30,000-- Minus "This is the part that doesn't make sense."

 I just saw that title elsewhere, but it applies in so many ways. When it comes to health care, for instance. Any time you receive a notification from an organization that carries the word "transition," you can be pretty sure that sonething not to your benefit is in the works. And medical organizations are no exception, though the stated premise for the transition is always to better serve the client or the customer or the patient. (Take warning.)

  I was sent a notification from Capital Cardiology Associates, from whom I've received care for over 20 years, though minimal to be sure, for borderline and controlled high blood pressure, until sudden escalation in the year 2023. 

    The message read that CCA , always re-evaluating how they can continue to bring the gold standard of cardiac care to their patients, and in order to fulfill that ongoing commitment, are making changes to how and where to provide certain inpatient services. Thus, the TRANSITION begins. Starting on Jan. 1, 2026,  routine inpatient cardiology services will be provided at Albany Medical Center Hospital and St. Peter's, no longer at Samaritan Hospital in Troy. Thus, they say, they can provide more consistent, comprehensive services with the full strength of team and resources. 

The Troy office at Burdett will remain open, they say, to continue to provide patient care and services. I would say that it seems their staff of more than 35 certified cardiologists is not keen on the idea of traveling to Troy. If so, then Samaritan would be a second rate choice of doctors. 

The Board  says the reason for the change is to consolidate care at AMC and  SPH, which  allows the delivery of more  coordinated care. 

(Whoever set the practice in that location in the first place should have recognized that it was not a good idea for cardiac patients to have to make a left turn to enter the parking lot, while driving uphill and stopping for downhill traffic from the RPI Fieldhouse, but that's beside the point in my diatribe here.) 

 Of course, all upper management, Board of Director decisions are made from the viewpoint of finances. We all have to accept that decision. What we shouldn't have to accept is being insulted as to the reason for that decision. 

  Here is the insult to our collective intelligence and,  even more than insulting, a disregard for the health of patients needing critical care:                                                                                                   "We will no longer provide routine inpatient cardiology services OR EMERGENCY CATHETERIZATIONS at Samaritan Hospital,but will continue to perform outpatient cardiac catheterization at Samaritan Hospital."

  I would propose that of the large staff of cardiologists present at the 2 Albany hospitals,  a qualified cardiologist might consider a presence at Samaritan in the fully functioning Catheterization Lab there when an emergency room evaluation results in the diagnosis of a severely blocked coronary artery, for which the preferred treatment is coronary catheterization and stent insertion. In such cases, time is of the essence, with a time window of 50-90 minutes before the heart is severely damaged or death ensues.

Capital Cardiology has about a dozen of the elite Interventional Cardiologists who perform heart catheterizations and stenting, as well as other cardiac surgeries. Their "large presence" could include those who are willing to travel 10 minutes to Troy to work their magic. And save a life.

  Scenario: A person is at home when he or she feels as if  they might be having a heart attack. Ideally, they don't wait too long before calling 911 Emergency Services. In more rural areas, depending on which district that person resides in, and the distance from the designated Responder, it may take 20 minutes or longer from the time of the call until the ambulance arrives at the afflicted person's home. 

I was informed by a spokesperson from the local Rescue Squad that they are  obligated to transport all cardiac cases to the nearest hospital, so off to Samaritan Hospital, maybe a 15 minute trip, and evaluated there for their condition. If it is deemed that the proper treatment is a trip to the Cath Lab for potentially life saving treatment, and while Samaritan has a state of the art Cath Lab, the patient's Capital Cardiology medical practice will no longer  perform emergency catheterizations there, only scheduled procedures. 

   I have no information as to what  arrangements, if any, are made to transport the patient to one of the Albany hospitals for treatment at their Cath Labs. I called the telephone number included in the email from Capital Cardiology --"Who can I  contact with questions about this change? Call us at 518-292-6000 and our staff will be happy to help."  I called this number on November 5, 2025. The person who answered had no idea what I was talking about, as to answering questions about the change, and said I could call the front desk. 

      TIME IS RUNNING OUT.

  To be continued in Rant #2 Cardio

 

    

30,000 Words in November

 I almost signed up for this challenge, of writing and submitting 30,000 words in the month of November. That would be about 1,000 words a day, a mere fraction of the words, now mostly unspoken, that flow through my mind in the course of a day. That these words would be unlistened to or unread is irrelevant. Here are some examples of what I might have written if I'd accepted the challenge:

  I had a vivid dream last night but because I hadn't documented it in writing, I'm doomed to having snippits of it insert themselves at random into my mind. Here goes: Marilyn is to come to my house and pick me up to take me somewhere, most likely to a doctor's appointment. Someone else is here with me, I can't recall who, a doppelganger maybe. It seems M. is late as when she enters, she is in a hurry (Big surprise.) I'm not ready, have not showered, so am afraid I may offend the doctor, say I won't bother to go, but I am overruled. We leave, but first must stop at the fairground and as we go by one of the main buildings, we can see that it is a fully stocked store, with all imaginable items on colorful display, awaiting buyers. I remark to M. that I had seen this before, in a dream I'd had. The rest of this present  dream is now lost, presumably never to resurface.

  Yesterday, at my final session of Cardiac Rehabilitation, the daily trivia question appeared on the board on the wall, as usual. I usually pose this question to my sons, one on email and the other in person. As I drove out of the parking lot, I realized I couldn't recall the question, had absolutely no memory of it. No big deal, benign question and probably delivered to patronizing recipients anyway. 

  This morning, as I was waking up, going through the process of what words would flood my mind that day, yesterday's trivia question sprung, unbidden, into my mind. I recalled the question, uncharacteristically trivial even in the spectrum of trivia:  "How many CHUGGAS  are there before CHOO CHOO?"  I had thought only 2 chuggas, but I must have been thinking of the title, because as Chris pointed out, by reciting, there are considerably more. 

(I don't have word count, or if I do, I don't know how to access  it, but this must be several hundred words and I could continue,  but I'll spare you, O Blog.

Ask and you shall receive---

 It's always the tires. And the TPMS light, which likes to stay lit, so I can't be sure if the tires are under-inflated or the light is just wonky. If a grandson is in the area, I ask their help in determining which is to blame. I used to check for myself, but can no longer trust finger dexterity to remove the valves, to say nothing of assuming the position. While the boys are at Stewart's, I may ask them to fill the gas tank as well. That is sweet of them, but can give rise to a complication. G. did both chores last week. This week, when  I went to gas up my car, I at first thought I'd lost my strength. I had to struggle to get the gas cap off, having to use 2 hands to unloosen it, until I remembered G. had fueled up and of course put the cap on. I should have known, because earlier this year, after B. had fueled my car, I was at Stewart's,  totally unable to remove the cap,was low on gas, and, spotting some construction workers crossing the lot, asked if they could help me. One very friendly guy, said sure and while holding his cup of coffee, reached down to remove the cap. He then put his coffee cup on the ground in order to give the cap a good twist, exclaiming, "That was really on there!"  Some people just don't know their own strength. 

  Well, it's now 3:10 AM by the clock on the computer, so Spelling Bee is on.

(Not Very) Much Ado About (Almost) Nothing

 I was out of bread yesterday, Halloween, so I went to sNs to get a loaf. I didn't need other groceries, but I picked up a few yogurts and a bag of candy, for the holiday if anyone showed up. On checkout, I thought the price of almost $13 seemed high, for just 4 items, but chalked it up to those inflationary increases. I don't usually check prices on my grocery receipts, as everything is computerized anyway, but I happened to look at this receipt and saw I'd been charged for 2 bags of candy, at $3.99 each, when I'd only bought one bag. 

  I figured I should have noticed it at the time and reported it, because how could I prove that I hadn't left the store with the 2 bags of candy. I didn't feel like returning that evening, so I almost gave up on going back to the store to claim I hadn't received a paltry $3.99 item. 

But I had nothing else to do today, so decided to try my luck; maybe they'd believe me and tell me to pick up another bag of the candy. I needed some other stuff anyway. So I go to the Courtesy Desk and no one is there, as is usual. But I saw a man with a SNs shirt taking inventory, so I asked him if anyone would be at the desk. Soon a woman appeared behind the counter. I told her I had been double charged for an item and presented my receipt. She spoke not a word, but opened the register, counted out 4 dollar bills, and handed them  to me, along with my receipt. I said thank you and left.   (She didn't say "I came all the way out of the break room for this!"  But maybe she felt that way. 

   As I said, no big deal. 

Here I am at the computer, expecting to open Spelling Bee, which comes on at 3:a.m. While my clock reads 3:05 AM., the computer reads 2:05 AM. I suppose Daylight Savings has come to an end. So I wrote the above account to pass some time. 

Dog bites I have known

My family and I have always loved dogs and I have lived with at least one dog all my life, until the death of Cosmo. But I  also know that dogs can and do inflict harm with thier teeth, deliberately meaning to harm humans. 

 I was about 3 years old when I saw the first dog bite. My brother and I were outside our house and playing in the front yard. Our dog was lying on the lawn, sleeping in the sun. I seem to remember that the dog had been given to my father by someone he knew, fellow worker or neighbor, I can't say. It was a chow and I  don't know what its name was, so it was probably fairly new to our family. My brother decided we should cover up the dog with whatever we could find to do so. We were placing leaves and maybe little branches or pieces of grass on top of the sleeping dog. I had stepped away, most likely to find another piece to apply to the animal, when suddenly the dog leapt up and bit my brother's face, right near his eye. Maybe he'd stepped on the dog's foot or maybe the dog just woke up and went into defense mode. The blood streamed down his face. My mother ran out and picked him up. I remember her standing in the driveway waiting for the mailman, (probably Billy O'Neill) to come to take him to the doctor, as we had no transportation or telephone. All went well, except for the dog. I don't know if Dr. Sproat stitched up his wound, which may still  remain  as a scar.

    I have been bitten by dogs 3 times in my life, all during my childhood. 

          The first time was at a visit to a relative's house in the country. I may have been 7 or 8 years old. The adults were inside talking big people talk, and we kids were outside exploring the farmstead,  accompanied by the friendly farm collie-shepherd. All was fine. When the time came to leave, all the adults came outside to see us off. I think my sister was already inside on the back seat of my father's car. I went to get in the open door to join her and had taken my first step in when the dog, who was standing by with its owners, leaped up and bit me in the forehead. It caused a bruise which bled some, and I remember I felt embarrassed to have been attacked by such a friendly dog. I remember the owner stopped by our house some time afterward to check on the bite. I was even more humiliated.

         The second time of dog bite history happened a few years later when I was riding a bicycle, (either my brother's or one left by a neighbor boy for a period of time, as I never owned a bike until Dave gave me one as a present.) I rode down the sidewalk to the end of River Road, and was about to turn to head for home when a large tan great-dane type dog came running out of its yard from the house near the end  of the sidewalk, and bit me in the leg, knocking me off the bike. The owner came out and retrieved the dog, but never followed up. Times were  different back then.

   The last, or maybe I should say latest, dogbite occurred several years later, when I was riding a bike on the road past the Catholic church. A mongrel,  owned by the family who lived near the playground,  ran out across the playground and into the street and bit my leg.  I have a permanent bloodbruise on that leg. I don't think anybody was aware or notified. As I said, times were different then.

    I won't expound on the last and most serious dog bite, as I've written about it before. In February of 1973, my 2 year-old son was attacked by a large German Shepherd on the porch of the Valley Falls Post Office, approached by the dog from behind and evidently with the intent to kill, as it knocked him down and made repeated bites on his head, stopping only when I turned the few steps back and yelled.  The other dog bites I have enumerated were single bites, with each of the animals retreating, bite and run,one might say. This dog was actively intent on a kill, as the bites came fast and furious, and the surgeon used hundreds of stitches to close a number of wounds. The doctor said if this 22 lb. child had been bitten on any other part of his body with that force, from a dog weighing well over 100 lbs. that he would not have survived. The skull is made of  strong bone.

Musing about Meds

 For several years, I regularly drove my mother and her sister to their local primary care doctor, about once a month I think, where they adhered to the single prescription he had prescribed for them, which we picked up at the then local pharmacy. My mother died suddenly, of a heart attack, on October 30, 1983, at the age of 78.  Shortly after that, her sister, at age 83, decided to forego both doctor visits and medications. She died in July of 1995, at the age of 94. 

Life is but a dream...

 We were all in a hospital room, a large undefinable space,with family members coming and going, nobody confined to a bed. I had some difficulty communicating with any of the family members. All were going about their own business, so I couldn't help but feel somewhat isolated. But all seemed to be going in the right direction. Then we received a call from Oprah Winfrey, who was a patient on a floor or two above. She was direct and demanded to know who was going to bring her sugar. Dorothy had done so in the past and we all were pretty much in agreement that Oprah had self-prescribed this dosage of sugar, because otherwise the hospital staff would have  administered it to her. 

 But we wanted to help her with her wishes so I tried to get one of the many family members to comply. I was unable to get anybody to even listen to me, much less to agree to bring Oprah's supply of sugar to her. I finally told myself that if I prepared the sugar dose, maybe somebody would drop it off. I tried to figure what the dosage would be, and decided on 2 tablespoons of sugar  to a cup. I wondered where I could get a cup, and remembered the water station at the Cardiac Rehab facility, where I went and took one of the many plastic cups available there. I filled another of the cups from the water supply nearby and then went to the dining room for some sugar. Now I have the sugar in one cup and the water in another, but I had to search for something to stir them together.

   Unfortunately, I was awakened before I could locate the plastic spoon I was searching for, so as far as I know, the sugar was not delivered to Oprah.