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Wednesday, March 25, 2026

3/25/2026

 Wednesday, March 25, 2026

1954 Pope Pius XII's encyclical "Sacra virginitas" (On consecrated virginity)

2024 UN Special Rapporteur said there are “reasonable grounds” to believe Israel is committing genocide against Palestinians in Gaza in a report "Anatomy of a Genocide."

In bed around 8:30, half awake from 5:15 till 5:40, when I got up for the weigh-in,     140/71/33 100 207.2. 36/30/63/35

Morning meds at. 7:00 a.m.  Ranolazine at 6:00 a.m. and 5:45. p.m.  

Symptoms:  Yesterday, a lot of lightheadedness, using the rollator a lot.

Today, Very tired this morning, even after a decent night's sleep last night. Also, slight lightheadedness in the morning, not as bad as yesterday afternoon.  The dizzies got more significant later in the morning, only when standing, not when sitting.  Still with me in the afternoon.

The botched discharge process at the hospital and change of medications, on top of the 5 days of hospitalization, has shaken my heretofore confidence in the VA's medical care.  I've done more research about congestive heart failure, arrythmias, PVCs, bradycardia, and treatment options and think my conditions with all of those condtions is more serious than I had thought.  The problem of lightheadedness is my major concern.  It sounds like not much of a problem, but it invovles a substantially greater risk of falling down, which means risk of breaking a hip, e.g., or of hitting my head and experiencing a brain bleed.  These are potential life-altering events.  The lightheadedness is a common side effect of the Ranolazine medication I'm on and I'm surprised I've received no counseling about this, either at the hospital or otherwise.  On a relateed manner, I note that I am increasingly aware of the fact that, were it not for Geri being here with me, I'd be in an assisted living faciltiy, or at least a congregate "independent living" facility for the aged.  My major accomplishment today was taking two trips to the bird feeders to refill the tube feeder and the tray feeders.  I want to add another one or two seedcakes to that feeder as well, but all I could handle this afternoon was the two short walks from the garage where I keep my stock of birdseed to the front of the house where the feeders are.  I thought I had "lost a step" after the week of hospitalization last September/October, but I'm worse after the latest hospitalization.  I'm increasingly useless.  It would be prudent to sell our house and move into an apartment or condo (or some 'facility'), but Geri's not ready for that and I hate the thought.  Just dealing with the process of prepping the place for a move would be daunting.  Geri would have to handle almost everything, and she's just a few weeks away from her 82nd birthday (and her new knee has been giving her problems lately.).  Much to consider.

From 3 years ago today:

Finished reading Gilead: "While I am thinking about it - when you are an old man like I am, you might think of writing some sort of account of yourself, as I am doing.  In my experience of it, age has a tendency to make one's sense of oneself harder to maintain, less robust in some way."  John Ames' frequent description of himself as old and tired, the metaphor being "ember," dull and gray but with an internal heat and fire, ready to be refulgent again when the Lord breathes life on it.  I was struck by "one's sense of oneself [being] harder to maintain," how true that seems of old age, the age with little new except daily diminishment, little to look forward to but more diminishment, but filled with so many old memories, 80+ years of memories.  The good ones fade away, the regretful ones linger and haunt.  The good ones are almost all of the goodness of others - mother, sister, Uncle Jim, Aunt Monica, Brother Coogan, Wally Halperin, Johnny Flynn, Troy Major, Father Matthew, so many nurse-nuns - while the regretful ones are of my own failings, ingratitude, cowardice,  selfishness, vanity, pettiness, indifference.  It's curious that Marilynne Robinson named her fictional town "Gilead."  I suppose  she intended her novel to be healing, affirming.  "There is a balm in Gilead / To make the wounded whole / There is a balm in Gilea / .To heal the sin-sick soul. / Sometimes I feel discouraged / And deep I feel the pain / In prayers the holy spirit / Revives my soul again"  For those without the faith of a John Ames or Marilynne Robinson, hope comes harder.

From 2 years ago today, when I was in really bad shape with undiagnosed and untreated polymyalgia rheumatica and kvetching about it:

I'm losing the physical and mental energy to write.   I suspect I may abandon this journalling project one of these days.⁺⁺ I've never been entirely sure why I do it in the first place except perhaps that I have no attractive alternative, certainly not watching television.  Reading is increasingly difficult for me except on a Kindle or on my laptop with its ability to enlarge fonts.  There's certainly enough wretchedly bad news to read about, to think about, and to write about but I haven't much energy.  I am bowled over by how seemingly fast I have gone downhill with these chronic pain problems, with the interstitial cystitis assortment of pains lasting about a year and a half (?) only to be resolved by surgery and replaced by rotator cuff and various arthritis pains, all debilitating and at least semi-crippling.  At least as distressing as the physical pain is the cognitive decline that has accompanied it.  It's very noticeable to me, both in terms of executive function and in terms of increasing short-term memory problems and confusion.

About one month later, I stopped writing in these notes for about 16 days.  With the PMR, it was too painful to hold my laptop and type.   On April 26th, I stopped writing until May 13th, when I was finally diagnosed with PMR and put on prednisone.  Daily and nightly thoughts of suicide, similar period to when I was beset with ulcers in my bladder years before.  


 


Tuesday, March 24, 2026

3/24/2026

Tuesday, March 24, 2026

2019 Attorney General William Barr summarized the report submitted by Special Counsel Robert Mueller (The Mueller Report) in a letter to Congress stating that the "investigation did not establish that members of the Trump Campaign conspired or coordinated with the Russian government in its election interference activities" and "Deputy Attorney General Rod Rosenstein and I have concluded that the evidence developed during the Special Counsel's investigation is not sufficient to establish that the President committed an obstruction-of-justice offense"

2025  A Signal group chat containing many of Trump's cabinet, discussing several topics including potential strikes in Yemen, is discovered after journalist Jeffrey Goldberg is accidentally added to it.

2025  Ninety people are injured, including 17 children, in a Russian missile attack on a hospital, a school, and a residential area in Sumy, Ukraine. 

2025  Greenlandic prime minister Múte Bourup Egede says a planned visit to the island by senior American officials, including National Security Advisor Mike Waltz and Second Lady Usha Vance, is "highly aggressive" and was designed to "demonstrate power over us".

In bed at 9:30 after watching Lawence O'Donnell excoriate Trump (and creepy Scott Bessent) for their comments on Robert Mueller's death, awake and at 2:30 for the daily weigh-in, BP, glucose, do a load of laundry & a load in the dishwasher.

Morning Meds at 5:35 a.m.   Ranolazine at 5:20 a.m. and 5:30 p.m.

Messages to Dr. Singh, NP Angeli, and NP Kisro this morning:

Date: March 24, 2026 at 6:39 a.m. CDT

From: CLAUSEN, CHARLES DENNIS

To: MK Cardiology Team@

Not yet opened by your care team

Attn: Dr. Singh, Arrhythmia cliic.  Further to my last message, I note that my medical record at va.gov (opens in new tab) represents that I received counseling about the discontinuation of Bisopalol and the addition of the new medication of Ranolazine.  The referenced consultation never happened.  Also, the only physician I spoke with during 4 days of hospitalization was Dr. Tsemo, an internist.  I copied pertinent parts of the entry, which follow:

PHARMACY DISCHARGE MEDICATION INSTRUCTIONS [DT]

Date entered: March 23, 2026, 9:21 AM

Location:  MILWAUKEE VAMC

Written by:  NICOLE C ENDRES

Signed by:  NICOLE C ENDRES

Date signed:  March 23, 2026, 10:02 A

Note

    Pharmacy Discharge Medication Instructions:

      Patient is being discharged to home 

      Discharge counseling was provided by the pharmacist. 

      Date of Discharge: Mar 23,2026

      Learning Barriers/Preferences reviewed, remain the same.

     Active Outpatient Medications (including Supplies):

     Outpatient Medications                                        Status 

  Patient was asked about outside prescription medication use, reports taking no outside prescription medications. 

      Patient did not have home medications sent to pharmacy. 

      ASSESSMENT: 

        1. Medication reconciliation was performed and medication 

           consultation was provided to the patient and/or caregiver.

        2. Patient and/or caregiver were given a Patient Medication List  which lists all of the patient's active medications. 

        3. Pharmacist provided education on new medications including indication, dose, directions, administration, side effects, and monitoring. Patient and/or caregiver were given printed patient medication information sheets for all new medications.

        4. Patient and/or caregiver understand how to get medication refills and how to contact the triage nurse or primary careclinic if needed. 

        5. Patient and/or caregiver demonstrate understanding of medications. 

        6. The patient was asked about non-VA medications (both non-prescription (OTC) and prescription medications) and thenon-VA med profile was updated. 

        7. Allergy/ADR information was reviewed with the patient and the patient's profile was updated as appropriate.

8. Patient is aware that one medication(s) are ready for pick up in pharmacy.

        9. Patient did not need or request any additional refills.

 PLAN: 

        1. Medication changes at time of discharge:

        New medications: Ranolazine

        Discontinued medications: Bisoprolol

        Medications with change in directions: None

        Patient did not have any Clinic Medication orders auto-DC on Admission, Discharge, or Transfer that require re-ordering.

I was surprised that I received no counseling about such a significant change in my cardiac medications, no discharge instructions, conflicting information about wearing a Holter monitor, and that I was literally almost out the door of the hospital without the prescribed Ranolazine before that omission was remediated.

Message ID: 8335308608

.....................................................

I received calls from Nurse Michelle in the Congestive Heart Failure clinic before 9 a.m. and from Nurse Kim in the Gold around 10 a.m.   I also got calls from the PT clinic resscheduling my appointment with Deena from today to later, and from the Rheumatology clinic rescheduling my next appointment with Dr. Ryzka.

Ranolazine Symptoms:  (1)  Significant lightheadedness starting this afternoon, while standing and walking.  Usingf the rollator.


Monday, March 23, 2026

3/23/2026

 Monday, March 23, 2026

Day 5 as a guest of the VA

1933 The German Reichstag hastily passed the Enabling Act and President Paul von Hindenburg signed it the same day, granting Adolf Hitler dictatorial powers

2003 In Nasiriyah, Iraq, 11 soldiers and 18 U.S. Marines were killed during the first major conflict of Operation Iraqi Freedom

2010  President Barack Obama signed the Affordable Care Act (ACA), nicknamed 'Obamacare', expanding the availability and affordability of health care insurance

2025. U.S. National Security Advisor Mike Waltz says that the U.S. wants the "full dismantlement" of Iran's nuclear program and that "all options are on the table"

Lights out and in bed around 8:30 and awakened for another round of "vitals" by Nurse Vina at 11:30.  She had flushed my IV shortly before 8:30 so I escaped that early wake-up.  After a pit stop, I returned to bed but couldn't sleep, and I was up and about, in a manner of speaking, at 12:10 a.m.  The photo is the view from my bed, with the telemetry transmitter temporarily out of the pocket of my trou and on my table.  Its other end is attached to 5 or 6 sensors adhered all around my chest monitoring my heart activity.  I had some intestinal pain before I got out of bed, probably (I think) because of some constipation.  Also, both of my feet are still semi-numb and tingly, as they were all day yesterday.  I guess it's from poor blood circulation from everything that's been going on since last Thursday, the meds, lack of mobility and activity, etc. I'll inform the nurse on her next visit.  Meanwhile, at 1 a.m., I'm tired but awake and wondering what to do next.😕.   I'm cold and wearing a folded cotton blanket around my shoulders and arms, like a shawl, and another draped over my lap and legs.  I look like an old guy holding on to life in Bosky Dells Home for Broken-down Old Guys, which I guess I just what I am.😡.  My bladder has evidently been leaking and I've developed some "diaper rash," another old age indignity.  I went back to bed at some point and was awakened twice (I think) for 'vitals' and then again at 5:10 to give me omeprazole and do my weigh-in. 207.8.  This diaper rash situation is what? - miserable, nasty, unopleasant, what's the right word?  I'll have to ask Geri to bring me a supply of underwear and Shields and a tube of Desitin.  This is my 5th day here as an ER/inpatient and, other than my 12 hours in the ER, this is the only day I'm which I'm beginning to feel miserable, not from pain or discernable sickness, but from being confined and semi-bedridden.  Will I be discharged today?  What's going on with my feet?  This pred-dawn kvetch continues with being cold.  I'm in the chair, wrapped up like a mummy.  I downloaded a thermometer app to my phone and it tells me the temperature in this room is 60.8℉.  Yikes.😰

Facebook post this morning:

Today is an historic day.  In 2003 In Nasiriyah, Iraq, 11 soldiers and 18 U.S. Marines were killed during the first major conflict of Operation Iraqi Freedom.  In 2010,  President Barack Obama signed the Affordable Care Act (ACA), nicknamed 'Obamacare', expanding the availability and affordability of health care insurance.  And one year ago, National Security Advisor Mike Waltz said that the U.S. wants the "full dismantlement" of Iran's nuclear program and that "all options are on the table".  The anniversary I'm most focused on today, however, is from 1933, when the German Reichstag hastily passed the Enabling Act and President Paul von Hindenburg signed it the same day, granting Adolf Hitler dictatorial powers.  It took Hitler only 53 days from the time he took office to become a legal dictator, for Germany to morph from Weimar Republic to dictatorship, all done legally.  Hmm . . .

Shared with Your friendsToday is an historic day. In 2003 In Nasiriyah, Iraq, 11 soldiers and 18 U.S. Marines were killed during the first major conflict of Operation Iraqi Freedom. In 2010, President Barack Obama signed the Affordable Care Act (ACA), nicknamed 'Obamacare', expanding the availability and affordability of health care insurance. And one year ago, National Security Advisor Mike Waltz said that the U.S. wants the "full dismantlement" of Iran's nuclear program and that "all options are on the table". The anniversary I'm most focused on today, however, is from 1933, when the German Reichstag hastily passed the Enabling Act and President Paul von Hindenburg signed it the same day, granting Adolf Hitler dictatorial powers. It took Hitler only 53 days from the time he took office to become a legal dictator, for Germany to morph from Weimar Republic to dictatorship, all done legally. Hmm . . .

Free at last, free at last! Doctor Gisaine came in a 11 a.m. and told me that I would be discharged today, maybe by lunchtime. I'll have to wear a Holter monitor for 30 days and I don't know what else. Calloo callay. I need to be back tomorrow for an 11 a.m. appointment with the lymphedema specialist in the Physical Theraphy clinic and on Thursday for a 3 p,m,CT scan of my abdomen in the Radiology clinic. Thursday will also be Opening Day for the Brewers at American Family Stadium.

Secure messages sent to Dr. Singh, NP Angeli, and NP Kisro this afternoon from home.
Date: March 23, 2026 at 4:40 p.m. CDT From: CLAUSEN, CHARLES DENNIS To: MK Cardiology Team@ Not yet opened by your care teamAttn: Dr. Singh  
I was discharged as an inpatient from Zablocki medical center today after a day in the emergency department and 4 days in the hospital for bradycardia, low BP, slow heart rate, lightheadedness, etc., apparently related, at least in part, to the Bisoprolol I had been taking I/a/w instructions. (1) I received a "medication grid" ; (2) a list of future appointments , and (3) a copy of a FINAL DISCHARGE ORDER, entered by Dr. Gislaine Tsemo. I did not receive any specific discharge instructions about what to do upon return home. When Dr. Tsemo visited me this morning, she advised me that I would be advised to wear a Holter Monitor for 30 days, but upon discharge, nothing was said about this, or contained in any discharge instructions. I am confused about whether you or another cardiologist has made a recommendation in this regard. Also, when I left the 7th floor hospital unit, I was not advised to stop taking the Bisoprolol or to start taking Ranolazine, nor did I have any Ranolazine. As I waited at the medical center's East Entrance for my wife to pick me up, Nurse Domenica followed me with an updated medication list removing the Bisoprolol and adding the Ranolazine. When I advised her that I didn't have any Ranolazine, she personally went to the pharmacy and obtained a supply for me. She had been diligent throughout the discharge process in attempting to find out the medication issues and my Holter monitor confusion. I'm wondering whether you or some other appropriate person in Cardiology can clear up the Holter question and whether or not I should be following any other advice in light of the 5 days of hospitalization. Thank you.