Friday, January 20, 2012

Nesting 1

I am having major surgery Monday, and the usual pre-op jitters have set in, full force.

In other news, my kidney function decided that *now* would be the ideal time to decline.  The great thing is that I've no symptoms, unless this Edema From Hell is related.  If Dr. ShoulderMan's SideKick had not called, I'd never have known... which would have been infinitely better, don't you think?

I predict a weekend of intense nesting activity.  Choose to stand still while in my general vicinity?  You risk being cleaned, rearranged, painted.  The middle of the night was meant for stirring, for building flavors, for sauces, for loving marinara.

When the pain is so bad that I cannot clean, cook, or repurpose irrational crockery, my domestic urges will find fulfillment in cat videos.  I wish that I'd had this little Flip camera while Sammy was alive, because nothing would touch my heart like visiting with him this weekend, fending off his weird amorous cat kisses... but the fluorishing Buddy the Kitten Collection will have to do.  Buddy is more Struggle and Scratch than Smooches and Mystery -- and maybe that's a good thing, at this stage of the game.

I had forgotten his herculean struggles with the blanket kept folded at the foot of the bed, a blanket which mocks him by not being where it clearly ought to be.  We still come upon him fiercely attempting the necessary relocation.

Truth be told, the pain is nearing the magic 10 on the 10 scale at this very moment, and Buddy happens to be snoozing with his head on the aforementioned blanket -- clearly, a sign that the first cat video of the weekend should be that May 2011 YouTube classic, Buddy the Kitten versus The Blanket.

I am going to try and finish a few drafts for the blog between nesting activities but I have promised as much twice already this week.  If I don't, please think good thoughts around 3 pm Monday, Tête de Hergé time, and I'll see you on the other side of anesthesia.

Soft Paw* Perils

[*If you are unfamiliar with the feline command "Soft Paw," please read up on the subject HERE. A short video on Soft Paw Training is included.]

We recently bought a 16 pound bag of Friskies cat kibble. The price sealed the deal, although the promise of an enclosed cat toy sweetened the pot, let me tell you. It's impossible to litter the floor with enough small, squeaky playthings.

The chow is about gone, a pretty amazing feat for three cats, but not, I guess, when you figure that one of those three is a healthy, young Maine Coon. That would be Citizen Buddy, the Freakishly Large Kitten.

From elle est belle la seine la seine elle est belle

Buddy it was who assumed ownership of the Friskies enclosure, one very weird "Crinkling Paw Toy" that purportedly depicts Humpty-Dumpty, as featured in the 2011 blockbuster film Puss in Boots. It's made of felt, has a crispy creaking bit of something inside, and spindly legs and arms that flop around. Humpty sports an unlikely hat, a weird waistcoat, and drug-addled eyes. An embroidered porcine pug nose.

To a cat, I suppose it might look like a bug. A creepy, overweight bug.

Buddy is obsessed with his Humpty toy. In the course of a day, I've seen the thing staring up at me from almost every room in the West Wing of The Manor. I doublechecked to see if we had more than the one Freak of a Pastime. We don't.

Beady-eyed lippy creature.

We still spend lots of time each day playing fetch, in the hopes of reinforcing the "soft-paw" command in little Buddy's tiny mind. I cannot trim his claws and Fred refuses to. That leaves the natural erosive effect of running, sliding, and skidding like a cartoon across rough-hewn medieval timber flooring, as well as fine renaissance era parquet, plus vigorous scratching of fine leather furniture as the tacitly approved nail-trimming activities for indoor Manor cats. We are resigned to letting him work off the scalpel ends of his talons on Haddock finery, because we have experienced their entry into our flesh, and were humbled.

Teaching him to use "soft paws" on my CRPS limbs was a stroke of genius on my part, and I expect award upon award once he generalizes the command from the game of fetch and applies his learned gentleness to my hands and legs. In the interim, we just continue to strap extra large, industrial grade feminine napkins to my limbs with duct tape.

I am not sure how Humpty Dumpty fits into the Puss in Boots story, or even what the Puss in Boots story is, to begin with. I cannot imagine the narrative need for a ruined and bitter egg, who looks to be a bit of a failed metrosexual.

When I set out to find the lore at the heart of this eggy tale, I landed on a Christian movie review site. Great Caesar's ghost!

While this film was cleaner than the Shrek series, there was still some questionable material that I feel must be noted in order for parents to make an informed decision about whether or not to see this movie

Violence: Moderate. There are several fight scenes between Puss in Boots and other characters in the film, including a few sword fights. Of course, Puss in Boots steals from people. There is a scene where Puss in Boots, Kitty Soft paws, and Humpty Dumpty, are being shot at with guns and cannons. There is another scene where Humpty Dumpty pretends to be hit by a cart. Kitty Soft Paws scratches Jack’s face. There is another scene where Puss in Boots scratches faces (unintentionally). There is a brief scene where Humpty Dumpty is hit in his private area. Lastly, Puss in Boots is knocked out.

Profanity: Mild. One character says the phrase “Holy Frijoles.” There is a scene where Kitty Soft Paws mentions to Humpty Dumpty that she knows how to speak “meow.” The word “pooper” is mentioned, and Puss in Boots is referred as “frisky” two times.

Sex/Nudity: Mild. There are a couple scenes where a man’s pants fall down. Humpty Dumpty is seen changing in front of Puss and Soft Paws. Lastly, toward the end of the film, one man is seen bathing.

Other: There is one dance sequence in the film where Puss in Boots makes a couple obscene dance gestures, but this is brief. There is a mention of “catnip” (a mild drug reference). ***SPOILER*** One of the main characters dies ***SPOILER END***.

Spiritual issues/morals:

As we see Puss in Boots progress through this film, he realizes toward the end that he never had to steal, in the first place. He realizes he was wrong, and he tries to repay the town of San Ricardo for his misdoing. He seeks forgiveness. In the same way, God is willing to forgive us of all our sins, if we are truly sorry and repent of our sins. The Bible says in 1 John 1:9,

“If we confess our sins he is faithful and just and will forgive us our sins and purify us from all unrighteousness.” (NIV)

Well, that scared the hell out of me, for sure.  The story of Puss in Boots is a Shrek spinoff?  Is there no respect for... oh, I dunno... Charles Perrault and his Histoires ou contes du temps passé, avec des moralités: Contes de ma mère l'Oye? You know, the father of Mother Goose? Wouldn't making that link bring the whole moralizing side of things into something of a clearer focus?

I've been glaring at Buddy, but none of this is his fault. He thinks it's a bug, this floppy, felted, belted (and hatted) toy.

My shoulders hurt, but then, you know that. You likely assume, though, that I baby them, that I spare myself the pain that would come from stuff like clearing the deck of a season of oak leaves or gathering six miles of garden hose coils onto a wall-mounted reel. It wouldn't occur to you that I'd expend any energy, much less necrotic bone and pus-imbued tissue, on attempts to throw a piffling bit of fluff like the Friskies Crinkling Humpty-Dumpty Paw Toy.

If you don't have one of these creatures, try throwing a feather. Or a dandelion seed head. Go on, give it your all.

Fred gives Humpty's hat a firm grip between his index and thumb, then flicks the thing like he'd toss a frisbee. He achieves loft but has no lateral control, and so, when he does the deed while lying in bed, for instance, Humpty often lands on The Fred's head, performing more as a perversely soft boomerang weapon system than a dependable and proper flying pie pan.

I'll try most anything once, and will repeat most anything to near death if I get a whiff of success and enjoyment out of it. So it is that my titanium shoulders have nearly come undone trying to please Buddy by launching the Friskies Humpty-Dumpty into very thin air.

My best efforts seem to come when I ball the darned thing up and whip it, side-armed, aiming for one of the dozen linen closets in our well-appointed living quarters, in front of which is a flimsy bit of area rug, the perfect foil for a cat pretending to be a torpedo.

Humpty Dumpty sat on a wall,
Humpty Dumpty had a great fall.
All the king's horses and all the king's men
Couldn't put Humpty together again.
We mutter that bit of doggerel all the live long day, as if it were a promise from the Creator.  Fred has dropped the zombie toy into the kissing stones of the grist mill.  I have run it through various graters, coffee grinders, and even sliced the thing on my Calphalon Precision Mandoline.  And still, when we creep back into our luxurious apartment, our hearts lighter at the thought of Humpty's unexpected demise, there he sits, lank legs crossed, shell intact, weird headgear perched jauntily on his big, fat, pointy head.

Who knew, back when we started Project Soft Paw, where it would lead?

Save yourselves, Friends.  Beware the Crinkling Paw Toy.

Sunday, January 15, 2012

sunday night check-in

i apologize for not "checking in" before now -- and hope to post something worth a read tomorrow or tuesday.  my legs are giving me fits, and the pain/fevers/chills from the infected shoulder make me a very uninteresting person, indeed.

saw the surgeon thursday, and remembered why he and his staff will always be heros to me.  what they are attempting to do for me is technically and medically difficult, something my go-to-guy doctor and i both tend to forget.  so it mattered to take a few minutes thursday to recognize that fact.

the down side of such emoting was the ensuing hug fest -- which rapidly degenerated into friendly shoulder pats that nearly made me scream.

there was one little bit of unexpected news.

dr. shoulderman was trying to walk me through the process and i was only half-listening, as this is not exactly new territory.  he'd gone over the ins-and-outs of the first surgery, talked about the need for a new infectious disease specialist, the PICC line, and 6 weeks or so or intravenous antibiotics.  (he briefly cradled his head in what might have been exasperation at the news that i was still taking oral doxicycline when surgery was 10 days away.  so shoot me... no one told me to stop and it just did not occur to me that it would screw up the culture sampling.  i stopped taking it thursday and pray that was soon enough for it to exit my tissues.)

he paused, and i entertained notions of actually going home and curling up under a few inches of soft flannel, as i just could not get warm.  i have even resorted to covering my feet, something that causes severe burning pain, as even my feet feel cold these days -- and this, after a decade of sleeping with them uncovered.  i also thought about trying to line up the roto-rooter treatment for my port, which, at the moment, will allow stuff to be administered but will not, in turn, surrender any blood for testing.  and, to be honest, there were some thoughts of stopping somewhere for lunch.  i was thinking taco bell when dr. shoulderman's voice took on a new tone...

"after 3-6 months, if all goes well, we will want to go in and remove the spacer, of course.  if it appears successful and we find no obvious evidence of infection, there are then two choices."

i think i probably smiled.  i didn't know i had choices!  this was great news!  i thought there was just the one option, the option we had bandied about for over a year -- the old reverse total shoulder replacement.  a woman with choice, a woman with options, now that's a happening woman.  i put taco bell and roto-rooting plans away, and tried to pay attention.

"we can put in a new prosthesis..." he said this in the most desultory way, as if it were something too awful to contemplate.  odd, i thought, since that is, of course, the best outcome -- a clean shoulder, a new bit of bionic wonder.

"i thought of you last week as we finished surgery on a gentleman in much the same situation. i put in a new prosthesis, the frozen sections looked good, it seems like he had beat the infection.  then eight days later, i get a call saying that something has grown in his cultures -- p. acnes.(this is the major suspect in my case, as well) -- and now he is back on the merry-go-round."

why, dr. shoulderman, that sounds suspiciously like a cautionary tale!

more sober talking, more somber scenarios in which it looks like i have beat the pathogens all to pieces when, behold!  the suckers were just lurking in the hope of reasserting themselves on some new implant.  there were dire descriptions of the state of my bones (no news there), and at the opportune moment, shoulderman shifted gears...

"and so it may very well be that at the time of the second surgery, i will have to assess the situation and consider leaving you with a flail shoulder."

the smile stayed on my face because i had not the least notion of what a flail shoulder was.  i knew the term flail chest from some EMT courses way back when -- and knew it to be a horrible trauma that basically unhinged the rib cage in folks who slam into the steering wheel in a car wreck.  inane smile still plastered on my face, i interrupted to make my inquiry into our brave new lexicon.

turns out that flail shoulder is the polite surgical term for no-freaking-shoulder-at-all.

in truth, this result had been mentioned before, but only in passing, and only, i thought, as a conversational oddity, a bit of ripley's believe it or not.  i remember, most specifically, my go-to-guy doctor whispering, several years back, "this is not going to end well."

dr. shoulderman, kind and handsome, talked on.  some people were able to train themselves to use scar tissue as a kind of new muscle, thereby allowing for some arm movement. i was particularly thrilled to hear that "some people can learn to bring their hand to the mouth."

unfortunately, even the most scintillating of conversations have to end (this one, as that one!).  but i've carried on the talk inside my head, a few minutes at a time, more if the fever spikes a good bit and my frustrations pop out.  i keep imagining what ifs that don't help one bit but are nonetheless all too probable.  how will i do x now, how will i do y?

within two days, fred was already able to think productive, forward-inclining thoughts.  yesterday, he even inquired about the possibility of an external bit of hardware with which i might regain control of my left arm, once it's been rendered flail.  i was dismissive, as it seems like dr. shoulderman would have brought that up right away in his extemporaneous powerpoint presentation.  fred, as usual, is a great point man, and a quick googling of "flail arm" turns up many examples of braces, hooks, and goth-inspired hardware that can be strapped on, and, if nothing else, used to make me look fierce, tough, and borderline biker.

Stanmore orthosis with hook:
Add a clutch and silvertone choker studded with Swarovski crystals for an easy day-to-evening look.

i don't know whether it is the stress of it all, suddenly, or what, but my left leg is now the fugly spitting image of the right one, and both are spasming to the beat of a whacked-out drummer.  i refuse to repeat the die hard description that one crps-er after another has ripped off and reiterated: "imagine being doused in gasoline, lit on fire, and then kept that way 24 hours a day, 7 days a week, and knowing it was never going to be put out..." it's... depressing.

dr. shoulderman is wonderfully cognizant of my crps, and though we rarely discuss it, he is well-informed, as every orthopedic surgeon should be.  he has been distressed by the obvious crps spread, and the condition of my arms, as surgery anywhere is never wise with crps on board, and repeated surgeries in an area of lots of rsd activity is what polite society calls a "no-no."  so he decided to order repeat regional blocks in an effort to prevent further spread.  it was comforting, reassuring -- he cited a recent study, and did so in depth, an impressive feat for a man whose brain must be chock full o'important stuff.

tomorrow will be a long and uncomfortable day.  it's off to the hospital we go, for testing, testing, testing, and -- i predict -- some arguing with the billing office.  they say i owe over $3000 from a few years back -- they didn't file with my insurance company until 18 months passed from the date-of-service, and by then, i had switched to a new insurance, and -- of course -- the former company refused to pay.  if they make this admission contingent on paying that bill?  i will be in a tough spot.

ah, and tomorrow they'll culture skin and nares for mrsa... i have cultured positive several times before, therefore spending my time in isolation, with a very frustrated fred having to wear those awful yellow paper gowns, and be gloved up.

maybe i can have them give me the roto-rooter port clean-up tomorrow.  if we have to spend the day, may as well check off as many chores as possible.

so that's what has me away from the blog... although my heart is always at the manor, safe in marlinspike hall.