I went to have a hair cut today and went in three shops since I was downtown anyhow.
There are lots of tourists and visitors walking around without masks.
In one shop the owner asks if I am Dr. O, and it turns out her daughter babysat for my children 19-20 years ago. We had a nice discussion about our offspring. We are both wearing masks.
In a mineral store somehow the covid-19 subject comes up. I say that I am wearing a mask because I am on oxygen and vulnerable, and even though I am vaccinated, if I get covid-19, it might kill me.
The two owners are not wearing masks. The woman says, “We are both vaccinated, but I am just really confused about what to do.”
I say, “Well, I am a Family Physician. Let’s take chicken pox. If someone is exposed, it can take 21 days for them to break out in the rash. They will be contagious for 1-2 days before they have symptoms. The problem is that it can be ANY of those 21 days. After they break out in the rash, they are contagious until every pox is crusted over. So it can be six weeks that they are possibly or certainly contagious. With Covid-19, the Delta Variant is so infectious and again people may not have symptoms yet, so I am wearing a mask any time I am around strangers.”
The woman says, “Thank you for telling me about it. It’s helpful to hear from a professional.”
I never see you again you never speak to me again you never love your bearish parts you never let yourself get angry you never let yourself get sad you never let yourself feel you tell yourself you are happy you tell yourself everything is the way it should be
“If oxygen might help with chronic fatigue, as it has helped you,” a friend asks, “how do I get on oxygen?”
Complicated answer.
First of all, one of the things that is not clear, is what recovery looks like. I think I’ve had low grade chronic fatigue for the last 7 years compared to my “normal”. Now, will I get off oxygen? I don’t know. I am hoping for September but it may be that 7 years of low grade hypoxia means I have lung damage and no, I won’t get totally off oxygen.
They have apparently recently made the guidelines for oxygen more stringent. I sort of missed that update, even though I just recertified in Advanced Cardiac Life Support. You now have to have an oxygen saturation that goes to 87% or below. It used to be 88.
Now, you can test this at home with a pulse oximeter. In 2005 after the influenza, I held my saturations but my heart rate would go up to 135. Which means that I walked across the room very very slowly because a heart rate of 135 sustained does not feel good at all. Normal is 70-100 beats per minute. You can measure pulse with just a second hand, number of beats in a minute. For oxygen saturation, you need the pulse ox and it will measure both heart rate and oxygen saturation.
So: measure pulse and saturation at rest first. Write them down. Then walk. I usually send patients up and down the hall three times then sit them down and watch the pulse ox. In some, the heart rate jumps up. If it’s over 100 and they are getting over pneumonia, I don’t want them back at work until it is staying under 100. Or if sitting they are at a pulse of 60 and then walking it’s 95, well, I think that person needs to convalesce for a while yet. They can test at home.
As the heart rate returns to the baseline, the oxygen level will often start to drop. Does it drop to 87? Describe the test to the doctor and make sure the respiratory technician does it that way and also they should do pulmonary function tests. Mine were not normal.
Now, what if the oxygen doesn’t drop to 87? We are not done yet. What does the person do for work or do they have a toddler? If they have a toddler do the same test carrying the toddler: they sit down, exhausted and grey and this time the oxygen level drops below 87. If they do not have a toddler, do the test with two bags of groceries. Or four bricks.
When I did the formal test, the respiratory therapist said, “Let’s have you put your things down so you don’t have to carry so much.”
“I’d rather not.” I said, “I want to be able to walk on the beach, so I need the two small oxygen tanks, my bird book, camera, binoculars and something to eat.”
“Oh, ok,” she said.
So I did the test with two full tanks of oxygen, small ones, and my bird book and etc. I dropped like a rock loaded. I think I would have dropped not loaded but perhaps not as definitively. Still hurts to carry anything, even one tank of oxygen.
We are making a mistake medically when we test people without having them carry the groceries, the toddler, the oxygen tank. My father’s concentrator is pre 2013. It weighs nearly 30 pounds. Now they make ones that weight 5 pounds. Huge massive difference.
Darn it. I went from two months of no hiking or beach walking to too fast too much… oops. Injured left tibialis anterior. Oxygen AND a boot. Dang blang curses… guess I have to behave slightly better.
Another outfit not appropriate for work: on the morning before the boot…. I am holding out my hand to be kissed. That area on my lower left shin is red… and later in the day I got in with ortho and got the boot.
flowered dress with long beads and above the elbow white gloves, hey, put that oxygen back on!
Let’s see. I have a sprained left shin. I fell on Monday, walking around a piece of property trying to find out if it had two streams. It doesn’t. It has one, three feet deep and over 18 inches wide. Who cares? Well, if it’s over 18 inches wide, it’s a salmon stream and to build a house you have to be 150 feet away. Which means you can’t because it cuts diagonally right through the property. Darn. I did not fall in the stream. I fell into a nice hole by a tree and rolled my left ankle a little. My ankles are pretty strong from dancing. It seemed fine.
So the next day I hike the beach twice, with my daughter and then B, maybe 6 miles. I am tired of hiking boots and try the toe shoes instead. “You have toe SOCKS?” said my minimalist daughter. “Of course,” I said, “Otherwise they are uncomfortable.”
Ankle is fine.
Next day I end up moving furniture. Ankle is a little sore.
Next day I hike a couple miles of beach in the morning and then a friend from Portland and I do the spit. We get to within a mile of the lighthouse, which means we hike 5-6 miles out on sand. It is gorgeous. I am limping on both feet by the time we get back, but left shin is worse. It’s really dumb to hike 14 miles in shoes that you have only worn once in the last year. I elevate my ankle once in the car.
View from North Beach
The NEXT day B and I are on a jaunt. My ankle now makes it known that it is NOT HAPPY with me. We stop at the store for fud, as my son calls it, and I get an ace wrap and wrap it. Later we pay $1.00 at a Fast Food Joint for a cup of ice water and I ice it. At his park unit he mows and I limp along the river until I am in the sun. Later we hike Rialto Beach. I wore my hiking boots. My ankle is not appeased.
Now we are at yesterday. I have tickets to the Sweet Honey in the Rock on line concert. At noon. Junteenth. Ooops, no, at 3 pm. Ooops, no, on the west coast at 5 pm. Then I can’t make the stupid ticket work. I am really really frustrated. Well. I send them emails, try to get a new password, I have the ticket number. I keep getting a 503 server OVERWHELMED. Dang. I give up after an hour.
But I am invited to a Sinatra Solstice Juneteenth Bash, formal dress up. In my town that means wearing anything you can think of. I put on a gray dress, sleeveless but it has little gray flowers with silver gray pearls in the middle, all over the front. I have above the elbow white gloves. My ankle has a snug wrap and I put on dark gray hose and silver shoes with a 1.5 inch heel. I won’t dance, too hard on the ankle. I have acquired a set of gray pearlish beads which is so long that if I do not wrap it around twice it reaches to my knees. Mysteriously enough, it has a clasp. Why does it have a clasp? So some giant can put it around their neck? I complete the outfit with lipstick and my oxygen tank. The tanks are lighter than the concentrator, though bulkier. They are slightly bigger around than a tall oxygen tank but are light. I change the tank before I go. A full one lasts about 3-4 hours.
It is an outdoor party, there is tons of yummy food and there is wine and mead but no beer. I brought one beer along with my contribution, so I nurse my one beer⦠and dance. My ankle does not like this, but the music is so fun. Our host sings sets intermittently and then there is a DJ. The above the elbow white gloves are very fun to wear dancing and I have to try not to whack people when I spin with the awkward oxygen tank.
One gentleman thanks me for dancing. He says I am having so much fun that he’s having fun just watching. Cool. I LOVE to dance. One woman says something about wanting to pick one of the gray flowers off my dress, and I say dramatically, “No, I shall not be deflowered!” A line that one cannot use often… People have wonderful costumes and feathers and gloves and hats. It is fun just seeing what people are wearing. People were asked to come only if vaccinated and I am mostly distanced. I mostly dance alone, but have a couple of dances with guys. It’s a bit tricky to spin without whacking them with the tank. Tank girl, heh, heh.
At last I get home. I got to the party at 6 and it is not dark when I get home. Maybe 8 or 8:30? I lie down on the bed with an ice pack, propping my pissed off shin up on a pillow, just for a few minutes. Crash and wake up three or four hours later with the light still on. I turn out the lights, move the ice pack and go back to sleep.
Long white gloves and an oxygen tank. I am so grateful for the oxygen. I feel better than I have in the last seven yearsβ¦.
….and today I might just rest the ankle.
Here is one of my favorite Sweet Honey in the Rock songs:
Sweet Honey in the Rock “breaths”
Happy Father’s Day. My father died in 2013, emphysema from unfiltered Camel cigarettes. Damn cigarettes. I miss him.
My daughter is home and we went on a beach walk yesterday! The stupid oxygen keeps me from going fast. She went for a bike ride afterwards. Hooray!
Yesterday evening she brought up social distancing and how careful she should be. She has about 5 friends who are home that she is going to walk with. I am still wearing a mask over my oxygen tubing most places. She will unmask if they are vaccinated and they don’t have a cold or anything else. Even a cold would make me worse at this point. It makes me grumpy to be vulnerable, but I appreciate the discussion.
Ok, maybe it is not inappropriate for work. But it would be a little weird for work… I was going in the woods with my oxygen tank. “Local doctor of 21 years found eaten by cougar, which then died because it couldn’t digest the oxygen tank.” Heh.
Discover and re-discover Mexicoβs cuisine, culture and history through the recipes, backyard stories and other interesting findings of an expatriate in Canada
Engaging in some lyrical athletics whilst painting pictures with words and pounding the pavement. I run; blog; write poetry; chase after my kids & drink coffee.
Refugees welcome - FlΓΌchtlinge willkommen I am teaching German to refugees. Ich unterrichte geflΓΌchtete Menschen in der deutschen Sprache. I am writing this blog in English and German because my friends speak English and German. Ich schreibe auf Deutsch und Englisch, weil meine Freunde Deutsch und Englisch sprechen.
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