Praise then darkness, and creation unfinished

Adrian got back from Ohio late last night, and was very tired. She'd been in Columbus for her uncle's funeral, and to support her aunt and cousins.

This trip involved unmasked dining in restaurants, so we are all three masking at least through tonight, while I/we think about whether that's long enough, assuming a negative covid test tomorrow morning and no relevant symptoms. "Relevant" is fuzzy here, between her existing medical stuff and exhaustion from travel. (Obviously, a positive test would mean a call to her doctor.)

We discussed covid risks before she left, and the tradeoff between that and wanting to provide emotional support. She, Cattitude, and I are generally in agreement on levels of precaution here, and part of that is what to do if/when exposure is necessary.

I am going to post this and then use the iota carrageenan nasal spray, which is some protection against airborne viruses taking hold. The spray is by no means perfect, but it's useful either when I can't mask (e.g. dental work) or as part of the Swiss cheese model of protection.

We had company yesterday: Alan and Jeanne, who are visiting from California, and Elly, who they are staying with. Alan is one of my oldest friends; I met him at a party in roadnotes' apartment in 1983 (so, more than 40 years ago). I've known Elly almost as long, and she lived next door to us for several years; I've "only" known Jeanne for about half that long.

We had the party with food, and without masks: everyone took covid tests Saturday morning, and we opened one kitchen and one living room window for ventilation with a bit of a cross-breeze, and ran two air purifiers. (Normally, one of them sits in Adrian's room.)

Good conversation, about a variety of topics, some more serious than others--some life catch-up, which included both health and health health insurance, and random other topics including travel, cats, memorably bad weather, and geography, both natural and the built environment (mostly streets and street names, not fanous or unusual buildings).

Molly was delighted by the open window, and by attention from more people.

We had pizza delivered for dinner, from Veggie Crust. At Elly's suggestion, we tried the portobello mushroom pizza with pistachio pesto. The pesto tasted mostly of basil, but it's a good combination, which we may get again.

Adrian baked chocolate chip pumpkin bread, and Elly made a custard pie. The pie is very rich, and I realized a few minutes after our friends left that the pie was still in our fridge. I'm not even going to try to finish it, because it's very rich (neither Cattitude nor Adrian can eat it, because there's a lot of cream in the custard).

[We have spent today quietly at home, by ourselves, because even the best socializing can be tiring.]

Adrian and I are planning to be seeing a friend of hers, outdoors in the friend's backyard, this afternoon. Crystal is even more covid-cautious than we are, so we both took covid tests this morning, which were negative, as expected.

The thing about having bronchiectasis is that yes, that cough isn't anything contagious, but also I might not notice if I was coughing for some other reason.

I'm going to use the iota carrageenan nasal spray before I leave, because it might help and won't do any harm.

I saw my pulmonologist this morning, for a routine follow-up appointment. She is happy with how my lungs sounded, and the plan is (a) another CT scan and then follow-up appointment in April, (b) she asked about my plans for fall vaccines, and said I should get an RSV vaccine as well as the flu and covid vaccines, but I should wait two weeks after finishing the steroids before getting any vaccinations; and (c) she sent me home with a sputum cup, for a sample in case the gunk I am coughing up with the help of the flutter vavle gets darker, thicker, or otherwise seems icky (my term, not hers).

I was surprised that Dr. Koster took one look at me and asked about the cane, because she remembered that I wasn't using one in March. Also, when they checked vitals, my blood pressure was a bit high (no surpise, given the context of medical appointment), and blood oxygen lower than I'd like at 93. (Since I started paying attention in 2020, it had been reliably 97-99 until a few months ago.

I started the antibiotic first thing this morning, and the steroid about an hour later. I was already moving better by the time we got to the doctor, which suggests that one or both of the steroid and the doxycycline is working faster than I expected. We took a Lyft both ways, and by the time I got out of the car again at this end, I felt like I should sit down right away, less because I was in a lot of pain than because standing and walking were starting to hurt again.

As a side note, the communicable disease screening part of checking in online for my appointment is back to asking about recent travel, and they've added more symptoms to the checklist, but I still had to ask the doctor to put on a mask. However, when I asked, she said "my pleasure" and stepped outside to get one, rather than arguing with me, so it could be worse.

Update, six hours later: my legs and hips are definitely feeling better, and I am consciously reminding myself not to restart All the Things right away. So, I have done a bit more walking around the apartment, but with the cane, and one (one) carefully selected PT exercise that I do standing up, but with a little support, and I would have stopped immediately if it had started to hurt.

I took a covid test this morning, and it was unsurprisingly but reassuringly negative.

I tested because I had dental surgery on Tuesday, and that felt inherently risky. I was less worried about covid exposure by the time I left the dentist's pffice than I had been before I got there, because the dentist and his assistant were masked, and I only saw a couple of other people while I was there, but testing was still the right idea.

Also: I used the flutter valve this morning, after skipping it for a couple of days around the dental surgery. The post-operative instruction sheet said not to exercise for two or three days. I rested yesterday, and PT and a walk this afternoon/evening seem plausible, as does waiting until tomorrow.

I just learned that they are closing my current dental office (which is in Watertown Square) in about a month. They're suggesting patients either go to Westborough, which is out past 495, or a Gentle Dental in Belmont, but my current dentist will be working entirely in Westborough. I can get to the Belmont office about as easily as to the Watertown one, but it looks like I'm changing dentists anyway, and am looking for suggestions.

I'm in Brighton, near the ends of the B and C branches of the green line, and being reachable by transit is more important than distance in miles as the crow flies.

I want somewhere that still takes some level of covid precautions (masking, air filtering, and/or good ventilation), and that won't have a problem with me only masking in the dental chair.

Update on Covid booster vaccines for this coming fall, in the US and probably Canada:

On Thursday, the FDA changed its recommendation to COVID vaccine manufacturers telling them to use KP.2 for the Fall 2024 vaccine formulas instead of JN.1 if possible. This makes a lot of sense since KP.2 [JN.1 + F456L + R346T mutations] is expected to protect better against all of the newer variants that contain F456L mutations. Basing the vaccines on an older variant (JN.1) would not be expected to protect against the newer variants as well. Moderna and Pfizer will be able to change their vaccine formula to use the KP.2 antigen because of the agility of mRNA vaccines.

Novavax will supply JN.1 protein-based vaccines because those take at least 6 months to make. Novavax put out a statement that they hope to have their JN.1 COVID vaccine available in pre-filled syringes for US distribution by mid-July. They also stated that in non-human primates, their JN.1 vaccine provided good protection against KP.2 and KP.3 in animals that had received the XBB.1.5 vaccine previously.

(Copied from Ruth Ann Crystal's Covid News and More newsletter)

Cattitude, Adrian, and I went to supergee, Bernadette, and womzilla's wedding/anniversary celebration at the Bronx Zoo yesterday. We had fun, but the trip itself was tiring: Lyft to South Station, Amtrak to New Rochelle, then a cab to a hotel in Yonkers and a Lyft to the Bronx. We stayed overnight, and took a late-morning train home.

I had a good time, and saw several people in person for the first time in years, and I think a few I wasn't even in email or social media touch with. Supergee had to participate over Zoom, because he is in a hospital, but fortunately not sick enough that they needed to cancel/reschedule the wedding.

The plan had been to have most of the event outdoors: the ceremony itself, and some of the socializing+food part of the evening. It turned out that between the weather (rainy and low 50s F) and the move to Zoom for the ceremony, the entire event was indoors. Based on what Bernadette had said a week or so ahead of time about ventilation, air filters, and UV, we decided to take the hopefully slight risk of unmasking indoors for a couple of hours of food and conversation, rather than eating something quickly and then remasking. This feels a little odd because if the event hadn't originally been planned to be outdoors, I probably wouldn't have gone; I have turned down a lot of indoor events in the last few years.

Even so, I spent a lot of time masked yesterday and today, enough that the skin right behind my ears was feeling a little tender earlier. (I'm using N-95s, which fasten behind my head rather than having earloops, but the behind-the-head straps tend to slip down and run into the ear-pieces of my glasses.)

!markdown

An interesting angle on discussions of long covid, from rezendi:

Relatedly I have come across a truly bizarre pair of articles about long COVID that kind of encapsulates the debate?

* April 2023: 'You're less likely to get long COVID after a second infection than a first' from NPR, cites a study from late 2022 and quotes its lead investigator saying: "Undeniably, we are seeing very, very clearly that for the second infection the risk is lower than the first infection."

* September 2023: 'Does the risk of getting long Covid increase each time you get reinfected?' from STAT news also cites a study and quotes its lead investigator saying: "What we found is really undeniable: It’s very clear in our data that reinfection contributes additional risk of long Covid."


The catch? It's the same study and the same lead investigator.

(Both of these things can be and are true at the same time, but people are obviously going to take very different things away from those two articles. Throughout this pandemic the public health communication has been just mindblowingly inconsistent.)

I just bought a couple of rapid tests at the supermarket pharmacy, because we were down to the last two tests we got for free, and I want to keep more tests on hand than people who live here.

I think I can get some rapid tests free from the city government, but I need to make calls to confirm hours etc. That's Boston-specific, but I don't know if they're going to ask for proof of residence (or even if the program is running anymore).