Getting warm

About my body — my core body, and, separately, my peripheral and surface body — and how it’s been changing, dramatically in the past few days. Dramatically improved, I hasten to add, in case you were worried you were about to hear another litany of my sorrows.

Two things. Thing 1, my (normal) core body temperature. Over the years, this has steadily lowered, to the point where my normal body temperature (taken by thermometer) is about a full degree F lower than most people’s (on awakening this morning it was 96.8). This is apparently fairly common in the aged (I turn 83 in a month), and it’s normally no issue, except when my temperature is around 98.6 (classic “normal” temperature) and nurses and caregivers think that’s just fine, when in fact it means I have about a degree of fever, and usually feel a bit feverish too.

High core body temperature will manifest as high surface temperature on the face — it feels to others like you’re burning up — but low core body temperature turns out not to have much to do with whether the surface of your body, in particular the surface of your extremities, your hands and feet, feels cold to the touch.

That’s thing 2, peripheral / surface body temperature. That too apparently declines in many people as they age. It certainly did decline for me, palpably in the past few months. When I arose in the morning, as soon as I got myself cleaned up and into fresh clothes, I rushed to get into my nice warm velour bathrobe and lovely warm fleece-lined slippers, sometimes shivering until I could get warm.

My hands and feet were in fact cold to the touch. Cold hands on my warm thighs, whoa! Hands so cold that I couldn’t get readings from an oximeter on (any) one of my fingers. (This was an issue when I was in Stanford Hospital.) With real work — warming my fingers on the outside of a fresh cup of tea — I could sometimes coax a reading from the device (always around 98%, I’m not sure why I bothered), which just refuses to function at low temperatures.

Getting warm. So things stood for quite some time, with the bathrobe and slippers a crucial part of my morning routine. Then, a few days ago I just stopped needing the bathrobe and slippers; in fact they were uncomfortably warm. Almost immediately I moved from t-shirts of some substance to minimal tank tops, in which I was happy, even in the cool of 3 am. I stopped wearing the fleecy slippers, in favor of going barefoot (which I’m supposed to do as much as possible as therapy for my poor fallen arches).  Barefoot felt great, and I could flex my toes for pleasure and for exercise. I took to going barefoot on my front and back patios, doing domestic tasks, even when it was quite cool outside. (Not out on the street — too many chances for doing damage to my feet.)

I didn’t reflect in any way on these changes, and I no longer had anyone visiting to notice or comment on them (León Hernández’s last daily visit was last Saturday; now I’m entirely on my own at home, managing everything on my own, and no friend ever comes to visit me any more). Until Tuesday, when my caregiver Erick Barros did one of his two weekly check-up visits.

Erick was stunned, bowled over by the way I looked, He catalogued changes in the color and texture of my skin, the way I move, the way I carry myself. Even my fingernails looked wonderful, according to Erick. And then I realized that the old-man wrinkling skin on the back of my hands was gone; you could still see the blood vessels under the skin, but that was all. I was, in fact, transformed.

On some questioning from Erick, I admitted that I’d been feeling pleasantly warm, in fact that I’d been feeling fabulously well and full of energy (and reeled off a gigantic list of things I’d accomplished in the last day or so, including taking a shower — a very long, difficult, and intricate operation — and giving myself a fresh buzzcut). In no way manic, just very, well, competent. He felt my hands, and they were warm to the touch (still are). Why don’t you try the oximeter (previously unusable because my hands were too cold)?, he suggested. I did, and it worked like a charm. 98%, of course.

All thanks to two things: a change in my daily care regimen, prescribed by my nephrologist (advanced kidney disease is my really big affliction, so he’s my main guy); and the adjustments my body is making on its own as it recovers from my gall bladder surgery.

There’s a downside to the nephrologist’s adjustments: a blood pressure on waking that’s a bit too high (though not actually alarming): 143/87 at 3:30 am yesterday, 146/76 at 2:30 am today; but then it goes down to just a bit too high in a few hours (136/71 at 6:30 am yesterday, 132/75 at 6:30 am today); then goes down further, to my target range, later in the day (120/63 at 2:30 pm yesterday), or to a bit below it (112/64 just now, at 2:50 pm today).

In celebration, I have bought myself an excellent birthday present, but I’ll describe it in another posting.  As I will other pleasing developments, notably longer and longer walks with my excellent outdoor walker, now on my own, and without any shortness of breath on exertion, though my muscles (somewhat atrophied from those long hospital stays) screamed for me to break for periodic rests.

The thing is, I am healing, bit by bit. Getting back to normal awful, plus some improvements.






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