A Day In The Life: Monkey Gland Sauce

Life in a Wheelchair                     

© L. Ryan, All rights reserved

Written July 12, saved for this rainy day.

"this, too, shall pass," opines the man who will ultimately pocket my co-pay.  i want to ask whether i could get some non-biblical, less aphoristic comfort if i paid, say, an extra ten bucks.

"nancy will help you check out and schedule your next appointment," and i steel myself, waiting for it.  it comes, not because i am prescient, but because people in the people-helping killing fields cannot refrain from touching me.  he claps me on the left shoulder.

as most of you know, i don't have a left shoulder, just a mass of infected tissue and the sawed off ends of a clavicle and humerus.

a "clap" differs from a "slap," however, and so he gets a point from me for that bit of restraint. perhaps he remembered as his arm swung down, and he quickly revised the shape of his hand, cupping the palm at the last possible moment.  perhaps he remembered nothing, and that was just the fortuitous highlight of my day.

nancy is efficient.  she does not believe me when i say i do not need an appointment reminder card. my various purses, bags, organizers, and sac-like anythings-with-zippers are littered with reminder cards.  you see "organizers" there in that list, yes?  that's where the appointment goes, should i manage to get my hand to grip a pen, to shuffle the pages of my beloved red moleskine to the correct month and day.

i insult nancy, i am sure, when i leave the card on the counter.  i am equally sure that someone even ruder than myself, will wrench the memory from her mind's grasp within a quarter hour. maybe a dirty old man will ogle her smashed and quivering cleavage.

when you sit in a wheelchair, often times, you go unnoticed because unseen by the persons on the other side of service dividers -- be they counters, or shelves or desks with the added visual obstruction of a computer screen or cash register. however, some locations have customer care and check-out stations situated on an elevated platform, in which case, ironically, their line of sight is positively perfect and people in wheelchairs are no trouble to visualize, no trouble at all.

this is most often the case at a pharmacy window, and the acting party, therefore, a pharmacist.

what fred and i usually witness is a clear visual check, a thought bubble, and then a choice, the choice being to address fred, who is invariably sleepy and biding the time with ill will.  i am the person making the transaction, holding the wallet, the responsible party, but after the visual check, the thought, the choice, i clearly cannot be competent.

once that conclusion is writ in the over-the-head bubble, i used to give in.

fred and i are fans of the absurd, however, being absurdity's familiars.

the chef-jacketed pharmacist asks fred a question. fred asks me the question, loudly. i yell the answer to fred.  fred screams it at the purveyor of goods, who adopts the universal look of offended sensibility -- a slight jut to the chin, a supernatural pinch that actually whitens the bridge of a narrow snoot of a nose.  incredibly, though, the precise professional does not switch, does not become enlightened, but continues to address fred, who is awake now and having fun.

"will she be paying with cash or with a credit card?" spits the pharmacist, teeth either gnashing or clenched, it's hard to say.

"i dunno, let me find out," hollers fred.

"honey," screams fred, "will you be paying with cash or with a credit card?"

"what?" i yell.

and so on and so forth.
 
we savor the moment when the credit card receipt needs signing.  that affords us the opportunity for physical comedy, so that we can expand our vaudeville act.  what usually lessens the tension that otherwise might catapult me through whatever tangible barrier separates me from my pill-pushing sparring partner -- a pane of glass, usually, and a row of neti pots -- are the other customers, because you know that we bring enterprise to a screeching halt.

they're usually laughing like fools.  we try to straighten up and make our transaction as fast as possible while still being true to our principles -- these folks might just want a tube of lip balm or a condom, but one surly teen also might be picking up an antibiotic for her twelve year old kid brother who is at home, wheezing with congestion, propped up on two pillows, eating tater tots. we don't want to leave such an angry pharmacist in our wake that he mistake a sulfa drug with a first generation cephalosporin to which young benjamin is allergic, thereby murdering a mere child, who had his whole life before him.

no way, not on our account.  not on our watch.

we have other routines.   not too many, as i do not get out much.

one i particularly enjoy employs the opposite approach to the skit methods we rely on when appearing together.  fred doesn't often leave my side when we are out.  i've never asked him to stick to me like a velcro-buddy, but he does, and so serves as a buffer zone, keeping me from people who may inadvertently bump into me or touch me in some way.  the few times that we grocery shop together, though, i try to pull my weight and take on half the shopping list, carrying a basket in my lap for the herbs, rices, and dried beans.

let's say i am perusing various prepared broths, deciding just how lazy a cook i want to be, and marveling at the sodium levels in chicken stock, when a shadow looms and a voice booms:

"CAN I HELP YOU REACH ANYTHING, DEAR?"

once my heart regains its normal rhythm, i turn the chair to face them, and whisper in the smallest of all possible whispers, "no thank you, i don't need any help." and then beam at them, making sure my cheeks are as rosy apples but my eyes, crossed.  on a good day, i work up a smidgen of froth that hangs from the corner of my mouth.
sometimes it goes on and on, as they then proceed to decide what it is i want.  no kidding! whatever it is they choose to plunk into my basket, it comes from the tip top shelf, is usually dusty and sports three different pricing labels.

i whisper something, maybe a line from my fair lady:   "I've a right to sell flowers if I keep off the kerb."

my strange helpmate will assume an expression of profound gratitude has slipped through my foaming vocal cords, and continue in the dance of code, proffering a goddamned slap on the shoulder and a screeching, "YOU'RE WELCOME, OF COURSE.  NOW DON'T YOU EVER, EVER GIVE UP BECAUSE GOD LOVES YOU."

a few minutes later, fred will spot me in the aisle, come to consolidate my basket with his full-sized grocery cart, and ask, bemused -- but in a voice of normal volume -- "what exactly, are you planning to do with monkey gland sauce?"

 

Author notes

please excuse my lack of caps, the moments of ear-bursting yowls excepted, of course.

X-treme Wheelchair Vacuuming: Don't Try This At Home

Today, I hit the 20 mg/day mark on the memantine, and tripled the titrating dose of the anti-spasmodic used mostly in MS, dantrolene (being taken with baclofen, clonazepam as well -- we are talking serious spasticity, my Darling Readers).

That ain't interesting news, but it does contribute to the hilarity of my current situation.  Nothing would be funny if it had turned out that I had no WIGGLE room, and I mean that literally.  But WIGGLE I have, enough to be able to grab the video camera that I still cannot work well, and by WIGGLE and GIGGLE I submit this multimedia assessment of my current predicament:   

Should I fail to extricate myself from this dastardly conundrum, it has been fun knowing you, Sweet Readers.  I will be the smiling corpse on the very clean floor in the back bedroom, West Wing, Marlinspike Hall, deep, deep in the Tête de Hergé.

$3 Million

What a morning.  Don't trust surgical paper tape to hold your PICC line thingies firmly attached to your forearm, and forget that ridiculous webbed fabric designed to hold everything in place.  I woke to find my two ports and their attached plastic tubules all a-wandering around the bed, one even under a Maine Coon.

For the record, I've decided that Buddy was misnamed, by me.  Instead of following Fred's advice of waiting for the cat to name itself, I rushed and forced "Buddy" upon him.  He is clearly a "Bubba." Whatever the case, he answers to bonito flakes.  We are actually concerned now that he is not putting on sufficient weight to compensate for the alarming length he has acquired.  He's a thin guy, not a swarthy molecule to my Bubba, no.

The great thing about finding blood in your PICC lines for the third or fourth times, is that it is the third or fourth time, and you didn't expire during those first few incidences, so likelihood is in your favor.

Also, I was all wrapped up in this warm dream about being offered $3 million by some lawyer that my infectious disease dood introduced to me, in a meeting with him, both of my PAs (Jacqueline and Susan), the wondrous on-site pharmacist (Lauren), and yes, this swell dude in a three-piece tweed suit and a bowler.  No shit!  Very clever and full of excitement, I had Fred drive us to the Best Credit Union West of the Lone Alp in Tête de Hergé.  He was pretty pissed (in real life as in my sleeping version) at me for bossing him around, didn't want to go to the Credit Union.  I don't know why, they love him there.  He shows them his sweet, shy side and is sweet on Ruth, the Head Credit Union Honchette.

They have lots of rocking chairs, braided rugs, beautiful quilts on the walls, chocolate cookies and milk in one corner, also a cage for toddlers disguised as a welcoming play pen.

Anyway, I zoomed into my banking institution, gave Ruth the eye, and she and I left Fred in a rocking chair with a spare Credit Union cat and an experimental latte (they're trying out a bikini barista -- bikinis à la Annette Funicello).

Framed art print for sale at eu.artcom

So Ruth opened a few dozen accounts, some for me, some for Fred, one for Bianca, one each for the Brother-Units, one for a few former best friends.  I gave Ruth a big freaking tip which she deftly tucked into her G-cup over-the-shoulder-boulder-holder.

Then I make Fred drive us to a car dealership.  Not just any car dealership, but the one that sells the car of his dreams.  You know, the old Pagani Zonda dealership.  You can find them, usually, near a KFC.  Anyway, yes, the order is in for one Zonda 760LH, (convertible).

The dream ended there, almost.  The last memory I have of it is receiving a phone call from Doctor ShoulderMan who told me two things:  that he had bought me a home of  my own, where I could live, comfortably, safely, and happily alone, and that in it he had put a very special bed that would ease much of my pain.

Then I woke up.

Back to the bloody PICC lines, the Former Buddy, a sweet-natured Dobby, and the echo of a slammed bathroom door that I assume came from the aforementioned Fred.  Marmy Fluffy Butt's tail drifted in and out of my sclerotic vision.  Sven, no doubt tightly spooned with La Bonne et Belle Bianca Castafiore, gave an angry yell at the door slam, then apparently lapsed back into the redemptive, cushy love of our Diva.

I am tempted to give Fred a new name, too.   And it ain't "Bubba."

So hauling my ass out of this bed without the use of one arm, and with both legs currently in awful shape -- the right refusing to bend at knee or hip for a good few minutes, mostly from swelling, partly from spite -- and with none of the expected orthopedic help apparatus in place.  You know, like a trapeze bar.  Mostly that.  I could do wonders, I could qualify for the Olympics were there a trapeze up there. Marta Károlyi, herself, has said, sighing, "Prof, dah-link, working with the over-bed trapeze would make you incomparable in uneven bars, and with just a little make-up and disguising do-dads, we could slip you into the men's still rings, maybe even the pommel horse.

Marta Károlyi is disappointed in me.  Hey, Marta, gimme $3 million and a decent gourmand for a coach, and I'm your girl/guy.  Kisses to Bela.

I use my wheelchair, parallel-parked by the bed, a cane, and sometimes a grabber, to achieve an upright status.  Lately, frustration has led me to also use a fair amount of force on the underside of the bedside table. This is likely a poor idea, as all things give, all things give way.

Careful to keep our small wing of The Manor steeped in good quiet, I squelched my way to the Medieval Kitchen, stoked the fire (in spite of forecasts of temps above 100 for the day), started the coffee, retrieved a 200 ml medicine ball of daptomycin, three saline flushes, two heparin flushes, two alcohol wipes, and washed the singularity out of my hands.  Wash, wash, wash, clean towel.  

The mewling, meowing, and outright cat screaming interrupts the PICC process and kibble is presented, to each according to the proper bowl, each with its own protocol.  

The kettle whistles precisely in the middle of the PICC flushes, and I opt for quieting the overly excited Paul Revere, since Sven may de-spoon from The Castafiore and come kill me, and Fred might make a fast break to lower the drawbridge, as -- when rudely wakened -- he mistakes loud noises for requests to cross the moat.

So my huge scoop of Italian roast is sitting in its nice hot water in my café presse, and I start the 9-minute timer in my head.  That's right -- I steep the stuff for 9 minutes, despite the expert admonition to stop at four. I'm a freaking radical.

So there are two ports, one purple, one red.  Because daptomycin only needs to be given once a day, we cleverly use the purple port for all infusions and the red one for all blood draws.  Red::blood, get it?  Because, yes, unbelievably, when we had to do twice-a-day infusions, and alternate ports, we'd get confused.  But now, all I gotta remember is red is for blood.  

This morning, though, both ports are streaked with blood, and the coffee isn't ready.  So I flush them both, using the whole saline and heparin repertoire, twice.  I have no idea if this will impact anything -- I doubt it, when I stop to think about it, after having done it, after having a few sips of excellent 9-minute café presse Italian roast with a good splash of milk ("It does a body good!").  

Finally, I hook up the stupid medicine ball, which is the whole point.  I am wearing scrubs (great pajamas) because the pockets are perfect for holding medicine balls.  The technical term for these med balls is "elastomeric device," and they look like this, when fresh from the fridge:

See?  So you just tuck the sucker in a large pocket and before you know it, poof!  It's a shrunken bit o'plastic and all the medicine is running around your body, curing you of whatever.  And you've been ambulating, catapulting, scrubbing, and pruning tree branches that loom way too close to a Chagall stained glass that we just discovered this spring.  

This disposable plastic dodad is the kind of inventions that I really admire.  I am not at all sure, but the clever inventors seem to be:

Thompson, Thomas C. (Dallas, TX)

Center, John L. (Dallas, TX)

Stocton, Paul M. (Clarendon Hills, IL)

They called it: WINGED INFUSION HOLDING DEVICE WITH THERMOPLASTIC ELASTOMERIC BODY and the date for the patent is 1974.

Ah, clearly, I have lost le fil de ma pensée.  What a shocker.

Because I haven't even told you about the invasion.  The ant invasion.

I keep a clean Manor, damn it.  There is no sugar being all sexy on my counters or floors.  The honeysuckle is strictly kept in line with the out-of-doors.

So it was that my eyes bugged out to see a four-lane highway of teeny, tiny ants marching, marching, marching, with clear intent and purpose, across the floor of our communal craft room (you know how I feel about scrapbooking!).  

All right, it is not an interesting story and hardly a catastrophe, but for a woman who has yet to take her pain meds, with bloody PICC lines, and who has just rolled her wheelchair through a fresh heavy-on-kibble and very wet hair ball, it wasn't packaged happiness.

Fred, who knows a lot about a lot, later explained to me that sometimes a heat wave will inspire these annoyingly cute little insects to up and move their home base somewhere cooler.  This "somewhere cooler" for our crowd was a certain spot under a large throw rug.  Careful inspection of their destination revealed nothing special -- no spills, no nothing.  Just a huge rally of a few thousand peewee ants.

It took me three hours to feel comfortable that they'd all been eradicated -- and greenly, safely, so as to pose no danger to man, woman, or beast.  I followed their highways and byways, swept, mopped, wept, swept, and mopped some more.  I washed the offensive section of the rug.  I vacuumed the whole damn rug -- each side.

And when I was done, sometime around 2 PM?  Everyone got up, stretching, meandering for the bathrooms, searching for good coffee, murmuring vague "good mornings" to the bloody, red-faced, mop-wielding me.  Only Sven paused to listen to my exciting tale and wonderings about formic acid, scratching his crotch as if a few of the invaders had somehow invaded him.

In my next dream, when I meet with Ruth at the Best Credit Union West of the Lone Alp in Tête de Hergé in order to deposit my $3 million, I get all the money, in cash, and Fred doesn't even have to drive me to the border.  I'll take a cab.

Ruth still gets the wad of bills to stuff in her bra, though.  Fair is fair.

A Year Ago: Bed 5, Round 4

first published on 4/12/2011

I had my first opportunity to serve as Ambassador of Ketamine yesterday, a duty that I discharged with vigor, if not honesty.

About a half hour before being escorted to the treatment area, ketamine patients are instructed to stop by the outpatient pharmacy, sidle nonchalantly on up to the counter and hit the pharmacist up for 10 mg of Valium.

I think nonchalant sidling is akin to the skedaddle of the detritus loving Fiddler Crab.

You ask for your Valium out of the side of your mouth;  You cover your purchase with a bag of sour Skittles and maybe some Milk Duds;  You pay your dollar, pop your pill, and go wait to be called for treatment.

So I'm in line, humming, fondling the candy.  There is a guy in a wheelchair taking up a lot of time -- like, they tell him it will be a few minutes before his medication is ready, and he says okay, I'll just wait *here*... but, like, I can't get to the counter because he is entrenched, waiting *there*... 

Jeez, people in wheelchairs think they own the world.

Fred does his clear-the-throat routine.  That doesn't work because, heck, we're in the middle of a hospital where half the population has tubes running down their throats and the sound of raspy retching is the sound of normal.

I finally just call out over the guy's shoulder -- "Yo!  I'm here to get my one-buckValium and to pay for these Skittles and maybe some Milk Duds before I go fall in my K-hole, yo, y'all."

At which point the guy in front of me practically does a wheelie.

"You, too, huh?  This is my first time.  I'm really nervous.  Does it really work?  What are you getting it for?"

Aw, fudge.

I'm nervous, myself, and this is my fourth treatment.  And I am not feeling chatty, or excited, or even vaguely benevolent.

Nonetheless, I proceed to be a fine ambassador of subanesthetic ketamine infusion therapy for intractable pain.  My routine is peppered (and salted) with plenty of "it varies from patient to patient..."

"Is it working for you?  How long does it take before it works?  Is it scary?" And so on, and so forth.  I meet his Blessed Mother, who has blue helmet hair and clearly thinks I might be one of them "drug atticks."  He rolls up his pants to show me his red lobster legs, trying to convince me that his pain is horrible, that he cannot sleep, that he's tried everything.  I tell him he is obviously a cry baby, signal the money-grubbing pharmacist tech, peel off wide, and catch my neatly packaged diazepam on the fly.  Fred tucks the candy into his backpack, I leave an IOU tucked in the Bowel Program For High Quadriplegia aisle (next to the cards and magazine rack), promise to settle accounts "next time," and we leave that big old cry baby and his helmet-headed mama with mouths hanging open, sucking in our dust.

When I am assigned an area back in the treatment room -- Bed 5 -- guess who is put in Bed 4?  You guessed it!  And his mama, too.

Big fat paralyzed cry baby seems to know every doctor and nurse who strolls by... and for some reason, people seemed to be taking their lunch-break power promenades down Ketamine Alley, peeking in at us weirdos and our wheelchairs, canes, catheters, ports, and world-weary loved ones valiantly trying to stay awake as lights and sounds dim, then mute. Fred and I listen to my neighbor bitch and moan as a namby pamby, softspoken, I-think-I-can-help-you type doctor attempts to tweek his spinal cord stimulator so that the cry baby can sleep long enough to have a wet dream. The doctor leaves him with several programs to try and some inspirational thoughts by Jack Handey.

I am the last person to be hooked up, even though I have the largest dose to be given.  As usual, when I start the infusion, ketamine greets me with one of its more dependable effects -- a kind of sepia treatment, a brownish, sometimes greenish, tint or wash that rubs out details and crosses soft edges.  That, and hearing so acute that I perceive Fred thinking of ducking out to grab a sandwich -- and his loud, booming hope for a kosher dill on the side.

Big fat paralyzed red-legged mama's boy cry baby, like many of us, has brought music to listen to in the form of an MP3 player.  In fact, I had spent a fair amount of time during the night making a playlist specifically for the Ketamine Experience, hoping to avoid Jimi Hendrix and the Banner, "Knockin' On Heaven's Door" and stuff like the giggle-inspiring "Illegal Smile."  Me and my 54 songs were ready for Round 4, all negativity purged, insipid pop privileged over mind-bending instrumentals, rock classics, and Mozart.

But now, in the cozy environs of Bed 5, there was this competing roar that I couldn't at first locate and never managed to silence.  That's right -- the cry baby's music (if it can be called that! sniff:sniff) vibrated all over the damned place, bleeding from his earbuds.  His taste in songs seemed to be limited to groups formed by cousins.

I apparently don't rise above a whisper during ketamine infusions.  Fred has to lean in close to hear me and says that I perpetually inquire as to whether or not I am being too loud, and seek reassurances that I am not, in fact, shouting. 

So there was that to contend with -- supersensitive hearing and leaky earbuds.

And yes, once again, I became hyperconcerned about a little old lady who was stashed in the last bed on Ketamine Row.  She was moaning so, and weeping.  Would these people never shut the hell up?

Part of the reason I was late getting started was that they accessed my portacath for the first time. Thankfully, that went fine, despite the nurse's contention that it was still too "infected" to use.  The problem is now relegated to one tiny area of the incision, through which pokes this recalcitrant little stitch that refuses to "dissolve" and be absorbed by my body.  Every few days or so, I clip the ends, and to keep things free of pus, crusty critters, and squishy maggots, first thing every morning and last thing at night, I douse the area with cognac and smear bacon grease over the wound, concentrating on that problematic corner.

Sorry.  That's what I felt like telling the nurse every time she inquired whether or not I was applying neomycin, keeping it clean and covered, etcetera.  It seemed she asked a hundred times and that was before the pharmacy even delivered the right dose of ketamine -- they had prepared a bag of 50 mg when I had graduated to 125, and the time required to correct the error was sufficient for her to worry enough about my site to page the doctor for "clearance" to use the port.

Clearly peeved at having been pulled from his clinic patients, he glared at me (not her, mind you, but me), poked at it meaningfully with an ungloved index finger, and declared it "perfect."  Before dashing back to the crowded exam rooms and stacks of charts, he gave me a short pep talk, even using the word "miraculous" to describe the relief that would be coming my way any day now.  Fred had a sneezing fit in the middle of the doctor's testimony, and I thought I saw the word bullshit fly out of his delicate aquiline nose and dance in the air before diving into his fine linen handkerchief.

If you are dying to know whether I got any pain relief from Round 4 of subanesthetic ketamine, you're not alone.  So am I.

At 4:10 pm, I had no pain in my feet, no pain below my knees.  I laughed, I smiled.  I announced it.  And then it was gone.  No one reacted to my news, so I am not sure whether I actually said it out loud.  Even when I retold the tale on the ride home, Fred didn't think I was serious.

When people describe how heartbreaking it is to have pain relieved only to have it return?  There is no melodrama there.  It really does tear the heart asunder -- bundles of ischemic cardiac muscle fall apart, shred, and twitch in extremis.

To answer the question, then, I don't know.  I might have dreamed it, I might have hallucinated it, but at 4:10 pm, I had no pain in my feet, no pain below my knees.

All I can conclude is that maybe we are nearing the right dose of ketamine... I heard the nurse and the doctor discussing something about adjusting the rate but not the dose, but I am not sure they were talking about me.

 The big fat paralyzed red-legged mama's boy cry baby next to me?  When they inquired about his pain level following the infusion, he crowed -- "Zero!  Zero, man, zero!"

His little blue-haired mama looked confused, but pleased, and announced that they were gonna go get them some Taco Bell.

My next treatment is set for next Wednesday at which time the dose will be 150 mg.




"cocorosie K-hole {independent} music video" uploaded to YouTube by ensnyggflicka on Dec 4, 2006

Tiny spirit in a k-hole

Bloated like soggy cereal

God will come and wash away

Our tattoos and all the cocaine

And all of the aborted babies

Will turn into little bambies

Wounded river push along

Searching for that desert song

And mozart's requiem will play

On tiny spearkers made of clay

Tell my mother that i love her

Martin luther you're an angel

Charming monkey saunter swagger

Drunken donkey limbs disjointed

Your chest is a petting zoo

Mexican pony fucked up shoes

I dreamt one thousand basketball courts

Nothing holier than sports

Dragonfly kiss your tail

Precious robot built so frail

Universe of milk and ember

Your hot kiss in mid december

What's god name i can't remember

Trough the crack eye lovely weather

this wild urge to have a parade

Technically, this is a repost.  In its first incarnation, it was called "Aesthetics of Catastrophe." 
I needed some evidence, tonight, that I really had tried.  You know?  That I went the distance, even beyond -- kept running, dolt that I can be, past the finish line!  This post commemorates the end of CRPS treatment, the end of the subanesthetic ketamine infusions last year, and it goes to the head of the line today.  


I did try.  


Didn't I?

Etymology of catastrophe:
1530s, "reversal of what is expected" (especially a fatal turning point in a drama), from L. catastropha, from Gk. katastrophe "an overturning; a sudden end," from katastrephein "to overturn, turn down, trample on; to come to an end," from kata "down" + strephein "turn" (see strophe). Extension to "sudden disaster" is first recorded 1748.

[Wikipedia] From Ancient Greek καταστροφή (katastrophē) from καταστρέφω (katastrephō, “I overturn”) from κατά (kata, “down, against”) + στρέφω (strephō, “I turn”)

Perhaps I miss the point.

I have two appointments today at the "catastrophic care hospital" where I received Ketamine infusions in an effort to conquer some of the pain inherent in CRPS.  There are many people being helped by this treatment there, most with some sort of neuropathic pain following brain or spinal injury or one of the chronic progressive neurological diseases -- but also many folks in the end stage of cancer, stroke patients, amputees with "phantom" pain.

It's a stalwart, funky bunch, with an alternative sense of style, a different notion of bling. 

"I like your cane" -- something I hear a lot.  I ditched the utilitarian bronze standard issue for one that is a screaming mess of blue flowers and leafy, leafy greens.

"Where'd you get those shoes?" -- and, oh dear God, if you have neuropathic pain in your feet -- presuming you have feet -- the Shoe Issue is never far from your thoughts.  I only wear shoes when I have to, like during a visit to the catastrophic care hospital, or for a quick waltz in the middle of a nasty parking lot strewn with bits of broken glass and bullet casings -- by the light (not the dark but the light) of the silvery moon (not the sun but the moon).

Sorry.

I loved shoes, loved wearing them, loved Italian leather, loved my legs.  A Top Ten Moment in my young life?  Waiting for a tennis court, feeling myself perused, turning in curiosity in the direction of the stare (always turn in the direction of the stare), meeting a handsome, frank face, hearing:  "Damn.  You've got nice legs for a white girl..."  The shoe?  A Stan Smith, I believe.

Now, of course, I cannot wear a proper shoe and only own one pair of foot-covering, an Old Friend brand "slipper" that literally folds on, with the Gimp's Favorite Aid, Velcro.  It is lined with shearling, the toe is open, the sole is flat, the size huge.  Over the course of the last nine years, I've slowly thrown out my shoe collection and added inevitably earth-toned, garment-dyed, loose-fitting organic cotton clothing, born of no discernible style, and often involving drawstrings instead of pesky zippers or buttons. 

Who owns just one pair of shoes?  (If you're about to deliver a sermon that includes references to very poor and/or saintly persons, I hope you choke on it.) 

Anyway, I dole out the fashion advice, extending my flowery cane for inspection, modelling my fancy footwear, and I covet, in my turn, their superior wheelchair, or the personal assistant carrying all their excess stuff, filling out their forms.

A person in pain, surrounded by other people in pain, will zero in on anyone who projects a measure of physical comfort, and deconstruct his circumstances, examine her measures and countermeasures, desperate to take away something worth a try. 

One day soon I need to record the bizarre scene we witnessed in the pharmacy, where the Gimps gather prior to Ketamine treatments in order to get the "dollar special," a ten-milligram Valium that is supposed to help with spasticity.  {Snort}  I can tell you exactly what happened, but what the scene requires is beyond my aptitude for description.  A young woman, about 25 years old, was ensconced in the most intricate power chair I've ever seen.  Do you know what I mean if I say:  "She had too much chair"?  Too much for her body -- thin but wiry, with good muscle tone, the all of her nestled in what must have been a herd's worth of fleece.  Her face blank, her eyes flashing angry, she was in good control of her upper body, and something made me remember her as in control of her legs as well.  No, maybe all I knew was that she wasn't a quad.  Memory, schmemory.

She was abusing her chair, abusing those of us near her chair, and was being so curt with the pharmacy clerk that some sort of implosion seemed imminent.  Head Pharmacy Dood glowered down upon her from his place on high, under glass.

Using the joy stick on a power wheelchair becomes completely intuitive within minutes of first use, and most are now quite sensitive and require only a light touch.  She was doing zero to 4 mph in jerky lines and semi-circles, those eyes grim and sucking the giddy joy out of the rest of us sickly excuses for deformity. 

As waiting was the name of the game, most of us powered down and stared at CNN, ubiquitous CNN, or read the headlines in The Chronicle, comparing them to the ubiquitous USAToday piled underneath the local option.  But scoping out the media became impossible as The Chair Abuser hit her stride.

In an alcove near the check-out counter were several carts ready to be taken out into the larger store, priced, and displayed.  It was an interesting mix of sterling silver jewelry, gift vases, and zippered-and-velcroed nylon contraptions meant to accessorize our wheeled conveyances -- in a vast color array that extended from teal to hunter green. 

The Crazy Lady decided that was where she and her oversized, tricked-out behemoth needed to be.  It was doable -- I could have done it -- but I've a hesitant, cautious hand when out in public.  Hell, I file a flight plan with my cerebral authorities when venturing my handy dandy Invacare into tight spaces.  I use hand signals, I organize committees before undertaking a three-point turn. 

She barrelled ahead, weaving, almost taking out an able-bodied adolescent, who squeaked as he leapt aside, all floppy.  She rammed the first cart.  The domino effect ensued.  Clearly enjoying her role as Mayhem, she grabbed a few pieces of jewelry, blithely dropped them, rocked her chair forward, rocked her chair back, ran over the jewelry -- the flat, tread-lined pieces of sterling transformed into embedded bling in the institutional gray carpet. 

At least five of us stumbled through sentences that died out with our mutual verb choice:  Does she need help, do you think?  She needs help, should we help, how can we help, oh, God, she needs help-p-p-p.

Okay, so I might have tossed in a gratuitous, Damn, but she scares me...

She was moving at a speed far beyond our half-hearted verbiage.  Instead of a controlled centrifugal turn to escape the alcove -- where most everything was now on the floor, and trampled -- she rammed, slammed, smushed and smashed the chair controls as far as each could go in every direction and dimension, she twirled and whirled (but no dervish, she!), and while a part of me wanted to cheer, most of me wanted to cry.

A display -- lip balms, gums, Swarovski crystal-encrusted earring-and-necklace sets, and an odd tray of Original Fruit Skittles --  fell victim to her frantic exit.  I say frantic, but there was no frenzy in her, in the her, proper. 

I thought, "She's evil," but I said, "She's new to this, she's angry, and she has too much chair!"  The Ketamine Crew responded with sage nods, with murmurs;  The pharmacy clerk sighed and began passing around the Valium.

Yeah, so.  One day, I will tell you all about it.  Okay, so it was transparent;  It was like being hit across the face with a big, stinky fish posing as a big, stinky metaphor.

I've visited this hospital at least weekly since March.  There are a few things that bother me immensely about the place, but that might have to do with issues more properly situated between my ears.  Most of the time, once the pharmacy trip was done, the forms signed, when Fred and I were just hanging out, waiting to be taken back and assigned a bed -- we were humbled to be sharing air with all those wise-cracking, sweet-hearted heros.

While the hospital is an absolute marvel of technologies and innovation, someone somewhere gets perverse pleasure in manipulating the décor.  Who knows, maybe it's the latest in Occupational Therapy.

The Pain Institute itself is a sudden offshoot from one of the hospital's central corridors.  Well, one of the hospital's many central corridors.  Lost in one of the area's numerous parking structures (think parking deck, but perverted and amplified by Feng Shui for the Disabled), I managed to get close to a bird's eye view of the complex, and while, yes, it's linear, it's also the victim of haphazard planning, possibly by someone trained young on squat little green and red Monopoly houses and hotels. 

You know what I mean -- you get on an elevator and already you've the choice to exit via the front or the back folding accordion door, with options for switching to various color-coded floors that have life-altering and destination-screwing walkways, breezeways, or "bridges." There is also a tunnel connecting the Catastrophic Hospital with another award-winning, world-class (i miss ross perot) hospital of the regular variety -- though I tend to think that catastrophe is as catastrophe does, but hey, that's just me.
The tunnel also serves as a conduit to some of the larger satellite clinics and prominant private practices located across one of this city's busiest and most famous streets.  Fred and I are very familiar with the tunnel, having many times crossed under the street to get from the regular, non-catastrophic hospital to my Infectious Disease Doc's place.  Ah, the joyous hours there -- trying to get PICC lines to work and cozying up to piggybacks of vancomycin. 

We never tunnelled our way, though, to the catastrophic hospital.  You know, that place that is the subject of this blog post.  Damn, but I run a tight ship.

So anyway, once you've found the Pain Institute within all that mess, you're likely to feel some vague anxiety just by the look of the waiting area.  The layout is linear clutter that screams impermanence.  We theorize that the Institute staff plays with the seating arrangements much in the way some families rearrange their Christmas crèche. [Fred enjoys recreating Stonehenge designs;  He also likes to use alternative characters -- We always have at least one Winnie-the-Pooh Nativity somewhere in The Manor, having bought up a warehouse of Disney knock-off figurines a few decades back -- a shrewd investment,  let me tell you!  Tigger, Rabbit, and Owl make great Magi, while in other poses they can repeat as Shepherds.  Eeyore is a fabulous herd animal or camel, and even once served as Joseph. The dozens of honey pots have dozens of uses, structural as well as thematic.  Piglet, of course, is the Christ Child, with Kanga as Mary.]

You'd think that this institutional waiting room would be limited by the number of its individual elements of design:  two very long sofas, three wingback chairs, and what must be the leftover seating from a dozen or so discontinued dining room sets.  We've shown up for morning appointments, sipping coffee midst sofas placed back to back.  We've then left, had lunch, and returned for an afternoon meeting -- iced tea at the ready -- to find those same sofas separated and holding up opposite walls. The next week, there might be only one couch, and from a completely different design line. We finally figured out that the Institute Design Elves swap the furniture with other clinics that also extend from the catastrophic hospital's main corridors -- "Look!  The Pain Institute's Llama Hide Sectional Loveseat is dressing up things over at the Multiple Sclerosis Clinic!  I think they swapped it out for those sleek, stackable Lego Original Dining Chairs we had stashed by the water fountain.  Shoulda nailed those suckers down..."

I'm tempted to tell some ugly truths about the Temporal Lobe Dysfunction Subcortical Mini WalkIn Clinic, especially what those Klüver-Bucy Syndrome wankers* try and pull.  They may act all meek and mild, but that doesn't mean they don't wanna have intercourse with the sexier pieces of the Pain Institute's furniture or suck on our doctors' elbows (Dr. BlinkALot found that out the hard way when he tried to retrieve the Pain Institute's antique coffee urn.  He claims one of the patients winked at the departing carafe, grinned and said, "Best lay of my life and I didn't even get her name...").  Some lobes just don't take well to being divided.

The truly weird aspect to the Institute's wait area?  Someone tried to make the Institute adhere to a nautical theme, complete with rope-wrapped portholes as mirrors, a series of nonfunctional barometers,and the requisite oars -- jauntily crossed and mounted on the betadine-splashed, sand-colored wallpaper like those giant wooden forks and spoons handcarved by angry artisans with food issues. (Why are there never giant wooden knives?)  As every interior decorator worth his salt knows, strategically placed sails can hide a multitude of sins. Therefore, the Pain Institute has spinnakers;  It has jennies;  It has proper jibs. And, of course, what are you going to do with perpendicular horizontal spars but put up the square rig for which they practically scream?

There's a bronze plaque honoring the design firm responsible for the Pain Institute's décor -- I assume they mean the permanent décor, that part of things that is nailed or glued in place, impervious to Parkinson's Posse and those Fearless Souls in the Diaphragm Pacing Stimulation Outpatient Clinic.  The award must be based on Superior Oddity.  It's not like "Ahoy, Matey" leitmotifs run rampant through this place, catastrophe's home in the urban heart of a huge city.

I'd say roughly 60% of the outpatients bring their own chairs which makes for some interesting traffic issues.  It's tough to figure out whether a seemingly random grouping of wheelchaired people are waiting in a line or whether we all just ran out of battery power in random proximity to one another. 

No one comes alone.  We all have "caretakers" -- hired, borrowed, or trapped into it by circumstances of love, hate, guilt, whatever.

I can be brought mentally and emotionally quite low by the mere thought of that waiting area.

But self-pity and fear go out the window, or the porthole, really quickly when my attention turns to the hallway traffic traipsing, limping, and rolling by.

Most of the inpatients are so young, and so terribly injured and altered.  Think about it... who has the most chance of being catastrophically injured?  The young and adventurous, the young and stupid, the young and talented -- the young. 

It's humbling, and my rate of bitching and moaning drops to new lows after every visit, however briefly.  I wonder whether it's a change that merits permanence.  I am not sure.

You see families whose lives and histories were altered in the course of a second.  There are almost always trim women chattering away, nimble and tan, walking self-consciously behind their children, who lead these strange parades with walkers, splints, manual chairs, power chairs, crutches -- forearm, underarm, strutters, platforms. Blunt therapists amble alongside, offering advice but not help, providing the will and the wherewithal until the patient can supply his own, her own.  Fathers and brothers are more rare, usually bring up the rear, are pale, and blink a lot. 

A couple of the parades we've watched have been of young families, and then the grace of little kids kisses the whole affair.  No one told them the Parade Rules.  Spunky toddlers cannot remember to stay behind the behemoth wheelchair, not to climb on Daddy's lap, not to hitch a ride on the walker frame, not to laugh, not to be selfish.  Children are anathema for sanctimony.

I don't mean to make it sound like every patient one sees is a rad skateboarder or that the families are all impossibly optimistic units devoid of realism.  But there is a difference, hard as it is to describe, between people whose brains and spines were injured while engaged in sport, or driving a car, and the large group representing stroke, chronic/progressive neurological disease, amputees, and brain injury folk.

And many people journey essentially alone.

When I think of the patients who have yet to have a parade, and who might never have one, it becomes too much.  There is, for example, a "pre-rehab" program for those patients who are "minimally conscious." 

Yeah, so... So this is the blog post that I started on Tuesday, before heading over for my two appointments, and this is the blog post that I finally finished this morning, three days later.  In between, I have raged, cried, embarrassed myself, embarrassed others, jerked, spasmed, and hurt.  I mopped, swept, cooked, made lists, did laundry, read two books, groomed cats, and then raged-cried-embarrassed-myself-and-others-jerked-spasmed-and-hurt some more.

I was a total ass during the first appointment, and even though I apologized promptly, it was a tantrum that needed to happen, just so I could get over myself.  The second appointment was a breeze, as my nurse was one of the Ketamine Crew who was pulling clinic duty that day, and the doctor failed to show up, sending his PA instead, whom I much prefer.  Both of those women could probably finish my many sentences with close to perfect accuracy, and better spelling.

One "hugged my neck" upon hearing that my experience there was ending, the other blinked a lot.  I was encouraged to call every few months to see if there might be a drug trial or a new therapy in place or in the proverbial pipeline.

It didn't feel like a failure (whereas it had, earlier, at the first appointment).  I was incredibly lucky to have the opportunity to try -- to try again and again, past the point most medicos would consider sensible.  That said, I am very sad, and tired.  A little confused.  None of which was unexpected, really.

What I didn't expect was to miss the place, to dream of the maze of corridors and peculiarly specialized alcoves, each peopled by peculiarly specialized men and women. 

I sure didn't expect to spend so much time eyeballing Marlinspike Hall's layout, making my various routes around The Manor more wheelchair friendly, learning to not hate my adaptive equipment.

I definitely did not expect this wild urge to have a parade.






* [Courtesy of The Urban Dictionary] WANKER:

ONE:  While "to wank" means "to masturbate", the term "wanker" is seldom if ever used in British slang to denote "one who wanks". It is quite wrong to infer from somebody's being a wanker that they in fact wank (and vice versa), but of course, fair to assume they do in any case. Herein lies the genius of the insult: if you call someone a wanker, it's probably true, but only literally.


I suppose it all originates from our repressed Victorian sexualities, from back when everybody thought they were the only ones to suffer the secret shame of being an actual wanker.


Most children these days learn the word "wanker" long before they learn its literal meaning.


You're such a wanker.
Oh gosh! How did you know?


He lost both of his hands in a childhood kiting accident.
What a wanker!

TWO:  George W Bush.
Wankers can't be trusted with their own dicks let alone anyone elses.

Have you seen my grabber?

Good morning, Dear Readers.

Dobby is glaring at me, having been dumped on the floor in the panic of my waking.  I do not normally use alarm clocks, so when the radio screamed itself into existence, pillows, books, remotes, telephones, an empty can of mixed nuts (with sea salt), and a pet hair roller pickup thingy all went flying.  The great news is that I seem to have much improved range of motion in that left arm, judging by how far I threw the grabber.

And, as anyone with a love, or need, of a grabber/reacher knows, the first thing one needs upon tossing one's grabber... is a grabber.

I haven't celebrated my birthday yet.  We had anticipated simply postponing the traditionally wild affair a week or so, but our plans were superceded by rude reality.  I did, however, put together a dreamy Wish List of things any girl would want, using a dog-eared, glossy medical supply catalog as my Wish Book.  Chief among my desires?  New grabbers.

Stashed in corners, hanging from bookcases, I have a good number of these things already.  However, each has its peculiarities, and most have been modified. One won't pick up paper, or do any work requiring a decent pinch action.  One is inexplicably marvelous for picking up tiny white pills.  Another has been run over so many times that its only remaining use is as a kind of hook to retrieve heavy, wet laundry from the washing machine -- or as some sort of weapon, I suppose.

By the rapid clenching and unclenching of his jaw muscles, I can attest that one of Fred's least favorite things to hear is:  Would you hand me my grabber?  There are variations that may actually be worse, like:  Have you seen my grabber?


Several times a day, I can be spotted trying to pry a grabber off the floor with the assistance of salad tongs, a cane or mop handle, or -- my favorite, and a sign of immense frustration -- by carefully depressing one end of the thing with a wheelchair wheel, thereby leveraging the other into the air enough that it can be... grabbed.  [My understanding of lever-fulcrum dynamics may not be the standard understanding.]

After politely declining to purchase a state-of-the-art pink bedside commode, and shaking his head at the idea of a fancy new whirligig mattress -- a motor-powered pinwheel construction that takes being bedbound into new realms of possibility, Fred said he would order some new grabbers for my birthday present.

Having opened with the image of Dobby flying through the air, it's worth noting that each of the Feline Remnant has a special relationship with the grabbers.  Buddy the Freakishly Large Kitten is determined to consume one, and his penchant for a good chew is evident on each of the gimp utensils.  Marmy Fluffy Butt becomes scarily amorous in their presence, rubbing her cheeks against the handles, purring, all squinty-eyed.  Dobby sees them as foes, and challengers to the strict hierarchy of The Manor, according to which, he, Dobby, is always Number Two.

Yesterday, I saw the good MDVIP Go-To-Guy doctor, a trip which left me exhausted, and this morning we are headed out to the infectious disease dude's place, hopefully to have good news about last week's labs, and to have this PICC line REMOVED!  Pain is a bother, but it is coming more in waves now, so that's not so bad.  The wound is healing nicely under my careful ministrations [hoot!], no more pseudomonas that I can see, and none that I can whiff, either.  I continue to walk from bed to bathroom, scuffing and scuffling along.  Can a rousing soft-shoe routine be far behind?

Have you seen my grabber?

postoperative poopy-doops, and so on, and so, forth!

dear kind reader[s],

here's a [very] rough breakdown of Things Since Surgery, as composed earlier today [friday]:

one of the first things i heard while coming around was some news broadcaster calling newt gingrich "a nimble politician," so i knew i was either in hell or awake. 

here's a quick summary: 

the prosthesis was very infected, confirmed by frozen section during surgery
but whether it will grow in the lab is anyone's guess [if you have celestial influence, that's the wish to use it on]
he had to split the bone, unfortunately
he put in antibiotic laced spacer made of what's called "surgical cement"
i arrived in room from PACU with NO i.v. access and that was surely fun
on my birthday, i got a PICC line and a second regional block -- woo hoo!
the spasms arrived, along with dr. b, my favorite infectious disease doctor
dr. b, too, wants YOU to pray for The Crud to grow in the lab
spasms and pain brought me to my first ever declaration of 10/10 on the pain scale
needed 2 units of blood
they got permission, over my protests, to use my left forearm for the BP cuff during transfusion

i protested because that could cause CRPS spread in a freshly operated limb

and... the CRPS promptly spread
i was devastated
asked my ortho and dr. b to send me home so i could get pain control
they agreed
fred got to the hospital after the last drop o'blood, riding my wheelchair into the room like a knight in shining armor
we needed all kind of help to get my massively swollen and oh-so-fetching body folded into my wheelchair
[did i mention that the chair is on its last legs? that we were hoping the new one would arrive before surgery?]
fred had kept it nonstop on its charger
so, of course, we turned on the power, and... NOTHING... DEAD... KAPUT...
we got home but it was not pretty, nor comfortable
fred has been challenged and we are just trying to survive
we had to be at dr. b's place the next morning at 10
we made it... got re-trained in PICC line administration of vancomycin
by the time we got home, nerves and tempers were shot
but it's been uphill since then
fred forwarded all your email replies earlier today
and he was so wise to do that - as it gave me a wonderful lift.
he thanks you
i thank you
i love you!

Soft Paw [with a side of Sweet Honey in the Rock]

All you need to know is that you get to see "more Buddy," and we'll be fine, you and I, youse guys and me.

Don't worry, as soon as the need for a bathroom assumes gigantonormous proportions, I will find a way to exit this wheelchair and knee-knobble to the loo.  But at the moment, my legs won't work and I am -- as the Bible might put it -- sore irritated.  Sore afraid.  Sore stuck.  Not to mention sore sore.

—adv
	archaic direly; sorely (now only in such phrases as sorepressed, sore afraid)
[Old English sār; related to Old Norse sārr, Old High German sēr, Gothic sair sore, Latin saevus angry]

Until then, it's cat videos and anything else that is both inane and distracting.  Oh, a new episode of Hoarders is on.  Be still my heart.  Quick, give me something to clean, a feline to brush, lint to pick, dust to scatter, a suspicion of dirt!  I bet this show has inspired a whole heck of a lot of cleaning in Amerika.

Okay, back to the subject at hand.  Mostly, that is Buddy the Freakishly Large Kitten Recently Discovered to be of the Maine Coon Variety.

I've previously explained that he is trained to the command "Soft Paw," by necessity, as his natural Paw State is far from being one of squishy-soft, pastel-colored angelic intentions.  His paws will one day be registered lethal weapons.  To the immunosuppressed among us, they are killers right *now*!

So the big-little guy loves to play Fetch with his mice, and will in fact, bug the badinage right out of you until you acquiesce to his every freaking fetching ploy and demand.  Mwa ha ha!  Help!  

In order to give the Soft Paw command some currency in the World of Buddy, we train him through his love of Fetch.  In short, we do what all animal lovers/owners do but I am trying so hard not to think of how I need to peeeeeeeeeeeee but cannot get out of this magnificent red Pronto that I will expound and pound upon the least little detail just to get through one more blessed [dry] minute.

Oh dear God, I'm gonna die laughing, at least.  Fred just flew by, telling me, at a high rate of speed, that he discovered that Marmy Fluffy Butt has organized the entire Feline Remnant of Marlinspike Hall such that Dobby the Runt and Buddy the Freakishly Large Kitten are pooping in one litter box, and urinating in a second one.  Marmy herself?  She pees in a third litter box, and poops... well, at the moment, she is pooping, very neatly and discreetly, right next to the paper we put down for her by the back door.  Right... the back door leading to the Private Palatial Porch.  Making yet another delightful obstacle to my getting out that door into the fresh, pine-scented air.  Wait!  That was yesterday's rant!

Anyway, God bless Fred.  Because I am not supposed to dabble in things kitty-litter related.  Also, thank the dear Lord that Fred shares every toileting detail with me as I would otherwise be oblivious to that important part of the animals' lives.  Now I know what Dobby has been whining about -- Marmy has extended the web of her powerful influence to actually designating which waste receptacles are to be used for which waste.  

shiver::of::pure::terror 

Right.

Hmm.

So.

Ah, yes!  Soft Paws.  I was able to make two very short videos of Buddy's training.  As usual, what I recorded turned out to be aberrant from the norm.  Dobby has become jealous of the Big-Little Guy and so his pink nose turns up quite close to the camera every time.  He's a bit of a diva.  And Marmy even has decided that there must be something inherently rewarding about this camera business, but when she pops up (she's the one who always looks a little confused), that scares Buddy in the extreme.  Her terrorism of him, early and often, is now paying its dividends.  In one of these videos, he has turned to chase the beloved mouse, after successfully tapping my hand at the Soft Paw command, and then he FREEZES.  That would be because Marmy Fluffy Butt decided to appear, just out of camera range.  It is a testimonial to her ridiculous power that the kitten nearly ceases to breathe, holds his crouch, and -- though we cannot see them -- allows his pupils to madly dilate as he points like a Bracco Italiano after feathered game in old Lombardy.

I've come to dearly love Buddy's face.  He is so clueless, you might think.  You might even hold this wrongheaded opinion for six months or so, and who could blame you?  Because until you have the chance to watch his cagey self on video -- hitting rewind with frequency -- you are fooled by the vacant expression, the goofy grin.

He's sly, this one.

He has developed little tics as he plays Soft Paw Fetch.  He wants to NOT tap my hand.  Or if he gives in, and goes for a tap, he wants to claw me to death, just a little.  But then he won't get the mouse.  So he bobs and weaves, ducks his head, does a little rope-a-dope.  Oh Lord, I have to pee!

If you see Buddy tap my hand but not receive the Fetch reward of a Tossed Mouse, it's because he forgot the soft part of the command.  When that happens, he does sometimes have to do some Quality Control calibrations, the first of which is always to offer his head as a paw replacement.  This is terribly important to him, so I give him verbal praise, but repeat the request for a Soft Paw.  It's cool, watching him weigh how much he wants what, what he's willing to do, etcetera.

All right, that's it.  I'll be right back.  If I drive the wheelchair to the threshold of the bathroom door and then throw myself forward with all my might, I am bound to hit porcelain of some kind.  Wish me luck.  If I am not back in 10 minutes, please, would someone call Tante Louise?