Feet First

“It is much more important to know what sort of a patient has a disease than what sort of a disease a patient has.” - Sir William Osler

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    Tuesday, January 19, 2021

     Recent Developments 

    I'm trying to blog more. Partly because of the new crackdowns and censorship on social media platforms (namely, F and T), and partly because so much has been happening here, most of it not good. 

    I left full-time work a year ago and have not regretted it one bit, though I have been continuing to see patients part time. One main reason I left was my parents' and aunt's ill health. My mother in particular has been in a slow decline for months. Just before Christmas, their caregivers were diagnosed with COVID and my parents tested positive the day after Christmas; I tested positive one week later. Fortunately none of us had to be hospitalized. My father had basically no symptoms, I had the equivalent of a bad cold; my mother had a heavy cough and bronchitis but no fever. All the caregivers were out sick and it was a very rough two weeks, but things are much better now. 

    Unfortunately my aunt has metastatic cancer and without giving details, she is not doing well. I will be staying with her to provide support as she tries to make a decision about stopping treatment. Ironically, my COVID infection could not have been better timed; I'm bulletproof now, at least for the next few months, and am no longer infectious. I tested positive 17 days ago.

    The inauguration is tomorrow, I have no plans to watch. I am honestly disappointed with the results of the election. I don't see things going well, what with immigrants on the march from Central America and the president-elect's plan to shut down the Keystone XL pipeline (what the hell is that about?) - and the New Management hasn't even been sworn in yet.

    As for the immigration issue, I have one word: COVID. Uncontrolled immigration into Southern California and other areas of the Southwest US, already a hotbed for COVID infection: what could possibly go wrong? Or to put it another way, how is our already overloaded health system supposed to cope with this? No one has thought to ask that question so far. 

    I'm going to sign off for now and try to find something else to think about.

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    Tuesday, January 12, 2021

    Another Mystery Series

    Over the past ten days I have taken advantage of being in quarantine by reading my eyeballs to stubs. One of my favorite websites, Ace of Spades, has a weekly book post from which I have benefited many times: the book recommendations are always worth paying attention to. Recently someone on the site mentioned the Liturgical Mysteries series by Mark Schweizer and I wholeheartedly recommend these books.

    The series is set in a small town in the mountains of North Carolina and narrated by Hayden Konig, the town chief of police who doubles as the organist and choir director at St. Barnabas. In his spare time the chief, a rabid Raymond Chandler fan, bends his efforts to writing hardboiled mystery novels. He even went to the effort of purchasing Chandler's typewriter at auction, refurbishing it and using it to write. There's just one problem: He's a terrible writer. 

    The books are great. Vivid characterization, scathing religious satire, hilarious town developments, terrible puns and erudite musical and theological references which sail right over my head - they have it all. It is rare that I laugh out loud when I am reading, but every book in this series has made me do exactly that. And the mystery portion of the plots are really good. Do give these a try - you won't regret it. $2.99 apiece on Amazon, if you have a Kindle.

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    Monday, January 11, 2021
    So Here We Are 

    Ridiculous, yes? - to run a medically-based blog and to have no specific posts addressing the defining medical issue of the early twenty-first century. I drafted a post on COVID months ago but never got around to completing it, but it's nearly a year later and here we are. We continue to be plagued by The Virus and the vaccine is just beginning to be rolled out.

    Like everything else about the COVID phenomenon, the vaccine is surrounded by fierce argument and conflict. There are groups who state that preference should be given to various groups based on age, race, profession; or conversely that these groups should NOT be given preference as there are other groups that need it more. All of these arguments have a grain or more of truth. But as happens so often, each group is ignoring or downgrading the needs of other groups at the expense of their own. Not to mention that there are many potential recipients who plan to refuse the vaccine for various reasons.

    The good news is that testing accuracy has improved, and the majority of those who get COVID don't get that sick. For those who do get really sick, the immediate and long-term consequences are severe. I type this as I sit at home on my last day of quarantine (I tested positive on January 2). I was one of the exceedingly fortunate ones who never got that sick. It was the equivalent of a nasty cold, and I still can't smell or taste much of anything. 

    This thing spreads. Our little epic began just before Christmas when one of my parents' caregivers informed me that she had tested positive. Her husband and son are two of the other caregivers and they tested positive a day or two later. Then everybody else got sick. Do you know how difficult it is to find people willing to care for COVID-positive elderly? Pretty damn hard. My mother was coughing heavily and after examining her it was clear that she had bronchitis at the very least. I dragged my parents in to our urgent care on December 26; they tested positive and I was negative. I helped care for them as we frantically searched for a home health company willing to take on COVID positive patients, and finally found one. (My mother is bedridden and can't even sit up by herself, so this was necessary.) 

    One week later with the onset of cough I retested, and this time I was positive. One of our regular caregivers and her daughter both wound up in the hospital with low oxygen, but my parents never ran a fever and their oxygen levels remained good. We were so, so lucky.

    Many were and are much worse off. Plenty of people younger than I have died from COVID or are still disabled from it with severe shortness of breath, memory issues and cardiac problems. The US was unable to react to the infection in an organized manner, as we run more on a state-based system than federal; so some states reacted better than others, plus travel was not locked down as soon as it could have been. (I'm looking at you, New York.) This assisted the spread of the virus over the holiday season last year. 

    Speaking of New York, many state/county/city governments packed the elderly into nursing homes like sardines and then we had to watch them die, in many cases alone and abandoned by terrified health care workers. The fact that 2020 was also an election year contributed to the general chaos as blame was thrown like hand grenades, resulting in a massive delay and waste of effort which could have been put to much better use in reacting to the pandemic.

    I have been among the privileged few in the medical field in that I retired just before the whole thing kicked off. I don't do hospital work. I have been doing both in-office and telemedicine visits - my first experience with telemedicine, and I must say it has gone rather well. 

    Everyone is pinning their hopes on the vaccine. Many feel that now the election has passed and a new (demented) sheriff is in town that things will be handled better; I myself don't agree, but I do hope that government leaders everywhere will learn from this and prioritize planning for potential future pandemics. You never know when it will happen again. 

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