Oh great, I forgot to write today. It’s 10 PM, I haven’t eaten dinner or written. Dinner is in the oven, when it’s finished I’ll eat then write. I have things to write about. Sorry I wasted the evening. Dinner if finished, it was a good one, Buffalo wings and Parmesan Garlic Hot Crash Potatoes. I haven’t made the latter in over a year. They are not that labor intensive. I should make them more often. But that’s getting ahead of myself I have two days to cover and that was tonight’s dinner.
Today’s Wise Madness is about me taking care of my physical health and how that bodes well for my mental health. It started when my left shoulder hurt so much that I couldn’t stick my left arm out to the side. That was right before Falcon Ridge. As I was going camping and needed to be able to use both arms I was motivated enough to overcome my anxiety and go to the ER of Montefiore Hospital, a 15-minute walk from here. My anxiety was never about my health or doctors or being afraid of procedures. Those things that scare most people don’t bother me. I can face pain and discomfort and perhaps even death. My fears all have to do with bureaucracy and money. I lived out my nightmare a few years ago when I got my ACA insurance. I finally worked up the nerve to see the ophthalmologist. I have severe cataracts and need surgery. I’m going blind. I made the appointment and the follow up. And then found out that my insurance had lapsed. I couldn’t pay for it. I crumbled. It’s taken me till now to get the nerve up again. Now I have Medicaid; it’s been paying for my therapy and psychiatrist I still was not confident and get anxious every time I fill my prescriptions.
I made it to the ER and showed them my insurance card from Medicaid. They made things very easy for me. There were not a million forms to fill out. It was not that stressful. They found I had mile arthritis in the shoulder that hurt and suggested I see an orthopedic surgeon. I was hoping they’d give me a cortisone shot but discovered that they don’t do that in the ER. I needed to see the orthopedist. I could not get an appointment for almost a month. I went yesterday.
The orthopedist’s office was in Montefiore, that same short walk away. That made things easier too. I had to fill out paperwork but was able to handle it. The Prozac is helping as has the therapy. Since I went to the ER the problem spread. It had started with the left elbow before moving on to the shoulder. I couldn’t use my arm at Falcon Ridge and had to rely on the kindness of strangers. My name means white woods.
After FRFF the pain spread to my right shoulder, right him, the right side of coccyx, the left side of the coccyx, the soft tissue to the left of the small of my back, and my right ankle. The orthopedist could help with my shoulder, he gave me a cortisone shot, and told me to see a rheumatologist. He also sent me to physical therapy as my left shoulder was frozen. That means that scar tissue prevents the full range of motion. The inflammation must have been severe to create that much scar tissue in so little time. It didn’t surprise me it hurt like hell and I have a hell of a tolerance for pain. It’s one of those skills that I wish I hadn’t had the chance to practice to proficiency.
This morning as I was about to blog I remembered that I hadn’t made my appointment for therapy or the rheumatologist. I was given a list of PT centers, one was right in the neighborhood and called to make an appointment. I was told there were no appointments, to just walk in. After I hung up I realized I had forgotten to ask if they took my insurance. Then came the difficult part, calling them back and asking. I did! They took it; whew.
Then I called the rheumatologist whose card I had picked up the day before. I was told that she wasn’t taking new patients. The receptionist should not have given me her card. She knew I was there as a new patient. I found out today that the doctor wasn’t taking any patients. She transferred to another facility at the Albert Einstein School of Medicine. Back to this morning. The receptionist said there was one doctor taking new patients and that I could get an appointment with him today at 1:00. It was already after 11:00, or in … January. That’s exactly the kind of setback that could have set me back off the track. I don’t know if I could have handled it; we’ll never know. I told her that I’d take the 1:00 appointment. That’s why I didn’t blog this morning. I had to eat and get ready to go out
I got to the hospital and it was like a switched flipped. I was not anxious, I was back to being a professional patient. I function very well in healthcare facilities when I’m not worried about paying for treatment. I was not only not anxious I was thriving. I was on my home turf and knew it. I acted very much like I do in the music world, joking and flirting with everyone.
Two disturbing things. First, everyone tells me that I look like I lost weight. I thought that I hadn’t but I haven’t been checking. I got on a doctor’s scaled, I had gained significant weight. I am over 180 lbs. That’s too much. My blood pressure was fine for most people but not for me, 140/88. I’m supposed to be 118/60. I don’t know if it was the hustle and activity or if I was more nervous than I thought, or my blood pressure was just higher now. Next visit I mediate first and see if I can bring it down
I liked the new doctor, Kumthekar. Nobody knew how to pronounce his name so I asked him. It’s Kum-ticker. I asked hi a few times, now I have it. The trick is to think what his name would be if he were a cardiologist Can you guess where the name comes from? India. I liked him a lot. He laughed at my jokes, even when they were about his name. He’s very young. He suspects that the joints are the result of my Crohn’s disease. It’s a known symptom. He’s sending me to a gastroenterologist. That’s great. I need to see one; it’s been over a decade. Making the appointment is tomorrow’s homework. I have made an appointment to see him again in the beginning of October
My next step was the basement. I needed blood tests and x-rays. The blood test took forever. Most of the time was waiting. I think I set a personal record, they took six vials. They need to test for many things. Then I went to x-ray and faced the greatest ordeal of the day, sitting in the men’s waiting room. I don’t know who thought it would be a good idea, but they had Ellen on the TV. I like Ellen DeGeneres but she wasn’t even on the show. The guest host was Lea Michelle. It was like a bad parody of women’s TV to be shown to a male audience. Her guest was one of the Spice Girls, and a magician. Even the magician was annoying.
When I finished that I made my way over to Physical Therapy. One of the bakers knew what was good. Where did that last sentence come from? I fell asleep while typing. I just deleted a 24,000-character word with no spaces. I left my hands on the keyboard. Before that I must have written than mystery sentence. Did I dream something where that made sense? I slept past my alarm that tells me it’s time to go to sleep. I’m trying to get myself on regular hours. I’m not going to ignore that. I’ll pick this up in the morning.
It’s morning. I did not get enough sleep and I’m going out tonight. I hope I can take a nap.
I have never had PT before. I would have had intense PT if it existed when I was six and recovering from a broken leg that had me not walking for over 3 months. Instead when the cast came off, my wheelchair was taken away and I was told, “learn to walk again kid.” It took me forever. I was using my arms to help me up stairs for months. Some things have gotten much better.
There PT facility was walk in. I knew they took my insurance but had no idea how it would work. All the signs were in Spanish. I could figure out something cost $14 and it had to do with friends, the word Amigos was on it. None of it mattered, I had no co-pay. I filled out forms before I went in. When they asked for my emergency contact I said my sister Alison. I checked my phone; her address wasn’t there. How did that happen? I needed it right away so I texted her. At least I thought I texted her. Turns out I called her. Fortunately she was available and told me her address. I gave her the Reader’s Digest version of why was at PT. Now she can read this and get the whole story.
I didn’t know how the therapy would work. The problem was frozen shoulder, scar tissue had built up and limited my motion. I had to break down that scar tissue. I had to do that in my abdomen after surgery. It was not pleasant. I was looking forward to learning how it worked but not to the therapy. I figured pain would be involved.
When my name was called I was taken to a small treatment area, the kind they have in an ER. It’s just a doctor’s table behind a curtain. I didn’t sit on the table but a chair next to it. Then came what I didn’t expect at all. The PT applied electrodes and a heating bad to the shoulder. That felt great. The electricity tingled and the heat was soothing. Then she gave me a massage. That was nice too, expect for the sore spot, my rotator cuff, that hurt. I forgot to tell you that’s where the doctors determined the damage was done. I suspect it was from watching the Mets’ pitchers. We know the team is a training nightmare. Just watching causes injury.
Then came the part that was more of what I suspected. I exercised on two devises. The first was nothing but a rope and pulley. I pulled down with one arm and the other was lifted up. The idea was to stretch out the shoulder; it makes perfect sense. I felt my range of motion increasing. Then I pedaled a bike but with my arms. That was wearing and caused pain. Not just in the frozen shoulder but the other shoulder and my left elbow. I was happy when that was over. That was it. I was sent home. They are going to contact my insurance to see if and when I’ll be back. Unfortunately that’s how these things work. That’s bad for the patient and it’s bad for the cost of medicine. They don’t treat you as long as you need it but as long as they can charge. That can be either insufficient or too much. Medical, surgical, and chiropractic treatment of back pain are equally ineffective. I don’t know why insurance covers any of them except in specific situations. It’s not evidence based. Counter-intuitively chiropractors are the most expensive; why? They charge the same way as PTs so the incentive is to prolong treatment to maximize revenue.
I made a point of saying that the theory behind PT makes sense. The scar tissue is stretched and even broken to restore movement. I would like to see evidence it works. As I pointed out earlier back pain treatments are not effective. The theory is sound so it doesn’t require the amount of evidence that something like acupuncture does. That’s based on theory that has no grounding in reality. That doesn’t mean it can’t work. Practitioners could have stumbled on something efficacious guided by false reasons. Oddly that’s how James Clark Maxwell came up with his theory of electromagnetism. When he was developing it he used a model based on mechanical wheels and gears that have no grounding in reality. Yet it works but we only accept it because it’s been tested to limits far beyond anything that occurs in medicine The weaker the reasoning is the more proof that is required.
Today I have to make an appointment with the gastroenterologist. I’m going to do it. The Walls of Jericho have fallen. It’s going to be more difficult with the ophthalmologist as I have to find the doctor on my own.
As for my shoulder? It feels better. Might just be placebo effect. It’s too easy to convince yourself that something works. It’s been improving on its own before I ever saw a doctor. Time might not heal all wounds but it heals many of them.
More significant than my physical health was what this meant for my psyche. I was able to do things I have not done consistently for years I did it with a minimum of anxiety. That is not as encouraging as it sounds. I might have just learned to trust my Medicaid instead of learning how to deal with the uncertainty. Let’s see if I make get my eyes taken care of. Let’s see if I can get other things I need to do taken care of.
When LORi posted on Facebook that she took her cat to the vet I said I was at the human vet. Today I should bring my computer into the tech vet at Best Buy. I have insurance on that will run out soon. When the computer is jarred at all it can’t find the hard drive. I figured that’s a small adjustment someplace. That’s been going on for nearly a year. The other problem just happened but it won’t be covered by the warranty; the power cord has a break in it. I sometimes have to jiggle it to make it work. I might as well buy it at Best Buy. That way I will get it fast and know it’s the right one. I’d like to work on my Falcon Ridge pictures but I need to get the computer fixed while it’s under the warrantee.
Tonight I’m off to see No Fuss and Feathers at Rockwood along with many of my friends. I’m trying to arrange a post-show soiree. Unless I’m lucky I won’t get the computer back today so I won’t blog tomorrow.
Wise Madness 