April 3rd The 5th Day

Stunned at the void

First, I’ll suggest if you are new to these pages you can get the background by scrolling down until you get to the beginning of March, then read forward.
I provided Brookside Funeral with a text and photo (2019, April) of Nancy holding her violin. I have tried to show important things in her life that many may not know. Most will know that her career was that of a geographer at the college/university level. There is more of that aspect on the CWU Geography page.

Friend Elise has provided a ‘pdf’ of the obituary that you can see by following this link:
Nancy’s Obituary

The Funeral home – Brookside, Ellensburg – folks, Kelly and Charity have been great. On that page – Brookside – they have added the banner across the top, and the “remembrance” things under her photo. Please do not do those things. We planted lots of trees, some now 50 feet tall, and our Tulips and Daffodils are soon to bloom.
I have not yet gone there to see the guestbook nor the condolences. It is too soon for me.
While there has been much to do this week, the hardest was taking the obituary to the facilities where the Fiddlers and Friends played and asking if they could place the page on a bulletin board therein.

There is no service planned. Later in the year I expect there to be a couple of gatherings with sort of a theme list; maybe neighbors one time, musicians another, just friends another. I suspect these to be more spontaneous, rather than planned or elaborate.

Nancy’s ashes will be brought back to the Naneum Fan, her home for 32 of her 77 years.

There are several things about what happens when a person dies that I want to share with family and friends. That will have to wait, until next Saturday or the following one. They are just “things” and do not belong here.

Thanks for all the good thoughts.
John

March 28th Health post

Plan still unsettled . . .

Yesterday and earlier reports follow after this.

I have now had several phone conversations with nurses and hospital “care” workers. I have the feeling the initial view there was that they were getting an older woman with ‘just‘ a nosebleed.
Nancy’s year of inactivity, and then the fluid build-up, has left her immobile to a severe degree. Her damaged heart is not going to provide for much exertion or sustained activity.
A physical therapist came (about 11:15 am) and got her out of bed and for a walk in the hall. His assessment – conveyed to me later by another person – was that Nancy should be sent to a rehabilitation facility. This, I had already urged (explained) to two of the nurses for her room.
Insofar as she is quite rational (mostly), the “care” person (sorry, don’t know job title) questioned me about home versus a facility – because Nancy seems capable of making decisions for herself.

I need time to work with the Home Health folks here in EBRG to get in-home help, not just nurse and PT visits. But she needs to be in better physical shape, even for that. If she can’t get to that (low) level of physical shape, there is a good change she will need a long term care facility.

There are many moving parts to this situation, so very unsettled.
_ _ _ _
The hospital’s phone system got chaotic this afternoon. She was to call me after 3:00, but didn’t. When I called the system did not connect with her room. I called back. That connection sounded like someone was keying in a number. I switched handsets; that helped. But, she wanted to call me back, so I hit the off button. She didn’t call, so I tried again. Busy signal. Now at 9:00 pm I don’t know any more than I did at 1:30.
What’s the phrase: There is always tomorrow.

Hope your day went better than ours did.
John

March 27th – – Health post

Not part of the plan . . .

I tucked Nancy in bed and turned the lights down about 9:30 last night.
Then I came to the computer to write an update. A few minutes later she buzzed the phone intercom. Her nose was bleeding and she was using tissue after tissue to sop it up. I tried a more appropriate technique – pressure for 5 minutes, for a couple or four tries. As soon as the pressure was released the blood would flow again.

So, I put pressure on with one hand and between the two of us managed to clean her up, get warm clothing on, and get in the car. At that point I needed two hands and insisted she not release pressure for the next 20 minutes – our drive time to the ER. Repeated urgings during the drive worked and we were soon being attended to.

Pressure and nasal packing slowed, but did not stop the flow. The solution was a small “balloon” insert, then inflated.

The doctor and I talked through the next steps. I did not think it safe for me to bring Nancy home. Getting some in home care – beyond hour visits by nurses and physical therapists – was going to be a Monday to-do thing. Second option was to admit her to the hospital where we were. But, going through the ER to the regular wing without weekend Nose & Throat + Cardioloigst seemed to be a stretch. The best option seemed to be a transfer to the Yakima Hospital. Those providers have to agree, and did with the team lead being the Nose & Throat specialist.
Yakima County has had a larger Covid experience than here. They, therefore, want a recent negative test; another bit of a delay. She arrived there at about 10:30.
The hospital – newly named Virginia Mason Memorial Hospital in Yakima – has a very restrictive visitors code. I won’t be visiting, but there is a phone in her room. I know that because the nurse for today called to ask a few questions of me, and answer mine.
I will call there tonight and sometime on Sunday, and post what I learn late on Sunday evening.
Having been active since 6:30 am Friday to ~1:30 pm Saturday, I think it is time for a nap.

John

A less than exciting week

John writing:
Not a lot to write about this week.

Nancy is having problems with her lap top. Sometimes I can help, mostly not. She uses a Dell touch screen. I am almost cured of touching the screen unintenionaly. Also, it is not a large screen. I have 2 monitors and about 4 times the amount of screen space. She uses programs about which I haven’t a clue.
She appears to need to do something about the Jacquie Lawson ecards site, while my advice is to sign off and sign out.
Our small county is well into vaccinating folks and our experience, recounted below, seems to be much different from other states. It really was the only episode, this week, worth a report. I am just going to copy what I wrote for the Saturday update. Here it is:

Tuesday was a blood draw with INR and K both within range.
Getting a plump vein to tap has been a problem. Conversations with others suggest diet and fluid intake need an increase. Looking back, I think she drastically cut Powerade (sports drink) along with total removal of Ensure protein drink (about the highest Vit K item in her diet – still not real high).

As a substitute I’ve been making what I call “blurpies”. If you put fruit, ice cream, and yogurt in a blender the first sound produced sounds like “blurp.” Well, it does to me.
She uses Almond Water (COSTCO brand) to dilute coffee, so we also add that to the Blurpy.
So, we are working in this.

COVID SHOTS
Friday at 3:30 we went for the 1st dose of the Pfizer vaccine. We were met in the parking lot and handed a 2-sided survey – filled out in the car. I took those to the greeting table. We were escorted inside and passed off to person #3. We asked for a high chair for Nancy. Most chairs were of the folding metal type, and 10 inches lower. (More of the higher chairs are needed in this world.)
Because Nancy is on a blood thinner (question was on the survey) we were visited by a Nurse (#4), who explained possible bruising from a shot. Nancy showed her a few, and she was satisfied we would not be startled if such happened at the site of the poke. (Without a mirror we can’t see that spot.) The nurse summoned #5 who led us to a table (with a high chair) where #6 was waiting.
We wore short sleeve shirts and warm vests without sleeves; and a warm winter coat. Remove the coat, and there is the bare arm ready for the shot. Next we were off with person #6 to the waiting area. Chest tag had the time 1551 (24 hour clock) at which we could leave. About five minutes into the wait, person #7 arrived with a computer on a high rolling cart. For maybe the forth time we gave names, birth date, address, phone number, e-mail.
Person #8 appeared and we asked to short-circuit the longer exit route, pass through curtains, and exited where we came in, about 30 feet from the car.

Our 2nd dose was scheduled, but she could not alter the 21 day period. We want to stagger those by 3 days. Some folks can feel a bit off (symptoms vary) as the body’s immune system ramps up after the 2nd dose. It is not likely that both of us would be impacted, but that is possible, and easily prevented. We just have to call the County Health folks and reschedule. I had to call to get us in the same time slot on Friday. The computer system tossed me out when I tried to fill a second slot from my computer. {End Copy}

Saturday morning and into the evening we could feel where the shot was given, only if we put a hand on the arm. Otherwise, it was not noticeable. Now Sunday evening and still no reaction.
Sunny and cool here today. 53°F was the high at the airport.

From me and Nancy, that’s it for now.
Still on the Naneum Fan

Cold and snow starting to go

Nancy’s health & medical issues are discussed here:

http://rocknXXXponderosa.com/?p=11858
Copy and delete the 3 Xs. The ‘ XXX ‘

That takes care of Monday, Tuesday, and Wednesday.

Otherwise, all that is going on is continuation of construction work.
Our deal is that workers come here when weather or other circumstances mean it is better here than elsewhere.
The stone and siding is now finished under the car port. Painting will wait for warmer temperature. The north end (old 2 car garage) siding is about 95% finished. All the beams and wood for the patio+ cover on the back side is there and the 3 posts are up (on concrete footings and form tubes).

The horizontal timber beams are up, connected to the house, to each other, and squared.
The inside wall, with sliding glass door that opens onto that soon to be covered area,has been paneled similar to the room that was the garage. More to do inside, so no photo yet.

We have had cold mornings, but most of the work time has been above freezing. The 10 inches of snow has been slowly melting so moving around is a bit of a mess out there. An old-old bale of hay may find a home there for this coming week.

Saturday night rain came and there was a drizzle all day Sunday.
Except for brief trips outside, John cleaned, sorted, and tossed things like old Christmas cards and materials from trips to geography meetings. There is much more equally useless stuff we never tossed. A load of dirty clothes got washed and dried.

Nancy slept a lot.
Hope your week was fine.

Nancy and John
Still on the Naneum Fan

More than you want to know – Nancy

Hi Folks,
John writing. Not much new here, as of Saturday morning.
I’m late with this, so this one is just a marker.
I need another hour, and then will post on this simple link below.

http://rocknponderosa.com/

February 27th
FIFTH OF UPDATES More than you want to know – Nancy

Tuesday was a blood draw with INR and K both within range.
Getting a plump vein to tap has been a problem. Conversations with others suggest diet and fluid intake need an increase. Looking back, I think she drastically cut Powerade (sports drink) along with total removal of Ensure protein drink (about the highest Vit K item in her diet – still not real high).

As a substitute I’ve been making what I call “blurpies”. If you put fruit, ice cream, and yogurt in a blender the first sound produced sounds like “blurp.” Well, it does to me. She uses Almond Water (COSTCO brand) to dilute coffee, so we also add that to the Blurpy.
So, we are working in this.

COVID SHOTS
Friday at 3:30 we went for the 1st dose of the Pfizer vaccine. We were met in the parking lot and handed a 2-sided survey – filled out in the car. I took those to the greeting table. We were escorted inside and passed off to person #3. We asked for a high chair for Nancy. Most chairs were of the folding metal type, and 10 inches lower. (More of the higher chairs are needed in this world.)
Because Nancy is on a blood thinner (question was on the survey) we were visited by a Nurse (#4), who explained possible bruising from a shot. Nancy showed her a few, and she was satisfied we would not be startled if such happened at the site of the poke. (Without a mirror we can’t see that spot.) The nurse summoned #5 who led us to a table (with a high chair) where #6 was waiting.
We wore short sleeve shirts and warm vests without sleeves; and a warm winter coat. Remove the coat, and there is the bare arm ready for the shot. Next we were off with person #7 to the waiting area. Chest tag had the time 1551 (24 hour clock) at which we could leave. About five minutes into the wait, person #8 arrived with a computer on a high rolling cart. For maybe the forth time we gave names, birth date, address, phone number, e-mail.
Person #9 appeared and we asked to short-circuit the longer exit route, pass through curtains, and exited where we came in, about 30 feet from the car. We thanked all the outside greeters as we passed.

Our 2nd dose was scheduled, but she could not alter the 21 day period. We want to stagger those by 3 days. Some folks can feel a bit off (symptoms vary) as the body’s immune system ramps up after the 2nd dose. It is not likely that both of us would be impacted, but that is possible, and easily prevented. We just have to call the County Health folks and reschedule. I had to call to get us in the same time slot on Friday. The computer system tossed me out when I tried to fill a second slot from my computer.

Saturday morning and into the evening we can feel where the shot was given, only if we put a hand on the arm. Otherwise, it is not noticeable.
That’s it for now.

February 20th
FORTH OF UPDATES More than you want to know – Nancy

We started off the week with a haircut, just around our rural block, from Nancy’s long ago (in EBRG) “find” – – Celia Winingham and husband Bob. He was cleaning snow from the driveway as we arrived. I passed her off to Celia at the door, and then I came back home where a couple of workers were working under the carport. Forth minutes later I went back and picked her up.

Tuesday was the blood draw – INR and Potassium were within range.
Kidney function remains an issue with a high marks for “blood urea Nitrogen” (BUN) and Creatinine. No surprises.

Wednesday, with nice weather and dry roads, we visited with Dr. David Krueger, cardiologist in Yakima (50 miles). He was pleased with the lowering of swelling in feet and legs. We talked about how to ease the pressure on her heart – see the section under the red stars, below, Saturday January 30th. Lots of protein can be an issue, but her intake of meat protein is low, so I don’t see a lot of help via diet. He is also thinking the CPAP (sleep study day is March 10th) apparatus will help. Next visit with him is March 31st, after CPAP or whatever. We also need a new “pulse Oxygen meter” (oximeter). The one we had quite working. $20 for a simple one; $100+ for a recording one, but I haven’t figured out if our WiFi will work (no smart phones here).

General: cast is off unless we are out-&-about. Sling isn’t needed in the recliner, and she has use of her right hand for laptop use. That makes things easier.
An elderly local lady is reported to have had a serious reaction to the 2nd Pfizer Covid dose. I don’t think that means Nancy will have an issue, but on Monday we will ask about this. Our 1st dose shots are scheduled for next Friday.

For now: “That’s all folks!”

Saturday February 13
THIRD OF UPDATES (2nd follows, then 1st at the end)

Not a lot happened on the health front this past week. The Tuesday trip to town allowed her to walk a few hundred steps in the grocery store. Much more exercise would be good.

I had removed the wrap that enclosed her thumb and wrist late last week. Swelling on the back of her hand/thumb/fingers did not increase after that, and maybe went down a bit. Feeling and color were normal, so that is how we left it.
Thursday, after 3 weeks, we did go to Cle Elum for cast removal and a follow-up X-ray. That seems to show normal healing. We were instructed to replace the cast if out & about and, also, take the arm out of the sling a few times a day and do mild exercise of that arm. After 2, days the swelling is now gone, or almost.

I had hoped to get her outside and walk for more general exercise, but the cold air mass seeped into the area – a rare event. Thursday evening we got snow, about 4 inches and a morning temperature of 12 degrees F. The snow and the cold continue. Outside exercise is cancelled.
Neighbor Allen cleared the snow from the driveway. That was the first for this year. He commented that with much more in our forecast he was making sure the equipment {John Deere tractor} was working. As expected, snow continued. He came back just before Noon today and cleared it all again. I need to clean up around the edges.

Drawing blood on January 26th was a left arm affair, and even then had to be from the back of her hand. Both INR and Potassium were in range so we didn’t do them this week. Next week they can go back to the right arm. That’s Tuesday.

On Wednesday (2/17) there is a cardiologist visit in Yakima. Previously an interim meeting (1/20) with his assistant, Buffy Sawyer, provided a “maintenance” status. This will be a more thorough and important exam.

Nancy may add a few notes tomorrow, but that’s all I have for today – 2/13/21.
John

Saturday, February 6th
SECOND OF UPDATES (1st follows below)

ZOOM to sleep [Tuesday, 2nd]
A consultation with a person at Memorial Sleep Specialists (Yakima) had the expected result. Nancy has to go for a sleep test. This may be later in February, with cast off, but maybe not the sling.
The ZOOM experience was horrendous. Lighting on their end was poor and the audio was worse. We understood enough of the words (2/3) such that we did not have to use another method. A phone call would have been better. An in-person consultation preferred.
The doctor that we dealt with in 2014 has assumed higher level administrative duties so the contact was with Allison Morgan, about whom we know zilch. She read the letter I wrote about Nancy’s non-apnea results from back then. Nancy’s issue is, apparently, hypopnea, or shallow breathing that results in reduced Oxygen in her blood.
However, Nancy – on Dr. Kim’s strong urging – lost weight, enough so that a new test is called for. Something about properly prescribing and calibrating the equipment.
Nancy and I thought her CPAP equipment was less than stellar, and not highly advanced in the sense of being tuneable to a particular situation. Have these things gotten better? We can’t find that they have with respect to Nancy’s needs.
We’ll see.

Moving on to COMPRESSION: I wrote earlier:
“Meanwhile there was significant swelling in the legs, below the knees. Not good.”

I intended to explain our encounter with (think of a mad Badger) compression socks. One soon learns of the lies photos tell. Below is the evidence.
First, nothing so colorful seems to be available in EBRG. We bought the largest size (white) at BiMart. Doc Chelsea showed us how to put these on. She is young, with nimble fingers, and experienced. Still it was difficult. She suggested getting a “sock donner” and that we did. Cost was $45 and a second set of stockings ($10.00); also White. A friend offered a pair of black socks. From “all colors” to no color – great!
Notice the enticing look in the left photo above. Note also the legs are not swollen. Same thing on the right. No swelling. Easy-peasy.
We are now experts at sock donnering. Meaning, with significant effort on my part and great patience on Nancy’s the mad Badger has surrendered – each leg gets donned. The amount of Lasix {LAst SIX hours} is doubled, so Nancy is wearing out the carpet in the hallway.

Next: arm wrap
In this image the cast is in light blue. That is dressed with a Velcro closure elastic wrap; horse owners will recognize this. Also, I bought a dozen rolls and carry a few in my backpack. I took one out over a 10 year period. That was on a trail repair workday at Mt. Rainier. A tourist fell and our best trained crew raided my pack, then went to help. The roll was not used so I still have it. I digressed there.
Note where the hard cast and the wrap end. Well the back of Nancy’s hand, and fingers, became swollen. We’d been keeping Nurse Lacey and Chelsea informed, and on Wednesday (the 3rd) I wanted to either go to the Clinic, or release some of the pressure.
About 10:30 AM, with Lacey having heard my latest concern, and having consulted with Chelsea, we cut the wrap away from the hand and back to the yellow line.
I also realized the hard cast came out to the carpal bones (pisiform bone?) [Yeah, I looked that up.] The cast will have been on for 2 weeks on Thursday the 4th and it immobilizes both elbow and wrist.
We’ve been advised that the cast can be removed for an hour or so if Nancy is a good girl and doesn’t move the elbow much. If we do that, I think I will take about 3 inches of the end – red line above.
Not only has the exposed part of the hand puffed out a bit, but she has complained of it being cold. With slowed circulation out to her fingers, I suppose that’s not a surprise.
We’ll see if we can fix that.
Saturday afternoon we have keep the cast on.

End of 2nd update (1st post follows)

Saturday January 30th

A few years ago the computer place in Ellensburg shut down and we had to create our own domain name. We either lost, or just can’t find the early editions of the writings about Nancy’s health. For any new acquaintances, I will briefly summarize. Skip to the red stars line below if you like.
Nancy, the child, had rheumatic fever. Heart valve damage is a complication. This isn’t a big deal, until it becomes so. For Nancy that started in 2009.
She began that year with a slight persistent cough. No one thought much of that except me. However, either from a dental procedure or bad luck, she contracted “Endocarditis”, a life-threatening inflammation of the inner lining of the heart’s chambers and valves (endocardium). That was taken care of, then followed with a visit to an amazing (we agree on this) cardiologist, in Yakima, WA. Dr. Anatole S. Kim is responsible for Nancy being alive. Next in that sequence is Dr. Baljit Sharma, heart surgeon. But I just jumped ahead.

Early Friday morning, after Thanksgiving Day in 2009, Nancy developed an artery blockage that took us to EBRG Emergency and then on to Yakima and a Cardiac Catheterization unit to remove a blockage in an artery across the front of her heart. From home to removal of the blockage took about 4 hours, enough time for some heart muscle damage. Not good, but not a catastrophe either. Then a sudden calamity. An anticoagulant, unfractionated heparin (UFH), was given to prevent clotting. Most people do not have a problem with Heparin. Nancy was unlucky. By Saturday afternoon she was experiencing a reaction that makes red blood a target of immunological response, resulting in the degradation of platelets, which causes thrombocytopenia. In simple words, her red blood cells were dying. The shorthand for this is HIT, for Heparin-induced thrombocytopenia.
She was sedated and put on life support for 8 days. When I got to the intensive care unit, I was advised that she might not live. She surprised them all.
Over the next few weeks we learned about the intra-aortic balloon pump (IABP), a mechanical device that increases myocardial oxygen perfusion and indirectly increases cardiac output through afterload reduction. A computer-controlled mechanism inflates the balloon with helium and so on. Wow. Look it up. A typical yard-stick leaned against the bed. Among all this high-tech (science fiction like) stuff, a wooden stick was used to make sure the heart and pump controller were at the same height. [Clarke’s third law: “Any sufficiently advanced technology is indistinguishable from magic.” Arthur C. Clarke, Profiles of The Future, 1961]
With a bit of time and prodding by Dr. Kim, the surgical team went to work on December 29th, cut Nancy’s chest open, fixed two arteries, replaced her native Mitral Valve with one from a pig, and used fractionated heparin with low molecular weight to finish the day.
Whew!
Eleven years later she is using her second implanted cardioverter-defibrillator (ICD). Actually, the ICD is there, but not used. The first was used once, shortly after being implanted when she was, again, ill with Endocarditis. The “pacer” part is almost never used, but it is there too.Late last year (2020) a routine blood exam [Basic Metabolic Panel; BMP] showed a spike in Potassium (K). We cannot identify dietary or other reasons for this, so a few tweaks in medication and dropping Ensure from her diet have followed. (Ensure has K, but not all that much.) One med was dropped, a second was cut by a third, just this week. The test on Tuesday was still high for K, but not as critically high as a few weeks ago.
Meanwhile there was significant swelling in the legs, below the knees. Not good.
We visited, on the 20th, with Buffy Sawyer, the Cardiologist’s assistant and will see Dr. David Krueger in February. Our “doctor” is Chelsea Newman (physician assistant, certified) at the Cle Elum Clinic. Nancy’s favorite drawer of blood (Kim) is in EBRG, where her blood is most often tested. Chelsea’s nurses are Lacey and Summer. A great team – we like all.
A recent echocardiogram (echo) was not a whole lot different than in previous years, although the pulmonary artery pressure was higher, causing swelling of legs (edema), and Tricuspid Regurgitation – backward leakage through an intended one-way valve. Not good.
Images have “exploded” views on the lower left of each heart.
On the left image, blue arrows show flow of blood in open & closed positions. The right side image has a red arrow showing back-flow or regurgitation through a valve that does not completely close.

The hypothesis is that improvement is possible if the cause is Hypoxemia – oxygen deficiency in arterial blood. This can be caused by slow breathing and heart activity while sleeping. This is undesirable because the amount of Oxygen in the blood drops and the organs have an insufficient supply. An exam in a doctor’s office now (for us) includes using a Pulse Oximeter to discover the peripheral capillary oxygen saturation (SpO2). When the heart and lungs do not send sufficient oxygenated hemoglobin to your finger, the rest of your body suffers. A good reading is shown in the image below, along with the pulse.

Low readings, say near 88, are seriously low.
However, when the saturation drops by 3%, say from 97 to 94, that’s not good either.
Nancy used breathing apparatus (continuous positive airway pressure) (CPAP) and an Oximeter for about 4 years but lost a few pounds and seemed not to need it. Now stopped for about 4 years.
Our issue with CPAP was/is that it is designed with stopped breathing [obstructive sleep apnea (OSA)] in mind, rather than shallow breathing – and there was no way to record the SpO2 monitor readings with the rest of the (cumbersome) setup.
Nancy will likely return to the CPAP, maybe with a newer and better technology. Consultation will be by ZOOM, on Tuesday February 2nd.

NEXT (problem):
Nancy goes to Kim (phlebotomist) almost every Tuesday for a blood draw to check clotting time [international normalized ratio (INR)], and now for the Potassium level. When INR is stable she is only tested about once a month. The spike in K changed the routine.

Heading for the medical building, On January 19th, Nancy was turning to get into our Crosstrek and fell. She landed with her right arm between her body and the ground. Ouch!
This resulted in a “closed fracture” with a tiny bit of movement, about where the blue line is in the diagram.
This shows on the X-ray, but we can’t get to that via the medical portal, and Chelsea would have had to use a cell phone camera to send us the image. It was not worth the effort.

She got a modern-day splint, with arm in sling. Photos below are not Nancy.
They put a cotton sleeve on first. The photo does not show the first cotton sleeve.
Then a mixed fiber/plaster (wet first) “splint”, and then wrapped with an outer fabric.

The right photo shows the fiber/plastic that quickly hardens.
Left photo shows the outer wrap, that can be loosened if more swelling (not expected) occurs. Why? Because the fracture happened on Tuesday, we had the visit with cardiologist Buffy Sawyer scheduled on Wednesday, and didn’t get to Chelsea and Racine until Thursday, the 21st.
Because hers is the right arm, and the left shoulder is the one that is bad – the next 8 weeks will be a pain – literally and figuratively.
Chelsea (our “doc”) sees very few fractures, so Racine, who has worked in a special ortho (bone) clinic came to help. She was a pro, so Nancy got all fixed up like a high performance downhill skier. Neither elbow or wrist can move.

They also fitted her with a nondescript black sling, very un-photogenic, unlike in the photo here. I’d add some decorations, but who’s to see?
The restraining cast is due to come off about noon on Tuesday, February 11th. I think Chelsea said the sling should be used for at least a month after that. Maybe Nancy will have enough allowed movement to use the right hand on the keyboard.
The sleep/breathing issue will be addressed starting on the 2nd of February.

Better news:
Nancy has been using a 40 (?) year old recliner, sleeping beside a monitor that sends nightly updates to the ICD folks. It uses the plain old telephone system (POTS). The chair’s lift system died, or the buttons did. We ordered a new chair, but there is a two month wait. So, Korbie, a former student from 16 years ago gave us a very new chair (dog chewed the right side arm and left a hole), used briefly by her father-in-law. I gave her 10 pounds of home grown onions. What a deal! When Nancy’s new one arrives, I’ll move the given one into the converted (new) room.

That’s it for now.
Updates to follow, when things happen.
Such will appear at the top of the page.
Thanks for the good wishes being sent Nancy’s way.
Typing is hard for her, but you can call:

1-509-925-3304

Week of Doctor Visits

Monday, Jan 18

Shortened weekly blog because of typing one fingered with splint over fractured elbow bone. Also in a sling to keep things in place. Much less typing for me (being right handed). Simple daily notes.

Tuesday, Jan 19

Sunrises – We don’t see most parts of sky from home.

Sunrise photo in EBRG by Lori Waters

This is errands day when we drive to town to do all my medical needs. Start with before NOON to Medical Arts Bldg for Kim to draw my blood for MCP test and for my normal INR. I fell getting into the Crosstrek and landed on my right side, with arm and elbow between me and the gravel. See coming Thursday.

Picked up my Metoprolol prescription medicine from Bi-Mart Pharmacy. Sunset photo by Christopher Cyrus Peterson

Wednesday, Jan 20

John drove to Yakima, WA today leaving at 10:15 for two locations, Costco & Yakima Heart Center to appointment with Cardiologist Buffy Sawyer. Not returning home until 3:30.

Reason for Costco trip was to buy the 2020 TurboTax software to have for all medical costs and to buy some Vitamin D3 2000 IU.

Reason for Yakima Heart Center was to meet with Dave Krueger’s assistant to view my swollen legs. We left her at 2:30.

Thursday, Jan 21

We drove to Cle Elum Clinic to see our PCP, Chelsea Newman about our talk with Buffy Sawyer yesterday in Yakima. Swelling in legs responding to increased dose diuretic to 80 mg. That’s good. But, . . .
X-ray of elbow showed a fracture with a slight movement – thus the need for the splint to immobilize broken bone. That to last until a 3-weeks out visit (Feb, 11th). Likely after that just a sling for another 5/6 weeks. That’s not good. So, with my good hand out of commission and my left shoulder of dubious character – I’m not very functional.

Friday, Jan 22

We have been Brittany breeders since 1977 and made a lot of friends. Here below is one, Ray Trimble. Read the text on the feat he accomplished this week.

Saturday, Jan 23

We’d were up at 4:00 am to take medication and potty. Then back for more Zzzees. John slept in until 6:30 am, then up to open our gates for the Contractor to arrive at 7:00 with a load of decking lumber that will be the roofing over the back patio area.

Prior to Noon, I spent 41 mins reminiscing by phone with Dot Smith about our childhood days in Atlanta, GA.
John is shopping in town leaving a little after 10:00 and the house temp is now down to 70.2° – – at 10:30 the programmable thermostat lowers to 67. I’m getting colder hoping he’s back soon; here at 12:04. I’m used to 74°. {Okay, time to re-program.}

Once home John made me a blender strawberry smoothie.
Managed donning the compression socks we bought when we bought the Sock Donner at the Medical Supply store. The package contained a cm measuring tape for the calf sizing. So we used that and wrote the circumferences.

Sunday, Jan 24

Slept in till 8:00 after being up at 4:00 AM to take my medications.

Because of the immobilized right arm/hand, I need John’s help filling in a form for the Sleep Center. We are having a ZOOM consultation, they still want a bunch of information. The form deals mostly with Sleep Apnea while my problem is (apparently) shallow night-time breathing. More next week.

Hope your week was fine.
Nancy and John
Still on the Naneum Fan

Not so nasty news January 8th

Not much to report this week, except I had a birthday.

Picked this photo off the web; no idea who it is or if he got cake.
I made a “spice” cake from a box — well past its best by date.
It doesn’t taste like much of anything, but what is a spice cake supposed to taste like?

Today we made a trip to the Kittitas Food Pantry. The lady we have been taking food to for a year or more was apprechitive.
We missed both times last week. The lady at the Pantry gave me a single layer chocolate cake. Something to look forward to this weekend.

The weather is cool, damp and overcast — has been and continues.

Maybe your week was more exciting. Hope so.
John

End of Year 2020

Monday, Dec 21

Up at 6:30, then back to sleep without doing much.

Been working on emails and Jacquie Lawson Cards. After my issue with the Potassium spike in my bloodstream John looked at the Ensure® package and saw that it has a high K content. I requested the following this morning:
Ellensburg The Free Box:My, neighbor, Teri Swedberg, a mile up the road replied back that hubby Ron would drive it down to deliver to our house. Our gate was closed & he left it beside the drive, where John found it the next a.m. We have run it & appreciate the gift.

The total number of robocaller connections for Dec 21=3.

Tuesday, Dec 22

Tuesdays are the days I have to begin with a special pill to swallow with a glass of water, before I can have any food or coffee added to my system. It’s also our day to go to town for shopping and other errands, a blood draw, and now that is going to increase to every two weeks for the next 2 months. I’m going to be poked a lot.
Late afternoon check in call from Gerald; he’s fine.
The total number of robocaller connections: Dec 22=2.

Wednesday, Dec 23

I talked to Nurse Lacey about the things that happened yesterday. Test showed the K level going down. She and (PA) “doc” Chelsea confer and want to keep testing, as mentioned above.
Lacey listened (patiently) while I related my doings. I sat down before supper in my recliner to change my recliner chair’s seat cushion to a smaller level to help raise my height of my feet above my heart. The recliner doesn’t do that, so I tried a pillow and some foam pads. One pad is an egg-carton type on one side and solid on other. I was falling asleep often at the computer laptop from the chair earlier.

So the ramifications of this were that I fell asleep in my chair holding the pillow in the pillowcase. John saw me there, and did nothing when it was time for me to get up and go to supper. I never got out of the chair for supper. I missed any meal. He told me at some point I needed to wake and get up to go to bed. I acknowledged his comment, but did not. I awoke, still sitting in the chair with the pillow & pillow case in my lap, uncompleted. I finally, finished it, reconstructed my pillows, and covers, turned up the heater in the house, and went back to sleep (with my feet up). I awoke a time or two during the night to go ‘pee’, and went back to recliner bed, (next to my ICD reader for 2:00 a.m. every morning.
I woke again at 4:50 a.m. and took my 2 Acetaminophen tabs, pee’d, and lay back down until got up at daylight.
That was a long (very interrupted) sleeping situation last night again.
Now I have to take my morning pills, I had not yet taken with my meal. Took them, but have a question. 2:23 pm.

Still having swelling in my legs and feet. Yesterday when putting on my leather walking shoes to go for the blood draws, I had trouble tying the shoestrings to close & had to do with a small “bow” tie on top, with thin socks. Do I want to alternate Furosemide days yet? Or go back to daily until this swelling is gone? The doctor decided against that.

I have adjusted to putting a pillow on the end of my recliner because just putting the swelled legs down on the recliner HURTS them way too much. The pillow is difficult to manipulate from the table to my right, but I can manage the pillow while using my laptop not to have the severe pain pressure without the pillow. There is still some pain from the swelling in the legs on the pillow.

{A COSTCO book arrived with an ad for the sort of chair that might work – gets feet higher. John tried to find it on the company’s web site, and found nothing. Odd.]

However, Chelsea needs to know I still am having slight instability, most recently at the Medical Arts blood lab yesterday where the better K test was performed. I’ve still some, difficulty moving around the house, some painful muscle movements today, changed from the leather shoes today and now using an open non-lased shoe for walking.

John went out to move some logs but skipped that, and rebuilt a fence near the pasture. Now shorter, better, and looks less hillbilly-like.

Tonight is the first of putting softening drops in John’s ears — to be cleaned out next Wednesday at the Cle Elum Clinic. We are using a form of Carbamide Peroxide that is supposed to add Oxygen to the wax (Cerumen from Latin), and cause it to soften. Some studies have fund little evidence of prior treatment being effective. A few years ago the nurse used hot water in a large syringe – think turkey baster.

Late, but I finally sent Thank-Yous to the folks whose photos I used last time. I must do a better job this week!

I filled in all my medications in my case for the entire week.

Supper: Cornbread with maple syrup; Progresso Soup with chicken, extra cooked chicken breast meat added, carrots, tomatoes, and wild rice, plus Cheez*its crackers for me. For dessert, we each had a piece of heated Apple Pie with Winegar’s special homemade ice cream from Ellensburg, flavor: Kookie Kayla – a Vanilla base with Peanut butter, sea salt cookie and fudge swirl, piled beside it. Kayla is part of the Winegar clan, and clerks at the ice cream counter, thusly explained “her flavor” to me as I shopped for quarts of it.

Number of robocaller connections for Dec 23=1.

Thursday, Dec 24

The Senior Center folks sent a new Zoom link, prior to GAME Day at AAC noon. However, I missed it today. Not enough time.
John will go to White Heron next Tuesday, not today as originally planned in last week’s blog, with a pickup load of horse manure for the Mariposa Vineyard vines. The delay is because the Seattle caretakers of Panic2020 closures, quarantine, and mis-information decided Pike Place Market could open some of the shops, with restrictions. So Cameron is going there to make some sales: Northwest Tastings
Today: 5:25: message to Lacey at portal at KVH medical in Cle Elum . . . long quote . . .
“I have had the going to sleep problem since the Potassium spiked, and then continued after it spiked back down, and just confirmed with John that is correct. Today was another sleeping day, when he saw me sitting in my recliner, feet on pillow on raised base of chair, laptop in lap, cell phone turned on in my lap, and computer and I was asleep for 1/2 hour. I was asleep again, when you called the last time to tell me to check the account for the 11:05 notice, that I never saw because I was expecting a telephone call to tell me around 10:00 that River had proceeded in telling you how to get a me to through getting a message back to your email domain, which we still cannot do, because you do not have one in the system.
Yes, this whole process is confusing, and not what I expected. But, I can deal with it this way. Just will not have any contact with anyone there over the weekend, by email.
Thanks for all you have done with what you have access to with the portal and teaching me how to use it for messaging. It’s timing me out now. I’ll sign off. Nancy” …end quote
On another front, regarding the blender: . . . long quote
“I’m sorry, I never got back to respond to this, because when I went to the lab for the blood draw I had such a problematic result that we have been going back and forth to the lab and the doctor and the portal to pass information about my medication condition for which I needed the blender. The condition: extremely high spike of my potassium in my blood for (still this afternoon) unknown reasons. We’re keeping attention to effects over the weekend. I confused the issue by using the words that were “translated” that the blender was broken into pieces. That was not the case. They were only separated, but we had not yet reassembled them & finally did just now, assemble, turn on, and it works fine, even has a smoothie button. We’ve been consumed by the other concerns for the reason as late as 5:30 p.m. today, talking to my doctor in Cle Elum. Thank you for the gift, and thank for the delivery. Now if someone will just fix my medical condition, that would be a nice Christmas present.” . . . end quote

Supper: Chicken thigh roasted, baked apples, potatoes & with gravy.
Fun 53-minute phone call late (for her) with sister Peggy in Parma, OH, about much fun history in the family while they lived in Clarion, PA. She’s beginning to get snow, and may be snowed out of getting her driveway tomorrow, possibly by a foot. She’s supposed to go to church at 9:30 a.m. – does have a snow blower.

The total number of robocaller connections for Dec 24=0.

Friday, Nov Dec 25

First, early morning sunrise from the Kittitas Valley looking across to Badger Pocket, photographed early by Sid Peterson. Badger Pocket (or The Pocket) is a farming and ranch area to the southeast of EBRG. It is shaped like an arrowhead pointing in that direction and runs up to the Army’s Yakima Training Center.
The lower photo is by Cindi Crawford Ackerman from the Thorp Highway, to our southwest.

Tree Bottles, and Merry Christmas wish !Area Code 273 is Mexico, can you read words under the number behind the tree? Another possible Area Code is 473 is New Zealand. Not sure where this is located, but it’s neat.
Interesting cultural cuisine.

Left, sent from friend Kathy William-DeVries in Queensland, Australia is a photo of the traditional seafood lunch (contents: Prawns, oysters, smoked salmon and Moreton Bay Bugs.

Our Christmas dinner on the right was Broiled Salmon Fillet, a potato pancake, baked apples & pears. Blueberry Cheesecake Ice Cream for dessert.

Photo by Christopher Cyrus Peterson at Bar 14 Ranch, 12-25-20
Location is 1.25 miles south of us on Naneum Fan, but another of the distributaries, yet right on the premises of Bar 14 Ranch.

Saturday, Dec 26

Cannot stay awake.
Warm coffee, and go pee, be sure I took diuretic (I did).
We both slept in this morning, John a little longer than I because I had a more interrupted sleep last night caused by a dream/nightmare.
I was waiting to take my pill at the normal time 11:05. My increase potassium in my bloodstream was responsible. It had been putting me to sleep all day, as I sat at my computer trying to work. I had the dream I was talking with a Doctor friend in Kittitas, WA, and she was suggesting I do it now. I dreamed I did, but I did not; instead I fell asleep in my chair, without my legs up on pillows, or blankets on, and no neck pillow on. The dog walked in at 12:13 and awoke me. Then I got up and went to bed, and put my computer away.
Brunch: John has gone out for a half hour to push-broom snow , feed birds, and horses. For lunch he’s going to make a grilled cheese sandwich for me, with a glass of Strawberry-Lemonade PowerAde. Left-overs for him: broiled Salmon from last night in some Progresso soup and heated up, with Corn Chips.
For an afternoon snack, John made some fudge brownies & added roasted walnuts.
Supper: There is some Broiled Salmon Fillet left for my supper tonight to have along with baked apples, and John added a half of a heated baked potato we cut and put Bleu Cheese dressing on.

The total number of robocaller connections for Dec 26=0.

Sunday, Dec 27

We’ve gotten a little snow this week – 5 inches maybe.Photo by David Standish – Sunrise 12-27-20 from Bowers Road
This is looking SE from where the road crosses an irrigation canal.

Slept in. Potassium or something still bothering me. Tuesday, I’m being re-tested for two different things. I hope I can make it as I have to drive myself. Previously mentioned is John’s manure delivery trip.
Last fall, I would have been involved in a Nick from Home Lecture and operating at full capacity.

One of the mid-morning tasks I had to do this morning was send a PDF file to all in the study group. I’m trying to get a way for members to enlarge images (pdf and jpgs) to get an enlarged font, making the words readable. I think this was successful, but it was also time-consuming. I’ve since sending, many thank you notes, so I must be functioning OK to some degree.

Everything quit working on my laptop, so I finally had to completely restart the computer. At least it fixed it but required a lot of rebuilding things I’m still doing.

Brunch: Strawberries and maple syrup on blueberry pancake, with bacon, my beverage was strawberry-lemonade PowerAde.

Afternoon filled with many inside and outside chores, and I worked almost solely on the blog creation to get posted late tonight.

Supper: Baked Chicken leg/thigh, mushroom gravy, mashed potatoes, and cinnamon with brown sugar on baked pears/apples.

The total number of robocaller connections for Dec 27=0.

Hope your week was fine.

Nancy and John
Still on the Naneum Fan

Mother’s Day Delay

We expect Nancy’s words of wisdom will get edited and posted sometime Monday evening — Pacific Time.
Workers will be arriving early here on the Fan, and I have to have the gate open at 7 A.M.
Sweet dreams.
John