captainsblog | Roger and Me

Weird week for work. Four mornings I had outside appointments, three of them stupid early (8:30 for me is stupid early), and none of them involved courts or clients. Two were for the previously reported car appointments to inspect mine and replace a cracked windshield on Eleanor's. The others were health-related, one directly and one indirectly related to the neuro workups I've been getting.

Monday's was a long-scheduled Medicare-pays-them consultation with the practice's weight management specialist. This investigation is tertiary to the main problem. The tests so far indicate mild cognitive impairment as my primary condition; and that it may be caused or aggravated by sleep apnea, the secondary one; but, tertiarilly, that may be caused or aggravated by how much weight I'm putting on the respiratory system at night. This is the condition that got to the head of the waiting list first. Before even going, I'd happily noticed that I'd brought things down on my own by close to 10 pounds since my most recent checkin with the practice back in early October. Eleanor came with, and the MD for this program was pleased with how well I was doing early on. After dispelling some myths about weight loss (red meat not necessarily bad, bean-based products not necessarily good), he brought out a sample diet and some ideas for proceeding. It's not calling for radical changes but for reducing some things and adding others.

By a few mornings later after the details had set in, Eleanor was more worried about it than I was. She made a remark about all the things "we couldn't eat anymore." I'd heard that part of the consult differently- that it was a matter of degree more than total exclusion. It relieved her of a lot of stress not having to go that far.

Another of the recommendations was keeping a food diary. No specifics on how often or how detailed, although it probably should try to track some of the specific guidelines for preferred intakes of protein, fruits and vegetables. One remark Eleanor made to encourage me in this venture brought back a weird but funny memory from ages ago:

Her: "One of the benefits of doing it is to raise your consciousness level about what and how often you're eating."

Me: "Yeah, that goes back to my sixth grade science teacher. He told us that HEARING something puts it into your memory, then WRITING it down puts it in a second time, and then READING what you wrote does it a third."

Her: "That sounds like he knew what he was talking about and wasn't on drugs or something."

Me: "Well, yeah, except HE was the science teacher who put 12 year olds in a battery-wired 'electric chair' in the back of his classroom...."

Thanks, Mr. Zura. I'll think of you every time I do this now;) And THAT, at least, was good advice. Even Dexter Morgan solved actual crimes. Just not his own:)

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So who is "Roger" and what does HE have to do with this? Well, he's not a he but an it:

I don't even know where the name came from, but it seemed to need one once we got real chummy over the preceding 25 or so hours. For the Friday visit was to take the next step in the clinical trial I was selected for as an offshoot of this tertiary condition monitoring. This was for further consent forms related to the sub-study portion of the program related to weight, to provide the debit cards where they pay ME for going to the doctor, and, this time, to give them an initial full-day monitoring of my BP to be sure it is within, and stays within, certain pre-trial ranges for the study. Roger rode sidesaddle on me in that velcro pouch from the time of the appointment until about two hours ago; he's connected to a BP cuff that I wore the entire time:

That's him in all his blueness on my left upper arm, his home for the day. So he basically is a portable sphygmomanometer with a battery and reporting pack, connected by that holster to a strap that wrapped around my waist. Once an hour, the cuff goes off. If it gets a good reading, it records it; if it instead pops an E2 code, it will try again in a few minutes. There was no rhyme or reason to when it would go off, and I usually couldn't tell if the reading had "taken" or not until I just noticed it not going off a few minutes later.

Naturally the first time it went off after I left was when I stepped up to a bank teller to make a deposit. I had to reassure the teller, who could see that cord running from my wrist to the strap, that I didn’t have explosives around my waist in a reenactment of Dog Day Afternoon. Somehow I managed to get through the entire day, overnight and this morning without the cuff loosening on my sleeve or the monitor disengaging from the cord on either end. I did catch it on furniture a few times, but never causing any damage to it or me. Also fortunate was that it didn't freak out the dog when it went off making the hum-thump noise that BP cuffs will, not even when she was sleeping next to me all night. And neither it nor I fell out of bed wearing the thing, so that was good, too. I bring it and its readings back to them Monday, and they will then set up more testing, including a full body scan that measures muscle mass and bone density. My gym has a variant on this called InBody and they charge extra to get a scan from it, so this becomes another freebie that could be of benefit even if I wind up with the placebo of the study medication itself.

At the end of yesterday's consult, the same doctor came in that had done my weight management consult on Monday. He's not the lead on the study- that's Dr. Laszlo of song, story and batflight-

- but Dr. B is also on the team for it. His diet recommendations were much stricter for the 24 hours on the monitor than for the program in general. Particularly, he wanted me to avoid any kind of salty food for the duration so the BP didn't go out of the study's qualification range. The few times I was able to see the readings, they all appeared in my usual pretty-damn-good-although-medicated range for it, so I think I probably passed the audition.

There aren't supposed to be any more extended visits with Roger or any other kind of monitoring for the study. Next on the agenda is back to the apnea people early next month to probably get one of their sleep-study boxes connected for a more extended series of overnights at home. I'll need to come up with a name for that one, too; maybe "Brian" in loving memory of the United Health CEO who got murdered on a Manhattan street by a hail of bullets labeled "DENY" "DELAY" and "DEPOSE" on their casings. Oddly, we both have our Medigap plans with that lot, and their usual premium pulls didn't come out on Thursday as usual the day after his demise. We thought maybe they'd apply his $10 million annual salary to pay premiums to keep the masses from any further attempts.

Nahhhhh. They came out a day later. At least we got the DELAY part:P