April 27, 2017

The Pain in My Back is a Pain in the Neck

My Primary Care Physician (previously known as a ‘family doctor’) will never get back the fifteen minutes I spent ranting in his office yesterday.  But at least it made me feel a little better.  Maybe even a lot better.
I am the not-very-proud owner of an extremely strained set of latissimus dorsi muscles.  Two evenings ago, what had been a two-month-long minor back ache turned into a full-fledged all-hands-on-deck, fifteen-minute-long spasm of my back muscles.  It happened at an especially inopportune time.  I was fifty miles from home, just finishing up a speaking gig.  I was carrying books, my laptop, and a projector out the door when several attendees stopped me to ask questions.  It was 9 p.m. and I had an hour’s drive in front of me to get home.

Instead of putting down my belongings, I continued to hold them.  After about seven or eight minutes of pleasant conversation, I turned to push open a door.  My back muscles decided this was the perfect time for an insurrection.  For the better part of fifteen minutes, I felt the most intense pain I have ever felt in my life as a wave of spasms went up and down my back.

Two of the witnesses to this event happened to be nurses, bless their hearts.  They saw the look on my face and began offering professional guidance. 

An MRI machine
In my view, those back spasms were entirely preventable.  Their genesis goes back to last summer when I had my decennial colonoscopy which showed a lone anomaly in an otherwise quite healthy colon: there was a slight indentation in a location that corresponded to my appendix.  Upon being told this by a Colorectal Specialist, I explained that my appendix had been removed at the age of 4 or 5.
 And so, to clear up the mystery, an MRI was ordered.

Think about this: I am on Medicare.  The Center for Medicare Services (CMS) has decreed that all Medicare subscribers are eligible for a $7,500 colonoscopy every ten years.  Because I dutifully agreed to have this procedure done, I am now in the hands of a Colorectal Specialist who had never laid eyed on me until last year.  My medical records from the early 1950s have almost certainly long since gone to a landfill in South Florida.  I cannot prove I ever had said appendectomy (the scar seems to have vanished).  It will take a $6,000 MRI to determine if I have an appendix and if said appendix is gently pushing into my colon.

Your appendix, if you still have one
The MRI results came back.  The Colorectal Specialist determined that I had the stub of an appendix, and that the stub appeared to be filled with some kind of fluid.  I was told I needed an appendectomy, which would be performed laparoscopically.  And so, on the eve of Thanksgiving, I went in for a $20,000 laparoscopic appendectomy (known as a “lappy appy” as the cheerful surgical resident informed me) at one of Boston’s major teaching hospitals.

Laparoscopic appendectomy
Five hours later I was sent home with written instructions: DO NOT LIFT ANYTHING OVER FIVE POUNDS.  OTHERWISE, YOU WILL PULL YOUR STITCHES AND YOU WILL REQUIRE A SECOND OPERATION.  Left unsaid but quite understood was that the fine folks at CMS would kick that bill back in my direction for full payment.  And so, for the next six weeks, including Thanksgiving, Christmas, and New Years, I adhered to those orders.  In the meantime, I also received the biopsy results of my “lappy appy”.  The full page, jargon-filled letter boiled down to one word:  “Ooops.”

There was indeed a tiny stub of an appendix, but it was not filled with fluid and it was not causing any problem.  It was all a matter of an ‘ambiguous reflection’ on the MRI.  Call it a ‘false positive’.
Like I said.  “Ooops.”

But I had emerged from my enforced inactivity at the beginning of February with some unwanted extra pounds, sort of like the ‘Freshman Fifteen’ but at the age of 67.  I am by nature an active person and I had just gone through the prime holiday period with no acceptable outlet for that energy.  And so I began doing things.  I moved furniture.  I shoveled snow rather than use the snow blower.  I carried stuff just to get the exercise. 

I tackled spring clean-up chores
with gusto
And I began to feel twinges in my back.  I ignored them.  I am a tough guy.  Spring finally arrived and Betty and I planted dozens of new shrubs and perennials.  I sawed tree limbs, raked with relish and toted brush-filled bags to the transfer station.  I was bound and determined to work off those pounds.  I also had a busy speaking schedule and I carried two bulging bags of books with me.
And so I was understandably angry when my back revolted.  And I freely admit that I was also more than a little frightened.  Which is why I called my Primary Care Physician, who cleared time for me because he could recall only one time in a three-decade relationship when I called to request a same-day appointment (it was my first encounter with Lyme Disease).

He listened to my rant.  He looked at the computerized reports.  He agreed that I had received $26,000 of ‘overly cautious’ medical attention, but that the blame lay with Congress for failing to rein in tort reform when the Affordable Care Act was being drafted. 

So, what was he going to do about my back?  After a full examination, his learned advice could best be paraphrased as “suck it up”. 

 
Yoga was prescibed
“I could set you up with physical therapy appointments or you could try acupuncture,” he said.  “But the real treatment is ice and yoga.  Your muscle will recover when you stop stressing it.”  

Because I whined, he also gave me a prescription for $1.86 worth of muscle relaxers, but cautioned that the pills don’t know which muscles need to be relaxed.  “They could decide to relax some muscles you’d rather keep under control.”  Message received.


And so I write this as part of my therapy.  All things in moderation.  This too shall pass.

April 5, 2017

The Seven Cent Solution

Feeder Enemy #1
Last month, I wrote that a gang of marauding squirrels had deemed my bird feeders to be their personal fiefdom.  They would shamelessly scamper up the three slender poles in my back yard to wantonly attack the five suet, seed, and worm feeders that hung from those poles.  While overwintering birds watched helplessly, the squirrels (Latin name: Sciurus carolinensis, which translates as ‘rats with bushy tails’) would gorge themselves on sunflower seed.  One even made off with a hamburger-sized chunk of suet.  My solution, I wrote, was to oil the poles; a process that had to be repeated every few days.

Yankee Flipper
I was pleasantly surprised to receive dozens of emails from readers offering advice.  A few also admonished me for blatantly favoring avians over phyla mammalia.  I responded to the latter group by underscoring that I had specifically purchased ‘bird’ feeders.

But I was excited by the reader suggestions for varmint-proofing my feeders.  Many were commercial products.  Two readers touted something called the Yankee Flipper, which incorporates a free-spinning base that takes any squirrel that jumps from a pole onto it for a ride akin to something that belongs in an amusement park.  Target carries them for $24.99, but I noticed two things in the video I watched.  First, as the feeder spun round and round, it also spewed out a sizeable serving of seeds.  The second, and perhaps more disturbing finding from viewing the product in action was that the squirrel appeared to be enjoying itself.  It hung on for half a dozen rotations and I would swear it was grinning.

Plexiglas works, but at a high cost
Plexiglas domes also figured strongly into reader suggestions.  The idea is simple: the dome hangs over the feeder.  The squirrel climbs a tree, drops down onto the dome and cannot gain a foothold.  After half a dozen tries, it adjusts to the new reality of a seed-free diet.  Simple domes start at about $15 although, for reasons I cannot fathom, they also are sold for twice and three timer that amount.  But the operative word at the top of this paragraph is ‘tree’.  Plexiglas-covered feeders mounted on a pole are child’s play to your average squirrel: they just jump the few inches from the pole to the feeder, then scarf down a pound of seed while being protected against the rain.

Clearly, for a pole-mounted feeder to work, the squirrel has to be kept from getting up the pole in the first place.  One reader suggested a product with the imposing name of the Stokes Select 38023 Squirrel Baffle.  It’s a simple device: a conical metal ‘hat’ that rests on a disc tightened to fit around the pole.  I was impressed but, at $13 each, I would be spending $40 to protect my feeders.  Was there a less expensive solution?

Squirrels are natural acrobats
I found one via another reader’s exciting suggestion: use a Slinky.  This sent me to the internet to view what turns out to be dozens of videos of squirrels being unable to master that ubiquitous, simple childhood toy.  I watched in fascination as squirrel after squirrel was defeated by a resilient spring.  Checking prices, I found that Home Depot (who knew?) even sells a three-pack of Slinkys for $12.94.
But was there something just as effective for even less?  Trolling more YouTube videos, I came across one that showed the use of two-liter plastic bottles.  The bottom had been cut off and the neck clamped to the pole with screws.  Well, we had a used, two-liter plastic seltzer bottle in a bag awaiting the opportunity to return it to the supermarket for the five-cent deposit.  I sacrificed the deposit, cut off the bottom, and taped it to one of our poles with about two cents worth of strapping tape. 

My 7 cent solution
Less than an hour later, a squirrel scampered up the pole and found itself inside a tiny jail cell made of polyethylene terephthalate.  The squirrel moved below the bottle and reconnoitered its situation.  It tried and failed to grab the bottom of the bottle.  It reached a paw up to gain purchase on the side of the bottle without success.  It again hunkered inside the bottle attempting to hatch some fiendish plan.  After three minutes, it gave up.

Yesterday, Betty and I consumed another bottle of seltzer to protect a second pole and I thoroughly oiled the third one.  As of this morning, only birds are enjoying the seed, suet, and worms. 

At least for the moment, we have found a solution to our squirrel problem for just seven cents a feeder.  I think even Sherlock Holmes would approve.