Showing posts with label Aspiration. Show all posts
Showing posts with label Aspiration. Show all posts

Thursday, November 17, 2011

And... we're off!

How is it that hearing exactly what I expected to hear from the surgeon could depress me?  What is the point of even having expectations if they don't shield you from the negative effects of your own neurotransmitters?  Hmm?                              

Also, in case anyone had any lingering doubts, yes, pain is, indeed, subjective.

I recall this scenario having unfolded every time I've received the "we need to operate" response from ShoulderMan, a scenario that is now over the half-dozen mark.  By the time we are back home at The Manor, my pain levels rise to an obscene point, approaching the landmark "ten."  It honestly seems to hurt worse just because my excellent surgeon has opined that yes, surgery does look necessary.  That's nuts, makes no sense, and yet, is true.

We are going to proceed with the usual futility first, though:  Yes, another aspiration of the shoulder under fluoroscopy!  The eighth one.  May it be productive, because the first seven were not... Then, in 2 weeks, I will go back to hear how nothing continues to grow in the lab, and to finalize the scheduling for surgery.

At least I have an excellent excuse for bailing on the Wheelchair Negotiations for today.  The man handling my case is an idiot.  No, really, he is.  He also lies with excessive ease.  I don't know whether we are going to take our relationship to the next level of actually acquiring the new lightweight and speedy transport.

But, as I am trying to convince myself -- let that go until tomorrow.  I am spoiling for a fight, for anything that might distract me from the prospect of major surgery during the holidays, PICC lines and vancomycin (can't use the bleepety-bleep-bleep port installed in my chest wall for the post-op antibiotics), surgical cement spacers, and the subsequent surgery or surgeries to try and put in another prosthetic shoulder.

It's a darned good thing that The Nutcracker is such a piece of crap, both as music and as ballet -- because I am going to miss seeing it performed again this year!

That was supposed to be funny.

Fred has that deer caught in the headlights stare going on. Bless his heart, bless his bones.

The only good thing thus far today?  My surgeon just got back from Haiti, where things are, of course, really bad -- though he said things were more settled than they were immediately following the major quake, at least.  They desperately need orthopedic supplies -- crutches, walkers, canes, splints, slings, etc. -- and we have at our disposal an entire closet dedicated to the storage of such supplies.  It feels good to be able to put the stuff to some use, or it will, once Fred, Bianca, Sven, and I go over each item and refurbish things as best we can.  So that is one good thing for the day...

I just feel like weeping:  Therefore, let's post some cat videos!  If sending my orthopedic closet collection to Haiti and uploading a bunch of cute cat action doesn't dry my tears, what will?

First, we have Buddy in a Box.  Unfortunately, most of the footage of Buddy in a Box consists of no sign of Buddy but minute after minute of a mysteriously wiggling box.  Since he is more interested in me, for some reason, than his Bodacious Box, you lucked out this time, Beloved Readers!

Isn't it amazing how HUGE he has gotten, this freakishly large kitten that turned out to be a Maine Coon? Fred and I peer helplessly at one another and cry, "Who knew?" several times each day.



Next we have the Old Married Couple Series.  These are three videos of Dobby and Buddy, who suddenly have decided to promulgate peace, love, and understanding instead of trying to wipe each other from the face of the planet.  Okay, so Buddy is something of a recidivist, as he goes for Dobby's throat in the second video -- but he gets over the impulse and is soon right back to being a perversely large kitten, and all cuddly again in the third take.




As usual, please ignore the audio.  Seriously, it's embarrassing.

Friday, September 17, 2010

de colores

hullo, you cutie-pies, you!

i am taking a brief hiatus from blogging.

monday, we are attempting another aspiration under fluoroscopy, the seventh, trying to identify the little buggers still burrowing in my bones.  i am looking forward to it, as these things have gone oh-so-well in the past.  in fact, the first aspiration was inspiration for this post, back in the infancy of elle est belle la seineA question for nurses, techs,  doctors...

for some reason, i am rapidly cycling between the red and blue phases of CRPS.  normally, the deep cold, deep purple version rules the roost and i am glad, for the bright red edematous side of things takes allodynia and hyperalgesia to new and unimagined heights.  

the pain of being rouge.

{fade to the dulcet tones of the militant lesbian existential feminists as they belt out de colores... a-swayin' to the left, then a-swayin' to the right.}






De colores
De colores se visten los campos en la primavera
De colores
De colores son los pajarillos que vienen de afuera
De colores
De colores es el arco iris que vemos lucir

Y por eso los grandes amores
De muchos colores me gustan a mi
Y por eso los grandes amores
De muchos colores me gustan a mi

Canta el gallo
Canta el gallo con el quiri quiri quiri quiri quiri
La gallina
La gallina con el cara cara cara cara cara
Los polluelos
Los polluelos con el pio pio pio pio pi

Y por eso los grandes amores
De muchos colores me gustan a mi
Y por eso los grandes amores
De muchos colores me gustan a mi

Thursday, March 25, 2010

More Close Encounters of the "Bob" Kind

Has enough time passed since the jubilant signing of the Health Care Reform Bill and its necessity of 20 pens that we can settle down and speak the truth?

Like... what a terrible disappointment it is that the public option was sacrificed, when it alone would have made this true reform?

Like... how despicable conservative obstructionists have been? How heartless, and cruel? How manipulative and disrespectful of their own followers, that they have, essentially, abused free speech by inciting to riot, by screaming "fire, fire, fire" in the cramped and dark theatre that is the U.S.A.?

Like... how uninformed and illogical many citizens are, and how driven by out-of-control emotion -- fuming, frustrated anger that has all the hallmarks of a two-year-old's temper tantrum, except that two-year-olds don't usually wield the weapons of bigotry?

And (having taken a quick look at today's news headlines) like... how if the Democrats could adopt just a tiny bit of right-wing anality, the bill would not be subject to a re-vote on the basis of parliamentary mistakes? Just because you have succeeded in doing, in a marginal way, what is minimally moral, does not mean that you should fail at following the rules for governance. Yes, I am a nerd, and often a wonk. Yes, I am frequently appointed to be the Ball Buster Rule Diviner -- often seen as a curse, due to the thankless nature of the work, but that role is necessary to success. I haven't yet scoped out who the House Parliamentarian is... but 30 lashes with a limp noodle might be appropriate.

So I ran across this Emperor Bob person/persona on Twitter, then briefly visited his blog, Emperors Rants and Observations, where he can be found addressing the Various Issues of the Day, from campaign finance reform and climate change to the health care reform initiative and Alaskan politics. He's keen.

Oh, Faithful Readers:
I am so tired this morning.

My internist and I, recognizing an infection flaring in my left shoulder, decided that I should return to my poor orthopedic surgeon. Um, poor in the sense that the man has operated on me eight times since 2005, replacing shoulders, removing shoulders, putting in antibiotic spacers, taking them out, and so on, but has not managed to get any of the bacterial specimens to grow in the laboratory environment. Without identifying the offending bug, the correct antibiotics cannot be applied to the situation.

And now the pain is getting worse on the right side, and... {whisperofdenial} my left hip. Both of those joints have "hardware" implanted, thus making them attractive breeding grounds for germs. But we won't think about that today.

So, Fred loaded me and my super-duper powerchair into Ruby, the Honda CR-V, and we sped off to see said surgeon.

You are a fool if you believe that being without health insurance does not affect the standard of the care you receive, even in the form of advice.

ShoulderMan opined that he wanted another "aspiration under fluoroscopy," which would be the fifth or sixth time we tried that particular trick. It is painful, not particularly dangerous, and expensive. But, for me, the overriding factor was that it has never produced a piece of useful data.

If samples of purulent pus taken directly from my humerus during surgery and rushed to the awaiting petri dishes in a sophisticated hospital lab also cannot produce the identification of the offending organism, why do we keep pretending that these painful and expensive aspirations are in any way superior?

I reminded ShoulderMan that since I had last seen him, I had been priced out of my health insurance -- my Faithful Readers know well that I just could not swing $1513 a month for premiums, plus the $5000 more in deductible, and all of that on top of the thousands not covered. I live on private disability insurance due to the combined effects of CRPS in all my limbs (and now, face), avascular necrosis, lupus, Addison's disease, aortic insufficiency and so on, ad infinitem, ad nauseum.

Believe me, I tried to stay insured. It took the help of my state's Insurance Commissioner for me to have coverage to begin with, once COBRA expired. But BCBS eventually was demanding 97% of my income... and I dare you to criticize me for folding, at that point.

ShoulderMan said: "I don't get it. You ought to have MEDICARE."

{we have had this exact conversation already several times over and over again, not to be repetitive or fall into a déjà-vu sort of iterative redundancy}

Moi: "Yes, Dear ShoulderMan, I ought to. {actually, i tried to pull off an oughtn't i? but couldn't spit it out.} However, I fail to qualify because most of my working years were spent in university systems that did not pay into Social Security but rather into poorly funded and criminally operated pension funds. I lack ONE work credit, in the amount of $830, toward eligibility."

ShoulderMan replied, with a fair amount of dripping condemnation in his voice: "Well, why don't you do some work for a week, maybe tutor some local college kids, and turn that in?"

Moi: "Hmm, wow, I never thought of that." Okay, that's a lie. What I really said was:

"I have been informed by my Disability Insurer that to do so would mean the loss of my disability income, and it would be well over two years before any substantive replacement from governmental sources would kick in."

ShoulderMan muttered: "Oh, well... Okay. So I think we need to get this aspiration done and consult with a new Infectious Disease doctor, maybe over at Charity Hospital. This is the kind of thing that cannot be ignored..."

And he promptly exited, stage left.

His minion, PA Bob, then did something that reduced me to tears. Yep, here I go again, even crying into my laptop.

He came over to me, handed me the official pink and yellow copies of codes for the visit, so that I could check out and pay (which I obviously was prepared to do). As he walked into the crowded hallway, he said, loudly:

"Why, wasn't that nice of Dr. ShoulderMan. Look, he marked the box for 'No Charge' so that you don't have to pay for this consult."

Dr. ShoulderMan, who moves at roughly the speed of light, was long gone and already ensconced in the next exam room, so Bob was not making points with him... Leaving me, once again, to wonder why Bobs, in particular, are so intent on confusing me! For a succinct treatment of my history with Bobs, read this.

I've never engaged in a political dialogue with either PA Bob or his boss, having intimated from various remarks that they are both ultra-conservative and that ShoulderMan may, in fact, be an Evangelical (I intend that to reference the Conservative Evangelical Movement, à la George W. Bush).

Aside: Here is one of the fairest succinct explanations of Evangelicalism that I've run across. It comes from an address by conservative EPPC Senior Fellow Wilfred McClay* entitled American Culture and the Presidency, delivered either in Fall 2004 or early 2005.

As a faith that revolves around the experience of individual transformation, it inevitably exists in tension with settled ways, established social hierarchies, customary usages, and entrenched institutional forms. Because evangelicalism places such powerful emphasis upon the individual act of conversion, and insists upon the individual's ability to have a personal and unmediated relationship to the Deity and to the Holy Scriptures, it fits well with the American tendency to treat all existing institutions, even the church itself, as if their existence and authority were provisional and subordinate, merely serving as a vehicle for the proclamation of the Gospel and the achievement of a richer and more vibrant individual faith.

Anyway, there is nothing abstract in the nature of how being an uninsured (and uninsurable) citizen impacts my life. It truly may contribute to my death, as I have spent the first few working hours of this day on the phone with the aforementioned Charity Hospital -- and the helpful pickings are, let's say, slim. The clinic system there may eventually help me, but there are no appointments to be had anytime soon.

Unbelievably, three times (like Peter's crowing cocks), I was told to go to the Emergency Room!

I have avoided a close rereading of what Obama signed, and what Congress is continuing to work through, precisely because I am not yet convinced of the permanence of any change -- but clearly, I am going to have to dedicate time to it today.

Because if there is no fairly immediate help for me in the legislation, I am close to abandoning all hope. I cannot continue with daily fevers up to 101, the attendant sweats, chills, and pain -- on top of my usual severe pain from CRPS and AVN -- I cannot sit in waiting rooms for hours, especially now that my left hip may have joined with the Infected Skeletal Alliance.

Oh, boo-hoo! What a sob fest this post has turned into! But I am going to leave it as is, if only for its potential to serve as a shaming mirror the next time I decide to whine.

The saving grace here is this YouTube video from Emperor Bob, an amazingly calm rant to which I will return with frequency... Thanks, Bob! [Correction -- a correction which blows the whole Bob Phenomenon to hell, but maybe you won't notice -- that is not Bob on the video. No, the star of that show is one "old fart rants," who has quite the head of steam built up over on YouTube!]






*Wilfred McClay is the 2009-2010 William E. Simon Distinguished Visiting Professor at the School of Public Policy. He is the SunTrust Bank Chair of Excellence in Humanities at the University of Tennessee at Chattanooga, where he is also professor of history, since 1999. He is Senior Scholar at the Woodrow Wilson International Center for Scholars in Washington, DC, Senior Fellow at the Ethics and Public Policy Center, and has served since 2002 on the National Council on the Humanities.

Major sigh, and where is the ibuprofen? "The SunTrust Bank Chair of Excellence in Humanities"?