Sometimes I ask myself what's the point of eating?
As we opened the door, the woman started to walk towards our car. I got out, the Girl got out of the passenger side, and walked around to meet up on my side. As we started walking, Ms Bleached Blond said "Well, You don't look very handicapped" like it was her business to comment upon my right to park with MY placard (including my photo, birthdate, and expiration date of placard, all of which were in order and uncovered). I was flabbergasted. Never had anyone been so outrageously rude about my right to park in a handicap space. The Girl looked at me in horror because she knows what I mouth I have when I'm pissed. "What the hell business it of yours what my handicap is, you C**T" is what I said. She was ready to start a fight, but I just walked away into the medical building as a security guard walked towards her.
I was seething the rest of the day. I mean it, I was literally bullshit. When a person has a legitimate tag displayed in a car with her photo, name, DOB, and expiration date on it, who the hell thinks it's OK to question a handicap. Obviously it was a legal tag. In MA, many people use tags that aren't legal. That is because the RMV allows, no PROVIDES those with hangtags a sliding coverup to hide the photo, name, and identifying information of those to whom the tag is issued. A recent study found that of 1000 tags, almost all of them were being used improperly. I've seen it happen. But even when I am sitting and waiting for a legitimate handicap space and I see a young mother who is obviously healthy as a horse get into a car with a hang tag that couldn't possibly belong to her, I wouldn't challange her. As long as there is a tag, the only people that have the right to challange the tags are the police. Not some half drunk asshat smoking illegally in front of a doctor's office.
Anyhow, it bothered me probably more than it would have before certain "special" bloggers decided that I wasn't really handicapped and that I could definately go to work despite what my cardiologists (yes, that's plural) and the American Heart Association say about patients with congestive heart failure Stage 4.
Although much progress has been made in the treatment of heart failure, there is a 20% overall annual mortality, particularly in patients with New York Heart Association Class IV symptoms.2 Many patients succumb to progressive pump failure and congestion, although half die from either tachycardia or bradycardia-induced sudden cardiac death. Some patients die from end organ failure resulting from inadequate systemic organ perfusion, particularly to the kidneys. Indicators of poor cardiac prognosis include ventricular arrhythmias, higher NYHA Heart Failure Class, lower left ventricular ejection fraction, high catecholamine and B-type natriuretic peptide levels, low serum sodium, hypocholesterolemia, and marked left ventricular dilatation. Patients with combined systolic and diastolic left ventricular dysfunction also have a worse prognosis than patients with either in isolation.3I thought you might find it interesting to see what a stage 4 CHF patient takes every night. It is probably the reason I can't make myself eat breakfast in the morning. I'm too full from the pills. That would be 13 bottles of pills. I take these at night. There are more pills in the morning. I'm such a lucky duck!
Stage 1 includes patients at risk of developing heart failure but who have no structural heart disease at present. These include patients with hypertension, diabetes mellitus, coronary artery disease, use of cardiac toxins, and familial history of cardiomyopathy. Strategies to prevent ventricular remodeling, including ACE inhibitors in selected cases, are advised.
Stage 2 includes patients with structural heart disease but no symptoms. The use of ACE inhibitors and beta-blockers is recommended.
Stage 3 includes patients with structural heart disease and symptomatic heart failure. Diuretics, digoxin, and aldosterone antagonists may be added to ACE inhibitors and beta-blockers depending upon the severity of symptoms. Cardiac resynchronization therapy also may be considered in selected patients.
Stage 4 includes patients with severe refractory heart failure. Physicians are urged to consider either end-of-life care or high-tech therapies such as cardiac transplantation, based on individual cases.
While a simple rule for the treatment of all patients with heart failure can not be formulated because of varied etiologies, hemodynamic features, clinical manifestations, and severity of heart failure, insofar as the treatment of chronic congestive heart failure is concerned the administration of an angiotensin-converting enzyme inhibitor has been shown to retard the development of heart failure and should be begun early in patients with cardiac dilatation and/or hypertrophy, even if they are asymptomatic. Then, as symptoms develop, simple measures such as moderate restriction of activity and sodium intake should be encouraged. If these and the use of an ACE inhibitor are insufficient, therapy with a combination of a diuretic, a vasodilator, and usually a digitalis glycoside is then begun. The next step is more rigorous restriction of salt intake and high doses of a loop diuretic, sometimes accompanied by other diuretics. If heart failure persists, hospitalization with rigid salt restriction, bed rest, intravenous vasodilators, and positive inotropic agents follows.
Kinda of astounding, isn't it? Just so you know I'm not faking illness so I can be a welfare queen and sit on my ass all day eating bonbons and watching the soaps before I take my cadillac out for a spin around town, and then return back to my palatial mansion for a dunk in the pool.
See that water glass? That's the palatial pool. I take every one of these pills all at once. I'm a master of stuffing huge amounts of pills down my throat. The two big white ones on the left? Metformin. The two colored ones on the front left? Effexor. Green pills, Vitamin D and Allegra. Pink in back? Verapamil. Blue in front? I can't remember what it's called. The darker pink is my Lisinopril. The square one is Singulair. I can't remember which is which in the photo. I take them every day. It is too much to remember. One is the lorazapam. One is fexophenadine. One is simvastatin.
Whatever. Let's just way it's way too much medicine. Stumble It! JBlog Me