Saturday, May 27, 2017

New Sighting

I've heard about them from the neighbors ever since we moved down here. Of course I believed them. They had to  be more than just another urban myth. After all, it took a couple years for me to spot actual tarantulas out in the desert, over a year to see coyotes in the neighborhood, and until a year ago to see a javelina. And while I've still not spotted scorpions or rattlers down here, my reaction is not disbelief, just gratitude.

I love watching the various doves, finches, owls, hawks, and especially the Gambels quail with their little topknot black feather. I even feed them, waiting till spring to attract parents with babies. This year the home baby count was one family with a single, likely day-old chick, and another with 4, either 2 or three days old. Unfortunately the baby quail sighting was limited to a total of about five minutes in a single day.

Too many predators, I guess.

But the bird the neighbors have raved about is the peach faced lovebird. I finally spotted one this morning, while doing a bit of yard cleanup before summer. It sat up on a wire, studying me as I studied it, though I'm sure I'm the only one of us who was regretting that the camera was all the way through to the opposite end of the house, charging. Perhaps my inactivity upon finally spotting one became boring to the lovebird, as it flew off elsewhere, leaving me to finish my cleaning.

In case you can't look one up - though if you have enough internet connection to be reading this, I can't imagine why - think small parrot slightly larger and fatter than a parakeet, emerald green throughout the body though pictures show some royal blue if you get closer than I was, a tiny white parrot's bill, and a black eye set in a face and throat ranging from peach to rose, depending on the bird.

Native to southwest Africa, it is believed some kept as pets escaped their cages in the Phoenix area and found a habitat well suited to them, including roosting spaces in old woodpecker holes in saguaros. They have been spreading throughout the greater urban area, possibly due to plenty of water sources though they are adapted to dry areas, and an abundance of seeds either from everybody's landscaping or the very popular 20-pound quail seed blocks that folks like me set out.

Either way, I count myself lucky to have seen one.

Tuesday, May 23, 2017

AWWW, Another X-mas Tree Denied

Yep, Christians are under attack in this country. Uh huh, sure. Boo hoody hoo. They're so-o-o forced underground with their beliefs. To be "forced" to wish 'Happy Holidays' instead of 'Merry Christmas' because all good Christians know that there are no other holidays, religious or secular, happening at that time of year... scandalous!

It's not enough that all the stores in the country set up decorations and special sales even before Halloween half clears the shelves. Not enough that lamp posts are festooned and cables high over streets are decorated in greens and lights, not enough that every mall has a Santa and elves for photo ops. Not enough that houses up and down the streets hang lights and inflate snowmen and Santas and reindeer, poke candy canes and stars and blond angels and fake packages in holes in their lawns, competing with every other house in the city for the most garish display and the biggest waste of power ever ever, as if any of that makes them holier than their neighbor because we all know it's a competition and the richest, most ostentatious one wins.

Hey, if a church wants to put a creche on their lawn to illustrate the story of their particular belief, goody for them. That's the proper place for it. I'm not about to haul them aside to quote the forgotten commandment about no graven images. Not my place. And after all, how many of the trappings of Christianity actually follow the principles of Christianity anyway? Was there a decorated tree in the manger in Bethlehem? Did Santa squirm his was down the chimney, not to mention the advisability of even having a chimney for a fire in a building full of straw? Did the shepherds make candy canes? Were the gifts of the wise men wrapped in pretty papers with curly bows? Did the angels smite unto death all who didn't believe the exactly proper way about what happened and what all it meant?

So despite the ubiquity of silly celebrations of Christmas, down here in Phoenix land there is yet another attack on Christmas. Or at least that's one interpretation of what's happening. It's not mine.

First, keep in mind two immutable things about this part of the world. 1:  There are mountains scattered about within our metropolitan area. Used to be they pretty much enclosed the area, but we've grown.  2:  This is a desert. It's made of rocks and tinder. If you want to argue with that last term, consider the amount of rainfall it takes to first, grow a tree or suchlike, and second, the amount of water it takes to decompose a tree or suchlike. See the first sentence of this section. We don't have it.

As a result, any trash you drop, stays. Wind may relocate it, but until the sun degrades it, years on, it's still here, somewhere. All our city parks, generally designated to be on mountaintops where it's just too damn difficult to haul construction materials up that high, and also too damn high to pump water that far, but not too high to keep an endless supply of athletically endowed but often intellectually challenged people from heading to the top, have their own unique set of rules.  By unique, I mean something beyond the usual ones of tell somebody else where you plan to go and when you plan to return, take plenty of water, stay on the trails. You know, the seemingly obvious. We've had to add that you will pay for your own rescue off the mountain.

At least we don't make you prove solvency first!

Unique rules, for example, say dogs are not allowed on the trails, or what passes for trails, once the temperatures reach 100 degrees. Yes, there are folks both stupid and cruel enough to ignore those signs. And no, you can't leave them in your car while you head out, either. I'm not sure if not playing with the local wildlife, like the Africanized bees, scorpions, gila monsters or rattlesnakes are rules, but they should be. And we're fussy about whatever you take in, you pack out.

Which brings us back to Christmas "persecution".  For over a dozen years, hikers have been carrying a decorated X-mas tree up to the top of Camelback mountain, to leave there for weeks, and then haul down again. Well, mostly, anyway. Winter winds do blow. Ornaments get fastened loosely, as if the tree were inside somebody's home with the breezes limited to what emerges from the HVAC system.

I bet you can guess how much of what goes up actually comes down. You might even have an idea of just how dangerous it might be to retrieve something that's blown just... over.... Oops! So the city is working to prevent the placement of another X-mas tree on top of Camelback. I bet you can also guess just how many folks who believe themselves to be well-meaning are fighting that prohibition.

Me? I'm with the city. Put that damn tree in your own yard! Better yet, in your own window, letting your personal message shine out into the neighborhood without your personal mess joining it! And let the mountain stay a mountain. You know, just the way whichever deity you believe in, or don't, intended it!

Tuesday, May 9, 2017

Just When You Think It's Over...

The day finally arrives: Stent Removal!

It starts out pretty lazily, the appointment not being until 4. Yes, I know I'm supposed to keep drinking a lot, but it's difficult to force myself. Every movement means a new pressure against the stent, a new poke. More pain. Weeks ago, what is seemingly months ago, it was just a spasming reminder of something there.  My body didn't like it, but it was nothing like it is now. I tell those who ask that it only hurts when I move around or I'm sitting still.

They look at me funny.

I don't add that I think now I know what The Clap feels like, a burning every time I pee. It's a bonus.

I take what I hope is my last percoset in a long while, early enough in the morning that I'm legal to drive myself to the appointment. Steve has cards tonight, and one thing or another, mostly me, has kept him from going lately. If he feels up to going, I don't want to spoil it for him. If I need a driver, I can still pop another pill. Or is it that if I need another pill, I can still get a driver. Cause and effect is sometimes getting lost here. Like time. Has it already/only been how many weeks?

It turns out I don't grab another pill. Not then.  Not wanting to offer them any chance to figure out a reason to cancel this one on me, I show up to my appointment 45 minutes early, carrying purse, kindle, paperwork with complete address, jar of dried bits from the filter, and disc from the x-ray. Hmmm, maybe I should have brought a bag, too. There is an open seat next to a magazine table, so I take advantage of that space. Over the next minutes, the crammed waiting room empties out. I'm the last patient.

Maybe they even stayed open late for me.

According to the hand-out sheet on my chair with my clothes afterwards, they're supposed to ask me whether I've had my antibiotic pills as scheduled. They don't, but I'm not going to protest, since I have taken them religiously. They're the same nasty two-tone green ones I had upon leaving the hospital however many weeks ago, the ones which left that peculiarly repulsive chemical tang on my tongue. They didn't this time, but maybe that's a side effect of having taken them in concert with all the other stuff I was given after checking out. Any single piece of good news is not to be questioned.

Like getting to leave my socks on, keeping my feet warm.

The procedure itself is even briefer than promised. It's also surprisingly more painful. I try to dismiss that with the consolation that the stabbing of increasingly tender tissues is now over, and that's true. I can tell that just in sitting up again. While there is residual burning like I still really gotta pee, it's not that stabbing pain. I can start improving!

I wanted to take the stent home with me, partly out of a desire to abuse the thing, torture it like it has me, get revenge. I know, inanimate object and all that. The Doc refuses my request, vaguely referring to some state law. But I get a good look, trying to figure just which part of it was poking, stabbing, creating so much misery. All I see is what looks like a blue piece of plastic coated wire, spiral curled inside itself at both ends with only the outer curl able to touch anything. I can only conclude that either my body was overreacting, or whatever it was had sprung back into shape, erasing any clues. The Doc had nothing to offer as to why, seemed indifferent to my complaint of severe stabbing. Maybe they are too used to this. Maybe they just think we all are a big bunch of whiners. Worse, maybe they just think I am.

I wish him the joy of having one of these stents someday. He takes it with humor. Little does he know.

I'm just happy to be done with it all, heading directly home for one last percoset, the one I didn't think I was going to have to take. Or should I say, the first that I didn't think I'd need.

The burning didn't get better. As ordered, I forced liquids, more than willing to flush out any malingering bits that might remain as irritants. It didn't help. Not only that, but the pain was increasing in my back, what I'd come to recognize as the location of my kidney. I reread the handout about what to expect and when to call the doctor if....

Meanwhile I popped another percoset. This was just 3 hours after the previous one, meaning I'd be overlapping for a total dose of 10 mg. for a few hours. Sitting on the throne and rocking was the only thing that even hinted at relief, so the back of my legs got real used to the discomforts of a hard plastic seat. And yes, now for the first time in this whole journey, there was blood on the tissue. Barely, but there. It didn't qualify me for that late evening call to the doctor, but the steadily increasing pain did.

I got a callback from a member of the practice I'd never heard the name of before. Whatever. He indicated this was "to be expected" (so why hadn't I been warned to expect it? Did they think we were so suggestible that being aware of possibilities would create the effect?), and was just my body swelling temporarily and blocking kidney drainage. I should go take a couple of ibuprofin.

Uh, yes, we have that. Bottles full. I took 3. Then planted myself on the throne for more rocking. Any ease at all, I was clinging for dear life. This doc advised me to wait through it for an hour before heading off to the ER if it hadn't let up. I had changed into my PJs a couple hours earlier, so decided to be prepared and changed back into daytime clothes. Really: who wants to show off our PJs in the ER?

With all the comfort available having been claimed from my last half hour of rocking, I returned to the living room to see if a little conversation with Steve and a bit of late night TV humor might distract me while I waited to see if I needed the ER? About 45 minutes into the ibuprofin, the "bite" of the kidney pain began to ease off. I started counting down the pain levels. By the time I'd watched Trevor and Steve and tried to solve a few Wheels of Fortune - not my best night - we were down to a three and still dropping.

Steve and I decided it was safe to count on heading off to bed. And, I could finally enjoy the scent of wet desert, as we'd finally gotten enough rain to kick those mesquite trees into production. Windows open, everyone!

Friday, May 5, 2017

FUBAR! FUBAR! FUBAR!

The saga continues... unmercifully.

Last night after 5:00, as in, after it's to late to do anything about it, I get a reminder call from the urologist's office reminding me of Friday's appointment and to bring the latest KUV x-ray. Wait! What x-ray? Why didn't I know about this? And why, if you're going to "remind" me about it, don't you make this call a day earlier? Somebody else called to confirm the date and time a couple days earlier, after all.

OK, well, I can hit the drop-in radiology place they sent me to last time, early in the morning to maybe cut down on the wait, and bring the disc along with me to my afternoon appointment.

Simple, right?

Yeah, no. Not so much.

I walk in a few minutes after 8AM, and the check-in person searched her computer records. "I don't have any orders for you. Go away." That's not a direct quote, that last sentence, but it's the gist.

I called the urologist's office, left voicemail. Half an hour later, repeat. A little less politely. Fifteen minutes later, call the front desk appointment line, get an actual human. Arrange - I thought - to get the orders faxed over.

Mission accomplished? Of course not. I get put on hold several times while she has to check a few other details with the staff. Did I take my antibiotic pills today and yesterday? No, I took them back when they were prescribed, 1xday for 3 days, per label. Oh, said label also happened to refer to my "colonoscopy", but who's counting? More consultation. OK, they can deal with my having taken them last week, no biggie.  Another discussion ensued, same put-on-hold, come-back process, regarding whether I could get the x-ray done on time. I asked them flat out, citing the process of waiting an hour and a half, getting the x-ray, waiting 10 minutes for the disc, bringing the disc to my appointment this afternoon, if there was anything in that process which would preclude my making my appointment this afternoon? Mmmmm... no, that would be fine.

I left again, since I made it home during the waiting time, back to the radiology office. Still no orders received. Sit and wait for them to show up. 20 minutes later, my Minnesota Nice has evaporated and paranoia sets in. I get back into the line for attention at the check-in desk, and verify that the number highlighted on the business card she handed me this morning, which I passed on to the urologist's office, was the right one.

It wasn't. Naturally.

I called the urologist back from inside my car for privacy, giving them the new number. I decided to wait in my car a couple minutes, needing to fight my way back to some semblance of calm. More than a few f-bombs, or near bombs ("What the effing...?" etc.) had been dropped by this time. Most of the causes for them had nothing to do with the radiology folks. After another wait in the check-in line, I was informed that the orders had shown up just as I was walking out the door to call with the right fax number. Of course.

So there's the waiting, long enough for the super duper AC in the waiting room to make me wish I'd brought a jacket. On a day forecast to top out at 105 degrees, that hadn't exactly been a consideration when I left the house.  (Note: it reached 108.) Then there's the metal-free trousers and backless gown to change into for the x-ray, something which had been skipped last time I was there. They came in one-size-fits-other-folks, so I can't bring my arms all the way forward to properly hold the pants up where they don't make it past the hips. Oh well, who needs modesty? After changing back into civvies, another little wait in the check-in line to start the copying-of-the-disc wait. In other words, everything went pretty much exactly as expected.

Precisely as I'm sitting back in the car, noting that the earlier shade has moved elsewhere and the car is now stultifying, my phone rings. Seeing a too-familiar number, I answer it with the announcement that I have disc in hand and am leaving as we speak. I get a hesitation, then am asked to hold for a minute. Then she comes back and announces that my appointment has been changed to Monday afternoon because there will not be time for the technician to make his report before 3:30. The disc isn't enough? No. You couldn't have mentioned this earlier? Apparently not, despite the previous long consultation pauses before confirming that I could actually make my appointment. He can't read the films himself? He did before the lithotripsy, or at least said that he did. Again, apparently not.

Remember, all this back and forth has been aggravating the spot where the stent decided to poke into my bladder last Tuesday after a few minutes light yard work. It has the entirely predictable effect of continuing to shorten my temper. It doesn't help that Samantha, my caller/contact at the urologist's office, has taken this time to start getting defensive about how all this is my fault, not a speck of theirs. I asked how I was to know this was needed when all 13 pages of paperwork, still stapled tidily together, say absolutely zilch about this x-ray, and the prescription doesn't give a more specific timing of  which days to take the pills and even references a treatment I'm not getting. I even refer to an earlier phone conversation where I ask them to verify my assumption that I need to stay out of the pool until everything's over, during which I'm assured that info was already in my papers because it always is - until she checked their copy of my orders and... surprise! It's not there.

I was getting ready to unload a bit more, but decided to take a deep breath instead, flatly say I'll see them Monday, and hang up.

It's so-o-o-o past time to head home and take a percoset.

While I'm waiting for it to kick in, I get another call from Samantha. They have decided now that they do, in fact, want me to take another 3-day cycle of antibiotics, starting with Sunday. I inform her I'm not able to drive any more today, and they'll have to call it in to my pharmacy for me to pick up tomorrow.  (I purposefully neglect to ask if this also means thaat the x-ray I just had done would also be obsolete by Monday, since it's supposed to be exactly one or two days ahead of the appointment. Enough boat rocking, already!)

In the process, I explain about how the pain has been driving my lack of patience, and dear old Samantha decided I need to leave a message about what the pain is like with my doc's medical assistant, the same one who hasn't been able to return my first two phone calls. I ask Samantha what's the point, since they won't/can't do anything about the stent until Monday now, anyway? She suggests they can maybe tell me if the pain is normal or not, and transfers me back. I duly leave a message, along with, yet again, my callback number.

You all just know I'm holding my breath. Right?

Thursday, May 4, 2017

Aftershocks

This is the follow up to my "Easter" post. That will give this some context.

I suppose we all thought once you're sent home from the hospital, all's over, you're well. OK, well, perhaps a lot of us really knew better, but there is a dollop of relief in the fact of the discharge. Just not the end of the story. In fact, barely the beginning. I think that's been the biggest surprise in this whole thing. I started by thinking kidney stone = a few hours of "discomfort". Boy, did I have a lot to learn!

The stent was causing problems. My bladder was spasming, the infection just starting to get knocked down so everything was still extra sensitive, meaning I registered every spasm as a flash of sharp pain. And with everything a bit swollen, the end of the stent was poking the wrong things if I sat straight up in a chair. (What are those wrong things, you ask? Whatever it touched!) So I was stuck on percoset for a few days, which diminished but didn't clear the pain. I could definitely tell the individual spasms now that the background pain was controlled.

While an improvement, it came with side effects, forgotten about in the year since my knee surgeries. It slows the intestines. That's one of the reasons everyone in the hospital inquires about their function. Since I went in empty, was denied food until after surgery, and had no appetite for a couple days afterwards, I wasn't upset about lack of production. Nor were the staff, listening to all the gurgling and rumbling. Something was happening. Back in the olden days, I'd not have been released until they had visible evidence, meaning they would have kept me in for nearly a week.

Glad I didn't have to wait.

Dry mouth came back with a vengeance. It was bad enough the day of surgery when I wasn't allowed anything by mouth. I still fail to comprehend that one can have enough fluids in the system to produce copious amounts of urine but none of that water makes its way to the salivary glands. The first morning waking in my own bed, my mouth was so dry I couldn't talk or swallow until after a sip of water. Unfortunately that persisted for days. I even needed to have water between bites of food, or it would get stuck in the back of my throat, as I found out the hard way.  I couldn't breathe momentarily! Between that and the snafu with not getting anything through the mask jammed down on my face for surgery, I had the makings for the beginning of a new phobia!

I took that as an incentive to get off the percoset ASAP. (Turns out I was wrong about the cause, but...)

Fortunately, my pain levels were decreasing as the spasms were backing off. I figured the infection was getting knocked down. All the pain wasn't gone, but what was left was tolerable. It simply told me now I had to pee.

Every hour.

Day or night.

Screw sleep!

Off percoset a couple days, I somehow had this silly idea in the back of my head that my appetite would come back, when the reality was I could be quite satisfied with three tiny meals a day. Hunger never struck. No cravings. Just eat because I needed to, and let the persisting dry mouth drive hydration.

Now I thought the tap water down here was terrible the first year. Lemons and filters please!! After that, it was just... water. No flavor. Not till a day or so past being home. Every time water hit my mouth, I got a chemical taste on my tongue. OK, plenty of bottled water in stock, time to start using that. Same reaction! It was me, not the water. (Turns out whatever is going on also ruins the flavor of chocolate!) Maybe something in my other meds? I came home with 3, after all, percoset, an antibiotic, and something to treat the regional bladder pain. I'd never heard of the last two, my only concern was that the antibiotic NOT be Cipro, as it makes my heart rhythm regulator do just the opposite. This one came in two-tone green capsules, and as the days wore on, started stinking more strongly every time I took the cap off the bottle. Sulphur! Ick. I can't help wonder if having that in my system is flavoring my food and water. If so, just put up with it till they're gone, and hope my system rights itself.

Tuesday, 8 days post surgery, was doctors' visits day. Morning for the urologist, afternoon for my Primary for a generic after-hospital check. Both of them are the same building, but I couldn't arrange back-to-back appointments. At least it's a very short drive back and forth from home.

My primary basically just said hi and charged me for the visit. After all, the hospital did all kinds of tests, so what did he need to follow up on? Plus, "my" urologist (Never thought I'd have reason to use that term) was following up. So again, nothing for him to do. Makes me wonder just why the hospital sends you back to your primary after discharge.

The urologist visit was only a little less perfunctory. How was I doing, those were all normal side effects, go get an x-ray to see if the stone has moved, and schedule both lithotripsy and his follow up visit to remove the stent. Here's a packet of information, yada yada. Oh, and a free sample of meds for the bladder spasms that should be without the dry mouth symptoms.

Wait, what? That's what was causing the dry mouth?

Meanwhile I decided, if a bit late, to go online and do some more research on the new meds I was taking, or finishing, as the case may be. Turns out that yes, the sulpha was ruining my taste buds. A couple days after finishing with those, I could again drink a sip of water without recoiling from the chemical slap. It was indeed the anti-spasming drug (not a localized pain med as had been explained to me) which caused the dry mouth. I switched over to the freebee but after the first day with no improvement to dry mouth, and finding that it also caused that symptom (but only in 5% of users!) I just quit altogether. With the percoset, pain levels were way down and the spasms were noticeable but tolerable. Way more so than the dry mouth.

Lithotripsy was scheduled for the following Friday, out-patient surgery at a different hospital over in Sun City West. Now the barrage of phone calls started. I was given a time, to be changed later, of course. Why would I expect anything different? I was given directions on where to park and which entrance to use. On the day of, it only took circling the parking lot about 5 times to find any spot at all. ("Oh yeah, we're really busy here Friday mornings, which is why we tell you to park over there instead.") Yeah, right. My meds history was gone over, letting me know which I could take and what needed stopping when. And NPO after midnight, so no cheating by taking more than one tiny sip to swallow those 5 pills! Also no gum, cough drop, or rinse to ease this newest case of dry mouth either!

The funniest was their insistence that I take an antibacterial shower that morning before coming in. Dial soap was suggested. Now, I know enough to appreciate how ubiquitous bacteria are. Also how soap and water actually multiply rather than cut their numbers on your skin. And what's the point when your towel is not germ free, nor your clothes, nor the chair or car seat you sit in, not the dogs who say "Hi" before you leave, nor...? You get the picture.

Besides, lithotripsy is noninvasive surgery. No skin gets broken in the process. It the germ wasn't already there, it won't get added to the system. So why all the fuss?

After getting checked in, getting a new pink-stuff scrub by a nurse who insists there is a point to the home shower, a new show-your-booty gown, and given a final chance to pee (non sterile toilet), it's a ride down the hall to x-ray (also not sterile) for a final look at where the stone currently resides. Yep, there's a light shadow there. Steve is allowed in my cubicle. Oh, fyi, he's not sterile either. A few more items fussed over, and it's wheel away time.

There are two major improvements over the previous surgery. OK, maybe three. First, though I still have to transfer myself from my gurney to the operating table, at least this time the table coverings offer traction so I can actually do it. Second, my memory stops there. No fighting to breathe, nothing. Must have been a pretty good shot they gave me. Third, did I remember to mention the two big bruises on my belly that I came back from the first surgery with? I mean, it's not that they hurt or anything. I had to see them in my home mirror to even know they were there. But no new ones this time.

I don't even remember waking up. Let me just assure you that I did. Must have been a really good shot! The only discomfort was needing badly to pee. I was given a cup that fit into the toilet and a paper and mesh strainer to capture any and all stone bits coming through, plus a container with a lid to put them in. I used them twice before being sent home, and before even hitting the parking lot, I needed to again so much that we went straight home. No lunch, no stopping for prescriptions, nothing. Ahhhh!

That first bit of detectable stone is almost exciting. I know,weird, huh? But it's proof positive that something happened. Even then, it's more of a hint of lint showing up in the paper cone than an actual piece of anything. Less than dust. Silt is about right. A grey shadow slowly grows, until finally! On day two or three there's an actual something in the bottom of the pee cup, something to follow as you pour through the strainer, something to capture, something to prove it really worked.

Of course, all that paraphernalia is logistically impossible to drag around with you. Can you imagine, hauling the big cup and the paper cone with a slowly rising yellow ring working its way up the paper along to a public restroom? And forget about visiting a friend's house! Even if you could get past the disgust and embarrassment, how would you collect the bits for transfer to the container, then clean up after all the mess? At home, the container sits on a few layers of folded TP on the side of the sink, drying out until everything can be scraped out with the rounded end of a nail clipper or something.

Steve and I agreed that our planned restaurant meal would be postponed until the collecting was done. I did manage to hit my pharmacy for my new prescriptions that first evening, finally getting the capacity to wait over an hour between bathroom trips. I only filled two of them, though. The third was another anti-spasming dry mouth drug. Not only was I not spasming, I figured even if I started, the cure was worse than the problem. I still had percoset if it got annoying.

I'm not sure if all the bits have passed. When my urologist told me he blew the stone to smithereens, he wasn't kidding. Most of what collected was silt, and I'm convinced some of that made it through the screen. Still, I dutifully scraped and transferred, noting the occasional dog hair or mine. When a visible piece of something was produced, by the time it dried, it often was about a fifth of its "wet" size, and frequently stuck onto the mesh. It all doesn't seem to add up to a 5mm anything. And nothing has shown up the last few days.

I decided to become a bit more active, since things were going so well. The yard needed pooper scooping again, a couple bushes needed water, and an old sun-rotted hose needed collecting and tossing. Nothing much. But apparently the rhythmic motions resulted in the stent irritating the bladder again, and the spasms are back. Nothing big, but there.

Tomorrow, however, should be my last visit with the urologist, where the stent is removed. He says it's just a quick procedure, no painkillers needed, just reaching a tool in, hooking onto the stent, and pulling it out.

I hope he's right.

Wednesday, April 19, 2017

So, How Was YOUR Easter?

I had plans, I promise you. There was laundry, and typing up 2 meetings worth of minutes, and hunting all the... um... chocolate Easter eggs in the back yard and scooping them up.

Instead, I woke up feeling a bit off. I took my morning pills and decided to postpone breakfast.That turned into a wise idea. I was thirsty a bit later so drank some water, then hit the bed because "off" was turning into something worse. When Steve woke up, half an hour later, I called him to come talk to me. I let him know I was sick, and by the time I'd spoken five sentences, I needed to make a mad dash to the throne. It was my first set of dry heaves for the morning. I admit I was a bit surprised this soon the stomach was already empty. But it certainly got our attention.

Meanwhile, the pain had been traveling as well as increasing. I first thought bladder infection, then bowel, then appendix despite not having one of those for 56 years! Then the pain climbed up my back to sit waist high, just right of the spine. Almost like is was in the kidney. I decided Steve was going to drive me to the ER, that being the only available medical care available on the holiday. While he was tending to the dogs so they could stay home for a while, just in case, I was digging around for the least dirty clothes I could find. Laundry was due, after all, and would soon become overdue.

At the ER I asked if I could lie down anywhere, since I certainly didn't feel like sitting up by then. I got their routine response that was only a mite more civil and helpful than "Take a number and wait", but that's what it meant. They also answered my request for a pan, since the nausea was returning, and when it hits, it doesn't wait on a trip to a possibly already occupied restroom. As soon as I sat down, it became useful. My fellow waiting room inmates were treated to a spectacular series of dry heaves. I figured they must think I was hung over. By the time my name was called, the count was up to 4 sets, with two more to follow before they shot me up with an appropriate medicine. It kept Steve running to resupply me with tissues for after, since each bout left my eyes and nose streaming as well as the mouth.

The only good thing was I wasn't producing any bile, so no horrible taste or smell. On the other hand, it didn't do a thing to ease the pain, and left me even now with sore muscles across my back from over-use.

I asked Steve to hit the front window again with my request to lie - somewhere, anywhere - down while I was waiting. A couple minutes later they took us and my pan back... to a room with chairs!

I do believe there are times when it's appropriate to let someone know, even to the point of raising your voice, that they are not listening! A room with a bed miraculously opened up right then, and it almost felt better to lie back. I say almost because that still did nothing for my pain. But I was done with having to sit up. We even figured out how to hold the pan while I was horizontal so everything went into the pan and not on me, the bed, or the floor. By the time I finished the last bout, what was collected in the pan totaled about two tablespoons, all saliva I figured.

Things improved. The anti-nausea meds via IV worked. I can't tell you what they used, even though they told me twice. The brain was on hold for certain higher functions. I did recognize the term fentanyl , which started easing the pain, but it took the addition of toradol to really bring it down. In fact, it was good enough that I could raise my arms up for the CAT scan, a real challenge after rotator cuff injuries. And that CAT scan gave them their diagnosis, confirming a kidney stone.

I was getting admitted.

I learned a lot the next few days. The CAT scan only showed the one kidney stone. I would need to be concerned and adjust my diet if, like most who show up with one, already had a bunch of others sitting up in the kidneys just waiting their turn. Being lucky doesn't always feel like lucky.

There were several different options for treatment, depending on a variety of factors. Did this one also show on an X-ray? Size is a factor, graded by under or over 5 millimeters. Mine is exactly 5. How they go in, as in down from the top or up from the bottom, depends on how far down the tube it is. Following a pattern here, mine was exactly halfway. Options include a couple different ways of smashing up the stone, but neither is possible if there is a UTI, or urinary tract infection, which I tested positive for. Turned out to be e coli, the most typical culprit. It can be hard to clear the infection, since with a stone still imbedded, there is lots of habitat, if you will, for the little buggers to hide in. "Stone" brings to mind something smooth and round, so think more like sand burr. Surgeons can reach the stone with a lighted gripper thingy and pull it out, and not need a stent to keep urine from continuing to back up in the kidney. However, if the tool accidentally punctures the ureter the stent will still be needed so urine bypasses that spot to let it heal. But if it's more than a tiny hole, they have to open you up immediately and practice their knot tying, and you still get the stent.

But hey! maybe none of those options would be necessary if the stone flushed itself out, so they pump IV fluids through me at a high rate to keep me peeing, and catch that in a little insert under the toilet seat, then strain the contents before anything gets flushed and see if any little 5mm something shows up.

None of the information influencing options was available yet, so I made it onto the surgery schedule for the next morning. Something was needing to get done, unless I could produce a stone in the strainer. By then we know I had a UTI, limiting some options, that no stone had passed, so the first procedure was to be -hopefully - a simple stent. 20 minutes under. Nothing to eat or drink before surgery, of course.

With my kidney in the shape it was in, I wasn't feeling hungry anyway. Painkillers didn't change that. Good thing, since the hospital food absolutely sucked, except for the red grapes or the banana I got later. Not only was the meat over-cooked, dry, and tasteless, the baked potato like a rock that didn't even smell inviting, the whole wheat dinner rolls were old and cold and again, yuk in the flavor department, but every tray had about 12 carb units where I'm allowed 3, so I had to make choices of what is the least worst. Then again, even now I barely have an appetite, so much of that food would have been tossed anyway. At least the grapes and banana could be saved for a late night snack.

Most of the nurses were great. However, both my roommate and I had special attention needs, primarily for being unplugged from multiple outlets, and quickly enough that we could make it to the bathroom without either creating a mess or enduring an unnecessary level of pain. Sunday night was the worst. A couple of the nurses made sure we knew how much inconvenience we were causing them.  What made it worse was them sounding like there was a party out there.

If we hadn't shift-changed to new sets of teams, we both would have gotten very good at becoming even more of an inconvenience. I had pain pills I needed on schedule, especially since my pills were only 2.5 mg of percoset and wore off well before I was allowed the next. You better believe even at my most out-of-it, I was a clock watcher. And yes, I was a bit out of it that night with a low grade fever.

One issue I solved for myself by figuring out how to take stuff apart so I didn't need help every 2 hours or sooner. The pink plug came out and went back into the wall behind my bed, and the IV rack it was attached to had a display showing battery life, usually 4 to 5 hours. No way I was going to need it unplugged that long. The leg cuffs that squeeze alternate legs in order to prevent blood clots took a bit longer to figure out, since they had an alarm that sounded if they were disconnected for a certain length of time. I finally just decided to just unplug my cuffs and wear them into the bathroom, and it the alarm brought somebody, well, all to the better. Ann and I had different staff assigned to us, and that first night they were very territorial, in a not-my-problem kind of way. Again, that improved, and we had gotten very good at saying, "while you're here could you just....?" Ann had extra complications keeping her from unplugging herself, including being hooked up to O2, and a bed alarm.

After both of us were feeling better we started chatting occasionally. You never knew when the other was sleeping, with the curtain kept pulled. She has led a very interesting life, traveling to many different countries for work, on all 6 of the major continents. At present she was battling COPD on top of Valley Fever, had been here 5 days already, and had only one sleeping pill in her history that worked for her, which the hospital pharmacy didn't stock. After 5 sleepless nights, the staff finally threw up their hands at a problem they couldn't solve, and consented to let her have somebody bring her own labeled bottle of sleeping pills. They were talking about discharging her soon, but she'd been through the repeated routine of going home and needing to return two weeks later, stay a while, go home, come back. She wanted not only more care, but better.

Back to me: Monday morning I was awakened with the news that surgery was at 11:20, and the CNA needed to assist me with two antibacterial "baths". Think towel, washcloth, and thin pink soap. I informed her no way until I got my already overdue pain pill. Maybe it takes messing with their schedule to get your needs met, because the pill arrived shortly. In between the two baths, I was informed surgery was now moved to 12:30. That worked for me because my pain pill would just be wearing off then and the OR staff could deal with it however was needed. I should be under, and then on whatever was needed for after surgery. One way or another, my kidney would be unblocked and stop trying to kill itself. Even if the stone remained, it was the kidney causing all the pain, not the stone traveling the length of the tube, as most people think.

So my morning was devoted to getting 2 scrubbings, blood drawn, vitals checked, and trips to the toilet, straining my own urine because the staff had somehow lost orders for that in the transfer, so the "not my job" resurfaced, and it was really simple. Whether that stone had passed was vital information for the surgeon. Plus for hygeine there was a nice sink with soap and paper towels, the strainer rested in another container, and the toilet insert sat next to it all in the shower, out of the way. Get over it: after changing thousands of dirty diapers, this was not obnoxious.

Once down in surgery, we knew the stone hadn't passed,  I had a fever, a UTI was presumed, so a stent to relieve the pressure was the only task of the day. Taking out the stone under these circumstances risked a blood infection. Antibiotics before and after surgery, and a follow through with my urologist to make sure the bug was gone, and we'd schedule lithotripsy and stent removal. Oh yeah, and now the schedule was changed again, so surgery something like 2:20. Or whatever. I wasn't going anywhere. I just laid there quietly, not even up to reading. (Nor for most of my stay.)

I didn't particularly appreciate the lead-in to surgery. I got wheeled in on the gurney to a spot reasonably close to the operating table, and asked to transfer myself over. Uhh, sure, you bet. Of course it means sliding from one slippery surface to another even slicker one, nothing to grip or that would stay put for leverage, and it took them a while to decide they probably shouldn't leave me half over the edge of the second because I might fall. Well duh! I was a long way from worrying about falling yet, with the two gurneys touching. My issue was the hard inch-wide, inch-high rim on #2, not - so - cozily nestled right under my spine.

Hey guys, a little assist?

Then the anesthesiologist shoved this plastic mask down over my nose and mouth. I couldn't breathe, so started wiggling my face around to create an air gap, and gasping. As far as he was concerned it wasn't possible that I was having trouble breathing, and he just told me to slow it down. Hey, my body is slipping into full panic mode right now! He removed the mask for a few seconds, then clamped it back on me again. Same result. He removed it once more. The third time he told me he was putting something in it to help me sleep. Well, about effing time! So down came the mask, and... I wasn't going under for what seemed an age. "Breathe deep."  Hey, what the hell do you think I'm doing here, trying somewhere to find some air or sleep or something! My eyes are rolling, searching the room for help, but nobody's looking. I started counting breaths. I remember 10. Way-y-y-y too long, guys! And why should it be so difficult in the first place? Hose kinked? Nobody turned the O2 on?

If it takes surgery to remove the stent, I want a different assisting staff!

In the recovery room, I was mentally out of it long after being physically awake. I knew who I was, I'd just had surgery, and why. But it was still too hard to connect the verbal part of my brain to answer the basic questions they shoot at you. Finally I was able to answer. "Do you know your name?" "Yes." Hey, everybody asks you that, every time you see them. Birth date too. So far the best I could do was answer the question they asked. It went rapidly uphill from there, giving full name, date, and volunteering,"I have to pee!" They heard me. Within a couple minutes, they had me sitting up, making sure I had balance, and brought over a commode chair next to the bed. Ahhhhhhh....

The fever stuck around most of that evening, not too unusual after this surgery I'm told. My blood pressure was also well  up there past the healthy zone. I was loaded with pills, the IV with antibiotics, potassium to make up for the IV flushing practically everything out of my system, and settled in to
 trying to get out of bed in time. The fever shot down hope of leaving Monday night, but maybe Tuesday, if....

I improved overnight and through suppertime Tuesday, but so far only the urologist had signed off on my going home. Steve was trying to arrange his schedule for picking me up, a challenge when nobody will commit to anything. A pair of good friends stopped in for a visit, after finding out I was still going to be there in the hospital to see them.

It turned out the doctor who was needed to sign off on my leaving had no idea my urologist had already given the OK. Once she heard, things got rolling. Fast! I was out the door and in the car in half an hour. That was still time to get to my pharmacy for my 3 new prescriptions, then home to a comfy chair, even better a comfy bed. Steve and I watched a half hour of TV, and by the time I got back to the living room after that next potty break, I was ready to crash. No more TV. No more pills as I'd just taken what was needed. Just sleep.

The good news is the kidney pain was gone by the time I woke up from surgery. However, I'm one of those who find the stent very uncomfortable. I've got pills for that. Next Tuesday I see the urologist for a post-op evaluation. If all goes well, we can schedule Lithotripsy for about a week later, but there are "ifs". Later that same day I see my primary for a post-hospital evaluation. Of course the calendar is already spotted with the last post-op check with the eye surgeon, the 1 year check on my knees with my orthopedic surgeon, and the 6-month cardiologist visit, all before we head north. Hmmm, funny, I don't feel like I'm falling apart.

I do feel... good that the laundry finally got done today. And maybe ambitious enough tomorrow to go harvest those chocolate Easter eggs. I'd like to head back into lapidary, but if it comes to a choice between taking the good meds and spending more time working on rocks, you can guess my priority.

Anyway, that was my Easter. How was yours?

Better food, I bet!

Saturday, April 15, 2017

Getting Rid of Trump

Historically, assassination has been the way to get rid of leaders whom you have decided have got to go, when there seems no other way to accomplish the task. We tried to get rid of Castro that way, Iraq tried to get rid of Daddy Bush. Whether it's for idiological reasons, or a power play so you can take over, it's been a tactic throughout history.

It's tempting to at least think of somebody going for it with Trump, say, before he creates a total catastrophe. But recent reports  in the news suggest there's no need to actively assassinate Trump. Just let him continue spending his weekends down at Mara Lago, eating his wonderful chocolate cake and whatever else from their filthy kitchen. That'll do it for ya! We just have to be careful his kitchen doesn't kill off some other world leader and start the catastrophe we'd like to avoid.

As a side note, one of our local news stations has a weekly feature called "Dirty Dining", where they inform us of which restaurants around the valley get the most - and best - ratings for health violations. But even their worst kitchens only get half or fewer of the violations Mara Lago got.

Yummy.

So I guess that when Trump brags that whatever he's got is the biggest, the best, the most, this is one time we can believe him. That list of code violations in Mara Lago's kitchen is  HUGE! HUGE!