Medical and weather events

Monday, Jan 9

For Jan 8 CPAP. Reported figures. AHI= 0.59. Events: 2 CSR, 4 H, 8 RERA. Time on 6 hrs 44 min with (max = 21 L/min). Oximetry: SpO2 low 71 spurious at start, actual low, 87, on the graphic chart, 3 events <88% with avg., 91.5%. Pulse avg. 55.0, low 50.

We called David H. last night to cancel Myst’s hoof trimming because of the cold and snow. Need to reschedule when the weather is better.

What a great New Year’s Gift! Our neighbor, Allen Aronica, appeared in our driveway with this tractor and blade and made 4-5 swipes to clean out a lot of snow. We always appreciate his help, but this timing was perfect so we can get out to go to the cardiologist tomorrow. This is the second time this winter he has plowed our 300′ driveway and the area near our parked cars. Later this week he made a third run, and plowed out three, or more) other neighbors. John cleans up a bit (1%) after Allen does the 99%.
On the left he has backed up to my blue Forester (John has provided a 4 ft. space for Allen to set the blade into). Check out the video below of his third swipe.John Deere Green in the Drive

I also talked with our leader of the retired geographers and we canceled tomorrow morning’s meeting. I sent emails but then called people in case they did not see their email. This was part weather related and part some folks not able to come.

I think I have corrected all the music for Thursday.

Tuesday, Jan 10

For Jan 9 CPAP. Reported figures. AHI= 0.42. Events: 3 H, 9 RERA. Time on 7 hrs 13 min with mask leakage at start. Oximetry: SpO2 low 54 spurious, actual low, 84, was off CPAP; 25 events <88% with avg., 91.3%. Pulse avg. 57.8, low 50.

I rewrote my blood pressure readings for the previous week for Kim’s (heart doc) requested history.

Talked with our Northwestern Mutual representative at the main office in Spokane, because our old rep and friend retired in Idaho. We want to have her send us annual reports at the first of the year, as we were used to receiving.

We were scheduled to leave about Noon to get 50 miles to Costco and lunch before arriving at the Yakima Heart Center (YHC) for a 2:40 check-in.

At 10:27, John was still out doing chores, in the snow, and I received a call from the YHC scheduler, asking if I could arrive earlier because of a cancellation of a 12:40 p.m. appt because of snow. I still had to shower, but I told her we were over an hour away and we would do our best to make it. We did. I drove both ways. It snowed nicely until we were almost there. We got in the examination room before noon, and the nurse gave me an ECG, took my vitals, and other info. My blood pressure was okay (130/80), considering I had driven through some bad patches of snow on the Interstate, and found a main thoroughfare (16th Avenue) closed that we had to detour around in Yakima without the benefit of any detour signs. It is not a nice even grid system in that part of town. John read later there was a water line break.

My doctor arrived about 1:00 and we started through all his concerns by reviewing my Pulmonary Function Test (PFT), my labs, and my fasting lab in Nov. Not all reports had arrived to my file, but I had copies of several (the PFT and the fasting one from my primary care physician). We were interrupted for about 25 minutes, while he had to consult with a PA about a patient that needed his observation and diagnosis, and several more issues. We continued when he returned, and he examined me. Everything was fine. He has been concerned about the medications I’m on for my heart’s health. The reason for the PFT test is to measure my lung diffusion ratio, and mine could use some improvement. We have decided that I should have the test at an interval less than a year as it has been. I felt the last one in December ’16 was too close to my getting over a cough that lasted 4 weeks and kept me home to get well. He agreed and I will be having another test in April. I am on Amiodarone therapy, which can scar my lungs, but I have successfully been on it since 2010, and I am not a good candidate for the replacement drug.

We also discussed the heart medication I have been on for a couple of years, Telemisartan (generic) for Micardis. He has been following the literature on a new drug, Entresto, which is a combination of two drugs, Sacubitril (24 mg) and Valsartan (26 mg). [That’s actually half-n-half, going by the number of molecules.] Dr. Kim is convinced that while it is an expensive drug, he recommends it for me because it will make me feel better now for my activities (not that I have any complaints), and it will prolong my life. How can one say no to that statement? The frustration is, I am being taken off a heart medication that was previously thought to be superior for my case, and we were slowly increasing the dosage to reach the amount shown in cases to prolong life. That medication (mentioned above) was very expensive and my insurance was not covering it sufficiently. I could get it less expensively at a different pharmacy by paying cash and not going through my insurance company (Group Health). The other frustration was that I did not know of this possibility of change, and I had just last week bought 135 tablets of the Micardis. Oh, well. My Dr. said, “Just keep it, in case your body will not tolerate this new one.” I have to watch out for a blood pressure over 140 (systolic) and not less than 100. I need to be aware of my potassium level, and if I experience shortness of breath or flu-like symptoms, I am to go to the ER. Well, that is a bit scary. I am to leave off the Micardis for 2 days, and start taking the Entresto Thursday morning. The cardiologist’s nurse gave me a week’s supply.

We had another interruption while visiting with the doctor. He was paged from the hospital’s Critical Care unit about one of his patients there. He managed that with us in the room. It was a fascinating dialogue. He returned to dictating our discussion of the day, and answering my questions. He is always very patient with all our discussions and John and I both are involved. I always receive a copy of his comments, mailed to me by the transcriptionist.

He finally called in the nurse to go over the new medication with us, and said his adieus, but not before saying he wants me to come back in a month to see how I’m doing on the new drug. I looked at my watch and realized he was with us (including the interruptions) for 2 hours. That is a record. Previously, he has spent normally an hour every visit, and at the most I think we were with him previously was for 1.5 hrs.

When we left, we still had to go to Costco, and we never had eaten lunch. John had packed along two large chocolate chip/nut cookies, a Snickers bar, and Pepsis, so we nibbled on the way home. The snow started hard while we were in with the doctor. Our car was covered when we went out. I drove for the return trip too. First stop was Costco to fill my car, and it was $2.49/gal., which is 9¢/gal cheaper than Ellensburg. Then we went inside and bought over $200 worth of long-term products and some groceries. The ‘Tax’ software was the biggest single item.

I returned a $9 pair of slippers (good) and we forgot a $9 pizza (bad) that got put on the bottom rack under the basket. We came upon slowing traffic and could see it stopped way out in front. I managed to get to the off ramp for the downtown exit and we went around (whatever it was) via city streets and back to I-82 at the Selah Gap. We thought we might have to drive through Selah to enter the freeway farther north, but we were able to re-enter where Hwy 12 comes in from the west. The trip home was complicated by snow blowing across the road making some icy spots. I slowed down considerably. We were getting snow/icy rain all the way home for the last 25 miles. Finally, we made it safely home at 6:00 p.m. in the dark. A couple of cats were waiting to be fed, and our dog was happy to greet us. The horses had been preemptively fed – hay left for them in several places so John only had to unload some of the items from the car.

My cell phone stopped working today. It will not hold a charge, and when it is charged, it will not dial a number, even where I am close to a tower. The Consumer Cellular folks think it is the SIM card, and I think it is the battery.

Wednesday, Jan 11

For Jan 10 CPAP. Reported figures. AHI= 0.35. Events: 2 H, 9 RERA. Time on 5 hrs 47 min with (max = 20 L/min). Oximetry: SpO2 % low on a 54 spurious start; actual low, 84, avg. low was 89.1, 25 events <88% with overall avg., 91.3%. Pulse avg. 57.8, low 50.

Today was another cold day. I picked up Gloria and her sister and we went to the Food Bank to sing and eat, and on to the SAIL exercise class at the Ellensburg Adult Activity Center. We stopped at Grocery Outlet on the way home, and they got some stuff they needed. Gloria brought me some of her homemade peanut butter cookies.

John checked the web and gave me some links to the Novartis Pharmaceutical Corporation site about my new medication. The company is in Boston, MA, so getting through to the Eastern Time Zone could not happen until tomorrow. Meanwhile, I studied their website and found some programs I am interested in, and for which I will apply. One is a free 30-day supply (one time only) of the new medication. Second is an application for a cash rebate on the price for a month’s supply (60 tablets), when paid for through my insurance. It costs me $10 to use the system to apply $100 off the price. In order to qualify for both I have to download and fill out an Enrollment Form for the ENTRESTO Central Patient Support Program. To speed up the process, I could FAX it to Boston. I cannot FAX, so I filled in the form, printed it, along with both sides of my Group Health insurance card, and took it to my pharmacist on Thursday afternoon to send in with the prescription.

We do not yet know the cost to me, but the normal cost ranges from $400 to $500 per month. I hope to know by Tuesday with a telephone call from Boston, MA.

I am happy John found this support. The folks at the Yakima Heart Center were not aware of it, so I sent all the details via email to my cardiologist’s nurse so that they can give that information to anyone else put on the drug. There is one other opportunity for help with the cost of the drug for people in financial need. We do not qualify for that, but it is nice the company provides the option.

I did not have time today to worry about the cell phone problems.

Thursday, Jan 12

For Jan 11 CPAP. Reported figures. AHI= 0.34. Events: 2 CSR, 2 H, 13 RERA. Time on 5 hrs 51 min with (max = 16 L/min). Oximetry: SpO2 low 87, 5 events <88% with avg., 91.3%. Pulse avg. 56.5, low 51.

This morning, I dealt with the drug cost reduction request and my cell phone.

I called the pharmaceutical company in Boston and learned that they had received my application this morning that was FAXed yesterday afternoon. At least the process has begun, and they will call me Tuesday with the determination of in network pharmacy vs. out of network pharmacy costs to me.

I also called Oregon about my cell phone problems. We went through several “shocks” to the system but it failed to kick in. They suggested I move to a place in Ellensburg and they would try again. I carried it and John’s cell phone with me to check this afternoon after we finish our music.

Before I change the SIM card in my phone I have to record all the numbers in my cell phone onto hard copy. I have started that process, but have many to go. I have over 500 numbers in my phone! Thankfully, it will keep a charge long enough for me to work on the number retrieval.

We play at the Meadows today, and John is coming along with me to buy groceries and animal feed while I am inside playing music. I handed out the new music for Jan/Feb. We had a turnout of 10 with two new players, one on the harmonica and the other on guitar. We only had two fiddlers there today. The rest of the group was playing guitars. One of our guitar players will be gone for at least 3 weeks for knee surgery.

I attempted calling the cell phone place, and it did not work. The alternative was to go to a Target store to buy a new SIM card. The closest Target store is 50 miles away. She then asked if we had a Sears store. They will reimburse me for the changed SIM card cost ($10). We went by our small local Sears on the way home, and I bought one, but as of yet, I have not been able to put it in my phone, because the new one will not fit. She said they would send me a new one (but if I cannot make the Sears one get into the slot, I will not get a credit). The other one coming is free, in the mail. I plan to continue recording numbers, try to fit the Sears one in the phone, and if it does not fit into my old flip phone, I will wait for the new one to arrive in the mail after Monday’s holiday.

Friday, Jan 13

For Jan 12 CPAP. Reported figures. AHI= 0.12. Events: 1 H, 12 RERA. Time on 8 hrs 20 min with (max = 12 L/min). Oximetry: SpO2 low 89, 0 events <88% with avg., 92.1%. Pulse avg. 59.2, low 52. This was a good night, probably the best in months.

Our temperature was -7°F here last night and it was -12 at the airport (located 5 miles down valley).Our full moon has been lovely, and this morning’s sunrise skies were beautiful with pastel colors, but I did not get my picture of the moon before it went behind the trees, so I will show you, but you best get the wonderful views from the Seattle area.
People in Seattle have cameras

Here are my shots this morning, only of the sunrise:Left is our backyard view where the moon is setting behind the trees, and right is out the front door.
See tomorrow’s blog below for the full moon a day later.

John just came in and said the water to the horse trough was not functioning. It is almost full, but he took some water out to add, and the heater is still keeping the water in it from freezing. The heater has to stay submerged. I guess that is what many hours of “minus” temperatures causes. But more below.

I called and found that my paperwork to Novartis had made it, but they will not have a decision until next Tuesday or Wednesday about the cost of my prescription using my insurance.

I called the Cardiopulmonary Services at KVH Hospital to check on an appointment for me in April. I need to have a work order sent to them by my cardiologist. I wrote an email to my cardiologist’s nurse requesting she do that.

We stayed home today.

Saturday, Jan 14

For Jan 12 CPAP. Reported figures. AHI= 0.50. Events: 1 CSR, 4 H, 19 RERA. Time on 8 hrs 2 min with (max = 22 L/min). Oximetry: SpO2 low 44 spurious, actual low, 89, 0 events <88% with avg., 92.6%. Pulse avg. 56.4, low 50.

These were my views of the morning’s slightly less than full moon viewed out the back patio door, where I missed photographing it the past couple of days.Compare to the link given above for yesterday from KOMONEWS (in Seattle) of the beautiful full moon.

Travel to town was scheduled – despite the cold. It was only 4° when we got to Ellensburg. It was warmer at our elevation.

The first visit was to a friend from my past and present, Trinity Turner. I have known her mother for 25 years (through fiddling). She is now a student at CWU (in the Geography Dept.), and when classes do not conflict, she plays fiddle with our group visiting nursing homes. Small world. She was giving this desk away on the Free Box site on Facebook, and I asked John if he could use it for his computer and our moved router. He figured he could, so I asked for it, and she was happy to give to a friend. It had been given to her. We got the measurements and John figured we could fit it into the back of my Subaru with the back seats pushed down. It is 56.5″ high, about 3′ wide, and about 17″ deep.It is still in the back of my car, along with 80 pounds of Black Oil Sunflower seeds in 20# bags that were on sale (through the end of January) at Ace Hardware. Buy one at $15.99 and get one free. John has now removed the sunflower seeds.
Maybe on Monday, the cart.

I picked up my one med (cheaper, $5.00) at Super 1 Pharmacy. I wish all my pills were that price. This is for 3 months of Spironolact, one pill daily.

Today we bought a heat tape for our horse trough pipe and the temps went up enough that John got a pencil trickle, left it open, went to feed the horses, and when he returned, the pencil-thin stream had rid the stand-pipe of the ice and it was in full gush. He has wrapped the pipe with a plastic tarp, then mounded wood chips and snow to keep the minus air off. Later he will install the heat tape in proper fashion. We are, in fact, a bit warmer now but a major change will not occur until Tuesday.

We also picked up a package for a gal in town who lives near us, delivered it, and in return she is giving me a sheet I can spread over my recliner. The flannel sheet I have had has worn threadbare, with holes in the part over the right arm of the chair. I cannot pick up the sheet until next week when I drive by her house from town on my way home.

Sunday, Jan 15

For Jan 14 CPAP. Reported figures. AHI= 0.96. Events: 1 CSR, 8 H, 19 RERA. Time on 8 hrs 21 min with (max = 21 L/min). Oximetry: SpO2 low 82 spurious at start, actual low, 87, the 1 event <88% with overall avg., 92.6%. Pulse avg. 58.1, low 52.

We just spent a lovely 20 minutes on the phone with John’s cousin Ethel and her daughter Pat in Brookville, PA. Ethel is 98, still living by herself, but goes for Sunday lunch to her daughter’s, when the weather is not too icy for walking. They had temperatures in the thirties today and not much snow. We are at 18.5° now with a little snow occurring.

John made Crockpot candy (Chocolate, Almond Bark, and dry roasted peanuts) today. The ingredients were left from many months ago – and it was time for them to be used.

Late afternoon, we had a call from Jeri Conklin reporting on our co-owned dog, Daisy, in CA. She and her husband were returning from a Vizsla field trial, where her new trainer had run her in an Open Limited Gun Dog stake. Jeri was able to ride along on one of her trainer’s horses.

Here is the story in her own words when she sent the pictures below (and more) on Facebook:
Today was one of those days when you get to go out and see your child who has been at a trainers for three weeks! Daisy ran in the OLGD this morning at the Vizsla trial – and it was so good to see her so happy! She was confident on her point and the flush was above and beyond as she stood still as a rock. She and Scott have come a long way in a short time and I can only think their relationship will get better and better. The old Daisy was gone and the Daisy Bug that I knew was in there came out in full bloom today. Perhaps her time away from the field made all the difference, she was definitely “hungry” to be out there again and that was very evident. She didn’t place, but she had a gorgeous forward run, sharp/clean bird work – couldn’t ask for more. Thank you Scott for a great job, well done. Here are a few pictures to share with Nancy B. Hultquist and others.
My choice of photos Jeri took today. First, our Happy DAYSeee gal has returned: (the sparkle is back in her eyes at the end of the run today).Now for a peek at today’s action in California at the Vizsla field trial for Cedaridge Kip’s Camelot Shay Tre’ JH (call name Daisy), co-owned by Nancy with Jeri Conklin in Lancaster, CA. The timing for the trial was good. CA is getting hit with rain and/or snow in great amounts, but today was between storms. Friend Sonja with horses and dogs, in South Lake Tahoe, is up to her keister in snow. The Tahoe area has power outages and washed out roads. At the line, wetting down and ready for the breakaway.Daisy on point, with judge’s boot blocking her face. Holding and turning to watch the flush, made her head visible.
{John says: The judge rode in too close to a dog on point. Unless that’s a camera effect.}Scott Azevedo wetting her down after the find before finishing the stake, and on the right, in the “spa” at the end of her run. Look at the water droplets in each photo.

Thank you Jeri for such wonderful coverage of such a happy day in the field. Placements will return. She is back with us. Thanks for all your hard work bringing back her spirit.

Hope your week was fine.

Nancy and John
Still on the Naneum Fan