Tag: health

grossly unremarkable

Ugh! I’ve been putting off writing a health update post, hoping to get to a more definitive place before sharing but it’s taking long enough that I figured I better try.

Regular readers may recall that I started having trouble with tinnitus on my left side a few months back and wrote more about it on Mother’s Day. An MRI had been scheduled for June 21 with a hearing test to follow the next week.

Unfortunately, I was accumulating more symptoms on my left side, some visual difficulties in my left eye though the eye itself was fine, pressure or headache behind that eye, discomfort on the left side of my neck, intermittent tingling behind my left ear, a tendency to get lightheaded and feel off-balance, fatigue, and difficulty concentrating, perhaps caused by having to divert conscious attention to things like vision and equilibrium that are usually unconscious. I had been to my primary care provider several times but they needed the information from the MRI before we could proceed further, so the plan was that, if my symptoms worsened, I would go to the emergency room at our local hospital.

In early June, things did get worse. The most alarming part was that the tingling on the side of my head started spreading into my face and toward my neck and became almost constant. I also was having increased problems with my thought processes slowing down as I spent more and more brainpower remembering to move my head and body slowly so that I could keep my balance.

So, B took me to the hospital emergency department, arriving a bit before 9 AM. It was very busy, partially a result (we found out later) of difficulties at a neighboring hospital due to a cyber attack. It was so busy that I spent the first six hours based in the waiting room, going out for various tests and then being returned there. They did a brain CT relatively quickly to make sure I wasn’t having a stroke or some other acute thing. The results came back as “grossly normal” with some aspects being labelled as “grossly unremarkable,” which quickly became a favorite phrase for me, thus, the title of this post.

The waiting room became so crowded that they asked non-patients to leave shortly before noon, unless they were needed for patient care, such as parents of children or people who were acting as translators. So, B had to leave me; he waited at the hospital for most of the afternoon but eventually headed for home.

Mid-afternoon, there was finally a space in the treatment area for me, albeit on a gurney in the hallway, and the decision was made that I needed an MRI – which I already knew because I had one scheduled – but it was too late in the day to fit me in. I got to eat supper and eventually was moved to a room with hospital beds where several of us were on observation for the night.

Or so I thought.

Around 3 AM, I was moved upstairs to a unit that houses neurology patients. Somehow, they seemed to have missed all the stuff that happened in the ER and I had to prove to them that I wasn’t having a stroke all over again. I did have the MRI with contrast in the morning, which also proved to be grossly normal. This was, of course, good news in that it ruled out any tumors in my brain or sinuses, as well as other brain diseases or strokes. However, it didn’t tell us what was causing my symptoms.

The most useful thing that happened was a consultation with physical therapy. Dianne detected that my eyes weren’t tracking as well as they should be. She also did an evaluation for inner ear problems, where crystals in the inner ear loosen and migrate and cause eye and balance symptoms. While I don’t have the most common form of benign paroxysmal positional vertigo, I may have a variation of it with the crystals in a different part of the inner ear canal affected.

The maneuvers that Dianne did with my head and neck during the evaluation did help relieve some of my symptoms. The constant discomfort on the left side of my neck went away and I could move my head more easily. The tingling on the side of my head, which by then was constant, disappeared. Dianne recommended that I see a physical therapist who specializes in vestibular therapy and I have an appointment scheduled for next week. She also gave me an eye exercise to do at home in the meantime and some tips on posture. Additionally, a neck X-ray revealed some arthritis, which will be useful knowledge for the physical therapist.

I was discharged from the hospital that evening. There are supposed to be appointments for follow-up with a neurologist and a referral to an ear, nose, and throat specialist but I haven’t heard when those will be. The tinnitus is still constant and I may or may not have answers about that from my hearing test next week.

Over these last couple of weeks since my hospital visit, the severity of symptoms overall has been creeping higher. The current heat dome that is parked over us here in the Northeast US hasn’t been helpful; I’ve been feeling worse despite staying in our geothermal-heat-pump-cooled home as much as possible.

I’m looking forward to my vestibular therapy appointment on Wednesday, hoping that their experience will make more sense of my situation and maybe even arrive at a diagnosis that will explain some of my symptoms. It’s possible that there is more than one condition going on. For example, the tinnitus could have a cause not related to the possible inner ear issue.

Meanwhile, I’ve had to clear most of my usual activities from my schedule. My lack of concentration is making reading and writing more challenging, which is a shame, given that that is what I usually spend most of my time doing. I will try to do a quick update late next week after my vestibular therapy appointment and hearing test.

Hoping for some good news to share.

Other than being grossly unremarkable.

One-Liner Wednesday: household COVID update

Spouse B seems to be through most of his symptoms on Day 5, but will continue to mask and isolate at home, while daughter T and I are continuing to be symptom free and are masking at home when we are with each other and when we have to go out in public. (COVID Photo by Martin Sanchez on Unsplash)
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This update brought to you as part of Linda’s One-Liner Wednesdays! Join us in these brief (usually fun or inspirational) posts! Find out more here: https://lindaghill.com/2023/11/15/one-liner-wednesday-worried-who-me/

age and/or competence

Here in the United States, there is lots of discussion and public opinion polling around whether there should be an upper age limit for the presidency and other powerful federal positions, such as Supreme Court justices.

This is sometimes termed more simply as “Is Joe Biden too old to run for re-election?” Joe Biden is currently 80. Donald Trump, current leader in the race for the Republican party nomination, is 77.

Thirty-five is the Constitutional minimum age for the presidency, presumably to allow the president to have gained some measure of life experience and maturity to handle such a demanding position, but there is no upper limit specified.

I prefer that there not be one.

Rather, I want to be able to look at the personal qualities and policy positions of the candidate. Their physical and mental health status is part of that analysis.

Age is not necessarily a good indicator of health status or fitness. Joe Biden, as evidenced by his physical examination results from February, 2023, does not have major medical issues. His gait is stiff due to some arthritis. He works out on a regular basis. He has been able to keep up a rigorous daily schedule, including frequent travel, both domestically and internationally.

The president has a stutter; sometimes, his word pacing and choice are efforts to compensate. That we seldom hear him stutter is a testament to the work he has done over the years to address this issue. There is no evidence of cognitive impairment.

Of course, not all recent presidents have been as extensive in reporting their physical exam results. Donald Trump’s results were not reported in detail.

In the more distant past, the physical condition of the president was often kept private. For example, the public did not know the extent of damage caused by Woodrow Wilson’s 1919 stroke. Franklin Roosevelt’s post-polio condition was kept out of the public eye as much as possible. Not even Harry Truman as vice-president knew how ill FDR was with cardiovascular disease before his death in 1945 at age 63.

My mother, who had experience with family members dealing with cognitive decline, observed that Ronald Reagan’s behavior and speech while he was president reminded her of someone who was developing dementia. She was not surprised when his diagnosis with Alzheimer’s disease was made public five years after he left the presidency. There was a lot of debate about when Reagan’s cognitive decline began and there is no definitive determination, although some analysis has shown that his speech patterns changed over the years of his presidency in ways that indicate cognitive decline. Reagan was 77 when he left office at the end of his second term.

So, circling back to the present debate on the age of presidential candidates, it seems to me that age alone is not a good indicator of health or fitness for the rigors of the presidency. President Biden seems to be doing well at age 80 with both the physical and mental demands of the job. I also appreciate his even temperament and moral grounding, which, as a fellow Catholic, I recognize as rooted in Catholic social justice doctrine and in line with the American concept of working for the common good, articulated in the Constitution as a call to “promote the general welfare.”

On the other hand, when Donald Trump was president, he was not known to keep a very rigorous schedule of official duties. He didn’t seem to understand the complexities of the job, such as dealing with classified materials. He was volatile and resorted to bullying, name calling, and lying to try to get his way, regardless of facts, laws, or policies. Sometimes, when he is speaking without a teleprompter, he doesn’t seem able to construct cogent sentences. I don’t know if there is a medical diagnosis that elucidates these behaviors or not, but I don’t think his age is the salient factor.

While I would prefer younger presidential candidates, in their fifties or sixties perhaps, it is much more important for me that the president be someone who is dedicated to the American people and the rule of law, trying to do what is right for the good of the country and protecting those who are under threat.

If that person happens to be 80-something, so be it.

One-Liner Wednesday: booster

Today, I’m getting my sixth dose of Pfizer/BioNTech COVID-19 vaccine, this one targeting Omicron variant XBB.1.5 and shown to be effective against other currently circulating Omicron sub-variants. Please consider joining me if your health professional or public health agency recommends it for you.
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This public health message is brought to you as part of Linda’s One-Liner Wednesdays. Join us! Find out more here: https://lindaghill.com/2023/09/20/one-liner-wednesday-the-ultimate-404-error/

two years into COVID vaccines

After yet another period of high community risk level for COVID here in Broome County, New York, we have just today returned to medium level. After a post-Thanksgiving spike in infections, we experienced a hospitalization spike which had increased our community risk level. With the US health system also dealing with an early, hard-hitting flu season and RSV, the dreaded triple-demic, in some areas hospitals are reaching capacity and sending patients to other locations. Additionally, infection rates are predicted to rise as family and friends gather for Hanukkah, Christmas, and New Year celebrations in the coming weeks.

This comes at a time when only 14.1% of people five and over in the US have received the new bivalent COVID booster, which was designed to better combat the Omicron BA.4/5 variants and is proving effective against the current dominant strains, BQ1 and BQ1.1, which are part of the BA.5 lineage.

Furthermore, a recent study indicates that the US vaccination program likely saved 3.2 million lives and prevented 18.5 million COVID-related hospitalizations. The vaccines are estimated to have averted nearly 120 million infections. Another recent study shows that in the two years of COVID vaccine availability in the US, the excess death rate among Republicans is significantly higher than among Democrats, mirroring the difference in vaccination rates, a sad reflection of the politicization and misinformation around vaccines by many prominent Republicans.

It’s horrifying.

The mistrust sown over the COVID vaccine among Republicans seems to be spreading to other vaccines as well. A newly published survey finds that over 40% of Republican or Republican-leaning respondents oppose requirements for the MMR (measles, mumps, rubella) for school children.

This does not bode well for public health measures. It’s frightening how many people will believe politicians or media figures rather than doctors and public health experts on these important issues. People have been infected because they weren’t up to date on vaccinations. People have been hospitalized, developed long COVID, experienced complications, or died at higher rates because they refused vaccines or boosters. The data show this.

Please, get a bivalent COVID booster if you are eligible. Begin or continue the primary vaccination series if you haven’t completed it. If you get symptoms, test immediately and contact a health professional if you test positive to see if antiviral medication is right for you. Don’t go out and expose others if you sick with COVID, flu, or anything else. Mask indoors when infection levels for COVID, flu, RSV, etc. are high in your area. Avoid crowds. Increase ventilation. Wash hands and avoid touching your face – more for flu/cold prevention than COVID. Try to eat and sleep as well as possible.

If you are someone who has been getting health information from pundits, please turn to your personal health care provider, public health department, or national health organizations, such as the CDC. Look for data and advice from public health experts, not anecdotes.

For readers outside the US, turn to your public health experts to see what measures are available and appropriate for you.

Reminder to all: COVID 19 is still a global pandemic. Act accordingly for your health, your household’s and community’s health, and global health.

Triple whammy

There are a lot of people sick with respiratory viruses here in the US.

We are still struggling with COVID. Today’s (Oct. 28, 2022) statistics from the Centers for Disease Control show a weekly case count of 265,893 with 2,649 deaths. The case count is almost certainly low, as many at-home positive tests are never reported to health departments and some jurisdictions don’t gather data at all. The uptake of the reformulated boosters has been poor, with only 7.3% of people age five and over having received an updated booster.

While the community risk level map shows the majority of the country in the low (green) level, the community transmission rate is substantial or high in much of the county. You can see the various maps using a drop down menu here. The community transmission rate is based on case counts and/or positive test results; the community risk map also includes data on other factors, such as hospital admissions and stresses on the health care system. A personal illustration: Although the community risk level in my county (Broome in New York State) has been low in recent days, I have had a rash of friends being sickened with COVID. This is explained by our community transmission rate being high, which is the highest of four levels. (As I was writing this post, the maps were updated. Due to the emerging strains on the health care system, our county community risk just shifted from low to high.)

Meanwhile, the flu season has hit earlier and harder than usual. The predominant strain is H3N2, which is known to have a high incidence of complications, especially among young children, elders, and the medically vulnerable. Like many other illnesses, the effects of inflammation from the flu raise the risk of heart attack and stroke for weeks following the initial infection, further endangering not just personal health but also the stability of medical institutions, such as hospitals. So far this flu season in the US, the CDC reports 880,000 flu cases, with 6,900 hospitalizations and 360 deaths. Generally, flu season starts in October but this year it is running about six weeks earlier than usual.

The third virus that is currently surging is RSV (respiratory syncytial virus). For most people, RSV is like a cold but for infants, young children, and elders it can progress to lung infections. These can lead to hospitalization and even death, especially among elders. Unfortunately, there is not yet a vaccine against RSV. I actually participated in a clinical trial for one a few years ago but none has yet reached a level of effectiveness to be approved.

The triple whammy of COVID plus flu plus RSV has already pushed some pediatric hospitals to the edge of their capabilities. Ironically, the RSV rate is a critical factor. Because so many infants and young children were isolated due to COVID risk and lack of day care/school interaction during the pandemic, there is a much larger group than normal that is vulnerable to RSV infection.

There is also concern that the rate of new cases of all three viruses may climb even higher as the weather gets colder and people spend more time indoors.

Some things that people can do to help: Vaccinate as appropriate. Wash hands frequently. Avoid touching your face. Cover coughs and sneezes. Stay home and away from people as much as possible if you get sick. Mask in crowded places or avoid going to them. Get adequate rest and eat healthy foods. If you develop symptoms, talk to a health care provider so you can get testing and supportive treatments to help keep you from developing more severe symptoms and avert a hospital stay, if possible.

I know some level of sickness is inevitable but we can help cut down the case numbers if we watch out for ourselves and our communities.

One-Liner Wednesday: holiday wishes

Wishing good health and safety to travelers this holiday season and good health and safety to those who stay close to home.
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Please join us for Linda’s One-Liner Wednesday! Find out more here: https://lindaghill.com/2021/12/15/one-liner-wednesday-pro-tip/

B

SoCS: blogging mode

A few days ago, I posted about going into a new blogging mode.

I shouldn’t have.

While I did manage one post in line with my new mode, a complication has arisen with Paco’s health. I’ve had very little sleep and no real idea of what today will bring.

This is where I would usually say something like “stay tuned” but I have no idea if it will be a few hours or a few days or longer before I have an opportunity to post again – about Paco or anything else.

I’ll be heading over to the nursing home as soon as we get to a reasonable hour – unless the phone rings before a reasonable hour arrives…

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Linda’s prompt for Stream of Consciousness Saturday this week is “ode or a one or two syllable word that rhymes with ode.” Join us! Find out more here: https://lindaghill.com/2021/08/20/the-friday-reminder-and-prompt-for-socs-aug-21-2021/

Paco update

Linda’s prompt for Stream of Consciousness Saturday last week was to base the post around a word that contained -igh. My thought was to write a post beginning with “Sigh” about my father’s continuing health struggles, following up on two previous SoCS posts.

The day after I wrote the post linked above, Paco’s condition deteriorated and I made the decision to send him to the emergency room. After the initial check-in, I was allowed to be with him. The ER team was very thorough and found that he was dehydrated and had three new fractures in his lumbar vertebrae. After some IV fluids, he went back to the rehab facility by ambulance at 3 AM.

I caught a nap and was very grateful to learn that my older sister had moved up a planned visit and would arrive that afternoon. She spent a lot of time with Paco on compassionate care visits while I worked out a lot of logistics. It turned out that a rehab room opened up within his senior community; the place where he currently was in rehab was a sister facility in a nearby city. Paco was set to move back on Friday and I spent a lot of time packing up things in his assisted living unit, some to send up to his rehab room there and some to bring back to our house as we had decided to give up his place in assisted, as we know he won’t be well enough to return there any time soon – and may never recover to that point.

The plan on Friday had been that our family would finish clearing out his place in assisted and help Paco to get settled into rehab, but we arrived to find that someone in the assisted wing had tested positive for COVID, so it had to go into lockdown. Fortunately, this didn’t affect Paco’s move and he arrived safely via medivan. I signed yet another cache of documents and was allowed a short visit to help him get settled.

Unfortunately, our hard-won rights to expanded compassionate care visits got lost in the bureaucracy with the impending holiday weekend adding another layer of complications with so many staff away on vacation. I was able to get permission for some extra visiting time over the weekend but face another round of changing personnel, location, rules, etc. this coming week.

Meanwhile, Paco is confused and exhausted. The silver lining is that his pain level is generally low.

The big question mark remains how much recovery is possible in regards to daily living functions. I don’t know if the rehab team will be able to make a valid prediction or not.

It may be a situation of wait and watch and work and hope and pray and see where we end up.

good news, bad news, and uncertainty

Yesterday, I got my second dose of the Pfizer/BioNTech coronavirus vaccine as part of their ongoing Phase III trial. As I have written about previously, spouse B, daughter T, and I are all participants but they both received the vaccine last August, while I was in the placebo group. After the vaccine received emergency use authorization, Pfizer unmasked the study so that placebo group folks could receive the vaccine as well, which I gladly did.

B and T both had a day after their second vaccination that they didn’t feel very well, so I planned today as a down day for me. I do have a sore arm, headache, some body aches, fatigue, and a low-grade fever, but ibuprofen and rest are helping somewhat. Only a small minority of people have this level of side effects, but I am more than willing to not feel well for a day in order to have as much protection as I can from the severe form of COVID-19. While the science is not yet clear if the vaccine prevents asymptomatic or mild disease, the data show that moderate and severe cases that lead to hospitalization and/or death are rare.

I am grateful that Paco was among the first at the Health Center in his senior residential facility to receive the vaccine. Two weeks from now, when I will be considered to have peak immunity, it will ease my mind when I am allowed to meet with him indoors to know we are both fully vaccinated. We will still need to wear our masks and keep some distance, but it will feel safer than it has over this past year.

More good news on the vaccine front is that Pfizer and Moderna have been able to ship more doses of their vaccines than they had previously and that the Biden administration has improved distribution in conjunction with the states and local pharmacies and health centers. Pfizer has applied for permission to store its vaccine at regular, rather than ultra-cold, freezer temperatures for up to two weeks, which will make distribution easier. Another positive development is that the Johnson & Johnson vaccine candidate may receive emergency use authorization as early as this weekend. It is a one-dose vaccine that can be stored in the refrigerator, which will make distribution in rural areas and neighborhoods without good transportation options much more effective.

The worry, though, is that more variants of the virus are appearing. Some of them are more easily transmitted and may cause more severe disease. It’s not clear how well some of the vaccines work against some of these variants. It’s also not always apparent which variants will become widespread. For example, a new variant has been identified in New York City, but no one knows if it will become dominant, cause greater sickness, or be prevented by the vaccine.

To combat this, both Pfizer and Moderna are looking at changing their mRNA vaccines to account for new variants, as well as studying if a third dose – or even an annual booster – might be necessary to tame the coronavirus and keep it at bay. It’s part of the reason that it is so important for the Phase III trials to continue collecting data, so we can keep immunity levels in the populations as high as possible.

For now, I’m resting, cuddled under a black fleece throw that the clinical research center gave me, with their name embroidered on it, of course. While study participants do receive a stipend, they also occasionally receive little gifts and it’s nice to have this throw to keep me warm today. The best thing, though, is knowing that the vaccines are helping people and that, despite the uncertainties, we are gaining ground in the battle to end the pandemic.

There is still a long way to go and I beg people to continue to wear masks, keep appropriate distance, wash their hands, and avoid large gatherings. Get whatever vaccine is available to you when it is your turn. Check on vulnerable people in your community to see if they need help to stay safe. Support efforts to get the vaccine to vulnerable people around the world.

It takes all of us working together to end the pandemic and rebuild our communities.