Nov 30, 2013

Black Friday Madness for a Stroke Survivor, aka Am I Crazy or What?

In 2011, The Huffington Post reported this story: "A Black Friday shopper who collapsed while shopping at a Target store in West Virginia went almost unnoticed as customers continued to hunt for bargain deals. Walter Vance, a 61-year-old pharmacist who reportedly suffered from a prior heart condition, later died in the hospital. Witnesses say some shoppers ignored and even walked over the man's body as they continued to shop. Friends and co-workers, saddened to learn of his death, expressed outrage over the way he was treated by shoppers. Lynne Vance [Walter's wife] said six nurses shopping in the store came to her husband's rescue and performed CPR until paramedics arrived."

This wasn't the only incident to put America's biggest shopping day in a bad light. There were more, and these are some of the horrific

highlights: In 2006, a man shopping at Best Buy was recorded on video assaulting another shopper. In the same year, raucous Walmart shoppers at a store outside Columbus, Ohio, quickly poured in the doors when the store opened, plastering a few employees against stacks of merchandise. When the crowd rushed to grab gift certificates that had been trickled down from the ceiling, nine shoppers in a California mall were injured, including an old woman who had to be rushed to the hospital.

In 2008, two people were fatally shot during a fight at a Toys 'r Us in Palm Desert, California. In 2010, a Wisconsin woman was arrested as she cut into the line outside of a Toys 'R' Us store, and threatening to shoot other shoppers who tried to voice their opinion. On Black Friday 2012, two people were shot outside a Wal-Mart in Florida during a dispute over a parking space. I remember those incidents and more.

Every year, Black Friday (the term originated in Philadelphia) inches a little closer to exterminating Thanksgiving by the stores opening earlier and earlier, taking a bigger bite out of Thanksgiving. I mean, THANKSGIVING, that wonderful time of year when the whole family gets together to show off their kids and tell everybody how prosperous their lives are. (At least, it was so in my family). It's all a sham, but don't mess with tradition. Traditions are what keeps families together, at least according to the advertisements.

We once went to Black Friday while we were visiting my son in Pittsburgh. We arrived, my son from Boston and I, at a Best Buy store

at around 3 am. The store was opening at 6 am. The one from Pittsburgh said we were nuts to go. We stood out there in sub-freezing temperatures to buy a bargain GPS. But, hey, Black Friday has come to be a tradition, too. But with all that pushing and shoving once the store opened, I vowed I would never go again.

That was ten years ago. And now, I had a stroke to contend with, but I never go out alone and it was 11 am. I thought about Black Friday again as I was going to get my nails done, not the death of the pharmacist but Black Friday in general.

"Hey! I always love a great challenge! Do you want to stop by the mall on the way to just see what everybody's buying?" I asked.

My aide looked at me, and her look wasn't at all good.

"Really? You want to go shopping with those lunatics?"

I didn't have to be a rocket scientist to know what she was thinking.

We were now two blocks away from the mall.

"'I'm just sayin'. I want to go in and get the experience all over again." I was in the mood to do, not think.

This time, the aide didn't look at me. She didn't speak either. She just drove, but she took me in the mall direction. Despite the heavy traffic, like some foreboding sign of crowds-soon-to-appear, I went right on.

"The mall's right over there," I pointed. We had a block to go, and it took us 9 minutes to go one block, or converted to travel time, 1.5 miles an hour. (That's what I do a treadmill).

Anyway, when we arrived at the mall, she couldn't find a parking place. In fact, there were cars parked where parking spaces weren't. The thought of the pharmacist who died and the woman who used pepper spray and the fatigued Target worker in the canal and the assaulters and the shooters all came back to me in one collage. My brain was on overload. I changed my mind but didn't admit it. Besides, I knew she wouldn't get back in time before my time with her was up.

"Maybe later, OK?" I said.

She broke out into a smile, the first of the day.

Nov 24, 2013

The Invaluable Hearing Aids, aka Me? Wrong? You Betcha!

In June, 2001, when I started a new job at Jefferson University Hospital in Philadelphia, I was a Technical Trainer and Compliance Administrator, all by myself, for close to 15,000 people. The compliance system we had consisted of reading a set of compliance regulations, like Fire Procedures, Hazardous Materials, and Safety in the Workplace, and answering a series of questions about what they read. 

As soon as July rolled around in '01, a high level meeting took place with the CEO, CIO, President of the Health System, and other muckety-muck types.  I was furtively taking notes because it was my responsibility and I didn't want to miss anything, but I missed half of the discussion and didn't even know it. I felt an arm in my ribs. 

"They're talking to you," a new friend whispered.

I looked up, but I could barely hear the discussion around me. "Yes?" I asked.

The Chairman of the Board repeated the question and I was reading his lips. Then about 10 minutes passed and it happened again. That's when I first learned I was hard of hearing.

A month before when I was hired, it turns out that I was put in a room where, unbeknownst to everybody (at least, no one who admitted it) there were blocked vents, mice droppings and roaches galore. And one of my top allergies, I found out later, was roach dust. I didn't say anything because it was a new job. And I was already a late-blooming 51. I went back to the job and a room that held contagion for me every day until I couldn't. Then I said something and I was moved to little table in another room which I shared with the manager and the training assistant.

I soon had an office when my manager resigned because she couldn't handle me (the final straws were: asking for time off to celebrate the Jewish High Holidays and the manager, aghast at my not knowing you have to ask for time off at least two weeks ahead of time, let me go begrudgingly, and when 9/11 hit, she demanded that I stay in the office, but I said that I had to use the ladies room as a faux excuse in order to call my sons where one who was going to school near D.C. and the other one in Pittsburgh, both places where some of the disaster struck), but that is another story for another day. L. was a disaster as far as managers go. It's a hell of a story.

Anyway, I realized that I needed hearing aids for 11 years. But I waited because I thought they would make me look older, but they don't. They are practically invisible. I can't say enough about my relatively new hearing aids. So apologies all around for the people whom I asked to repeat themselves. When you can't hear, and the words are muffled, it's a fuckin' mess.

No American insurance policy covers hearing aids like they do glasses. Hearing loss is just as important as deficient eyesight, but the insurance masters don't think so. In other parts of the world, industrialized countries supply free or heavily-discounted hearing aids through their publicly-funded health care system.

From a website that dwells on derivations of words, hard of hearing came from the Greek kratos (strength)  from root *kar-/*ker meaning "difficult to do" which is placed c.1200 BC. The term then transferred to the obsolete Middle English meaning "sense of having difficulty in doing something."

I only wish I had a dollar for everybody who asked me (and there were a lot), "Did your hearing aids come about when you had a stroke?" And my answer is always the same: "I got my hearing aids a year and a half after my stroke." Sigh.

A hearing aid is a small electronic device that fits snugly into the ear, consisting of a tiny microphone to pick up the sounds, an amplifier that increases the volume, and a tiny speaker that transmits sounds to the ear, usually with the goal of making speech more intelligible. In the US, hearing aids are considered medical devices and are regulated by the Food and Drug Administration.

But sudden hearing loss for no reason was studied in 2008. The American Heart Association links a relationship between sudden "sensorineural" hearing loss, more easily called SSNHL, and stroke. The SSNHL study, conducted in Taiwan, showed a profound relationship between the onset of sudden hearing loss and stroke. Published in the American Heart Association Stroke Journal, the study implies that sudden loss of hearing might be an precursor to stroke, an actual cerebrovascular event, aka stroke, as much as two years later.

The study, conducted by Dr. Herng-Ching Lin and colleagues at Taipei Medical University, took place over five years and monitored 1,423 patients who had been hospitalized for mysterious and acute sudden hearing loss. Also included as a control group for comparison purposes were 5,692 patients who were admitted for appendectomies. The first group indicating an acute hearing loss was more than 150% more likely to experience a stroke within the two year limit when compared to the control group for appendectomies, leading the researchers to conclude that the number fell "well outside the margin of error." In other words, among patients with sudden hearing loss, 12 percent of strokes occurred within 3 months, 31 percent occurred in the first year, and 51 percent by the end of the second year. That's not coincidental.

Let's take these findings in perspective.
In the website "Healthy Hearing,"

  • Increasing age (the older you are, the more apt you are to have a stroke, though even young people are susceptible.
  • Men are more likely to experience a stroke in their lifetimes than women.
  • African-Americans are more likely to experience a stroke than other races and ethnic groups.
  • Those with a family history of stroke are at higher risk.
  • People with high blood pressure (hypertension) have increased susceptibility.
  • Diabetics have more strokes.
  • Smoking contributes to the likelihood of a stroke and recently has been tied to hearing loss.
  • High levels of cholesterol could mean an impending stroke.
  • Obesity is a contributing factor.
So visit your physician or nearest medical center as soon as possible if you have sudden hearing loss. Although there is no standard procedure in treating sudden hearing loss, many physicians will treat with steroids like Prednisone. But you should have more tests for stroke risk. As I say in my book, "The Tales of a Stroke Patient" (the same name as this blog), "If you go to your private doctor, if he or she hasn't thought of it already, demand these tests:

* CBC (This is a routine test to determine the number of red blood cells, white blood cells, and platelets in your blood are A-OK).

* Coagulation tests (PT, PTT, and INR measure how quickly your blood clots. An abnormality could result in excessive bleeding or clotting leading to a stroke).

* Blood chemistry tests (These tests measure the levels of normal chemical substances in your blood).

* Blood lipid tests (This test measures Cholesterol, total lipids, HDL, and LDL, particularly 'bad' cholesterol, or LDL, because it's a risk factor for heart disease and stroke).

Those tests should be enough. If the doctor suspects anything, he or she will send you for additional tests."

Keep this in mind: there's more than a 150% risk of stroke in that patient group that experienced sudden hearing loss when there's no reason. You hear and then you don't. Don't ignore that sign.