09 August 2008

Let Me Get This Straight...

...you're telling me that three pots of coffee and several large iced teas a day might result in too much caffeine?

I found this nugget of wisdom courtesy of a stubborn case of swimmer's ear. Yes, I've been turning too many flips in the pool to make up for lost time. My pool officially became swim-worthy last Friday so I had a lot of time to make up for and, well, I worked hard to get in as much swimming and flipping as I could. Any reasonable person would do the same right?

I noticed Monday that the hearing in my right ear was fading in and out and noises started sounding more like gurgles. I tossed it off as a fluke and tossed my business clothes off right along with it and ignored the percolating annoyance as something that would go away in a day or two. I spent a couple of hours Monday evening in the water and by Tuesday Morning, as I was driving to work, discovered that I couldn't even listen to Sting on my cd player. Clearly, this was getting serious.

Wednesday, I spent my lunch hour at the CVS on Wrightsville Beach, perusing the aisle featuring over-the-counter remedies that promised to dry up my ear and restore my hearing. When I got back to the office, I administered the drops and waited for everything to clear up only, well, everything didn't clear up. The gurgling became more intense, so much so that I even cut my swim time down from 2 hours to one and applied the drops both before and after my swim. They didn't work. Someone mentioned that perhaps if I stayed out of the pool for a few days and gave my ears a chance to dry out, it might resolve, but I thought that sounded rather radical and I dismissed it instantly.

By Thursday Morning, I realized the time had come to seek professional help. I had googled the daylights out of "swimmer's ear". I thought google was good for everything. I guess nothing is perfect, not even Google.

I called and requested an appointment with my physician's office. As it turns out, my doc was out Thursday Afternoon (probably swimming), but I could see the PA. Of course that would be fine - it was just a simple case of swimmer's ear and I had no doubt that a PA could easily take care of it. Besides, I had my shiny new insurance card and it's always less painful going to the doctor when you know it won't break the bank. I had researched my benefit package and without a doubt it's the best health plan I have ever seen. I'm impressed with it and I hope it gets very little use but, well, let's face it - it's a huge comfort to know I am covered.

I made the appointment for 3:15 and skipped lunch, thinking I would pick something up after the visit. In the meantime, I tossed back a few cups of coffee, an iced tea and some nuts. I was so preoccupied with trying to hear, that hunger took a back seat.

However, as I was sitting in the waiting room, after checking in with my favorite ladies at the front desk who are always smiling and truly can make you forget you're in a doctor's office, I was directed to the "PA" side of the office and met another very kind staff member who took my information, updated my new insurance info and even complimented me on what great insurance it was - only $10 an office visit, she commented in admiration. "Yeah, pretty cool, huh?". I never thought I would arrive at the place where health insurance benefits would be on my top ten list of things to shoot for but, given the cost of healthcare today, it's a pretty big deal.

After a few minutes, I was called back for the obligatory weight and vitals check. We sailed through the weighing in and I was directed to a seat for my least favorite part of any exam - pulse and blood pressure. I tried to prepare them that the values would probably be higher than what they were accustomed to seeing and not to be too excited if my pulse was 100 and my bp was a tiny bit elevated. It's just how I'm wired and I get high-wired when I'm surrounded by white coat types. She smiled and started pumping up the dreaded cuff.

I was watching her face as she pumped and when she released a little air and pumped again, I knew I was in trouble. Again, I reminded her that my vitals "show off" when in the presence of medical professionals. She excused herself and within a couple of minutes returned with another more serious looking nurse who commandeered the cuff and resumed the pumping. The other nurse was busy on the computer looking up my chart and medical history. I was now flirting with full-borne panic and wondering how weird it would look if I told them my ear had miraculously recovered and apologized for taking up their valuable time. It was a very small room and when the third member of the staff entered, it was becoming a little too crowded for me.

"OK, what's the problem?", I reluctantly asked the really tall nurse with the officious manner.

"Honey, your blood pressure is 160/100 and according to your chart, it's never been that elevated. Let's see what your pulse is."

Oh boy, I knew I was in trouble now and they didn't seem at all concerned with my ear which was probably just as well because by now, I could hear my heart beating in there, amidst the gurgling. I was starting to feel trapped.

The tall nurse was now shaking her head, walked out as if she was on a mission and returned with a pulse-ox meter and placed it on my shaky finger. Great, just great. My pulse was 170 and they were not at all pleased with it. I told them I had a history of panic disorder, was on medication for it, (though I had not taken it yet that day), and that honestly, as soon as I left the premises things would slow way down.

The three of them eyed me suspicously as that stupid meter started tapping too fast and too loudly for my taste. So much so that I took it off and handed it right back to them and told them I would take my meds right then and there and they would see that if they just calmed down, so would I and we could all be pals again.

They seemed kind of stunned that I removed their medical equipment and, quite frankly, so was I. But I felt secure in doing so because I know me and I know how my resting pulse can reach most people's targeted heart rate in less than 60 seconds and besides, I hadn't eaten anything (stupid move) and my plummeting blood sugar and all of the caffeine swirling in me wasn't helping anything at all.

The tall nurse walked out and came back in bearing a can of orange juice and peanut butter crackers, while the other one was perusing my 8 year medical history and notes penned by my primary care physician who insensibly picked THIS AFTERNOON to be out of the office, leaving me to scare these fine people who were in a dither and hadn't even gotten to the original point of my visit.

Finally, blessedly, the PA walked in and sized up the situation and my growing panic. I'm sure I had already flashed the obligatory "deer in the headlights" visage and if I hadn't been so hungry and shaky, I would have bolted straight away.

She smiled, introduced herself and a calm fell over the room. I finshed up the OJ and crackers and again, repeated my spiel on how I just naturally have a rapid resting pulse and that the blood pressure numbers were probably tainted by hypoglycemia and caffeine saturation. She listened intently, and let me finish my tired tale - the only thing I didn't offer in my defense was "and the dog ate my homework", but if it would have worked, I would have blamed Cassie in a NY, hyper-heartrate minute. Cassie would have understood - she's loyal like that.

As a welcome change of pace, she moved from the cardiac craze and actually started quizzing me about my water-logged ears. Finally we were getting down to business. She first peered into the one that was only marginally impaired and when she got to the problem ear, she nodded in compassionate understanding. "I bet that's pretty painful. There's even some blood in there. How's it feel?".

Well, it felt clogged up, but it wasn't really so much painful as it was annoying. Everything sounded muffled and distant. I missed my hearing. I missed shaking my head without feeling half the pool was trapped in there.

My new best friend the PA returned to her computer and in a matter of a couple of minutes faxed a couple of prescriptions to my neighborhood CVS. Relief was on the way!!!! Yippee - I could blow this joint.

Not so fast. As she was typing longer than the epistle of my episodic ear inflammation would have required, I asked her if she was writing a book? Did a case of "swimmer's ear" really merit so much typing?

"No, this is about that other issue - I have to document your bp and heart rate and add it to your chart.". Then she stopped typing and looked at me and very kindly, non-threateningly turned to the topic of tachycardia. Tachycardia is defined as a rapid heartbeat of more than 100 beats per minute. At my current rate of 170 bpm, I more than meet the criteria.

"Listen, I realize that folks get tense in a doctor's office and there's no question that when you are presenting with a pair of swollen, infected ears - that, too, will elevate one's vitals. But 170 is extremely high. You didn't come in here with a severed limb or raging infection. You came in with swimmer's ear and there is no rationalization for those vitals.".

Of course, I knew she was right. And now that the OJ and protein had kicked in, I found I was able to listen more intently about this tacky tachycardia. And, to be honest, my heart had been beating faster, at increasing intervals, in the last few months. It had been an eventful spring and summer - new job, new routines, offspring relocation, nocturnal parental falls, one failing feature after another on my car and a $540 bill to get it repaired this past Monday, and trying to find a new routine in this suddenly quiet, empty nest.

This kind PA listened to it all and she appeared to be around my age and could relate to my rationalization, and I completely admitted that I consume way too much caffeine. I owned my caffeine consumption.

She said she wouldn't be able to sleep that night unless she offered a possible solution. As long as it didn't involve more tests and I could get out of there, I was all ears - even if they were waterlogged. Besides, I trusted her and she had cleared the room out and got rid of that pulse-ox meter. I told her I was open to suggestions.

She offered that she didn't think there was anything "organically" amiss with my ticker, but she said even the most healthy heart muscle gets tired of sprinting for no good reason and mine needed a rest. I could buy that. She asked me if I would be willing to cut the caffeine intake and mix the caff with decaf, keep a two week, 3 times a day record of my pulse, and try a very low dose of a beta blocker.

And before I knew it, I found myself promising that I would cut the caffeine in half, measure my pulse and yes, I would even be willing to swallow the medicine. She made a very thoughtful, reasonable pitch for it and she empathetically made a great deal of sense. Besides, I did have great health insurance now so, well, sure. No excuse not to. She even gave me her personal number in case I had questions or concerns which I thought was very kind. This visit was beginning to look up after all.

She promised me I would feel better and my heart would thank me and she said I could still get in the pool, but to keep my head out of the water for a couple of days. I knew that was pointless. I can't get in the pool without being underwater. I didn't even walk near it yesterday - too much temptation. Today, however, will be 48 hours and I will be back in business. I can hear again! Well, sort of. OK, it's much, much better.

Which brings us to the medication. On the way home Thursday evening, I picked up my scripts and again, thanked God for my health insurance, and brought the meds home. I immediately administered the ear meds hoping for a fast resolution but, I will admit, I couldn't bring myself to take the beta blocker Thursday Night. I had to google it first. I googled the heck out of it.

Inderal LA 60 mg
. Overall reviews were positive and impressive. Hardly any negative press to be found and I tried to avoid focusing on those as to do so could become a self-fulfilling prophecy and I know how powerful the mind can be. However, I still wasn't ready.

Last night, my Mom asked me if I could tell any difference yet from taking the Inderal. I told her I couldn't detect any difference at all and then I mumbled, "probably because I haven't taken it yet...". My Mom's hearing is just fine and she caught my mumble.

"Susan - take the medicine! You're so silly. Take it right now. It's safe!".

I wanted to believe her and she's got a great track record for being right. I went upstairs, took the capsule from the bottle and slowly walked downstairs for a glass of water. My Dad was sitting at the table and of course, I love my Dad, but his hearing isn't quite perfect.

My Dad asked my Mom what the name of the medicine was and she told him it was called Inderal.

"End it all? Suz, did you take that "end_it_all" yet?".

I was in mid-swallow and I almost choked - giggling - which was probably his primary purpose. My Mom was just shaking her head, having reaffirmed yet again that she lived in a house with crazy people. Funny...but crazy.

So after I took my "end it all", I went back upstairs and waited. For what, I'm not sure, but I'm pleased to report that the pretty purple and pink capsule didn't "end it all" and I woke up after a really good sleep. My pulse is a healthy (for me) 88 and my ear feels much better.

In other news, the newly-relocated WV couple, known as Justin and Stephanie, seem to be settling in quite well and apparently they both report that West Virginia isn't as bad as they feared it might be! Justin shared with us that it's cool enough at night in them thar mountains that they have found it necessary to don a sweater and jacket. I assured them that if there had been in Wilmington this past week, they would have found no need for either. It's been oppressively hot and humid and even my 33,000 gallon sparkling clean pool has felt like warm bathwater. It's still water though, and I love it. It centers me.

Justin has been busy learning the ropes of his new position and will be heading to Roanoke on Monday with his Dad to get some realtime experience in opening up a huge Direct Buy store. It's interesting and fun hearing his stories when we connect on the phone now.

My other offspring, Ms. Katie Parker and her tall boyfriend John, are flying to attend a wedding in Virginia this evening. It will be a quick trip and they will return to Manhattan tomorrow afternoon. On 4 September (less than a month), she and John will take off, first class, for a ten day vacation that will find them in Paris for 7 days and London for three. She's been looking forward to revisiting Paris for a long time and to do so with John will be extra special for her, I'm sure. She can't wait to show him one of her favorite cities and, I do believe, she's going to try and get up with our beloved friend Michel, who lives in Nantes, but frequents Paris quite often. I hope they have a great time. I can't wait to hear all about it.

I'm now six weeks into my new position as Operations Manager at Senior Solutions NorthStar and I'm still learning new things everyday, but I just have to say I work with some of the kindest, sweetest and comical people I've ever been associated with. From George, the enigmatic president of the company in Greenville; Rich, our VP here in Wilmington, who hails from DC and LOVES to surf, adores his wife and is patient, affable and always smiling,; Bobby, our 30 year old manager who is originally from Philly and has the most enthusiastic, compassionate personality and Ryan, the talented, knowledgeable young man who trained me in Greenville, who shares my love of cichlids, gadgets and kindly reminds me he is always as close as a phone call away when I have questions and need guidance.

I have managed to land in a business that not only challenges me, but provides a very essential and vital service to those who are senior citizens, and those of us who hope to be. In a short amount of time, our little office has grown into more than a collection of co-workers; these people are so much more than that and it feels as if we're growing into a sturdy team, a family, and by doing so, work feels less like work and more closely resembles a mission. It's a blessing when one finds oneself in such a situation and I enjoy the people that I work with, respect their talents and knowledge and I manage to learn new things every single day. I feel deeply blessed to be there and I must thank my friend David for alerting me to the opening back in early June. David has done many kind things for me in the almost five years I've known him, but exposing me to this position and company has to be one of the best. I'm deeply grateful. Thank you, David C.

Finally, as I mentioned earlier, the car has been repaired. I no longer have to fear oncoming rainstorms because the windows are finally functional again and the door handle has been replaced. The "status window" still says, "check traction control", but after the $540 price tag of repairing those issues, and being assured by the mechanic that the traction control is really OK and that it's a faulty sensor, I can live with the message window, which would have tacked an addtional $140 to the repair bill. It's a great treat to have the windows go up and down again and be able to open the car door without having to roll the window down first. Hey, it's the little things, right?

Where has the summer gone? On one hand, it feels like it's been a long one. This summer has certainly been filled with changes, challenges and twists and turns and at the same time, it seems to be flying by and how can it be mid-August? I have no idea how we got here, but we're here, we're hanging and at the end of each day there's a long, unending list of things to be grateful for and smile when recalled.

I need to send a "shout out" to my friends who have called, left voice mails, text-messaged and e-mailed me to let me know they were thinking of me this first week with Justin now living in West Virginia. I have a great family and an incredible and growing posse of friends and my gosh - more blessings than I can count. I'm happy to say I haven't had too much time this past week to feel sad and I haven't been lonely at all. I can't imagine where I would be without the special people in my life. Each one of them display love, compassion and kindness that many times just blow me away and are stellar examples of the truest epitome of what friendship is all about. Thanks to each one for this exceptional gift.

Everyone of us will come across times in our lives where we need hands to hold, warm hugs, the heartfelt kind, the sense of knowing that we're not walking alone, no matter where it is we're being directed to walk. Now of course, my recent experiences haven't required very much of me in terms of being serious or even terribly frightening, but if we're alive, those times will visit each of us now and again. Not only have I been comforted and felt loved through the rough patches, in my life, but I've learned something more - by sheer example of those close to me - and hopefully I've gathered knowledge on how to be there for these same people when they travel through their own unavoidable valleys. I've not been at all disappointed and, by the same token, I hope not to disappoint my angels by sending them to voice mail, not returning calls or ignoring them at a time when they might need me.

Every single day reminds me that maybe some of the most important lessons my teachers and parents taught me pertained to the essential magic and inestimable values of friendship and I swear, it seems that every single day there is an instance in my own life or someone's life close to me, that sort of validates that - sometimes in small ways, many times in profound ones. The code of the "playground" kind of follows us all through life. Play fair, take turns, be kind and always share. Always share with a glad heart. You can't go wrong remembering those things but you will wind up in a miserable place if you don't practice them. Thanks to my parents for teaching me that lesson- it's timeless.