doctoring…the old, fashioned way…with new possibilities

Posted on September 21, 2014 by hugmamma

I’ve written previously that I often seek out alternative health practitioners to help resolve whatever physical issues I might be experiencing. While I do so wholeheartedly it is still not without hesitation at the thought of leaving behind the more familiar world of medical doctors. Those wizened, old men in white garb with stethoscopes dangling about their necks.

My husband and I thought the world of the last 2 doctors we saw with some regularity. They were both General Practitioners, not specialists. Drs. Kinnish and Purden had what many in the medical practice lack these days…a warm, bedside manner. We never felt rushed for time during appointments. We felt as though we had their undivided attention. We could ask questions and not feel dumb. We could even laugh at something funny.

While neither physician had all the answers, I felt as though they were in the trenches right alongside me trying to figure things out as best they could.

Dr. Kinnish retired at 67. Dr. Purden returned home to Canada to work as a hospital Medical Director and teach medicine to wannabe doctors. Both losses left me a little sad because of the compassionate human beings that they were, as well as my being left to seek out a new family doctor.

Even while I was seeing Dr. Purden, I began seeing a naturopath for digestive problems. With a thorough food allergy testing, she got me up and running better than I had been for a long time. Had I continued seeing her, I’m sure she could have helped me resolve other issues as well. Unfortunately, many naturopaths don’t accept insurance which makes filing claims a little tricky. Paying for services up front gets pricey, and dealing directly with insurance carriers can be a headache. Trust me! I use to work for one.

Well, lo and behold. I found a naturopath, Dr. Brooke, who files insurance claims on my behalf and accepts whatever is allowed. I just remit the copay. Hallelujah! And, as with most naturopaths, she’ll spend an hour with me if that’s what I require. I can ask all the questions I want. We can actually have a conversation about all the ailments I’m experiencing. There’s not the usual limitation as there can be with medical doctors…one symptom per appointment, please!

My latest venture with Dr. Brooke, and her colleague Dr. Kerns, is hormone replacement therapy.

Most women seek help when they go through “the change of life,” as my mother use to say. In other words, the dreaded…menopause. Contending with hot flashes and night sweats are debilitating, from what I’ve heard. I was one of the lucky few who didn’t experience these dastardly symptoms. My main problem was insomnia. I don’t think it helped that I was a night owl, inclined to stay up way past the bewitching hour. As I got older, vaginal dryness was also something with which I had to contend.

There are medical resolutions to the menopausal dilemma, such as Premarin. The fact that its literature specifically states there might be a small chance of contracting cancer put me off. And then when I learned it was derived from, of all things, horse’s urine, I was really turned off.

As I started to feel better with the thyroid supplement Dr. Brooke prescribed, and my fibromyalgia symptoms subsided, I began discussing the possibility of doing hormone replacement therapy, specifically The Wiley Protocol. Up to that point it had helped relieve my dryness symptoms.

Following several discussions I decided to take the plunge, beginning treatment a few months ago. No expert yet, I’m still trying to acclimate myself to the nuances of HRT. I don’t prescribe it for others, unless they’ve done their own research. The decision to alter the course of one’s life is individual. There are pluses and minuses to everything.

What I can speak to is my own experience.

Mine has been a hectic 2014 thus far…having a young adult back in the fold as she decided the next step in her career…a bath remodel that had its hiccups throughout…a dear pet whose life has disintegrated with chronic sciatica…a couple of roundtrip flights which hyper-activates my fibromyalgia…and moving my dancer daughter 3,000 miles away for the second time in a year.

Amazingly enough, with a few late mornings of sleeping in after recently returning from helping my daughter with her move, I have been…good to go. No. I’ve been…great to go! A call from my chiropractor’s office asking if I needed an appointment met with a resounding…”No! I’m fine. Thank you for calling though.”

While I may look the same on the outside…a bulging midriff…chipmunk cheeks…sagging chest…I feel more youthful on the inside. And with that, I can keep on…keeping on.

Baby Boomers are expected to live longer, thanks to technology advancing at the speed of light. However longer lives don’t mean better lives. Our internal clocks have not been altered. We’re still genetically tied to our ancestors whose lives were shorter by decades.

There’s no fountain of youth. Only possibilities which might help give us quality of life for as long as we live.

…and that…I can live with.

………hugmamma.

The Next Generation of Care Providers

Posted on August 31, 2014 by hugmamma

Bless medical providers like Dr. Washington who are helping provide us with the next generation of physicians. Fortunate we are when they are not only taught the necessary skills, but also the compassion and concern to help their patients through the medical process.

Hugs, Dr. Washington…for all you do.

………hugmamma.

A Family Doctor's Reflection

Every month that I post the latest update from “The Ladder” I smile at the amount of fun the kids are having. They are being introduced to physical exam and radiological tests I did not see until I went to medical school. They are smiling and I was terrified. I can only hope that some of the kids go on to become health care professionals. They are the future doctor, nurse, physician’s assistant or radiology technician. Medical schools are expensive in the United States. So a physician’s assistant (PA) or a nurse practitioner can be a rewarding career with less long-term student loan debt. The first hurdle is to stay in school. They need the encouragement to struggle through math and science and not get discouraged.
Recently I had an opportunity to refer one of my patients to a former resident. He has a sports medicine practice. I remember the first and last day…

View original post 405 more words

nurturing thursdays: choices…changes…part 2

Posted on June 5, 2014 by hugmamma

This is where I come in…

This year I turn 65. The year of Medicare. On the thresh hold to formally entering…old age.

I’ve been practicing for a while, even telling folks I was already 65. My husband who turned 66 recently, pointed out my mistake. Seems I was rushing him along.

Funny thing. As the years pile up I’ve become more preoccupied with, of all things, death.

Without realizing it, death has become my point of reference these days. Not in a morbid sense, more like savoring the pluses in my life while trying to downplay or diminish the minuses.

So with my daughter as ring master, I’m jumping through the hoops and…going for the gusto!

On Facebook the other day, I saw a photo of my mother-in-law seated with her 7 daughters. They were the picture of health and happiness. She sat shrunken, a shadow of her former, robust self. A quick glimpse of her eyes spoke of a woman growing older by the second. Yes, she looked all of her 80+ years. But she seemed to me, even older on the inside.

Years before my mom died, she fell in the bathroom of a vacation home we rented near the beach on Oahu. Her legs were like toothpicks, bowed from years of suffering the effects of arthritis. She was probably mortified that it took several of us to get her to her feet. Sadness seemed to hover over her like a black cloud in spite of her efforts to smile away her tears.

Both images are permanently embedded into my brain. Old age is not a pretty sight to behold.

For more than a decade now fibromyalgia, arthritis and I have occupied the same body…mine. In recent years I’ve been forced to take a backseat, while they’ve taken to calling all the shots. By late afternoon, I’m totally fatigued. Muscling through dinner preparation and evening chores, I usually fall into bed exhausted, aching from head to toe.

Caring for our dog who has heart disease and chronic neck and back stiffness, has only added to my own aches and pains. I must cajole her into taking her meds morning and night, including forcing a capsule down her throat. I must lift her in and out of the car when taking her to the vet, as well as carry her up and down flights of stairs.

Knowing that we women are often the designated caretakers, I wonder how long I can manage to help those about whom I care, as my own health dwindles. How can I help my husband should his health fail?

It’s more than likely my chronic pain was caused by the statin CRESTOR which I started taking to lower my cholesterol. I alerted the prescribing doctor to the fact that news reports indicated Asian women were susceptible to muscle pain caused by the drug. He’d not heard about it so I remained on Crestor, especially since it did the job intended. Even a subsequent physician, who happened to be female and Asian, ballyhooed my information. Not until a third physician drew blood to measure my C-Reactive Protein number and found it to be 1000+ instead of within the normal range of mid-100, did I stop taking CRESTOR. Only after trial and error did I end up with the one I’m currently taking which doesn’t have the same effect…yet.

In the midst of trying to determine the cause of my chronic pain, the doctor sent me to a rheumatologist who diagnosed me as having fibromyalgia. Like the “kiss of death,” I’ve been living with it ever since. Thanks, CRESTOR!

Alternative medical practitioners, including chiropractors and massage therapists, have helped me live a fairly normal life. I’ve done pretty much whatever I’ve wanted to do. But with old age settling in for the duration, quality of life becomes harder and harder to sustain.

After much reading, discussions with my naturopath, and soul searching, I have begun the WILEY PROTOCOL natural hormone replacement therapy.

Not having had the truly bothersome effects of menopause like hot flashes and night sweats, I never felt the need for hormone replacement treatment. But now that old age is staring me in the face and my quality of life is in jeopardy, renewing my body’s resources seems imperative.

Without hormonal balance, our bodies are going the inevitable route of shutting down. And while that is the natural order of things, I’d like to make the journey as enjoyable as I possibly can.

I’d like to savor the moments I can still do for others, and with others. I’d like to continue laughing, and hugging. I’d like to feel the excitement of learning new things no matter how old I get. I want to keep on writing, and blogging.

Essentially, I’d like to keep on…keeping on.

So why choose to change things up? What’s my goal? Well I’ll tell you…it’s for quality of life…no matter the quanity of years.

…here’s to living life…the best way i possibly can!!!

………hugmamma.

please…take care…

Posted on January 12, 2013 by hugmamma

Saturday Morning: Cartoons’ Greatest Hits (Photo credit: Wikipedia)

It’s Saturday morning!

What got me out of bed so bright and early?

Another post…what else!

Before I go there however, I’d like to explain why my flaws are often the jumping off point for my writing.

It’s because I’d really like to help you learn from my mistakes or inaction…if possible.

So back to the story at hand.

My previous piece…“Wellness”…got me thinking about my mom.

Raising a large family as a widow meant we lived from paycheck to paycheck. As a result my mom’s needs came last.

I never remember her visiting the doctor. She could barely afford to take us. We were lucky to have a kind physician minister to our health problems. Dr. Fleming never pressed my mom for payment, allowing her to pay what she could…when she could.

My mom suffered greatly from arthritis, especially in her knees.

Her sorrowful groans would awaken me in the early morning hours. The floor boards creaked as she paced back and forth. Until the pain subsided, she could not sleep.

I’d lay quietly, praying for God’s help, tears streaming down my cheeks.

Not even her arthritis could keep my mom from going to work, an hour’s drive from home.

She was the laundress for a Catholic orphanage…The Children’s Home. She often helped in the kitchen, and sometimes chaperoned the older kids, driving them to school functions on the weekends.

It’s difficult to understand how my mom dealt with her health issues, including high blood pressure and diabetes, without the help of doctors. As sole breadwinner, she had no time for self-pity. My mom took care of herself, and us, as best she could.

Comparing our lives would be like comparing apples and oranges.

I’m extremely fortunate to have my husband of 42 years by my side. His generosity has been a blessing for my daughter and me. We are truly grateful for his loving care and support.

Whenever I think of my mom it is with deep regret that she could not have enjoyed a better life. One that included a lifelong companion.

Someone of her own to love…and love her.

Someone who would have helped shoulder the burdens…and kiss away her tears.

Someone with whom she might have shared secrets…and belly laughs.

My mom might have been spared much of the physical and mental anguish she suffered throughout her life…had she someone to help pay for her medical care.

Alzheimer’s stole whatever remained of my mom’s indomitable spirit…when she died at 86.

It’s never too late…

…to look to your own well-being…and that of a loved one…whatever their age…

………hugmamma.

wellness…

Posted on January 12, 2013 by hugmamma

It might seem to some of you that I’m forever making reference to certain failings of mine.

Why is that you ask?

Some time ago I read a small, thin paperback on how to write well. One piece of advice stood out from the rest.

Write what you know. That’s just what I’ve tried to do.

For some time now I’ve had health concerns…from chronic inflammation…to digestive issues.

A firm believer in alternative medicine, I see a massage therapist monthly and a chiropractor as needed.

Within the last year or so, things have gone haywire.

naturopath (Photo credit: mugley)

I chalked it up to old age and moved forward as best I could.

I sought help from everyone in my bag of medical practitioners….family doctor…hand orthopedist…gastroenterologist…chiropractor…massage therapist…physical therapist…and most recently, a naturopath.

I credit all of them for bringing me along physically, mentally, and even emotionally.

What I’ve learned from all of them…and from my daughter, a professional dancer…is that life makes perfect health...impossible!

The experts do their best to get my body functioning again. However a resumption of my normal activities eventually erodes the progress made.

That’s life…in a nutshell!

Every now and then, however, there are “aha” moments.

Today I had a followup appointment with my naturopath. I left her office with a lot of good, useful information.

I discovered I’m sensitive to certain foods…almonds, walnuts, peanuts, sesame, wheat, eggs and egg yolks (from chickens…I can eat the ones ducks lay), pineapple, green beans and lima beans, cauliflower, mushrooms, garlic, both baker’s and brewer’s yeast, cheddar cheese, and yogurt.

How will I ever forgo…peanut butter slathered on a slice of bread? Asian food cooked in sesame oil? The occasional glass of wine or fruity martini?

Only time will tell, I guess.

Then there’s the fact that the level of the good bacteria in my stomach is too low to offset the effects of my bad bacteria. As a result, sugar intake increases the growth of the bad bacteria.

Oy vay!

These lips will never taste sugar again. It’s a good thing I got my fill of holiday candies and cookies when I did.

My thyroid is slightly elevated. “Why the concern?” I asked. “It affects your metabolism.” I was told. No doctor had ever…in my 63 years…mentioned my thyroid. Let alone test it.

Now for a little good news. The ratio of my good cholesterol to my bad cholesterol…HDL to LDL…is 1.8. Well within the acceptable range of 0.0-3.2.

As a result of what we learned from my blood tests, we discussed the diet I should follow over the next several weeks. After that I’ll check back to discuss how it affected my overall health.

If the news is positive, I’ll reintroduce some of the questionable foods to see how well I tolerate them. Eggs being the first challenge, according to my naturopath.

Following that eye-opening appointment, I had another one with the chiropractor.

Since my favorite practitioner had the day off, I was treated by a doctor who had recently joined the staff.

After an adjustment that took roughly 20 minutes, I left the office talking to myself.

“WOW!!! Oh, my God! I feel great! My back feels great! My hand feels great! My hips don’t ache! I feel taller! I can stand up straight! I don’t feel so fatigued! My head isn’t fuzzy!”

On and on I mumbled, unable to fathom that all my symptoms could be completely cured in such a short time.

Upon “returning to earth,” I knew it’d take a day or two for my body to settle into the adjustment. Another visit with the chiropractor on Monday will ascertain whether or not he needs to do any tweaking.

My faith in alternative health practitioners has grown steadily over the years. They have helped me understand my body. From them I have learned to take precautionary measures to ensure…quality of life…as I continue to age.

…i write about…what i know…

………hugmamma.

it takes a village…the punch line (read part 1 first)

Posted on January 8, 2012 by hugmamma

This part of the yarn is not as long as the set up…true for most punch line endings.

Image via Wikipedia

According to my husband, present throughout, I was happy…and loving…in the recovery room.

“You were very happy.”

“You kept telling everyone ‘I love you. I love you.’…the nurse who was there the entire time…the Asian nurse who came in for a few minutes to see how things went…and Dr. Patterson.”

“They all smiled and chuckled. As they did when you went on to say ‘This was good. I like this.’ “

“You asked Dr. Patterson if you could hug him. He said “yes” and leaned over for a hug, still in his scrubs and custom-designed cap. In fact when he left, about 10 minutes later, you asked if you could give him a second hug. Again Dr. Patterson let you hug him…smiling the whole time.”

“Then you announced that you would make him teriyaki meatballs. To which he laughingly replied ‘Okay! Anytime!’ “

Throughout my “loving everyone up,” my husband said I was lucid. When the doctor showed me the photos taken during my colonoscopy I was pleased there were no problems. That’s probably why I was so ecstatic.

Besides the colonoscopy, I’d had an endoscopy. Suffering heartburn for some time and having difficulty swallowing certain foods, like rice, Dr. Purdon, my general practitioner, suggested the procedure. Being a gastroenterologist, Dr. Patterson could do both at the same time. How convenient not to have to make 2 trips to the hospital and down nasty liquids twice…yuck! I’m sure Premera Blue Cross is also glad not to see my costs doubled.

Dr. Patterson had thought that there might be a thin membrane obstructing the passage of foods in my esophagus. If there was, the endoscopic tube would easily break the membrane. However the procedure showed no such obstruction. So the only conclusion drawn was that the sticky texture of rice might be an issue. No worries since I normally eat brown rice as a part of my high-fiber diet.

It seems I was focused enough, not totally la-la, to ask if Nexium might be something I should take for my heartburn. In response Dr. Patterson likened the drug to taking out the “big guns” to solve a little problem. Instead he recommended I use Pepcid AC or Zantac, as needed.

Not too long after my “pow wow” with the doctor, he and the nurses left me to get dressed to leave. When the time came to actually walk out I needed the aid of a nurse pushing me in a wheelchair. Even then I continued to say how I loved them all…and that I would be returning with the promised teriyaki meatballs.

I wonder if Dr. Patterson and the nurses have stopped talking about the babbling, Hawaiian islander who couldn’t stop showering them with love, hugs and food? A lot of yada…yada…yada…

…but I meant everything…i did…and said…right down to the meatballs…

………hugmamma. 😉

swedish hospital…a 5-star resort?

Posted on July 14, 2011 by hugmamma

Hubby and I had a date Saturday…touring the brand, spanking new Swedish Hospital in the Issaquah Highlands. We thought we’d make a quick stop, check it out, and be on our way to our real destination…Molbak’s Nursery, gift shop and cafe in Woodinville. Well, we never made it to see the flowers, plants and knick-knacks, or lunch among the lush foliage. Instead we wandered around the new hospital with thousands of other curious tourists to what seemed like a resort, not a place where the sick and maimed go to be cured and put back together again. I’m sure I wandered around, my mouth agape the whole time. We were all like children in a new candy shop, sampling everything with our eyes. I wasn’t the only one who was bug-eyed either.

Walking through glass doors which parted without hesitation, I immediately saw a Starbuck’s to my right…already with a line of people. No small wonder there. Tucked in the corner between the cafe and the front door was the restaurant. Visiting it later, I saw that it was on the caliber of any good dining destination in the community at large. Viewing the grandeur of the Pacific Northwest through the surrounding glass walls would also be a treat…a very calming one for sure.

Wandering further inside through what felt like a grand foyer, a reception desk sat to the left, and next to it a staircase leading to the second floor. Straight ahead was the bank of elevators, and to the right, past Starbuck’s was a gift shop. Rather, I should say, a mall of shops. After touring the floors above, I spent some time wandering in and out of the several stores. This is probably when I most felt like I was not in a hospital.

What appeared to be the main gift shop was lit up with a beautifully handrafted chandelier made by a local artist. Directly beneath was a table also crafted by another homegrown talent. In fact, most of the items in the shop were made here in the Pacific Northwest according to the shop’s lovely manager. She spent a few moments of her time talking with me, smiling all the while. A definite asset to what could be an intimidating environment for some. After all, this was still a hospital.

Walking through an oversized open doorway into the next shop, I delighted in seeing all manner of gifts for newborns and toddlers. Some items I’d never seen elsewhere. Across the way was another, very large, retailer selling exercise clothes, lingerie, and if I’m not mistaken, some maternity items for expectant mothers. One fun gift for you or someone else was a “snap” watch for around $16. The salesclerk kindly showed me how it operated. She stretched out the watchband, snapped it across her wrist, and “voile!” the watchband wrapped itself securely in place. What don’t people invent these days?!?

Down the hallway, next door to the shop with baby gifts, was a small studio for yoga classes. The nice volunteer offered information on how I could sign up for classes. Of course, it involved the internet. What doesn’t these days? Evidently I can check out the schedule for times and styles of yoga on the Swedish Hospital website. I might have to do that. I’ve always wanted to take a yoga class on a regular basis. Good for the body…and mind.

There were doctors, nurses, and technicians milling about to answer any questions. It was amazing to see so many of the staff smiling and relaxed. I’ve usually only seen them hurrying off to tend to patients. And I mean hurrying! Hopefully they’ll continue to smile once they get back to business as usual. I like smiling medical staff. They calm my nerves. Wouldn’t they make you feel more comfortable? They would me.

In October I’ll be having a colonoscopy and endoscopy done by Dr. David Patterson, Medical Director of Gastroenterology at Swedish. I met up with him again at the open house, after having talked with him a month or so ago at our initial consultation. Originally from New Zealand, he retains very little of his accent. Having lived here in the States for 35 years, I can understand why. Dr. Patterson’s ready smile and easy “bedside” manner goes far in steadying my nerves for the impending procedures. Knowing he sees many people in the course of his practice, and having met me only once, I was amazed that he could recall who I was as throngs of people were milling all around us. The key to unlocking his memory about me was that my daughter was a ballerina. We’d discussed it at our first meeting when he asked if I had children. Of course, ask a mom about her offspring…and you’ve got a friend for life. Well, let’s see what I think after the doc goes to work on me in the Fall. I’ll let you know then…

Meanwhile I’ve only good things to say about the new Swedish Hospital and their staff. They’ve served me well for more than a decade, the doctors and nurses, that is. Oh, and the ER team at the old facility. Between my husband and me, we’ve seen them a few times over the years, for various and sundry minor crises, which seemed somewhat major at the time…episodes of asthma, pains mimicking a heart attack. You know, the usual.

The new Emergency Room check-in looked like that in any 5-star hotel. But that’s as far as we went. I’m hoping we won’t have to see the rest of the ER anytime soon. Unfortunately we didn’t do any of the tours offered. The one to see the surgical facility had a line of people the length of the hallway. Since hubby and I were on a “date,” and we’d already spent a couple of hours sightseeing, we decided we’d seen enough to convince us that the hospital was pretty much just what the hype was all about.

it’s what the doctor ordered…and it’s just fine by me…hugmamma.

This slideshow requires JavaScript.

details…little known facts

Posted on July 3, 2011 by hugmamma

Image via Wikipedia

In summing up what I’ve learned about President Ronald Reagan and First Lady Nancy Reagan from reading I Love You, Ronnie, a couple of details came to light which I’d not known before. And according to Mrs. Reagan, only those close to what occurred at the time, knew. The first dealt with the assassination attempt on the President’s life 3 months after he took office. The second was an incident that probably caused the premature onset of his Alzheimer’s. Only a handful, it seems, were privvy to both occurrences.

Waiting for news, Nancy Reagan sat with Sarah Brady, whose husband Jim had also been shot in the attempt on the President’s life.

As we waited, I looked out the window and saw how, in the buildings all around the hospital, people had thrown sheets out the window saying things like GET WELL, MR. PRESIDENT and WE LOVE YOU, MR. PRESIDENT. Every now and then, a nurse would come and report to me on Ronnie’s progress. At first, the doctors were having trouble finding the bullet, which was a devastator bullet, the kind that explodes inside. One time, the nurse came and said, “We just can’t seem to get it out. We may just have to leave it in.” Well, that didn’t sound so good to me. And then another time, she said, “They’ve found it, but the doctor is having a hard time removing it–it keeps slipping from his fingers.” Finally, she came back and told me that the doctor had gotten it out, but I almost lost him then. The bullet had been lodged an inch from Ronnie’s heart.

We were lucky–we didn’t realize how lucky, in fact–because when Ronnie had arrived, all the doctors were in the hospital for a meeting. No one had to be called in. Everyone Ronnie needed was right on hand, and there was no waiting. …

I wanted to stay there all night, but the feeling was that it would be better for the country if I left and went back to sleep at the White House. Otherwise, people would have assumed the worst and there would have been panic. As it was, Ronnie’s aides had to do all they could to calm the country down. The briefings made to the press were partial, to say the least. The assassination attempt was really a much closer call than people were led to believe at the time. Everyone was trying not to frighten the people in the country, but the fact was, Ronnie almost died. It was a miracle that he didn’t. And I knew all along how serious things really were. …

Needless to say, I was terrified. After the shooting, every time Ronnie walked out the door to make a public appearance, my heart would stop–and it wouldn’t start again until he came back home safely. Ronnie knew how scared I was. But if he was frightened too, he never let me know it. As always, he was cheerful and optimistic. God had spared him, he believed; there had to be a reason why. By making jokes…he tried to take the edge off my fear.

Image via Wikipedia

Who could fault the First Lady’s hovering over the President thereafter? No wonder her seeming control of his life, personal and public, for which the media liked to criticize her. I know because they had me convinced she was running the country with her husband, an unofficial cabinet member, as was constantly written and spoken of in the news. How the spinmeisters love to slant the facts. Readers, beware!

Fast forward to July 1989, after the Reagans had left the White House. Visiting with friends Betty and Bill Wilson at their ranch in Mexico, the President went riding. An accident occurred.

Ronnie had been thrown off his horse. He was riding with some other men, going up an incline, when one of the ranch hands had hit something that made a loud noise and spooked Ronnie’s horse.

The horse reared once, and Ronnie stayed on. It reared a second time, and Ronnie stayed on again. Two Secret Service men tried to move in and calm the horse, but they couldn’t do it. The horse reared a third time, bucking so hard that Ronnie fell off and hit his head on the ground, miraculously missing the jagged rocks all around.

Image by edalisse via Flickr

We got him on a plane and immediately took him to a hospital in Tucson, Arizona. He should really have stayed there, but it was my birthday and the Wilsons had planned a celebration, and Ronnie was determined to go back to the ranch. We went back–but at my insistence, we took a doctor with me.

The day after…we flew home. I was very uneasy and kept at Ronnie until he agreed to get his head X-rayed. We went to the Mayo Clinic, where we’d gone every year for checkups. It turned out that Ronnie had a concussion and a subdural hematoma. He needed to be operated on right away. It all happened so quickly that I think, once again, I was in shock. …

I’ve always had the feeling that the severe blow to his head in 1989 hastened the onset of Ronnie’s Alzheimer’s. The doctors think so, too. In the years leading up to the diagnosis of the disease, in August 1994, he had not shown symptoms of the illness. I didn’t suspect that Ronnie was ill when we went back to the Mayo Clinic that summer for our regular checkup. When the doctors told us they’d found symptoms of Alzheimer’s, I was dumbfounded. Ronnie’s fall from the horse had worried me terribly, of course, and I’d had to urge him to take time out to recover after his operation. But I had seen no signs of anything else.

There’s no telling if President Reagan would have enjoyed more years of retirement, free from the debilitating symptoms of Alzheimer’s. How fragile the brain, with only the skull as protection from the hazards of everyday life…like horse back riding. Spared from the assassin’s bullet, Reagan succumbed to no less a devastating end. As his devoted wife, and true witness to her husband’s last 50 years on earth, Nancy Reagan suffered Alzheimer’s alongside him.

Image via Wikipedia

…First of all, there is a feeling of loneliness when you’re in this situation. Not that your friends aren’t supportive of you; they are. But no one can really know what it’s like unless they’ve traveled this path–and there are many right now traveling the same path I am. You know that it’s a progressive disease and that there’s no place to go but down, no light at the end of the tunnel. You get tired and frustrated, because you have no control and you feel helpless. We’ve had an extraordinary life, and I’ve been blessed to have been married for almost fifty years to a man I deeply love–but the other side of the coin is that it makes it harder. There are so many memories that I can no longer share, which makes it very difficult. When it comes right down to it, you’re in it alone. Each day is different, and you get up, put one foot in front of the other, and go–and love; just love.

I try to remember Ronnie telling me so many times that God has a plan for us which we don’t understand now but one day will, or my mother saying that you play the hand that’s dealt you. It’s hard, but even now there are moments Ronnie has given me that I wouldn’t trade for anything. Alzheimer’s is a truly long, long good-bye. But it’s the living out of love.

Photograph of Newlyweds Ronald Reagan and Nanc...

Image by The U.S. National Archives via Flickr

…blest by true love…even in the face of adversity…hugmamma.

no a/c, a stroke, and bedbugs…???

Posted on June 25, 2011 by hugmamma

So we finally come to the end of this tragi-comedy about bedbugs in my daughter’s apartment, the old one that is. Content with having secured a new place in the nick of time, my daughter felt extremely fortunate to have somewhere to go, leaving her unwelcome buddies behind. (Fingers xxxxx.) But just when things seemed to be going her way, the a/c in her new apartment went on the fritz…almost immediately.

Traveling west to be with my husband and me, my daughter missed the initial couple of weeks without a/c in her new digs. A couple of friends took turns trying to have repair people stop by to put more freeon in the old a/c unit. The excuse given by the company who was referred by the apartment’s owner and landlord, was that the technician didn’t have a ladder long enough to get to the roof where the unit stood. When my daughter and I returned to her home, that was the same excuse given by a couple of other a/c servicers. In fact one technician who did come, left without even telling us he couldn’t do the job. Not until an hour-and-a-half slipped by without a knock at the front door, did my daughter learn after calling his company that he left because they don’t service that particular brand. Upon relaying this info to the landlord, he exclaimed that the company got the brand name wrong. He indicated he would try to track down another company through the insurance he had for repair services. My daughter also gave him the name of the company whose truck we had seen in the parking lot of the neighboring apartment house, the same day our disappearing a/c guy showed up. Those workers looked like they were diligently working to get some problem resolved, even in the sweltering 90+ temperatures. As it turned out, a couple of men from that company visited my daughter’s apartment later that afternoon.

Upon checking the interior part of the a/c unit in my daughter’s apartment, it was determined that there was a leak. After reporting this to the landlord, the company’s co-owner visited us the next day under orders to do whatever it took to fix the a/c. Because it was so old, the replacement part could only be gotten from a manufacturer in Texas. It wasn’t expected to arrive until the following Tuesday, so that the a/c couldn’t be fixed until Wednesday or Thursday. That meant several days of sweltering heat inside the apartment.

Happy that the a/c was going to be fixed, I didn’t calculate the hours we would have to suffer through the 90+ degrees even as we tried to sleep. I imagined with 5 fans blowing day and night we would manage. Was I ever wrong! One night is all it took to decide that my aging body was not up to the task. I awoke to find my hands and fingers, feet and toes swollen. The blood had rushed to the surface of my skin as if to escape the confinement. I’d never had to worry about high blood pressure before. But I was certain if I slept there another night, my pressure would be through the roof!

And that’s why we made the unlikely decision to bed down with the bedbugs, my daughter on the couch, me on the bed in the second bedroom. Because both had been treated, we hoped we wouldn’t make a hearty 9-course meal for any starving bedbugs. I think we willed ourselves not to scratch.

My daughter’s new landlord must’ve “paid an arm and a leg” to repair the a/c. Besides it being an emergency repair with a new servicer, the necessary part had to be Fed Exed from out of state, and a crane was hired to haul the a/c from atop the apartment building so that it could be fixed on the ground and then put back in place. Added to that, the servicer had to repair the indoor unit which had been leaking the freeon. Why the a/c was installed atop the three-story building in the first place is unknown to us. I guess things were done differently in the 70s. But it was while my daughter and I were waiting for the a/c to be fixed that we got food poisoning. After that, everything else became “background music.”

A Bed Bath and Beyond store in a shopping cent...

Image via Wikipedia

How did we manage to contract salmonella, you ask? Well on one of our outings to Bed, Bath and Beyond to secure new pillows and their corresponding bedbug resistant covers, we stopped to buy a few groceries on the way home. Remember, the temperatures were in the mid-90s. Deciding to eat a light, healthy lunch, we opted for a veggie platter. Not realizing that the included dip was probably turning rancid as we drove another 20 minutes home, we proceeded to chow down once there. With floor fans set to their highest levels, we munched away feeling the cool blasts on our faces and bodies. Mind you, the indoor temperature over the next several hours was also in the mid-90s. It’s my belief that we were ignorant to the fact that salmonella was probably making its way into our digestive tracts. My daughter’s case may have been slightly more severe since she also feasted on a dessert of chocolate pudding pie. Something we’d picked up from a nearby restaurant the day before, which served up real southern cooking, a haven for high cholesterol foods.

As I mentioned before, my daughter’s recovery from food poisoning went relatively smoothely. There were no residual effects, unlike my bout. While my vomiting and diarrhea ended, the nausea, queasiness, and mild dizziness persisted. I just didn’t feel 100%. A couple of times I was overcome by tears, so frustrated that I couldn’t attack the chores with the same gusto I’d had prior to being ill. The second time was when I heard my husband’s voice on the phone asking how we were. Bawling, I told him how much I missed him and couldn’t wait for him to arrive to assume control. My brains were “fried,” I told him.

I’d wanted to accomplish so much before my husband joined us. Because of the extreme heat and humidity I feared his asthma would flare up if he tried to do too much. I didn’t want him landing in the ER during his short, four day visit. I even contracted a private mover to transport my daughter’s large pieces of furniture from one apartment to another. The price was fair for the heavy lifting involved, and the 2 flights of stairs the men had to climb at her new place. My husband was immensely grateful for my last minute decision to hire someonelse. He’d forgotten how weighty the huge, glass bookcase was. Not one to drink bottles and bottles of water, my husband felt moving such massive furniture in the heat would have been very difficult for him. I also took pity on any male dancer friend of my daughter’s who had offered their services. I didn’t want their aches and pains or worse, broken bones, on my conscience.

Grateful for my husband’s contribution to our ongoing efforts to move stuff from storage to the old apartment, and then to the new apartment, I continued to deal with the lingering effects of food poisoning. It was distressing to have to stop what I was doing and rest until I felt better. I attempted to ignore what I was feeling, but wasn’t able to in the end. I had to give in, and go with what was happening. Such an occasion occurred while we were shopping for hardware at a local Lowe’s Hardware.

A typical Lowe's storefront in Santa Clara, Ca...

Image via Wikipedia

Walking up and down the aisles looking at storage paraphernalia, I felt lightheaded, as if I were about to faint. After a few more aisles, I nearly passed out. We decided to leave, my husband quickly making his purchases. He headed out to get the car so that he could pick me up at the exit. My family and I decided I should go to a nearby walk-in clinic.

Upon arrival at the clinic, I felt spacey. My husband and daughter each held an elbow as they escorted me inside where I immediately took a seat. My husband checked me in and filled out the necessary paperwork. When my name was called, my daughter accompanied me in to see the doctor. After waiting a short while, he appeared. After asking me questions, and listening to my replies, he asked me to follow his moving finger with my eyes. I did okay although I felt myself struggling a bit. The doctor then asked me to stand and walk towards him, which I did with some hesitation. After I sat down, he advised us that I might be having a stroke. I must admit, strokes never come to mind when I feel something might be awry. Heart attack, maybe. Stroke, never. And yet two of my brothers have had strokes, serious ones, from which they’ve thankfully recovered.

Image via Wikipedia

At the doctor’s insistence I went to the nearest ER. I think my husband and daughter were somewhat alarmed as we drove to the hospital near my daughter’s new apartment. I was going to the same ER I’d taken my daughter to in February, when she suffered from an unremitting migraine headache. I think I felt relieved that I might finally discover why I wasn’t “up to snuff.” I was really sick of feeling sick!

Unlike the lengthy wait my daughter had during her prior visit, I bypassed much of the bureaucratic mumbo-jumbo because I was a possible stroke victim. It didn’t help when I burst into tears because I couldn’t remember what day it was when the receptionist asked me. I turned to my husband for help, crying as I asked him what day he’d arrived. Even as I lay on the hospital bed answering the doctor’s questions, I felt I had to will myself to relax, taking my time to mouthe the answers.

Treatment began with forcing fluids into me intravenously, along with a medicine for nausea. After that there was an EKG, cat scans of my brain, and abdomen (I’d felt a sharp pain when the doctor’s hand compressed my side), and a chest xray. I’d also given them a urine sample. Happily, all tests came back negative for a stroke, heart problem, appendicitis, or anythingelse. And by the time the fluids had made their way throughout my body, I was feeling much better. So in the end I was probably suffering extreme dehydration brought on by my bout of food poisoning, and possibly some heat exhaustion as well.

With my new lease on life, we finally settled our daughter into her new apartment, cleaned out the old one, assembled a treasure trove of stuff for her to cart off to Goodwill, and transported a nominal amount into her storage unit for safekeeping. The last 2 nights my husband and I were with her, my daughter and I were up Saturday until 4 a.m. putting things away. On Sunday my husband fell asleep on the air mattress (not the old one, but a new one) at 2 a.m. I remained up again with my daughter, laying down for just one hour before getting up to prepare myself for the trip home to Seattle. Grateful for all my husband and I had done, our daughter tumbled contentedly back into bed after our car drove away.

I’m sure you’ll understand now why my daughter and I agree that “you should let the bedbugs bite.” It makes life a helluva lot easier that way…

Image by LarimdaME via Flickr

you think?…hugmamma. 😉

a role model?…more than

Posted on March 23, 2011 by hugmamma

Most of you know of my dear friend Sylvia. From time to time she visits me on the internet, sharing some juicy tidbit sent by her UK network of friends and family. I first wrote of her in my post, “role models, aging gracefully,” dated 8-24-10.

My friend who’s 70ish is admirable not only because she’s such a fashion-plate, which she is, but also because she is laden with health issues that would bring a younger, stronger woman, like me, to my knees. I’m a wuss by comparison. Like an older sister, sometimes a mom, my girlfriend was a smoker for many years, but was finally able to kick the habit. Whether as a result of smoking or having had it beforehand, she continues to suffer with emphysema which is compounded by asthma. Weighing under 100 pounds she’s a lightweight, but she can be as “tough as nails” when debating her opinion. I’ve never tested her, and am not about to try. I’d rather have her in my corner. When a coughing fit overtakes her, she can easily bruise some ribs. As a last resort her doctor prescribes prednisone which eliminates the cough, but leaves my friend with side effects that linger. She has bouts of diverticulitis which has her curled up in great pain. Throughout our 13 years of friendship, she’s been poked, probed, xrayed, cat-scanned, MRI’d more than anyonelse I know. With the help of a physician who’s cared for her, REALLY CARED, my amazing friend always seems “as fit as a fiddle.” I forget her medical history until another episode occurs, and it always does.

I think I dress rather smartly, but when I’m out with my friend and her husband I know she’s outdone me. Not that I mind, for I am simply in awe of her sense of style, wearing skirts and dresses that I never would, simply because they wouldn’t look as well on me. They’re not my “cup of tea,” but they suit my girlfriend to a tee. And the jewelry, she can wear several gold bangles, rings on several fingers, including on her toes, and of course, earrings. Stunning is the only word to describe her. Whether she’s lounging at home or stepping out, in my estimation, she’s always “dressed to the nines.”

You can continue to read more wonderful things about Sylvia, for there’s definitely more good things to be said about her, by going to the original post mentioned above. I just wanted to give you an inkling of who she is, before you read further. And you’ll want to read further, I guarantee you. Enjoy this little “gem” from Sylvia…

NO CHEATING!!!

I was really surprised to find out who my role was.

DON’T scroll down until you do the SIMPLE math below. It’s crazy how accurate this is!

NO PEEKING!

1) Pick your favorite number between 1-9
2) Multiply by 3, then
3) Add 3
4) Then again multiply by 3 (Go get the calculator…). You’ll get a 2 or 3 digit number
5) Add the digits together

Now scroll down…

With the last number, see who YOUR ROLE MODEL is from the following list:

Image via Wikipedia

1) Bill Clinton
2) Oprah Winfrey
3) Jessica Simpson
4) Sarah Palin
5) Laura Bush
6) Hilary Clinton
7) Ronald Reagan
8) Ron De Roma
9) my friend Sylvia
10) Barbara Walters

I know. I know. I just have that effect on people. One day, you too can be like me.

P.S. Stop picking different numbers! I AM YOUR ROLE MODEL! Deal with it!!!

now she’s your role model too…gotta love sylvia…i do…hugmamma.

“affection, good for you,” experts

Posted on February 3, 2011 by hugmamma

No need to convince me. I’m a hugger, and a “masher.” But maybe these experts will persuade those of you who need convincing.

The moment we indulge our affections, the earth is metamorphosed…Emerson

Talk not of wasted affection. Affection never was wasted…Longfellow

“You’re the first man who has hugged me since my husband died seven years ago!”…elderly woman to author Leo Buscaglia

“It’s like going home again.”…a man who exchanged hugs with author Leo Buscaglia

…arrive at a state in which all contact seems repellent, where to touch or to be touched means to hurt or be hurt. This, in a sense, has become one of the greatest ailments of our time, a major social disease of modern society that we would be well to cure before it is too late. It the danger remains unheeded then–like poisonous chemicals in our food–it may increase from generation to generation until the damage has gone beyond repair…Desmond Morris in “Intimate Behavior”

A simple caress has the potential of changing a whole life. The warm embrace, withheld at the vital moment when it is most desperately needed, can easily be the act, or rather the non-act, that finally destroys a relationship, or even a nation!…Leo Buscaglia in “Loving Each Other”

Hugging can lift depression–enabling the body’s immune system to become tuned up. Hugging breathes fresh life into a tired body and makes you feel younger and more vibrant. In the home, daily hugging will strengthen relationships and significantly reduce friction…Dr. Harold Voth, psychiatrist at the Menninger Foundation in Kansas

…when a person is touched, the amount of hemoglobin in the blood increases significantly. Hemoglobin is a part of the blood that carries vital supplies of oxygen to all organs of the body–including the heart and brain. An increase in hemoglobin tones up the whole body, helps prevent disease and speeds recovery from illness…Helen Colton in “The Gift of Touch”

We can all benefit by learning to express and meet our physical needs in a loving, caressing way. Thus, I give many of my patients a homework assignment: During the upcoming weeks, they are to get and give four hugs a day. I even write out a formal prescription that says simply, “Four hugs a day–without fail.” Don’t ever underestimate how powerful this therapy can be, and the role it can play in the healing process. And it’s a safe prescription, too. To my knowledge, no one has ever died of an overdose of hugging. However, as one of my patients told me, “It is addicting. Once you start hugging, it’s a hard habit to break!”…Dr. David Bressler, while director of the Pain Control Unit at UCLA

I’m living proof that hugging is the greatest form of therapy for whatever ails me, and very much habit forming. I couldn’t give up hugging if I tried. Hugging and outward affection are who I am.

sending you early hugs for a happy valentine’s day!…hugmamma.

moms do what’s needed

Posted on January 28, 2011 by hugmamma

Got a surprise call from a blogging friend today. Jaclyn and I met months ago in Cat Rambo’s “Blogging 101” class at Bellevue College. I got good vibes from Jaclyn while in class. And she’s every bit as nice as I thought she would be.

During our conversation today, she reminded me what her life is like on a daily basis. For 18 years Jaclyn has been caretaker for her only child. While this doesn’t seem an unusual situation from that of other moms, her situation is unique in that her daughter has a rare disease known as Galactosemia, a milk sugar disorder.

Galactosemia is a rare congenital disorder which affects the body’s inability to convert galactose into glucose. Galactose is a type of sugar, which is a breakdown product of lactose. Lactose is found in milk and milk products, including breast milk. Given that the galactose can not be broken down, it builds up in the body and acts as a poison that can cause serious damage to it‘s carrier(“galactosemia“). “As milk is important to a baby’s diet, early diagnosis is essential to avoid lifelong problems from this potentially fatal disorder.”

The first trace of information that was brought to light about galactosemia was in 1908 by Von Ruess. He composed an article of his findings in an infant with many of the symptoms we now relate to galactosemia. This work has widely been accepted by scientists as the first reported case of galactosemia. However, at this time the diagnosis of galactosemia was not yet possible. It would be nine years before a similar diagnosis of galactosuria was largely accepted by scientists as a hereditary disorder.

At the time Jaclyn’s daughter was born, galactosemia was not yet within the mainstream of medical knowledge. So doctors failed to correctly diagnose her digestive problems. Meanwhile the disease took its toll on the youngster’s body, leaving her permanently handicapped, mentally and physically. Having recently turned 18, the young woman reads at the level of a 4th grader.

Needless to say Jaclyn has been at the forefront of fighting her daughter’s fight to make the most of her life, such as it is. Where schools were not willing to pursue academics at a more challenging level, consigning her daughter to classes for children with special needs, Jaclyn decided to home school instead. With the help of other adults, her daughter is experiencing as full a life as she can. Their assistance also allows my friend some much-needed respite from her 24/7 role as caretaker.

Surprisingly, or maybe not, I never find anything in my friend’s voice to suggest that she is pained to be saddled with her daughter’s predicament. Jaclyn sounds like other moms I know who love their children, and do what needs to be done for them. Jaclyn is always upbeat, never belaboring the fact that her child is, in fact, unlike those now capable of venturing forth to make their own way in the world.

When Jaclyn calls it’s usually to ask how I’m faring with my blog. The last time she phoned it was to suggest an online site where I might want to self-publish. Today she recalled that I’d mentioned that my writing skills were honed when I had served as a paralegal for TWA in NYC. She wondered if I had the title of the book which had been instrumental in my learning to write. I replied that I learned on the job. I was enrolled in classes at night to obtain a paralegal certificate, a condition for the job to which I had already been promoted. So writing legal briefs for the attorneys with whom I worked during the day, quickly instilled me with the skills I still possess today. I learned to organize my thoughts on paper, and offer support for my assertions. Blogging has enabled me to regain my skills as a writer, after a 24-year hiatus.

When I asked with what she was currently involved, Jaclyn explained that she’s trying to secure social security benefits, however meagre, for her adult daughter. We both agreed that government bureaucracy can be mind-boggling. Because galactosemia is unfamiliar to most, she has found it daunting trying to convince bureaucrats of her daughter’s disability which has essentially robbed her of an independent life.

Ending the phone call with her usual laughter, Jaclyn admitted to signing up for Cat Rambo’s class on the writing of fantasy stories. My friend wants to take a breather from reality, and escape to the land of fantasy. God knows she deserves to enjoy a little make-believe.

for a mom whose life is her daughter’s, huge hugs…hugmamma.

on a mission to clean up the “mess”

Posted on January 6, 2011 by hugmamma

Straying from a somewhat healthy regimen the last couple of months had me ending up a mess, literally. While my daughter retained some semblance of her usual diet, I threw caution to the wind and gorged. It didn’t happen overnight; it never does. And it didn’t sneak up on me, not really. My hand and my mouth became best buds. My hand kept shoveling tasty morsels into my open mouth, which just couldn’t seem to get enough. I think Halloween, with its usual tempting delights, got me started, and I never looked back. Beware that first delectable bite! Needless to say, I’m on a mission!

“Cervical thoracic strain” (doctor’s words), combined with heartburn, had me laying awake a couple of nights several weeks ago wondering if I was in the throes of a heart attack. After spending a restless night analyzing my symptoms, I got the first available appointment with a doctor the following afternoon. Suspecting I might be experiencing muscle pain, I saw my chiropractor first. Her adjustment provided some relief, so that when I saw the internist I had already surmised that chronic pain was the real culprit. An EKG, performed just to be sure, corroborated my diagnosis. A much-needed massage a few days later, brought almost complete relief. It loosened up all the tight muscles in my neck, shoulders and back, that had probably been creeping upwards for months, as a reaction to internalized stress over my daughter’s situation, and the holiday crush. I’ve a physical therapy appointment next week. I’m hoping it’ll work out the few remaining aches and pains.

Prilosec works well to resolve my intermittent heartburn. I’ve a few days left of that regimen. But just when one set of issues was minimized, another came calling. Let’s just say it had to do with my “plumbing.” Seniors will know what I’m talking about. Younger folk, like my daughter, would say “TMI! TMI!” All I’ll say is it’s no fun seeking medical help from an ER doctor. Been there, done that, don’t ever want to do that again. Uh, uh, no way.

So while I was recovering from that bad experience, I caught my husband’s cold, and couldn’t stop hacking my head off, coughing and coughing, relentlessly. More sleepless nights until yesterday, when I finally drove myself to a walk-in clinic. The doctor prescribed an antibiotic for a sinus infection, an ailment I suffered annually in the past, but which I’ve not had for a couple of years. Because drugs are hard on the liver, I prefer not to take antibiotics. But it already seems to be working its magic, for my coughing has lessened considerably. As with all things, moderation is the key, and everything has its time and place. Although, the drug I’m taking has also done a number on my “plumbing,” in the other direction. Okay, okay. TMI! TMI!

I’m reading several books concurrently, one of which is “Healthy Aging – A Lifelong Guide to Your Well-Being,” by Andrew Weil, M.D. On page 1 of its introduction, Dr. Weil says something with which I fully agree.

In 2002, I turned sixty. To help celebrate the occasion, friends organized a surprise party for me. After the festivities, there came a time to reflect, and when I did I came to an uncomfortable conclusion: I am closer to a time when my energy and powers will diminish, when I will lose my independence. Sixty is about the time that organs of the body begin gradually to fail, when the first hints of age-related disease begin to appear.

I hardly notice my aging on a day-to-day basis. When I look in the mirror in the morning, my face and white beard seem the same as the day before. But in photographs of myself from the 1970s, my beard is completely black. Looking at old photographs, I can’t help but notice the physical change that has taken place in the course of thirty years. If I pay attention, I can notice other changes in my body: more aches and pains, less resilience in meeting the challenges of traveling, less vigor on occasion. And my memory may not be quite what it used to be. At the same time, despite the evidence, some part of me feels unchanged, in fact feels the same as when I was six. Almost everyone I talk to about aging reports similar experiences.

It’s true, all true. You’re invited to continue journeying with me through the aging process. Perhaps it’ll give you a heads up when your time comes, or maybe you’ll nod your head in recognition of an experience or two that “rings a bell.”

for aging gracefully, huge hugs…and a mountain of effort…hugmamma.

inhale…exhale…2011

Posted on December 31, 2010 by hugmamma

Not sure what the holidays have been like for you, but they seemed like a whirlwind to me. I finally feel I can breathe again, deep breaths that is, not short, gasping-for-air breaths. While I got a tremendous head start on decorating for the season, completed a couple of days prior to Thanksgiving, my life seemed to move in slow motion after that. Not that everything around me did likewise. No. It was as though I was in the audience, watching my life unfold on a theatre screen. Much of it was a blur, like going through the motions, mindlessly. Many decisions, big and small, were probably made half, not wholeheartedly. But I made it through the “speed boat ride,” enjoying the scenery that sailed by me as best I could.

Since my daughter returned home in October to recover from health issues, I’ve set my life aside. Moms do that. Nothing seems more important at the time than seeing one’s child happy and healthy again, nothing. Tears come easily when my daughter’s life has gone awry, for whatever reason. While it’s natural to advise her that things will get better, that life experiences build character, that everyone faces challenges, it seems like a never-ending repertoire of blah, blah, blah that moms access so readily. So after two-and-a-half months of it, I’m worn to the bone.

The great news is that my daughter’s feeling great, so great, that she’s returning to work on Monday, a month earlier than expected. So her support system here at home worked fabulously, from doctors and their staff, to family and friends. Even her bosses and coworkers rallied around. It was like circling the wagons in the days of the Wild West, to better fight off the attacking Indians. Well it took a “village” to successfully battle my daughter’s “Indians.”

So our family is counting its blessings as the New Year begins. My husband and I have already begun our healthful regimen, eliminating unnecessary calories and saturated fats, and exercising at least half-an-hour daily. This is not new to 2011. It’s actually a “renewal,” since we always lose sight of our resolve throughout the old year. Life has its ups and downs, as do our eating habits. But we remain positive, and hopeful.

Recent news from a fellow dancer left our daughter elated. Upon returning to work, she will be learning the soloist’s role in a contemporary piece being staged upon her ballet company by an internationally renowned choreographer. For a dancer, that’s like taking home Olympic Gold. For our daughter, recovering from a health setback, being given the role is tremendous recognition for a decade of passion, hard work, sacrifice, and always smiling while “picking herself up and dusting herself off.”

My daughter’s journey is proof positive that a commitment to hope can have great results. But my advice to her has always been that she should enjoy the process, for even if the end result is not what she hoped for, she will have fully lived each moment along the way. And true happiness is knowing who she is every day of her life, and having no regrets about any of it, including the not-so-good moments.

And so I have no regrets about the last few months, for I did what I do best…mother. Now I must “pick myself up, dust myself off,” and return to nurturing my mind, body and soul, and that of my husband’s. As the old adage goes,“There’s no greater love than that we lay down our lives, one for another.” Doing so for my child is a no-brainer.

take a deep, luxurious breath…and dive into 2011…huge hugs…hugmamma.

“a fox in the hen house?”

Posted on October 29, 2010 by hugmamma

Health care is rampant in the news these days. One article that got my interest in the Wall Street Journal on 10/27 was “Physician Panel Prescribes The Fees Paid by Medicare.” As my husband and I near retirement age, Medicare looms large on the horizon. I’ve already gotten an earful from friends, who gave me one more reason to take care of my health now.

The article, written by Anna Wilde Mathews and Tom McGinty, gives insight into the significant role played by physicians, in determining how much doctors are paid by Medicare.

Three times a year, 29 doctors gather around a table in a hotel meeting room. Their job is an unusual one: divvying up billions of Medicare dollars. The group, convened by the American Medical Association, has no official government standing. Members are mostly selected by medical-specialty trade groups. Anyone who attends its meetings must sign a confidentiality agreement.

Yet the influence of the secretive panel, known as the Relative Value Scale Update Committee, is enormous. The Centers for Medicare and Medicaid Services, which oversee Medicare, typically follow at least 90% of its recommendations in figuring out how much to pay doctors for their work. Medicare spends over $60 billion a year on doctors and other practitioners. Many private insurers and Medicaid programs also use the federal system in creating their own fee schedules.

The problem, it seems, other than the obvious one mentioned by Tom Scully, a former administrator of the Medicare and Medicaid agency that “it’s not healthy to have the interested party essentially driving the decision-making process,” is that the committee is “contributing to a system that spends too much money on sophisticated procedures, while shorting the type of nuts-and-bolts primary care that could keep patients healthier from the start–and save money.” Dr. Barbara Levy, Seattle gynecologist and RUC chairwoman has indicated that the committee is aggressively moving “to correct evaluations that lead to higher-than-appropriate payments for some services.” Next month Medicare will render doctors fees for 2011, which should include the committee’s recommendations.

Another inherent dilemma in the assignation of monetary values to medical procedures, is that doctors will be motivated to perform those that pay more. An inevitable by-product is spending growth, since there’s “all the associated costs for hospitals, lab tests and drugs.” Also of great concern are Journal findings that “services were paid too generously in some cases because the fees were based on out-of-date assumptions about how the work is done…more than 550 doctor services that, despite being mostly performed outpatient or in doctors’ offices in 2008, still automatically include significant payments for hospital visits after the day of the procedure, which would typically be part of an inpatient stay.” As an example, is an operation to treat male urinary incontinence which, according to Medicare’s 2008 statistics, were performed as outpatient services or in doctors offices 80% of the time. But because the procedure was last evaluated by RUC in 2003, the service still “wraps in payment for 118 minutes of hospital visit time after the day of surgery.” However, the Journal goes on to say that it’s unclear if the committee will suggest doctors now be paid less for the procedure anyway.

Granted, there’s great debate among physicians as to the value of medical procedures based upon personal experiences. It’s also fair to say that nobody wants to surrender what they’ve already come to expect in financial recompense. Nonetheless, having RUC rely “heavily upon surveys performed by doctor specialty groups, requiring as few as 30 responses,” with the instruction that it “is important to you and other physicians because these values determine the rate at which Medicare and other payers reimburse for procedures,” is an enticement to score high. “William Hsiao, the Harvard professor who led the original physician-work research used to set Medicare fees, argues the approach is almost guaranteed to inflate the values used to calculate fees. ‘You do not turn this over to the people who have a strong interest in the outcome.’ he says. ‘Every society only wants its specialty’s value to go up….You cannot avoid the potential conflict.’”

Medicare requires that out-of-sync payments be reviewed every 5 years. MedPac, a congressional watchdog, reveals that “ in the three previous reviews, the RUC endorsed boosts for 1,050 services, and decreases for just 167.”

Reimbursements for placing cardiac stents in a single blood vessel are based upon a 1994 RUC analysis. In 2008, doctors were paid $205 million for 326,000 such procedures. Cardiologists suggest that stenting today, as compared to the mid-1990s, “is more routine and may often be less stressful.” According to David L. Brown, cardiologist at SUNY-Stony Brook School of Medicine, ‘The example used to set the code’s value is ‘way out of date,’…’In those days, stents were used when you were having a catastrophic event or thought you might have a catastrophic event.’ Stents and the catheters used to thread them into arteries are now smaller and easier to use, he says. The time varies by patient, but Dr. Brown says he required around 45 minutes on average to perform a single-vessel stenting. The RUC’s valuation suggests a two-hour procedure.”

On the other hand RUC member, representing The American College of Cardiology, and director of cardiology at Geisinger Medical Center, James Blankenship feels the stenting procedure is “ ‘fairly valued’. ” While he agrees that 2 hours may be too long, he “argues that the procedure may be harder because cardiologists now take on challenging patients who might once have gotten bypass surgeries.”

While we may not be inclined to question cardiologists’ fees since they have the power of life and death over us, how about payments for carpal tunnel surgeries. “A study published this June in the journal Medical Care Research and Review found the procedure times used by the RUC to calculate values may sometimes be exaggerated.” While Medicare’s payment of $44 million paid in 2008 was based upon a procedure time of 25 minutes for carpal tunnel surgery, Sullivan Healthcare Consulting Inc, which keeps the hospital database, showed the average time for teaching hospitals, based upon 2,602 surgeries was 17 minutes, and for community hospitals, based upon 4,093 surgeries was 18 minutes. Meanwhile, RUC’s figure of 25 minutes came from “39 surveys of surgeons, out of 150 sent out by groups representing hand surgeons, orthopedic surgeons and plastic surgeons.” Upholding Medicare’s payment, former medical director for the American Academy of Orthopedic Surgeons, Robert H. Haralson III, says the “payment isn’t too high, because the surgery is a more intense procedure than the current value implies.” And RUC leaders wrote to the medical journal insisting that the article was “outdated” and that different standards were used to classify the procedures than that used by the committee. I guess they were suggesting that it was like comparing “apples to oranges.” Hmmm.

It seems we must leave matters in the capable hands of RUC’s head Dr. Levy who assures us that the committee “has reduced values for nearly 400 services in the past and it is now reviewing hundreds more.” And in answer to primary-care groups who are pushing for more representation, we should accept her retort that “ ‘The outcomes are independent of who’s sitting at the table from one specialty or another.’” We should also feel reassured by Jonathan Blum, deputy administrator for the Centers for Medicare and Medicaid Services, who “says that for now, ‘we are comfortable’ with the RUC process. The federal health-care overhaul requires the government to insure that the doctor-fee values adopted by Medicare are accurate. ‘We’re not going to rubber-stamp recommendations,’ he says.”

I feel so much better now.

Yeah right!…hugmamma.