Friday, March 18, 2011

the cheesehead bites again...

how. do. you. stop. a. kitten. from. biting? 

more specifically:  how do you stop a kitten from biting ME?

i did not have a portacath inserted into my body just to then be repeatedly punctured by a wild animal passing himself off as a cute-l'il-puff-o'nothin'.

[don't make me have to feed you to the Marmy, Little Stinky CheeseHead...]

for your reference purposes, this is what has been tried thus far:

no, no, no!
uh-uh, no, no, no!
je vais t'envoyer directement aux feux de l'enfer!
je vais t'envoyer directement aux feux de l'enfer!  &^%%*()##@!!!
non, non, non!
puffs of air to the face
taps on the nose
redirection to a cat toy
redirection to a cat
redirection into a dark and endless closet
redirection to passing monks or strangers

Enter the Cheesehead, Goo goo g' joob

This is... well, he has no name yet, except for Muenster, which we don't anticipate choosing as a permanent moniker.  Part of a litter discovered abandoned at a nearby horse farm, the rescuers gifted each kitten with the name of a cheese.

I dunno.  He's more of a Camembert, don't you think?

He is full of bad habits -- he bites (to the point of drawing blood and leaving little vampiresque punctures that hurt like the dickens);  he chews (more like a puppy than any kitten of my acquaintance);  he hisses and growls (given Marmy Fluffy Butt's aggression, understandable); and, in an apparent homage to Dobby, he climbs, and climbs, and climbs -- insisting on the highest ground.

The guess is that he is a Christmas 2010 baby, now approaching 12 weeks.  Exactly like a stubborn toddler, he plays to the point of exhaustion and then stubbornly fights sleep.  We have had a tendency to nod off while attempting to convince him of the benefits of slumber.  It's embarrassing.

The Feline Remnant is slowly coming around, although the outcome of his relationship with Our Favorite (and Only) Girl, Marmy Fluffy Butt, has yet to move beyond her active efforts to kill him.

Dobby is fascinated, pupils wide, pink nose sniffing, even taking gulps of mouth-whiffs.  It was a relief to not hear him pacing and calling all night long.

The efforts to save Uncle Kitty Big Balls, Fred's Little Boy, amounted, in dollars, to $2200.  Ouch.  But again, we made the decision, we would make the same decision today, so it is just time to pay up and thank the professionals for their hard work on his behalf.  I knew that I'd have to sell some shares of stock in order to cover the recent flooring adventure, so now I just have to dip a little deeper.  I am thinking of becoming a vegetarian again, and of giving up colas.  Cutting back on coffee.  Putting a moratorium on all non-essential purchases.  Selling my soul.

Fred is exhausted.  I just checked on him, and he's passed out, The Gnawing Cheesehead passed out with him, held close in the crook of an elbow.

He has been my stalwart companion this week, has Fred.  I don't express anywhere near often enough how much I love him -- in a daily, regular, unexciting way.  Add to that steady fondness, when he loves me through a hard time, I seem to lose all capacity to thank him, to show him how much he means, how thoroughly blessed I am.
1871 illustration by John Tenniel
Through the Looking Glass, Lewis Carroll

Wednesday afternoon, when I was doing pre-op stuff at the hospital, I kind of got swept into a back area before he got to the waiting room after parking Ruby, the Honda CRV.  It was one of a handful of times that I considered screaming his name, calling for help, for a salvation-oriented Knight of Marlinspike!

The first stumbling block was my fever.  Explaining to them that it's kinda status quo for me, that part of the point of the portacath was to make future endeavors like i.v. antibiotics that much easier... did not help the nurse's list of rules, according to which you just don't allow febrile women with high white counts to have surgery on some sort of ridiculous whim!

Then, just as I calmed that storm, she decided that I needed to be interviewed by anesthesia, even though I was just going to be sent into a twilight sleep for the very short and easy procedure. 

I am not sure that you can be a regular reader of this scintillating blog without having read at least one good rant about the events of May-June 2002, when I "acquired" CRPS during a hospitalization that was essentially a recreation of the Book of Job.  If you need a refresher, you'll find some of the details HERE.
Part of the rotten doings discovered by the State during their investigation were some problems in how the Anesthesia Department conducted itself.  I know the extent of the subsequent anger directed toward me because my pain management doctor at the time chaired that department... and chose to attack me during my next visit to him.  What he said to me was ludicrous;  The way he chose to strut his omniscient stuff, demean, misrepresent, and attempt to terrify me?  That was more criminal than ludicrous.

That is one way I know, with certainty, that St. Jo's and its doctors and nurses never really took responsibility for harnessing me with unending pain and terrible, worsening disability, for ending my career, for wiping me out financially, physically, emotionally, for probably being at the root of my current infection problems with osteomyelitis.  I know from hearing him yell and whine about how a 2-day investigation caused him and his underlings some temporary and fixable upset.

How dare I? was the essential tenor.

Shit.  Here I am, weeping again, furious, tired, so very damned defeated.

So... the rep from Anesthesia was apparently sent in to make a point.  I planned to reply honestly but as shortly as possible to any questions coming from them.  But who would start such an interview by saying this:

"So, in 2002, you came to the hospital to have your ankle repaired..."

What?  My mouth was flapping, but no noise came out.

Finally:  "Errr, no.  I came to have a shoulder replacement.  But there was a failure to supply me with stress-dosed steroids and..."

Ever so quickly, and with evident pleasure, she interrupted:  "We did supply you with appropriate steroids.  I have the order right here, and the notation that it was given..."

Still floored that we were even having this conversation, I told her I wasn't surprised, that I was sure that chart had seen numerous changes over the years...

It went on like that.  She either did not know or was coached to believe that the repair of my ankle was not a separate and elective hospitalization.  She told me "That's not so..." when I tried to explain that the ankle fractures occurred in the hospital, that I had arrived at good old St. Jo's with two good ankles, in fact.  I told her about the shoulder replacement, the code, ICU, the fall, the embolectomy, the g.i. bleed, the concussion, and finally, yes, the ankle repair -- all part and parcel of the same hospitalization.

"That's not so..."

I had a fever, of course, and was functioning on little sleep and a bit of sadness.  This was what I had feared -- being attacked while alone.  I vividly remembered that deaf nurse on that May day hissing at me... "Get up, get up.  Your leg is not broken.  Get up!" I vividly remembered my ankle hanging twisted in an unnatural way, rapidly swelling and turning purple.  I had just hit my head and my arm, was lying on the floor, alone with this strange nurse who spent most of her time without the hearing aid upon which she was dependent.  I was in ICU, had not been out of bed, much less on my feet, in over 5 days.

I vividly remembered trying to get up, trying to do what she said, trying not to make her more angry (she was quickly closing the door to my "room" as she hissed her directive to get up, get up, get up).  I remember the pain of trying to stand on that mangled foot, the terror of trying to please someone who may well have been crazy and who had control over me.

"That's not so..."

The surgeon who put in the port is a great guy and I am really glad to have had access to him.  Whether he knew "who I was" or not, I don't know.  All I cared about was getting that intravenous access to fulfill the demands of the doctor doing the ketamine infusions.  I just wanted to slip into the hospital and slip out again before triggering their memories or mine.

The surgeon was satisfied with the blood work we had done last Thursday at my Go-To-Guy's office.  We even called to make sure there was nothing else he needed, as far as pretesting, and was told that I just needed to sign some papers the day before the procedure.

I knew better.  I knew they wouldn't let my being on their campus go unchallenged.

Suddenly, I needed an EKG.  I needed more bloodwork, I needed this, I needed that.  Attempting to get out of it, I told them of our conversations with the attending surgeon.  Averting their eyes, the nurses mumbled that the orders were coming from... Anesthesia. 

I found some emotional reserve and said just one more thing before shutting down:  "All I ask is that tomorrow, when I come for surgery, you keep Dr. Steven S. away from me.  Keep him the hell away from me."

When I was finally back with Fred, who was getting worried about why this short appointment was taking so very long, it seemed the perfect thing to do... to go to the shelter to find a cat to save.

And so it was that in the midst of my ridiculousness, we adopted Muenster, The Cheesehead.

Yesterday, the day of surgery, everyone was polite, helpful, professional.  And, amazingly, most seemed not to know anything of the events of 2002.  What was also touching?  When they left my side, brow furrowed at how my history just did not seem to add up (How did all of this happen to you?  I fell down.) -- they went to read my chart.  The next time I saw them, I heard things like -- "I am so sorry you've had to go through all this..." 

It's nine years late and totally insufficient, and I was so grateful to hear it.

Thursday, March 17, 2011

Port in...

Whew, port is in.

And I am whipped.  At 6:30 am, my temp was 101.  Really neat nurse, though... through ingenuity, we got it down to 100 and a smidge.  She was sure they wouldn't take me to the OR if it were 101...

I wish that Evil People were required to wear a Scarlet E or something.  It makes one something of an ass to assume evil at random, even at a site with a very high ratio of evil to non-evil people.

More on that later, or not.

It was difficult to answer questions from hospital staff about how I "got" CRPS without wanting to punch someone. 

"Was it due to an injury, sweetie?"
An injury? You could call it an injury. You guys committed malpractice and
 negligence all over my ass...

"Do they even know what caused it, hon?"
Sure, they even know the hour and minute it started! Of course, then they
pretended otherwise for over 19 months...

"That's a weird disease, isn't it?"
'Weird?' I guess you could call it 'weird.'  I'm just glad youse guys
weren't distributing necrotizing fasciitis that day...

Anyway, they treated me very well today.  Yesterday?  Not so much.  But yesterday is over.

The port is in... I haven't even looked at it yet.  There is some slight bleeding.  The surgeon was way cool.
I finagled my way into getting a Toradol shot... I love Toradol. 

Er... my last BP check there was 215 over something.  What?  I was in pain... that's the only explanation I can think of.

Speaking of yesterday, there is a 10-week old kitten with needles for teeth running around here raising hell.  He has no name yet.  He and his siblings were discovered as newborns abandoned at a horse farm and they were hauled in to this regional no-kill shelter.  They were all given cheese names -- This guy was Muenster.  I didn't meet them, but stashed in the back were Brie, Edam, and other luscious dairy concoctions.

Temporary Muenster is a biter.  I had just settled into bed to nap through this relatively mild discomfort and he joined me.  Almost immediately, he sank his teeth into my left index finger, and I promptly bled all over the bed and my clothing. 

So I have been doing laundry...

Anyway.  That's all I feel like passing on right now.  I need food...

I hope all is well in your world today...

Wednesday, March 16, 2011

Round One: The First Ketamine Treatment

My first ketamine treatment took a little over three hours. 

We were emotionally pretty flat, still reeling from the sudden loss of a pet the day before.  Physically tired, too, from insufficient rest and sleep.

My pain score (a ridiculous way to measure it, but whaddaya gonna do?) was a solid seven before the infusion and a lie of a six afterward.  It was really unchanged but the nurse looked so expectant...

I only received 70 mg. and will be bumped up toward 100 over the next two treatments.

The thing most people want to know is whether or not I hallucinated, and, if so, what did I see/hear/do?

Sorry, folks, but beyond altered perceptions that Fred effectively helped me process on the spot, there were no fireworks, no Elvis, no trips to the moon.

Music failed me, though, and might have morphed into an hallucinogenic experience had I not ripped the plugs out of my bleeding ears...

Just kidding. 

Bruce Springsteen happened to be singing when the ketamine first hit me... and he quickly began to sound just like Alvin, of The Chipmunks fame.  I tried to listen a few more times, choosing different  genres, different artists, messing with the equalizer, the volume, and there was no relief from the cartoonization of music.

There was some difficulty getting the i.v. in, so proceeding with the port continues to make sense. 

The doctor over there rubbed Fred the wrong way, something I've been worried about, but so long as we remember why we are there and that this is a momentous service, they WILL get along.  THEY *WILL*, I say...

The guy has, I think, a fractured foot -- He's wearing one of those heavy walking boot/cast thingies (I have at least four of them stashed in my office closet), so when Fred accused him of that horrid moral failure of "lurching about like Frankenstein," I was able to defend his gait.

It was hard to defend him when he snapped at a nice, worried elderly lady who had a question that she wanted answered.  She had travelled here with her husband, who is a quad and in terrible pain, and they were living in a motel while he received three weeks of ketamine treatments.  She had no one with her and was clearly doing her best to be cheerful.  I wanted to shoot her.

Anyway, as the doctor lurched about like Frankenstein, she called out to him, "May I ask you a quick question, Doctor?"

First, he gave her a fine view of his back.  Then he lurched like Frankensteing a few steps.  Then, we all thought, he thought better of being such an ass, and turned back around.

"No," he fairly snarled, "You may not ask me a quick question."


That would be roughly the moment when Fred decided he was a Lurching TurdMonster. 

I already knew there was something off about his personality from my initial meeting, though I chalked it up to fatigue, a strong science interest (versus "people" focus), and... yes, pain from his foot.  He could have been the reincarnation of Josef Mengele for all I cared about his freaking personality.  But then, I wasn't the one, this time, who needed a "quick question" answered.

Maybe he had a history with this little old "country" lady.  Would that matter?  It shouldn't, but I had found, after a minimal amount of exposure to her chatter, that I -- oh, what was it?  Oh yeah, I wanted to shoot her.
[With a water gun.  With soft water.]

The worst thing about him is his concentration on... worst things.  No one -- except perhaps for my neurologist, but he is a special fellow -- has ever painted so bleak a picture of my life.  Not that it was a surprise to me, of course, but it was a disappointment to know that my [physical] misery was so obvious.  Psychically, of course, no one has a clue because I am relentlessly funny, smiling, and murderous of any challenge to my evident good will and bright outlook.  It's top secret, my depression.

Beyond that... Monday was okay.  My vision took a real hit but seemed to recover to its usual bad status within a few minutes of stopping the drug.  I was dizzy.  I had more problems with sound than anything.  For instance, I was convinced that I was speaking too loudly, though Fred assured me that I was actually whispering and that if I did not stop, he was going to start yelling questions out to the Lurching TurdMonster, and then I would know what LOUD really was...

No, Fred was marvelous.  He had a book and hoped to read it.  Until the ketamine kicked in, he was able to.  From the first drop, though, I was overcome with if-I-think-it-I-speak-it-itis.  Apparently, one loses the edit function, or at least I do.  Good thing I don't have any currently active secrets.

We made the startling discovery that we each wanted to get another cat, immediately.  This is very strange, as we are reasonable people who understand that making a decision so quickly is likely not a great notion.  But under ketamine, I fessed up that I was worried about the The Remnant, our two remaining felines, mother and son.  To say that Dobby is upset is a wild understatement.  Even Marmy has been crying during the night.

We simply know that it will be fine to go ahead and adopt another.  I gave Fred full authority, as I still feel like Uncle Kitty Big Balls was mostly "his," as much as a cat can belong to a human.

He has fallen for a young cat featured at an online service representing a local no-kill shelter.  Called Tyler, he looks not unlike "one of the family," but his biggest selling points are his small size, young age, and mischieveous air.  We'll see... but as this was the first thing Fred spoke of this morning, as we are getting ready to go to the hospital for pre-op stuff relating to tomorrow's minor surgery, I may well be taking care of a third cat this evening.  I can imagine us "just swinging by to take a look..."

I wish I could report pain relief.  But I can't, yet.

Next week, a stronger dosage, and maybe a better result.  Eh?

Thanks for pulling for me, as I insist on imagining that anyone dropping in here must be doing... midst worries about the Japanese disasters, the Libyan crisis, and whatever is happening in your own lives. 

And yes, I am *slightly* disappointed not to have a tale to tell about some derring-do exploits under the influence of Special K... Again, maybe next week!

If I don't get myself in gear, I won't make this appointment at the hospital.  To say I have anxieties about running into doctors, nurses, and/or administrators who actively helped me get and then suffer (perhaps needlessly) CRPS in the first place... is to put it mildly.  I HATE that hospital.

Sunday, March 13, 2011

Uncle Kitty Big Balls (Little Boy) Did Not Survive Ketoacidosis

Little Boy, known on the street as Uncle Kitty Big Balls, passed away this afternoon.  He was 4 years old.

UKBB was a very good cat and an especially close friend to Fred. 

We are comforted by the knowledge that he was afforded, at least, his "thirty minutes of wonderful" in the course of his stay here at Marlinspike Hall.

Brother to Marmy Fluffy Butt and Uncle to Dobby the Runt, we are going to miss his devotion to family and his laid back approach to life, love, food, sleep, and play. 

I'm really glad now to have made those very amateurish videos... and wish I hadn't deleted any.

We are concerned for Dobby's wellbeing, as he spent much of the night prowling in a search for UKBB, calling and calling.  He (and we) are not really over losing Sammy yet;  This added insult is gonna be rough on The Feline Remnant of Marlinspike Hall -- even odd Marmy Fluffy Butt's universe will tilt askew for a bit.

We feel very much like we let the little guy down, and hindsight clearly shows that we should have had him at the vet last week.  Please, if your cat shows signs of illness, be proactive and get him checked out as soon as possible.  We were still piecing our various observations together when he succombed to ketoacidosis.  It happened very quickly.

Also... in honor of UKBB, be kind to the cats you may meet on the street and under your houses and cars.  He had obviously had encounters with humans who were relentlessly sadistic.  Even with Fred, he sometimes reacted from a memory of fearful, painful experience.  At some point, he was beaten about the head and face;  That he still gave us a chance to be his friends was in itself remarkable.