health

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Seven-ish for Saturday

Oh hey, it’s the middle of May and this is only the second time I’m posting this month.

Summer Scheduling Success

Finally, finally, I think I have summer figured out. By my calculations, Carla has approximately 20 days of summer that are currently void of Established Plans, and they are mainly spread out – two days here, three days there – with only two full weeks that she has nothing. Those two weeks are spread out, too – one in June and one in July – so we’re not talking endless consecutive days of fighting boredom and negotiating screen time. Will this be enough? No idea. But I feel much better about our summer schedule than I had. All that’s left to do is a) fill out and submit all the eight bazillion forms each camp requires, b) buy all the things that each camp requires Carla to have, and c) figure out how to fill the remaining twenty days. (Swimming? Horseback riding lessons? Dog walking? Friend gatherings?) That’s something for Near Future Suzanne to deal with, I think.

Roof Repair Roundup

Apparently I am going for an alliterative subhead thing. A large portion of my days, lately, have been spent trying to navigate my roof replacement. Our insurance company was very prompt about sending out an insurance adjuster to review our property damage, and very quick to cut us a check. Our contractor has been very responsive in addressing questions and in reaching out to the insurance company for supplemental coverage. My brain is inundated with terms I sort of but don’t 100% understand, like soffits and ridge caps and fascia and flashings. I am grasping to understand exactly what the contractor is saying, and hoping that the insurance company gives us the money he requires to do the work he needs to do. (Like, apparently you need to disconnect the soffits or maybe the fascia or possibly both from the top plank of siding if you replace or repair the siding, but the insurance hasn’t offered any coverage for that, even though they have offered coverage for the siding itself. That kind of thing.)

I pored over an eleven (11) page review of my insurance policy and the replacement cost estimate, I pored over a thirty-eight (38) (THIRTY-EIGHT) page quote and contract from the contractor, which seemed mostly clear and reasonable, except for a couple of things that apparently don’t apply to us because of reasons. And there was a whole list of potential upgrades that we don’t need unless the insurance company decides against things like “covering the disconnecting and replacement of soffits and/or fascia” in which case we will then need to decide whether to spend an additional $XXXX of our own money. And then there is something called a “punchlist,” which I now know is a list, at the end of the project, of things are incomplete or need to be readdressed, like scratches made by a tool during construction, or a half-finished something-or-other. And we need to somehow figure out how to schedule the repairs/replacements so that they don’t coincide with or overlap our summer travel. And are we going to have a port-a-potty on our lawn/driveway for weeks on end? Let’s leave all this for Future Suzanne to deal with. Man, is she going to be pissy with me.

Another Absurd Trigger of (Truly) Trivial Obsession

My husband and I got a new scale. It’s a “smart” scale. It has an app. And it measures more than just weight. Supposedly it also monitors things like your muscle mass and body fat percentage. (Supposedly it monitors these things less accurately than one would hope; my husband suggests we use it to observe trends rather than to give us exact numbers.) I am interested in maintaining and increasing my muscle mass as I age. I am also interested in seeing if my kiddo can increase her muscle mass – a recommendation from her coach. I am quite excited about the pet feature. I mean, it’s just a way to weigh your pet without doing mental math. But as I am constantly fretting about whether I’m feeding Lenny enough or too much, I am pretty pumped.

The scale collects all this information about you, via some sort of magical (electrical) currents that travel through your feet, and beams the data to the app on your phone. I know so much about technology. Then you can read all sorts of interesting slash mystifying metrics about yourself.

The one that I keep thinking about is my metabolic age. I have never once thought about my metabolic age, nor do I really know what it is beyond a hazy semi-understanding. But now that we have the scale, I’m thinking about it. My metabolic age is 44. I am 45. This seems positive, right? The scale thinks I am younger than I am.

Here’s the thing. My husband’s metabolic age is 43. He is not only also 45, he is half a year older than I am. SO HOW COME HIS METABOLIC AGE IS LOWER THAN MINE?!

Obviously I am now obsessed with pressing questions like, can I reduce my metabolic age? If so, HOW? And by HOW MUCH?

Possibly I need to sideline my extreme spousal competitiveness and find out what metabolic age means and if it matters.

Colonoscopy Complete!

This week I undertook my first-ever colonoscopy. I was, as some of us are, a wee bit anxious about the whole thing. The only bad part was drinking the prep. The rest of it was fine. Well, the anxiety wasn’t great, but it was preferable to drinking the prep.

A ton of different bowel prep options exist, from a giant jug of GoLYTELY to 24 enormous SUTAB pills and everything in between, what a time to be alive, and each gastroenterologist has her preference, not to mention health insurance companies only cover certain options. (That doesn’t mean you can’t ask for a different prep if you, too, have a preference.) I now have an anti-preference. My GI prescribed SUPREP, which is the only prep my insurance covers. (I don’t know why all the bowel preps have names that scream at you.) It comes in two little six-ounce bottles. I needed to mix one bottle with ten ounces of cool water at 6:00 the evening before my procedure, and drink it before 7:00. While also drinking two additional 16-ounce glasses of water. Then I needed to repeat the prep and additional water intake again five hours before my procedure. The SUPREP was ABSOLUTELY FOUL. It was salty and forcefully bitter with a very faint citrus flavor. I tried mixing the first batch with a bit of lemon-lime Gatorade powder; this was a bad idea. I will never drink lemon-lime Gatorade again, that’s for sure. I tried plugging my nose while I drank it, but that didn’t really disguise the taste (although that particular trick has never worked for me). I tried drinking it through a straw, which is supposed to bypass the tastebuds on your tongue, but I found it to be even worse. I tried adding ice to the glass, but – as my husband cautioned – that just increased the amount of awfulness I had to get down. What worked was taking two giant gulps, while plugging my nose, then following those gulps up with as much ice-cold pure fresh tasteless water as I needed. Still, by the end of the second bottle of SUPREP, I was struggling not to gag.

Let’s back up a little, because I know you want More Detail about my colonoscopy prep. I was anxious about the procedure because I have a family history of colon cancer (grandmother and great-grandmother) and polyps (parents), but also because the procedure took place within my husband’s hospital system and among people he knows and works with. Consequently, I felt that I had to be The Best Patient, or, at least, A Model Patient. So I did a pre-prep two days before my procedure (seven capsful of Miralax in 32 ounces of red Gatorade). The Miralax, which is supposed to dissolve completely in liquid, made the Gatorade slightly viscous and gave it a very very mild but noticeable Miralax flavor. Is that flavor something I can characterize more descriptively? No, it is not. It was gross, but I would drink ten bottles of Miralax-flavored Gatorade before I would do SUPREP again. This was in addition to starting a low-fiber/low-residue diet (no nuts, seeds, of fresh fruits or veggies, limited high-fat foods) four days prior to my colonoscopy, and a day of clear liquids the day before the procedure.

“That sounds excessive,” my friend noted, when I told her my Miralax-flavored plans. Perhaps. But I will say that the nurses and techs were all chatting about their own colonoscopies, and every one of them did some sort of extra prep on top of what’s required. (The concern is that your colon won’t be clean enough for the GI to see what they need to see, and you’ll have to come back… after doing the prep AGAIN. Shudder. Obviously, this is not an issue for most people, and I am not advocating that YOU do additional prep, unless you, too, are partially insane. And even in that case, please consult a doctor, which I am not, before you do anything.)

On a personal note, I think the additional measures helped make my prep easier (and less disruptive; I slept just fine both nights) while also ensuring that my colon was pristine for my procedure. You might be thinking, no one gets a GRADE for colonoscopy prep, Suzanne, and you would be right. But also, my post-procedure summary includes the glorious phrase “the quality of the bowel preparation was excellent.”

Oh and also I had no polyps, thank everything, next colonoscopy in ten years, which of course is much more important than getting an A+ on my prep.

Imagining the Ideal Instruction Manual

When I made my colonoscopy appointment back in February, my doctor put in an order for the SUPREP, which I picked up from my pharmacy. I also received a packet of instructions from the gastroenterologist. A thick packet, with many pages of instructions. Listen, it was fine! Helpful, even. And yet, it could bear some improvement. Some of the instructions were in all caps. Some of them were highlighted. Some were in bullet points. Some of them were vague. Some of them directly contradicted the instructions on the Suprep box. There were lists of prohibited foods/drinks; there were some lists of foods/drinks that were allowable; none of the lists were in any way comprehensive.

As I’ve spent the past twenty-odd years writing and editing things, I’ve been thinking a lot more than is healthy about how I might improve upon this packet.

The major problem I see is attention span vs quantity of information. As any writing professional knows, people don’t read. The fewer words the better. The clearer the better. (Sometimes those two dictates are in opposition.) And yet the gastroenterologist needs to convey quite a lot of complex information, and there’s not a great way to get all of it across to the patient. (I also got two phone calls in advance of my colonoscopy, but they conveyed both less and different information than the packet did.)

As a patient, I think I would like the packet to contain these things:

1. How to prepare for the colonoscopy. Like I said, the packet from my doctor directly contradicted some of the instructions on the Suprep box. The box, for instance, said I could eat a light breakfast the day before the procedure; my doctor said NO DO NOT DO THAT. The box said orange and grapefruit juices were among the “clear” liquids I could drink; my doctor said NOPE. So I think I want to know right away, right up front, that I should ignore the box. (This was one of the highlighted, all caps sentences on the front of the packet I received, but there were several other highlighted, all caps sentences on the front, so I could have easily downplayed its importance or missed it entirely.) I think I might like to know that there are many prep options, and that I should focus on these instructions because they are specific to my prep, and not listen to my cousin who didn’t have to do a single day of low-fiber eating and who thought his prep wasn’t half bad. I think I might like some strategies for getting enough calories and protein (even bone broth only has around 45 calories and 10 grams of protein per cup), and not making oneself queasy with too much sugar. It might also be nice to have a little calendar that lays out Day 1 through Day of Procedure with brief bullets about what to do each day (“Day 1: low-residue diet; see pgs 2-3”).

2. What to expect from the colonoscopy. Before the procedure, first the nurse and then the anesthesiologist both talked to me about what would happen, but I always like to know that stuff well in advance. Like, you will need an IV. You will have to change into a gown and those little grippy socks. You will need to arrive an hour before the procedure, the procedure itself should take around thirty minutes, and you will require about thirty minutes in recovery afterward. It might be nice to know a teeny bit about the procedure itself (“the doctor will introduce a flexible tube into your large intestine; she may use water to flush your colon as examines the lining; she will attempt to remove any polyps she finds; you will be sedated the whole time”). I’d like to know that the GI will come in and give you your results right then; that might affect who I would bring with me as a driver. I’d like to know that I might feel tired for X hours after the procedure, or that the anesthesia might make my stomach a little more sensitive to greasy foods than normal.

3. A more-or-less complete list of prohibited / allowed foods and drinks. The packet I received had some lists, but they were slightly confusing. Like, on the low-fiber/low-residue diet, you shouldn’t eat fruits and veggies, but you could eat canned or frozen fruits and veggies? What? As far as I can tell, the real issue is FIBER, so, like, an apple without the skin is okay, mango is okay, but strawberries are not okay. (I did not ask about bananas.) Tomatoes are prohibited but tomato paste is okay. Cooked onions are okay, shredded fresh basil is not. On the “clear liquids only” day, green and yellow and orange Gatorade/Kool-Aid/Jell-O/popsicles are fine; red or purple or blue are not. Black coffee or tea are also fine. No milk or non-dairy creamers, though. (But what about coconut milk? Or almond milk? No idea.) Sugar and sweetener are fine in your coffee or tea, even though they aren’t liquids. (I put honey in my tea without even asking, am such a rebel.)

My husband and I discussed that the existing lists kind of leave patients to make their own judgment calls, which I’m sure can have varying results. The internet says that sucking on hard candies during your clear-liquids day is totally acceptable, and I feel like it probably is; it’s just sugar! But I might also think it’s okay to chew gum in the waiting room before my colonoscopy, since that’s neither food nor liquid… but it ISN’T okay. Other patients may read the lists and think those are the ONLY restrictions/allowances. A friend, before her colonoscopy a few months ago, was worried about drinking her own homemade chicken stock, because she uses celery and garlic and onion to make the stock, and celery and garlic and onion were not on the list of allowable foods.  

4. Other Important Things to keep in mind. This might include which medications you can and cannot take the day of your procedure, and that you literally cannot take even a sip of water in the three hours before your colonoscopy or they will delay your procedure, and that you can wear a bra under your surgical gown as long as it doesn’t have an underwire, and you should avoid applying lotion the day of your procedure, and that yes you really do need a driver who will wait there with you and drive you home, and that you CANNOT CHEW GUM the day of your procedure.

It might also be nice to know what to do if, say, you vomit up half of your prep. Does that mean you have to start again? Or what to do if you have a medication you take at a specific time that needs to be taken with food. I am sure there is a whole host of FAQs that gastroenterologists field on the regular that would be useful to include.

I know a packet of information that a decent percentage of patients aren’t even going to glance at cannot possibly address every eventuality. And, of course, people successfully undergo colonoscopies every day, even without all these details. But I know there are others who are as anxious and rule-abiding as I am who would really appreciate a thorough and well-organized document.

Car-Trip Compromise

My husband and I are in ongoing negotiations about our summer road trip. We have agreed on one thing and one thing only, which is the location of our First Major Stop. From there, we will make a circle to return to our starting place. But which way will the circle go? We could drive West, to a big city my husband has never visited before. We could drive East, through the mountains, and, importantly, through my best friend’s city. This is really a choice between urban and rural, city experiences vs unspoiled landscapes. It feels like a choice between him and me, our very essences, and – while both of us are being very careful and tactful when laying out our pros and cons for each option – neither of us seems willing to budge an inch. WHAT WILL HAPPEN? I am guessing that we will end up going the urban route. My husband is much more excited about that option, and our first stop – during which I hope to see another of MY friends – was my idea in the first place. I suppose I shouldn’t get to determine everything about our trip, even if I want to.

Pussy Cat Palate Cleanser

After my whole losing-the-pole-toy-behind-the-bookcase disaster, I have been storing Lenny’s new pole toys on the second shelf of my bookcases. He knows this. And he has spent a lot of time this week trying to get to them.

He has also spent some time trying out poses for the cover of Classical Cat magazine.

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Seven for Sunday

Thank goodness for Elisabeth: her F.I.G. Collective project is not only keeping my brain primed to find things to be grateful for this month, but getting me to blog when I feel completely sapped of post ideas.

Here are seven things I’ve been especially thankful for over the past week.

Sunday, February 15: Carla has the day off tomorrow (for President’s Day), so the three of us plus my parents left town for a mini ski getaway. We had great snow, great weather, and a lot of fun. I adore skiing, and I am so grateful to be able to do something I love, with the people I love.

The morning started out foggy but the snow was perfect and no one was there!

Monday, February 16: The grocery store still has a TON of beautiful Valentine’s Day floral arrangements – and they’re all half off! I snapped up this cute little planter.

Tuesday, February 17: Even though we hire a cat sitter to come take care of the kitty twice a day while we’re out of town, he acts as though we have abandoned him for years to fend for himself. He demonstrates his relief at our return through days of intense and unending purrs and Velcro-ing himself to our sides, and I’m not going lie: I love it.

Who knew purring could be so accusatory?

Wednesday, February 18: Guess what arrived in the mail today?!?! What a thrill to be able to experience Nicole’s writing in book form, and to have my own copy of her first novel for my home library.

Thursday, February 19: I had my annual physical with my doctor today. I am grateful that all my labs are normal. I am also grateful that my doctor listens to me and that she was happy to refill prescriptions and submit orders for my first ever colonoscopy. Am I looking forward to this procedure? Hell no. But I have a family history of colon cancer and I am grateful that I’ll be able to get some insights into my intestinal health.

I really would like to decline, but I am NOT GOING TO.

Friday, February 20: For the first time in A WEEK, I sleep through the entire night without waking up. I have been seeing many of the wee hours of the morning lately, and when I’m in a spate of poor sleep it’s easy to feel like it will always be that way. I’m so thankful that I am still capable of sleeping six hours in a row.

Saturday, February 21: Today is the bat mitzvah of a family friend, and it was such a joy to witness her confidence and satisfaction as she led the service in Hebrew. I’ve known this kiddo for more than half a decade now, and as I watched her recite the Torah portion of the service, I could see her little second-grade face superimposed over the face of the beautiful young woman she’s become. Being able to watch Carla grow up and into herself is, of course, such a gift, but I am surprised by how moving it is to watch her friends grow up alongside her. The entire day was joyful and celebratory and I am so thankful to have been part of it.

The cat is wondering why I am using him as a prop.

That’s all I’ve got for you today, Internet. Snow is falling quietly, the cat is waiting for me to play with him, my family is still asleep. I hope you found many things that filled your heart with gratitude and joy this week, and that the week ahead is similarly full.

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Routine Doctors Appointments

Why have my insurance plan and my annual schedule conspired to make January the month when I have All the Appointments? I was trying to make plans to write with a writing friend and I looked at the calendar and it is PACKED. I feel like January is nearly over and it has only just begun. 

One of my upcoming appointments is with my OB/GYN, and I have been steeling myself to insist a little more forcefully that I believe I am in perimenopause. You will likely not recall that last year, my tentative questions about it were dismissed due to my age. The array of symptoms that seem to be perimenopause-related continues to grow, so I just want to confirm that a) yes, this is happening and b) there is nothing I can really DO about any of it, beyond what I am already doing. (TMI note: I take oral contraceptives which both prevent a period, so I don’t have that to clue me in as to actual menopause, and, according to the OB/GYN, oral contraceptives are supposedly the first line of defense against perimenopause symptoms anyway.) I had also been steeling myself to ask for a physical exam this year, should it be bewilderingly optional as it was last year, but I am pleased I am relieved I see from last year’s post that I should expect a pap test this year so that shouldn’t be an issue.

The other upcoming appointment is with a new-to-me internist. I have been mildly fretting about the appointment for, oh, several months now. I am eager to have a primary care physician again; my last PCP, whom I adored, prescribed me a new medication two Decembers ago, then went on leave until March, then left her practice to become a concierge physician. I love her enough that I strongly considered following her to her new practice, but I did not. Anyway, I have ostensibly been without a PCP since December of 2023. The old practice has been kindly refilling my prescription all this time, but I will be relieved to have a regular doctor again. (Yes, it has taken me since approximately March of 2024 to get in to see a new physician. This is both because I wanted a doctor whose office is closer to where I live now and because I wanted the specific provider my husband recommended.)

The thing I am fretting about is that this appointment is about establishing me as a patient… but I also have A List of things to discuss with the doctor. So I am worrying both about coming across as someone the new doc wants to have as a patient… and about addressing my concerns. 

Is the first fret ridiculous? Yes, yes it is. I can acknowledge that without being able to eliminate it from my worry database. I am sure this doctor sees a thousand middle-aged women just like me; I am not going to be any more or less desirable as a patient. Plus, physician’s job is to deal with the patient in front of them, not reject them based on some sort of Simon Cowellian checklist. (Is Simon Cowell still a contemporary reference?) And in any case, physicians treat patients all the time that they might not otherwise hang out with or befriend; we do not need to be besties. 

STILL. I want to make a good first impression. That’s weird, right? And yet, there it is. 

Let’s move on to the less-ridiculous portion of my frets, which is how to address all the things I want to address without overwhelming the doctor or myself, and without doing that thing where I make a careful list and then get to item three and suddenly feel like I’m overstaying my welcome or talking too much or whatever. I cannot tell you how many times I have gone to see a doctor with Very Specific Things To Discuss, and have decided in the moment that they are silly and I won’t bother the doctor with them. Even when I bring a written list with me, I still do this. 

(You might think that having grown up with a physician for a parent, and then marrying a physician would negate some of the awkwardness I feel when at the doctor. But no.) 

Since three seems to be the magic number, I think I have narrowed my Must Discuss List to three topics: 

  1. Fatigue. I am tired all the time. Like, more tired than in years past. (I feel like I’ve been chronically tired since at least 2012.) So tired that I see the effects of the tiredness in other areas of my life. Is this… The result of a medication I’m taking? A symptom of perimenopause? A deficiency of iron or vitamin D or something else? Because I am terrible at sleeping? Subset of the previous: it is because of my horrifically restless legs? Is the terrible sleeping a result of poor sleep hygiene? Or perimenopause? Or some lifestyle choice I am making? Is the tiredness (and/or terrible sleeping and/or restless legs) fixable? Or is this just my current phase of life (The Tired Phase) and I need to accept and lean into it? 
  2. Medication. I started taking anxiety medication in December 2023 after a series of escalating panic attacks. The medication has been very helpful. I think I am in a less anxious state now than I was then; is it time to try to discontinue the medication? If so, how do I do that? And what happens if I decide it was a terrible plan to discontinue it? Yes, 2023 was a wildly exciting and action-packed year which ended spiking my anxiety to new heights, but it’s not like I was NOT anxious before that. I am not opposed to taking medication when it is helpful, but I also don’t really want to take medication if I don’t need to.
  3. Weight. Due to some fairly significant weight gain over the past year, I am heavier than I have ever been in my life. Aside from not being pleasant in a variety of ways for a variety of reasons, I am wondering if I need to Be Worried. Is my weight gain a side effect of the aforementioned anxiety medication? A symptom of perimenopause? The result of too many nachos? Something else? Is it causing any problems I should be aware of, aside from the expected and unwelcome not-fitting-into-my-clothing and poor-self-esteem issues? (Like perhaps my extreme tiredness?) Beyond trying to eat less and move my body more, is there anything I should be doing?

You may notice that this very tidy list of three contains many, many subtopics. That feels a little like cheating. (I imagine myself telling the new doctor, “I want to discuss three health concerns with you!” and then bombarding her with restless legs! and perimenopause symptoms! and anxiety! and insomnia! as she crumples to the floor under the weight of my hypochondria.) (Yes, I do realize this is not how doctors work.)

You may also notice that “weight” is at the bottom of the list, in case three topics ends up feeling like too many topics with which to burden the doctor. (I know; I cannot stop thinking this way.) I put it at the bottom because it is the topic that, to me, seems to have the most obvious solution (eat less and move your body more), and also because it is the topic that I feel least comfortable bringing up. It’s such an uncomfortable topic! And possibly the doctor will bring it up anyway, without me having to say anything. 

I have a new, third fret: that I will inadvertently turn my New Patient Appointment into a Sick Visit. Why yes, this fret IS brought to you by two weeks of my family being sick plus waking up at four o’clock this morning with a terrible headache and a sore throat that feels worse than yesterday’s mildly scratchy throat and ear pain and a low-grade fever. 

What happens if I AM sick for my appointment? Is that… allowed? I feel like the “rules,” insofar as I (don’t) understand them are that you can’t be treated by a new physician until you have established with them as a patient. This is why I have been scrupulously healthy this year, because I would much rather go see my PCP than visit urgent care. 

If I AM sick for my appointment, then identifying/treating that illness probably jumps to the top of my list of concerns… but can I also address the other less-urgent topics?

Should I perhaps be badgering my husband with these questions instead of fretting about them on the internet? I mean, yes, but what is the internet for if not for airing ridiculous worries.