Bone-on-Bone” by Orthopedic Surgeon

Monday, Sept 19

For Sept 18 CPAP. Reported figures. Time on 6 hrs 1 min with AHI=0.17. Events: 1 CSR, 1 H, 16 RERA. No mask leaks (max= 13 L/min). Oximetry: SpO2 one blip to low 90, all rest above, into high nineties with avg 93.3%, marred and lowered by a spurious 72, when changing fingers.

John and I made a trip to Dr. Richard Roux, orthopedic surgeon, for an evaluation of my shoulder issues, which we were unable to relieve through physical therapy. Fortunately, he comes up from Yakima on Mondays to Ellensburg, so it saved us a 50-mile round trip.

Regular readers of our blog have gathered over the past year (since the defibrillator surgery last December) that my shoulder’s range of motion (ROM) has increasingly become more bothersome and limited than before. It has been a continuing problem since 2009, but noticeable before then.

This year, the first attempt to resolution was to pursue Physical Therapy to see if I could regain my range of motion of my left shoulder. Readers followed me through that introduction in May, and have listened to and viewed my reports since starting with a referral to Natalie Joyce at Canyon View Physical Therapy, in conjunction with my primary physician, Paul Schmitt. Dr. Schmitt has been my family physician since I arrived in town in 1988. He is retiring at the end of the year, and John and I both will miss his care and personal concern through the years with more than one body part.

My recent physical therapy sessions began May 24, 2016. I tracked that involvement in this blog.

From Dr. Roux, we now know what is wrong. It is not a frozen shoulder (stiff bands of tissue — called adhesions). X-rays taken at the start of my appointment demonstrate that I have severe arthritis, displayed as bone on bone between the socket and the humeral head (now flattened), with no cartilage and no joint space existing, along with cysts, and bone spurs on both bones to prohibit my external rotation (one of several different ranges of motion).

I am not a candidate for surgery, because the only thing that would help this arthritis situation is a complete replacement of the damaged boney parts. I cannot proceed with that operation because of the complications and risks associated with my cardiac involvement. I could . . . die!

Dr. Roux talked with us, examined my range of motion and muscle strength on both arms and shoulders from the back and from the front. He then left us to go examine the X-rays. When he returned to give his evaluation, I asked if I could record his comments and he allowed me to do so.

He started by telling us his observations. Then he sat down with us to go through more discussion, answer questions, and make suggestions about the future. At the end, he invited us to review the X-rays with him, and allowed me to videotape that as well.

I transcribed my recordings and will present his diagnosis below. This took awhile because I had to educate myself on the terminology he used to describe my shoulder’s condition. Thank goodness for the web to search out the words and definitions, watch videos, and examine reports.

The following is rather long, but I include it for my records, and for whoever is interested. I have put Dr. Roux’s comment in italics, in chronological order of our visit description. When John and I interjected something into the conversation, I put our names with an open parenthesis.

To summarize, when I first heard your story, I thought it was probably a frozen shoulder, because a lot of people who have had cardiac procedures do get frozen shoulders. But, when I looked at your X-rays, that’s not your only problem. You almost certainly have an element of a frozen shoulder, because it hasn’t moved normally in 5 or 6 years. But, you also have underlying that, a bigger problem, which is arthritis, where you have worn out that joint, such that your ball and socket joint are now bone on bone.

If you only had a frozen shoulder, we would do a manipulation under anesthesia, where we kind of pop the adhesions loose and then do physical therapy afterwards – and we have a high degree of success of restoring motion with that procedure. That won’t work for you because it doesn’t address the primary problem, your arthritis. So, I think to deal with all of your problems, you’d have to consider surgery, and that surgery would be a complete shoulder replacement. (He asked me to stop recording for a minute, so we changed places and he sat on my stool and I moved over next to John in a chair, and we continued our conversation.)

Continuing: Fortunately, I think your rotator cuff is still functioning, and if you were going to contemplate surgery, the replacement is different, based on whether your rotator cuff is functioning, or if it isn’t. But, it sounds like you are not a candidate for general anesthesia – is that what they told you?
(Nancy, well, that’s what they said when I had my recent oral surgery, and both my defibrillators were done using local anesthesia.
(John: I think her problem is that she – because of her heart and the medications she’s on – any surgery has to be thought through very precisely.

(Dr. Roux: I agree 100%. So understand this, without surgery, you are not likely to get more motion. And, so, it depends on how debilitated you are with this, whether you would ever consider it. You’ve got some motion with it, and you probably function pretty well; it sounds like your main complaint is the fact you don’t have full motion, is that right? (Nancy, yes.
(Dr. Roux: Are you having a lot of pain with that left shoulder?
(Nancy, occasionally, like this weekend, I really did, and painkillers wouldn’t do anything for me.

(Dr. Roux: I’m not surprised by that. So, if you’re thinking of shoulder replacement, I’d suggest either a standard shoulder replacement or something called a Reverse total shoulder, which I don’t think you need.

Shoulder replacement can be quite effective at relieving pain, not always as effective at increasing motion. So for you, it’s really a very serious consideration, considering your heart, and that you could have potential serious, even life-threatening, complications that can occur with that.
(Nancy: How long does it take to recover from shoulder surgery?
(Dr. Roux, from a replacement, about 3 months. It’s not something I’m doing now – I do a lot of arthroscopic surgeries and I do knee replacements, but I don’t do shoulder replacements.
(Nancy: I was hoping for arthroscopic.
(Dr. Roux: Yeah, the arthroscopic procedure wouldn’t help you because you’ve got severe arthritis in there, so again, if you’re going to do surgery, it would be a replacement procedure.
If you wanted to consider that, I have three partners that do shoulder replacement commonly, (and we’ve done that on purpose, you know we want to have people doing it so they are doing enough of them a year, that they stay very current at it.) My three partners include Dr. Wong, Dr. Griffiths, and Dr. Orvald. They all do a fine job, and I’m happy to refer you for a second opinion, but I’m not sure that you want to, considering your cardiac status.

(Nancy: I think I’ll probably not. I’ve learned to compensate, but I guess I would like to know if I should not continue with Physical Therapy, because it isn’t going to help?
(Dr. Roux: It’s not going to help because it’s a mechanical problem with that arthritic joint. I would do what you are doing to maintain what you have, and if you started to lose motion, then I think physical therapy might be appropriate. Right now, I don’t think they are going to get any more motion with it because I think the primary problem with it is arthritis.
(Nancy: yeah, that’s what we were worried about.
(John: When you said you had pain this weekend, was that after playing your fiddle for 2.5 hours. (Nancy, yeah, and through a wind storm – it was crazy. (Dr. Roux, you were playing outside? I was up here covering the Central football game – it was blowing. (Nancy: yeah, it was! Also, I’ve been able to lift my arm up farther to wash my hair, after this physical therapy, but I still compensate. It’s not a big deal.

(Dr. Roux, I think you have compensated very well, and considering everything you’ve told me, I wouldn’t recommend doing a shoulder replacement.
(Nancy: Thank you. We appreciate your evaluation.

(John: One of her problems was when she had a heart blockage in 2009, she was scheduled to have the heart valve replacement in March of 2010, but she had the heart attack the day after Thanksgiving, in 2009…
(Nancy: and they took out the clot, successfully, but then the next evening, all my systems shut down and I was put on life support for 8 days.
(John: She had a reaction to Heparin, and she was in intensive care, flat on her back, and so her muscles… (Nancy: I lost all my muscles, even throat and stomach ones.
(Dr. Roux, “Sorry.” (Nancy, it’s okay, I got out of it.
(Dr. Roux, yeah you look good.
(John, so … this shoulder has bothered her a lot longer than that, but I think that time of total inactivity …
(Dr. Roux, on the shoulder, if you’ve got arthritis in there, and you have all that inactivity, it doesn’t respond well to the shoulder. All joints like to move; it helps nourish the joints, and so I’m sure a lot of your Chondrocytes (cells found in cartilage connective tissue) –> The cells in your cartilage die, and that contributed to your arthritis.
(Dr. Roux, You want me to show you that X-ray?

(Nancy: YES ! can I take pictures ? (Dr. Roux, yes.

Below, Dr. Roux’s evaluation provides diagnosis of my shoulder X-rays, 9-19-16:
1-drroux-youdonthaveanyjointspacehereanymore-1(Dr. Roux points out: You don’t have any joint space here anymore, and he continues with this question and comments.

What are the signs of arthritis in a shoulder?

1. Joint space narrowing. You have joint space obliteration.

2. The other: Subchondral schlerosis, that’s where the bone is a little bit whiter on the socket side. You’ve got that.

3. Sometimes, you form Subchondral cysts, and you have them (cysts) on both the socket and the humeral head,

and,

4. Bone spurs (also called osteophytes). So really, you have all the signs of arthritis: Joint space narrowing, subchondral schlerosis, osteophyte formation, and cysts.

John and I have annotated my own photo of my X-ray below. I do not have the original X-ray image to work with, so this is a bit fuzzy, being captured from my video camera “movie” of Dr. Roux’s explanation.
2-diagramusingnancys-shoulder-with-labels-of-arthritisSubchondral schlerosis refers to the whitish line between the femoral head and the socket. Further, subchondral sclerosis is a disease that affects the bones and specifically the joints, of people who have osteoarthritis. Subchondral sclerosis causes joint pain and numbness (I have not experienced) by increased bone density and mass, and that produces a thin layer of bone beneath the cartilage in the joints.

John asked Dr. Roux if he had a normal shoulder X-ray to show us, but he did not have one on that computer. So, here is my attempt to compare:
3-collagenormalwebtonancysleftshoulderThe left image is a normal shoulder I took from the web (from an Australian doctor’s explanation of shoulder arthritis). The right image is my left shoulder from the 9-19-16 X-ray. The big white spot in the lower left of mine is a metal ball hung around my neck for scale and density measurements. My image shows the obliterated joint space and the flattened head of the humerus bone on the bone of my socket. Note also the bone spurs protruding from the bottom sides of the two bones.

For further clarification of bone spurs (osteophyte formation), see the images below:
4-bonespurcollagefromwebThe left image is of a pig’s bone spurs (follow the arrows). The right diagram is of a human shoulder with annotations of the symptoms of osteoarthritis disease. (Osteo=bone)

Wrap-up: Physical therapy is not an option, except if needed to maintain the slight range of motion I have gained since May. A complete shoulder replacement is potentially an option, but the surgeon (Dr. Roux) did not recommend because of the complications associated with my cardiac situation, which could be life threatening. I shall continue to do what I can, especially low impact and low aerobic exercising. Pain killers are not very effective, and because of being on Coumadin®, I cannot take the supplements often given for pain relief from joint arthritis (e.g., Glucosamine or NSAIDs [non-steroidal anti-inflammatory drugs] such as ibuprofen (Motrin®, Advil®) or naproxen (Naprosyn®, Aleve®). In addition, I am not allowed to partake of herbal and green tea solutions.

John quotes somebody: Getting old is not for sissies.

Tuesday, Sept 20

For Sept 19 CPAP. Reported figures. Time on 4 hrs 13 min with AHI=1.43. Events: 1 CSR, 6 H, 13 RERA. No mask leaks (max= 17 L/min). Oximetry: only on for three hours, and okay.

I reported in at 10:30 a.m. this morning to Natalie Joyce, owner of and therapist at Canyon View Physical Therapy. I took my printed transcription of what was said yesterday and carried my computer laptop to show her the videos of Dr. Roux’s analysis of the X-rays of my shoulder. She was grateful for the feedback. Much of it she had suspected from the work we had done on trying to increase my range of motion in several directions. When I left, they gave me a turquoise T-shirt, normally gifted at the end of a person’s time with them. We agreed to keep in touch. As well, if I realize I am backsliding on the gains with my ranges of motion, I will go back through my doctor for another referral to receive stretching sessions from the therapists there. I have worked with all the staff at Canyon View Physical Therapy (Ellensburg), and find them to be excellent, professional, and communicative about a person’s condition. They are pleasant and sincere educators and motivators. I send all of them a huge thank you commendation, along with my admiration, praise, and appreciation.

On my way home, I checked by Jerrol’s and got my $10 birthday present. I bought seven containers of 3-ring dividers to use for separation in the music books for our group. While there, I received instructions in how to make the white-out work that I bought earlier (in a tube). It needed squeezed just the correct way.

Wednesday, Sept 21

For Sept 20 CPAP. Reported figures. Time on 8 hrs 22 min with AHI=0.36. Events: 3 H, 16 RERA. No mask leaks (max= 13 L/min). Oximetry: looks nice entire time, with only one SpO2 blip to low of 88, all rest above, with avg 92.3%.

Today was a usual middle of the week activity. I normally pick up my friend, Gloria, and travel to the Food Bank for our singing with and for the audience, and afterwards we join a table for our lunch. Today was no exception but we grabbed some Starbuck’s day old chocolate chip cookies, and visited with some of the patrons, before the music. We eventually started at noon, and our youngest member, Kyle, brought his cigar box guitar that caused a lot of interest and discussion.

Thursday, Sept 22

For Sept 21 CPAP. Reported figures. Time on 7 hrs 6 min with AHI=0.99. Events: 7 H, 15 RERA. No mask leaks (max= 13 L/min). Oximetry: SpO2 one blip to low 85, a few below 88, with avg 91.6%.

Tried to finish the request for my medical records but did not finish before leaving for town. John drove so he could fill up his car for a long trip to Lake Serene tomorrow. I moved music stuff from my car into his.

We had nine people there today, plus Haley, our little dancer, and we had a good audience as well. My friend Clare returned my glass vase, and we carried a throwaway vase with beautiful gladioli for Jim and Lillian Brooks’ recent 69th anniversary. They carried them back to their apartment. Wheeled-Walkers are useful for such transport (even better for going through buffet lines).

I came home to work on dishes and computer issues and to put heat on my sore shoulder. Usually, I do moist heat before exercise and ice after.

Friday, Sept 23

For Sept 22 CPAP. Reported figures. Time on 5 hrs 11 min with AHI=1.16. Events: 5 H, 11 RERA. No mask leaks (max= 9 L/min). Oximetry: Fine all night.

I went to a CWU/Ruth Harrington scholarship luncheon today, donated my money for the year, had lunch, visited, and gave away a new shirt (still with tags) to a friend in the group. I realized my parking sticker expired 9/15/16, but I have to go across campus to renew it, so that awaits being done. I went directly to an exercise class at the senior center, and afterward, by Anne’s to water plants and pick up her mail. I stopped at a yard sale, where I found two nice plastic bins (with tops to keep the dust out) that have inside edges that hold hanging folders, so I can use them to encourage me to use my time saved from PT to get my monthly paperwork in order. My filing cabinets are filling. Yeah, I need to toss more stuff out of the ones we have in 3 rooms of the house. I already have recycled a lot, but there is a lot more to go. Amazing what >40 years of teaching will accumulate. I also found two containers: one I can use for John to carry his cell phone in, and protect it, and maybe he will not lose it. Another smaller one will work for my other cell phone.

On my way home, I dropped by a front porch to pick up a free gift of four unused lined journals that I can use in our cars to register tax deductible mileage for volunteer work and for medical trips. My Subaru Forester glove compartment is too small for the normally sold journals. John’s Subaru Outback’s is larger (go figure).

John was 130 miles away today working on the Lake Serene Trail near Index, WA. Actually, the trail is a 2-destination hike and the crew worked on the Bridal Veil Falls part. See:

Lake Serene WTA report

They did not take the trail from the designated trailhead. Instead, they opened a nearby fancy gate (electric trigger and security camera monitored) and on a circuitous road through some nice small houses and then past your average meth-encampment – shacks and abandoned cars and trucks. The link above explains the trail and mentions the steps, as in the photo below.

You can get a better view from Google Earth than John had. It rained. Use the following coordinates in Google Earth:
47.789586, -121.569468

Zoom way in and realize you are looking down (and North). The Falls trail is on the west or left. The Lake trail crosses the stream at a lower elevation, then climbs up a slope until above the lake level and then comes back down.
lake-serene-labels-from-northWe did get some photos from today’s work party..
5-crewfromarchfirm9-23-16Entire volunteer group came from MG2, an architectural firm, with this bunch all in a sector that designs Costco stores.

Below is John with his crew with their stair-filling project. Rain and mist all day explains the whitish background of the left image.

This project was digging and filling to rehabilitate the steps, and to rock-in the sides to hold everything in place. After lunch they moved on.
6-lakeserenejohnscrewstairsfilledHe called from Leavenworth at 4:35 and got home about 70 minutes later. We had leftovers for dinner.

For me, much time this afternoon was trying to arrange to fill in music tomorrow at lunch for a conference at CWU, but no one was available, and I am not a sole performer. Maybe next year with more notice and not on the first weekend the nearly 12,000 students are back in town, we’ll be able to help. They needed someone to play from noon to 1:00 and payment was a free lunch.

Saturday, Sept 24

For Sept 23 CPAP. Reported figures. Time on 5 hrs 41 min with AHI=0.88. Events: 1 CA, 4 H, 23 RERA. No mask leaks (max= 10 L/min). Oximetry: Stopped from low battery 4.5 hrs in. SpO2 two blips to low of 89, all well above, with avg 92.9%. Total time sleeping was nearly 9 hours.

Nothing on tap today, except to cut John’s hair and work on the blog. I succeeded in cutting his hair.

Not all the dirty dishes got loaded, but the entire washer of clean dishes I unloaded. I spent most of the day on chores, the main one being this blog.

Sunday, Sept 25

For Sept 24 CPAP. Reported figures. Time on 7 hrs 28 min with AHI=0.13. Events: 1 H, 18 RERA. No mask leaks (max= 9 L/min). Oximetry: Good all night, except for several spurious finger changes recording in the 70s. Most were in the mid- to high nineties range (95-98).

John met neighbor Kenny in the morning to load a couple of bales of hay for him. He’s only recently out of the hospital with a 7-way bypass. He has 1 horse he will feed out of the truck for a couple of days and then let us know if he needs help loading again. John cut some brush and loaded it into the pickup, we ate, he napped, and now we have (nearly) completed this blog.

Nancy mixed in a few other chores but primarily worked on this report.

Hope your week was fine.

Nancy and John
Still on the Naneum Fan

Harvest Moon

Sunday, Sept 11
For Sept 10 CPAP. Reported figures. Time on 4 hrs 15 min with AHI=0.24. Events: 1 H, 7 RERA. No mask leaks (max= 22 L/min). Oximetry: SpO2 one blip to low 89, all rest above, with avg 93.2% and that’s marred by a spurious 80, caused when taking the oximeter off.

I saw John off at 6:00 a.m. and stayed up to do things. Before feeding two kitties who arrived at the front door for their morning food, I saw the two fawns (now without spots) in the front with their mom, so I grabbed my camera.
1-spotlessfawnsMom out front (on the right of both photos) with twin fawns, no longer with spots.

Been finishing chores around the house, washed a huge load of dishes, spent time on the phone with my neighbor, Louaine, time on email, and time on music.

I finally sent all the pictures from Clare’s 90th birthday party to her email. I called Monday morning to alert her and that I would see her tomorrow night at Hearthstone. 🙂
middle-fork-snoqualmie-river-2_640Bridge near the Middle Fork trail head.

We had a late supper, after John made it back safely from his day’s work on the trail, at the Middle Fork of the Snoqualmie River.

Monday, Sept 12

For Sept 11. Reported figures. Time on 8 hrs 24 min with AHI=0.36. Events: 3 H, 10 RERA. No mask leaks (max= 22 L/min). Oximetry: Good night.

I fed the cats their morning vittles. We both were working early on our computers, and John finally just went back out for yard chores. I get to work on house chores. He came in and fixed Nachos for lunch.

Worked up the song, On the Sunny Side of the Street; one of the hardest songs I have ever entered into our repertoire. Ended up putting in different chords for the key of C, and then changing to G, and lowering an octave. I hope this works. It is going to be difficult for some of our chord players, I’m afraid, but at least I think most people know the song.

John is back out moving rocks, this time, from out where the logs came through the fence. He is slowly digging a shallow trench around the house, filling with rocks, and covering with gravel (recycled concrete). This will pack hard and be a wheel-chair route to the den and eating area. He hopes this will be a selling point at some future date. It consumes a lot of rocks too, of which we have many, being situated on an alluvial fan.

I cleaned more dishes, did some bill paperwork, called about subscriptions at a savings through the College Publishing sales, and finished more music corrections.

Tuesday, Sept 13

For Sept 12 CPAP. Reported figures. Time on 6 hrs 16 min with AHI=0.00. Events: 1 CSR, 0 H, 8 RERA. Small acceptable leaks. Off at 5:30, another 2 hrs sleep. Oximetry: SpO2 one blip to low 89, all rest above 90, with avg 92.8% all night.

I had to take my morning pills at 9:15 before leaving for a physical therapy appointment.

I missed the retired geographers’ meeting to get to my morning appointment, earlier than usual in my day. Then on to other Tuesday stops: Jeanne at Rehab with flowers for her 87th birthday (yesterday), Bi-Mart to check number, Hospice Friends to sign paperwork for a friend, by Carole’s for cat food, on up Water to home for a fast lunch, and back on my second trip to town for Jazzercise.

I went back in for music at Hearthstone and took a 3-ring binder to a gal on the Buy Nothing site who requested it, and she met me there. We did not have a lot of people there – just our pianist, me on fiddle, and 3 other singers. I sing and play. The group is The Connections, and the type of music is religious (old church anthems) and the audience has the lyrics. I came home by way of Dominoes and brought home for dinner a large 3-topping (all meat) pizza, and called John to have him cook mushrooms to put on it. He also had grated Cheddar cheese and Parmesan ready, and I added little tomatoes from our garden to my plate with one large piece of pizza. He freezes the leftovers by piece, and takes one for his lunch on his WTA work trips.

Wednesday, Sept 14

For Sept 13 CPAP. Reported figures. Time on 8 hrs 12 min with AHI=0.37. Events: 1 CSR, 3 H, 1 PP, 18 RERA. No mask leaks (max= 18 L/min). Oximetry: SpO2 had 2 blips below 88, all rest above, with 92.1% all night, affected by a spurious 79 from a finger change.

I stopped by to pick up Gloria to go to the Food Bank and to SAIL. I have to set up chairs because Bob will not be there. Thankfully, one of our singers, Richard, helped. We had a good bunch of appreciative audience members, and 6 regular members joined by Roger McCune in his retirement from directing the F.I.S.H. Food Bank for many years. It was nice to have him join our music group.

Gloria and I went to the Senior Center to our SAIL exercise class, and Evelyn (our banjo player) continued there as our leader for exercise. We had several new members and good attendance. After dropping off Gloria, I came home. We did stop at my bank to deposit and to cash some checks I had recently received.
I finally got out the count for tomorrow’s music players, and I will call and report the total chairs needed, in the morning.

I also succeeded in getting my PT appointments scheduled for the month of October. All on Tuesdays and Fridays, at 3:15, with Natalie, the owner.

Thursday, Sept 15

For Sept 14 CPAP. Reported figures. Time on 7 hrs 23 min with AHI=0.54. Events: 1 CSR, 4 H, 2 PP, 15 RERA. Acceptable amt of leakage. Oximetry: I was unable to removed the oximetry with either program. I hope my oximeter is not broken. Update: it is working again, after restarting my computer and uploading the required updates.

Morning brunch was nice.
2-brunchI picked up Gerald from RV Canopy Country on Dolarway just after 1:00 p.m., where he left his “new” truck to have its canopy installed. Fortunately, his son came and picked him up to take him back, because I had to go directly from music to a PT appointment on my shoulder.

We had only a few of us there: 2 guitars, a baritone mandolin, 2 fiddlers, and a flute (with her dancing little 3-year-old daughter. The room temperature was too warm and I had on a tank top under my blouse (for my PT follow-up), and the outside temperature was 86.

When I got to my appointment, I was too warm.

I made it there just at 3:15 p.m. and was happy to have a circulating fan blowing on me during my “warm-up” exercise. I had taken some pain pills prior to playing fiddle, but they didn’t seem to help either with the playing and certainly not with the 10-minute arm “cycle” workout, where I keep my feet stationary and use dual-moving handlebars for warming up my arm and shoulder muscles. Every movement hurt today, including the stretching sessions by my therapist.

Afterwards, I stopped by to water plants and pick up my friend’s mail.

Friday, Sept 16

For Sept 15 CPAP. Reported figures. Time on 6 hrs 33 min with AHI=0.31. Events: 2 H, 13 RERA. No mask leaks (max= 22 L/min). I slept another 3 hrs w/o CPAP, but with oximeter. Oximetry: Cannot get SpO2 Review to work; via SleepyHead software, I could see the SpO2 dipped to the high 80s but most were above 90. I had no way to calculate avg % all night, without the SpO2 Review Report.

Haircut for me around the rural block at 1:00 p.m. (the round trip is not bad at 4.3 miles). I actually made it twice because as I was leaving, Celia gave me two jars of jelly, one blackberry & and the other mixed fruit. I have to eat blackberry jelly, because the seeds stick in my teeth. We have several cups of berries in the frig. I came home and John and I picked the rest of the ripe berries from our plants, and added those from our fridge. John also cut her some limbs of green cherry tomatoes at her request. She also gave me 3 ripe tomatoes from her sister’s garden, after hearing all we had were green ones.

John’s hair I hoped to do tonight, long overdue, but it will have to wait until another day. He’s out working on yard chores before the expected rain tomorrow after 11:00. The front moved in already, within sight. This will help slow a couple of fires in the mountains.

Checked on Annie’s meds for seizure. Ordered 90 tablets from Rite Aid. I’ll pick up soon.

I had a double pear, plum, peach, Ensure, protein, yogurt shake for lunch. For dinner, John fixed a hamburger with fried cauliflower, yellow squash, mushrooms, with Parmesan cheese and spices, served with 3 types of tomatoes.

Saturday, Sept 17

For Sept 9 CPAP. Reported figures. Time on 5 hrs 29 min with AHI=0.18. Events: 1 CSR, 1 H, 11 RERA. No mask leaks (max= 10 L/min). Oximetry: SpO2 one blip to low 89, all rest fine all night. A move to a different finger caused a spurious low, which affected the avg. % all night.

1:00 start: Big outside music session at Briarwood. Several of our group joined another group, called Heather & Sage. They have a bass fiddler, a banjo/guitar/Irish drum player, and two fiddlers. Our group had two guitars, two fiddlers, a mandolin, and a flute/penny whistle player. We made some pretty music for 2.5 hours with a break for lunch. (I had a half a Polish hotdog), but we missed getting a root beer float.

John and I went to a 90th birthday party for the father of friends, now living west of Yakima. I actually knew the parents before I met the kids through CWU. In the 1990s shortly after arriving in town, I was playing with our music group, Kittitas Valley Fiddlers & Friends, at the Senior Center for a Friday afternoon dance group. These folks were regular dancers there. Tonight was the 90th birthday bash for Grandpa Orcutt. Dinner was slow-roasted & smokey tender Tri-tip roast with side dishes and a big birthday cake with 90 candles, homemade ice cream, served with frozen fruit punch, if desired. Fruit was raspberries & blackberries in orange juice and something else.
3-orcutt90thbirthdaycake9-17-16Birthday cake celebration.

Connections are through two parts of the family we have been included in for many years, since the 1990s. You might guess there are lots of Orcutt family in the County. He worked on the big dams here in the West and then moved to a farm about 10 miles east of EBRG.
4-suzybobwestlelandberniceorcuttSuzy Orcutt West and Bob West and her dad and mom on the right. They had a large family of 12. Suzy we knew because Bob was my student in the 1990s (graduating from CWU Geography in 1997).

We joined the celebration.
5-bobwestjohnnancyhultquist9-17-16The large party was held in a barn at one of their children’s homes, on the other side of the valley. We enjoyed the Harvest Moon on the way home, but I was unable to capture it on my camera. John said I would find a better rendition on the web. I would have loved to have had what we saw surrounded by clouds.

This is the closest I can come to the moon tonight in clouds. This is from the web from Dennis Doucet, taken in Japan. The only difference is that the clouds we saw our view through were rather spectacularly layered, horizontally. I thought too late I should have taken it with the video part of my camera rather than the still shot, which adjusts for darkness.
6-harvestmoonjapaninclouds-dennisdoucet
Sunday, Sept 18

For Sept 17 CPAP. Reported figures. Time on 7 hrs 44 min with AHI=0.78. Events: 3 CSR, 5 H, 1OA, 2 PP, 11 RERA. No mask leaks (max= 10 L/min). Nothing to report on Oximetry as it was only on a couple hours, and nothing unusual happened.

Sad tale here: Until last fall Jerry and Janis Anderson lived down-ditch from us. She was one of the original “Rodeo Grandmas” of local, state, and even a bit of national fame.

Newspaper story prior to Rodeo

They moved a year ago. After being inducted into the Rodeo’s Hall of Fame this year, and speaking briefly, she was in a car with the one other surviving member of the group, Chloe Weidenbach, whom Nancy knows from her volunteering at the Food Bank. Janis complained of a severe headache and died shortly after at the local hospital from an aneurysm.

Janis Anderson’s celebration of life was today at the Kittitas County Events Center (aka Rodeo/Fairgrounds) with lunch and a beautiful program put together and presented by the family and friends. The large room (Teanaway) was packed. I arrived about 11:40 and left 3 hours later. The family served lunch with Janis’s Rodeo Beans recipe as the main course, along with Coleslaw, and a roll.

I made two more stops in town and came home.

Hope your week was fine.

Nancy and John
Still on the Naneum Fan

Celebrations

Sunday, Sept 4

For Sept 3 CPAP. Reported figures. Time on 4 hrs 49 min with AHI=3.74. Events: 3 OA, 2 CSR, 15 H, 1 RERA. No mask leaks (max= 19 L/min). Comments: Something was going crazy between 1:45 a.m. and 2:30 a.m. with 3 OAs (I never have), 2 CSR, & 13 H, with 6 vibratory snores (I never have). Maybe caused my first time back on CPAP in 10 days and maybe I didn’t have my mask properly fit, or positioned wrongly. I did awake at 3:30 sneezing and with a runny nose, continued the rest of the night. Maybe the sneezes caused the vibratory snores I never have. Oximetry: SpO2 one blip to low 86, all rest above 88, with avg 93% all night.

I published this last night after John had retired, and the Internet connection lasted only long enough to send me a message to show me it made it to the web. I took another half hour to make it to bed after setting up my CPAP with new filters for its first run in over a week. The Internet connection was still off when I bedded down, so I waited until this morning.

The connection opened briefly, and went off again, but John got to check for last minute changes at Rainier or travel alerts on the roads. The WA-DOT is good about posting these.
John left at 5:15 a.m. for Mt. Rainier. I went back to bed, and slept until almost 9:00 a.m. The sun is shining but the temperatures are cold. Low last night of 46° (when John left), our heater, set at 69°, come on during the night, and the front porch temperature was up to 54° when I went out to feed all 3 cats. Now the Internet connection is off still at 9:30.

Once it returned, 20 minutes later, I started watching the livestream of the Grand Master Fiddler championship. I know two families back there in Nashville, supporting their fiddlers competing: Noemi Turner from Spokane (Trinity’s sister) and Katrina Nicolayeff, Meridian, ID, daughter of our WOTFA fiddle teacher, Bobbie Pearce, Nampa, ID. Katrina is there with her hubby. Katrina won third place overall (later today), but I was gone in town and missed seeing her.

On tap today are trips to several places in town. At 2:00, I pick up Gloria Swanson to go to Clare Panattoni’s 90th birthday celebration early, officially not until 9/8, but her family is in town for the Labor Day Fair & Rodeo activities, so they are honoring her. While in town, I have several stops to make at Bi-Mart for pate’ for the cats, at Super 1 for five # ground beef on sale for John to freeze (also bought some red grapes). I tried to drive by to pick up mail for Anne, but the key would not work. I plan to process pictures I took at the party and send to Clare. Meanwhile, here is one.1-collage-nancyclare-flowersA gladiolus that matches her outfit and Tiara is not showing in the left picture of the vase. It’s behind the orange one. Look at the right photo, and see it. The Tiara was my gift from Kathryn Carlson last year on my birthday during our Buy Nothing Clothing Share. This seemed like an appropriate gift to Clare Panattoni today. The glads are in a vase given to me by Renee Moore (on the buy nothing site), just last week. I’m behind Clare. Thanks to Valerie a professional photographer at the party for taking our picture on my camera. It was a nice party her family put on for her. Gloria and I had a nice visit with a number of mutual friends there. The party was from 2:00 to 4:00, and we got there a little after it started and were near last leaving.

The family served cake, cookies, rainbow sherbet punch, coffee, and sugar mints. I did not participate, but they gave out glasses of champagne for a toast to Clare. Gloria and I had met Clare in our exercise class at the senior center, and we have known each other for at least 6 years.

Monday, Sept 5 Happy Labor Day !

For Sept 4. Reported figures. Time on 8 hrs 11 min with AHI=0.49. Events: 2 CSR, 4 H, 12 RERA. No mask leaks (max= 20 L/min). A much better night than last. Oximetry: Excellent all night, avg. 93.2, with one blip low of 89. The low represented in the average calculation was a spurious reading from switching fingers on the oximeter.

I have been working on computerized (Jacquie Lawson) greeting cards this morning; I got behind with all stuff going on. This month has many birthdays and anniversaries. I need to make time to move to the kitchen and load dirty dishes to be cleaned, as we are out of saucers for kitty food. We use 4/day twice a day. We treat them to canned food, but they have hard food available 24/7.

Today we received pictures from John’s trail work last week. Here is a cool collage of his time at Talapus Lake trail on 9/2.
2-collage-talapuslaketrail9-2-16John, with a small rock in his left hand and a large rock-net (multi-person carrier) in his right, middle picture is lunch, and right photo is him with a colleague discussing the project.

We had visits from Merriam turkeys. Eight of them were on the most recent visit but I never captured all in one photo. They have been in the neighborhood for over a week.
3-collageturkeyTonight, I decided to put blackberries on John’s piece of pie (he picked them today), and I don’t like the seeds, so I put all the juice on mine and cut up one of our purple plums for my topping. This was on a piece of key lime pie.
4-ourplumandblackberryjuiceonpie
Tuesday, Sept 6

For Sept 5 CPAP. Reported figures. Time on 6 hrs 9 min with AHI=1.30. Actually, CPAP off from 2:20 a.m. until right before 4:45. During that time was the low SpO2. Events: 1 CSR, 8 H, 3 RERA. No mask leaks (max= 15x L/min). Oximetry: 92.3% avg SpO2, low 85, okay all night; 3 blips below 88%.

Goodness… what a full day this was.

I awoke, had coffee and a piece of toast, fed the cats, and took a shower. At 9:35, I took my large premed dose (2000 mg) of Amoxicillin to protect my heart for the removal of the stitches, and possible exposure to bacteria getting into my blood. Shortly thereafter, we left for Yakima (I was driving).

We got there with 2 minutes to spare for my 10:45 appt, and they took me right in. Less than 6 minutes later, I returned without my stitches to the waiting room, and off we went for an early lunch. We stayed longer than we should, probably, but got to Costco, filled with gasoline, ($2.459/gal), found a space to park, and went around the store shopping for us, and for 3 other people. We spent $299.01. (The clerk tossed in a penny.) One nice thing about that is by putting it on our Costco credit card, we will receive 2% in $ rewards next year in February. This trip will pay for 2 gallons of gasoline to get there. We got 2 jars of CoQ10 (300 mg) and some prunes for a friend, we got some yogurt, Glucerna, and cereal for another friend, and a package of candy for yet another.

We made it home but not until almost 1:30, when I had planned to leave for Ellensburg for an exercise class, for a blood draw at the hospital to check my INR (it was 2.0), and for another stop or two. Luckily, I checked the telephone and found a message that came in at 9:56 a.m. that our exercise class was cancelled because a plumbing problem had closed the Senior Center. What a nice gesture for them to notify people! That gave me time to help John unload the car and we were able to deliver a large amount of food to our neighbors. I dropped John off at the house and returned to Ellensburg to have my blood draw. From there to Bi-Mart to check my number, and I won a metal package of cough drops, Fisherman’s Friend (Menthol Cough Suppressant Lozenges), that sell for $2.50, for matching the last number in my membership #, 1.

Then I went by my friend Anne’s house to pick up extra copies of her mailbox keys to get her mail. I have a working key now. Then I came home by way of another friend’s to drop off what I picked up Costco and didn’t make it home until 4:30.

We were planning to leave for a wedding just 1.5 miles from our house, and John had washed 20 pounds of smallish Gala apples he picked a week ago. We took them in two boxes and put on the table near the beverages, not many were eaten but some went home with new friends. The wedding was outside and the tents were tied down well enough to withstand the wind. After the wedding, they served a taco bar in the house. It was very good, and I was hungry, having not eaten since 11:15. We stayed and visited until almost dark, but we got home in time for John to feed the horses and for me to feed all 4 cats.

Wedding: Pattie & Steve McDaniel

John and I were among about 35 guests.
5-nancyjohnatstevepattiemcdanielswedding-9-6-16This was a selfie of the two of us, and John is talking to the lady in front of us who lives on the west side and he has visited her (to pick Blueberries) house with the groom’s mom.

Wednesday, Sept 7

For Sept 6 CPAP. Reported figures. Time on 5 hrs 3 min with AHI=0.72. Events: 0 CSR, 4 H, 9 RERA. No mask leaks (max= 19 L/min). Oximetry: Avg 92.8% .. no blips. W/o CPAP, all 90s.

I took our other group’s music to the Food Bank today, and we only had 4 people there. Bob (voice and small travel guitar), me (fiddle and voice), Reta & Yvonne (voices). Evelyn was not with us because of jury duty. Kyle rode the bus to get there but arrived after we were already eating and done playing. I gave him a ride back to a place in town he wanted to go (Boogie Man, a music store). Our mandolin player, Joanie, was hurting badly from hip pain. From there I went to my PT appointment, by way of a stop at Petsen$e (new pet supply store in EBRG) to sign up for a one time chance at a raffle for a new Jeep Cherokee, no purchase necessary, but you have to sign up in the store.

Once in Physical Therapy, I checked on my status for my appointment with an orthopedic surgeon 9/19 at the adjacent NW Orthopedics office. Everything was in order except they needed to see my original health insurance cards. I no longer have my Medicare, but I have a color scan of it from 7 years ago. She took that and my Group Health card, and my driver’s license for a picture ID.

I went through my PT session with Natalie with amazing movement, considering I had not been able to do my home exercises since last there a couple weeks ago.

Thursday, Sept 8

For Sept 7 CPAP. Reported figures. Time on 4 hrs 10 min with AHI=2.88. Events: 1 CA, 0 CSR, 9 H, 2 OA, 5 PP, 6 RERA. No mask leaks (max= 16 L/min). Bad night of sneezing** and turned off CPAP after the last episode. Nose running badly. Maybe I’m allergic to the ragweed or rabbit brush pollen, perhaps coming in on the cat. Oximetry: Avg. 92.5%, one blip low 84 off CPAP. Good all night.
[** Might be Rabbit Bush – Ericameria nauseosa or a close relative; now looking like the – from Web – picture below.]
rabbit-bush-chrysothamnus_nauseosusThere are a few wild purple Asters blooming and some non-blooming Ragweed. The Rabbit bushes are abundant and the bees are all over them. Thus, that’s our vote.

Go to Meadows, take Anne’s keys on my red bag, do her plants, and freeze the cookies on the counter. John will drive to get gasoline in his car and go by Super 1. We had a lot of people there (12), so had to use a piano bench for seating one person.

Once we were home, we packed up and went to our neighbor’s for a visit. John picked apples (old trees, small unknown apples; to feed to deer), and I visited inside the house with the folks. While there I was able to lift a heavy box of supplies that arrived from Amazon.com via the post office and was put on their front porch. The two of them in their nineties were too frail to be able to lift the box. I got it, brought it to their backroom, opened it, and now it is usable. I also shared some information about physical therapy and read a letter to them that came in the mail and was a little difficult to see. These folks have health issues, but still live at their long-time home.

Friday, Sept 9 my late birthday celebration

For Sept 8 CPAP. Reported figures. Time on 7 hrs 27 min with AHI=10.16. Events: 1 CSR, 9 H, 18 RERA. No mask leaks (max= 22 L/min). Oximetry: Avg 92.1, avg low SpO2 91.2, low blip, 88%, and really good all night.

I have been working this morning on arrangements for next Saturday’s jam session planned at Briarwood. We have decided to start early and join others that were invited. Only about 3 of our people are in town and able to play.

I worked this morning on a few SongWriter songs with needed lyric changes. I need to print them and put into the master copies. I wrote revised in the title and comments so I will be sure to send the right form out for future play times at assisted living homes, and other places we play.

Friday, September 9, 2016, Chef Extravaganza, at 6 PM. Thomas Didra of Dueling Irons restaurant in Post Falls, ID, and a Quincy High School alumnus will be coming to display his prowess with the local produce and meats that we collect from all over the Quincy Basin this week (the fridge is already starting to fill up). This event is held in conjunction with Quincy’s Farmer Consumer Awareness Day and is designed to demonstrate the bounty of the Quincy Basin. Farmer Consumer Day itself is held on Saturday with a parade and all kinds of family activities,
Schedule for Quincy’s FCAD.

As for Friday evening, we will also have Mugsy’s Groove joining us with their very funky Cascade Mountain Funk
Mugsy’s Groove.
$25 at the door for all you can eat and for enjoying the musicians.

Every year, John and I enjoy this celebration of my birthday, a week late.
6-people-johnnancyhultquist9-9-16

This year, we attended with Kathy Allen and Todd Schaefer.
7-viewvineyard-toddschaeferkathyallen-9-9-16Todd is the chair of Political Science at CWU there for 20 years and wife Kathy I got to know independently through my SAIL activity class, in which she was a participant, being the caregiver for one of the older active community women of Ellensburg, Helen Wise. Small world continues in our lives. They are kayakers and learned about this event from an email I sent to my music group, which she likes to attend. They have kayaked at the Columbia and stopped by White Heron several times. They had a great time and want to join us next year as well.

Saturday, Sept 10

For Sept 9 CPAP. Reported figures. Time on 5 hrs 10 min with AHI=0.97. Events: 0 CSR, 5 H, 3 PP, 4 RERA. No mask leaks (max= 21 L/min). Oximetry: Great with CPAP, and without, a blip to 84 low, and a few below 88. Overall avg. 92.6%.

I have spent the morning creating a collection of photos I took last night to share with White Heron Cellars owners, friends there, and to send to Sunshine at the Quincy Valley Post-Register newspaper, maybe for their Facebook page. Stay tuned, but check their page if you are on Facebook. The newspaper began in 1949, and “proudly serves Quincy, George, Crescent Bar, Sunland, Trinidad, and Winchester.”
[Sunland Estates is hard to find, but about 10 miles south of the vineyard, look here: 47.079136, -120.029217 ] John and I have driven through there, long ago.

John picked strawberries and small tomatoes. We just finished cleaning the berries and he is putting 2 pounds of them in the freezer. We will have some after supper on our lemon meringue pie. He has done just a little outside work all day, and finally the wind began blowing and has cooled things down a lot. High was 86 today, and now at 6:00 p.m., it is 77. Highest wind gusts today were 38 mph, but did not start until 2:25, and we have experienced wind all afternoon.

Another limb came down yesterday while we were away, where one came down last week. Both fell where John and Annie frequently go (not in strong winds, though), so he used the truck to pull them to an out-of-way place. They will make a few day’s firewood for next year.

Sunday, Sept 11

John leaves this morning at 6:00 a.m. for another WTA trail maintenance trip, this one to the Middle Fork of the Snoqualmie River. I’m staying home and have no trips planned. He’ll close our front gate fence, in case the horses get out again, as they did yesterday.

Hope your week was fine.

Nancy and John
Still on the Naneum Fan

Happy Birthday and Healing

Sunday, Aug 28

For Aug 27. CPAP not on until this coming Saturday because of potential-conflict with healing implant abutments protruding through gum, and my desire not to break the clots. I am continuing my Oximetry separately all week. It was good all night, with only one blip to 89%. All the rest of 8 hours displayed the majority above 90% in the mid 90s. I am capturing the graphs and reports to show my doctors. Again, the sole reason I use a CPAP machine is to elevate my SpO2 while I sleep. (Blood oxygen % saturation level to keep it flowing to my vital organs, in the 90s. My average overnight without CPAP has been averaging 92%.

Had my first non-liquid lunch, a piece of Key Lime pie completely covered with strawberries.

I cut and froze into ~> 1/2# packages all the rest of the nectarines. John made it home a little before 6:00 p.m. We are still eating peaches and they need attention.

I spent time on the computer on records this morning, after it finally came on and stayed. With our sporadic Internet connection, it is not wise to contact me wanting an answer soon on email or Facebook. Call our landline home number. If no answer, you can try my cell phone, but realize it gets NO reception at our house; however, it will accept Voicemail messages and ring a bell to alert me.

Yesterday afternoon I ordered John a replacement cell phone for his lost one. Turns out it is a nicer phone than he lost. The cost was $10.80 (originally $30) because it was returned. Not bad, with free shipping to arrive on my birthday. Nice present for me because he has driven all over the state since he lost the last one, and I am not in touch after he leaves at 6:00 or 7:00 a.m. until he returns. When Mt. Rainier is the destination it is ~ 6-to-6. This will decrease my stress level considerably.

John made it home just before 5:00.

Here is a photo of John at Talapus Lake trail work today.
0-JohnTalapusLakeTrail8-28-16John has an iron bar (aka the rock bar) behind a rock that needs moved. This is a re-route of an old trail that followed a logging road from years ago. It took about 4 years of planning, layout, environmental review, paper work, and meetings to get the “go ahead” for this project. WTA volunteers will do about 15 days of work on this before fall, then continue next summer after the snow melts and the tread dries out. (3,000 ft. elevation)

Monday, Aug 29

For Aug 28. CPAP not turned on. Oximetry continued separately, however: SpO2 mostly ~92% all night, with a few blips below 88, and a low of 86.

Wrote check for David Hazlett for trimming Myst, and he completed her feet about noon. Our long-time farrier is slowing down, age, and they just paid off their 30 year mortgage. He is only doing about half the number of horses as 5 years ago. He doesn’t schedule anything after 1 P.M. anymore. He is just 65 but he, and most people that work on large animals, get various physical aliments (and injuries). John claims that those in Washington, D. C. (District of Criminals) who advocate that folks work until 70 or 72, have never actually worked.

I am pulling out of activities in order to recuperate better and had e-mails and calls to make that happen. Wednesday Noon at the Food Bank was one such thing that got cut. I plan to make it Thursday to play with the music group, and we will have an additional fiddler from my past, joining us.
I worked on a sympathy note to Amanda and Alex Taub for the loss of their dad, Jack. Amanda is a student of many years ago with a job based in Wenatchee, though they live in the pseudo-Bavarian village of Leavenworth.
Leavenworth web captureLate afternoon I received several X-rays and photographs of my procedure planning and culmination of the two dental implants for teeth #19 & 18 in my mouth. The photos must be sent in an encrypted computer file (medical record security), and it took me until the next day to figure out how to obtain them.

Because of people reading this blog who do not like to see blood, I shall not include the ones taken during the surgery, but I am happy to have them to see what I was hearing, watching, and feeling. Instead, here I will show a collage below of the results of an earlier 3D scan of my entire mouth so they would have all the details to make the correct mouth mold and take the measurements needed for doing the surgery 8/26 that I already described for you in last week’s blog.
1-CollageMoldPlanningFinaleImplants8-26-16nancyHLeft to right: (1) the ceramic mold of my teeth, with the plastic guide on the bottom teeth. (2) another view to the bottom jaw with placement. The two metal spots are holes for access of the drill to the correct spot, and they had to line up the correct angle and size of drill bit to make the hole in my bone. (3) the plastic guide out of the mouth mold showing the marks for the insertion of both places for an implant “screw.” (4) the final X-ray, shows when two implants had been screwed into the bone and the abutments for the future crown had been attached.

In the same mail, I received more photos of 3-D scans that were completed and shared with John and me before the surgery occurred. Now that it is over, I am happy I went through the process. Stitches come out this coming Tuesday. I have to wait at least 12 weeks to be sure the bone has surrounded the screw implant properly. During this implant insertion procedure, they put more of my blood platelets into the bone structure surrounding the implants to assist in the grafting process that began 5 months ago in the first surgery when they removed my old infected root canal tooth. I cannot chew on that side until the crowns are installed and that might be Jan or Feb, 2017. It’s fine; I have lots of practice.

This evening I had another large shake tonight for dinner made of Ensure, half a peach, and a heaping tablespoon of New Zealand Whey protein powder, made in Canada. Later in the week, I learned I could add 4 ounces of yogurt and make it even larger and thicker.

Tuesday, Aug 30

For Aug 29. CPAP not planning to turn on until this coming Saturday-conflict with healing implant abutments protruding through gum, and desire not to break the clots. Oximetry continued separately, however. Last night was smooth sailing all night, with only one low of 85%, Avg. low, 88%, and overall average ~ 92%

From a give on the Buy Nothing Ellensburg site, I picked up vases from Renee Moore and took her tomatoes to the parking lot behind her place of work at Argonaut Peak Physical Therapy. I found out she is Peggy Coble’s daughter, whom I know from the Food Bank. I will be using one of the vases later this week to take flowers to a friend’s 90th birthday party.

From there, I went down the street to the KVH lab, for checking my INR, post surgery. Found when I got home it was only 1.6, but I will have it checked again next Tuesday, after I go have my stitches removed. The low value was actually expected because I had been off Coumadin for 2.5 days, and only back for 2.5 tabs.

From there, I went to Hospice Friends to pick up some supplies for another 90 yr old friend. While there, I wrote a check for a donation. They provide such a wonderful service to those in need of medical supplies, without any questions of income or insurance. I borrowed a walker there when I was needing one, and donated it back when Medicare paid for a new one for me at the end of my rehabilitation stay. I borrowed a high toilet seat with handles, until I could get up on my own. I borrowed a seat for the bathtub when I could not get up and down from the tub. I recently borrowed a wooden cane for use of my physical therapy exercises for my shoulder. The organization also provides free trips for those who cannot drive, to places such as Yakima. I have never needed that service, but I have recommended several people to call there about it. Back to today. I carried in a pie plate full of cherry tomatoes with a few Early Girls included. The gal in charge lives in town but her cherry tomatoes are still all green.
We have started to get some of the small Yellow Pear type:
Yellow Pear tomatoesFrom there, I went to the senior center. I had no intention to go through Jazzercise, so close to my surgery, but I carried 3 large gladioli stems with different colored blooms: orange, red, and a beautiful variegated red & white. I should have taken a picture because I can’t find one on the web that is the same. No one had ever seen such a nifty arrangement.
The Senior Center is closing to have a place at the fair for people to rest, have snacks, and coffee, manned by volunteers from the pc-named Adult Activity Center. While there, I also picked up the instructions for helping another friend, Anne, who will be gone with her son for 2 months back east and south. I am in charge of the mail and watering the plants. A young gal, friend of their family, will be coming every other day to take care of the cat that I took care of last year.

I went by Bi-Mart to check my number and the price on Ensure, forgot to buy potato chips on sale for John that he likes, but will be able to get them Thursday (actually, any time before 9/11, and will need to go back for the sale on cat food by that date as well).

While in town, I dropped by Grocery Outlet for more pies. In addition, I came home by way of my friend’s to drop off her supplies I picked up at Hospice Friends. We had a nice little visit, and I made it home later than planned.

Once home, I ate a piece of key lime cream pie covered with half a fresh peach, peeled, and cut. Late afternoon, I had a spiked blueberry yogurt with protein powder whey filled with the other half of the peach from earlier. Protein is supposed to help me heal but is lacking in the soft food diet.

I helped fix the food for outside cats, waiting for darkness to send away the bees. I also made two calls to catch up on neighbors and my older (music) friend with whom I check every night.

John fixed his own dinner and I started working on the strawberries he picked this morning. After they were washed and drained, he came over to help me cut them. We probably had at least a quart of berries, maybe more, kept some for later, and John froze the rest. We will expand this patch of day-neutral plants next year.

Wednesday, Aug 31

For Aug 30. CPAP not turned on. Oximetry continued separately, however: Avg SpO2 was 92.1%, 3 jumps below 88%, but low was 85%, with avg low of 89.2%.

I am staying home today to recuperate. So, no food bank soup kitchen music or food (could not eat it today, anyway).

I called Clare Panattoni to see when her 90th birthday party is on Sunday. She had invited me last Thursday when we were playing music at Hearthstone. It will be 2:00 to 4:00, drop in for cake and punch. I will take Gloria (also 90), who knows Clare from our SAIL exercise class at the senior center. I will take John’s gladioli and a little tiara for her that was given to me on my birthday in 2015.

Boy, today was filled with medical issues. I am sorry I missed going to the Food Bank, but happy I stayed home to try to sort out some of this still unfinished business.

John’s phone arrived this afternoon at 3:25 in our mailbox, after starting in Portland, and going through Spokane to get to us.
Now to open, and activate, and add some phone numbers to his address book. At least he will have it for his late (near end of season) volunteer trips. He has 3 scheduled, but might add another.

Thursday, Sept 1 (My birthday!)

For Aug 31. CPAP not turned on. Oximetry continued separately, however: Several blips of SpO2 below 88, but nothing serious, and only one minimum of 82.

Awoke to many birthday wishes on email and Facebook. Actually an amazing number. They are still coming in late afternoon. My first one of the morning was an email from John:

HAPPY BIRTHDAY!

And this link: The Science of Color in Autumn Leaves

I received emails all day and cards came in the postal mail through Saturday.

We called and talked to Helen Burgoon in PA, John’s 91 yr old cousin who shares my birthday. She is as amazing as her 97-year old sister, Ethel, also in PA. Helen, and lots of other family, live near Bradford, PA. John says it is the coldest place in all the World. He says they couldn’t have Seals in the local zoo ’cause the seals would attract Polar Bears – if they had a zoo.

Now to eat breakfast and work on getting John’s replacement cell phone initiated for this weekend’s use.

I will go to the Rehab where I was for 7 weeks in the beginning of 2010, to play music. We should have at least eight players there.

Not doing anything for my birthday until next week, when we go to our annual fun event (harvest festival) over at the winery and vineyard where John helps prune. It will be held Friday, Sept 9, and you’ll hear more about that in next week’s blog.

On the way home, we stopped off at Joanie and Ken’s to pick up my birthday present she knitted. They are called “muffatees” and they are an authentic revolutionary war pattern, “allowing you to shoot and poop without taking your mitts off.” – Joanie further said there was a lady selling homespun wool and things she had knitted and crocheted – (hers were all real wool, to be period appropriate – yours are acrylic and machine washable). She knitted them for me last June, while attending the Pacific Primitive Rendezvous in Seneca, OR (they have a website). Last year she and her hubby, Ken, treated me on my birthday to a tuna melt and will later this year, with John, after I am back totally on a solid food diet. Here is a photo of her gift:
2-SeattleSeahawkColorsKnittedMuffateesShe used Seattle Seahawk colors, so I placed them in the photo with my special cap. It was a challenge taking left-handed with a flash that pops up on the left holding side and needing to focus and shoot while leaving my mittened right hand in the picture with my vintage Seattle Seahawks hat. I will be right in style at next year’s Sportzpalooza at the senior center. (Last year’s blog showed John and me there on Jan 29, 2015, with my hat and colors on. John wore a red/white/blue Phillies jacket, yard sale edition. Next year I’ll have him add his Bronco T shirt (free with a beer purchase, or something) and wear my Chicago Cubs baseball hat. We’ll be all decked out. [John says, explain that: “adorn” (as in deck the halls), c.1500, from M.Du. dekken “to cover,” from the same P.Gmc. root as deck (n.).]

We got home in time before the downpour to take my photo in my western attire I wore to play music. This was the first day of the Fair and everyone was in the mood. We began with the western cowboy songs we had done at the Rodeo/Fair kick off breakfast on Aug 20. Today, we had a good turnout and a lot of fun. At the end of the playtime, I started Happy Birthday in G, and the audience and players played and sang to me.

Before the photo below are some of my memories I shared with my music group after we played today:

Thanks everyone who made my birthday celebration complete yesterday, 9/1. Our afternoon at the Rehab was the best memory in my experience at that place. A few of you know the previous best time was sitting in that room in my wheelchair, barely playing and singing with the group (Kittitas Valley Fiddlers & Friends) in 2010, and watching Charlie smile at having me back with the group. I spent 7 weeks there Jan-Feb that year learning to use ALL my muscles after they atrophied being in the ICU for 55 days leading up to, including the heart valve replacement surgery, and getting out for physical therapy and care at Rehab. Mae Opperman (now a resident there) was in the room today. She was my roommate in the room next door, when I arrived. I always called her my sunshine and inspiration for encouraging me by letting me know I would be back on my feet and able to walk again, as she was. Now, it hurts me to see her health declining.

We all (and the audience) were really on a roll and had a blast. Thanks, Minerva, Maury, Sharon, Manord, Charlie, Evie, and Trinity for making my 73rd birthday memorable. Having our fan club there was special too. Trinity, we appreciated your joining us, and hope you’ll have another chance in the future. Safe travels on your trip back from Spokane and the best wishes to your mom, Muriel (whom I have known almost 25 years from Bobbie Pearce’s Intermediate Fiddling class in Kittitas, WA at the WA Old Time Fiddler’s summer workshop).

Here I am in front of one of our Carpathian walnut trees, check the photo to the left of my hat brim for 3 walnuts (English type) still encased on the tree.
3- Sept 1-2016 Birthday 73 Nancy, Sept 1, 2016, on 73rd birthday

John made me a nice moist birthday cake tonight – lemon, filled with fresh peaches cut into small pieces. I frosted it with cream cheese frosting.
4-Collage-Nancy's73rdBirthdayCake2016Cake (Lemon/Peach) with frosting added (cream cheese)

It started raining after we got home and we hope it is over sooner than expected, before John leaves in the morning for Talapus Lake for trail work. He does not want to work all day in the rain.

Friday, Sept 2

For Sept 1. CPAP still not turned on, oximetry only: Avg SpO2 was 92.1%, 3 jumps below 88%, but low was 85%, with avg low of 89.2%

John fed two of the cats before leaving and the sun is shining. The main precipitation activity is still over near the Juan de Fuca Strait and Victoria. He has along his new backpack cover to protect from rain if it happens. He wore his new waterproof camouflage (Mossy Oak!) boots. He drops me off, goes and buys stuff, and comes back to pick me up. He’s heard the music and says he’s too young for that stuff. He and the crew were fortunate with only some sprinkles and the rain didn’t start until they were leaving the trail. About the time he got to I-90 it was raining hard and the first afternoon of a holiday weekend. The traffic was crazy slow because all the folks heading east out of Puget Sound area on 3 to 4 lanes have to choke down to 2 lanes just east of Snoqualmie Pass.

He also has his new phone, and called me from the trailhead in the morning, about 9. Today, my work is cut out for me – thanking people for my birthday greetings yesterday, and trying to get the blog ready for John to help edit tomorrow while he is back home.

I spent this morning communicating on email with Colleen (my cardiologist’s nurse at the Yakima Heart Center) about some of the protein powder supplement I have been using with the Ensure and yogurt. I was concerned about raising my potassium level because of being on a medication (Spironolact), which provides enough potassium to override the diuretic that I have to take every other day. I had been taken off potassium tablets. She assured me I was within the range in May, and didn’t really need to supplement further.

John was caught in horrible traffic on I-90 at the pass that had delayed people for an hour most of the afternoon. Get out of the lane, off, and back on I-90 seemed foolish – so he didn’t, and didn’t call. I was watching on the web cams and reading the travel alerts. Finally he called from the gas station in Ellensburg. He stopped by for ice cream and salsa so we could have nachos for supper tonight. I’m looking forward to that after getting very tired of the liquid diet.

I never got to my thank you notes for my birthday, and the messages keep arriving all day, including more cards in the mail. John’s sister Peggy called for a nice long phone conversation this morning. My Facebook account continues to have birthday wishes expressed in many ways – homemade illustrations (here’s a collage of Dave Covert’s photographs he sends one every year – with the one on the left he sent this year, but with others taken the same day (Aug 27, ’16), my mom’s birthday.
CollageDavidCovertPhotography-2016The flower on the left he sent to my Facebook account. It is a dinnerplate Hibiscus. The middle tub of birds is neat, and the one on the right is Crocus.

Others sent cute stories and memories. I think that is the best part of Facebook. I try to acknowledge all my FB friends and relatives on their birthdays too (we are notified the day of their birthday to write a note on their timeline, which means all our contacts are reminded each time someone writes). As of Saturday morning, I was up to 158 messages from all over the country and around the world (Cuzco, Peru, Australia, New Zealand, Canada (two in Nova Scotia, one a high school buddy) British Columbia, and Alberta). Gifts in different forms – for example, from my friend in Brittanys, for over 20 years, Karen Barrows, a message that her 3 yr old Brittany (lines go back to ours) won an Open Limited Gun Dog stake (19 starters) at the Oregon Brittany Club field trial in Madras, Oregon. For many years from the late 1970s, we traveled to those grounds and that trial. That win for “Cinder,” a tri-colored Brittany finished her field championship.

The first greeting of the morning on Facebook came from Anna & Paul Friesen in Wisconsin, who have two Brittanys from us, Tobie & Molly, who she reminded me would be 10 years old today, 9/2/16, a day after my birthday. I drove to Spokane to meet Paul who took them home inside the airplane with him, in 2006. They actually have had more Brittanys in their family from us, and they have passed across the rainbow bridge to happy hunting grounds there. Paul is an avid bird hunter and they are his buddies.

For memory’s sake:
CollageFriesenBrittanysTobie&MollyWithPaul&AnnaFriesenTobie & Molly (left – 2006) to adult members of the Friesen family

Saturday, Sept 3

For Sept 2 CPAP still not on. Oximetry: SpO2 avg was 91.8%. Low was 85%.

Today will be working on this blog to finish before John takes off tomorrow for Mt. Rainier.

This morning was the rodeo parade but we did not go. I watched some videos and photos of the parade on Facebook.

I hope the battery holds out on John’s new phone for the day. Yesterday, it was exhausted from being on all day and making two calls. That is one disadvantage of the phone reported by users. I’ll discourage him from taking any videos which I know are rapid eaters of battery life, and he will only turn it on when making a call, or taking a photo.

John just arrived for lunch after much work in the yard, moving a large downed cottonwood branch (no doubt from the recent high winds), cleaning up weeds around his planned loading platform (while waiting for a doe to move from her bed near the old pickup). He reported that we have very many little red and yellow tomatoes needing picked. Then he cut and buried some Burdock, Arctium minus.

Click on the little photos (if you go there) to see the larger images. Or, you can click on the pdf link. The other link to a weed management handbook did not open for me. Note this: “Marble sized burs are covered with many slender, hooked spines that gave rise to the idea for ‘Velcro’.”

I’m still working on the blog but getting ready to have my lunch of leftovers from nachos last night and tuna/egg salad from lunch yesterday. I finished with a piece of key lime pie covered with 1/2 a fresh peach.

Night found me going back to my combo of Ensure, yogurt, protein whey, and four of our yellow plums cut up for dinner, and John had a ham & cheese sandwich.

Hope your week was fine.

Nancy and John
Still on the Naneum Fan

Start with tires, end with teeth

Monday, August 22

For Aug 21 CPAP. Reported figures. Time on 4 hrs 58 min with AHI=1.01. Events: 0 CSR, 5 H, 4 RERA. No mask leaks (max= 21 L/min). Oximetry: Two blips below 88% on the CPAP & off, but fine all night. Actually, the down was lower on CPAP than off.

I have taken care of a bunch of medical planning issues all day, answered emails (not finished), done dishes, and put medications for the week into my little case.

John went to town in the truck to pick up our new tires for the RV trailer that had been installed on their powder metalized-coated rims to rejuvenate the old pitted/weathered ones (34 years old) that were causing one of the 15-year-old tires not to stay inflated.
1-NewRVTrailerRimsTiresSeveral colors are possible but because the trailer has “earth” colors, John picked orange. It is Kobota-orange and brighter than the trailer’s colors (somewhat faded). Hubcaps cover most of the rim, so only a little orange shows. The technology is new to us, but not new.

The tires are not top-of-the-line, but good enough for a trailer that doesn’t go anywhere. Well, it did go up on wood blocks, likely until a fire causes us to evacuate – or we decide to become vagabonds.

Note the brand: Venezia! Sounds sort of Italian. Not so. Not even from The Rubber Capital of the World – Akron. They are produced in Thailand. Oh, the tragedy!

While out to photograph the tires, I stepped over to John’s number one garden where he was watering his little hen & chicks. They are within a 6′ fence because the deer love these tasty treats. 2-John'sHen&ChicksNurseryWe gave away 12 pots the beginning of summer, a couple last week, and more need to be separated and potted anew.

I talked to Janel at Hospice Friends and will stop by tomorrow before 2:30 to see her and pick up some stuff for my neighbor and me. She suggested giving me a light hospital blanket to fold and put into a pillowcase to use in the dental chair this Friday to protect my back. Great idea (and it worked perfectly).

Tuesday, Aug 23

For Aug 22 CPAP. Reported figures. Time on 4 hrs 45 min with AHI=0.42. Events: 0 CSR, 2 H, 8 RERA. No mask leaks (max= 14 L/min). Oximetry: SpO2 up all night on & off CPAP except right before I stopped the oximeter and might be from moving to a different finger.

Today starts my Amoxicillin three times a day (8 hr intervals) for 10 days.

I went for my INR at KVH, and found out late afternoon that it was high, at 3.2. From there on to Hospice Friends, on my way to the 2:00 Jazzercise (taking $3 to Katrina, although I will not likely be there next week, but I also owed some from last month). We meet once a week, and pay 50¢/day for the class.

I carried a container of Early Girl and cherry tomatoes. Everyone was happy. While there, I picked up keys from Anne so I can get her mail and water her plants for the 2 months she and her son are gone back east and south. This year a friend’s younger girl will take care of the cat I took care of last year.

After today’s vigorous aerobic exercise, I went to Physical Therapy for my Progress Report. I did not do as well today as I have done in the past, on most all the measurements.

I stopped by Safeway to pick up my Telmisartan (Micardis) at the reduced price (still a lot for 90 tablets), $67.89, through GoodRx. I take cash for the purchase, as I cannot qualify for a co-pay through insurance at my regular pharmacy because the price for the same amount is triple this cash price (for some reason).

The temperatures were quite hot today. I came home tired.

Wednesday, Aug 24

For Aug 23 CPAP. Reported figures. Time on 5 hrs 42 min with AHI=0.00. Events: 0 CSR, 0 H, 11 RERA. No mask leaks (max= 8 L/min). Oximetry: Good all night, with one blip to 88.

I shall begin midweek today with a Facebook photo posting and note from Tony Bynum, professional photographer extraordinaire, from Montana, and my friend from long ago, since he was our geography student at CWU and in resource management.
3-Tony Bynum PhotographyElk
Tony’s comments to his Facebook friends are below, marked with a left column.

Once in awhile you get lucky. 🙂 Just another day at the office – yeah, right! Sat at this location for the past 10 years or more waiting for a shot like this. You can imagine how I felt … All those days waiting, hoping. Everything has to be right, the light, the wind, the sun, and the animals. At the end of the day, I would have never have been able to bring shots like this to reality, if not for our public lands keeping it wild. See: www.tonybynum.com for more photography in the wilderness.

Early 5:00 a.m. Amoxicillin. I went to food bank for music, and ate a little, but I left without going to SAIL exercise to come home to work on medical records, in consultation with my family physician’s records keeper. I did not take my friend, Gloria, with me because she had other appointments.

The rest of the afternoon I worked on 7 pages of Medical history (in a form they emailed me as a .pdf file so I could print out, fill in by hand, and also then scan into a .pdf of all the pages plus a paged of my medication dosages, and ship back with my signatures and all the information. Again, this was necessary to share all details to be considered for an evaluation of my left shoulder by Dr. Richard Roux, an orthopedic surgeon. Before I can even schedule an appointment, I have to do all this paperwork, after the referral from my family physician (that I received Monday, this week). I had to consult with the record keeper at my primary care doctor’s office to coordinate dates on procedures connected to medical ailments over my past. In addition, I had to get the full name of a drug I was allergic to in the past and what my reaction was. That is the second allergy on my list. I know Heparin as the important first “allergy,” of which a H.I.T. would be fatal. I wear a medic alert bracelet for that and for the various artificial parts associated with my heart.

Now to send the count for tomorrow’s music to the people who will set up the chairs. Done. We will need 10; ended up needing 11.

This evening we went to the neighbors to carry in the stuff from my car I got from Hospice Friends and take them a few each of peaches, plums, nectarines, and cherry & pear tomatoes. After lugging the stuff in, John walked home to feed horses, deer, cats, and do a few other things, and I stayed to visit.

Thursday, August 25

For Aug 24 CPAP. Reported figures. Time on 4 hrs 21 min with AHI=0.69. Events: 2 CSR, 3 H, 10 RERA. No mask leaks (max= 21 L/min). Oximetry: Good all night, only 2 blips to 88%, SpO2.

Early morning call (7:56 a.m.) about scheduling an appointment for my shoulder evaluation with the orthopedic surgeon. I was dead asleep, having been up at 5:00 a.m. to take an antibiotic first dose for the day. Laid back down with a heating pad on my shoulder and neck.

I had cancelled my teeth cleaning for this morning, because I was afraid the extra Amoxicillin was going to raise my INR, which cannot be above 2.5 for Friday’s surgery. Therefore, I will just go play music at Hearthstone, afterwards, go for an INR late afternoon (at the hospital lab, a block north), to see if it is below 2.5 (required for surgery), and call my Coumadin counselor to report the number. Ended up having a vein draw rather than a pinprick and called before 5:00 to get the reading. Happily, it was 2.0, so I am good to go for the surgery.

We had a lot of music folks today. Pretty cool. At one point we had 4 fiddlers.

Finally changed my nose piece and tubing on the CPAP; I need to do the filters.

Friday, August 26

For Aug 25 CPAP. Reported figures. Time on 6hrs 37min with AHI=0.00. Events: 0 CSR, 0 H, 10 RERA. No mask leaks (max= 10 L/min). Oximetry: Great all night.

Introduction: Dental Implant Surgery, definition by the Mayo Clinic staff:

Dental implant surgery is a procedure that replaces tooth roots with metal, screw-like posts and replaces damaged or missing teeth with artificial teeth that look and function much like real ones. Dental implant surgery can offer a welcome alternative to dentures or bridgework that doesn’t fit well.
How dental implant surgery is performed depends on the type of implant and the condition of your jawbone. But all dental implant surgery occurs in stages and may involve several procedures. The major benefit of implants is solid support for your new teeth — a process that requires the bone to heal tightly around the implant. Because this healing requires time, the process can take many months.

My surgery was a follow-up from 5 months ago when I had a tooth pulled (a root canal that became infected and was realized when the gold crown came off and could not be reseated. The surgeon had to take my blood platelets and insert bone graft materials to regenerate the bone in which to connect the implants. That requires a minimum of 4 months.
Because of my heart issues, and valve replacement, I have been on Amoxicillin 3 times a day since Tuesday, and my premed (4 500 mg tablets) occurs an hour before surgery, so I took it on the way down to Yakima; John driving. I was at the dental surgeon’s office for check in at 11:00 a.m., and surgery prep began at 11:15. Surgery lasted 1.5 hrs. I went through the surgery, and am providing some description below. We left the office at 1:00 and came home via my Ellensburg pharmacy for Oral Rinse (a pint and I’m only supposed to dab a Q-tip in two places twice a day). Insurance doesn’t cover it, and so we had to fork out $15.48. My pain killer (not working) was only $3.49. Saddest is that my blood doesn’t want to clot either. The 30 minutes of biting on gauze pads (they gave me) has not stopped it. I continued for a couple hours and finally stopped, and the bleeding slowed. I continued with cold compresses to my cheek on and off for 20 minutes. (That’s primarily for swelling.)

During the prepping, I was able to have help with setting up my three “pillows” I brought for the chair. I had folded a light hospital blanket and put into a pillow case wrapped to half size, to place between my back and the back of the chair, which had pressed uncomfortably (and painfully) 5 months ago in the beginning surgery setup. The second pillow I sat on – a pillow case around an egg-carton type foam pad. The third pillow was my normal smallest sleeping pillow, which we put under my left shoulder/arm.

Surgery went for 1.5 hours, I was awake the entire time, and knew everything going on, what was said, and when my anesthetic quit working. The pressure of stretching all of my mouth’s facial skin and lips was painful and I had no numbing for that. Pressure under my chin was also required. The doctor had two immediate assistants, (1) running the suction, pulling out my cheek, advising on positioning of the drill and screwing in the implants eventually, and this person also took X-rays of the jaw as we progressed; (2) handing drill bits, controlling the direction and speed, changing implements/tools/inserts, accepting measurement directions from the surgeon, and acting as another set of eyes to position from her side (right) of my mouth. I was able to see (and hear all the tools used and the directions given). I also received explanations of the process and what was happening along the way. The doctor asked in advance if I wanted such information, because many patients do not want any explanation while the surgery proceeds. I assured him I wanted to know everything he had time to slip in between instructions to his assistants. A fourth person was also helping with various tasks, and with setting the X-rays that proceeded throughout. I had a heavy lead cover protection over me the entire time.

I had had a 3D CT scan at a previous visit, and the surgeon, Dr. Tew, created a plastic form with the emplacement locations he used (with it placed in my mouth) for setting up the hole drilling into the bone to house the implant “screw” (metal post). During surgery to place the dental implant, the oral surgeon makes a cut to open the gum and expose the bone. Holes are drilled into the bone where the dental implant metal post will be placed.
Because the post will serve as the tooth root, it is implanted deeply into the bone, but not so deep as to reach the nerve. Also occurring during the surgery was attaching the abutment to the top of the metal post that will be the base attached to the crown. That work will be put off for early next year.

I will not wear the CPAP machine for a week after oral surgery. I learned that by myself 5 months ago. It was not a pleasant experience to start the blood flowing again, after two days. I was told not to drink from a straw, but nothing about the CPAP’s interference. I rewrote their post-operative procedures and questions. Not everyone is the same, but I am to stay off a week, sleep doctor’s orders. I do not have sleep apnea problems, but am on it solely to increase my SpO2 (blood saturated oxygen percentage level for my organ health, particularly my heart).

My afternoon recovery was painful, and I alternated doing all the things suggested, and took another pain killer, but I guess the Yogurt and the Ensure was not enough to counteract the “empty” stomach, and I suffered from a little nausea. Thankfully, John had picked up some generic-Sprite for me when he got the pain meds… and oral rinse.

While resting, John went through and explained some of the photos that arrived from a trail worker during the Jack Creek work in Icicle Canyon this past weekend. We just received these photos today.

Here are a three of collages John can review what he described to me and I tried to share below each.
4-JackCr_IcicleCanyon8-19-21-16Starts with Jack Creek a mile away from the trail work; sign entrance to two Alpine Wilderness Trails, Paula working on root removal, and John working on the top of a large root. The tree is already dead but removing the entire root might destabilize the tree, causing it to fall, and ripping up the newly refurbished trail. He took about 6 inches off the top, using saw and ax.5-TheRockPoleStoryJohnPaulaAlanThis is the rock and pole story at the end of a lot of hard digging by Paula and Carol to expose the rock. The previous day, thinking they were done with the heavy lifting, they had carried a continuous rope puller out to the truck …

Maasdam Rope Puller

… and some other gear. John got his rock moving stick, Alan has a shovel, and the iron bar is in the hands of the lady.
6-AlanRootBradDumingJohnBrokeRcksJohnBehindTurnpikeAlan with a large removed root, Bradley dumping rocks John broke up from a nearby granitic, and well weathered, boulder. Alan watched from the end of turnpike, and on the right look past the turnpike and see John creating the buckets of small rocks with a one handed sledge hammer (aka, single Jack).

Tonight we also had some nice views more to the northwest from our back patio.
7-CollageTwoNWSunsetsOurPatio

Saturday, August 27

For Aug 26 CPAP. Not using; however, I recorded the oximetry all night: Without the machine, the SpO2 jumped below 88 a few times, below 80, twice.

This morning I was up early to take my antibiotic and acetaminophen, but I did not take any pain pill. I managed to sleep until 9:00 a.m.

John fed the 3 outside cats, picked some cherry tomatoes, and left for the Eberhart orchards to pick a few boxes of Gala apples, early ripeners. Honeycrisp won’t be ready until later. We have two neighbor things going on and want to provide a box of apples to each. He got about 90-100 pounds of good apples and another box of windfalls to give to the fawns and their mom.

He went by way of Ellensburg to buy gasoline, a bucket of ice cream, and 2 frozen pies.

About 11:30 a.m. a car drove in (not John), so Annie announced it. I walked out and received a beautiful flower arrangement sent by my dentists. Here’s a photo.

8-WilliamsFloristDelivery8-27-16-11amThe photo is outside (overcast today then). On the right is the florist and the card from the sender attached. I appreciated receiving the pretty flowers from my dentist and my surgeon for yesterday’s activity in my mouth.

9-CollageJustFlowersFlorist&John'sInside the house I added a picture of the flower delivery vase beside a vase with the gladioli John brought to me when he got home. Both are in my kitchen window to cheer me when I fix my liquids mixed with filtered water and mix in a heaping tablespoon of New Zealand Whey (protein powder manufactured in Canada). I received a container of it from Tanya Myers, that John brought back to me with several boxes of apples picked this morning.

Temps went to 82 high today, but so did the wind gusts (to 43 mph twice).

John and I had a piece of Key Lime pie this afternoon and for supper, I had a yogurt with another whopping tablespoon of whey protein powder. Then before bedtime, we’ll have another piece of Key Lime Pie with our strawberries on top. I should be able to slither those down my throat and chew a little on the right side, if needed. The crust is crushed graham cracker so not as hard as a flour-based cooked pie shell.

Hope your week was fine.

Nancy and John
Still on the Naneum Fan

Music on a truck

fiddle player cartoon

Monday, August 15

For Aug 14 CPAP. Reported figures. Time on 6 hrs 49 min with AHI=0.29. Events: 0 CSR, 2 H, 17 RERA. No mask leaks (max= 15 L/min). Oximetry: none for the night.

Nothing on tap in town – just catch up at home on numerous tasks. They expanded. I finished the Carly going-away party photography and videography to send to the Ellensburg Adult Activity Center folks and shipped it off by email.

Fed the cats.

Then I decided to set up the music I need this week for taking to town to run off Xerox copies rather than trying to do it all on my printer with very little flat hard space in our home for collating and organization and, in addition, I would have to punch all with 3-holes. John took the other 3 tires off the Travel Trailer and put them in the truck for the trip to town, letting me off to make my copies.

I have been sorting since arriving home at almost 5:00 p.m. Oh, we delivered some plums, peaches, and flowers to our older neighbors, and we ate a very late supper. So did the cats because the bees/wasps keep going after their food. We have to wait to feed until almost dark, and sometimes then it’s still a problem. We are spraying as well.

I almost have the music finished sorting and filling in from my printer two pages I forgot to Xerox today. I needed them for 10 copies. Dang. So much for planning.

Problem with the index finger on my left hand. Broken blood vessel? Arthritis? Severe pain late tonight, cannot bend it (it’s acting like a trigger finger). Iced it all night. I have no clue what caused it. I noticed it first at night while going to bed and lifting a light comforter with my left hand.

Tuesday, Aug 16

For Aug 15 CPAP. Reported figures. Time on 5 hrs 59 min with AHI=0.00. Events: 1 CSR, 0 H, 13 RERA. No mask leaks (max= 15 L/min). Oximetry: Okay.

My index finger is still hurting. I am unhappy, as it is my violin fingering hand. Right now, it hurts to type on the computer.

I was supposed to take $2 to AAC jazzercise, but forgot to take in the cash. I did manage going through an active session of routines.

I went to my 3:15 appt with Shawn at PT. Came home and was wiped out the rest of the evening.

Wednesday, Aug 17

For Aug 16 CPAP. Reported figures. Time on 5 hrs 8 min with AHI=0.19. Events: 1 CSR, 1 H, 5 RERA. No mask leaks (max= 10 L/min). Oximetry: Okay all night.

John picked me some cherry tomatoes to take with my tuna fish/egg salad today to lunch at the Food Bank to supplement the stuff I cannot eat.

I left to pick up Gloria to take to the Food Bank for music and eating. My index finger was hurting me to play the violin, so I sang more than I played, and avoided using that finger. Any song that has a note A on the G string, E on the D string, B on the A string, or F on the E string, uses the index finger in first position. It was a challenge to play. I came home and put ice on it again. I hope I can make it through tomorrow’s hour at Dry Creek/Brookdale. Then I have one more day to heal before our Saturday gig.

For food from the buffet line, I took the shrimp, peppers and cooked onions from the pasta served to mix with my tuna/egg salad, and added the tomatoes to my light green lettuce and radishes, leaving behind the spinach.

We went on to SAIL exercise, and had a nice 45 minutes, but left for another appointment. The temperature was 93, and so I left Gloria in the car, motor running with the a/c, while I went into Safeway to return the too highly salted groceries I bought yesterday on sale. John is careful to stay away from highly salted items such as Rice-A-Roni, spaghetti sauce, in his cooking for me to hold down the salt. On home with a treat for John – an apple fritter.

Thursday, August 18

For Aug 17 CPAP. Reported figures. Time on 4 hrs 12 min with AHI=0.71. Events: 2 CSR, 6 H, 6 RERA. No mask leaks (max= 17 L/min). Oximetry: Strange SpO2 activity for an hour just before 2:00 a.m.

John leaves early for getting his 2009 Subaru serviced, and will go by Costco for gas and groceries. The car needed an alignment. Too much driving on Cascade Mountain roads?

Finished and checked the music.

We played at Dry Creek Brookdale. It was a very hot day, 91 outside, and we had 11 players. I made it through pretty well, but still with pain. I drove by Dave and Janet’s house on the way home to deliver the music in order by the way we will play it on Saturday. They’re arriving Friday, so I just put behind their screen door because I was not planning to go to town tomorrow.

This evening we left at 5:00 p.m. to drive across the valley to the home of the Lindstroms for the annual summer gathering of the Kittitas Audubon Society. KAS provided the grilled beef burgers or veggie burgers and fixings, including grilled onions. Members brought appetizers, salads, sides, and desserts. We carried a Costco Peach pie that was large & awesome. The setting in their yard was lovely with shade provided by a large variety of plants they acquired over the last 40 years, fruit trees, and more. We met folks we know, some new, and others known of but never met. We sat at a table with long time Valley hay growers (Marilyn and Gerry Sorensen); now leasing their land to younger workers. I talked “hay” with them, and plan to send a paper I co-wrote on the export hay industry with pictures from our valley of the whole process. John went and talked with the hosts. We had a delightful dinner and got home just before dark.

Friday, August 19

For Aug 18 CPAP. Reported figures. Time on 5 hrs 51 min with AHI=0.00. Events: 1 CSR, 0 H, 12 RERA. No mask leaks (max= 16 L/min). Oximetry: A few dips of SpO2 below 88, but rest OK.

I had cancelled my appointment was cancelled today in PT because of conflicts with preparations for oral surgery in a week.

John left at 6:00 and I slept in. Needed it a lot.

I finally wrote Dr. Schmitt about shoulder problem request, and called to have him see the email (it’s through the patient portal, NextMD). Turns out he doesn’t work on Fridays, so I imagine he won’t see it until Monday, when they will give him a message to check that he will likely do anyway. He is good about communication.

Prepared for tomorrow: printing out copies of the music list to hand off tomorrow for a last minute check; worked on all the lead-ins so we can start in unison, in the right tempo; considered what I would wear to dress western; contacted two players with directions of where to park and how to get to the location, with the closed streets.

John made it home all right and had to shut off the irrigation water to our neighbor on the south, once he got back from a day working on the trail, and he also had to stand a fence panel up and tie it in place. The plastic baling twine he often used gets abraded when the wind blows, and we’ve had lots this summer. He is mostly using wire now unless a fix is meant to be temporary.

Saturday, August 20

For Aug 19 CPAP. Reported figures. Time on 6 hrs 8 min with AHI=0.49. Events: 0 CSR, 3 H, 2 PP, 5 RERA. No mask leaks (max= 11 L/min). Oximetry: Good all night, one blip below 88% in SpO2 around midnight, but high between 2:00-3:00, and fine all night.

At 6:00 a.m., John took off for Icicle Creek canyon and Jack Creek. This will be the 8th day for John and Alan, the WTA lead crew chief. They will finish Sunday.

I left about 7:30 a.m. to go the kick-off breakfast for the Rodeo/Fair. I intended to park in my bank’s parking lot, but had told others in our group to park there and walk down the alley. So, seeing it was filling up, I went back east and parked on 5th Street.

We were late starting and had challenges with the stage setup and timing of events, but we made it through and received accolades from everyone. Check below on Sunday’s entry for more information.

I made it home quite tired at midday and immediately put an ice compress on my left index finger with heated compresses on my neck and shoulders. Finally, at 5:00 I lay down for a 20-minute power nap, and slept for 1.5 hrs until John arrived.

Sunday, August 21

For Aug 20 CPAP. Reported figures. Time on 5 hrs 10 min with AHI=1.35. Events: 1 CSR, 7 H, 9 RERA. No mask leaks (max= 22 L/min). Strange inexplicable night. CPAP off for 10 minutes at 2:07 a.m. no recollection of waking and turning off. ? no clue. Oximetry: not bad on SpO2, 3 times below 88% on CPAP, and 1 time while off CPAP. Fine the rest of the night.

I awoke and put John’s colas in the freezer at 5:30, went back to bed, then up to say goodbye and feed Woody, and back to bed with heat on my shoulders, neck, and ice on my left index finger. I put my oximeter on right hand for longer, and then I guess I was totally exhausted because I slept until almost 10:00 a.m.

Here is an update on yesterday’s festivities at the Kick-off Breakfast for the Rodeo/Fair coming September 1. This photo is our Kittitas Valley Fiddlers & Friends group, and our fiddler, Evie Scheutz’s friend, Gene, took the video below. Thanks Gene for letting us know how we sounded out front, despite the noise from the crowd, while enjoying their pancakes, sausage, juice, and coffee. Below the photo identification is a link to some of our performance yesterday.
1-KickOffRodeo-Fair2016Breakfast-0This I captured from the lead in to the video, which Evie took from her camera and posted on You Tube, and then tagged me on the post, so that all my Facebook friends would receive it. All in the group were grateful for her efforts.
2-KickOffRodeo-Fair2016Breakfast-5Identifying the players in the photos above: Left to right top row, Tim Henebry (mandolin), Roberta Clark (guitar), Dave Perkins (bass fiddle), Janet Perkins (fiddle), Nancy Hultquist (fiddle; red and white hat), Laina Brown (fiddle), Evie Scheutz (fiddle), Amy Davison (flute). Bottom front, Gerald Gordon (guitar), Minerva Caples (guitar), Sharon Jenson (bass guitar), and Anne Engels (tambourine). Our other mandolin player, Joanie Taylor was there, but realized she couldn’t make it up on the last minute stage (a flatbed trailer with hay bale step access). I needed help as well, and others decided because of the space problem and climb, to sit down front. We would have had room for Joanie there, but she’d already left. We were quite late starting after our originally planned 8:30 a.m. start.

We had many accolades from the audience and we were extremely happy not to also have to cope with the famous Ellensburg wind, which thankfully waited until today to howl. Today, we started with winds in the 20 mph range, 30s, with gusts to 40 mph (at the airport), which is only 2 miles north of where we were playing yesterday. Late afternoon today there were 48 mph gusts.

August 20, 2016 Kittitas Valley Fiddlers and Friends Performance
Click here.
This links to the video to hear some of the 11 songs we played, in two one-half hour segments of the program, including:

A Little Street Where Old Friends Meet
I’m an Old Cowhand
Oklahoma Hills
Sweet Betsy from Pike
Tennessee Waltz
The Cowboy’s Dream
Waltz Across Texas
Whoopee Ti Yi Yo
Git Along Little Dogies
Angel Band
By the Light of the Silvery Moon
Gotta Travel On – Done Laid Around

John got home a little after 6:00 p.m. and has been outside the entire time. The irrigation water from the creek has gone to a trickle and the channel is muddy. He is cleaning and filling a 70- gallon tank with well water.

Today was the last day for him being in the Wenatchee River Valley – one of WA’s tree fruit areas. He brought home Peaches, Nectarines, Gala apples, and Pluots (Plum X Apricot), red Raspberry color inside. The apples are gorgeous and just 89 ¢ per pound. He only got a few pounds, ’cause we will soon go pick in our friend’s orchard. The handful of Pluots were free, but we have our own yellow plums, so he wasn’t looking for these. They got put in the apple box after the seller weighed it (and the apples were lightly weighed) – late Sunday and maybe he was ready to empty the bin. Peaches and Nectarines were 75 ¢ / lb.
And the boxes were rated at 20 pounds, or 10. We haven’t weighed them, but did eat one of the Peaches. Anyway, we have ~20 pounds peaches (minus 1) and 10 pounds of Nectarines.
Smithson FruitJohn has been stopping at this fruit stand for many years and has learned the weights are always heavy and something is always free.

Here was today’s weather alert:
3-WeatherAlertSunday8-21-16With the strong wind, bees (?) are less bothersome and the cats can eat in peace. All cats got fed supper, and two of them had two servings. Now it’s our turn to eat. We started with sharing a large peach and a plum-cot. John bought chunk of ham while at Costco, and will be adding an egg. It will be almost 9:00 p.m. by the time we eat. I cut up one of our Early Girl tomatoes to have with it. It was very tasty. Next time, I will have the whole tomato. We have been eating our little cherry tomatoes too.

Guess I’ll end this week with a nice sunset clearly showing the work of the wind over the valley (just this evening).
4-August21-WindyDay2016-2

Hope your week was fine.

Nancy and John
Still on the Naneum Fan

multitudinous doings

fiddle player cartoon

Nancy and her music friends played at the breakfast for the opening day of the County Fair and the somewhat related rodeo. They started early when the temp was about 65 and might have finished before warmth came, but the organization of the multitudinous doings did not go well.
They were done about the time the temp got to 80.
Late in the afternoon the airport reported 98.

This and more will be on the web Sunday night late or Monday A.M.

Best to all from

Nancy & John
still on the Naneum Fan

Little tomatoes, flowers, and rocks

Monday, August 8

For Aug 7 CPAP. Reported figures. Time on 7 hrs 42 min with AHI=0.78. Events: 0 CSR, 6 H, 11 RERA. No mask leaks (max= 20 L/min). Oximetry: all good

We both went to the foot doctor for toenail trimming (covered by Medicare), to Super 1 for groceries, by the Kittitas Medical Supply Company to deliver a 1/2-gallon plastic container of Dahlias to the staff there, whom I see every 3 months for new CPAP supplies (filters, tubing and mask). On the final leg home, we stopped near the airport to pick up a battery-operated alarm clock from the free BNEE site. It has been a nice back up for early morning departures for John in case the electricity goes off in the middle of the night. We already took advantage of it this week, and he reset for me to get up after he had left (tomorrow a.m.).

John helped Dale Swedberg get small drill bits for working to remove an oil filter, and gave him a container of diesel to help with the fix up of his folks’ old motor home. It is the same year as our travel trailer (TT), 1983. Since we got ours, it has been under cover, but it was out in a lot prior to our buying it, but may have been under a roof earlier. The metal siding looks better than the one Dale is working on.

Tuesday, Aug 9

For Aug 8 CPAP. Reported figures. Time on 6 hrs 14 min with AHI=0.32. Events: 1 CSR, 1 H, 1 OA, 5 RERA. No mask leaks (max= 6 L/min). Oximetry: it was fine all night.

John left very early for a trail called Greenwater Lakes. This was a new trail for him, and the only reason he went. While I don’t have any pictures of that day’s work, I will include the “cover” photo from the new Orange Hat On-line report for Assistant Crew Leaders. WTA has used this photo from a crosscut saw training session. Blue Hat is Mason (Mace) White. Lauren Glass (under bucking – saw coming up from under the tree) has a new orange hat – John’s and Rick Zitsmann’s have the dull patina of many days in the sun. WTA provides new ones about every 10 years.
1- Blue&OrangeHats AtCrewLeaderCollegThis morning, I had a nice meeting with a few of the retired CWU Geography profs and heard/saw a presentation by Jim Huckabay (also a retired Geographer). It was of his recent trip to South Africa, where he shot a Warthog and a Springbok and saw much other wildlife. He was there with long time friends on a 10-day Safari where he and others actually lived in the fancy house of an African and his wife, and they hunted with a PH (professional hunter) from the area. Jim provided a picturesque and enjoyable education.

I made two collages below of the animals mentioned above. Info is from the web.

First the Warthog:
2-CollageWarthogSouthAfricaWarthog (Phacochoerus africanus)
Warthogs are day animals and spend most of their time looking for food. They are normally found in family groups. Warthogs have the peculiar habit of kneeling on the front knees while feeding and foraging in a localized area. They shelter in burrows at night, which they enter tail first. Socially, three main groups are encountered, namely solitary boars, bachelor groups and matriarchal groups. Matriarchal groups consist of adult sows with their young and yearlings. Boars play no part in rearing piglets and seldom associate with sows outside the mating process. Warthogs can frequently be found at waterholes where they dig in the marsh and wallow in the mud with enthusiasm.

Lastly, the regal and beautiful, Springbok, the National animal of South Africa.
3-CollageSpringbok-SouthAfricaNat'lWildlifeAnimalThe Springbok (Afrikaans: spring = jump; bok = antelope, deer, or goat) (Antidorcas marsupialis) is a small brown and white gazelle that stands about 75 cm high (30 inches). The males can weigh up to 50 kg (110 pounds) and the females up to 37 kg. The Latin name marsupialis derives from a pocket-like skin flap which extends along the middle of the back on to the tail. The springbok can lift this flap, which makes the white hairs underneath stand up in a conspicuous ‘fan’. That’s shown in the photo on the right.

Typical of this species is the pronk (jumping display), which led to its common name. Both sexes have horns but those of the ram are thicker and rougher. This species has adapted to the dry, barren areas and open grass plains and is thus found especially in the Free State, North West province and in the Karoo up to the west coast of South Africa.

I took plain donuts I frosted with chocolate frosting and sprinkled chopped pecans on top for our treat with coffee, tea, or hot chocolate. At 11:00, I came home to fix lunch and change clothes to go to my Jazzercise class, with 4 participants, and a new routine. I followed with my Physical Therapy session. I have to wear a tank top for that work. It was painful, but necessary, and a little improvement was noted on a few ranges of motion. Deanna was my therapist and gave me nice information and evaluation explanations as she worked. At least there was no backsliding in my angle measurements, as had occurred in my previous visit, last Friday. I only am able to go Tuesdays and Fridays each week. Upcoming oral surgery the end of August will hamper that schedule.

I carried by music for Tim and Roberta (occasional participants in our music group), because I had run a copy for them of our August/September playlist, and they will also be participating in the August 20th Rodeo/Fair Kick-Off Breakfast. For that venue, we will do selected songs from our Aug/Sept playlist, and we will add a few from a previous last year’s listing that includes cowboy, country, and western songs appropriate for the occasion.

Wednesday, Aug 10

For Aug 9 CPAP. Reported figures. Time on 8 hrs 6 min with AHI=0.12. Events: 3 CSR, 1 H, 17 RERA. No mask leaks (max= 7 L/min). Oximetry: all right, but had it off part of the night.

Today, I had to get our payment off an old American Express card from Costco, changed to CITI Visa card, and set up auto payment from there. This was for our yearly fee for AAA road insurance on our vehicles. I missed that it was being paid there, and when Costco switched, none of the automatic withdrawals any longer worked. I think those should have been processed as all the other expenses were on the transfer. I thought I had caught them all, but missed this. It is fixed with no problem now. I hope there’s not another outlier I missed. Good we were not gone on a long trip. The mail came with a 10-day deadline or we would no longer have the service available.

Today I left with a few things for the Food Bank. I finally found a person to give a gym bag to that I found and have never used. I tried giving it away on the BNE site to no avail. In addition, I fixed up music for the group at the Food Bank to try today to get some cowboy tunes in the mix for the upcoming Kick off breakfast for our Rodeo and Fair. We get a free breakfast between our 2 sets on stage.

Food bank did not have a great meal today for me but I carried along some of my tuna/egg salad I made yesterday, and was happy for it. The salad had all stuff (except carrots and a little red pepper), that was green and I could not eat … spinach, Romaine lettuce, other types of dark greens, and the other “salad” was shredded zucchini in vinegar, which I didn’t want either. Mostly it looked like shredded skins of the zucchini. I chose a nice piece of chocolate cake with chocolate frosting and did not realize until I sat down and saw other folks’ that they had German chocolate cake as well that I would have preferred.
From there I was off to SAIL exercise class, having a full class with a new member. I brought home two cookies and 3 ears of corn someone had donated to the senior center. John and I split the corn over 3 dinners.

On my way back to drop Gloria off at her home, I stopped by and filled my car with gasoline. Of course, a day later, they lowered the price a few cents/gallon. Story of my life. John is driving his car tomorrow to let me off to play music and we also will be delivering a bunch of dahlias to the AAC for a going away party for another AmeriCorps person from Portland who has been with us for a 10.5 months. We will miss her. The party is not until Friday, but having them ahead will allow them to put them in vases on tables and counters. And John will be gone early on Friday, so of no help.

Thursday, August 11

For Aug 10 CPAP. Reported figures. Time on 6 hrs 40 min with AHI=0.00. Events: 0 CSR, 0 H, 13 RERA. No mask leaks (max= x 8/min). Oximetry: perfect all night.

I fixed music to take to a few for the Aug 20 and now have to change to a different copy, on Saturday and for the future. We realized that some of the original playlist needed to be put off until we learn it better.

As planned, we delivered 2 buckets of Dahlias, and 2 Gladioli, to AAC with an added small container of our yellow plums.
John picked cherry tomatoes for Gerald, who was was happy to receive them. We have been enjoying tomatoes and plums too.

Friday, August 12

For Aug 11 CPAP. Reported figures. Time on 5 hrs 46 min with AHI=0.52. Events: 1 CSR, 3 H, 11 RERA. No mask leaks (max= 7 L/min). Oximetry:

John left at 5:30 a.m. for trail work at Mt. Rainier. Parking was at Sunrise, 6,400 feet, walk was a mile, up to 6,700 feet. They moved big rocks and many buckets of sandy/gravel to make steps where folks have been having a hard time negotiating a sloping rock. They were on the Sourdough Ridge Trail. He didn’t make it home until 7:00 p.m. I was up early with him and stayed up to do a bunch of chores.

First wildlife view was of one of the fawns and his mom chowing down on raspberry cuttings John took out from our back fenced yard. This collage was taken at 6:10 a.m.
4-CollageFawn&RaspberriesClippingsJohn trimmed some of the long Raspberry canes and tossed them out back under Pine trees. The deer soon found them. Note the dark patch on Mamma’s face in front of the eye. The second fawn, back to the left where the mother is looking, came over as the first one moved away.

I contacted the College Subscription Service and we are now set for getting the Smithsonian for another year for $12.00. They cannot process a subscription for more than one year, but I know the service rep’s private extension and can call each year to renew. She has been around for several years.

When my friend in New Jersey heard about our dog Annie’s seizure, she told me that she had used Niacinamide to treat her 7 year old dog, successfully, and that it is cheaper and less hard on the liver than Phenobarbital. She told me to research it and check with my vet.

When I got to nearly needing a refill, I called this morning and asked for a consultation with my veterinarian. She called me back and we had a nice discussion. I explained that I had checked on line and found nothing about using it for seizures. It is used for all sorts of things in humans, but not seizures. She appreciated knowing what had been used on my friend’s dog, but she said she had never heard of that use. She also said that because my dog was responding well to the medication and had had no reoccurrences or apparent side effects from the drug, that she saw no reason to stop using it.
She acknowledged the cost was higher than she expected. I told her I would search around for the best price and get back to her and the staff for the next client with the same need.

Niacinamide is a compound C6H6N2O of the vitamin B complex found especially as a constituent of coenzymes and used similarly to niacin.

I found a cheaper (by month) of the Phenobarbital at Rite Aid (at half the price I recently paid at my pharmacy). I still need to check around to see prices at all local pharmacies. Rite Aid is listed on the GoodRx website with the best price, but in contacting them to set up an account and take in my coupon for the “good” prices, they said they would not honor the coupon, because it cost them the difference, as they are not reimbursed by GoodRx. Still their regular price for a month of the Phenobarbital was half what I paid last month. They did not have 90 tablets in stock, and it is cheaper per pill to buy a larger quantity of any drug. If Annie is still doing fine at the end of this bottle, I will give the pharmacy advanced notice to order a larger supply. The prescription was written for 6 months, and I have used only one month of the new script. Keeping up with animals’ meds and my own is a full-time job. The GoodRx issue bothered me because I use that for my Telmisartan, and save a ton by paying cash at another different pharmacy in town. I checked and I am still eligible for that savings (which is significant). I pay for 90 tablets what I paid for 30 with my insurance co-pay. I do NOT understand the difference in cost for the exact same medicine.

I went to Carly’s going-away party with my camera. Everyone appreciated John’s Dahlias and Gladioli. I should have taken a pitcher of them into the picture of me with Carly, but I didn’t. Anne loved them and she would have enjoyed holding a vase, I am sure. Oh well. I have photos of them on the counter, and many comments to share with John.

I went by Safeway on the way home and bought a ton of stuff at good sale prices. Got potato chips low salt on sale for $1.00, and there was a digital app price for people with smart phones (which I do not have). I had asked previously for the price, and was given it. I did today and got the chips for $ .79 /bag. Then I bought a special of dark meat (4 thighs / 4 legs) for $5.00 with crispy fried batter. This was a Friday special. Went for John’s colas and found 4 for only 79 cents each 2-liter size. I left my coupon at home, but found a paper at the front of the store with one and got Bumblebee White Tuna for $.58 / can, (limit 6). That is my standby for lunches away from home, and today, realizing I wouldn’t be able to eat the green salad, I took a small portion of my tuna fish/egg salad I had made.

Below are a few photos at the party and below that are a couple of video clips.
We started at 11:30 a.m. and had a few beginning presentations, then were served a lunch (Pizza on English Muffin, green salad, and banana/chocolate pudding or fruit for dessert. Then we had fun passing the microphone for accolades and memories of Carly and how much she’s meant to us all. I videotaped almost all of them to give to Carly as a going away present.
5-Collage-KatrinaGift&CarlyThis was a gift of a picture photograph book that Katrina, the Director (on the left) made with photos of all the events, classes, and associated activities at our center she participated in, or lead, over her time here.
6-Collage-NancyCarlyAnne&John'sDahlias&GladioliAbove, I’m on the left with Carly Waymire and Anne Engels, and on the right is one of the vases of flowers that John picked and we delivered the day before. The Dahlias and Gladioli he planted, grew, and harvested. Some other things were added but I don’t have names.

Here are three of my chosen videos for the day:

Katrina Douglas about Carly & Carly Presents Her Story

Katrina Presents a Gift Book of Photos to Carly

Accolade: Audience sings, You Are My Sunshine, Carly

After the party, I stuck around to write my note in the book gifted to her, picked up the two 5-gallon buckets we delivered the flowers in yesterday, put in a few minutes in the computer room, visited with some others, and stayed for 45 minutes of my SAIL exercise class. It was the last class Carly taught. I left early to get to my physical therapy appointment which was earlier than normally on Fridays.

Saturday, August 13

For Aug 12 CPAP. Reported figures. Time on 5 hrs 19 min with AHI=0.56. Events: 1 CSR, 2 H, 1 OA, 2PP, 13 RERA. No mask leaks (max= 19 L/min). Oximetry: Fine all night.

I did the music changes for those expected there today, and I will run off more next week to give out to the rest of the people and audience.

We went to Briarwood. We ended up with 8 players there today. John took a tire from the travel trailer to Les Schwab after letting me off at Briarwood. We stayed to eat a bite of late lunch they potluck for us to say thanks for the music. It was largely salads, with hot rolls, cheese, and dessert. Very good. Afterwards, we went by to pick up the repaired tire.
One of our TT tires lost air and only held air for 3 days when John pressurized. Les Schwab (Konner, actually as Les died in 2007) repaired it, but they think all the rims (manufactured in 1982) need to be refinished. Rim refinishing includes preparation, iron phosphate bath, powder paint application, and oven curing. So the TT will have to be up on blocks for a week while the rims get sent (don’t know where) for their rehabilitation, and a color change. More later on this – ’cause who knew?

I worked on the blog some, on pictures taken at yesterday’s going-away party, and on future music to Xerox for the changes for this coming Saturday and also until the end of September. It won’t be much, but it is easier for me to Xerox them for the few people who will need them, rather than print them myself or send them to some of the other players to print. I have to go in to add 6 songs to the current audience copies.

Sunday, August 14

For Aug 13 CPAP. Reported figures. Time on 5 hrs 45 min with AHI=0.52. Events: 1 CSR, 3 H, 8 RERA. No mask leaks (max= 10 L/min). Oximetry: Battery ran out at X hours, but was fine for the rest of the night.

I was dead tired last night at midnight, and then this morning, having been up at 3:30 a.m. with the dog, at 6:00 a.m. with John, I went back to bed until almost 9:00. Guess I needed it. Okay, John fed Woody on his trip out, and Lemon was waiting when I finally got up, so I fed him. It is already 79° on our front porch, and 81° at the airport. It went to 97° at the airport today, 9 degrees higher than forecast. I spent the day working on dishes, photos, blog, and a few other things – not getting to all I needed to accomplish.

John made it home earlier than I expected, but he was dead tired too, so he rested for almost 2 hours. Now he’s out feeding the horses. After we eat, he will try to put this into Word Press, and we will proof it, and publish.

Hope your week was fine.

Nancy and John
Still on the Naneum Fan

Dog Days of Summer

Some say we have just finished the “Dog Days of Summer.” The 40 days, beginning July 3 and ending August 11 coincide with the heliacal (at sunrise) rising of the Dog Star, Sirius.
dog-star-constellation

For the ancient Egyptians, Sirius appeared just before the Nile’s flooding season, so they used the star as an indicator of the flood. Because its rising also coincided with a time of extreme heat, the connection with hot, sultry weather was made for all time.

That August 11 date seems a bit out of wack this year. Maybe Egypt was different way back when.
Anyway, we’ve got hot, the south has floods, the east is sultry, and Nancy doesn’t have the blog done.

I’ll be gone Sunday and may get her work into Word Press in the evening. I’ll be working on WA’s Talapus Lake Trail just over the crest of Snoqualmie Pass. Here on the Naneum Fan the high today was 99° and they claim only 89° Sunday. Our work on the trail will start at about 65° and end at about 75°. I can be useful during that range of temperature but above 80 I don’t do much outside.

So, here’s to the end of the Dog Days of Summer. Cheers! Next?

Parties, Hay, Accidents, Music, & Trails

Sunday, July 31

For July 30 CPAP. Reported figures. Time on 5 hrs 8 min with AHI=0.00. Events: 0 CSR, 0 H, 7 RERA. No major mask leaks (max= 6 L/min). Oximetry: Okay all night.

Saw John off at 5:40 a.m. for Mount Rainier, and I stayed up to tackle the many chores awaiting me: KV F&F Music, cat feeding, AAC photos, dishes, clothes, shoulder exercises.

This link is the best ever of Ashokan Farewell. The singer was 13 at the time recorded, 3 years ago:

Ashokan Farewell

Monday, August 1

For July 31 CPAP. Reported figures. Time on 3 hrs 42 min with AHI=0.54. Events: 1 CSR, 2 H, 11 RERA. No mask leaks (max= 6 L/min). Oximetry: nothing special to report.

Early call about getting our hay delivered this week (finally). We are about out of hay.

I have been catching up on music finalities and going tomorrow to copy pages for players and audience.

John is off to have his teeth cleaned and to pick up more frozen food dinners for our neighbors. Mentioned last week: no one is available to cook their meals, while their caregiver son recovers from his heart surgery. Another son is helping except on weekends, when he is working out of town.

We received an email report from Evonne (the Crew Leader) on yesterday’s WTA trip.
In part, here is some of her words of thanks to the crews, particularly to John and his crew.

Thank you so much for joining me on the Owyhigh Lakes Trail yesterday! Yesterday was truly epic – the hike, the work, and the wonderful place where it all happened. Yet, none of it would have been possible without your presence and effort out there. Yesterday took a huge joint effort on everyone’s part to see each task through. You made a real difference with the energy that you poured into the day.

John, as always, it was a pleasure to work with you. Thank you for helping with everything that you did yesterday! From doing a double check at the campground for volunteers to heading up the poles and railing crew, you executed every task. I really appreciate that you come all of the way from Ellensburg to assist with work parties, and I always look forward to working with you.

Shon, Alle, and Kathleen – thank you for searching the forest for poles with John. All of you did a wonderful job of pealing, cutting, and transporting poles for the bridge. Great job! Thank you all for the extra tasks that you completed throughout the day.

I have chosen a few of my favorites but John went through the entire bunch with me explaining the full story of the work accomplished.
1-Collage7-31-16MtRnrComealongLogLeft photo, the new log is being pulled (on rollers) toward the creek.
Right photo, the plan is to skid the new log on top of the old one.
Middle photo, note the blue-shirt fellow working the come-along as others guide the log.2-CollageCrewGettingPostsJohn’s crew went to find downed trees of a size to make posts for the rail. Once found they can be cut to size, trimmed, and pealed. Below (left), the crew included a Nat’l Park member with a chainsaw, here cutting the old structure into pieces that could be moved and hidden well away from the trail.
3-CollageEndOfMtRainerProjectEvonne&KarenCrew leader (Blue hat), Evonne Ellis, with her boss, Karen Daubert, who is retiring but came out on a walk at Mt. Rainier as part of the Hike-A-Thon project for WA Trails Association. She and hiking friends and/or WTA Board members arrived in time to hike up the trail with the crew.

This evening we attended the going away dinner (food fixed by the young visitors from Belarus) as part of their 5-week stay with the Children from Chernobyl program.
4-CollageChildrenOfChernobyl2016-FoodThese were the participants this year, two boys and 4 girls, all teenagers. They lived with host families, and you have already met the girl on the right, Aryna, 16, who stayed with our friends, Helga & Charlie Firkins, and whom we met early in her stay to pick cherries from our trees (look back in a previous blog for that story). The photo on the right above is a shot of part of the table of food the kids prepared for the dinner for us. It was a tasty treat. The desserts were in a different place.
5-CollageNatastaSashaAryna
Various bags of items (including medications to take home for family) were given to the kids. Above is a photo of Natasha, their chaperone and surrogate mom for the trip, with Sasha and Aryna on the right. Sasha entertained us with a piece played on the piano during the evening.

Tuesday, Aug 2

For Aug 1 CPAP. Reported figures. Time on 5 hrs 7 min with AHI=0.20. Events: 0 CSR, 1 H, 9 RERA. No mask leaks (max= 4 L/min). Oximetry: even and fine all night.

Soaked feet, washed dishes, completed voting ballet, put numbers on music and figured out required numbers of copies, wrote my instructions, and got copy paper.

I had to carry meds along to take at 2:00, in prep for Physical Therapy session and to run copies of the music for August & September for our group who visits assisted-living homes.

I went by Grocery Outlet, the UPS store, returning the wrongly sent Amazon item for turtle feed, and by the Courthouse to deposit our Primary Election ballots.

When I came out of the PT appointment, I almost was blown away and uncomfortably hit by flying spruce tree needles. Checked the airport later when I got home, and at the time I was walking a block to my car, the gusts were 45 mph.

I organized music I had run and sent out job announcements to the Google Groups list serve, NW Geography Jobs (which reaches far beyond the PNW). I am still not through with either, but do not need the music finished until Thursday. I have a few ready for the people I will see tomorrow and will take it by to them at the Food Bank music.

Wednesday, Aug 3

For Aug 2 CPAP. Reported figures. Time on 3 hrs 42 min with AHI=1.08. Events: It’s unclear what happened at 2:00 a.m. and system quit working/recording.

This was the morning the group from Ellensburg of all the host families with their “kids” left for their return trip. They had to be at the SeaTac airport by 10:00 and we had been concerned about checking travel alerts for I-90. We learned that 2 of 3 lanes on the Easton hill were closed to west bound traffic, but early this morning, I was on the computer and heard of a horrible tanker truck collision and fire about 8:45 a.m. at milepost 88 a few miles east of Cle Elum. That accident closed all east and westbound lanes because of the spill and toxic fumes of anhydrous ammonia.

The first photo was alarming; John checked KOMONEWS and also used Google Earth’s street view to identify the location, 18.8 miles from our house. I turned on the police scanner (via my computer) to keep up with the story. About 9:30, I called our friend’s cell phone to see if they made it through, and they were all entering the airport. That elicited a huge sigh of relief.
6-CollageI-90crashAug3-16Images above are from the Komonews site in Seattle.

I left to pick up Gloria for our trip to the Food Bank & SAIL exercise afterwards.

Afterwards, on my way home, I took music and a doll to Amy for Haley. The story that follows is hilarious. Below the photo collage, I will explain.
7-CollageOfBabyDollyStoryThe story starts on the left with a doll advertised as free on the Buy Nothing site group I’m on, from a gal in Kittitas. I spoke for it for a friend’s daughter, who is pictured with it a week later (today in the 2nd picture above). She played with it about 1/2 hour and then gave it a dust bath, as birds do, (3rd above). Her mom retrieved it, scolded her daughter, bathed the doll, and redressed her. It all ended all right, and she brought it to our play gig the next day (after sleeping in bed with the little girl, Haley, all night).

My first thought for the dolly was to add to the gift of goodies for the baby shower last Saturday, but when I saw it was from a Facebook friend of my friend, I decided to give it to her.

Meanwhile, speaking of that container of clothes, it was emptied and I picked it up on my way to town this morning from the high grass at the end of their very long driveway. Raychel sent me photos that were taken at the gift opening and during the party that evening by the grandmother of the baby. Below are those with an explanation.
8-CollageAtBabyShowerTop left is the table for gifts at the entrance. The last two things at the right of the table next to the flowers are our gifts – recycled gently used baby things. The Sterolite container holds dresses, pullovers, jackets, pants, T-shirts, wraps, blankets, and a teddy bear. The package on top holds a car seat. Beneath that is a picture of our table where we enjoyed smoked meat and veggies on a skewer with salads, chips, and conversations. The fellow in red is Dr. Lundy, the grandfather of the baby. On the right is the mom, Raychel, going through our box of goodies. Myles, the father, is holding their doggy, modeling one of the baby’s dresses.

Today was a busy day. Once I was home at 4:00, we started receiving the hay from our broker, Mario Giorgianna, with only 1.5 bales left for our horses, so the timing was perfect. He delivered it in two runs, a total of 15 tons. 13.5 of that went into our pole barn, 16 bales into the little red barn, and 14 more onto the truck that John took to an old horse trailer down in the pasture.
9-CollageHayAug3In the above collage, on the left is John walking into the Pole Barn with a “hay elevator” sending bales to the top of the stack. To the right shows the front of the stack with John, Nancy, and Mario in their hats for his business: High Valley Hay and Cattle. Mario has been delivering hay for our horses for several years. John used to have to drive across the valley and load hay into our stock trailer and pickup bed (2 tons, max), and then come back and unload it and stack himself. This is far superior to that old way but when we got up to 5 horses it became a necessity.

Thursday, August 4

For Aug 3 CPAP. Reported figures. Time on 5 hrs 18 min with AHI=0.57. Events: 1 CSR, 3 H, 18 RERA. No mask leaks (max= 14 L/min). Back to sleep w/o CPAP for 3 hrs, continuing Oximetry: AHI- 0.36, 8h 25m total. Clearly shows about 1/2 hr with SpO2 below 88.

Rehab for music today – many people (14) with a new violinist, who also plays a Viola. Her name is Andrea. She was brought to the group by another group member, Laura. She’s a CWU student we hope will not have too many conflicts with her classes in the fall. When I was teaching, I always worked my class schedule around the hours every Thursday when we needed to play. I started with this group in 1991.

I carried by wine corks from my friend who cuts my hair to give to Meagan Huber at her work to make a nursing necklace for her 5-month old baby.

John drove so he could drop me off and get gasoline in his car for the trip to the PCT* tomorrow, and he went shopping at Super 1. [*Pacific Crest Trail, north from Snoqualmie Pass]

Friday, August 5

For Aug 4 CPAP. Reported figures. Time on 3 hrs 1 min with AHI=0.33. Events: 1 CSR, 1 H, 8 RERA. No mask leaks (max= 6 L/min). Kept Oximeter on for longer: Oximetry: from up at 3:00 on to 6:00 with lower than 88 SpO2. SH. AHI-0.16, 6h 13m

About 6:35 a.m., John left. He hadn’t been on I-90 for weeks and did not know how much the construction would delay him. Not much as it turned out, so he was first of the crew to arrive.

I went first for CPAP supplies and got them. That includes new filters, tubing, and a head gear with mask.

I went for a session of PT at to 3:15. Rather painful. I then went for lemon meringue pies at Super 1 and by a BNEE house to pick up two suspense novels for a friend.

Saturday, August 6

For Aug 5 CPAP. Reported figures. Time on 6 hrs 42 min with AHI=0.60. Events: 1 CSR, 4 H, 9 RERA. No mask leaks (max= 12 L/min). Oximetry: went off sometime.

We went to town for a grand opening of a new Petsen$e store in town. We bought canned cat food for $.40/can and an ID for Annie’s collar:
10-Annie'sIDtag2016
We were allowed 4 lines and I chose to put her name with our last name, our road address, zip and phone number, her age and that she is Epileptic, (assuming if found, someone would recognize she might need meds). I just realized Epilepic is misspelled on the last line.

We also got some tops for opened canned food, but they don’t fit as well as the others we have had with a little rim inside, the only difference I can see.

Tonight we met Tanya Myers and family (Andrew, Jessica, & Michael) at the Red Horse Diner (old car theme and the flying red horse of Mobil Oil). The old station and garage is still standing with the gasoline pump (price $0.229/gallon).
History lesson

We had a large dinner and a fun time. I brought half mine home for lunch tomorrow. John had a fancy hamburger with home fries, and I had sandwich named: Tri-Power – roast beef, with sautéed green pepper, onions, mushrooms, and Swiss cheese, au jus (very watery gravy), served with sweet potato fries. I almost bought the Desoto one, remembering the old 1950 Desoto my family had.

Sunday, August 7

For Aug 6 CPAP. Reported figures. Time on 8 hrs 9 min with AHI=0.12. Events: 0 CSR, 1 H, 12 RERA. No mask leaks (max= 12 L/min). Long quiet night. Annie asked to go out at 4:15, but I went right back to sleep. I had a good night. Oximetry: AOK.

This morning I told John I took some photos of the yellow plum tree earlier this week, but the lighting was wrong and the pictures did not come out well. He took some with morning sun. Here is a cheerful collage I made from those he took.
11-Collage-Aug7-16morningPlums
The only plums I saw were on ONE tree that is full of yellow plums, Shiro, but he found one fully colored but not ripe of a variety called Bubblegum, the reddish bronze one. That tree has only about a dozen. A third tree has a dozen – still green. This started my day off right. We will eat some yellow ones with supper tonight.

I have worked on various projects all day, including this blog, and John has done yard work. We had leftovers for lunch from my dinner last night.

Hope your week was fine.

Nancy and John
Still on the Naneum Fan