Category Archives: medicine

The Last Quarter Moon Gives A Pale Wintry Light/Late Night Thoughts Following Spinal Surgery

{Author’s Note: This blog post contains a photograph of an x-ray of my lower back taken six days after my spinal fusion. If the image of hardware screwing together two of my vertebra is irksome to you, my gentle readers, then feel free to search for another fine read. I have 645 in the bank. Find a good one and enjoy, just…please don’t check out A Brief History of Chains and Chain-making. It’s good, but there are other good ones out there, and far, far too many people have checked that one out. I have put this graphic at the end of the post for obvious reasons. The lead image is a generic photo taken from Google. Be warned. Enjoy.}

[A surgical room. Place: unknown. My room was more densely packed with instruments that went “Ping”. Source: Google search.]

An idea that fixed him to one spot was that life was a death dance, and that he had quickly passed through the spring and summer of his life and was halfway through the fall. He had better do a better job on the fall because everyone on earth knew what winter was like.

–Jim Harrison “Farmer”.

Do not go gentle into that good night,

Old age should burn and rave at close of day;

Rage, rage against the dying of the light.

–Dylan Thomas “Do Not Go Gentle into That Good Night”.

I removed my Bluetooth earphones and shifted my body up against the pillows that were packed hard against the headboard of our bed. No relief. The pain was white-hot. Intense. Bitter. Sharp. I reached for the small plastic amber bottle of painkillers. I shook it. Not a lot left. I put the bottle back and stared out at the patio. The half disk of the moon lit the patio with a soft light. Enough to see the BBQ, the umbrella, the covered table and the sturdy English Ivy, hanging out, wanting to grow, waiting for the spring warmth.

I had been listening to a podcast called A Voice From Darkness. The narrator, a young man on a road trip, described driving through New Mexico and suddenly finding himself in a city that appeared out of nowhere. He told of becoming hopelessly lost in a labyrinth of passages, streets, tunnels, sidewalks and dark lanes. He was filled with panic. Where did the city come from? It wasn’t Santa Fe. No indeed. And it wasn’t Albuquerque, either.

I looked out at the pale light and the patio.

I pondered what I had heard.

What the guy in the podcast (Category: Fantasy/Horror) was describing was uncannily familiar. I had the exact same experience, in many dreams, of being lost and confused in an endless series of false paths and empty halls and deserted passages. Often, it was set in New York City. I began having these dreams after moving to northern New York State in 2011. Sometimes the landscape was post-apocalyptic in nature. Sometimes it was a version of my hometown of Owego, NY. It was all too close to me. Too close to my own experiences. How did this storyline emerge from me and find its way into a podcast?

Recently, I have found myself having an abundance of reemerging thoughts and memories that I have not felt in decades. Tiny memories of tiny events–if any events in life can be thought of as tiny. In some weird Proustian way, I can smell a little bit of food and find myself back in 1954. I can hear music of a sort that takes me back to the sweet smell of a fifteen-year-old girl in high school. She’s in my arms, and I’m dancing with her in the gym after the big game. It’s 1964. A woman on Amsterdam Avenue is wearing retro bell-bottoms. It’s 1977.

Was I being set up for something? Why was a trickle of long-buried experiences flowing through the levee in my mind that separates the past from the present? Is this what happens to all people as they age? As they see less of the light and more of the twilight?

I reflected on my memories.

Wait! Do I want, really want to expose my inner fears and seemingly morbid thoughts and force them into the minds of my loving readers? They have their own problems. I can’t add to anyone else’s anxiety. That’s not what I do these posts for. I’m here to entertain and amuse, not deflate and depress.

I mulled over my thoughts.

The solution is likely in the extent of my pain. Pain can do odd things to one’s psyche. It can energize and it can terrify. It can lay you low, and it can cattle-prod you to attention. Make you laugh while you cry out. Run when you want to stop running, and get up when you’d rather sit. And sleep in quiet repose instead of writhing in a pool of nerve endings.

And it can remind you of your mortality. Slap you upside the head and say: You’re not twenty-one anymore. “You’re not thirty-three or forty-seven. You’re seventy-six, soon to be…well, do the math”.

Walt Whitman wrote something…

I paraphrase.

Grass. The beautiful uncut hair of graves.

One of my avocations is being a volunteer for Find-a-Grave.com. I get a request to photograph the headstone of someone. The request may come from a relative who lives somewhere on the map but west of New Jersey, who will never plan to make the trip to New York State to visit Aunt Polly’s grave. So, I do the deed. And, more often than not, I get a thank-you email. They are grateful. I am happy. Their family tree fills out, and I had a chance to walk through the uncut hair.

The uncut hair. As I searched for the requested headstone, I often thought of grass as a shroud. But not hair. I get the analogy now. The earth is so very old that perhaps there are only a few places where we do not tread on a forgotten grave.

I mused over these thoughts.

The patio is still bathed in that pale light. I’m tired, but I have a plan. I will listen to one more song by Nanci Griffith: Late Night Grande Hotel.

“I’m just learning to fly away again.”

I will take my headset off and play one game of solitaire on my iPad.

Then I will go on Reddit and read an article I saw earlier:

A Cool Guide To Escaping Killer Bees

Only then will I pull the covers to my chin. Sip ice water and fluff my squishy pillow. Close my eyes and look out at the pale light on the patio.

And as I fall into sleep, fall hopefully into a sweet sleep… I find myself thinking of my hometown. Owego.

It’s that old blue line that you can never go back home…

I don’t know why I always come here in my dreams…

I only come here to remember my dreams.

–Sarah Jarosz

[R-Before. See the offset? L-After. See the Titanium screws? Photo is mine.]

The Angels of Midnight

“I’ve learned that people will forget what you said, people will forget what you did, but people will never forget how you made them feel.”

~~Maya Angelou

I

You’re trying to sleep in the ER of the Albany Medical Center. It’s sometime between the hour of midnight and dawn. You know things are going bad for you when all your dreams and desires are for a red paper cup of ice chips.

Even the night shift nurses with $1,000 worth of tats were of little distraction. And the finger nail polish that glowed (only the tips) were heavenly pink and emitted a beam of ethereal light that was almost supernatural in nature, did little to distract me from my greatest need…ICE!

On one level I was in the middle of an older man’s fantasy. On the other level I was positive I had yet to pay my moral dues. I felt caught in a special kind of medically induced purgatory. My entire right side was in a kind of agony that one only begins to imagine. I’d rather have triplets.

On the other side was a cadre of highly trained nurses, nurse practitioners and medical staff. They wanted to hold off on the water in case there was a test in my future that demanded nothing by mouth.

II

One of the midnight angels gave me a powerful pain killer. I was asleep in minutes. I dreamt about drowning in ice cold lemonade.

In my man’s eye, these women were all as beautiful as Aphrodite…but with green masks they likely resembled a woman you’d pass on the street on your way to Starbucks. It was the inner beauty that I was drawn to…something to be said in favor of a veil. The more that is hidden, the more you’re imagination is free to run wild.

III

So leaving out a great many details, how did it all turn out? I was discharged late Friday morning. It was hotter than Hades so we stopped at the nearest Panera and I had the best lemonade on the planet. From there to Starbucks in the lobby of our hotel. I couldn’t face a Cold Brew which I love and tried a Kiwi Starfruit Refresher with Lemonade. It was heavenly.

IV

Settled in our room at the Hilton Garden Inn, I ate for for the first time in days, a steak salad, while Mariam had a salmon salad. I was fully awake and asked to watch Mulan, a film I wanted to see for months. I was asleep before the opening credits.

I don’t remember my dreams anymore but they must have included the kindness of the ambulance EMTs that got me to Albany, the attending staff in general and the orderlies.

And the angels of midnight who choose to dedicate their lives to alleviating the pain of shleps like me.

A Winter’s Drive

[Source: Google Search]

The elderly couple had the kind neighbor woman to help in loading their car. It was late morning and the temperature bounced around the zero level. When they first pulled the car down the drive, it was -0 F. Then it climbed to +0 F. What a difference.

Their car was a Honda Fit, dazzling blue on a dazzling day, but now it was white with dried road salt, reflecting the overcast black and white world of snow and more snow. Every time the elderly man brushed against the car, a part of his down coat or new L.L.Bean cargo pants would turn white. The last bag went in and the couple drove off. Their destination was Albany, about 150 miles away when you consider driving through Saranac Lake and Lake Placid. Time was the last concern on their minds. It was just one of several drives to New York City for doctors. This time it was important, no, essential that they were at Mount Sinai on Monday afternoon for tests.

He had a Starbucks thermos of cold brew so the first real stop was the High Peaks Visitors Center at the beginning of the 100 mile stretch to Albany.

“I’ll drop you close to the door”, the wife said. Near the curb was a crunch and a scrape. The man got out, checked the car (everything seemed well) and went inside to relieve himself.

Twenty miles further south, the wife asked if he heard anything coming from the right rear tire. She pulled over at the shuttered gate of the old Schroon Lake rest stop. He got out and to add to his mountain of other worries saw that the tire was flat. That’s when he smelled the burnt rubber.

Out came the AAA roadside assistance card. A call was made. The wife was put on hold and the call was cut off.

The elderly man looked around. Only a few cars and a semi or two roared passed (probably from Canada). All else…nothing.

They were very luck to have the flat in a zone that had cell phone service. Some stretches along I-87 were dead zones. Being a worrisome sort, the man began to imagine the worst case scenarios. Just then he felt the need to urinate (he’s on a diuretic). The minutes passed in silence. The couple discussed the situation. The man suggested calling AAA back when the wife said:

“Call 911.”

The man checked the south bound lane. Empty. Just as he was approaching the snow bank to empty his bladder, he saw the State Police cruiser about a mile away and the lights were flashing, The trooper had located us. The old man stood next to the once-blue Honda as the couple explained the situation. He knew there was a spare (a donut) in a pit under 300 pounds of luggage. He realized he hadn’t changed a tire since the late 1970’s. Despite the pain of two hernias, the trooper talked the man into the proper jack position and began to change the tire. The man had to ask for help in getting the spare up and out of the car.

“This is one of those baby spares, right?” he asked the officer.

“Yes.”

“The kind you’re not supposed to drive very far?”

“Yup.”

“So how far is recommended?”

“About fifty miles.”

“How far is it to Albany?”

“Ninety miles, but you’ll be okay if you don’t speed. Keep it at 65 mph.”

The trooper drove off. The old man felt like he had just earned a Merit Badge. Should they head to the Honda dealer in Albany or find a tire store? Minutes passed in silence. Honda closed at five. Firestone at six. So many decisions. They went to the Firestone store, they had the tire we needed and they checked to make sure the rim wasn’t damaged, then we had it aligned. While listening to power tools and phone calls, the old fellow realized he hadn’t urniated. That was ninety miles ago. He wandered off to the mens room. After he was done he settled back in the waiting room to watch a few more minutes of Saving Private Ryan. Watching it rain heavily on Tom Hanks, he realized he hadn’t taken his medicine for the day. You know, the box of pills which contained a serious diuretic. He swallowed his dosage and awaited the first urges in his bladder.

Soon the stressed-out and exhausted elderly couple were in their hotel room.

They had all day sunday to get to New York for the old guys monday afternoon tests. Except for the final challenge. The parking lot closed at four.

They turned on the giant hotel TV and watched an NCIS rerun. Then, thinking all was well with the world, the elderly man checked his weather app on his iPhone. Monday was to be the height of a major weather warning. The accumulation was expected to be 23″.

The old man put a bottle of leg cramp lotion at his bedside and looked forward to a night of pain, as exhausted as he was. The diuretic kicked in.

He was not disappointed.

Till Their Hearts Content

My normal blogs are usually free of self pity. I don’t complain very much about my state of life. What follows is an exception.

Sometime early this afternoon, at a major New York City hospital, (when the moon is 22.8% waning crescent) I will lie face down, half naked, hands gripping the mattress by my forehead, to have two needles inserted in my lower back.

I won’t be alone. Countless others have the same condition. We endure Epidural Steroid Injections (ESI). The procedure is part of a “non-surgical management” of sciatica and lower back pain. It sounds as though it were developed in some forgotten gulag during the Stalin era. It was just his kind of thing.

My procedural relief normally lasts about four months, then it is back to New York City again. I have a great pain management doctor. But this past winter we were stuck in Portugal, then COVID, then travel restrictions. On the way home we were ahead of the virus by only a few days. As a consequence, I was months behind in my injections. My pain level rose like an escalator to Macy’s Santa Land.

So we made appointments to get THE SHOT that would make the lumbar discomfort vanish like the snows of winter. The procedure isn’t without flaws however. There is an occasional error. The MIRACLE INJECTION failed to take. Within a few weeks I was suffering as before.

Well here I am again waiting for my turn devouring the latest issue of Arthritis Today. I’m ready this time. No trembling with fear, no nervousness, no worries and no projectile vomiting. Now I’ll be able to return to my normal quality of life like tying my shoes, picking up a stray raisin or hopefully handling my brand new red snow blower that has yet to see a single flake. They can inject till their hearts content.

[Source: Google search and Dr. Richard Staehler, MD]

For Pete’s Sake

[Lenny Schmidt (L) & Peter Gillette on the ‘Going to Gramma’s House’. A 73- mile bike trip from Owego, NY to Lake Winola, PA. Circa 1960]

How many kids, in the innocent ’50’s can say they were lucky enough to have a river in their backyard? Not many would be my guess. And it didn’t hurt that the Gillette family owned Hiawatha Island, one of the most famous and historic tracts of land in New York State.

I was a patient of Dr. Tracey Gillette on several occasions.  Our regular family doctor at the time was Dr. Philip Nichols. If Dr. Nichols was busy, Dr. Gillette would almost always take me.  After all, that’s what small town doctors did in those carefree days. And it certainly hurt that Dr. Gillette’s only son was one of my best friends.

Pete and I became the best of friends.

If not for him, we would never have had the numerous island adventures that enlivened our teenage years.  

. . .

If not for him, we would never have produced, directed and acted in at least four eight mm home-made monster movies. [While we played at film making, a guy our age named Spielberg was doing the same thing in California.]

. . .

If not for him, Greg Stella, Chuck Carter, Pete and myself would never have found a cozy nook hidden behind the shelving in the school library. Behind those shelves we discussed philosophy, religion, fools and kings. [All with the librarian’s knowledge and permission. Making trouble was not on our minds.]

. . .

Pete missed several months of eighth grade at St. Patrick’s School in Owego, NY. The entire class knew that his father had terminal cancer. Tracy Gillette’s final months were spent taking his wife, 6 daughters and one boy on a tour of America. 

We all suspected that Pete would follow in his father’s footsteps…take up medicine. Lord knows he had the brains for it. But instead he ended up in the construction business as a laborer. He suffered a back injury which ultimately contributed to his death, passing on September 2nd.

I cannot walk down Front Street, even today, over 60 years since I last spoke to him, without a million memories filling my brain. People tend to keep memories alive. I intend to do this

for Pete’s sake.

 

 

What To Do?

[The puzzle as of April 9.]

Dear Dr. Fauchi,

I am in need of a motivation transplant. I know that isn’t your field but I felt it wouldn’t hurt to ask. And I ask this at this particular time because you probably have little or nothing to do since the pandemic situation is totally under control because of the perfect job our President is doing. It’s just that I’m losing my way here. The Troll of Boredom has begun to knock on our front door. I am a senior citizen and because of a tangle with leukemia in 2003, my immune system is quite compromised so I have to be very careful.

But, I digress.

All is not lost.

I am a man not without some talents and skills. After all, I’m writing this, correct? Other interests have occupied my time in the past. I’ve written several books (all are self-published, but we don’t need to mention that, do we?)

For example, here are the collected notes, outlines, drafts and research of a novel I began several years ago. It needs a little work but I lack the motivation.

[Note the fireplace in the corner.]

I also have a more than passing interest in watercolor painting. This is my art table:

[The Art Table. The tubes of paint have been stored for the winter.]

Another interest of mine is to learn to play a musical instrument. I’ve been through the Recorder, Guitar, Harmonica, Penny Whistle and, as you see, I’m ready to take on the Banjo. But I lack the motivation.

[An almost unused banjo.]

:

[My next project.]

I enjoy Needlepoint. I’ve already did a lady-bug as practice, so I know I can to it…if I get some motivation.

Right now, Doctor, my time is spent attempting to assemble a 1,000 piece jigsaw puzzle. The top photo shows our progress as of April 9. It is, by far, the most detailed and difficult puzzle I’ve ever done.

A few minutes ago I sat in the dining room staring at the puzzle. The glare of the overhead light made all the pieces look the same. That is not a good thing. I stand up and look down. It’s an impossible task. I feel like a sort of god looking at lost people who are crying out to me:

“Please put me where I belong. Please don’t leave me unattached.”

I begin to feel pity until I think of the tens of thousands of humans who are crying out that very plea. I turn around to the window to take my attention away from misplaced pieces…and I see this:

[?]

Am I lost in time? I rush to the calendar, passing my Weather Monitor. It’s April 10 and the humidity is still low. The only comfort is that we’ll be enjoying a White Easter. I tried holding an Easter Egg Hunt once when we had a surprise snowfall. I ran around the yard hiding the eggs and then realized I forgot to color them. Needless to say the neighborhood children weren’t pleased.

In conclusion, I’d like to thank you for what you’ve done. But I beg you…I truly beg you not to do any harm to yourself after standing on the podium for two hours listening to The Man Who’s Named Must Not Be Mentioned.

Don’t worry about me, Doctor. I’ll check the yellow pages for a Motivational Doctor nearby.

Patrick

[All photos are mine.]

 

 

 

Dead Man’s Bone

[Source: Google search]

This is not about a toothache as the photo suggests.  It’s about me walking around with 0.5 cc of granules of a dead persons bone in my gums (ignore the gender reference in the title.  It’s purely for dramatic effect.  I thought it sounded spooky).  For the next several months, my body is being tricked into recognizing these grains as being foreign to my body…and then, theoretically, form my own bone material in preparation for an implant.

Got that?  Hope so, because I barely get it.

When I turned seventy at the end of last May, no one took me aside and informed me that now I was going to have a new and more involved relationship with the dental profession.  No one spoke to me of crowns, broken fillings or implants.

All that’s changed now.  I just got home yesterday afternoon after having my third extraction since January.  Looking at me trying to force a smile, you wouldn’t take me for a neo-Nazi, a National Hockey League goalie or some survivalist named Skeeter living in an RV forty-five miles from downtown Las Vegas.  No, I’ve been pretty lucky with my teeth.  Up until January, I had all my real teeth (I still have my real teeth…most of them) despite the fact that I spent more than a few nickels at Harvey’s grocery store when I was a child.  The small change didn’t go into raisins or apples.  I was more interested in Mars bars, Milky Way bars and Tootsie Rolls.  Yes, I paid for it all with trips to the dentist (a guy who didn’t believe in Novocaine) and got my fair share of fillings.  At the time, it was a small price to pay for a candy bar.

A month or so ago, my regular dentist in Saranac Lake was in the process of replacing a cracked filling when he stopped and said: “This is worse than the x-ray showed.  You’re root is very deep.  This tooth needs to come out.”

So a month later I was sitting in an exam room of an oral surgeon in Lake Placid.  It was a sparsely appointed room.  There was the usual sink, etc, behind me and the light above my head.  On a shelf in the corner was a computer monitor with an x-ray of my mouth on the screen.  Somewhere amid the white dots (fillings) and a lot of gray stuff were the images of about five of my teeth.  One of those was coming out.

[My photo]

The walls of the room were green, but my wife is convinced I’m color blind, so they may have been brown.  I’ll never know.

After a check of my BP I was led into another room.  This one had a similar x-ray of my mouth, but there was more stuff around.  Soon I was nearly flat on my back with a light in my face that was so bright it made my eyes water.  Maybe the doctor thought I was crying.  More than likely I was.  My fear of dentists goes back to childhood.  In fact it probably pre-dates my birth.

[My photo]

“Any questions?” asked the surgeon.

I had opted for an implant at a later date so that meant I needed something to put into the empty hole in my gum.  Leaving a vacancy in my gums was not something wanted.  I’m certain it would affect my whistling of “Old Man River”.

I said: “You said earlier that the temporary ‘tooth’ was from a donor.  Would you walk me through the donor thing?”

In the back of my mind, I knew that people didn’t ‘donate’ teeth…while they were alive.

“Well,” the doctor said, “it’s really not a donated tooth.  It’s donated bone.”

“Like from a cadaver?” I tentatively inquired.

“Yes,” she said, keeping a straight face.

The top of the chair held my head in a tight position.  I tried to turn and look at the tray of instruments, but I was afraid I’d catch a glimpse of a pair of pliers from Home Depot.  Instead, I stared at the x-ray and silently bid farewell to my doomed tooth.  After all, we’ve been through a lot together.  The pain injections made my mouth feel like I looked like Quasimodo.  I touched my left lower lip expecting a flow of saliva like the dogs in Stephen King novels.

[For those of you who are still with me, the stuff she was going to pack the empty hole with is called “Mineralized Ground Cancellous.  250-1,000 microns].

“Can we start?”

[Source: Google search]

“I’m ready,” I said. For the dead person’s bone matter, I thought.

After the pain of the injections that was giving me the drug that was to stop the pain, it was all over in about twenty minutes.

It was rather a simple procedure…not like in the movies.

Now I’m on a liquid diet for a week or so.  The implant will come later.  I’m over the worst of it.

But I can’t stop thinking of who the donor was.  Was it someone I once knew?  Perhaps someone I dated?

It’ll keep me awake for a few nights.

Most things do.