Category Archives: Uncategorized

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.

 

Health Update – New Doctor and Polypharmacy

IMG_1881

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!

IMG_8317

Merry Christmas/Happy Channukah

Many years ago in my past life with a previous husband, I was struggling very hard to cope. It was Christmas Eve and my careful plan was to have a nice Christmas dinner with turkey and all the trimmings at home, open a few presents, and then go to my in-laws for Christmas day. The reason for the two meals was there were certain dishes that were part of my family tradition and they were not served by my mother-in-law. I also loved having leftover turkey to make into a whole variety of special holiday associated dishes such as turkey curry.

At my ex-husband’s workplace they were going to stop work early and then the men would have a couple of drinks and pick up their bonus and come home. My ex-husband promised me he would come home right after work. I hoped he would but I was filled with dread anyway. A few weeks before I had started attending meetings with the friends of Bill W and I had learned a few things there already. Previously I had blamed the bosses at his company for putting out a bottle of Christmas cheer at work. Honestly didn’t they know this was a bad thing to do? With my new friends I learned that the company was not responsible for my ex-husband’s behaviour. He made his choices and he was responsible for his choices.

Inevitably, dinner rolled around and he wasn’t home. There were no cell phones in those days so I couldn’t just call him and ask where he was, not that this would have done any good. I figured I’d wait until 6:30pm and then assume the worse. At 6:25 the wife of one my husband’s workplace buddies, one he often went on long binges with, showed up looking for her husband. I invited her in with her two boys about six and eight years old. She was horribly upset because her husband was missing too. The children were hungry and started crying and the wife stalked about ranting about why oh why was did the company have to ruin every Christmas by getting the men started on drinking.

 

Holiday Depression

I called my sponsor of that time. She told me to go about enjoying the holiday. Feed the children and have a nice evening. Just because my husband was out on a bender didn’t mean I could not enjoy Christmas. And so I did. First I calmed down the poor wife by handing her some eggnog and telling her she and her children were staying for Christmas Eve dinner. I put the food on the table and the hungry crying children soon became the happy stuffed children. With a bit of quick rearranging on my part, I was able to come up with a nice gift for each child. We read the poem “Night Before Christmas” and we watched the Charlie Brown Christmas Special while the children played with their new toys. We then tucked them into bed exhausted and happy. The atmosphere felt happy, wonderful and even a bit holy.

The wife and I sat enjoying a glass of red wine by the Christmas tree and we quietly contemplated the lovely lights and shared some laughs. Shortly after 3:00am our men rolled in, drunk as the skunks they were, loudly singing Christmas carols off key and staggering about. As soon they walked in the door the poor wife went from contented tree light watcher to shrieking harridan. They say you can always tell if someone in the family has a drinking problem by watching how crazy their spouse gets and she proceeded to do a very fine demonstration of that fact. Since I had only recently indulged in the same crazies, I simply watched and made some mental notes about how much my attitude had changed. There but for the grace of God went I. Meanwhile my drunk staggered off to bed and fell asleep. I helped them bundle up their weeping frightened boys and they left over my protests because her drunken husband insisted he was capable of driving. I prayed they would get home safe.

Christmas Day dawned and my ex-husband was sleeping off his drunk so the children and I enjoyed the Santa presents and opened our gifts. The drunk finally staggered out of bed about the time I was dressing the kids to go to their grandparents home. He told me he was not going. Tell them he had flu. With my new attitude about making him take responsibility for himself and not enabling him in his drunkenness, I refused but I did not fight with him about it. I did not give me usual lecture about how disappointed his mother would be or how embarrassed I would be or how much he was letting his children down. When all the assorted relatives asked where he was I simply told them he had been out drinking until 3:00am and was too hung over to join us. When they said things like “Why do you let him do that?” I answered honestly and said I had tried everything to get him to stop and nothing I did made any difference. They were free to try for themselves. I then changed the subject and concentrated on enjoying the company of my in-laws and all my little nieces and nephews. I can’t say I had a lot of fun, but my children did and that made it worth it.

I eventually left my drunk, who never did stop drinking and his family who had never stopped blaming me for it. (They now say I broke his heart and that is why he drinks.) I created a new and happy life with my happy nondrinking Jewish husband. There were so many negative memories of Christmas that it was a great relief to simply give it up. When I lit the first candle on the Menorah last night, I reflected on how many wonderful memories I have over my thirty years of celebrating Channukah with him. Virtually every Channukah has been a trauma free event for the entire eight day stretch. My daughter called to wish me a Hag Semeach. She had just come from a wonderful party with her Jewish mother-in-law and we shared some of our favourite Channukah memories. She is young enough that she does not know anything else.

051dedfddaf6cb458ec79a91a00506cf

Now before you think I detest Christmas because I gave it up, let me assure you that is not the case. My neighbours have dozens of Christmas lights and now those new blow up figures that are all the rage. I love them! I attended a community Christmas party Sunday and I wore a silly blinking Christmas light necklace they gave all attendees. I laughed a lot. I enjoyed the music and the food and the wonderful sense of community real Christmas spirit brings. It’s just not my holiday anymore. One of the things I liked best about Christmas before my retirement was taking double and triple shifts so my Christian coworkers could be with their family. It was my way of sharing my blessings.

Child wearing Christmas hat

About five years ago I was contacted over Facebook by one of those little boys with whom I shared that Christmas Eve long ago. He said it was the best Christmas he ever had as a child. The experience made him determined that no matter what went on in his childhood, he was going to be happy and he and his wife would have a wonderful peaceful Christmas the way I had demonstrated it should be done. He thanked me. This gave me a wonderful warm glow inside. It also showed me yet again how when a child wants to live happy and well, small acts of kindness and good examples from strangers can help overcome a lifetime of abuse and dysfunction. I can not take credit for that evening. My sponsor taught me that lesson.

The Holiday Season is a time for joy and reflection and peace. Family dysfunction can mar that holiday and the season can bring back powerful negative, even evil memories. Even if you have been blessed with mostly good memories, Christmas can also be a time to grieve a lost loved one who will not be at the table. If you are one of those who has such a Christmas issue, my wish for you is that you are able to find your own way to set aside your pain, to create a positive memory and have joy instead this year. May your days be trauma free and may all your bad memories be placed where they can no longer hurt you. May you be blessed to find thirty years of happy holidays as I have. If you are one of those fortunate enough to be born into non dysfunctional families my wish is very simple. I wish you another Merry Christmas, or another Happy Channukah, whichever applies, and my hopes for you to have the finest and best New Year ever.

Joy to the World!

Screen Shot 2019-12-23 at 11.37.12 AM

Butler Pantry Update – 2

My butler pantry is turning out to be a major project pushing the limits of my carpentry skills but I am having such a blast! Once I got the trap door in, I spent a long time surveying the space and trying to figure out the best use for the planned shelving. I have several specific needs. One I need a place to put a variety of kitchen items that I use rarely but need to keep. This includes things like my husband’s juicer he uses to make fresh apple juice each fall from our apple trees and my lovely big red turkey roaster pan I use two or three times a year. There are quite a few of such things floating about in a disorganized mess on shelves in the basement. I decided on wide shelves around the top that I need a step stool to access but given how rarely I do need them will be fine.

My second need is for more pantry space. Because we live in the country, it is a long way to any grocery store so trips to town are trips to provision and I hardly ever buy just one of anything. I also am a die hard clearance bin and sale shopper. For example on yesterday’s doctor appointment trip I found brown rice flour at half price and I bought all five small bags. Things tend to get buried on our basement shelving. I need a whole range of sizes of shelves so I can see at a glance what I have lots of and what I am getting short on when I look at flyers and plan my shopping trips. I have planned lots of narrow shelves for holding cans and boxes and bottles.

The third need is for a place to store my vacuum and some assorted cleaning aids. They have no specific spot right now. They kind of get shoved into whatever spot they fit and then get tripped over. This is especially true for the vacuum which currently resides in front of my husband’s lab desk. I need to have designated a broom closet space.

My fourth need is a place to hang my indoor light for starting seedlings each spring. The basement is too cold and the space I used last season is now occupied by my husband’s indoor pond scum growing area. The space required is long and narrow. I will need to be able to have space to raise and lower the light. However since it will only be used a few weeks out of the year, I decided to put in a floating shelf so I can use the space the rest of the year for something else. This also means I need a plug. Fortunately the wiring we put in for a second set of outdoor plugs is right nearby so it was trivial to run a wire down through the floor and our family electrician will connect it with a junction box.

IMG_1829

With all those needs in mind I went on a careful measuring binge. I used a level and pencil to mark all the shelf lines I want and then measured again and again and adjusted. One thing I have to do is make sure there is no obstruction to movement up and down into the basement. The closer to the upstairs door, the higher the lowest shelf must go. I also used a nifty on line tool called a sagulator to plan supports and their placements. The result is a mess of lines and notes and crossed out lines where I adjusted the plan. Given all my storage and organizing needs, the space seems to get smaller and smaller. I do have a good plan though.

This also made me realize that I am going to need to put in some lighting so I can see. When the trap door is down and there is no daylight. that space is really dark. This led to a pause in the shelf construction to run wiring for a light. That is when I discovered that the farmer who added the the wall between the stair and the bathroom decided to do so using 2X4s and laying them flat to save space before putting on a 1/2 inch plywood layer on both sides. Very sturdy, of course, but that left me with the need to run wiring through the longer width of the 2X4. This turned what should have been a two cuss job into a seven or eight cuss job but it is done. The result (also waiting for the family electrician to do the final wiring) is in and looks very nice. I’ll be even happier when it has power!

IMG_1842

And I got myself another new tool. It is a fun little thing I saw on a youtube video called a “jig” it makes nifty little sideways holes which look much nicer and work much better for inserting screws sideways. It was extremely confusing to use at first because the directions made no sense to me. However I followed them faithfully step by step and it worked like magic on my very first try. I got a fine hole and used it. Such fun!

The final space is actually starting to look like a real pantry. I tried my vacuum and it sits perfectly in the new space I made for it. I even have one high shelf in place and it is now in use for storing my electric cord. I have a long way to go before the pantry is done but I am beginning to see some real results. I’m looking forward to getting a lot of stuff in my basement off the floor and some walking space and organization created. I must say though, I would not want to make my living doing this stuff. No one would hire me at an hourly wage and if I did it as a contractor I’d starve to death. I don’t move fast.

IMG_1840

“He Took Aspirin.” Stroke and Aspirin

June 24th, 2019 my husband had a stroke. It started with a funny headache around his left eye. He also had ringing in the ears and pain in his upper molar. He decided it was eye strain and took a nap to try to shake it. When he awoke an hour or so later, he was having trouble with his arm and he felt “funny”. The headache, while not bad, was different from anything he had experienced before.

Normally I recommend ibuprofen for a headache. I get periodic headaches with aura that last about three days. Aspirin and Tylenol don’t do a thing for those but 200mg of ibuprofen works like magic. For some reason, a little alarm bell went off in my head and I told him to take two regular aspirin. (325mg each meaning 650mg total.) It was while he was pouring the water to swallow the aspirin that I could clearly see his arm wasn’t working properly. He was overshooting and knocking stuff over. As he swallowed the aspirin I first began thinking maybe we should go to the hospital because it might be a stroke.

The drive to our nearest local hospital is typically one hour and fifteen minutes. I made it in under fifty. I was speeding. At the hospital, they said I should have called 911 and waited for an ambulance. If I had done that, the paramedics could have started the stroke protocol immediately and my husband could have been in a CT machine about an hour and fifteen minutes after paramedics arrived on scene. I felt horrible. I felt crushed. However, talking to the local folks here since we got home, many have told me that paramedics take at minimum forty minutes to arrive at our small rural town. And that forty minutes is on a good day with nice weather and only if the nearest ambulance is not busy with another call. Sometimes in an urgent emergency like a stroke of heart attack, it can take an hour and half to two hours for the nearest ambulance to arrive. They would also have had to then make the same drive I did.

It is possible we would not have had to go through the one hour delay to CT involved in a transfer from the small hospital I went to first. That hospital had no CT machine. They had to arrange the transfer to the large teaching hospital for the CT. There are two local smaller community hospitals that have CTs. They are slightly further than the one I went to in different directions. They usually have staff on hand to do a CT. However neither one are equipped for acute care beyond contacting a neurologist at the major centre, administering clot busting drugs and then transferring to the large teaching hospital we ended up at anyway.

The neurologist told me to stop fretting about it. It does no good to blame myself. I did the right thing and the outcome was excellent. He told us that since my husband’s symptoms were resolving on their own and had largely resolved by the time he had the CT and the symptoms were so very mild, he would not have been eligible for the clot buster drug anyway. The clot busting drug is high risk resulting in 6% of patients dying. Compared to a catastrophic brain injury its well worth the risk but that was not what we were dealing with. His kind words took a huge load off my mind and eased my conscious considerably. Analysis of events to improve future response is one thing. Second guessing and regret is another and it is a waste.

In retrospect, I should have called 911 and then took off and met an ambulance somewhere on the trip in to one of the hospitals. The 911 people would have known where the nearest hospital open to do a CT was. Also when we arrived at the local hospital, my husband’s systolic blood pressure was over 220. They treated that while arranging the CT and transfer. The paramedics could have started that treatment sooner. Given their travel time, however, that meant only ten minutes sooner. I risked him having a major medical crash after a catastrophic stroke affecting his breathing and heart during those extra ten minutes. They would have been better equipped to handle that event.

The symptoms of arm weakness and headache my husband was experiencing dropped to about half by the time we hit the first town near us, a 38km (23miles) drive away. It was twenty minutes after he took the aspirin. While he was in the CT machine, the last of the symptoms went away. His arm was still a bit weak but it was working properly and the head ache was gone. The diagnosis was inner carotid artery dissection clearly visible on CT. At that point they weren’t sure if he’d had a full stroke or a transient ischaemic attack (TIA) or transient symptoms due to the carotid artery dissection. They had not yet determined if he had thrown a clot that had traveled and lodged somewhere deeper in the brain or if the relatively small area of carotid artery had partial closed due to the dissection and reopened. Later, the neurologist would tell us he suspected it was a mild but full stroke and a clot had traveled and lodged in the area of the brain that controls arm movement and it has done a small amount of damage. (That damage will remain but the slight weakness should disappear as the brain heals and rewires itself around the stroke site.) Only an MRI will tell for sure if there is damage and it was a full stroke or a transient ischemic attack related to the carotid artery dissection.

We went through four days in hospital of careful monitoring, 24 hour heparin drip, a barrage of drugs and lots of fighting his blood pressure. (It needs to be up to get blood into compromised areas but not high enough to encourage another clot of break off and travel. The doctors fretted and administered drugs every time the systolic number went over 180.) Students came and went along with the many doctors and one thing I kept hearing over and over again was how lucky my husband was and how mild the event was. This was invariably followed by a lowering of the voice, heads coming closer and then in a near awe-struck tone someone would say, “He took aspirin.” This would be followed by knowledgable head nods and as if that explained it all. At the time it made no sense to me. I fretted that maybe I had made things worse by telling him to take two aspirin instead of an ibuprofen. I even asked if the aspirin made it worse. “Oh no, not at all,” everyone assured me. No one mentioned it might have been absolutely best thing to do.

I have since put things together in my mind. In ScienceDaily, 18 May 2016, there was commentary on how taking aspirin as soon as you have symptoms of a stroke, especially if you are far from medical help, reduced the chances of a major stroke by 70-80%.

The authors concluded ‘Our findings confirm the effectiveness of urgent treatment after TIA and minor stroke — and show that aspirin is the most important component. Immediate treatment with aspirin can substantially reduce the risk and severity of early recurrent stroke. This finding has implications for doctors, who should give aspirin immediately if a TIA or minor stroke is suspected, rather than waiting for specialist assessment and investigations.’

Furthermore: ‘The findings suggest that anyone who has stroke symptoms, which are improving while they are awaiting urgent medical attention can, if they are able, take one dose of 300 mg aspirin.’ [Note I gave him 625mg which may have been too much but then again….]

I am an avid follower and reader of science news consolidators such as Science Daily. I often then go back and read the entire article they reference. In retrospect, I think I must have read that article about stroke and aspirin and it sat in my subconscious. I now also think the dramatic improvement we saw in twenty minutes was due to the aspirin starting to dissolve the clot. The fact that the symptoms pretty much vanished even as he had the CT was when the clot was fully dissolved. All the other stuff the doctors did, like keeping his blood pressure in a range that allowed more blood to get to the brain but not so much as to cause the delicate healing process of the carotid artery dissection to break open, those anti-inflammatory drugs to stop the brain from overreacting to the damage, and the blood thinners, all prevented something much worse from coming afterward.

Am I recommending taking an aspirin if you have symptoms of stroke? I can’t do that. I am not a doctor. (Okay, I am a doctor but the PhD kind not the medical kind.) There are two kinds of stroke. One kind (about 30%) is caused by blood vessels rupturing and bleeding into the brain causing damage. The other kind, the 70% kind like the one my husband had, is due to a blockage, usually but not always by a clot. Aspirin could make the bleeding kind worse. That’s why doctors don’t just give you clot busters if they think you are having a stroke. They do the CT first to make sure they don’t make a bleeder worse. I also don’t know if it will help all kinds of blockage. There are also people who should not take aspirin because of other reasons. So no, I can’t recommend you take aspirin if you are having stroke symptoms.

I recommend instead that everyone read up on the symptoms of stroke so you know if it happens to you or someone you love. Understand your best options for getting to medical care quickly before you need it. Talk to your own doctor about it and read up on taking aspirin. Weigh the risks. Make your own decision once you are fully informed and do it before you need to deal with an emergency. If you live next door to a major teaching hospital you can afford to wait to treat. If you live 250km from the nearest hospital, like we do, you have to play different odds. Aspirin might be your answer. Maybe.

We got lucky. As Louis Pasteur said, “Luck favours the prepared mind.” We were also prepared with knowledge even though I did not recall from where during the emergency. We had aspirin on hand. I distinctly remember buying that aspirin even though we never use it, in order to have it in the house, just in case. [My husband has been on the low dose aspirin for decades which he takes with a multivitamin which is why we don’t use it randomly for other things.] I don’t recall just in case of what. The aspirin bottle has an expiration date of this year. That means I likely bought it around the time I read that article in 2016. It doesn’t have the vinegar smell of spoiled aspirin and aspirin lasts a lot longer than the three years or so written on the bottle. Even so, I will be buying a new bottle next trip to town. I might even buy a half dozen or so and keep aspirin in my truck, my RV and a couple in my purse.

We got lucky. Luck favours the prepared mind. Be prepared.

 

Solar Water Heater for Pool

After the Alonsa tornado the beach got full of wood bits and broken glass. We’re a bit hesitant about swimming there. I have always wanted a pool in my yard but never felt I should waste the money when we had a perfectly good beach 12km away. This year I did it! I bought myself a pool.

IMG_1706

Okay, it’s not exactly an Olympic pool but I am delighted by it. I also ordered a water test kit and some chlorine stabilizer and several bottles of household bleach. I now have the chlorine and stabilizer in the water and the test kit shows the level of chlorine and the pH are perfect. The big problem is temperature. The water came out of the well at 6C (43F) and it was COLD in that pool. It’s been cool at night so the temperature is now up to 19C (66F) which is a lot better than the heart stopping cold of the initial fill but still not what I consider good for a casual dip.

In order to more quickly raise the temperature I cobbled together a solar water heater using some stuff we had laying about. I stapled a black mat onto some plywood and then wound 50 feet of black hose in a loop. I purchased a submersible pond pump and attached it.

IMG_7574

IMG_7576

The pump sits on the bottom of the pool where the water is coldest. It pumps the water up to the looped hose. The cord was long enough to easily have the plug outside but I will have to remove it if we’re using the pool because it is in a spot it could get wet and deliver a nasty shock.

IMG_7575

The result? Well in full sun water goes in and then comes out a full 2C (3.6F) higher. The pump is strong enough that the water is going out at a good pace. Given it took 16 hours to fill, it will take 8 hours for each degree it goes up. However we are going into a stretch of nice hot weather with daily highs predicted to be 27C (80F). I regard 24C (76F) as perfect swimming pool temperature so we’re on the road to that. The pump is also working well enough I plan to buy some more black hose and add another 50 ft.

I look forward to taking a swim in my pool shortly.

DUMBER …

Spot on. I could not have written this any better myself.

Regie's Blog

A lot of people have pretty much had enough. And I get it.

Actor Jeff Daniels said, this week, that one more term of Donald Trump would end Democracy as we know it. Okay, there cowboy. Settle down. Hitler couldn’t do that. The Civil War couldn’t do that. Nixon couldn’t do that. No, Obama couldn’t do that. FDR couldn’t do that (although he and Lincoln got the closest), even the Soviet Union couldn’t do that. I get it. You hate the guy. But ending Democracy as we know it is simply not happening. It’ll be here long after the Donald is replaced.

But then he said something that simply makes my blood boil. He said other than not wanting to pay taxes, the only reason he could see for people voting for Trump was racism. My eyes rolled so far back in my head I could see that phone number…

View original post 1,162 more words