Saturday, November 29, 2008

Repost of Raw Silk Dreams: An Epistemology of Movement

I don't actually remember November 2008, but I confess to liking the things I posted back then. I wonder what the difference was -- why was I more interesting and a better writer at that particular time?

Anyway, the Reposts continue!

I spent about 430 seconds pondering. Ponder, ponder, ponder. That's pretty impressive for me these days, as my attention span seems to have been ably kimbo-sliced.

I am weaning myself off of the only antidepressant that has ever been magic to my dour mood. Cymbalta. Prescribed as an adjunct pain medication, it really worked wonders for me. The Lesser Pains were indeed helped, but wayyyyy more impressive was that weird, weird sound that accosted my ears about 5 days after the first dose.

Laughter.

I actually did say, "What is that sound?" Fred almost wept with relief and La Bonne et Belle Bianca promptly began plotting little plots to steal the medication and replace it with saltpeter.*

[*About saltpeter, the good Wikipedia tells us:

Potassium nitrate is a chemical compound with the chemical formula KNO3. A naturally occurring mineral source of nitrogen, KNO3 constitutes a critical oxidizing component of black powder/gunpowder. In the past it was also used for several kinds of burning fuses, including slow matches. Potassium nitrate readily precipitates from mixtures of salts, and decomposing urine was the main commercial source of the nitrate ion, through various means, from the Late Middle Ages and Early Modern era through the 19th century.

Its common names include saltpetre (saltpeter in American English), from Medieval Latin sal petræ: "stone salt" or possibly "Salt of Petra", nitrate of potash, and nitre (American niter). For specific information about the naturally occurring mineral, see niter. The name Peru saltpetre or Chile saltpetre (American "Peru saltpeter" or "Chile saltpeter") is applied to sodium nitrate, a similar nitrogen compound that is also used in explosives and fertilizers. The major problem of using the cheaper sodium nitrate in gunpowder is its tendency to go damp.
]


Of course, Bianca had some odd notion of the fabled death-to-potency capacity of saltpeter, sort of an extrapolation of "going damp." [Ewww, that doesn't quite work, does it. Ewww.] But then, this is just another example of why we so love La Bonne et Belle Dame Sans Merci -- also why we like to keep her within our sights at all times. Have I ever extolled the virtues of the Nanny Cam, carefully inserted into "the cans of half-eaten Libby's Vienna Sausage stuffed in the serpentine bottom drawer of a 16th century French armoire -- beautifully restored as a well-stocked wet bar"? No? Well, put that on the lists of fascinating future blog posts! (I confess that the link to "Anacoluthe" is probably my most-linked production; I love that post; I find that it quite competently explains the nuances of the pandemic economic disaster -- from which we have yet to be truly delivered. {Thank you, BushWad.})

Are you still with me?

So, as I too-rapidly wean myself off this very effective medication that I can no longer afford, I am battling the return of The Minor Aches and The Lesser Pains. No biggie, pain is a constant. True, I am not usually brought to the proverbial edge, sobbing that "I can't do it..." or crying out in full pathos "Why does everything have to be so hard?"

The pain battle will be ongoing. The battle against depression, though? I can't do it... Why does everything have to be so hard?

Ha! This Conflict of the Neurotransmitters, Uptoken and Retooked, looks to be a very hard and enduring contest.

Against both physical and psychic pain, my best weapon doesn't come from pills, tablets, or fizzing seltzers. It comes from the knife's edge of hyperfocus and a heightened relaxation response, both the result of many years of biofeedback, now expertly practiced sans wires, books, helpmates, or monitors.

And, lo! It turns out that rereading some of my blogposts is one touchstone that launches me into hours of monotonous orbits, as I microprocess the meaning of words, as I enjoy linguistic histories, and lather up from head-to-fucked-up-toe in my many absurdities.

I don't know if my posts ever help you, My Beloved Readers, to leave it all behind, to enjoy an anachronistic Calgon moment, but that's the rationale behind my recent penchant for reposting.

This one? Easy enough to decipher. The videos easy enough to people, to enter, to mentally fly, jump, twist, and lightly land. It's a dream of having legs that work, having a body that remembers.







I dream in parkour and free running.
"Silk, or soie in French, is the strongest natural fiber."*
I wake at the catch of gulping sound that is my laughter.





Late at night, when I cannot sleep, and am mentally weak,
I watch parkour videos and cry.
The music that I play -- preferring my picks to theirs -- is very, very loud,
so in my fashion I twitch and rock. I plant my feet, and roll. (In my fashion.)





It surely doesn't belong to me,the blue grey knots,
but I don't think they mind me watching, tetanus-toed.
If they do, there are some shadows to hide in,
over there.





It's as smooth as silk isn't, and as dependent on
texture for its beauty. Raw silk.


Traces, traceurs, traceuses.




*"A steel filament of the same diameter as silk will break before a filament of silk."

CRPS Clinical Trials

Open CRPS Studies at clinicaltrials.gov:

1 Recruiting Safety and Efficacy Study of Ethosuximide for the Treatment of Complex Regional Pain Syndrome (CRPS) Type I
Condition: Complex Regional Pain Syndrome, Type I
Interventions: Drug: Placebo; Drug: Ethosuximide

2 Not yet recruiting Graded Exposure (GEXP) in Vivo Versus Physiotherapy in Complex Regional Pain Syndrome Type I (CRPS-I)
Condition: Complex Regional Pain Syndrome Type I
Interventions: Behavioral: Graded exposure in vivo; Behavioral: Physiotherapy

3 Recruiting Autonomic Dysfunction and Spinal Cord Stimulation in Complex Regional Pain Syndrome
Condition: Complex Regional Pain Syndrome
Interventions: Device: Spinal Cord Stimulator; Other: CRPS patients under treatment other than spinal cord stimulator

4 Recruiting A Study of the Effect of Lenalidamide on Complex Regional Pain Syndrome
Type 1
Condition: Complex Regional Pain Syndrome, Type 1
Intervention: Drug: Lenalidamide

5 Recruiting Association Between Focal Dystonia and Complex Regional Pain Syndrome
Conditions: Focal Dystonia; Peripheral Nervous System Disease
Intervention:

6 Recruiting Effect of Delta-9-Tetrahydrocannabinol on the Prevention of Chronic Pain in Patients With Acute CRPS (ETIC-Study)
Conditions: Complex Regional Pain Syndromes; CRPS
Intervention: Drug: Delta9-Tetrahydrocannabinol

7 Recruiting The Efficacy of Motor Cortex Stimulation for Pain Control
Conditions: Neuropathic Pain; Phantom Limb Pain; Stump Pain; Brachial Plexus Avulsion; Deafferentation Pain; Facial Pain; Complex Regional Pain Syndrome
Intervention: Device: motor cortex stimulation

8 Recruiting Evaluation and Diagnosis of People With Pain and Fatigue Syndromes
Conditions: Fatigue; Fibromyalgia; Pain; Complex Regional Pain Syndrome; Reflex Sympathetic Dystrophy
Intervention:

9 Recruiting Evoked Fields After Median and Ulnar Stimulation
Condition: Complex Regional Pain Syndromes
Intervention: Procedure: Evoked fields before and after a local block (Xylocaine)

10 Recruiting Regional Anesthesia Military Battlefield Pain Outcomes Study
Conditions: Anxiety Disorders; Complex Regional Pain Syndrome Type II; Depressive Disorders; Post-Traumatic Stress Disorder; Substance Abuse
Intervention: Procedure: Regional Anesthesia

11 Recruiting Double Blind Placebo Controlled Study of Outpatient Intravenous Ketamine for the Treatment of CRPS
Condition: Complex Regional Pain Syndrome
Interventions: Drug: Ketamine; Other: IV NSS; Other: Normal Saline

12 Recruiting Neurotropin to Treat Chronic Neuropathic Pain
Conditions: Causalgia; Reflex Sympathetic Dystrophy
Intervention: Drug: Neurotropin

13 Recruiting Susceptibility to Chronic Post-Traumatic Extremity Pain
Condition: Chronic Pain
Intervention:


My interest is in #11 -- the study of outpatient ketamine infusions overseen by Dr. Robert J. Schwartzman at Drexel. What's wrong with me that I don't move mountains to make it happen?

Friday, November 28, 2008

Sam-I-Am on the left, Dobby on the right

funny pictures

We've always adored Sammy and hoped that he knew it. We had no idea, however, how much love he must have felt was missing until little Dobby was born. Dobby is selfless love embodied and brightens the day of every creature he meets (-- crows his proud Stupid Human Companion). In his presence, Sam-I-Am can no more be dignified and aloof than I can do cartwheels or wipe my ass. He plays more than he did even as a kitten and is often found in some sort of cheerful embrace that involves either Dobby or Fred, who apparently provides the best belly rubs and tail pulls.

That's not to say that they each don't search out periods of solitude, cat-ti-tude -- Fred included.
Occasionally, when in some sort of fugue state and half-asleep, Sammy tries to boink little Dobby! No, Sammy, no! Run, Dobby, run!

Luckily, Dobby has a healthy set of lungs and a well-defined sense of proprietary parameters, and promptly raises the general alarm with something closer to a sea lion's bark than a meow.

They have been neutered -- as kittens, both. During the waiting period (after having her litter and before having her spayed), Sam repeatedly tried to mount Dobby's mother, the inimitable Marmy.

Ergo, we conclude that:

A. his neutering didn't "take," and

2. he is a switch-hitter.

There are times when, even though he is interrupted and often rebuffed, Sammy is the only one in the house getting any action.

Getting Down To Brass Tacks*

Sometime today -- I'll spare you a description of where, how, when, and why -- I realized that coming home after the upcoming surgery may not be the wisest course. Coming directly home, that is!

How in heck am I going to be able to care for myself, much less keep The Manor neat as a pin? The Old Masters dusted and straight (not to mention the occasional Rubens or Velasquez restoration project on long weekends)? All the antique Blue Jasper Wedgwood plaques free of nasty cat fuzz? The lawns -- replete with a scale replica of Wimbledon courts 1-19 plus Centre Court, sans that awful poof of a retractable roof that's going up for next year -- deeply green and trim? Oh, and how in the world can I keep the black algae out of the moat without a daily brushing and correction of chlorine requirements? I mean, I doubt that I'll be able to sport SCUBA gear anytime soon.

As I was experimenting on basic hygiene techniques without benefit of either shoulder, my spritely spirit plumbed the depths of despair.

Oh, am I being too theatrical for you? Well, tough titties! Whoseblogisitanyway?

Continuing my efforts at putting the Fredster first, for a change, the idea came to me fairly effortlessly: This time, when they ask "Don't you think you would benefit from some time in Rehab?" I will say "You know, that might be a hell of a good notion."

Usually, I curse and produce spittle. Rant. Cry. You know, all of those wonderfully adult Drama Queen reactions. The Pout. The Woe-Is-Moi. Really, though, everyone who knows me knows that I am filled with ice, absolutely cold-terrified at the notion of being "put away" away and forgotten.

The problem is that there really is not much that can be "rehabilitated." I mean, if you have no shoulders, even intensive PT (with the most motivated of clients) has limitations.

I guess this is more a case for OT and an 1,000-page medical supply catalog than a muscle bound attendant with an American Physical Therapy Association (APTA) endorsed gait transfer belt stashed in his dark blue fanny pack.

*HERE

*THERE

Between here and there, I sneaked up on Darling Fred and blurted: "DoYouThinkIShouldGoToARehab(OrANursingHome)AfterSurgery?" and then, with no intent for emotional blackmail, burst into tears.

He fairly yawned, and he definitely laughed at me.

"No, I don't think so. I know it is embarrassing for you, but I can help you wipe your ass... or we can convert all the damn bidets around here back from planters to their intended usage. What else are you worried about?"

Well, all I can say is -- thank goodness someone is willing to get down to Brass Tacks* -- and aren't I lucky to be with such a gentleman, here at Marlinspike Hall, deep, deep in the Tête de Hergé ?

********************************************************************************
*Brass tacks is an object used in the popular expression "get down to brass tacks". The expression usually means clearing out confusing details and finding out the real facts about something.

The etymology of the expression is unclear. It may have roots in the way fabric manufacturers used to mark out a yard in tacks on the counter so customers could buy their fabric accordingly. It was common for some customers buying material or draperies to say to the salesperson "Let's use the brass tacks" which were embedded in the counter. Usually the salesperson would use his or her arm to measure the material. This has been seen in the UK even in the 1950s. This was done to save time overall, but the suspicious customer would often insist on having the material measured exactly, right up to the line of brass tacks.

Another possibility is that in the 1860s the US government issued boots for soldiers that were constructed using brass tacks to hold the leather soles on to the bottoms of their boots. As the boots wore down, the tacks would protrude through the sole and in to the bottom of the soldier's feet. 'Brass tacks' could mean to get to the absolute bottom of things in reference to shoes.

It is also argued that the idiom is derived from the "Brass Tax of 1854". When the makers of clothing, shoes, instruments, tools, etc. that required brass would gather the materials and count up the cost, accounting for the brass tax was the last - and most expensive - step. Therefore the phrase "get down to brass tax" could mean to get to the last and final thing, or to get past the formalities and get down to the crux of the matter.

It is also noteworthy that the tax, in addition to creating revenue for the government, led to a sharp increase in the cost of many instruments. tubas, trumpets, cornets, french horns, and other popular brass instruments gave way to flutes, piccolos, clarinets and oboes as the more affordable woodwind instruments' popularity skyrocketed. Evidence of this is most notable when examining Civil War marching music which relies heavily on the beating of percussion instruments and melodies from the woodwind family. Brass instruments are noticeably absent.

The earliest known use of the complete phrase in print, in the March 4, 1871 issue of the Galveston News (page 3), is "filing down to brass tacks"; hence, a shoemaker filing away too much material in excessive zeal to do a thorough job. The meaning was originally about the same as "putting too fine a point on it" or "over-arguing the point."

The expression might also be Cockney rhyming slang for "facts."

Another suggested Cockney etymology is that the expression "down to the brass tacks" may have originated from a similar British expression: "down to the crass facts." This original phrase is used to describe dealing with the basic details. Because of the Cockney British accent, it was incorrectly pronounced "down to the brass tacks," but still holds the original meaning.


Wednesday, November 26, 2008

Thanksgiving


Lordy. I almost forgot Thanksgiving.


And *that* should wake me up, the part of me that needs to be taking the forefront -- the grateful me.


For I am grateful, deeply so.


I have been plentifully blessed --


by the gentle, loving Fred;

by the crazy and carousing Belle et Bonne Bianca Castafiore;

by the Feline Contingent;

by Brother Bob, Fearless Educator and Grader Boob;

by Brother TW, Lost and Now Found, Long Missed (indeed, TW was the figural centerpiece for my last Thanksgiving -- it now seems like forever since I did *not* know him --

currently my favorite personal illusion!);

by Lale and Adrean, Hilmi and Tina, et al;

by Mother and her struggles this year, pulling through;

by the Carolina folks in absentia, always on my mind and heart;

by Ginny, by Ramak, and yes, by memories of beloved people,

even those who might prefer to spit as I pass by,

(maybe especially those!);

by the talented and caring medicos who keep me going;

by a renewed political energy in the country and

by the hope that Barack Obama will lead us out of the morass;


and I have been blessed by an attentive, loving, and responsive God.


What I never thought would hardly matter?

Academia -- Religion -- and my Reputation

inside of each construct.


Thank you, God, for everything, for I am, in all ways, blessed.
*Oh, and I really appreciate my new pink purse -- but especially the lovely women in my life who encourage me to use it, no matter the occasion!

Tuesday, November 25, 2008

Potpourri III: Jadis, si je me souviens bien...


Jadis, si je me souviens bien...***


The odd pot is putrid again -- for my more attentive readers, you know that I am referencing a blog post with no structure beyond whatever the heck is on my mind: Potpourri!

The word puts me in mind of whatshisface -- I usually think first of Verlaine, and indeed, that is so. But that is so wrong. Hmmmm. Fred tells me to relax the brain, think of other things, expend no effort to uncover the correct name/person and what is sought will be made manifest. Harrumph. That's cranky talk for: Not bloody likely. This man was a criminal (having, among other things, committed murder), wrote his last testament, a moving piece -- and PRESTO! Francois Villon! Get it -- Verlaine/Villon?

Unfortunately, my EEG is likely spiking ominously, because Verlaine brings the idea of Rimbaud, and Rimbaud gifts me with Le dormeur du val -- which, of course, makes me think of war... Iraq... Bush... al Qaeda... 9/11 -- careening, careening, out of control, while the walls come tumbling down.

So we stop, me and my thoughts, to find Le dormeur du val, when the exercise was to find Villon à travers Paul Verlaine, to whom Rimbaud sent L.d.d.v. -- something that was, at the time, a perversion of romanticism. Believe it or not, while rereading the poem, what interrupts are thoughts of how to curb the sexual appetite of our oldest (neutered) cat, who has been suffering some confusion of late. Poor Sam-I-Am. (And, certainly, poor little Dobby, the unwitting object of Sam's ardor.)


It only happens when Sammy is in between sleeping and waking, caught in what looks to be a fugue state, poor fellow. I am often wakened by Dobby's cries for help.


Oh, and I am assuming (yeah, yeah, yeah) that you know Verlaine and Rimbaud were lovers. That Verlaine shot Rimbaud -- who suffered a booboo on the hand. That Rimbaud had him arrested. That there was much public humiliation ensuite, après, puis, donc et enfin -- and Verlaine served a couple of years. Rimbaud? He wrote Saison en enfer -- a sweet little domestic cautionary tale that I hope my felines will take to heart.


It appears I will think of anything to avoid thinking of that smiling soldier in the grass, even to the point of musing about homosexual cats. Oh, but I left out Marmy, Dobby's mother. She is straight but likes to watch.

Le dormeur du val

C’est un trou de verdure où chante une rivière
Accrochant follement aux herbes des haillons
D’argent; où le soleil de la montagne fière,
Luit; C’est un petit val qui mousse de rayons.

Un soldat jeune bouche ouverte, tête nue,
Et la nuque baignant dans le frais cresson bleu,
Dort; il est étendu dans l’herbe, sous la nue,
Pale dans son lit vert où la lumière pleut.

Les pieds dans les glaïeuls, il dort. Souriant comme
Sourirait un enfant malade, il fait un somme:
Nature, berce-le chaudement: il a froid.

Les parfums ne font plus frissonner sa narine;
Il dort dans le soleil, la main sur sa poitrine
Tranquille. Il a deux trous rouges au coté droit


Surely it has been done, some sort of dynamic brain scan (PET? MRI? Or, if your fingers miss the correct keys: MEO?) Nurse, nurse, we need an MEO scan, presto! No... not presto... pronto! No, not pronto. Ah, yes, STAT! Sounds like accurate, reality-based, cutting edge medical dialogue to me. Anyway, surely it has been done, some sort of dynamic brain scan designed to follow the bouncing brain balls as the subject searches for a lost word.

I am horrible with names. This is not a great thing for a prof. I handled it well, I think, when teaching at university level. There was no dearth of personalities to make my students memorable. The merde hit the fan when I descended into that Hell known as public "urban" high school. Used to dealing with not more than 40 or so names, personalities, and talents, suddenly I had over 190 students, excluding homeroom. All these kids were determined to establish themselves as rabid individualists by means of dressing and acting alike.

Ah, but as for problem students? I always remember them -- by name, by issues, by their uniqueness -- their actual individuality. I have even continued to follow the escapades and achievements of a few, one of whom actually ended up on live television leading a police chase that rivaled O.J. Simpson's laconic trip on the L.A. freeways. God, I wish I could share his name, but obviously cannot. In fact, if my brother-unit discovers that I put his email exchange with a student smack dab in the middle of my blog -- big trouble! My former student's name was a combination of a garden implement and a past participle, together forming an unforgettable label. His family circumstances were never clear -- I met with his mother, uncle, and two siblings, all of whom had different last names.

He was tall, lanky, good-looking, with dreadlocks that one could not help but admire, that must have begun at birth, they were so long. He was quite brilliant, one of the few language students interested in francophone history and culture. He and his mother traveled to Senegal one Spring Break, and he derived enormous benefit from that trip -- not just in the old "broadening of horizons" category but in calmness and focus. He began what I hope will be a lifelong passion for African history and politics, particularly for the sometimes nefarious influences of European colonization. So he robbed a convenience store! So he flashed a gun in the process! So he drove that rusty old two-toned brown-on-brown Oldsmobile Cutlass Supreme at a top speed of under 45 down one of the busiest highways in the country, cops trailing him like breadcrumbs. So what? He never passed a test, written or oral, but he was a great student.

Fred (remember Fred?) is being quite the trooper these days, and I need to find ways to make his life easier, less worrisome. Yesterday, he chauffeured me to the Wound Care Center, then across town for my appointment with Dr. PainDude. I did at least treat him to a nice lunch of lovely salad -- we had been discussing his elevated cholesterol! Tomorrow? We're off to the races! An aspiration of my left shoulder under fluoroscopy in the Outpatient Diagnostic Center! WooHoo. It is hard to find ways to honor Fred so I will try to be observant and ready.

Brandi -- we call her Brandi because that is her name -- was a tad bit overzealous in her debridement treatment efforts. There is nothing like having an ulcer scraped until bleeding to set off a nice cavalcade of pain in that particular CRPS-afflicted extremity.


"We love red!" she crows.

I was already at an 8/10 (Brandi *loves* the pain scale) prior to the Scraping Incident, and proceeded to held steady at that level of crankiness throughout the day. Our next stop was chez Dr, PainDude.

I never ask for an increase in pain medications -- in number of doses or strengths. I do sometimes try to get some sort of parallel adjunct therapy when dealing with something like acute-on-chronic pain situations, which has been the order of things since last October. I know, I know -- that sounds both stupid and improbable -- but I don't know how else to characterize the pain of infected prostheses. The *hope*, certainly, is that the problem is acute and not chronic, though strictly speaking, hairs are most likely being split. Anyway, always keeping it new and real, I try to ascertain what is behind the pain. Is it inflammation? Is it neuropathy? Am I in spasm? (NSAID; intercessionary prayer; Baclofen, respectively)

Dr. PainDude, thanks to God's goodness, has pretty much left me in the hands of his capable PA, less harried and hurried, with a great personality and "bedside" manner. Also, dare I say it -- oh, whoseblogisitanyway? She is a better practitioner than he is. Better questioner, history-taker. She teased out the fuzzy fact that I have been taking my breakthrough medication on a scheduled basis. I mean, I don't put Endocet into my labeled drug boxes. There is no actual schedule... I just end up usually needing help twice a day, around the same times. I am allowed four 7.5 mg pills and I have been taking 15 mg between 11 am and 1 pm, and another 15 mg between 9 pm and 11 pm. If there is pain during the night (hooting and slapping my knees!) or at any other time, I take ibuprofen. Lots of ibuprofen! In fact, I have been gobbling about 2000 mg a day, to the chagrin of my internist, who cannot seem to shake off my past kidney failures, the poor stickler.


We loves our ibuprofen, we does.

Capable PA asks: "Did it ever occur to you that we could increase your methadone dose and that that might decrease or eliminate your need for breakthrough meds?" Um, well, no. Never crossed my mind.

I try to switch the long-acting pain medication whenever a pattern of increasing dosage presents itself -- we try, again, to make a horizontal shift to an "equivalent" drug, but also try to come down on the dosage "equivalent." This method, I believe, has been what has kept me from needing more and more, and prevented dependence (beyond the minimal). I also play mindgames with myself by taking a monthly drug holiday, where I taper off the pain meds and spend a weekend unmedicated for pain. I taper pretty quickly -- over two or three days -- and that is probably stupid -- but I firmly believe that I am resetting and rebooting my "system." Dr. PainDude would likely shit a brick if he knew. Good thing he doesn't know, then, though I hate to deprive him of the experience.

Okay... however! The old "yes, but."

My experience with methadone has been squirrelly. The last time we used it? During a time when I had been hit by pneumonia and then a stomach virus, my dose was apparently too high for my metabolism (or sumpthin') and built up alarmingly fast in my body until achieving toxic levels. Given its long half-life and with the precarious nature of my immune and endocrine systems, I went into Addisonian crisis -- and the Addisonian crisis was not picked up until I was on a ventilator, with another pneumonia, and in organ failure. It took a lot of convincing to get me back on methadone (Fentanyl was what we turned to after that, um, event) and I only agreed to a relatively small dosage initially. In fact, the dose is less than half what it was when I crashed and burned. It has been two years, and the dose has never been increased! The Fredster is scared to death of the stuff -- and I can understand his feelings -- he is the one, after all, who found me on the bathroom floor, not breathing.
Poor baby. He could not think to call 911 -- he called my internist, was put on hold, and then was told, of course, to call 911. He shakes and cries at the memory. I wish I could give the gift of forgetfulness.

I am so glad that Dr. PainDude's Capable PA walked me through my fears, that she took her undoubtedly precious time to allow me a few moments to consider stuff and ask questions. She left it like this: a prescription adding one more dose of methadone per day, which I can take however it seems most effective after some experimentation. As always, I am free to not take it. (That is one of the many things that bugs me! You will hear "pain patients" moaning about side effects -- never to the extent where they consider stopping the drug, mind you! If you question them, you'll find that they missed out on the distribution of Free Will and cannot conceive of NOT taking a medication "as directed" despite the fact that they are obviously abusing the drugs. I have met people who insist that it makes perfect sense to take every pain or mind-altering drug that has ever been ordered for them on a mix-and-max basis -- never mind that most were meant to be taken as needed, or that different doctors, essentially revolving around different spheres, have been the Rx authors. Why, it seems that I could go on and on about the faults of other people: the luxury of the perfect.)

An additional perk comes with Capable PA -- she used to work for a surgeon who ended up in the same spot as me, having only one shoulder due to the removal of an infected prosthesis. And his OS is also my OS. Speak of the damn devil, eh? She says he is still without a new prosthesis over a year later and is going, in her words, insane. He is also having trouble getting his pain under good management -- and he doesn't have to deal with my underlying stuff of AVN, CRPS and SLE (and the partridge in a pear tree...). Poor me! He also is not facing the loss of his other damned shoulder.

I am trying to be good and calm, a well-balanced adult-type person, as I plan for coming home shoulderless. Fred can't seem to grasp it, at all, which I can understand. Who thinks of things like "how will I wipe my butt, wash, eat, get in and out of bed, and so on" but the patient? How will I manage the pain given that it is out of control *now* is more of a truly private point to ponder. I have already had to abuse my right arm -- to the point where you can actually hear the grinding of the spacer -- just to do mundane tasks for which I refuse to ask assistance. I know how much my dear Fred can take, and it is nowhere near as much as he loves to allege!

Aw, hell.

There has been no date set. They would dearly love to identify the freakish little pathogens at the root of this evil and so are hoping that this aspiration yields information. From dropped hints, though, I gather that surgery will be sooner rather than later.

I have a great deal more orthopedic hardware in me... how will they know that those other spots are or are not infected? I cannot keep going through this.

The cats, television, four books, several magazines, and one obsessive computer game have also become integral to my pain management. Taking care of the pets, of Fred, of Marlinspike Hall, sweeping up the Tête de Hergé? These are great for providing what little movement I am allowed to make. And I do ask Fred for help. For instance, transferring clothes from the washer to the dryer? Impossible. He is a terrific laundry aid and bed clothes changer. And last week he mopped the kitchen floor. Never forget that he hauls my sorry ass and the chair it sits in all around the city and does not complain. He curses a lot but he does not overtly complain!

I was planning to clean the house on Sunday but Sunday turned out to be pain-filled and I just could not do it. Yesterday was even worse. Today? I think I will give it a go. In my household manager parlance, one has the choice between doing a Full-Assed Job Of It or a Half-Assed Job Of It. The latter option appeals... and, of course, two back-to-back Half-Assed Jobs more than equals one Full-Assed Job.

Last night, Fred started pitching the idea of starting a Book Club. This evolved into holding play readings -- something we used to do with regularity up at Gothic Wonderland University. It was really quite fun -- gathering with a bunch of people to read Shakespeare by candlelight, throwing off our pod covers of restraint so that it was read with depth and soul. There was something liberating about the constant shift in attendees and the freedom of being part-hidden. We gave it our all and left behind daily cares and fatigue. Okay, so there were occasional awkward moments when ex-lovers found themselves paired by Shakespearean banter! (Amazingly, the love action at Gothic Wonderland University was INTENSE and often kinda bawdy, earthily chaucerian.)


Anyway, Fred finally landed on the notion of actually staging plays, and would like to start with Sartre's No Exit. Okie-dokie, honey! He once wrote an extensive study of the staging of Equus, and I am just grateful he didn't pick that.


Jadis, si je me souviens bien... Once, if memory serves me well, I was happy there.

No, Retired Educator! Don't look into that bright light, don't go there!

There is much more in my rotting pot today... but am decidedly losing my edge. And so, ciao babies. Oh, Villon! How about closing with his most famous?

Ballade des dames du temps jadis

Dites-moi où, n'en quel pays,
Est Flora la belle Romaine,
Archipiades, ni Thaïs,
Qui fut sa cousine germaine,
Écho parlant quand bruit on mène
Dessus rivière ou sur étang,
Qui beauté eut trop plus qu'humaine
Mais où sont les neiges d'antan?

Où est la très sage Héloïs,
Pour qui fut châtré et puis moine
Pierre Abelard à Saint-Denis?
Pour son amour eut cette essoine.
Semblablement, où est la reine
Qui commanda que Buridan
Fut jeté en un sac en Seine?
Mais où sont les neiges d'antan?

La reine Blanche comme lis
Qui chantait à voix de sirène,
Berthe au grand pied, Bietris, Alis,
Haremburgis qui tint le Maine,
Et Jeanne la bonne Lorraine
Qu'Anglais brûlèrent à Rouen;
Où sont-ils, où, Vierge souvraine?
Mais où sont les neiges d'antan?

Prince, n'enquerez de semaine
Où elles sont, ne de cest an,
Qu'à ce refrain ne vous remaine:
Mais où sont les neiges d'antan?

*********************************************************************************

***Unbelievable! It occured to me that the reference to "Jadis, si je me souviens bien..." needed elucidation, and then my thinking went off course {shock!}, wondering what those of you who might be inclined toward such arcane knowledge might find, were you to plug the phrase into Google... and? Ohmygod-Ohmygod-Obladi-Oblada! Such a Rash of Errata! Folks, please spread the word, that thus begins Rimbaud's Une Saison en Enfer:



Jadis, si je me souviens bien, ma vie était un festin où s'ouvraient tous les coeurs, où tous les vins coulaient.

Un soir, j'ai assis la Beauté sur mes genoux. - Et je l'ai trouvée amère. - Et je l'ai injuriée.


It chaps my hide to find it cited and either falsely attributed or declared one of the more profound thoughts that Anonymous ever had. Grrrrrrrrr.

Monday, November 24, 2008

shoulderless


so it turns out that my remaining shoulder prosthesis is also infected and must be removed. i feel like the punchline of a cosmic joke.

ADDENDUM:
Wednesday PM -- Well, the aspiration was successful, at least. They tapped three different spots around the hemi- on my left side. One step down... maybe this time, knowing in advance what little booger is in there growing and causing trouble will make the whole rigmarole go smoother. (Last time, the aspiration was futile... and then the specimens taken at surgery were left overnight in the OR, rendering them invalid. The only positive result came from my nares --the oh-so-common MRSA -- and pray, above all, that *that* bug is not the culprit. How could it be?)

The White Album at 40 Years


November 22, 1968: The White Album is released. Where were you then? What were you like?

DEAR PRUDENCE
(Lennon/McCartney)
JOHN 1980: "'Dear Prudence' is me. Written in India. A song about Mia Farrow's sister, who seemed to go slightly balmy, meditating too long, and couldn't come out of the little hut we were livin' in. They selected me and George to try and bring her out because she would trust us. If she'd been in the West, they would have put her away... We got her out of the house. She'd been locked in for three weeks and was trying to reach God quicker than anybody else. That was the competition in Maharishi's camp-- who was going to get cosmic first. What I didn't know was I was 'already' cosmic." (laughs)

PAUL circa-1994: "He (John) wrote 'Dear Prudence, won't you come out and play...' and went in and sang it to her, and I think that actually did help."


I'M SO TIRED
(Lennon/McCartney)

JOHN 1980: "'I'm So Tired' was me, in India again. I couldn't sleep, I'm meditating all day and couldn't sleep at night. The story is that. One of my favorite tracks. I just like the sound of it, and I sing it well."

PAUL circa-1994: "It has that very special line, 'And curse Sir Walter Raleigh/ He was such a stupid git.' That's a classic line and it's so John that there's no doubt who wrote it. I think it's 100 percent John."


PIGGIES
(Harrison)


GEORGE 1980: "'Piggies' is a social comment. I was stuck for one line in the middle until my mother came up with the lyric, 'What they need is a damn good whacking' which is a nice simple way of saying they need a good hiding. It needed to rhyme with 'backing,' 'lacking,' and had absolutely nothing to do with American policemen or Californian shagnasties!"


JOHN 1980: "I gave George a couple of lines about forks and knives and eating bacon."


EVERYBODY'S GOT SOMETHING TO HIDE EXCEPT FOR ME AND MY MONKEY
(Lennon/McCartney)


JOHN 1980: "That was just a sort of nice line that I made into a song. It was about me and Yoko. Everybody seemed to be paranoid except for us two, who were in the glow of love. Everything is clear and open when you're in love. Everybody was sort of tense around us-- you know, 'What is SHE doing here at the session? Why is she with him?' All this sort of madness is going on around us because we just happened to want to be together all the time."


citations from here.

The Yuck-Yuck Factor


I am writing this here so as to not write it there. Yeah, I would be the crying unicorn, the knee-jerk liberal, the Obama-loving nitwit.

What is the deal with the paranoid conservative bent so common with emergency medical professionals, particularly the ambulance boys and girls?

Actually, I have reached the point in my life where I don't pursue certain topics with others of a profoundly different take on things, unless I know that the person with whom I am speaking is capable of suspending their beliefs for the sake of examining them by argument. That doesn't happen very often.

So I rarely go berserk about the death penalty, abortion, gun rights, or obvious politicking.

But I am tired this morning. And I just don't care. What kind of an asshole would choose to write: "Yesterday, on Saturday, 22 of November in the Year of Our Lord 2008... Sarah Brady died a little inside"?

I mean, it is not as if AD doesn't have an incredible readership. On Google Reader alone, there are 674 subscribers, better than I have seen at some equally well-written medical scribe spots. His latest post will get lots of yuck-yuck visitors, so if that's his need, his need will be met. I just thought he was more responsible -- an attribute one hopes belongs to every gun-owner.

Is it fun to hurt other people?

Not with guns, I mean, but with words?

Words are powerful weapons. The recoil, alone, is crushing. The yuck-yuck is just... well, childish comes to mind -- but isn't quite accurate. Gleeful? Yes, it is glee -- not unlike the kind I have observed in highschoolers. Unadulterated joy at sticking it to someone, at laughing at the ready-made arguments, believing that, by doing so, those (liberal/other) values are rendered invalid. But -- and I really want to know the answer to this question -- what is accomplished, what thought or opinion is advanced, by base meanness? If someone thinks to answer me by saying that I have no sense of humor, or that I need to get laid, or that I am just incapable of understanding, please don't bother.

You might be surprised about some of my beliefs. I understand that I need to remain open to surprise when thinking of the monolithic "you." I promise that I will, because fairness is crucial. But that's not going to be happening today. Tomorrow, tomorrow, tomorrow -- I will retrieve that hallmark attribute of leftists everywhere: openness to diversity, and the accompanying usual yadda.

Tell me, is March 30, 1981, a Feast Day?

O Come, All Ye Faithful.