Returned as a Donor

It's been a tough couple of months in Blood Bank of Delmarva exile.  My Hb dropped below their 13 g/dl threshold two months ago, far enough under to not be borderline and confirmed by the lab.  Search for blood loss via stool testing and colonoscopy was unrevealing.  My eGFR had dropped gradually to 55 which assigns me CKD 3a but, which the gastroenterologist attributes the minor anemia, though I think the creatinine has been stable a while and the reduction seemed a little precipitous since the Hb measured 13.5 when I had my appendix out a year and a half earlier and had been rather stable at just about 13 on blood bank screening as recently as a couple of months earlier.  Sit tight two months.  Repeat Hb 12.9 which restores me to recent baseline.  Back to the Blood Bank to give more platelets.  I passed, with the desktop Hb at 14.0, which is probably just as wrong as the low ones, but an uneventful extraction of blood with return of the RBCs.  Thought they were having a cap promotion for donors, but nobody offered me a Kewpie doll of any type.  What I wanted I got, some reassurance that health decline was not inexorable and the ability to be useful to somebody I didn't know without any expectation  of anything in return.  

Summertime 2021

And the living is easy.  Or maybe not that easy.  Sweltering days have arrived, though to my surprise the container plantings with commercial potting soil have all retained their moisture from the last deluge a few  days back.  I've not checked the backyard square foot garden.  Deck plants appear healthy even though their soil has dried.  Maybe try staking the four tomato plants later.

Summer marks fewer appointments.  One doctor's visit later in the week.  Maybe see if the Blood Bank will have me back as a donor.  No OLLI classes.  No looming deadlines.  In that sense, the living is easy though better not to be too easy.

Post-Covid travel has begun to open.  I went to the Delaware beaches twice amid prudent restrictions, plan to do this again in the more open environment.  Maybe go to Lancaster after my medical appointment, as I've not done that at all during the pandemic.

Significant blocks of unstructured times also create opportunities.  My traditional six month cycle reaches its conclusion soon, more successful than most given the pandemic's limitations, but still with enough loose ends to require some element of self-directed effort within some specific self-assigned work times.  Still another kg to go on my weight goal.  Still sitting on three completed essays of good quality but lackadaisical about seeking a publication for submission.  Not exactly summertime activities but still on the not yet completed list.  Too soon to harvest my gardens.  I've had a little too much medical care of late.  Complete this appointment and steer clear of providers the remainder of the summer.  And shul reopens but for now without me.  

Since my initiatives get created in June to transition in July, summer for me is never really hazy or lazy.  I have made peace with what I did, didn't do, or could have done, thought about what I'd like to continue or do instead, and come the hottest days with the least fixed structure, immerse myself onward.

Kitchen Surfaces

With Ezrat HaShem and some personal commitment, this will be the week that I create fully functional surfaces in my kitchen to make the rest of my kitchen functional.  I have an orderly plan, already started, with multiple zones to be done in sequence.  It makes sense this time to follow classic decluttering principles, handling each object not more than once if possible.  Boxes for Put Away, Throw Away, Recycle, Give Away, It Goes Someplace Else should make this more straightforward.  Interestingly, as I create zones, only four require a lot of decisions on placement of excess objects.  All will be cleaned.  It's important not to rearrange clutter though, something that has undermined other similar initiatives.  This time do it and do it properly and try to only do it once.

Failures and Shortfalls

My long anticipated colonoscopy did not go well but offered an important insight.  My label of CKD, that I poo-pooed amid a fairly stable top normal creatinine captured more significance by the gastroenterologist who omitted Mg Citrate from my preparation.  My preparation using primarily polyethylene glycol did not fully do the job so she recommended a second procedure in a year.  But since I had a drop in Hemoglobin which banned me from my valuable role as a platelet donor, she concluded that the marginal eGFR over time was responsible for the borderline anemia, as in not really correctable.  She's exceedingly astute which is why I selected her among my physicians.  A more serious post procedure review of CKD 3a, which is what my lab results show, suggests she is right.  The renal function causes no symptoms or proteinuria but has other considerations, from colonoscopy prep to blood donations.

Need to give it a go again next year and need to give platelet donation another try next month.  

Last month saw a return of graduations with distinguished speakers whose remarks reach public media.  They often talk of failure, which is inevitable, and not just for bowel preps and body parts.  There was also my own limited insight to the significance of my lab results.  The colonoscopy screener and wellness screener asked me about falls, which included one.  I failed to control clutter on my own floors.  As much as I wanted to visit my kids this half-year, that won't happen, nor did my anticipated tour of the Everglades as an initiative the previous semi-annual cycle.  I haven't rescheduled either.

I wrote the things I wanted but stumbled on submitting them.  My weight improved with effort but my strength and stamina did not.  My Great Course turned out not as understandable as anticipated.  My social security monthly calculation fell short of what I had expected by enough to keep my travel or donations less.  No shortage of recent shortfalls, though probably no different than any six month cycle or any portion of my life, which had the success of reaching threescore and ten.

Here's where the college speakers, all of whom had their down moments, vary in their advice.  They agree not to wallow or claim victimhood.  So do I.  Opinions divide on whether to dust yourself off and try again, or dust yourself off and move on.  I cannot reverse my eGFR, nor restore my hemoglobin to blood bank acceptability if that creates the anemia.  Platelet donation may be history for me.  Have to move on.  Social Security will provide what its employees calculate but eventually my IRAs will need t distribute making donations and travel more postponed than lost.

I know where my kids live and have the means to get there.  Those visits will happen, just later than I had hoped.  And I have a laptop with Word plus a creative mind so expressing myself will still happen.  I just need a better grasp of desired recipients.

As a Stanford commencement speaker who moved from top of the world to sudden pre-mature widow in an instant noted, not everything that happens to us is because of us.  And while feeling low comes with the package, there are other parts of the package unaffected by these particular personal failures.  And for the most part, you can dust yourself off, whether you opt to try again or try something different.

With that context, I will need to assess the last six month's blend of accomplishments and shortfalls while I choose activities for the next six months which will also have tasks fulfilled and others not completed.

Sprouting

This would be the year for a great garden, and maybe it still can be.  With attention to pots at the front door easily accessible for care, layering of soil and nutrients in the backyard beds, nearly daily care to the aerogarden, and not getting too frustrated with chia pot disappointments, real progress emerges.  Planting seeds or placing nursery plants in the soil has its measure of satisfaction.  Weeding and thinning much less so.  But I'm at the weeding and thinning stage.  The pots only needed coriander selected as the healthiest looking of adjacent stems.  In the backyard, though, things appeared more challenging.  While I know where I placed the seeds, having made a good map, some rain or hose watering may have shifted some of the upper soil and the seeds with them.  For early sprouts I am often not sure which are the desired plants, therefore they have to be left alone until the appearance declares itself.  Some such as dill have delicate stems where more than one seedling in a planting hole germinated.  

Census in the backyard thus far:  tomatoes less vigorous growth than hoped but all viable.  Pepper, one schvok plant, replanted new seeds in each of the two allotted squares.  Eggplant not sure.  Bok Choi not sure.  Beans mostly OK.  Arugula too delicate to thin.  Swiss Chard limited sprouting from a usually easy to grow seed, though mine were dated for previous years.  Cucumber looked great.  Weeded and thinned.

Dill thinned with difficulty in hopes of more vigorous sprouts.  Chives needed some big weeds removed.  Marjoram and oregano uncertain.  Sage had a small plant with characteristic leaves right in the center of its square.  All other greenery plucked from that square.  Basil uncertain.  Thyme too delicate to thin. Coriander too delicate to thin.

Benign neglect for another week or so, then reassess.

Eliminating Readers' Comments

Our electronic media has its advantages along with its disadvantages.  Inviting readers to comment, even with a screener to approve what appears often enriches the original thoughts or moves them in a different direction but it can introduce some ugliness too.  Blog formats such as Medscape and KevinMD where my medical articles appear depend on input from specialized and interested readers who share some of the skills and experiences of the original articles.  They are moderated, at least until the responder is known by the editors not to be a troll, and are invariably polite even when expressing disapproval of what was published.

Major forums like CNN or big daily newspapers will get thousands of comments.  Once a critical number is passed, any being read becomes less likely while trolls getting through becomes nearly a certainty so editing may not be very important.

People may not like doctors as a group or their doctor specifically but medical care does not engender hate.  Political news does, perhaps even depends on some of it, religion can, which may be why the Freemasons devoted to brotherhood among members has banned these topics of discussion from their gatherings.

The Forward, the Jewish daily that now only has an electronic version to which I subscribe, sits at the intersection of Jewish identity, American political divisions, and Israel as a frequent flash point.  Many of their news and opinion pieces reflect top notch reporting and analysis, others seem more amateurish.  Irrespective of the individual writers' talents at expression, the subjects stand on their own.  They used to invite reader comments but recently eliminated this forum, even with mandatory approval of a moderator before appearing.  My input had been somewhat frequent, viewed by me as a perk for my annual subscription fee, though I almost never came back the next day to see if their editor approved what I had submitted.  That's probably because I really didn't care.  The purpose of that input was more for me to digest what I thought I had understood of the article or editorial, its implications, maybe possible future directions.  Influencing any other reader was not part of my personal expectation.  And if they eliminate that feature for everyone, it may be they didn't like the readers' feedback, other readers complained, or they frittered too much valuable editors' salaries reviewing the comments.  I don't feel slighted but do think they may have disinvited some readers who valued their own opportunities to contribute.

That feels very different from a temporary tact by David Harris, CEO of the American Jewish Committee, and fellow two years ahead of me in college.  He expresses his views on Israel and Anti-Semitism in many forums, including Twitter.  What he did, and apparently reversed, was set criteria of who met his importance standards for offering feedback to what he expressed.  Being a Nobody, I didn't, something I resented enough to Unfollow him for a few weeks in lieu of his more junior staff who would retweet the boss' positions.  Some of us value our place in the community of readers and very much resent being selectively declared Nobodies even when we are.

While I liked commenting on some of what The Forward brings to the Jewish arena of ideas, I don't feel deprived by this editorial decision on their part.  They have a Facebook presence which does not require a subscription fee and where trolls are part of the platform.  And I can always submit a more formal Letter to the Editor.

Creating New Habits

One of the interesting books that I had to wait in a library queue to read has been James Clear's Atomic Habits which explored habit development, its advantages and its impediments.  As I start to select the next dozen projects for the coming half-year, I looked at my daily and weekly task lists to get a better idea of what activities have become entirely ingrained, what get done but not really habitual, and which have defied my efforts or met with resistance.  On Mondays I weigh myself and measure waist circumference, largely without fail, though I do need to schedule these.  Same with checking the oil level of my car on set days twice monthly.  My wake time is set by a wrist vibrator, bedtime by the clock.  My day always begins with dental care, for all practical purposes now habitual.  Treadmill sessions are pretty reliable but need a conscious prod from my conscience.  I take my medicine at suppertime.  Each morning I make coffee, arguably my most truly habitual activity.  Food is off limits from 8PM to 6AM, something done so long and so successfully that it probably makes the grade as a habit.  I check my indoor plants and the containers outside my front door every morning with little prodding.  Dishes in the sink from the night before get washed early each morning.  I retrieve the newspaper from the end of the driveway and deposit it at the front door for my wife's reading pleasure.  All largely now ingrained activities.  It's hard to say how long it took to create these largely habitual activities, probably longer than the three weeks often cited for habit creation.

Some of my initiatives would have gone better if habitual.  Writing times never got fixed.  Even my contractually obligated monthly submission requires scheduling and fortitude.  OLLI classes remain a defined task more than a habit.  I have been writing three laudable activities at the end of each day so appreciation seems to be on its way to becoming habitual, or at least an evening task that I rank higher than other options.  Thursday review of weekly Parsha commentary happens each week, but more as a scheduled task than an automated activity.  It gets done for all practical purposes 100% of the time.  And alas, no truly recreational activities have become inviolable.

As I embark on my annual June effort to assemble twelve laudable goals for the remainder of the calendar year, I need to recognize that none really go without effort, though most can still take advantage of the many things I now seem to perform without much thought.