Sunday, Jan 27
We published the blog at 10:38 p.m. after a series of computer problems.
Star-studded sky shine tonight, by Evie Schuetz, taken over their playhouse in Kittitas Sunday night.
Her description is as priceless as her photo:
I thought it was extra special seeing Orion directly over the playhouse, and finding out that my brother Mike had been flying overhead on his way to Spokane around the time this photo was taken. His nickname has always been “The Shining Star,” so it seemed a bit magical.
Monday, Jan 28
My first call this morning was to the orthopedic surgeon, from Yakima, who diagnosed my left shoulder arthritis, in September of 2016. His assistant suggested I go instead to my doctor for an X-ray and a referral to a shoulder surgeon.
I got off the phone and called Patrice at the front desk in Cle Elum, WA. I knew my doctor was in the office today.
She set me up in Cle Elum for a 10:45 appointment with Dr. Norman Wood. John drove my car. We have a 45-minute drive to get there, and have to check in at 10:30 a.m.
Our drive up via I-90 was spectacular with Mt. Stuart (7,416’) reaching up above the nearby peaks of the Stuart Range backed by beautiful dark blue skies. The view cheered me through the pain I was suffering from my “fall.”
We were rushing to make my appointment, and while I had my camera along, we didn’t take time to pull off onto to the road’s shoulder to take a still shot. When I got home I wrote a request for such a photo from that location, and Lise McGowan offered me one. It is exactly the view, with added valley fog, taken last year, that she was happy to give me permission to display in our blog:
Thanks, Lise McGowan, my photographer friend, for this lovely landscape view, using your talents of exposure and composure.
My appointment started on time in a part of the building we had not been in. There was a water break in the part where we normally go, and when they started work on that they found asbestos. That section is now encased in a plastic sheet.
The new exam room was nearly twice the size of what we would normally see.
I was weighed in at the least I have been in some time, 144.7#, and was ushered in for my vitals. I reported one change less in my medication list (by my cardiologist; now no Allopurinal required). Then the nurse took my blood pressure (it has been higher than usual). My pulse was up a little too, but temperature was fine. After an explanation of my problem, with my doctor, I was sent to the lab for two X-rays, and blood draw (for my normal monthly INR & K reading). That took a half hour and I returned to the examination room.
In not too long, Dr. Wood returned with the results and his suggestions. I showed him the bruise on my upper left arm. It was diagnosed from the X-ray as a strained or pulled muscle, although he thought he saw a small hairline crack at the ‘head’ of my Humerus bone, which is already a culprit for the severe arthritis I have, with bone-on-bone, bone spurs, and bone cysts. I first thought I might have broken off a bone spur with the impact. We didn’t see the X-ray, which was reviewed by my doctor and his P.A., but I will be able to get it on a CD later to review from medical records at our local hospital. (I picked it up the next day at the hospital in Ellensburg).
We drove back by Super 1 Pharmacy in Ellensburg, and I walked in for my prescriptions. They were amazingly inexpensive; both totaled $3.50. I went inside to get some water to take the first dose of each, right then.
Here is the evaluation of the X-rayed image, [provided with the CD of the image] by the Radiological Technician (Eric J. Lundstrom) at KVH: (1/29/19 10:23 am)
Reason for Exam:
(XR Humerus Min 2 Views Lt) fall
Radiology Report
Comparison: None
FINDINGS: There is no evidence of fracture, subluxation. Glenohumeral osteoarthritis with medial hypertrophic bony change in the humeral head. No radiodense foreign body or erosions. Osteoporosis.
IMPRESSION: No evidence of acute osseous abnormality.
Meanwhile, he wrote a prescription for pain using Prednisone for 6 days (Dose: 3/day for 2 days; 2/day for 2 days; and 1/day for 2 days) and Ultram for pain (an opioid) (Dose: 1-2 every 4 hours; no more than 6/day.
I’m adding two diagrams from the web to show the various parts of my shoulder involved and mentioned by my doctor, by the radiological technician in the radiology report, as well as in the informational links below.
His last comment was that he is writing a referral to Dr. Frederick Matsen at University Hospital in Seattle. Dr. Matsen is the head person, but may (or may not) do my surgery. John and I will make that appointment to discuss my situation. Perhaps medical technology has improved the procedure since 2016, when it was recommended (by my then Cardiologist) that I not consider it for the life-threatening possibility of complete sedation with my heart issues. Or, maybe they can provide a superior local to get me through the surgery without endangering my life. My Primary Care Doctor had his own complete shoulder replacement done by this same surgeon in 2017.
Below is an exciting (to me, anyway) biographical description of him. I like it that he is interested in outdoor recreation and music, and in performing less invasive surgery.
Below is a video of ~ 28 minutes
It’s a close-up Look – Not for the faint of heart or someone who doesn’t want to see blood. This is a very informative presentation, so a person knows exactly what will be done during their surgery. It was done a few years ago, so there maybe some changes.
Close-up of an Actual Shoulder Surgery
Dr. Richard Matsen has a blog on line (see link below). It has over 1 million followers!
This is a short, one minute, 12 second, statement by Dr. Matsen explaining their team’s different procedures of regular and reverse shoulder replacement. Just a discussion; no diagrams.
Short Arthritic Shoulder Replacement Description
Here’s an informative write-up (discussion with photos) of Shoulder Joint Replacement from the American Academy of Orthopaedic Surgeons:
AAOS- Shoulder Joint Replacement
A one minute, nice video of the procedure, by arthritis health (click on the triangle to the left of the title on the video):
Animation of Shoulder Replacement
I have more than enough reading material to digest before going to our consultation with Dr. Frederick A. Matsen III, M.D.
Tuesday, Jan 29
John left early for pruning at White Heron.
I have now, this morning, restarted uploading this video from Nick on the Rocks, the last of the programs Thursday night 1/24/19, published in last week’s blog. On the original upload, the blue screen of death appeared right at the finish of the couple hour upload, saying my PC had problems and was being restarted. When it returned, I had a message from YouTube that the link was still uploading and I would be able to refresh and continue. That never happened – would not allow it. I was so busy dealing with my shoulder issues yesterday that I never had time to get out and delete the bad file to reload under a different title.
When it is working, I will correctly update the new link in last week’s blog, but meanwhile I had to notify those few folks I’d already sent the bad link to. I have now re-sent the corrected link on the blog, with the revised update, as follows:
New Upload – Great Ripples of the Scablands
I dressed to go to KVH to sign for and pick up (no cost) my shoulder X-rays on a CD that were taken yesterday. Then we went to the AAC center to pick up winter boots left for me there by my friend, Anne, from her time at the community clothing exchange. It is open on Saturday, but we did not want to drive in just for these. 
Used winter boots given to me.
Also we went for purchases at Bi-Mart and to Super 1 for needed groceries. Lastly, we drove by a friend’s house who was returning my loaned rice bag, because her family bought her one. I was happy to receive it back to be able to be able to alternate heat and iced ones on my shoulder joint. The one heats up in 2 minutes in the microwave but cooling the other takes a lot longer in the freezer.
Wednesday, Jan 30
John left early for pruning at White Heron.
Called Cle Elum regarding values of my INR & K drawn there Monday, 1-28-19, the same time and lab in Cle Elum, when the X-rays were taken.
Page did the draw and filled the blood vials for each, to send to KVH lab for analysis (I doubted it was in time to connect with the courier until Tuesday morning, so I predict it won’t get delivered until Tuesday afternoon, for access, analysis, and the radiological evaluation report not accessible until Wednesday. We had to return to Ellensburg for my two meds, and in hindsight, I should have sped up the process by carrying it by the lab. All the staff knows me well there.
I planned to stay home all day Wednesday, so I was available for the reporting. The nurse only has access to the blood tests results, however, and not to the X-ray evaluation.
Page (the Cle Elum phlebotomist) also put a drop on the pin prick machine and got a reading of 3.2. I’m never comfortable with that method because of the calibration often not agreeing with the blood draw results; however, it was confirmed to be the same.
Then Samantha updated Dr. Wood’s standing order in the system with Diane’s help. I guess it had expired, but now is fixed.
I was hurting worse yesterday, but maybe because I was feeling better this morning I did too many things too soon with the left arm. I drove to town today Tuesday, to see if I could drive. I have not been driving since before the fall/and jamming my shoulder and apparently straining, pulling, or stretching? my shoulder muscles. I have a bruise too, on the top front probably from hitting the metal on the bottom of a flipped-up theater seat, which I must have hit on my way down to the riser where it was connected, and the spot I ended up sitting, facing forward. A young student was next to me and pulled me up by my right arm. John was in front of me, because I was behind him with one camera on the tripod and one hand-held from the seat above on the riser. I could not drive home, so we switched seats for the return trip.
Thursday, Jan 31
Missed knowing about this in time to view early a.m. to the east. 
Link to story is below:
We had noticed the proximity of two planets over the past few nights.
John went to prune grapes. It was cold.
I called for Lacey, the triage nurse in Cle Elum. Needed to have her consult with my doctor about refilling orders to get me through the weekend to be at Super 1 Pharmacy this afternoon, just the Tramadol and 3 Tablets of 50mg of Prednisone.
John drove to town alone. He will pick up the rest on Monday, late in the day.
I called Dr. Richard Roux’s local number 925-4114 about my request for the 2016 September X-rays to be sent to the shoulder surgeon referral in Seattle. Shelly transferred me to Medical Records in their Yakima office.
Felicia there suggested getting them out for me to carry with me to Dr. Matsen, when I go for my consultation. She will be coming to the Ellensburg office next Wednesday, and I can pick up there between 1:00 and 3:00 at the NW Orthopedics clinic, saving me a trip to Yakima. That made me very happy.
If you are interested in shoulder health updates, let me know. I’ll email them too, if preferred, or if you want off the update list, let me know that too. I won’t be offended.
Friday, Feb 1
Went to Ellensburg for 3 more tablets of Prednisone for Monday’s a.m. dose. Go back in afternoon to receive and pay for the entire purchase, and pick up the remaining 6 tablets.
From there, we went to Fred Meyer for special prices on Red Baron pizza, getting the allowed 5 ($1.99/each), and then 10 bottles of Gatorade for a price of 69₵ each. Places such as this are expecting folks to have smart phones and ‘texting’ so as to encourage “engagement” with them. We do neither except when an ad in the newspaper shows a sale on something we want. Then the clerk has to go through extra steps because we do not have a digital coupon.
On home by 3:00. We had a nice warmed piece of Kirkland fruit cake from the freezer that John had cut up from a December purchase at Costco.
Saturday, Feb 2
Morning fog filling the Kittitas Valley and engulfing Ellensburg.
The photo is from the highway camera near the ridge top, about 2,300 feet.
We live on the far side of the fog. We had minimal fog at our location, so the sun was streaming through. We enjoy our home’s elevation (2,240’) because we frequently get sun when the fog starts a mile or so south of us.
We read the morning paper too late to get into a show at the Planetarium at Science II building at CWU. This article announces it (we are friends with Bruce Palmquist, the columnist from our days in Lind Hall with the Physics and Geology departments). His column is in the Saturday paper. Because of monetary concerns, this year they stopped publishing the Daily Record on Fridays, and combine the two days to come out on Saturday.
In the Thursday part of the above, Bruce mentions the planets shown in the image I’ve included above.
Sunday, Feb 3
There is a 7 lb. rolled pork roast in a slow oven. Dinner and beyond. This one has been in the freezer since an end-of-year gathering of the music group was cancelled in 2017. John figured it was time.
Brunch for me was sausage, eggs, toast, and peaches. John had toast much earlier, so now had just sausage and peaches. Afternoon snack, warmed Fruitcake.
Dinner: Roast pork with mushroom/onion gravy, carrots, tomatoes, Yukon gold potatoes, and slices of a Honeycrisp apple. Now the left-overs have to be cared for.
Our weather is getting colder, such that after Monday we won’t get above freezing for several days. The cold is moving into the Seattle are too, and they may get snow at sea level. Meanwhile, friends down at South Lake Tahoe are goings to get snow 2 or 3 feet deep. Above 7,000 feet in the nearby mountains there may be 8 feet of snow. Yikes!
Hope your week was fine.
Nancy and John
Still on the Naneum Fan