Wednesday, June 2, 2021

On the Table Once More

Next week, I will assume the patient's position on an operating table. Again. For the 8th time since reaching these "golden" retirement years. 

Let me hasten to say being a surgical patient has not become a hobby of mine, though I have had everything from total knee replacement to cataract procedures on both eyes. No surgeries are small. They all carry some level of risk. They can be scary. But all have been necessary in order to retain to retain the mobility and vision necessary to continue an active life.

The coming one is not directly heart-related, though it is linked in a way to the open-heart surgery I came through 20 months ago, the second one I've undergone since becoming a senior. That complicated surgery succeeded wonderfully in addressing a congenital defect and eliminating an aortic aneurysm and replacing a heart valve, just as the first one did in 2005. 

This time, though, four months post-op, a nurse and I in cardiac rehabilitation noticed a small, puffy place high up the sternal incision, at the top of the abdomen, close to the breastbone. "That's a hernia," she said, without hesitation -- a conclusion that a string of MDs would confirm over the next several months.

Hernias are not uncommon when you are along in your years and especially when you have had multiple open surgeries. The flesh can grow thinner or weaker, literally, and fatty tissue or even part of an intestine can poke through an abdominal wall into an area it doesn't belong. Most hernias evidently occur lower down the frame than mine, which is in the epigastric region up high --making it look almost as though you have grown a third man-boob when you wear a tight tee-shirt.

You can live with these hernias for years -- until you can't. They do not heal on their own. You risk reaching the point that the hernia is "incarcerated,"meaning stuck in the "out" position, and from there possibly reaching a "strangulated" condition, meaning that the blob cuts off blood supply and kills tissue. My ventral hernia is no longer tiny; it has grown larger and larger. Which is not good. Rather than waiting for an emergency to happen, I concluded that it makes sense to be proactive and find a highly skilled surgeon with a great track record of doing these procedures successfully. I have done that, and so with my daughter's help, I will be traveling some distance to his hospital next week.

After we return, I will have to take it easy for several weeks. (No lifting anything heavier than a gallon of milk, for example.) But after that, I want to become active again. Get back to the gym. Walk the dog twice a day if she's good with that. Play with the grandkids. And return to the senior fitness class I miss so much. Who wants to be "tabled" unless it is to be able to get up off that platform and live life to the fullest again?

© Robert Gray Holland  (2021)

Thursday, January 14, 2021

2020's Medical Gift to 2021

As 2021 began, I looked over my cluttered desk and found several medical testing instruments that were not there as 2020 began. And I wonder if they are the start of a trend: more home-based tools to measure personal health, combined with online linkage with doctors' offices to analyze troublesome test readings.

The COVID-19 pandemic wasn't responsible for all of this amassing of medical hardware, but it certainly took me to CVS with my 40%-off coupon to purchase a Pulse Oximeter. An emergency-room physician wrote a powerful article in The New York Times about the importance of being able to monitor your pulse rate and particularly your oxygen level.  A drop of oxygen intake below 90 percent could indicate the start of Covid's insidious choke-hold on respiration. After my most recent heart surgery, I remember how nurses ran into my room when a below-90 reading set off alarm bells. (Heck, a guy wouldn't learn to tinker with his oxygen line just to receive that pampering, would he? Hmmm.)

Ideally, you should be staying at a steady 95-to-98 percent. If you suddenly drop below 90, it would be a good idea to let your doctor know. Early detection could help emerging therapies be effective in combatting the virus. Just stick a finger in this marvelous little instrument and in a few seconds it tells you your pulse rate and oxygen level.

A Pulse Oximeter is just one of my new medical devices crowding my desk. I also have a no-touch thermometer to take my temperature several times a day, one arm and one wrist blood pressure monitor, an At Home A1C Test Kit (which gives you a 3-month average of your blood sugar), and not least an absolutely amazing watch with medical capabilities.

No, it is not one of those smart watches costing upwards of $500. I found it (where else?) on Amazon for just under $50 -- from a company called More Pro. The watch not only gives you date and time and steps/miles walked during your day, but heart rate, blood pressure, oxygen level, and even an assessment of the quality of sleep you had last night. Most mind-boggling of all, you can sync it with your smart-phone and run an ECG (similar to an EKG) with all those up-and-down squiggly lines, and if something was out of whack, you actually could transmit the whole danged thing to your cardiologist.

I have now had two online visits with doctors -- one my general practitioner, and one an eminent surgeon -- and I have found both appointments quite productive. With home-based medical testing devices to inform online consultations, I believe this could be part of a new way of heading off medical problems before they become severe, a way for patients to become more involved in their own care. So let it not be said that 2020 yielded nothing good.

© Robert Gray Holland 2021

Tuesday, December 15, 2020

Dogwalking Away the Senior Blues

I entered this piece in a 2020 contest sponsored by the Petco Foundation for the benefit of animal rescue organizations. Winning essays yielded charitable awards of thousands of dollars to rescues nationwide. My piece did not win gold in the field of 10,000 contenders, but I was prouder of it than anything I've written in quite a while. I am honored that All 4 Paws published it in their Fall newsletter. So I thought I would share my heartfelt recollections of life the past two decades with two of my best friends. And yes I may pen another essay for the 2021 contest.

How My Rescue Dog Walked My Senior Sadness Away

 By Bob Holland

 Were it not for our retriever-mix Ellie whom we adopted from the good folks at All 4 Paws of Pawleys Island, S.C., I likely would not have made it through my 70s to the verge of turning 80. In your senior years, it is all too easy to succumb to sadness and slide into sedentary ways.
From that first day we made connections with an All 4 Paws representative to meet Ellie at a Petco adoption event in 2015, she started breaking me out of a deep funk that had begun six months earlier when my first senior-years walking companion, Sadie, passed away at age 15. 
A sweet golden retriever, Sadie had walked me through my 60s around the leafy suburbs of Northern Virginia and later along the Blue Ridge Parkway and parts of the Appalachian Trail when we tested mountain living. When I had a scary open-heart surgery at age 63, Sadie (herself a rescue dog) became my personal trainer by patiently waiting beside my recliner and then coaxing me outside for walks of steadily increasing distances.
Almost immediately I knew that Ellie was the perfect Sadie successor to help me take on an even bigger challenge: staying active through my 70s. She excitedly went on a trial walk with me in a lot beside Petco. When we got home, she used her long legs and nimble paws to jiggle open the storm-door latch and start a solo jaunt through the neighborhood. She quickly learned to call on me, the old man, when she wanted to take a hike. And has she ever made her wishes known!
 If I am on the computer too long, she literally barks me off it to get up and get moving – something we seniors need to do. At other times, she is more subtle, pleading with me with her big brown eyes or a low whine to grab the leash, poop bags, and a bottle of water and get our walk in gear. Many are the adventures we’ve had. For instance, we have participated in Audubon Society bird counts (though squirrels are of more interest to Ellie). And with my Garmin Vivofit step-tracker we have even won some international step-counting challenges.
It is almost uncanny that Ellie was my nurse and fitness companion when I had a second open-heart (aortic aneurysm) surgery last fall at age 77. Like Sadie before her, Ellie was there for me every step of the way in recovery. 
Now Ellie’s face, like Sadie’s before her, is steadily turning a sweet gray, because, after all, she was 7 years old at adoption. I purposely wanted a senior like myself as a soul-mate. Before the All 4 Paws folks obtained her, Ellie was in a high-kill shelter where she was going to be put down for being “too old.” To the contrary, Ellie has shown over and over that she has life to live and love to give. To me specifically her love has been a passport out of the old-age doldrums and into enhanced resilience to meet whatever challenges life throws my way.

© Robert Gray Holland and The Petco Foundation

Sunday, August 23, 2020

The Walking Dog Is Slowing Down

(Revised October 14, 2020)

Tempus fugit. Time flies. The sweet dog we rescued as a senior is now advanced-senior. Ellie still pleads at some point every day for a walk, but then she hesitates at the door as though asking herself, "Do I really want to do this? Am I up for it?" She pants heavily before we take the first step. And if she takes care of her business within just a few blocks, she often turns us around and wants to head home instead of walking a few miles.

These days, Ellie also frequently passes on breakfast, which is something she never used to do. She is hungry by suppertime, though, so that's good. She can no longer jump on the bed, and she can get onto a sofa only with much difficulty and sometimes after failed leaps.

So a lot has changed. She's not just losing a step; she's losing three. I adopted her as a senior dawg so I knew this time was coming. Still, it's hard. The joy is still there when she manages to lie down on a corner of the sofa next to my recliner and snuggle with me and slumber while I gently pat her head. Ellie is another in a long line of dear sweet family dogs who have done so much to keep me active while boosting my morale. I hope that after this summer of miserable humidity we both can perk up and enjoy our walks once again.

Time does indeed fly, and sometimes it is hard to keep track of your faithful companion's age. When Ellie was up for adoption, the rescue people labeled her as 7 years old. I think they estimated on the low side in the interest of landing her a forever home. (Wouldn't blame them if they did.) Family and friends said her graying indicated she was closer to 8 or 9.  Doing the math, she could be close to 13 or 14 years old now, exceeding the average life expectancy of a retriever. The family lost dear Dasher, a yellow lab, earlier this year to cancer before he reached his 10th birthday.

On the positive side, Ellie still shows her zest for life -- her joie de vivre as the French would say. Even if she doesn't wind up walking very far, she still usually wants to go out the door and walk. She remains my faithful assistant in walking me through the ups and downs of seniorhood. In appreciation of that, I wrote an essay about our journeys for a contest sponsored by the Petco Foundation for the benefit of animal rescue organizations around the country. (All 4 Paws in Pawleys Island, S.C. is the wonderful organization that connected us to Ellie.) Winning essays snag much-needed money for their local rescues. Given that some 10,000 essays are usually entered, it is a long shot that mine (entitled "How My Rescue Dog Walked My Senior Sadness Away") will win. In any event, I would like to post my piece here by the turn of 2021. Petco announces the winners during blessed Christmastide.

                                   © Robert G. Holland  2020

Tuesday, July 21, 2020

Hurricanes on Top of Pandemic?

Given the spread of the coronavirus, some South Carolina folks have mused about posting "No Hurricanes Allowed!" signs along our coastlines for the rest of the year. Dealing with a pandemic and another hurricane like Florence in September 2018 or Matthew in October 2016 (or huge Hazel from back in '54) is painful to contemplate. Nevertheless, Mother Nature does her own thing. And I am fully anticipating at least one major 'cane in the August/September/October timeframe. (After all, could 2020 -- the freaky year of calamities, natural or manmade -- be complete without a few hurricanes?)

Heat fuels these monsters. It's not just that it's been unrelentingly blistering here on the coast and farther inland, with a long series of 100-plus "real-feel"readings and no end in sight. The big deal is that ocean temps in the storm-brewing cauldrons are frightfully high -- way up in the 80s! And the Sarahan sand clouds that have been suppressing tropical-storm development are now dissipating.

So the course I am beginning to stay now is hurricane prep. Having lived through dozens of these starting with Hazel, I am probably ahead of the game. Nevertheless, there are gaps and unknowns in my plan. Such as where would we go in the event we decided to evacuate. 

We've only done that once. It was when trackers detected a late wobble by Florence that seemed to put us directly in the crosshairs. (Turns out, it wobbled again after we left, so our home was intact, thank goodness, when we finally were able to return.) The state's official hurricane planner advises that you decide months ahead of time where you will stay when you evacuate. The big problem with that is that hurricanes often set out in directions not foreseen. We headed north to our long-time home city of Richmond, and damned if the remnants of Florence didn't follow us! The swirling winds spawned a record outbreak of tornadoes in and around Richmond -- nearly 20 in one day, and we barely dodged a couple of them. And then in trying to go home we found that Florence flooding had blocked off major southbound routes forcing us to do a long western end run in order to find an opening. So evacuation is no picnic.

We have sheltered in place without harm for several Category 1 hurricanes (74-95 mph). Matthew's back winds may have touched Cat 2 (96-110) and it was scary as hell but we survived. Cat 3-5 -- no thank you! Would need to skedaddle -- to wherever. South Dakota maybe.

Whether staying or going, it is important to have a disaster kit at the ready. We are doing well with stocking some things, such as a portable radio, extra batteries, all our meds and first-aid items, a NOAA weather radio, flashlights with extra batteries, and waterproof case for all important documents. We are storing bottled water. You should have drinking water stored in airtight containers amounting to one gallon per person per day. And at least a week's supply. In case you're sheltering in place, you also should have water stored in case waterwater disposal is disrupted. A family of four might need 25 gallons for sanitary purposes. We fill up old two-liter soda bottles and save them for that.

Of course, we would never forget our beloved dog. So extra food for her, leash, carrier, vaccination records. And I guess you really do need to research in advance the location of pet-friendly motels within your zone of possible evacuation. Wouldn't want to be flitting between motels trying to find one at a time of emergency.

Something I need to find is a reliable mobile device charger in the event power goes off at home or if you are at a remote location. Not even sure how those work or where you find them. Maybe someone can educate me. Got to stay connected.

One item on the disaster kit list is hand sanitizer. Thanks to the pandemic, we have tons of that now, though it was hard to find for a while.

My family kids me about being such a disaster-planning nut. Maybe someday they will thank me.

© Robert Gray Holland  2020

Tuesday, July 7, 2020

Pedaling Through a Pandemic

It is hard to stay a course with great cheer during this Year of the Pandemic that is trying on so many fronts. On top of that, as I write this, we are socked in with what is shaping up to a week's worth of off-and-on tropical downpours. Nevertheless, let us power on and think good thoughts.

I am deriving some joy from a new fitness gadget I found on the Internet: a "Magnetic Under Desk Elliptical." Caught my attention with the declaration that it came "fully assembled," a plus for a Dad who spent many a Christmas Eve struggling to help Santa put toys together. And indeed it did come completely assembled, and tightly packed so as to keep all parts intact:  Pedal-ready right out of the box. As the name suggests, you can place it under your desk and get in a little pedaling exercise while you do things like update your social media. However, even more ideal, I find, is syncing with a lift recliner like the one I purchased for recovery after my open-heart surgery last September.

The lift will take you up high so you can stand up without having to put any strain on your arms. I found the upright position the perfect angle for pedaling the portable (25-pound) elliptical. For a little upper-body work at the same time I use some stretch bands that physical therapists have gifted me over the years. 

Obviously this is far from a complete fitness program; however, it is a nice supplement to my daily dogwalking, and something that can be done at home when Covid-19 still makes visits to gyms problematic. I might get a recumbent exercise bike, too, but this mini-elliptical doesn't hog space like an x-bike does. You can find this gadget and others like it on Amazon, if you're interested. The company is Sunny Health and Fitness.

Below is a selfie of my grizzled legs grinding away on the elliptical, from an upright position in the lift recliner.

This little gizmo also has an exercise computer that gives you: speed, time, distance, and calories. And there is easy-to-use knob to adjust tension.

During stay-at-home recommendations (or orders), I see many adults, even of my advanced age, out pedaling bicycles on the neighborhood streets. Good for them! However, my own preference for outdoor exercise is walking. I can enjoy the sights and sounds more that way than if having to worry about being blindsided by a kid riding a motor scooter recklessly or an inattentive motorist failing to give space to pedalers. And my senior dog likes me to walk her.

May you find your own rays of sunshine in these rather gloomy times. And stay safe.

© Robert Gray Holland  2020

On the Table Once More

Next week, I will assume the patient's position on an operating table. Again . For the 8th time since reaching these "golden" ...