Wednesday, March 29, 2023

Save Your Radiation

I had an MRI of my neck recently. No radiation from that, but the radiologist who read the images recommended a CT scan to follow up on an abnormality he noted. My doctor said he'd order the scan. Because I was given excessive radiation as a child (my adenoids destroyed with radiation because at the time it was thought to be safer than surgery), I'm careful about radiation exposure. I told my doctor I'd have the CT scan if he thought it was really necessary, but asked if it really was. In response, he referred me to a specialist for evaluation.

The specialist examined me, found nothing wrong, and said I absolutely didn't need a CT scan. Pointing out that CT scans carry a high dose of radiation and yet are ordered almost casually these days, he declared, "Save your radiation."

A Harvard Medical School website says, “Over 80 million CT scans are performed in the United States each year, compared with just 3 million in 1980.” The article talks about radiation exposure, and concludes: 

“So until we know more, you will want to keep your exposure to medical radiation as low as possible. You can do that in several ways, including these: 

Discuss any high-dose diagnostic imaging with your clinician. If you need a CT or nuclear scan to treat or diagnose a medical condition, the benefits usually outweigh the risks. Still, if your clinician has ordered a CT, it's reasonable to ask what difference the result will make in how your condition is managed; for example, will it save you an invasive procedure? 

Keep track of your x-ray history. It won't be completely accurate because different machines deliver different amounts of radiation, and because the dose you absorb depends on your size, your weight, and the part of the body targeted by the x-ray. But you and your clinician will get a ballpark estimate of your exposure.

Consider a lower-dose radiation test. If your clinician recommends a CT or nuclear medicine scan, ask if another technique would work, such as a lower-dose x-ray or a test that uses no radiation, such as ultrasound (which uses high-frequency sound waves) or MRI (which relies on magnetic energy). Neither ultrasound nor MRI appears to harm DNA or increase cancer risk. 

Consider less-frequent testing. If you're getting regular CT scans for a chronic condition, ask your clinician if it's possible to increase the time between scans. And if you feel the CT scans aren't helping, discuss whether you might take a different approach, such as lower-dose imaging or observation without imaging. 

Don't seek out scans. Don't ask for a CT scan just because you want to feel assured that you've had a "thorough checkup." CT scans rarely produce important findings in people without relevant symptoms. And there's a chance the scan will find something incidental, spurring additional CT scans or x-rays that add to your radiation exposure.”


Sunday, March 26, 2023

Something New in My Old Woodstove

 My woodstove (like my lawn tractor) is a "hard start." I've used this big, beautiful Jotul for decades, and after I stopped burning wood all night it always took some time (and multiple matches) to get it going in the morning. I started with crumpled newspaper topped with three pieces of fatwood (split by me with a cleaver in the kitchen), and kindling wood on top of that. Once it caught fire (whenever that might be) I added larger pieces of wood, and eventually larger still. 

I forget what I was looking for at the time, but one day last year I went down an internet rabbit hole of wood burning advice and found myself reading a blog by a guy who advocated the opposite approach: He starts his woodstove fires from the top down. With his stove loaded with wood, starting with the largest logs on the bottom and ending with kindling on top, he added "Nantucket Knots" of newspaper. He said the knots—made by rolling a sheet of newspaper corner to corner and then tying a loose knot in the middle—stay in place better than crumpled paper. He lit the knots and soon all the wood ignited and he had a roaring fire in the stove. Much too roaring for me.

I was intrigued with the knots, which I'd never heard of, and tried my hand at making some. I could have called them New York Nots. They were not neat, not effective, and not worth trying again. 

But something about the blogger's "top down" method had me thinking, and as I mulled it over a very much simplified version came to me. I tried it out, and ended up using it for the whole rest of the season. It provided quicker heat. It turned a somewhat dreaded chore into one I actually looked forward to. And most of the time it required only one match!

First, I lay down two medium-size split lots, leaving about 2" of space between them. Then I fold a full double sheet of newspaper, make a roll about 11" long, and put it in that space, starting at the back (farthest from me). If I have a cardboard cylinder from a roll of toilet paper I put it over the newspaper like a napkin ring. About 4 or 5" of space is left to fill at the front. I do this by rolling up a single sheet of newspaper into another 11" roll and then folding it in half. I stuff this in between the logs at the front.

On top of the paper I place two or three split pieces of fatwood, and on top of that a handful of what I call "twigs"-- small debris from dead tree branches, easily obtained in my yard, especially after a strong wind. Next comes one or two pieces of kindling my son splits for me, and finally a couple of smallish logs--round ones in these pictures. The twigs are good at making things stay put.

Then comes the fun part: lighting the paper. Despite the fact that my Jotul doesn't have the best airflow, everything catches fire quickly, including the larger logs at the bottom. It isn't long before the fire looks like this, and cats Rocky and Scruffy have moved into their favorite spots by the warm stove.

Perhaps you can keep this method in mind for next year!

Saturday, February 11, 2023

One Year to the Day

I don't know why this post sat in Drafts for almost two years, but here it is.

March 8, 2021:  Today is one year to the day that I started isolating. When I first heard about the strange new illness that appeared in China, I knew it was going to be big. Big and awful. I ignored the advice to prepare "as if for a snowstorm," and I stocked up--not with two weeks worth of food, but vastly more than that. "I may have bought too much," I said to my son. He said, "Don't worry,  you'll use it up." 

Well, that sure hasn't happened yet. The pandemic has brought out my inner hoarder. Instead of emptying a big plastic bin one food item at a time, I've replaced each item as I used it. You might say I was trained well; I was the daughter of parents who lived through the Depression and kept a kitchen cabinet full of canned goods that they rotated, and I was the wife of a man who was a "prepper" before his time. I think I still have decades-outdated tubs of nitrogen-packed emergency foods in the basement.

I also have:

Pandemic House

Other than occasional visits from members of my son's family, I'm the only one who's been in my house for the past year. When you combine this with my long history of random housekeeping and essential focus on activities that brought me pleasure during isolation, you have the perfect storm of clutter.

Pandemic Hair

I know women who let their hair grow over this past year and look fine, but I know I look like a witch with long grey hair, so I've been cutting it myself. I cut it often, mostly in a never-ending (and futile) attempt to improve the previous haircut. All these trims, and I still have no idea what the back looks like. But it isn't just my hairstyle that's changed. It's a lot greyer--that's okay, my bangs and side hair in the front is silvery, which is nice--and a lot straighter. I used to need a curling iron to straighten out the corkscrew curls of my bangs, but now I need a curling iron to create a soft bend in them.

Pandemic Face

This is a face that rarely looks in the mirror. This is a face devoid of makeup. It's a face that doesn't smile as often as it used to, is somewhat greyish in color, and has sets of wrinkles that didn't exist a year ago. It is hoped the summer sun and the eventual opportunity to actually see people will improve this face.

Pandemic Wardrobe

Pandemic wardrobe isn't as bad as it sounds. I discovered the comfort and fun of jeggings and fleece leggings, and treated myself to a bunch of brand-new turtlenecks when Boscov's and Macy's had pre-Christmas sales. Topped with the Eddie Bauer fleece pullovers my daughter Suzanne bought me many years ago (Eddie Bauers last forever) or the grey Cabela's hoodie from Salvation Army last year that I'm equally attached to, my around-the-house look is a look I actually like. Best of all, it keeps me warm. When the season changes I will miss these winter clothes as they cover a multitude of sins.

Pandemic Purse

I've never been a woman obsessed with handbags, but I do change them with the seasons. Not this year.

Pandemic Pantry

Yes, I bought all those things that everyone else bought--not because I wanted to follow the crowd, but because, like I said, I've been well trained. So my pantry shelves contain lentils in red, brown, and grey, as well as dried cranberry beans, garbanzo beans, lima beans, cannellini beans; kidney beans, black beans, and pinto beans. Also cans of beans. Jasmine rice. White rice. Brown rice. Brown jasmine rice. Basmati rice. Brown basmati rice. Pretty, multi-color rice blends. Chia seeds. Sesame seeds. Peanut butter. Tahini. Four or five kinds of oils. Five kinds of nuts. The pantry has a reassuring look to it.

Pandemic Paint

Like so many others, I took up a new hobby this year. I had photography and rug hooking, but the same old photo ops didn't inspire me, and I felt I needed to learn something new. Plus I thought it was time I stopped feeling guilty about the stack of books on watercolor painting I read years ago and never actually did anything with. So I decided to take lessons, but I wanted lessons that were a) not live, so I could participate whenever I felt like it, and b) cheap. Domestika, a company out of Spain, fulfilled both requirements. From their zillion (200+) online courses I chose one on watercolor techniques. The course was given in Spanish, and the generic translation so confusing that I often watched the video at least twice--once to read the instructions, and a second time to make sense of the instructions by watching to see what the instructor did. But the translations created some hilarity, too, always appreciated during isolation. The course cost less then $10! I enjoyed it so much that I ordered another on portraits . . . and another on painting birds. I haven't started those yet.

Pandemic Projects

My first pandemic project was my most successful so far. I cleared out the stuffed (and piled high) alcove at the top of the stairs that had been neglected for years, and created an "art spot" for myself. I started with my old sewing workstation and added a rug, new lamp, a cool extension cord with USB ports, a little new electric heater--and lots of art supplies. I've always loved buying art supplies. I'm also somewhat fond of buying sewing supplies, which served me well when (like so many other people) I started making pandemic face masks.

Pandemic Presents

I've always been fairly frugal and grateful for it--especially at this point in my life. Since I've been living alone I take advantage of pre-holiday sales to buy myself a Christmas present (don't feel bad for me--it is not the only one I get!), but tend not to indulge myself very often otherwise. But in my isolation it didn't take me long to realize we all needed pandemic treats. So I bought myself a new smart TV (50" isn't all that large by today's standards, but it was huge to me) and a Netflix subscription. 

Pandemic Vehicles

I still drive my 1992 Chevy Caprice in the warm months and my 2011 Subaru Outback in winter. Neither vehicle has gotten much exercise this past year. I haven't visited anyone, and most of my shopping is done online. For groceries, I order online from Walmart and pick them up curbside in Honesdale. Last year was when I'd planned to a) sell the Caprice (sad, but it was time) and b) trade in the Outback--probably for a newer one. But the pandemic cancelled those plans. Over the course of the year two things happened: car prices rose, and dealers' inventories of good used vehicles dried up. They disappeared! It was pretty amazing. Occasionally I'd check out the websites of Subaru dealers in the area, and the sections on Certified Pre-Owned vehicles were empty. So I don't know when I'll be making a change.

Pandemic Mental Health

It didn't take me long to realize that all the articles I've read over the years about the importance of social contact for the elderly were spot on. I may not think of myself as elderly, but I'll turn 78 next month. Even before we ever heard of Covid, I was thinking I really needed to find myself some new friends. Even one or two. Most of my friends have either died or moved away. For years I've joked that my entire social life takes place in December when I go to Beverly's Solstice party and Kathy's Christmas party. It's only a slight exaggeration. My only consistent social gathering was the Thursday afternoon Scrabble games at the library, which I'd been participating in for several years. Of course, they stopped when the pandemic started. 

Most days I speak with no one. At some point I started Zoom meetings with two friends every Tuesday evening, but that's it. It's not enough. Facebook has become my community, my social outlet. I'm beyond grateful for it, but of course it's not enough either. I realized how much I missed laughter one day when I started laughing at a funny Facebook post, and didn't stop. We sometimes say, "I was hysterical" when describing something hilariously funny, but that time I really was hysterical. It's not healthy.

But then again, neither is Covid-19.

Monday, March 29, 2021

Gabapentin: Another Drug I'll Avoid

I realize I've never written about my experience with Gabapentin, a popularly prescribed drug, so here's what I wrote about it a couple of years ago:

My shingles saga began more than two months ago, and I feel as though it's not over yet. The blisters, which were on the back of my scalp, have been gone for some time. I was scrupulously careful about not scratching them because I'd read scarring could lead to permanent hair loss. But I've been losing hair the whole time, and it's still falling out. At some point I realized I was losing hair from both sides of my head--not just the right side where the blisters were. So I blame the drug gabapentin, which apparently can cause "long-lasting" hair loss. I still don't know what is meant by "long-lasting," but I plan to ask the neurologist.

I was prescribed gabapentin at a low dose (two 100mg capsules once a day) and I cut it in half early on. I was grateful for it at first, as it gave me relief from the unremitting nerve pain I'd experienced from my neck down into my arm, but it soon became obvious it was messing with my mood and memory. My brain is one thing I don't want to mess with! Many thanks to the friends who informed me of some of the downsides of gabapentin, including depression. I got off it after a few weeks, and waited for my memory to get back to normal and my hair to stop falling out. I'm still waiting.

But now I have another issue to deal with: weird tooth problems involving nerves that act up and settle down. I wondered . . . since gabapentin acts on nerves, could there be a connection? I Googled gabapentin teeth and found all sorts of complaints about the drug. People claimed it was responsible for their tooth decay and loss. Whether all the accounts are true I have no idea, but the possibility of a connection makes sense to me.

I ended up needing a root canal. I'd gone to the dentist because one of my teeth had become so sensitive. He tested the nerve, and the nerves in surrounding teeth, and they were all fine. The next day the tooth looked darker than the others. I went back to the dentist, and they found the nerve had died. I'm now pretty certain all those reports about tooth loss from gabapentin were true.

A pharmacist told me the dose I’d been prescribed was unusually low. She said many people take 300 mg three times a day. With its history of causing depression, I wonder if gabapentin is partly responsibly for the huge number of prescriptions written to combat depression in this country.

Sunday, August 02, 2020

The State of Our Union

I always read in bed at night, and last week I started reading Lilac Girls, a debut novel about three women during WWII. It seemed clear, given the setting, that one or more of them would be in peril at some point, and I hoped the book wouldn't be too suspenseful. I don't handle suspense well.

Last night I was introduced to the third woman, a young medical student in Germany. The year is 1939. She has been taught (brainwashed) that Jews are bad people who want to corner the market on law and medical jobs, and she has a real aversion to them. Her father does not, but her mother does. Lists are posted in public places (there is a name for these lists) of Aryans who shop in stores owned by Jews, and those on the list are ostracized, and sometimes arrested. Meanwhile, Jews were being pulled out of their homes, and all their possessions were either looted by the SS or spread out on tables in the street and sold for cheap. 

There was such a horrible divide between the followers of the Fuhrer and those who had compassion for the Jews and felt the Fuhrer was a dangerous man. (The book, thus far, didn't even mention the others who were persecuted and killed, such as homosexuals and the disabled, which I believe happened before they turned on the Jews.) People had to be careful of what they said in public. Strangers sniped at one another in stores. Marriages and friendships were strained. The divide produced a pervasive atmosphere of suspicion, animosity and lurking violence. It reminded me of the situation building in the U.S., and I had to abandon the book permanently. It kept me awake for hours.

Friday, May 08, 2020

Staying Home vs. "Staying Home"

I like New York Governor Andrew Cuomo, but I wish he had never mentioned the "shocking" 66% of people who contracted Covid-19 while staying home. The lunatic fringe has jumped on this, and now we have protesters carrying signs that read COVID IS A LIE.

What they don't seem to have thought through (do they think through anything?)  is that "staying home" doesn't necessarily mean staying safe. I'm pretty strict about my isolation because I don't dare get the virus, But  some people, while staying home from work, shop at Walmart and  Home Depot, and who knows where else. They don't bother to sanitize what they bring home from the stores, and they don't pay attention to their mail and UPS packages either.

And they have visitors. "It's only family," I've heard more than once online. They let their daughter in because she's their daughter--even though she goes to work every day or lives with someone who goes to work every day or gathers with her friends on weekends "because it's hard not to socialize when you're  young." Or their grandkids get dropped off at their house every morning because they've always watched them and they're just little kids. Or they invited the whole extended family over for Easter dinner because they always get together for Easter and they're not about to give that up because some stupid governor issued an order.

So I don't find the 66% shocking, and I wish the protesters would get off the street and back in their houses where they belong.

Wednesday, April 01, 2020

Home Sweet Home

I've been self-isolating since March 6, and up to now I've had it relatively easy as my son and his family (my only visible neighbors) have been isolating too, so we've been in the same isolation circle.My son has stopped in every day, and the boys (8 and 6) are in and out of my house. I get to see the baby (4 months) too. But now my son has been called back to the office once a week, and that changes everything. Because of my age (77 in a few weeks) I have to be extra cautious. So now my isolation really is isolated! Good thing I'm pretty good at solitary confinement. Also, being an only child means I'm never bored.

My rural county has 10 Covid cases, but an hour to the east--closer to NYC--another county has 236. Both counties are under a stay-at-home order. I have a good supply of food and other things, and we've picked up a couple of online Walmart orders when we got low on fresh produce and other perishables. Not everything is always available, but we're flexible.

I do worry, though, about the magnitude of the crisis and how it's going to play out. I've heard experts state firmly that we will have a resurgence in the fall. It's hard not to envision an endless loop. But as much as I've bad-mouthed pharmaceuticals, the companies are working hard on a vaccine (whether from altruism or the profit motive, it doesn't much matter), and the same goes for treatments.

And I'm grateful for technology! Imagine doing this in the years when I was growing up when my parents had one phone (squat and black) and one small TV. Or before that, with no phone and no TV. Like the 1918 Spanish Flu. Or the 1800's, when diphtheria ravaged communities. Be grateful for the internet, and stay safe, everyone!