Guilt Over Complications of the Heart

This morning I'm feeling a bit guilty about something from last night...

In the evening, Leena came to me in a panic thinking she might be having a heart attack.  She said her Apple Watch was telling her something about "heart rate complications," and she knows she's at some risk as both of her parents have had heart attacks...

I guess while I know the Apple Watch has heart beat monitoring stuff, I don't know how much to trust it.  I asked her if maybe she'd had the Watch on too loose.  She didn't really answer, and I asked if maybe it was too tight?  Or maybe not aligned on her wrist properly or what.

Leena's not one for answering questions, as she doesn't like feeling like she's being interrogated and rebels at the idea of just simply answering.  She prefers talking and still kept saying stuff about "heart rate (or beat) complications".

Eventually I got out of her that she hadn't even been wearing the Watch.  She was holding it, and it was in some mode for configuring what gets displayed on the screen.  And it was giving her "heart rate complications".

Ah, that clarified things...  "Complications" in watchmaking means features on a watch beyond merely time keeping.  I only learned that a few years ago, through work, with our associating to a grey market luxury watch dealer.  I asked Leena if she was familiar with the term, since her family all has luxury watches, but she hadn't heard of "complications" in the horological sense.

Leena's older Rolex with a date "complication".

Here are some random Heart Rate Complications screen shots I just grabbed via Google:

I thought it was all resolved last night when I went to bed.  But this morning, thinking about it, I feel guilty that when Leena first told me she might be having a heart attack, I didn't even think of it as a medical emergency, I didn't think to call 911, that she might really be having a heart attack.

We're lucky this was just a misunderstanding of an obscure watchmaking term.  What'll happen if we have a genuine medical emergency in the future?

 COVID-19 Follow Up

To follow up after my March 3rd post about Leena getting sick with COVID-19 and testing positive....

I probably had it the first time in March of 2020, after I was exposed to it at the office, before New York City closed offices down.  One of my coworkers came to work sick, with a fever and coughing up a storm.  That time I had about three weeks of an on again off again sore throat and fever.  Both were so mild my wife didn’t realize it, and at times I had to remind her I wasn’t feeling well.  At that time tests were only available to the terribly sick, the wealthy, and the powerful, so I never got tested and can only speculate what I had.

Then I had it in March this year, 2021, and while it wasn’t the worst, most painful illness I’ve had, it was far from pleasant.  Both me and my wife had it, but we were fortunate enough not to have it so severely we needed hospitalization.

In hindsight, the first effects of it in me turned up before I knew I was sick.  I knew I was exposed to it, because my wife was sick with it, and had tested positive.  About a week or so after her test I read a news article about the governor of Mississippi, which had his photo.  And for a few days every time I was by a mirror I kept silently remarking how Tate Reeves was my doppelgänger, how we looked so uncannily alike, as though we were twins.

Me and Tate Reeves, side-by-side

Around the same time I also noticed a lot more red spots on my skin.  I’ve had acne problems since puberty, but that week I had more reddish, prominent bumps around.  Not large numbers, not like a rash, but red bumps on my face, my arms, my belly…. It’s rare I don’t have any, but this was more than I’d normally have at one time.

After a few days of that, one evening I had a sore throat.  I felt it, but I held out hope that I was merely dehydrated, although drinking water didn’t help.  The next day my throat was still more sore and I was unquestionably sick and my whole body felt sick.

Then I had a weekend and I developed a mild cough.  Monday I actually felt slightly less sick, overall, but the cough was worse, more coughing more often, while still not being terribly forceful.  I went for a COVID-19 test that afternoon at a nearby clinic, and two days later it came back positive.

Tuesday, though, Tuesday it all got worse.  Tuesday morning I woke up to eat breakfast and begin work, but all I could do after I ate was lie down on the floor and take a nap for an hour and a half.  Then I got up and worked, not feeling well, having trouble focusing.  I had a headache and I felt like I had a fever, even though our thermometer never measured a temperature above 98.6 degrees F.  Whenever I tried to speak I coughed.

The following day was worse.  After breakfast I felt everything from the day before, sick, sore throat, cough, with an even worse headache, and adding in nausea.  I took my 90 minute on the floor by the computer, and when I woke up realized I couldn’t work, so I sent some emails that I was sick.

I slept on the living room floor till my wife woke up in the bedroom (she’s on a wildly different schedule than me) and then I slept in the bedroom, waking up now and again to use the bathroom and sip some water.

That evening I took a shower, a long, hot shower.  It felt nice.  I just sat in the tub, reclining against the back of it, feeling the hot water hit my belly to ease the nausea, slam into my throat to ease the cough, and pound my face and forehead to massage away the headache.  

I was in there for an hour and a half or so, then I got up and I was dizzy.  I could barely stand, wobbling on my legs all over.  I bashed my nose against the tiles of the tub, and while trying to gauge how much blood was pouring out I lost my balance and crashed out of the shower, banging my head against the tiled floor.  I found myself looking up at the toilet, my feet still in the tub.  

I called for my wife, who came in and helped me sit up.  She got me a few glasses of water and held an ice pack to my bleeding nose for a while until I’d calmed down.  

Following the bathroom incident I felt like the peak of the COVID-19 infection had passed.  The next few days I still had a headache, still felt sick in my body, still had a sore throat and cough, but it wasn’t as bad as leading up to the shower.

I took the next couple of days off from work, spending most of the time sleeping.  By the end of the following weekend I no longer felt sick all over.  The headache was gone and I felt normal, except for being fatigued and having a cough when I tried to speak aloud much.  Cough drops didn’t work on it, cough syrup did little, if anything.  Cherry flavored candy helped as long as I sucked on them, not ones that purported to be cough drops, just plain old candy.  Other flavors, not so much.

Now it’s close to two months since the first symptoms and I still feel tired more easily.  If I’m active I get to the end of my energy a lot faster than I would’ve before COVID-19.  I’ve had Raynaud’s Syndrome as long as I can remember, but now my fingers and toes, and my arms, are much colder for the current weather than they would’ve been in previous spring seasons.  When my wife wants to test out the new air conditioner in preparation for summer, I’m fighting it because I feel cold.

For other health reasons I’ve been checking my blood pressure almost daily, and during the couple of weeks I was sick with COVID-19 my blood pressure was noticeably higher.  

So that was COVID-19 for me…. I’m lucky I didn’t have it as bad as millions of other people have.

And it's here...  The Coronavirus...

So, Friday afternoon Leena was just out and about, running errands.  She saw there was no line outside the nearby urgent care clinic by our apartment and just went in to ask how quick it is to get a COVID-19 test and if it's free.  It was, with our insurance, so she scheduled one for Monday afternoon.

Monday afternoon she went out for her 3pm test.  She described it as a terrible experience.  She checked in and was put into a stuffy exam room.  And nothing happened.  Nobody came, she just waited.  Finally when she opened the door to ask someone if she could wait with the door open, someone realized she was in there.  

The test itself was quick and easy, if mildly uncomfortable.

Then Monday night, after I went to bed, she developed a stomach ache, a sore throat and a fever.

Tuesday morning I got up as usual to begin my workday and she felt horrible.  She had some Tylenol and went back to sleep.  The rest of Tuesday she was clearly sick.

Around 3pm on Tuesday she got an email from the urgent care clinic that she had a 5pm telehealth call with the clinic's doctor, which made no sense as she hadn't requested one and she was afraid they'd charge us hundreds of dollars for it.

Then she saw she also had an email with the test results...  In big bold red letters it said the coronavirus was "DETECTED".  Then I guessed that the 5pm telehealth call was probably required by the doctor to discuss the positive test with her.

We put together a list of questions to ask the doctor about Leena's condition, about what we should do to take care of her, about what I should do regarding my own upcoming doctor visits, and so forth...

Only at 5pm we got into the telehealth website the email linked to, and waited.  And waited.  And waited some more.  By 5:20pm the doctor never signed in and Leena gave up.  She's less patient than I am, and she was sick.

After that she called the clinic and gave a rough overview of the situation to the receptionist who said she'd get a doctor on the phone.  And Leena waited and waited and waited, for nearly an hour on hold without ever getting the doctor.  So she gave up.

Today she's feeling much improved, talking with a lot more energy.  I think her sore throat is mostly gone, and the fever is more mild than it was yesterday.

I've scheduled a test for myself for tomorrow morning to see if I might have it, since I've definitely now been exposed to it as we live in a tiny apartment.

-- --

Follow up Friday afternoon...  I got my test results: Negative.

And I keep thinking of the band W.A.S.P. with their Live... In the Raw album.  It's got a short sequence in the song I Wanna Be Somebody where Blackie Lawless leads the crowd in a bit of "audience participation".  They do a bad job so he admonishes them, "What, are you guys sick or something?  I'm supposed to be the sick motherfucker around here."  Well, after all my heart related exams and appointments recently, it's not Leena, it's me, "I'm supposed to be the sick motherfucker around here," not her...

 An Apple a Day Keeps the Doctor Away

Over the years I've found this cliche actually works out to be true.

For years I've eaten an apple a day as part of breakfast.  Not because the cliche, because they're healthy and I like sweet apples.  In India I ate ones that tasted like sweetened apple juice, which may have been imported from China.  Here in the U.S. I eat Fuji apples, which are pretty similar.

After I had my high blood pressure crash & burn that landed me in the emergency room in 2014 I set myself up with a primary care physician, Dr. M who we really liked.  The day of my first appointment with her was her first day at that practice, so she had a lot of time to spend with us answering questions and what-not.

And a few years later she moved out of New York City, leaving the large practice where we went.

They assigned me a new primary care physician, Dr. Z and I went to her a couple of times.  While Leena never joined me and didn't meet her, I liked her, she seemed like a pretty good doctor.  But then she moved out of New York City.

Following Dr. Z's departure I continued to eat an apple a day as part of breakfast and didn't go see a doctor at all, not wanting to start over all my history again with a new one.  Better to just skip the whole thing.

But last autumn Leena had an urgent need to see a doctor.  So, thinking back to when I first went to Dr. M, I remembered another doctor at that clinic who Dr. M used on billing and referrals until she was completely set up in their computer system, Dr. A, I set us up with Dr. A as our primary care physician.  Leena went to Dr. A and really loved her, recommending I go to see her about my long running high blood pressure.

Great.  I prepared some notes and how to introduce myself to Dr. A for my own appointment with her.  I told her I picked her at that clinic because she was the one Dr. M used for billing and referrals when she was still too new at the clinic to be set up in their computer system.  Dr. A acknowledged that and we continued on.

And now we recently got an email from the clinic that Dr. A is leaving in a couple of weeks.

I have to wonder, back at my first in-person appointment with her, when I told her why I chose her as my new doctor, did she already know she was on her way out?  Or did she get a new opportunity at some point after that...  

Thinking back farther, back in India, sometimes when we'd make a plan to go see Dr. S for whatever reason, Leena would usually tell me to eat something before we go.  Sometimes, I'd eat an apple, and then Leena would call the doctor's cell phone to confirm (Leena was an old school friend of the doctor's wife, also a doctor) and he'd say something like, "sorry, I'm stuck in Mumbai on some work," and we'd have to postpone, cancel or maybe go see Dr. P instead...

My only conclusion is that eating apples regularly somehow repels doctors.

Maybe it's time I switch to a pear a day...

A picture of Fuji apples I snagged off the internet...  (not my apples, not my photo...)

The Heart of the Matter

So, in November last year I finally went to a new primary care physician to discuss my long-running high blood pressure issues.  I'd been putting it off for a few years because I didn't want to get into things with yet another new doctor after my previous two both left New York City...  

But Leena had gone to her for a skin issue and really liked her, so she talked me into going.  I actually picked this doctor because I knew her name at the clinic since she was well established there when I first started going for another doctor in 2014.

So, Dr. A. talked to me, took some blood and later when we followed up via video call (coronavirus pandemic, you know...) she changed my high blood pressure medication and put me on a statin for cholesterol, which she described with "sky rocket".  The new medications were giving me headaches, but as they were lowering my blood pressure she didn't want to change them without my seeing a cardiologist first.

When I saw the cardiologist, Dr. T. he didn't believe me that the medications were causing the headaches, which started the day after I started those medications, but was willing to change the prescription to ease my mind at a minimum. 

Dr. T. was concerned about my state of health, my long running high blood pressure, that I got out of breathe when I was active, and my family history, since my father had a heart attack and quadruple bypass at 64 years old and one of my grandfathers died of a heart attack at 62 (granted, he'd been a lifelong smoker, which wasn't my case).  Dr. T. said things like my father's heart attack usually started showing signs about fifteen years in advance, and that puts me easily into the beginning of that 15 year range compared to my father's heart attack...

Dr. T. also scheduled me for a CAT scan, a "CTA Coronary Artery" at the hospital for a week and a half ago.  I went for that, which involved spending an enormous amount of time waiting my turn, and then feeling like I peed my pants when they injected me with the radiocontrast dye (I didn't, it just felt that way when the warmth spread through my body, getting to my crotch region...)

And Monday last week I met with Dr. T. at his office where he reviewed all the images from the CAT scan and some other ultrasound images done that morning.

He then told me that the scans of blockage scored me in the 89th percentile for men aged 51.  Um, ok.  I had to ask if that meant 89th percentile good, or 89th percentile bad.  He then clarified that it was bad.  So, these are like golf scores, a lower number is far better...  It turns out I have more blockage in my heart's arteries than 88% of men aged 51.

Well, I figure that's trivial to beat.  Later this year I'll turn 52, invalidating the whole statistic.  

Dr. T. recently uploading the results to the MyChart system so I could read it and here's an excerpt of the key parts.

1. The calcium score is 119 in the 89th percentile for age, gender and ethnicity.

2. There is no calcified aortic plaque.

3. Normal LM. 

4. 25-50% stenosis of the proximal LAD due to mixed plaque with a high risk feature of spotty calcification. Normal remaining LAD.

5. 50-69% stenosis of the ostial to proximal large high D1 due to mixed plaque with a high risk feature of low attenuation plaque.  50-69% stenosis of the mid D1 due to non-calcified plaque. Norma distal D1. Normal branch of D1. 

6. <25% stenosis of the proximal LCx due to non-calcified plaque.  Normal remaining non-dominant LCx. Normal OM1.

7. Normal proximal RCA. Mid RCA is ectatic with 50-69% stenosis in the mid segment due to mixed plaque with a high risk feature of low attenuation plaque and spotty calcification. <25% stenosis of the distal RCA due to mixed plaque. Normal RPLA and RPDA.

I sent this to my wife with this description, including links to Wikipedia:

Here's a Wikipedia article that explains the arteries in question.  

And here's a grabshot of the vector drawing in the Wikipedia article:

Note that the picture is reversed, showing the patient's left side on the right and right side on the left.  This is because the picture is drawn the way a doctor would see it looking at the patient.

In the picture you can see the LAD mentioned in the doctor's #4 item.  It's on the right side of the picture.  This is 25-50% blocked (I'm not sure why there's a range that size, whether it's because different parts of the artery are blocked different amounts, or because that's as accurate as the scan can get).

His #5 item refers to D1, which is on the lower right side of the picture.  This is blocked 50-69%.

His #6 item is LCx which is in the middle of the right hand side of the picture.  This is blocked less than 25%.

His #7 item is RCA which is on the left middle side of the picture.  This is blocked 50-69%

For now Dr. T. has increased my blood pressure and cholesterol medications as well as including a new one, a beta blocker.  He suggested (was it a suggestion or an order?) a no cholesterol diet.  And I'm to follow up with him later this month to see where to go from there.

He talked about maybe scheduling another procedure to look closely at the blockages with a camera inserted up in there, and possibly inserting stents.  I assume it wasn't an immediate life threatening emergency or he would've done more than sending me home with some medication prescriptions for now.

Dr. T. also emphasized my need to get a sleep study from a sleep specialist.  I was lazy about scheduling that, with the idea that it would be a lot less stressful to deal with one specialist's area of my body at a time.  

At home we're trying to deal with my diet.  I need to be more careful about not cheating as much, since now the damage that's doing is more concrete and less abstract.  But convincing Leena to change how she's cooking for me is harder because she doesn't want to believe she's been cooking food that's unhealthy for my heart as it is.  She wants to think she's been doing everything perfectly.

I also made an appointment with the sleep specialist for next week...

Close-Up U.S.A.

Close-Up U.S.A.

When I was a kid in the 1970s and my parents were preparing to drive across the country and find a new place to live, they bought a boxed set of maps from National Geographic named Close-Up U.S.A.  Now, as a kid, I misread the title, thinking it meant the heteronym, like a business at the end of the day would "close up the shop," I thought the USA, my home country, was closing!

It was a relief some time later to realize that the title meant something more like "I'm ready for my close-up now," and the U.S.A. wan't actually closing.  And it was kind of funny for years to think of my childhood misunderstanding.

However, now in March 2020, the U.S.A. is sort of closing up, like "close up shop" kind of closing.  With the novel coronavirus pandemic spreading and people getting sick with the COVID-19 from it.  The president is belated closing our borders, starting first with travelers from China, but now from Europe (minus the one European country where this president owns commercial properties).

States are closing schools all over.  New York State just shot down all Broadway plays in order to reduce the number of people in close proximity.  Several states have put a limit on the number of people gathered together.

It'll probably get more restricted before it gets back to normal, whenever it does...

The U.S.A., bit by bit, is closing!

Here are some photos of Close-Up U.S.A. thought I found on the internet.  None of these photos are mine.

LeoDude's Passing

Just over a month ago I wrote a somewhat humorous rant to a college buddy, Leo Winters.  And now he's passed away.

He replied to my rant with his recent experiences becoming a middle-aged man, too, getting fat, and then cleaning up his diet to lose 50 pounds.  He said he mainly just started eating healthier, cutting out junk food, soda, chips and processed meats in favor of lighter stuff with more natural ingredients.

He offered me some advice on dietary supplements, lemon balm and red clover.  He said the lemon balm helped him sleep better and get closer to the required 7 hours a night.

Then a few weeks ago he went into the hospital himself with liver and kidney problems.  The first word was that he wasn't going to leave, then he started getting better, sending more emails, complaining about the medication and about the new PlayStation 4 games he'd gotten to keep from being bored there.

Then two weeks back he died in the hospital...

I guess it hits pretty hard because while a few of my old friends have passed away, not many, just a few, none of them were as close a friend to me as LeoDude was...

Sure, life had taken us different directions since we were going to Oregon Tech together, and sometimes we only emailed sporadically.  But the time at OIT we were such close friends that this is kind of hard.

And the last email exchange I'd initiated to complain about my own bad health, and he's the one who passes away.  

I mean, I don't feel guilt, it's not anything I did (except maybe encouraging a lot of unhealthy drinking back in our younger days), but I feel awfully bad about it.

Since then I've only been listening to music that he got me into, Skinny Puppy, A Split Second, My Life with the Thrill Kill Kult and so forth.  And thinking of old conversations we had, some of which I wish I could clarify, but now it's too late.

Below is what I wrote on his Facebook wall after hearing the news that he passed away...

-- -- --

Aw shit, dude… 

I know I started us writing emails back and forth last month complaining about becoming middle-aged men, but I didn’t mean to skip it altogether! 

I guess now you’ve done exactly what you said that one night when we recorded you talking in your sleep, “I’m going to de-energize…. totally…” And now we’ll have no more opportunities to eat breakfast and listen to recordings of what you talk about when you dream. 

Anyway, those sure were fun times back at Oregon Tech… I felt a bit like a fish out of water for the first half of the year, until someone introduced us and I started to hang out with you. That was when I finally felt like I belonged there. 

I suppose now you never will answer that question I ask every few years about what song that was you used to play on a tape when driving your Plexipod car our freshman year at college… I keep buying CDs from the group I thought it was, but nothing sounds like it did when we were teenagers. 

This must now be the ultimate swim in the Shark Zone, huh… 

“Ch… Ch….” … … (after 25 years of this game, I guess this round goes unfinished.)

NYC Commuting 90 Minutes Later

After a trip to the emergency room two weeks ago, I followed some of the doctor’s advice about caffeine and “sleep hygiene,”  and now I’m going to work an hour and a half later every day than I had been for the last few years.

New York City is very, very different at 7:30am to 8:30am than it was at 6am to 7am…  So much busier.  So much noisier.  So much more chaos.

At 6am there was only one grocery store on my route with big trucks unloading, at 7:30am there’s business with deliveries all up and down the street between our apartment and the subway.

By 7:30am there are construction crews out blocking the roads and moving big equipment around, so no more just walking across the street once there’s a big enough break in traffic.  Not that there is a big enough break in traffic at 7:30am without a light or construction flagger to stop it, the cars are simply non-stop on the avenues.

Whereas I used to always get a seat on the subway, every time, often the only person on a bench, now I usually have to squeeze in to a crowded train and wait till a mass of people get off at Times Square to quickly grab a seat, feeling guilty because there’s still plenty of people standing up, and worried that I might be taking a seat someone who really needs it more than me could use.

On the 4 train in Brooklyn I used to sit with young 20-something school teachers who work at some schools near my office, a crowd that often grades papers or talks in nice, quiet conversational tones and has manners when we’re all heading to the same exits at the same time.  Now after 8am in Crown Heights, the trains are mostly full of rowdy school kids.

Fortunately, with the doctor-recommended change in sleeping habits, I don’t feel the desperate need to sleep on the train like I used to, so I can close my eyes to relax, but the noise and chaos isn't affecting me as much.

Middle Age Motherfucker!

While getting my life on track following some health issues last month, it dawned on me that I'm totally a middle-aged man now.  On Facebook I saw a post by a college buddy's wife and we swapped some messages and we're both in the same boat now.  So, I banged out a ranty email about this to another college buddy...

Middle Age Motherfucker!

It sure hit me last month, like a BB to the nuts(1).

I ended up in the emergency room two weeks ago because my blood pressure was through the fucking roof.  I had a headache like never before, and decided to go to the urgent care clinic up the street.  The doctor there checked my blood pressure and said the risk of a stroke was severe and sent me straight to the ER, no walking, either ambulance or taxi for the two blocks (we chose taxi).

He gave me a pill for it, and some notes to take to the ER...

The pill worked, so the ER doctors didn't "do" anything except monitor me for five hours, then prescribe some blood pressure medicine to take daily, pretty much for life (or until I make lifestyle changes that'll make me healthy enough I won't require it.)  The doctor there also gave me advice including following up with a primary care physician, especially since I'm now 45 and entering middle age and can expect upcoming age-related health issues.

Two days later, when the headache receded enough that I could look at the computer and phone screens without cringing in pain I began what I'd put off for twenty years, finding a primary care doctor.  You know small town life, well, Waldport only had one doctor (whose son was one of my classmates) and once I finished college and started working the big city, Portland, the choices were too overwhelming that I never got a doctor or went for visits.  Now in NYC, the choices are even more so. In our insurance company's listings there were hundreds of primary care doctors within 10 blocks of our apartment...  The hospital had a referral service so she started listing them and I stopped her after the second clinic, then called that clinic who had one doctor available that afternoon, and now she's "my doctor".

Actually, luckily, after the first visit we really like her.  Leena really, really liked her.  We told her about how I got to the ER and what was done since and she talked a bit about diet, said I was definitely overweight and needed to lose some pounds, and took some blood samples, and EKG and measured my blood pressure several times and we talked quite a bit...  Since the problem and medication were still new to me she didn't want to change much, except for me to avoid obviously bad foods...

Last week she called with results of the blood tests and said my cholesterol is very high and put me on the famous Lipitor (another nail in the end of youth coffin for me...)

We have a two week follow-up with her later this week and she gave me a preview on the phone, that she wants to talk a lot more about food...

I saw a Facebook post from Craig's wife, and he's going through the same shit.  Overweight, high blood pressure and all that.  And similar problems, he felt fat, but whenever he talked to people about eating better and shedding weight, they just said "what? you're not fat..."

I get that all the time, even now after the doctor's appointments my coworkers are telling me I'm not fat, I'm not overweight, the doctor is stupid.  Never mind that I knew I was fat ten years ago, when I bent down to put my socks on and couldn't breath because I suddenly had a gut in the way...  I was getting out of breath walking up steps and everyone's all "you're not overweight..."

So, yeah, I'm on three prescription medications now, my blood pressure is high and my cholesterol is very high.  I'm a middle-aged man.  What the fuck happened?

How about us all sucking down a bottle of Oregon Springs(2) and walking down to the Market Casket(3) to buy some junk food...

Anyway, Leena's sprung into action.  She has a mission now, get me back to health.  She was learning to cook in January, but with lots of oil and salt, so now she's researching online and learning to cook healthier foods to help lower my blood pressure and cholesterol.  She found out how to get to the nearest fish market to bake salmon for me instead of frying beef, and she's learned to cook some vegetables so they actually taste good (hint, lots of garlic).

The fresh salads are also a reminder of lost youth...  As a kid I always used massive amounts of French salad dressing to choke down a salad and the grown-ups used olive oil and balsamic vinegar.  This week I found myself looking at a salad and trying oil and vinegar so it wouldn't be plain old, boring vegetables....  And I kind of liked it...  Until I thought about that thing with the kids and grown-ups.

In two weeks I'm noticeably less chubby, my watch is loose on my wrist and my feet are slipping out of my sandals.  So, it's a start...

notes:
(1) the first day of our sophomore year he was showing his new BB gun, pointing it at me.  I said "hey, don't point it at me" and he said "it's not loaded" then preceded to pull the trigger, with a bunch of BBs shooting and bouncing off the door, just below my crotch (good thing he lowered it...)

(2) we drank a shit-ton of Oregon Springs vodka back then...  it was the cheapest liquor we know of at either of the Klamath Falls liquor stores.

(3) just a funny nickname for the grocery store near our college campus, the Market Basket.

Sexual Inadequacy: Out of shape and overweight...

I’m feeling totally inadequate right this morning…  Last night, around 1am, we got woken up by a woman in a nearby apartment screaming in total ecstasy for about forty-five minutes…  It was almost constant “Oh yes!  Fuck Yes!  Oh Fuck, Oh Fuck, Yes, Yes!  Fuck Me Hard, Hard, Fuck Me! Fuck Me!” with a minute or two of wordless moaning here and there before building up into pleasurable screams again. There was the occasional grunting of a guy’s voice, a bit more towards the end as he was probably climaxing, then the two of them mumbling together for a bit…

Leena hates hearing it, saying that women having sex is a turn-off for her.  I’m sort of the opposite, I like it, like hearing a “live performance” and get totally turned on by it.  Granted, this woman isn’t as good as a former neighbor who lived across the hall, who didn’t last as long, but just sounded a bit “sweeter” and sexier...

Leena was nearly asleep a while after that, but I was totally awake, thinking solely about sex, of course.  I’d wanted us to make out earlier in the morning, but she wasn’t feeling too well, bad acid reflux, so we didn’t go beyond cuddling till she wanted to get up (despite her clear invitation for morning action the night before, before she could’ve anticipated that she’d not be feeling well in the morning…).

Not able to sleep, I joined her in her part of the bed and things went okay while I went down on her.  But then when it was time for the condom, I lost it…  Then after that, once my own member was lubricated from unrolling the condom on it as I was losing it, her messaging me made me lose control and come before I could get another rubber out…  A disappointing, though not unpleasurable end, but nowhere near as good as it could’ve been.

This sort of thing happens regularly and Leena is usually comforting and reassuring that I’m ok, but after hearing quite a performance from nearby, it just left me feeling pretty bad in the sexual department (especially after managing a condom twice last weekend and hoping for a repeat…).

Now it’s later in the morning and that neighbor has had two more sessions of the same thing, although each seems to be about ten minutes shorter than the last.  But still, I’m just thinking about how great in bed her guy must be.  And at this point in life, it’s unlikely I’ll ever be such a stud…

Rarely have I felt more like what I am turning into, an overweight, out-of-shape, middle-aged guy with erectile trouble.

Ug, dreams while sick in India

Ug... Not well, headache, diarrhea, nausea and feverish, hot and cold, shivering and sweating....

But after being up in the middle of the night for relief of some, and a few hot showers to wash and relax I got a few hours of sleep.

Back in bed, wrapped tightly in a cozy, cotton blanket, if I was laying on my back I felt worse, necessitating at least one extra trip out to the bathroom.

Curled up on either side in a fetal position and I had science fiction dreams, space stations, bug-eyed monsters and me and the characters kept escaping, while sending texts via mobile to people outside the dream world. And then waking with feeling a bit improved.

Lying belly down, slightly more comfortable in the time between waking and sleeping, led to similar dreams, but the bug-eyed monsters winning and catching the made-up characters, followed by waking and feeling slightly worse.

Now the sun is up and while I don't feel good, the degree of wretchedness is less... I'll drink some water and try getting more sleep...

(Sorry about the font, it's just copy paste from another app and I don't feel like solving it now)

Open Letter to My Wife

Dear Leena,

Simple.  I need your help.

While I know you'll deny both statements, but you're so thin and I'm awfully chubby.  And I need your help to deal with it.

I liked it when you first arrived in the U.S. a few months ago, after we were apart for so long waiting on your green card, and you said "wow, you've lost weight."  I felt great when you said that.  I know I wasn't even close to thin then, but I was certainly less fat than I am now.

It wasn't easy losing the weight I'd lost, but it was a lot easier doing it alone than it is now that you're here with me.  Don't get me wrong, I'm very, very happy you're here with me, but we need to change some things if you're ever going to tell me the same thing again.

By myself I ate less, and I ate more of what I wanted to and I avoided a lot more temptation.  I lived by a few loose rules related to food.  I didn't order much greasy, oily food, and not large quantities of it.  I only ate pizza at restaurants where I could get a small amount, never a whole pizza.  I often didn't bother with dinner at all if I didn't really feel like it.  And I walked a whole lot on the weekends...

Now that you're here, though, we're keeping a lot more food in the kitchen.  And you know I can't resist some of the temptations, especially when you leave a container of something delicious, still warm, on the countertop.

There's a few things we can do that won't have a great effect on your enjoyment of great food here in New York City...

When you ask if I want salad for dinner and I say I do, and then you buy greasy fried Chinese food for yourself, don't leave it on the counter, put it in the fridge so it's far less tempting for me (and at the back, I might not even see it!).  And don't ask me over and over "are you sure you don't want chicken? It's really good!"

When we got out for pizza, just because we can eat a large pizza, that doesn't mean we should...  We can get a smaller one and you can eat your fill, and I'll eat what I think is more appropriate for me without overeating.

When you offer me Doritos or potato chips and I say "no, thank you," please respect that "no means no" and doesn't mean "try again and again."  At some point, it because more difficult, especially when you make disappointed faces and sounds, for me to keep turning down something delicious that I know is bad for me.  You often make it look like I'm hurting you by turning down your offer, which hurts me more immediately than the longer term effects of chowing down half a bag of greasy, salty chips.

I'm getting uncomfortable with my expanding gut, I'm getting out of breath walking up the steps or bending down to put my socks on.

But I need your help to work on it...

Love,
Kevin

Sex Life Improvements in New York City

One of the reasons I was getting homesick in India was because our sex life was, well, very dull...  Both of us were sick much of the time, going from one throat infection to a stomach ailment to a sinus infection, to the flu and so forth, and there was very little overlap when both of us were between illnesses.

In between those, there was a lot more pressure to overeat at most meals, and neither of us was exercising at all.  I was afraid to step out the door because of the traffic, heat, pollution, noise and general chaos of Indian streets made me horribly uncomfortable and relieved to spend most of my free time inside reading books or playing on the computer.

Unfortunately, all that really ruined our sex life, neither of us was "in the mood" at the same times, and when we were, I was so out of shape that my "performance" left a lot to be desired, not really satisfying either one of us.

But now that I've been in New York City nearly two years, eating somewhat better (I mean, no dietician is going to cheer over my diet, but it's not as bad as in India where Leena and her mother really pressured me to overeat continuously with oily, rich, fried Indian foods (I mean, don't get me wrong, most of it was delicious!)) and walking heavily on the weekends, I'm in better shape.  When Leena arrived a month and a half ago she commented on how I've lost a lot of weight.  She's also bee joining me in walking hard on the weekends and is overeating less here.

With both of us in less bad shape than we were in India, and healthier, our sex life is getting a lot better!

Some of what helps is we get to be more romantic on a day-to-day basis, holding hands while walking, and unlike India, where any time we move near a window there's someone down below looking up, drivers, watchmen, laborers walking by, here we can walk around the apartment in various states of undress without worrying about an audience staring at us.

Another big help is the smaller apartment, making us bump into each other quite a bit more...  In India we lived in a 3 bedroom flat, each with our own bedroom (she said my panic about being late every morning kept her from sleeping), and it was up to me to make visits in the mornings when I was in the mood (which sometimes didn't last in a chilly walk across the flat).  Now we have a single, tiny bedroom so we're sleeping next to each other, finally.

And having inspiring neighbors doesn't hurt, either...

So, yeah, life is better in New York City!

One Year in New York

Well, it was just a year ago today that I arrived in New York City after nearly a decade in India...

It's been good to be here and I'm totally loving New York City.  It's a great city to explore, with fascinating architecture, both old and new, next to each other.  Old, run down industrial areas have been revitalized as new, modern parks.  And there's a million restaurants of every variety to try out (though no Indian food I've had compares to what's in India...)

I've been walking and walking and getting exercise.  While no one will mistake me for skinny, I've lost a bit of weight since I got here, while my legs are definitely a lot stronger and I'm in better shape than I was.

During my year here I've switched from reading up to 100 books a year to reading five or six (well, maybe twenty if you count comic books) because I just want to be outside all the time, not sitting in the apartment.  

I've developed quite a taste for sushi...  And I'm thoroughly enjoying New York style pizza and hamburgers, which I missed in India (but admittedly, not a single burger I've had in NYC compares to the Ultimate Burger restaurant in London where I traveled on business...)

I'm still thinking about one of the things that annoyed me in India, coworkers talking on cell phones a lot more than I thought was appropriate for work time.  Only to come here and find the same thing.  So maybe that was time, working in Oregon was before cell phone usage exploded...  Maybe?

Overall my health is better than it was in India.  While not perfect, I'm not falling sick with fevers and sore throats and colds every few weeks.  I'm still getting migraines, but not as bad as the last few years in India, especially the long, long one in 2010.  My stomach problems aren't completely gone, but I'm not having diarrhea three weeks a month...  So that's all good...

I've only gotten my hair cut once, in May, and it's getting long again...

I've been trying various green teas here in New York, but can't get any of them to taste as good as I was making in India.  I've talked to a couple of coffee & tea store owners and the general consensus is it's the water...

But I am getting lonely...

Leena and I didn't realize how long it'd take for her to get a green card.  We envisioned that I'd get here, get an apartment, make sure my job was okay and stable, start the application and she'd follow a few months later.  Well, it turns out that this is a one and a half to two year project...  And the immigration service hasn't even started processing our application yet...

And when I got here Leena's cousin, Nitu, was over in New Jersey, not far from New York.  We used to get together once or twice a month to explore the city, bowl, get a nice meal and chit chat and all that.  She's one of my closer friends.  However she flew to India on April 1st for a two week vacation, during which something went wrong with her visa and she hasn't been able to return to the U.S.

Since then I've pretty much been going about New York City solo all the time.  While I enjoy solitude, possibly more than is healthy, it's been a bit much...  I met up with another friend from India and some of his friends on August 20th for the Indian Independence Day parade.

Over the year, I enjoyed autumn, winter and spring, but found summer a bit hard to handle.  I know that sounds funny after having spent ten summers in tropical India, but I think some of it what I do.  In India I mostly stayed indoors, not just because the weather, but the pollution, the crowds, the noise, the chaos and all that, and I was happy enough to laze around the apartment playing computer games or reading books (especially with the unreliability of the electricity).

But here in New York City I want to get outside almost every waking moment.  It's hard enough just sitting in the office all day, but on weekends I don't want to stay in the apartment, I WANT OUT!

But it was hot outside...  Whew...  That really slowed down my photography and even more my writing about my adventures and sorting my photos, requiring sitting at the computer in the heat to do it.

Of course, with summer, I enjoyed reading in parks and watching people, especially women in short skirts, so there was that...  Compared with India in the summer, though...  In India summer is mango season, sweet, juicy, tender mangos...  Summer in New York is women in short skirts...  Look & smile vs. touch, taste & smell.  Which also brings to mind what a lesbian former coworker once said around fifteen years ago when I brought some mango to work as a snack...  She said the color and texture of mangoes, especially when heated up, was just like giving a woman oral sex...  Which I probably thought of every single time I ate a mango since...

Yeah, missing Leena, coming home every day to an empty apartment is about the toughest part of the year here...

So, that's a quick rundown of a year, written late, at bedtime...

Here's hoping Leena's visa comes quickly....

House Cleaning is Hell

I'm not known for my love of doing house cleaning...  In fact, probably just the opposite...  The apartment I lived in Beaverton, Oregon in the 90's I don't think I ever thoroughly cleaned in the seven years I lived in it.  The only thing I like to clean are the dishes...

It's not that I don't appreciate a clean house.  I mean, I like how Leena keeps the apartment all nice and clean and puts such a tremendous effort into either doing it herself or managing the servant through it, or a combination of both.  Especially in Pune where the amount of dust blowing in is simply incredible and most of the tools are sub-par.  And I've always enjoyed visiting my Aunt Lenore in Florida where I can walk around her apartment in bare feet without them getting filthy (my parents' house misses this qualification not because of dirt, but because the Oregon coast weather means always wearing socks in the house...)

But rather, it's just that I don't find the act of cleaning to be worth the time, effort and energy.  I work my butt off at the office, and while I earn a decent living, I pay a heavy price in terms of time, so when I have free time, there's so many other, far more rewarding ways to spend the time: reading, writing, web surfing, programming, playing computer games, exploring the city, baking, eating, watching a movie, sleeping, laying back and staring at the ceiling...

And it's worse because I'm not very good at it.  Or is that an understatement?  I suck at house cleaning.  Sure, I possess the knowledge of how to do it, but it seems like after I sweep a floor there's still dirt everywhere, if I wash a bathroom there's still dirty water streaked all over the place.  So on top of the miserable work, there's the end result that just makes me feel angry, frustrated, like I'm totally incompetent and I wasted my time.

To top it off, whenever I sweep I usually end up getting a sore throat and a cold that lasts for a week or two of sneezing, sniffling and coughing afterwards, while using cleaning chemicals gives me headaches and makes me nauseas...   And the noise of the vacuum cleaner causes pain to shoot through my ears...

I'll go out of my way to avoid making messes, but over time it does accumulate...  And I just don't find it worth it to deal with it...

Anyway...

I for one welcome our new robotic vacuum cleaner overlords...

I've had this now for a bit less than a week...  It's less noisy than most vacuums, which is good, and best of all I can just start it and step out...

Perfect?  No...  As one friend pointed out, he bought one six years ago and hopes they've improved its algorithms since then.  But even if they haven't it still probably cleans better than I will over the course of six years...  

Cold Hands

As a teenager my mother got worried about my cold, white fingers and a doctor diagnosed me with Raynaud's Phenomenon (fortunately my hands never look as bad as the ones shown in the article!), so it's not uncommon for my hands and feet to be really cold, and sometimes really pale coloured.

In India it was rarely bad, since it's tropical and hot most of the time.  And so far here in New York City, even though the winter, it never got bad, either.  Once in a while in the office, and I usually warmed up one hand at a time wrapping them around a hot cup of tea (fortunately I can use the computer mouse with either hand).  After warming up one hand, when I grab it with the other, the part I was holding onto is often cooler than the rest of the cup.

But I really notice it on the subway, holding onto the metal poles.  They're usually chilly.

But if someone else has recently held one it's hot there.  Sometimes I'll grab onto the pole and then someone else gets off at a station.  It could be several stops later, but I change my grip and hold on where they held on, and the metal still feels hot.  Then if I move my hand to where I'd been holding on for a few stops it'll barely be warmer than the parts no one touched.

When outside most of the winter I walked and walked and kept moving, so that kept my blood flowing without much trouble with circulation.  My fingers got cold when taking photographs, but not the same as the Raynaud's symptoms...

Reading through that Wikipedia article, there's an interesting fact, "Sufferers are more like to have migraine ... than controls."  No doubt...  I certainly have the migraines...

Now that I think about it, maybe that's how I developed my love of long, hot showers...

Headache Medicines

So, after the last follow-up with the neurophysician in Pune in which I asked him about getting completely off the medicines he'd prescribed for the nasty headache and migraines I was having, he agreed to lower the dosage, first to 10mg for a month and then cut it out.

The schedule worked out to stopping it sometime around now.  I didn't calculate the exact date, but having two four-day weekends in a row here in New York seemed good.  Tuesday night last week was the last time I took either of the medicines, figuring that would get me through Wednesday at work and if I had withdrawal issues I'd have four days to recover.

I didn't get a headache till Sunday, but even then it was pretty mild and didn't really interfere with my plans (about which I still need to process the photos and blog).  Monday, Tuesday and Wednesday this week I had headaches.

Monday was the worst of them, and I took four aspirin in the morning before work which helped ease it.  By later in the afternoon it was getting pretty bad and I felt a bit nauseas, too.  Going out after work to deposit my paycheck in the cool rain helped and I didn't notice the headache too much while I was doing that and eating pizza near the ATM.

Tuesday and Wednesday weren't so bad, but it was definitely there.

Today, however, I was in a rush to get out the door and grab a bag of garbage to take downstairs that I completely forgot the aspirin pills.  I didn't remember until I got to work and didn't have a headache at all.

So, this is good.  Hopefully the headaches are back under control again.  And hopefully the side effects will start easing off, too, especially that nonstop ringing in my ears.

Final Follow-up with the Neurophysician

A couple of weeks ago we followed up with the neurophysician about how the medication-based treatment of my headaches has been going. I quickly found on previous visits that when he'd ask me how things were going he wouldn't let me really talk and say what I felt I needed to say, before cutting me off and him talking. So, I got in the habit of writing the details.

This visit was the first one after we got the printer, so I was able to elaborate even more by typing instead of hand-writing, and include a picture, found using Google, to demonstrate what I was trying to say.

With the last visit you increased the dosage of Amitone from 10mg per day to 25mg per day. But we still had a strip of unused 10mg pills, so you said to take two a day, or 20mg, until they ran out, then get the 25mg pills.

The first week, using 20mg a day, I had no headaches whatsoever.

When switching to 25mg per day, I started with the same headaches I had on 10mg per day. After a week of that I went back to 20mg per day, but no change, still had the same headaches, and then after a couple of weeks went back to the prescribed 25mg per day.

Overall I'm still getting headaches a couple of times most weeks. Usually they're not as severe as they were before the month-long one that prompted us to go to you, and the Suminat 50 almost always halts them.

With the increase of Amitone from 10mg to 25mg, the unpleasant side effects are also noticeably worse:

• The confusion and disorientation when waking up after dawn in the mornings is much worse than when taking 10mg, and that was much worse than not taking anything. If I happen to see myself in a mirror at those times, I don't recognize myself and think there's a stranger in the room.
• The ringing sound in my ears is louder and more persistent. My ears were ringing pretty steadily for some months before we visited you the first time, but as the dosage has increased, so is the ringing.
• I've gotten very fat… Despite actually cutting down my meal portions and eating a lot less junk food (e.g. potato chips, Kur Kure, etc.) I'm gaining weight and getting fatter and fatter.
• When I'm tired and the lights are dim I'm getting more and more hallucinations. These include seeing insects and spiders crawling all over the bed and my arms, though I know they're not real so I don't panic, or seeing things, birds, bats, butterflies, some look real, some look like glass, floating up and into the ceiling.
• When I look at many things that are brightly colored, they sparkle at those times, too, shimmering like they were covered in glitter, looking a bit like this photo:

At first he started answering me about the hallucinations, that they were absolutely normal and everyone experiences them, and write the medical term on the sheet, something including the root "som" which I know has to do with sleep.

But then he said "this is really well written" and handed it to an assistant (or intern or whatever) and said "insert this into his file, I'd like to keep it on record".

After discussing with him I asked if we could work on eliminating the medications altogether and he put together a plan, one week on 20mg a day of Amitone, then down to 10mg a day for a month and then stop it. He recommended keeping on with the Betacap, which he'd actually forgotten he prescribed until we asked about it, as well as recommending I keep using the Suminat when I get a migraine.

He wrote down what he thought were some of the brand names for the same drugs in the U.S. but didn't know which were prescription-only and which might be over-the-counter. He also gave me an address to email him if I need any advice while I'm in the U.S.

Food Poison on Thursday

Ug, really rotten day yesterday, Thursday. Food poison from breakfast. I was cutting up tomatos and some of them were kind of black inside and I threw them out, but one only had a little black stuff, so I trimmed around it. Big mistake...

After getting to work I had a headache, by late morning I was shivering and sweating, the headache got worse and a bit of nausea... My computer mouse was disgusting to touch, slimy from my sweating hands...

I called Leena to pick me up and take me home shortly after noon, then sat out in the sunshine near the entrance to the office building. She picked me up a few minutes later, dropped me at home and went out to run errands (she offered to stay home, but I said I was just going to sleep, so there was no need).

Once in bed I couldn't sleep, just tossed and turned, feeling absolutely rotten and uncomfortable. I was freezing cold, shivering violently at times, while sweat was running off my body in rivers, soaking the sheet and the blanket on top of me.

What I really wanted was a nice, hot shower, just sit under the hot water. When I don't feel well, that almost always helps, the water beating on my aching head helps relieve it, when my stomach's upset, the hot shower eases that off. I guess it just relaxes me. Unfortunately, it was Thursday, which is Pune's day for long power outages, so there was no hot water all day.

Eventually my burps had the flavor of the cantaloupe I ate before work, but as though it was rotten, a sure sign my digestive system wasn't working right. And a bit after that the vomiting started... Each time I vomited I felt a little bit better afterwards.

After the third time, around 4:30pm, the worst seemed to ease off and I felt more calm, and less cold, less sweat. Leena came home shortly after that from running errands.

I got up from bed around 6pm when the power came back on (it'd been off since around 8am), hallucinating a bunch of glass hummingbirds floating around the room. I got a nice, hot shower for a while, and that lasted till the power went out again and I used up all the hot water in that bathroom...

Then a cold coconut cut open to drink the water inside, followed by a three hour or so nap. By 10:30pm I was able to eat a little bit, nothing with powerful flavor, of course. And I drank a big glass of water and Electrol to replenish the salt and sugar I lost from throwing up. I stayed up reading a while till I thought I could go to bed without getting up to use the bathroom a number of times after the drink.

Now it's Friday and I feel a lot better. Not altogether well. Still a bit of a headache, and Leena said I'm warmer than usual, so the fever's not completely gone. She called the doctor who recommended I take paracetamol twice a day to bring the fever down, but wants to stay away from strong medicines if I can shake it off more naturally.

However, she didn't ask him my burning question... What about single malt Scotch whisky?

Side Effects

The thing about a migraine-type experience is that it's like being only half alive. You find yourself walking through this tomb world, everything gets far away and kind of dull and dead.

- Perkus Tooth in Jonathan Letham's Chronic City

So, I've been taking the two medications as a prophylactic for my migraines since early March now. One is an antidepressant and one is a beta blocker. For the most part they're working. While I'm not completely without migraines, they've reduced an awful lot. And for when I do get them, there's a triptan I can take that usually relieves one.

But wow, there's side effects, too...

• Every time I wake up I'm extremely confused and disoriented. Especially if I go to sleep when it's dark and wake up when it's light. Then I have no idea where the light came from or who's shining it through the curtains. The doctor assures me it's normal, everyone wakes up confused in the morning, but if I compare the roughly 14,800+ times I've waken up before I was on the medications with the 70 times I've woken up after taking it, I know the difference.
• Hallucinations, especially when I'm tired. When I wake up from sleep, the view from the bed is almost always that I'm on the edge of a huge chasm, and the little foot board that sticks up from the bed is a railing to keep me from falling off. The dressing table, a couple of feet away, looks to be a mile away, across the chasm. Whoever's in the mirror on the dressing table when I wake up, I usually don't recognize them for a couple of minutes and I'd swear there's someone else in the room.
• One hallucination I had was when Leena came in on a weekend morning I waved to her in the doorway, but my impression of it was that I was holding a picture postcard of her, with the doorway being the white border around it.
• Songs get stuck in my head more often. It's harder to get them out once they're there, even when I'm concentrating on other things. I think early on, before I recognized this I may have blurted out some lyrics at work when someone asked me a question. It's probably a good thing I haven't been in a Soundgarden mood much to listen to Louder than Love.
• I'm a lot more angry than I was before taking the medications. I've lost a bit of my former easy-going nature. I think I've snapped at coworkers, and I know I've written at least one email at work I regret (not the concepts, but I think I could've phrased things a bit gentler).
• Impotence, I just have no interested in sex since starting the medications. On the other hand, before that I had the interest but was in too much pain to do anything about it, so maybe it's not a bad trade-off for the short term. But it still makes me wonder, "what the fuck's wrong with me?" (which of course, I can answer...)

Hopefully I won't be on these medications for too much longer. From what I've read the usual time is in the neighborhood of six months, give or take a little. Although the one night I forgot to take it (actually, I was super-sleepy and couldn't remember if I took it or not and didn't want to double the doses in case I had) I had a bad, bad headache the second day after that, the worst one since I started it, so maybe I'm not ready to quit them yet...