Author Archives: tumbleweedstumbling

About tumbleweedstumbling

I have three blogs, embryogenesis explained, tumbleweed tumbling AND fulltimetumbleweed. I am a retired scientist, and my husband and I have written a book which was published by World Scientific Publishing in Nov 2016 called Embryogensis Explained. Full time tumbleweed was my first blog which I worked on during five years of living full time in a travel trailer. I have now retired that blog in favour of Tumbleweeds Tumbling since we bought a stick house in April 2015 and are no longer full-time. I have a blended family of five sons and one daughter, all grown up now. I am (step)grandmother to nine boys and one girl. My husband and I have a dog and a cat. We live in Manitoba, Canada, in a 480 square foot house on a half acre of land in the tiny town of Alonsa.

Coronavirus Concerns Covid 19

During my education I studied biochemistry as a young woman and then after finishing my biochemistry degree, I had to make a choice. On the one hand I could take a route that would involve training to deal with diseases like Ebola and on the other hand I could head towards human genetics. Both fields require a solid understanding of epidemiology and use of statistics to analyze results. Both also require understanding how humans think, especially when herd instinct kicks in. After much consideration I decided to do Human Genetics and not virology. I had two reason that really swayed my decision. First I had young children. People who work with outbreaks are at a higher risk because of their job. The job also requires a lot of travel and being away from home. The second reason was my asthma. My asthma is relatively mild. I can go for weeks at a time without any trouble. However if I get a cold, even a minor one, I tend to be wheezy for weeks afterward. Plus I have to avoid strange perfumes, strange food and just about everything you would require to be flying around the world dealing with outbreaks. And so, with great reluctance and much regret, I did not to pursue a career in virology. However I have been fascinated with the epidemiology of outbreaks ever since.

The novel coronavirus is now properly named severe acute respiratory coronavirus 2 or SARS-CoV-2. People who are sick with it have a cluster of symptoms creating a disease called Covid19. There is all sorts of on line speculation about whether or not this was a bioweapon or made by humans. Personally, I think not simply because nature is always a lot better doing these things than we are plus natural viruses of this type have been occurring since before humans ever smeared a petri dish. It’s also irrelevant. Whether or not its human made, the virus is out there and it’s making people sick so who cares how it happened. We can take someone out to the firing squad after this is all over.

There is a lot we don’t know yet about this brand new virus. What we do know indicates that it is a lot more deadly than the flu. The flu kills a lot of people, mostly elderly with preexisting conditions or children with health problems like being on chemo therapy for cancer. The new virus seems to target those who are weaker in the same way but with much more ferocity. There are a couple of peculiarities. For one thing it seems that children are not being as affected. Also men die more than women. For some interesting theories as to why this, The Scientist (Katarina Zimmer Feb 24, 2020) has some neat educated guesses.

Should you worry? Well…government officials in Canada and the USA are now making cautious worried noises about how we should all be getting ready, just in case.

…I am definitely getting worried. This virus is showing all the signs of becoming a pandemic. I say that based on my own background and training even as the worry tone officials talking on TV have is kind of getting to me. Take this quote for example:

Meanwhile in the US, the Centers for Disease Control and Prevention warned that Americans should “prepare for the expectation that this might be bad”. “It’s not so much of a question of if this will happen in this country any more but a question of when this will happen,” said Dr Nancy Messonnier, director of the National Center for Immunization and Respiratory Diseases.

…I think you should probably be worried too, but in a sensible way.

Those who live in hurricane country will recognize this feeling. We are at the stage where there is a hurricane out there. It is is wobbling in the general direction of where we live. It might land. It might miss us and go out to sea and dissipate. It would be a good idea to start getting ready now before any big panic just in case it does land at our homes, but we certainly shouldn’t panic yet. The best cure for panic is preparations. So how do you prepare for a pandemic?

Here is the basics of what you need to know.

  1. If the virus hits your area (and if you are in Italy and Iran it already has) the local medical system will be overwhelmed. About 20% (1 out of 5) people will need to be in hospital to have a chance to survive. That is a lot of people in hospital. By way of comparison my small town has 76 people in it. That means if the virus infected everyone in my town 15 people would need an intensive care unit. Our local hospital which serves over a hundred such small towns has four intensive beds. In a pandemic only the lucky ones of that 20% who need an intensive care unit will get into a hospital that can provide one. So you need to avoid getting sick, not depend on the local medical system helping you after you get sick. The poorer your country and worse the medical system, the more important that is. I live in Canada which is one of the best health care systems in the world. If I am worried about my health care system being able to handle this here, you should be too. Avoid this virus, don’t hope you can get treated for it.
  2. Think about your water supply. I get my water from a small independent well. If you have to depend on others for your water you may want to stockpile some.
  3. In several places the government has responded to the outbreak by simply shutting down entire sections of  the population. No one goes in, no one goes out. This means no one coming in to stock up the grocery stores and pharmacies.
  4. People will panic and people will stop showing up to work. (This is already happening in South Korea.) Be ready to take care of yourself in your home.

What can you do? What preparations should you be considering?

Pandemic Preparations

The US government has lots of good common sense advice on how to be ready for a pandemic. You don’t need a bunker ten years of food, guns and ammo and entire suits with independent air supply. You do need to have a good look at your home and ask yourself how will your family fare if the government suddenly shuts down all the roads and you are stuck in your house for two weeks to one month.

Things you can do now:

Stock up on the regular medications you would use anyway and have enough on hand so if the government does shut down your town for two weeks to a month, you don’t have to worry about finding enough of your medication to survive. Don’t buy ten years worth but do have enough on hand for a while. In Canada, most of us on regular prescriptions buy them three months at a time. So buy now if you are on your last week of meds. While you are at the pharmacy, top up your supplies of non-prescription stuff like allergy medicine, heartburn medicine, pain killers, and bandages. You don’t want to risk walking out among sick people in a pharmacy just because you didn’t have anything at home for your burning gut after you ate too much chilli.

Stock up on groceries including water. Don’t waste your money on military style emergency meals (unless you like eating those anyway.) None of this may happen and you’ll feel like an idiot if you spent a whole bunch of money on groceries you’ll never use. Think of that approaching hurricane idea. Just buy a little extra of the stuff you already use. Plus think about what you will eat if the grocery store is closed for a month. If you normally drink fresh milk, what can you use to replace that if you can’t get to the store? Maybe you want to try freezing a couple of extra jugs, just in case. If you like almond or soy milk just as much maybe get a few extra of those. Use common sense. Stuff like oatmeal keeps forever so if you normally eat oatmeal, just make sure you have enough for a month instead of a week. If you don’t normally eat oatmeal don’t buy it now. If you stick to food you will eventually eat anyway you won’t be wasting your money if this particular hurricane veers off to sea instead of landing. And don’t forget spices and sauces. You’ll want to avoid food boredom. Toilet paper and tissues don’t spoil either.

If there is a pandemic, schools and daycares will close. Plan for that. Think about entertaining the kids if you are stuck inside your house for two weeks. Now might be a good time to hide a few new toys and games in the house. (If nothing happens you can give them as gifts when birthday or holiday time comes around. ) If you work in an occupation where you know you’ll be called out to deal with this (doctor, nurse, hospital worker) plan your back up for who cares for the kids now. Again, you’re ready without wasting your money.

Don’t bother buying all kinds of medical equipment. Honestly, if there is a pandemic and you self isolate properly you won’t need it because you won’t be exposed. If you end up having to care for a mildly sick family member there are simply common sense replacements you can use. Again the US government has plenty of solid advice for coping with a pandemic. Now is the time to read it and plan. Planning prevents panic. Panic over this virus will hurt and kill a lot more people than this virus ever will.

Keep up to date. My favourite place for updates is Coronavirus Update which seems to give news faster and sooner than our local news media and they appear to check it carefully before posting. They also have lots of background details like incubation periods, mortality, probably more than you need to know.

Good luck, wherever you are in the world. Let’s hope and pray this virus fizzles out soon and we can all laugh and say our preparations were not required.

 

Carotid Artery Dissection is Healed!

We had two updates, one from the neurologist by telephone and one from the interventional radiologist via another telehealth conference. The MRI results were carefully quantified and reviewed and then forwarded to both of these specialist. The neurologist called and told us that the carotid artery shows up in the MRI as healed, no more pseudoaneurysm and, providing the interventional radiologist agrees, we can declare the carotid artery dissection completely healed and stop the blood thinners.

After this news I found myself feelings like I was in shock. It was a pleasant shock, but still a shock. I was trembling. I was in tears. All these longs months, all the worry, all the fear, all the careful watching. We are done. He is healed. We can start thinking longer term again. It was really hard to wrap my brain around the news. I ended up suppressing all my happy happy thoughts a bit and reminding myself the interventional radiologist must agree first.

And the interventional radiologist agrees with one caveat. It can be difficult to do comparisons between imaging modalities. There has been so much improvement between the last CT and this MRI he can’t quite believe it or trust it. He agrees the MRI does indeed look like the artery is fully healed a huge and very pleasant surprise since he did not think pseudoaneurysm ever would given how big it was. He even had another radiologist (someone whose ability and skills he really trusts) look at it just to make sure and this fellow also agreed the artery has healed.

His recommendation is that my husband continue with the blood thinner (generic form of plavix for a full six months since the last time we saw the pseudoaneurysm just to be on the safe side and follow the standard recommendations for a dissection and then image one last time with CT to really confirm the astonishing healing shown in the MRI. We agreed to this. My husband has six weeks of his blood thinner left so he will finish the bottle and have the hopefully one last CT and then we can call the carotid artery dissection incident finished and done with. Amazingly enough, there is no evidence of any kind of a stroke from the dissection on MRI. So if asked, we can honestly say no it was not a stroke, it was carotid artery dissection with transient symptoms.

I had another happy cry.

Can you see me smiling?

Choose Joy

 

Health Update – Carotid Artery Dissection with Pseudoaneurysm.

A short report that is nice because it contains good news. We are seven months since the diagnosis of a carotid artery dissection. My husband got called in for an MRI. The reason for the doctors being concerned about this is because my husband is at a much higher risk of throwing a clot due to the healing carotid artery dissection with a large pseudoaneurysm because of narrowing at the site of the injury.  You may recall there was a debate about stenting (relatively high risk especially when compared with his clinical symptoms which are none.) The MRI was for testing if the carotid artery dissection caused a stroke of if it is throwing off small clots and causing micro strokes. Micro strokes are tiny strokes that do not show up clinically but accumulate over time and eventually can lead to dementia. They can only be seen using MRI. Our doctor gave us a copy of the report on the MRI and the neurologist’s report and it was overall positive.

The MRI did not show sign of anything beyond a “smooth narrowing” of the artery. Compared to the last report from October with a CT that is an improvement. To be properly cautious, it is hard to compare across modalities however since the clinicians seem to think that’s a positive improvement, we’ll definitely take it. There is still a thrombus/clot where there was before but the MRI seems to show it was smaller (again the cross modality issue makes me hesitant to say it.) Also the MRI works by producing a specific signal when a specific magnetic frequency is used. The signal that came back was for a blood clot and not the later final stage of a healed clot. It apparently takes 4-6 months for this process to start so it is not a surprise nor is it bad news. It just means the healing is not finished. The thrombus certainly is no bigger.

The really good news is the MRI could not detect the stroke damage. Strokes show up as bright spots and the brighter and more solid the spot, the worse the stroke. In my husband’s case there is only one very small, very faint and only slightly brighter spot and no where near where he should have he had caused by the carotid artery dissection. Best of all, no sign of any other micro strokes or secondary damage or anything else. He has two tiny plaques in his arteries, matched on both sides, which are often found even in healthy young men and we already knew about those from the previous CTs. The letter from the neurologist states he has ruled out any progressive neuropathies or vasculopathies (i.e. blood vessels and nerves, brain are as normal as can be for 76 years). The specialist thinks it was just the unlucky seatbelt accident. Further our family doctor told us he can confidently state my husband is now clinically stable if a travel insurance company were to ask. (Due to the past history of carted artery dissection that might still be an issue but we’re not ready to start traveling right now anyway.)

We also got permission to try reducing the last of three blood pressure medications he is on back down to the level he was using to control his blood pressure before all this started. (He has been on a double dose of his ace inhibiter since the dissection after using it for many years to lower his blood pressure.) Again, it has to be done carefully with daily monitoring twice a day (morning before taking the pill and evening) but six days into it and my husband’s blood pressure has actually been a bit lower sitting nicely at about 130/80 give or take 5 points with the majority being about 125/75 for the evening check and slightly higher for the morning check before taking the pill.

There we are. Slight improvement, no sign of the bad stuff the MRI was supposed to detect, no need for stenting at this time, no more visits to the doctor until late spring unless something changes. Blood pressure med down to the previous level. At some future point yet to be determined, another imaging check of the artery will be done (likely by ultrasound) and if it is healed my husband can stop taking the generic plavix blood thinner although the neurologist said he should be taking a baby aspirin for the rest of his life.

There is a special Hebrew blessing for when one has had a near miss with death and been delivered from it. I am tempted to ask my husband to arrange now. (It has to be said in a minyan of ten Jews after a Torah reading) but I won’t just yet. Instead, I’ll ask for the continued healing prayer to keep on being said since we are not all the way there yet. (You can hear a woman sing the prayer in Hebrew here.) In English it goes like this:

May the One who blessed our ancestors Abraham, Isaac, and Jacob, Sarah, Rebecca, Rachel, and Leah bless and heal Yitzhak son of Dina. May the Holy Blessed One overflow with compassion upon him, to restore him, to heal him, to strengthen him, to enliven him. The One will send him, speedily, a complete healing, healing of the soul and healing of the body along with all the ill, among the people of Israel and all humankind, soon, speedily, without delay, and let us all say:  Amen!

Halfway through Winter

Winter in Manitoba up here near the 51st parallel arrives sometime in late October and early November and slowly disappears by about mid to late April. That being said, it is not unheard of for winter to arrive with October (like it did this year) or hang around well into May. The severity of winter varies just as much. Last year there were extended periods of weeks at a time where our home town was under extreme cold warnings with daytime highs rarely breaking -40C (-40F). This winter’s temperatures have so far been mild with many days with the highs running in the single digit negative zone (30-16F range) with night time values dipping into the high teens (-1F). Snowfall is about midrange normal this year with three blizzards and multiple days of light flurries. The ground is covered with 20 cm (8 inches) of the white stuff in the lowest spots with drifts running well over a metres (yard) deep.

I think of the end of January as being the midpoint of winter for two reasons. First there is almost always a brief spell of relative warmth that lasts a week or two. Temperatures will get up to the freezing mark. There will be some thawing and maybe a bit of freeing rain. This is always followed by most of February dropping into the extreme cold range. It’s like Mother Nature comes up for air, takes a breath, and plunges down into the deep cold again. We are in one of those January warm spells right now.

After spending ten years of winters in the south it has been quite an experience for me to live through a Manitoba winter again. Thus far it has been far less awful than I worried about and far more pleasurable than I expected. The main reason is because being retired, if it is bitterly cold outside I just stay home. I don’t have to layer up and go outside and start a cold vehicle and leave it to warm up which my teeth chatter and I freeze. I don’t have to stand in the wind waiting for a bus to arrive because my husband’s work schedule did not overlap mine that day and it was his turn to take the car. I get to miss the worst part of winter.

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A particularly fine example of sun dogs.

The other thing that has astonished me is that winter is far prettier in a rural area. The snow stays a lovely white instead of filthy slushy brown. The trees are beautifully decorated in ice that twinkles like stars in the sunlight. Wildlife is suddenly visible in ways it has not been before because animal leave tracks everywhere. The trees are bare so you can see wondrous sights like one of Manitoba’s official provincial bird, the great grey owl on a post or red flash of a fox in a field. Sun dogs make sparkling bright lights or even rainbows beside the sun. The sky is so blue it almost hurts the eyes and the night sky is stunning in ways it never is in summer. The sun rises late and sets early so even though I am not a morning person I get to enjoy both.

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Animal tracks in fresh snow.

The other thing I have discovered is that my community goes into high social gear in winter. We have had more socials, more dinners, more reasons to be among our neighbours this past month than over the entire summer season. I took up curling to have a reason to get out of the house and get some exercise and discovered I love it. It is a combination of luck and skill and there is few things more satisfying than that perfect two rock knock out or putting your rock “on the button”. I even splurged on myself and bought my very own pink curling broom from Canadian Tire. Twice a week I walk one block to the local curling rink and have a blast playing senior stick curling.

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Winter sunset with lovely clouds.

I decided I would not feel sorry for myself and whine and carry on about the cold. I decided I would be positive. And with that attitude I find I have actually been enjoying this winter. It has passed this approximate halfway point far more quickly than I expected. I still dread February but it begins with curling bonspiels so maybe it will be just as much fun as January has been. Some of my friends in this community have told me they prefer winter. I always thought they were crazy. I can’t say I prefer winter but I can now see why they do.

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Sunshine on frost decorated Trees from my son’s backyard in Neepawa Manitoba

Fixing My KitchenAid Mixer.

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I have allergies of all sorts and my husband is supposed to be on a no added salt diet. This means most processed food is unsafe for us. I make almost everything from scratch to accommodate this. Over the years I have found that doing it all from scratch means better quality at a lower cost, often much lower. There is the time factor, of course, but being retired, I have time. My husband bought me this KitchenAid when he found it on sale many years ago. We paid $399 at the time. I have worked it plenty hard since and purchased most of the attachments that go with it. The hardest chore is kneading my homemade breads which I make weekly. Thus, I was heartbroken when the planetary stopped spinning. It felt almost like an old friend was dead.

Rather than simply toss the machine and run out and buy a new one, I decided to try to fix it. I was delighted to find a number of excellent videos on youtube that explain how to do it. I followed the instructions and took it all apart. After some wiping away of black grease and inspecting everything, I exposed a gear that was obviously stripped. Following the instructions on line, I ordered a new gear and the grease required to repack the mechanism. I had such a ghastly time with my first ever encounter with a retaining ring that I almost gave up and had a good cry. I was finally able to get it off with two carpentry hooks.

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One of my dear friends once told me when you need a tool, buy it. That way, over time, you’ll build up a nicely equipped shop and be able to do more and more. Following his advice I also ordered the special pliers required to deal with retaining ring on the planetary shaft. The hardest part of taking it apart, after struggling with that retaining ring, was wiping away as much of the old black grease as possible. The gear that got stripped had many bits broken off. These little metal bits were embedded in the grease and some of them were sharp. Fortunately, all the other gears looked fine. I went through an entire box of tissues wiping out cruddy old black grease.

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I ordered the part from Amazon and after about three weeks of doing without my wonderful KitchenAid, the parts arrived. I then carefully followed the directions in the videos and put the thing back together with the new part and the new grease. I was relieved that the new grease was clean and white and washed off with wiping, and soap and water. Because it was clear/white it didn’t make much mess even though I ended up smearing it everywhere. I had some issues getting the gears to mesh properly but, with some fiddling and few crude words not be used in front grandchildren, eventually it worked. That part was not as easy as the video showed. I also discovered, once again, a job is much easier with the proper tool. It was ridiculously easy to get that retaining ring back in place with the special pliers. Finally, I tested the machine, except for the cover, and it spun perfectly with that old familiar hum.

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Hubby dearest helped me finish up the process. That decorative metal ring around the outside is a three hand job. He finished off the job with me by helping me clean up and he presented me with a case he had to keep all the parts of my newest tool together. My total cost was $49.86 Canadian plus taxes. The new gear was the most expensive part at $24.20. Since I have half a can of grease left I can take $10 off that. I have already used the grease on some other stuff like a super squeaky door. I did not get all new gears. If I had replaced all the new gears, it would have come to half of the cost a whole new machine. According to one video, the machine is designed so one gear goes before the rest precisely so you don’t have to redo everything.

I am very proud of myself. Replacing my machine would have cost me $500-$700 at today’s prices. Many manufacturers deliberately create circumstances so you can’t fix your machine yourself. They do their best to force you throw out the old one at the first sign of trouble and buy a new one. I was delighted to find the KitchenAid people are not among them. My wonderful durable user friendly machine is back in good working order. What’s more, I now know if it dies again, I can probably fix it myself. Today was a good day.

Choose Joy

Health Update – New Doctor and Polypharmacy

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This month we attended the Grand Ole Kinosota Opry (think Karaoke with a few professional musicians thrown in doing old country favourites) and we had a great time. I snapped this selfie sitting on my husband’s lap.

Yesterday we made yet another trip to Neepawa where, among other things, we saw the new neurologist. Mostly I came away feeling really positive. The new fellow agreed with all the reductions in medication our own family doctor has implemented. Recall my husband was on five different drugs, three of which were to lower his blood pressure. He was having some very nasty side effects. One drug a generic version of lipitor was in the cocktail even though my husband has no issues with high cholesterol or any other lipid issue. His lipid levels were normal. I’m not sure why this drug was included in the cocktail but for three months my husband suffered terrible leg cramps, especially in his thighs, that would wake him in the middle of the night with pain so bad he would literally scream. We were told to stop that drug as soon as the first neurologist heard about it. While the cramps got better right away, it was another two months before the cramps finally stopped completely.

The two extra blood pressure medications had side effects including sleepiness, swollen ankles, sudden drops where his vision would go black, dizziness, inability to tolerate heat, problems with becoming dehydrated, an inability to tolerate even the most mild exercise beyond slow walking, and “The Wall”. “The Wall” being terrible fatigue that came on without warning and required he immediately going to bed, lie down and sleep. Initially, we assumed that The Wall was purely an effect of the suspected stroke. Now I am not so sure all of it was that. Second to go on the cocktail list was a drug called amlodipene, a calcium channel blocker. First, we reduced it by half for two weeks while monitoring his blood pressure and then we got rid of it completely. For the first couple of days after the drug was reduced/removed my husband got some wonky readings including a couple of weird high ones but they soon settled. There was an immediate and very noticeable improvement in just about every measure of my husband’s alertness, ability to tolerate exercise. Plus “The Wall” rather abruptly vanished.

Third to go was the diuretic, hydrochlorothiazide. Again, the same few days of wonky readings and then the readings not only settled down nicely, in fact, they went lower than before. We are now consistently below 140/80 with the majority readings in under 130/80. And much to everyone’s surprise but mine, so did the swollen ankles. Now hydrochlorothiazide is supposed to prevent swollen ankles by draining away excess water but if you read the fine print the pharmacist gives you, it can actually cause higher blood pressure and swollen ankles in some individuals. Another very nice bonus was issues with our love life vanished. I’ll spare you the details but hydrochlorothiazide is renowned for its ability to turn vigorous healthy men into limp noodles. Some people may prefer their men in that state. I am not among them.

My husband is now back to the single blood pressure medication he has been on for the last twelve years, a drug that was prescribed to him by another metabolic specialist after a lot of tests and (I am most annoyed by this part) a trial of both another calcium channel blocker and hydrochlorothiazide. The first was ineffective and the second proved to make things worse, not better for him. So why did no one listen to me when I complained about adding drugs that we already knew didn’t work? I’m just the stupid wife with a PhD in human genetics specializing in metabolic pathways, so what could I possibly know compared to Almighty Doctor? Can you see my eyes rolling so far back in my head I can see my tenth birthday? My only regret is I caved in and let the doctors push me into putting him on these drugs and it took a lot to finally get someone, namely our family doctor, to actually listen to me and agree to try stopping them in a safe supervised way.

The new neurologist did not talk about putting my husband back on any of those drugs. (Much to my relief as I was ready for a fight.) He did explain why my husband needs the anti platelet drug clopidogrel bisulfate (generic form of Plavix.) As long as my husband has this narrowing of his carotid artery the blood is rushing through like rapids through a chasm. Blood can get caught in eddies and swirls that can cause a clot to form. A clot could trigger a stroke. Now I “get” it. However the new neurologist was also specific that when the pseudoanuerysm heals, we can stop the clopidogrel bisulfate. The neurologist says my husband will need to be on baby aspirin for the rest of his life. We’re both fine with that since he’s been on the baby aspirin since he started the high blood pressure medication and he’s tolerating the clopidogrel bisulfate very well.

The neurologist also agreed with the interventional radiologist that a 5-10% chance of having a stroke or even dying while having the stent put in for someone who has no symptoms, means the stent is a bad idea. He also agreed my husband needs to have an MRI to rule out so called “silent strokes”. Silent strokes are very tiny strokes that have a nasty cumulative effect and eventually can cause dementia. The anti platelet medicine should be preventing these silent strokes from happening. Only an MRI will tell for sure. I explained how the doctors in Brandon had decided he could not have an MRI due to some metal in his leg from a bad break many years ago. The interventional radiologist had told us that was nonsense and the new neurologist agreed. At some point, we will get the appointment to go have an MRI. Given this is now elective, that could take a while with Canadian wait times. The new neurologist asked about homocysteine since that is a key factor in many silent strokes, but the previous neurologist had already ruled out high blood homocysteine levels via the blood tests. It was nice he explained the connection between homocysteine and silent stroke as opposed to saying the equivalent of “It’s normal so don’t worry your pretty little head about it.”

I was also very happy to be able to tell the new neurologist that from our perspective, life has pretty much returned to normal. I came away feeling very positive about the longer term as well because this specialist seems to think that eventually the artery will heal and the sword of Damocles hanging over my husband’s inner carotid artery will eventually be gone. June is when we will reassess and we can do it with ultrasound. For now, we carry on as we have been, living normally.

This entire adventure got me thinking about a very common problem with the way we practice medicine. Polypharmacy is a real and dangerous problem. I’m not sure why my husband was sent home with a cornucopia of fives drugs in a messy cocktail that caused him so much trouble. Maybe he needed all that in the early days post carotid artery dissection. Maybe it helped his healing and then once the healing was done, it would have been safely stopped eventually even if I had not fussed so much about it. Maybe he was ‘overmedicated” right from the beginning. We’ll never know. My personal feeling is he was given a standard cocktail of post stroke drugs appropriate for someone with multiple risk factors like diabetes, poor lipid profile, and uncontrolled high blood pressure. No one took into consideration that his supposed stroke was not caused by any of these and two of these drugs had already failed in his past history. Rather, his stroke symptoms was that typical of a much younger person caused by an accident that tore his inner artery.

My advice is one should never just stop the drugs doctors prescribe. However you should question each and every drug as soon as it is prescribed. If you think past history means the drug is not a good idea, say so and keep saying so until the doctor listens. If the doctor won’t listen, find a new doctor. Don’t take glib explanations for the reason for taking the drug. Do take the time to read all the fine print in those sheets the pharmacists hand out. Know exactly what those side effects are and promptly report them to the doctor. Insist on a serious reconsideration of the drug with an eye to deprescribing as soon as the side effects pop up. Wave the pharmacist’s sheet in front of the doctor if you have to, to make the point. Finally, conditions change and you need to review all the drugs you take with an eye to deprescribing at least once a year and certainly whenever a change in your health happens. Always reduce the number of drugs you are on under the supervision of a doctor you are confident with. NEVER just stop taking them on your own. If your doctor is not listening, find another doctor. Doctors are human beings, not minor deities. No one sues them for over prescribing. They only get sued for under prescribing.

On a final note, to be fair, I have two dear friends with complex health issues who are seeing the first neurologist and they think the world of him. They are convinced he saved their lives and they can’t say enough good things about them. I still think the first one was competent. He just wasn’t the right one for us and part of that was his personality (he’s a ‘pat on the head you need to trust me’ type) and I directly and absolutely butted heads with my (I need to know at least as much as you and strive to learn more than you because it’s my problem) personality type. His refusal to listen to me could well be simply because I got his back up. More than one doctor has said I am a difficult patient, or in this case, a difficult wife.

And so that is our update. We are now feeling “back to normal”. Travel outside of Canada is still out of the question due to insurance issues. We are thinking about some camping trips with our travel trailer to places like the Yukon this summer since we are spending the winter here. Wonder of wonders, I am actually enjoying this winter. I think that is because I don’t have to stand and wait for a bus in the extreme cold. If it’s horrible outside I cocoon inside under my electric blanket. I have also been trying winter sports I never had time for when I was working. I discovered I really like curling. The community has been hosting a whole whack of fun events. The farmers are not as busy in winter and folks get sick of being shut inside so fun things tend to happen. We have been to multiple events including one where we won 15 pounds of pickerel. This year is off to a great start!

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Good Riddance Annus Horribilis

I sat down and wrote about the top ten things for 2019. It hasn’t been a great year for us. They say retirement comes in three phases. Phase One you are healthy so you travel and do and see things and have a blast. Phase Two something happens health wise and you slow down and enter a period of peaceful quiet living. Phase three, well that’s when you end up in a home so we won’t go there, I hope. 2019 is the year I think we transitioned from Phase One to Phase Two. I still have some hope 2020 will see us back on the road again, but not that much hope.

Here is my top ten blessings for 2019.

  1. One of my children separated from his wife but they reconciled only a few weeks later, much to my intense relief and many thankful prayers.
  2. My beautiful Misty was attacked by two pitbull dogs but she got away relatively unscathed when they turned on each other instead. She also got to swim with dolphins.

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    Misty had great fun with a friend she made at our second campsite. This little guy was actually faster than her. We don’t meet a lot of dogs who can outrun her but this boy sure could. He was also an important part of helping Misty get over being attacked.

  3. A dear friend’s daughter got married. We feel like she was almost a daughter to us and we saw her grow up so it was lovely to know she is married even though we could not make it to the wedding due to my husband’s health issues. She just recently announced she’s expecting this summer to add to the joy. Can you see me smiling?
  4. I discovered I love curling. I decided to keep active during our first winter out in the country and I joined the local senior curling group. I did it just for the exercise and the social contact so it was a real surprise to discover I really like curling. So living through winter after ten years of missing it is turning out to be not so bad.
  5. We came through the horrible storm of Canadian Thanksgiving 2019 unscathed. We were prepped and we were fine even though we had no power, no cell phone service, no land line, and no internet for nearly three days.IMG_8099
  6. We found a buyer for our precious property we could not longer manage. The buyer is going to continue to care for the property as it should be, including retaining the conservation agreement. Plus he will clean up the horrible mess left from the EF4 tornado of 2018.IMG_8189
  7. I discovered I have a lot more fix it talent than I thought after I designed and installed a new pantry space for our tiny house along with a few other projects to prepare for living here over the winter, like the new garage door opener.
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  8. My health has been great. I was really worried about my asthma acting up again since it always was worse in winter but so far I have not had any trouble at all. I credit that in part to our fresh air intake which has made our indoor air so much better.
  9. We got through the terrible flooding and disastrous storms in the south and midwest without harm and we had a nice time in our travels in spite of it.
  10. The stroke my husband had in June due to a carotid artery dissection after a seat belt accident was very minor and he has made an almost complete recovery. Plus he is finally tackling some risk factors and he’s lost 14 pounds and dropped three pant sizes just by switching to a treadmill desk. We were very fortunate.IMG_1709

 

So I say farewell to 2019 with gratitude for the blessings and thanks that it is over. Here’s hoping 2020 is better. 2019 certainly could have been a lot worse. I hope we all have the best year ever in 2020!

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The view from Riding Mountain National Park to our home some forty kilometres west.