Pastiche or Another Pot, Pourri

So it turns out that hydrogen peroxide is not all that mysterious, also not all that great for disinfection. My personal wound care maven -- I like to call her Brandi, because that's her name -- made big Os with her mouth and little tiny gasps when I told her that I had been cleaning my nasty foot ulcer (sorry) with a half hydrogen peroxide, half water concoction. I felt like it was working hard, bubbling, bubbling, bubbling!

Were Brandi French, she might well have said, "Non, non, non, et non!"
But she was not. Far from it!

She explained the secret workings of peroxide, most importantly: The Fizz, the incredible foaming action that puts Scrubbing Bubbles to profound shame. We have the super abundant enzyme catalase to thank for the decomposition of the stuff into water and oxygen gas.
That's 2H2O2 --> 2H2O + O2 to you!

So who knew that I would then become fascinated with catalase itself?
Catalase is extremely efficient and nearly ubiquitous. I'm going out on a limb, crazed woman that I am, to posit that there is a common etymology to catalase and catalysis:

Greek katalusis, κατάλυσις dissolution, from katalein, to dissolve, loosen down, disintegrate, to demolish, specially to halt for the night: kata-, intensive pref.; see cata- + lein, λύω to loosen; derived from the Proto-Indo-European root *leu- (English: forlorn, loosen, lose, loss, losel, lost; Greek: luein; Latin: lues, solvere; Norse: ljosta, lauss

Isn't it fantastic fodder? "[T]o demolish, specially to halt for the night"? What the hell does that mean? Seriously, I plan to meditate upon this distinction; Given catalase, alone, Vonnegut could write a short novel.

(I miss Vonnegut. Very briefly, in the 1970s, I was a planetary citizen*. What happened? Well, I had to renew my passport, and the dream died. So it goes.)

Umm. Has anyone seen my train of thought? Choo. Choo?



Ah, yes. What a wonder that the scrubbing bubbles of hydrogen peroxide are of pure oxygen, that a single molecule of catalase can breakdown millions of hydrogen peroxide molecules! So efficient! Yes, those *are* exclamation points!


No matter what I plan to write about, my topic almost always becomes words.



To that end, I have decided to challenge myself, to exercise the little grey cells that shiver with orgasmic delight over verbiage -- be it grandiloquent**, be it essential to knowing how to put on a sweater, be it formulaic, like "I'm sorry for your loss." I am spiffing up the languages that hang out in my head -- a daily review of Latin, French, and Spanish. In order to have an honest chance at establishing this as routine, my goals are unusually modest: perhaps an hour and a half per day, or -- more likely -- 20 minutes per language. I know that I ought to work on Turkish but that would be too... hard. There are six noun cases. Shoot, I probably ought to give up on the Latin, as well. Do you see how quickly I decerebrate? (Language and Communication, Learning and Memory -- bye-bye!)

Oh, the pot is definitely pourri.



Current bedtime reading material? In Cold Blood, Capote. It's been sitting on the bookshelf for so long that I took pity. Nothing like mass murder in the middle of the night. A tour de force of narration and research, it achieves something considerably more (and other) than true crime designation. I have another nonfiction book going and feel the need to crack open a third tome, something wonderfully imaginative and easy.

No Wound Care Center visit this week! Why? Because I refuse to go! Yes, I called and cancelled. However, the next trip is scheduled for Monday, not the usual Wednesday, so the time between visits won't be too long. Most importantly, I would not have done this were my foot not suddenly healing so well. Seriously -- in the last four days, even I can see that it is healing at a phenomenal rate. There is not so much slough***, not so much drainage, and, as Brandi says, as only Brandi can: "We like red!"



Brandi and I have been thrown together now a good half dozen times. Bless her everloving sterile fields. I have gone off on her several times, and -- just like the inappropriate dressing down that I delivered the other day to an Unsuspecting Innocent online -- I've given up on the notion of apology. She, and the doctor overseeing her work, an Infectious Disease specialist, have both attempted to reinvent the wheel and I just have no patience for it. So when I was six, I stubbed my left big toe... how, why, dear mental midgets, does that come to matter? I am not sure why an ID doctor is involved, anyway -- we are dealing with an ulcer that is the result of injury (someone dropped a laptop on it). Granted, the fact that this particular foot has been highly compromised by CRPS/RSD and avascular necrosis lends it a certain cachet... (This is my stock photo of the right foot -- the ulcer is smack dab in the middle of the top of it. You *really* don't want to see it...)

Anyway, there are now distinct patches of sexy red and bright perky pink -- versus the weeks of depressing white and tan. Beige? Eggshell. We are using an enzyme on it -- Santyl -- that is supposed to chow down on "the bad cells" and invigorate the rest. What seems to have helped is the elimination of zinc oxide on the surrounding skin, in favor of AllKare, a skin barrier. Or it is just a huge coincidence!

Note: I cannot, for the life of me, remember why I have tape on my foot -- around the toes. That is an area that has been repeatedly injured but I don't see a bandage of any sort. Hmm. Oh, and the intense *purpleness* of my feet is not done justice. This must have been a warm weather photo, because winter mode for my limbs is shrunken, way-way-way purple, and unbelievably cold (well, to be honest, they are always unbelievably cold, just more adverbally unbelievable in the winter months). Warm weather mode involves more red than purple and correlates to HUGEness. All weather involves severe pain. Hélas. {inverted palm to forehead, deep soulfull sigh}

Yesterday was important to me. I had an appointment with my internist, my primary care doctor. He is terrific and performs the crucial task of keeping me oriented to what is happening with my health, and getting all the specialists coordinated and relatively on task. That makes me sound rather stupid, but I wouldn't argue the fact these days.

Why? Because I simply cannot wrap my mind around the various things that may soon be happening.

Should there be an interested reader who has somehow managed to elude these details, this is, in short, my situation: Due to avascular necrosis, I have had a number of orthopedic surgeries that have left me close to bionic. Late last year, I began having daily fevers with sweats, fatigue, and a rotten attitude -- for garnish. Because I take a fair amount of steroids (therapy for Addison's, SLE, and some of the weirdness of CRPS/RSD), my bloodwork wasn't taken at face value. That is, even if my white count was high, that was attributed to the effect of steroids. However, as I became more and more snappish, and more and more febrile, the presence of infection couldn't be denied. Thus began the search for answers. A gallium scan pointed the way to my right shoulder prosthesis -- and that seemed appropriate since pain in that area was steadily increasing. Finally, this August, my orthopedic surgeon went in and found four big pockets of pus (sorry!). He had to remove the prosthesis -- things must have been kind of iffy at that point, because they took me to the ICU and then back to surgery a few days later to finish up. I was trying to be positive, forward-thinking, optimistic before this surgeon who always couches his statements this way: "If and when I operate to give you another prosthesis..." I completed six weeks of i.v. antibiotics at home -- four infusions a day.

The reason my mood shifted toward the blue horizon? Severe pain has steadily established itself in my LEFT shoulder. For weeks, I have been kidding myself that it was just Overuse Syndrome, since my right arm is useless and the left has been doing double duty. However, it has become clear that the infection either was never eradicated to begin with, or has recurred.

That boggles the mind, at least mine; My mind is, indeed, well boggled.

How can it be that six weeks of antibiotics did not eradicate The Beasties? They tell me that it only takes one stubborn microbe, and that since an abscess is the likely form The Beasties have taken, the antibiotics may not have been able to access the Little Boogers.

I have fevers again -- but at least the debilitating sweat attacks are much fewer this go 'round. The hike in my white count was, once again, pooh-poohed as being steroid-induced. My left shoulder hurts like hell, in that familiar way, and I finally confessed yesterday that the right shoulder is back in its deep-down, throes-of-throbbing pain ways.

Next week, I revisit the Infectious Disease Dude and his PA Dudette, with whom I have the better relationship (of trust). And a few hours later, I revisit the Orthopedic Surgeon. A red letter day, if ever there was one.

And so, I will hear then all the things that I was told yesterday, yet cannot comprehend.

Like losing my remaining shoulder, and never being given another prosthesis for either side.

Like the possibility that these Beasties have seeded other areas, created other abscesses. Both hips have hardware, as does my right elbow and right foot.

Just a few days before the first surgery this past August, I had an echo done to see if my aortic valve was in good shape -- at one time, I had quite a few battles with heart failure, then cardiomyopathy, and since I have a congenital bicuspid aortic valve with insufficiency, to boot, I condescend to see a cardiologist every few years. Cough. Okay, so I am supposed to have a yearly echo but have failed to do so for a good while -- 6 years. Anyway, here is the kicker: There where the aorta attaches to the heart, the aortic arch, the vessel has dilated. Gotten kinda large. Approaching the benchmark size of 5 cm. Holding steady at 4.76 cm. (Hmmm. Maybe it was 4.86? I cannot remember. Go brain!)

My attitude has been imminently logical. I have enough nonsense going on, and don't need to have any more trouble. Hence, no annual echos, no cardiology appointments.

I asked yesterday whether I should be worried about getting the aortic aneurysm addressed, and my doctor said, "Not now. You have too much other stuff on your plate." Okie-dokie then!

Is that how I am going to die? From a ruptured aneurysm? What will that be like, I wonder. Sudden. No time to -- what? Say something? Do something? Weep? Laugh? Stand on my head? What are the odds that will I live to share the experience of a ruptured aneurysm, just another war story? I want time for dying.

Ah, terrific. Panic is setting in. Time to return to the Putrid Pots, the Pots Pourris, this Pastiche.

This; Here.



*"Vonnegut's father once complained that there were no bad guys in his books, and Vonnegut attributed his largely blame-free world view to having studied 1940s anthropology, with its total relativism and deliberate lack of value judgments, as well as its sense of human cultures and religions as arbitrary artifacts and 'Rube Goldberg inventions.' He received a less friendly complaint while speaking at the Library of Congress in the early 1970s, when a man stood up during his speech and asked 'What right have you, as a leader of America's young people, to make those people so cynical and pessimistic?' Vonnegut had no ready reply, so left the stage. He later commented: 'The beliefs I have to defend are so soft and complicated, actually, and, when vivisected, turn into bowls of undifferentiated mush. I am a pacifist, I am an anarchist, I am a planetary citizen, and so on.'"

**Allow me to shamelessly plug the Grandiloquent Dictionary! What a lovely idea.



***"The term for the viscous yellow layer which often covers the wound and is strongly adherent to it. Its presence can be related to the end of the inflammatory stage of healing when dead cells have accumulated in the exudate."