Showing posts with label Prosthesis. Show all posts
Showing posts with label Prosthesis. Show all posts

Sunday, December 14, 2014

Dr. Hackenbush! Calling Dr. Hackenbush!

Originally published back in the holiday season of 2008, shortly after our summer discovery that my prosthetic shoulders were harboring pathogens, this piece returns as a 2014 holiday tribute to the medical nitwits currently in my life. Among the nitwits this go-'round? Auxiliary personnel in the billing department of the same hospital depicted below. Also, the various board-certified neurologists who are gleefully passing the buck to their neurosurgical colleagues. Again, this is a repost, Dear Reader, as the Surgical Shoulder Wars are now ended, the bacteria having defeated even the inimitable and marvelous Doctor ShoulderMan.  But the hilarious conversations with medical professionals continue, even if the laughter has become markedly insincere.

*******************************************************************************************

Fred drove through driving rain and piles of slick wet leaves late yesterday (early for us!), so as to get me to the pre-admission registration process at the hospital -- before they stopped taking patients for the day.

No problem. Ruby the Honda CR-V putt-putted happily, veering down the hilly streets, passing the elegant homes on the tree-lined way.

We even managed to snag the premier gimp parking space, and this at a parking deck notorious for being full -- and gimp spaces usually taken by remarkably spry looking folk, and cars without placard or "disabled" license plate. Okay, okay, the correct line is supposed to be something like: "You can't tell by looking!" (Shit, you sure can... It takes a gimp to know a gimp.)

So, Dear Reader, what am I supposed to do when, despite my best efforts... Okay, okay, jeez, you are a tough one, Dear Reader. What am I supposed to do when, after a few lame attempts to keep things on the straight and narrow, the nurse in charge of registering me for Monday's major surgery makes mistake after mistake?

Here is a sample of our stellar communication, verbatim:

The Nurse: When did you last have an EKG?
Me: In August, the last time I was here.
The Nurse: And when was that?
Me: In August.
The Nurse: And where can we get a record of that?
Me: Ummm, here? In my medical records? (See? She managed to get to me -- my "intonation ascendante" is a dead give-away. Ar! I used to get hit on the head with a ruler whenever my "intonation ascendante" gave way. What was that dear old teacher's name? I can't remember, in large part due to his pedagogical concussing, but I loved him.)

[Choo choo! Train of thought! Choo... Back to the scene of the crime... ]

Me: Ummm, here? In my medical records?
The Nurse: Hmmm. Maybe in your medical records.

Then we tried to exchange the information about my last echocardiogram. Should be simple enough. Doctor's name, address, phone and fax numbers, date of the test.

And I have to say that it sort of mattered a lot to me for this information to be correctly received, given that they discovered an aortic arch aneurysm via that test. I had even had a serious bout of chest pain the night before, during which I was unable to banish the thought that, well, "this could be it." I made it from the bed to the wheelchair and then out to Fred's office, and he got me the under-the-tongue stuff. Three of those, five minutes later, I was fine. Still. I cannot banish that fear, not entirely. And so, I faced The Nurse full of conviction in the wonderful potential of our communication skills.

The Nurse: Where was the echocardiogram performed?
Me: In Dr. Rosenstein's office, as an outpatient. He's in the Doctors' Building over at St. Mellifluous. Anyway, it was August 22. 9:30 AM. It showed my usual aortic insufficiency due to a congenital bicuspid aortic valve. Oh, and they found a... dilation... of the aorta, where the aortic arch attaches... so, yeah, that's Dr. Rosenstein, over at St. Mellifluous. His phone is 555-555-5555 and, surprisingly, that doubles as his fax.
The Nurse: Well, I don't know what to do.
Me: Pardon? Can't he just fax the report to you? That's 555-555-5555...
The Nurse: I hate to be the one to break it to you...
Me: What? Break what to me? Does this mean I can't have the surgery Monday? They went ahead back in August, just 3 days later, on the 25th... Why is it different this time, why? [Blither and blather, generalized anxiety bursts loose and flies around the room, backward.]
The Nurse: Dr. Schrödinger passed away last week.
Me: Who is Dr. Schrödinger? He did?
The Nurse: It was very sudden, a massive heart attack. I am sure all of his patients must be terribly upset.
Me: I'm sorry for your loss? [And there it is again -- she's screwing with my intonation encore une fois, de nouveau.]
The Nurse: So I don't know what has gone on over at his office -- hmm, maybe the staff can dig up your records. I'll give Judy a call.
Me: Judy? No, no, I think we have a misunderstanding. My cardiologist is Dr. Rosenstein. And his nurse is Linda...
The Nurse: Well then, why did you bring up Dr. Schrödinger?

It was a rough afternoon. I will say this for her -- she got my blood on the first stick, for which I remain grateful. A few things worry me -- for instance, she didn't give me the red arm band I usually get -- it has something to do with blood, the blood bank?

Wow, even away from her, she screws up my intonation, long distance.

Also, I did as instructed by Dr. Boutiqueur, and emphasized my need for stress-dose steroids (adrenal insufficiency) pre-op -- intra-op -- and post-op! I don't think it was even received by any of her grey cells. "That's okay," thought I, "I will just bring it up again when I speak with anesthesia."

Except -- I did not get to speak to anesthesia, despite the fact that my intubations have been difficult
-- to the extent that, at this same facility, back in 2005, they broke three of my front teeth trying to get the damned tube in. Yes, that's right. I have had a slight attitude about their anesthesia department ever since. They paid for the dental surgery, and for the very creative partial that had to be created. But I forgot to make any arrangement for the FOUR other partials that have had to be made. Some major, and ill-afforded, pocket change has been thrown at what looks to be a never ending problem.

Also, the good anesthesia rep is supposed to tell me which of my many meds I can take come Monday morning. The Nurse asked me to take whatever I "thought was right." Okie-dokie. So I am going to dig up the green folder from my orthopedic surgeon's office for the last go around, in hopes that I have the notes from the anesthesiologist about meds.

Because I've a sneaking suspicion that what "I think is right" is probably wrong.

I wonder who it was who cleaned out all sorts of unnecessary paperwork from my office a few months back? Ar! Must have been the same idiot who thought ShoulderMan victorious in the Shoulder Wars.

In summation [Oh, sit down and stop clapping.]: Major confusion about the tests done back in August, and from where the results can be obtained -- and whether the ordering physicians are even alive; no blood being readied for surgery, despite the fact that, back in August, I had a hemoglobin of SIX after surgery; no interview with anesthesia about stress-dose steroids and historic difficulty with intubation.

She jumped all over the MRSA in the nares issue, though. Thank goodness. Whew. What a load off...

Good grief! I got MRSA at the hospital to begin with, and the Fredster absolutely refuses to don the yellow dress and blue gloves -- not only do they offend his fashion sensitivities, but he overheats. There is also a tendency on my part to NOT ask for nursing assistance when I really do need it -- I hate to make someone get all that isolation gear on for what can seem awfully minor (bedpans, pain meds, help turning -- hey, you try it without using your shoulders/arms!).

So this weekend, my ID doctor has prescribed some antibacterial ointment that I am to stick up my nose. Excuse me, up my nares.

My question? If this antibacterial ointment kills the MRSA... why is it considered resistant to antibiotics -- or even at all virulent?

I forgot to mention that The Nurse's understanding of CRPS/RSD, which initially seemed quite promising, ended with her asking about the acronym: "How do you get 'RSD' out of rheumatoid arthritis? I usually say 'RA.'"

Me, too, when I am talking about rheumatoid arthritis!
Sigh.

Calling Dr. Hackenbush, calling Dr. Hackenbush!
(Below, please find the lyrics to Dr. Hackenbush, a musical number that was dropped from A Day at the Races due to concerns about the film's length.)


CHORUS:
So this is Dr. Hackenbush, the famous medico,
You're welcome, Dr. Hackenbush...

HACKENBUSH:
If that's the case, I'll go

CHORUS:
Oh, no, you mustn't go...

HACKENBUSH
Who said I mustn't go?
The only reason that I came is so that I can go.

I'm Dr. Hackenbush,
My medical standing's very high,
Well, anyways, ladies and gentlemen, I
am Dr. Hackenbush

CHORUS
He's Dr. Hackenbush...

HACKENBUSH:
I'm Dr. Hackenbush,
As a matter of fact, to be exact,
I'm Dr. Hackenbush!

FEMALE SINGER (Judy?)
I'm sure that they'd all like to hear,
Some facts about your great career

HACKENBUSH
Although my horn I hate to blow,
There's one thing that you ought to know:

I'm Dr. Hackenbush
Which all my friends will verify
Well, anyways ladies and gentlemen, I
am Dr. Hackenbush

CHORUS:
He's Dr. Hackenbush

HACKENBUSH
I'm Dr. Hackenbush,
You never would guess, but nevertheless
I'm Dr. Hackenbush!

For ailments abdominal, my charges are nominal
Though I'm great for I've a rate for tonsillectomy,
Sick and healthy, poor and wealthy, come direct to me
"Oh, God bless you!" they yell
When I send them home well,
But they never, no they never, send a check to me.

I've won acclaim for curing ills, both in the north and south,
You'll find my name just like my pills in everybody's mouth;
I've never lost a case...

CHORUS:
He's never lost a case...

HACKENBUSH:
I've lost a lot of patients, but I've never lost a case!

My diagnosis never fails, I know just what to do,
Whenever anybody ails, I'm sympathetic too,
My heart within me melts...

CHORUS:
His heart within him melts...

HACKENBUSH:
No matter what I treat 'em for, they die from something else.

When your nerves start to rock, put your faith in your doc,
When you're sick he will stick to the end,
With the possible exception of your mother,
A doctor's a man's best friend!

CHORUS:
Yes, a doctor's a man's best friend!

HACKENBUSH:
A doctor's a man's best friend, whoa-oh,
A doctor's a man's best friend,

HACKENBUSH & CHORUS:
A doctor is a man's best friend!

HACKENBUSH:
Right or wrong, wrong or right,
Night and day, day and night,
On his call you can always depend;
With the possible exception of your mother and your father
And your uncles and your brothers and your nephews and your nieces
And your sisters and your cousins, whom you number by the dozens...

HACKENBUSH & CHORUS:
A doctor's a man's best friend!

Saturday, November 13, 2010

I left my shoulder in San Francisco [repost]

this is a repost from the summer of 2008, and i had just had the nuts-and-bolts of the upcoming surgeries explained to me -- you know, spacers and stuff!  well, apparently, i took temporary leave of my senses, in a very lingual way...



La Belle Bianca Castafiore, ici --

Zee Retired Educator? She is, comment le dire? She is settled up, I think you say. She will be tossing the Pity Party soon, yes, yes.

Il se peut que... Er, it will be necessary that she will lose the faux shoulder for a period of the time. This? This she can not arrive at wrapping around her little mentation.



But I am knowing her since long time, long distances, and she? She will wrap around her little mentation, bien sûr. Elle va accepter les changements que son état de santé a rendus nécessaires. And she tosses the good Pity Party also as well, too, yes, yes.

It is not impossible that this will not happen, eh? Moi, La Belle Bianca Castafiore,
je reste confiante et optimiste. La prof retraitée va avoir besoin de mon aide considérable (et très bien connu, le monde entier, il faut ajouter.). Je suis prête à aider. Mieux que d'être "prête-à-porter!" Oh, les jeux de mots, que j'en suis la maitresse!

Encore un verre, les mecs! (Oooo, I am not saying that out of loud, am I not?)

Still, where is the Captain? La la la... "Ah my beauty past compare, these jewels bright I wear!...Was I ever Margarita? Is it I? Come reply...Mirror mirror tell me truly!” Oh, scruffy little schoolboy, mon cher Captain Hoddack, où est-il? If there exists anyone who can fix a broken shoulder, it is he! We will simplement build a replacement while the replacement is out, if you arrive at following my route! Ah, oui, on a toujours tellement besoin de moi, de ma sagesse.
Hmmm! Ah, je ris de me voir si belle dans ce miroir!

Sunday, December 14, 2008

Nerves are setting in

I couldn't sleep last night. I have the Hospital Terrors and was so hoping to avoid them. There are mountains of things that need to be done and my tendency to make lists has kicked into high gear.

Now it would be spiffy if I could just check a few things off.

I will be the last surgical case of the day. Apparently, orthopedic surgeons have this hangup about operating on infected joints when there is the most remote chance that a microbe will escape into the rarefied air of the surgical suite... and then jump into the open wound of another patient. My bacteria are very social.

The pain is kind of out of sight but I am not medicating for it. I am doing a modified Drug Holiday (yes, on my own; no, Shoulderman hasn't a clue). It will help me post-op. But the pain is starting to suck, so I may have to end the vacation.

Fred has gone off to... church. Here at Marlinspike Hall, deep, deep in the Tête de Hergé, his worshiping options are plentiful. He attends the First Existential Congregation of TdH, an interesting group of very strange people. I stopped attending over a dispute about the ordination of Transgendered Alien Republicans [TAR]. Nothing gets to me like the pointed exclusion of a group of people, even if they are TARs.

It occurs to me that these infections may be my end. Maybe their concern over the MRSA is not so puerile after all. Shoulderman has intoned that we may end up chasing these nasty bugs from joint to joint. I haven''t had the courage to tell him my left hip is hurting.

How much hardware do (well, at this point, *did*) I have?

1999-left hip fractured and pinned
2001-right hip replaced after collapse
2002-left shoulder replaced after collapse
2002-right ankle reconstructed after fall in ICU (the beginning of a Sentinel Event that ushered in the era of CRPS)
2005-right shoulder replaced after collapse
2007-right elbow reconstructed after a fall
2008-right shoulder prosthesis removed, replaced with cement spacer
2008-Monday, December 15... left shoulder prosthesis [probably, but pray not] removed, replaced with cement spacer impregnated with killer antibiotics...

We're going to chase infection in all of these possible incubation hot spots? In that same space of time, there have been four ressuscitations, three Addisonian crises, two pneumonias, many lupus inflammations of heart and kidneys, and *way* too much time spent hanging around on ventilators. My terrific luck cannot continue to hold.

Way to talk myself into a funk!

Solution? Scrub the golden toilets of the Manor! Change the bedding of the various Sleep Chambers! Clean the Moat! Mow the Wimbledon Miniature Courts! Dust the Rubens! Refinish the Velasquez! Go to town and snag more Gold Leaf for the 16th century dinette!

Ar! Temp? 101.2. Ar! Would that those First Existentialist Congregants prayed...

I have great faith in ShoulderMan. He is easily one of the top ten OS in the country, very humble, and tenacious as heck. He is also an unusually talented *doctor* -- and by that, I mean that he doesn't shrug, mutter, and disappear when my medical crapola surfaces after his surgeries. He listens, absorbs, and doesn't coddle -- the perfect combination for me and my increasingly woe-is-me attitude. He will do his part and I must do mine. What is my part, though? I have been living with pain that stays on the very high end of that stupid 10-point scale, running fevers daily, sweating, able to do less and less, not sleeping for all the pain, and... chest pain is becoming way too frequent an occurence. It is hard not to worry about that freaking "dilation" of the aortic arch.

When did I become so fearful, so tentative?

Where is La Belle et Bonne Bianca Castafiore? On those rare days where I need that Diva-Witch, she is nowhere to be found!

Saturday, October 11, 2008

More Rotten Pot -- That's "Pot Pourri" to You!


    Hmmm. I began this hodge-podge of an entry on October 3, and promptly forgot about it. In fact, when I stumbled upon the list of my dozen or so drafts, it was quite enlightening. As in: Oh, so that's where I left that thought.


      Today is October 11, 2008, and I am different than I was on October 3. Primarily, I am much, much poorer, having lost beaucoup d'argent in the market. My health care costs (insurance premiums, co-pays, out-of-pocket, and care not covered) use over 85% of my private disability income. I am responsible for keeping the household afloat, so supplementary monies from my investments are the only help I have. Rather: HAD. I pay all utilities (except water), groceries, and half the mortgage -- plus, I cover the inevitable unscheduled expenses that occur in the maintenance of your average centuries-old European manor located in the Tête de Hergé. Stuff like the costs of reparation of smoky Rembrandts when Marmy decides to do a little vertical marking. Like weaving a textile patch to match the one-of-a-kind medieval tapestries that depict the warring and artistic history of the Castafiore family. Yes, and the more mundane stuff -- a better grade of lawn mower, hedge clippers, HVAC repair, and the odd new roof. So, as my investment account was decimated, my panic grew in countertime, in immensity. I cannot show fear to the Fredster, to the Felines -- not even to La Belle Biance Castafiore. "Don't worry!" I practically crow. And my-oh-my, the afflictions that go with living with CRPS / RSD? The exacerbations due to emotional stress? I've got 'em! For once, I will spare you the laundry list. (There is one thing, though, that has me confounded -- a blistery rash that feels and looks like a bad burn. Not knowing what to do, I slathered on some betamethasone dipropionate cream. When in doubt, find the closest steroidal concoction!)



          After deleting all the now irrelevant detritus from the draft, and after adding all the flaming issues of the day, this is the sad bit that remains:



        • I have fallen in love with Jon & Kate plus 8 -- I sometimes watch marathon sessions of the television show and am simply in awe... Laughter comes easily: yesterday, one of the sextuplet boys ran to Daddy, full of eureka and aha, to whisper "I am your son!"; Kate keeps her toenails painted because another one of the boys has a toe fetish; The twin girls shop for each other's Christmas gifts but insist, as well, that they each *receive* the same item that is being gifted... Still, I wish Kate would ease up -- verbally -- on Jon, although I get that she is maxed out in every imaginable way. He's amazing, she is awesome -- I am slack-jawed, and those children are blessed.

        • Austrian National-Socialist Joerg Haider is dead. Saves me some trouble. Why is Mugabe still alive?

        • I killed Pinochet. Yes. Yes, I did. Shush! I did, too! Much in the same way that I kept the paper cutout of the life-sized head of Jesse Helms impaled on my cork bulletin board with a 5.5-inch Henckels boning knife.

        • What makes hydrogen peroxide fizz?

        • The mail just came -- and despite my instructions that no bills find their way to me this morning, Fred somehow allowed Plumtree Orthopaedic Dudes' bill into the pile of junk mail (a Vera Bradley catalog, a Fidelity mailer on "retirement planning," and my yearly "invoice" for our CCF-sponsored Ethiopian child). How is it that my insurance refuses to pay for the services of the PA who apparently assisted my orthopedic surgeon in my recent surgeries? Even more wondrous... how is it that said PA *dares* to charge me $7,427.12 for his services when he is as much a surgeon as I am? And... jagged deep breath... what the hell is this additional $17, 125 listed as a balance? Plumtree Orthopaedic Dudes have always engaged in crooked billing, in my experience, but after two go-rounds, years back, I gave up trying to fight it. So how screwed am I? If you have followed my saga, you know that my real and actual (i.e., not the PA) orthopod is yammering the pros and cons of gifting me with a new right shoulder prosthesis, once he is convinced the infection that decimated the success of the old one is definitively gone. Will he proceed if these charges are still in dispute? Because in dispute they are. The hospital bill was over $100,000 and was paid in full by insurance... what is the problem with resolving the surgeon's fees? Could it be that they have finally caught on to the fraudulent billing (primarily double-dipping, duplicate charges in masquerade)? I have excellent coverage and am darned lucky to have it -- but I pay over $17,000 a year for the privilege (privilege?). Where did I stash those spare millions?

        • Sarah Palin, reverse-nepotism in action!

        • Does crystal meth give women a high, whiny voice? Or do women with high, whiny voices have an unusual affinity for the drug?

        • And, as always, I wonder, along with Bill Cosby: Why is there air?



        Thursday, September 11, 2008

        Home

        On 25 August, I had surgery to see if my right shoulder prosthesis (one of three -- prostheses, not shoulders) was infected and needed removal. After finding 4 pockets of pus and having the prosthesis fall out of its own accord, I wasn't doing well. So they decided to keep me on the ventilator, hide me in the ICU, and not close the wound. On 29 August, the second surgery was performed with the goal of "washing out" the wound, putting in several drains, and inserting a sorry looking cement spacer impregnated with antibiotics.

        My cultures were inadvertently left in the OR overnight, so what organisms were growing became a topic of consternation between my surgeon and his staff and the infectious disease guru and his minions.

        I did, however, clearly grow MRSA, and so spent my 10-day stay in isolation. Yellow is a most unbecoming color and Fred found those blue gloves hot and cruel.

        My supremely talented orthopedic surgeons are adroit at deflecting my pleas for promises of a new prosthesis in a few months -- they just won't commit. My main orthopod does a bad imitation of a spastic retard when I ask him what my arm movements would be like without a shoulder.

        He fails to understand that this would leave me with one functional extremity. He fails to understand, indeed, everyone seems to fail to understand, that I cannot lose any more.

        Did you hear me?

        I cannot lose any more.

        I am on i.v. antibiotics at home -- vancomycin and *bleep* (I cannot remember and don't feel up to rolling into the kitchen). So that is 4 infusions a day for 6 weeks. It is not a big deal -- except insofar as it reminds me of circumstances I'd rather ignore for a bit.

        The pain is horrible but I believe the management of it is at the optimum.

        (Don't touch that sentence... It was difficult enought to formulate once -- I won't do it again.)

        The Friday before surgery, I had an echocardiogram to rule out endocarditis, as I have a bicuspid aortic valve. Thankfully, I came out "clean." Oh, except for the aortic arch aneurysm that is currently measuring at about 4.7 cm. The cardiologist who called and reamed me out for missing a few years of testing was not hesitant to scare me to death.

        So there is much on my mind and much that is hurting the body -- the CRPS/RSD, for example, is unbelievably inflamed (my legs have never ever looked/felt this terrible).

        Despite getting two units of blood to boost my hemoglobin of 6 -- I am tired and wonder what my H & H is now. My surgeon's admonition of how to go about life until seeing him at the 6 week mark? "Rest and think healing thoughts." What a lovely man, not to mention a talented physician. I don't know if it is technically true, but my heart says that he saved my life.

        Well, off I go to try and catch up on some reading in the ether of the blogosphere... Thank you for any stray good thoughts you can label and let loose on my behalf in the coming weeks.

        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.

        Friday, August 15, 2008

        Today's Diary: The Man on the Train

        Retired Educator, here --

        I am in an odd place, and by that I do not mean merely living in Tintin-world with a quasi-fictive diva, La Belle Bianca Castafiore, my darling intrepid Fred, and three very wily cats -- always half-stuck in Marlinspike Hall et (ce qui est beaucoup plus important) dans la Tête de Hergé, qui est, d'ailleurs, très décédé.

        Quasi-fictive -- what do I mean by "quasi-fictive"? Have you ever heard La Belle Bianca Castafiore belt it out? Do you really have a clue as to how "belle" she is in "ce miroir" -- how captivating is her laugh? No? Then check yourself, my friend, check yourself! The tree, it falls in the forest -- the one hand, it claps.

        Since December or January, I have been fighting an infection which translated into daily fevers and sweats, pain and general misery. Since this was an addition to an already difficult mix of SLE, CRPS / RSD, multifocal AVN, and adrenal insufficiency, I haven't been, ummm, well. Finally, my white count fought its way out of the 13,000s and the 15,000s, making its way to the 17,000s -- the platelet count went bonkers -- and so on. In spite of several visits to high-dose-steroid land, the pain and inflammation were not self-limiting or even slightly improved. So I was sent to my favorite orthopedic surgeon to determine whether one of my three joint replacements, or one of my three reconstructed joints, was infected. Yesterday, after managing to finally unearth my gallium scan results, it was declared a fait accompli. The right shoulder is the offender.

        So I have been in this weird, strange place of fever and fiction, dread and denial. I am not sure that I can go through the process of losing that prosthesis, being further limited in what I can do. I am already living this vida loca from the perch of my wheelchair.

        I maintain a diary and while a part of me knows this is nothing but an intentional confusion, some days, I want the diary to speak on the blog. The interstices, they have always fascinated me, even -- no, *especially*-- in my academic life -- which, I'd best acknowledge, is as dead as Hergé's tête.

        Public blithering, always a pleasure. En tout cas, this is what I wrote today, in diaryspeak:


        dear diary,

        i sat down to purge my soul and instead got hung up thinking about an album by the roches. it must have been one of their first, as most of the songs were written around 1979. ah, yes, it was their first. that LP once felt like the soundtrack for my pretty awesome and full life. with the help of heavy denial, amnesia, hard drugs and heavy metals, it still can!

        that was around the time that i both worked 40 hour weekends (...) and had a side gig working nights at a convenience store. the fact that i was also going to school full time ought to be more important but somehow it just sits there like an overweight, exhausted factoid. i was sharing a house with the woman i still call my best friend, all current evidence being, unfortunately, to the contrary. we were a tad bit wild, so it is safe to say that my approximate 60 hours of work a week plus my 21 semester hours probably saved my sorry ass. it turned out that she wasn’t actually *enrolled* in school – she had dropped out and was spending most of her time waging war against corporate america (she is iranienne). [ha! neither assertion complements the other! what a hoot that i had a moment of thinking the one danced with the other!] still, we managed to meet up most weekday afternoons in the foreign language department lounge – i thought we were meeting after classes! in reality, who knows what she had been doing all day beyond passing bad checks to buy such household staples as cognac and fresh flowers.

        not terribly domestic (or domesticated), she was famous for waxing and polishing the twisting wooden staircase to our second floor. i was well-known for almost breaking my neck upon said stairs.

        she saved my convenience store job on several occasions. perhaps it was due to a slow build up of fatigue, perhaps i just really hated that job, but i developed a serious pathological aversion to the task of cleaning, straightening, and filling the cooler section of the store. it was cold, it was creepy – when you are the only one there and it is 2 am – everything is creepy! i began to leave it a sad mess, as my dedicated manager quickly noted. few things escaped her jaundiced alcoholic eye, except the occasional bank deposit bag that she tended to leave on the hood of her car.

        romy began driving over and doing the cooler part of the job for me! bless her sweet bones! the real gift was one of company. i betrayed little of the fear that some nights obsessed me. after an incident that ended with me chasing away four or five guys intent on robbery (don’t ask. to this day i don’t know what possessed me! i was so angry that they would even *think* of robbing “my” store. harrumph.) – i was happy for her company. if my manager had ever come in... ah, but did i mention her jaundiced alcoholic eye? i could easily just have cued romy to switch off the back cooler lights and waited her out – luckily we never had to do that.

        we did, one night, have to escape two idiot guys (sum doods) who were not stellar citizens. they wanted admission to the store of Convenient Wonders, but i had closed. romy and i headed for the pristine 1965 baby blue cadillac that was to serve as our cushy ride home -- only to find a flat tire.

        lucky us, we had the two yahoos to change it. they were three sheets to the wind (someone tell me of that phrase's origin.) but still focused enough to realize that they had two pretty girls, and that one of them was kinda foreign looking. small detail... this was during the “hostage crisis” in iran. romy did not advertise her background, her home. relatives and friends of hers in the states had been attacked, and calumnied.

        so our sum doods played twenty questions and by the end, we had them convinced that romy was CUBAN. they had a brief offer of persian, but did not seem to understand the term, and kept arguing that she looked like an “island girl,” and the island heavy on their little minds was cuba, and only cuba. to keep them happy, we interspersed some spanish in our witty conversation, encouraging them to “andale, andale, ariba!” with that there tire change.

        if my memory does not fail me, little miss anti-everything actually worked in the cotton fields for one or two weeks that same summer. it was a magical summer of possibilities – we were at an age where we successfully confounded world fears with dastardly daring, panache, and other-funkily-worded grand attitudes. it would take me many pages to write enough that the sexual energy of that time could be distilled into the one, or two, right words. Quelquefois, il n'y a pas de mots justes.

        anyway... the jobs! the hot, sweaty, elevating and demeaning, safe and dangerous work – comingling with our existential confusions, and our out-and-out joy in living. my mind goes to the roches’ plaintive mr. sellack:

        Mr. Sellack
        ( Words & Music by Terre Roche )

        O Mr Sellack
        Can I have my job back?
        I've run out of money again.
        Last time I saw ya
        I was singing Hallelujah
        I'm so glad to be leavin' this restaurant.

        Now the only thing I want
        Is to have my old job back again.
        I'll clean the tables;
        I'll do the creams;
        I'll get down on my knees and scrub
        behind the steam table.

        O Mr. Sellack
        I didn't think I'd be back.
        I worked here last year
        Remember?
        I came when Annie
        Was going on vacation
        And I stayed on almost till December.

        Now the only thing I want
        Is to have my old job back again.
        I won't be nasty to customers no more.
        When they send their burger back
        I'll tell them thatI'm sorry.

        Waiting tables ain't that bad.
        Since I've seen you last,
        I've waitedfor some things that you would not believe
        To come true.

        Give me a broom and I'll sweep my way to heaven.
        Give me a job;
        You name it.
        Let the other forty-million three-hundred and seven
        People who want to get famous.

        Now the only thing I want
        Is to have that old job back again.
        I'll clean the tables;
        I'll do the creams;
        I'll get down on my knees and scrub
        behind the steam table.


        **************************
        i won’t drive you all crazy with my demented trip down memory lane with the roches... i actually did not start with mr. sellack – no, i began with a pity party driven by the refrain of i am trying not to have a bad day...

        it was another night of not sleeping, of actually fighting my way through some kind of dense, heavy fog of fatigue – hearing myself begin to snore, trying to relax and go with it – but twitching back to wakefulness – afraid of sleeping? it was hot because my fever would not *quite* break and i alternated between sweating and burning dry, and because our demented cat marmy has decided to literally stick to me.

        and i came into today ungrateful, full of dramatic suffering. i also had to contend with more cat piss – but that doesn’t fit the heroic theme of my wounded travails... thank god fred was sleeping... it gave me time to get over myself somewhat.

        as a result of the beginning of this rapid prednisone taper, i was hit with major gastro-intestinal upset and backache, plus a headache. i don’t *do* headaches very well. i also fear addisonian crises -- having had three of them when fighting infections in the past. you've no idea how stupid it feels to completely forget about your adrenal insufficiency and end up in a crisis.

        so i started trying to clean up my pitiable pity-party – and into my feeble head sauntered the roches... and the train.

        The Train
        (Words & Music by Suzzy Roche)
        I sit down on the train
        with my big pocketbook
        the guitar and a sugar-free drink
        I wipe the sweat off of my brow
        with the side of my arm
        and take off all that I can
        I am trying not to have a bad day
        everybody knows the way that is
        Even though my baggage and I
        are using up a two person seat
        I'm not trying to be funny
        but the guy who sits down next to me
        is even bigger than that
        we are overflowing out of the seat
        I can't look at him
        he doesn't look at me....
        My face is pressed upagainst the window
        and through it I can see
        the reflection of the train
        I spy on the big guy
        sitting next to me
        he's drinking two beers
        and reading the New York Post
        trying not to get in my way
        everybody knows the kind of day that is
        He is miserable
        I am miserable
        we are miserable
        can't we have a party
        would he rather have a party
        after all we have to sit here
        and he's even drinking a beer
        I want to ask him what's his name
        but I can't cause I'm so afraid
        of the man on the train
        ****************
        it has become my pity-party theme song. we’re all of us screwed up and scared, why can’t we turn and share all that we know we share?

        because we are all so damned afraid of the man on the train.

        love,
        retired educator