Final Trip Prep, 3 Doctors, Pills Are Pau For Now

[Note: This is another blog based on my weekly emails to my family on the mainland. In the last few editions I've related my aging woes to the extent that this might be called The Geezer Gazette.]

11/2/24

 

Aloha Everybody  -- 

 

The flab index in Kona rose dramatically this week as the triathletes left town. The weather didn't
cooperate entirely for race day as rain moved in during the afternoon.  I'm sure they've endured worse

Jingle Bells

conditions, though. The storm that came through brought the first snow of the season on the summit of Mauna Kea, which is unusually early.  It is now quiet for the next month or so, one of our least touristy times of year.  We'll soon get an influx of migrating snow birds and then lots of tourists during the holiday season until early January.

We're in the final prep stage for our trip.  This is the time when all the last minute things get done, including gardening of course, but also things like cancelling the mail and newspaper, arranging for house checks with my handyman, last minute shopping, etc., etc.  We've done this so often that I have a check list to make sure it all gets completed.. This year the preparations include doctor visits, which are unwelcome additions to the list.

On Monday I saw my regular doctor to get clearance for my upcoming cataract surgery. I had to do this now because there might not be enough time when we return.  I also needed renewals for my bp and cholesterol prescriptions which would have run out during the trip.  On Tuesday I had a preemptive eyeball shot from my retina doctor to avoid problems while traveling.  I'll see him again right before my cataract surgery in case the eye that is being operated on needs a shot.  Finally, on Thursday I saw my cardiologist for an EKG to see if I was still ok after reducing the arrhythmia drug.  It was.  However, the side effects are still so bad that I told him I wanted to stop it altogether,  He seemed surprised that the side effects were so severe and said he's never had a patient as bad as me.  Of course, the effects I'm experiencing  occur in only about 5% of those taking the drug.  In other words, 95% of his patients wouldn't complain about them.  At any rate, by the time I saw him I had decided that the effects were so debilitating that I'd rather have Afib.  He reluctantly agreed that I should stop taking the drug altogether and see what happens.  The drug has a very long half-life, so the anti-arrhythmia effects should last though most of trip.   If the Afib returns it shouldn't interfere with the trip, and we'll take a different treatment approach when I get back.  I also have quit my heart rate medication, at least for the time being because my rate was way too low. That makes my blood thinner the only heart medication I'm on.  Other than easy bruising it hasn't given me problems. Fun times!

 

This will be my last missive for awhile because of our trip and because of my cataract surgery when we return.  I should have plenty of news to share after that.. In the meantime, Carpe Vitae, VOTE, and try to keep calm for the next few weeks or months.  I'm very glad that I'll be far away after this election.

Race Day, SS Syndrome, Side Effects Suck

[Note: This is another blog based on my weekly emails to my family on the mainland.]

10/26/24

 

Aloha All --

 

Well, today is  race day for the Ironman Triathlon .  It started about 6:30 for the swim portion. This year the ocean is pretty calm, but in the past it has been so rough that some athletes got seasick.  After the swim the athletes jump on their bikes and head on the highway to the north end of the island. The road is closed for part pf the day.  This is one of only two routes  along the west side of the island, so it causes some problems for motorists, who have to find other ways of reaching their destination. In town, where a part of the running course is plotted, the streets are shut down as well.  All of this discombobulation is particularly frustrating and irritating to people who aren't Ironman fans .  We're ok with it and don't mind the inconvenience for just one day a year.  Besides, we know a back way to Costco and this is one day when it isn't crowded.  Another is Super Bowl Sunday. On both days we try to do some nice relaxed shopping .  

 

On Wednesday I saw my cardiologist and went over all the tests I've had since I started going to him.  This included the report from my heart monitor that I wore for about 10 days.  Bottom line is that I'm still alive and likely to stay that way.  For one thing, I have no significant clogging in any of my arteries or veins.

Also, the blood flow to my head and to the lower parts of me is nearly normal. However. the flow to my lungs is problematic because of my emphysema.  The heart monitor results showed that my Afib is being well controlled by the medicine I've been taking (Amlodarone)-- very few episodes were recorded.  This has come at a cost, however, in terms of extreme loss of balance, lethargy, and even more vision problems than I had before. These side effects might be because my heart rate has dropped to the low 40's, even after exercising.  Also, the monitor showed a high number of pauses, times when the heart stops altogether for a few seconds.  This could be due to the drug, but it also could be due to something cardiologists call Sick Sinus Syndrome (SSS)-- a cute way of saying "You need a pacemaker."  In this case the "Sinus" is the node in your heart that initiates the heartbeat -- nothing to do with the sinuses in your head.  The plan is to cut my drug dosage in half and see what happens. If the pauses are still frequent I may have some hardware installed.  I'm hoping that the reduction also lessens my side effects.  BTW, the cardiologist has no qualms about me traveling -- this is because the test results indicate that a sudden and acute problem isn't likely in my case.

We're only two weeks away from our SE Asia trip.  This is when I usually kick up the gardening preparations, but at the moment I don't have the energy nor the balance to do this.  Hopefully I'll be better in a few days.

Ok, that's if for the week.  As the cartoonist Wiley Miller said in his strip Non Sequitur: “It’s much easier to fool people than it is to convince them that they’ve been fooled"  (3/24/19). Carpe Vita!

Tow Truck, Travel Prep, Tight Buns

[Note: This is another blog based on my weekly emails to my family on the mainland.]

10/19/24

 

Aloha Everybody --

 

One thing I neglected to mention last week was that a clutch problem developed with Karen's Miata.  This was the same thing that happened a couple of years ago, where suddenly the clutch pedal went nearly to

The Car Ambulance

the floor without engaging the clutch.  Naturally this makes it hard to change gears.  The last time I was able to drive in 2nd gear to the garage, where the  mechanic   diagnosed  the problem as a bad clutch slave cylinder  -- part of the car's hydraulic system that controls the operation pf the clutch.  However, this time the loss of pressure made it impossible to drive,  Fortunately Karen made it home before the cylinder failed completely.  I made an appointment to take the car to my mechanic, and I scheduled a tow truck to get it there last Wednesday.  This was a novel experience for both me and the car -- I've never had to call for a tow truck before in my life. and the Mazda has never needed one.  Anyway, it went very smoothly.  The truck arrived on time and the driver expertly and carefully loaded the car onto a flat-bed truck.  The analogy to an ambulance seemed apt.  The clutch problem was fixed that same day. but I had asked my mechanic to also look at the driver's side window, which had a problem going down without sticking about six inches from the top.  We've lived with this for several months by applying pressure to the window as it goes down.  Since the car was already in the shop, it seemed like a good idea to have this fixed at the same time as the clutch.  However, Mazda no longer makes the needed parts  -- it's 21 years old, after all. But the mechanic managed to locate another source for them. He placed the order but they won't arrive before next week  So we're driving without a window in the meantime, looking carefully at the rain forecast.

 

It's only a few weeks until we leave for SE Asia, so we've begun getting the garden and the house ready.  Yesterday we got our flu shots but held off on the latest Covid boosters because it hasn't been  4 months since we had Covid while on my ill-fated birthday trip to Canada.  The renewal point will be about halfway through the trip, so we've decided to wing it and get our boosters when we return. That's going to be a busy time -- besides re-opening the house and whacking back the garden, I'll have my first cataract surgery the following week.  Should be "interesting."

 

The Iron Man athletes are arriving in force now.  This past week dozens were zipping along on their high-end bikes or loping along like antelopes at the side of the street.  As I said last time, they're easy to spot  -- no body fat and buns like bagels.   Yogurt has become very hard to come by in the stores, as has anything else containing protein.  Our usual mix of languages has been supplemented by several more, making for a very cosmopolitan  atmosphere.  Also, the average age of Kailua has dropped by 10-15 years, I'm sure.

Ok, I'll skip the medical carping this week..  Next week I'll see my cardiologist to go over all my test results (including data from the heart monitor, which I sent in for analysis on Tuesday), and talk about an appropriate treatment plan. I'll regale you with that next time.

Off to market and breakfast on the beach.  Fasten your mental and emotional seat belts  -- we're in for a bumpy ride for the next couple of months.

Repositioning Ships, Fall in Hawai'i, Eye Surgery Ahead

[Note: This is another blog based on my weekly emails to my family on the mainland.]

10/12/24

 

Aloha Everyone --

 

Poor Florida and other parts of the East!  Two whammies almost back to back.  My condolences and sympathies for whatever losses you might have incurred, and best wishes for recovering.

 

Here our fall has continued with much less drama.  This is repositioning time, when the cruise ships have sailings to Hawai'i as they get ships from the northern summer routes to more southerly ones.  They

Time to Snooze

usually run a couple of trips from the mainland to the islands, and we've had several in our port in addition to our usual Wednesday visit from the one based permanently in Honolulu.  One even stayed overnight, something that is very rare.  Another sign of fall is that the flowering foliage shifts. For instance our various varieties of plumeria, nearly stop flowering altogether and even lose their leaves.  Many others, of course, bloom more or less year around. It's hardly barren here in the late fall and winter, though --there's always something blooming.  Another sign of fall is the annual Iron Man World Championship  Triathlon that occurs near the end of October.  This year is the men's final, whereas last year it was women's.  This brings in thousands of hard bodies from all over the world, some of which have already arrived to train for the grueling  event.  They are easy to spot -- absolutely no body fat, broad shoulders and narrow hips.  There are usually about 50 professionals who compete, but the ones I admire the most are the 2200 or so amateurs in various age categories who somehow have managed to train in addition to holding jobs.  

 

This was a pretty light week for physical exertion.  We did manage to work out at Planet Fitness, but we didn't play golf.  Our usual partner was out of comission because she fell off her horse and was too sore to play.  We could have gone alone, but she's an excellent ball spotter, and right now both of us need help. Speaking of eyesight, on Tuesday I had an appointment with my eye surgeon and I've decided to definitely go ahead and have him do my cataracts.  The first one is scheduled for the week after we return from southeast Asia in early December.  The other is scheduled for late January.  I'm doing my worst eye first, though it is doubtful a new lens will help much because that eye has considerable retina damage from my vein occlusion 12 years or so ago.  If it does help that will be a terrific Christmas present! My other eye has a better chance of improvement because the retina is in better shape, even though I've had a vein occlusion in it as well.  

OK, that's it for this week.  We're off to market and breakfast at the beach.  Take care and keep reminding yourself that morality does matter.

Cataract Culprits, Cardio Consult, Magic Golf Balls

[Note: This is another blog based on my weekly emails to my family on the mainland.]

10/5/24

 

Aloha All --

 

Although it was a challenge, this week we managed somewhat to overcome our laziness since we returned from the mainland.  First, on Sunday we did a mild workout at Planet Fitness, the first in many weeks. Then on Thursday we played golf at Makalei for the first time in months.  For me the golf was largely "aspirational." I'd hit a tee shot, then skip the approach shots and just putt out.  On a few par 3 holes, though,  I played for real, and even got one bogie! I had to rely heavily on Karen and our partner because if I hit the ball any distance at all, it would magically disappear because of my lousy vision.  All things considered, I did pretty good given how long it had been since we played last.  Oh, and we saw about 8 Nenes who have arrived for their winter visit.

Speaking of vision, I saw my retina doctor on Tuesday and as expected, got a shot it my right eye.  We also talked seriously about cataracts and whether I should have them removed.  The conclusion is to have the surgery because it will eliminate one possible cause of my recent sudden vision downturn.  At first I asked him for a referral to the same surgeon on Oahu that did Karen's eyes because the only surgeon on our island has a somewhat iffy reputation.  Then I learned that a new surgeon has recently joined the eye clinic I go to, and my retinologist thinks very highly of him.  It turned out the new guy was in the clinic and I was able to have a quick consult,  I was very impressed with his credentials and experience, and I may have him do the surgery.  This would be in an out-patient clinic in Hilo, which is a100-mile drive each way, but much easier and less expensive that flying over to Honolulu.  I have an appointment next week to talk some more and take measurements  I'm thinking of going with tried-and-true plain vanilla lenses tuned to distance vision -- anything more than an outstretched arm's length. I may still need reading glasses but that's ok.  I want my vision for every day activities (like driving) to be as good as possible.

In still more geezer health news, on Wednesday I saw my cardiologist for the 2nd time.  This was a quick visit to redo my ECG, with which my cardiologist said he was "very pleased."  Naturally, I am very

Only 5"

pleased he's pleased.  He recommended that now I'm mostly in normal rhythm that I wear a portable monitor for a couple of weeks that will record any Afib events.  Since I don't feel a thing when they happen, this seems like a good idea.  These devices have become marvels of hi-tech.  The model I am using is remarkably small and tapes to my chest,  There are no wires -- the electrodes are embedded in the tape that holds it on.  I can get it wet but I have to make sure the electrodes remain taped down.  The device records continuously for two weeks, then I send it to a lab which analyses the data and generates a report. This is better than my own ECG device because it measures even when I'm asleep. 

 

I know I'm writing a lot about my health issues lately, but unfortunately this is a major component of my life these days. My advice is don't turn 80!

Ok, off to market and the beach.  As you are bombarded with election rhetoric, keep in mind a Finnish saying:  "you have a right to your own opinion, but not to your own facts."'

Carpe vita.

wet Fall, Medical Ambiguity, Heart to Heart

[Note: This is another blog based on my weekly emails to my family on the mainland.]

9/28/24

 

Aloha Folks --

 

Well, it's officially fall,  Back in Ohio when we had our apple orchard we'd be racing gravity  to get  the crop picked and sold.  Hard, time-sensitive work that was anything but a nice relaxing retirement activity. Here the fall is still prime growing season and although I complain about the challenge of keeping our plants under control, amount of effort  pales in comparison,

As I write this the east coast is getting whacked by another major hurricane.  My condolences to the coastal residents, particularly in Florida, who are  going through yet another devastating weather event this year.  We have to cope with hurricanes here in Hawai'i, of course but not on the scale of the mainland,  Our fall so far has been very warm and wet -- last week we had a couple of storms that dropped a total of nearly 6 inches of rain in our specific area,  The pool is full to overflowing, and has been delightfully warm for our daily workouts. Our sunny afternoons have helped our pv system produce a surplus of electrons that have more than compensated for running the ac that we have in a few rooms.  We're coming to the end our our contract year with HELCO and it looks like we'll be giving them abut $150 this time -- whatever surplus we have at the end of the contact resets to zero.  The company needs it, I guess, in part to offset the costs of lawsuits from the Lahaina fires on Maui last year.  

I'm a little over one week from starting heart care from my new cardiologist.  The arrhythmia drug he prescribed has continued to keep my heart in normal rhythm most of the time, including during my Echo

Cardio-Selfie

Cardiogram last Thursday.  This is an amazingly informative ultrasound examination of the chambers, valves, veins and arteries of heart as it is actually beating.  I've seen the results online but I will get the full interpretation when I see my cardiologist on Wednesday.  For an 80-year-old muscle that has been beating even before I was born, it seems to be in fair shape and I forgive it for my AFib problem.  I  also had an ultra sound exam of my carotid arteries, tee ones that send blood to the brain and visual system. I was hoping there might be a fixable problem that would account for my vision difficulties, but I don't think that is the case.  On Wednesday the ambiguity about my sight continued when I saw my optometrist.  He can't correct my distance vision with glasses, and he can see no structural reason for my vision loss, with the exception of cataracts.  However, they are not severe and can't account for the sudden loss of acuity,  So I'm still searching for a solution.  Ambiguity and uncertainty suck..........

Ok. Back to your reality-choosing dilemma.

Back Home, Cheers for Cardio Normality, Pele Spits Up

[Note: This is another blog based on my weekly emails to my family on the mainland.]

9/21/24

 

Aloha Everyone -- 

We returned from our mainland trip Wednesday evening.  It was short for us -- a bit under two weeks -- but long enough for the weeds and other plants to be noticeably in need of being whacked back.  The trip was very enjoyable even though short.  The first week we spent in Ohio, where we arrived in time for an early fall cool spell -- one night it got down to 43d!  The days were sunny, though, and by the time we left it had warmed back to the 90's.  We had a great time visiting old friends, eating barbecue, and sampling a few of Cincinnati's outstanding micro-brews.  Karen's routine checkup at UC Health Center went well, also.  We then flew to Colorado and stayed two nights with college friends who live in Boulder. They generously hosted a couple of get-togethers with other friends.  The final two days we stayed in Denver, where we got together with my nephew and his wife, and also played tourists in the downtown area, where we had a fabulous upscale Mexican meal at a restaurant namedTomayo in the LODO area.We hadn't been in Denver for seven years, and we were amazed at the positive changes in the downtown area.

The day after we returned hone I finally saw a cardiologist about my persistent Afib problem.  He was personable, competent, and paid close attention to my specific issues, particularly to the possible link

Thumpa-Thumpa

between Afib and my vision problems.  (By the way, my vision has declined to the point that Karen had to take over the driving on our trip,  I can barely read even with very strong reading glasses, and I am able to write this on my computer only by making the print very large,) An office ECG confirmed my Afib and the doctor ordered a bunch of additional tests, He also recommended trying to get my heart to revert to a normal rhythm using a drug that blocks the unwanted electrical signals in the atrium.  I got the drug that same day and started taking it immediately.  Yesterday morning I tested my rhythm with my portable device and for the first time since July it assessed the pattern as normal!!!!  This was much appreciated progress, to say the least.  I haven't noticed much improvement yet in my vision, but I'm still hopeful.  If this doesn't hold there are other techniques that can be used, including the good old paddles that deliver a nice electrical dope-slap to the heart telling it to straighten out.....

 

In other geezer news, Karen's cataract surgery didn't correct her vision as much as it should have,  She still has to use glasses for distance vision and for close up.  The new fancy lenses were supposed to eliminate the need for correction altogether, The surgeon is puzzled and wants to wait about three months for Karen's eyes to heal completely before trying to correct the problem.  The correction will undoubtedly require one or more trips to Oahu for either laser tweaks or to completely redo the surgery. Karen is understandably not happy with this situation.  I'll keep you posted on what happens.

I've been mentioning that Kilauea has been recharging its supply of magma and that the volcanologists have said it wasn't a matter of "if" but "when" the next eruption would occur.  Well, a couple of days before we returned Pele squirted out some lava in an area called the middle east rift zone, a few miles from the main caldera. The eruption was brief and has petered out at the moment. It may stall entirely soon.  The main  consequence so far has been a slight increase in vog that makes the air kind of hazy,

Ok enough for now.  You can now return to your onslaught of political ads and trying to figure out how to live in a  "post-factual," "post-civil" world......  Take care, carpe vita.