E:\LETTERS\2018DAR.HTM 

<a name="6Dec2018">
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<h3>                 9 December 2018 
</h3>
<h2>                 Kyphoscoliosis, sciatica, and meralgia 
                     paresthetica 
</h2> 
<p>                  The physical therapist modified my back exercises.  
                     (A copy of my guide sheet is enclosed.)  I'm 
                     beginning to have doubts about the one where I 
                     lift a knee across the other leg; he said the 
                     back-arch one was bad for me, but didn't mention 
                     what I call the "knee cross" one way or the other.  

</p><p>              For years, I've been sporadically doing 
                     "pushuplets" for my arm bones.  Now I do them 
                     before getting off the floor after back exercises, 
                     and continue to do them at the church, after I 
                     climb stairs slowly to strengthen my quads. 

</p><p>              Dr. Rahn sent me to Dr. Bojrab for three shots in 
                     the spine, and also put me on Gabapentin at bed 
                     time.  

</p><p>              My last bad day was the day after the last shot.  
                     There have been occasions when I got up for an 
                     hour, but I slept well when I went back to bed. 

</p><p>              That last shot was on September 26, which means 
                     that I can't have more steroids until January 26.  
                     I'm wondering whether it would be a good idea to 
                     take a six-day treatment early in February, in the 
                     hope that it won't get so bad again.

</p><p>              Now and again I've had pain in the right leg.  
                     Symptoms have been consistent with over-use, 
                     cramped non-use, and lying on it to spare the 
                     other leg, but it's unsettling. 

</p><p>              It's hard to be sure, but I think the Gabapentin 
                     has been helping me sleep.  Does Gabapentin 
                     improve damaged nerves, or merely cover up the 
                     pain? 

</p> 
<h2>                 Cataracts 
</h2>               
<p>                  I had my cataracts out in September.  I think I 
                     should have waited a few more years.

</p>
<h2>                 Peripheral Neuropathy
</h2>
<p>                  I've pretty much learned to ignore it.  Sometimes 
                     the ends of the small toes on my right foot seem a 
                     bit sensitive when they brush against the 
                     bedsheet, which is new.  

</p><p>              On the spring hike, I learned that wearing shoes 
                     aggravates it -- I got the "wrinkled sock" 
                     sensation on the way back, and felt the neuropathy 
                     the rest of the day.

</p><p>              On the fall hike, I got "wrinkled socks" as soon 
                     as I put my shoes on, but went back to not 
                     noticing as soon as I took them off.

</p>
<h2>                 Corns
</h2>
<p>                  I haven't heard from my corns since I gave up 
                     wearing shoes, but there's a little lump of callus 
                     on each foot where they used to be. 
</p> 
<h2>                 Thick toenail
</h2>
<p>                  One of my toenails has gotten thick like Dave's 
                     toenails.  I've been putting a speck of Dave's 
                     urea cream on it whenever I wear socks, and that 
                     has improved it enough that I can scrub the black 
                     off when I've been in the garden.
</p> 
<h2>                 Bug bite on back
</h2> 
<p>                  I've got a bug bite on my back, a bit to the right 
                     of the spine and an inch or two below the waist.  
                     It seems as though I always have a bug bite in 
                     that spot, but in that location, it's hard to be 
                     sure. 


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<h2>Exercise</h2>

<p>                  I walk to church nearly every Sunday, half a mile 
                     each way.  If I remember, I'll climb to the second 
                     floor and do twelve pushuplets. 

</p><p>              I aspire to one quarter-century (25-mile) bike 
                     ride per week.  In the winter this is restricted 
                     by slick roads; in the summer, I have a severe 
                     shortage of places to go.  I often have something 
                     else I have to do when the weather is good.  <!-- 
                     Extreme heat isn't a problem on account of the 
                     steady breeze while riding (and lots of fluid), 
                     but wearing five or six pairs of pants in the 
                     winter is a royal pain, and I tend to eschew the 
                     short rides that I need to build back up to long 
                     ones. --> 
 
<h2>Meralgia paresthetica with arthritic changes</h2>            I'm 
                     pretty much aware of it all the time, but often 
                     only when I pay attention, and usually it's only a 
                     vague awareness that the hip isn't right.  I've 
                     begun to notice it when walking, particularly on 
                     the second half of the trip back from church.  
                     (The church is about half a mile from our house.) 

</p><p>              I coughed from Christmas through January.  During 
                     that time, it hurt to roll over in bed.  That has 
                     mostly cleared up. 

</p><p>              I try to ration standing-still time, and don't 
                     often stand long enough to touch it off.  It is 
                     frequently impossible to avoid standing in line; I 
                     fidget as much as I can. 

</p><h2>Neuropathy in feet</h2>                           I no longer 
                     notice it:  no "wrinkled socks", no "something 
                     stuck to my foot".  I think that it's my brain 
                     learning to deal with it rather than improvement, 
                     but at least it isn't getting worse. 

</h2><h2>Little Blisters</h2>                     When I was a 
                     teenager, I got severe itching of the palms with 
                     little blisters under the skin.  While Mom and I 
                     were walking from the car to the doctor's door, 
                     the symptoms disappeared.  The doctor said it was 
                     neurodermatitis brought on by stress.  I ignored 
                     all subsequent incidents and they went away.  The 
                     August before last they didn't stay on the palms, 
                     climbed up onto my fingers, and came to the 
                     surface and broke open.  This was still going on 
                     when I saw you in (February?) and you said to try 
                     cortizone and show it to Darr if that didn't work.  
                     The blisters went away in a couple of weeks and 
                     haven't been back.

</p><p>              I looked up "neurodermatitis" and little blisters 
                     aren't it.  The description does fit what I get on 
                     my shins, where the bone is just under the skin.  
                     If I rub it with a wet rag as soon as I feel the 
                     urge to scratch, it isn't any trouble.  Happens 
                     mostly when I have been wearing tights -- but not, 
                     thank goodness, *while* I am wearing tights. 
                      
<h2>Pain in good leg</h2> 

On the evening of 31 March 2018 my right leg hurt so badly that I 
                     couldn't concetrate to write or edit.

</p><p>              Symptoms were consistent with over-use, and I had 
                     increased my bicycle miles on the previous day, 
                     but I'm very careful to avoid favoring my left 
                     leg.&nbsp;   Mounting and dismounting is 
                     inherently assymetrical, but I didn't do any more 
                     of that than on my previous ride. 

</p><p>              I had noticed smaller pains in that leg on 
                     previous occasions.

</p><p>              I took aspirin that evening and Sunday afternoon. 

</p><p>              


<!-- Food: 

</p><p>              We frequently share a frozen pre-cooked meal for 
                     supper, and lunch is usually a sandwich.  I still 
                     cook, but not as often as twenty years ago.  It's 
                     hard to get more than token amounts of vegetables 
                     into Dave.  One trick I use is meatloaf with 
                     chopped vegetables instead of bread; it helps that 
                     he prefers bread-free meatloaf. 

</p><p>              Breakfast is pretty much what we ate when we were 
                     younger. 

</p><p>              For refueling during bike rides, I prefer fast 
                     food to sit down and wait to be noticed places, 
                     but the last two times I went to Leesburg, I ate 
                     at Stacy's Sports bar. --> 



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