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What is contentment? We used to hear about contented cows every now and then. It was actually an advertisement for a milk company that introduced us to the contented cow concept. But, I wonder just how would you know if a cow really is contented?

Are the cows in the above photo content? In a state of peaceful happiness? They don’t appear concerned about anything, as far as I can tell, but what do I know? Discontent can strike at any time. Try forcing those same creatures into a squeeze chute and you will likely witness extreme discontent.

This is the story of one man’s encounter with genuine discontent and it came upon him abruptly, without warning and struck repeatedly.

In this particular year he had health issues like he had never experienced before. The following is a summary of his infliction by Mother Nature (a.k.a. Old Age), which led directly to The Summer of his Discontent.

Of course, names and places have been changed to avoid potential lawsuits.

To set the stage, we have to relate a little history.

George has had trouble with his left knee for several years. I don’t remember exactly when, but it started while he was still working. The problem began when the knee would ‘lock up’ in the ‘flexed’ position, and he would have to force the leg out (using his other leg as a lever) until it would “pop” back into place. Then he could use it again. It would hurt like heck as he tried to force it to straighten and afterward it would be sore for a while, with an ache behind the kneecap. But, then it would gradually feel ok and George could resume his activities.

It happened one day that while George was in the floor under a desk trying to work on a network connection that the knee ‘locked’ on him. He wallowed around for a bit until he could get his right leg behind the left one and force the leg back out. It made an audible “pop” when it moved past the “locked” point. That incident made an impression on Van, his co-worker, and Van has never forgotten how George had to perform the “pop back into place” routine while lying in someone’s office floor. Fortunately, those sorts of incidents didn’t occur frequently, but they still happened often enough to be annoying. George had to be careful about how he positioned his leg when he got down on his knees for any reason.

He never really seriously considered going to the doctor with the problem, though, mainly because he was always able to ‘fix’ it on his own. And then, there would be a fairly long stretch of time before it happened again – and only then after George had forgotten to be careful and allowed the leg to get into an awkward position. The knee would also lock up sometimes after he had gone to bed, when he would toss or turn while the leg may have been flexed back a little too far. But, again, it could be ‘fixed’ by straightening the leg back out.

Then, one day George was bent over sorting some clothes for the laundry when the knee hung on him. He was in an awkward position, was off-balance and couldn’t get his leg straightened out. George toppled over into the floor on top of the leg, forcing it even further back into the flexed position. This was the worst pain that he had yet experienced with the knee and it was a struggle to get the leg straight and when it finally did it gave a loud ‘pop’ and the pain just shot up and down the leg.

Then, he found that the leg would not support his weight and because the knee was so painful, he couldn’t move around to get hold of something to pull himself up and out of the floor. His wife heard the commotion and came to see what was wrong. She was not physically able to help George get up but after a bit he was finally able to get to the edge of the bed and using his arms, mainly, to pull himself up. But, he couldn’t stand on the leg. His wife remembered that they had a pair of crutches in a closet somewhere and went to find them while he struggled to stand.

George used the crutches for two or three days before the soreness eased up and the knee felt well enough that he could get around without them. Since the problem seemed to be resolving itself, George decided against going to the doctor and it was quite a while before he had any more problems with the knee.

Then, one day (several months after the fall-over-in-the-floor episode) the knee locked again – but this time the fully extended position, not flexed back as before. He actually had to force the leg backward to get it to “pop” back into place, just the opposite of the way it was before. This, then, was the condition of the knee for the next several years.

As for overall health, with the (major) exception of a heart attack in the early part of the second decade of the new century, he has had very few complaints.

Now, we come to the year of problems.

Sometime around the first of the year (near the end of the previous year, actually) George noticed that something seemed to be wrong with his computer monitor. The images on the screen weren’t as clear as they should have been and the right edge of the screen seemed to be distorted. He wore non-prescription “computer reader” glasses (1.25 power) and the screen has always been very clear and sharp when he used them.

George thought that he might have to replace the monitor (or get some new reader glasses, he couldn’t tell which was the actual problem). I don’t know what made him do it, but at some point he covered his right eye with his hand and the screen problems disappeared. He covered his left eye and the problem was much worse – the entire screen was distorted. It was at this moment that George realized that his vision was the problem.

He immediately scheduled an appointment with an optometrist (whoever they have at the local Walmart) to see if they could tell him what was going on with his vision. They did a ‘complete exam’, including ‘pictures’ of the eye with whatever specialized equipment that they have to detect inner-eye problems, and told him that it looked like he had developed a cataract in the right eye. It also appeared that his vision had changed in his left eye and the 1.25 power computer reader glasses would not work for him any more. The optometrist did not mention what they thought that he should do about the problem in his right eye.

George got a prescription for a new pair of reader glasses, and left it at that for the moment. Although the new glasses made the screen clearer for the left eye, the right eye had a “dark spot” right in the center of the field of view and distortion resembling something similar to an ‘hour glass’. It made using a computer (or reading print) more difficult.

This was an entirely unsatisfactory situation because George ‘lived’ in front of his computer screen.

Then, one morning George noticed that his urine had a foul odor. This was the first hint that he may have a urinary tract infection. George doesn’t remember if the act of peeing was painful but he does recall that it was not a very good stream and it actually “dribbled” a bit.

George’s urination stream had been a tad on the weak side for quite some time (a few years) and he frequently had difficulty getting the bladder to feel like it had emptied completely. But, he really didn’t think much about it – old people have these sorts of problems, right? George also noticed that on many occasions he would have to return to the bathroom shortly after going, to ‘go again’. He now realizes that that was a sign that the bladder did not empty properly.

George went to the local urgent care clinic to see what could be done about the UTI. Of course he had to provide a urine specimen and they told him that he did, indeed, have an infection. He was prescribed an antibiotic to help get rid of it, and a product called AZO to help with easing the urination process and the associated pain. They also sent the urine specimen to a lab for further analysis.

He had been taking the prescribed antibiotic for a few days when the clinic called to tell him that the lab had determined that that particular antibiotic was not effective for his infection, and that they were switching him to a different antibiotic that should take care of the problem.

During this time he had also been using the AZO product and found that if it relieved any of the UTI symptoms it was very slight but that it was also ruining his clothes. The product contained some sort of dye that colored the urine a bright reddish-orange and if it got on his underpants it would stain them this color and it could not be washed out of them. George had to throw away several pairs of shorts because of the stains.

In the meantime he was wondering if the problem could have been caused by a kidney stone. George had exactly one kidney stone in his life, and that was over forty years previous. He had passed the stone (at the hospital) and never had another problem of that sort. However, the difficulty urinating (he had to really force the stream) and the pain associated with it made him wonder if the UTI issue could be related to a kidney stone.

George’s son told him that he had been prescribed a drug called Flomax when he recently had his own kidney stone, and that it helped him pass the stone very quickly. He had some capsules left that George could have if he wanted to try it. He did try it and found that within a day or two the urine stream had improved, the “dribble” was all but eliminated and he wasn’t experiencing as much pain in the process.

In the meantime, he finished the new antibiotic but the UTI appeared to still be hanging on (the smell gave it away, if nothing else). So, George went back to the clinic to see what they wanted to do. They decided to prescribe another antibiotic, Cipro, which is much stronger than either of the previous two. Apparently the standard procedure when treating a UTI is to start with the first antibiotic and if that is not effective, to go on to the second one. Then, if that fails to solve the problem to move on to the ‘third level’ antibiotic, which not only is more powerful but apparently has potentially more serious side effects.

While he was at the clinic, George mentioned that he had been using some “bootleg” Flomax and that it seemed to help, much better than the AZO stuff, which was making a mess of everything. It not only ruined several pair of underpants but also a throw rug that was kept just in front of the toilet (the floor gets extremely cold in the winter). The combination of the dribble and the AZO stain was just too much for the poor rug to handle.

The doctor, actually a Nurse Practitioner, mentioned that if Flomax was making a difference than perhaps he was having issues with his prostate. She asked if he had ever had a prostate exam, which he had not, and would he like to have one? Which he politely declined for the moment. She also suggested that George have his blood tested to see if anything would show up there. He agreed to have the blood draw, and the NP actually called in a prescription for Flomax to the pharmacy. She also suggested that it would be good if he would consult a Urologist and would arrange a referral for him.

George had just started using the new antibiotic (which they eventually doubled from a five-day treatment to ten days) when the clinic called to ask him to come in and receive an injection of another, even stronger, antibiotic. He went in the next morning and got a shot in the right butt cheek of Rocephin.

The combination of those last two antibiotics eventually took care of the UTI. However, George got the lab results back and learned that he an abnormally high PSA reading. Normal would be something less than 4 and his was 40. However, as he learned more about the testing process, he found that the raging UTI could have influenced the test results.

After a couple of weeks George had heard nothing of his urology referral, so he called the clinic to see what he needed to do about it. They checked and found that they were using an old, discontinued cell phone number as his contact phone, so they updated the primary contact number. He asked if they could tell him who they had referred so that he could call them directly, but he was told that they use a ‘referral service’ and that they couldn’t give him that information, but that urology clinic should be in touch within a couple of weeks at the latest. Right.

It was Easter Sunday. George still had not heard anything from the urology referral.

The family was over for Easter dinner and afterward they gathered in the yard for the ritual Easter Egg hunt for the little one.

As the afternoon progressed, one of George’s older grandchildren found some baseball equipment and decided to take a little batting practice, hitting baseballs off a tee into a large open field. The youngest grandson, Finch had received a toddler bat and tee for Christmas but had not been able to take use it before now, so it was set up so that they could all take full swings, hitting into what used to be their baseball practice diamond’s outfield.

Some of the baseball gear that had been found included some of George’s old wooden baseball bats, including one that was a very heavy 1954 model. George joined in and took several healthy cuts off the tee. Nothing like he could have done a few years earlier, but better than he expected. Neither his back nor his knee bothered him at the time.

The next morning, however, George discovered that his left knee was throbbing with an ache, which seemed to be just behind the kneecap. His lower back was sore, too. Usually these early-morning aches and pains would wear off in a short while after he get up, but this time it persisted all day.

George had some Bio-Freeze type pain relieving gel and he smeared that all around the knee area and also took some Ibuprofen, and that seemed to help some, but the pain was back in full-force that afternoon.

George’s joint pain persisted for several days without letup (weeks, actually, because he kept thinking that it would eventually calm down and go away – like it always has). It was really becoming a problem, almost incapacitating at times. Eventually, George’s daughter suggested that he see a Chiropractor to find out if he could help with the pain, especially if it was originating in his back. George made an appointment with the local chiropractic clinic.

On the first visit to the Chiropractor, George received an x-ray of his lower back and the doctor performed an evaluation of his condition. He concluded that George’s spine was in need of corrective adjustment, and showed him images of the x-rays that indicated that George had a right-leaning curvature.

The Chiropractor thinks that George’s joint problems may be a combination of actual knee damage and lower back issues. The Chiropractor said that he couldn’t fix an actual knee injury, but he felt that spinal adjustment may help alleviate some of the discomfort in the leg because back pain can actually ‘radiate’ down into the leg area.

OK. George decided to give it a try and see if it would help. If it kept him out of the Orthopedic clinic it would be worth it, he thought.

George learned that his health insurance, Medicare and Medipak, would only pay for actual treatment (spinal adjustment) and not for ‘therapy’ or any of the preliminary exams and x-rays. “Great”, he thought.

And, the Medipak secondary insurance plan would also not pay for any Medicare deductible amount. The chiropractor’s staff could see that George still had $30 left before his deductible was satisfied. The first charges for the x-rays and evaluation were more than $250, but eventually Medicare would cover the cost of the treatments.

However, George had to have three treatments per week for three weeks and then two weeks of two treatments per week and then once a week thereafter. Or Medicare won’t pay. “Weird”, he thought.

George started the treatment schedule the next week with three treatments per week. After three weeks, he really couldn’t tell much difference in the way he felt. It may be a little better immediately after the treatment session (which lasts about fifteen minutes, tops) but it’s hard to tell.

George found that the ‘therapy’ session consisted of placing electrode patches on either side of his lower back and his left kneecap and then running a TENS unit for about fifteen minutes. TENS stands for Transcutaneous Electrical Nerve Stimulation, which uses low-voltage electrical currents to relieve pain.

The unit is a small device that delivers a current at or near the nerves to block pain. Wires connect the unit to electrodes imbedded in sticky patches (that look like EKG patches) that are then attached to the skin in the vicinity of the painful area. The current is delivered in pulses that can vary in intensity. A timer can be set to automatically end the session after a given time

As George learned, Medicare doesn’t pay for this therapy and it costs about $50 per session. After a few of these, he declined the therapy during future visits. He didn’t think that he could afford $150 per week.

Besides, George’s son sent him a personal TENS unit that he had picked up somewhere or other, and it seemed to deliver exactly the same sensation as the unit that they used at the chiropractor’s office. George even bought a newer unit from an online seller (cost less than $40) and at one time he was using both units at the same time (four patches across the lower back and four patches around his knee). Again, if there was any relief from the pain, it was extremely temporary – mainly while the unit was actually running

A reputable clinic web page says that TENS units are used to treat a range of conditions, including osteoarthritis, tendinitis and fibromyalgia. Ok, George didn’t see any great benefit, “But what do I know?”, he thought.

George had an appointment with his cardiologist at the cardiology clinic for his 6-month checkup in June. He was also scheduled for lab just before the Drs appointment, for a cholesterol check. The Cardiologist said that his EKG, blood pressure and other vitals looked good. There was also no evidence of swelling in the lower extremities. Looks like he’s ‘good to go’ for another six months.

George had suffered a heart attack in about 2012 and had undergone cardiac bypass surgery. Since then he had been under the care of a cardiologist. George’s original physician had died unexpectedly and George (and his wife, who had cardiac problems of her own) had been forced to select another physician. The doctor that they settled on is a fine physician in his own right, but they both sorely missed their former cardiologist who they considered to be a friend as well.

George received a letter in about a week about the lab results. His cholesterol looks good, too.

Immediately after his cardiology appointment George decided to make an appointment with an ophthalmologist to see if anything could be done for his right eye. The eye clinic is only a block or two from the cardiac clinic, so George just took a quick detour on his way home from the cardio clinic to set up an appointment.

He was scheduled to see a cataract specialist in late June. The ophthalmologist is the same surgeon who took care of his former associate, Van’s cataracts.

George finally got an appointment with the Urology clinic. He received a letter in the mail informing him that he had missed his appointment, which was in February, and asking if he wanted to reschedule. This was news to George. He had been waiting for weeks to hear from whomever he had been referred to. In fact, George was just about to the point of calling that very clinic to see if he could get an appointment on his own when he received the letter. So, George called and set up an appointment with a urologist.

George also found out that they still had the wrong contact phone number. They were calling his old cell phone number, which he had discarded a couple of years ago. The clinic updated the contact number, so they shouldn’t have that problem again. In fact, they also have George’s email address so they can communicate that way too. And, thanks to 21st century technology, he was able to take care of the new patient paperwork online, before his first visit.

George met with the Urologist in mid-June. Of course, the doctor had to perform a ‘digital’ prostate exam, but he told George that the prostate seemed a bit enlarged but that were are “no bumps” on it. Whatever that means. The doctor wanted to see if George’s bladder was emptying completely, so they did some sort of ultrasound check and it looked like it had not (George had given a urine specimen, so the bladder should have been empty). The doctor then doubled the Flomax use to twice per day and had George come back in two weeks to see if it made any difference. He was scheduled to return to see a nurse practitioner in late June.

George had been wondering if the Flomax could have been responsible for his joint pain (or at least contributing to it). He had read on an authoritative drug web page that it could, but the Urologist discounted the possibility, saying that it was extremely rare and that George was only the second person who had ever asked about it. Ok, rare but still possible? If George is doubling the dosage and Flomax is a culprit, is he in for more trouble? He guessed that we shall see.