Monday, October 23, 2017

Pain Management? Seriously?

Warning: The greater Phoenix area has two seasons: Sizzling, and Snow Birds. The latter is characterized by a wild increase in population, attended by all the microbes they bring along with them. Some of you think of it as Flu Season. Don't ever have to go to the hospital during Snowbird Season.

Why? There is no room!

Steve got booted out early this morning. He wasn't busy dying, and never mind his problems, somebody else wanted his bed.

Pain management? Are you shitting me? He got a seat cushion along with good wishes for his ability to figure out a comfy way to use it by finding a spot that didn't push too badly against his broken tailbone, and a prescription for painkillers that don't even match in strength what he's already got. And don't let the door slam you in the ass on your way out!

Especially not there!

But scram!

Lest you think of this as a one-off, this shove out the door, it's a well known phenomenon down here. Back when Steve was wintering here and I was still working back north, he had some now-forgotten reason to call our local paramedics. They stayed here in the house with him for a while, finally managing his problem without transport. They bluntly told him they weren't going to even bother taking him in unless he was dying, as the hospital had no beds available. And (Spoiler Alert!) he wasn't dying.

At least this time he got a few hours of good pain relief. He managed to actually sit in the car for his trip home, with a stop at his local pharmacy where he was informed they could have his meds ready in around 90 minutes, should he care to sit and wait. Unsurprisingly, he didn't care to.

Sit. Or wait. Not to mention both together.

Both of us being short on sleep, on arriving home we both went to remedy our situations. I'm now waiting on him to wake up for his (our) return to his pharmacy. Late as it is now, tomorrow I'm going to nag him to call his spine doctor with the request for the doctor to contact the medical records department for a copy and findings from his CAT scan, and get back to us with the info on whether they are sufficient for Steve's next month appointment or whether he needs to schedule more or different ones taken before then. I asked at the hospital if there wasn't paperwork Steve could sign before leaving the hospital to authorize them sending the results on. But nope, according to them, his doctor had to do the requesting, exactly opposite of how my records were handled after my Utah hospitalization last summer.

Color me cynical, but I can't help but wonder if nobody wanted to be bothered with one more piece of paperwork.

Ass In A Sling!

Oh, if only it were  that simple a fix! I mean, that expression had to come from somewhere, didn't it?

Yes, Steve is in the hospital, we don't know for how long. They're talking physical and occupational therapy, perhaps in some rehab center where he'd stay until they feel he can function for himself around the house again.

It began 4 days ago. There was a rather prolonged session sitting on the throne, something about a good book being involved in his ignoring the passage of time, and his legs going to sleep. He stood up anyway. Or tried.

I heard the thunk from the living room. He'd landed on his seat on a concrete floor, and, incidentally scraped his leg. So there was a bit of time spent in tracking down a pair of sturdy pillows  that would actually provide cushioning for his knees as we worked together to shift him into a position he could help himself stand from. Then bandaids, of course.

But he hurt to sit, to stand, to walk, to lie down at every angle, and to move from any one of those positions into the next. For the first day he feared he'd broken his tailbone. On the second, it seemed better, so maybe it was just bruised. Could I see a bruise there? Nope. How about the next day? Still nope.

By Sunday, he couldn't find any position comfortable, but especially not sitting. We rearranged the couch with pillows in the living room so he could watch TV, but he still couldn't tolerate more than an hour or two, even after taking fairly strong meds, which he has on hand for that day or two a month, usually, where he twists his knee or something. His doctor prescribes him a bottle and it usually lasts about a year.

By about 7:00 PM his pain was so severe he asked me to call 911 for a stretcher ride to the hospital. Now, I could have driven him, but he would have had to sit up, stand, walk to the car, maneuver into a sitting position, bounce on his tailbone for a bit over 2 miles, twist, stand, walk into the ER, be sent to sit in a chair for however along it took them to take him seriously and get him in to be seen, stand up, walk, get on a gurney, and still wait for pain relief until they had decided what was wrong and where they could fit him into their busy schedule with most of the rooms full and a waiting room of more customers looking for their service too.

I think there's a violation of the Geneva Convention in there.

Now the ride in the ambulance would have several advantages. He didn't have to move himself, the paramedics would transfer him onto a nice flat stretcher from the nice flat couch, on which he'd stay until being transferred onto a nice flat gurney. No sitting, standing, walking, sitting, etc. And one there, arriving via ambulance is the best way of getting prompt attention from the medical staff.

He still screamed when four strong men shifted him from the couch to the stretcher. I couldn't imagine having to hear that, or his attempts to muffle that, for however long it took me to drive him there. I followed the ambulance in the car.

By the way, our paramedics are really great here. After calling 911 and getting transferred to them, part of the process was giving them my phone number. I actually blanked after the 3 digit area code. So they told me what my number was, just asking for confirmation! This on top of being fast, thorough, helpful, friendly and just plain good at what they do!

He got a fairly prompt CAT scan at the hospital, which revealed a broken tailbone. At least it hadn't shifted relative to its original position. As soon as they had that information, in came the dilaudid, and something for nausea. That's the gooooood stuff!. I know. It's what I had, in a self-demand IV, after fairly extensive abdominal surgery. Nothing hurt for a week, even as I was cutting down and spreading out the dosages. Within about ten minutes, he was comfortable enough to actually fall asleep, something he hadn't been able to do much of for the last four days. About 20 minutes later, he even got another dose, and was willing to try changing his position in the bed.

In additional to the physical relief, there was the psychological relief of somebody telling him they found a real reason for what he was going through. Vindication!

They also decided to admit him for a couple days for pain control and evaluation of how he could function around the house on his own. Or whether he can even go straight home, what kind(s) of therapy he may need.

Hearing he was going to be admitted rather than sprung, he sent me home with orders to get a good night's sleep and a list of stuff to bring. Basics like his cell phone, laptop, the next book in the series he's been reading. I guess he feels like he'll be both pain free and alert for the next several days. I always figured it was an either/or kind of thing, but who knows?

Anyway, those of you who wish to contact him on his cell or Facebook should be able to do so by tomorrow afternoon. He wants me to sleep in.

That sounds good.

Friday, October 20, 2017

At Last! Back To Lapidary

I haven't been to the Club for more than a few minutes since last April. There were medical reasons, seasonal condensation of hours to times that didn't work well for me, and the emotional drag of having what was supposed to be a major project wind up showing me graphically where the gaps in my skills lay.

This month, I had required attendance as secretary for a couple of meetings, but nothing much else changed. Perhaps it can be considered on the plus side that I was no longer spinning the wheels in my brain, keeping me alert and awake, trying to figure out the next design, the best (perhaps) technique, the special project, instead of falling asleep when I wanted to rather than an hour or two later. But required attendance and winter longer hours got me started up again.

It's starting to feel good. I spent parts of two days with the grinding wheels on various rocks. Unfortunately, every one I chose to work on was either agate or jasper, both very hard, thus a slow slog. Nothing got much closer to completion.

But I was working again. And there was incentive to keep on working with receipt of a check for my share of three items that sold over the summer.

I managed to pop in for the last half of a workshop on a new way to use copper to make a bail which was also big enough to glue on the back of a stone. No more wrecked wire wrapping! In many ways the technique is similar to making bolos, which is where I started out, but hanging from a chain necklace rather than on a braided leather cord.

The slowness of bolo sales meant that I spent most of two years worth of energy in making stones without anything good looking to mount them on to wear. There are a whole pile of polished cabs sitting in a drawer waiting to go.

So today wound up being a long day in the club. I bought a sheet of copper, consulted on a few techniques along the way (one of the best reasons for going to the club, besides all the equipment), cut half the sheet into strips in a couple lengths, and sanded all the sharp edges and corners.

In case you wondered, it's not by using sandpaper, which sounds like an impossible task. Instead, the club saves old grinding wheels which have worn out on the outer circle, but if you lay them flat on the table, you have a big round flat block of surface area to move your metal across. There are a combination of techniques how to best move across that surface to make all the edges and corners smooth without ruining the flat of the copper strip.

Next comes the shaping/punching/fastening the loop part, where the final product becomes an actual bail ready to attach to your stone. Or so I thought. But somebody asked had I thought about decorating the strips, rather than having a plain flat strip which you have to polish smudges, stains and fingerprints off of.

Hmmm, work and work for something plain and flat and showing all its flaws despite your best efforts? Or, the technique I picked from many possible, hammer a design into the copper leaving it already textured and no longer so shiny, so imperfections become merely part of the finished product?

Silly question!

I saw a variety of hammered designs on sample bails and one jumped right out at me. Unfortunately, the person who'd done it, having done a variety of samples, didn't remember just which tools she'd used to produce that particular effect. She did know the technique involved a flat steel hammering surface to lay your metal on, and the technique of how to use the hammer to mark whichever design you wanted,  though not which surface of which tool was the one for this design.

The club only has about 30 hammers and uncounted punches and similar kinds of metal marking equipment. It's good that we have them all. It's just a pain figuring out which to use and how. Take a simple carpentry hammer: you can strike with about 5 or 6 different parts of the head and each will make a different dent. The next hammer offers as many options, slightly different results. And some heads are larger or smaller, some flat, some curved, some have corners, some sides have points or are flat....  There are a variety of wooden ones too, just not for this use.

It can take a while to figure which and how for your desired result. I took a couple small flat copper scrap pieces and tried different things. Not wanting to waste too many, they wound up with several layers of strike-overs. Eventually I figured it out.

Then I had to practice so the strike would both land where I wanted it - fortunately I picked random distribution instead of uniform - and work on holding the hammer head aimed vertically a little further away from me than felt natural, so I could get the right shape in the pattern, shallow oval rather than deep circular.

In addition, there was always the issue of landing on the copper instead of a finger! There is incentive to master that one quickly.

Liking what I'd done with the first strip, I decided to make all of them that way. It was so engrossing that I was still pounding away well after official club closing time. Lucky for me, several others were also there, so I wasn't kicked out, and finished all my strips. I have a zipper bag full of copper strips ready for shaping, punching, fastening both together and to a stone.

Next visit.

I'm back in the groove!

Tuesday, October 17, 2017

A Little Night Music

When the TV is off, conversation gives way to reading, traffic and neighborhood noises are all but nonexistent, and the weather is perfect for having the windows open in the house, that's when it's time for a little night music. At least on the nights when you are lucky. It's not like we live anywhere but in the middle of a vastly overdeveloped desert.

One can almost pretend one is the only person awake in the world, until, a mile and a half away, the oh-dark-thirty train goes by. If the pack is anywhere nearby, or better yet, if competing packs are out running the neighborhood, the coyotes start to sing. One can tell where they are hunting this evening by the direction and distance of the songs, but one has to pay attention because they don't last long.

I can always hope the music stops because the pack has scented another rabbit to rid the world of, but maybe that's just me, hating having to fence the world.

Nighttime, when you are really lucky, is also when an owl might come and sit in a tree and hoot briefly for whatever owl reasons they do. We occasionally had one visiting the big pine in the front yard. Now that the front yard tree has died and been removed, we're much more likely to hear an owl from the back of the house, presumably from a perch in the remaining big pine. If we go out to try to view it, the music stops, so we just enjoy it from the house.

This weekend I was having trouble deciding whether I was hearing "our" owl from the front or back window. I was hearing a lot more hooting and lasting much longer than usual, so I had more time to try to figure it out. It was in the usual pattern, two quick hoots, then two slower ones. In a bit, a slight difference in pitch caught my attention. On a musical scale there might have been a half tone of difference, like between a B flat and a B. Not being blessed with perfect pitch, having only fairly decent relative pitch, I am making absolutely no claim on what the two pitches were, just their slight difference.

Just as I was detecting the pitch differences, I was able to sort out that the deeper pitch came through the rear windows, and the higher from the front. There were two owls! I just closed up my book and sat and enjoyed the concert while it lasted.

Wednesday, October 11, 2017

Go, Learn Things

Anyone who's a fan of NCIS New Orleans knows that when Pride sends his team out, those are his instructions. Sometimes, however, it's not that deliberate in real life. A chance comment in somebody else's conversation can lead to tons of information.

And now I've got something else to explore and worry about.

One of our lapidary club's oldest and sickest members made a long-awaited appearance at our general meeting on Monday. He and his wife sat at the same table I was at. Unsurprisingly, much of the conversation before the official meeting started was about his health. It turns out that he, too, has to deal with A-fib. Only these days he has to deal with it without the benefit of the medications that keep my cardiac rhythms  pretty normal. Of course my ears perked up, particularly when his wife started talking about the toxicity of what he was, and I am, taking.

If you follow this regularly, you know about the health problems I had when Steve and I tried camping in Wyoming in order to see the totality of the August eclipse this summer, when I spent a few days finding out about the (high) quality of the hospital food in St. George, Utah instead.

I have since seen my cardiologist, a pulmonologist, and my primary, and have follow-up tests and visits upcoming with all of them. We've ruled out a number of things, such as Valley Fever. I am not having problems breathing when I do stuff, but that's probably because I don't have any energy to do anything that might remotely be considered exercise. OK, I vacuumed the house, do laundry, have changed my sheets, done some dishes. But there's a list of "haven'ts" that ought to be easy to do but hasn't been managed yet. There are small bushes to prune, and need another watering. Weeds need to be plucked out of the front yard. I need to work on lapidary stuff, from polishing rocks to putting them in settings in order to make a product to sell.

Somehow the energy isn't there. I take my bag of stuff to the club, and find myself just sitting there. I can't even quite settle on whichever next project there is to do.

OK, I know it's easy to say right off, "depression." It doesn't feel  like it. I have emotional energy, and an optimistic mood.

I have a heck of a time getting up and staying up in the morning, leading to a heck of a time getting to bed when I feel sleepy at night. Shorting myself on sleep to put things right just winds up putting me on the edge of A-fib. Not a top choice.

My cardiologist says everything is perfect. We're trying some experiments to see about cutting down on some meds to see whether and how much I can lower them without causing problems. We're on a try-this-and-report-back-in-a-couple-weeks program.

My primary - well, I'm debating switching but somehow that seems like too much work when I'm already filling out medical forms and more medical forms and.... It's not just that he's terrible about refilling prescriptions, it's that he doesn't seem to have any interest in more than one tiny detail of what's happening at a time, like he only cares about how he can write up each visit for billing. He had, several months ago, noted my thyroid levels are a bit low and I'm now taking pills for that. May I add without his retesting my lab levels? Or my A1C, or...  fill in the list.

Then there's that thing in my lung, which we have to wait till the end of this month for the next CAT scan to see what may have changed and how.

So where is all this going? Well, that table conversation, the part that really perked up my ears, was the phrase "amiodarone toxicity".  My cardiologist had just mentioned that amiodarone is the one of my drugs that he really hoped I would be able to cut down on, since it's very effective but has bad side effects. No details to go along with that statement, of course. Now here was a font of information, first-hand knowledge of the negative effects, backed by life-threatening issues, and all the time in the world to share their story. (OK, 'till the end of lunch, anyway.)

You know that the pharmacist sends every bottle of pills out with a two-page print-out of stuff to watch out for. It's always either too vague (OMG, a headache in some people?) or way too technical, and soon they all sound the same. I know to avoid alcohol,  grapefruit, and too much sunshine, but not for which drugs, and don't care anyway because those are just not me. In contrast, this conversation was hitting a few too many notes close to home. So was follow-up research online.

The toxicity can be a reaction to stressors to the body, such as surgery. (I count 5 procedures in the last 2 1/6 years, two major.) It can mess with your thyroid levels, your lungs (some technical term for damage that shows up on CAT scans), change sleep patterns....

Are you seeing any patterns here? So far my exams have been in aid of looking for horses, as they say, in the array of symptom hoofbeats. It's time to start asking about zebras, now that I know what the questions are. And I know a lung biopsy can make a definitive diagnosis. When you're spread out between three different doctors, the likelihood of any one seeing the whole picture is less. Every one can easily assume somebody else is putting the whole thing together. Throw in a couple of out-of-state docs with their own long-ago reasons for some of these prescriptions, and it can get to be a bit much. Everybody acts in good faith so who questions previous decisions?

I now also know that it can take months to clear the drug out of the system, if it has become a problem. The process involves a lot of steroids, which sounds like a whole 'nother set of battles. But I can go armed to this month's appointments with a different set of questions. In other words, go, learn things.

By the way, that friend from the club? He's had to quit both of the medications I currently take for A-fib. And yep, he's living with it uncontrolled. Day by day. Prognosis uncertain. If you are one of those who believes in prayer, send some Bob's way. Maybe just a well-wish. He's a nice guy.

Monday, October 2, 2017

Raising the Bar

The numbers keep going up. Right now, the Las Vegas shooter has a death toll of 58 and there are over 500 wounded. There is absolutely no reason to think those numbers are final.

But again, I'm absolutely sure that the NRA and their political puppets are going to claim that "now is not the time" to reexamine our gun laws. Like they said after Sandy Hook, or (_______ insert a dozen names here).

Sure, there is a Second Amendment. Most of our country doesn't know there is an introduction to the sentence talking about a standing militia as the reason for bearing arms, since we were breaking away from a powerful country overseas who sent their military over to stop that process.  They don't care to know enough history to realize the framers of the constitution lived in a frontier situation where muskets were loaded one bullet, then gunpowder, for one shot at a time. They forget we were the invaders and the folks whom we were displacing might just have had a legitimate reason to protest losing their land, their livelihoods, their very lives. They forget four-footed predators were abundant in the woods all these immigrants were busy clearing. They just hear it as carte blanche to own all the firepower they can get their hands on, including arms appropriate only for soldiers in war. And as others stock up, that means they have to stock up more.

And don't give me the crapfest about a "good guy with a gun" being able to stop the bad guy. Ask a cop. That alleged "good guy" is indistinguishable  from a bad guy and only adds to the chaos. And is your "good guy" weapon going to be any help against automatic weapons fired from the 32nd floor? You think if you pulled your good-guy weapon during that shooting you were going to do anything but get identified as the threat, get yourself killed, and delay locating the real threat? Remember, there were off-duty cops at that Las Vegas concert. All they could do was identify the direction of the threat and help concertgoers clear the area. Hooray for them, but....

Look, I get hunting. I was raised in a family that hunted deer, grouse, pheasant, geese. Delicious! There are all sorts of other animals which can be shot for the dinner table. I get skeet and other kinds of target shooting as a sport. You don't do any of it with automatic weapons, however.

I get having, or feeling like you need to have, a pistol or two for self protection if somebody breaks into your home. I do, however, lament the accessibility of those weapons to children. We'd know how many are killed and injured from unsafely stored guns in the home if there weren't laws prohibiting the study and collection of such statistics. So we just get the headlines. And these days, those injuries and deaths are so common they often don't even make the news.

Las Vegas, of course, is the only news right now. Nothing about the Russia investigation, the dire need for help for Puerto Ricans and the ignoring of them, or worse, blaming the citizens for needing assistance beyond the dedicating of a golfing trophy, on the part of our... resident of the White House. Just Las Vegas.

I'm not saying that coverage isn't appropriate or necessary. It is. But somewhere out there, some other bumfuck idiots, hearing the numbers rise, are thinking to themselves, this guy has really raised the bar. But I can do it better. I can be even more famous. I can be more important.

And they start planning the next tragedy.

Sunday, October 1, 2017

"Friendly" Planet?

I was introduced to, and immersed myself in, science fiction books back in the late '60s through, oh, somewhere in the '90s, I guess. That of course included the old masters, writing from back in the '40s and on up. I relished having my assumptions challenged by new worlds, new species, new problems and their solutions. My mind expanded. Boggled, too, but that was a good thing.

There was one theme that ran through a huge number of books I read in those days. (Perhaps it still does, but I'm into a lot of other things these days and wouldn't know.) Space travel was the big thing. We would explore and colonize other planets, grow interstellar cultures. We'd find all these other friendly planets, maybe solve an adjustment problem or two, and settle in. Or maybe a previous exploratory colony ship would hit that one insurmountable problem that nobody expected and get wiped out, leaving the next colony ship to land and figure it all out.

What fun!

These books would explore faster than light travel, or the consequences of not having it and what could go wrong with a multi-generations ship. We'd meet other cultures, figure out why they were intelligent though very different from us, make friends or enemies, and sometimes get invaded ourselves.

Underlying all these different adventures was one basic assumption, both stupid and erroneous. We'd be looking for a friendly planet, just like the one we'd left behind.

What friendly planet? I don't mean that old mathematical theory about how many billion of the right kind of stars with how many billion of the right kind of planet kind of idea. Hey, it's got appeal. I get it. But just where is this so-called friendly planet we're living on now?

Yes, I know that we've been successful at spreading our species, 7 billion plus, into nearly every nook and cranny on the globe. That means we're an adaptable species, not that we're living on a so-called friendly planet. Sure, there are a couple of things going for us. The atmosphere has a pretty decent amount of oxygen and not too many toxins in it, though we're working on that. It's got temperature ranges we can comfortably adapt to, or even not so comfortably. There's plenty of water. The other flora and fauna, for a big part, are edible enough to sustain our bodily needs.

All that is the stuff of a desirable colony planet, and way too many authors have stopped there in developing the ecosystems, weather, geography, and what have you in our supposed new homes.

But how on earth did we survive on this planet? Pretty much everything here is trying to kill us. And often does.

First, we're not stable. Our surface challenges us with earthquakes, volcanoes, tsunamis, quicksand, too much or too little water, fires, blizzards, heat waves, extreme winds, lightning, rock slides, mudslides, avalanches... and that's just the surface.

Our food supply can be deadly, whether a poisonous berry, a nut that needs cooking before eating, a predator that wants to eat us first, or some small little snake or bug that just wants to stay alive by sacrificing a few to teach us to avoid the many. Heck! Have you noticed we haven't even figured out the mosquito yet?

That doesn't begin to cover the microscopic threats, all the fungi, bacteria, viruses, prions, and parasites whose only goal is to destroy us. Not all of us, mind you, leaving just enough behind that we can multiply again before they launch their next attack.

Let us not forget what a splendid job we are doing of killing off each other, as if all these other challenges weren't enough.

We all know all this. Yet we think of this as a friendly planet to our species. And try to imagine there are other planets out there in space that can be "friendly" homes for us?

Who are we kidding?