Saturday, November 13, 2010

"Don't have no gun. Don't have no bullets, neither." [repost]

this is another repost from the same period of time -- the fall of 2008. why am i resubmitting these pieces? am i hoping that the very public shame of not having progressed even one iota of an inch forward in my ways of thinking will somehow so shake me that change will be inevitable (or shame permanent)? perhaps.

but i also think the lesson is simpler than that: what blessings might have been had proper permitting, appropriate ammunition, and heartfelt intent been allowed to coincide?

Last Wednesday, I had my second appointment at the Wound Care Center, and my six-week follow-up with the orthopedic surgeon:

We were 20 minutes late for the wound care. Two highway accidents with rubbernecking at high pitch, and then trouble finding a parking space. I apologized profusely, and meant it. That is, I meant it the first four times the tech deigned to elicit the response. As she began to deign for the fifth and sixth time, however, I felt fairly elicitless.

It was 9 am, and it turned out that I was hypertensive and febrile. (Yes, I was looking for an excuse.) Normally, my blood pressure is alarmingly low -- usually in the realm of 80/50. I have never given it much thought -- but since being told of the issues with my aortic arch, I have sort of cherished my low numbers. And so it was that when told my pressure was 160/110, I fairly laughed in their faces. "No way, no way! I am *always* low... check it again." Five rechecks later? 160/110.

The fever was more of an annoyance than anything else. I am tired of it -- tired of sweating -- tired of feeling *this* close to bursting into tears. Definitely tired of having to tell its story, having to let yet another clueless health care professional try to invent the freaking wheel. Why cannot they simply accede to the truth that it is being tracked, followed, and investigated -- just not by them! Why order bloodwork, why lather at the mouth, why cause me difficulties? Here is a clue: I am *sick* and had to deal with an ill-tempered partner to get here, through hellacious traffic, pain that you cannot imagine. All I want from you is treatment of my ulcered foot -- and, to be perfectly honest, I don't even want that. We are more than capable of taking care of this at home. We are here because of CYA Mentality Medicine.

Oh, if only you could see, and properly appreciate, the sentences that have been typed and then erased between the paragraph above and the next.

Anyway, they changed how we are to dress the cavernous ulcer on my foot (I dropped my laptop on my right foot -- ground zero for my CRPS / RSD -- and the tissue would not absorb the hematoma and extra fluid, so it all burst outward. Yuck. Then would not heal, apparently due to all the extant vascular and nerve damage.). We had used SelectSilver by Milliken for the first week, which drew out an incredible amount of fluid from the foot, and even the lower leg. I kid you not! There were times that the bandage was dripping wet a mere half hour after being applied. Now we will use plain wicking material but must use an ointment called Collagenase Santyl. As it was explained to me, the stuff is akin to a chemical leech. I am gifted with a fair amount of "slough" -- which they swore was a scientific term for the material that normally would be absorbed by the body. Detritus. Junk. Goo. Ick. It is supposedly "smart," in that it will chow down on necrotic tissues but leave untouched the healthy stuff.

The tech took her sweet time, dragging out the minutes, until I had but four of them to get across the street to the orthopod's office. Revenge?

Fred had gone to bed at 3 am; I got up at 3 am. We are, at times, ships passing in the night. And so we were basically Stupid Squared as we sat in the next waiting room.

I have to say, dear blog, that I came away from my meeting with my world-reknowned surgeon quite perturbed.

We verbally ran through all that happened with the two surgeries and what he thinks the future will hold for the right side of my body. I almost hated to tell him what his PA already knew -- that I am having fevers again, that there is now severe pain and restriction of movement in my *left* shoulder. And my white count is again hovering between 11.5 and 13,000.

He says what good luck it is that there is no metal on that side, no prosthesis to deal with.

I stared at him. "There *is* a prosthesis on that side," I tell him. His mouth falls open. "But I didn't do it," he counters, with unassailable logic. "True," I say, "but Dr. Do-DoHead did..."

It boggles my mind that he did not know there were more prostheses. Why do I fill out all the pre-op paperwork, get those pre-op clearances?

He thinks I have abscesses on that side.

He put his head in his hands.

My what an uncomplicated course I am looking at. A bad ulcer to heal -- now that I have this sucky history of hospital acquired MRSA. A long recovery after having one shoulder prosthesis removed due to massive infection. Apparent infection on the opposite side. A promised surgery to implant a new prosthesis... once all of these other things are cleared up. He was mumbling by then. He never looked me in the eye.

The daily pain of CRPS / RSD in all limbs and the lower half of my face. The pain and disability of avascular necrosis in all major joints. Juggling adrenal insufficiency. The ins-and-outs of SLE.

Depression, deepening. Isolation, deepening. Despair? Admitted to only here. Just between you and me.

I am dizzy. I am sad. I am mad. I am crying, again.

160/110. 100.7 (not supposed to be possible on steroids...). My heart rate stays in triple digits.

I feel like quitting. Like shooting myself in the head, say. Here I am, just as I was back in early August, and then as I was last October, November -- dripping wet with sweat, burning up, shivering, a sick insomniac with a wicked headache and out-of-this-world pain.
I just asked Fred if he would shoot me.
His reply? "Don't have no gun. Don't have no bullets, neither."

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