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!

Lazy Daze

So I played my "tease" earlier this afternoon, by mentioning that Fred and I had taken Ruby the Honda CR-V on a jaunt to the orthopedic surgeon's office.

That's right, we zigged north, then zagged a bit back to the south on a different parallel, turned left (which I like to call "west") and followed the edge of the Airport Lagoon (very near the government offices for the theocratic divisions of the Lost Alp canton) until we reached ShoulderMan's hip-and-happening, totally digital office suites.  We have been there so often since the summer of 2008 that Fred is considering adding it to the underground tunnels issuing from the Haddock's ancestral home, Marlinspike Hall.  But since we are really just Lower Caste Caretakers of The Manor, he feels like he needs Captain Haddock's permission before digging.

You will note that I did take the time to copy-and-paste an entry earlier, as I felt like blogging but also wanted to pout and drink a fifth of whiskey.  It was a long appointment and we got lost on the way home.  My fault completely, because for some reason I said "straight ahead" when I meant "northeast."

I just spent a fair amount of time filtering the day through my sieve of a brain as I composed an email to a dear friend, Ms. Diana-With-An-H.  And since another dear friend or five will be dropping by the blog tonight, I figured I'd post my second cut-and-pasted email of the day.  You'll probably learn more details about ShoulderMan's digs and doings that way than if I just sat down and started some sort of fantastical preamble...

So "Howdy High" to my several Carols, the Brother-Units, Tully, and the incomparable Pig Man -- plus to all my favorite Spammer Blog Bots and especially to whomever it is back in Berkeley who still visits every 17.2 hours, as well as The Weirdo from Ames, my most faithful reader.

And how is this for a promise?  The next post, which may come tonight, actually, will be the long awaited Feline Video Update you've been CLAMORING for.  "Clamoring,"  I say, "CLAMORING!"  Yes, we are in need of some not-so-serious amusement around here.

Here is the missive just delivered to one of the Interwebs Best Buddies, Diana-With-An-H.  Oh, so that I may be even *more* lazy, here's what you need to know about her, beyond her general wonderfulness: she was cooking up something awesome for her husband (a very lucky man, in ways I cannot begin to explain) and she has been helping nurse a friend who just had a mastectomy.  "Lazy Son" is, specifically, Nanette's son... and the three of them went out to lunch yesterday.

Krapola!  I probably should peck out a bunch of footnotes to further erode your reading pleasure!

But I won't!

hey.

good for you -- now come cook us something!  nah -- yesterday i whipped up some soup for fred and the lesbians (+ miss kitty, grrrr) for the famous wednesday night "church" supper.  i was so out of it, it took me about 4 hours, which was ridiculous.  but it was good!  cream of potato with charred red pepper, black beans, and caramelized veggies.  he brought home the leftovers and it fed us today, which was nice.

we are doing a lot better today, for some reason.  or ... NEWS FLASH:  when i don't say a word about how i am feeling, he perks up and chatters away, the sweet boy.

i bet brenda did feel awful today... she sounded a little too energetic the other day.  and the radiation can be very debilitating but she knows that. she sounds like one tough cookie.  i hope she gets some rest... bless her heart. (and yours)

hey, is lazy son any sharper when annette is around?  and how are you and annette doing these days?

okay... so.  the visit was not good.  there were, however, two hysterical moments.  

1.  remember, i practically LIVED in the man's office from august 2008 thru the fall of 2010, and even popped in after losing my insurance.  he has an intellectually-challenged guy who works as his nursing aide, named Rex.  Rex is sweet as heck and knows me very well.  when he called my name to go back to the exam room, i was filling out paperwork and promptly dropped the clipboard, sending the forms flying, then knocked over a sign on the table when i reached to retrieve them.  well, while i was picking all that up... a woman got up, said "here i am," and went back to the back with him!  so that left me in front of the closed lock door yelling "rex!  rex!  i am locked out!"  finally a receptionist went and opened the door for me.  and there was rex, giving me the evil eye.  i didn't know rex had an evil eye in him!  i said "hi" and flashed him a toothy grin.  he said, suspiciously, "who are you? and who is the woman i just put in your room?"  turns out this long, lithe, lovely lady was pissed at having had to wait, and that, according to her, she should gone before me, having arrived earlier.  i mean, who gives a shit about stuff like "appointment time"?!  rex thought he had lost his mind, or that there were two profderiens (an *absurd* proposition) or that i had experienced a miracle, been cured, and was out of the wheelchair, looking like a fox.  they didn't even make her go back to the waiting room, but he did at least get my chart out of the box on her exam room!  rex is really wonderful, usually -- the time i kept landing in icu hitched up to a respirator?  when i went for the first postop appt, rex gave me a bear hug (can you say OUCH?) and burst into tears. "i was so worried about you!" 

2.  where was fred during all of that?  well, last night, at the "church" supper, he was washing a dish, put his hand in the dish drainer and got stabbed in the finger by a knife that someone had left point-up.  in the doctor's waiting rm, it opened up and started bleeding again.  so he got up to ask for a bandaid... and the woman handed him a "medical history" form, saying "you'll have to fill this out, first."  
the whole room cracked up...

okay, now for the serious stuff.  there is a 2 mm "black-ish" space surrounding the shaft portion of the implant, extending around its end for at least 3-4 inches.  that's the major change... and it usually means you-know-what.  it is very likely an infection as the only other option is air and he didn't 
agree with me that maybe i hiccuped and the air went down the shaft of my prosthesis into 
the humerus itself.  

he's a spoil sport.

the other changes were not "new,"  they were just "worse."  my rotator cuff is *still* missing!  it ran away and just left me with a bunch of painful calcium deposits, and they aren't even in the bone (since there isn't anything but titanium in that area now) but are sitting in the soft tissue.  ouch.  okay, so i thought it might reappear after it first ran away back in february 
-- i have always been fond of my rotator cuff tendons.

come home to moi, my tendons!

shoulder humor.  sad.  

anyway, there's been a widening of the space between the "ball" and the "shaft" parts of the shoulder prosthesis as a result.  it was also just very... i dunno... irregular looking.

he did not even push the range of motion of the arm -- first, he sees what you can do, unassisted (which was almost nothing), then he asks you to relax it while he moves it.  he almost never STOPS when you say/yell "stop," but today he barely even tried to move it.  second, he asks you to put your palms together and then he tries to hold them together while you attempt to move them apart. we did some weird imaginary form of that part of the exam. then everyone stood around and made noises-of-sadness-and-pity over the progression of the CRPS in my arms and legs.  {rolling eyes toward heaven}  shoulderman won many points by asking "why did you shake my hand?" now *that*, my friend, is CRPS/RSD*awareness*.

there *may* be more fractures up above as well as perhaps in the shaft.  i don't really care about that but he does, because of the fact that the next prosthesis -- IF there will be a new one -- has to be a REVERSE prosthesis.  to understand how different that is, here is a normal prosthesis: 

and this... is a "reverse" prosthesis. The Tribunal of the Holy Office of the Spanish Inquisition is credited with its design:

anyway, for today, he gave me a shot of [what else?!] steroids and some local anesthetics.  he asked me to have go-to-guy try to get some sort of results from the CT scan they did while i was in the hospital last week.  in other words, like me, he doesn't believe that they "didn't scan the left shoulder."  i hate to be the queen of conspiracy theorists but hell, i was *there* and i *know* they scanned it.  the a-holes just didn't want to be suspected "liable" for even more damage to this rock star of a body than they already have been.  grumble, grumble, curse, curse.  they should know that if i haven't sued them by now, they are not gonna get sued... i've never sued anyone in my life. 

i should have taken every available penny from the bastards back in 2002. 

the plan is that i am going back in about 6 weeks -- if i can wait that long.  i get to go in early if i reach what we are calling "desperation."  i wanted to respond to that escape clause with something really snarky, but then realized i'd probably burst into wimp gimp tears.  he wants me to hang in there until after i finish the antibiotics i started last week, then get back on the other antibiotic that go-to-guy is experimenting with... after he chats with go-to-guy and orders maybe another aspiration of the joint (i am against that... we have done EIGHT aspirations and NOTHING grows in the damn lab... why do we keep doing them?), after more imaging studies... and then he will likely remove the current prosthesis and insert one of those spacers laced with antibiotics.  

why? because he can't put in any sort of prosthesis if there is infection.  the spacers can stay in for months, tho the last two he implanted on that side had to be taken out because they were causing fractures and blahblahblah. in other words, i may end up with a series of spacers.  i also have a pretty good chance of ending up without a shoulder at all.  but we won't go there now.

this is what a spacer looks like (modigliani design):

 he gave me one like that once, but he also made one on the spot in the operating room by shaping it himself out of surgical cement.  that, i would have liked to witness!

well... this is way too long, sorry.  my brain is on overdrive, my temp is 101, and i feel like my legs are aflame!  woo hoo!  it's party central in the manor tonight.

i hope you are in your jammies, warm, cozy, and chilling out.  tell brenda i send her good wishes and hope she kicks cancer's big fat ugly butt.

oh -- when we got home?  we found rampant destruction... since dobby and marmy fluffy butt both came for the butt whacks they love so much, it was easy enough to infer that the guilty party was one buddy the kitten, whom we found hiding in the dirty clothes hamper.  more on that in tomorrow's tome!

smooches galore and fruited loops,

moi 

Prof is Pissed and Buddy the Kitten Finally Goes UP!

I am, as they say in the Southern Realms of the United States of America, fit to be tied.

First, I'm febrile, oh so febrile, as febrile as febrile can be....    ♪ ♫

Second, there is a person on YouTube who keeps leaving me kind messages.  The person claims to be a Mom whose son was cured of CRPS by a contraption and bless her, she thinks I should get cured by a contraption, too.

And all those good wishes and sweet suggestions are about to piss me off in a royally major way.
That's what you get for ending all your messages to me with a cheerful "God bless" and for being all conciliatory and stuff.

This person is pushing the bleeping Calmare Magic Poof-the-Pain-Away Crap Technology... and you probably haven't heard of it, but then you probably don't hang out on message boards dealing with CRPS.  It's utter nonsense and is being put out there by the devious, the deviant, and the people that the devious and the deviant have hoodwinked.

By the way, no one should hang out on message boards dealing with CRPS. It's not a healthy habit.  I mean, you get a bunch of people who are not getting better (why else would they be there?), who are, by self-definition, People of Pain, and who are likely socially isolated due to disability, the aforementioned pain, and pain's stalwart companion, depression.  It just sounds like so much... FUN! 

So that's a rule, then.  No hanging out in such spots.  But a regular check on good threads, that's permitted.  I would be lost without the helpful suggestions I encounter on those boards -- where to find the softest clothes, what doctor is doing what treatment, news of clinical trials, morbid jokes. 

Mostly, though, I check in -- at least 3 times a week -- to take a look in a mirror, mentally as much as physically.  Has anyone else considered taking a chainsaw to their legs?  After we lop off one arm, who can we rely on to get rid of the other one?  Important things.

I also check in to see if what is happening to me should send me screaming into the frozen hinterlands or if it is just part of the normal abnormality of this weird, weird disease.  Like the fact that my leg is leaking... Or that I have 2 blue toes, 1 red, and 2 tartan plaids.  It is somewhat reassuring to see pictures of other people's fingernails -- Hey, their nails are falling off and cruddy looking, too!

I promise you, however, that it will be a cold day in Hell before I author any version of the phrase "Being here makes me feel less alone..."   I suppose I should explain myself, but I'm not going to.  Because I know what I mean.  And whose blog is it, anyway?  Harrumph, squared.

Back to this irritant of a Calmare thingy.

At the moment, the only physician in the entire United States who has suckled at the tit of the inventor of the Calmare Magic Poof-the-Pain-Away Crap Technology is one Dr. D'Amato, of Rhode Island (or so I hear, over here in Tête de Hergé, where there is no illness, of course, nor traffic accidents).

Yeah, there *is* a guy opening up 14 pain clinics using the Calmare Magic Poof-the-Pain-Away Crap Technology (Spero Pain Relief Therapy clinics).  Guess what?  He's an OB/Gyn.  Just who I want doing pain management for a central nervous system degenerative disorder.  More from him in a moment.

Cut me some slack today, would'ya?
Give me some latitude.
I don't feel well and I can't get a'holt o'that there magic poof machine (and it ain't covered by insurance, neither.)

Ahem.  Okay.  The ibuprofen is kicking in.  I love ibuprofen.  I should own stock...

Speaking of stock: CTT is the parent company in the USA...and it's now a penny stock.  Or almost -- it closed today at 1.70.  Because some rubber-stamping idiot approved Calmare Magic Poof-the-Pain-Away Crap Technology as a vendor to the VA, all the devious, deviants, and the hoodwinked are going on and on about how if it's good enough for our Wounded Warriors at the "flagship" Walter Reed (I'm thinking they don't read the Washington Post), then, by gum, it's good enough for you CRPSers!

The Italian inventor was less circumspect, if you can believe it.  He claimed that Calmare Magic Poof-the-Pain-Away Crap Technology could reverse aging.

Now you're talking!

Meet, my friends, Giuseppe Marineo, and his explanatory woo and gobbledy-gook from the Italian arm of operations, Delta R&D:

Delta R&D is a bioengineering research centre with a unique history. It was born out of individual research work begun in 1983 by Giuseppe Marineo, a researcher and bioengineer, who advanced theories to reformulate the concept of disease (and the corresponding treatment) from a biophysical rather than biochemical point of view. The idea was to restructure the known features of both according to the principles of thermodynamics by means of an analysis and the detailed specification of the relations between entropy, disease, repair processes and ageing.


This new approach to the interpretation of the traditional aspects of medical science makes it possible to go from a highly heuristic system to an extremely conceptual and rationalized system, which can create models of disease and treatment so sophisticated as to render the experimental results highly predictable. If the latter are in line with the predictions they automatically validate the development model.
Furthermore, the very name of the theoretical system developed entails a natural transition from reductionist methods to systems theory which, in the present research, takes the form of a powerful working tool capable of providing adequate support for the development of therapies of practical utility.


In practice Marineo introduced into medical science the research and development criteria typical of engineering, in which the thoroughness of the preliminary theoretical work fully determines the expectations of the experimental verification of the method used. In 1987 the basic research was already sufficiently well structured to be supported by a technology capable of translating the theoretical system into a truly useful therapy.


The first experimental verifications fully confirmed the validity of the theoretical models developed and opened up concrete future prospects for the safe and non-invasive treatment of pathologies for which conventional methods had proved ineffective.
In 1998 the Italian scientific community, which had been constantly informed of all research developments, deemed the product of 15 years research to be scientifically valid, the theoretical principles and experimental data to have been clearly demonstrated and the bioethical principles regarding the respect and protection of the patient to have been respected.


In other words, the research carried out by a private individual was accepted and supported by the public authorities. It was consequently possible to begin official university and hospital studies, at the conclusion of which the first international publications were produced.


In order to support these changes, in May 1998 Delta R&D was set up, thus marking the beginning of the mature stage of this individual research endeavour. Although the original philosophy was retained, a logistical structure was now available to satisfy the new phases of development and to maintain and expand relations with the international scientific community.


In Italy the Delta R&D company became a research centre incorporated into a public structure thanks to the prestigious acknowledgement of the Tor Vergata University of Rome in the form of an agreement in which Delta R&D is recognized as part of the scientific structure of the university while retaining its autonomy and individuality.


Outside Italy, Delta R&D, the theoretical and research work on the Delta-S Entropy Variation Systems and “Scrambler Therapy” pain therapy resulted in Giuseppe Marineo receiving scientific awards for the originality of the basic research, in addition to numerous other acknowledgements by the international scientific community inherent in the acceptance of the proposed published works.

I dunno, maybe that's not your favorite type of woo and gobbledy-gook.  How about this?  From the lips of Dr. Robert Chalmers, former OB/Gyn:

Q-How do you do Calmare , Exactly?


The treatment is actually quite simple. It involved the machine, wires and surface electrodes that deliver the electrical waveforms. The surface electrodes are the same used in heart monitoring such as an EKG. The patients sits or lies comfortable during each 45 minute treatment session. The electrodes are placed OUTSIDE the area of pain so they will not increase the pain in patients with allodynia from CRPS




Q-How does it work?


The mechanism is completely unique. The primary issue with CPRS is the so called physiologic "wind-up" in the brain. This is a complicated change in the nervous system and can be traced at least in part to changes in NMDA receptors in the brain. We need to get to the brain to help with this disease. The use of electricity for the management of pain is not unique to the Calmare system and I am sure many RSD sufferers have tried traditional TENS therapy. However, the Calmare system is not anything like a TENS unit. Injury or other noxious stimulus in the body creates pain chemicals. These chemicals in turn get converted into electrical impulses by your nerves which get transmitted to the brain and get INTERPRETED by the brain. When we use the Calmare system we "control" the electrical impulses that the brain is recieving. By manipulating the input into the brain we "convince" the brain that the area of the body where pain was present is now normal. We know that the brain can be taught, in medicine we refer to thoses changes as Neuroplasticity and there is quite a bit of interesting reading on that topic on the internet if you have the time. I was the worlds biggest cynic prior to actually treating patients with the machine. I thought it was TENS or Placebo but nearly every patient I have treated has already tried TENS therapy and they can tell you this is nothing like TENS.It works!

Mystery solved.  "It works!" He hits all the right buzz words:  allodynia, neuroplasticity, NMDA receptors, physiologic wind-up...  Oh, gag me with a spoon.  Does any of it make sense?  Not a bit.

You want real breaking news?  Hmm?  Do you think you can handle some real news?  Well, do ya?

Jessep: You want answers?

Kaffee (Tom Cruise): I think I'm entitled to them.

Jessep: You want answers?

Kaffee: I want the truth!

Jessep: You can't handle the truth! Son, we live in a world that has walls. And those walls have to be guarded by men with guns. Who's gonna do it? You? You, Lt. Weinberg? I have a greater responsibility than you can possibly fathom. You weep for Santiago and you curse the Marines. You have that luxury. You have the luxury of not knowing what I know: that Santiago's death, while tragic, probably saved lives. And my existence, while grotesque and incomprehensible to you, saves lives...You don't want the truth. Because deep down, in places you don't talk about at parties, you want me on that wall. You need me on that wall.

We use words like honor, code, loyalty...we use these words as the backbone to a life spent defending something. You use 'em as a punchline. I have neither the time nor the inclination to explain myself to a man who rises and sleeps under the blanket of the very freedom I provide, then questions the manner in which I provide it! I'd rather you just said thank you and went on your way. Otherwise, I suggest you pick up a weapon and stand a post. Either way, I don't give a damn what you think you're entitled to!

Kaffee: Did you order the code red?

Jessep: (quietly) I did the job you sent me to do.

Kaffee: Did you order the code red?

Jessep: You're goddamn right I did!!

Oops.  Sorry...  It just feels like A Few Good Men kind of an afternoon.  Did I mention that I am febrile?
That I'm febrile, oh so febrile, as febrile as febrile can be?   ♪ ♫
Oh, I did.  Okay.  Well, I bet you don't know that I sprang a leak!  Yep, drip, drip, drip goes my leg, leg, leg...  Oh, I mentioned that. 

How about this?  I feel cranky.  That's gotta be news, because I am NEVER cranky!

WHAT IS THE CURE FOR CRANKY?

BUDDY THE KITTEN, of course.

It turns out that the kitten was not being a contemplative, not waxing philosophical.   He wasn't meditating on the idea of UP after all.  The Kitten wants the cord to the ceiling fan!  That's what he's been gazing at in adoration for the last few weeks.  What cracks me up is that he had the other two cats doing it, as well as a human or two.