Too much gratitude...PO Day 230

It may seem this subject has little to do with shoulder replacement surgery but it really does. I have never in my life been grateful to so many people for so many things, big and little. So I have had plenty of opportunity to ponder the problem of saying thanks. It's very complicated.

If someone does something nice for you, you may want to give them a gift. That's when it gets to be a problem. I sent a gift card to the radiologist who diagnosed my collapsed lung. He sent it back! It came home with a nice note that said he was just doing his job, no reward necessary. Now what do I do? Life would have been so much easier if he had accepted the gift.

But I know how he felt. I recently did something for a good friend. I was glad to help her and it was no big deal. She gave me a nice thank you card and a too much gift card. So when her birthday came up, I returned the gift card along with a small birthday present. She sent me a thank you note with the gift card. I am waiting for a " card-worthy event" to return the gift card to her. This could become a tradition.

A friend of Dear Daughter's, who lives very far away, often does helpful things for her, things I would do if I lived nearby. So when, through a serendipitous combination of events, I acquired a new piece of Le Creuset cookware, I sent it to the friend as a thank you gift for helping my daughter and her family. I expected a nice thank you card but received a beautiful blooming orchid with a nice note. Now I owe her a thank you. Where does this end!

If someone gives you a gift in person and you thank them profusely in person, should you send a written thank you? I never knew before how much it meant to receive "get well" cards. Should I send thank you notes? The cards were greatly appreciated. And what if someone does something really nice for you, I mean really thoughtful, and you fail to write them a thank you note in a timely period...when does the acceptable "thank you" window close? The longer time passes the harder it is to do or say the proper thing. It is complicated.

Twice in my life I have sent a small "gift" anonymously. I wanted to do something and I really did not want any thanks or gratitude. Both times it caused such a fuss, a ruckus, an unpleasant aura of suspicion, that I finally had to confess I was the one who had sent the gift. Wow, did those good intentions backfire! I guess it is okay to make an anonymous donation to a charity, even noble, but don't try it with family. It will only get you in trouble.

I confess, I am not good at saying or writing the right thing. It is all there in my heart. I just have a hard time putting my gratitude into words on paper. And yet I know how much I appreciate a sincere thank you note. I think I am going to close out this post and go write a couple thank you notes for Christmas presents. Is it too late?

Exercise...PO Day 229

Our company leaves today and life will settle down into the post holidays-winter routine. Maybe I will be able to get back to my walking exercise routine which is what always suffers if there is any disrupting influence in life. Between Christmas, New Years, and guests we have continued to eat too richly. It's time to exert some discipline in the kitchen.

I also need to develop a strength building exercise program for my operated arm. I've postponed expecting strength in that arm since I read the 6–12 month time span was when power would increase. But I suppose it won't increase if I don't do something to help it. There is certainly some wasting of muscle in that arm. And the tricep part of the upper arm has a definite crinkly appearance, from reduced use I suppose.

Prior to breaking my right shoulder and the subsequent surgery, I walked with two hiking polls. While the activity is pretty passive, I suppose it is the repetitive motion that has such a beneficial effect on upper arm musculature. I had tried using weights and modified push ups without noticeable improvement but when I switched to the walking sticks I really could see a difference,

It seems a bit shallow to worry about appearance when I have struggled so with function. Maybe it is sign that function is becoming less of an issue. I find that my use of the operated arm is very nearly equal to what I normally do with the other arm. I no longer have to remind myself to use my right arm, it happens automatically. The only limitation remains strength. Possibly the heaviest thing I lift is a gallon of milk which weighs about eight pounds, I can carry it, preferably with arm extended , not bent. But when it comes to lifting it to put it in the fridge I have to let the unaffected arm take over. I think Dear Husband has some eight pound weights but that doesn't seem like a good starting place.

I have the exercise bands given to me right at the end of my official course of physical therapy. I think that will be my starting point. I don't want to go back to physical therapy now. Surely I can create my own exercise program. First step is just to get back to walking regularly and using two walking sticks. Even when l have walked since surgery I have only carried one stick and switched back and forth between which hand held it. Not enough, I think.

So if you see one of those kind of funny looking walkers, the ones with the Euro style sticks that are meant to be hiking rough paths in the alps, it might be me. My walking course is pretty tame, flat and mostly asphalt or concrete. The roughest thing I encounter is a neighborhood dog. Even the most passive, friendly canine acquaintance does not like the walking sticks. I don't know if it is the tap-tap of the sticks as they strike the paved ground or if the sticks look too much like weapons. But while dogs, and even cats, are a little intimidated by the sticks, my real walking nemesises are unimpressed, the vultures!

A neighbor, well intentioned no doubt, is dedicated to feeding the feral cats, in spite of City advice not to. Unfortunately, the cat food placed in vacant wooded lots attracts vultures who roost in tree canopies and supplement their diets by tearing up garbage bags looking for food scraps. Waving a walking stick threateningly or clanking them together has little affect on the urbanized scavengers. Under extreme threat they will grudgingly hop out of range, only to return to the buffet table as soon as I pass. I guess they know my right arm isn't strong enough to be a danger. Well, just wait... I am about to turn that around!

Video conference...PO Day 228

Thinking about video conference type visits to your doctor reminded me of an article I read about interviewing for a job by video conference. There were some suggestions that had not occurred to me.

For instance:

Try to position yourself where there is not a lot of distracting home decor behind you. You want to be the focus of the screen shot, not your bookcase or your living room background.

Don't assume your chat partner will only see you from the waist up. Be sure you are dressed on the lower half appropriately so if you have to stand up they're not getting a peek at your pajama bottoms.

Shut pets out of the room while you are on screen. Cats, especially, have a habit of jumping up onto the table or desk and becoming a huge distraction.

Try to enlist someone to entertain small children during your e-visit. Even an off- screen crying baby makes it difficult to focus on your problem.

Plan ahead to have things you might need at hand. Current medications, even over the counter, beside you will prevent wasted time getting up to retrieve them if the doctor asks about them.

Don't allow yourself to be distracted by a ringing phone or a knock on the door. Either Turn down the ringer or arrange for someone else to answer it.

Alert fsmily members to what is going on so they don't barge into the room in the room in the middle of your appointment.

Have a note pad and pen available to make written notes.

Finally, don't position yourself with a window behind you. If you are backlit the doctor won't be able to see you clearly.

I would wrap this up by saying something about saving money at your e-visit but...I just read that CME has proposed reimbursing for e-visits at the same rate as in-office visits. I thought the whole point of on-line appointments was to save money. I guess it is very difficult to keep medical costs down.

Expectations....PO Day 227

I read a brief article about happiness recently. It purported that the lower your expectations the happier you were if something went well. It made me think of my post 121 "Judging Success." While objective postoperative tests did not show great improvement in a group of shoulder replacement patients, subjectively they were generally quite satisfied with the results of their surgery. Their surgeons were rather disappointed that the results were not better and conversely the patients thought they were doing very well all things considered.

It's that "all things considered" part that makes such a big difference. Maybe the older we get the more realistic we are in what we expect out of life. When I consider the fact that I could not raise my arm more than about 15 degrees prior to surgery, I am quite happy with a full range of motion at the price of some discomfort. When I look around and see the serious illness that afflicts one friend or another, I am not so sorry for what I have to deal with. There's that parable in which everyone puts their troubles in a pile and is permitted to take out the troubles they would rather have. In the end, everyone chooses to take back their own troubles, the ones they came with, the ones they know.

But...

Is expecting less a cop out? It hardly seems the American way. Aren't we supposed to shoot for the moon, aim for the stars, something like that. What if Steve Jobs had settled for a less innovative computer, had not taken the gui and run with it? What if Bill  Gates had agreed that his software should be shareware because that was the way it had always been before? Is it that only geniuses like them can get away with aiming too high? That the rest of us have to be realistic?

Is realistic expectations the equivalent of lowering your expectations? Or does lowering your  expectations imply that you had lofty dreams and you gave up on them? As a mother none of us is ever going to tell our child to aim lower, although we may discourage the idea of a pro sports career, for instance. Realistic expectations allow for less stellar accomplishments while not ruling out the possibility of pulling off an heroic, game winning shot at the basket.

So, expect less and you'll be happier? I don't think so. I want it all. It's okay to be surprised, even astonished by events but I want to reach for the stars and perhaps surprise everyone else when I catch one but I knew I could do it! I accept the occasional disappointment for the rare thrill of total shocking success.

No post...PO Day 226

Can I blame the snow storm (is it Juno?) for not writing a post for today? Hardly. It is the usual winter day here, sunny and high in the mid 60s to low 70s.

Is it due to the funk I am in because Dear Son and his family have moved to a very north central state and it makes me every sad? Maybe, but that has been an ongoing situation and I have managed to crank out something for my blog along and along.

Perhaps it is because we have company, relatives from Oklahoma, and being social has used up all of my chatter and gossip and goodwill so I am left with nothing intelligent to say.

Maybe it is because I have been awake most of the night, when I would normally be writing my daily post, watching the Weather Channel or CNN to see what is happening with the storm. Being a southerner it is as hard for me to imagine coping with a blizzard as it is for northerners to think about living with hurricanes.

Am I just disappointed that the pork loin roast last night was over cooked and tough? The rice and green beans were good, at least. Good food is an important part of life and I don't like to churn out something less than good. Doesn't have to be great, just good satisfies.

Am I out of sorts that, due to guests, my routine is messed up and I am not walking? It's true, we get addicted to our exercise program and don't like it when it gets interrupted. Maybe I can walk today?

Or, after 225 days, have I run out of things to talk about? I hope not as I would miss you all. I've loved the writing and the reading that sometimes goes into the writing. Anyway, we'll see what happens today.

Will Willet survive or won't she?

Can't prevent everything..PO Day 225

Even if we are attentive and proactive, we can't prevent everything.

In 2012 there was a "superbug outbreak" that infected dozens of people in Pittsburgh, Seattle and Chicago. If everyone involved had washed their hands a hundred times it would have made no difference. The dangerous infection, Carbapenem-resistant Enterobacteriaceae (CRE) is one of the superbugs that have developed because of the overuse of antibiotics.

The infection was spread through the use of duodenoscopes used in gastrointestinal scopes of patients with gallstones, cancers and other digestive system problems. It was spread from patient to patient because the. CRE can survive traditional cleaning methods.

A Seattle investigation revealed 35 infected patients and eleven deaths, although it is difficult to rule out death from other problems as many of the patients were critically ill already.

In spite of this this, the FDA has not issued a recall for the devices saying it remains important to have the procedure available for use. One approach has been to culture and isolate the equipment for forty eight hours after use to be sure it is safe to use again. Hospitals and clinicians are having to think outside the box in designing protocols for infection control. Studies have shown, for instance, that wiping equipment down with chlorhexidine every day is not as effective as doing it every other day. Now how does that make sense?

All you can do is express concern and hope your doctor and hospital are tuned in to the problem. Sometimes merely asking a question is enough to ensure people do the right thing. Now if we just knew what that is!

Childhood Memories..PO Day 224

I know this is off topic but I found it fascinating. Dear husband was reading an article in The Week magazine by Kristin Ohlson and I happened to see it. The subject is what Sigmund Freud called Childhood Ammesia.

What is your earliest memory?  Not the story the family has told so many times that you think you remember, your earliest independent memory. For most of us, we may have sketchy memories, more like impressions, from age three or four, but not full memory of events until about age seven. It's not that young children aren't remembering things at a young age. It's that they don't form permanent memories. Ask a two and a half year old about something that happened when he was two, a trip or a birthday party - something memorable - and he remembers it and can talk about it. Fast forward to age  four or five and he has no recall of the event at all.

Whatever is going on as to development in the brain, the memory thing doesn't fully happen until we are about seven. Before that, while we do have some memories, they are small vignettes filled more with emotion than with details. As a parent we may be trying to create these perfect movie moments for our child but, in spite of our best efforts, they may not remember the family vacation to Disney World at all but can vividly recall the popcorn machine in the lobby of the hotel where you stayed traveling to the theme park on I-95.

That's not to say all those wonderful bonding moments were a waste of time and energy. While they are not remembered, impressions and emotions are created and become part of the equation of who we become, who we are.

Reading the article caused me to call my sister. I remembered an epic snow fall and walking, with her, through shoveled paths where the walls of the paths were much higher than my head. It had the effect of being in a frozen maze. I wanted to know what year that might have been. Since she is four years older than I, was sure she would remember it perfectly. Well, my memories are not her memories, she did not recall the snow, the paths, the events at all. A little internet searching revealed the record snowfall in November the year I had just turned four. Obviously the whole experience made a much greater impression on me than on her.

Anyway, when the family conversation around the dinner table lags next big holiday, ask the question, "What is your earliest memory?" It may totally surprise and amaze you.

http://youtu.be/78Ruh0ewBVo