Medical Whack-A-Mole

Recently I learned that one of my band mates had died, apparently quite suddenly. None of us knew he was seriously ill. It occurred to me that with all the health issues I’ve been dealing with over the past few years, my demise would hardly come as a surprise. More likely friends would wonder: “Which ailment was it that finally got her?”

 

The more I thought about it, the more I realized that I’ve been playing Medical Whack-A-Mole. When I finally get one illness under control, another one pops up to take its place. Many times, it was the treatment for the first that caused the next one. Let’s start with my lung cancer, which was diagnosed about two and a half years ago. I entered a clinical trial through Yale, in which I received regular infusions of three drugs: two chemo therapy and an immunotherapy, plus study pills that might have been a placebo.

 

The program was to last two years, but one year into it, I developed pneumonitis, a severe inflammation of the lung. My oncologist and my pulmonologist agreed that the likely cause was one of the drugs I was getting. There was no simple way to know which one. Pulling any of them would take me out of the study in any case, so we stopped my cancer therapy completely.

 

Mercifully, it appeared that the year of treatment had halted the cancer before the pneumonitis popped up like a mole. We whacked that sucker back down with a heavy course of Prednisone. For those of you not familiar with it, Prednisone is a steroid. I was on it for weeks, but it cleared up most of the lung inflammation. It’s a go-to treatment for many ailments.  I’ve concluded that it’s one of three things every household needs on hand, along with duct tape and WD-40.

 

But true to my Whack-A-Mole analogy, the Prednisone gave me a major face rash and I blew up like the Pillsbury Doughboy. I also developed edema in my feet and lower legs. An ultrasound made sure the fluid retention wasn’t due to vein leakage and that I had no blood clots. The edema was just another mole that popped up when we used the steroids to whack something else.

 

An online search led me to taking high supplements of magnesium to reduce water retention. Sadly that whack led to a pop up mole of severe diarrhea. Needless to say, I decided to live with the fluid build up. Fortunately, shortly after the course of steroids was completed, that problem disappeared. Unfortunately, it did not mean I was headed for clear sailing with my health.

 

Even with the pneumonitis under control, I was increasingly short of breath. Tests performed by my pulmonologist turned up two new “moles” to whack. Turns out I have a paralyzed right diaphragm muscle, usually caused by an injury. In my case, there’s no clue why and it might never be normal again. A few weeks of physical therapy could help. More on that later.

 

The other “mole” was pleural effusion, a build up of fluid around the lung. That was drained via a thoracentesis procedure. My breathing improved immediately. Nevertheless, my pulmonologist prescribed a steroidal inhaler to keep my airways clear. The mole from that turned out to be a side effect of some hoarseness, but I can live with that. Back to the pulmonary rehab, which I had two afternoons a week.

 

The rehab included education and light stretching, leg and arm exercises, followed by time on a treadmill. At each session, the treadmill speed and time were increased, but never to anything too stressful. The morning after what would be my last session, I woke up with horrific neck and back pain. Plus I also had a partly paralyzed right hand. I assumed I had slept crooked and pinched a nerve, or something like that.

 

When the pain persisted for days, I made several appointments with specialists. The last was with a neurologist, who has ordered several tests. He also prescribed Gabapentin to address the nerve pain. It has serious mole-like side effects. You can get tired and dizzy, so I take it only late at night.

 

I feel like I’m in a fairy tale. If I stopped dying my hair, I’d be Snow White, but I’m already most of the Seven Dwarfs. Allergy season has me Sneezy. Though I’m certainly never Bashful, much of today’s news leaves me feeling Dopey. I ask so many questions of my physicians that I might as well be a Doc. Gabapentin leaves me Snoozy and Dizzy. Despite spending most of my time playing Medical Whack-A-Mole, I’m rarely Grumpy and I’m usually Happy. I won’t ask for more than that.

 

Copyright 2023 Business Theatre Unlimited

Acronym Overload

My grandniece, Isabella, has an impressive vocabulary for a twelve-year-old. She and her mother, Pam, went to see the new super computer that her father, a Burlington, VT police detective, will be using in his investigations. Pam posted on Facebook that as they entered the police department, Isabella noticed a bin labeled OIC (which means Officer In Charge). She asked: “Daddy, why is there an inbox for Opioid Induced Constipation? Do police officers have a lot of trouble with that?”

After I picked myself up off the floor, it dawned on me that there’s been an explosion in the use of acronyms lately, especially in the field of medicine. They’ve been proliferating at such a rate that a lot of them have multiple meanings. As long as we’re going to have more than one usage, we might as well have one of those relate specifically to seniors.

Take for example the popular term NSAID. You probably know that as NonSteroidal Anti-Inflammatory Drug (like aspirin, ibuprofen and naproxen). For me, NSAID means No Sense Asking—I’m Dieting. I need to practice that reply when I’m offered second helpings. And desserts. And, sadly, a glass of wine.

Those who have heart issues will be familiar with ECASA (Enteric Coated Aspirin), one of the medications my husband carries in his travel kit. An equally useful translation at our age is Every Calorie Adds Some Adipose. That’s the fat around our bellies.

ICS (Inhaled Cortico Steroids) are a lifeline for anyone with asthma. In our house we call ICS Inhaled Cat Stuff. That can be anything from their hair to dander to litter than has hitched a ride between their toes and landed on our bed. For people with respiratory problems, our ICS makes the medical ICS a good item to have handy.

Women my age are frequently prone to bladder issues and the advertising community has a field day with the acronyms for what ails us. I’m willing to bet that OAB (OverActive Bladder) and LBL (Light Bladder Leakage) began life on a storyboard in some agency creative’s office. In the age of gluten intolerance, OAB must also stand for Oats And Beans, two fiber sources to substitute for wheat. For many women, LBL means Laughter Brings Leakage. So does sneezing.

My favorite bladder-related acronym is BBS (Bashful Bladder Syndrome), an apparently common anxiety disorder also known as paruresis. This seems to be the opposite of a leaky one. Folks with BBS just can’t go if anyone else is around. I feel bad for anyone who has trouble peeing when they feel the urge; (I can pretty much pee on cue). But I love the phrase so much I’m not going to make up a replacement definition. Wikipedia has a list of déclassé nicknames for this condition, so you don’t need one from me.

“Syndromes” is a word that pops up frequently in these disorders. In addition to Bashful Bladder Syndrome, You have IBS (Inflammatory Bowel Syndrome) and FMS (FibroMyalgia Syndrome). Or as, I prefer to define the latter two: Inhale, Breathe, Snort (how I clear my sinuses during allergy season) and the self-explanatory Feline Mothering Syndrome.

“Disease” also appears in many conditions that are familiar in senior circles. First we have CAD (Coronary Artery Disease), not to be confused with CSD (Cat Scratch Disease), whatever that is. I’ll leave CSD alone, but I’m changing CAD to Check And Double-check. Did we turn off the appliances before we left? Count cat noses? Close the garage door? Then there’s GERD (Gastro Esophageal Reflux Disease), or as I think of it: Gotta Exercise, but Rarely Do. That one was a no-brainer.

The final medical acronym on my list is EDS (Excessive Daytime Sleepiness). I was surprised when this turned up in my research. It’s such an appropriate phrase for seniors (well, for me anyway) that there’s no way I’m going to tinker with it. I get sleepy after lunch, during excessive heat (like the past few days) and when I’ve been reading or typing for more than twenty minutes.

That puts me at three for three right now. On that note, I think I’ll grab a cat and go take a nap.

Retirement Transitions—Donut Holes and Paper Trails

Yesterday I had my semi-annual checkup. It was the first time I used my new insurance (other than for prescriptions.) I presented my Medicare card, but could not find the one for my supplemental coverage. I rooted through a rubber-banded stack of cards an inch thick. Bank card, AAA, two AARP, countless membership and contact cards, a variety of appointment paperwork as far ahead as next summer. But no United Health card.

I stood there feeling half-naked, as though I had been caught without my “Friday” panties. (See posting from September 7 for explanation on that.) By dumb luck, I had next month’s bill in my purse, so they took my information from that.

Last night I scoured my purse for the missing card. It was there all along. That second AARP card I mentioned? A supplemental coverage card branded with their logo. The provider’s name, United Health, was buried in the mice type.

This experience added fuel to a fire that was sparked by some insurance paperwork that came last week. Since I have now completed my first month on Medicare, I received a report of my prescription drug claims for September. As I read closely, I realized I was holding the first accounting of my march toward the infamous donut hole.

You’ve probably heard of the donut hole. It’s that gap in coverage in a range of prescription drug payments. Coverage stops from $2,830 to $4,550 and then picks up again. I’m on several prescription medications, but if I’m ever taking so many drugs that I pass $2,800 a year in claims, I’ve been scarfing far too many donuts. Still, attention must be paid.

The report I received caused a bulb to light up. Not only do I now have multiple health insurance cards, I’ll have to set up a complicated system to track my medical expenses. I’ll need to record date of service, doctor’s name, amount billed, date and amount paid by Medicare, ditto for supplemental coverage and for payments I make. I haven’t met my deductible, so I’ll need to track that, too.

I am suddenly reminded of the later years of my mother’s life. My sister would come from Vermont and spend a week with our mother in New Jersey every summer. One of Barb’s tasks was to sort through all of Mom’s medical expenses and payments so she could file any errant claims. There were few personal computers back then, so everything was posted to green ledger paper using a system our father had set up years earlier.

Since I lived closer, I took our mother to doctors’ appointments, on special shopping trips and out to dinner occasionally. The medical paperwork was Barb’s contribution to Mom’s care. I remember thinking even back then that I had the better end of the deal. Now I feel that I owe my sister big time.

Back to my present day paperwork. I was finally feeling somewhat in control again when a hefty packet arrived in the mail. Turns out we’re about to enter the much-hyped “open enrollment period,” that once-a-year window when we can change our health care coverage without penalty.

Be still my heart. I spent much of August figuring out what coverage I wanted. Do you really think that just two months later I’m going to change my mind? (No comments, please.) I suppose I should at least open the envelope and skim the contents. What if there’s something I need to do even if I don’t want to change plans?

My lack of knowledge embarrasses me. With my self-confidence waning, I’m compelled to check my panties to make sure I’m wearing the right day. I discover they’re inside out, so I can’t tell. At least they’re clean and free of holes. My mother would be proud.