Acid reflux, etc.

I had no interest in this topic until I witnessed a rather alarming episode when I was visiting an old friend and some of her family. We were at a restaurant and my friend had eaten about two-thirds of her salmon burger when she experienced pain between her shoulder blades. Soon after, she turned pale, had a vacant look in her eyes, broke out in a cold sweat, her hand shook, she threw up, and briefly passed out. It seemed to us she might be having a heart attack or stroke, so her daughter called 911 and my friend was hauled off to the hospital in an ambulance.

At the hospital, she immediately began to feel better. Her heart, blood pressure, and blood sugar were all fine. The doctor told her she had esophageal reflux, which astounded all of us. He assured my friend that her symptoms were consistent with that disease. For one thing, if she’d had a stroke, she certainly wouldn’t have recovered so quickly. The pain she experienced had triggered a cascade of the symptoms we observed. (People often experience pain in their chests from acid reflux; in my friend’s case, the pain was in her upper back.) After an hour or two the doctor discharged her and she was quickly her normal self.

Months prior to this event a doctor had told her she had acid reflux, but she pooh-poohed this idea—as I would have. I thought that with acid reflux a bit of stomach acid leaks into your esophagus but that it was no big deal. I’ve learned that it can be a big deal because of the damage it can do to your esophagus. In my friend’s case, the injury to her esophagus occasionally caused internal bleeding and anemia. As you can see in the illustration below, the leakage is a result of a faulty sphincter muscle between the stomach and esophagus.

The terminology used for this condition can be confusing: Acid reflux is a rather common condition that can range in severity from mild to serious; gastroesophageal reflux disease (GERD) is the chronic, more severe form of acid reflux; heartburn is a symptom of acid reflux and GERD.

Even though my friend would have been fine had she not gone to the hospital, we’re glad she did. We all learned a lot.

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Carpal tunnel syndrome

Because one of my daughters has had surgery for carpal tunnel syndrome—plus additional surgeries on her hands—I was drawn to an article inThe Daily Beast that reported on a ten-minute surgery for the ailment (small incision in palm; snip a tendon [!]). As I was reading about symptoms I was brought up short. Whoa! That’s what I have! The symptoms include tingling and numbness in the hand, usually affecting the thumb, index, and middle fingers; perhaps also a burning or pins-and-needles sensation. The discomfort frequently occurs at night, mostly because the way the sufferer positions his or her hands.

I’d been having these symptoms for a couple of months and assumed it was a pinched nerve—perhaps in my shoulder or neck (my shoulder had been hurting). I’d have the symptoms nearly every night, sometimes with severe pain in my lower right arm. Getting up and walking around seemed to help. Sleeping on my side was impossible, so I began to sleep on my stomach. Sometimes I’d have the symptoms just sitting in a chair and reading. Massage, chiropractic, and acupuncture didn’t help. 

Your carpal tunnel is a narrow, rigid passageway composed of ligament and bones at the base of your hand. It houses tendons as well as the median nerve, which runs from the forearm into your hand. The tunnel is a rather tight space. Carpal tunnel syndrome develops when the median nerve, which passes through the tunnel, gets compressed within the tunnel—usually by irritated tendons that swell or thicken. It’s that compression on the nerve that causes the pain.

Medical people don’t precisely know the causes of the disease: perhaps genetic, or injury to the wrist, or mechanical problems with the wrist joint, fluid retention, development of a cyst, and so forth. I certainly don’t know why I got it at the age of 83. But once I figured out my problem, I’ve been able to avoid the discomfort just by paying attention to what my hands are doing. I now sleep on my side again, but I place my wrists in a neutral position, making sure not to curl my hands under the pillow. Apparently, wrist braces also help, which I might try. For sure, I don't want a tendon snipped.

For an introduction to this blog, see I Just Say No; for a list of blog topics, click the Topics tab.

Sued by your hospital? You’re not alone

The Carlsbad Medical Center in New Mexico has sued nearly 3,000 people since 2015 and more than 500 through August of this year. (One of those who was sued was a county judge!) If the bills are not paid, the hospital garnishes patients' wages and put liens on their homes. Likewise, Methodist Le Bonheur Healthcare in Memphis filed 8,300 lawsuits in the past five years, including some against their own employees. In Virginia, hospitals filed more than 20,000 lawsuits over patient debt in 2017 alone. These are all charges still owed after their insurance has paid the hospitals. 

Many are in one-hospital towns where there’s no competition. They can charge whatever they want. In Carlsbad, for example, the medical center charges five times more than Medicare would have paid for the same services. One employer in Carlsbad discovered that it would be cheaper for one of its workers to travel to Hawaii for a gall bladder operation—including airfare for two, and seven-day island cruise—than to get the procedure at the local hospital.

In 2018, more than one in four consumers nationwide were reported to credit bureaus for unpaid debt. Of those, more than half were the result of medical bills. One survey of women with breast cancer found that a third of those with health insurance had been referred to bill collectors; among those without insurance, the number rose to 77 percent. Overall, two-thirds of all bankruptcies and nearly half of all foreclosures in America today are related to medical costs.

Eighteen percent of the US economy ($3.5 trillion) is tied to health care, up from 5 percent in 1960. In 1999, medical expenses consumed 14 percent, on average, of American’s take-home pay. Now it's 31 percent of our take-home pay. I can think of better ways to spend my money.

For an introduction to this blog, see I Just Say No; for a list of blog topics, click the Topics tab.

Waste not. Want not

We don’t waste much food at our house: we eat all our leftovers; I pay no attention to “use by” dates; we scrape mold off food and eat what’s left, and so forth. This doesn’t make us sick; just makes for a robust immune system. Besides, some of my best meals are made from leftovers. Such habits have nothing to do with a world view. We’re just old fashioned “waste not want not” people. But I recently learned that food waste is a big contributor to climate change. About a third of food produced and packaged for human consumption is wasted. All the thrown-out food goes into landfills where it rots and gives off methane gas that is roughly 25 times more harmful than carbon dioxide. Plus there’s the waste of the land as well as trillions of gallons of water and vast amounts of fossil fuels required to grow and bring all this food to market.

A grocery store chain of 900 stores in Finland has undertaken a program to thwart food waste. Food that will reach its expiration date at midnight goes on sale at a 60% discount at 9:00 that evening. One man bought two pounds of shrink-wrapped pork tenderloin for $4.53. I’d do that in a heartbeat. A restaurant, also in Finland, serves only food made from past-due ingredients donated by grocery stores and bakeries. Because the donations vary, the restaurant chefs have no idea what they’ll be making until they walk into the restaurant’s kitchen. In the US, the Center for Biological Diversity gave nine out of ten supermarket chains a C grade or lower on food-waste issues. Only Walmart did better. Buying in bulk to save money also contributes to waste (think Costco). Fortunately, half-gallon-size bottles of bourbon never go bad.

Now I’m wondering about our compost pile where our vegetable waste goes. Is it giving off methane? Maybe not. The gophers have done a pretty good job of covering it with dirt.

For an introduction to this blog, see I Just Say No; for a list of blog topics, click the Topics tab.