The Good Doctor 🩺

I know that’s the name of a TV show (I’ve never watched it), but I’m talking about a very good doctor I saw today, and that helps to balance the poor experience I had with the orthopedic surgeon last month.
https://enchantedseashells.com/2023/02/18/not-the-bees-knees-%f0%9f%90%9d/

A few years ago, I had a series of white flashes that warned of a retinal tear in my left eye–DANGER AHEAD!

Fortunately I caught it early, so it wasn’t yet detached and therefore able to be repaired by a laser. https://enchantedseashells.com/2022/03/16/i-see-you-eye-health-seriously/

In a roundabout way, that’s how I ended up meeting Vice President Al Gore. https://enchantedseashells.com/2015/11/04/i-met-vice-president-al-gore-at-the-apple-store/

Every year, I return to the retinal specialist for a comprehensive check of both eyes.

This was a completely different situation to the ortho; night and day.

Usually I see the female specialist but she wasn’t available, so I was warmly welcomed by one of the senior doctors in the practice.

We exchanged pleasantries and courteous chitchat while he readied the tools to see behind my eyes.

Continually gentle and respectful, with reassurances and explanations during the exam, including me in the process to let me know what, if anything, had changed since my last visit.

There was none of that disdain, no eye-rolling, no rush to get me in and out. He kindly explained the details of the exam procedure, answered my questions, and eased my worries about any deterioration or new tears or leaky vitreal fluid.

After the exam, which revealed that everything appeared healthy, he shook my hand and told me not to worry and he’d see me next year.

That’s the way to do it. Thank you, Doctor R! Peace of mind is priceless.

Not the Bees Knees 🐝

Of course I had to research the origin of that term "bees knees". The phrase was originally an 18th century fanciful phrase which referred to something that didn't exist. It was used as the kind of spoof item apprentices would be sent to the stores to fetch - like tartan paint or a left-handed hammer. That meaning is no longer used. In the Roaring Twenties in America, bright young things invented nonsense language to refer to things that were 'the tops' - like 'the cat's pajamas', 'the snake's hips' and so on. They utilized the existing 'bee's knees' phrase to add to that list. The expression has since spread and is now used worldwide to mean 'excellent/the very best'.

🐝 🐝 🐝 🐝 🐝 🐝

My visit with an orthopedic specialist was unsatisfactory on many levels.

First of all, the referral happened to send me to the same office that I had been to in the past for other random fractures and torn ligaments, which I thought was a great coincidence.

However, there was a major difference.

Before, I had PPO health insurance, (Preferred Provider Organization), which offers more doctor flexibility and has a higher monthly premium.

Now I have an HMO (Health Maintenance Organization), a network of health care professionals and hospitals who agree to provide medical care at minimal costs.

See the difference?

With PPO insurance, the attitude of staff and doctors is markedly more welcoming when scheduling an appointment than when you call to see a doctor who has first been referred by one’s primary doctor in an HMO. In fact, you can only see a specialist IF it’s been approved and authorized by the primary physician (who’s usually an internist) with a letter of referral from the insurance company.

I had always been treated respectfully — not this time, however!

Initially, when I called to make the appointment and they looked up my previous visits, the communication was pleasant and professional UNTIL I told them I had different insurance, no longer a premium PPO, but an HMO.

She said “Oh”. Her voice changed; her attitude changed. I didn’t think too much of it, didn’t take it personally, maybe it was a busy day or the scheduler had other things on her mind.

When I arrived for my consultation, to be fair, the front desk employees were friendly and professional which bolstered my view that the slight rudeness was a one-off…

However…

I finally saw the doctor about thirty minutes after my appointment time. From the moment he entered the room, I sensed that he was annoyed. He never made eye contact with me. He sat on his stupid little round stool and said “What’s the problem?” and when I I started to explain how it all occurred, he interrupted me to say, “But why are you here TODAY?”

As I started to explain, I could tell he wasn’t listening. He had that faraway look in his eyes that some people get when you know they’re not paying attention. My appointment was in the morning so it wasn’t like he had endured a full day of complaining patients.

He abruptly said, “Sit on the table and let me do an exam”.

It was rushed and cursory. He turned my knee in a few different directions, one of which caused a REALLY sharp pain, and then he pulled my shoes off without warning.

Let’s back up.

I’ve mostly always had great relationships with medical professionals. I like to consider that I’m an informed team member in my own health issues. It’s my body and all that. Because I know a bit about medicine, I feel that I offer valuable insights and points of view that MOST doctors seem to appreciate. I can talk the talk, as it were.

But while I was on the exam table, HE PULLED MY SHOES OFF.

He didn’t ask if I was OK with it, he didn’t ask ME to unlace and take off my workout shoes, he roughly pulled them off my feet — still laced up — and tossed them on the floor.

To me, that was absolutely disrespectful. No one should touch any part of one’s body without permission. Dignity, respect, and civility is not too much to ask of anyone, right?

I was definitely receiving the budget office visit, that’s for sure.

I asked a bunch of questions like I always do and he was SO ANNOYED with me, he didn’t even try to hide it. I could sense the eye roll…

Can I repeat that he never once made eye contact?

While my shoes were still off and on the floor, he opened the door and walked out of the room, turning around to say, “I’ll explain your MRI and x-rays.”

I said, “Am I supposed to follow you?”

No answer.

“Do I have time to put my shoes on?”

No answer.

So…I took my sweet time jumping off the table, bending down to pick up my shoes, unlacing my shoes and then put them on, re-lacing each shoe with a beautifully arranged bow, mindfully, lol.

I wasn’t feeling very comfortable with him as a doctor I’d ever allow to treat my knee.

His assessment of the data was pretty much as the MRI report stated, only more bleak because part of my knee is bone on bone, that’s why it hurts to do squats or lunges.

Here’s what he said, “When it gets bad enough, you’ll want knee surgery.”

“In the meantime, don’t do squats or lunges.” The unspoken words were apparently, “don’t be STUPID” and do squats or lunges.” He didn’t have to say that because his pass-agg attitude was clear.

He also offered to give me a cortisone injection. When I said that I have a bad reaction to steroids, he used “air quotes” to repeat what I said as if he didn’t believe me (really a jerky misogynist move) and instead offered a plasma injection spun out of my own blood which MY insurance doesn’t pay for and is $700 per injection.

“So what do you want to do?” he asked.

I responded that I’d discuss his opinion with my primary physician before I could intelligently decide any course of action, but it’s not bloody likely that I’ll have surgery that includes a recovery time frame of up to twelve weeks OFF my feet. Not bloody likely.

As he was halfway up off his stupid little round stool with his hand already on the door, I said, “But what about physical therapy or some kind of brace to protect and stabilize my knee?”

“What about the torn meniscus or inflamed bursa? That’s actually why I’m here. That’s what hurts. Is there something to do about that?”

“No, nothing will help.”

Then he said, “If you won’t do those things I suggested, there’s nothing I can do for you.”

And he was gone.

I had most likely run over my allotted budget appointment time.

I’m not being melodramatic or overly sensitive.

This is why people bemoan America’s healthcare system, one of many reasons why it’s all messed up.

It was a new experience for me to endure disrespectful and abbreviated treatment like I’m “less than”, a second class citizen solely based on the hierarchy of my health insurance.

Will I tell my own doctor how this one made me feel? You bet I will, and I’m going to request a second opinion, too.

I believe this doc was scalpel happy for sure, but there’s no way I’d trust him to slice open any part of my little body, no matter how many pictures he had on his wall of satisfied customers.

What’s the prognosis for my poor knee? I’m not sure, but at least I know what’s going on in there.

Will I stop doing squats and lunges? NOPE.

Update: I went for a walk along our beach seawall and saw a physical therapist had set up a tent and table for free consultations on a little grassy area. What great timing! I stopped to chat with him and I’m so glad I did! He offered better information about the mechanics of a knee and how to obtain relief (including a brace recommendation) than I did from that orthopedic specialist who wanted to slice and dice. PLUS he was respectful and gentle as he moved my leg around.

Call Me Dr. Rosebud

After all this time, after all my injuries, once again I accurately diagnosed a medical issue.

Last March I did a deep weighted squat and felt something pop in my right knee. My stubborn self chose to overlook the subsequent discomfort and stoically carry on.

We need a backstory here...This is the same knee that was injured when I carelessly pulled a full and very topheavy garden waste trash can to the street, blithely ignoring the fact that the wheels were tangled up in fruit tree netting.

I mean, for a split second the thought crossed my mind that I should probably untangle it before I rolled it down the hilly driveway but I did not.

So…as you can probably guess, my feet became entwined in the netting which then pulled the heavy can down on me, twisting my leg and knee beneath it.

I know, I know. I’m not bright, also extremely impatient.

Once I deduced that my knee/leg wasn’t broken, I iced it for a while and endured the pain on the lateral side of my knee. A few months later, I had some physical therapy which actually seemed to help and I was back to normal movement.

And that’s how I ended up doing a weighted squat. Again, I iced it and figured it would take a while to heal, whatever it was, but this time there was no specific pain location. I wore a brace and compression sleeve and that didn’t really help.

Finally, I was able to pinpoint the pain, did my research and thought it was a medial meniscus tear along with an inflamed bursa, right below the knee.

I waited a really long time before telling my doctor (too stubborn to admit defeat), but when the pain wouldn’t subside, I did. She ordered an x-ray and when the results were unremarkable, she ordered an MRI, the appropriate course of action.

That was my first ever MRI. For me, it was a pleasant experience, probably because only my legs were in the machine.

The results came back as I had predicted:

  1. There is a complex meniscal tear involving the posterior horn of the medial meniscus.
  2. Severe chondromalacia involving the lateral patellar facet (also known as Runner’s Knee)
  3. Mild joint effusion. (I believe it’s the pes anserine bursa.)

Now I have an appointment with the same orthopedic office where I’ve often visited for other dumb accidental broken bones and torn ligaments.

SIGH.

Just call me Doctor Rosebud BUT don’t be like me and wait months suffering before seeing a professional!

Chakra Awakening Chart

I thought this was super cool and wanted to share.

Downward Spiral

If you read about my non-conversation with a haughty school secretary, you might remember I had a bit of a mild cold, but NOT Covid.

Well…on Saturday night the landscape changed. I started to run a low grade fever, went to bed, woke up wracked with chills and my temp had climbed to 102. I was nauseous and developed a very ugly, very productive cough (TMI, I know.)

With my asthma and history of viral lung infections, I had an idea that I now had a secondary bacterial infection.

All day Sunday I tried to lower my temp with acetominophen since I can’t take ibuprofen but my chest wasn’t feeling particularly great.

Early Monday morning I was able to schedule a video appointment with the doc who ordered a chest x-ray.

And just like that, the diagnosis was bilateral pneumonia!

Doc said I was very lucky. My proactive attention to the symptoms stopped me from having to be hospitalized, that’s how bad it was becoming.

That is my WORST nightmare, for sure. With a mom for a nurse, I’ve heard too many horror stories to want to end up at the mercy of strangers, no matter how talented or dedicated they may be to the craft of nursing.

Being hospitalized also triggers memories of my son’s near death experience and I literally can’t stand the smell or the bright lights or the constant sounds.

So now I’m taking two kinds of antibiotics which I also hate because I don’t tolerate them well, but no steroids because I have even worse reactions to them. I’m also taking probiotics because I definitely don’t want to contract C-difficile, which is what my son suffered from AFTER his surgery. We almost lost my precious boy twice.

How it went so quickly from a slight sore throat and congestion to full blown pneumonia in two days, I’ll never know.

There’s always a silver lining though, right? At least the x-rays showed no pleural effusion or pneumothorax and the cardiomediastinal silhouette is stable. (You medical professionals will know this is good news.)

But the real life lesson here is to never stop being your own best medical advocate. I’m only giving myself permission to have one more day of feeling poorly (and slightly sorry for myself.)

Always Wear Sunscreen! A Cautionary Tale…

I just got home from having surgery for a spot of basel cell carcinoma on my shoulder. The anesthetic is wearing off and my arm is sore and achy.

Even though the cancer was caught early thanks to my amazing dermatologist, let me tell you that it’s NO FUN to endure a biopsy and the subsequent treatment.

I’ve had Mohs surgery before for basel/squamous cell skin cancer on the back of my neck and that was even less fun because they had to dig deeper and my movements were limited for a longer period of time.

Since then, I’ve been more diligent about staying out of the sun, wearing a big floppy hat and UV sleeves to protect my arms while gardening.

There will be no more four-hour suntanning marathons at the beach with baby oil or cocoa butter.

According to my doctor, the damage was done decades ago when that was all we did during summer vacation; lie out in the sun. Because I live in Southern California, there’s a LOT of sun and lots of opportunities to attain that deep bronze-y glow.

I’m sure this won’t be the last time I have to endure these kinds of procedures. I also had about five pre-cancerous spots removed from my face and chest, but so far none of the suspicious areas are melanoma, the scariest diagnosis of all.

While I’m indoors on the sofa, out of the sun, I thought it’d be a good time to remind everyone to use sunscreen and wear protective clothing when you’re outside.

Another good suggestion is to visit a dermatologist and get checked out so you’ll have an established baseline for the future.

Now I’ll head over to Amazon and look for adorable things to buy for the almost three-year-old Angel Girl. Whatever it is MUST be pink and she loves Hello Kitty. She’s definitely MY little one, that’s for sure!

I See You. Eye Health. Seriously.

Every year I have a checkup with a specialist because I had a torn retina in my left eye in 2014 and a vitreous fluid issue in 2016 in my other eye that so far hasn’t deteriorated. (Knock on wood.)

I thought I had previously written a post about this medical condition but I couldn’t find it which is odd yet timely because I have my annual appointment on Friday to check my retinas. I don’t like ambiguity and their high tech equipment calms my anxiety.

I was told that my severe myopia was the leading cause of my retinal tear. I also believe that the crazy stress I endured because of my son’s life threatening medical condition and subsequent emergency surgery contributed to the tear, but I can’t find any facts to back up my theory. However, we know stress can do crazy things to our body, right?

In my case, I knew what it was the exact moment I saw the white flashes (Photopsia) that didn’t disappear if my eyes were open or closed. A family member was an ophthalmologist and I had worked for him during high school and college thinking I might like to go to med school, but I didn’t really want to spend another decade cooped up in classrooms. And then there was my nemesis, organic chemistry…

I called my eye doctor after hours to explain what I saw; he told me to come in at 7am the following morning, no appointment needed, and by the end of the day I had been referred to and had already been seen by a specialist who confirmed that it was a retinal tear. Laser surgery was scheduled for the next day.

My advice is not to delay seeking medical attention when you see flashes.

I won’t lie; the laser repair is the most painful procedure I’ve ever endured, worse than my C-section when the anesthetic wore off as my OB was suturing me (REALLY) and worse than a poorly done root canal. It was like a thousand sharp knives were stabbing my brain. Some people just feel a dull ache/discomfort and they’re the lucky ones.

The bright lights leave you blind for a brief period after it’s all done. For the first 72 hours after the surgery, you can’t read ANYTHING, no computer, nothing –because the eye has to stay stable and not track back and forth in order for the laser treatment to fully seal the tear. I had to sit up and could only watch TV. My friend brought books on tape to listen to, which was great. Yoga and weight lifting and jumping and pushups and plank were prohibited for about a month to reduce any pressure and inhibit healing. That drove me crazy too, but I still limit my downward dogs because I don’t like how it feels when I keep my head down. I’m scared it’s going to happen again.

As painful as it was, I’d prefer that to the repair options for a total detachment which can take place in a hospital and can involve a gas bubble insertion and/or a scleral buckle. You must hold your head in a certain position for several days to keep the bubble in the right spot.

According to the National Library of Medicine, the risk of developing a retinal detachment is five or six times greater in people with high myopia compared to those with low myopia. People with high myopia have longer eyes (axial elongation), which means that the retina is more stretched and therefore prone to peripheral retinal tears. High myopia is said to occur when a person’s myopia progresses until they need −5 diopters or more of spherical correction.

A retinal tear can lead to fluid and blood collecting in the eye, which can cause the development of several new floaters and loss of vision if the tear leads to a retinal detachment.

The retina is the thin layer of tissue that lines the back of the eye on the inside. Located near the optic nerve, the retina’s purpose is to receive light and then send pictures to the brain of what the eye sees.

If the retina is unable to receive and process light, the brain won’t receive information. One condition that can stop this communication between the retina and the brain is a retinal detachment, which can result from a retinal tear.

Symptoms

The most common symptoms of a retinal tear include flashes in the eye and visible spots called floaters. Retinal tears can develop and progress quickly, which may lead to retinal detachment.

The most common signs and symptoms of retinal tears include:

  • Sudden appearance of floaters.
  • Black spots in field of vision.
  • Flashes of light.
  • Blurry vision.
  • Darker/dimmer vision.
  • Loss of peripheral vision.

Retinal detachments and retinal tears

Those seemingly harmless “floaters” and “flashes” in your vision can indicate serious trouble. “Floaters” are tiny black specks that you may occasionally see floating in your line of vision.

What causes floaters and flashers?

As we age, the gel-like fluid in our eyes (called vitreous fluid) begins to liquefy and pull away from our retina. As vitreous gel changes it can pull on our retina enough to cause a retinal tear or detachment.

Having a few long-standing floaters in your vision is normal. However, if you notice flashes or an increase in floaters — or if you see a curtain or shaded area in your side vision — these can indicate serious eye disease and the need for immediate treatment. Left untreated, retinal tears and detachments can lead to permanent blindness. Prompt diagnosis and treatment are critical. In fact, vision loss could have been prevented or minimized by early detection in 50% of all medical cases involving blindness.

Please take your eye health seriously!

Planting Seeds: Bija Mantras for Chakras

I hope everyone had all their Christmas wishes come true!

Instead of writing about resolutions for 2022, I think it’s more helpful to share info about things that are easier to attain so I’ll share what I learned about seed mantras– bija mantras–to create and enable healthy transformations all year long.

What is a Mantra? A sound, syllable, word, or group of words considered capable of “creating transformation.” The Sanskrit word mantra means “instrument of thought”.

What is Bija Mantra? Bija means seed. Bija mantras are one-syllable seed sounds that, when said aloud, activate the energy of the chakras in order to purify and balance mind/body.

What is a chakra? In Sanskrit, chakra translates into “wheel”. These “wheels” can be thought of as vortexes that both receive and radiate energy. There are seven major energy centers in the human body, from the base of the spine to the crown of the head. Emotions, physical health, and mental clarity affect how well each chakra can filter energy. This in turn dictates how pure the energy is that’s emitted from different regions of the body.

Chant the bija mantras, either one at a time or in sequences. Repetition can help you access a meditative state. Try to focus on the different regions of the body associated with each syllable/chakra as you go through the bija mantras. 

  • LAM: Root Chakra – I am
  • VAM: Sacral Chakra – I feel
  • RAM: Solar Plexus Chakra – I do
  • YAM: Heart Chakra – I love
  • HAM: Throat Chakra – I speak
  • OM: Third Eye Chakra – I see
  • OM: Crown Chakra – I understand

Option: Choose one sound that really resonates with you and repeat that one several times. I like this brief seven minute chant, but there are literally hundreds of them on YouTube. Search for a voice that feels good.

Some info curated from http://ar-yoga.com/2011/10/bija-mantras-the-sounds-of-the-chakras-lam-vam-ram-yam-ham-om/

November is Pancreatic Cancer Awareness Month

No eclipse viewing for me, the sky was overcast last night!

Let’s all be aware of the signs of pancreatic cancer.

My mom had CA of the pancreas, even though she had very low risk factors. Back when she got it, the only way to know for sure was to open her up for exploratory surgery. After that, it was a brief three months until she died.

I miss her every day. I’m sad she died when the original Angel Boy was only six and never got to see him get his doctorate from Yale, get married, and have his own Angels. She loved him so much and was such a big part of his life that he started calling both of us “Mom” and we’d answer in unison, “Which one do you want?”

We took care of her here at home with hospice support. Although she was able to tolerate high doses of morphine, the pain was overwhelming.

About ten years before an official diagnosis, she was consistently nauseous after eating and started taking papaya enzymes.

With her vast medical knowledge as the head RN at a local hospital, she probably had a really good idea what was wrong with her but did all she could to find any other reason for her symptoms. She had her gall bladder and spleen removed but nothing helped. As it still is, pancreatic cancer is a death sentence.

It’s the same horrible disease that killed Alex Trebek, Steve Jobs, Ruth Bader Ginsburg, and Patrick Swayze.

The most significant symptom I’d suggest to be aware of is nausea after eating. Start keeping a journal and get to the right doctor as soon as possible.

We need more research to stop this terrible disease.

Image

Foot Fetish

Due to a communications mixup, I didn’t get to see the new podiatrist until today.

Lemme back up…about a month ago, my foot started to hurt after a long walk. At first I thought it was a stress fracture, but there was no bruising.

Pretend doc that I think I am, I decided it was a joint or tendon injury: extensor tendonitis and possibly capsulitis of the second metatarsal. I wore a boot in the house, iced it, soaked in epsom salts, taped it up with KT tape, and did a lot of stretching.

Refusing to give in to the pain, I forced my poor foot to go on long walks that were excruciatingly painful.

Finally, this morning, I got an xray and waited for the doc. Actually there were two of them that came in to see me, ‘cos I guess it was a slow Monday. They asked me what happened and I gave them both the benefit of my ZERO years of medical school.

I was pretty chatty and finally, one of them broke in and said, “How’d you like to look at the xray?”

I said, “Well, you could have shut me up about five minutes ago haha”, but he said he liked listening to my diagnosis, even though I was totally wrong.

The xray left no doubt as to what the problem is IT’S a COMPLETELY BROKEN stress fracture at the base of the toe and not healing because I kept re-injuring it.

My initial diagnosis was correct! I should have gone to medical school for real, oh well, too late now…

I hate my feet, I really do, they’re tiny but completely deformed from too many years of ballet and toe-crushing pointe shoes, in addition to breaking every toe multiple times because I’m CARELESS. I call them my fat little trotters.

I can’t walk anywhere for two weeks, I have to wear a hiking boot in the house, I can’t go barefoot at all, and I had to promise to actually and truly wear the boot so I wouldn’t be forced to have an aircast up to my knee. In other words, my foot needs to be completely immobilized.

On the plus side, they told me I had the softest feet they had ever seen, (which was only slightly weird) and they loved my high arches–from an anatomical perspective. The docs said I should see the rest of the feet THEY have to look at all day, and in that regard, my feet were a PLEASURE. LOL. AND that my sunny disposition cheered them both up because they were having a not-so-great Monday. We spent a lot of time laughing which made me happy, too.

There’s a SLIGHT chance I’ll have to have surgery in January, but only if it doesn’t finish healing correctly if I disregard their expert advice.

That’s my Monday, I hope yours is less fraught with injury!