Thursday, November 28, 2019

My knee versus Hapi

What ElizabethAnn saw on a recent trip to the big city

My knee gave out last week. I have a longterm issue with my left knee, stemming from an injury in 1975 now turned arthritic. During the summer the pain gradually increased but I ignored it, figuring it would go away on its own. Not so. Last week it became almost intolerable climbing stairs and then driving my car. Since my car has a standard transmission and clutch and the problem is in my left knee, that proved to be an unfortunate combination. These days they don't make standard transmissions any more but my car is old. I know I have to replace it but was hoping to keep it going at least as long as I have Hapi because it accommodates her quite nicely.

Now it's a race to the finish, my knee versus Hapi. A couple of months ago I would have said my knee was going to last much longer but Hapi has perked up so much with the onset of cold weather that I think she will outlast my knee. With a knee brace and some knee exercises and a slight adjustment of the seat in my car I can get by. I've signed up for physiotherapy as well. We have a free physio clinic in town but of course there is a waitlist for that. I spoke to one of the physiotherapists there and she thought I had a good chance of getting in before Christmas.

One of my dog walking friends at the Reservoir cautioned me against getting knee surgery. She has had numerous surgeries on her knees and back and says that in retrospect she never would have had the knee surgeries; it was a downhill run right from the get-go. The back surgeries are another story, although they were high risk she felt she had no alternative if she wanted to save her mobility for a few more years.

My friend B was checked into the hospital last week by her doctor (good news: B has a doctor now!!). She can't breathe and I guess he was quite horrified by her condition. I went to visit her in the hospital in the next town over and was amazed at her improvement. They had her on an oxygen tank and she was her old self again. Not exactly mobile but in good spirits and joking about everything. I think the nurses were quite enjoying her rough good humour. However she was quite bored and the hospital charged almost fifty dollars a week for watching TV, which is B's main activity during the day. She doesn't read, she rarely knits and she was in a room by herself. So after a few days she checked herself out.

Her son came to drive her home and her breathing problem immediately resumed. I came to visit her a few days later and she was in a far worse mood than she had been before the hospital stay: depressed, angry, spiteful, self-pitying. I commented on how being able to breathe while in the hospital had enormously improved her mood, her son seemed relieved that someone besides himself was telling her that.

B said that she couldn't get an oxygen tank at home until she was assessed and that they wanted to keep her in the hospital for another four days to do the assessment, but she refused to do that because it was too boring. She had been given a bunch of forms by the Housing Authority to get her doctor to sign but he would only sign one of them. She showed me the forms he refused to sign and frankly, I can't say that I blame him. In order to jump the housing waitlist queue she has to prove that she is in dire need and although it is plain as day to anyone familiar with her situation that that is the case, the form is so bureaucratic and convoluted that the doctor would be forced to sign his name to things that he could not prove.

I can certainly understand B's mood in the face of her ill health and all the barriers to getting help, the problem is that she is lashing out at the people who are trying to help her and that is not furthering her cause. But I'd be mad and spiteful in her shoes too.

Another friend suggested that perhaps B would be better off in a nursing home. I am now inclined to agree, but as near as I can tell the process of getting her into one is almost as bad as getting her into decent subsidized housing. Never mind that she will fight tooth and nail against being consigned to a nursing home.

This is all taking a toll on me, I feel quite helpless to do anything for her and visiting her when she is in such a foul mood is not fun at all. Besides her son, I am the only person who sets foot in her apartment, and the main purpose of the visit is for B to feed treats to Hapi. They adore each other. I am thinking that my next visit will be at a time of day when her son is not around and I am going to have a hard talk with her about hospitals and nursing homes. She is very hard on her son but inclined to be gentle with me since I am her only friend now, so I might be able to get through to her if he is not around.

On the positive side of the ledger, I have been invited for Christmas dinner with a bunch of fun people, and am considering joining a committee to bring another refugee family to town. This committee has already successfully settled four Syrian families and is looking to take on a fifth. Apparently there are a million Syrian refugees currently living in Turkey and the Turkish government is looking to send them all back to Syria as soon as their push to end the Syrian war is done. Many Syrians are desperate to get out of Turkey before that happens, they do not think their chances of survival in a war-torn Syria are great. I think that for all our problems one of the big pluses of living in this country is our attitude towards refugees and immigrants. It would be nice to be actively involved in that.

Thursday, November 14, 2019

Sleep

Hapi at the Reservoir after the snow
The cold snap we are having fueled an energy burst in Hapi, she is enjoying the weather a lot. She still limps but it doesn't seem to bother her, we are doing a lot more walking than I thought she was capable of.

I had an appointment with my doctor this week, I was hoping to convince her to give me a prescription for sleeping pills. Not that I want to be on sleeping pills but I don't know what else to do, I've tried everything else. It took six weeks to get the appointment, and then the day prior to the appointment the clinic called me to say the doctor was sick and would I mind rescheduling with a substitute doctor the same day. I didn't know whether that was a good thing or a bad thing but I sure wasn't going to say no.

The substitute doctor was a locum, a young woman who does not have her own practice but just substitutes for other doctors as necessary. She scheduled extra time because she didn't know any of the patients she would be seeing, and it became immediately obvious that she had done her homework. She knew why I was there, my medical history and recent bloodwork results, and was very engaging. I quite enjoyed the meeting with her and she was very informative and helpful.

I asked a question about my hearing. I know it is going and I am trying to put off hearing aids as long as possible. I can hear better if I can clear my Eustachian tubes, but the one on the left is difficult to clear. She said she had the same problem and had been told she should blow balloons. She had never tried it but hoped that I would so she could find out if it really works. She said I could also try decongestants but they don't work well on Eustachian tubes and the side effects are not good.

In the end she gave me the prescription for sleeping pills, saying that my regular doctor was probably going to kill her for that but she wasn't going to be around then so I will have to deal with that in three months time. She also told me that my bloodwork was fine, and not only that but she said that it was reasonable to expect that it would stay that way more or less indefinitely. She saw no warning signs of impending trouble. Of course all that can change on a dime but it's nice to know that for now everything is fine.

Interestingly, doctors (in this province anyway) are being strongly advised not to prescribe sleeping pills to seniors. There is currently no recommended treatment for chronic or longterm insomnia with the exception of cognitive behaviour therapy, which is essentially not available due to lack of certified therapists. But provincial Pharmacare for seniors subsidizes sleeping pills at the highest strengths available (formerly they only subsidized lower strengths). I guess the right hand does not talk to the left hand. Not only did I get my prescription but it cost me less than ten dollars for a three month supply, which is a lot cheaper than any over-the-counter medication.

I spent some time on the internet following up on some of the stuff the locum had referred to. I found an interesting article about a sleep clinic in the UK that apparently is very successful and popular, with a years-long wait list of patients. They do cognitive behaviour therapy for insomnia (CBT-I) and apparently have a 50% cure rate, with around 80% of patients experiencing significant improvement. That means half of patients who come to this clinic are not cured, and 20% see little or no improvement. The head doctor of the clinic is rightly proud of their record, nevertheless he says that doctors should be prescribing sleep medication because chronic insomnia is a severe malady and there are simply not enough therapists to provide CBT-I for everyone who needs it.

Also, not everyone responds to CBT-I. I have read that seniors are less likely to see significant improvement because of age-related changes, although some studies seem to show that seniors are especially benefitted by CBT-I. I tried to do it on my own last winter and had some success, but could not break through a limit of six hours a night. Months of six hours a night left me exhausted. Non-prescription medications—including herbal remedies and cannabis—have been unreliable, ineffective, and/or left me groggy during the day. My one experience of sleeping pills for about one month of daily use a couple of years ago was effective, reliable and did not leave me groggy during the day. But they were hell getting off of when the supply ran out.

I haven't used my new pills yet. The bottle sits in my bedside table drawer, a kind of talisman against sleeplessness.


Sunday, November 10, 2019

Super powers and other odds and ends

You know how some people talk about having a super power? I just realized today that I have one too. Unfortunately I don't have a lot of control over it, it just pops up spontaneously, usually in the middle of the night. Kind of inconvenient but at least it makes being sleepless a little more entertaining. So the super power is a kind of laser-like clarity on any issue I choose to focus it on. When it is happening I think of questions that I have been puzzling over and then shine my laser light on it. Instant clarity! Sometimes I might be wondering what makes someone I know tick, I just shine this light on them and then I know. It is non-judgmental, there is no right or wrong about it or emotional content, just it is what it is.

Last night it kicked in and I focussed it on some emotional stuff I've been dealing with lately. Nothing like lack of sleep to leave you off-balance emotionally. The whole issue was laid out clear as day. What it was I was feeling, where it came from, how I was misdirecting it, what I needed to do about it. I played around with it for awhile, directed it towards some other things on my mind to see if I could get more answers, and then it went away and I went back to sleep. It's a weird super power. But it definitely gave me some clarity.


My new birth certificate finally arrived. It's very odd looking, everyone I have shown it to agrees with me on that. It is so thin and light (I think it is made of the same plastic that they make dollar bills from now) that I almost threw it out with the envelope it came in. I was expecting a little plasticized card and there was none in the envelope. First I pulled out a blank sheet of paper and stared at it, then I looked into the envelope and thought I saw some writing inside the envelope. Sure enough there was this really thin piece of plastic in there that was my birth certifcate. I went to the bank to change my name on my account, the teller said she was born in another country and had never seen a birth certificate like that. Then I went to another bank to change my name on my credit card and the teller there pulled out her own New Brunswick birth certificate which was a conventional plasticized card. I still have to go back to Service Canada to get my SIN name changed.

I harvested my second crop of peas, my pathetic squash crop, and a couple of turnips. I have two rows of snow peas, I pulled up one row but left the other row in place. It dawned on me that snow peas might be aptly named. So I am leaving the second row out to see what it will do in the snow. I took most of the peas off the plants and left some of the smaller ones in place. The plants are very green and still flowering vigourously. The pea pods are still growing. I still have beets, kale and turnips in the garden and a few onions that hadn't sprouted when I harvested their cohorts. Now they are providing me with green onions. I like beets but I like beet greens better, so mostly I grow beets to get the greens. Also, I found what appears to be a single oakleaf lettuce plant growing in my garden. I did not plant it, I don't know where it came from.

I changed out the rope that I hang my birdfeeder on in preparation for putting the feeder out soon. The old rope was frayed and brittle and broke a couple of times last winter so it's time for a new one. The board I put peanut butter on was mouldy because I left it out all summer so I will have to replace that too.

Thursday, November 7, 2019

What Crows Know

The other day I was walking to the Reservoir with my dog and we stopped to chat with a woman I know who lives on the road to the park. She is a bit older than me and lives in the cutest little blue cottage set in a garden lot with a screen of trees and shrubs along the roadway for privacy. In the good weather she is often out in her yard with her cat, who happens to like Hapi. Hapi has come to know who I am friends with along our route and she always wants me to stop there and chat with them, regardless of whether their cats are friendly or not.

Anyway the woman was in her yard and I crossed the road to chat. She told me she has been watching the crows and their reactions to different people walking by. Apparently they have been dive bombing some passers-by.

"Really? They don't dive bomb me!" I said.

"Of course not," she said, "They know you because of your dog, and they know me because of my cane, but it is interesting to watch how they react to people they don't know."

That took me aback. They know me?

"Well of course they know you! You have that big gray dog!"

I know that crows are smart and it is interesting to watch them go about their business, but it did not occur to me that it was a two-way street. When I left my friend's yard to continue on to the Reservoir I was thinking about the crows. What exactly do they know about me? For sure they know where I live, and they must recognize my car. But mostly I am on foot around town so they know my comings and goings, they know something of my daily routine.

Do they talk about me?

When I hear them cawing as we walk by, are they saying, "Here they come, there they go"?

The crows must know quite a few people around town, I can't be the only identifiable person to them. Do they keep track of relationships, who knows who and what they do together?

Or maybe they are completely uninterested in me, it's my dog they are keen to watch. The day that Hapi took so long to get out of bed I saw a crow standing in my driveway near the back door where Hapi usually emerges first thing in the morning.

It was pecking at the ground, as if pretending that it was there hunting for food when really it was wondering what had happened that the dog was not outside yet.

My smarty pants kid

My youngest son wants to buy a house here. He doesn't want to live here, he just wants it for rental income. I've been going out with a real estate agent off and on for a year or more to look at possibilities. He's got a condo out west that he is selling to buy the house. The condo sale has been a torturous affair but it now looks like it might actually happen. So I went out yet again looking at houses and I found one. I really liked the look of it, it is in a good neighbourhood and within my son's budget. The price is reasonable for the current state of the housing market here.

My son was not enamoured with it, he thought it was too "suburban" for his taste. He sent me links to houses that he thought were more to his liking. I pointed out to him that while the houses he liked would probably be nice places for him to live, they were not really suitable as income property. He thought he could get a twofer, something that he could make money off of and also enjoy living in himself some day. I said I didn't think that was really possible unless he came down here himself to do the house hunting. It's one thing for me to choose an income property for him, quite another for me to choose a place he might like to live in.

So I think he is reconciled to this house. In any case he made an offer and it was accepted, we did the home inspection and I made the deposit on the house. Until he closes the sale of the condo he has no money. Let's hope the condo sale goes smoothly.

The weekend before the home inspection my son found another place for sale that he wanted me to look at. It was well beyond his budget, I think he was just getting jittery about the house. I think I talked him out of it, then felt jittery myself that I might be pushing him in a direction he did not want to go. But I think he is okay with it. We chatted last night after I paid the deposit and he told me of his plans for the future. It's all very ambitious and I really hope it works for him. We talked about him coming for a visit to see Hapi, who used to be his dog. I said travel in the winter is a bit dicey here, he should either come right away or later in the spring, but I didn't know if Hapi would still be around in the spring. Some days she's full of beans, other days I think she's just barely hanging in.

I mentioned to him a book I was reading. I said it contained a lot of philosophical references which I was not expecting and were kind of over my head. He asked who the author was and I couldn't remember, then I looked at the book and told him the author's name.

"Oh that guy is garbage, don't read it," he says.

"What do you mean, why is he garbage?"

My son starts in on how the author has off-the-wall theories about ethics, but this book I am reading I don't think is about ethics. Although I could be wrong on that, I'm only on the first chapter.

"Well I think I'm going to read it anyway, I'll let you know what I think when I'm done," I said.

He told me once that I was the smartest person he knows (aw shucks!) but he's pretty smart himself. I'm kind of proud of him.

Sunday, November 3, 2019

The sorry month of November

High tide in the harbour
Hapi has her good days and her bad days, today was a bad day.

Yesterday at the Reservoir she took off on her own into the woods and was gone for almost twenty minutes. She came back looking quite proud of herself but very shortly started limping. By the time we got to the parking lot she was limping pretty badly and another dog walker offered to drive us home.

During the night she was licking her paw and in the morning she had no desire to get out of bed. She didn't seem ill, she just didn't want to get up. Around 11am (with the time change that would have been the equivalent of noon) I made her get up. I decided that even though she was limping very badly now it would still be a good idea to go to the Reservoir. I drove this time. She limped slowly down the road to the ponds. We met several dogs along the way and she was happy to greet them all. Three dogs were leaving the Reservoir and she looked like she really wanted to go with them but I coaxed her down to the pond. She went in the water and just stood there. Some more dogs arrived and she got out of the water to greet them too. Then I took her home. I think that even though she was in pain she still appreciated the little bit of social time she had there. She spent the rest of the day in her doghouse. I hope she is a little better tomorrow.

I'm not in great shape either. Sleep has become elusive and after multiple nights of insufficient sleep I am tired all the time and quite lacking in energy for anything. Even reading has become difficult, a couple of pages and I'm done. It's depressing. I have pretty much exhausted all the various remedies and relaxation techniques out there and am wondering how I am supposed to function. Hapi and I are a sorry pair right now.