Survival

Ms Ché and I are well into our seventies. Neither of us really thought we'd be around this long, especially given our wild youth. But her mother lived to be 89, and she would have lived longer if she'd been diagnosed and treated correctly for a couple of serious ailments that somehow the doctors missed -- over and over. Makes you wonder, I guess... Her father died when he was 84, I believe, in a board and care home where he was not well looked-after, but that's how that goes, isn't it? There are so many horror stories of what happens to the elderly in our society. I think he was an early victim of the System. Nevertheless, after his stroke, he held on for quite a while despite the deplorable conditions of the care home. 

I'm now and then in cahoots with the Winter Practice sangha, a Buddhist practice community of several hundred participants around the world who come together mostly online to share experience and insight and just be together for a period of sitting and study. Many -- most by far -- of the participants are elderly women, some of whom are not in the best of health, some bed-bound, a few alone. Maybe more than a few. And my heart goes out to them. They know how easy it is for things to fall to pieces when your health gives out and you're by yourself and you can't take care of any more than the simplest of things. You know how easy it is for small failings to pile up and multiply like locusts and to bury you in their debris. This is how most of the elderly single women on the "Hoarders" TV program wind up in that condition. Their health goes haywire and they can't physically or sometimes mentally take care of their residence anymore. The debris of living piles up and they can't get rid of it. They don't have the kind of help they need -- and sometimes they reject it if offered -- and eventually they give up trying. There's no point, right?

No point. Well, no, there is "no point," but that doesn't mean that your life or mine has no meaning, usefulness, or direction. You may take a Bodhisattva Vow and your life becomes dedicated to service.That can take many forms whether publicly and prominently or on a modest personal level. Many of the elders in the sangha have lived a Bodhisattva life but now near the end of it, they are set adrift. So many things that they want to do and feel they need to do both for themselves and for others they can't do without help or at all, and they're left feeling they've failed. A feeling that compounds. So the sangha serves to relieve some of that feeling, for in community, we're not alone. 

But still, it must be tough for those who can't get around very well, or in some cases at all. Doing takes mobility. Other problems include chronic pain. Our practice and training says "Lean into the pain." Welcome it, even learn to enjoy it., Well, maybe that's too strong a term, but the upshot is to use the power of your mind to overcome the pain or at least to control it. This works for some people, not for everyone. Pain manifests differently in different people and it may be controlled or overcome by different means depending on the individual. I've had to deal with so much pain over the years. "Making it go away" by mind power alone doesn't work for me, but it may work for others. Certainly worth giving it a try.

What surprises both Ms Ché and me about still being around at our now-advanced age is that we don't feel "old" -- except when physical limitations intervene, and we can't do what we used to or think we should be able to. Physically our age has begun to catch up with us. There are times when we just can't "do." And it's frustrating. 

For me of course, I was caught unaware by the growing infection in my spine, and I was initially undiagnosed and misdiagnosed when I sought medical care. So the infection had at least another month to develop. 

For a time in the hospital, I couldn't sit up, stand or walk. Pain was so great I was in agony. I lost control of my bowels and bladder. I was a wreck. Useless, right? Well, no. For half the time I was hospitalized, I had a roommate whose condition was considerably worse than mine. He'd had surgery for a blown-out knee, and something had clearly not gone right. He was in extreme pain, could not stand or walk, and not even morphine made his condition tolerable. I had my own problems, but I offered what I could -- mainly friendly listening and modest advice -- to help him feel a little better. Encourage him not to give up. Give him some psychological tools to cope with the pain if not overcome it. And so on. I don't feel I did much, but he sure thought so.

Ms Ché visited every day and she did what she could, too. Between us, we were tag-teaming help for Mike, letting him know we were there and cared and would help.

Bodhisattvas? Sure, why not? It was little enough, but it was something. When called, we don't say no.

I'm so glad to be home, but since I've been home, it's been quite a struggle. A month of physical therapy got me up off my back and moving, but once I finished the 12 week antibiotic treatment pain returned, initially just like the pain I felt prior to being correctly diagnosed and hospitalized. Sometimes the pain has been severe. I need to adjust my meds, but from experimenting, I've been able to mostly control the pain, but the downside is I have very limited mobility because of the numbness in my left leg and foot. As Ms Ché pointed out yesterday, "You can barely get around in the house; you're not going out on your own." I was planning on going to the grocery store to save her a trip, and she said "no." And she went on her own so cheerfully!

We've come this far. There's no telling when our time will be up, and it's really not an issue. We carry on. 

Survival is a strange thing. That we're still around is allowing us time for more service. As little as it might be.

Time for an Update

 

I'm getting better! I think I'll go for a walk!

Welp, It's a little hard to describe what my recovery has been like. I am doing better. I can walk, usually without the assistance of a cane or a walker, but I'm pretty unsteady on my feet and weak on my right side. I've been doing physical therapy exercises, but it will be weeks/months before I get my strength back. Oh well!

Meanwhile, I'm having dental work done that will go into next year -- and cost me more out of pocket than hospitalization. This is kind of criminal of our health care System and I know it affects a lot of people and causes a lot of misery. We have dental insurance, too. As do many people. But the out of pocket costs for dental care with insurance can often be astronomical.

I checked the bill for the rehab hospital stay (10 days) and was surprised. It was over $92,000. All of it was paid by insurance. Wow. The initial hospitalization (13 days) was about $52,000 of which I owe about $1,500. Not too bad. There will be some follow up bills, maybe another $1,000 for ambulances and so on. But the dental work -- with what is considered "good" insurance -- will cost me almost $8,000 out of pocket. I can just about handle that, but what of people who can't? It's crazy.

Overall, I think I'm lucky in many ways and a fool in many ways. I neglect my health and dental care all the time, and yet so far I've been able to get through -- with a lot of help, including that of my wife for whom there is no comparison. It's a learning experience, an opportunity, here in my dottage, to still come to realization, "enlightenment" and greater compassion for those not so lucky -- or foolish as the case may be. 

Yes, I am getting better. But oh my goodness, this has been the toughest one yet. 

The Hospital

I've been hospitalized since August 28 with a serious bone infection affecting my spine and hips. I've been essentially bedridden the entire time, although I can get up and out of bed for short periods with help. It's not so much getting up and about that's the problem as that my blood pressure plunges when I get up or do any exercise. Sometimes it's so low I practically pass out and would if I weren't able to lie down in bed promptly -- which so far, I've always been able to do.

I spent about a month at home attempting to wrangle with whatever was going on, but my condition kept worsening and it couldn't be accurately diagnosed without proper tests which could only be done at the hospital or ER. So finally I called an ambulance and made the 40 mile journey to the nearest ER where alarms started ringing right away. Something was wrong, bad wrong, and after the test results started coming in, they thought they knew what it was. An infection, possibly cancer, that would require extended treatment.

So, here I am, waiting for more tests scheduled for tomorrow, and eager to get out and be whole again. 

What a drag it is getting old.

Living With The Old Things (Redux)

Our 70 year old coffee percolator seemed to be on its last legs the other day (still works, though, as long as you jiggle the electric connection just so) and I got to thinking about living with the old things again.

Yeah, we still do. The house is old (c. 1900), and most of the stuff we have inside is old as well. So are we, both Ms. Ché and I now 70 ourselves. The car is ten years old (and supposedly needs a new engine thanks to extreme oil consumption, but that's another issue for another time.) The van is more than 20 years old and is decrepit, but it runs and transports things just fine,  so we keep it though there have been many offers to buy it from passers-by who want an Astro van (who wouldn't?)

Most of what's in the house is old, from the Philco radio (c. 1942), to the "Downton Abbey"-ish floor lamp (c. 1930), to the high back chair (c. 1880). We kept our California neighbor Joe Francis's easy chair (c. 1940) after he died, though the Pickles (other neighbors who took care of Joe until they put him in a home) wanted to take it to the dump. Looking around the room, the only things that aren't old are the couch (c. 2015), the TeeVee (c. 2014) and a shelf unit and a small table I picked up for my meds last year. Oh, and some books and magazines. Always books and magazines!

Living with the old stuff is comforting in many ways, but it requires a certain level of constant care to keep the old things decent condition and I couldn't do much of anything those several years I was pretty much incapacitated with RA.

Then you wonder: should we just get rid of it?

Like people, stuff deteriorates over time. Especially in the dry and dusty air of our current home in New Mexico. We don't require utility from things, but I know that some of the older books (and we have many of those) have reached the point of disintegration. They look fine as long as you don't open them. If you do, the pages may crumble away to dust.

Now that the treatment I'm having for RA seems to be working, I can do more things -- yay! -- but I'm still limited, and under the circumstances, it's wise for us to consider eliminating the unnecessary old things we've lived with for so many years.

That won't be easy.

Health-X Update

The roller coaster continues, but it's on the slower part of the ride right now. Good.

It's been just about two months since my second Rituxan infusion, and so far, so good. I still get joint pains regularly, almost clockwork for early morning pains (3:00am, sometimes 4:00) but they're not as frequent as they were, and they are never as painful as they were. I call it a "3" instead of a "10" or higher. The pains last a few minutes to an hour and then they're gone. I spend most of every day almost pain free. Last time I saw my rheumatologist, I told the nurse my pain level was "0" -- almost unheard of in that office.

So, this is all very positive.

Of course the cost for the Rituxan treatment was/is breathtaking, incomprehensible. $42,000 for two 50mg infusions? (According to the prior authorization, however, I'm supposed to get 2000mg over the six months of treatment. Not sure what the deal is with that...)

When I finally got a more or less comprehensible bill, I found I was charged 10% of the approved cost of the Rituxan for each infusion, ($9,492 x 10%= $949 x 2= $1,898.) I wasn't charged for anything else connected with the treatments.

I made something of a stink because this wasn't anything like what I was told the charges would be. Because I wasn't given accurate information, I wasn't able to prepare.

I applied for financial assistance through the hospital, and after some back and forth over income documentation, it was granted: 50% reduction in all my costs associated with the hospital and my providers for the 240 days prior to my application.

Ergo, $949 for the two treatments. Somewhat more than I was prepared for, but not outrageous. I guess. Well, how can one know? Still trying to understand what I actually owe, as the charges for the Rituxan treatment have been reduced by some of the out of pocket charges I've paid for doctor visits and tests.

I am told that I will need another two infusions in October  or November, and I will have to reapply for financial assistance at that time, but it will most likely be granted. So my ultimate cost for the four infusions of Rituxan should be $1,898. More than I was anticipating, but still within a manageable amount. Much more than that, though...

Which brings me to medication costs. I've been in the notorious Part D "donut hole" since last month, My prescription for mycophenolate alone is now costing $450 a month out of pocket. Add in Spiriva, Albuterol, Plaquinil, and miscellaneous other meds, and we're  looking at about $1,000 a month out of pocket for the next four-five months. OK. How do we pay for that?

I checked online, and discovered a source for mycophenolate at $106 a month, such a deal. I don't use Spiriva or Albutertol unless I need them, and I rarely need them. Hardly ever. So I still have them from months ago. The other meds I take are relatively inexpensive, so if I can get the cost of mycophenolate down and can continue not using Spiriva or Albuterol, drug costs will be more or less manageable as well.

I'm supposed to see a pulmonologist at UNM today for an assessment of my lung condition which was becoming quite severe. Recent CT scan indicates that the condition has stabilized and has not progressed beyond the damage noted almost a year ago when I started taking mycophenolate. I still have some breathing difficulty but I don't use oxygen or inhalers any more.

And I'm able to get around and do things with far less difficulty than before.

It's the New Normal. Slower, more deliberate and careful, as if Old Age were settling in.

Ms. Ché is facing a whole raft of issues of her own, most of them consequences of diabetes and most of them more or less under control. I urge her to slow down. She won't, but still I urge her. She'll be going back to IAIA full time next month, three more semesters she says before she gets her degree in Creative Writing. Getting through it is somewhat more of a challenge than she was anticipating, but she's as determined as ever, come what may. And she has a lot of support. From the administration, from the faculty, and from fellow students. She may be an "old broad" as she calls herself, but she feels perfectly at home among the young pups. Sadly, we don't have the money to buy more of their art.

I know so many people are in much worse shape than we are, and I'm grateful for what we have and what we are able to share. Some of what's been going on, particularly since Ms Ché's wreck in January, has been a shock no doubt. But we carry on.

Ché the Pneumoniac

Yes, I have pneumonia again. Third time. I wanted not to think it was true, but symptoms were too similar to previous episodes, and I was not getting better. So, got doctored for "persistent cough" and sure enough, pneumonia.

This is  annoying as all heck because I've had both pneumonia vaccines. What in tarnation is the point if I get pneumonia anyway? And where did it come from this time?

It's a mystery, but this is my suspicion: When I went to the doctor for RA symptoms, I got a flu shot because I didn't get one last fall. The nurse who administered the injection had a severe cough. A few days later I developed flu-like symptoms, but I attributed them at the time to side effects from the RA medication I was taking.

After I finished the high dose course of RA medication, I figured the flu-mimic symptoms would go away. They didn't. It became more and more obvious that I had somehow acquired pneumonia again.

How? My suspicion is that I had flu after the flu shot -- either from the nurse or from the vaccine itself. I had no treatment for flu, of course, because it didn't really register with me that that's what I had. The flu led directly to a pulmonary infection that became the pneumonia I'm being treated for now.

If it is viral pneumonia, the antibiotics are not going to work, but so far they seem to be working, so we'll see what happens over the longer term.

For the record, RA symptoms have been largely under control since the five-day high-dosage prednisone treatment -- which ended on 4/18. Not a cure, no. But at least it's less debilitating.

What a drag it is getting old...

RA

I'm coming to grips with an impending diagnosis of early stage rheumatoid arthritis as soon as my doctor gets around to coordinating and evaluating the avalanche of test results that have come in this week.

It's hard to state coherently how much pain I've been in for the last several months, but it has periodically been severe and debilitating. Joint pain. It began with two episodes of general joint pain -- involving practically every joint -- last summer, pain which did not respond to pain relievers -- aspirin and naproxen -- that I had been taking. My doctor recommended that I try ibuprofen, which I did, and sure enough, it seemed to help. On recommendation by a relative, I tried turmeric curcumin which also seemed to help.

After the second episode of general joint pain, the problem became one of a pattern of periodic joint pain that would center in one set of joints after another. Ibuprofen continued to control the pain until mid January of this year when the inflammation and pain seemed to concentrate in my hands and wrists and the pain was nearly constant no matter how much ibuprofen I took. I was up to as much as 2400 mg per day, and still would wake up in the middle of the night needing more.

I'd stiffen up during the night so much it would take hours for me to unstiffen enough in the mornings to even brush my teeth.

Finally the pain became so bad and so constant that I tried an old left-over prescription of Tylenol and codeine that I'd gotten years ago for back spasms. I hated taking it then, and I didn't want to now, but something had to be done. It controlled the pain long enough for me to get some sleep, so that was good. The side effects were still unpleasant, though, and I didn't want to rely on it for pain control.

So it was time to see the doctor again. After hearing what I had to say about what had been going on, the doctor ordered a raft of blood tests, x-rays, and suggested this was probably an auto-immune issue, not osteoarthritis that is caused by degeneration of joints.

She also prescribed an anti-inflammatory drug diclofenac -- which I'd never heard of -- which she said I must not take with ibuprofen. In fact she said over 800 mg a day was ineffective anyway. Oh, well. I beg to differ, but that's another issue for another day.

The anti-inflammatory helped right away. I'd s say the pain in my hands and wrists was 60% controlled almost immediately, and by the second day of taking it, the pain was almost gone for most of the day, though there was still a good deal of stiffness and swelling.

Then the test  results started coming in. At first they were ambiguous, suggestive of an auto-immune issue, but not clearly pinpointing it.

Then results came in that confirmed a  diagnosis of rheumatoid arthritis with an possible other autoimmune component on top of mild osteoarthritis.

Understanding what it is is taking me a while. My sister had lupus for the last 20 years of her life, and I really never knew what it was. She was periodically in intense pain, but she seemed to be getting along reasonably well at other times. Medication helped, and after the first few episodes, the pain seemed to diminish though it kept coming back.

My doctor tested for lupus, and that's the other autoimmune component that appears to be confirmed.

I'm noticing that the anti-inflammatory's effectiveness appears to be diminishing. From 60% control, it's down to about 40% and overnight stiffness and pain seems to be returning in force.

I'm not the world's best patient, so this is going to be an interesting time.

I'll try not to be too self-pitying!

On Geezers Passing

I think I've mentioned on this blog that when I got an invitation to the 45th anniversary reunion of my high school graduating class, along with it was a link to the Dead List from that class. And when I checked it, I was shocked (really) to see the names of at least half the graduating seniors from my class listed as already dead. It was a small class, less than a hundred, and I counted fifty three names, though I knew at least two of them were still alive, so there may have been more errors.

None of the dead ones made it to age 65. I noticed that a lot of those who passed away did so suddenly in their forties or early fifties from heart attacks or lingeringly from congestive heart failure. A lot of deaths were from accidents -- either traffic fatalities or otherwise, or in one case a gun accident. Three that I knew of died of AIDS. There may have been more. Three were killed in Vietnam when they were... young. But a whole raft of guys I hung out with in high school were dead from unlisted causes. Four of their names were alphabetically sequential, and so they all knew each other from the time they'd been in elementary school, they were good friends with one another and their families were close. I was the New Kid, came into the district in 9th grade, and I got to be friends with all of them. After high school, I went to college and they didn't so we lost touch, yet it was a real blow to find out they were all dead. Good doG.

The list went on and on. Practically everyone I considered a close friend in high school was on it. That was hard to take. The handful of friends from those days who had not passed were people whose whereabouts I was pretty sure of and whose contact information I probably had in some address book in the desk in the dining room since I had last seen them no more than ten years before. I noted that some of them were on the "do you know what happened to...?" list and laughed because a couple of them were very well known about town, got their names and faces in the papers all the time, and it struck me as silly that the Reunion Committee didn't know where they were. Oh really?

Given that I knew what had become of the four or five high school chums who were still alive, and none of the rest of the people I'd want to see from my high school class had survived, I skipped that reunion. In fact, I haven't been to one since the 10th, whenever that was. The 50th will be coming up in a couple of years, and I have a hard time imagining I'd go -- or that literally anyone I'd want to see would live to show up at it!

I still have a link to the Dead List, and I checked it yesterday to find another half-dozen or so names added since last I checked, a couple of whom I knew had died, but others surprising me. There was also now a list of Dead Faculty and Staff. Yes, well. Practically all of them are no longer with us, wouldn't you know. But many seemed to have made it well into their eighties before passing. Good for them!

Then I looked up a post-high school buddy, my closest off-campus friend during early college years, someone I lost touch with for years, then briefly reconnected with about 15 years ago through his adult daughter who was part of the crew for a play I produced, but then I lost touch with him again, as our lives didn't really intersect anymore. Now that we were both in our dottage, I was curious to see if he was still working or had retired or whatever. What did I find but his obit.

Oh, Jeebus.

He died nearly three years ago, it turned out, from what was described as "a brief illness." No, he didn't make it to 65, either. I couldn't imagine what kind of "brief illness" might have killed him, as he was sturdy as an ox, but I could well imagine that if he had to be hospitalized something could have gone terribly wrong. There was a picture of him with the obit that was taken fairly recently -- I'd say within the last five years --  and I was struck with how well he'd aged, looking mature, yes, but not really old as so many of my age-group do. His death hit me hard when I saw his picture. It's still upsetting.

The passing of so many of these people I knew, all of them dying before they reached age 65, more than half of my high school graduating class for example, should have an effect on the canard that's become conventional wisdom that "people are living longer" and "life expectancy has increased" since the establishment of Social Security back in the Dark Ages.

Some people are living longer, to be sure. And some people's  life expectancies have increased. But for many, it just ain't so. Some people's life expectancies have actually been in decline for years. I'd like to see a statistical analysis of the life-spans of those Boomers in my high school graduating class, because if so many are dead now -- more than half -- then the average life expectancy can't be all that much beyond 65 -- if that, depending on how young the dead ones were when they passed and how much longer the rest of us geezers are going to hang on before we, too, shuffle off this mortal coil.

While it's possible there is a distinct anomaly in the high number of pre-age-65 deaths in my particular high school class and among my friends, I'm dubious. So far as I know, there is no special risk factor among them, though I could be wrong.

We were all living in middle class (white) suburban neighborhoods; there was no perceptible crime, certainly none of violence, and no gangs or widespread drug use (there was some, though, that I can recall from before graduation but far less than the routine use of alcohol.)  We were near an Air Force base, however, and lot of the households were military. A lot. The base has since been closed by the Air Force, and it took years to clean up the pollutants before it could re-open for civilian use, so I'm wondering if pollution might be an anomalous risk factor.

Vietnam took three from my class, AIDS another three, accidents perhaps ten, heart attack or heart failure another fifteen or so. I only counted two or three listed as cancer deaths, but I know several who survived bouts with cancer and -- so far as I know -- are still alive. As for the rest of the deaths most have no cause listed.

My post high school buddy didn't live near the base, but he had grown up near -- and his father had worked for  -- the railroad yards, which was/is even more contaminated than the base was. Which might have been a factor. He worked in construction for 40 years, specializing in drywall installation later on, had his own company and such, and he was very busy during the construction/real estate boom. That was probably a more immediate factor in his death, but I don't know specifics, so I can't say for sure.

My own parents died relatively young, but not that young -- my father of  cancer at age 69, my mother of emphysema/lung failure leading to heart failure at 74. My sister, however, died at age 61 from a blood clot following surgery to repair knee injuries she sustained in a prisoner take-down; my brother died at age 40 or 41 of unspecified causes.

So even in my own family, a relatively small sample to be sure, the average age of the dead ones is 61. (If we threw in the twins that died at birth, the number would be much lower.)

What I'm getting at is that the "longer lifespan" argument for cutting Social Security benefits and making Medicare access more difficult and expensive is simply bogus for larger and larger numbers of people. A few people -- mostly the very rich with access to more expensive and higher quality medical care -- are living longer (and longer) which may be driving up statistical averages (much as their income does), but the vast majority are not living longer and most have no chance of living longer; too many will have shorter lifespans than those of their parents. The panic over "longer lifespans" has been whipped up by the media (in the pay of certain billionaires it would appear) and it is nothing but propaganda.

Breaking through this propaganda barrage is essential on many levels. It seems to me that what passes for the "left" in this country is very late to the game, letting the propaganda go essentially unchallenged until fairly recently, too recently to be able to counter it effectively. Unfortunately, a sizable percentage of the leftish commentariat has bought the bogus "longer lifespan" argument, and while not openly supportive of cuts to Social Security and Medicare, will not substantively argue against them nor indeed will they argue the correct policies of expanding rather than restricting these and other social programs, increasing Social Security benefits, lowering retirement ages, and instituting something like Medicare For All.

What passes for the "left" in this country is among our many failed institutions since the turn of the millennium. Somehow, the People have to take control for their future and their own sakes.

San Francisco (2)

 

That was interesting.

I managed to injure my left hand Thursday evening around 7:00. It was surprisingly bloody and whatnot necessitating more than a little attention. There would be no show with some Brit geezer at the Fillmore for me.

But that's all right. I got to thinking about the City and my ambivalence toward it. I have to say that I felt surprisingly comfortable there this last time, even with an injury -- or perhaps because of it.

We spent some time at Ghirardelli and Aquatic Park, having lunch at McCormick and Kuleto, walking a bit, checking out the artisans' stalls rather than the galleries, musing over the sour faces worn by so many of the tourists on the top decks of the innumerable tour buses. The Segwayers, on the other hand, all wore silly grins as they roamed and glided the North Beach and Fisherman's Wharf areas in packs.

The line for the cable car turnaround at Hyde and Beach was as long as it usually is, but the passengers were patient as they usually are, and their clanging journey over hill and dale was no doubt the thrill of a lifetime.

At $6 a ride, no transfers, the cable car is only for tourists now, but back in My Day, cable cars were actually public transit means for getting from Market Street or Union Square or wherever you happened to be Downtown over those hills to where you wanted to be by the bay. They were crowded, yes, but that was part of the charm. They got you where you wanted to go. At $.50, it cost more to ride one than a bus or trolley, but if I recall correctly, you could get an all day pass for a dollar or something, ride as often as you wanted, and I believe the pass was good on Muni, too. Those were the days.

The fog was coming in already in the early afternoon and the Golden Gate Bridge was almost completely obscured, but the Marin hillsides stood out proud and golden on the northern rim of the Bay. Then they too disappeared into the enveloping fog. This fog never seemed to come into Fisherman's Wharf and the Marina district, though we could see its tendrils coming over the tops of the western hills. For some reason, the northern end of San Fransisco stayed in sunshine the rest of the day. It was still sunny and even a bit warm when I bashed my hand.

There was an Urgent Care down the street, but I decided not to go that route and toughed it out with some Walgreen's first aid as it was even closer. The staff there was wonderful. You take your chances at Walgreen's (I've had very good and very awful experiences at Walgreen's over the years, and I will not recommend their pharmacy any time soon given atrocious service and screwed up prescriptions in the past.) But this particular Walgreen's had excellent, cheerful and very helpful staff; I got what I needed in short order and proceeded to tend my wounds myself.

After the blood was staunched and I'd calmed down a bit, I went for a walk along Lombard St; it hasn't changed a great deal since I made it my in town overnight destination when I had work assignments in San Francisco -- and I could get a room. Some places hadn't changed at all which is always one of the comforting things about San Francisco. You can rely on at least some of the City to stay the same -- or at least similar -- no matter how long you are away.

The video up top is kind of striking to me because it is so evocative of the City as I first recall it. The home movies the video is taken from were shot in 1941, well before I was born, and even longer before I first visited San Francisco (which would have been about 1957 or 1958.)   I've seen film of San Francisco taken in the 1950's, and the city views don't have the powerful evocative effect this earlier film does (there are others in the series that are just as evocative for me.)  The only things I can recall that appear in later films that aren't in the earlier ones are the Cliff House and Playland At The Beach, but they weren't really "in the City" so much as out at the beach.

I loved going to the beach when I was young; not so much now, though. An exception is Aquatic Park in San Francisco, which isn't actually the beach --s though there is sand so it will do. Aquatic Park is a protected area on the Bay rather than on the ocean, so it's generally not as windy and not as cold as things typically get along the Pacific. When I was younger, the wind and the cold at the ocean didn't bother me at all. Now it does. The perils of age. Things that you once enjoyed no longer seem so fine. Things you never appreciated before take on new importance.

Had a nice chat with Mr. Patel at the place where we were staying. The A/C in our room stopped functioning and I let him know. He said he'd come up to check on it, but there was probably nothing he could do, it being after 5:00pm and "nobody would come out after 5, you know." Yes, well...

He did come up, and by golly got the machine to function, and we laughed over it, and I asked him his name ("Patel," of course!) and we got to talking for a bit. He asked my age, and I told him. He said, "Well, I'm seventy-five, you know." He didn't look it and I told him as much. "Oh yes! Indeed, I was born in India in 1937! I worked in hotels in India for 35 years." I asked him when he came to the United States. "Oh, it must have been about 12 years ago. My sons were already here."

He said he missed India sometimes, "But India can be such a cruel place." I said, "That's true of almost any place, isn't it?" He said that in his opinion, America was much gentler most of the time. "It's so much newer, you know."

He said his family had bought the place where we were staying a few years ago, and they bought the building next door, too for additional lodging space. The buildings were pretty run down at the time, but they fixed them up. They put the fancy suites in the neighboring building. Did I think the room was nice?  It was, actually. Not fancy at all, but quite large, with all the requisite amenities and a few more. It had been fairly recently renovated, obviously, but it was done well. The bed was comfortable. Just needed to make sure that pesky A/C kept working. It was not that hot outside, but the room faced west, and the sun was hitting the room directly. Solar heating! Bonus! He said, "You know the suites don't have the air conditioning at all. They have to open windows and turn on the ceiling fans. So you're lucky!"

Indeed.

It helps to keep that in mind.

Segwayers along Bay St at Polk

Aquatic Park, Marin hills in the distance

Ghirardelli Square from Aquatic Park

Fog obscures the Golden Gate

At the After Hours Clinic Yesterday

Well.

Yesterday, I went to Kaiser for the first time since this spring when I was being treated for pneumonia (that had been suspected erroneously to be tuberculosis, which was repeatedly tested for and never found. Oh. Whell.)

I had to go because I'd developed an annoying and painful rash, much of which had appeared suddenly, overnight. Good gott, what was it? When I called up the advice nurse, she went through the flow chart routine, "Does it hurt?" Yes. "Is it blistery?" Yes? "Is it on one side of the body?" Yes. Etc. She said there were no appointments available, but she could have a doctor call me in half an hour or so. Ok.

Doctor called, went through the symptoms again. She said, "Have you ever had shingles?" No. "Chicken pox?" Yes. "How far away are you?" A few miles. "Get over here, quick." She told me where the clinic was, and she said she'd expect me within fifteen minutes.

Sure enough, she took one look, said, "Shingles." Oh fine. Said it was going to get a LOT worse -- it has -- and there wasn't a lot they could do, but she would prescribe ointments, anti-viral drugs, and Vicodin. If it got way worse, come back, otherwise, endure it.

How long? I asked. She said, "You don't want to know." I repeated, how long? She said, first time outbreak like this, could be months. And it can get very painful. If the pain gets out of control, call back, she'll prescribe something stronger.

Great.

It was a quick evaluation, to say the least, but I had realized that it was shingles when the flowchart of the advice nurse pointed there. Actually, the earliest symptom was a sharp burning pain deep in my leg that I attributed to a recurrence of the sciatica that had cropped up a few years ago. When I saw a small skin eruption on my leg, I did not relate it to sciatica. Instead, I thought it might be incipient melanoma -- what my father died of. But it didn't really fit any sort of melanoma symptom set I could find. It was something else, I was sure. When a few days later, the eruption spread suddenly, I still didn't connect it with shingles, though I was trying to figure out some connection with the nerve irritation and pain of sciatica.

When I talked to the nurse, the "ah ha!" moment arrived. Sure. That's what it is.

It is painful, annoying, interferes with sleep. I hate taking codeine. But it seems to control the pain (and scramble my brain!), so... one does what one must.

I asked the doctor what could have caused it. She said it was probably just my age and the fact I had had chicken pox when I was younger.

Thanks.

Grr. Talk about poison. Well, there you are.