Coffee heat rising

Health care

The Blood Pressure Project: Update

by

Exactly one week ago I decided that enough was enough with the blood pressure conundrum. By this time last week, I had myself so worked up that I was spiking 150/97 readings(!!) and feeling just like you feel when you have to make a cold call and tell or ask some total stranger something, or like you feel in the 6th grade when you’re about to take a math or spelling quiz. At length I realized that the tension caused by obsessing over this bullshit simply had to be what is pushing up those crazy, never-before-seen spikes.

So I decided to put the damn Omron contraption away, close the BP spreadsheet, and stop thinking about the stuff for a full week.

That was good.

The project was to do a daily two-mile dog-free walk, an evening 1.5-mile dog walk (for a total of 3.5 miles a day), plus one 20-minute yoga practice, plus the 10-minute back-pain exercises the physical therapists showed me some time ago.

Three days into said project, along came…amazing! an ocular migraine! Sumbeach! A pair of pinking shears meandering across the field of vision… Who’d’ve thunk it?

I haven’t had a true, verifiable ocular migraine in years. Many years. This cleared, as of yore, in about 15 minutes, leaving behind a mild headache. Mercifully in my precincts these auras do not end in severe pain. That’s something. I guess.

This was followed, that very night, by the single most brain-blowing terrifying nightmare I’ve had since I was a small child. It was really, I think, more on the order of a hallucination: awaking in the midnight darkness, I heard two men in the front of the house, speaking to each other in subdued voices.

For an instant, I was dead convinced there was a pair of prowlers in the living-room. Mercifully, the dogs were on the bed and I had not completely lost my grip: if there really was anyone in the house, the dogs would be going screaming batshit. They were not. They were awake (dogs are often awake at night, interestingly) and just sitting there quietly. Unfazed. Unalerted. Totally unbatshit.

It actually took a second to persuade myself that the “visitors” were phantasms, because if they were real the dogs would have…well….noticed.

Stress and migraine are connected, and migraine is also associated with a wide variety of sleep disturbances, among them dramatic nightmares. And it can take a few days for an episode of stress to evince its various side-effects.

Come dawn, now freshly re-obsessed, I decided I should see what the BP was, in light of the Episode of the Fantastical Night Visitors. So dragged out the contraption again, hating every minute of it. Dogs yapping in the background (not exactly a restful environment), the average was 130/84. Not great, but a far cry from stroke-worthy. As of that evening, the overall average for the several days since I’d decided to quit obsessing was 125.5/79.4. That also is not ideal, but it certainly isn’t in the “high blood pressure” range. Unless, of course, you’re in the business of peddling pharmaceuticals…

Today — another couple days later — the average of readings is 124.6/84.6. So it doesn’t look like I’m going to die soon.

The exercise routine has gone well except for yesterday, when I had so many out-of-the-house things to do that there really was no time for walks or calisthenics. A shallow search online did not come up with any very credible figure for how long it should take for a determined lifestyle change to affect one’s blood pressure. Many sites insist that lifestyle changes do lower moderately inflated BP, but they decline to say how long one might expect this to take. One (1) modestly credible site suggests about 10 weeks.

Meanwhile, YouTube has any number of nice videos demonstrating various yoga routines. Picked a couple by a character named Adriene, who has a pleasing demeanor and does not annoy with too much rah-rah or very much woo-woo. Her “relaxation” practice and her “back pain” practice are nice, easy routines that each occupy about 20 minutes. Then I found a guy who demonstrates beginning weight-lifting workouts for the geriatric set! Chortle! These are absurdly easy but go on long enough to work up a very light sweat, which is supposedly ideal for circulatory purposes.

So. Today is the start of another week, during which I hope not to see the damned machine for seven whole days and nights. Barring a rainstorm (highly unlikely), nothing should get in the way of the proposed fitness exercises, spread out, on any given day, from 7 in the morning to ten at night. And then we shall see what we shall see.

Flu Fury

by

So the flu is reaching its apogee here in lovely (crowded, dirty) Arizona. I’ve been trying to avoid touching things or people, and carrying wet countertop-sanitizing wipes around. The latter, I figure, will be a little more fierce than the sweetly perfumed things you buy to wipe your hands and your grocery cart with.

As yet I haven’t caught it, but my son emailed to say he’s sick. Hopes it’s not the flu…but of course it’ll be a day or so before he can tell.

Every year I get a flu shot. It doesn’t always work — I still get the flu about once every four or five years. And it’s time. A-n-n-n-d…when I do get the flu, it makes me magnificently sick. Most people get over it in a couple of weeks. For me, it hangs on at least four to six weeks. Often much longer. Whatever I picked up last March didn’t go away completely till around the end of October: eight months.

So as you can imagine, I’m not looking forward to the double-whammy version that’s going around this year. The shot is said to be about 32% effective at blocking an infection…which doesn’t sound a whole lot better than nil to me. It means you have about a 70% chance of contracting an infection once you’re exposed. And sure, it’s ducky that the shot supposedly attenuates the infection’s severity if you do catch it. That would mean, presumably, that if I hadn’t taken last year’s flu shot the bug that took six or eight months to clear up would have killed me dead.

SDXB invariably used to catch the flu or at least a heavy cold a few days before Christmas. Every year. Never failed. Well naturally, I didn’t want to pick it up from him every holiday. Coincidentally, the Great Desert University started offering free flu shots to employees about the time I moved in with him. So that was when I started lining up every year to get a jab. After that, I got sick a lot less often.

But…once in a while is once in a while too often. 🙄

One thing I simply can not understand is what on earth goes through the minds of people who insist on going out and about when they’re effin’ blue-in-the-face sick. WHY would you go to the office or to a gathering of friends when you KNOW just breathing on them, to say nothing of coughing and speaking (the latter spreads flu contagion nicely) and touching their hands or handing them a cup of coffee is likely to make them sick?

It might be kind of faintly understandable that you wouldn’t give a damn about strangers. Who cares if you make some fellow passenger on an airplane sick, when it’s going to cost you an arm and a leg to reschedule a flight? Sh!t-headed, but…people being people, it at least is comprehensible. But deliberately exposing your friends? That is incomprehensible.

Maybe people are just too stupid to understand that the flu is not a benign disease. Maybe just because they get over it in two or three weeks, they can’t even conceive that someone else might take six, eight, ten, twelve weeks to get over it. Maybe they really are so ignorant that they don’t know people can die of this disease.

My uncle died of the flu. He was a young and healthy man when he got caught up in the 1918 epidemic.

He left his young wife with a baby. My cousin couldn’t have been more than a year old when his father died. The widow spent the rest of her life working (in an era when women didn’t work) to support her son and later, her mother.

Please.

Do you have the flu?
Do you even think you have the flu?

STAY HOME, DAMN IT!

Have a little fekkin’ consideration.

Gut Instinct…or Doctor Knows Best?

by

So I remain undecided about whether to start taking the calcium-channel blocker (blood-pressure lowering pills) recently prescribed by Cardiodoc. Gut instinct tells me not to do this! But of course, Cardiodoc is a doctor, and I was brought up by a mother who believed with all her heart that doctor knows best.

In her case, he didn’t…but that’s another story, hm?

Moving on, here is the basis of my skepticism: In 2016 a six-year randomized study of 12,705 patients (published in the New England Journal of Medicine and widely known as the Hope-3 study) showed that the use of blood pressure medications (such as calcium-channel blockers) indeed did lower blood pressure, but that among people with only moderately elevated blood pressure, they did not reduce the incidence of strokes and cardiovascular events compared, over time, with the control group whose members were given a placebo. The use of statins did show a positive benefit in this group, which did not vary by LDL level or risk level.

The evidence is clearest [we are told] in the cholesterol-lowering arm of the trial. For the intermediate risk population tested in HOPE-3, the trial adds to the large amount of “clear evidence” showing the benefit of statins, said Yusuf. In sharp contrast, the blood pressure arm did not find any overall benefit for antihypertensive therapy, though there was a benefit in the prespecified subgroup with the highest blood pressure levels. The benefits of statins, on the other hand, did not vary by LDL level or level of risk.

Results in the blood pressure arm were more complicated. Overall there was no significant difference in clinical outcomes, but there were significant differences based on the prespecified subgroups of blood pressure at baseline. Trial patients with the highest third of blood pressure at baseline (above 143 mm Hg) derived benefit from antihypertensive therapy. For patients in the middle third, antihypertensive therapy had a neutral effect. For patients in the lowest third, antihypertensive therapy had a harmful effect. [My emphasis.]

So what WERE the middle third, first third, bottom third??

The average blood pressure at baseline for the study participants was 138/82 mm Hg. The authors describe “patients who truly had hypertension” as those with systolic pressure of more than 143.5 mm Hg. I’m not finding explicit figures delineating these groups in the published study; however, the Mayo Clinic  lists these:

  • Normal blood pressure. Your blood pressure is normal if it’s below 120/80 mm Hg.
  • Elevated blood pressure. Elevated blood pressure is a systolic pressure ranging from 120 to 129 mm Hg and a diastolic pressure below 80 mm Hg. Elevated blood pressure tends to get worse over time unless steps are taken to control blood pressure.
  • Stage 1 hypertension. Stage 1 hypertension is a systolic pressure ranging from 130 to 139 mm Hg or a diastolic pressure ranging from 80 to 89 mm Hg.
  • Stage 2 hypertension. More severe hypertension, stage 2 hypertension is a systolic pressure of 140 mm Hg or higher or a diastolic pressure of 90 mm Hg or higher.

Depending on the time span, you could place me in the Stage 1 category (in December 2017 my average figures for the month were 132.5/83.3) or in the “Elevated” category (between June 2017 and today, my average blood pressure has been 128.1/77.5). I can push the systolic figure down by 6 or 8 points simply by doing a 20-minute yoga routine or by performing five minutes of deep-breathing exercises. This presumably would put me in the “middle third” of the Hope-3 study’s subjects, most of the time and in the lower third (120-128/<80) some of the time.

Apparently, what the HOPE-3 researchers regard as “intermediate” is significantly higher than that. We have this from them (NEJM):

Observational studies involving persons without cardiovascular disease show a graded increase in risk at systolic blood-pres sure levels above 115 mm Hg. It has been suggested that lowering blood pressure at any level above this value will reduce the risk of cardiovascular events. . . . However, the role of therapy in persons at intermediate risk (defined as an annual risk of major cardiovascular events of approximately 1%) who do not have vascular disease and who have a systolic blood pressure of less than 160 mm Hg (who represent the majority of middle-aged and older persons) remains less clear. We evaluated this question in the HeartOutcomes Prevention Evaluation (HOPE)–3 trial. [My emphasis.]

IMHO, 1 percent per year is not a very  high risk. After 20 years, that would give you about a 20% chance of a stroke or cardiac event. Since most women would start to see this elevation in their 60s, they’d be their 80s before they had a one-in-five chance of an incident. No, 20% is not great. One would prefer better odds. But it’s not an extremely high risk, either.

So what does this mean in real life? For practicing physicians and their patients?

At last we are able to cite reliable ball-park figures from a representative population at intermediate risk of cardiovascular disease. They confirm that statins reduce risk by about a quarter, whatever the starting point, whereas for blood pressure lowering below a systolic of 143, this does not appear to be true over 5-6 years. However, it may be that BP lowering has benefits over a longer period of time, particularly for the risk of heart failure. [My emphasis.]

And further:

However, treating those with lower blood pressure with the combination is not justifiable. Only statins should be used for them, [said Dr. Eva Lonn, one of the researchers; my emphasis.]

Statins have fewer side effects than blood-pressure-lowering medications. In the Hope-3 study, many fewer people discontinued them than those who discontinued antihypertensives. Neverthless, these treatments may be associated with one dreaded side effect: “Cognitive decline was noted in all patients. The primary outcome, processing speed (measured by Digit Symbol Substitution Test [DSST] at study end) for rosuvastatin vs. placebo: 29.1 vs. 29.4 (p = 0.38); for BP lowering vs. placebo: 29.1 vs. 29.4 (p = 0.86); for combination vs. placebo: 29.3 vs. 29.9 (p = 0.63). Any functional impairment for rosuvastatin vs. placebo: 57% vs. 59%, p = 0.89; for BP lowering vs. placebo: 59% vs. 56%, p = 0.19.” [My emphasis.] Appears to be about the same for either class of drug…since many of the subjects were in their 70s, this effect could simply be age-related.

So, the new American Heart Association guidelines make these recommendations:

  • Only prescribing medication for Stage I hypertension if a patient has already had a cardiovascular event such as a heart attack or stroke, or is at high risk of heart attack or stroke based on age, the presence of diabetes mellitus, chronic kidney disease or calculation of atherosclerotic risk (using the same risk calculator used in evaluating high cholesterol).
  • Recognizing that many people will need two or more types of medications to control their blood pressure, and that people may take their pills more consistently if multiple medications are combined into a single pill.

So if you believe this, I should be on a statin, not on a BP lowering med.  Okay, fine…so what is this stuff I have in this bottle of pills here?

The stuff Cardiodoc prescribed, amlodipine besylate, is a calcium-channel blocker, an antihypertensive. It most commonly gifts you with these fine effects:

Y’know…the last time a cardiodoc inflicted one of these drugs on me, it caused such extravagant vertigo that it became unsafe for me to drive my car. And look at this: it causes palpitations: the very symptom that drove me to seek a doctor in the first place!

We  now have determined that my underlying vertigo complaint probably results from inner-ear congestion, which itself probably results from chronic sinus congestion caused by living with two furry dogs in a climate most richly characterized by airborne dust.

The main negative side effect of statins is cataracts. Most people will get cataracts anyway, should we live long enough. Thus I don’t see that as a deal-killer.

But dizziness that could cause me to fall on the hard tile floors or crash my car? Fatigue, swelling of legs and ankles, heart arrhythmia or palpitations, tremors? Yeah, those are deal-killers, in the present circumstances.

Those circumstances being a) it’s unclear that my blood pressure is high enough to justify treatment with drugs at all; and b) the Powers That Be are now recommending a different class of drugs.

Why is the guy  not following AHA guidelines? Is his knowledge out of date? Has something new been reported that I’m not finding? Unknown…but in the absence of other data, I am very skeptical about taking this stuff. I just do not need to cope with another raft of nasty side effects.

A Different Strategy…or Gaming the BP Monitor?

Interestingly, I learned from a friend that you can push your blood pressure readings down by doing some deep-breathing for about three minutes before the machine is turned on.

The day before yesterday I tried this. I’d just raced in the door from a particularly exasperating drive through a round of frustrating and annoying errands. Before even putting anything away, I instantly attached the BP cuff and ran the machine (you’re supposed to sit quietly without moving or speaking for about five minutes before running a test). The result was blood-curdling: 149/93.

Cripes! I should be dead!

Now I do a series of deep, diaphragmatic breaths, as learned from LaMaze and voice classes. After five minutes of this and another minute of normal breathing, I try again…and get a 19-point drop in blood-pressure reading!

Holy crap!

Well, obviously that’s too bizarre to put much stock in.

Restarting minutes later, though, the Omron (which was just checked against Cardiodoc’s machine) showed three consistent measures in a row of 130/86, 131/89, and 131/89.

That is still 18 points below the height to which driving in Phoenix traffic had just driven my blood pressure.

Ohhhkayyyy…  Let’s try that again after the dust settles. An hour later, the machine produced these results:

120/77, pulse 84
124/72, p. 87
116/72, p. 84
Average of the three readings: 120/74, p. 85

And that, folks, ain’t bad for an old bat who’s pushing 73.

Yesterday, I decided to see what would appear after a 20-minute yoga routine. And what did that elicit?

130/83, p. 87
121/77, p. 87
117/78, p. 87

This, after a full meal, 2½ glasses of wine, and a fistful of chocolate chips. The belly was uncomfortably full…and that should push one’s BP figures up markedly.

So what happens if you test after yoga, on an empty stomach? This morning we have the results, obtained while the dogs were hassling around and I was in a rush to get out of the house for a dental appointment:

117/85, p. 84
117/84, p. 79
113/80, p. 77

Doesn’t look like I’m gonna keel over dead very soon, does it?

So I’m not sure what to make of this.

Is it credible, or is it really just a form of gaming the machine? If you did yoga on a regular basis — at least once a day, or maybe even two or three times a day, would your blood pressure drop into the “mildly elevated” or into the “normal” range and stay there most of the time, barring any enraging events?

That, I do not yet know. Yesterday, when the yoga routine was followed by a whole lot of food, readings remained in the “mildly elevated” region a few hours later: average was 126/83.

Today I was unable to test the status after a round-trip to the dentist’s office, an hour in the chair getting my teeth cleaned, and a side-trip to a grocery store, because the minute I sat down to run the Omron machine, a worker showed up at the front door. That person is still here working on a series of minor maintenance tasks, and so it will be another hour or two before I can see what the story is. By then I probably will have had something to eat, which will skew the results some. I guess.

If eating skews results, are the results real?
If deep breathing skews the results, are the results real?
If a short yoga routine skews the results, are the results real?

Those, in my none-too-humble opinion, are the kinds of question that cast doubt on this whole already doubtful affair.

First, it’s doubtful whether the doctors themselves know whether subjecting middle-aged and elder adults to expensive medication (one jar of this stuff goes for $125!!!) does any good. Some researchers think that for some categories of such adults drugging does no good and so (because of the inevitable side effects) actually does harm. And research has shown that one class of drugs, while it does push the numbers down, does exactly nothing to decrease mortality and morbidity rates.

Meanwhile, if you’re looking for something to focus on for your meditation: consider the enormity of the profit that can result from putting every aging Baby-Boomer on drugs that cost $125 a bottle.

Who, really, benefits from this?

Still undecided, then, whether to start gulping these pills.

But my sense is, as usual…

When in doubt, don’t.

Life’s Daily Vicissitudes vs. Blood Pressure

by

Or, we could say, vicissitudes vs. your health…

Okay, so here’s what happened:

1) A friend noticed the post in which I whinged at great length about Cardiodoc and the crazy blood-pressure reading in his office taken, after a nightmare drive down there, by a clerk who didn’t know what she was doing and…oh, hell, on and on and freaking on. She remarked that stress indeed does jack up your blood pressure, and that you can often bring the numbers down by deep-breathing for a few minutes before allowing yourself to be subjected to the test. If you’ve ever taken LaMaze or yoga or voice classes, you know how to do this breathing technique.

2) I think…oh, yeah? That sounds like woo-woo. A brief Google search shows it is not woo-woo and that indeed, a study has been done that shows a five- to ten-minute period of controlled breathing indeed can lower blood pressure numbers. Yea verily, no less an authority than Harvard University reports the results of said study. Indeed, there’s a gadget — which the Mayo approves(!) — that can help with this scheme. Alternatively, silently repeating a mantra about 100 to 150 times will also do the trick. One such mantra is the Ave Maria, in Latin (not the English version), which I can rattle off as easily as my usual mantra, “Quit that damn barking!”

3) Izzat so? think I. Okay, let’s test that little fucker. Why ohhhh why do I not believe it? So along about 5:30 in the afternoon, I take the usual series of three readings, one after another, as instructed by the cardiodocs who have harassed…uhm, seen me. Then I try a brief period, about three to five minutes, of deep breathing, the kind I was taught to do in LaMaze classes and then later by a yoga instructor. And… God help us, here are the results:

Got that? Systolic pressure — the one that really counts — dropped from 136 (on the high side of “moderately elevated”) to 129 (on the low side of “moderately elevated”) after just a few minutes of relaxation exercise. That’s seven points. Diastolic, interestingly, rose a point…

4) I think that is batshit crazy and prepare to disregard it. But still: I’m kinda impressed.

5) A night goes by and the next morning SDXB shows up at the door with NG (New Girlfriend). This alone is enough to raise my blood pressure, but, as usual, that’s another story. We go out and walk for an hour or so behind North Mountain. Then we go to a restaurant, where I have a cup of iced tea and they reveal their right-wing tendencies. Which is OK, but…blood-pressure enhancing. On the way, we have been discussing the craziness that is Phoenix-area traffic…and…just as we’re all agreeing that given our choice we would stay off the roads here, the sounds of brakes and a CRASH erupt behind us. The woman behind us has been rear-ended by the chucklehead behind her. By the grace of God, she was far enough behind us to miss rear-ending SDXB’s car. But it was a close call, and it was evident that her passenger was injured. In the Suspicions Confirmed Department: charming.

6) So I am stressed when I get home. Also very hungry. I fix a fairly hefty meal of a couple lamb chops, grilled potatoes, tomatoes, and spinach braised in butter with almonds and pine nuts. And I have two glasses of wine and a fistful of chocolate chips. (Bad!) Then I start to tear around to pick up the backyard, the kitchen, and the house, test the pool, cope with barking dogs, dodge the daily cop helicopter buzz-over, pay the bills and…and…

7) As all this controlled chaos is going on, I think “What would happen if I tried the deep-breathing thing with the BP monitor, right now in the middle of all this hectic racing around?

Hmmm…. As noted in this spreadsheet, I did not wait several minutes to “rest” before running the BP monitor. Between the first and second test, I did about three or four minutes of deep breathing. The second test, interestingly, registered a 10-point drop in systolic pressure; five points for diastolic. Trying again without the fancy breathing maneuver got a rise in PB of four points. That notwithstanding, 125 is within the permissible range for an old bat like me.

Average BPs were 132/80.8 last night and 125.7/81 this afternoon. Last night: after sitting quietly before testing, and including one (1) test with deep breathing. This afternoon: no rest before the first measure but with deep-breathing before the first and second measures; with no deep breathing between the second and third measures.

Normally, if I did not sit and rest before the first measure, my blood pressure would be several points higher. I simply hate, loathe, and despise the blood-pressure test — not because it’s uncomfortable especially, but because it’s a damned time-suck and because it makes me nervous. I just really, really do not enjoy this procedure, whether done at home or in a doctor’s office. It stresses me out every time, and I suspect that alone elevates my blood pressure.

So what is implied here is that deep breathing before the first effort this afternoon, done — against all advice — directly after eating a large meal, after drinking alcohol, and after hassling around physically, probably pushed the first measure down significantly, to 131/80. Since my average blood pressure readings over the entire month of December was 133/83, always taken on an empty stomach and after resting, that is very probably a nontrivial difference. Certainly 121/75 is nontrivial.

What if my belly were not stuffed and I had not just scarfed down two glasses of wine and I had been sitting quietly as usual and then had tried the LaMaze/yoga/chanteuse breathing maneuver?  Welp, we’ll have to wait awhile for that part of the experiment. But…it’s interesting, isn’t it?

By the time I got to Cardiodoc’s office the other day, I was in a rage. I’d encountered two truly crazed drivers, one of whom tried to get me to break the law before doing so himself. I was trying to balance a computer and a blood-pressure machine in my arms when the receptionist shoved a bureaucratic form in my face to fill out — one that I’ve filled out three times already, identically every time — and then demanded that I dig out a bunch of Medicare and insurance cards that she also had photocopied three or four times already in the past and that had not changed. Before I could fill out even half a page of the damned form I was called into the back office, where an apparently oblivious underling took my blood pressure incorrectly — clearly had no training (or if she did, it hadn’t registered in her pea brain…).

So, if stress and annoyance affect your blood pressure — and they most certainly do — then it was not surprising the figures elicited at Cardiodoc’s office were outrageously high.

Do they justify putting me on a medication that will make me sick? Possibly, if the numbers were consistent. But they’re not.

One of Those High Blood-Pressure Days

by

Hugely one of those days, for Godsake.

This morning I had what I expected to be my LAST regular appointment with CardioDoc. The blood pressure has been well in the normal zone most of the time, except for a few moments of rage or drunkenness, despite the fact that I’ve gained 12 pounds since going off the Great Diet Plan and I only get off my duff when forced to it. Overall average for December was 132/83, despite several spikes attributable to a) dental pain and b) episodic stress.

Like, for example, today’s episodic stress.

You know how much I love sharing the roads with my fellow homicidal drivers. This morning, as per usual, all my pet morons sensed that I was climbing into my car and so leapt into theirs and swarmed onto the roads.

Dear God, where do You find these people?????

Notable winners:

Runner-up: The guy who decided to dawdle down Indian School Road. Traffic is moving OK, but this one thinks 35 mph (5 mph under the limit) is too fast and he’d better hold up the parade. He’s in the center lane. We come to the signal at Central. The light turns green and he…sits there. That might seem reasonable because the four or five cars ahead of him are also very slow off the mark: we all just sit there. I notice the adjacent traffic lane is empty, so glide into that…and find space for three or four cars between him and the car ahead of him, who is not moving, either. He has stopped for the light at least three car-lengths behind the guy ahead of him.

Grand Prize: Now I’m headed south and need to turn left off Seventh Street. The light is green and the northbound lanes are clear except for ONE guy, who, instead of moving through, STOPS in the fast, left-most traffic lane. I’m in the southbound left-turn lane waiting for him to get the fuck out of the way so I can make my turn. He stands there, in the traffic lane, and starts FLASHING HIS LIGHTS AT ME.

I think…Whaaa? Am I in the wrong lane? Am I standing in the oncoming lane??? Noooo. Close inspection reveals that I am indeed in the left-turn lane and he is not: the northbound left-turn lane is vacant, and he is in the fast northbound traffic lane. Sitting there. Flashing his lights.

What the FUCK? Finally the idiot swerves left in front of me, across four southbound lanes. Apparently he decided belatedly that he needed to turn west there, after he’d missed his chance to go into the left-turn lane; so, of course, instead of proceeding north a block where he could have turned left into the neighborhood and made his way right back to where he was supposed to be going, he went wackshit.

Meanwhile, in the Where’s Yore Sign competition, I make a wrong turn. Actually I make two wrong turns: one is just a normal wrong turn that sends me in the wrong direction; the other is a stupid decision. Second “wrong turn” is an effort to turn left onto 7th Street off the side street where I now find myself….you’d think I’d know better by now, wouldn’t you? Eventually I had to make an Arizona Turn: this maneuver involves turning right, then left, then right again so as to turn left across or onto a major thoroughfare. Or even a minor thoroughfare.

These exercises slow me down considerably, but I reach CardioDoc’s office in plenty of time. I’m clenching my teeth by the time I pull into his office.

My blood pressure is always higher than usual in any doctor’s office, so much do I love dealing with those places. Truly, I do hate doctors’ offices and hospitals as much as I hate and fear anything. But we’ve found that if I’m allowed to sit quietly in his waiting room focusing on something that doesn’t annoy me and doesn’t scare me, by the time I get in to see him and his army of sidekicks, the numbers are in the normal range. So yes, I’ve brought my computer so as to have something to amuse myself.

But no. First thing they do is shove a two-page form in my face: fill this out AGAIN — same form I’ve filled out four or five times. Then they demand insurance cards: I say nothing has changed. They say insurance companies require that they scan the cards once a year. I say look, give me an e-mail address and I’ll scan them and send you a PDF. She says she can’t do that. I’m irked. Go off to find some place to sit down and jump through these aggravating hoops. Again.

Before I can even fill in half of page 1, they’re calling me back there!

They do an EKG, requiring me to pull off my shirt in front of a man (yes, and a woman) and expose my exquisite scars. Then his tech takes my blood pressure. She does it wrong, allowing my arm to fall down by my side. This will jack up the blood pressure reading, even if you have, as advised, sat quietly for half an hour without any distraction or annoyance. Which (this latter) was decidedly not the case. I say to her, why don’t doctor’s offices follow the instructions put out by the makers of these devices and by the Mayo Clinic?

Huh?

You know, you’re supposed to have the person’s arm at about the level of the heart.

Okay, let’s try again.

Now she holds my arm at shoulder-joint height! Shit…I give up.

The doc surfaces forthwith. Of course, the result of this test is sky-high, after a half-hour on the road and the bullshit in the clinic and now this ignoramus. I’ve enjoyed a good 40 minutes of aggravation and hassle and haven’t even had a chance to take a deep breath.

He now decides he should put me on blood pressure medication. This is something to which I highly object and that I suspect can be avoided. I point out that my regular BP is not that high. Well, says he, nevertheless, better a few side effects (like swollen ankles and vertigo…) than a stroke.

Welp, I do not think I am in immediate danger of a stroke, although it must be admitted that less risk would apply if I never had to drive another frikkin automobile as long as I live. Nor am I about to put myself on a possibly unneeded drug after the circus I’ve just been through.

On the way home, I decide I will pick up the medication at the Walgreen’s; then set it on the kitchen counter for a week. During that time I will a) get back to exercising every day (have let that lapse with a vengeance!); stay completely off the sauce; and start working on shedding the ten pounds that I could do without.

When I point out to him that I drink a fair amount, for a little old lady, he says you can drink two glasses a day without affecting your blood pressure.

Oh yeah? That’s news to me. Apparently to the American Heart Association, too, which says women should drink no more than one (very small!) glass of wine a day. SDXB’s docs told him to stop drinking altogether, and the Mayo seems to favor that strategy, too.

I figure a week of brisk daily exercise — of better quality than being dragged forward by Ruby and backward by Cassie around a mile-long trace through Richistan — will start to have an effect, if an effect is to be had. Plus if I quit drinking and lay off the pasta and the sweets, in a week I’ll drop a pound or two, no problem.

Let us, I think, make a baseline measure after a half-hour or forty-five minutes of quiet this afternoon, and then compare it with a new set of measures after a week of this mild proposed routine. If there’s no change, then I’ll start swallowing pills. But if it’s back down into the normal range, I’ll call the Mayo itself and arrange an appointment to discuss the issue.

Right. A half-hour or forty-five minutes of quiet: NOT so much.

Run by the Walgreen’s to pick up the pills. Line is out the door. I stand and stand and stand and stand watching nothing happen…and finally think, oh screw it! This can wait for a day or for the proposed week.

Get home: Decide to make my first dog-free speed-walk of the day right now, hoping to run off some of the frustration and residual jaw-clenching stress. Fly around the park — that’s a mile and a half. When I get back, the phone is jangling with a recorded message to come pick up the effin’ pills. But meanwhile a lot of other Hell has broken loose. Gerardo, who was supposed to come over tomorrow to do a messy and much-needed job in back, has left word on the machine saying he wants to come today and will  be here around 2 p.m.  It is now after 1:00.

I need to do a bunch of stuff out back before they can get to the jungle vines that need to be hacked back. Race out there to do that; find some tarps to help keep the worst of the mess down. Haul around and thrash around.

SDXB gets on the phone and announces he wants to come over not on Thursday but on Friday, a typical swivel-hipped move. What is it about men — TWO of them in one day! — that they think women have nothing to do but sit around waiting with bated breath for them to show up? Hassle with the junk in back, hassle with an Excel spreadsheet, hear Gerardo’s truck pull up in front.

By the time he and his guys leave, it’s after 3 p.m. and I’ve been charging around since 10:30 in the morning.

Needless to say, I have not spent five minutes seated in a straight chair with my feet flat on the floor, trying to relax. 😀

Lazy, Hazy, Dusty Days of Autumn…

by

Dust. And, dollars to donuts, grass pollen. My house is infested with dust. And dog hair, of course: let us not forget that.

About the only constructive thing I’ve managed today, aside from running a couple loads of clothes thru the laundry, has been the daily dust-mopping with a microfiber rag attached to the head of a Swiffer mop.

This jury-rigged device works exceptionally well to pick up dog hair and dust. Of late, I’ve been trying to remember to Swifferoid up the floors every afternoon, along about 3 or 4 p.m.

At first, this collected vast wads of dog hair. But after about four or five days, less and less dog hair came up…just a light skiff from all 1868 square feet. But what DIDN’T stop coming up was the dust. Every afternoon, the microfiber rag comes up BROWN, uniformly brown, same as the day before and the day before and the day before.

So the only thing I can figure is that even when the air is still as the tomb (as it has been the past couple weeks), a uniform amount of dust is settling out of the air onto the floors.

What that suggests is that whatever has been ailing me may not be dog hair after all. Or at least it may not be 100% the dogs’ fault. It certainly could be something in the dirt that floats around in Arizona’s lovely atmosphere.

This year’s months-long choking-and-gagging episode started in March. At the time, I thought it was some kind of weird respiratory infection, because just then a very severe cold was circulating around the city.

But it never went away. Several months later, no change in evidence, I speculated that it was in fact GERD. Back to the gastroenterologist after unsuccessfully trying omeprazole and then ranitidine for eight weeks. She speculated that nay, it was an allergy.

Visited Young Dr. Kildare, who allowed as to how it prob’ly was an allergy, because experience shows that omeprazole works on me eventually and ranitidine works right away. He recommended an ENT. That guy’s punch-a-button phone maze was SO gawdawful I gave up after about ten minutes with no hope of reaching a human.

Still more eventually, I visited my doc at the Mayo, who suggested I try a double-dose of Claritin — making sure it didn’t have any decongestant in it (that’s pseudoephedrine, a really bad chemical). That DID work. So the conclusion was, I must have been enjoying a marathon allergy.

Figured it must be the dogs, since I let them sleep on the bed (I know: b-a-a-a-d human!) and am not about to throw them off because they will never let me get ANY sleep if I try that. Started cleaning all the bedding every day, with minimal results.

Then looked under the bed and thought…oh, shit! That was when I realized how much dirt and dog hair gathers on the floor between house-cleaning frenzies.

Fortunately the entire house is tiled, which makes it very, very easy to dustmop from stem to stern. When I started doing that, and especially trying to keep the floor in the bedroom super-clean, the ailment started to clear up.

Possibly not coincidentally, this clearing up business began the first of November. Since we now can see that no matter HOW much I swiffer up dust, the air inside the house must be a haze of dust pretty much all the time, it’s probably safe to assume that whatever pollen or crap was making me allergic is subsiding.

A-n-n-n-n-d…what plant that grows in Arizona spews pollen into the air from March to November?

Yeah: bermudagrass.

Bermudagrass starts to come to life in the spring and thrives through the summer here. It goes dormant when the weather cools and the nights shorten, at which time lawn-lovers seed over their yards with rye grass.

That’s what I suspect. If it was dog hair, it wouldn’t get better for no good reason.

The young people who are moving into the ‘hood as us old people dodder off into the sunset have a) families of small children who play outside in the yards and b) jobs that pay enough to cover the hefty water bills demanded by an Arizona lawn. As they’ve bought houses here, they’ve promptly back-hoed the Sun City-style gravel off the yards and planted grass. So…over the past year or two, we’ve started growing a lot more bermudagrass here.

Damn.

So if this allergy comes back next spring, I’ll have to go back to Wonder-Accountant’s allergist, ask him to test me for allergies, and get in line for the shots. Yippee.