I don't know how it happened, but Tuesday morning in my office has somehow become "Medicare Morning." Almost every patient seems to be over 65 years of age - and it's understandable. After all, working folks have a hard time getting away from the job during morning hours.Plus, Tuesday is sort of an "off day," not as attractive to those two- or three-time-a-week acute or rehab patients. So, I now have become accustomed to seeing walkers and canes parked in the waiting room, like motorcycles lined up in front of a biker bar. Just like dressing up one's custom "hog," some of the elders have even put some extra trimmings on their walkers and canes. Decorative tape spiraled around the aluminum shafts are popular, some looking like candy canes. But my favorite walker buggy is the one that has "all wheels, all the time," hand brakes, a seat in the middle and a cool basket. Joe, one of my senior patients, tells me that at his nursing home, the more able residents actually have races with these buggies on the way to the dining room. The winner gets extra dessert.
Another common accouterment is the portable oxygen tank. This is especially common here in the Rocky Mountain region, where the air is thin and the people are dizzy. I have learned to recognize the different types of oxygen tanks, and even which ones the individual insurance companies buy for their members. "I like this Cigna tank better than that Aetna tank," a patient recently told me. There are tanks no bigger than a musk melon, which is a huge improvement over the ones seen years ago. In those days, patients showed up looking like propane delivery men, pushing a hand truck.
But, when it comes to hearing aids, no one seems to like the ones they bought: "They make everything sound like I'm at the bottom of a big oil drum." One lady told me that she hated her aids so much, that she put them on the driveway and ran over them. Each Tuesday morning, it probably costs me an extra 20 minutes just waiting for patients to take out their hearing aids before I begin working.
Many of the seniors are over age 80. Some are extraordinary. Helen is 98, and I have taken care of her extended family for many years. One day, she came in with her daughter, and said, "They're dying like flies at the Old Ladies' Home!" But she's not ready to go yet. When I adjust her, she reminds me, "Be careful Doctor, those are 98-year-old bones you are working on!" Eight years ago, she was reminding me that "those are 90-year-old bones." She is tough enough, that I can imagine being semi-retired, and she is still reminding me that "those are 106-year-old bones" that I am working on.
Another inspiring senior patient was 100 years old when I met her as a new patient. She had driven to the office by herself and did not use a cane or walker. When she was born, Grover Cleveland was president. As a young girl, she actually knew African Americans who had been slaves. On her new patient form, under "chief complaint," she simply wrote, "I'm tired!"
One of the major advances in surgery and geriatrics has been the evolution of the total joint replacement. On Tuesday morning, it seems every patient either has a total knee or hip replacement, or is planning to get one. I have learned to keep much better notes so that I can remember which knee or hip has had the surgery. Patients get very nervous if you act like you're about to adjust their artificial joint.
Why is it that after about age 75, men quit buying clothes? I have actually torn a man's shirt or pants a couple of times during an adjustment because the fabrics were so threadbare. I know budgets are tight in retirement, but even Goodwill would not accept some of these clothes. You know your clothes are old when the brand name is no longer produced.
Tuesday mornings, we all try to have some fun, because life is not easy when you're old. "Getting older is easy," one senior guy told me. "I just wake up and I'm a day older. Nothing to it!"
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