Now is the winter of our viral crud made glorious summer by improving health. This last week has been a bit of a trial. I had last Thursday off and was feeling a bit tired so I went to bed early to wake up to an underwhelming inch and a half of snow on Friday morning. UAB took pity on us and decided we could do our clinical work for the day from home via telehealth. This may be the last time that this is possible. Medicare has been paying for video visits as if they are in person visits under emergency legislation which is set to expire in March unless renewed by congress. Given what I have seen of the new congress and the incoming administration, I doubt prompt attention to the nation’s laws is terribly high up on their list of priorities. It will remove a valuable tool and convenience for frail older people who need a check up but who have a difficult time getting in to the office. (And our house call program has about a nine month waiting list). Of course, I can still do video visits (and likely will as it will be the right thing to do in certain situations). It just means there will be no Medicare reimbursement and the bean counters that run health systems tend to take a very dim view of any activity that does not contribute to the health of the next quarter’s balance sheet.
I was still feeling fatigued so I walked out on the terrace on Friday morning, said something along the line of ‘yep – snow’ and went back inside to get my work done and take a nap. I had nothing specific planned over the weekend so I continued to sleep a lot as I just wasn’t feeling well. I couldn’t put my finger on it. Some body and joint aches but no real respiratory complaints, no fever, no sweats, vital signs all normal other than some mild tachycardia. I decided winter crud viral syndrome. It got worse on Monday and Tuesday. Still no specific symptoms other than fatigue increasing to exhaustion. Those were both fourteen hour days between work and rehearsal but I powered through as I am want to do. Wednesday was excruciating and I finished my work up around 4 PM and came home and fell into bed, too tired to read, write, pay attention to the TV, game, or even sleep. I finally did get to sleep about midnight and when I woke up this morning, success! That feeling that you’ve broken the back on something and your body systems are restoring themselves to normal. I am happy to say that I expect to be fully recovered by the end of the week (when I have to make a stage appearance on Sunday) but that I am continuing to curtail activities so I can sleep as much as possible. I have found that sleep does me much better than all of the various nostrums pushed upon the unwell by consumer culture (although I do have a bit of a fondness for the DayQuil/NyQuil combination).
I don’t know what it was. I was thinking, when I was feeling at my worst yesterday evening, that it was some sort of karmic retribution for my writings and that I had Long Covid without a preceding Covid infection. No. Probably some no name winter virus that my immune system really really didn’t like and which caused a major flare in my prostacyclins, prostaglandins, and interleukins. For anyone who was around me this week, don’t worry too much. The time I would have been infectious was when I was fatigued but not yet symptomatic – Friday, Saturday, and Sunday and I spent most of that time in the condo by myself. The cats might have some concern, but the community at large need not. Speaking of cats, Edward the ghost cat continues his tutelage under Binx in how to be a cat and is much more present, even willing to be in the same room as me for a few minutes. He’s also now vocalizing normally. He wouldn’t utter a sound when he first arrived. I’m taking this as progress.
My original plan for this past weekend was to do a bunch of writing on new book project. That didn’t happen. (Sorry, Steve). I have another long weekend this weekend with minimal things scheduled so maybe I’ll be able to hack out a few essays starting tomorrow now that I’m no longer feeling like I’ve been run over a London bus and dragged through Piccadilly Circus. The next one I’m launching into is on the failure of the health care system to provide even the most basic services to patients and how this relates to the changes wrought by the pandemic – covering such topics as why you can’t get a primary care physician, why when you need to see a doctor, you usually only get a nurse practitioner (nothing against them – I respect the ones I work with a whole lot), why it can take six months or more to get an urgent appointment with a specialist, why treatment plans are often delayed, and why you can’t get your usual medication in a timely fashion at an appropriate price. If anyone would like to chime in below with an anecdote, I’m all ears.
The fractures in the system are not going to get better in the near future. Given the philosophies of the individuals being nominated by the incoming administration to key positions, they will almost certainly get worse. The pandemic is a huge contributor (and one that was not foreseen – although given how the world operates, it should have been anticipated better). Demography is another enormous piece of the puzzle. And that one has been modeled and discussed for half a century without anyone in the US health system being willing to make the adaptations needed as it would bring no short term profits. Other pieces of our socio-political makeup are also involved. So what can we all do to cope with this?
Dr. Duxbury”s Rules for Thriving in a Collapsing Health Care System:
1. Choose your parents carefully. You are what your genes make you.
2. Remember all the things your mother taught you – eat right, go out and get your exercise, not too much TV
3. Don’t fall down. If your balance isn’t what it used to be, admit you’ve hit your patriarch/matriarch stage and get out your staff. Not only will it help you balance, you can use it to wallop those who annoy you.
4. Treat medications with respect. They are controlled doses of poison.
5. Don’t develop too many bad habits. You know what they are. On the other hand, complete abstinence from all of life’s pleasures is also probably not the best idea. Moderation.
6. Health care is a partnership between patient and provider. Find someone who will partner with you. You’re the one who lives in that body and you will always know it better than anyone else ever can.
7. The range of ‘normal’, especially as you get older, is huge. Don’t get fixated on numbers or on what you hear about the experiences of others.
8.More is often not better – not everything needs to be tested, scanned, measured and for gods sake, if one pill is good, four is never a good idea.
9. No one should be making decisions regarding your health other than yourself or your legal representative and your provider. No other decision maker belongs in that room. And don’t insert yourself in other’s decisions
10. Trust to sheer dumb luck.
Maybe I can shorten those down somewhat for another T-shirt… Maybe a ten commandments motif
Life, The Universe, and Everything 