Diagnosis

I have been to four doctors (so far) and ending my eighth week of non-stop coughing. After laying out what diagnoses three of the four doctors had provided, I asked friends and family to vote, to offer their diagnosis. I offered them these five choices:

A - Acid reflux
B - Whooping cough
C - Both acid reflux and whooping cough
D - Some unknown confluence of things that no one will really figure out and will go away some day
E - I am a human experiment by the Bush administration to develop personal weapons of mass destruction

Twenty-four people voted (about 80 percent of those who could vote). On top of this, we did have two people who tried to redefine the choices. Only Captain Kirk can do that. And there were the two cats who kept insisting that they could vote. However, the Department of Homeland Peculiarity disqualified them. The results (all precincts reporting) are as follows:

A – 1
B – 10
C – 1
D – 6
E – 6

By early in the week, my blood test will be back on whooping cough, the winner. Right now, I am still coughing 24-7 and I have developed at least four styles of coughing. Very versatile, don’t you think?

Confused at a Higher Level...Again

The mystery of my eight weeks of coughing continues. I have been to my internist and to a lung specialist. I have taken antibiotics, steroids, asthma inhalers, antihistamines, codeine, etc. to no avail. And while my coughing had its ups and downs in the early weeks, the one constant now is 24-7. When I cough, children hide behind their mothers, women weep, men wince, and horses whinny (can you say “Frau Blucher?”). Yes, it’s an Olympic cough in duration, debilitating qualities, and vicious sound.

So, today I went to two new doctors: an allergist and another lung specialist. Both read my X-ray and CT scan films and my lung function test results. And they each weighed me, took my blood pressure and temperature, listened to my lungs and my heart, took my pulse, and looked in all the usual orifices. After all of this, here are their independent conclusions:

Allergist: It’s whooping cough. Let’s draw blood and look for antibodies. All that coughing has to do with exposed nerves in your bronchia being fired off at any provocation.

Lung Specialist: It’s acid reflux. Nothing you’ve taken has affected the cough and, even though you show no symptoms, that’s what it probably is.

Results: I am stopping Lipitor for a while since it can cause a runny nose. I am taking Prevacid, spraying my nose with Nasonex, and inhaling Spiriva for lung relief.

The really good news of the day is that my height is 66.5 inches…so I have only shrunk a half-inch rather than over an inch as last reported.

Vital Information

I am frequenting lots of new doctors as we all try to figure out why I have been coughing for seven weeks and counting. This morning I called the office of a second lung specialist who is seeing me at the behest of a good friend (bless both of them). The person I was talking to had been told I was going to call and the doctor had already set up an appointment for me. So, she began to take down some vital information.

It goes something like this (in order):

Name
Social Security number
Date of birth
Medicare number
Secondary insurance number and how to contact them for benefits

The above are the most vital of the vital statistics. Not what’s going on, who referred me, how long have I been sick, etc. Key to everything is knowing what your insurance is and what it covers.

With all this, it’s a mystery what’s covered and by whom. None of these doctors seem to want money from me when I leave their offices (nor do the hospitals). I get one notice from Medicare and, sometime later, another one from my state insurance plan saying what they have paid to whom and for what. There are cryptic asterisk codes in the margin that are supposed to illuminate why certain charges are denied and/or the “discount” I receive (and am not liable for) from certain providers. On top of this, Medicare seems to have a calendar-year deductible; my other plan’s deductible starts on July 1 of each year. And when all the insurance dust settles, I get a summary bill from the doctor telling me what I still owe.

I’m getting a headache.

Fiber Fone Cull

I use a fiber supplement to help to control my cholesterol. Well, since I am on the last container, I called the 800 number to reorder. I was told to press “1” if I had never ordered before or “2” for a return customer. After pressing “2,” I think I was passed into a general call center where the operators are dealing with several companies. The woman on the line sort of stumbled on a greeting and then asked if I could wait. I could hear keystroking in the background while I waited.

She then asked what I wanted to order and I told her. We went through the credit card number, email address, etc. and got to my name and address. She started with the address. I am always careful to enunciate my address and to put in pauses between words to let the person on the other end of the line know that all the words are separate and not concatenated.

She: What is your address?
Me: xxxxx Wild......Horse......Creek......Road
She: Is that one or two words?
Me: Two.
She: So it’s xxxxx W-h-i-l-e …
Me: No. Wild…W-i-l-d.
She: Okay. Wild. W-i-l-d.
Me: Right.
She: Wild H-o-a-r-s-e.
Me: No. Horse…H-o-r-s-e.
She: Okay. Wild W-i-l-d Horse H-o-r-s-e
Me: Correct.
She: Is the rest of it one word or two?
Me: Two. Creek......Road

We went on to finish. I almost asked her what time of day it was in India, but didn’t.

But it is interesting to ponder a one-word part of my address that would be Whilehoarse, which certainly coincides with my current bout of coughing and such.

Grannie Annie

I highly commend your looking at the web site for the Grannie Annie project. It's an endeavor spearheaded by my friend and editor, Connie McIntyre, and an associate. Many of the stories are now available to read and you can order a book until the end of April.

Black Saturday

There were 42 of us that graduated together back in 1958. There are 37 of us left. One went in a bar fight, they say, the other four from cancer.

I got a call on Friday from Dan, who, bless him, facilitates and coordinates everything for the rest of us in the class. Seems like Denny has had cancer for over five years, had not told anyone except his family, and was in the hospital with only days to live. It was too late on Friday for me to go, but I made plans for Saturday.

Saturday morning, Marian, Robin, and I went to the St. Louis Art Museum to see an exhibition of pictorial photographs. The web site for the museum says this about pictorialism:

“Using soft-focus lenses and hand-made materials, Pictorial photographers produced beautiful and engaging photographs. Dedicated to the creation of photographs that look like paintings or drawings, these artists were among the first to elevate photography to the status of fine art.”

Later, I went to lunch by myself, delaying what I wanted to and had to do. Going to see Denny was very much in soft focus for me. He certainly qualifies as a hand-made person, unique. But I was having a hard time thinking about being there with him, looking him in the eyes and talking to him. We’re not close, just fellow horsemen and classmates who share experiences and are part of a group planning our 50th reunion. We had put together a big 45th reunion since we had asked ourselves: Who else is going to die in the next five years? Two have so far.

When I got to the hospital, another classmate, Charlie, was there as were Denny’s son and daughter. Denny had just been given a dose of morphine. Charlie yelled at Denny: “Hey, Black, Bud Hirsch is here.” Denny, on his side, eyes partially open but not moving, mumbled my name. But he quickly started snoring and remained that way the rest of the time I was there. That was our whole conversation.

His son told me Denny would be released on Monday and they were trying to figure out where to take him. After talking with his son about photography and computers and listening to stories from his daughter, I said goodbye to Denny. His eyes were open, but it was impossible to know if he heard me.

Charlie and I went downstairs and into the parking lot and stood talking for a half an hour. We talked about school, “Sophie Scholl: The Final Days,” anti-Semitism when we went to school, and Denny. We reflected on the luck that brought us to be standing in the parking lot, warming in the sun, talking to one another.

Charlie wants me to write some poems for our 50th emphasizing the good memories, getting away from the ones that seem to haunt my poems about that time. I agreed.

Then I drove home slowly, the long way, and sat down to draft a poem about all of this.

Dan called after dinner to tell me that Denny had passed…an interesting turn of phrase.

Must be Summer, ...

I got a full lung evaluation today. Nice technician, taken on time, took the amount of time they said it would. She fitted a mouthpiece onto a device that had four tiny tubes coming out of it that ran down into a computer. Mouthpiece is about the size around of the core of a roll of toilet paper, but quite a bit more sturdy. And I had to place a clip on my nose so I could only breathe through my mouth. While this is no biggie, if you swallow with the nose clip on, your ears clog up.

She cranked up her PC and off we went. Holding the tube in my mouth, I was asked to breathe normally for about four or five times and then to inhale sharply and then exhale all the way and then inhale again. We did this about three or four times. Then it was breathing normally four or five times (that is part of every one of the tests), a full inhale and a forceful exhale…keeping exhaling for about 8 to 10 seconds, then inhale. Again, as with all of these, we did this three or four times.

She then placed the breathing device in a bracket within a door that she closed around me. It’s all clear plastic, so no claustrophobia. I had to put my fingers on my cheeks (so they could not puff out), breathe, then pant (against some resistance from the machine), breathe, pant, big breath in, full exhale, repeat.

During one of these rounds, her PC gave her a Norton Antivirus Alert which, of course, meant the specific round we had just finished could not be recorded and we had to do it over. Love PCs.

Then she put a liquid into something that would be akin to an inhaler, passed air through it to make it mist, and I inhaled all the mist over the next few minutes. This was to dilate my lungs so she could run the same series of tests again to see any differences.

I was told that my doctor would call me with the results. She did a printout of her work. I saw that some of the numbers were red while others black. Guess the red ones were outside of some normal range. But she did tell me that it did not look bad overall.

I didn’t cough the entire time I was being tested, but started to cough as soon as I was in the hall heading toward the elevator.

… my breath is coming in short pants

I Had to Cough Up the Answers

Here are some of the questions that the lung specialist asked today. I have not listed all of them, just the ones I can remember at this point.

How long has this coughing been going on?
What time of day do you cough more?
Is it usually worse in the morning or the evening?
What do you do?
Do you clean stalls daily?
What did you do before you retired?
Do you have central heating and air?
Wall-to-wall carpets?
Humidifier? Does it work?
Pets in the house? Cats?
Is any of the hay in your barn moldy?
Any mold in your house?
Any seasonal allergies? Hay fever?
Any heartburn? Indigestion?
Do you partially regurgitate food?
Do you feel any acid at night when in bed?
What medicines do you take?
What medicines have you taken for your cough?
Ever smoke?
Anyone in your house smoke?
Ever been told you have asthma?
Any family history of asthma?

1950s: Popocatepetl – Soundless Dogma In The City

This true story came to my mind over the last few weeks as I have been visiting different doctors to diagnose my maladies:


The little white Chihuahua had fallen hitting her head causing an unknown malady. Consulting with the best medical minds, Mom made an appointment for that week. At the same time, she (not the dog) suffered from a singer’s node and could not speak. So, she carried around a tablet and a pen.

With the tiny dog in her arms, Mom entered the lobby of the psychiatric wing of the big hospital. There, she had to check in with a receptionist.

“What doctor do you have an appointment with?”

Mom scribbled his name.

“You know, you will have to leave the dog outside,” the receptionist exclaimed.

Her written reply: “But, the appointment is for the dog.”

Pause.