Monthly Archives: January 2026

What a Week!

Posted on by MaryO

Following last Friday’s Emergency Room Adventure, I have seen both a thumb surgeon and a heart specialist.

Wednesday, was the thumb surgeon.  Surprisingly, he accepted the xrays from the hospital and their diagnosis:

A closed avulsion fracture of the right thumb phalanx means a small piece of bone at the end of a thumb bone (phalanx) broke off, usually where a tendon or ligament attaches, without the skin breaking. Treatment often involves splinting, rest, ice, and physical therapy, aiming for healing within weeks, but surgery might be needed for significant displacement or instability to restore full function, preventing chronic weakness or arthritis.

So far, so good.  He recommended a hand therapist who would make me a custom cast which I will wear for 6 weeks and see him again to decide the next steps.

I have called twice and sent a message to this person with no response.  If I’ve heard nothing by Monday, I guess I’ll have to go to the second recommendation.

 

Yesterday, Friday, I went to the heart specialist.  They actually did call me to remind me that the ER wanted me to have this appointment ASAP.

They redid the EKG, asked lots of questions, took my blood pressure several times.  Now, they’re worried that my blood pressure is possibly too low (112/ 68 mmHg) so they may lower the meds that the hospital gave me.

I still have bloodwork to do, an appointment with them in 2 weeks and another in 6 months.

All in all, really good news.

It Was a Day Like All Days. Or, Was It?

Posted on by MaryO

This is the followup to yesterdays post Good News for Me! Drinking Coffee in the Morning Reduces the Risk for Death.

Friday, January 2, 2026 started normal enough.  I went to Pender to practice my upcoming piano-organ duet with a friend.  Then, I was going to the local stand-alone emergency room to check out my thumb.

No big deal, right?

The practice went well and I went home to pick up DH to go to Inova-GoHealth Urgent Care – Greenbriar to see about my painful thumb.  This is the same thumb from my May 17 post but a different problem.

Last weekend starting Christmas Day until Sunday, December 28 we had been to NYC to visit our son and his family.  Leaving Sunday evening, we got to Moynihan Station to take the train home.  Because I had a rolling suitcase, we took the ramp to the train hall instead of the stairs.

It’s unclear what happened next but I know DH fell on the ramp and knocked me over as well as a sign.  My hand was still wrapped around the handle of the suitcase and was hurting quite a bit.

Fast forward to yesterday – my thumb was still hurting so we headed off to the Inova-GoHealth.  They do the usual, weight, height, review meds, take blood pressure.  A bit high.  Take it again – higher still.  Tech person calls in doctor.  Higher again.  He says that they can’t help me or my thumb.  I have to go to the real hospital emergency room.  NOW.

So, we drive over to the ER.  I found that my keys set off the metal detector. While I was signing in with my referral papers, they called me back to triage.  BP is higher again (mine was now over 200/90!).  White Coat Syndrome, maybe?

 

According to google:
“White coat syndrome (or hypertension) is when your blood pressure spikes to high levels in a doctor’s office due to anxiety or stress about the visit, but returns to normal at home, marked by elevated readings (>140/90 mmHg) in the clinic but normal readings (<135/85 mmHg) elsewhere, requiring home monitoring to prevent misdiagnosis and potential long-term risks like heart issues.”

Symptoms

  • No symptoms at home: The primary sign is normal blood pressure outside the clinic.
  • Anxiety/Stress: Feeling nervous, anxious, or stressed during a medical appointment or when a blood pressure cuff is applied.
  • Elevated readings: Blood pressure consistently over 140/90 mmHg in the office, but below 135/85 mmHg at home.

Causes & Risk Factors

  • Anxiety: The stress and fear associated with medical settings, doctors, or past negative experiences.
  • Stressful environment: The clinical setting itself triggers a physiological stress response.
  • Risk factors for hypertension: Being older, overweight, or having certain chronic conditions can increase risk.

Management & Prevention

  • Home Monitoring: Regularly checking blood pressure at home or using 24-hour ambulatory monitoring to get accurate readings.
  • Stress Reduction: Identifying and addressing the sources of anxiety about doctor visits.
  • Lifestyle Changes: Adopting healthy habits like a good diet, exercise, and managing stress.
  • Provider Communication: Talking to your healthcare team to rule out actual hypertension and avoid unnecessary medication.

Why it matters

  • Misdiagnosis: Can lead to unnecessary hypertension treatment.
  • Increased Risk: Even temporary spikes can strain the heart, potentially increasing long-term risks for heart attack, stroke, and heart failure, say Adventist Health and American Heart Association Journals.

So, I was put in a room and all kinds of tests were started, lots of blood taken, EKG leads applied, more blood pressure monitoring.  This went on for a couple hours, just watching numbers fluctuate.

Then – finally – the long-coveted x-ray of my hand!

Some more monitoring,  Various medical staff told us what some of the numbers meant.  A doctor came in.  One of the staff told him that he was concerned/confused about my EKG results.  The doctor came back and told me that he was going to do a consultation with a cardiac doctor about the EKG.

More monitoring.

The doctor finally came back and said that we could go home.  BUT.  I have to call their cardiac doctor ASAP on Monday morning followed by their recommended Orthopedic Surgeon, followed by my PCP.  I saved some time with all this and arranged the PCP through MyChart.

The nurse came back to remove the EKG leads and give me some Losartan and HCTZ  (hydrochlorothiazide) pills.  I couldn’t hold the water to take the pills so I handed it to DH.  Of course, he immediately started drinking my pill water.

Got the water back, clothes back on and finally on our way home.

Total time: 7 hours.

Test results

And that thumb?

An avulsion fracture fragment.  Google says: “An avulsed fracture fragment is a small piece of bone that breaks off from the main bone, pulled away by a strong force exerted by a tendon or ligament, often during sudden movements in sports, leading to pain, swelling, and instability, with treatment ranging from rest and casting for small fragments to surgery if the fragment is large or significantly displaced”.

Everything else normal except “Regarding her elevated blood pressure, patient has some interesting changes in her EKG while she is here including left bundle branch block but then back to sinus rhythm. No cardiac symptoms. Cardiac workup otherwise reassuring including troponin. Normal creatinine in regards to elevated blood pressure. I will discuss with Virginia Heart cardiology but generally with think that discharge on blood pressure medication outpatient follow-up might be reasonable”.

So,

Maybe more after the cardiologist, maybe surgery after the Orthopedic Surgeon, maybe just a weird day for me.

Good News for Me! Drinking Coffee in the Morning Reduces the Risk for Death

Posted on by MaryO

Did drinking coffee save my life yesterday?  More on that after I reflect more on the events of the last 24 hours.

This morning, from my email:

Drinking Coffee in the Morning Reduces the Risk for Death

Key takeaways:

  • Morning coffee drinkers had a 16% risk reduction for death from all causes.
  • Morning coffee drinkers who consumed between over two to three or more cups achieved the greatest benefits.

People who drink coffee in the morning have a lower risk for death from all causes compared with those who do not drink coffee at all, results from an observational cohort study published in the European Heart Journal showed.

The association between morning coffee consumption and reduced mortality risk appeared especially strong with respect to CVD, according to researchers. Meanwhile, the analysis revealed that those who drank coffee throughout the day did not achieve the same mortality benefits as morning drinkers.

“While moderate coffee drinking has been recommended for the beneficial relations with health based on previous studies, primary care providers [should] be informed that the time of coffee drinking also matters, beyond the amounts consumed,” Lu Qi, MD, PhD, a professor at Tulane University Celia Scott Weatherhead School of Public Health and Tropical Medicine, told Healio.

Current research suggests that coffee consumption “doesn’t raise the risk of cardiovascular disease, and it seems to lower the risk of some chronic diseases, such as type 2 diabetes,” Qi said in a press release.

“Given the effects that caffeine has on our bodies, we wanted to see if the time of day when you drink coffee has any impact on heart health.”

In the study, Qi and colleagues assessed links between mortality and coffee consumption — including the volume and timing — using data from the National Health and Nutrition Examination Survey from 1999 to 2018.

The analysis comprised 40,725 adults who had given dietary data of what they consumed on at least one day. This included a subgroup of 1,463 adults who completed a detailed food and drink diary for an entire week.

Overall, 48% of the cohort did not drink coffee, 36% had a morning-type coffee drinking pattern — primarily drinking from 4 a.m. to 11:59 a.m. — and 16% had an all-day drinking pattern.

The researchers found that, after adjusting for factors like sleep hours and caffeinated and decaffeinated coffee intake amounts, morning coffee drinkers were 16% (HR = 0.84; 95% CI, 0.74-0.95) less likely to die of any cause and 31% (HR = 0.69; 95% CI, 0.55-0.87) less likely to die from CVD compared with those who did not drink coffee.

People who drank coffee all day did not have any risk reductions vs. those who did not drink coffee.

The amount of coffee consumed among morning drinkers also influenced risk reductions, as researchers reported HRs for all-cause mortality of:

  • 0.85 (95% CI, 0.71-1.01) among those who consumed more than zero to one cup;
  • 0.84 (95% CI, 0.73-0.96) among those who consumed more than one to two cups;
  • 0.72 (95% CI, 0.6-0.86) among those who consumed more than two to three cups; and
  • 0.79 (95% CI, 0.65-0.97) among those who consumed more than three cups.

Study results showed similar patterns for mortality from CVD, “but the interaction term was not significant,” Qi and colleagues wrote.

The researchers identified a couple of study limitations. For example, the analysis used self-reported dietary data, opening the potential for recall bias, while they also could not rule out possible residual and unmeasured cofounders.

The study did not explain why morning coffee consumption reduced the risk for death from CVD, Qi said in the release.

“A possible explanation is that consuming coffee in the afternoon or evening may disrupt circadian rhythms and levels of hormones such as melatonin,” he said. “This, in turn, leads to changes in cardiovascular risk factors such as inflammation and [BP].”

Qi told Healio that regarding future research, “more studies are needed to investigate coffee drinking timing with other health outcomes, in different populations, and clinical trials would be helpful to provide evidence for causality.”

References:

Sources/Disclosures

Source:

Wang X, et al. Eur Heart J. et al. 2025;doi:10.1093/eurheartj/ehae871.

From https://www.healio.com/news/primary-care/20250110/drinking-coffee-in-the-morning-reduces-the-risk-for-death?utm_source=selligent&utm_medium=email&utm_campaign=20260103HM&utm_content=20260103HM