1/30/24

 Tuesday, January 30, 2024

In bed at 10:40, awake and up at 5:25.  36°, high of 37°, cloudy all day,  Wind NW a 10 mph, 6-11/18. Sunrise 7:09, sunset 5:00, 9+51.     

Treadmill; pain.  Normal waking-up pains: back, shoulder, wrist.  7:30 p.m., 20:00 & 0.41, while watching the concluding half of Chris Hedges' speech to a Muslim audience, 'The Death of Israel.'   

 I'm grateful for the Veteran's Administration.  This morning's WaPo has an article by Linda Searing entitled "Seniors spend the equivalent of 3 weeks a year on health care, study says: About 11 percent of people over 65 spend 50 or more days each year (nearly one day a week) obtaining routine health care"  I wondered what my statistics are for last year, 2023.   I had 53 engagements with the VA Medical Center, a tad more than one each week on average.  Some of them are arguably net medical, i.e., 4 or 4 podiatry visits for a pedicure.  Some of them were video appointment with my personal diabetes pharmacist who transitioned me away from Metformin, on to Jardiance/empagliflozin, and increased my Trulicity dosage for 1.5 mg. weekly to 4.5 mg.  Some were video meetings with my 'health coach' who provided advice about yoga, tai chi, meditation, acupuncture, etc.  Others required many hours, e.g., my visit to the ER in severe IC pain, my 'double dip' endoscopy & colonoscopy.  Others required at least, on average, 3 hours, counting travel time, wait time, and treatment/examination time, like visits to the Eye Clinic, the Physical Therapy Clinic, Urology Clinic, and semi-annual check-ups with my Primary Care physician.  Of the total 53 appointments, 40 required a trip to the VA Medical Center.The study also found that about 11 percent of people 65 and over spend even more time — 50 or more days each year (nearly one day a week) — obtaining routine health care away from home. The research was based on Medicare data from a nationally representative sample of 6,619 people 65 and older.  So the average for folks 65 and over is 21 days a week, actually only 17 days, the other 4 were for ER visits, nursing homes, etc.  My stats include 40 days (subtrackting the podiatry visits, 36 days) physically present at the VA, only one at the ER. That comes out to about 3 on-site visits every two weeks.   Add to that about 13 video visits.  It looks like I'm a rate-buster.  I am mindful of how fortunate I am to be enrolled in the VA health program.  What is the cost of all the medical assistance I receive at no cost from the VA?  I'm sure it is tens of thousands of dollars, especially when the cost of my medications are added to the total.  It's not entirely accurate to say that I receive the medical care and medications at no cost.  The VA charges my Medicare account, my Medicare Supplement insurer, and my Medicare Part D prescription drug insurer for my care and I am responsible for those insurance premiums, but I pay no deductibles or co-pays. (I've lost control over the font color and underscoring.  Rats!)

Decision on Lilly's 'miracle' arthritis injection.  After a little research on line about Librela and reviewing my notes on her behavior after receiving the first injection, the decision not to take her in for a second shot was clear:

LILLY AND LIBRELA

• From DOGS NATURALLY:   Librela (Beransa) – Wonder Drug Or Disaster In The Making? BY Dr Edward Bassingthwaighte 

• Last Updated: October 31, 2023

Other owners (in the Librela Experiences Facebook group) report much more serious adverse effects, including …

• Lethargy

• Drooling, shaking

• Change in behavior, acting scared, hiding

• Urinary incontinence

• Refusing food or water

• Diarrhea, vomiting

• Ataxia, staggering, falling over

• Hind end weakness, unable to get up

• Kidney or liver damage

• Seizures (new or increased)

Saturday, December 30, 2023 – daily journal entry

“In bed before 10, awake and up at 11 with Lilly in the bedroom with me, terribly agitated, pacing, heavy breathing, lying down and immediately getting up, moving to another spot, repeating the behavior.  I let her out but the behavior continued when she came in.  I stayed in the TV room until 2, mainly listening to her pacing which sounded clumsy.  Up around 8 wondering whether she may have been suffering a stroke and was dead, but she was like her old self, took a long walk around the property, came in for her treat and a long drink of water, and laid down.  Was it all the vaccines she received yesterday?”

Monday, January 1, 2024 – daily journal entry

“Lilly distressed?  6:20 a.m.  Something is wrong with Lilly.  She noisily clomped or stomped into the TV room from the living room, stood by my chair, walked backward a couple of steps and a couple of times, and then plopped heavily onto his mattress, not in her customary location, but rather on the very edge, leaning against the book cabinet, with her left front leg off the mattress.  Something is not right.  She lays her head down for a minute or two but then raises it again, unable to rest.  After some time, she fell asleep.  At 7:15, she got up and stretched and lay down in her favorite spot, on the carpet but abutting her mattress.  Crisis over?

    No.  At about 3:15 this afternoon, she had a similar distressing experience.  I let her out and she lay on the cold ground for 11 or 12 minutes before I lured her back inside with treats.  Something is definitely not right with her.  Back to the vet? “

Wednesday, January 3, 2024 – journal entry

“Lilly distressed.  Geri returned from the groomer's with Lilly in rough shape, her rear legs very weak.  We had to lift ther out out the Honda.  Grim.  Heartbreaking.”

Thursday, January 4, 2024 – journal entry

“Callback from the vet re: Lilly.  He says it looks like she injured her knee, which could have happened when we struggled to help her into the back of the Honda to go to the groomer's shop yesterday.  But that doesn't address the distress I witnessed and recorded in this journal a few days ago.”

Tuesday, January 9, 2024 – journal entry

“Lilly is having trouble with a lack of strength and control in her hind legs.  Very worrisome.”

Sunday, January 14, 2024 – journal entry

‘Another Lilly scare.  I got up to go to bed at 9 last night but Geri called to me that Lilly was in trouble again, couldn't stand up, again, and appeared to be in pain.  She called David who came over to help get her into a car to take to the Blue Pearl Pet Hospital.  By the time David arrived, she was on her feet and walking, even wagging her tail.  She went outside twice, the first time to no avail.  We are facing the grim reality with her.  We are probably unable to lift her or get her into or out of a car to take her to the vet's office or hospital.  Geri gets down on the floor and comforts her.  If I get on the floor, it's a struggle to get up.  I still call Lilly "Puppy" but she is 14 years, 3 months, and 1 week old.

She has been lying on the floor of the living room since I got up an hour and a half ago.  Ordinarily, she gets up when I get up and goes out to relieve herself.  Should I wake her up or let her sleep?  If I wake her up and she can't stand, what do I do?  I'll get dressed to be ready to take her to the emergency hospital if necessary. . . I just noticed she has an open sore on her left front elbow.  Is this from her struggles to stand up?”

Wednesday, January 17, 2024 – journal entry

“Took Lilly to the vet.  Slow proprioception, degenerative something or other, age-related.  Callous on her right elbow, needs lanolin to protect it from infection.”

Friday, January 19, 2024 – journal entry

“Lilly has been sprightly today,  but she stumbles when turning around.  Proprioception?”