Friday, August 22, 2008

a cup of trouble, anyone?

dear all,

would anyone like to borrow some trouble?

i had my echo at 8:30 this morning. i asked the tech how it looked and she gave me a thumbs up and a "looks good to me." so we go home and i plan to pay some bills, declutter my piles of paper, etc.

ring ring ring.

it is one of the cardiologists. he is talking fast, and i cannot understand the words.

so... my heart is pumping well. i still have my usual aortic regurgitation from my bum aortic valve. and then there was that other thing. oh what was it?

oh yeah! where the aorta attaches to the heart ("the aortic root"), well... it is kind of dilated. like in an aneurism. i become a regular chatty cathy -- i ask if this precludes me having the surgery on monday and he says, no, that will be fine. then he starts to yell at me about how i need to have echos regularly -- that they found this dilation back in 2003. i don't *remember* that! (after i hang up and am talking to a weeping fred, he reminds me -- my cardiologist told us that it wasn't as bad as it looked on the echo -- and that i did NOT need to foillow up with him anymore! fred remembers that vividly.)

anyway, it measures 4.65 centimeters. i ask what needs to be done about it -- and the guy fairly hoots! (he actually was very nice) "major open heart surgery," says he.

well, what kind of symptoms should i be looking out for? and i am getting a chill just typing his response.

"you won't have any symptoms."

as in, it blows, i die. (hence, the weeping fred.)

there must be something extremely wrong with my mental health, this all seems like a great big joke to me! whahaha! what's gonna happen next?

i told fred that this is definitely an incentive to live in the moment.

so -- i guess it is a good thing i don't have hypertension.

whahahahahahahahaha!

love,
prof

Thursday, August 21, 2008

Hiatus

Retired Educator here,

I am having surgery Monday to remove an infected shoulder prosthesis. No one was able to tell me whether or not I will have internet access if I bring my computer. The closest intel was "Well, I know that we are a wired hospital because we have these things everywhere!"

Huh. I anticipate major 'puter withdrawal. The distraction would have been nice and I also was looking forward to blogging the patient-side of a hospitalization -- now that I am more familiar with the major gripes let off by medical types, I think it could be an interesting exercise.

Yes, thank you very much, I know that there is nothing preventing me from taking notes, even sketching the pieces out long-hand. I can still do it. Still -- stop trying to solve my problems, you people, you! I need to fuel useless angst -- it serves to crowd out the more dire reality! You're just messing with my Trojan Horse of Denial.

I'll be in the hospital between 5 days and several weeks, according to the surgeon. According to his nurse, I'll be there 3 days. I'm thinking she probably knows best. They will put in a cement spacer that is laced with antibiotic -- after a "few months" that can be replaced with a new prosthesis. I'll also get i.v. antibiotics through a PICC line. My orthopedic surgeon, however, seems intent on depressing me further by saying, and saying again, that I could end up "without a shoulder joint." There is nothing someone who is already a geeky gimp stuck in a wheelchair wants to hear more! Excuse me while I panic.

I couldn't even get him to give me odds. That's low, when someone won't even give you odds.

Wednesday, August 20, 2008

If Dr. Seuss had written for ER

by Brent Fogel

Kerry: Now Mark, I think this ER's great,But...there are problems that can't wait!Now Benton's fine, and Carter too,But Ross and Susan just won't do!Now who do you think that we should hire,Since both of them today I'll fire?

Mark: Kerry, maybe we should wait and see...

Kerry: That's great Mark! I knew you would agree...

Jerry: Dr. Weaver? Sorry to interrupt...But the paramedics just pulled up.

Mark: Ok, I'm here. What have you got?

Shep: This little boy has just been shot!His pulse is faint, his breath is weak.We did all we could to stop the leak.

Riley: And this woman here, she has a broken hip...

Carol: How did she fall? How did she trip?

Shep: The kid's mom was getting in my hair,So I shoved her--lightly--down some stairs.

Mark: Benton, Kerry! Take the mom to three!Doug and Susan! Come with me!

Riley: But wait, but wait! Oh don't you see?We've got some more; one, two, and three.

Kerry: You've got three more? How can this be?Explain it, tell it all to me!

Riley: Well, Shep was driving. Really fast.A light turned red. Shep hit the gas.We hit a car, it hit two more.Soon the total rose by four.Another bang! Another crash!But we couldn't stay, we had to dash!We grabbed these three but I am sure,The injured totaled sixty score!

Carter: These people really are a mess!Their injuries I cannot guess!It makes me sick, my knees are weak,A toilet I must soon go seek...

Benton: It's ok Carter! Stay on your toes!It doesn't get worse than this you know!To Trauma four let's take these three.You can do it, come with me!

Green: Ok, let's get this boy on the table.To save his life if we are able!

Haleh: Dr. Green! This boy is cyanotic!I can't find a pulse...oh, wait I've got it!But it is weak! Oh, woe is us!

Doug: Give him saline! IV push! CBC, chem 7, stat!We will save him, bet on that! Oh no, he's showing poor perfusion!Lydia, start a blood tranfusion!

Lydia: But Dr. Ross, I hate to say.The blood bank didn't come today!We're out of blood, I can't believe!

Doug: Here, use mine! (rolls up his sleeve)

Kerry: We need some help! There's been a crash!Someone's heart stopped with a flash!But Dr. Benton saved the day,And Carter's going to be ok.

Susan: What can I do, where can I go?I'm not incompetent you know!I deserve a chance and with good reason,I only killed one guy last season!

Chloe: Hey, Suze? Look! It's me...I doing great...oh, can't you see?I'm back on drugs and feeling woozy,Can you take care of little Susie?

Susan: Not now Chloe! I'm in a panic!

Kerry: Get Susan out, she can't handle it!

Mark: It's fine! It's done, the kid's ok.We're sending him up on his way.To surgery he's off to go,They must sew up that bullet hole.But Dr. Ross, he's out of sorts...We had to take a dozen quarts.

Benton: Ok, we're done. I did it all.I used a double breasted suture saw.I closed them up, I fixed their ills.I patched their wounds, I gave them pills.I have their livers in this sack.I did it all, behind my back.I need more patients, give me more!I just cured three, now give me four!

Carter: What happened? Did I miss it all?I saw some blood. I took a fall.But it doesn't matter, we saved the day!

Carol: Get ready! There's more on the way!

Tuesday, August 19, 2008

$25,000 ou La Litote

Comment se fait-il qu'en lisant l'article cité ci-dessous, j'ai pensé tout d'abord à Corneille, à cette litote célèbre de sa Chimène?

Qu'est-ce que c'est, une litote?

Selon un certain D. Fontaine: "Affaiblir une expression pour lui donner davantage de force." Supposément une figure de style délicate... ici cela me semble aussi délicat qu'un marteau. "Shoddy care"? $25,000?

"Va, je ne te hais point."

California fines 18 hospitals for shoddy care
Published: 8/19/08, 9:46 AM EDT
By SHAYA TAYEFE MOHAJERLOS ANGELES (AP) - Eighteen hospitals in California were fined for state health code violations in which patients died from various mishaps such as an improperly inserted tube and a ventilator that wasn't turned on. Other violations include surgical tools left inside patients after surgery.

The fines made public Monday stem from investigations by the California Department of Public Health that found shoddy care had either killed or endangered the lives of several patients. The hospitals were each fined $25,000 - the latest of dozens of penalties the state has issued in recent years to more than 40 hospitals.

Kathleen Billingsley, director of the health department's Center for Healthcare Quality [said,] "The entire intent of these fines is to improve the overall quality of care in California."

The report detailed a death at a La Mesa hospital in which a worker failed to turn on a ventilator for a patient who was being transferred....