Sunday Bloody Sunday

Well, my prediction for a frenzied Sunday came true. Sunday morning around here generally is not pretty. She is up by 7:30 or so, full of energy and ready to do all the jobs around the house that we both know will never get done during the work week. It's typical household maintenance stuff, trips to various stores to buy presents, returning things, etc, etc. Oh, and also the obligatory trip to Her mother's house to do dishes, clean up and make sure no problems are brewing. Things generally quiet down by the afternoon, but not today. The heat in Her mother's house had gone out, and being 83, stubborn and perhaps mildly demented she failed to mention it to us for a week. After arranging for the plumber to come Monday we spent the rest of the afternoon trying to convince her that it's not good to be in a house without heat in the winter. She wouldn't budge. This caused great consternation to us but we weren't going to wrestle with her or call the police to remove her (yet). We thought perhaps (since she wouldn't come to our house) that she would go to her brother's place, but no. She ended staying home all night under the electric blanket. We hope she lets the plumber in. Her excuse for not calling anyone to fix things was that she didn't want anyone to see how messy her basement was. Oh well.
At 4:00 AM we got a call that our daughter's "water" had broken so off we went to the hospital.
We're now waiting for her to get to the "pushing" time. Because it was so close to morning, I couldn't get anyone to cover the rehab facility for me so I'm sitting here, watching everyone exercise and waiting for news.

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Weekend

Action packed day on Saturday. Went to Synagogue in the morning followed by lunch at a friend's house. Conversation was lively and I surprised everyone (except my bride) with my near encyclopedic grasp of the subject of Sea Monkeys (more on that to come). Later, She stayed home to wash her hair and I went to my daughter's house. We took a long walk in her neighborhood hoping to start her contractions. Of course that didn't work. Since she is several days past due (and since she is very slender and the docs don't want the baby to get too big), she will likely be induced. They don't schedule inductions over the weekend so Monday may be the day, unless the baby decides to appear on its own before that. In the late afternoon She went back to Shul and I remained home reading Londonistan, an interesting and frightening account of what has occurred in the U.K. We later drove to the old Friends Meeting House near the Hopkins Homewood Campus where we participated in an International Folk Dance session, leaping and twirling and coming up with steps we haven't done in over thirty years. It is amazing that these patterns are so ingrained that they remain intact after all of this time. The Balkan and Israeli music DJ'd by our old friend Paul reminded of us of how She and I first met at a folk dance session at the JCC in 1971. The group is small and comprised of unique types so typically seen in folk dance circles. They are, however, welcoming and forgiving (when a complex step is not quite remembered) and they encourage us to request the dances we wish to do. After that, we drove home and returned to our respective computers where I did some cooperative flying with some members of my online wing (more on this to come as well) and She chatted with some friends. A pretty good day, I'd say. Tomorrow:Sunday frenzy.

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I thought this was a retirement blog

I thought so too, but it doesn't seem like it. Last few posts were really about work, weren't they? Another month or so just doing the rehab and then I'm hoping I'll get the very part time and flexible gig at Social Security.The fact is I'm presently only doing about 15 hours per week and it is very low key, but I'll be relieved when it's over. The rest of my time is spent on the computer doing various things, reading and also spending time with my daughter and grandson. Having them (and my son-in-law) just a few blocks away is wonderful, though I do tend to get tapped alot for babysitting. Another baby is due this week so I suspect the babysitting will only increase. As for my wife, She works more than full time and is devoted to her job. I call her a few times a day to harass her. The projects I promised I'd start during retirement have not yet been fully realized (see Procrastination). I've also managed not to call the car dealership for the service that I alluded to in that post, nor have I started going through the online computer course that I signed up for 4 or 5 months ago. Sigh....

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Wonder Ball 2

Thought about wonder ball again this morning when the program director told me that a new client who (among her many other medical problems) has an internal cardiac defibrillator that keeps on shocking her because her potassium level is unable to be maintained, is being sent for cardiac rehab. A low potassium level, particularly in someone who has underlying heart problems, may result in lethal heart rhythm disturbances. Knowing that this program, currently in a "freestanding" facility, will soon be moving to an "in hospital" setting made this an easy call. She won't start until after the move. My feeling is that if this person is unstable but needs to have low level rehab, it's better to do it in the hospital.

This blog won't be a forum for my medical "war stories" but I'll tell you this one: In 1992 I was performing a stress test in the office on one of my long term patients (not clients), then in his 70's. After a few minutes I noticed that he was having a disturbing number of "extra" beats (PVC's) and short bursts of Ventricular Tachycardia. I immediately stopped the test and had him lay on the cot next to the treadmill. Within seconds he developed Ventricular Fibrillation. In other words, he had no effective heart pumping and would be dead within minutes. We, of course, had a defibrillator right there and I gave him one shock (like you see in E.R. on TV) and his regular rhythm reappeared on the monitor (Thank God). He subsequently had Coronary Bypass performed and an internal defibrillator placed. I saw him last summer- still happy as a clam-now in his 80's and frustrated only in that he can't bowl or play "table-tennis" ( I kid him about this and tell him that you can tell a serious player when they call it table-tennis rather than ping-pong) as well as he used to. He was actually thankful that the incident had occurred back in '92 since he had a Nordic Track at home and had been using it every day. In the scheme of things I suppose it was better that his heart had stopped with me around rather than when he was alone in his basement-but I could have done without the drama.

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If you're the one to hold it last.....

Cardiac rehab in the gym continues. Saw one extremely elderly fellow who has nonrevascularizable coronary disease, that is his docs couldn't open up his blood vessels by angioplasty or stenting. So our job is to let him walk on the treadmill, use the other exercise equipment, and hope that nothing bad happens while he's here. It's a game of medical wonder ball. Of course all of medicine is like that. You hope you aren't left holding the ball when the music stops. But sometimes you are.

Just as an aside, I'm going to share a little medical secret: DOCTORS CAN'T FORETELL THE FUTURE. Any doctor who tells you he or she can should prompt you to do something very quickly--Find another doctor. The best we can do is analyze what your risks for a particular problem are and based on that assessment, make a very general prediction as to which broad group of similar patients you seem to fit into. Since we know (in a very general way) what the so called "natural history" of many diseases are, some prediction can be made as to what you might expect will happen to you. Notice all the hedging? It's there by design. We get fooled all of the time.

Over the years I often chuckled to myself when someone having a heart attack would ask, " How can this be happening? I just had a normal checkup (or a normal stress test) and my doctor said I would live to be 100 ." The doctor should have been flogged. Pure hubris. But many of us never learn.

Anyway, one of the other clients (we don't call them patients in the gym) had chest pain on the way up the stairs to the rehab area. Called 911 for him and sent him to the E.R. The nurse sent another client to her doc for recurrent episodes of chest pain while exercising. Geez-this sounds like I'm still working. The fact of the matter is, this was just a busy day. Most of the time things are much more relaxed.

Went home and made dinner for myself and Her. I've been doing a fair amount of cooking since I cut back my hours which is the preferred method of refering to it. Today I tried citrus marinated mahi-mahi, Cajun spiced beans and rice (my own concoction), and a green veggie. Usually She's a little tentative about my experiments in the kitchen. Today I was nicely complimented on my efforts.

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Procrastination

She finally said it last week: "You're a damn procrastinator!" Like I didn't know that. Why now, thought I..after all this time, does she finally choose to reveal to me this great insight into the only flaw in my character? "At least before (you retired) you had an excuse not to get things done. Now there's no reason for it!"

Busted! Of course She's correct. I have elevated putting things off to a fine art. I even manage to forget about many of these tasks but this results in free floating anxiety that is even more disturbing than the idea of completing the things I have suppressed from my consciousness. For instance, I know I'm supposed to call the car dealership for scheduled maintenance, but somehow I have managed not to do this for three months. One of these days the SERVICE NOW light will appear and I'll have to scramble to get the car in before I'm discovered. I guess I should confess that last year, on my way to work, the light did go on just as I turned the corner 3 blocks from our house, and the engine did seize and cough to a stop, and I had burnt out the engine. That's why we bought this new car which needs to be serviced. I'm gonna do it..I will. Of course not today since it's Christmas and the dealership's not open. I will get to it, though. I promise.

Just found this Self Test on procrastination for those who are willing to give it a go. Silly, though, since most afflicted individuals are painfully aware of their problem. I think I'll take it a little later. One of these days I hope to transform myself into a Structured Procrastinator, but not now.

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First four months

It is hard to believe. After so many years of working, to know that I actually pulled it off and was able to retire...You know whodoesn't let me call it retirement. It's too jarring for her to think that someone actually gives up a medical practice...or any type of job for that matter. For me, it was easy despite my age (56). But I did it. I'd been slowly reducing my involvement in the practice over 5 or 6 years. First not doing night call and weekends, then not seeing patients in the hospital, and finally no more office patients to see and no stress tests or echocardiograms to read.

I spend 15 or so hours in the gym per week "putting out fires" in the cardiac rehab program, but that's it. In another 2 months that program will evaporate as they move to a hospital and no longer need a physician's constant presence. I am working on getting a part time job at Social Security reviewing charts of cardiac patients seeking disability. If that comes through (and if I like doing it), it is completely flexible and pays well.

People ask what I've been doing with my time. The answer is..Enjoying it! There's a sense of calm present that I haven't experienced in years. I think I am a little less inclined to let daily frustrations get to me or anger me. Best of all is I don't feel the guilt I thought I'd experience by giving up my patients and having my former partners and colleagues in other groups manage them-well, maybe a little guilt. That can't be helped. It's genetic.

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