Taking the conservative route

2025-12-08

Finally saw my neurologist regarding herniated discs, and most notably, what to do about the nerve impingement at C5-6 that’s at the root of my numb/tingly finger on my right hand.

We talked about the varying treatment options and evaluated what makes the most sense. At the extreme end of the spectrum would be surgery and whether that means disc replacement or fusion. Fusion would be really bad as it means that I would have limited range of motion around my neck. Disc replacement is complicated and made more complicated by my age and the arthritis that is present. For now, this is a hard pass.

Next level down are some kind of steroidal injection to manage the pain and inflammation. Luckily, after about a week of really severe pain, that has largely subsided through rest. There is still some inflammation, which is why the numbness is still present but it’s less than it was, and maybe it’s closer to being tingly at the fingertip all the time. Regardless, seeing that my condition is improving, I’m taking a pass on this, too.

That leaves 2 more options to consider: physical therapy and chiropractic care/massage therapy. As I am pretty stubborn about resolving things on my own, I am opting to treat my injury with physical therapy for the next several weeks. I can still fall back to seeing a chiropractor or massage therapist if we find that pt is really not working, with some caveats: manipulating my neck with my condition is not without its own risks. So pt it is.

So right now, I’m working on getting scheduled for pt. That requires a pt doctor to interview me and also getting insurance approval. It’s probably going to be a week before all that is settled so the waiting game continues.

The upside, I’ve been given a provisional ok to start occasional play but definitely not at my 2 to 3 times a day for 5 or 6 days like I have been before all this started. See you on the courts and golf course again soon! Let’s Go!

Move over, Graves’

2025-11-25

Ah, the curse of getting older (and maybe being too active?). I’m going to be on the shelf and may need to stay there for an extended timeline. I’ve had some upper back/neck pain, on and off, for the last couple of weeks. It wasn’t stopping me from playing pickleball or any other activity. After all, what’s a ‘little’ ache and pain considering how many hours I spend per week on the courts? But then I hurt my right foot so took the last week off.

Well, during that time off, the pain in the neck returned, and shortly after that, I started experiencing some numbness in my right hand. Anyone who’s seen me these last couple of days might have known about the pain. I don’t generally complain about pain but I’ll just say that I haven’t been this uncomfortable since having a kidney stone.

Actually, it’s worse. That one, I was able to ‘turn the pain off’ once I recognized what it was from. This one is more insidious. Laying down, sitting at a desk, working the keyboard and mouse, whatever the activity, I cannot get into a comfortable position so it’s constantly reminding me it’s there, needling me.

I got some guidance from a good friend, who has knowledge in this area, and he recommended I go for an MRI and X-ray. Well, he was pretty spot on with my issue: I have a herniated disc with arthritis in my neck and that’s intruding on the nerve. Working on getting doctor appointments setup and will be reviewing my options for a treatment plan.

This is just a pause – I’ll be back! (Get it?)

Midyear Graves’ Update

2025-07-11

Just a quick update for those who are still following my Graves’ Disease condition.

My condition remains stable, even if my TSH is still super low at 0.161, but is magnitudes better than my January number of 0.016. Both T4 and T3 are still within the ‘normal’ range at 1.38 and 118, respectively. The T4 is actually more squarely in the normal range (1.74 previously) and T3 is fairly unchanged (123 in January).

I certainly have nothing to complain about. Living the dream, playing pickleball almost daily, smoking (meats) up a storm, and maybe enjoying an adult beverage or two a little too frequently. Winning!

Annual Graves’ update, plus cataract surgery follow-up

2025-01-23

My condition with Graves’ continues to be stable, to the point that my endocrinologist is at point to want to stop my biannual checkups and let my primary care physician perform the assessment, absent any issues as they are now.

I’m not against it but it creates a slight issue with my continuing my biannual blood work as the primary care physician relies on the endocrinologist to add that panel to the standard labs. For now, we agree to have the endocrinologist continue scheduling those thyroid tests and adding the next office visit to the calendar, Ah, the medical insurance dance is a joy.

Not much to say about my vitals other than I did gain a little weight from the previous visit (3 lbs). Not sure if that is from enjoying myself a little too much or from resuming some weight training.

Cholesterol and prostate levels also look good, although the cholesterol is slightly higher but still with a good ratio of HDL to LDL. Me thinks I enjoyth smoked meats and mead a bit too much!

The doctor proceeded to whip out his calculator and informs me that I’m just a tick over the ideal risk for heart attack at something like a 6.4% chance. I’ll take it!

As for my thyroid levels, my TSH is still showing me as being hyper but it’s almost 3x better than from the previous reading. T4 and T3 are still within the ‘normal’ range but both a tad bit on the higher side from before. More importantly, I am still asymptomatic and feeling great!

Cataract Followup:

After a long pause in my laser treatments following cataract surgery, I can report that the vision in my right eye is now at about 20/15 and in my left, around 20/25. In both eyes, I did lose my ability to read without glasses and am now about 20/40 for near vision. The left eye does have an anomaly (a fold in the retina) that made nailing down the final adjustment to the lens difficult, hence settling at 20/25.

I can’t complain because now I don’t need to wear glasses for sports although I am wearing protective goggles while playing pickleball. And having to wear glasses for reading and computer work is little different from when I had to where glasses glasses previously, just now for reading. Other than correcting my vision for sports, the treatment also seems to have eliminated nearly all of the ‘star’ effects when looking at lights at night, an artifact from my lasik surgery back in 2001. Booyah, I call that a win!

Pause in my post cataract laser treatments

2024-10-03

Looks like my treatment timeline will be extending a little longer than expected. I was hoping to be done by the end of this month but a known issue has put a pause in finalizing my laser adjustable lenses.

Right eye is pretty good but the left eye has a thickening on the retina that needs to be addressed first. It’s preventing a good read on what remaining adjustments will be needed to lock my prescription in. Took a steroidal shot into the left eye to try and get the swelling under control and will be taking a different prescription eye drop for the next few weeks in hopes of getting the eye to settle down.

So now I’m ‘looking’ at maybe the end of November before I’m all said and done. 🤞🙏

Right eye cataract post-op day 1

July 24, 2024

Immediately after surgery, vision was a blur and that was to be expected. The whole process was pain-free and the longest part was just getting the light dose of anesthesia and waiting for the eye to get numb before surgery.

Once the eye is ready, you are wheeled into one of two stages. The first is to have your natural lens broken up by a laser and the second is to then go and have the lens fragments removed (suctioned) and inserting the replacement lens. The whole process was finished in about 15 minutes.

In my case, I opted for what’s called a “light adjustable lens.” Rather than being a fixed lens, these lens can be adjusted by uv laser up to 3 times to refine the prescription to suit me. The lens that’s implanted already has a prescription but due to my having lasik some 23 years ago, my cornea is not of a uniform shape. Using a light adjustable lens, they can compensate for those irregularities.

As the implanted lens is sensitive to uv light, I need to be vigilent about wearing uv blocking glasses for the duration of the adjusting period, which doesn’t begin until 3 weeks after the second surgery on August 6 (too much uv light can cause the lenses to be ‘fixed’ prematurely). They issued a clear set for indoors and a tinted set for outdoors. These have to be worn during the entire time I’m awake. To complicate the timeline, I’m taking a vacation in mid-September and my ophthalmologist is taking a vacation in late September, stretching the end date to October 14.

Here are my other gotchas:

– no highly physical activity for 1 week after surgery (yes, that means no pickleball!)

– I need to wear an eye shield while sleeping to prevent me from rubbing my eyes at night or other incidental contact with the eye for 1 week after surgery

For me, I think I will be forgoing pickleball until the lenses are finalized. It’s going to be rough but there’s too much risk of me losing my glasses during play. On the upside, I think I’ll be able to resume golfing as soon as August 13, but I’ll have to reassess my availability based on how my vision is.

So as of the morning of day 1, things are looking promising. I’d say the blurry vision has reduced to where it’s no longer like looking through heavy fog to more like light fog or wet glass. I don’t plan on reporting out everyday but will provide updates as milestones are reached.

Here’s to a brighter future!

Stay the course and other news

July 23, 2024

A little late with this post but long story short, not much has changed with my Graves’ Disease. While I’m no longer needing bi-annual visits with my endocrinologist, I am still getting blood work done to help me monitor how I’m doing.

So the latest tests from July 11 are still showing really low levels of TSH (0.006), it’s a slight improvement from January where it was less than 0.005. And I also had a slight improvement for my T4, where it’s at 1.67 (in the ‘normal’ range) compared to 2.20 previously. Lastly, T3 continues to be in that ‘normal’ range, now sitting at 122 (pretty much in the middle) vs 171. All in all, pretty happy with the numbers!

In other news, my cataracts are finally at a point where surgery is recommended. Yeah, I know, I’m pretty young (61) to be getting cataract surgery but it’s one of the safest procedures out there and once it’s done, it’s done and I can enjoy perfect (🤞) vision for the rest of my life.

My right eye will be worked on today, followed by my left eye on August 6. As I have had lasik performed some 23 years ago, meaning my cornea is now flatter than normal, I’m opting for what they call “light adjustable lenses.” While I hope to come out with 20/20 or better vision after surgery, the light adjustable lens can be fine tuned by uv laser light up to 3 times if I have the results I’m looking for.

The downside is that they won’t start making adjustments until 3 weeks after the second surgery. Add that my ophthalmologist has a vacation and then I have a vacation in the middle of September, my vision may not get finalized until mid-October! And during that interval, I’ll be needing to wear uv blocking glasses to prevent the lenses from getting too much uv light before they get finalized. This also means that I’ll be going on the shelf for pickleball so as to not risk loosing my glasses during play. Small price to pay if I can have great vision without having to wear glasses (with the possible exception of readers) going forward.

Looking forward to a bright future! (see what I did there?)

Half year later and still doing fine!

2024-01-24

A little late with the latest results of my latest annual physical and follow-up with my endocrinologist.

Long story short, not much is different from when I was on meds to now being off meds. My BP at the time of my physical was 125/76, heart rate was 49 (it’s only been this low when I was running and my all time low was a calm 42 bpm), cholesterol at 175, weight at 161.2 lbs.

My thyroid levels still gives my endocrinologist fits but as I’m still asymptomatic, there was little he could offer to make me want to irradiate or surgically remove my thyroid. The TSH was again below 0.005 (0.165 at the last half year check), T4 at a modestly high 2.20 (1.67) and T3 within the ‘normal’ at 171 (106).

We also had another bone density test performed as one of the side effects to Graves is osteoporosis. Rather than losing bone mass, I managed to gain 11.1% in the spine, 4.4 % at my femur and a total mean improvement of 6.6% since the last test in Aug of 2020.

As a last Hail Mary, he warns me of the risk for heart problems but, as you can already see from my physical, that doesn’t appear to be presenting itself either.

To his credit, he recognizes that there is little he can do for me without further consent and so we agreed to reduce my endocrinology visits to annually but maintain doing blood tests bi-annually and to contact him if there were any changes to my condition.

Personally, I think my best medicine has been to stay active every day and that’s not a problem living here in The Villages, and particularly with the sport of pickleball. On top of playing, I’m one of the instructors for The Villages run practice sessions, I have my own practice group that meets 3 times a week, I’m a referee for when The Villages has tournaments, and since last summer, I host my own weekly tournaments every Sunday with 18 teams with skill levels going from beginners to advanced play. I’ve picked up golfing again and, when I have time, I squeeze volleyball into the mix.

Yeah, I’m busy but I wouldn’t have it any other way!

Life is a rollercoaster

2023-07-18

Well, my run of ‘normal’ thyroid blood work ends with 2 but it’s not all bad news.

On the positive side, both my T3 and T4 readings are still in the normal range, however my TSH (thyroid stimulating hormone) slipped below normal once again.

Since my T3 and T4 are still within the norm, it’s hard to determine whether or not my TSH is low because those hormones are already within the norm and my body doesn’t need to produce any more thyroid hormones or that the pituitary gland is not functioning correctly and regardless of my T3 or T4, the TSH should be somewhere within that normal range.

For now, since I am still asymptomatic, I will stay the course and remain off methimazole. We will re-evaluate at my next bi-annual checkup (beginning of 2024), adding a pituitary blood test to confirm if it is functioning as expected and also doing another bone density test to assure I’m not losing any bone mass (a hidden symptom – and none detected the last time this was tested).

Time to get back on that rollercoaster and keep on enjoying life!

Two consecutive ‘normal’ levels!

2023-01-17

Ecstatic that my thyroid labs came back with results in the ‘normal’ range for the second time since this summer. Vitals also remains good with BP of 127/71, pulse of 55 and weight stable at 156.4 . And no excitement with Covid or pneumonia this year, thank goodness!

Here are the numbers:

The only other item of note was that my white blood cell count is still below the reference range pf between 3.4 and 10.8 at 3.1, same as the last test. My doctors aren’t concerned over this so I’m not going to worry over it anymore either. And with 2 consecutive ‘normal’ reads, I did ask my endocrinologist to stop taking the methimazole (2.5mg daily) and then see how I do at my next visit in July. Fingers crossed that all stays good!

As I close in on my 60th trip around the sun this spring, who would have guessed that my health would be as good as it has been. I owe a lot of that to my retirement in The Villages, FL and the active lifestyle I’m leading (can you say pickleball?) and the abundance of friends I’ve made here.

Laissez les bons temps rouler!

Pulled Pork! 2023-01-14

Standing Rib Roast! 2023-01-14