In two days, May 5, I meet with my internist for a semi-annual physical, I haven't seen him since before leaving for the winter, last year. Since we hear a great deal these days about taking our health care into our own hands I thought I would prepare a precis of where my condition is currently and where it might be necessary to tweak it. This I will use to guide the discussion during the physical. So, in sort of chronological order, here is a description of the condition my condition is in aka the wreck of the hesperus (with apologies to Longfellow).
1. Low back/spinal injury: Current manifestation in worn-out knees and weak legs. To do: nada except occasional spinal cortisone shot. Note: exercise does not alleviate this weakness.
2. Heart: stress-induced SVT episodes led to beta blocker; recently removed given pausing in the ventricles. Outcome: higher, more variable hr, higher bp (Mean = 143/94), fewer ventricle pauses, occasional SVT; occasional pre-syncope, sensitivity to CNS stimulants like caffeine, sugar. To do: manage higher bp with diet and exercise. The other stuff?? Ditto?
3. Acalasia: managed by omeprazole and slight elevation in sleep posture. To do: nada
4. Chronic, obstructive sleep apnea: Use of CPAP machine quite satisfactory, until lately. Lately, pneumonia has led to a vicious cycle of anxiety upon attempting to sleep and becoming O2 deprived. Conditioning has led to anxiety pre-sleep. Managing this by Melatonin at bedtime and calming activities pre-sleep. To do: Wean off Melatonin??
5. Mantle cell lymphoma: treated by chemo with RCHOP + V. By Aug - Oct 2016 the remission length will qualify for "cure" status in that field. (Yeah, right.). Outcomes: clear remission of symptoms. Side effect: neuropathy in feet and hands making it difficult to walk without pain and effort.. Exercise does not improve this. Side effect: lowered immune system function, seen in several bouts of pneumonia over the past 18 months, congruent or subsequent to exercise.
6. Restricted lungs: one diaphragm muscle overgrown on ribs doesn't appear functional leading to 44% lung capacity. This condition appears to relate to several of those above, namely: breathing! and sleep! and exercise! Doesn't appear to relate immediately to playing trumpet, except in phrasing, nor to aerobic exercise. Those activities appear to lead to later problems, like pneumonia, bronchial spasms.
General Outcomes:
1. Get emergency inhaler, cortisone-based for short-action relief of shortness of breath/bronchial spasms. Long-term inhaler (symbicort) not necessary at this time. Albuteral inhaler contraindicated
2. Begin systematic program of weight loss. Goal = long-term management of bp. Goal = reduction of 10% body weight = 24 lb (based on today's weight of 238.7 lb) = 215 lb.
3. Monitor occurrences of SVT episodes and pre-syncopal events. There has only been one noticeable SVT episode (probably produced by social stimulation combined with a couple ounces of neat whiskey). It ceased upon brief self instruction. Pre-syncopal events occur every few days. They seem orthostatic = happening while sitting. (Two in car are worrisome.) Currently managed by putting head down, or breathing rapidly, or coughing.
Anything medical for this???
General Feelings
1. I have felt "off" (funny in the head) since dc'ing the beta blocker. I speed real easily.
2. I am really easily fatigued. Now more than ever.
That's it. Maybe all this is, is: getting old and not getting over it!
More when I see what the doc thinks about all of this....
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