I came across this link the other day, to an article aimed at the “sandwich generation” (people “sandwiched” between the needs of kids and the needs of aging parents).  It’s a list of questions you should ask your parents, regarding their health/medical care.

I thought it was valuable; perhaps it will prompt some important conversations.

This article has us a little concerned.  It says you should never let your medications get hot.

Um, ours come in the mail–in North Carolina.  It gets mighty hot in our black mailbox, with the summer sun beating down.  And insurance companies are beginning to require the use of mail-order prescription services like Medco.

(Of course, when Lee read the article last week, I posed a broader question:  even if we get our prescriptions filled at the local pharmacy, how do we know the medications were kept cool en route to the drugstore?  It’s all quite troubling.)

Hey!  How was your weekend?

Ours started off with a bang.  Lee got up Friday morning and announced he was having chest pain.

To make a long story short, I took him to the emergency room at Duke Hospital.  They kept him for about 30 hours (till almost dinnertime on Saturday), then sent him home.  Diagnosis:  reflux.

Reflux?  Yay!  We can handle a little misdirected stomach acid.

All in all, it was sort of a non-event (which is a Good Thing, because it started off seeming like it might be a Bad Thing).  It was really mostly a very long, drawn-out doctor’s appointment, with unattractive fashion options.

We did come away from the experience with some useful insights into the emergency room/hospitalization experience, which I will now share, just in case (heaven forbid) you ever need such advice.

–If you’re having an actual emergency, for which you might need speedy care, call 911.  With so much of the population uninsured these days, emergency rooms seem to function primarily as urgent care clinics.  If you drive yourself, you’ll have to wait forever to be seen.  I did drive Lee, but luckily he had the presence of mind to call his cardiologist on the way, so he was moved into triage very quickly–AFTER he waited in the check-in line.  The only way to avoid that line is to come in on an ambulance.

–If you go in with chest pain, you will be there overnight.  Take plenty of entertainment; there’s a lot of waiting that goes on in a hospital.

–Don’t expect to get much sleep, especially at night.  Hospitals are not restful places.

–If you’re going to be unconscious or heavily medicated, you should probably have some sort of support person who can talk to the doctors and make sure things are going smoothly (because, as far as we can tell, things rarely do).  But because Lee was fine (once he knew he wasn’t having a heart attack) and mostly just waiting, he didn’t particularly want company.  He was in a tiny room, contentedly reading his book and surfing the interwebz.  Visitors, given the short duration of his stay, would not have been helpful.

–If you are going to drive to the hospital, try to think clearly about what you need to take with you.  We both, independently, thought about throwing the defibrillator into the car, just in case.  We both, independently, forgot to do so.  Good thing we didn’t need it.

–Skype is extraordinarily useful, and goes a long way toward calming melodramatic teens.

–As is so often true in life, your experience will be much more pleasant if you befriend the people around you.  Lee had a grand time–I suspect those nurses will remember him for quite a while!

I have a deep-seated phobia of eye problems.  I think it started when I was in high school; my mother and my grandmother both had fairly complicated eye problems in those years, and I got stuck helping them both with their home care. It was kind of traumatic, and I’ve never quite gotten over it.  Now when I have to listen to a friend or acquaintance (or health reporter, or spouse) describe something like Lasik, or the treatment for a detached retina, I kind of freak out.  Eye problems make me feel sick to my stomach.

Ironically, I have dreadful eyesight, and have worn glasses and/or contacts since those same high school years.  So I’m weirdly comfortable with touching my own eyeballs–but I really, really hate it when anyone else touches them.

Especially the eye doctor.

So getting my annual eye exam (especially that horrible glaucoma test–*shudder*) is always a challenge*.  I put it off, and put it off, ignoring the reminders and phone calls, until finally I run out of contacts and my prescription expires.  With a stomach full of dread, I go for my appointment, and the rest of the day is a complete loss.  I manage to get myself home in one piece (always a challenge with dilated eyes), and then I lie around moaning for the rest of the day.  No reading, no computer, no knitting, no bright lights, and a brutal headache.  I’d vastly prefer a mammogram.

Anyway, last week, when this year’s appointment rolled around, I started wondering about something.  No doctor has ever asked me about my eye exams.  I’ve always gotten them, because of being blind as a bat.  But it’s not like my internist is reminding me to go get my eyes checked.  On the rare occasion that I go for a general physical, they always ask if I’m getting annual pap smears.  And I actually like having shiny clean teeth, so I’m motivated to go to the dentist.  But if I were lucky enough to have good vision, would anyone be paying attention to my eyes?

I checked in with a couple of folks whom I know to have good vision, asking them how often they get their eyes dilated.

Never.

Um, seriously??  I decided that maybe all this dilation business is a scam, and made up my mind to get to the bottom of it.**

So I go for my appointment.  The tech checks my vision, does the glaucoma test, and goes to put the dilating drops in my eyes.  I pose my question.  She flips out a little, and rants at me about how I have to have my eyes dilated because the doctor needs to be able to see the backs of my eyes to tell if I have high blood pressure (um, maybe they should just get a blood pressure cuff) or if I’ve had a stroke (I’m thinking my annual eye exam is not going to be the first indicator).  She seemed really wound up about it, so I just decided to behave and let her put the drops in.

Finally, after the agony of having my pupils chemically wrenched open in a not-nearly-dim-enough waiting room (where I waited for a long, miserable HOUR), I got my 3 minutes with the doctor.  So I asked him.

Turns out every other year would be just fine.  He’s totally comfortable with that.  Wow.  And why, exactly, has no one mentioned this before now?

He then went on to explain why they dilate eyes–so they can see into the corners–and what they’re looking for.  Apparently, wide-open pupils allow them to see early signs of a torn or detached retina.

Which, it turns out, is a thing I really, REALLY don’t want.  It’s way worse than having your eyes dilated.

The take-away lesson here is this:  eye doctors (real eye doctors–ophthalmologists) know way more about eyeballs than I do.  I should let them look at (and in) my eyes every year, so that they can (hopefully) catch the small problems before they turn into big problems.  *Sigh*  I guess I’ll go ahead and schedule next year’s appointment . . .

*Remember that machine that blew a puff of air into your eye?  They don’t use that any more.  Now they numb your eyeball, then touch it with a blue light.  The only problem with this system:  the first time they gave me the numbing agent, I had a tachycardia episode (whether it was a reaction to the drug, or just a panic response to not being able to feel my eyes, I don’t know, and frankly I don’t care.  It was awful, so they don’t numb me anymore, which makes things . . . complicated).

**Did you know that there is a drop they can use to reverse the dilation?  They never tell you it’s available, so no one knows it’s an option.  So my eye doctor stopped stocking it, because no one ever asked for it.  Does anyone else see the giant failure of logic here?

Here’s something cool:  an iPhone app that will analyze your moles and tell you if you ought to go to a dermatologist.

An article about the app, called Skin Scan, is here.

I bought it, partly because I’m just fascinated by the technology, but also partly because I have a couple of spots that I want to test it out on.  I just haven’t thought to do it during daylight yet (and it seems like the photography aspect of the thing might work better in natural light).

Lee, of course, tried it immediately.  He’s had a whole bunch of skin cancers removed, so it would be great to be able to check some things out in between mole-checks at the dermatologist.  Unfortunately, it doesn’t work on him.  He’s too hairy (not kidding).

(One would assume, of course, that it will always err on the side of caution, and recommend a doctor visit for anything remotely suspicious.  That remains to be seen–as soon as I remember to try it out.)

I did the most awesome-sauce thing on Tuesday.

I got a cortisone shot in my hip.

It was awesome-sauce for two reasons:

1) Cortisone shots are my new best friend.  I’m having a tiny little bursitis problem (gah–that makes me sound decrepit, which I am distinctly NOT), and ten days of NSAIDs did absolutely no good, so this was the next step.  I was a little nervous about it (Lee’s fault–he had a cortisone shot in his ankle once, and said it hurt like nobody’s business).  It was kind of intense, because it took a good thirty seconds or so, but it didn’t really hurt at all, so that was good.  Best of all–my hip is so much better.  I didn’t whine about it a single time yesterday.  Awesome.*

2) I used Duke Health’s new online check-in system–I’ve been secretly looking for an opportunity to try it.  This is truly awesome-sauce.  We’ve been going to Duke for almost all of our medical stuff for years now, and the only complaint I’ve ever had is the inefficiency of checking in.  It always involves standing in a long line, waiting forever, and having to pay prior to the appointment.  All of which is probably fine for normal, punctual people, but I’m not in that category.  I’m more in the I-was-on-time-till-I-had-to-wait-in-that-stupid-long-line category.

So when I got the reminder email about my appointment, I clicked on the “check in now” link, and bing-bang-boom!  I did all the paperwork/paying/standing in line stuff from the comfort of my own kitchen.  The system shot back a confirmation email, with a barcode, that I could use to sign in at a special kiosk (really just a tablet on the wall) when I got there.  I was hoping the kiosk would be able to read the barcode on my iPhone (because that would’ve made me feel uber-cool and technologically sophisticated), but it couldn’t.  Luckily I’d had the good sense to print the email before I left home, just in case.

The whole process took about two minutes at home, then about twenty seconds in the waiting room, leaving me plenty of time to have a small panic attack in anticipation of the dreaded injection in my hip.

Awesome-sauce.

*The only fly in the ointment:  the doctor said I should take a week off running, just to be sure the bursa settles down.  He clearly doesn’t have to live with me.

Lee is having eye problems.  Poor Lee.

His eyes were irritated and uncomfortable, so he went to the eye doctor.  The doctor gave him some drops and said come back in a couple of months.  So that’s what he did.

Fast forward to the follow-up appointment:  the doctor is a bit horrified by the condition of Lee’s eyes.  He mentions, helpfully, that they look really irritated.  Lee is not especially comforted by this.  The doctor gives him some more drops, and says to come back if they get worse.

Lee makes an appointment with another doctor (at Duke, where the smart people all seem to be).

The new doctor takes one look, rolls up his sleeves, and gets serious about solving the problem.  First he puts plugs in the tear ducts in both eyes (at the first appointment, mind you).  Instant relief.  Then he outlines a treatment regimen that includes hot compresses and some thick, sticky drops that will really lube things up.

Lee is much happier.  This means that I am much happier.  It also means that I am switching over to the new eye doctor.

I had one of those conversations with my kids on Saturday.  You know, the ones you know you ought to have, but never quite work up the nerve for?

This one was about death, the process of dying, and my wishes for my end-of-life care.

Yep.  The whole nine yards.

They already knew that I want to be cremated; I’ve been very clear about that all their lives.  But we got into the nitty-gritty of life support, and DNR orders, and pulling the plug, and how Lee and I would want them to make those decisions, when the time comes.

I think it helped that we had the conversation a) when it came up, not at some random time that I designated, and b) now, when we’re (relatively) young and healthy, with no major health issues looming.

Interestingly, the thing that seemed to sink in the most was when they started to snipe at each other (because that’s what they do), and I interrupted them, saying that they’d better remember that one day, they’ll be making this decision together.

We’ll revisit the topic, of course–it’s not something you just mention once, then ignore.  But at least it’s on the table now, and not some scary, morbid elephant-in-the-room that no one’s willing to talk about.

Another interesting tidbit:  I tweeted about our conversation on Saturday, and was surprised at the number of responses I got.  I had no idea it would strike such a chord.  One guy I chat with regularly said he had recently seen a statistic that said 67% of men are too uncomfortable to discuss life insurance with their SPOUSE.

Wow.  People:  if you have an opinion about how you want your last days to be, you need to have these conversations with your family.  Chances are good that they’ll be calling the shots.

Confession:  we have a cabinet full of unused medications.  I’m kind of compulsive about not wanting drugs to end up in either the water supply or the landfill, so I’m always at a loss as to how to get rid of things we’re not going to use.  And I’m not happy having it in my house–we have teenagers (they’re generally well-behaved, but still), and small nieces and nephews–no sense tempting fate.

We have expired prescriptions, leftover stimulants from a (wildly unsuccessful) experiment with Toby’s attention span, birth control pills that I stopped using when I stopped randonneuring, OTC stuff that’s just been hanging around for too long . . .

And I keep coming up against these bottles and boxes and blister-packs in my big stuff-purge, and not knowing how to get rid of them.

Problem solved.  I heard a blurb on the radio this morning about something called Operation Medicine Drop.  The North Carolina event runs from March 20th-26th.  Collection sites will be set up around the state; we can drop off expired/unwanted medications and they’ll be disposed of safely.

Click here to find a location near you.  Then go clean out your medicine cabinet.

My friend Alane did an interview with MSNBC recently about her experience with a scarred heart valve and congestive heart failure.  I’m sooo proud of her.  Her heart disease has had a profound impact on her life  (you can read more about it on her blog; see the post called “My Cupcake Heart”), but she refuses to be defined by it.

We don’t talk enough about heart disease and women.  For a lot of us, it’s hard to admit we’re not perfect, or we don’t have it all under control, or, ultimately, that we’re mortal.  Kudos to Alane for speaking up.