more, unless somebody in a medical office makes a coding error. Then we have a chat, their office and I. Last time it happened, my annual exam got scheduled 3 days early and I was stuck with about $500! They need to be 366 days apart at least. Visits in between need a different reason, and apparently you can't go back and relabel the bill to Medicare. Their first reaction isn't that it was a mistake. They think fraud.

I started going through the pages, curious about pricing as well as checking coverage. The first item was the hospital stay, one overnight: $60,000! All the numbers are followed by what Medicare allows to be charged, what got paid, what was sent to the Supplement F folks and paid. Finally there's a line of how much I might still owe. That's routinely zeros. I was still in shock over just the hospital costs this time. The surgeon was an extra cost from the hospital, along with the PT, the OT making sure I could take care of myself once home, the meds and supplies used during surgery, separate from those given me in my room, all separate from those sent home with me so I didn't need to hit my own pharmacy before I had access to, for example, the narcotic I already held 30 pills of in my hand. Of course the single allowed refill of that would be from my own pharmacy, and as usual would need to be called in and picked up after signing for. (I didn't bother to refill it.) Those were just costs from that surgery. All other medical costs for a quarter year filled up the rest of the sheets, except for pharmacy, dealt with at the pharmacy per visit per usual.

Of all those things, I owed a bit for the meds I took home since they did not come from the pharmacy my Part D required. I plan this next time to refuse the ones I don't/won't be using, like Tylenol. I still have parts of two bottles! These days I only take it for pain from the second shoulder, presumably to be fixed post surgery and post PT. It's worked that way on the first shoulder, though still helpful while muscles are getting stretched into new positions, and maybe at bedtime when I roll over onto a shoulder in my sleep, waking me up.

I discovered that the PT I had been doing after my arm was out of the sling was not paid for by anybody. Medicare didn't allow it! For whatever reason they were not allowed to charge me for it either! So now I feel guilty about all those weekly visits working to get it back into usable shape. The staff there are such nice people! I had inquired once months earlier after needing to cancel one visit whether that cut into my therapist's income if they couldn't fill the slot, even despite the usual need to make appointments four weeks ahead. She informed me that she was paid on an hourly basis, so cancellations didn't cut into her income. I'd felt better from knowing that after one icy day when nearly all patients cancelled last minute due to roads, especially since I was one of them. But if nobody is paying for me going there, how do they get paid? Should I feel guilty for going there, especially since I plan to go again this summer after the other shoulder? After all I know the exercises and could do it at home.

(As a side note, my therapist and I had long chats during the PT. Once you get directions for what to do and are simply repeating a movement a number of times, it can get boring otherwise. So we discussed gardening, among other things, something both of us do. Her garden is much larger, and she likes many of the same flowers I do. But it turns out I have a lot more color varieties in some plants she likes. I promised when my two purple daylilies bloom again so I can tell which are which, I'd get her one of each, a Grapette and a Nosferatu, one short, one tall. Both came over from Paul's house last year  from where I'd planted them several years earlier. They can use thinning occasionally anyway. Hey, I brought some balloon flower seeds into their office a couple weeks back and the staff all wanted to share. Since there were a couple hundred tiny little things, I trusted them to leave some for my therapist, and later heard they had. So.... maybe not too guilty about my insurance not paying.) Still....

As for that decision, I had been wondering if it was still worth it to carry my "Cadillac" policy. I'd never gotten such a complete listing of my medical expenses. Had I listed them here we'd still only be on page 3. As I said, there were many more pages, and I was only on the hock for some pills, which I promptly paid. I still have the same thing, opposite side, coming up, next week in fact, as well as a couple diagnostics my Primary doc still wants me to catch up with. (I will after mobility returns. Who wants a mammogram requiring one to lift arms way high, before the surgery that makes that bearable?) And who knows what might be next? Now that I have some hard numbers, you can be assured the extra coverage will remain on the monthly bills list.

I do still wonder what those 4 days in the hospital for our "vacation"on the North Shore last summer would have cost. Never did see a summary bill, telling me I owe nothing, all was covered. Having seen this one, I'm not in a big hurry to ask.

Thoughts On Health On A Cruise Ship

I have been on one. Overall it was fantastic. The experience was a gift to me from my mother-in-law, a retired teacher/librarian who spent her healthy retirement years traveling the globe. We'd routinely get small presents as souvenirs of the places she'd been, like carved ebony from a trip to Africa, tiny baskets woven from pine needles from a visit to the Copper Canyon, small framed needlework from China from a trip including a visit to the Great Wall. As a retired teacher she had access to group travel discounts, and was blessed with fairly good health until extreme old age.

One of her trips was a combination cruise/land trip in Alaska. She had planned to share the experience with a friend but that woman became ill and had to cancel. She invited me to accompany her instead. I actually had to think about it! At the time I was divorced from her son, working a low paying job, not getting child support for three kids, and couldn't figure out how to afford it even with her paying all my trip expenses. My parents stepped up in taking care of the kids, I scheduled the vacation, and wound up with the experience of my life! We flew into Fairbanks, and did land activities as a large group from there to Seward, boarded a cruise ship, and enjoyed some kind of off-ship expedition at every port stop until Vancouver, when a bus took us across the border to the Seattle airport to fly home.

I had little in the way of properly thanking her, until I got my pictures developed. Yes, digital cameras were newly available but I had a Pentax K1000, budgeted buying 36 rolls of 36 exposure film, somehow managed to afford developing them all before Christmas that year. I divided them into two piles of nearly identical photos, split each half into a photo album, and gave her one for Christmas to enjoy our trip over again as many times as she wished.

That is my one experience with a cruise. The cruise line was Holland America, the ships were enormous, and the only illness we heard about was when a couple members of our group became a bit seasick after a couple days when winds created barely perceptible motion on the ship. Mostly the route was along the inside passage, so it was actually quite sheltered from waves.  Knowing I had gotten seasick as a young teen on a family trip along the west coast including being out on a small fishing boat (caught a small shark instead of the wanted tuna), I'd started the ocean part of the trip with medication to prevent a repeat of that misery, and had my sea legs by the time any waves kicked up. I was fine.

This was long before anybody heard about the norovirus. Years later when my best friend and her husband took a cruise west coast to east via the Panama Canal their trip was made miserable by that, a combination of cabin quarantining and sick guts for days. It became common in the news, and even if I could afford such a trip, I decided it was not my choice to go on any cruise again. Occasionally one hears about it again, often enough to confirm my choice. 

When covid made the news, keeping ships offshore until somebody decided passengers could finally leave, I was simply confirmed in the wisdom of my decision. As a snowbird, travel was limited to automobile and either motels or family visits. The first year vaccinations were available, national parks were all but deserted and photography opportunities were exceptional. Covid is still with us, but so is norovirus, occasionally making the news for plaguing cruise ships. I still treasure the experience, but with no plans or wish to repeat it.

Now there's hanta virus reported on cruise ships. Everybody acts shocked by such an unlikely thing. 

Unlikely? Seriously?

We all heard about hanta long ago, spread by rodents in the dry desert southwest. It wasn't reported in rainy climates, or if it was, no longer made headlines. We  knew how to treat it... most times. It could still be a killer. But it was "over there," not "around here." True, cruise ships are in wet areas, if that is the only consideration.  But rodents? On the ocean?

Apparently everybody has forgotten our history. From the time humans set sail their ships were plagued with rodents, aka rats. I use "plagued" advisedly, since they literally spread plague from port to port, carrying fleas everywhere they went. I also have a friend whose ancestors came to America long ago in a rat-filled ship and "lost" all their children to rats. They managed to restart their family once on land and were able to work their farm in central Minnesota.  We want to believe we've "fixed" that rat problem. But we happen to be a pretty arrogant species. Perhaps it's time to start keeping cats on board ships again, eh? Not the spoiled ones overfed on special kibbble, but the proven hunters. 

Or at least until somebody comes up with a hanta vaccine and people aren't too stupid to take it.

Happy Mother's Day!

 To all of you mothers out there who visit my blog, whether or not you celebrate Mother's Day on this particular date that America set aside for it or not, whether you still have a mother to share these with or not any longer, I wish you the best for this day. 

 

A bit of history from my personal perspective: it was designated as such back in 1914 to fall on the second Sunday in May. That happened to be the 10th. The reason I will always know that as long as I can still keep track of any kind of a date is that a particular woman, Jane Elizabeth Maxson, gave birth for the 7th (?) time on that particular day... to my father, John Dufty Maxson. It just happens that once again it rolls around to the tenth of May.

I thought I'd send you all, whether you celebrate or not, whether you be mothers or not, some flowers, all of which have meaning to me, since at one time or another I had a hand in planting or growing them, and of course in shooting each picture.

May these give you as much pleasure as they have to me over the years... and still do, thanks to a camera. I don't still live in all the places these were shot. But I can carry these around with me wherever I go, and share with whomever can appreciate them. The critters some of them come with today are long since dust, but still yours - and mine - to find.