Saturday, February 25, 2012

Specialists



it's been a difficult day.

on the other hand, burly firemen and wise-acre EMTs did not traipse across my freshly mopped floors, and no one told me the doctor on call had to approve the benadryl capsule i needed for a dire case of itching.  when there was despair -- somewhere around 1:58 pm -- there were also three cats and sunshine.

the wound care nurse came and provided a fast and efficient assessment and dressing change.  like me, like the wound care team at the LTAC, he is reluctant to reapply the wound vac -- it is healing well on its own. he's gonna voice his opinion to th doc on monday.

i don't need another machine to trip me up or more wire/cords to touch my arms or legs..

i'm feeling some anger.

today's amusing anecdote?  the three conscious encounters with the hospitalist who admitted me to the ICU from the emergency department -- obviously, she and i met while i was unconscious. how rude of me.

first encounter:  "well, hello!  you are the lovely lady with the two beautiful lovely daughters who came to my emergency room last weekend...oh! what is wrong with these legs?" [reaches out... and yes, grabs one.]

second encounter:  "well, hello!  did we get you set up with a cpap machine?  when is your cardiologist coming to see you so we can order that test?" [don't ask me!  don't use cpap, didn't know why my cardiologist should even be consulted.  so i continued eating a yogurt...]

third encounter:  this was the day i saved my own life.  in the midst of extreme muddle, it occurred to me to doublecheck on my "usual" meds, especially corticosteroids, as i have adrenal insufficiency.  turns out she'd discontinued ALL my meds.  no steroids for 6 days, shining a light on my increasing weakness, confusion, etc. this despite a duly delivered medication list, a medical alert necklace, and the presence of fred.  also, i'd just had surgery there a week earlier -- one of seven shoulder operations in the last 3 years.  in other words, you'd have to be willful in your ignorance NOT to know what meds i need.  she  cruised in after the nurse paged her in a panic, offering me this explanation:  "i didn't do that!"  panicked eyes.  never saw her again.

"the lovely lady with the two beautiful lovely daughters" would've been more understanding, i am sure. and sometimes i do miss my cardiologist -- he once told me that i'd never die so long as he was caring for me.

ah, specialists!


Friday, February 24, 2012

To My MDVIP Go-to-Guy and His Nurse Sidekick

rough strife

howdy hi, there, buckaroos!

taking wednesday as reference point, some things are better and nothing is worse, so i'm declaring today a holiday.

when i shut my eyes last night, i was afraid.  my body was sending conflicting signals. doom doom THUD doom doom THUD pulsed my temples.  desperate for a cool cloth, or several, the terror of trying to stand up overruled all desire.  i made myself cry to release tension, then i slept.

the home-based wound care service hasn't happened yet and forms the basis of my anxiety of the moment.  i am employing the tried-and-true method of doing something to trump the nihilism of worry.  note that something does not entirely mean anything.

don't fall for corporate preciosity, dear buckaroos. at the LTAC [long term acute care], the reason they were stringing me along and refusing to discharge moi to marlinspike hall involved convoluted difficulties in arranging for wound care nurses to visit the manor.  insurance minutiae, complicated machinery, documents, manuals... i expected to hear "Best Practices" at any moment...

i was cowed by the evidence of the heroic effort being made on my behalf, but against the good judgment of the best medical minds housed within that five-floored, modular facility.

a plucky social worker, however, let slip that the problem involved the one home health agency with which the LTAC was contracted:  "the guy who does wound care is on vacation."

and so it was that i roared, and after roaring, left.

my MDVIP go-to-guy and his able sidekick had offered to help arrange for home health services once i flew the coop.  they're wonderful and they mean well... by which i mean, of course, that the first company they called didn't take my insurance -- and they didn't think to ask.  we live in different worlds, we do.  so, bushy-eyed and bright-tailed, i was up at 4 am yesterday, in anticipation of an "intake assessment" by wound management.

i ended up carefully rewetting the gauze crammed in the gaping maw of the incision... and blithely mouthing schtuff about sufficient unto the day, not borrowing trouble, sparrows, and lilies.

we've made progress today, but it's 3 something on a friday, when even the highways of tête de hergé (très décédé, d'ailleurs) can cause traffic headaches.

there was a fair amount of drainage, but it looked like innocent blood, and did not smell.  it itched like a mofo, but it did not smell.

with the exception of cramming gauze into the aforementioned gaping maw, i just copied the work of the LTAC's wound care specialist.  i was a nervous wreck.  i engaged in more negative self-talk than in the whole previous week.

maybe i'll get some help over the weekend.  if i infect this wound somehow, i will never forgive myself.  [yay! there is an agency wound care nurse coming tomorrow morning!]

the spasms returned, but the pain is less than it would be were i still trapped by a hospital bed, complete with rails, a bed frame,and a flying trapeze...

i need to rest now.  various sweetie-pies have told me that things get better after periods of rough strife*.





* i love lynne sharon schwartz... and recommend her novel, rough strife.  better than that, though?  disturbances in the field...




*To his Coy Mistress
by Andrew Marvell
[....]
Now therefore, while the youthful hue
Sits on thy skin like morning dew,
And while thy willing soul transpires
At every pore with instant fires,
Now let us sport us while we may;
And now, like am'rous birds of prey,
Rather at once our time devour,
Than languish in his slow-chapp'd power.
Let us roll all our strength, and all
Our sweetness, up into one ball;
And tear our pleasures with rough strife
Thorough the iron gates of life.
Thus, though we cannot make our sun
Stand still, yet we will make him run. 




Wednesday, February 22, 2012

i am home

i'm home.

i signed out "against medical advice" after being carted by ambulance from the effed-up hospital to the effed-up LTAC facility [a nursing home in disguise].

many long and funny stories about such nether worlds are queuing up for future blog post status.

a total of 26 days in hospital, ICU, LTAC.  a wound care service arriving early in the morning, since to make my escape, i had to force the disconnection of my gaping shoulder wound from its pal, the "wound vac."

i had a second surgery on feb 13 [correcting a boo-boo from the more major one on jan 23] and the decision was made to hook me up to an oreck...

don't anyone dare tsk-tsk me over ducking out AMA -- trust me, i was getting weaker and more spastic by the hour.  there were people on my side -- notably the doctor, the floor manager, the social worker -- but they cannot change by fiat the ignorance [wielded on my legs like billy clubs] that reigns among their staff.

my favorite RN? i asked her to please look up CRPS.  she snapped, "i will not!"

and then told me she was going to have the doctors "evaluate [my] legs, 'cause that ain't right!"

so... god bless us all, be kind to one another, but take care of yourself when no one else will.

i'm gonna take it verrrryyyyy slow for a good bit.

but i am home.