It’s All in the Wrist

I’ve heard it said that growing old is a privilege because it’s something that is denied to many. Yeah, that’s probably true, so I don’t have an issue with that.

But it probably isn’t true about being old. Being old appears to be more of a pain than it is a privilege. And I mean that in the most literal sense that I can.

* * * *

I think it was last week that I finally realized that my blog has become an on-line diary of my incredibly bucolic and mostly boring life. I’m not a smart man, but even I know that. It mostly surprises me that it took me so long to figure it out.

I’m starting to remind myself of our 1997 Chevy S-10 Blazer. We had it for 11 years, and it’s my favorite vehicle of all time. It was a deep metallic maroon color. It had running boards and heated seats. And it had four-wheel drive. Because of the length of time we had it, and possibly because of the way we utilized it — we took it down the most spurious roads we could find on the North Shore of Lake Superior– the Blazer required far more serious maintenance than all of the other cars we’ve had in the last 33 years combined.

I’m pretty sure I ended up replacing every mechanical apparatus on it except the engine and the transmission. And I upgraded the sound system at least once. Lea eventually got tired of all the upkeep on it and more or less demanded that I get rid of it.

* * * *

It’s all in the wrist is a phrase typically used to indicate a certain level of skill or mastery at something where the hands are involved somehow. It’s a reference to the deft skill required to successfully perform certain activities. It’s mostly a sports reference.

Toss a ball in the hoop with nothing but net. Sink a long putt in golf. Throw a Frisbee. Throwing a perfect spiral with a football. Casting a line or better yet — fly fishing — you got it. It is all in the wrist. That’s the latest part of my body that has been malfunctioning for the last month. And I’ll apologize in advance for putting you through this yet again

* * * *

The weird part is I couldn’t think of anything I had done to injure my wrist. The only thing I did on the day it started hurting was wait in line for my first COVID-19 vaccine injection. It took ten and one-half hours. You wouldn’t think that any mishap could befall you by doing essentially nothing except play on your phone while you wait seemingly forever for the process to run its course, but that’s what I was doing on St. Patrick’s Day this year. And that’s the only reason why I remember that date.

* * * *

Why am I here? That’s a question I have asked myself countless times in my lifetime. Not necessarily in any spiritual or existential sense. It’s more like unto Why did I come into the kitchen? I was in the bedroom, and I know I came in here for a reason… I just can’t remember why anymore…

I can’t even say that this is something new. I did it thirty years ago, too. The only difference is the number of stairs I have to climb before I forget why went up them in the first place. Here, it’s only one. In Minnesota, it was a flight of stairs that led up from the basement. And it usually took three trips up and down the stairs before I could remember what I was trying to accomplish.

_{If anything, you’d think that my ability to concentrate would actually improve…}

* * * *

If you’ve read any of my previous posts about my adventures with the aging process, you know that the first thing I do when something like unto this happens to me is diagnosis my ailment. I have described this as the process of ruling shit out until you can’t rule something out anymore. Because I am both a guy and a nurse, I tend to pick the worst outcome I can think of, then work my way back to sanity from there.

So, yes, we can eliminate getting stabbed by knives and being attacked by wolverines. Some of you might possibly be thinking, You know, a much more common wrist malady is Carpal Tunnel Syndrome… And that’s what I’ve come to believe it is, too.

* * * *

Carpal Tunnel Syndrome is a condition that causes numbness, tingling, or weakness in your hand, or a combination of any/all of the above. And a ridiculous amount of pain in your wrist. It’s my right wrist, and I am right-handed. It has changed almost everything about my life, so much so that I’ve contemplated coming out as Left-handed and trying out that lifestyle for awhile. I’ve even stopped playing golf because I don’t want to have start wearing Depends®.

CTS is caused by too much pressure on your median nerve. It runs the length of your arm, goes through a passage in your wrist called the carpal tunnel, hence the name, and ends in your hand. The median nerve controls the movement and feeling of your thumb and the movement of all your fingers, except your little pinky.

The main cause of CTS is chronic, repetitive motion — like typing, or any wrist movements that you do over and over when your hands are lower than your wrists, like, playing with your mobile device while you wait in line for ten and a half hours straight without a break.

Studies have shown that the incidence of CTS exploded with the emergence of the Computer Age for one simple reason. Not everyone used a typewriter before the age of computerization. Then, pretty much just like that! Everyone was using a keyboard to conduct business, for personal use, and entertainment. Up to five percent pf the world population is currently effected by CTS with varying levels of severity.

I have broken bones, sprained both of my ankles, pulled muscles, damaged my right knee three times, and partially separated my left shoulder. Those things hurt. But there is nothing that compares to the sheer motherfucking agony of putting too much pressure on one little nerve for an extended period of time.

It takes your breath away. It consumes all of your attention, so don’t get any stupid ideas about going into another room for anything. You could get lost for hours. You might end up as a Silver Alert, and that would just be embarrassing when the search party finds you in the bedroom staring at the ceiling…

* * * *

Being a nurse probably caused my CTS. At the very least, it played a significant part in my developing it. I’ve had CTS symptoms on and off for the last twenty years. My decision to try to become a rich and famous author certainly didn’t help any. And writing my blog is probably the stupidest thing I could do right now.

See? I told you I wasn’t smart.

I have a wrist splint that I have sometimes worn when I go to bed ever since the late 1990’s. I only use them whenever my right wrist greatly pains me. Historically, it has happened in streaks, then has disappeared for sometimes extended periods of time. I wouldn’t have described my symptoms as severe, until this last flareup. At least, that’s how I remember it.

I don’t think my CTS was progressively getting worse. This was more of an unanticipated blitzkrieg of pain. From hell. This was, hands down, the worst recurrence of it ever for me, and I’m hoping that it will go away again and go bother someone else for awhile. That’s probably how that phenomenon works, too.

The treatment of CTS is simple. Rest — stop doing the stuff that caused the flare up, Wrist splinting. A splint that holds your wrist still while you sleep can help relieve nighttime symptoms of tingling and numbness. And NSAIDS, drugs like Motrin® and Aleve®. And if those don’t work, you’ll probably need surgery.

* * * *

I’m not a huge fan of surgical interventions for anything, especially when there are so many non-surgical options available, so I’ve been doing all of the preventative measures mentioned above, plus, stretching exercises to try to pop my wrist into non-pain producing positions My caddy taught me how to do them. And I bought a new splint because I figured splint technology has probably changed a little in the last two decades.

My right wrist is mostly better now. Except for the low-grade ache that never really goes away, and sometimes hurts like unto two hells whenever I try to do something manly, like, open a jar of pickles. And the tingly sensation that sometimes extends from my elbow to my fingertips. And the fact that my fine motor skills are sometimes greatly diminished. My only fear is this flare up has lasted longer than any of the others. I’m not sure it’s going to bounce back all the way this time.

All of these things are more annoying than they are anything else most of the time, and I am more than accustomed to dealing with stuff like unto that on a daily basis. There are several parts of my body that are working at 80% of the capacity they had only ten years ago. As much as it sucks sometimes, getting older still beats the hell out of the alternative. It just seems to be the price most of us have to pay for staying alive.

* * * *

I want to jump back to the ten and a half hour wait that Lea, my lovely supermodel wife, Phyllis, my golf wife, and I had to endure for our first COVID-19 vaccine. It’s probably the most exciting thing I’ve done all year.

Obviously, it wasn’t well-organized. If it was publicly advertised, I didn’t see or hear about it. Almost everyone we talked to while we waited, and waited, and waited some more — had heard about from word of mouth — like us. Or they read about it on Facebook.

It was held in the little village of Ajijic — in the park down by the malecón, and it was a first come-first serve administration of all the vials that happened to make it into town on that particular day. It was sponsored by the Mexican government, and was free of charge to anyone in the country. All you had to do was produce three pieces of mandatory paperwork at the time the vaccine was being dispensed.

One of these pieces of paper was a form you actually had to fill out on-line to register for the program, then print out that form and bring to the administration site. Yes, you’re absolutely correct. You would think that once you registered on-line that would’ve done the trick. It probably would’ve worked in any other country on the planet. The other two pieces of paper contained essentially the same information as the on-line form. Failure to have the three correct pieces of paper meant that you could not receive the shot, no matter how long you had waited.

Lea said she filled out her online in form about ten minutes. It took me more than half an hour to even sign into the goddamn website. Phyllis was easily as challenged as I was by the process, and at the end she couldn’t get the form to print. Phyllis emailed all her information to Lea, and even she couldn’t get it to print. Fortunately, Phyllis had brought along almost every piece of legal paper she has collected in her time here. A government official somewhere in the vicinity of the park okayed a different piece of paper as an acceptable alternative, and she was allowed to receive the vaccine.

I’m going to guess that Phyllis wasn’t the only one who wasn’t able to print the registration form.

* * * *

It is a well-known fact of modern life that all bureaucracies run on paperwork. But the Mexican bureaucracy appears to worship paperwork. Getting a legal document down here can be one of the most frustrating processes you will ever experience. Every document has to drawn up by a notario. They’re like unto attorneys down here, only more important. All legal documents are written in a highly specialized form of Mexican-Spanish that is so stylized it’s almost incomprehensible, and the entire thing must be correct down to the punctuation. If there are any errors, the entire document must be completely re-written and that process can take months. And months…

That’s why notarios are so important. They make sure every i is dotted, every t is crossed, and every comma and period are all in the right places at the right times.

And there isn’t much logic when it comes to what is deemed to be the correct pieces of paper to have in any given situation. There are a few forms you always seem to need, but after that it is anyone’s guess.

You have to fill out reams of paperwork to get a Mexican driver’s license — which has your name, your address, a picture of you — and a shitload of other information that the Mexican government generates — but it cannot be used to prove who you are, where you live, or any of the other numbers and codes that the government provided to you, and only you.

A driver’s license is just that. Something that allows you to get behind the wheel of a motorized vehicle and do pretty much whatever you want when you’re on the roads down here. And that is all.

A rental agreement, something that is written in that very specific Mexican-Spanish jargon of inestimable profundity, cannot be used to provide proof of residency. You need something much more vital. A utility bill for telephone or internet service. Or you need a bank statement.

Evidently, commercial billing is far more of a reliable source of information to the government than anything the government actually produces.

* * * *

At the end of our ten hour wait to get our injection, there was another half-hour process where dozens of high school volunteers filled out one more piece of paper that verified all of the information we had already provided to get the shot, and they also wrote down telephone numbers and email addresses. I asked if anyone was actually going to contact me so I could get my second shot of the vaccine. Everyone that heard my question laughed. Even the people taking down all of our information.

* * * *

Yes. Three weeks later we had to go back down into the little village of Ajijic, in the park by the malecón again and wait in line once more, but this time for only two and a half hours. We had to have the three all-important pieces of paperwork with essentially all the same information again so we could to receive the piece of paper that had been filled out for us, but not given to us, after we received our first shot. You know, the one with all of the same information on it one more time, plus our telephone numbers and email addresses that no one needed because no one contacted us. We heard we had to go get this piece of paper by word of mouth, again.

This is just a guess, but I figure we’re going to need four pieces of paper to qualify to get the second COVID -19 vaccination, whenever that might be. Phyllis will probably hear about first, and then she’ll let us know once more.

* * * *

I have serious doubts about how effective this global vaccination program is going to be in the long run. I’ve read reports about people who have received the vaccine coming down with COVID. I even saw one report about a woman that survived the illness, got the vaccine, then came down with the ‘Rona again. I guess the good news is she’s still alive, but this disease doesn’t seem to play by the rules, and that’s a serious cause for concern.

The Mexican government bought all their vaccines from China. By all accounts I’ve seen, this vaccine is the least effective of all the vaccines that are currently being employed against the pandemic. I may have wasted half a day of my life for a vaccine that might not do anything against the disease it’s supposed to prevent. I had lab work done about two weeks after I received the vaccine. One of tests I had done was a COVID antibody titer test.

It came back negative.

I have no idea if I have any COVID antibodies in my system even though I may have had COVID when we went to Mexico City in December of 2019, and I most definitely received the vaccine in March of this year. The world has changed. There isn’t as much certainty as there was before the pandemic. There aren’t as many answers as there used to be. And many of the answers we have right now are I don’t know. We’ll have to see. Maybe…

* * * *

The world has been in the closest thing to a total shutdown that it could achieve for the last year. People have quarantined, worn PPE, and social distanced during that entire time. Pandemic fatigue started occurring about ten minutes after the lockdowns started, and it has continued to fester away ever since. It has been boiling over for awhile, but now it’s starting to reach a fever pitch almost everywhere on the planet

I watched a news story this morning about revenge travel. It’s a visceral reaction to not being able to travel anywhere. With the gradual relaxation of travel restrictions, people are starting to hit the road and airways to any place they can. They don’t even care where they’re going. It just has to a be a destination that isn’t the fuckin’ couch in the fucking living room.

It’s possible that this is going to be the most dangerous stage of the pandemic. Only time will tell. We’ll know soon whether or not all of the things we have done as a global society will be enough to stop the spread and continuation of the Coronavirus pandemic.

The Big Question is, have we done enough?

* * * *

I remember the first time I had to administer an injection as a nursing student. My patient was an elderly nun. If I screwed this up, I’d probably get kicked out of nursing school, and I would surely go straight to Hell for torturing Mother Teresa. I’m pretty sure my hands were shaking as I drew up the medication. I told my instructor how nervous I was, and she reassured me that I was going to be fine.

“Take a deep breath. Relax. Giving a shot is easy. Pretend you’re throwing a dart. It’s all in the wrist.”

I did all of those things, except the imaginary dart I threw probably would have traveled halfway to the moon. I felt the tip of the need hit the periosteum of her femur. That had to hurt like unto three hells. It was the worst shot I would ever administer in my life. And it was probably the worst injection Mother Teresa ever received in hers.

And she didn’t say a word.

My next injection went much better. By the time I gave my third injection it was like I had done it hundreds of times. It no longer produced the adrenaline rush that it did the first time. And I had gotten past the idea that I was intentionally inflicting pain on another human, even if I was doing it for a good cause.

* * * *

There comes a time in everyone’s life when you cease to be a highly-skilled participant and transition into being a once-great-but-now-mostly-forgotten spectator. For me, that transition started on the day that I retired. Four and a half years later, I had assumed that almost everyone I used to work with had forgotten all about me.

Yesterday, something I wasn’t expecting happened. I received a message from a nurse had I worked with at the last hospital I worked. She had just started a new job a new hospital — the second hospital I worked at in Phoenix. I worked on a Gero/Psych Unit there. All of the nurses on the unit knew how to handle the myriad of medical issues their patients brought to the hospital with them, but they had no idea how to address the psychiatric issues their patients had been admitted for. I taught my Med/Surg nurses how to think like Psych nurses.

Lynn said the staff there still talked about me all the time, and what a great mentor I had been to them. She ended her message saying, Thank you for the difference you have made in all our lives!!!

No. Thank you, Lynn. And Julia. And Al. And Liligene. And all of the rest of the staff on the SAGE Unit at Del E. Webb Medical Center.

You see? Being a psych nurse is easy. All you have to do relax. And find a way to make your patients laugh. It’s the most important therapy you will give them.

It’s all in the wrist.