Tag Archives: photography

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Healing

I realized I had pneumonia for the fourth time on March 20, 2021. It has been a year and five months now. I do not have an “overarching diagnosis” for why I am so vulnerable to pneumonia, though not for lack of trying. I have seen twenty specialists since 2012, including four pulmonologists.

Most specialists dismiss me as soon as their tests don’t fit me into one of their boxes.

I have one now who is not dismissing me. He referred me to the Mayo Clinic. They did not call back when I did a self referral three months ago nor when my primary care physician referred me. However, they called within a week of his referral.

Mayo Clinic called yesterday. I may need a prior authorization or something, I have a number to call today.

I am healing. I still am on oxygen for singing, flute, night and heavy exercise, but pulmonary rehabilitation is working. I have built up steadily on the treadmill for 6 weeks. I have 5-6 more. Many of the pulmonary rehabilitation people are on oxygen and will not get off oxygen, so I am an outlier here too.

I feel better than I have in seven years, since the 2014 pneumonia. I had strep A pneumonia in 2012 and 2014 and really did not fully heal after 2014. I was tired all the time. I think I went back to work too soon and just did what I could. Not returning to work is helping immensely. I can’t return anyhow, unless the Mayo Clinic or someone figures out my “overarching diagnosis” and how to make me less vulnerable to pneumonia. Seems unlikely after 19 years. My first round was influenza in 2003. Maybe choosing a different career than primary care would have made a difference, though maybe I would not have survived a pneumonia without being a primary care doctor. We aren’t supposed to treat ourselves, but if no one believes us, well, there is not much choice, is there?

The photograph is from a beach hike in November 2021.

For the Ragtag Daily Prompt: heal.

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the gang’s all here

Hale hale the gang’s all here
wrong hale, it’s a hale of a thing
but it should be hail
the same sort that falls from the sky

but on the other foot, hale hale
anyone who has survived the pandemic
is more hale than those who haven’t
so hale hale for the gang still here

For the Ragtag Daily Prompt: hale.

Let’s dance!

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pigeon guillemots

These are called sea pigeons locally.

We were trying to figure out who lives in the sand cliff holes on Marrowstone Island.

We see something fly out but weren’t quite sure who it is.

And then, aha! We see an owner.

https://www.allaboutbirds.org/guide/Pigeon_Guillemot/id

They look like ducks except the beak is not duck like. From the Cornell All About Birds Site: “Ornithologists recognize five subspecies that differ mostly in size: eureka in Oregon and California; adianta from Washington to the central Aleutians; kaiurka in the west-central Aleutians and the Commander Islands; columba from the Bering Strait to the Kamchatka Peninsula of Russia. The subspecies of Pigeon Guillemot that inhabits the Kuril Islands of Japan, snowi, has little to no white in the upperwing, unlike other subspecies.” They are in the family with auks and murres and puffins, rather than ducks. How aukward, heh, heh. I am informed that they “are not good eating”. Too fishy.

For the Ragtag Daily Prompt: float. They are very good at floating and diving, and make a whirring sound as they fly. They have a high piping song.

The range map is cool: https://www.allaboutbirds.org/guide/Pigeon_Guillemot/maps-range.

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Hello universe

You know what?

I want to get remarried. Add that, Beloved, to me wanting someone to love and to love someone.

Commit, damn it.

And that is what I now want. Thank you recent ex for showing me what I want.

I want to be myself from the start.

I want to notice bullshit and walk away before we get involved.

I don’t want to be controlled, I don’t want to control, I want a partner.

I don’t want to be enabled, I don’t want to enable, I want mutual respect and caring.

I am not your shrink, you are not my shrink, and if one of us needs a shrink, we should find one.

I want to notice lies and walk away before we get involved.

I want to speak up if you tell me lies, or I want to back away for good.

I want to be loved and I want to love. By the same person, damn it.

Hear my prayer, Beloved. Hello, universe. Here I am.

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Top ten causes of death, US, 2020, and doctor time pressure

https://www.cdc.gov/nchs/fastats/leading-causes-of-death.htm

There is an article about US doctors, that primary care would have to work around the clock to apply all of the guidelines, here: https://news.uchicago.edu/story/primary-care-doctors-would-need-more-24-hours-day-provide-recommended-care.

Yes, but this is not new news. There was a trio of articles twenty years ago that said the same thing. And the guidelines have only expanded. Primary care is doing the same thing it has always done: what it can. Meanwhile we go to “Continuing Medical Education” and the other specialists ALL say we are not doing enough, we need to do more. Makes a woman cynical, don’t it?

Family Practice is a specialty, did you know that? We do a three year residency. Internal medicine is also three years, but many then “sub specialize” — further training in cardiology or rheumatology or nephrology, and etc. Sometimes we get a primary care doctor who doesn’t do the extra years but gets interested in something and they learn to subspecialize. We had a pulmonologist on the peninsula here, best I’ve worked with, who had not done the fellowship but learned it on the job. She was excellent and is now retired.

So you as a patient need to be aware of the top ten causes of death and do some thinking. Heart is still number one, in spite of Covid-19. All the cancer deaths are number two, but that’s only a fraction of the cancers. You want cancer screening, to pick it up before it is lethal. Pap smears, colon cancer screening, get your skin checked. Covid-19 is number three in 2020. Let’s look at the list.

US top ten causes of death, 2020.

  • Heart disease: 696,962
  • Cancer: 602,350
  • COVID-19: 350,831
  • Accidents (unintentional injuries): 200,955
  • Stroke (cerebrovascular diseases): 160,264
  • Chronic lower respiratory diseases: 152,657
  • Alzheimer’s disease: 134,242
  • Diabetes: 102,188
  • Influenza and pneumonia: 53,544
  • Nephritis, nephrotic syndrome, and nephrosis: 52,547

The list changes. What has fallen out of the top ten, since Covid-19 was not on the list back in 2019? “Intentional self-harm” aka suicide, was number ten in 2019.

Let’s go through the list one at a time and give you some basic tools and ideas about prevention, since your physician doesn’t have enough time to deal with all of it.

  1. Heart: The people who have not seen a doctor for twenty years, um, go see a doctor. If you have high blood pressure for twenty years, you will also have heart failure, which means pump failure. This is bad and will kill you. Check in at least every three to five years. In the US currently, you are a “new” patient after three years, so it’s best to show up just before that three year mark. Call ahead, everyone is short staffed. Check blood pressure, cholesterol and quit smoking (that includes pot, also bad for the heart), cocaine is very effective at trashing the heart, alcohol is bad for it, so is methamphetamines, and any other silly and stupid substance “overuse”. Kratom? Bad. Fake pot? Also bad. Turn off the tube or computer and go for a daily walk. Outside. Without headphones or earbuds. Try to figure out the bird noises, ok? Eat more vegetables. Don’t be stupid.
  2. Cancer: do the screening tests. Get the HPV vaccine for your children. Get pap smears. Use sun screen. Get your colonoscopy when you hit that age. Want to read about a screening test? Go to this site: https://uspreventiveservicestaskforce.org/uspstf/home . This is the clearing house for the current guidelines AND THEY CHANGE. They get updated. The vaccines are all here too. Get them.
  3. Covid-19. If you aren’t vaccinated then I don’t even want to talk to you, unless you are seriously immunosuppressed and your docs told you not to. Otherwise your brain has been taken over by non-scientist crazy whackos. IMHO.
  4. Accidents have been rising up the list and currently number one is opioid overuse deaths. Do not buy pills on the street because even if they claim to be oxycodone they may actually be fentanyl. The drug cartels aren’t so good at diluting the fentanyl enough to not kill you. If you are on prescribed opioids you should have a shot to reverse it (narcan shot or nasal spray) and your family or friends should know where it is and how to use it. Next is guns and cars. Guns should be locked up with the ammunition locked up separately when you are not working as a policemen or hunting a deer or rhinoceros. Cars should not be driven under the influence and hello seat belts. Oh, let’s see, wear your helmet on the bicycle, roller blades, e-bike, jet-skateboard or whatever. Wear a life jacket in the boat. Don’t point Axe towards your face and try to light the spray on fire.
  5. Stroke. This is all the same stuff as heart. And also Covid-19 increases your risk of stroke.
  6. Chronic lower respiratory disease: this is mostly caused by tobacco, tobacco, tobacco, marijuana, tobacco, asbestos, tobacco and woodsmoke or firefighting. Smoke is bad. Vapor is smoke, ok? See your doctor to get help quitting smoking. My father quit after 55 years of 2 packs a day of unfiltered Camels, so don’t tell me you can’t. Also it takes an average of 8 tries or so to quit. Yes you can.
  7. Alzheimer’s: keep your brain active, eyes are important, ears are important, eat those vegetables and if you live where I do, vitamin D in the winter.
  8. Diabetes: sweet drinks are bad. Fake sweet drinks are bad. A coke has 32 grams of carbohydrate. A Starbuck’s mocha 12 oz has 60. Quit drinking sweet drinks. Your goal is no more than 15 grams of sweetener a day. Now, what exactly is a carbohydrate? It’s anything edible that is not fat or protein. However, there are lots of very low carbohydrate vegetables out there. A cup of kale only has 8 grams of carbohydrate. Sweet peas and sugar beets have a lot more. Diabetics and everyone else should have at least half of every meal be vegetables, green and yellow and orange. Fruit is sweeter and all of the portion sizes (except kale) are less than you’d like to eat. Prevention is good.
  9. Influenza and pneumonia. Get your flu shot. There are two pneumonia shots and the first is given at age 65 and the second at 66. Except in people with heart or lung problems, then they get the vaccine early and repeat at 65 and 66. I think we are going to have a group of people who always mask on planes. I am one of them.
  10. Nephritis and etc. This is kidneys. What can affect your kidneys? Pills and illegal drugs, mostly. All pills that are absorbed are metabolized (which means broken down) by either the liver or the kidneys. Kidney function goes down slowly over a lifetime with age. We are seeing a huge rise in kidney problems because of too many pills. Yes, supplements too. Natural does not mean safe and what the heck is natural about a pill anyhow? Take as few pills as possible. Take ALL the pills to show your doctor. Ok, your doctor might be clueless about supplements. We had one person nearly hit the liver transplant stage until she showed my partner her supplement’s new label “Can affect the liver.” Holy cow. Should say “Can kill you.” So back to prevention: my baseline was that people should have blood lab basic testing every five years before age 50 and every three years after that if they were on NO PILLS. If they are on ANY pills, I recommend yearly testing. Did you know that the supplement companies can change what is in the pill at any time without telling you? Isn’t that reassuring? Heck no.
  11. There are still a long list of other causes of death. Liver disease, intentional self-harm, and on.

Since your doctor does not have time to think about all of this every time you stop by, it’s partly up to you. I don’t trust Dr. Google at all, but the sites I go to are the CDC, the Mayo Clinic, NIH, AAFP (American Academy of Family Practice). I look at lots of quack sites too, to see what is being sold, but I am not advertising them!

Be careful out there.

The photograph is Elwha watching the four point buck and wondering if it will eat him or not. From last week.

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teen toys today

Um, you say, these don’t really look like toys.

I had friends visit last week. These are the thirteen year old’s toys: he enjoys fixing cell phones and computers and asked if we had any old game platforms. I talked to my son and the thirteen year old is taking the ones he wants. And what was he working on in the picture? Replacing the broken glass in my cell phone.

Now many of you are jealous and would like this teen to visit you. My cell phone has a lot of parts and many tiny screws. There was only one left over and the phone is working fine and the glass is unbroken! Wow! Toys of mine that were used in explorations and repairs included my vacuum and I provided the super glue.

I thanked him with a comic book subscription, since we share an enjoyment and appreciation of comic books.

One of the most useful toys I had growing up was a china doll. Useful you say? Yes. We sewed doll quilts and doll clothes and made our own furniture and hoped for the tiny books in the Cracker Jack boxes. How is this so helpful? Surgeons asked where I had learned my stitching techniques. It was quite delightful to reply, “Doll clothes.” It really did help. I made one old fashioned dress with miles of ruffle, all hemmed by hand. In the 1970s I was embroidering my jeans and adding studs and we dyed t-shirts with melted paraffin and crayons. My sister and I nearly burned down the kitchen once, but we did learn which techniques to use to stop wax fires.

I am not sure who made this dress for the doll. My grandmother Katy Burling sewed doll clothes for us and helped us make patterns and nine patch doll quilts. My other grandmother Evelyn Ottaway could knit the tiniest doll clothes on knitting needles: I still have some of those as well. A tiny stole knit out of a furry yarn and lined with brown satin. My mother was an artist and loved crafts as well but NOT sewing. Pottery yes, sewing no.

My daughter promptly illustrated her lack of the packrat gene by putting half the furniture and stuff away and having a spare and elegant doll house. She learned to sew but does not like it much to date.

What childhood toys and ideas contributed to your adult skills?

For the Ragtag Daily Prompt: toy.