Monday, July 15, 2019

Cornbread Cake

In mid-June, I went to visit my parents and sister and Amy and Ginny in Michigan. I didn’t get to see my uncle because he was at his cottage up north. It was a lovely visit, doing all the things I enjoy doing there: hanging around with my parents, getting caught up with my sister, watching MSNBC (Rachel!), going to Seva with Amy and Café Zola with Ginny.

It was also nice to be with Jack the cat, upon whom my father dotes, worrying over his appetite, shopping for new kinds of food, cooking things Jack might like. I joked to a friend about my father saying, “I have bought these 95 kinds of food for Jack and have tasted them all. I think this one is the best.” That’s an exaggeration, but not by much. I told my friend that my father is an excellent cat father and that he’s like that with people, too. He goes well out of his way to care for those he has identified as being in his flock: Mom, his own children, other relatives, Jack the cat, and another person I have finally concluded is my half-brother, since we in effect share a parent.

During my visit, my father hosted a birthday celebration for me: pizza delivery and cake suitable for the person who avoids sweets. He has approached this problem different ways over the years. This year, he made a cornbread cake, omitting the cup of sugar the recipe calls for. It had buttermilk in it, and was moist and pleasing. As for frosting, he was thinking he would put cream cheese on it, and was wondering what might be added to the cream cheese. I suggested fruit-only preserves. He used strawberry and the result was wonderful—light and delicately sweet.

When my mother said later in the day that she could go for another piece of cake, my father said there should be plenty in the fridge, as he had had to test his recipe by making it more than once, of course.

Back at home and at work, I greeted a patient on a gurney in the hallway who turned out to have likely C. diff. From now on, I will wait until the patient is situated in his or her room and any instructions about precautions have been posted.

I was asked to visit a dying patient whose mother wanted someone to read the Bible to her. When I got to the unit minutes later, her nurse said, sounding shocked, that the patient had just died. When I went into the room, I saw the patient lying on her bed with her eyes wide open, and I got a tingling sensation all over my body. (A similar thing happened once before with someone who had just died: goosebumps on my shins.) I spoke directly to the patient, since the strong energy in the room made it seem she was still there in some sense.

I also visited a patient who has lived in his car since parting from his spouse two years ago. A nurse in the ED wrote in his chart note that patient was “inappropriately focused on needing to move his car.” Worrying about your car being towed is far from inappropriate if your car is also your home, contains all your possessions and is the thing that prevents you from having to sleep on the sidewalk or in a shelter. I swallowed the urge to send the nurse a message to that effect.

Finally, I visited a patient who had left the hospital a month prior with a newly transplanted organ and high hopes. Bad labwork had put him back in the hospital.

I went for a sleep study late in June, after having noticed that my sleep requirement seemed to have gone way up. Long ago, I was diagnosed with mild sleep apnea after a sleep study, and thought maybe it had worsened, accounting for what seemed like undue weariness—needing as many as 13 hours of sleep some nights, with nine hours a night, which I had considered a minimum, now insufficient.

The technician festooned me with wires and said that if I woke up at least 15 times per hour in my first two hours of observed sleep, I would then be set up with a CPAP machine to try out for the rest of the night. He had me try a few different ways of attaching a CPAP to my face, and said that 75 percent of people being studied end up qualifying to try the CPAP. If a CPAP was indeed needed, then I was looking forward to having one and enjoying more restful sleep, but I was hoping I wouldn’t need one—not to have the diagnosis, hassle or expense.

I caught myself waking suddenly from sleep at least three times soon after retiring, so I was sure the technician would be coming along with the CPAP, but he never did. As for improved sleep, that has already occurred, thanks to my new PCP, who, when she ordered the sleep study, also reminded me about proper sleep hygiene: no screens starting two hours before bedtime, taking magnesium in the evening, not lying awake in bed for more than 15 minutes.

I have been faithfully following these instructions, including that I take 500 mg of magnesium glycinate 90 minutes before bedtime. Maybe five or six times, I did get up and read in my dimly lit room until I felt really drowsy, which more than once took hours, and I felt lousy the next day, but now, as a rule, I fall asleep fairly easily and quickly, and sleep much more soundly than before. Nine hours, alas, really isn’t enough, but if I sleep nine hours on work nights and maybe 11 or 12 hours one night a week, and 10 or 10.5 hours the rest of the week, it seems to balance out.

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