Category Archives: rural doctor

by

In the box

Wednesday was interesting and frustrating and part was beautiful.

The beautiful part was arriving at the Kingston, Washington ferry dock early. I took photographs of the quite gorgeous light display while I waited for the 6:25 ferry.

On the other side, I drove to Swedish Hospital, Cherry Hill. There I had another set of pulmonary function tests. The technician was very good. She said that since I have a normal forced vital capacity it does not look like asthma. However, a ratio was at 64% of normal, which is related to small airways.

“Have you had allergy testing?” she asks, “And a methacholine challenge?”

“Yes,” I say. “Both. In 2014. No allergies at all and the methacholine was negative.”

“Hmmmm.” she says.

Afterwards we call pulmonary. I have an appointment on this next Wednesday but we call and ask if there is a cancellation and I can get seen today, since I am two hours from home already.

Yes, there is, but I have to hurry to Issaquah, Washington.

There is an accident on the I90 bridge, so I do not think I will make it. But I am there by ten and the pulmonologist will see me. I check in, fill out paperwork, wait, go in the room, a medical assistant asks questions.

The pulmonologist comes in. He is nice and is able to pull up the chest CT from 2012, two of them since the first one “couldn’t rule out cancer”. Since I am referred for hypoxia without a clear cause, he questions me about my heart. Echocardiogram, zio patch (2), bubble study, yeah, it has all been normal. I describe getting sick and tachycardic and hypoxic and coughing.

“Do you cough anything up?”

“No.”

“Do you cough now?”

“Yes, if I exercise or get tired.”

He is like many physician specialists that I have seen. He has a number of pulmonary diagnoses, or boxes. Emphysema, COPD, lung cancer, bronchiectasis, chronic bronchitis, the progressive muscular disorders. All of those are ruled out in the past. So he puts me in the asthma box.

“I thought asthma was ruled out with the methacholine.” I say.

“Well, you have SOMETHING going on in the lower airways, and it was present in the 2021 and the 2012 pulmonary function tests. Maybe an asthma medicine will help.”

I mention ME-CFS and my muscles not working right, but he only deals with lungs. He won’t say a word about those disorders.

Sigh. I do not get the improvement with albuterol that diagnoses asthma on the pfts and never have. The formal reading of the pfts is that I do not meet criteria for asthma but there is something in the lower airways.

Monsters, maybe? I’ll try the inhaler, though with skepticism. Antibodies seem like a better guess, but antibodies are outside this pulmonologist’s set of boxes.

________________________

The photograph is from Swedish, Cherry Hill, bird’s eye view from the balcony.

Methacholine test.

by

Query tale

The Ragtag Daily Prompt today is question. Those cat tail question marks come to mind. When I am having tea in the morning, Elwha guards me, facing the doors of the kitchen. There are three doors, so he has to triangulate the angle just right.

I think the question here is clear: “WHY aren’t you rubbing my belly? WHAT do you have to do that is better than that?”

For the Ragtag Daily Prompt: question.

by

Grace the Sea Serpent

This is Grace, a Winter Break Sea Serpent. She is visiting the Kingson, WA, in the park right by the ferry dock. There are many other creatures. I am not sure what the Sea Turtle’s name is, but she and Grace are clearly friends.

This all seems to be very watery.

There are some more earthly critters, if this is what I think it is.

Striking terror in the heart of gardeners everywhere.

I still like Grace best.

For the Ragtag Daily Prompt: grace.

by

excrescence evolution

I’ve shown a photograph of these fungi from my yard a few weeks ago. They are changing. They still look like mushroom flowers but more mature. The fungal network still has not dragged me or the cats underground. Hopefully the network will be patient during winter break.

For Cee’s Flower of the Day.

by

No mosquitoes

Do they really have toes? I don’t know. Probably, tiny insect toes to hold on.

I still have a daisy blooming outside in spite of weather dropping below freezing off and on for a week. We had snow flurries, but further out in the county, they got inches of snow. Port Townsend is in on the Quimper Peninsula, sticking out from the Olympic Peninsula, so all that water gives us a different microclimate.

This is the second year for my “Christmas stick”. I put it up last year because I had these two kittens tearing things apart.

First I need to get the stick to stand. I had a bare stick, with the angel on top, for a week.

Then I cut four branches from the huge tree in my yard and added them to the stick.

The cats wondered, but this year they are not knocking it over so far. I put up lights and decorations yesterday. Not the glass ones: paper and soft ones. Because I’m not sure about the cats.

The cats still aren’t sure about it. We tend not to have a lot of mosquitoes even in summer, partly because the wind often howls up my street. The mosquitoes are blown inland. Too cold right now.

Happy Christmas stick!

For the Ragtag Daily Prompt: mosquito.

by

Thaw

This is Tiktok. In 2019 he overwintered at my house. We had snow and it got very cold at night and I worried. But every morning, he’d appear near the feeder when it got light. Then he would throw a mild conniption at me when I went outside with a hot towel to try to thaw the feeder. “Hurry up, hurry up, I am hungry!” He certainly figured out that I was the person who dealt with the feeder. He would buzz me if the feeder was empty, too. He makes a ticking sound, so that’s where the name is from. One of those old things called clocks, with hands, that ticked.

Right now I have two feeders up. I am seeing a female Anna’s hummingbird in the front, chasing others away, and a male at the kitchen feeder. It may be Tiktok still! I have named the female Emerald. I have seen them together in the top of the plum tree, but this is after Emerald chased Tiktok away from her feeder. It’s a bit unclear if they are friends or not.

Meanwhile, Elwha has the opposite of a conniption.

For the Ragtag Daily Prompt: conniption.

by

mad bad sad

I am not good at stopping loving people, because I kept losing people as a very small child. I wanted to be loved and have people stay. So how to deal with people who leave now? Well, I talk to my dead in my head all the time, so if I think of the person as dead, then I can just continue on. The friendship is certainly dead, love or not.

I am also thinking about poetry forms. I am enjoying writing sonnets, but after all, I’ve written limericks and haiku for years. Not to mention enjoying the brilliant rhymes of Dr. Suess.

mad bad sad

You are dead and I am glad
It makes me sad that I am glad
that you are dead you make me mad
when you are bad and make me sad
as well as mad you sad bad dad
not my dad who was bad as well
except when good as I can tell
bad angels fell but there’s no hell
hells angels tell that heaven’s swell
and you are dead and I am glad
it makes me sad that I am glad
that you are dead makes me so mad
you were bad and made me sad
as well as mad you sad dead dad

by

Yammer

You’ve joined my silent dead: doesn’t matter
whether you speak or not. You’d like this song
and be jealous of the skills. I yammer
to my dead, the number rising strong.
At sixty I declare that I am middle aged
Mom dies at sixty-one which feels unfair.
My sister dies at forty-nine, cancer rage.
I watched them both as chemo takes their hair.
You too are dead no words across the breach.
I yammer to you daily in my head.
Agates gleam, treasure on the beach.
You refuse to look, I mourn that you act dead.
You sit stubborn in a rocking chair alone.
You don’t believe your dead will call you home.

For the Ragtag Daily Prompt: yammer.