The Sierra foothills stay green, as in this photo, usually until mid-May. Then they totally dry out and turn pale yellow. By the end of the summer, they're almost silvery.

I saw my rheumatologist yesterday morning, bright and early. Although it takes most of an hour on a light-traffic day to drive down the mountain to the VA medical center, I like these early morning appointments. There’s something about being up and moving around while the birds are still tuning their instruments and the full colors of the day are only beginning to show promise that just jazzes me. Always has, even when I was rising early to go to work day in and day out.

So the drive was pleasant. There was very little traffic. It reminded me of my young adulthood in the Sacramento Valley, when a turn onto Highway 50 east meant leaving the suburban and city traffic behind within just a few miles. The whole area was much more lightly populated back then, of course (it didn’t seem like it at the time, though). The only reason anyone drove east out of Sac was to go camping in the mountains or visit Lake Tahoe for the lake or, just over the Nevada border, the casinos.

Today, suburbs stretch 20 miles around Sacramento in all directions, and it’s really not until the freeway passes through Placerville that the unbroken trees and wilderness really begins. Even that’s a illusion, though. There are small towns everywhere, dotted back in behind the tall evergreens and rising mountainsides. My own town is one of them.

Still, I enjoyed the drive. I got off the freeway about 30 miles down the mountain and into the valley and took a narrow, two-lane surface road the rest of the way in, just to be able to see the still-un-developed rolling, slowly flattening foothills in all their late-summer glory. These hills are covered with star-thistle along the verges of the roadsides and long grasses that turn a pale wheat color after the temperatures rise in late May and early June. By late August, they almost have a silver sheen to them. They roll along, seemingly without end, dotted with huge, ancient valley oaks, cottonwoods in the now-dry drainages, and red-tailed hawks on fenceposts. Once they were open grazing ranges for cattle; some areas still are. When I was very young, these hills really did stretch out almost forever. Now … not so much.

As anticipated, my doctor did prescribe plaquinil for me this time. He says my rheuma bloodwork still looks really good. I told him about my continuous, low-to-moderate level pain in my hands and wrists, and about the newer pain I’ve felt lately in my hips (not the bursitis), knees and feet. We talked. He conceded that while the disease might be slowed, it didn’t necessarily mean it was stopped, and that my pain wouldn’t necessarily stop, either. We’re both hoping the plaquinil, in combination with the Arava and sulfasalazine, might have a positive effect. In the meantime, it’s tramadol for pain, along with exercise, paraffin baths, and my spidey gloves. I’ve stopped, pretty much entirely, taking any stronger narcotics. I’m glad for that as for a while there, it was taking higher dosages of hydrocodone and percocet to achieve the same pain relief. Not good. I’m hoping I can stay away from them for a very long time, so that if I do need to take them again in the future, they’ll help me at normal dosages. Frankly, I get fearful when I think of having to take high dosage of those medications; I’ve been taking them long enough, off and on over the years, that needing a prescription outside of my PCP’s office means an inquisition and “the look” from unfamiliar doctors. Yuck.

The rest of the bloodwork had both good and bad news. The bad? My vitamin D levels are back in the rubbish bin again, so I’m back on 1,000 mgs per day of that, along with the calcium-plus-D supplement I’ve been taking all along. The good news is that my blood glucose level is wonderful. I continue to avoid pre-diabetes and the full-blown disease. I’d been indulging myself in the occasional white-bread PB&J, so I’d been a bit worried about it. But it seems as long as I can keep that sort of thing truly as an occasional “treat” rather than a daily indulgence, I’ll be fine. We don’t keep other sweets in the house at all, except for fruit. I’m relieved.

It’s unseasonably cool again today. The high is supposed to be 81, and it will be quite windy. That’s still a worry as far as summer wildfire is concerned, but man, is it comfortable otherwise.  You won’t hear me complaining about 81. As I’ve said before, these moderate temps are unusual for Northern California. In the past (and for nearly all my life) we’ve always slow-baked in the high-90s and low-100s here starting  in late May and just keep baking until mid-October. But it seems (based on the last few summers) our weather patterns are changing. I’m thankful, but it’s a bit disconcerting to find myself needing my light fleece jacket in the mornings during the hottest part of the year.

Good thing I’m not holding my breath. I just checked the weather report and learned that by Tuesday we’ll be near triple-digits here in the mountains, and in the valley … ohmygod. It hardly bears thinking about. Convection-oven heat is what I expect for this part of the year, so even as I wrinkle my nose and wonder how I’ll cope with it in a few days, the normalcy is oddly comforting.

At any rate, I think I’ll stay right up here at home, where the Stellar’s jays start arguing about 5 a.m., the tall firs whisper to each other in the breeze, and it’s several degrees cooler than the valley. Here’s wishing everyone a terrific week to come.