BROKEN DING-DONGS, HEARING AIDS, AND ONE MORE REASON TO HATE OUR GOVERNMENT

Hey everybody! It’s been a while. I thought it would be good to post again.

I’ve got a little time; I’m on a medical leave right now to take care of a sudden and troublesome condition. I’m hoping to return to work in January. So, I’m using the time for research and writing. Good time for a new post.

My time as a Medical Assistant has not been terribly long, but I have learned a few things. The world of healthcare is full of drama, intrigue, gossip, strong emotions, and downright assault. They didn’t exactly prepare me for that in school. But, many veterans of the industry are a bit burned out these days, so I joined the ranks just in time for the rampant profanity and frayed nerves. Good times!

But, all that’s for another time. Today, I’d like to write about broken male genitalia, hearing aids, and a federal government that just continues to annoy the crap out of me.

Okay, bear with me, because this is sort of round-about.

Older males can develop a condition called Peyronie’s Disease. Simply put, this a pronounced curvature of the ding-dong when it becomes ready for the old hoo-hoo cha cha with a nice lady. Many illnesses and conditions in medicine are eponymous; that is, they are named after the scientist or physician that first identified them. I have done no research, nor do I wish to, of who Peyronie was, and why he chose this area of study. Well, I suppose someone had to do it?

Anyway, this curvature of the little fella can be quite debilitating, preventing regular sexual intercourse. Please, please, please do not follow this link:

https://www.google.com/search?q=real+pictures+of+peyronie%27s+disease&tbm=isch&ved=2ahUKEwj6w5GU2v_zAhWLATQIHWN1AbAQ2-cCegQIABAA&oq=peyronie%27s+disease+pictures&gs_lcp=CgNpbWcQARgCMgcIIxDvAxAnMgQIABAeMgYIABAIEB4yBggAEAgQHjIGCAAQCBAeMgYIABAIEB4yBAgAEBhQAFgAYLQiaABwAHgAgAF0iAF0kgEDMC4xmAEAqgELZ3dzLXdpei1pbWfAAQE&sclient=img&ei=p1eEYbrUMYuD0PEP4-qFgAs&bih=757&biw=1600&rlz=1C1CHBF_enUS897US897

I warned you. Anyhoo, Peyronie’s Disease is generally caused by a buildup of scar tissue and plaque in Mr. Johnson. This is typically due to a number of various medical conditions, but most often due to penile trauma. What happens is, the old timer really, really wants to do the bang-bang dance with the pretty lady friend. However, along with age can often come another unfortunate condition, erectile dysfunction. ED, as it’s known, can be varied in its severity. If it is not too bad, the gentleman will do his darnedest to guide the not-so-stiffy into the nice lady’s fun zone. This invariably does not work, and is probably not all that fun for the female partner. I’m guessing. But, this continued practice will cause physical trauma, damage, to Mr. Johnson. This often results in Peyronie’s Disease. Oh, the tragedies of man…

But wait! Hope abounds! Modern modern medicine triumphs! There is a medication known as Xiaflex (triumphant music sounds) that can cure this condition!

Xiaflex is a medication that breaks down the plaque buildup in a shlong with Peyronie’s Disease.

https://en.wikipedia.org/wiki/Collagenase_clostridium_histolyticum

It is injected directly into the affected area of the penis. You are reading that correctly. A needle, made of metal, is inserted right into a crooked penis. In my practice as a Medical Assistant, I have seen Peyronie’s Disease, and I have seen it corrected by an injection of Xiaflex into the affected area of the male member. It cannot be unseen. I am different now.

Xiaflex is not inexpensive. Depending on the severity of the Peyronie’s Disease, it can take up to 12 injections of the medication. Each administration of Xiaflex costs roughly $3000.

Okay, so my 87 year old mother, who I love dearly, is nearly deaf. I know that there was no segue there, but bear with me. This all comes around. Nevertheless, I hope my Mom is not reading this.

Charlsia Schall is still very sharp mentally, and I inherited her wicked sense of humor. Physically, she’s doing okay for someone who is 87, but she needs to use a walker and she desperately needs hearing aids.

You can still speak with her, but it is usually best to speak directly in front of her, in a louder, clearer voice. Being that her cognitive acumen is still strong, it is easy to carry on a conversation with her. At her age of 87, I am truly lucky. Not many people have such a luxury. Again, I hope you’re not reading this, but I love you, Mom.

My mother and late father, through living frugally and saving as much as they could, did okay for themselves. You know, living within your means and saving as much money as you can. Like you’re supposed to do. Sheesh. Old people, wise with their money… I tell you… Anyway, though she could definitely afford it, Mom is not keen on making large purchases. On some level, I don’t blame her at all. Hearing aids are profoundly expensive, with decent ones starting at at least 4-5 thousand dollars. As my Mother is not entirely deaf, this is an economic button she is just not comfortable pushing.

Social Security was signed into law by President Franklin D. Roosevelt in 1935. Again, I got no segue here, but trust me, this is all going to come together. Hopefully. If this is a good day. Anyway, Social Security was part of the rescue package intended to mitigate the Great Depression. Apparently, economies occasionally need medication and therapy as well. The Great Depression had ravaged the United States. A recap of history is not needed here.

The government, at all levels, has always taken a strong interest in the American healthcare system. This can be a good thing, as government oversight can ensure the safety of patients and the efficacy of treatments, strengthening out healthcare system. (How we go about paying for this masterpiece is another story entirely). Federal agencies exist to oversee healthcare at all levels, ostensibly to protect the American patient: the FDA, the CDC, the DEA, the Joint Commission, etc. Occasionally, these departments can become weaponized for political reasons, as we are human, all of us flawed, and humans run the government.

My education and professional experience is in medicine. I dislike talking politics, as people can easily get all yelly-shouty-pissy. I know only the basics of our political system, and I hold opinions based on what I see. There is a branch of philosophy (I have dabbled, but am not educated) known as epistemology. This school of thought seeks to differentiate between what is fact and what is opinion. In today’s era of social media, it is quite easy for anyone, from any ideological camp, to loudly shout an opinion, with scarce facts backing it up, until, in this era of blatantly partisan media, their opinions are reinforced enough to become, in their world, facts. A nice twist of logic. It is difficult to speak of politics these days, as we live in a largely binary political belief system, with inflexible, unyielding opinions (not facts), and people quickly get emotional and confrontational. You cannot have a rational discussion with someone in that state. Hence, I avoid politics.

Anyway: back to politics nonetheless, the federal government, and Social Security. Over the years, the government has changed, tweaked, and adjusted Social Security, but the basics of the original intention still stand. All taxpaying Americans pay into it, and our senior citizens can enjoy an easier way of life, as medical bills mount with age. Be that as it may, there are certain things Social Security still will not pay for.

My beloved mother could really use those hearing aids. Hearing aids are not covered by Social Security.

Xiaflex, the medication that treats Peyronie’s disease, is covered by Social Security.

Let that sink in for a moment.

Hearing aids? Up to $7,000 or $8,000 dollars.

Xiaflex? Up to $36,000 dollars.

Yup. No hearing aids, no new glasses, no covered dental work for my Mom.

Bent weener? No problem. Got you covered.

I was a little stunned when I heard about this. Surely, I thought, the powers that be in Congress would have rectified this by now. An RN I was working with at the time gave me his opinion:

RN: Andrick, who do you think makes the laws in the Senate?

Me: Uhh… Well, for the most part, mostly older white males.

RN: And who do you think they have staffing their offices?

Me: Usually insanely hot 35 year-old women.

RN: Okay then, do the math.

Me: Aw, crap!

Joe Biden and the slim majority of Democrats in Congress have recently tried to stabilize the country and give long-needed help to the working class. Again, I hate speaking politics, but two of his Republican predecessors did the same thing. But, because half the country believes Joe Biden lost (dude… people… really?), the opposition is suddenly concerned about all this money we’ve been throwing around.

Initially, Biden’s rather largish spending plan included adding hearing aids, vision, and dental to Social Security recipients. Sounds like the right thing to do. But people balked at it. Biden has scaled his ambitions back. Recently, Congress at least passed an infrastructure spending bill. There is more work to be done. Biden and the Democrats are still trying to pass legislation that would help the needy. After much yelling, the plan was scaled back, as far as Social Security benefits go. Vision and dental are out, but hearing aids would be included. At least my Mom could finally hear again.

However, the opposition is again balking at this one. Along with them are two Democratic obstructionist Senators. One is a cranky old man, with an 85 year old body and 500 year old face,a Republican dressed as a Democrat, who doesn’t like spending money at all. He wears sensible shoes. He represents the state of Virginia. I had to Google Virginia; evidently it’s a suburb of West Virginia or something. East Virginia was infamously destroyed by the Cloverfield monster. The other Democratic obstructionist Senator is a woman from Arizona, who’s really pulling off the naughty-behind-closed-doors school librarian look. I’ve been to Arizona. Head south to the deserts of SoCal, go east, and stop where all the retired people are. Anyway, this Senator is rather hard to read. She doesn’t seem to stand for anything, and dislikes speaking to reporters, her constituents, or the clerk who asks paper or plastic. Maybe she’s just there collecting a paycheck. She certainly does not need the Viaflex. So, there is a good chance that the aid package that includes hearing aids in Social Security will not pass.

So, there you have it. Penny-pinching senior citizens can’t rely on Social Security for hearing aids, but senior citizen males, no matter what their station, can afford Xiaflex to fix their bent ding-dongs. Makes perfect sense to me!

Well, until next time! Thank you for reading!

A BAD ROLL OF THE DICE: THE MEDICAL DOUBLE-WHAMMY

Okay! I have a guest post today. It’s my brother Pedro (his name is Peter, I call him Pedro), and I asked him to share his experiences with a seriously bad roll of the medical dice. When he was about 11, in the 6th grade, he came down with a disease known as mononucleosis. He recovered, but six months later, he came down with another nasty disease known as meningitis. Dang! That’s some bad luck, big brother! So, he was kind enough to share his experiences of the ordeal(s). He was young, so many of his memories are hazy, but he clearly recalls the more painful moments during this time span of infections. Myself, I would have been about 6, so all I remember is that my big brother was home from school, not feeling well, and we had to have separate eating and drinking utensils for him. Then I probably played with my legos.

Both mononucleosis and meningitis are serious and potentially deadly diseases. During his narrative, I will jump in and do my best to explain what he may have been experiencing. Take it away, Pedro!

I left school one day, feeling kind of weak. By the time I got off the school bus, the weakness and fatigue had increased. I went to school the next day, but the teacher sent me to the nurses office, as it was obvious to her that I was feeling tired. I had also complained of a headache. By the time I got to the nurse’s office, I ended up barfing on her desk. Mom had to come pick me up.

It is widely known that younger adults, and specifically children, are more susceptible to disease. This is simply because their immune system has not been around long enough to develop antibodies to the various pathogens that love to call human beings home. Their defense mechanism is simply not yet developed, like the rest of their bodies. Most young children have 6 to 8 colds per year, according to John Hopkins Medicine.

Mom and Dad thought it might just be a cold or a flu, but I began to gradually feel weaker, I had a fever, no energy, and I had trouble keeping food down. I had a pretty bad sore throat. The weakness is what I remember the most. After a few days, Mom and Dad took me to the Doctor. My lymph nodes had begun to swell and actually felt like little rocks. I barfed in the Doctor’s office. Mom says I cried when they drew blood from me, but you ought to see my brother try and practice blood draws.

Shut up.

Later that day, the Doctor called to say that I had mononucleosis. I had no idea what that meant. Mom and Dad tried their best to explain it to me, but to me, it just felt like a really awful flu.

Unlike most diseases that infect children, mononucleosis typically effects young children in the early and mid puberty stages of life. Adults can definitely be infected with mononucleosis, but in those instances, the symptoms are usually mild to moderate. There is no vaccine against mononucleosis.

Yeah, like a bad flu. But it just wouldn’t go away. I started to feel better, but only gradually. I was out of school for almost two weeks. At the beginning of the second week, I started to feel a little better. My lymph nodes had returned to their normal state, I was no longer nauseaus, and my fever lowered back to an almost normal temperature. But I was seriously fatigued.

There is no specific treatment for mononucleosis. Like a flu, bedrest, OTC painkillers and a simple diet will do the trick. The disease itself is usually caused by the Epstein-Barr virus, one of the eleven or so types of herpes that can infect human beings (hey… it doesn’t have to be sex… my brother was 11…) In fact, about 90% of the world’s population is infected with the Epstein-Barr virus at some point in their lives, usually with no ill effects.

https://www.sciencedaily.com/releases/2010/12/101215121905.htm

The little virus is generally spread by contact with an infected person’s saliva, hence, it is often called the ‘kissing disease.’ My mother recalls the kids our age that lived in the house being sick just before my brother came down with mono, and if they were playing around, and shared a swig of soda pop, that might have done it. However, we all have to eat and drink, and we typically use utensils to do so, so Pedro could have caught it just about anywhere.

The virus usually attacks the epithelial (goop, mucous) that lines your alimentary canal (the passageway from your mouth to your pooper) in the pharynx, often causing a sore throat. Later, the virus goes to war and tried to replicate your B-cells (a lymphocyte, one of your system’s bodyguards). In most cases, your B-cells win this round, and develop antibodies, a sort of ‘memory’ of how to defeat this antigen (a substance, a pathogen, anything nasty that invades your body).

Viruses like human hosts. Viruses exist. Viruses can be easily transmitted. Some viruses are particularly nasty, aggressive, unpredictable, and opportunistic. Some of these viruses can kill over 600,000 Americans, even though there are precautions you can take to avoid them. If there is a vaccine against this virus, it would probably be a very good idea to get it. I don’t know what made me think of that. But I digress…

In the few days before I was supposed to go to school, my teachers started sending me stuff I had missed. I don’t know how people found out, but when I first got back to school, my friends were avoiding me like the plague. It didn’t last long, though, they could tell I wasn’t sick anymore, and I had a bunch of missed class stuff to catch up on.

Mononucleosis is not a reportable disease in Washington State, despite it’s prevalence to easily spread. It rarely causes serious problems, and it goes away with time. That’s not to say it’s an easy ordeal; like my brother said, it’s like a bad flu, only it last about two weeks.

I felt fine for a long time after that, with no lasting effects. But then, about 6 months later, I woke up Sunday, after going skiing on Saturday, with a sudden fever of 102 degrees. I felt cruddy and tired, worse than the mono.

Again, children and young adults have weaker immune systems. It was postulated, later on by his physician, that my brother’s mononucleosis, though he had recovered from it, was still doing lingering damage to his immune system as it rebuilt itself. The pathology is not well understood, but it has been estimated, by one study, that 1-18% of children who are infected with mononucleosis are susceptible to meningitis:

https://bmcinfectdis.biomedcentral.com/articles/10.1186/1471-2334-11-281

I was no better, in fact I was worse, Monday morning. My parents took me to Children’s Hospital. By that time, my fever had increased, my neck was terribly stiff, and I had trouble looking at bright lights. I had no idea what was going on.

Well, I’ve said it before. Seattle is a good place to get sick. Some of the best healthcare providers in the world are here. The sudden, rapid symptoms my brother was describing immediately cued the physician that this might be a case of meningitis. The definitive diagnostic to test for the presence of the disease is the performance of a lumbar puncture, better known as a spinal tap.

I remember laying on my right side. The doctor put anesthesia on my back, but it really didn’t do any good. Dad had to hold my legs down so that I wouldn’t buck and break the needle off in my spine. I really can’t describe the pain. Incredible pain. It was more like an electric shock. Thankfully, the needle was in my spine for only a few seconds.

A lumbar puncture is a medical procedure in which a needle is inserted into the spinal canal, most commonly to collect cerebrospinal fluid (CSF) for diagnostic testing. The main reason for a lumbar puncture is to help diagnose diseases of the central nervous system, including the brain and spine. In my brother’s case, meningitis. I love the movie Spinal Tap, but after hearing my brother’s story, the medical procedure is not something I’d look forward to.

There are protective layers covering the brain and spinal cord known as meninges. There are actually three layers of meninges: dura mater, the arachnoid mater, and the pia mater. I’ll take anatomy for $600, LeVar. The word meninges comes from the Greek ‘membrane.’ Then: ‘itis’ is the medical term for inflammation. Hence: meningitis. This puts enormous pressure on the brain and spinal cord, causing severe pain for the victim. The entire human body’s entire nervous system stems from this area, and the entire body will be in pain.

There are a few different types of meningitis. The most common are bacterial and viral. Either one, particularly bacterial, left untreated, can cause septicemia: the poisoning of the blood, frequently fatal.

I remember when the doctor pulled the needle out. There was an odd little kind of wet ‘pop’ sound. As the doctor took the specimen to the lab, a nurse brought me an orange popscicle. They offered one to Mom and Dad, but they passed. I was still in incredible, intense pain. Evidently, the testing procedure did not take long, as the doctor returned before I had finished my popscicle.

The ‘good’ news was that my brother had viral meningitis, as opposed to bacterial. There are vaccines against this virus, and my parents were good about keeping us up to date, but sometimes the little creature will find a way. Viral meningitis will generally go away on it’s own. Some virus do not.

It’s most likely that my brother, with his immune system still rebuilding itself after mononucleosis, caught the virus while he was on his ski trip. On the bus, in the lodge, who knows. Viruses are opportunistic pathogens, and can spread very easily. It’s too bad that my brother was not wearing his ski MASK. And staying safe while speeding down the slopes, practicing proper SOCIAL DISTANCING. Because viruses are REAL and can easily spread if you don’t take PRECAUTIONS.

Hey! Is this my story, or your rant about Covid again?

Sorry. Go on.

When we got home, and I tried to sleep, I couldn’t. The pain was incredible. It felt like a third-degree burn all over my body. Cold beverages didn’t help. Aspirin didn’t help. I was in misery. The folks called the hospital, and the doctor told them that I’d pretty much have to ride it out. It sucked.

Had my brother had bacterial meningitis, there is a good chance he would not be here today, or, at the very least, be severely crippled. Children that are fortunate enough to survive bacterial meningitis face a lifetime of medical problems: memory loss, cognitive difficulties, difficulty retaining information, motor-skill and coordination problems, headaches, hearing impairment, epilepsy and seizures, paralysis and spasms, speech problems, potential blindness; all or none to varying degrees. I understand now why my mother could never watch the Jerry Lewis Telethons. To see a child suffer is the worst image possible.

Unlike the mono I had, this one didn’t last as long. I gradually felt better in about a week. But those first few days were fucking awful. It’s impossible to describe the pain. You cannot comprehend it until you have been through it.

So, back to school I went, and once again, I was way behind on schoolwork, and my classmates steered clear of me. But, eventually, life returned to normal.

Meningitis is a reportable disease, as it is contagious. How myself and my parents, and anyone else at my brother’s school, managed to not catch it as well is… just a roll of the medical dice.

Thanks Pedro!

PARTS OF YOUR BODY HAVE REALLY STUPID NAMES

It is a well known fact that the healthcare industry does not speak English. Sure, when you’re talking to your doctor, or any practitioner, you’ll use layman’s terms, the ones we all know. Relatable, common sense terms. However, behind the scenes, healthcare has a needlessly complicated language. It’s like a strong tradition, a superstition almost. As if only the initiated can use this sacred tongue.

Typically, after any visit to a clinic or facility, you are given a sheet of paper, sometimes emailed, summarizing what your experience there was. It’s usually called an After Visit Summary, or a Visit Information Sheet. Depending on your facility, if you read the summary in-depth, you might see some of this obscure language pop up.

Much of the language of healthcare is derived from ancient Greek and Latin, when the smart people of the time began to (very slowly, often incorrectly) figure out how the human body works. The Latin work for uterus is ‘hyster,’ derived from hysteria, as the Greeks thought women could be overly emotional, as they did not understand that a woman ovulating can have her hormones thrown off. How charming of them. ‘Tomy’ means to cut, or remove. Thus: hysterectomy.

Today, much of the modern healthcare lexicon is an alphanumeric code, a relatively recent development. This eases communication between different languages, and it is also a common way for clinics to communicate with insurance companies.

Perhaps the most intriguing healthcare term of all is the eponym; that is, a procedure or discovery named after the person who pioneered it. The PAP smear was invented by Georgios Papanikolaou. The cruel disease of Alzheimer’s, an illness as old as humanity, was first pathologically described by Alois Alzheimer. Crohn’s disease was first identified by Burrill Crohn.

Now, considering anatomy, that is, the parts of the human body, there are many eponymous terms that, when first read, are downright silly. Here now, is a list of the most ridiculous sounding names for parts of your body:

Purkinje fibers: These are located near the bottom of the heart, and aid in the pumping action of the heart muscle and blood. They are named after Jan Evangelista Purkyně.

Bundle of His: (Actually pronounced bundle of HISS) These are fibers in your heart that help conduct the electrical impulse that keeps the heart beating. They were discovered by Wilhem His Jr.

Islets of Langerhans: These are parts of the pancreas that aid in the metabolism of glucose. They are named after researcher Paul Langerhans.

Cowper’s glands: These aid in the transmission of male semen from point A to point B. They are named after William Cowper.  Mama Cowper must have been proud.

Pouch of Douglas: This is the pouch between the rectum and the uterus of the female body. Anatomist James Douglas took his work very seriously.

Golgi apparatus: This cellular substance aids in protein packaging. They are named for the Italian Scientist Camillo Golgi.

Loop of Henle: This handy little structure aids in the production of urine. It is named after German anatomist Freidrich Gustav Jakob Henle. Dr. Henle liked to study how we pee.

Little’s plexus: This is part of your nasal septum. It was first discovered by American surgeon James Little. I don’t know much about him, but judging by his name, he was probably 6’4″ and 280 lbs.

Crypts of Lushka: These are the mucous membranes on the inside of the gallbladder. They are named after German anatomist Dr. Hubert Von Luschka.

Zonule of Zinn: This is a suspensory ligament in the eye. They are named after Johann Gottfried Zinn.

Spiral valves of Heister These are valves in the cystic duct, connecting the gallbladder to the bile duct. They are named after German anatomist Lorenz Heister.

Wormian Bones: These are structural bones in the skull. They are named after Ole Worm, professor of anatomy at Copenhagen. Cool name.

Artemis Schlong: After centuries of debate, a name was finally settled on the name of the male reproductive organ in 1692, by Costa Rican anesthesiologist Artemis Schlong.

All human beings, gender dependent, have within them these anatomical parts with unusual and odd sounding names. There are of course, many more. And still… more to be discovered.

Wash your hands!