The Hits Just Keep On Coming

My late December medical misadventures had mostly resolved only to be replaced by dental shenanigans. I’ve had some long neglected issues that I put off because they weren’t painful and I didn’t want to fork over hundreds or more likely thousands of dollars for what was mostly just an annoyance.

Whelp, as in the past, once a nerve root gets fully exposed even the most stalwart would likely put pain reduction over pocketbook. I’ve had both a broken tooth and crown (on separate teeth) for several years, but within the last month I had a cavity in my right upper first bicuspid (I think) which revealed itself when a cute little portal opened up in the bottom. Portals can be useful things, especially if they go to magical kingdoms or take you planetside, but they are less desirable in one’s chompers.

I scheduled a dental exam with a new clinic (it was the previous clinic, Monarch, that had soured both my wife and I from going for so long), and at the time time of the exam I wasn’t yet in a great deal of pain. Fast forward to three days ago and the pain started ramping up. It got bad enough that it woke me up at midnight on Thursday/Friday and I contacted the clinic requesting a same day/walk in appointment.

The clinic is normally closed on Friday, and additionally, Dr. Nguyen who performs the root canals is supposed to be on maternity leave, but they were willing to come into the clinic and take care of my problem. The procedure went smoothly and my only discomfort was due to bladder distension (don’t drink the coffee, you’ll soil yourself) (if you know that reference you’re old too). I had essentially no dental or oral pain once I was numbed up.

Once the anesthesia started to wear off yesterday and into last night the pain came back and was almost the same severity although the quality of the pain had changed since the nerve had been removed. Now the pain was spread over several teeth and also affected my mucosa. My face has swollen up to the point it looks like I’ve got a big chew in. I just need to throw on my baseball uniform and commence to spittin’.

Nothing has really touched the pain except for warm compresses and some Orajel cream that I had same-dayed (totes a word) this morning. Unfortunately it only seems to last about an hour when the recommended dosing schedule is 6 hours. Dosing schedule be damned until this pain and swelling start to decline.

I hope the succession of medical to dental chicanery was just random chance and not a sign of a larger problem. Meaning, it’s not typical for me to have big flare ups when I have injuries or illness. The shoulder/chest whatever it was accelerated above and beyond any notable triggers. Maybe there was something there that no one including my various providers or myself have been able to sus out. Maybe my immune system is getting more persnickety as I get older. I hope not.

This dental episode isn’t too removed from previous, although the severity has been higher not to mention the facial swelling which I’ve not had in the past. It was noted that I had a few elevated inflammatory markers during the shoulder/chest extravaganza (ESR, CRP), but these are non-specific and don’t clarify the source. I’m curious if they would be similarly elevated during this dental episode. As often happens, the diagnostic studies raise more questions than they provide answers.

Hopefully this dental shindig will start winding down and I can return to the regularly scheduled programming. It’s ironic because I had made several upgrades and fixed multiple issues in both my video studio and drum rooms, but I’ve been unable to enjoy them fully due to the pain and discomfort.

I should also mention that our girls have been very sweet in noting my discomfort. They are always quick to realize when their humans are distressed or in pain, and they adjust their behavior. Instead of negotiating (begging, harassing, etc.) for treats, walks, or playtime, they typically just lay down somehere near us and give us companionship without bothering us otherwise. Even Nynaeve, who is by far the most insistent for playtime, etc. has been following her sister’s lead and just staying close without asking for anything. Of course Aeyong is perpetually on the spot to give help or comfort when I’m in pain. I mostly deal with it myself, but her willing assistance is always appreciated.

A New Year and a Health Scare

Things are going fairly well as I type this on January 3rd, 2024. My health decided to close out the year by reminding me I’m not getting any younger. I’ve had this intermittent vague pain and paresthesias mostly in my left arm for years. I think I may have even posted about it several years ago when I had severe elbow and forearm issues that were aggravated by playing various musical instruments. That was more bilateral, but maybe the left was worse.

Fast forward to this last year and I’ve had recurrent mild issues almost solely in the left arm, starting at the shoulder and going all the way to my fingers. It seemed to predominate in a more ulnar distribution, but the entire limb can be affected. I think prolonged less than ergonomic fixed positions at my desk probably aggravated the issue.

On Christmas Eve we decided to drink the champagne that had been reserved for New Year’s Eve and that rolled into several glasses of wine as I had a pleasant evening watching the Police reunion concert and some other music videos. On Christmas Day I was slightly hungover, but not feeling too bad. I had a decent day - did some baking (rolls, cookies, pizza), walked the dogs, and felt better as the day progressed. As of dinner time, I was feeling fine, although maybe my arm had been acting up during the day, I hadn’t noted any change.

Around 6-7 pm, the pain in the arm increased in severity and was affecting the entire limb from the shoulder down. I couldn’t find a comfortable position and was unable to sit still. I got up and walked around, tried to move the arm through various rotations, and even went outside for a few minutes despite the cold. Nothing I could do was helping and the pain was spreading to my chest and then jaw, while also increasing in severity. I’d characterize the normal pain level at an annoying 2 most of the time, but this episode started as a 6 and was climbing towards 8-9.

I think I took some Tylenol and was still unable to sit still and get comfortable. I thought I might lie down and see if I could sleep it off. That aggravated the jaw and now neck pain, and the severity kept increasing. Being a PA, I recalled from my training in ACLS that one of the instructors referred to an acute myocardial infarction as “infarcting” as opposed to infarction. Meaning, the condition progresses if no actions are taken.

I was downstairs (I think to get Tylenol, but can’t remember the exact sequence of events) when Aeyong got up to get the dogs to go outside since they can be recalcitrant when the weather’s cold or rainy. She immediately noted something was wrong and I told her I thought I might need to go to the ER. She shifted to Defcon 1 in two seconds and was donning clothes and scurrying around the house to grab her purse and keys.

She was taking it more seriously than I was, although the fact this was my first ER trip in 29 years wasn’t lost on me. I decided to go to Medical City in Arlington since it had been recommended to us when Aeyong broke her wrist a few years ago. I think that recommendation was more based on the facility being a Level 1 trauma center as opposed to the quality of the ER.

To their credit, when I presented with chest pain they got me back for evaluation within a few minutes, performing an EKG, CXR, and drawing cardiac labs. We were sent back to the waiting room pending the results. I got a look at the EKG while still in the room and it was “abnormal” based on I think t wave inversion, but there was no significant ST elevation or Q waves that I could spot. Honestly, I had a low index of suspicion for cardiac since I still run regularly and although I have some risk factors, I don’t smoke and my blood pressure has been essentially normal during routine exams.

In the ER my BP was high - 162/98, and this trend would persist during most of this episode. We waited in the ER for several hours, although I think at one point one of the nurses came out and told us the cardiac enzymes were normal. This was my main concern, and with normal enzymes, I was relatively reassured that whatever was going on, it wasn’t cardiac. They kept us for six hours or so, primarily so that serial enzymes could be run and these were also normal.

Ironically, my pain was getting worse and was now becoming more diffuse across my chest, neck, and jaw. It stayed on the left side only, never crossing the midline in the chest, but it was bilateral in the neck and jaw area. Medical City did its main job, but other than that, I was underwhelmed. I was evaluated by a PA, and to his credit, he made sure the most life-threatening issue was cleared, but he never asked about my pain level from a therapeutic standpoint, and at the time he gave us the serial results his attitude was “enzymes are normal” as if there was nothing left to discuss. He never asked about whether my symptoms had changed or worsened, and he never offered any therapy or pain management.

In his defense, I didn’t ask or press the issue because I knew the ER wasn’t my PCM and it was 3:30 in the morning and we were ready to go home. The walk out to the car was some of the worst pain I had felt all night and Aeyong was asking me to go back in or to go to some other ER. I was inclined to believe it had to be neuropathic or musculoskeletal and although quite painful, not life-threatening.

We made it home and I think I took some Tylenol while we tried to get a few hours of sleep. I got up around 7ish and was able to book a follow-up with my PCM for the next morning. Throughout the day the pain never got much better so I tried a hot shower (which helped temporarily) and continued with Tylenol. Aeyong suggested her Robaxin which I tried but didn’t notice any difference. I think it was that night that I couldn’t sleep so I took some leftover Hydrocodone from a previous dental procedure. This gave me a good 4ish hours of uninterrupted sleep.

When I saw my PCM, she was concerned that this might still represent an undiagnosed cardiac or pulmonary issue so she recommended that we go across the street to the Mansfield Methodist ER. We followed her advice and were soon whisked in and went through the same initial workup. EKG, CXR, labs. The ER doc also wanted to run some additional inflammatory markers (ESR, CRP) as well as D-Dimer and BNP. Those markers were all elevated although the cardiac exam was still normal.

She then sent me for a CT Pulmonary Angiogram within the ER to rule out pulmonary embolus and this exam was essentially normal except for some nodules (benign) and a trace pleural effusion that was unlikely to be of any clinical concern. She suggested that there could still be underlying cardiac issues that would need a Cardiologist and further diagnostic studies to rule out. She recommended hospital admission to streamline and expedite the process, stating that it could take weeks or longer if pursued as an outpatient.

I was initially hesitant since this was my first ER visit and possible hospitalization since 1994, most importantly, my first since retirement and I was concerned about cost. Aeyong was adamant that I get a thorough workup and not leave questions unanswered. To her eternal credit, she is always going to push for me to get adequate healthcare and evaluation and not leave things to chance. Despite the possibility of a financially devastating hospital bill, I took Aeyong’s and the ER doc’s recommendation and decided to go forward with the admission.

Bed space was precious, so l was admitted to a just-opened room in the OB ward. The room was quite nice, almost more like a hotel with a private bathroom, desk, recliner, couch, and bed. I was kept under observation and offered some pain relief. I tried T3 with codeine which didn’t do much to blunt the pain. The pain had essentially continued but was coming in waves of severity and then settling down for no discernible reason. It seemed to be centered in the left shoulder and at times would shoot back up to a 7 or 8. After midnight the nurse offered pain relief and I said I didn’t want T3 and would prefer just a gram of Tylenol instead. She then said I could get Hydrocodone if I wanted and I related that it had helped at home, so I decided to have it.

Again, the Hydrocodone helped me get about four hours of sleep. I was NPO as of midnight so they could perform the cardiac stress test. I should mention they had given me nitroglycerin in the ER, and I think it helped some with my chest pain, but can’t state that with confidence. The one outcome I’m relatively sure about is that it gave me a headache and this persisted through the day into the evening. In the morning my primary pain was the headache, as the shoulder and chest pain had died down somewhat.

The night before and earlier that morning I was relatively certain I would need the chemical stress test as I would be unable to perform the treadmill stress test due to my headache and other pain. Once I got down to the testing suite in Radiology, my only pain was the headache and I felt capable of at least trying the TMST. I went through with it and was able to complete the test satisfactorily.

We went back to the room and Aeyong got some food so were able to share a brunch so to speak. Periodically throughout my stay, they would check vitals (Q4h I think) and at times of rest they would be more normal, but if I was up and moving around the BP especially would get higher. Thus far, most testing was normal, except for the D-Dimer, ESR, and CRP. These were all elevated, but they’re non-specific so they mostly only raised more questions rather than providing answers.

I eventually had another radiology tech come to my room in the late afternoon to conduct an echocardiogram there at my bedside. A little after 5 my nurse came in with some papers and notified me I had been discharged by the Cardiologist/Hospitalist. They were confident my issue was non-cardiac and didn’t warrant further testing or hospitalization. I agreed with them and had to get Aeyong out of bed back home to come pick me up. She had run herself ragged going back and forth between home to care for the dogs and coming to the hospital to look after me. Her gas tank is much smaller nowadays and she can quickly drive herself to exhaustion and pain when anything disrupts the normal schedule.

I’m now nine days past the initial episode. The shoulder and arm issues persist, albeit much decreased in severity. I have a follow-up pending on Friday with my PCM, Dr. Avenesyan. My working diagnosis is neuritis or radiculitis that flared up for whatever reason and spread to adjacent structures for reasons undetermined at this point. I’ve been able to walk the dogs every day and I even was able to run on the treadmill yesterday, although a bit slower (5 mph) and for only three miles. I made some changes in my office, removing the wheels from the desk so it’s slightly lower and even putting the keyboard in my lap as I type this long-winded explanation.

I’ll see on Friday whether my PCM wants to send me for further studies. I imagine a CT or MRI and possibly a Neuro/Pain Mgmt eval might be in the cards. All this rambling to relate the conclusion that my threshold for health problems is decreasing as the years pass. I had an acute episode of foot swelling this summer that I think was brought on by excessive sodium intake (snacks) as well as alcohol consumption. I hadn’t drunk any alcohol after that episode up until Thanksgiving. That week saw my frustration with Berklee at an all-time high and accelerated my previous holiday plans by nearly a month.

This rolled into drinking beer for about three weeks straight (we went through four cases of beer in that time frame) as well as not exercising or eating particularly healthy for over two weeks. Ironically, I had returned to my normal schedule for over a week and had run on Sunday without any significant issues. I don’t necessarily think the Christmas Eve champagne and wine were the direct cause of the episode, but a repeating theme in the past few years has been that my health isn’t quite as resilient as it was in my younger days.

I can no longer negate the alcohol and unhealthy food choices with exercise. Now, I have to manage my nutrition more closely than ever before. Alcohol and junk food can manifest as poor health outcomes within just a few days as opposed to being inconsequential (in the short-term) in the past. Whenever I drink now, almost every health metric starts to suffer - sleep quality, nutrition, activity level, mood, cognitive function, motivation, etc.

I haven’t sworn off alcohol permanently, but I’m going to need to shift to small amounts over brief periods, for example, a six-pack shared with Aeyong every few months and never the larger amounts consumed over consecutive days. I’m happy that I never became an alcoholic, but it’s easy for it to become more habitual if you’re complacent about it. To bring things back to the start of this novella, complacency is no longer an option when it comes to my health.

As we age, we have to an active role in managing our health or we’ll be forced to continually rely on the aid of others as we watch our health gradually decline. I’ve set a goal for myself that I won’t have any alcohol or junk food (like Doritos) until I get my weight back under 200 pounds. I had got it down under 210 just in November, but I think I probably gained back another 5-10 pounds since then. Hopefully, once I return to regular exercise and a better diet, those pounds will start coming off. I’ve been largely ambivalent about being overweight for a long time, but I’ve got to take a more holistic view because all aspects of my life tend to take their lead from my physical health.

Arry Starry…until we meet again

I don’t believe in heaven, but there are times I wish I did. Yesterday was another dark day. We had to let our sweet Arya cross the rainbow bridge to join her sisters in the beyond. We had grown accustomed to our dogs living for ~ fifteen years, but Arya was just reaching twelve when her health took a nosedive.

Similar to April, she stopped eating and could no longer stand and walk on her own. We knew she had liver problems, but she had been managing them for several years with no apparent symptoms. Her appetite, activity level, and personality were the same as they’d always been. She had gone to the vet for a checkup and ear infection but either that night or the following day she deteriorated significantly.

We tried to nurse her back to health over a few days, but with no improvement, we took her to the emergency vet. We didn’t learn much other than her liver function had continued to decline and she had an enlarged heart that was starting to press on her airway. The vet also looked at her liver but couldn’t identify anything discrete like a tumor. As luck would have it, this particular vet had to be the most insensitive and ambivalent vet we’ve ever encountered. We didn’t have any other choices, so when she recommended a long list of medications, we took her advice and tried for several days to see if Arya would improve.

Other than occasional brief bursts of energy and appetite, she continued just to lie down and sleep. She needed help to stand, and we had to coax her to walk outside just to use the bathroom and get a little exercise. Her appetite was mostly gone, but Aeyong would still spoon-feed her, at times having to force food by dragging the spoon against her front teeth so it would fall in her mouth. Arya would normally chew and swallow food at that point. Taking medication was an absolute ordeal for her. The vet prescribed what we now feel was a ridiculous amount of medication, and in hindsight, I feel she was just trying to check all the boxes that the workup indicated without considering how difficult and stressful this would be for Arya.

Arya endured these daily medications, although they distressed her visibly. Arya’s condition just slowly deteriorated over several weeks. She was in increasing pain and was more and more resistant when we would try to get her up to drink or go outside. At times she would cry and snip at both Aeyong and me. This was completely out of character for her and just demonstrated how bad she was feeling.

Just like our previous girls, there came a time when Arya’s quality of life was gone and she was no longer her real self. Truthfully this started when she took that first nosedive after the vet. She would have brief episodes of apparent improvement, but they were short-lived, typically just a few minutes of increased activity occurring only once or twice a week.

I spent her final weeks sleeping with her on the floor, typically by the front window, one of her favorite spots. At times her breathing was very labored, at times it would slow to nearly normal. I think the only time she wasn’t in pain was when she slept. After giving her enough time to improve, I knew we had reached her new normal, which was not normal at all. I will fight for my dogs for as long as they’re willing, but at some point, you can see the fight has left their eyes and they just want the pain to end. Aeyong would continue to nurse them for as long as they drew breath, and I know she’s never completely comfortable with making the hardest decision.

After going back and forth several times, I finally expressed to her that we just had to make that final decision and release Arya from her pain. We love our dogs more than anything in this world, and it’s the hardest decision by far. We draw some comfort from the amount of love we could give to Arya over her lifetime and especially in her last weeks. She was constantly attended to and showered with love around the clock. At times, she would show her old self with a loving look or kiss, but she mostly just looked tired and bereft of her old joy.

We decided yesterday would be the day, and after spending the morning with her we drove to the emergency vet around mid-morning. We learned that the same uncaring vet was on duty, so we decided to come back later when another vet would be available. We took her back home and brought her and Skittles to our little subdivision park where Arya and our dogs had taken so many walks. The drive back and forth from the vet and the visit to the park seemed to brighten Arya’s spirit for a while and she even was able to leave her mark in her home stomping ground (High Hawk Park) one last time.

We went back home to wait for a few hours and all the activity seemed to drain whatever gas Arya had in the tank so she immediately fell asleep and slept soundly for a few hours. When the time came we took her outside with her sister and snapped some final family photos and let Skittles and Arya say their final goodbyes. We drove her back to the emergency vet.

Things moved pretty quickly and this time the vet was much more caring and considerate. Arya did pretty well getting the catheter placed, but when they brought her back to us she was visibly stressed and wanted us to take her home. We spent several minutes just hugging and kissing her and she slowly calmed down. We had her home blanket that held her and Skittle’s smell for her to lay on. Soon we knew it was time. The vet came in and briefly discussed Arya’s condition and expressed sympathy and that she understood Arya’s quality of life was gone and it was time to release her from her pain.

The vet administered a sedative to first put Arya to sleep, and she quickly nodded off in our arms. At this point she was fully asleep and not feeling any pain anymore. The vet followed that with the euthanasia medication (presumably sodium pentathol) and in a few seconds Arya’s chest fell and her heart stopped. She was leaving her physical body and approaching the rainbow bridge. We told her to say hello to her Onis (big sisters) Bridget and April, and told her she would meet her new big sister Lucy. We told to her run and play and feel her young self again. We asked her to find a place for our family and told her we’d join her someday. It doesn’t matter whether I believe it or not, it’s a daydream that gives me comfort.

I’m sorry you had to go Arya, you were my shadow and constant companion these last twelve years. My life was so much better for having you in it. I’ll never forget you, my sweet girl.

The Darkest Day

Yesterday, after a very brief illness, we said goodbye to our sweet girl April. A week ago today, we had a nice normal day, went for a morning walk, and she was eating and behaving as she always has. As the next few days passed, her appetite began to wane until by Sunday, she had effectively stopped accepting food. Anyone who knew April would see this was completely out of character. I worked this last weekend, and as is usual, on those days I typically fed them their dinner. On Saturday night, she initially wouldn’t approach her food bowl. Only after I placed some of her food in my hand and held it out did she try eating it, probably mostly out of instinct. But, she wasn’t able to finish the bowl. We knew something was wrong. Aeyong later told me she had thrown up her breakfast. She became more lethargic and listless over the following days, and by Sunday we were already talking about taking her to the Vet. We decided to watch and nurse her overnight and then make a decision in the morning.

It was only a few days ago, but I can’t remember if she came into the kitchen when I woke up. Usually, April was the first to come out when the lights came on. I’m fairly sure she did on Sunday, but wouldn’t accept food and only drank some water. I can’t remember if she did on Monday, I think I may have had to find her. I went to my office and was looking at same day appointment options. There weren’t any I could find other than the emergency Vet. I was able to use the Vet Chat feature from Banfield, and after a brief exchange, their recommendation was getting her evaluated acutely, as labs and imaging would likely reveal the problem. This was my thinking beforehand, so we decided to take her to the Animal Emergency Hospital in Mansfield.

She was taken in and evaluated by Dr. Paules, and the first step was lab work. All of the steps were discussed up front in regards to cost and getting our approval before they were performed. It’s a necessary step, and honestly it was good to just get it settled and out of the way up front, knowing that we would hopefully get an answer. I had been looking at Yelp reviews of the facility, and most of them were positive. All the complaints I saw seemed to stem from the cost. As those online reviews go, the dissatisfied typically post reviews much more often than the satisfied. I can’t imagine there’s a price I would balk at to save one of my children’s lives. It’s hard to even have an opinion about the cost. It didn’t seem unreasonable and we almost certainly would have paid whatever was required to get an answer. We were told it would be about an hour, so we said we would drive home and wait for her answer, since we could come back within fifteen minutes.

We got a call about thirty minutes later, and the labs were mostly normal, only showing some anemia and slightly decreased renal function. Dr Paules related that her anemia would likely worsen with rehydration as they had to give her some IV fluids. We had been trying regularly to help her over to the water bowl and she would sometimes drink, but sometimes just stare as if she wasn’t sure what to do or just couldn’t stomach trying to swallow water. Aeyong was regularly giving her water by syringe and she had been trying extra hard to prepare some bland liquid food that April would accept and be able to keep down. It was a struggle for April, but she was able to swallow a bit of water and liquid food every few hours. Despite this, she was still not getting an adequate intake of fluids.

Dr Paules recommended imaging as the next step in evaluating her issue, and wanted to start with the abdomen. She predicted it would be about thirty minutes before she would call us with the results. It was around an hour later that she called and said April’s abdomen looked okay, but she had noticed something off about the fringe of her chest, which wasn’t completely imaged with the abdominal x-ray series. She ordered a chest series and it was there she discovered a tumor in April’s lung. Based on its size and shape, it was most likely cancer. She also had a noticeably enlarged heart with a pericardial effusion (liquid filling the sac that surrounds the heart), which was making her heart work much harder to beat and making it more difficult to get oxygen to her tissues.

As soon as I heard the word tumor, I knew that this was a terminal diagnosis for April. Dr Paules predicted that the definitive treatment would have to be a partial lobectomy, a highly invasive type of surgery. From what I know of this surgery in humans, they would have to crack her chest, separating her sternum and ribs to get access to her lungs. Even with this, the nature of lung cancer is that by the time it becomes symptomatic and is identified, it’s more than likely that the cancer has had time to metastasize given how highly vascularized the lungs are. Even if the lobectomy was “successful” and April survived, she would likely need chemotherapy and it would only be extending her lifespan temporarily, maybe only for a few months at best.

April was fourteen, so she was already in the predicted end of lifespan for cocker spaniels, which is typically 12-15 years. I didn’t clarify, but it’s possible Dr Paules noted that she had cardiomegaly/LVH that was present before she deteriorated, presumably in large part due to the lung cancer. From our observation, she hadn’t shown any significant changes in behavior up until her rapid decline. The more I think about it though, there was a walk last week, and I’m not sure if it was her last walk on Thursday or the day or two before that, that she was not quite as energetic as usual. April would always be in the lead and darting back and forth to follow her nose. This day she was hanging back more, and just looked slightly less interested. She wasn’t struggling to breathe that I noticed, she just didn’t seem as interested in the walk, which is something that we’ve seen in all of our pets occasionally, but it’s always been a temporary, fleeting behavior.

Maybe this change was the first real evidence that something was off, although Aeyong says she was noticing things even before then. Aeyong had mentioned that April looked like she was having a seizure earlier in the week, I’m not sure what day, maybe Sunday or Monday. This didn’t immediately concern me because all of our dogs have exhibited seizure like activity on one or two rare occasions for reasons unknown, but the seizures never persisted. With April, it had been several years since the last time as far as we could remember, probably at least five if not ten. I’m not even really sure I had witnessed a seizure in April, I can only remember Lucy having one and Bridget had a few right at the end.

Our decision to let April go was based on the realization that her time was fleeting. Sadly, her life as it had been for fourteen idyllic years, had already passed before our eyes. Once she declined, she wasn’t likely going to make it back to her old self, and the thought of putting her through such an invasive surgery followed by chemotherapy was untenable. We already know from experience how devastating chemotherapy can be, it’s the medical equivalent of an atomic bomb. If dogs could understand these choices and communicate their desires, I wouldn’t hesitate to accept their wishes. But, we can’t ask these questions and it’s hard to know if dogs truly understand death. Certainly, dogs understand when one of them is gone and I’m sure all of our dogs remember their sisters and miss them. I just don’t know that they have a real grasp of dying and how it’s a natural part of life.

All we can be relatively certain about April is that she knew she was suffering, and she probably didn’t understand why. She would stare into our eyes, and it seemed like there was just a question or plea for help in them. For our dogs, we have been everything to them (and they to us). They look to us for shelter, food, love, protection, companionship. April knew she was hurting and she probably didn’t understand why Mommy and Daddy just couldn’t make it better. It kills me to write that, but it’s probably all that her simple mind could form. That is why we had to make the decision to let her go. It’s the hardest decision we’ve ever had to make, by far. Nothing has compared to the pain of losing our daughters, nothing. I’m sure I’ve posted about it before. Losing my parents and grandmother was sad, and I missed them and regretted the time lost and mourned for what could have been. But, losing my dogs has been tearing a part of my soul out of me. It’s the same for Aeyong.

The decision mostly depends on when our dogs are suffering. When they reach a point in their lives where most of their time is spent hurting in some way, I try to understand what my frame of mind would be in their situation. Our dogs have always been happy, affectionate, playful, active, and just a source of energy and joy in our lives. Lucy, Bridget, and April all went through a change in personality, whether it was a slow change over months, or a rapid change over a few days like with April. When they are no longer their happy self, I can’t accept that they are in pain. It’s largely based on what I said before, we have no way to ask them what they want, but if the sum of their days are largely suffering, I want them to be without pain and so I know I must let them go. Keeping them around just prolongs their suffering and it’s likely only for our benefit and not theirs.

Aeyong has expressed regret and sorrow for how Lucy and Bridget passed on. Both of their lives had deteriorated and they were no longer themselves. With Lucy, she was declining for a few years, and it ultimately got to the point where it was obvious she was no longer herself. Lucy was always the sweetest, and most affectionate companion. Just like April was Momma’s shadow, Lucy was Daddy’s girl. Near the end, nothing seemed to make her happy. For most of her life, she would soak up attention. She would just stare into your eyes and snuggle with you as if she wanted nothing else in life. At the end, she didn’t respond to attention any more, and the only real activity she would show was when there was food, but even eating seemed like she was just going through the motions.

With Bridget, she declined over a matter of a few weeks. She had a mass on her abdomen that was starting to affect her breathing and energy levels. It then led to a change in her personality, where she would just stare and seem unresponsive. She then started to go into the backyard and just start digging at all hours of the night, and you couldn’t get her to stop or respond to you. She wouldn’t come when called and would struggle if you tried to stop her digging. At this point she ceased to be the Bridget we had known for fifteen years, just like her sister Lucy. Could more have been done? Maybe. My problem with pursuing more treatment is that I feel that their quality of life is never going to get back like we want. That’s a feeling and not objective fact. I can’t argue that it’s not possible something could have been done, but at the time I didn’t think we would have extended their quality of life for a reasonable amount of time considering what the treatment needed to be. I look at that decision as a mistake on my part. We could have possibly learned more about her and at least confirmed that her condition wasn’t treatable before going forward. I know Aeyong regrets this, but any of the blame lays on me and not her.

My wish will always be that my dogs don’t suffer. So, the decision with April was that because her condition was more than likely terminal, we could only prolong the inevitable. A small note about lung cancer - I’ve been the original provider for at least one case in the past that I remember, and it was during PA school. We had a middle aged male come into the ER for shortness of breath and chest pain, and plain chest x-rays revealed several lung masses. I had to break the news to him and his wife that although we couldn’t confirm it yet, it was likely lung cancer. As I recall, it was lung cancer and he died within a few months. There are some predictable features to lung cancer that can be seen on plain films, and I’m assuming that Dr Pauels is experienced enough that she was correct in her predicted diagnosis.

We discussed our options and we just wanted to know if it was possible we could have a little more time to say goodbye. Dr Pauels said it was hard to predict how she would respond, but a course of steroids and anti-emetics might help her to breathe a bit easier and regain enough appetite to get her to eat for a few days. She stressed it was only temporary and that she would succumb sooner rather than later. We accepted this plan and they gave her some more IV fluids as well as given her some subcutaneous rehydration that I assume was expected to resorb over a few days. She was given IV steroids and anti-emetics in the clinic and we took her home with oral prednisone and anti-emetic.

That was Monday morning, and we got her back home a bit before noon. We just spent the rest of that day/night and Tuesday right by her side. Other than showering and preparing meals, one of us was right by her side continuously until the end. I slept with her Monday and Tuesday night. We initially tried to get her to sleep between us in bed, but she started getting overheated fairly quickly, so I carried her down to the floor where it was cooler and let her crawl up on her favorite pillow. Periodically I would carry her over to the water bowl and she would sometimes drink, but would sometimes just stand and stare as if she was unsure what to do or didn’t have any energy. I carried her into the back yard and a few times she would pee, but she would often just stand and several times she would eventually turn around and try to come back inside.

As far as we could tell, she was still lucid. She would lift her head and look around if one of us wasn’t with her, or if there was a noise in the kitchen or our other girls were barking at something. On Tuesday morning she was laying on her favorite spot on the couch, and her head was facing outside. She suddenly raised her head and was looking at the back fence, and it was there I saw one of our neighborhood squirrels. She was still aware and her natural instinct as a sporting dog was still there. She just didn’t have the energy to run outside. We’re sure she knew we were there and that we loved her. We couldn’t fix her, but we never stopped loving her.

The medical interventions only seemed to be delaying the inevitable. Her breathing had become more labored on Monday and this remained an issue through Tuesday. At times it would be ever so slightly better, but she never stopped breathing rapidly and at times she was using all the muscles in her torso to draw breath, always seeming to be starving for oxygen. That’s why on Tuesday I made sure to discuss it with Aeyong that we really needed to accept her passing and let her leave this suffering. I called Tuesday to clarify that AEHM could perform the service and find out whether Dr Paules was available. She was working Wednesday but not Thursday, so we decided it would be Wednesday morning. We also decided to do it relatively early so that we could just have an hour or two after waking up but then could just let her go without prolonging it.

She laid on the couch in her favorite spot as a beautiful orange sunrise poked over the top of our back fence. It was a cloudy day, but there was sliver of clear sky to let the sunlight come through. I don’t know if she saw it, but she was facing the sunrise in her final hours. Aeyong had given her the nausea medication just to hopefully help her feel a bit better, and I was able to get her to drink some water from her bowl. I had to hold her up though, her legs were to weak to stand on the tile floor. I carried her outside and she was able to shakily remain standing and she eventually peed. She was so weak that she just sat down on the ground to go, she wasn’t able to hold her butt up off the ground. It’s hard to know what she was thinking, but she kept on fighting until the end, she just ran out of gas.

Aeyoung brought her favorite blanket and a shirt of Aeyong’s and mine so it would smell like home. Aeyong held her close as we drove to the clinic. April would normally get a bit of anxiety whenever we drove anywhere, because most of the time it was the Vet, and like most dogs, she was never a big fan. On this last drive, she didn’t appear to have the energy to get very upset, but she did hold her head up and look around at other cars and the people inside. Once we got to the clinic, they were able to bring her in within a few minutes. I had to pass her off to one of the Vet techs, but after filling out some paperwork and paying for the procedure, they brought us back to a room and a few minutes later April was brought back to us.

She had looked slightly distraught going inside, but she seemed to calm down once she was back with us in the room. They had placed an IV port with a syringe, presumably filled with saline. They made a point to tell us that there was no medication in the syringe yet, which I’m assuming may have been an issue with people in the past. I knew the Vet would have to make the injection based on our approval. They would have given us all the time we needed, but after spending several minutes with her we decided it was best just to let her go. No matter whether we were there or not, she wasn’t going to completely settle down given her condition and being in a strange place. Dr Paules came in shortly and let us know that she would get a sedative first, and that would be followed by what I presume was potassium chloride to stop her heart. The sedative put her to sleep and her breathing seemed to slow down slightly. The sedative was a clear liquid, but the medication was a pinkish color, and I seem to remember that was the case when we had to let Lucy and Bridget go, although my memory is a bit fuzzy.

A few seconds passed and then April’s chest stopped moving. Her spirit took flight and she was free of pain. We love her more than life itself and we’ll never let her leave our hearts. We love you our sweet baby April. You were the best girl we’ve ever had and we hope to see you again. Give a kiss to Lucy and Bridget and find a place to play. Chase those squirrels and rabbits until you’re tired and then rest. Get plenty to eat and sleep all you want. We’ll save up our kisses, hugs and scritches for you. Until we meet again.

Spring Has Sprung

In Texas, at least. After a slow start, it appears all of our trees, most of our shrubs and the lawn are making a full recovery from Snowmageddon ‘21. Our biggest tree, the one out front which was planted when they built the house, was probably the slowest to sprout buds. For awhile, I had serious concerns that it didn’t make it through the four day hard freeze back in February. Thankfully, it finally began to display some buds and eventually a full complement of leaves to get that good ‘ole photosynthesis jam going. By current estimates, it’s mainly some potted plants that appear to have met their demise. We have a few shrubs that look dead to me, but Aeyong is optimistic that by cutting them down to their base we’ll encourage some new growth from the roots. We’ll see. If they don’t recover, shrubs are easy enough to replace.

In that horticultural vein, I’ve taken a bit more interest in getting the yard in good trim. I apologize, that wasn’t intended as a pun, but now it is, so there. You’re welcome. We haven’t really gone to any great lengths with our yard, other than regular mowing and seasonal fertilization and occasional seeding. The front has remained pretty thick and healthy, but the backyard has some bare patches, including one large swath of dirt in the back corner. I’m going to try de-thatching and scarifying with, you guessed it, our new de-thatcher/scarifier. Hopefully it will clear up a lot of dead grass and leaves and open up the soil to allow more root growth and nutrient/water transfer where it’s needed. Along with that, I’ve got a big bag of Humic DG which is supposed to enhance nutrient absorption and improve soil structure. It’s a bunch of small spherical granules that disperse into the soil, some of which immediately break down into humic and fulvic acid, combining with essential nutrients and persisting in the soil to allow plant absorption for extended periods of time. The humate portion remains even longer, thereby further extending that nutrient cycle.

I’ve seen a few customer testimonials and just Humic DG alone can make a big difference to yards, plants, and larger agricultural applications. My plan is to de-thatch, scarify, mow up the detritus (I have so few opportunities to use that word, so back off), and then lay down probably half the 40 pound bag of Humic. I’ll be seeding and fertilizing in the near future, but I do want to give the yard a little time to recover so I’ll probably wait a few days to a week to do that. Not everyone recommends seeding in the spring, but our bare patches definitely need it. I probably need to get some peat moss to mix with the seed. Although it probably sounds like I’ve gone all 4H (when I was in school it was all farm kids, I’m probably showing my age), but I really just want a nice green lawn that I can maintain. I don’t want to spend a great deal of additional time keeping it in shape. Hopefully some well timed interventions will get it ready for summer.

In other developments, I got my second COVID vaccination last Wednesday, and the side effects were slightly worse, I suppose. The arm soreness was about the same, but I think I felt some more systemic effects this time. It’s a bit hard to tell because the day of the vaccination I also ran (a modified attempt at resumption that was triggered by the broken elliptical) and scalped the lawn. Scalping the lawn (and bagging the clippings) is something that’s useful to do 1-2 times per year based on the advice I’ve seen. It’s somewhat like de-thatching, I suppose. In my yard’s case, it takes considerably more effort to push the mower across high spots in the ground. All that to say, the additional fatigue I felt the day after was probably a combination of the vaccination and the physical efforts of the day before. I also woke up around midnight feeling febrile, but didn’t bother checking my temperature. I just took a gram of Tylenol every six hours for the first day or so and things slowly got better. As I’ve said, eminently better than getting sick with COVID.

Things at work are going well. I’ve worked in the new location the last two weekends, and it’s a nice setting. Essentially the same drive as before with the last two miles being on surface streets. VES has been keeping me gainfully scheduled, one weekend at a time. My no-show rate has dropped a bit, down to only 15% of the last two weekends. I’ve been averaging about $2500 per weekend, which is okay. I’ve been hoping to maintain closer to $3K per weekend, for a monthly total of $12K. Based on how they’ve been filling my schedule (partially) and the no-show rate, I’m not sure that’s achievable with only a two day workweek. At least it’s adequate for our financial goals of paying the house off slightly faster and maintaining a discretionary income. I only want to work enough for those two criteria, as I really value my free time.

Back to homefront matters, Aeyong is recovering fairly well. She had her cast removed the week before last, and she’s jumped back in to her normal routine. Maybe a bit too hard because she’s got some wrist swelling today and will need to rest a bit. She’s been catching up on several things she wanted to accomplish including trimming and bathing all the girls. She also has been out in the yard working, and this weekend she decided to help me out by dusting and cleaning the bathrooms upstairs. That was a nice surprise because it had been nagging me for several weeks and I had been too busy with regular work and work around the house. Still, she’s probably paying for the uptick in activity right now.

I’ve been trying to improve the garage layout the last few weeks to coincide with efforts in the yard. I installed some overhead storage shelves and moved the treadmill and elliptical all the way back against the wall. Not a huge change, but the added floor space has been nice. We took the vertical shelves that were previously on the back wall and moved them into the laundry room, giving us some more storage space in there. We had a little half shelf in the laundry room before, and now that has moved to the garage as a rolling storage cart for our air compressor and shop vac. I’ll eventually install another identical set of overhead shelves in the other garage slot and hopefully free up another section of the floor. Eventually I want to have a rolling workbench with some good working tools - table saw, miter saw, router, and maybe a few other tools depending on how things develop. I’m going to try to ease into woodworking, but I already have all sorts of ideas for projects. I don’t know if it’s just a natural part of aging, or a genetic thing I get from my father. He was definitely a DIYer at his core. Nature, nurture, or perhaps a bit of both?

After all this fairly mundane material, I haven’t stopped pursuing my core disciplines, although there have been more days “off” when I was working at VES or had my time manhandled by DIY, medical, etc. issues. I finished a Premiere Pro course, and I’ve just started a Photoshop course. I also signed up for a basic piano course, mostly to cover some fundamentals that I know I’ve been lacking. I’ve really only slowly learned songs and then just spent my time practicing them, but I haven’t spent any considerable time at learning scales, improvisation and some of the basic skill set I need if I want to advance further. The same could be said for my other disciplines as well. I’m alternating my drumming practice between Mike Michalkow’s course and trying to learn Xanadu for the eventual Rush AFTK deep dive video. Check back next year, probably. Then there’s also bass, guitar, singing, drawing, writing, learning to speak/read/write Korean. Not to mention maintaining my CMEs for work. The days are just packed, and that’s how I like it.

It's been one of those months...

I feel like I was thinking that through most of 2020, and 2021 is not showing any signs of let up. In 2020 there were times where days and weeks would seem to run together, but then there were many times that every day was a new reason the world was about to end. 2021 hasn’t been quite that severe, and by most metrics things are looking up, but February would prove to be a tremendously tumultuous month. Yes, I alliterated tumultuous. Gird yourself for more.

The weekend of February 13-14th would see me braving the oncoming winter storm to work on Saturday, but even by then I knew Sunday was going to be sketchy. I was already calling VES support to cancel my clinic for Sunday as I drove in for the Saturday clinic. Ironically, there would be multiple reasons why that was unnecessary because VES would ultimately decide to close down themselves as the severity of the winter storm developed. Even more importantly, I would be taking Aeyong to the emergency room. In a fit of youthful energy for the novelty of snow, she ventured out front, slid down the driveway (about two feet by my recollection); her feet went up and her right wrist came down. Hard.

The result was a displaced, angulated, comminuted, intra-articular fracture of her right radius. Hurts just saying it. We managed to get her into a nearby ER (thanks to USMD for actually being open when most places were closed), got her fracture partially reduced and splinted, and got her enough pain killers to tide her over until she could get seen by orthopedics, which would end up being nine days later. I cancelled my upcoming VES schedule for several weeks so I could tend to her needs while she recovered.

Thank Snowmageddon ‘21 and Texas’ feeble ability to cope for shutting down almost everything for a week. Not that we should complain too vociferously. All of our essential utilities remained functioning and by current accounts the only significant damage we incurred was a sprinkler system pipe and several plants and shrubs. Thanks to a frozen spigot, a neighbor sustained enough water damage that there were still reclamation trucks out in front of her house as of yesterday. I guess she had to hit the reset button on her ground floor.

The rest of February and early March was a challenging period of time. Aeyong underwent surgery on February 24th, and Dr. Niacaris was all we could have hoped for in an orthopedic surgeon. She has some extra hardware in the form of a plate and six screws, and it’s possible she may eventually need to get the plate removed as it was designed for bones larger than her relatively diminutive frame. She had her first post-op last week and things went well. She was gifted a new cast in sexy purple, although she’s been finding it a bit less comfortable than the splint she had before.

She was judged as lacking in her rehab milestones and I got a stern glance from Dr. Niacaris. She only responds so much to encouragement, so I try my best but it’s leading a horse to water doncha know. I went back to work at VES last weekend and things are going alright. I have one more weekend starting tomorrow, and then I’ll get yet another weekend off as they relocate to the new facility a few miles down the road in the Las Colinas area. As the crow flies it should be closer to home, but there are additional surface streets in the route, so based on google map’s prediction, it’s basically a wash in travel time compared to the current location.

Still, TXDot is adding lanes on the G-Dub, so it’s possible I might decide to switch to a weekday schedule in the future. With a slightly shorter drive and more lanes for traffic, it might not make as big a difference working weekends versus weekdays. While things progress with VES, things are finally about to completely shut down with the North Texas VA. I got a few text messages from Dr Hasan asking about my last workday, but when I asked what it was about, all he would say was “we’re trying to determine when fee basis last worked here”. Yeah, I gathered as much. When I got his message notification, I briefly felt optimistic, but clearly there’s no plan on bringing fee basis back at this point. To sort of bookend that interaction, I got an email from the VA remote access manager stating my authorization was about to expire. I wasn’t thinking about it, but I guess my access was approved the same day fee basis was laid off, 3/24/20.

So, it’s essentially been a year since me and my fellow fee basis examiners were laid off. What followed was in some ways a challenging year although we fared so much better than many people. The biggest frustration for us was being out of work and losing about 3/4ths of our income. It would be nine months later before I would return to income producing work with VES in December. After a few months, things seem to have stabilized. The treasury has helped restore our pre-pandemic checking balance thanks to a big refund as well as stimulus payments. I finally had the confidence to shift some more money to our mortgage payment, so we’ve gone from the minimum payment to one that will see the house paid off in three years. I might increase it yet again depending on our ability to continue running budget surpluses each month. This is contingent on a steady supply of exams from VES.

For giggles I checked with my former colleague, Dr C, who is working for QTC, to find out their current payment rates. I’m not sure if he gave me his rates or the PA rates, but they’re even less than VES. If they’re his MD rates, I can only imagine what they’re paying PAs. As I’ve said here before, it’s my strong feeling that VES is lowballing their payments to providers, but this is anecdotal based on what I previously received as a fee basis. There may be truth to their statements that they are having exams combined into one rate as the number of DBQs increases. Dr Brooks is still waiting on his FOIA request. My feeling is that it will reveal nothing or it won’t reveal enough to really discern whether VES is inappropriately paying their examiners.

One other positive development is that I was able to get my first of two COVID-19 vaccinations on Wednesday. I had signed up with Dallas County and I got a text message on Monday offering the shot. I took the first available appointment time on Wednesday and it was held at a joint Grand Prairie/Irving mass vaccination site being run at the Theatre at Grand Prairie. I was impressed with the efficiency and relative painlessness of the operation. The main side effect of the vaccination was pain at the injection site which was worst yesterday, the day after the shot. Today that pain has reduced substantially and I’m not really feeling any additional side effects. We’ve been told the second shot is worse for side effects, so I’ll see. It’s still exponentially better than getting COVID and potentially dying or suffering long term health effects from it.

Ten Years Gone

As of today, I have been officially retired from the Army for ten years. It’s been a fairly busy period of time and given a fair accounting, overwhelmingly positive on a personal level, if not in the national and international scope of things. I spent the first six and a half years or so continuing to work full time, and then switched to fee basis/part-time work about three and a half years ago. Despite the pandemic and forced layoff, I still think that decision was the right one to make. The three years of earning double for half the time made significant progress towards paying off our home and reaching our long term financial goals.

We haven’t neared the finish line as closely as planned for this point in time, but we still hold out hope that this temporary setback will eventually just be a historical footnote. I can say that there have been positive discoveries made in the context of the layoff. It’s not a big change to our philosophy, but we’ve learned to further appreciate the value of financial stability. Also, dialing back the continuous consumption has had little negative affect and it’s made me realize just how much fulfillment is available in what we already have. In a peripherally related issue, getting away from essentially all social media (FB, twitter, instagram) has had little downside in my estimation. Those mediums could offer occasional (and very temporary) entertainment, but they never offered anything of lasting value. And here lately, the constant daily onslaught of misery and controversy (especially twitter) just began to wear me down. I don’t miss it a bit.

We’ve learned how adequate (or not) our pure retirement income is against the cost of living. At present it’s a bit short, although as said before, some real belt-tightening might allow us to correct the course. The additional money from paying off the mortgage will make staying in the black a bit easier. Even at present, just a couple full days of clinic would be enough to keep that monthly ledger positive, so hopefully, in the not too distant future, I might get a little trickle of work to set the ship level.

On the creative side of things, in some areas, it’s felt like very incremental progress, but progress nonetheless. I should mention the considerable time I’ve spent at Berklee which has been a great boon to my artistic development, although I’m on an extended break at present. I still plan to return, but I want to shift my focus to guitar and I’m still slowly working towards what I consider a satisfactory audition. I have until 2025 to use my GI Bill benefits, and since I’ve already used around 75% of them, I should still be on track.

I’m not sure I’m where I would have wished to be on guitar and piano especially, but I can say that I didn’t necessarily expect I would have started on drums, bass, vocals, and songwriting as well. I also wouldn’t have thought my pursuits would turn towards writing and drawing, much less resuming my long procrastinated study of Korean. Things continue to inch forward a day at a time, but that they inch forward is the point. I’m happy with where I’m going (and maybe not totally unhappy with where I’m at creatively, either) and I still wake up every day looking forward to the work ahead.

The family is doing okay, as well as could be expected I suppose. We’re not any younger, but we’re holding in there I think. Ironically, our lifestyle was already suited to the pandemic since we’re homebodies with no social circles to speak of. The only inconvenience for us was delaying some routine medical care, concerts, and being more judicious about trips to the store. Otherwise, it’s situation normal here in the Hightower holdfast. We said goodbye to our sweet girls Lucy and Bridget, and still miss them all the time. We already had Arya by the time I retired and not long after we said goodbye to Bridget five years ago we added Skittles to our pack. A chihuahua mix, she’s the princess in the house and gets the lion’s share of the attention, although we don’t fail to shower our other two girls with affection.

My hopes for the future are largely unchanged. I want to continue working on my creative pursuits every day. I still hope that at some point I’ll spend more time in a purely creative headspace instead of practicing and developing my technique, but I expect that will always be part of the daily rituals. I hope to at least reach a level of competency (on the drums especially) where I can perform and record the sort of music I hear in my head. I’m closer to that on guitar, but there’s still a ways to go. Eventually, my goal is to combine the various disciplines of music, words, and art into cohesive works that tell compelling stories. I’ll get there, even if it takes a long time. I feel like this period of my life is when I can really create the works I have always needed to make. I don’t regret any part of my life, but it would be untrue to characterize my military service or medicine as my calling. These have been challenging and at times rewarding endeavors, but my creative efforts are where my true self lives.

As long as it’s available and I’m able, I’ll probably continue to earn an income to keep us afloat first and foremost, but also to have a comfortable discretionary budget for the quality of life expenses. As probably stated before, I hope we can get back on track and build our cash reserves back up and then pay the rest of the mortgage off. At that point, one decent shift a week would keep us pretty comfortable, methinks.

Looking ahead, it’s hard to surmise where we might be in ten years. I’ll be sixty-three, just having become eligible for my VA retirement (paltry as that may be) and about four years away from social security (if that hasn’t been stolen by then). I assume we’ll have the house fully paid off, and I’d say the odds are we’ll still be right here although might change as well. My main goal with writing is to continue to improve and just create some compelling stories. It would be the proverbial icing on the cake if that would ever reach a level of quality that someone would be willing to publish it. It would be a second cake with sprinkles on the icing to ever derive any sort of income from it. Still, I have to acknowledge that it is actually a goal. Musically, maybe I’ll actually be able to play those milestone songs (you know who you are) by then. A man can dream…

The Retirement Mindset

This will be a brief discussion as I’m not sure what that means, and I’m not currently planning on shifting to the retirement mindset anytime soon. My long term plan has always been to pay off the mortgage and remain debt-free before we think about a self-sustaining income/lifestyle. Due to the COVID-19 layoff, we’ve been granted the opportunity to explore those realities sooner than planned.

Thus far, it seems that if we decided to really buckle down and eliminate most if not all discretionary spending, then we’re already capable of living on my pensions alone. Notice the plural. The pension I draw due to my service-connected disabilities has been a key source of income now that I’m not earning any sort of a normal salary. We, fortunately, had a bit of an emergency fund, just because our checking balance had built up to a decent level by the time of the layoff. That balance has been slowly dropping, but there’s also been a great deal of arguably discretionary spending as mentioned in the last post.

We’re going to try and cut way down on that for the next few months and see if we can get that balance crawling back upwards. At our present payoff level (essentially the minimum), our mortgage should be paid off in about five and a half years. We had been paying it off at about three and a half times the required amount for the three years since I switched to fee basis, so we made quite a dent in the principal. We’ve been paying the mortgage off since late 2013, so we’ve managed about twenty-five year’s worth of payments in under seven years so far. Once the mortgage is paid off, that should free up about 1.5K in monthly expenses. We’ll still have the rather high property taxes and insurance that are just part of living where we do. I sometimes wish they had a state income tax and would pass on some relief to property tax rates, but I doubt that will happen anytime soon. Our property taxes and insurance are the equivalent of many people’s rent.

The biggest concern with the reduced income is if we get hit by a large financial requirement like home/car repairs, major dental/medical expenses, etc. If we had a few of those in succession, we could quickly drain the remaining cash balance we have at present. If I’m able to return to work in the next year or so (hope), then the goal is to build the cash reserves up a bit more and then work on paying off the mortgage. If I’m able to sustain the work level I had previously, this should be manageable in about two years. Having the mortgage paid off will give us quite a bit more breathing room. At that point, any work that I did would be mostly for discretionary income purposes. I can see working one day a week indefinitely at that point.

So, I don’t know if I’ve adopted the retirement mindset just yet because I’m hoping to be able to return to work and if I’m being honest, I don’t want to completely cut out the ability to earn discretionary funds by virtue of the odd shift here and there.

Thirty Years Today

On this day thirty years ago, we were rushing around Seoul by cab getting papers stamped and swearing oaths, and at the end of it we were married. It was a strange experience, but part of the normal process when a Korean national and American got married while still in Seoul. We had an agent to assist with the paperwork and she escorted us around to all the various stops. I can’t remember where, maybe it was the Seoul version of the justice of the peace, but we finished a set of paperwork and had to ask “Are we married now?”, and she excitedly responded “Yes!” and we kissed and hugged in front of a lot of confused onlookers.

Not the most momentous of ceremonies, but I can say the success of our marriage is more important than any pomp or circumstance. We were told that 80% of all Korean-American marriages fail within two years and that the number just increases with time. I think the person quoting that statistic (my commander at the time if I recall correctly) was pulling it out of his ass, but it’s probably true that more than half fail over time, as that’s true of all marriages if I have my numbers (sourced from a similar entity) correct.

Our marriage has lasted because we complement each other perfectly. We talk about the most important things and we’re always there for each other. We’ve been through some rough times and we’re going through some again, but we always have each other’s backs and know we can depend on one another. All the hollywood and romance novel drivel is meaningless over time. We truly love each other and that’s shown in our day to day actions, not a bunch of ephemeral gestures. I mean, I have bought gifts, flowers, cards, etc. but all that stuff fades with time. Always being there for each other is what has held us together.

A Few Milestones

Today marks nine years since my retirement from the Army, and it’s been overwhelmingly positive in retrospect. I got a good job, moved back home, and have spent a significant amount of time furthering my development as a musician, songwriter, and producer. There have been ebbs and flows over these years, some times of drama, but mostly a nice steady arc to the days. We got a great house six years ago, and I’ve been enrolled at Berklee Online for the past several years. Aeyong has turned our yard and house into a natural conservatory of sorts, and we’ve got a beautiful green space that envelops our house and will only shelter us further with time. We lost Bridget to the inevitable march of time, but have since welcomed Skittles, our Chihuahua mix and resident spoiled princess of the brood.

I spent about five and half years working the regular grind as a federal employee, but about two and a half years ago I switched to “Fee Basis” which is somewhat equivalent to a contractor, but without the contract. I get paid directly for the work and there’s no ongoing agreement or contract that binds either the VA or myself. That being said, our clinic has had Fee Basis examiners the entire time I’ve been there and long before as far as I know. That switch is probably the single biggest improvement in quality of life I’ve ever experienced, even compared to my retirement from the Army. I went from working full time to working nine days a month and earning twice as much. This is largely predicated by my ability to perform a large number of exams and handle complex cases that the regular federales don’t like to bother with. It’s really been a perfect storm of an employment situation for me.

I’ve had significantly more time to work on my various passions, and I’ve added filmmaking, video editing, video effects, drawing, and writing to the multitude of musical disciplines that provide great fulfillment and purpose to my life. As part of the added boon of income, we’ve been paying our mortgage off at more than triple the required amount, and so we’re hopefully going to see it paid off in the next two years, about twenty two years ahead of schedule. There’s one big milestone that we need to pass, and that’s another salary waiver approval for Fee Basis employees. The VA has been allowing Fee Basis to earn double their normal authorized annual salaries due to shortages of personnel and it’s been a policy that’s required renewal every two years. This year marks the end of a two year period, so we just need one more approval. By all signs it should happen because the VA has been one of the departments that’s seen expansion under the last several administrations.

Once the house is paid off, I intend to keep working at about the same rate I do now, but being completely debt free will put us in a position where we could probably survive without me working at all. I like the extra security of financial surplus, not to mention discretionary income, so I imagine I’ll keep working indefinitely, albeit on the reduced schedule which will eventually decrease even further. A lot more has happened over the last nine years - we’ve both passed fifty and it’s receding below the horizon, we’ve attended a lot of great concerts, and taken a few small trips. We plan to travel more once the house is paid off, although we’re limited by our dogs and some health issues. It can also be argued we’re both home bodies who really enjoy living in our own little world.

File under short term milestone, I’ve quit practicing any musical instruments for the past month, trying to get this chronic elbow tendonitis to fade away. It’s been in the left elbow for almost two years, and the right elbow started acting up a few months ago. It’s just the cumulative effect of playing so many different instruments - guitar, bass, drums, keyboards. It got worse when I bought acoustic drums and had been working on my double stroke by repetitively practicing the stick bounce off the drum head. That shock is transferred directly to my lateral elbow and it really has taken its toll. The problem with the elbows is that we’re constantly using them, and even something as trivial as picking up a coffee cup or tearing a piece of paper can tweak the injury. I have seen some improvement in the symptoms, so I’m hoping to start gradually re-introducing some practice to my schedule starting next month.

One benefit of the extra time is that I rekindled my interest in drawing and writing (which have been gathering dust for years) and I’ve made some progress, although I have a long way to go. I look forward to combining all my various disciplines into great storytelling in the future.

It's February, do you know where your posts are?

Some personal updates - the biggest event in the past few months was a brief cancer scare (I know that's so overused but it's actually kind of fitting) for Aeyoung over the past few months. She had been having some intermittent swelling and pain in her neck and a CT scan had showed some concerning calcifications. After much hoop jumping between the imaging center and our insurance (which saw her finally request the study get performed at a different clinic), she underwent a PET scan a little over a week ago.

It took us nearly a week to get the results, but we were thrilled there was no sign of any hypermetabolic activity anywhere in her body. Not only did that clear her of cancer in the area of concern, but it basically gives her entire body a clean bill of health from a cancer standpoint. This was a big weight off our shoulders. The past several weeks have been like 1997 all over again. There's nothing quite as demoralizing as a cancer diagnosis. You no longer know how much time you have and what the quality of that time will be. We were facing the possibility that we might only have months together, and they might be progressively more miserable for her. 

In the days before we received the results, all I could think about was if I could have one wish it would be for her to remain cancer free. That wish came true and we can return to a sense of normalcy for what lies ahead. My hope is that with a change to fee basis we can accelerate our mortgage payoff and give serious consideration to getting a 1-2 acre parcel of land and having a home and a free standing music studio built. Lots of miles to cover before then, but the horizon is wide open and the future looks bright.