Blood Pressure and

other normal activities

Monday, Jan 16

For Jan 15 CPAP. Reported figures. AHI= 2.00. Events: 1 CSR, 11 H, 1 OA, 16 RERA. Time on 6 hrs 0 min with (max = 18 L/min). Oximetry: SpO2 low 88, 0 events <88% with overall avg., 93.3%. Pulse avg. 56.7, low 48. Actually a good night; several this week.

Started out with spitting snow, and low temperature, 16 (lower) at the airport, but now the sun is out and the snow stopped.

I worked more on phone number retrieval from my old cell phone, because tomorrow the new SIM card should arrive.

John made Crockpot Chocolate Candy yesterday. I put some together to take to Outpatient Services workers where John was Dec 1, and I had been for many weeks daily for IVs in 2009 and twice in 2010 to kill the bacteria in my blood.

We received a suspected fraud call from AMEX. Someone used John’s Simply Cash card on line, first to check with a $1.00 charge (to Survivor International), followed by a $29.99 purchase from Target. I’m not sure how he was supposed to receive it, perhaps pick up at a store? We had not left home or ordered anything on the card, have never used it at Target, and whatever – somehow the AMEX alert system caught this and, so they did not approve the purchase. We got a call but missed part of the message and called back. We talked some and they voided the card, and are sending John a new card with a different number. Mine was not affected. In fact, we have only 3 automatic pays on that card each month, such as insurance and cell phone, and have not used it for any purchase since last July, and never in Target. Good work on their part –

I’ll end today with a photo from Celia Winingham of a herd of Elk that have frequented her yard and a neighbor saw them across the street from her house. She took this photo looking east from Wilson Creek road, south of Thomas road; just over a mile from us as the Eagle flies. Photo by Celia Winingham

Tuesday, Jan 17

For Jan 16 CPAP. Reported figures. AHI= 1.38. Events: 2 CSR, 1 CA, 1 OB, 2 PP, 8 H, 17 RERA. Time on 7 hrs 15 min with (max = 12 L/min). Oximetry: SpO2 low 68 spurious at start, actual low, 90, on the graphic chart, 0 events <88% with avg., 92.8%. Pulse avg. 55.9, low 50.

We’ll start today with a lovely sunrise taken by our geographer friends, Michelle & Bruce Seivertson from Eureka, CA. This is about 225 miles up the coast from San Jose. The Samoa Peninsula, a sandy place to play, is between the Pacific Ocean and Eureka. Photo by Bruce Seivertson

A morning telephone call from my Jazzercise teacher cancelled our class today because she sprained her ankle Sunday. Just as well I did not have to squeeze that into my otherwise extremely busy day of activities.

I went to the dentist for impressions for crowns to go over my two implants. I took my Amoxicillin at 11:30 just in case there was any chance of gums bleeding (as there was). The dentist had to remove the cover over the abutment with a screwdriver type wrench, put a higher one on that was taller than my teeth so I could not bite down. I imagine they needed to use that to capture the impression for the crown that will fit over the abutment of the implant. See the diagram below the X-ray of my implants today, showing the higher top holder.Left was the first taken but they needed to see the relationship to the adjacent tooth, so they retook the one on the right, and it didn’t matter that the pins are blurred. You can also see in these photos that the size of the screws differ because of the smaller size of my mouth. I’m pleased they emailed the images taken during my appointment.

I should have had all this work done on Monday, because the three people who worked on my mouth today, all have names beginning with the letter, M. Mandy was the first assistant with the first impressions taken. Then Molly entered to take some X-rays and help with the further impressions and manipulations done by my dentist, Margi. Dr. Margi Sullivan did the first removal of the cap over the abutment, and then installed the higher edged ones.

Here are some diagrams from the web to ponder:After insurance pays half, I will owe a total for the two, $1,614. At my next appointment, 2/6, I will pay the remaining 1K. Last year you were exposed to the cost for the two implants – a lot more costly than the crowns. It will be extremely nice not to have to only be able to chew on the right side of my mouth.

Finally, the last collage of photos planning for the color of the enamel on the composite for my crowns.On the right bottom of the left photo, you can see the cover of the abutment on the front implant.

I took candy to a crew in the hospital, walked in the Outpatient Services door to the front desk, and the receptionist said, “It’s Fancy Nancy!” She always called me that because of a book her little girl has. She was thrilled with the package. To be sure they got a piece of candy of thanks for their service, I mentioned as many of the names as I could remember who helped me in the past, and John recently for his surgery. She wrote names on top of the note, which ironically, I had signed with “Fancy” Nancy and John for the thank you.

I went by Super 1 for meds but they weren’t there yet. I was told to come tomorrow. It almost was a problem, as you will see.

On my way home, I stopped at Bi-Mart with my wrist-cuff Smart Heart BP monitor. I had called and asked for a brand other than that so I could buy a different one that got better ratings. As mentioned earlier, mine had been giving inconsistent readings, even after changing the batteries. They had an OMRON, series 3, which we looked up on line and found good reviews for. I carried my couple year old (past the warranty) with me in the box and told the manager it was no longer working and I thought they maybe should not carry that brand. It was on sale now for $19.95. The Omron was $39.99. I had it in my basket, but had not paid for it yet. The manager told me he would refund my money at the sale rate. I told him I did not expect that, but he said he would, and told me he recommended a cuff over a wrist one, and that he also has to take his BP daily. I thanked him and told him I realized they were more accurate, but that Omron cuff has good reviews, and I simply cannot handle the upper-arm cuff more than once or twice a year. We do use one on John and then check the wrist-cuff against that. With my return allowed, my new purchase was just over $21. I have been pleased with Bi-Mart’s return policy. If it is within a year and you keep your receipt you can get a full refund. Costco has a similar refund policy without a deadline. That’s how we got our current cuff, when another we’d had for 5 years stopped inflating. They GAVE us a completely new one.

Wednesday, Jan 18

For Jan 17 CPAP. Reported figures. AHI= 0.15. Events: 1 H, 12 RERA. Time on 6 hrs 44 min with (max = 12 L/min). Oximetry: SpO2 low 86 spurious at restart oximeter found off finger, actual low, 88, on the graphic chart, 0 events <88% with avg., 92.3%. Pulse avg. 59.2, low 51.

The weather turned nasty and shut down the pass for 2 days. There were accidents, trees, rocks, and snow. Ice and snow caused multiple trees to lean or fall. The DOT crews were not up to that so a commercial firm was contracted for the really dangerous stunts.

Snoqualmie Pass Closed:
Compact snow and ice on the roadway. I-90 is closed in both directions. East bound is closed at MP 34, near North Bend, due to falling trees and rocks, between MP 43 and MP 44. West Bound is closed at MP 106, near Ellensburg, MP 84 near Cle Elum and MP 70, near Easton. This is due to numerous snow slides by MP 50. Both directions will remain closed until DOT can assess the situations during daylight hours on Wednesday morning, January 18, 2017

Now back to my meds problem. With the Pass closed, I wrote an email to YHC and called my pharmacy because my meds probably won’t make it to the pharmacy today here, and I will run out after tonight’s pill. I was prepared to drive to Yakima for another sample of a week’s supply as they gave me Jan 10. After a 1.5 hour search by my pharmacy about their courier delivery person, they found it will be at my pharmacy today. I am waiting for a phone call, hoping to here they arrived before leaving for town.

Another pass report: 10:03 a.m. I-90 Snoqualmie Pass remains closed in both directions from mp 34 near North Bend to mp 106 near Ellensburg. Crews have assessed conditions and determined that the pass will not open today or tonight. Conditions are such that it is not safe in some areas for crews to do the work necessary to open the roadway. Crews are continuing to monitor conditions. Alternate routes are US-2 Stevens Pass and US-12 White Pass.

Snow and freezing rain

We got a phone call from the pharmacy at 1:45 and went to town to pick up my Entresto meds. The courier brought them from Spokane. They would not have made it from Seattle, where they also purchase meds from a distribution warehouse. This was my free month’s supply from the Pharmaceutical company. I still do not know what the cost will be to me. My cardiologist’s nurse had to FAX 17 pages of information to qualify me for the medication reduction in price. I hope that my insurance will cover some of it, because Novartis (manuf.) is only covering $90/month of a several hundred $ monthly cost.

Thursday, Jan 19 National Popcorn Day

For Jan 18 CPAP. Reported figures. AHI= 0.50. Events: 1 CSR, 3 H, 13 RERA. Time on 7 hrs 58 min with (max = 16 L/min). Oximetry: SpO2 low 74 spurious at start, actual low, 87, the only 1 event <88% with avg., 92.0%. Pulse avg. 58.9, low 48.

I called Rite Aid about the “moderate to severe” Gen Teal Gel drops, that Bi-Mart said they were out of stock and unable to get.
The Rite Aid representative checked the numbers and barcode from the box I still had, and found, sadly, they are no longer manufactured. I had John check on Amazon, and we have not been able to locate the item, anywhere. I have called to local pharmacies (still have two to do), and everyone I called is out. Downtown Pharmacy told me they were aware of its no longer being offered and had to find a replacement for their one shopper who used them. I asked her what brand they settled on. It was Refresh, which has been my second choice for awhile. The only thing I do not like is that while it comes with two larger containers (15 ml), also packaged with them are small containers which are difficult to use.
John was able to get my new SIM card loaded in my phone. Now when in town we will check and see if they can activate it. I still think it is the battery, or something wrong with the phone.

In honor of National Popcorn Day, John popped a quart or two. I enjoy popcorn, but not the little shells that get between my teeth. Then, on my last bite I got a piece on the roof of my mouth in the far back of my throat. It was nasty to get rid of.

The pass didn’t open until this afternoon between 5:00 p.m. and 6:00 p.m. A lot of unhappy truck drivers lost money while waiting for the WSDOT to clear the road of snow, trees, and rocks that slid onto the highway in several places. John saw a report on KOMONEWS, about a huge rock falling on Hwy 101 on the west side of our state, and showed me a photo (not very clear) of the rock covering one lane and across the centerline. Fortunately, no one was driving by at the time.

Friday, Jan 20

For Jan 19 CPAP. Reported figures. AHI= 0.64. Events: 5 H, 17 RERA. Time on 7 hrs 46 min with (max = 15 L/min). Oximetry: SpO2 low 88, 0 events <88% with avg., 92.2%. Pulse avg. 64.1, low 51.

Using a CBS news feed, we watched only the inauguration and The National Anthem on a nice ACER monitor and with good speakers. John had been reading about and listening to songs by Jacky Evanco, from the Pittsburgh area. She is still in high school, and has been singing since she was 8. You can find some videos of her on the web, but here is a link to the Inauguration Day windy and wet one:
Jacky Evanco’s Star-Spangled Banner

I hope this link remains available on line. It was still there Sunday, but you have to watch an ad before it comes up.

John left for taking care of the horses, and I need to clear out the sink for filling buckets of water for him to take to the horse trough. Deer and horses are drinking from it, and the feeder pipe is still frozen. He did get the insulation needed yesterday to put with his heat tape. He has a list of 3 or 4 must-do things before next winter.

I experienced some interesting activity this afternoon with my blood pressure, and even called John in to take my BP with our cuff (I know it is more accurate, supposedly, but it hurts like heck, and I bought a new wrist unit this week to replace an old one that was giving inconsistent readings. The readings (3rd # is pulse) that alerted me were 66/44 72; 92/53 83; 86/51 85; 94/52 84, starting at 2:13 p.m. I took it again at 2:23 and it was 104/43 67. John took mine at 2:28 with the cuff and it was 103/81 71. I took it with the wrist one at 2:34 and it was 111/57 74; at 2:43, 93/51 70.

Because of the potential side effects of the new medication for my heart, I am supposed to take my BP and report if my systolic pressure (the top number of the ratio) goes below 100 (or above 140).

It has gone low at evening measurements, but today it did so in the afternoon. I have a call into the doctor’s nurse at the Yakima Heart Center (she checks with him), but no response yet.

I received the call from my Cardiologist’s nurse at 5:43 p.m.  She listened to and recorded all my BP measurements and figured that Dr. Kim would not make any drastic changes, especially as I was not feeling bad at all during the lowest measurements.  She told me he was “on call” all Saturday, so I could get to him, if needed.  Meanwhile, she called him and read him all the data.  He agreed that nothing should be done at this point, and to keep recording details as I had been.  He was not worried as long as I had no dizziness, shortness of breath, not feeling bad, and to continue, but to report in as I had done if there were other lows that occur.  He looks at overall averages and how the patient feels.  I am to continue doing my activities tomorrow as usual, and not change the dosage of the new drug I have been on now for 8 days.  She called me back at 6:03 with the messages from him.  All is well. We get the impression he really likes the reported results of this combo-med.

Saturday, Jan 21

For Jan 20 CPAP. Reported figures. AHI= 0.53. Events: 1 CSR, 4 H, 15 RERA. Time on 7 hrs 35 min with (max = 19 L/min). Oximetry: SpO2 low 85 spurious at start, actual low, 89, on the graphic chart, 0 events <88% with avg., 92.7%. Pulse avg. 58.3, low 50.

John started early trying to divert water from our yard and overflow from our irrigation ditch which cannot get under the ice dam at the culvert under the neighbor’s driveway. Once out of the ditch, it isn’t where it should be to go under our driveway either.

As long as it doesn’t go under her garage door, all is good. John says he is learning. If we ever build a new place (not likely), there are many dos and many don’ts, such as do not have your driveway slope down to your garage door.

On my way out, I took a photo of the water (see below on the left of the composite), and I added the right on Sunday morning in the snow, which lasted most of the day and accumulated ~3″.Left photo shows the water standing around a fenced garden. I park my Forester farther to the left in a 3-sided shed. The right was taken the next morning to show my tire tracks and the closest black line across the driveway, which is the drain (with running water) that John dug through the snow, toward the downhill pasture that will drain to the low area to the south and back to the creek.

I drove to Briarwood for music today. The roads near us were covered with ice and snow for several miles toward town, then got better. We are 800 feet higher than the part of town I was headed to. We had a good group of players and a large responsive audience. Players included these instruments: a tambourine, banjo, two guitars, two fiddles, harmonica, flute and a singer, plus our audience “choir.” They had copies of the lyrics to 20 songs, and at the beginning, we did a couple of others they knew but were not in the book, before starting at 2:00 p.m. on the booklet. They sang along on You are my Sunshine and on Tennessee Waltz. Then we did a Happy Birthday song for one person, and I introduced the whole music group, for the primary reason of two new members they had not met. Also, a wife of one of the new folks, husband of another, and children of another were in the audience. I introduced them as well. Our little 3.5 yr old mascot Haley was also there with her parents and dancing occasionally.
After the music, they fed us a tasty bowl of chili with all sorts of toppings, 3 different salads (my favorite was a fruit salad with lemon Jello, marshmallows, & pineapple), thickly spread chicken-salad sandwiches in a nice roll, a choice of two desserts, and cookies, plus hot cider. Always available is iced water and coffee. I never have to eat supper afterwards.

I came home needing to put my BPs in a log journal, from the slips of paper sitting around my recliner chair during the last couple of weeks. John’s is neatly recorded in his own logbook, and I have one for me (starting in Jan 2017). I completed mine later this evening.

I stayed inside the warm building after our playing and eating with my cell phone and John’s to talk to our cell provider in Oregon to get my new SIM card activated (which supposedly had been activated Thursday, when we were in town). As it was, they had to verify the last four digits of the second line on the card and removing it and seeing it was troublesome. But I found the “2086” needed. I thought I was set to have a working cell phone again, and called John to tell him I would be leaving for home soon.
Once home, I had the same problem with reception as John has had for over a year with the same make phone. The ENVOY phone gets no reception in our vicinity, whereas my old Motorola did at least at the far end of the house or outside in the yard. It apparently “broke.” So I was correct that a new SIM card would not fix it.

Once home, I spent a very long time with Consumer Cellular complaining about my cell phone and trying for a solution.
The newly simmed phone will not get any reception in our house or in the yard. I called to see if they would replace the phone with one that works. They checked AT&T coverage and claim we are in the area served. They checked for T Mobile and it only serves 4 G phones, this is a 3 G. Finally, they sold me a new phone (no return ones at a lower price were available as we have gotten before to replace John’s lost phones), and it will cost $54.10. I will get it mid next week, and if it has reception here, I’ll keep it; if not, it gets returned to the company. I hate having a cell phone I cannot use at home. I forgot to ask if the new phone is a 3 or 4 G. I went on-line to read reviews of the DORO PhoneEasy 626 and about half of them (of the 20 pages I read) are not good. However, folks with problems do let them know, while those without problems are generally not going to engage.

Sunday, Jan 22

For Jan 21 CPAP. Reported figures. AHI= 0.88. Events: 7 H, 18 RERA. Time on 8 hrs 0 min with (max = 17 L/min). Oximetry: SpO2 low 77 spurious at 6:30 a.m. turn off, actual low, 88, on the graphic chart, 0 events <88% with avg., 92.4%. Pulse avg. 59.8, low 42.

Today we did a few chores – John outside and me inside. I did schedule a haircut for John tomorrow with our neighbor who cuts my hair. My arthritic bone on bone shoulder has been bothering me so much that John made the suggestion and I took him up on his offer. His hair is as long as mine right now. Look above a week to last Sunday to see the herd of elk near her house, that she photographed and gave me permission to use the photo.

John just brought me a bowl of dried peaches and dried pears. I’m eating slices of each together and enjoying them very much. I did not dry any fruit this year because we have frozen bags from previous years. Maybe we will intake the calories over this winter, and be ready to dry more for the freezer come fall.

We just had Nachos for supper. John did a nice job. We only ate half and will have leftovers tomorrow night.

We are not the only ones to have ice from snowmelt runoff. Here is a photo of their vineyard from our friends Barbara and Paul, the winemakers and owners of Paradisos del Sol Winery in Zillah, WA. Photo by Barbara Sherman

Hope your week was fine.

Nancy and John
Still on the Naneum Fan