Medical Concerns

For each of the areas below I will indicate the current status. If I take any medications for any of these, they will be shown as bullet points under that item.

 

Brain – no concerns. ABC (Aging Brain Cohort) testing continues to indicate no brain issues – yay! I’m also in a few other periodic testing groups which collect results from large groups to look for causes, etc. (MindCrowd, APT-Webstudy (Alzheimer’s Prevention Trials), PPMI (Parkinsons’s Progression Marker Initiative)). Apart from using my knowledge in this area to help minister to others at church, etc. who are having mental issues (Jerry Engle, Ron Shoemaker, etc.) I’m going to remove this from my list of concerns and periodic reporting.

 

Head – Still a small dent where a cyst was removed this summer. Not a significant issue, but I wish it would go away. I have a habit of picking at it, so I’ve temporarily gone back to having a band-aid on it.

·       Aquaphor healing ointment

·       Sensitive skin extra large band-aids. Regular band-aids irritate my skin, and smaller ones come loose too easily. This kind has areas to stick on all four sides and don’t come loose.

 

Heart – Since the heart attack I had back in January 2005 was such a major one (chance of survival about 7%), I continue to see my cardiologist every six months for close monitoring. I have had no issues with it in the ensuing nearly 20 years, but keeping close tabs on it is still important.

·       Baby aspirin (daily) – recommended for heart attack patients.

·       Carvedilol (twice daily) – a beta blocker. Keeps blood pressure from getting too high. Recently moved from metoprolol tartrate to carvedilol at the recommendation of my liver doctor as this will help in the liver area as well (see below). Monitored my blood pressure for the three days it took to stabilize during the transition, but I seem to be doing well with the minimum dosage.

 

Foot – Major concentration on staying off my foot as much as possible. Walking around the house in just socks seems to work okay, but I am sensitive to coming close to falling quite often. Definitely no walking outside or in non-home venues without cane support. It’s a bit frustrating to not be able to help with outside chores, but our grandsons are getting old enough that they are starting to pick up the slack. However, I’m aware of the extra strain this puts on my wife since I am unable to assist her as I used to. But since any further problems with my foot would have major implications on being able to walk or to drive and not sure how I’d deal with loss of mobility that “fear” drives my staying off my foot. But I’m aware that this impacts my being able to contribute to family functioning and the stress in the home.

·       Aquaphor healing ointment – in order to keep the line where the skin flap from the bottom of my foot was sewn to the top of my foot moist, I use this ointment every few days. If it were to get dry, then it would be subject to possible other issues in the future which is something that I DO NOT want to happen.

 

Diabetes – Change in medication at the beginning of the year (by hospital doctors during my amputation) and removal of Farxiga and Trulicity was not adequately compensated for by increase in Lantus. Also did not notice that my prescription for Metformin changed from 1000 unit pills to 500 unit pills, so inadvertently decreased my daily usage by half until I noticed the change in hardness of the new pills.  Definitely need to have input from an endocrinologist to determine path forward. Some possibility that I may end up having to take insulin with each meal – not something I’m looking forward to, but failure to get my blood sugars down could have other, more serious consequences. Liver specialist (see next item) has recommended taking Ozempic. This will impact several areas: (1) reduction of weight [goal is about 25 pounds]; assistance in diabetes; help with liver issues (next item).

·       Metformin – 1000 units twice daily

·       Lantus – currently taking 75 units/day each evening

·       Ozempic – TBD

 

Colon – I had three(!) colonoscopies last year. The first was a normal periodic one where they found several (9) polyps. The second one was a follow-up which found one more in the same area. Then the third was with a specialist checking to make sure that there was no inherent difficulty in that part of the colon. I have another colonoscopy scheduled this year since the number of polyps has me on an annual checkup instead of the more typical 5-year schedule. Hoping that this one will be uneventful.

 

Abdominal Issues – Latest report from MRI which confirmed issues such as enlarged spleen (splenomegaly), mild cirrhosis of liver, and portal hypertension is concerning. After consultation with a liver specialist and getting an ultrasound of my abdomen, he is recommending Ozempic which will address the mild cirrhosis as well as impact my diabetes. I’ll be discussing this with my primary care physician next month. Then I’ll be getting bloodwork and ultrasound every six months to ensure that things don’t get any worse. The primary concern here is with the cirrhosis of the liver with the other organs being “downstream” issues. The prescription of Ozempic (or possible Rybelsus instead) will not only affect my insulin levels, but is also expected to result in about a 10% weight loss as it slows the digestive process. This slowing will make it easier for my liver to deal with things and prevent further deterioration.

·       Ozempic - TBD

 

Blood – There are a number of factors here:

(1) Blood analysis – The amount of iron in my blood, as measured by things like red blood cells and hemoglobin, has always been on the low side. I started giving blood over a decade ago and went every two months. But the level of iron was always marginal and I would occasionally fail to meet the minimum and be rejected. Earlier this year, with all the other medical issues I was facing, I failed yet again and made the decision to stop giving.

(2) Clotting factor – My platelet count has also always been on the low end (60-110 when they prefer 140+). While it is not so low that I would be ineligible for various operations due to risk of bleeding, it is something that the doctor has been keeping an eye on.

(3) Cholesterol – following my heart attack back in 2005, they prescribed a statin to prevent my cholesterol from getting too high. That has worked very well. However, that med does not impact my triglycerides. I’m taking a fairly high dose of Omega-3 (fish oil) to try and lower it, but have only managed to get it from “off the charts” to “too high”.

·       Simvastatin – keeps cholesterol under control. My levels have been excellent since I started taking this several years ago.

·       Omega-3 – primary out-of-range item with my lipid levels is my triglycerides. While ideal would be to have them less than 150, this keeps them less than 400. That’s not ideal, but that’s the best I seem to be able to do.

 

Miscellaneous –

·       Pantoprazol – one small tablet a day. Because of the number of oral meds I’ve been taking, an endoscopy revealed some irritation of the lining of the stomach and duodenum. So the solution to too many pills is (of course) another pill. Since I have trouble swallowing pills without chewing them first, I take this one with a spoonful of applesauce.

·       Allopurinol – the kidney stone I had back in 2001 was a uric acid stone. This keeps my uric acid level down to prevent future stones of that type as well as preventing gout (which is also caused by a high level of uric acid). Just a maintenance issue at this point.

 

General – I’m definitely aware that I’m getting older and having a variety of aging issues. Not only do my grandchildren refer to me as “old,” but a number of people at church keep asking me how I’m doing. It’s nice to have others show their concern, but to know that I’m in the category of “older” and apparently looking that way is not something that I’m used to. With the number of physical issues I have listed above, will I live as long as those who came before me? It’s another eight years until Asher will be out of high school and I’d be almost 84 by then. Will I make it that long? I don’t know. Nearly half of my male cousins have already passed away. It’s concerning.