A1C

I’ve been having a lot of doctor visits and medical tests done in the past two months. December – 3 days in the hospital and 2 visits immediately after release; January – 7 visits/testing sessions; first week of February – 7 visits/tests (and at least 6 more in the remainder of the month). But I’d like to write here about the things that are more under my control, namely making sure I take the prescribed medications and the other foods/supplements that I eat. In particular, I’d like to focus on my diabetes and what changes I’ve made over the past several years to deal with it.

 

What’s an A1C?

One of the key measures with diabetes is checking your blood sugar levels. Levels that are too high can do damage to various organs. But levels that are too low are also dangerous. Either can lead to death. So it’s important to manage those sugar levels in your blood. But what do the numbers mean?

One of the most common tests is called the A1C. The CDC puts it this way: “When sugar enters your bloodstream, it attaches to hemoglobin, a protein in your red blood cells. Everybody has some sugar attached to their hemoglobin, but people with higher blood sugar levels have more. The A1C test measures the percentage of your red blood cells that have sugar-coated hemoglobin.”

Red blood cells have a lifespan of about three months. Therefore, when the A1C test is looking at those cells, you are getting an idea of the average blood sugar levels for the past 90 days or so. While the A1C result is reported as a percentage of those cells, it can also be reported as estimated average glucose (eAG), the same numbers that are reported when one does the typical “finger stick” and testing with a portable meter. But what levels in these reported results are “good” or “bad”. Here is one chart from the Cleveland Clinic.

As you can see, the various levels are colored green (OK, or “In-range”, <5.7%), yellow (prediabetes, 5.7-6.4%), and various intensity of red (Diabetes, >6.4%). The accompanying text also notes that “If you already have diabetes, an A1C results is a glimpse into how well your management plan has been working over the last three month. Management may involve oral pills, taking insulin, monitoring blood sugar levels and/or lifestyle changes, such as diet and exercise." I should also note here that the A1C is a 3-month average, so one person might have fairly consistent daily results whereas another person might have readings that vary widely. I know one person who has wild swings of the eAG with measurement of 50 then a few days later over 400! My results are pretty consistent.

 

So, how am I doing?

I was first tested for diabetes back in 2015 (8 years ago). My result was an A1C of 7.1, i.e. in the low diabetic range. Over the next nearly two years, subsequent tests gave increasing results in the 8.3-8.5 range. It was then that I was first prescribed some oral medication. My results dropped into the 6.2-6.6 range. Then they started climbing again. My doctor prescribed first higher doses of the same medication, then eventually additional drugs as well. I would initially respond well, then my numbers would start climbing again. By this time, I was also using a meter and finger sticks to check my levels daily. The meter would report things as “in range” when my results were 180 or below, and “out of range” for anything over 180. By 2021, I was taking the maximum dosage of two different drugs, but I was back up to the 7.5-8.0 range.

It was then that I was scheduled to meet with a nurse who specialized in transitioning patients to insulin. She started me off on a very low dose, had me check my sugar levels on a daily basis, and would check in with me every month and adjust the dosage higher until eventually I was getting readings that she approved of.

I should note that her “goal” for me was to have eAG readings in the 70-130 range, so as soon as I had a few readings in that range, that was the dosage she approved. I had started out with her in mid-2021 getting 3-day averages of 190-195. By October she had increased my dosage from 10 to 50 units each day and I was getting 3-day averages of around 120.

Unfortunately, the body adjusts to the dosage and it slowly becomes less effective. By the end of the year, I was getting 7-day averages in the 140-150 range – still a whole lot better than 190-195.

I continued to track on a daily basis for 2022. Whenever I had a reading that spiked over 180, I would think back through the prior day and what might have caused it. In May I bought some non-diet soda instead of my usual diet Mountain Dew. Wow, did I see the impact! For the better part of a week, my readings were 180-200! The same thing happened around Thanksgiving – having a piece or two of the pies that our family makes put me over 180 for nearly two weeks.

For 2023, I’m taking a more serious approach. And I’m happy to report that my 7-day average has stayed in the 130-150 range the entire time. I’ve also now recorded that if I forget to take my “night meds” (I take several pills each morning and just a couple at night) that my reading the next morning will be up about 30 points from the day before. I’ve only done that a few times, but sometimes life intervenes and I may have a meeting that runs long or a particularly stressful day and neglect to take those few pills. But seeing the higher results and a note “Forgot nite meds” on the log I keep is helping me to forget less often.

As for my A1C, I still get it checked a few times a year and I’m happy to report that my results have been under 7 since I began taking insulin back in mid-2021. My last two readings, including one a few days ago, were both 6.9.

Both the CDC site and the Cleveland Clinic site note that “The goal for most people with diabetes is 7% or less.” This recommendation comes from the American Diabetes Association. So while the chart above from the Cleveland Clinic shows that anything over 6.4 is in the “red zone”, as one who is attempting to “manage” their diabetes, 6.9 is absolutely fine with me. I will continue to monitor my blood sugars – both with daily finger sticks and with twice-a-year blood work that checks my A1C. But I feel that things are being “managed” properly.

 

Other medication/diet issues

I have two other medical conditions that also require paying attention to “managing” my medication/food inputs. One of these is going quite well, the other I need to begin paying attention to [again].

 

As I’ve reported previously on several occasions, I am working on getting a “hole” in the bottom of my foot to close up with skin grafts. To help speed the healing process, I have begun taking daily protein drinks. They appear to be helping quite a bit. My current efforts have resulted in the size of the hole diminishing by 2/3 in just two weeks. I’ve now put the protein powder that I mix up on a subscription plan (with Amazon.com) so I can keep it up.

 

Because of my focus on both the hole in my foot as well as managing my blood sugar levels, I have let one other area slide for a while. (I find it hard to pay attention to all my medical issues at the same time.) My cholesterol levels (HDL and LDL) have never been an issue. The only thing in my periodic Lipid blood tests that is “out of range” is my triglycerides. The expected readings are supposed to be <150. But my readings have never been anywhere near that. Back in 2016, my high water mark was 952! I began taking fish oil as a way of bringing down those results.

By taking a large tablespoon of it each day I was able to bring my results down into the low 300s. Getting any lower has proved next to impossible. A year ago I reached my low water mark of only 225. That’s still higher than recommended, but appears to be a reasonable level and I was quite happy with it. However, with the increased focus on my foot and all that was needed there, I have let my focus here slide. The effort of taking a liquid each morning as well as all my other medications (which are in pill form) was just too time-consuming with everything else I needed to do. My most recent lipid panel showed that I was back up close to 500 – certainly not the 700-1000 range that I used to be in, but it shows me that I need to add this area back to my daily concerns.

I’ve found a substitute (that was not available a few years ago) which delivers the benefits in a squeeze pouch instead of a bottle of liquid. It’s not only cheaper ($1.00/day instead of $1.50/day), but does not need to be refrigerated like the bottles of liquid need to be once you open it. So – cheaper, more convenient, and even more of the beneficial types of Omega-3 – I’ll take it! I’ve ordered a 3-month supply and I’ll then wait until my next round of blood work later this year to see what the impact will be.

 

Genealogy Story – Christabel Hamilton

Last year our church hired a new worship leader. Her name is Cristabelle – which I think is a rather nice name. Her mother is a distant cousin of mine – both on her father’s side (11^th cousin) and mother’s side (10^th cousin, twice removed), so that makes Cristabelle a distant cousin as well (11^th cousin, once removed and 10^th cousin, three times removed). Cristabelle is a talented musician – both as a singer/songwriter and as a pianist and guitar player.

But as I was reviewing some old blogs that I had written (see here), I became aware of another individual with that same name in my extended family tree – but spelled slightly different. Her name was Christabel Hamilton. I hadn’t done a whole lot of research on her, as the blog was about a picture of her mother, Hattie Giles, that someone had found in an antique shop. I was able to pass along that picture to Hattie’s great-granddaughter, my niece. But I thought it might be good to do some further investigation into Christabel Hamilton, the grandmother of my niece.

 

Christabel was born on 1 Aug 1901, in Brattleboro, VT. Her parents were Gilbert Wilson Richardson and Harriet (Hattie) Chenery Giles. As I noted in my prior blog, their marriage did not last and they divorced while Christabel was a young child. In 1909, Hattie remarried, this time to Robert Hugh Hamilton. Robert adopted Christabel and her name then became legally Christabel Giles Hamilton. Robert had four sons by his first marriage, but they were all older and had married and moved out by the time Robert and Hattie married. Robert, Hattie, and Christabel eventually moved to Montague, MA in late 1910 or early 1911.

Hattie was evidently a piano player and passed along her musical abilities to her daughter. At a very young age, Christabel began appearing in the local newspaper as she began making use of her considerable musical skills. Here are just a few of the newspaper articles I found about her:

·       28 Jan 1910 (age 8): in Vermont Phoenix – performing in a play about Mother Goose – played Baby Bunting and a flower girl.

·       20 May 1910 (age 9) in Brattleboro (VT) Reformer – “Pre-Memorial Exercises” from local school district “… recitation, The Blue and the Gray, Christabel Hamilton, grade four;…”

·       28 Oct 1911 (age 10): in Greenfield (MA) Recorder – in a play about the Pied Piper of Hamlin – performed a “flag dance”; article notes, “Christabel Hamilton has already won a reputation for her fine dancing and singing.”

·       13 Dec 1913 (age 12): in Recorder – “Miss Christabel Hamilton sang a solo sweetly.”; also noted that she was a violinist.

·       30 Oct 1921 (age 20): in The Musician – “The Boston Flute Player’s Club gave an interesting concert … The assisting artists were Miss Christabel Hamilton, soprano;”

·       6 Oct 1926 in Montreal Gazette – “… Miss Hamilton consisting of songs in Italian, French, English and Spanish…”, “Miss H showed herself to be possessed of a charming lyric soprano voice admirably suited to the delicate, light type of songs she had selected for her programme.”

·       27 Jan 1927 in Allentown (PA) Morning Call: announcement of upcoming radio programs – WPCH 1100AM – “Christabel Hamilton, soprano”

·       8 Apr 1927, Glen Falls Post-Star: “Lyric Soprano in Program of H.S. Music Club”, “Miss Christabel Hamilton, lyric soprano of New York, was presented in the third annual concert.” “Miss Hamilton has a pure soprano voice of high quality and displays excellent training. She has studied under Prof. Fredie E. Bristol of New York and has been in demand as soloist for club and social events.” “Her enunciation was so clear and distinct that even in the French and Spanish songs each syllable could be heard.”

·       Newspaper articles mentioning her were from VT, MA, NY, CT, PA and Canada.

 

On 16 Feb 1929, Christabel married George Chester Burns. His parents were already deceased. Being in their late 20’s, they immediately began efforts to have a family. Their son, George Robert Burns (who went by Robert) was born 9 months later on Nov 1^st. Despite being married, Christabel retained her maiden name as that was the name she was known under in the music circuit. She continued to perform for the next several decades.

·       31 May 1938, Greenfield (MA) Recorder: “…Mrs. Christabel Hamilton Burns … gave vocal solos.”

·       27 Nov 1948, Greenfield Recorder: “Miss Christabel Hamilton, who is studying voice in New York City, came home, Sunday, for a week.”

·       28 Jul 1951, Greenfield Recorder: “Miss Christabel Hamilton will broadcast from WBZ at Springfield this week Wednesday evening.”

·       9 Jul 1960, Greenfield Recorder: As You Like It, “Miss Christabel Hamilton … contributed much to the production”.

 

During just one ten-year period, all of Christabel’s ancestors passed away as well – her mother, Hattie, in 1938; her stepfather, Robert, in 1944; her biological father, Gilbert, in 1945; and her husband, George, in 1947. With Christabel and her son Robert only having each other, they remained close for the rest of Christabel’s life. She eventually passed away on 17 Mar 1970. As the above articles show, she was still going by her maiden name. However, her obituary finally calls her by her legal name of Mrs. Christabel (Hamilton) Burns. By that time Robert had married my cousin in 1963 – he was 33 and she was only 20.

I have searched in vain for any recording of Christabel singing. But since she was singing during an era when performances were done live, there are none to be found. However, the above newspaper clippings are just a small sample of the ones mentioning her name, and she was evidently a very good singer and quite well known.

 

I find it interesting that I only know two people with this beautiful name and both of them are skilled singers and musicians.

 

My First Car

I had finished my undergraduate degree at Michigan State with my sole transportation being the old one-speed bicycle I had bought when I was 12 years old. It was good enough to get me around campus as needed even though the fenders were dented and starting to rust and the handlebars were quite pitted. I never bothered to lock it up since it looked bad enough that no one would want to steal it.

That fall of 1970, I was starting grad school with a half-time assistantship in the Computer Science Department. They had established CPS as a separate department only a year before and I was one of their first graduates (there were 7 of us) – having switched majors from Engineering. Now I was one of the first graduate students.

As an employee of the university, I pedaled over to the MSU Credit Union and opened an account where my paycheck could be deposited. Once I’d been working for a few months and had built up a bit of a bank balance, I felt it was time to upgrade my transportation. So that winter I used that institution to apply for a loan so that I could buy my first car.

After shopping around a bit, I settled on a 1970 Dodge Dart Swinger like the one pictured here. It was red with a black vinyl top. I went with the basic model that had a slant-six engine, rather than the 340. The 340 had options like racing stripes, hood scoops, etc. So rather than the 340 small block eight cylinder that gave 225 hp, mine only had 225 cu. In. and 145 hp. But I was only looking for basic transportation, not performance. Including taxes, tags, and title, it cost me the grand sum of $2626 – not much compared to today’s prices, but certainly not cheap for a graduate student. That price also included getting it undercoated (Ziebart) – at the recommendation of the dealer.

 

Even though I was legally still a resident of CT, I had an address and a bank in MI, so I got the car with MI license plates and registration. Mine was as shown here. In the red/black color, it was pretty impressive – at least to me. However, I was not aware that it also made a statement to the local police department who could spot it gong by. I got two speeding tickets over the next two years – but only one more in the next 50+ years.

Now, when I went home during breaks (600 miles to CT), I could put a card on the ride-board in the student union as offering a ride – instead of having to post on the other side of the board as looking for one.

But it was also handy when the spring quarter began (we were on quarters, not semesters back then). That was because it was that quarter that I met the woman who would eventually become my wife. By the end of the quarter, we were pinned. That summer I would make the 200-mile trip to Petoskey where she was from just about every weekend. We got engaged at the end of the summer. Then at Christmas time, I took her with me to CT to meet all the relatives. And the following summer we married, and my new brothers-in-law tied some tin cans to the back bumper of that car.

Two weeks later I finished grad school and we drove that Dodge Dart from MI to CT where I had found a job. We took a week doing so as that was our honeymoon. I had a U-Haul trailer behind that probably weighted as much as the car did – being that most of what I owned at that point were all my books from five years of school. Our trip included going through the mountains of WV – probably a mistake on my part. Going up the mountains, that little slant-six was working pretty hard and going down, I was using both feet on the brakes to keep the car on the road around any corners. It was smoking by the time we got to the other side. It was Sunday and everything was closed so we got a motel for the evening. The next morning, I found the local Dodge dealer. Everything was ok, but the strain on the engine and drive train had burned up all the transmission fluid. Got it filled back up and drove the rest of the way to CT – but sticking to expressways instead of trying any more mountain roads!

Had that car for all of our four years in CT before moving to PA in 1975, then for another five years here. It was still running well and I had 92K miles on it by then. There was some rust on the body panels, but the undercoating had prevented most of that. But I was to find out that was not enough.

The Dodge Dart had a “unibody” construction. Meaning that there is no separate frame, rather there are bends/folds in the undercarriage that give the car its strength. It also had torsion bars on the front instead of springs – with one end of each bar fastened to the wheel assembly and the other end fastened to one of the U-channels in the unibody. That would prove to be the eventual downfall of that car.

Hitting a small bump one day, the right front corner of the car dipped – then did not come back up. Taking it to my local garage, it appeared that there were a few areas of the undercarriage that had not totally been undercoated. Some rust had developed there, and that small bump had caused the pressure of the torsion bar end to push that end right through the U-channel so it was now free floating and just riding through the hole in each side of the channel. The process to fix it would be to cut out that section of the unibody, fashion a replacement section, then fasten the end of the torsion bar to it. Certainly doable, but the cost would exceed what the car was worth.

Thus, reluctantly, I drove my beloved first car to a local junk yard where the owner gave me the princely sum of $200 for it. Despite still looking well, it was no longer road-worthy with that front corner dipped down. I’m sure that he got far more than that $200 as he dismantled it and parted it out.

We had that car from 1970 until 1980. By then it was my second car as we had added a 1973 VW Dasher station wagon while we were in CT. The Dodge was my back-and-forth to work car as by 1980 we had one child and another on the way and the two doors of the Dodge were not convenient for using car seats for young children.

One always has a love for their first car – as I did for mine. Besides all the memories of where I drove it, it was in the front seat as we parked overlooking Lake Michigan that I turned to the young lady next to me and asked her to marry me. (For the record, her initial response was “I’ll think about it.” By mail a few days later she actually said “yes.”) That was over five decades ago. That shiny red Dodge Dart bit the dust after only 10 years – but our love still carries on!

Medical Update

It’s been over a month since I last posted in my blog. While a week of that was due to my prior PC getting totally messed up during a Windows update, a lot was due to a few medical issues. These seem to be increasingly happening as my body ages, but the past few weeks it felt like I was falling apart in several places at once. So, I thought it would be good to recap what’s happening and where things are going.

In the past I’ve done this starting at the top of my head and moving downward, but I think I’ll change that up and move in the opposite direction this time. So, without further ado, here’s what’s going on.

 

Feet and Legs – In early December, I had a two-step skin graft put on the bottom of my foot. Everything seemed to be going well and by mid-month my weekly checkups were reduced to once a month. But then, on Christmas Day, I was not feeling well and my symptoms were similar to the times that I had sepsis in the past. Recognizing that, Donna said that we would not wait until the symptoms got worse, but that she would take me into the hospital immediately. The ER was thankfully quite empty, so I was taken to a room and admitted fairly quickly – for a 3-day stay. (Not the way I would have chosen to spend the week between Christmas and New Year’s.)

On removing my socks and shoes, it was obvious that my right foot was the source of the infection. There were two large blood blisters next to the graft area as well as cellulitis on the top of that foot and some red streaks starting up my ankle. They drained the two blisters and put me on antibiotics.

Donna called my podiatrist and scheduled an appointment for me to see him the day after I got released. It was obvious that both the blisters were “communicating” with the area under the graft, so he cut away both the graft as well as all the tissue over the blistered area. So, back to square one.

Since then, I’ve had a couple of diagnostic tests. The first was an MRI of my right foot because he was concerned that the cause might be an underlying infection in the bone. That was negative (whew!), so instead of considering bone removal, we’re going to go the graft route again. The other was a doppler check of the blood flow in both legs and feet. As I write this, that was this morning. Good news again, my blood flow is perfectly normal (which is often not the case with diabetic patients like myself). So, everything is set up for another round of skin grafts tomorrow.

 

Colon – I had my first colonoscopy back in early 2017 (at age 68 – I should have had it several years earlier, but it was not something that occurred to me). They found, and removed, nine polyps – none of them cancerous. Because there so many, I had another colonoscopy a year later in 2018. That found one additional very small one, also non-cancerous, which they removed. Colon cancer is VERY slow-growing, so they put me on their follow-up list for five years out. Thus, I got a letter last week asking me to set up an appointment. This should be the last one as the risk/reward of having a colonoscopy after age 75 does not warrant further testing since the average lifespan does not warrant it. So, another test in the next few months – not a big deal.

 

Pancreas – After some cycling up/down for a few months due to the stress of all the other medical issues, I’m now getting my sugar levels under control again for the past few weeks. In addition, I have lost four pounds so far this year and am encouraged to get off the weight that I’ve been stuck at for the past several years. I’ve actually managed to get my BMI under 30 for the first time in a few decades – Yay! Hitting such milestones is definitely encouraging me to continue and see if I can drop it further.

 

Heart – During my hospital stay, I had a few hours where I was feeling a tightness across my upper chest and pain if I tried to breathe too deeply. They alleviated the pain with a shot of morphine, but said that I should have another stress test in the near future. Because of the problems with my foot and not being able to do any extended walking on a treadmill, this would have to be a “nuclear” stress test like the last one I had in mid-2021. So, I contacted my cardiologist and got that scheduled for earlier this week. When I did this in 2021, they stressed me too hard, and I passed out (see here). This time everything went well. So, no issues here.

 

Mouth/Teeth – Over the years, I’ve had most of my teeth replaced with implants and titanium coated with enamel. My upper teeth are in two connected sections, but my lower ones are either single or pairs of teeth. I still have my original lower front teeth. But because the uppers are connected, they are quite strong and when chewing they are placing a lot of pressure on my lowers. This is particularly impacting my front teeth which are beginning to loosen and the jawbone starting to erode. So it’s finally time to do something with them as well.

The timing isn’t great because of all the other stuff going on, but next month they will remove the four front incisors (teeth numbered 23-26 for those who keep track of that kind of thing) and put some bone in the empty sockets. After that all heals, I’ll have a couple of implants there and a solid bridge put in that joins teeth 22-27 – anchored by my two canines which are still ok. That new strong bridge should be able to resist the pressure. At least I get to wait until next month for the next step on this.

 

Brain – In the middle of all the above, I had the PET scan of my brain. This is the last screening step for qualification for the Alzheimer’s drug study that I have enrolled in. Once they have evaluated the level of amyloid plaque in my brain, I will either be qualified for one of the two arms of the study, or I will be told that I am not qualified. So, right now I’m waiting for them to make that evaluation and call me to schedule my next trip to UPenn. If I’m qualified, then I will sign the forms acknowledging the level of risk and agreeing to the next four years of IV infusions of the study drug.

In talking to the study coordinator, I have learned that a number of people started the qualification steps, but then they later backed out. I have no intention of doing so. Is it without risk? No. But I’m willing to accept the risk if it will help to advance the development of drugs that can be used to treat this terrible disease. So, stay tuned.

 

Summary – It’s certainly been an interesting last few weeks! Nothing like starting off 2023 with multiple medical tests/appointments every week. So, while it’s been a bit stressful having to deal with so many things going on at once, none of the individual areas are ones which are overwhelming by themselves. God is good! With him at my side and with the support of all my family and friends, I have weathered the storm (so to speak). To those reading this, thanks for praying with me.

 

Christmas 2022

I guess winter must finally be here! Yesterday we had a combination of sleet, snow, and rain that lasted all day. And in the middle of it all, a medical emergency that required me to have to drive in it (more on that below). But we rejoice in having completed another year and seeing all that God had planned for us. Now we look forward to the start of 2023 in just a few weeks.

FAMILY

In January, Chris and family came up from Florida to help us move into the house across the street that we are now sharing with Kim and the boys. In preparation we’d gotten the basement level prepped so that we could move their bunkbeds down there. Pam organized the painting of one of the upstairs rooms so that we could move our platform bed set into it. I handled the taking things apart and putting back together, but Chris, Aryon, and Tiernan did all the “heavy lifting” of moving it. It’s been interesting – getting used to living in just two rooms instead of a whole house. We are very slowly tackling the elimination of all our accumulations in the old house, but various medical issues (more below on that too) have limited the amount of work that we’ve gotten accomplished.

Besides our typical week together at Pinebrook, we expanded the practice of having Kim’s boys getting to spend a month in Florida with Chris and family. Two years ago it was just Ethan, last year Ethan and Isaiah, and this year adding Caleb to the mix. Donna and I went down at the end of April for Aryon’s court of honor as he received his Eagle Scout badge. We took Caleb with us, then at the end of the week, left him there for the rest of the month of May. In July, following our week at Pinebrook, Ethan went back to FL with Chris and family, then in mid-August we did a swap – with Ethan coming home and Isaiah going there until mid-September. This schedule meant that Caleb had to finish the prior school year remotely from FL and Isaiah had to start this year from there – but we made it all work. For 2023 – we’ll have to see what works, especially since Aryon will be going off to college in the fall and Tiernan has applied to be an exchange student for a year. All the grandkids are growing up far too fast!

One thing that living together in one house has helped with is Donna and I helping with the schooling of Kim’s four boys. This year they are in grades 7, 5, 5, and 3. Ethan has a computer setup in his room downstairs but spends most of the day in Kim’s room where she is working from home and she can help him if/when he needs it. He’s pretty independent and is now taking Spanish as well as the typical Bible/Literacy/History/Math/Science. Isaiah and Caleb have workstations in the living room but bring their laptops into my “den” for me to check their work and for the submission of any assignments. Asher has a workstation in the kitchen/dining room and Donna works with him there. School hours are about 2.5 hours in the morning and another 1.5-2 in the afternoon each day. So we’re all kept pretty busy. Last year they all finished with overall averages of 97-99 and this year they’re maintaining their grades in the same range. But they each have their areas of strength and weakness as well as occasional attitude problems (“I have to write THREE paragraphs!?”). So Donna and I have our challenges.

Our FL grands have been involved in some sort of youth activity for several years – Aryon in Boy Scouts, Tiernan in Trail Life, and Ilyanna in American Heritage Girls. This fall our PA grands all began attending Trail Life as well. The closest troop is 30 minutes away and it’s quite small, but they all enjoy it. Matthew’s current job at a Home Depot warehouse has him working Sat/Sun/Mon/Wed (5am to 3pm), so he’s been taking them to the twice-a-month Thursday night meetings. But they also go camping one Saturday a month, so I take them on Fri evening and pick them up on Sun morning and take them to church.

MEDICAL/HEALTH

Getting older is not without its challenges. Donna was having more and more issues with her one leg, and after extensive checking and x-rays she had a hip replacement in March. When we finally got to see the x-rays ourselves, it was pretty obvious why she was having problems. The healing process was fairly quick, and she now has full use of that leg again. Makes us wonder why we didn’t do it sooner.

Her operation and time for healing meant that I had to delay a surgical procedure on my foot until May. I was just not making progress on the healing of the open wound on the bottom of my right foot, so the podiatrist had recommended a sesamoidectomy (new word for me – look that one up!) Long healing process for that meant many, many, many hours of sitting in my recliner (a present from our kids), two rounds of skin grafts (the first one failed), and finally getting the hole to seal up just a few weeks ago. I still have to take it easy while the deep healing takes place, but it’s nice to not have to rebandage my foot every few days like I have been for the past year.

Our latest adventure was just yesterday. We had planned on moving one of our cats (age about 14) from one house to the next. She objected and when Donna was putting her into a cat carrier for the move she got bitten rather badly on her right thumb. So, in the middle of the snow/sleet, I had to drive her to an express care location for checkup, cleanup, tetanus shot, and antibiotic prescription. Now we’ll have to pitch in to do some of her work for a few days until it gets healed up as well as watch to ensure that it heals properly without infection. Always a new challenge!

I’ve been accepted into a drug-based study for a new Alzheimer’s drug (lecanemab – you may have seen news articles about it). I’ve passed most of the screening, including verification that I have no symptoms yet. Now just awaiting a PET scan in early January as the final hurdle to see if I’m eligible. If accepted it will mean four years of monthly/bi-weekly infusions. But if this will help others in the future I’m willing to do so. Stay tuned!

GENEALOGY

I’ve continued to keep busy with various aspects of genealogical research. Earlier this year I checked out the genealogy of all the teachers I had while growing up. Just remembering all the names was a challenge, but then tracing them back to see who might be a distant cousin of mine was equally challenging. But the biggest excitement was my acquisition of a family coat-of-arms and related genealogy charts for Evelyn Pierrepont, Duke of Kingston-upon-Hull, that had been prepared and colored back in 1764 – over 250 years ago. I’ve had it archivally framed and it will be the centerpiece for the 100^th family reunion of the New England Pierpont family that will take place this coming June.

WRITING

Just to show that you can “teach an old dog new tricks,” this year I found myself writing a series of fictional books about Fred Forchelli. I had submitted an entry into a “bad writing” contest earlier this year (where one writes the opening sentence to a fictional book). I didn’t win, but then one of my cousins said that he wanted to know the rest of the story. So I took him up on the challenge and that turned into not one, but three books about Fred and the cases he has as a private investigator. Each of the books is 40-45 pages and they are available on Amazon in both paperback and kindle format.

It's been fun doing this, as I do it strictly in a stream-of-consciousness style – writing one chapter at a time and not having any idea where the next chapter will take things. Each book has taken just a week to a week-and-a-half to write. I’ll never get rich – but few do in the self-publishing world – but the enjoyment I get from it makes it worthwhile.

CONCLUDING THOUGHTS

One never knows where the “road of life” may take you. There are too many twists and bends that we can’t see beyond. Homeschooling of four grandsons was not something that Donna and I had ever predicted at this stage in our lives. It’s certainly not the typical retirement that one experiences. Mentally, we’re both doing well, but the number of physical challenges and difficulties are certainly more each year.

Having been married for over 50 years, we are now among the “seniors” at church. And there are tasks that we feel more comfortable leaving to others. Thankfully, our growing grandchildren can now take on more responsibilities. And the older ones have passed Donna in height and are gaining on me (if shoe size is an indication, I’m going to be facing challengers in that arena before too long). We love all our kids and grandkids and enjoy as many hugs as they are willing to give us (they just have to take it easy sometimes as especially grandma’s bones are not as strong as they used to be).

But most importantly, God and Christ are still the center and focus of our lives. (Someone remarked to Kim the other day that it’s nice to see all her boys actually excited to go to church and meet with their friends.) So, as long as we keep our eyes on HIM and try as best we can to follow the path he sets before us, we can’t go wrong.

This is the Christmas season, and Christ is the “reason for the season”. We pray that all of you are similarly blessed as we are.

Alan and Donna

[Grandchildren]

 

[Pierrepont Coat of Arms]

 

[Fred Forchelli book on Amazon (one of three)]

 

The Continuing Sagas

Three sagas to report on this week. The first is the continuing problem of the open sore on the bottom of my foot – now 4+ years. Last week I had a skin graft put on the remaining hole – which was 9mm x 7mm. That meant that I had to stay off my foot as much as possible while it healed. My recliner (which my children bought for me at Christmas) is getting a lot of use. I went back to the doctor yesterday. We’ve made some good progress and the hole is down to 5mm x 3mm! They put on a second graft – this time of “live” cells instead of the non-live product they used last week. He’s hopeful that when I see him again next week that the hole will be gone. Then we can put together a plan for keeping it that way. I’ll still have to wear special shoes and avoid too much use, but if we can get the hole to be sealed up that will be great! So, I’m staying off my foot as much as possible this week as well. It’s a little frustrating as my foot is all wrapped and I’m wearing a surgical shoe to prevent damage.

 

The second saga is my continuing involvement in Alzheimer’s studies. I was just notified yesterday that I’ve passed all the screening criteria so far and have now been approved for the next testing phase – a PET scan of my brain to determine the level of amyloid plaque I have. That is scheduled for early January. So far they have determined that I do have the APOe4 gene which makes me susceptible and the results of all the mental/physical acuity test have confirmed that I have no mental impairment. So this PET scan is the last hurdle before I become qualified for the study.

The final saga is my decision to turn my Fred Forchelli story into a three-book series. In the first book, “The Case of the Piece of Paper,” I had made the title page as follows:

Fred Forchelli

World-renowned

Well-known

Investigator and Lawyer

 

The Case of the Piece of Paper

 

I’m not sure why I did this, but when someone asked about it, I realized that it made for a perfect opportunity to turn this book into a three-part series. In the second part – currently being written – the “Well-known” is not crossed out. The subtitle of book two is “The Case of the D.A.’s Dilemma.” I hope to have it done in the next week or so and then it will join the first book on Amazon. The third book will follow shortly thereafter and the “World-renowned” will not be crossed out. I’m not yet sure of the subtitle, but I have some preliminary thoughts as to where it will take place and the opening chapter.

 

So, as I sit here in enforced offloading of my foot, I’m trying to use my creative “juices” to my advantage through this writing project. Three ongoing sagas at once! Who said that life is boring?

 

 

Medical Studies Update – October 2022

C-Diff Study

I was contacted to consider participation in this study while in the hospital in January 2018. This was looking at the efficacy of a new drug to prevent the occurrence of C-diff. You can read more about it at https://clinicaltrials.gov/ct2/show/study/NCT03090191. Over the next several months I had three doses of either the vaccine or a placebo. My participation ended in 2020, but no results had been posted at that time.

Earlier this year, Pfizer reported the results of the study (see here). While the study did not meet its primary endpoint of eliminating C-diff (there were 17 cases of C-diff among those receiving the drug and 25 cases among those receiving the placebo), there were some promising results. These included:

·         None of those who received the drug required hospitalization compared to 11 of those who received the placebo.

·         The median episode length of those who received the drug was 1 day vs 4 days for those who received the placebo.

·         The mean episode length of those who received the drug was 3 days vs 16 days for those who received the placebo.

Pfizer is currently evaluating what are the next steps to take.

Just a few weeks ago I received a phone call informing me that I had only received the placebo and not the drug being studied. This reveal was so that I did not need to be concerned about having to reveal my participation in this drug study for any future medical studies or hospitalizations. I’m happy to have participated and hope that the information received from this study will assist in the reduction of the impact of C-diff in the future.

[Injection]

 

 

Alzheimer’s non-drug studies

As I noted last year (see here), I am enrolled in three separate studies – known as ABC (Aging Brain Cohort), APT (Alzheimer’s Prevention Trials), and MTL (Medial-Temporal Lobe). The first two have no end date, the last is a 4-year study. I had my annual ABC and MTL visit last week.

Nothing of interest to report. However, I did find out that if I am accepted into the AHEAD study (see below), that my eligibility for the ABC study will end. I suspect that will be true for the APT and MTL studies as well. For now, I’ll continue on and see where things go with the AHEAD study.

 

Alzheimer’s drug study

Two weeks ago I had the memory testing for the AHEAD study that I had mentioned earlier (see here). Talk about comprehensive testing! It was essentially composed of the full ABC test (except tablet-based instead of paper-based), AND the full MTL test, AND the complete “Cogstate” test from the APT study. You name the type of Alzheimer’s test, I had it all on the same day. In addition, the day included a full suite of physical and neurological tests (blood pressure, ECG, visual and hearing acuity, “touch your nose, touch my finger”, walk to the end of the hall and back (looking for any gait issues or difference in left/right ability). Again, all the different ways that they try to detect if you have any symptoms of Alzheimer’s. Since they are looking for individuals who have no symptoms but who have a genetic predisposition and who have some level of amyloid plaque (my PET scan is next), this all makes sense. But it is pretty intense.

The AHEAD study is only looking for 1400 people at a number of test sites worldwide (compared to the C-diff study which has over 17,000 people). I asked how many were enrolled so far at UPenn. The answer was TWO – one in each arm of the study. There are a half-dozen at various phases of screening (which is where I am as well). But it’s evidently not that easy to find people who have no cognitive issues but who are disposed to Alzheimer’s (from their genetics and the presence of amyloid plaques).

Something else I learned for the first time. If I’m accepted into this study, then I will have to stop my practice of donating blood every eight weeks – because of the regular infusions that I’ll be having for four years. That’s a little bit of a bummer since I’ve been doing so regularly for several years now. The person who coordinates the blood drive at church will be disappointed, so I’ll wait until I’m actually accepted into the study before telling her (assuming that I keep passing the screening criteria).

So, are there weekly/bi-weekly infusions in my future? Time will tell…..

[infusion]