Showing posts with label wound care. Show all posts
Showing posts with label wound care. Show all posts

Friday, March 2, 2012

A Calm Acceptance Is Within My Grasp

we did okay yesterday.  at the end of the day, there we were:  accounted for, joking around, a little breathless.

the end of the day jars my memory -- i've never read kazuo ishiguro's the remains of the day. i enjoyed the film adaptation, despite not having much fondness for anthony hopkins. i chuckled nervously just now upon learning that there was a well-received musical version... surely someone is punking moi?

let's steal it as a theme, what do you think? the decline of aristocracy. i see it all about me, i see it in marlinspike hall, in spite of (or because of?) a strict tradition of genetically indentured servitude within the domestic staff's nucleic code.  i see it in the algae colorfully clinging to the edges of the moat, sliming the captain's miniature pink submarine.  all of tête de hergé (très décédé, d'ailleurs) is witness to the fading luster, what with budget cuts to roadside bonsai forests, as well as the recent spate of re-appropriations of museum donations -- primarily of period clothing -- by some of the oldest, most respected, and storied families of the realm.

first on the list yesterday morning was the infectious disease doctor and his fancy-schmancy new infusion center.  we left early, we got there late.  lots of tête de hergé traffic (balloons and the usual signage game play), lots of fender-benders -- but tiny fenders, at least, on the mostly clown cars.  red bulbous noses, yarn hair, voluminous striped britches.  it was hard to be upset in the middle of primary colors and popping jewel tones.  ruby, the honda cr-v, waded through the mess like the champion that she is.

the office had relocated since my last visit, and while the staff was perfectly calm, there were glazed eyes, lost supplies, misplaced charts (doctors' notes were being recorded on pink post-it notes) and rooms piled high with the disparate art work of gone-out-of-business motels.  the few finished walls boasted cooler fare, mostly activist expressions about HIV/AIDS, human rights, amnesty international, as well as small touches in each exam room, like autographed pictures of the docs with magic johnson or anthony fauci.

what they are gonna do with the motel art?  well, dear readers, i respectfully introduce the motel art show series, such as "The One Night Stand At The Ole Miss Motel on September 3, 2009":

Under the direction of photographer Erin Austen Abbott... [of Oxford, Mississippi] the show kicked off in 2007, followed by one in Los Angeles the next year. “I was taking pictures at an old Travelodge-style motel, the type that you drive up and park outside your room, set in a u-shape,” says Abbott. “All the doors had these wooden red hearts on them. I had heard rumors that the walls inside the rooms were brown wood paneling, and I suddenly had visions of T. Model Ford sitting on the edge of the bed, playing his hill country blues while fine art leaned against the furniture or replaced the current art hanging in the rooms.”


Abbott immediately went out and found 10 artist friends who were having a hard time showing their work locally. They made up the first show, and, in 2008, she took her motel art show on the road to Los Angeles. Over a thousand people showed up for “The One Night Stand at The Beverly Laurel Motel,” and the show was featured on Yelp and in the Los Angeles Times...


For art lovers who don’t live near Oxford, Abbott has good news. Next year, the show will be presented by The Yoknapatawpha Arts Council (named after Faulkner’s fictional county) and, in addition to being held in Oxford each October, travel to other locations in the spring and fall. For 2012, the Motel Art Show is scheduled to hit Brooklyn, New York, in May and Nashville in September.
so i am thinking, why not a variation on the motel art show model?  why not "decoration's remains," about medical office leftovers?

i'm jittery this morning, can you tell?

anyway... what i most appreciate chez the infectious disease dude's place are the boxes of tissues placed at intervals of every 2-3 feet.  i am always springing a leak of some sort when i visit.

it was determined that yesterday was day 36 of my 42-day intravenous antibiotic sentence, and that i would, all things being equal, have my PICC line pulled next wednesday after the final dosing of antibiotic tuesday evening.  there were arguments made over then beginning an unending course of oral antibiotic.  i didn't listen very closely -- spasms in the left leg and in the left shoulder (that's a distressing place to have muscles seize, smack dab in the middle of an open wound).  i have nothing to contribute to the conversation.  just tell me what to do.

ever since the head infectious disease doctor dude saved me from an ignominious end a few years back, i've trusted him implicitly.  i was an inpatient, crammed into a shoebox of a room ["it's a private room!"].  trapped by thick beige plastic bedrails, i could just make out the outline of my wheelchair, stashed in the corner by the leaking sink and plywood wardrobe.  a familiar urge overpowered my good sense and i crawled between the burglar bars, landing atop, although also landing askew, one of three bedside commodes. shoving aside four types of aluminum walkers [a rollator, a hemi-walker, a platform walker, and the drive knee thingy] before reaching my power chair.  satisfied sighs as she powered up, no worries in that regard, no need to find a charger midst all that junk.

long story short, yes, of course, now i was trapped in my chair instead of in my bed.  i strove to push my way out of the corner, tried equally hard to plot the path of least resistance in the general direction of freedom.

within five minutes, i was red-faced, hair all sweaty tendrils, cursing and sobbing, à la fois.

enter infectious disease dude, the head dood, in fact.  he's a geeky looking fellow, very tall, bent, kind of a craggy face, but kind. a marvelous sense of humor, but you have to be patient with it -- it's shy. better not to laugh too loud or too much.  in fact, better to arch a simple eyebrow and allow just a hint of a smile in the eye.

the doctors of today don't engage. they see a patient trapped as if surrounded by an ice floe in a room that draws junk to itself like a magnet attracts iron filings.  this doctor, however, fairly leapt over the obstacles, deftly (well, not deftly, but with dreams of deft-itude) piling and reworking the layout.

"there!" he crowed.  "you're free!"  i've been downright fond of the man ever since that liberation.  he laughed with me as i confessed that i really had nowhere to go but back to bed...

i saw a new PA there, my doctor and his usual PAs apparently having been lost among the huge boxes and crates.  [wow, a leitmotif!]  having a new PA was distracting, as she was staring at my feet and hands, her own hands suddenly anxious, her fingers picking at her fingers, now and then twirling a thumb ring.  she had some sort of medical blackberry, some sort of know-it-all electronic resource, and was peeking, picking and pecking, making furious inquiries.

CRPS is oddly symmetrical, i've noted that before.  the latest evidence comes in the form of "matching" pus leaks from below the cuticles on my middle fingers and thumbs.  it is bizarre and has held the attention of many hospital types, usually in lieu of dealing with my screamed complaints about the spasms.

so we all oooohed and aaahhhed over the pus on my hands, how weird, hmmm, and huh, wouldya look at that?

fred and i drove across town, got lost, got found, checked in, finally, at one of the satellite offices of dr. shoulderman, my orthopedic surgeon.  we stared at CNN. i zoned out. fred kicked me, and i was called back into the labyrinth of exam rooms and x-ray cloisters.

the x-ray tech looked very familiar and she positively lit up upon seeing me.  she and her pals had been working the last time i had been there, mere hours before ending up in an ambulance, heading for hell in the icu.  "you were so sick," she said.

"you look a thousand times better," she ended, and i decided she was the most talented and deserving of x-ray techs that i'd ever met.  cute, smart, perspicacious, insightful.

the gist of the visit?  pseudomonas in the wound, which had an unattractive green cast to it, and a smell which the surgeon described as "fruity," but which made moi gag.  he was completely calm, and swore that a vinegar solution, in place of the saline soaked wet-to-dry packing, would quickly solve the problem.

we hope so.

i especially hope that it is easy to do, since the first message on the answering machine upon our return home was my MDVIP go-to-guy's nurse saying that insurance was not covering home health visits and that she'd cancelled their plans for this wound.

my reaction to having compiled yet another huge bit of medical debt was to try and sleep a little bit.

thus far this morning?  the home health agency has called three times, and -- convincingly -- told me that my MDVIP go-to-guy's nursenurse is misinformed.

i don't care. someone is right, someone is wrong, but i just don't care.  i can do this dressing change -- piece of cake! fred, bianca and i have the antibiotic infusion under control; and i am getting stronger, day by day, thanks to not being trapped in bed by wires and tubes, and ignorant assumptions.

i'll let you know if there is any attitudinal shifting once i am faced with the green stinky evidence.

psychologically, i am not in a good place, but i am trying.  if the spasm-meanies will give me a bit of peace, i think a calm acceptance is within my grasp.








Friday, February 24, 2012

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.