2/24/24

 Saturday, February 24, 2024

In bed around 9:30 and then much the same routine as last night, unable to sleep in bed because of persistent pain, moving between the LZB and BCL, difficulty sleeping, up at 5:51.  Let Lilly out into 18°, wind chill 7° morning weather. Wind NNW at 10 mph, 4-16/29. A thin blanket of frozen snow on the ground from yesterday.  Sunrise at 6:36, sunset at 5:34, 10+57.  Solar noon at 12:04, altitude up to 38°.

Three months ago today I last enjoyed coffee in the morning, some Coke or ginger ale during the day, and a glass or two of Zinfandel wine at night because the following day I was in the VA emergency room in intense pain with my rescuers: Andy, the nurses, and Dr. Uilein.  The dreaded diagnosis after a CT scan, blood and urine tests, and other diagnostics: a "flare" of my IC.  Bye, bye, coffee, soda, wine.  Maybe after the upcoming fulguration, I can try these beverages again in moderation.  Maybe not.  I'm better off without all of them.

Treadmill; pain.  I've been avoiding the treadmill because of the pain conditions: shoulder, wrist, low back, and pelvis.  Maybe today . . .  Last night's sleep experience was modestly better than the night before, perhaps because I expected to be spending much of the night on the recliners rather than in bed.  I received a response from Dr. Cheng to my inquiries regarding the shoulder and wrist pains:

1) A hand brace might be helpful. I am going to send you to hand PT as they canshow you some intrinsic hand muscle exercises and also help with picking the proper brace glove.

2) That is correct, your x-ray shows findings that the radiologist read as a prior trapeziectomy but if you had not had a prior hand surgery, that is quite odd. Usually trapeziectomies are performed to help with base of the thumb arthritis (what you have). Your x-ray showed severe degeneration at the base of the thumb. Regardless, your pain is from the degenerative changes at the base of your thumb.

3) Yes, it can be expected that you will have wrist pain to some degree and it may even worsen as degenerative changes worsen. Try out the PT and if it is still bothersome I may send you to orthopedics hand specialists to see what thoughts they have.

4) For the left shoulder pain, I expect that if you are very consistent with the exercises that they give you and do them at home everyday, your shoulder pain will improve to a certain degree and may even resolve. Similar to the above about the wrist, though, we are fighting the natural process of the aging body and degeneration that results. I can perform a cortison injection to bathe around a bursa in the shoulder if you want. This can alleviate the pain symptoms. Downside is that recurrent cortisone/steroid usage is not good for joints and there is some thought it may lead to faster degeneration, but at this point I think symptomatic management so you can perform the exercises is more important. You can try the lidocaine patches around the shoulder, but generally speaking people tend to have more success with the diclofenac gel.

I will put in for the PT hand and let me know about the cortisone injection intothe shoulder.

I'm grateful that I was able to write a memoir about my first 30 or so years of life and that I had and have access to so many other memoirs and other histories of various experiences in my life.  I'm grateful that at some time somehow I came to derive some pleasure or satisfaction from writing, (or is it a need to write?).  When did this occur?  Not in high school or college, for I don't recall ever taking pleasure in writing an academically-required essay or report.  I suspect it started during my last year in the Marines at NAS Willow Grove when I had among my ancillary duties the job of Public Information Officer and I became familiar with Fowler's Modern English Usage, Follett's Modern American Usage, the New York Times Manual of Style and Usage, and a NYT newsletter that collected misusages from the newspaper that got past the copy editors.  After that, I found out in law school that I was pretty good at writing those 3-hour essay exams that were then de rigueur.  On top of that, I was Lead Article Editor and then Editor-in-Chief of the law review and had a job as the editorial assistant for two faculty-edited (really edited by me) commercial law publications.  In the following year, as a new faculty member, I was the Legal Writing professor for about 120 1L law students, a cruel and exploitative assignment but one that made me an expert on how poorly many, perhaps most, college graduates write.  In any case, over those 5 years between 1966 and 1971, I became a frequent and usually careful writer.  And of course as a faculty member and later as a practicing lawyer I did a lot of writing.  I relied on my good friend and law office colleague David Branch to edit some of my work and found out from him that I was (and still am) wordy.  I use too many words to say things that can be said more concisely.  His edits were always correct and useful and I usually accepted them but often opted to stick with my wordy excesses simply because it was the way I expressed myself then and still do, with lots of surplusage.  Plus, in writing these daily journal entries that I know will be read by no one but me, I easily fall into run-on sentences, inappropriate hyphenation and capitalization, misplaced modifiers, and awkward constructions.  David Branch's red pencils would need frequent sharpening editing of my daily musings.

    What prompted these reflections was reading Hillary Kelly's review of the several memoirs of Diana Athill  in the 2/21/2024 New Yorker titled "A Memoirist Who Told Everything and Repented Nothing."  I especially enjoyed this quote about old age from one of Athill's late-life memoirs:

We tend to become convinced that everything is getting worse simply because within our own boundaries things are doing so.  We are becoming less able to do things we would like to do, can hear less, see less, eat less, hurt more, our friends die, we know that we ourselves will soon be dead. . . . It’s not surprising, perhaps, that we easily slide into a general pessimism about life, but it is very boring and it makes dreary last years even drearier.

It made me wonder, only momentarily, whether my "general pessimism about life" is just attributable to my old age rather than to real conditions in the U.S. and in the world.  I don't think so since there appear to be so many much younger people who share my pessimism.