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September 27, 2013

Moving Forward and Looking Back

When ServiceMaster (SM) first arrived to help us with our sewage flood in our basement, they were helpful, attentive, and hard-working. Morris, the guy we initially dealt with, talked all about the benefits of having a bin brought in to store our stuff in while the reclamation project proceeded. He and "the girls" were quick to sort through everything, box up what could be salvaged and pile up and discard what couldn't.

SM then proceeded with the recovery phase. They were quick to get the wallboard cut out, the damp, moldy fiberglass removed, and the industrial-strength HEPA and dehumidifiers working. Morris talked about the process and the project as it moved forward. Then Morris left.

We were left calling Lynn at the main SM office. She was helpful and we told her what we needed and what SM had done. What we didn't know until about a week and half into talking with Lynn was that she was just relaying these messages to someone called Mike, who was our actual project manager (PM) for the project. But still, things were moving forward; we had new wallboard put in, new insulation installed. The painter came and started the mudding of the wallboard.

But then the painter said he and his wife were going on vacation for a week and was that okay? Not realizing the effect this would have on the project, I said it was okay. When he came back, he got busy right away (well, on Tuesday; Monday was a holiday). He had the whole thing painted in a couple of days and ... the project came to a screeching halt.

TD Insurance sent an appraiser out to review the work done to-date and ask me how I felt about SM's performance so far. I said it was very good, but I lamented the lack of communication with SM.

All of sudden, I get a phone call from Mike. He wants to come over and review the project and get it moving again. Great, I'm thinking, that's what I want to. So I met my PM about 4 weeks into the project. He makes a lot of promises about calling me, getting things moving again. And, for about three days, he was great about that. "The girls" came back to remove stuff from the bin and clean up after the painter.

More little bits of work were needed. I'd call SM and would leave messages, but never get phone calls back or, if I did, they were from Lynn. "The girls" missed a room when cleaning, so they came back after almost a week of back and forths. The lawn was damaged from the bin sitting on it and then the removal process (the truck gouged and scraped up pieces of lawn). All of a sudden, SM was claiming that we would have to pay for the bin and the lawn damage ourselves; they claimed we told them to put it where they did, when no one asked us.

For the last three weeks, starting September 9th, I have called SM each Monday or Tuesday, asking about the lawn project. Each time, Lynn said she'd talk with Mike or email him and have him contact us. Finally, after having my wife call today, Mike finally called her back. He finally admitted that he doesn't know anything about the lawn and was having to contact another company, Taylor's Landscaping, for advice. My wife has had bad dealings with Taylor's and doesn't trust them to shovel manure much less fix our lawn. So red flags went up. More red flags when Mike continued to insist the lawn damage wasn't really their (SM's) fault and they were doing us a favor repairing it. He then said that he was going to send "some guys" over to rake some fertilizer into place and that would be that. Huge red flag. After this conversation, I called SM and asked to speak with Chris, Mike's boss. He wasn't in, but they would give him the message.

We immediately contacted TD Insurance and told them that the SM was not going to provide the services they quoted to us (to the tune of $900!). TD took a dim view of that and canceled the check. I called Lynn at SM and explained that we had the check canceled and that we felt it was in everyone's best interests to move on and get our usual lawn care people, Garden Pro, to do the work. She apologized. I was quite clear with her that we liked dealing with her, and liked SM's overall handling of the process, but that the miscommunication and lack of contact continued to be a big issue for us.

If Mike had managed the project from the get-go, this probably wouldn't have happened. We should have met him the first day or two, and been given his cell phone number to contact him with questions, rather than dealing with a half-dozen other intermediaries. If Mike had been more responsive to our messages, if he had told us that he needed to subcontract the lawn care out, we could have had this all resolved three weeks ago, most likely. It is the constant lack of communication, poor communication, or downright incorrect communication that has caused all this ire.

In the end, I think we left things on decent terms with SM. I'm still irritated with Mike, and I want to speak to Chris about some ways that SM could improve the lines of communication (I will try to remain civil). I already made a phone call to our lawn care guy to give come out and give us an estimate. We're moving forward and putting this behind us.

Congressional Rules (Revised)

I have revised my set of rules for Congress.

A member of Congress:

  1. Shall be paid a Salary equal to the American Median Income + 10%. This amount cannot be raised or changed by Congress in any way.
    1. Must make public and easily accessible any and all Income made in addition to their Congressional salary, including any stock and bond transactions, gifts, gratuities, honorariums, speaking engagements, book deals, campaign funds/contributions, et al.
    2. Shall only have “free” health care provision while in office.
    3. Must make public and easily accessible all travel expenses while in office. Only those that are for official government functions and reasons will be paid for by the government. Campaigning, fundraising, vacations, travel for family members, and any other travel deemed to not be for official government purposes will not be reimbursed by the government. (UPDATED)

[Solves the problem of Congress being paid well more than the average person (current Congressional salary: $174,000/year; current median income: about $45,000/year), making it a job that, once earned, no one wants to leave, but it is still valuable enough that those who want to serve the people will run for office.]

[Provides incentive to Congress to make sure laws enacted are beneficial to all income demographics.]

[Solves the problem of Congress members getting rich via alternate means while in office.]

  1. Must spend a minimum of 12 days out of every month in their home location.
    1. Congress members must maintain a residence in their home during the entire time they are in office.

[Solves the problem of Congress spending all of their time in Washington, D.C. and losing touch with those whom they are supposed to serve and represent.]

  1. Cannot serve more than two consecutive terms in office, and no more than three terms total.

[Solves the problem of lifelong public jobs, cronyism, and the “good ole boy” club mentality. Forces Congress members to have to live under the laws they create.]

  1. Must vote in a minimum of 90% of all Congressional votes. If a Congressman does not vote in a minimum of 90% of voting opportunities, the House or Senate will immediately begin the process of removing the Congressman from office.
    1. Voting and abstentions will be documented per Congress member.
    2. Votes cannot be delegated to another member of Congress.
    3. Votes cannot be made anonymously.
    4. Abstained votes will count as a non vote toward the 90% minimum requirement.
    5. All voting records will be made public and easily accessible.

[Solves the problem of Congress members who are granted all the perks of a government job without the accountability of actually doing the job.]

[Solves the problem of a lack of accountability for votes.]

[Solves the problem of the public not being able to find out how their representative votes on any issue.]

  1. Cannot enact any law that does not include all members of Congress.
    1. Any existing law that excludes any member of Congress will be immediately and summarily changed to include all Congress members.
    2. The Laws of the land will be applied equally to all, regardless of position or status.

[Solves the problem of Congress exempting itself from laws that affect all other citizens. I.e., being able to trade stocks based on their inside information of which laws will pass/won’t pass.]

September 12, 2013

Fall Out

I saw my GP today. Or, rather, I saw the doctor he had filling in for him while he's on vacation or otherwise away from the office. She had me run through a series of tests to determine what may be going on with my back and, in the end, agreed that I am "MRI worthy." However, she also said that regardless of the MRI results, the immediate therapy will be the same and will probably do what is needed: stop the pain and strengthen the back.

As I said I would, I argued for the MRI anyway, saying that it can't hurt, it gives us new and better information, and, on the off chance that something serious happened, it will catch it and we can change course at that time. She agreed and wrote me the script. Now, the bad part: MRI availability is such that I probably won't be seen for three to six months. The joys of being in the Atlantic Provinces!

She was confused that the UC doctor gave me a script for Percocet for two reasons: 1. it doesn't treat potential (and most likely) nerve pain and 2. it is filtered through the liver, and I have a chronic liver condition. So she wrote me a script for both an anti-inflammatory and something to help with the nerve pain, which I will start taking tonight.

Her in-office tests showed that I don't appear to have any nerve damage. I'm to watch for incontinence and loss of muscle function and get to the ER immediately if either happens. That means the nerve has been damaged or pinched again, and the signals are not getting through to where they need to go. It also sort of confirms what was going on during the worst pain from a week ago, as I needed to use the bathroom much more often than I usually do (with large volume each time -- seemingly more than I had actually taken in) and I got to the point where my right leg would not support my weight at all. My nerve must have been under some serious stress at that time, so I'm glad my wife took me to the UC the next day.

I made yet another follow up appointment for November. Hopefully by then I will be back on my feet (literally and figuratively) and my normal doctor can suggest therapies and other regimens along with what I plan to ease back into doing (walking, riding my stationary bike, etc.). In the meantime, I need to avoid lifting and twisting, even after my back feels "fine," as I could re-injure it. I also need to be better about having assistance when I need to move something and not doing it on my own. I already have helpers/doers lined up for our upcoming heavy lifting needs, so that should work out.

September 11, 2013

Back Pain a Week Later

It is now September 11th, an auspicious day, and I am finally able to walk without too much effort and assistance. As long as I don't move around too much, lift anything heavy, or over-exert myself, my pain is minimal. However, I walk with a shuffle, as the pain is still there and my right leg doesn't want to take my weight as well as my left leg. At night, when I roll over, I am waking up and rolling slowly and carefully, due to the stabs of pain that still exist. Sitting in my work chair in the office is uncomfortable and I have to take frequent pauses to stretch and move so my back doesn't lock up and hurt worse when I finally do move.

All told, I hurt my back in the late afternoon of September 1st (around 4 pm) and I am only just starting to feel like I am getting back to normal on September 11th. That's 10 full days, plus a half of a day on the 1st itself. And that includes having the Percocet to take daily and being given 4 days of full rest from the doctor, during which I did next to nothing except sit or lie down and try not to move.

While I know spasming is occurring, and it is difficult for me to keep my back relaxed and loose throughout the day, I find it hard to believe that there is not some sort of underlying cause to this pain. Nearly every person who has had a similar situation happen to them has mentioned that they wound up having either a pinched nerve or some sort of back or disc trouble that needed further attention. In one case, it led to back surgery after years of trying to force her doctor to do the necessary tests to find out what the problem was. In most cases, it required at minimum physical therapy, massage, acupuncture, and/or chiropractic manipulation. In some cases, it has required changes to lifestyle, including one friend who had to get a standing desk at work and is still doing therapy over a year later.

I go to my family doctor tomorrow. Although I am obviously improving, I am going to press for an MRI so that we can definitively rule out or confirm disc issues and proceed with the proper course of action based on that conclusion. I still find it hard to believe that the urgent care doctor wouldn't have insisted on that being done at the time of my visit to rule out anything more severe. Maybe it is nothing -- maybe the MRI will show no damage and it truly is nothing more than severe spasms. Or maybe it will show the simplest form of damage, either a pinched nerve or a bulging disc, which typically require exercises and massage therapies to alleviate. Either way, I want to know.

This situation has driven home the point that I need to work on my weight and my core strength more consistently. I was to the point where I was using my stationary bicycle regularly, and was starting to see some results, when our basement flooded. That resulted in our workout equipment being put into a bin for over six weeks. I did continue to do walks, but walking is not very comfortable for me (rheumatoid arthritis), which is why I got the low-impact bicycle. Just as the situation started to turn around and we started moving our items back into the basement, I strained my back. So it has been since mid-June that I've used my bike. Once my back is to a point where I can walk and ride, I plan on pushing myself to improve my effort and get my endurance back up to a reasonable level (I still generally have my strength, what I lack is any endurance). This should help improve my weight, which will also help my back (as I carry nearly all of my extra weight on my belly).

What is frustrating me the most is that we are in the prime "John needs to do stuff" period of the year. There is wood that needs to be split. There is wood that needs to be ranked/stacked for winter. There is maintenance on the front porch needed. I need to take the AC out of the office window and store it. Even simple things have been affected: I haven't been able to stand well enough or long enough to help with dinner (usually one of my main tasks). We have new flooring coming soon, and I may not be able to move the furniture out of the way or back for when that is happening.

So, basically, during what is usually one of my busiest times around the house, I have been useless. My wife has had to do a lot more and she's got a lot of pressure on her from other sources (work, family, etc.) not to need my poor health and inability to help out adding more to her plate.

I am hopeful that my GP can help. Hopefully he will agree to the MRI. I assume he'll also provide me with some sort of therapy to help strengthen my back to resist this from happening in the future. For my part, I have firm plans to work out more regularly to build up my endurance, continue the plans to eat better to help lose weight (which should help my back as well), and move toward strengthening my core as I am able to do more. I have contacted friends who have offered to help with the wood, furniture moving, and a few other "John-tasks" around the house. And I hope to be able to start taking back some of my responsibilities around the house, like making dinner, soon, so I can relieve some of the pressure on my wife.

September 5, 2013

Back Pain

On the long weekend, my wife and I began the long process of recovery from our recent basement sewage flood. Servicemaster had finished most of its efforts to clean, repair, and recover the sheetrock, fiberglass insulation, etc., and had moved our vacated items back into the basement.

I went down on Sunday evening to assess the plan of action for Monday (my wife was away visiting some friends). As often happens, I started to move a little something, which led to moving a little something more, and next thing I knew, I had been down there for 90 minutes or more and had cleared a whole area. As one final act, I decided to lift a large bag filled with bathroom mats onto a spot in the downstairs closet. When I did, I felt a very tiny "pop" in my lower back and nearly fell to my knees from the pain that suddenly swept from my back through my legs.

I managed to hobble my way upstairs, grab the heating pad, and sit. I waited patiently for my wife to get home and didn't do much moving. She had to help me stand up and move into the bedroom that evening, as the pain was growing pretty bad.

Monday (the holiday) I could barely move. Any excess weight on my back at all, from trying to walk, standing up, and even some positions of sitting, caused intense pain. Any twisting and leaning also caused the pain. So Monday I spent most of the day in my comfy chair. I tried not to do much, rest it as much as I could, and withstand the pain. I finally took two Advil -- not even a dent in the pain. I then took a Motrin -- didn't even touch the pain. My wife went and spoke with a pharmacist an was given some Robaxin -- nothing, nada, zilch.

That night was horrible. I was in so much pain. On a scale of 1-10, it was 10. It was the most pain I have ever felt. At one point during the night, I had to use the bathroom. Even with my wife's help, I only made it about four small steps before the pain completely overwhelmed me. It was so intense that my entire body was sweating from those four steps enough that my sleeping attire was drenched through in seconds. I would have crumpled to my knees had my wife not been holding on to me for dear life. I was crying from the pain and starting to hyperventilate. Right then and there, we probably should have called an ambulance and gone to the ER. Instead, I peed into a cup my wife brought me and she folded me back into bed. I finally passed out for a couple of hours from about 5am to about 7:30am.

Tuesday morning we spoke with my mother in law (MIL), who is a nurse, and we all agreed I should go to either the ER or Urgent Care (UC). My MIL came down to help get me there, and off we went.

The UC had me go straight back to a stretcher. Soon enough, the doctor came. He jabbed a knuckle into my spine and didn't care how much he made me jump. He pronounced that I couldn't possibly have done anything structural to my body with what I described happening. He was going to give me a shot and a script and send me home. I had to ask him for an x-ray. When he got the x-ray back, he seemed surprised by the amount of spasm shown in them (it was straightening my spine). His goal seemed to be to get rid of me and make me my family doctor's problem, so he wrote a script for Percocet, a script for four days of bed rest, and sent me home.

What bothered me the most about this visit is that the doctor didn't want to look me in the eye, didn't want to do what, to me, seems like the bare minimum for someone presenting with unexplained and intense back pain (x-rays and an MRI), and didn't want to find the underlying cause. He just wanted me out of there. Not one person in the UC even glanced at my Medical Alert bracelet, no one seemed willing to pay attention to the medications I am on or care about the chronic conditions I have -- one of which is Rheumatoid Arthritis which, you know, just might be causing swelling in my spine? At the bare minimum, to find the source of the problem, it seems like a doctor should insist on an x-ray (for problems that could be detected there) and an MRI (for all the other problems that do not show up on x-ray or physical exam). Yet this doctor didn't want to do either and had to be persuaded to give me the x-ray!

Today is Thursday. I have been taking the Percocet, which makes me a bit loopy and groggy. It does not do much for the pain, but it makes me functionally able to move around, so I guess that is okay. I am staying off of it as much as I can and trying not to move around a great deal, but you use your back for everything.

Over the last few days, I have learned the pain is primarily on the right side of my spine and down my right leg. If I keep most of my weight off of that side of the body, the pain is much less than when using both legs or when I have to put weight on the right side (like while getting dressed, walking, etc.). I am spending most of my day in my comfy chair or in bed.

We also made a follow-up appointment with my GP. At that appointment, I am going to insist on an MRI, as a number of friends and colleagues have said that their bulging, herniated, or degenerating discs presented like my pain at first and it took weeks, months, and even years before they got an MRI and found the real problem and started to address it. And, since most of these types of issues do not show up via a physical exam nor on an x-ray, the MRI is the only way to find it. I have enough other issues that I will not stand for this to linger; if I need surgery or specialized treatment to fix this problem, I want to get to it now.

As we have our two cords of wood coming, more work in the basement, work coming for our living room and porch, and the rainy season almost upon us, I need to get healthy enough to start working again soon. But, being my back, I also don't want to screw it up in a permanent or chronic way. It will be a balancing act. Luckily, I have good friends who can likely help with the wood and furniture moving that will be needed.