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A New Ailment

Happy New Year!!!

Whoo Hoo! I discovered an unpleasant new health issue.  It’s new to me anyway, and I’m flaunting it like a new string bikini.  I’m sharing the story because it is a one-size-fits-all kind of thing.  It involves the mechanics of the human body, which is  a machine, the  mother of all machines. 

As I’ve written before, based on my observation, the normal human body is a perfectly designed machine.  Each and every part of it is located where it makes sense.  For example, the nose is on the face, not on top of the head.  Otherwise, we’d drown when it rains.  The arm bends at the elbow, the hand toward the mouth, so we don’t eat like pigs and other lower class mammals.  The leg bends at the knee, the foot toward the back so we can kick ourselves when we have knowingly allowed an opportunity to pass us by.  Maybe that’s just an expression.  I’m  tempted to cite more wowzy examples but I think you get the drift.

Now  to my earth-shattering discovery but first, I must confess, sometimes I’m always the last one to know.

I blame my Apple smartphone.

My smartphone is an integral part of my fingers.  It’s my go-to when I’m alone or waiting for my turn in line, for blood test for example.  I play Scrabble with my sister, sister-in-law, and one “random guest.”  One day I’ll try to figure out who that is.  I email, text, google, do online shopping, news reading, blogging, banking, some phoning, etc. etc..  One day I inadvertently hit something on the screen.  Suddenly out of nowhere appeared that day’s date, an ongoing count of steps, and miles covered by the steps.  There was even the number of flights of stairs climbed.  I thought OMG.  Siri follows my every move!  I know she occasionally injects herself into my life.  One time I burst into a karaoke song and she barged in, I did not understand what you said.

I closed the page on the phone and voila:  A step-counting app appeared!

Step counters had been all the rage but I refuse to buy apps or Fitbit.  I only do free apps.  Walmart.  Banks.  Amazon.  WordPress.  I noticed the app in front of my face is part of Apple’s smartphone package and therefore free.  Oh boy oh boy!  I showed it to my Plus-One, BT.  I told him, Now we can count our steps and keep up with the gang of old people who brag about their daily thousands of steps!  He got as excited as I was and responded, But I have Android in a cheap phone from Walmart.  I need my own step counter app.  No problem.  I downloaded a compatible free one in his smartphone.  I like to think I’m the tech-savvy one.

That was early September 2019.  Henceforth we established in the retirement resort a step-counting route, on which we walked religiously daily.  We raised the statistically normal person’s average of 4,000 steps to a minimum of 10,000 every day, no days off.  Sometimes we even made 20,000. We competed against each other.  When we went to separate destinations, we compared numbers at the end of the day.  If one did not have the minimum 10,000,  the laggard took off and walked some more to make up the deficit.  At the pool at night, we crowed about meeting our challenges to the other crowers.  Life is good in the retirement resort, where crowing about health habits – eating plant-based foods, gym routines –  is a favorite pastime.   

Two months later, in the beginning of November, BT and I traveled one way by train for a relaxing ride to Albuquerque to root for my Son the Sculptor at the dedication of his commissioned public art sculpture.  The train ride inside a first-class roomette was anything but relaxing.  After the art dedication, our bodies were not in a train-riding mode.  Fortunately we had a pre-arranged 900-mile road trip back from Albuquerque to South Orange County, CA, courtesy of my brother-in-law and his wife, Phoenix residents who had also attended the art event.  NO spring chickens, all four of us seniors who’ve convinced ourselves we can still do the limbo rock.  Okay, I just speak for myself.  But we all believe in step counting gadgets.  

During the trip, we drove for about 4 hours before taking a break for the first time to stretch our legs.  I noticed a pain on my left knee as I tried to stand up.  The pain showed up at each stretch break on the drive.  I blamed my sitting position.    

Upon arrival at the retirement resort, I took the blood test ordered by my primary care physician Dr PCP.  He would compare the result with the one I had a month ago.  He was monitoring my elevated liver enzyme count, which had fluctuated while I was on the CO-1686 clinical trial.  Maybe the high liver enzyme count was only caused by all the antibiotics I had taken during the seemingly endless urinary tract infections.  A couple of days later, my smart phone vibrated.  It showed an incoming call from Dr PCP’s office.  I thought, the blood test result must have alarmed him.  Maybe my liver enzyme count had doubled!  

I answered the phone.  

Celia, do you have any pains in your body?  The voice at the end of the line was that of PCP’s registered nurse, RN.  I answered, No, Why?  She responded, Your muscle enzyme count is elevated.  MUSCLE enzymes? I asked her.  What happened to LIVER enzymes?  Why does my body have more enzymes than the law allows?  She said if I did, Dr PCP would give me something to take.

After hanging up, I immediately consulted my colleague, Dr Google, who’s at my beck and call 24/7.  He said elevated muscle enzymes can be caused by trauma, arthritis, muscular dystrophy, Parkinson’s disease, heart attack, etc.  HEART ATTACK? 

I focused on trauma.  Trauma seemed more manageable and less scary.  I remembered the pain when I stood up after long periods of sitting.  I decided my left knee was traumatized by the awkward sitting position for hours.  I called RN and told her about the circumstances that traumatized knee.  She agreed it could elevate muscle enzyme count and passed the info on to Dr PCP.

Dr PCP is cool.  He was not automatically convinced.  He asked RN to mail me an order to repeat the blood test after a week.  I could imagine Dr PCP wanting to examine me again then refer me to a vascular specialist if my muscle enzyme count did not normalize.  I must hand it to Dr PCP.  He is a conscientious primary care physician.  He also loves the way referrers are made happy by the specialist doctors.  

I waited two weeks before I took the follow-up blood test.  The results came back and RN phoned me the news with a smile in her voice:  Your muscle enzymes back to normal!  She made no mention about the liver enzymes.  I was glad there was nothing to worry about. 

Days went by.  My left knee pain worsened.  Each time I stood up I felt like falling on my face.  Fortunately, it just so happened that I was scheduled to see Dr Paa, my podiatrist.  He does my big toe nails every three months.  The knee is part of the foot so I’d ask him. I was not optimistic because long ago when I asked Dr Google if the knees were too high for podiatrists, he responded:   orthopedic specialists for pain from diseases that affect the knee, physiotherapists, osteopathic or rehab physicians for pain from injuries, the list went  on and on.  OMG information overload!  All I wanted was a simple yes or no.  Sure enough, when I saw Dr Paa, he told me to see Dr PCP.  

Dr Paa and Dr PCP share offices.  I went to Dr PCP’s medical tech and tried to make an appointment.  Instead of making an appointment, she asked me all sorts of questions, with a view toward discussing my situation with Dr PCP and said she’d call me back. 

The following day, she phoned me.  She said, Dr PCP wants to know if the pain is in the back of the knee.  I answered, No why?  She responded, Dr PCP is thinking blood clot. I said, No way.  My blood flows continuously like the Niagara Falls.  It clots quickly but only when necessary like after a blood draw.  She said, Okay, then, Dr PCP said, take NSAID like Ibuprofen for one week and don’t exercise for one month.

After the phone conversation ended, it dawned on me:  I had bragged about my arterial blood.  When it comes to health, things can change rapidly.  No crowing be allowed about glowing health.  I remembered my late husband Octo, the second in the widowhood series.  He had enjoyed excellent health and one day laid out his plan to live to be a hundred.  Three weeks later his remains were cremated.  Leukemia got him.

So back to Dr Google I shuffled to ask about symptoms of blood clot in the leg.  He said, warmth and swelling on the affected area.  I looked.  Nope. None.  Another symptom: vomiting.  I had not vomited since my last post nasal drip.  Another symptom: Chest pain. None.  The last time I had chest pain was years ago when I became voluptuous and needed to move on to the next size bra.  And so with all the other symptoms.  Nada.  Blood clot was not the cause.   So back to sleuthing with the good doctor Dr Google.

Finally, we found the ailment that appeared to fit my symptoms.  It’s called patella femoral pain syndrome or PFPS for short.  Dr Google said, it is also called Moviegoer’s knee or Runner’s knee and is the most common cause of knee pain.  It comes from muscle overuse.  Obviously the daily 10,000+ steps for two straight months with zero break or rest were just too much for my aging legs and the knees took the brunt of the over exertion.  Sitting during the long drive exacerbated the problem.  The cure, among others listed, is RICE: Rest, Ice, Compression, and Elevation.  As always, here and now, I recite my disclaimer.  This post is not meant to give medical advice.  Check with your doctor.   I am not a doctor, a nurse, a therapist, or anything within miles of the medical profession.  I am a retired professional engineer, a civil engineer who delights in analyzing water puddles on the paved street after a rain and blaming the current young civil engineers for bad street design.

Dr PCP agreed with me. 

The new ailment is under control now.   My left knee hurts only when I stand up after sitting for a long time.  Once I start walking, everything is fine as long as I keep walking.  I can even do 10,000 steps no problem.  But what kind of a deal is that?  I need to rest sometime.  So the answer is moderation in sitting, standing, and exercising.  

I believe sauntering on the beach in my string bikini qualifies as moderate exercise.

 

The Sculptor’s Art Dedication

OMG! I was so excited! I just couldn’t hide it!

Remember? Almost one year ago I updated my blog with a post about the Sculptor’s Mother?  Well, that came to pass.  The County art board did commission my Son the Sculptor to design and build the art piece, which he consequently completed within budget and in time.  Then the County politicians got a marvelous idea to set aside a special day to dedicate the artwork – an opportunity for them to make points with the  Bernalillo County and Albuquerque, NM voters.   The notion got me excited anew!

Why the excitement for me?  Why not!  In 2012 I was diagnosed with Stage 4 Non-Small Cell Lung Cancer and sentenced to 8 months to live if no treatment, 11 months maybe 12 with treatment.  I had already resigned myself to say Bueno Bye world and tiptoe through the tulips at the Pearly Gates.  Now 7 years later, alive and kicking, bunion and all, I was presented the opportunity to see my Son the Sculptor, the once starving artist, ARRIVE as a professional sculptor.

So I concocted a plan to throw a major shindig honoring the celebrant artist, complete with caprese, burritos, champagne, and music – zumba, rock, whatever the DJ desired to spin.  I compiled a long list of friends and relatives from as far away as Washington DC and Georgia to be invited to the ribbon-cutting ceremony.  Okay, I must confess.  It was all about me.  That’s what insufferable proud stage mothers do.

Unfortunately,  the powers-that-be scheduled a date too soon and a time too early not conducive to effective event planning.  The county’s formal invitation showed the art dedication event to be less than 2 weeks away on a Saturday at 10:30a.m.  It would not be fair for my proposed invitees, who are mostly seniors, to plan their foreseeable future in less than 14 days.   The hoopla immediately after 10:30a.m. in November?  I’m retired.  It would be too early and too cold for me to be in my tutus and dancing shoes.  So my son and I scrapped the plans.

The only thing Drama Mama could do was to show up at the ribbon-cutting event, tell anyone who cared to listen: I’m the Sculptor’s Mother, and make the loudest noise.

So my Plus One (BT) and I decided to take an overnight train from Los Angeles to Albuquerque, something neither of us had ever experienced.  The trip would be a dry run for the same train ride we had reserved for the coming Thanksgiving – an accommodation called a “roomette first class” ensuring a more relaxing journey. 

We did not know the roomette was the size of a closet.  The seats that turn into a bed could only hold one small person, who would be me.  BT, who weighs 220 pounds, nicknamed “Killer” by his water polo team mates in his high school years, had no choice but to sleep on the upper bunk contraption.  I laid awake all night, hallucinating on a train wreck, the cantilevered bed unhinged with its content dropping on me and squashing me like a bug.  Not a pretty picture.  At 1:00 a.m., BT tried to go down to visit the restroom outside the roomette.  It was dark, neither of us could locate the light switch, and he could not see the way down.  His big foot missed the tiny support next to my head.  He valiantly tried to hold on and broke a rib in the process.  OMG, it was so hilarious I could not stop laughing.  What a morbid sense of humor!  He was not amused.  

Broken-rib BT and sleepless Celia made it to Albuquerque.

Fortunately, the dedication event proceeded smoothly. 

At exactly 10:30a.m., the television cameras started to grind.  The art board’s Big Kahuna thanked the audience then waxed poetic about the beauty of the sculpture and its significance.  Titled “Sanctuary” by its creator, the public art is located at the Bernalillo County Animal Care and Resource Facility, a place of safety and healing for all animals.  The sculpture, a steel structure with concrete base within a 24′ diameter circular landscaped site, embodies the spirit of the building it adorns.  In the best circumstances, the unwell animals are just temporary guests in the facility, a transitional space that is simply a pass-through.

If my description of the sculpture sounds impressive, it’s because it’s not original.  It came from the website of my Son the Sculptor.  What do I know about the depths of the meaning of a piece of fine art?  I am slow on profound stuff.  Even cowboy movies have to be explained to me. 

The art board’s Big Kahuna recognized everyone involved in the project.  Then on cue, the honored sculptor wielded a giant pair of scissors and cut the ceremonial ribbon and voila!  Applause erupted.  Smartphone cameras clicked away.  Soon it was over.  Parents and their children went in and out of the sculpture, admiring its abstract animals and vibrant colors.  Drama Mama did not make the loudest noise.  Quite the contrary.  For once she was quiet, in total AWE of her son’s accomplishment.  

BT and I returned to South Orange County, California by car courtesy of my brother-in-law and his wife and kept busy fighting Amtrak for a full refund of the Thanksgiving train tickets that we could obviously not use.  We bought airplane tickets instead.  Don’t get me wrong.  We did enjoy the train’s gourmet food, the observation deck, and the leisurely pace of travel.  We’d do the train again but only one person per roomette. 

And so, as one of my proposed invitees said in an email congratulatory note, my life goes on like the aquatic spiders that race over the water surface on long spindly legs, never slipping into depths.  Except they don’t laugh like I do!

Happy dance!!

The Foray into the World of Incontinence

Before finalizing the title of this blog update, I wanted to make sure “FORAY” fits the story.  So I asked my language consultant Ms Google.

I am so proud of being networked with the Googles, a family of awesome experts in various fields of knowledge.  I have consulted with Dr Google and Atty Google. Now it’s Ms Google, the know-it-all language chick. She advised me “foray” is the word if I am making a sudden attack or incursion into enemy territory, especially to obtain something, a raid. Her response got me all excited!  It doesn’t take much to get me so excited in old age.  My word choice is right. Foray is the word.

A couple of months ago a medical problem I couldn’t blame on Non-Small Cell Lung Cancer Stage 4 suddenly popped into my existence.  The issue: I was putting out copious amounts of urine.  On referrals of my primary care physician Dr PCP, I saw in quick succession a urologist, a gynecologist, back to urologist, back to PCP.  Urologist gave me a prescription for antidepressant pills that also treat bed wetting kids.  I did not comply because I was neither depressed nor a bed wetting kid. The gynecologist did nothing.  Instead, he gave me an insight to state-of-the-art treatments for Overactive Bladder and suggested I return to the urologist and bug her.  She might just try any of the new techniques.  On my revisit, the urologist floated an idea of sending me to a physical therapist. I ended up more baffled and less relieved.

As it turned out, the urine test at the urologist’s office revealed a severe urinary tract infection (UTI).  It was the mother of all UTI’s!  Treatment of the UTI eliminated everything that was ailing me. But until I started feeling better and convinced Overactive Bladder was not the cause of the tremendous amounts of urine I was dumping into sanitary sewer systems everywhere, I had no choice but to get a grip on what I thought was permanent incontinence.  Thus the word foray.  I forayed into the land of adult diapers.  I had the crying need to know.  Here and now, I share with those who give a hoot what I learned.

If incontinence is in fact in the cards,  I discovered there is nothing to worry about.  According to Dr Google, 13 studies revealed that 30% to 50% of adult women in the United Stated are incontinent.  That’s quite a big spread.  I decided 50% is the more accurate number because I was adding myself to it.  It’s more reassuring that incontinence is normal.  He also said there had been stigma about incontinence until adult diaper manufacturer Depends used  June Allison, the fabulous movie star of the 40’s and 50’s in adult diaper television commercials.  For me, personally, stigma means zip, nothing, nada.  As long as I’m not hurting anyone, I go ahead and do my thing.

I went shopping for adult diapers in brick-and-mortar stores and online.  What a world to behold!  All kinds and brands of incontinent products in existence greeted my eyeballs.  I saw absorbent pads of various thicknesses, pull-up diapers that resemble panties for all sizes, for day time use, night time use, and everything in between.  In my opinion, the biggest, most effective adult diapers come from Denmark.  Each piece has the dimensions of a thick rectangular kitchen cutting board.  I guess it is for a woman or man with a square crotch.  Okay, just kidding.  The diaper is not ideal for wearing under a skirt or pants and walking around but it is perfect for night time use.  I know.  I used it one night when I had no intentions of getting up to go potty.  I just let ‘er rip!  

I wish I had known about adult diapers when I was younger.  I could have used them a year after I became a widow the first time.  I was one of the women CEO’s invited to a camp with young California girls who wanted to learn about us CEO’s who were not men.  The camp took place in a forest outside San Francisco.  I flew in from New Mexico.  I remember the girls slept in tents outdoors in while the CEO’s enjoyed beds in a permanent rustic building.  But the plumbed toilet was located half the length of a  football field.  I remember clearly how I wished I was in a tent among the girls so I could just get out of the tent and go pee-pee.  Imagine walking in the dark on a woody rolling hill from the CEO quarters to the toilet!  Who knew what nocturnal animals lurked in the pitch dark?  I was not a seasoned camper and the thought of bringing a flashlight never occurred to me.  Those Danish adult diapers would certainly have guaranteed nice restful sleep nights for the camping duration.

The engineer in me told me to dismantle one of the best adult diapers to see how and why it works.   How can it hold a whole night of piss?  I found the answer.  Inside the pad is silica gel, the same material commercial plant nursery owners add to the soil to minimize frequency of watering for certain plants leased to offices.

Then I thought why should diapers have to be worn like panties? Why don’t manufacturers make a wide rectangular pad using the same material and the incontinent person just lie naked on top of it and let ‘er rip?  Then it dawned on me: Maybe I’m reinventing the wheel.  Maybe there is already such a product.  So back to online shopping I went and voila!  I chanced upon a bed pad advertised next to the pull-up diapers.  It promoted comfort, freedom from accidental spill, never having to worry ever again about lost sleep, yada yada.  Like a true red-blooded diaper warrior, I ordered one.

With great anticipation, I opened the package delivered by Fedex.  I used the bed pad that night.  Boy howdy! Was I in for a rude awakening from untruthful advertising!  Sure, the bed did not get wet but a cold dampness on my back woke me up in the middle of the night.  I was up to my neck in my unwanted body fluid.  I jumped up and yanked the pad out and tossed it in the trash can.

I continued my knowledge acquisition.  I found a group of men and women who do have diaper fetish!  They talk about loving the soft caress of the dry pad, the joy of being all dressed up, appearing normal, smiling demurely, and carrying on a delightful conversation while urinating in their diapers, unbeknownst to the party across the table and everybody else in the room.

Now I know I’m still in control of my bladder.  But I’m not jumping up and down in celebration.  Etched in my mind is a fine line that divides mature women into 50% continent and 50% incontinent.  I am the dot clinging precariously on that statistical line.   Fortunes do change rapidly.  If or when incontinence happens, my inner Mehitabel will simply tell me, You’re in the company of distinguished high-level folks, Ms Senior Babe!  The astronauts wear diapers in space.  Even on earth!  I know for a fact because I followed a True Crime story.  One female astronaut drove far to try to eliminate the competition for her male astronaut-lover’s affection.  But first she outfitted herself with a heavy-duty, super absorbent diaper.   It sure eliminated the need for a rest stop which would only have delayed her diabolical mission.     

I think my inclination would be more toward the positive and joyful applications of diapers — like what the diaper fetishists say and do.

Happy dance!

Annual Physical and CT Scan

Before my number’s up, I’m gonna fill my cup
I’m gonna live, live, live until I die

That’s the best part of my theme song.  I love its lyrics and conduct myself accordingly.  However in early September, instead of filling my cup, I kept the laboratory phlebotomists busy filling vials with my blood for tests ordered by Oncologist Dr Smiley and Primary Care Physician Dr PCP.  Dr Smiley needed them prior to my every-8-month CT scans while Dr PCP wanted them for my annual checkup.  The results help Dr PCP to determine everything or anything medically wrong with me so he can refer me to specialists, an activity that really sends him!

First up for eyeball-to-eyeball consultation was Dr Smiley.  He hasn’t changed much in the three years that we have been seeing each other.  His facial expression still looks like he’s going to burst into laughter any moment.  He gladly informed me the blood test results showed a low number of carcinoembryonic antigen (CEA) for blood proteins, which Oncs consider to gauge the efficacy of a cancer drug.  Tagrisso is working, he declared.  Then he moved on to his normal gyrations, letting his fingers do the walking.  He dug them deep into my armpits and searched for swollen lymph nodes.  Nothing there, he dictated to the 20-something male Asian sidekick who consequently clicked away the information on the laptop in front of him.  Next Dr Smiley kneaded my neck; maybe the nasties were hiding there.  Nothing there either, he told the typist.  Then he instructed me to lie on my back.  Using the palm of his hand he applied pressure all over the tummy.  Any pain? Coughs?  None.  Finally, he did the stethoscope motions on my chest and back.  Everything is good, permanent smile on his face.  We will not do a CT scan this time.  We’ll do it one year from February 2019, which would make it February 2020.  Congratulations! You have moved to the once-a-year CT scans.

Two days later, it was Dr PCP’s turn for the face-to-face meeting. 

My camo shorts and jungle hat caught Dr PCP’s attention.  Love the hat! He exclaimed.  Thus our friendly banter took off.

PCP:  May I take a picture of you?

Me:  Sure!  Do you take pictures of all your patients?

PCP:  No, just the hep and interesting ones.  That’s you.

Me:  Thank you.  I like it. 

With that our smart phones clicked away.  I just assumed it was okay for me to take his picture too. 

PCP:  Do you still wear string bikini swimsuits?

Me:  Yes, I do.  That’s why you should never refer me to a medical specialist who accesses innards by cutting the tummy below the belly button.  Dr Google told me there are all sorts of access through the pelvic floor.

And we laughed.  Dr PCP and I go back a little more than 3 years now.  I remember commenting on the photo of his beautiful wife on top of his desk at our first meeting: Is she also a doctor?  He answered, No, she is an RN and she owns a hospice business.  I said, Whoa! You guys have a conflict of interest.  He seemed to enjoy the irreverence.  

Back to the annual physical.  He reviewed the blood test results with me.  Everything is fine, he said except the liver function numbers are abnormal.  I explained: They should be.  I was on antibiotics for urinary tract infection (UTI) for half a year.  He decided, You should repeat the liver tests in November to see if the numbers improve.  Otherwise, I’ll refer you to a specialist.  I gasped in feigned horror:  Oh dear.  Here we go again.  Next, he did the stethoscope motions.  Everything sounds good, he concluded.  

Dr PCP’s registered nurse gave me the flu shot and recited a list of things to do: second shingles shot in October; blood test with fasting, another blood test without fasting, and bone density test in November,  gynecology RN in December.  What makes you think I’ll remember all those? I asked.  Don’t worry, she responded.  You’ll take home reminders. With that, I sashayed.

Gonna dance, gonna fly, I’ll take a chance riding high, Before my number’s up….

The Bladder Drama Continues

 

So there I was…resigned to the proposition that my bladder had abandoned normalcy.  It was out of whack, producing horrendous amounts of urine all day and all night – a debilitating condition I never imagined in my youth when I thought I was totally invincible.  

Then one afternoon, my muted smartphone sent me signals of an incoming call….from my primary care physician Dr PCP!  I could not think of a reason he’d call unless he was dreaming referrals.  Our annual find-what’s-wrong-with-Celia medical consultation would not be not til mid-September. 

I answered the phone.  At the other end of the line was his registered nurse, RN.  She gave me instructions to (a) pick up an antibiotic prescription from CVS but (b) take a urine take first before starting on the drug (c) finish all 14 pills in 7 days, and (d) take another urine test five days after the last pill.  OMG!  Too many instructions to memorize for a senior babe battered by nearly a month of a perceived incontinence!  

I had already forgotten what brought on Dr PCP’s action until it dawned on me that a week after the beginning of my nearly month-long pain and suffering at the end of the 4th urinary tract infection (UTI) in 4 months,  I had phoned RN to please, PLEASE ask Dr PCP to order a urine test for me.  I wanted to rule out UTI from my condition.  Evidently Dr PCP did order the urine test, I took it, and the culture result must have just arrived from the lab.   I love my compliant doctor!  

As instructed, I followed RN’s rigid instructions for the 7-day antibiotic regimen and VOILA!  After the first day of taking two antibiotics, all the symptoms of an overactive bladder disappeared.  Frequent urination ceased!  Evidently all I had been suffering from was the 5th UTI in 5 months.  It was the mother of all UTI’s!   The infection-caused inflammation of my internal organs was so severe that it altered my urination and bowel movements.  Amazingly, the infection did not spread to the kidneys.  Imagine! A fever was never present at any time in those 5 months.  I thank my long gone parents for my unhygienic upbringing in the filthy slum of Manila thousands of moons ago.  It sure conditioned the soldiers in my white blood cells for their fight in my ripe old age.  

So there we have it.  Overactive bladder is not the ailment, only the symptom of the mother of all UTI’s.  Nothing is wrong with my bladder.  I am not yet incontinent.  

Three days later I saw the Urologist Dr H for a follow-up appointment that had been scheduled before the killer UTI.  Since the antibiotics resolved the extreme frequency problem, I had zero complaint but I had to show up otherwise I would have been fined $75.  That’s a lot of money that can buy half a dozen cheap closeout string bikinis at Walmart!  With nothing to say or do to me, Dr H simply instructed me to return as needed.

And within a week I was back to see her to complain that the feeling something might drop returned along with discomfort when I was sitting.  There was also a new sensation of combined itch and ache here and there.  

Dr H is a small comely Caucasian in her early 50’s around 5’2″ tall.  She and I are almost eyeball to eyeball when standing.  I like that.  All the other doctors look down on me.

She:  What’s the problem today?

I went straight to the new sensation.

Me:  So okay.  The frequency is gone but there is this new sensation that is a cross between itch and ache.  I notice it happens before bowel movement time.

Big mistake!  She heard the word “bowel.”

She: You need to see a gastroenterologist.

Me:  I already saw a gastroenterologist.  He gave me a colonoscopy.

She (perplexed):  Let’s examine you again.

Back on the bed with stirrups!  On cue, a 20-something Chinese technician entered the room.  During hooha examination, the observer is always a female.  I guess the possibility of entertaining other ideas when in front of a vulnerable exposed hooha could occur to a doctor of any gender.

Only Dr H knew what she did while sitting on a stool, with her head and hands between the stirrups, but I know what I did.  I grimaced then I told her she had the perfect stature for her kind of work.  

She:  I reviewed all your recent past urine test results.  You have an ongoing low-level bacterial infection.  Let us try a low-dose antibiotic therapy for a month and see what happens.

With that I the examination ended.  She instructed the technician to give me a follow-up appointment after six weeks.  I was free to move about the country.

I have been on the low-dose antibiotic therapy for a week.  It appears like the symptoms have abated.  So there we have it again.  No overactive bladder!

My inner Mehitabel suggests I celebrate the fact that the temporary leaks are gone.

Back to the beach!

 

 

The Overactive Bladder

Last month, I saw a gynecologist, the latest specialist to whom my Primary Care Physician (Dr PCP), the Happy Referrer, directed me for solutions to an on-again off-again health issue of mine.

At first Dr PCP thought the answer to my latest health problem was a Urologist. The problem consists of urinary tract infection (UTI) every 3 weeks, overactive bladder, and constipation. All rolled into one, it indicates life is good; I haven’t croaked yet.

The Urologist subjected the compliant senior babe to a urine test, another ultrasound procedure, visual inspection or accessible body parts related to the problem, and grilling, answers to which might lead to the solution. She sure occupied the head of the future steady patient, who did not mind any of it at all. Busy is good as long as it doesn’t get in the way of cup-filling pastimes.

As it turned out the Urologist was not sympathetic to my cause. This was what I wanted to hear from her: Your problem can be fixed by a simple non-invasive surgery or some other not-too-scary remedies. But no! She simply blamed the aging process, which I already knew. In the blame game, cancer is my go-to guy first, followed by the aging process. I wanted to hear solutions, preferably easy ones, so back to Dr PCP I shuffled.

When I told Dr PCP I needed a second opinion but from a gynecologist, he became visibly excited. Another referral! I swear referring to specialists is a profit center for PCP’s. One day I implored Dr Google, Say it isn’t so, to which he replied: The specialists’s business depends on referrals from PCP’s so specialists do try to make PCP’s happy. There we have it.

So back to the Gynecologist. I asked Dr Google to define gynecologist and he said, A physician specialized in gynecology. Can we pin that down a little closer, as in, Define gynecology? And he responded, It is the branch of physiology and medicine which deals with the functions and diseases to women and girls, especially those affecting the reproductive system. In other words, these are doctors specialized in the hoohas. With that I made my appointment with the gynecologist of PCP’s choice, Dr Gyne, fictitious name to protect the new good doctor.

On the appointed day and hour, thanks to modern technology, I had already registered on line so all I had to do was show up and get measured for height and weight by the technician, a 20-something Mexican girl filled with hopes for a bright future in the field of ailments and their remediators. She then ushered me to a small vacant room and gave me specific instructions. Put your backpack there, take off your pants and underwear, sit on this chair, wait for the doctor. As I waited for the doctor, I stared at the examination bed. It has stirrups. Vivid memories from years of pap smear tests and ob-gyn pregnancy visits jumped from my head!

Soon Dr Gyne entered. He walked briskly, as a man in his early 50’s should, with a big smile on his face that reminded me of a young Dustin Hoffman. I sized him up. Much much shorter than a professional basketball player , perfect for the job, no neck craning required.

So, what brings you here today? He asked. And our conversation took off.

Me: I’m here for a second opinion about my plumbing problems. I had a series of urinary tract infections (UTIs) – one every 3 weeks for 4 months. All that time I felt an occasional sensation that something was falling out. Now the UTI’s are gone but the sensation has become a daily event. And the urination frequency! I’ve heard of bleeding to death. Is there such a thing as urinating to death?

Him (Smiling): No no such thing. You need to see a Urologist.

Me: I just came from a Urologist.

Him: Who?

Me: Dr H

Him: I was going to refer you to her. Actually she does more things than I do. Did she refer you to me?

Me: No.

Him: Who referred you to me?

Me: Dr PCP did.

Clearly I was in the front row seat, observing a member of the referral syndicate in action.

Him: What did Dr H say?

Me: She blamed the aging process and gave me a sample of Premarin to simulate estrogen production and a prescription for an anti-depressant drug. I am not depressed. I asked for the drug literature from Dr Google and it said it is also good for bedwetting kids. I’m hardly a kid and I’m not bedwetting either.

Him (his eyebrows arched): What’s the name of the doctor who gave you the literature?

Me (deadpan): Dr Google.

Light dawned. Dr Gyne burst into a bombastic laughter. We laughed together.

Him: There are many things now that can be done for overactive bladders. They can do botox injections to the bladder. Dr H was one of the first ones to use it successfully. How about Kegel exercises?

Me: I remember making a choice between Kegel exercises and hysterectomy a hundred years ago. Is it never too late for Kegels?

Him: No, never. And there is also now a chair designed to do the Kegels for you. We refer patients to Pelvic Floor Physiotherapists who supervise. Unfortunately insurance doesn’t cover Kegels by chair.

Me: Just for kicks, how much?

Him: About $300 to $500 per half-hour session.

Me: That’s it. I’m out. What else is in the gynecologist’s arsenal?

Him: There are also other drugs. Okay, let’s examine you. Lie down face up.

On the examination table with stirrups! Upon cue, a female Filipino Registered Nurse (RN) entered the room to observe. I remembered the need for a third party – a female – to witness in case the hooha doctor got other ideas.

RN and I exchanged furtive smiles and gestures of encouragement. Comrades.

The purpose of the examination was to determine if my pelvic floor still has integrity. He did his thing. I grimaced. I quivered. I groaned. Soon it was over. I stood up and looked at RN. We shared triumphant smiles. Comrades to the bone.

Him: Your pelvic floor structure is fine. This is good. Dr H and I work together. I will write her a note about this visit and give her my opinion. Comply with her orders and when you see her, tell her the result. Kind of bug her.

What a relief! Since my last visit with Dr H, I had done tons of consultations with Dr Google and I had already diagnosed myself with prolapse of all the 3 organs that end up as 3 orifices on my dilapidated pelvic floor. That explained my post-menopause hourglass figure – small waist, rounded hips. All the organs are on the floor! I resigned myself to the proposition that I’d have to get a new ultrasound, new mri, new blood test, wait for decisions, yada yada. I even cancelled my trip to visit a very dear friend in Philadelphia. But I was wrong! My pelvic floor is fine per the expert, the hooha doctor.

That wrong is a good thing for now. We’ll see what happens next.

Meanwhile, I’ll keep a clear path between me and the commode at all times. And maybe do a little happy dance after each event.

A Tale of Two Biopsies

I must break down and accept I’m like most people. Memories of “firsts” are strategically filed in my mind, instantly accessible. They are there forever etched in the brain: first boyfriend, first date, first kiss. You get the picture. One “first” that I’m discussing today is unfortunately far from the loin-trembling variety. It’s my very first biopsy.

My first biopsy happened at the turn of the century.  OMG!  That sounds so yesteryear! The year was 1998. As President and CEO of the engineering company that I had founded 15 years back, I had the world by the ears. I had broken barriers and earned bragging rights as a female engineer and a by-the-bootstrap entrepreneur. I was so riding high that I did not notice my neck had been bulging. I could not possibly notice it because each time I looked at the mirror, I got stuck on my face sans make-up, carefully searching for lines that might be appearing without my permission. Satisfied, I’d move on to other more pressing business. It was only after a friend gave me a recent snap shot of me that I noticed how big the base of my neck had bulged, like a frog holding its breath. I was so upset I confronted my mother. Bless her soul in her eternal resting place.  At that time, she had lived with me, my husband – the first in the widowhood series – and my growing son for 21 years. Wasn’t that marvelous? Yes, specially considering we had only invited her for dinner.  Actually we all had a great time with the arrangement. But I did blame her for not letting me know about my fat neck.  At breakfast time in front of my son and my husband, I asked Mother, How long have I had this neck?  She replied, As far as I know, after I gave birth to you, I noticed  your neck connected your head to your shoulders.  And we all cracked up.

Fortuitously, a retired anesthesiologist opened a walk-in medical practice half a mile from the office building that my company occupied. The name of his business was…ta da…”Walk-In Doctor.” After lunch one day, I walked in and met the good doctor.  You have goiter! The first words came tumbling right out of his mouth.  Right off the bat I liked the doctor.  Aside from not being too tall, which is number one qualification for waiters and doctors in my book, he also knew my problem without first asking me my problem.  I invited him, Tell me about it.  He replied, You need to see an Endoctrinologist (“Dr Endo”).  That was long before the start of my relationship with Dr Google.  All I knew those days was that people with goiter lacked iodine in their diet.  I did not believe my body was short of iodine, considering all the “bagoong” (Philippine fermented shrimp fry) that I had been consuming since time immemorial.  

I remember Dr Endo massaging my swollen neck, then having X-ray pictures taken of it.  I thought he was going to propose surgery.  But no!  He said this exactly: I’m going to stick a needle in your neck and draw some stuff so we’ll know what’s in there.  A needle perpendicular to my throat! It sounded horrible.  He scheduled the drilling in two weeks.  

If I had been Ms Worrywart, the two-week wait and imagination of a sharp instrument drilling through my neck would have been torturous.  Fortunately, there were more pressing things occupying my head:  projects to chase, payroll to cover, receivables to collect, string bikini figure to maintain. 

Time came for the mining for the stuff in my neck.  Then a few days to wait for the result.  Looking back,  they were just normal days in my busy calendar.

I remember I was preparing to call it a day when Dr Endo phoned me the result.  There was a smile in his voice.  Good news! He exclaimed.  The stuff in your neck is not cancerous.  We’ll schedule the surgery to remove your goiter.  All I could say to him was, Really!  I kept the reason for the shock to myself.  Truth was, it had not occurred to me that cancer was a consideration.  My head was so buried in the sand I was dense in most life matters.  But for sure density had its advantages.  I did not know I was supposed to be worried.

The parathyroidectomy – surgical removal of one or more of a human’s 4 parathyroids –  proceeded uneventfully.  A couple of days later, I was walking around with a normal-sized neck except for a bandage over the surgery area, like over a slit throat.  When friends asked me, What happened to your neck?  I always deadpanned, I was in a bar room brawl and the only one left standing!  I just loved to impress.

The second biopsy brought about by a cough that did not seem to quit in 2012 told a much different story.  I was 14 years older and a retired contented pensioner with nary a thing to worry about – no more employees, no more staring at the ceiling hoping money will drop to meet the payroll.  With my business closed for good at the time of my choosing, there was no more concern about losing my professional engineering license which totally defined me.  My head emerged from the sand!  Suddenly I noticed things around me.  I realized the stark difference between Republicans and Democrats!  I noticed deep purple lipsticks.  I read about famous people being diagnosed with lung cancer.  That was when I suspected the biopsy material scraped from my left lung could spell trouble and cause me to be afraid.  Very afraid. 

I just did the best I could to deal with the situation at hand.  I sought knowledge.  I forged an alliance with Dr Google and together we softened the blow from the fear of the unknown.  Knowledge is power.  It repels fear and can help in fighting any situation.

And always, there’s time for lightening up.

Happy dance!