10 Fruita 3 | My Website

Fruita 3: Waiting - June & July 2020

Risk vs Rewards in the Pandemic
In early June, we were suddenly off on an unplanned mission, heading to Denver for 3 to 4 nights with our trailer in tow. A daring move in the middle of the coronavirus pandemic for people like us who wiped all packages with a soapy sponge before stowing them in the freezer.

A couple of months before, Victoria, an Ohio woman with sacro-iliac joint (SIJ) pain, wrote me after finding my pieces on the subject in our webpage. Not many strangers contact us, but we get more attention for that subject than all others combined.

I’d been answering her questions, coaching her on myofascial release (MFR), and urging her not to give up in her quest for healing. Concurrent with our dialogue, she joined a workshop near her home given by a physical therapist (PT) from Denver. He was able to diagnose and fix her underlying problem, sacral torsion, in minutes. She had been seeing chiropractors and PTs for 10 years without relief.

Impressed with his treatment model, I emailed the PT the Sunday night after Victoria’s workshop and had a short reply in my mailbox the next morning inviting me to Denver for treatment. In my 5 am response, I urged him to contact me by 10 am, the time by which we needed to leave Fruita for an appointment with him the next day. He called at 9:45 and off we went. We drove most of the way there that day, to Golden, where we parked our trailer. We would commute between our trailer and his home in Aurora for the two, 2 hour appts on Tuesday and Wednesday without the trailer.

The roads were clear of snow in early June but traversing the Rocky Mountain passes with a trailer was hard work.

This excursion grossly violated our pandemic rules and it felt like we were taking both of our lives in our hands. I asked Victoria how obsessed the PT was about pandemic safety and she said “not.” She commented that he would wear a mask if asked and he did sanitize his equipment. I wore my homemade HEPA filter mask, took large paper napkins to spread on the treatment table as a barrier for my face, and used copious amounts of alcohol on my hands. I showered and changed my clothes as soon as we returned to our trailer each day.

His was a home office without assistants, which reduced the aerosols. It sounded like he only had 1 patient in his space at a time. At least we’d been practicing exceptional coronavirus avoidance technics for almost 3 months, so that gave me some confidence and, because of my ancient training as a lab tech, I was acutely aware of contamination trails. Like everyone, I do of course slip-up sometimes.

Jerry Hesch, PT schedules everyone for 2 hours though Victoria said the fix itself only took minutes, so I hoped to be in and out quickly. He does require a visit the next day, I suspect to check that his work is ‘holding.’ So, it was “here we go again,” having another regrettable, close encounter with an unknown amount of viral load, but at least this one had a pay-off and wasn’t just the result of someone else’s carelessness.

I’d had significant right buttock pain for several years that had largely been controlled by professional massage and my do-it-yourself MFR but, because of the lack of massage work during the pandemic, the pain was getting out of control.

I had suspected that there was an underlying structural issue, a misalignment somewhere, that threw my muscles into chaos. I knew from experience however, that it wasn’t a classical SIJ dislocation. The pain would start in 1 spot in my buttock muscles, expand horizontally then vertically, snake down my inner thigh, pop-out to my outer hip, and then migrate into my back. Some days, I limped off the trail. Both Bill and I were willing to take this risk for help from a pro that should be able to treat the root cause. It was a scary trade-off and yet we were gambling that this was the low point in the infection risk in the Denver area before the next spike. Hindsight would tell the story.

Supplies for self-treating my spinal alignment issues.

Jerry clearly knew his stuff. He was a specialist, only dealing with the bone alignment in the spine. He readily identified a rotation in my SIJ called “sacral torsion” (like Victoria’s) and misalignments with the top 2 vertebrae in my neck, at the base of my skull. He gave me 2 minute treatments to both those areas. It all made sense. I could feel the resulting increased mobility, the spring as he called it, of my 3rd left rib even though he didn’t work there.

I had 90 minute sessions with Jerry on 3 consecutive days, continued with the simple exercises he prescribed, and with my hiking for about 10 days, hoping the multiple irritated muscles would calm with the normal movement since my pelvis was symmetrical again. I improved, but I still had the same persistent pain, like Victoria. For us, he was too specialized: we both needed informed muscular intervention after correcting the spinal misalignments. Unfortunately, his treatment of my sacral torsion was only the first step of several towards restoring order in my hip and back muscles.

Next, I added Egoscue Method exercises for hip pain. It is a passive, postural technic I hadn’t used but Bill had successfully employed for his back problems. There was no apparent effect when doing the exercises but from day to day, I could feel subtle improvements from the Egoscue moves when performing Jerry’s daily exercise routine and while hiking.

My progress from the Egoscue exercises plateaued after 2 weeks, though I continued performing them, and I returned to my long-standing favorite intervention, MFR with a 5” massage ball. It looked like I now had the proper sequence of interventions: correcting the sacral torsion, calming the postural muscles with Egoscue, and releasing the related knots in the buttock muscles and fascia with MFR. Five weeks on and I was still in pain but I was getting better and neither of us had COVID-19 from the Denver excursion.

HBP Treatment Fiasco Concluded
June was a big month for me: in addition to obtaining professional help for my chronic buttock pain, I finally had a precise diagnosis and targeted treatment for my non-lifestyle-related high blood pressure (HBP). After 2 years of bullying and berating by several physicians, my horrible journey with HBP and the numerous disabling effects of 7 different antihypertensives was over!

With the use of 2 telemedicine appointments, one set of blood tests, and a trial on an out-of-favor drug, my new Portland nephrologist determined that I had Liddle Syndrome and it was what caused my HBP. The very rare syndrome is the result of a genetic mutation. I either inherited it from my mom (who stroked from her poorly controlled HBP) or I have a de novo mutation. I’m an outlier, not text book at all, and was deemed a “variant.” It usually presents as significant HBP in childhood. The $1400 genetic test to confirm the diagnosis would be interesting, but of no practical use and, since I’d already spent a king’s ransom getting to this point, I settled for my doctor’s opinion.

Celebrating the end of a little bit of uncertainty with a diagnosis.

As is sometimes the case in medicine, the diagnosis was made based on the drug to which my condition responded: amiloride, a “lousy diuretic” according to my nephrologist. It is the preferred of only 2 drugs used to treat the condition and sensitivity of HBP to this medication is diagnostic for Liddle Syndrome.

The mutated gene in Liddle Syndrome causes too many sodium reabsorption channels to be present in the kidney, resulting in too much sodium being reabsorbed from the urine, causing excess sodium to be retained by the body, leading to hypertension. The amiloride works by inactivating the excess sodium channels in the kidney that accumulate in Liddle Syndrome. These sodium channels are found throughout the body so perhaps I will discover other positive changes in my health in the coming year.

Like the nephrologist said, my body is “exquisitely sensitive” to the treatment: the smallest pill is 5 mg; I took half that for 5 weeks and my blood pressure (BP) dropped significantly into the mid-130’s over 90-ish in 4 days. And indeed, it is a “lousy” diuretic, I had no clue that I was on a diuretic. None. With subsequent experimenting on my part, I discovered that I could achieve the same BP control on slightly over 1/10th the usual starting dose. Talk about sensitive! The little piles of ground amiloride sitting on the table quickly became known to us as “pixie dust.”

I had headaches, dizziness, GI upset, and cognitive dysfunction side effects from the amiloride, which were difficult and disappointing, but at least my BP was down and I was no longer a stroke risk. The side effects diminished with the lowering of my dose but I was still forced to do what I hoped never to do, which was take a second drug to tolerate a first drug. I needed to take Imodium 2-3 times per day to control the persistent GI cramping, even at bedtime to sleep. Fortunately, it is a cheap, safe drug to take long term and doesn’t have other side effects. Too bad acetaminophen didn’t relieve the other symptoms.

A day & a half supply of “pixie dust” for Barb.

My nephrologist hopes that my side effects from the amiloride will subside after 3 to 6 months, though Bill thinks it might take longer than that. My BP has slowly been rising for 20 years and he believes that my body compensated and compensated until it couldn’t any more and then my BP started rising at a faster rate. Because of those decades of compensation, he thinks it likely that my recovery with treatment will be slow, an unwinding, and that my drug side effects may continue to diminish over a year. But a bit of good news for the long term: Liddle Syndrome does not contribute to chronic kidney disease like typical hypertension does because of its different chemistry.

Opportunities
It looked like 2020 was being defined by hoping, by waiting, by being patient for most of us because of the pandemic. That script was certainly mine with both my buttock pain and antihypertensive side effects: I trusted that they would both get better, resolve with time, but I had reached the point where there was nothing more to do with either other than to tread water and hope for the best.

Early in the pandemic, we were practically holding our breath, waiting for our little crises like food and TP shortages, to resolve. It was clear that we’d need a more sustainable strategy, like calmly, patiently waiting. We had to find that balance between wishing our lives away by wanting these problems to be over and feeling like we were thriving.

We watched in amazement while the COVID-19 pandemic created an abundance of time for many people, particularly those who could no longer go to work. It would seem that we should have had a lot of unscheduled time, but that had never been the case. We never seemed to have the leisure time that so many others enjoyed. Eating out, taking in entertainment, seeing movies, binge watching TV, reading books, and doing puzzles had never regularly squeezed into our days and nights and it was no different during the pandemic. We never had sensed that we had time to spare.

Even though we were long-retired, the demands of our “jobs” didn’t change during the crisis. Our “work” is being healthy, which includes a commitment to hiking 40 miles a week and making at least one 20-25 mile bike ride per week, preferably with 2000’ of elevation gain. We usually “work” a minimum of 4 hours a day, 6 days a week and occasionally our version of overtime adds many hours to that schedule. In addition to the moving time, there is the overhead of daily general mobility exercises, getting ready, getting underway, and doing the post-activity chores.

But by mid-June, I did notice that our perpetually backlogged chore list was shortening, we were having enough time to move off of the endlessly, self-regenerating “A” list to some “B” items. For me, that included following through on writing additional pieces for the webpage, particularly about the pandemic. In early June, I was working on 6 drafts; usually my upper limit is 3.

For Bill, those smidgens of extra time were directed towards organizing 30-year-old hardcopies of investment details and storing them electronically for tax purposes. Once postponed drudge work like that was completed, he moved on to selecting apps and learning how to add videos to our webpage. Still chores, but satisfying, new, and lower priority work. Serious bike maintenance, like new brake levers, were added to his list, as well as decommissioning an old laptop to be sold.

A cluster of little purchases for tidying the trailer.

While I watched our production focus broaden a bit, I realized that it was banning Americans from the EU this summer that had seemingly added more minutes to our days. Had we gone to England and Italy in May like planned, the many demands of travel would have added more delayed projects to our “To Do” list. We of course would have preferred to have pressed on as international travelers instead of shortening our lists, but there was an undeniable relief from finally getting ahead of the parade, perhaps for the first time in our adult lives. The most symbolic accomplishment was actually updating our end-of-life documents last touched over 20 years ago.

Still, the little hand mending chores didn’t move up on my list enough to get done—they always looked about a week away. Unlike many of our friends, our extra minutes didn’t turn into hours. Others shared how deeply they had cleaned, how much they had culled, how extensively they had tackled their backyards, and how substantial their home-owner projects had been. In contrast, we hadn’t gotten much beyond the equivalent of paper shuffling. Bill did re-organize a couple of small storage areas in our trailer and made some small repairs. My housekeeping contributions were more minor, like purchasing little items to tidy messy areas.

Italy
We’d expected to be in Italy in June, and in July, and in August, but there we sat in the US—slowly whittling down our To Do list. We refreshed old memories when looking at our electronic calendars each day, a calendar that still had Italian hotel names on all of the summer dates. “Ah, today we were to be at Rifugio Passo Sella for a week….” We reminisced a bit more by watching a Great Courses lecture series on Ancient Rome and by including a page of photos from prior years spent overseas in our 2020 photo album under construction to honor what had been planned and booked for this year.

And then there were reports from our Swiss friends who were “long leash hunker-downers” like us, who were hiking and biking locally. They noted that though borders were opening up a bit, each country in Europe encouraged its citizens to spend the upcoming summer vacations in their own country. He further wrote that “This uncertainty about where to spend one’s summer vacation was what helped the sale of our old (30 year-old) camper van. The run on campers is unbelievable, people plan to stay in their own country and fantasize about being safe without following the most basic hygienic precautions.”

He added: “Italy is especially suspect; Italians are desperate for tourists. Venice and Florence are on the brink of bankruptcy according to our media; infrastructure like garbage removal might soon have to be suspended. The Italian tourists hot spots that only a year ago had bitterly complained and protested about the tourist invasion are now literally dying for their return. Without a speedy and massive return of tourists Italy is in deep trouble; tourism is their main industry. Most neighboring countries are afraid Italy is opening its borders much too early, they still have way too many infections in Lombardy for instance.”

Of course, we could only dream of being overseas and appreciated their memory-triggering insights. Shortly after our friend’s comments, the EU banned Americans from entering the region because our country’s coronavirus infection rate was the highest in the world. Aside our friend’s comments, we had to settle for online news tidbits to trigger our memories, like the pink algae on the lingering snow in the Alps, something that we had seen.

Learning In A Time of Crisis
We pride ourselves in being lifelong learners and Bill repeatedly commented about the fabulous civics lessons that Trump had afforded us, particularly in 2020. Trump’s responses to the pandemic educated us about the lines between States rights and those of the federal government over and over again. Trump would announce an outrageous intended action and in minutes the reporting would be “He can’t do that.” Some of it was nuanced, some of it not, but we gained a deeper understanding of US government with every battle. The lessons were especially pointed with his multiple confrontations with the governors.

And “Who knew that the city of Atlanta owned the international airport?” In July, when feisty Mayor Bottoms mandated masks for the city, she underscored that she could enforce it at the airport and at other city-owned properties even though Governor Abbott said it was unenforceable. More lines in the sand that were new to us.

A sign that it was time to move on—wasps were building a nest on our propane tank.

Every crisis brings new vocabulary with it and we were all learning about the difference between Q-Tips and nasal swabs; the notion of viral load; and that “masking” could be a verb other than when talking about tape. We scrambled to integrate new and old phrases into our working vocabulary. I vividly remembered returning from 9 months overseas years ago and scratching my head at the unfamiliar but now commonly used word “bling.” In was everywhere; thank goodness for the Urban Dictionary. Here are some of the phrases we learned or brushed-up on this summer:
Yellow dog democrat: someone who votes for Democratic Party members no matter what.
RINO: Republican in name only
Riffing: as in “Trump was riffing again about the Wall”.
Delayed adulthood: teens and twenty year olds who, for the last 20 years, are having less and less sex
OK Boomer: an agist slur; a slur with no impact on us because we are proud to be boomers
(Perhaps the boomers will be riffing about the delayed adulthood of the younger generation?)
It’s a big ask.
She’s chill.
It’s not binary.
The through line.
Fragging: despite the fragging (of Fauci) by the White House ; attempts to kill

Little Horrors
Even in mid-July when we thought we’d seen everything that life pandemic times could throw at us, there were new, little, indirect horrors. Bill waited at the drive-up window of our bank to get 5 rolls of quarters for the laundromat but no, he could only have one. Quarters were being rationed; they were in short supply at the Federal Reserve. The bank clerk had no idea when quarters would be readily available to us. Really? Quarters? Aside from our horror, we had to wonder what other people knew to do with a quarter hoard that we didn’t know.

Bill came home with his one roll of quarters and called the Grand Junction dermatologist whom his Portland dermatologist had recommended he see. He had a second, more worrisome skin growth to be evaluated, but he wasn’t allowed to make an appointment. Presumably to decrease the patient load in their office, they were only seeing legal residents of the county. That was the first time we ever had been refused medical care anywhere.

Two days later, we were informed that RV repair supplies, even simple things like caulks and putties, were suddenly in short supply or totally unavailable. Again, these were very minor issues but they packed a wallop because they underscored the crazy amount of uncertainty still being triggered by the virus. And of course, events like these are all the more unnerving when they cluster like these did.

“Chasing 70°” Not!
“Chasing 70°” has been our quip for the last 10 years of RV travel when asked about our lifestyle. It is concise, a cute joke, and true. Maintaining our wellness and fitness has been our highest priority for the last 20 years and outdoor temperatures much over 70° (21°C) make it hard to be novice endurance athletes. A little warmer for our picnic lunch is nice, but 70° was a good target for exertion and sleeping well at night in a camper or trailer.

There were more sheep than people on the trails out of Fruita some days.

Spending 6 months this summer in Fruita, CO was not the plan when we arrived on April 2 because we knew from our bit of research that the summer temperatures would pop into the 90’s. We anticipated spending 6 weeks in Fruita while we waited for the snow to clear from the trails in the Colorado Rockies and then we’d move to the mountains. The high-prestige “14’ers”, the 52 peaks over 14,000’, were in our sights. But, the pandemic which was keeping us from Italy this summer, kept us out of the mountains too: the Rocky Mountain villagers dis-invited all visitors from coming to their communities. In nearby Moab, UT, visitors were forcibly evicted in March because of the pandemic.

For a second time, we feared not having a place to be. When we arrived in Fruita, we were fearful of not being allowed to stay because several state governors were threatening to close their borders to non-residents. Once there, we were fearful that if we relocated to a mountain village and the area had a spike in coronavirus infections, they’d kick us out, and our highly desirable Fruita RV park would be full. Travelers were on the move shortly after we arrived in Fruita and, to the delight of the nervous owners, their business was flourishing again. Soon, the park was chocked full of RVs every weekend, validating our fears of not having a nice place to which we could return.

With heavy hearts, we reconciled ourselves to learning how to live in a little trailer through a scorching summer at 4,500’ elevation. Early on, we envisioned escaping the valley heat by spending the hot afternoons at 6,000-6,500’ in the nearby Colorado National Monument, but we were incredibly naïve. June was unseasonably hot and by July, the overnight lows outdoors were often 75°. Driving up to a trailhead at 8 am one such morning, it was 82° when we arrived. It seemed that there was no more overnight cooling 2,000’ above us than occurred in the valley.

We’d set our trailer AC to come on when the indoor temperature reached 80°, which sometimes happened before we left at 7:30 am. It would run continuously, occasionally only holding the indoor temperature to 90° at dinner time. It took months to stop saying to myself “I’ll just step outside to cool off.” There was no where to go, there was no “cooling off” to be had day or night.

The successive heat waves made us so glad that we had paid the premium for double-paned windows in our special-order trailer 5 years ago and that we had a well-insulated, 4 season rig. Still, we resorted to aluminum foil on the 2 single-pane door windows that faced west. We were also relieved when, after 5 days in the RV park back in April, we had good reason to ask for a different slot, which positioned our awning to block the afternoon sun on the light wind days and spared our refrigerator from a west-facing position. Unfortunately, the front-end of the trailer that houses our bed was south facing and began heating-up by 7:30 am each day.

In May, we paid $900 for Bedjet mattress coolers, which were immediately as invaluable as we feared. Without them, we would not have slept well for weeks on end. We paid $300 to have used fans installed on the back of our refrigerator, which were effective in keeping our frig and freezer temperatures in acceptable ranges. We’d used after-market temperature gauges in both units for years and we closely monitored the readings multiple times a day, often adjusting the settings to prevent freezing items in the frig and thawing food in the freezer. Cooking ahead for dinner was either done indoors before daylight, the coolest time of the day, or outdoors on our single electric burner. And we routinely let our cooked dinner cool a bit before eating it to keep from warming-up from its heat.

After the first month or so in Fruita, Bill ‘bought-up’ for faster internet connection so that we could do video conferencing in our trailer instead in the backseat of our truck somewhere in town where there were higher speeds. Even in the trailer, frozen gel blocks sometimes had to be sat on or held when we just got too hot. On the hottest days, we’d each use a gel block to cool a bit of the mattress hours before bedtime. And a 2nd USB connection, 5”mini-fan was added to our kit in July to blow on our faces in order to tolerate sitting in our sustained, 90° space on the 100+° days. It was often still 90° outside when we went to bed.

I quickly learned not to squander any of our 10 gallons of hot water in my shower by waiting for the cold water to cool enough to adjust the water temperature. Like at home, I would begin my shower by drawing hot water, then mix in cold to adjust the temperature to my liking. But in the heat, I needed to run the cold water for 3-5 minutes to cool our sun-baked water hose routing water into our trailer. Initially, the water would be deceptively cool, likely the water in the line in the rig, then turn hot for minutes. Of course, diluting the hot water with the pre-heated cold water didn’t work. Only after the cold line actually delivered cool water could I proceed with my shower. I also started and finished my shower by standing in 2” of cool water in our mini-tub for a little more relief from overheating.

By mid-May, we’d abruptly switched from our standard 10-12 mile hikes wrapped around a leisurely picnic lunch on a scenic perch to 7 to 8 mile hikes without lunch because of the heat. Slow-motion departures after ample stretching and tissue repair work at 9:30, 10, or maybe 10:30 were reined in to 7:30. The goal was to get out, get it done, and get out of the heat. These became fitness activities, not recreation. We stopped exploring new trails and primarily did the same 2 highest elevation hikes over and over again to avoid pockets of heat in the lower canyons. Fortunately, they were stunningly beautiful hikes with grand panoramas.

Usually when we do moderate hikes of 7 to 8 miles, we don’t stop to rest, we just keep going. But in this heat, I suggested that we rest for 10 minutes or more at our turn around points to cool down or at least monitor, our heat stress. There was precious little shade on the trails but we set-up little “butt rocks” under well-positioned juniper bushes to reuse.

We repeatedly surprised ourselves by how well we tolerated the hot mornings while exercising. We let our well-trained bodies regulate our speed so as not to ‘red line.’ Amazingly, we never got noticeably dehydrated; we never spent the afternoon guzzling water to catch-up. We were also grateful for the cooled front seats in our truck which helped us more quickly bring our core temperatures down on the ride back to the trailer when it might be pushing 90°. Our transient accomplishments at our 4 month point in Fruita were altitude acclimation to 4,500’ and heat tolerance to about 90° while exercising at a modulated but sustained pace. Laughably, instead of chasing high temperatures of 70° for our venues, we were waiting for the return of overnight lows of 70°.

The Pine Gulch Fire after about 18 hours.

Triple Quarantine
During the first days of August, we were triple quarantined in the afternoons. We’d “shelter in place” in our trailer after our morning hike or bike ride because of the pandemic and isolate ourselves indoors the rest of the day because of the rapidly rising temperatures. Next, we needed to stay indoors because of the smoke from the Pine Gulch wildfire in the mountains about 20 miles away started by lightening on July 31.

Forty-eight hours after the lightning-started fire began, the air quality in Fruita was rated at 152 and ‘Unhealthy’. We are disappointed when it is above 50. Fortunately, during the first few days of the fire, we weren’t being affected at our RV or on our trails—the wind wasn’t blowing it our way. Only at bedtime after 24 hours could we smell the smoke. I am susceptible to mild asthma and I had zero trouble pushing the pace either day.

On BLM land with difficult terrain, the firefighters only achieved 5% containment after 2 days but at one week, it was 0% contained and had grown from several hundreds acres to 13,000. High temperatures, low humidity and winds were the perfect storm. The firefighters were in retreat and our lungs would be at the mercy of the winds for untold days or weeks. Our exercise plans would be made day-by-day in deference to the air quality.

Hanging-In There
As was the case for all of us because of the pandemic; me because of my ongoing buttock pain and medication side effects; and us because of the persistent heat and now, toxic wildfire smoke, 2020 was continuously being defined by hoping, by waiting, by being patient. Uncertainty was the constant. The endurance race continued for us all at a snail’s pace.