LOLCAT Weekly Roundup 3 June 2008, courtesy of Maggie Jochild's Meta Watershed.
I hate Mondays.
The root canal went good. (Grammarians: Should that be “it went well?”, or are we colloquial enough for “good”?)
Dr. Kenji Beppu did a terrific job (about which more later.) His office staff were wonderful and wonderfully diverse (also about which more later.)
The pain from the angry nerve went away. Turns out root canals have a bad rap as the scary monster under the bed of dentistry. I will explain (also, later.)
Root canals do hurt afterwards for seven to ten days. NOT, I hasten to add in the “oh my fuck I want to rip my tooth out” or knock myself unconscious kind of pain, as in prior to the root canal. More like a serious sprain, the type you take ibuprofen for and stay the hell off it till the pain totally goes away.
So... Still pain, but healing.
And it can't be said enough, Dr. Beppu and staff were amazing. Full report to follow later this week, including explaining root canals.
Working on other stuff which I can't talk about yet.
Monday's suck in general. At least today does. However I'm working hard, accomplishing much, and hard work and completion are of the good.
How goes your Monday?
Monday, June 16, 2008
Bleah
Wednesday, June 11, 2008
Pain: Pt. 4
LOLCAT Weekly Roundup 10, courtesy of Maggie Jochild's Meta Watershed.
Emergency Root Canal
Tomorrow afternoon I'm having an emergency root canal.
Till after it is done and this pain goes away, I'm pretty much off line.
It's been over ten years since I had an emergency tooth extraction. It was an emergency because the infection had gone too far for a root canal, and the pain was so intense I thought someone was beating me in the face with a pipe.
This is rapidly approaching that level of pain, and that's in the face of MASSIVE loads of penicillin, as well as three different pain medications along with drugs designed to ease how the pain meds work. (My pain doc just approved my increasing my major pain drug to almost double for three days.)
Feels precisely like someone is hitting me in the face with a one-inch pipe. (The scar on my left lower chin.) WHAM.
This is what Lower Manhattanite went through back in April. THE FUCKING PAIN... Pain: Pt. 2
I almost drove my car into a fucking bridge abutment back in the late 90s when I had no health insurance and was out of my goddamn head with the pain. I would have done almost anything, up to and including taking my head off, to just.make.it.stop.
I have dental insurance now; didn't then. I had to wait a day or two for the money to be transfered from Arizona from Mom to pay for the extraction, all the while reminding myself I had four children.
People used to die from dental infections (and poor people sometimes still do.)
Tomorrow. Root canal. (No dying, thank you very much.)
Till then, my pain and I are just lying here, watching old familiar DVD's and doing as little as possible. Sleeping even. If you have a genuinely urgent email I might respond. Most likely I'll get back to you Friday or Saturday. Or Monday. Sometime very much not now. If it is urgent, call me.
All Gods and that which can not be spoken of, bless Dentists, therapists of all types, and people who take care of people who are in pain.
Sunday, May 25, 2008
The Creator
Available Sunday's at Salon. Click for LARGE.
Damn straight. See every post on pain ever written at GNB.
It's 6 am. Time for my morning pain meds. (And going back to sleep. I won't be able to write worth a damn for a few hours.)
After which I'm heading over to a sports bar to drink Coke-Cola™ and watch Danica Patrick kick everyone's ass. (Qualified in fifth place with a speed of 225.197 mph, roughly 1.2 mph slower than the pole position.) The 92nd Indianapolis 500 starts at noon/9 am ET/PT, and I plan to watch it all.
Tradition. *smiles*
Open Thread:
1. Are you taking meds today and if so, for what? (No need to name the med.)
2. What are you drinking?
3. What are your plans for today? (And tomorrow, Memorial day?)
4. Danica, and any other sports conversation.
No politics please. *smiles*
Tuesday, May 20, 2008
Breaking: Senator Kennedy has Malignant Brain Tumor
Jack Nicholson and Edward Kennedy. June 6, 2005. photo Robert Scott Button/fotogblog.
Weekend Seizure Leads To Cancer Discovery
The seizure Sen. Edward Kennedy (D-MA) had over the weekend was caused by a malignant brain tumor, doctors at Massachusetts General Hospital said.
Associated Press*sighs*
"He remains in good spirits and full of energy," the doctors for the 76-year-old Massachusetts Democrat said in a statement.
They said tests conducted after the seizure showed a tumor in Kennedy's left parietal lobe. Preliminary results from a biopsy of the brain identified the cause of the seizure as a malignant glioma, they said.
His treatment will be decided after more tests but the usual course includes combinations of radiation and chemotherapy.
Kennedy has been hospitalized in Boston since Saturday, when he was airlifted from Cape Cod after a seizure at his home.
"He has had no further seizures, remains in good overall condition, and is up and walking around the hospital," said the statement by Dr. Lee Schwamm, vice chairman of the Department of Neurology at Massachusetts General Hospital and Dr. Larry Ronan, Kennedy's primary care physician.
They said Kennedy will remain in the hospital "for the next couple of days according to routine protocol."
Kennedy's wife and children have been with him each day since he was hospitalized. Senator Kennedy's son, Rep. Patrick Kennedy, D-R.I., plans to stay at the hospital for the time being.
Malignant gliomas are a type of brain cancer diagnosed in about 9,000 Americans a year — and the most common type among adults. It's an initial diagnosis: How well patients fare depends on what specific tumor type is determined by further testing.
Average survival can range from less than a year for very advanced and aggressive types — such as glioblastomas — or to about five years for different types that are slower growing.
There's more...
Please take a moment to pray, to direct kind thoughts towards the Kennedy family.
And remember to breath.
At the end of a good life, life ends. Besides... it isn't over yet. The Senator still has time, time to be with his family, time to say goodbye, time to wrap up his affairs.
Breathe. There's more...
Doctors Learn to Say “I'm Sorry”
X-ray of an electrode left inside a patient during a C-Section.
Photo: University of Illinois Medical Center. Published in The New York Times, May 18, 2008.
Transparency From Doctors Results in Less Lawsuits
Better Overall Results
Gee Gidge, you think?
Transparency damn near always works.
Hospitals which expose their mistakes to patients, are discovering their malpractice costs drop dramatically.
The New York TimesI had a major malpractice lawsuit against a physician once.By promptly disclosing medical errors and offering earnest apologies and fair compensation, they hope to restore integrity to dealings with patients, make it easier to learn from mistakes and dilute anger that often fuels lawsuits.
Malpractice lawyers say that what often transforms a reasonable patient into an indignant plaintiff is less an error than its concealment, and the victim’s concern that it will happen again.
Despite some projections that disclosure would prompt a flood of lawsuits, hospitals are reporting decreases in their caseloads and savings in legal costs. Malpractice premiums have declined in some instances, though market forces may be partly responsible.
At the University of Michigan Health System, one of the first to experiment with full disclosure, existing claims and lawsuits dropped to 83 in August 2007 from 262 in August 2001, said Richard C. Boothman, the medical center’s chief risk officer.
“Improving patient safety and patient communication is more likely to cure the malpractice crisis than defensiveness and denial,” Mr. Boothman said.
Mr. Boothman emphasized that he could not know whether the decline was due to disclosure or safer medicine, or both. But the hospital’s legal defense costs and the money it must set aside to pay claims have each been cut by two-thirds, he said. The time taken to dispose of cases has been halved.
The number of malpractice filings against the University of Illinois has dropped by half since it started its program just over two years ago, said Dr. Timothy B. McDonald, the hospital’s chief safety and risk officer. In the 37 cases where the hospital acknowledged a preventable error and apologized, only one patient has filed suit. Only six settlements have exceeded the hospital’s medical and related expenses.
The outcome is sealed, as is often the case. According to the terms, I'm forbidden to talk about how it turned out.
I will say, a large part of what drove the case, is how ANGRY I was at what I saw as brutal malpractice on the doctor's part. A genuine apology... I don't know what it would have done. I'm someone who believes in authentic apologies. At the same time, I had (and still have) permanent long-term damage, so I probably would have felt some compensation was appropriate.
But that's the point. When a mistake is made, admit it, clean up the mess, and move on. When there isn't a legitimate mess, fight it with everything you have.
The New York TimesIf you know that you'll be fairly compensated for genuine negligence, the adversarial relationship begins to shift between the trial bar and hospital staff.
There also has been an attitudinal shift among plaintiff’s lawyers who recognize that injured clients benefit when they are compensated quickly, even if for less. That is particularly true now that most states have placed limits on non-economic damages.
In Michigan, trial lawyers have come to understand that Mr. Boothman will offer prompt and fair compensation for real negligence but will give no quarter in defending doctors when the hospital believes that the care was appropriate.
“The filing of a lawsuit at the University of Michigan is now the last option, whereas with other hospitals it tends to be the first and only option,” said Norman D. Tucker, a trial lawyer in Southfield, Mich. “We might give cases a second look before filing because if it’s not going to settle quickly, tighten up your cinch. It’s probably going to be a long ride.”
Transparency -- telling the truth -- benefits everyone. Financially, in terms of time it takes to reach a settlement, in putting systems in place to correct problems, and emotionally both to the medical staff and the patients.
Medical staff from Day One of their training are raised with “First do no harm.” Transparency allows them to tell the truth about what happened, fix the problem, and know that their patients get treated fairly. And the medical staff know that patient outcomes benefit, while they are not held to blame for honest mistakes.
Patients know that in a system built around transparency, if something does go wrong, there is an institutional commitment to telling the truth, and making certain they as patients find out what happened, while simultaneously fixing the underlying problem in the system. And as patients they know, they will be fairly compensated for any damage.
All that is needed is trust, and a commitment to tell the truth.
Transparency is good for everyone. There's more...
Monday, May 5, 2008
Down In The Mouth
Recovering At Last. Thanks To Antibiotics And That Mind-Bending Mistress, Vicodin
Been out of the loop for the last few days as I had my second, and thankfully (hopefully) final round of gum/bone graft surgery last Thursday. I wasn't expecting it to be quite as intense as it was, thinking it would be more like the first round the previous week.
I was wrong, wrong, wrong.
While the previous week's work was palliative, this past week's surgery was the fix, the repair. I thank God my dentists are caring enough folks who take the time to talk with me and numb the area enough so I couldn't feel the pain from the pretty intensive job they were doing. Which basically entailed cutting open my gum, cleaning HARD around the affected pocketed area, putting in a synthetic membrane, then filling the gap with a bone-like polymer, letting that set a bit, then closing me up with sutures and applying lovely, custom-cut, in-mouth bandages I must somehow manage to keep on for two weeks until my follow-up. Again, there was no pain during the surgery, but I could feel the pressure of the doc and his hygienist doing hard, knuckle-cracking work in my grille for nearly three hours.
If you've ever had a fire in your home, you'll know the way fiirefighters in their quest to save lives have a tendency to bigfoot around with heavy steps, ripping this and that out, in search of flames and heat. Well, my mouth was a house afire, and it was only after they were done and I felt the numerous shots wearing off when I began to feel the effects of their going in hard and putting out my fire.
You know you're in for the shit when minutes after you're out of the chair (and spitting out what looked like what Dick Cheney would spit out if interrupted while eating a baby) they hand you a Vicodin and say. “Take this NOW.”
I'd kinda scrimped on the painkillers after Round One of my oral pain-a-palooza. Not this time. Thursday was bad. Friday was actually worse, as my lower right jaw swelled a little after having been sliced, diced and julienned and then having foreign substances—the membrane and synthetic bone put in at last. Didn't eat really until Saturday. Grits and scrambled eggs, chewed on the left side of my mouth—oh, so enjoyable. And of course, the prescriptions. Antibiotics, Vicodin, Peridox gargle. Lovely. But I am getting better. My body is still adjusting to the new stuff in my jawline, but things have stabilized considerably.
And best of all...after being told that I could not drink anything hot (or eat anything hot, spicy, or overly chew-intensive...which is everything that is yummy), today I had my first cup of coffee since Thursday.
And I love a good cup of coffee. My brother had gotten me a bag of South American beans, roasted on the day he'd gotten them himself, and we were on the final bit of that burlap bag of Brazilian bounty in my house for the weeks leading up to me getting my jaw sawed the fuck open. I was missing my Java and since the supply was dwindling of the good stuff at the house (It's gonna be hard goin' back to Dunkin' Donuts joe after this stuff), I had my wife set aside a bit of the last of the whole beans.
Today...I had some. And what sweet ambrosia it was. Ground 'em up m' self and made a big, steaming cup—which I carefully drank, still keeping mostly to one side of my mouth. But, ohhhhhhhh...
The bag, the bowl, the Brazilian Bounty still to be a' ground. Mmmmmmmm!!
So incrementally, I'm getting better. Thanks to all of you who wished me well and sent me good health vibes. Papa LM is recovering—even if the gauzy veil of Hydrocodone (Vicodin) makes the thought processes a little difficult of late. I swear, I don't know how people can pop this stuff recreationally. Fuck a “trip”. It sends me on scary voyages. The reflexes? Please. I couldn't quick-draw a salt-pained slug. I found myself waiting for the bus the other day—a long wait—watching the cars go by, and got entertained when they appeared to be going in slow-motion. I thought I was musing to myself on the taffy-pulled vehicles (that's what they looked like to me) when I noticed a woman who had been standing near me at the bus stop moving away from me.
Apparently, my dreamy “La-la-la-la”-ing I thought I was doing in my head while watching the Fantasia-esque parade of cars was actually being pharmaceutically vocalized.
Yikes.
So, that's why I've been away. The old judgement and common sense centers are still just a tad off. But they are getting better as I wean off this “stuff”. Coming backatcha, people. Coming backatacha!
Just do me a favor, though. If you notice me going “La-la-la-la-la-la-la-la” in a post, promise me you'll be kind and just hip me in comments and NOT cyber-back away from a brother, okay? Thanks!
Thursday, April 17, 2008
Long Day
Harborview Hospital/Trauma Center. Seattle.
Daughter #1 Was In a Car Wreck Yesterday
Avian, 21, my oldest, is fine. Mostly.
Shaken up, upset, and yes, in pain. But she's fine.
For 24 hours, I didn't know her status, other than she'd been in a wreck, and was in the regional Trauma Center. I talked -- briefly -- to her and the paramedic as they pulled up to Harborview.
The medic said she'd been wearing her seatbelt when her car was rear-ended on the freeway (I-90) at 25-30 mph. She wasn't knocked out. No apparently broken bones, no major bleeding.
This is my daughter who likes to knock players out on the soccer field. However she suffers from panic attacks in her personal life when life doesn't go as expected, which she's been working hard to get a handle on. Part of which is, she's committed to doing things herself, not calling on Dad and Mom to rescue her.
She said, very specifically, "Don't come to the hospital. I don't want you to see me when I'm this scared." And that it wasn't personal to me or her mom. She had her insurance card and her cell phone. After extracting a promise from her that she'd call me or or mom when she got out, the rig pulled in to the hospital and her cell cut off.
And the waiting started.
Six hours.
Twelve hours.
Twenty-four hours later.
The only good news was, she was at the TRAUMA CENTER, where presumably, if she was bleeding to death in her belly or head, they'd figure it out and save her. If she lost it, they'd medicate her. Harborview is a safe place, if you're seriously hurt. It's a pain-in-the-ass if you're not.
Her mom -- my ex -- didn't call me with any news (as she had promised to do no matter what time she heard from Avian) all night long.
There was only waiting, and then, waking up from sleep, worried. Nothing.
This morning I broke down and called daughter #3, Kyle, who had just heard news of Avian. "She's out of the hospital after she 'spent five hours strapped to a backboard' and they 'didn't even give [her] any pain medicine at all!'"
Which I interpret to mean as, there wasn't anything seriously wrong with her. Airbags and modern car construction. Good job.
Being a parent, teaching your children they can grow up and do the big things and then sitting back as they do... *shudders* ...not for wimps.
It's okay to be afraid. You gut it out, trusting you raised them right, remembering all that crap you used to get into your parents never knew about, and which somehow, you got out of. *waves to Mom*
I still haven't heard from Avian. No clue when her next call or txt will be. This one gets all the room to run she needs.
Tuesday, April 15, 2008
Pain
"Open Mouth Buddha, shedding Black Tears" Click for LARGE.
2007, Gallery #19, # 6915 - Kazuya Akimoto Art Museum.
Kyle and I were cleaning my room tonight. Hurt my back.
Nothing serious, but damn it hurts when it hurts.
In my head, I'm 30. *sighs* My body just doesn't play along. Grrrr.
Good news is, my bed is now clean. It had 20+ books, and a stack of magazines piled high. Now my bed's made neatly. I could stretch out before; now I can stretch way out.
I owe three people/magazine/journals, articles or notes on stuff they're writing. Plus I'm way behind in posting here at GNB. I've been sick (in pain or actually ill) off and on the last two months. Mostly pain stuff, which my medical team and I are trying to get a grip on. It lays me up for days and days at a time; I've pretty much given up explaining what's going on to anyone but my inner circle.
This month, I've been taking Opana on a trial basis -- in addition to my regular pain meds. While the pain control has been good, Opana's side effects haven't been good at all. The good news is, just as in when you're making a change in any operating system, you make ONE change at a time. I've been very stable in my, i.e.: the baseline which is "Jesse", for a while now. Unlike say, several years ago, or worse, back in 2001-2002 when I had just had the neurosurgery and was completely in the fog. So when the Opana threw me off a bit, in some very specific ways, I was able to sort out what was going on, fairly quickly and report.
After meeting with a key member of my medical team today (er, yesterday -- Monday) we've put the med on my allergic/contraindicated list:
- Neurontin (gabapentin)
- Effexor (venlafaxine hydrocholride)
- Celexa (citalopram)
- Lyrica (pregabalin)
- Opana (oxymorphone HCI)
It took years to work out the medications I'm on now. YEARS. And when pain happens which isn't controlled -- as I currently have in my right hip (from the car accident) which impacts my ability to walk (from an old ski injury on my left knee) -- it takes a while to figure out precisely how to control the pain. It's vastly more important to get it right, than to throw any damn thing up there.
Why?
Because these chemicals impact your brain. They change who "you" are. Literally, too much, too little, the wrong dose, the wrong med, and "you" go away. Who is there? Not you, sucker.
Maybe a younger version of you (an emotional teenager or twenty year old) with the memories you have? Maybe a paranoid, someone who is violent or repressed, asexual or very sexual, scared or angry, dominating or with almost no emotions...
Pouring brain-altering medicines directly into the bloodstream, fracks with who you are, right now. And "you" won't know it unless you and your entire medical team:
- has a long base-line on who "you" are,
- is actively looking for changes,
- is super-competent to detect changes,
- you have a support structure at home, work, and with your medical team prepared to work with you as the medicine is adjusted till it works properly, and is unafraid of changes in "you", and
- confident in their and your ability to return you to baseline.
Chronic pain patients; chronic patients of all kinds, do what we can do, when we can do it. The adjustments take however long they take. I write what I can, when I can. Pain is there till my Team and I figure out a way to make it go away, without taking "me" with it (or regressing or losing "me" in the process.) I am one of the key parts of all of this. Only my children, I, and a few key members of my medical team, can tell my Team as a whole, if "I" am still there. Which means sometimes, I have to trust, for example, Kyle's judgment or my therapist's judgment, over my own. Even when I am certain about something, if they say otherwise, under certain circumstances (like after certain med changes), we go with their assessment as to who I'm being, over mine.
I never lose sight of how fortunate I am. I have medical insurance. Good medical insurance. It pay co-pays at Tiers 1, 2 & 3. Even though I have to pay over $200 a month in prescription co-pays, I can handle that. This new tier 4 & 5 pricing as talked about today in The New York Times would make it impossible for me and others so situated to survive my kind of pain. Self-medication (a slow suicide) is the traditional option... booze and street-drugs. These not only cost too much -- thousands of dollars a month -- but they work poorly, as well as causing massive damage to one's body. In many cases they are illegal.
I have friends who were hooked on horse for years. Decades in one case. Decent pain medications are a recent deal. And you need money; the poor and working class don't get the good shit. They get booze and street drugs, as our fathers and grand-parents did after their wars. Want the good stuff? You'd better be middle to upper-class, or owning class. Then you can have decent drugs, legal drugs, and not worry about getting busted, keep your job, and be able to afford everything through your health plan.
Did I say drugs? I meant, medicine.
Enough. Time to sleep on my big clean bed, let the pain flush away. There's more...
Monday, April 14, 2008
Open Thread Monday
I'm heading to the doctor; a new pain med we've been trying isn't working well.
What are you doing? (As usual, no pie-fights please.)
I had waffles and bacon for a late afternoon brunch yesterday. And a BLT for dinner. The bacon was SO good. It's at this diner where I typically go once or twice over the weekend. Everyone knows me. I can sit and read for hours or blog if I want. Sometimes as I sit there, I just watch people; it's small town Americana. The owners are wonderful, the waitresses are great and the busboys are fast. And the food... *sighs* ...the food is so tasty.
Monday, January 14, 2008
How To Kill Someone, Lesson One.
Matthew Sepi's AK-47 & 180 rounds of ammo. He instinctively "engaged the targets."
photo Las Vegas Metropolitan Police Department.
Visualize Your Target. Eliminate Hesitancy. Act Reflexively.
Killing is a matter of training and intent.
If you train properly, you'll kill reflexively and automatically when the time comes. If you don't train properly, you'll likely die to someone who did train well.
Want to live? Train exactly how you intend to fight.
As medics, we ran countless simulations, all designed to have us act reflexively, precisely the way we were expected to, in the event of.
After each run and shift, we hot-washed the run, debriefing precisely what worked and what didn't, visualizing the runs over and over again, replaying them till we had the run working perfectly, down to stepping around the obstacle instead of bumping into it, asking the correct question at the perfect moment instead of missing the point, or blocking the punch instead of getting clocked in the ribs.
As paramedics, we trained to act with force on automatic pilot, totally on reflex, just as we train to swerve to avoid a car glimpsed out of the corner of our eye -- as the costs of thinking even for a moment could cause injury to our partner, patient or ourselves.
Troops are coming back deadly dangerous from the wars.
Even most Veteran's Associations won't talk, says The New York Times. The Associations hate the idea of vets who might be so out of control, regardless of what the statistics may show, fearing all vets will be viewed in the same light.
The Pentagon absolutely doesn't want to talk and has lame-ass excuses as to why -- even though they're not talking -- they're certain none of the results of The Times' study are valid.
Bullshit they're not valid.
The New York TimesThis is a fraction of The Times' article. The full article breaks your heart.
The Times used the same methods to research homicides involving all active-duty military personnel and new veterans for the six years before and after the present wartime period began with the invasion of Afghanistan in 2001.
This showed an 89 percent increase during the present wartime period, to 349 cases from 184, about three-quarters of which involved Iraq and Afghanistan war veterans. The increase occurred even though there have been fewer troops stationed in the United States in the last six years and the American homicide rate has been, on average, lower.
The Pentagon was given The Times’s roster of homicides. It declined to comment because, a spokesman, Lt. Col. Les Melnyk, said, the Department of Defense could not duplicate the newspaper’s research.
The Times’s analysis showed that the overwhelming majority of these young men, unlike most civilian homicide offenders, had no criminal history.
“He came back different” is the shared refrain of the defendants’ family members, who mention irritability, detachment, volatility, sleeplessness, excessive drinking or drug use, and keeping a gun at hand.
“You are unleashing certain things in a human being we don’t allow in civic society, and getting it all back in the box can be difficult for some people,” said William C. Gentry, an Army reservist and Iraq veteran who works as a prosecutor in San Diego County.
In earlier eras, various labels attached to the psychological injuries of war: soldier’s heart, shell shock, Vietnam disorder. Today the focus is on PTSD, but military health care officials are seeing a spectrum of psychological issues, with an estimated half of the returning National Guard members, 38 percent of soldiers and 31 percent of marines reporting mental health problems, according to a Pentagon task force.
The National Vietnam Veterans Readjustment Study, considered the most thorough analysis of this population, found that 15 percent of the male veterans still suffered from full-blown post-traumatic stress disorder more than a decade after the war ended. Half of the veterans with active PTSD had been arrested or in jail at least once, and 34.2 percent more than once. Some 11.5 percent of them had been convicted of felonies, and veterans are more likely to have committed violent crimes than nonveterans, according to government studies. In the mid-1980s, with so many Vietnam veterans behind bars that Vietnam Veterans of America created chapters in prisons, veterans made up a fifth of the nation’s inmate population.
There's more...
The New York Times - The CasesIt has been 19 years since my last patient as a paramedic. I didn't see combat during my military tour with the 101st Airborne, though I saw more than enough death as a civilian paramedic. No one put IEDs out for our rigs, thank you, and we didn't take sniper fire. Patient care in South Tucson and Oakland ghettos is still safer than being a medic in Iraq.
The New York Times found 121 cases in which veterans of Iraq and Afghanistan committed a killing in this country, or were charged with one, after their return from war.
Yet even 19 years later, there are days I want to take my walking stick and beat someone to death, no kidding. I smile at them sweetly, until the moment passes. Maybe excuse myself, go for a brief walk. Not that I can walk very far.
And this is nothing, compared to how I was immediately after I retired as a medic. I don't remember having a full night's sleep for years. And by years, I mean maybe the first 8-10 years. With the drugs available now, this is freaking heaven.
People who haven't walked (or crawled or limped) through the Valley of the Shadow of Death themselves, or watched as family did so, have no clue how desperate it gets.
The Times' reports an under-age (for drinking) kid back from the war trying to self-medicate with booze, reacted on instinct in Las Vegas and cut down two gang members, killing one, wounding other, by firing his AK-47 when startled.
Why is anyone surprised?
After ruining our military, the Bush Administration has yet again failed to take care of our troops. It's just so much easier simply to not count them as war casualties when they get triggered back in the world, then kill and maim. After all, then it isn't the service's fault; they just couldn't handle it. These screwed-up wack-jobs (whose stability was good enough while they were on active duty) end up in the criminal justice system. The DOD ends up not having to pay active duty pay, mental health benefits or VA benefits.
Now that's a win-win-win.
The thing is, if you're a combat troop, you are trained to run scenarios obsessively. Visualizing a scenario, over and over, honing it down, fine-tuning it, making it better and better, till you have the perfect mission.
And if now you're back in the States, running a kill scenario?
You just better hope no one accidentally hits your trigger. There's more...
Wednesday, January 9, 2008
An Apology
For those of you who don't know, I'm a chronic pain patient.
Monday, I screwed up my meds, sleep, and eating in such a way that late Monday night/Tuesday morning I went off very harshly on some people in a thread.
I apologize.
It was out of character for me and not how we normally do things at Group News Blog. Our intent is to make this a safe place, and for about 12 hours, it wasn't.
Friday, December 28, 2007
Family Comes First
diagram Wikipedia.
My Dad Is Having Open-Heart Surgery Today
My father, John Wendel, Ph.D., emeritus from The University of Arizona (German Studies), is having open heart surgery this morning at Denton Regional Medical Center in Denton, Texas, about 30 miles north of Dallas.
Yes, this is the Dad I didn't speak to but once in nine years. Whatever.
Family comes first.
Dad's mitral valve is leaking.
The mitral valve is on the left side of the heart, between the left atrium and the left ventricle. It's shown on the right of the above diagram, as if you were looking at a person directly across from you.
How blood flows through the human body:
Santa Barbara City College, diagram McGraw-Hill Companies, Inc.
1. De-oxygenated blood from the body flows through the veins into the right heart (into the right atrium through the tricuspid valve into the right ventricle) where the right ventricle PUSHES it out the pulmonary valve into the lungs.
2. At the lungs, carbon-dioxide (CO2) goes out, and oxygen (O2) passes in to the blood, in the capillaries as the blood passes next to the warm moist lungs.
3. The oxygenated blood flows to the left heart (into the left atrium, through the mitral valve, into the left ventricle) where the left ventricle PUSHES it out the aortic valve into the body.
4. Once in the body, oxygen (O2) goes out and carbon-dioxide passes in to the blood in the capillaries as they pass next to and through the tissues and organs of the body.
And we start all over again. (Go to #1 above as de-oxygenated blood...)
Because Dad's mitral valve is leaking, there are some issues which follow:
- Not as much oxygenated blood is getting to the rest of his body as should. Therefore
- his left heart has to pump harder to get enough oxygen out to his body. Therefore
- like any muscle, his left heart grew a bit bigger with the extra use. This isn't good. An enlarged heart needs more oxygen itself and is more prone to failure. But it didn't get too big, as it was caught fairly early.
- The leak spilled backwards, causing 'fluid in the lungs' or 'Pulmonary Edema.' This has been mostly fixed with oxygen and reducing his overall fluid level.
If the valve is too damaged, they'll replace it with a porcine (pig) valve. These valves typically last 10-15 years, meaning my 72 year old father would probably need another round of open-heart surgery at 82-87 years old, assuming they haven't figured a new way to handle this better by then, or assuming his naturopathic physician can't help extend the life of the valve.
The alternative replacement was a metal valve and daily blood-thinners for life plus an increased risk of stroke. Dad decided (and I agree) that a porcine valve is the better choice. Plus his own valve may be able to be repaired, which is what we're hoping.
Dad is in amazing physical condition. He hikes all over the mountains ranges of Utah for days at a time, year after year after year. Every other physical sign he has is that of a man in his mid 40s to early 50s.
While there is always the possibility of stroke, sudden cardiac death, and infection -- as with any open heart event (less than 10% chance of morbidity for this procedure, and that includes the really sick people) -- this is as much of a routine surgery as one gets during open heart work.
Dad's spirits are good. He trusts his surgeon (who does this procedure very often) and his cardiologist, both the best in the region, according to friends and colleagues. Dad is optimistic about the outcome, as am I.
I'll talk to him again first thing this morning. His operation is scheduled for 11 am Central Time. It will likely take a while, plus then he'll be in recovery before going to the CICU, and I may well not know anything till after all of that.
As soon as I know something, I'll update this post.
In advance, thank you for your thoughts, prayers, and best wishes for my father.
Update 11:30 AM PT/1:30 PM CT:
Dad's doing fine in surgery; no major issues so far.
His mitral valve was not repairable.
Dad is still on the heart-lung machine as the surgeons put in a porcine valve. He should be on the pump for about another 30 minutes. Then the surgical team will restart his heart, close up his chest, move him to recovery, and then to the CICU.
Next update roughly in three hours.
Update 2:45 PM PT/4:45 PM CT:
Dad is out of surgery and in the ICU. Post-op, he's damn near perfect. *grins*
He'll remain sedated on a ventilator with the breathing tube in, probably overnight. Will come off the vent tomorrow and start doing breathing exercises. Getting his lungs back into full working order is a big part of rehab for post-pump patients.
Should leave the ICU in a day or so to the step-down unit, where he'll go with other cardiac cases into a monitored bed, for about 4-5 days. Lots of breathing exercises and the start of his rehab work, so he can exercise his lungs and his chest, getting up and moving about, get everything working properly again, and the docs can make certain everything is put together properly and very important, that no infections spring up.
Then it's home and about a month of out-patient and then several months of in-home rehab -- increasingly longer walks, continuing the breathing exercises (very important), and at the end of it all, back to a normal life.
All is going well right now. Dad is resting comfortably and in as good a shape as anyone can in an ICU.
I talked directly to his personal ICU nurse. She has been on shift since he came out of the recovery room. He came out precisely on time -- indicating the surgery went as planned -- and there have been absolutely no issues since. I could recite a long list of negatives the nurse and I went over, including that his lungs are clear and he has urine output, both important given what he had going on with him -- but really, there's nothing to say except he's recovering properly and well from surgery and everything is fine, no issues.
*does happy dance*
Another update tomorrow.
However I can't leave for the day, without thanking all of you.
All day long I've felt the enormity of having all of you waiting with me.
Thank you, each of you, for your outpouring of love and support. It has made an enormous difference to me, and to my father.
Thank you. Thank you so very much.
Updated Saturday 12:45 pm PT/2:45 CT:
Dad's in wonderful shape.
Being transfered from CICU out to a monitored bed as I post this.
Middle of last night, I spoke with his night-shift nurse. She took him off the vent, took the tube out of his lungs, got him up and walking around. He was doing good then, even better now.
Just now, spoke again with his day-shift nurse, the same one he had yesterday. She's blown away with his progress. He's all active, talking up a storm, terrific progress.
His temporary pacemaker is hardly being used anymore, and most of the tubes and stuff are already disconnected. I should be able to talk with him later today or tomorrow, once he's in his new room.
Dad will likely be at the hospital another 4-5 days, and then head home for a month or more of rehab.
This is my last update. It's been a text-book case.
Thank you everyone for your care, concern, and for having been there. There's more...
Monday, December 17, 2007
Joe Arvizu Died Due To Institutional Racism
photo Armando Olea
Emergency Care, Si. Recovery Care, Drop Dead, Wetback.
Everyone involved denies it was racism.
How can anyone blame Nuns doing God's work for killing this boy, Joe Arvizu on the basis of race?
The nuns (and doctors and nurses) saved his life when he came into St. Joseph's Hospital and Medical Center in Phoenix on October 19 with bleeding in his brain after bumping his head messing around at church. Two days later, they discovered he had leukemia.
And on the seventh day, the nuns packed his poor brown undocumented ass in an ambulance and shipped him to Mexico. Where he died when his mother couldn't provide a blood transfusion. Game. Set. Match.
One to seven brown kids a week get shipped to Mexico. Undocumented. Poor.
Arizona RepublicRacism? Oh, of course not.
"They said they knew that we couldn't pay the bill, so they couldn't continue with the treatment anymore," Rosa said, through a translator. "I asked for a payment negotiation, but they said that no, we couldn't make it with the income we have. I didn't want to make any decision by myself, but they told me the ambulance was ready."
Over his mother's objections, Joe was taken first to a hospital in Agua Prieta, then transferred to one in Hermosillo. His mother followed the next day while his father, a bricklayer, stayed behind with their other children.
Joe died on Dec. 3. Rosa couldn't supply the hospital with blood for a needed transfusion.
His death has shocked this central Phoenix community, where teachers, students and parents are asking why one of our leading hospitals - and a Catholic one, at that - dumped a boy whose only goal was to join the Army.
"This is an absolute community disgrace," said Sue Stodola, a North parent. "And my question is, is this what it's come to?"
Sister Margaret McBride, vice president of St. Joseph's Mission Services, said the hospital's charity committee reviewed Joe's case but decided he could get treatment in Mexico.
While Medicaid picked up the cost of his emergency care, there was no one to pay the rest of the tab. He wasn't well enough to be sent home, and McBride said there were no skilled nursing or rehab facilities in Arizona that would have taken him, no one who would have offered to treat an illegal immigrant with no money.
The hospital simply can't afford to support everyone past the emergency phase, and they already lose $17 million a year over and above what the government will reimburse (as do most hospitals; it's a condition of having a hospital license.) Choices have to be made. Priorities have to be set. It isn't (gasp) racism!
EVERYONE is claiming this isn't about race or his undocumented status. It's about money.
Bullshit.
If Joe Arvizu'd simply been poor but with papers, he'd be alive today. Why? Because the hospital couldn't have shipped a U.S. citizen to freaking MEXICO, a goddamned third-world country when it comes to medical care. Joe Arvizu died because the hospital made a racist choice...
He has no papers -- dump him.
So a kid, 16 year-old Joe Arvizu died.
Because of a choice the nuns made -- send this kid to Mexico and hope for the best. But no matter what happens, we wash our hands of his blood. We simply can't "afford" to treat him.
Except it isn't true they couldn't afford to treat him. They chose not to treat him. Because if they were truly dealing with what they could and couldn't afford, they'd have done it fairly, without taking documented and undocumented status into account. Everyone who was poor would have had a fair shake at their resource pool, instead of just dooming the poor undocumented kids to shitty medical care. Because that is racism, plain and simple.
It's too much to expect for the Prosecutor in Maricopa "Let's Drive Out the Illegals" County to return an indictment of contributory negligent manslaughter against the Nuns... but wouldn't that be swell?
The mother says she isn't angry at St. Joe's. I'm sorry for her loss and glad she's finding some kind of piece.
I'm pissed as hell. Goddamn racist nuns. There's more...
Sunday, December 16, 2007
Every Damn Thing You Need To Know About Republicans
Darcy for Congress: Part 4
Earlier this week I was listening to Aaron Sorkin and Tommie Schlamme give the commentary on the Pilot episode of Studio 60 on the Sunset Strip.
In speaking of casting Steven Weber to play the network executive, they said the one thing you can never act is smart. You have to be smart already. From the moment they saw Steven audition, the part was his. He was so smart, so powerful, so obviously right for the part, no one else had a shot.
All week long I've been coming back to how with Republicans, acting smart, acting patriotic, acting moral, acting as if they give a damn for people -- being seen to appear as if this or that were true, that is what truly matters to Republicans... Appearances.
Real intelligence, authentic patriotism, genuine morality, and above all, truly taking care of people such that at the end of the day or the week, at the end of the month or the year, people are left saying reflexively, "Yeah. I've been taken care of. These people really took care of me."... it's not them. They can't even fake it. Like an actor can't act smart.
Republicans not only aren't interested in the genuine article, they're actively opposed.
Why?
Because the genuine article shows the Republicans up as no different than either the thieves, or the two who passed by the man who lay dying by the side of the road in the parable so long ago:
The BibleRemember as you read the Parable of the Good Samaritan it is also about race and class, not just helping those in need. The guy who helped was of a race and class which was despised and hated and lower working class to poor. None the less, he helped anyway, even though he could have had the crap beaten out of him just for daring to help anyone. From our perspective, the risk he took is as if a disabled black vet in his thirties at 59th St and Columbus Circle just outside the entrance to the subway -- that's the south-west corner of Central Park, for those of you who don't know the city -- dared after dark to help a rich white twenty-something lying half-naked on the ground just inside the park boundary. The odds of New York's finest accusing him of making the assault (or worse), rather than doing what he could to help her...THE GOSPEL ACCORDING TO
ST LUKE
CHAPTER 10Jesus calls, empowers, and instructs the seventy—They preach and heal—Those who receive his disciples receive Christ—The Father is revealed by the Son—Jesus gives the parable of the good Samaritan.25 ¶ And, behold, a certain lawyer stood up, and tempted him, saying, Master, what shall I do to inherit aeternal life?27 And he answering said, Thou shalt love the Lord thy God with all thy aheart, and with all thy soul, and with all thy strength, and with all thy mind; and thy neighbour as thyself.28 And he said unto him, Thou hast answered right: this do, and thou shalt alive.30 And Jesus answering said, A certain man went down from Jerusalem to Jericho, and fell among thieves, which stripped him of his raiment, and awounded him, and departed, leaving him half dead.31 And by chance there came down a certain priest that way: and when he saw him, he passed by on the other side.32 And likewise a Levite, when he was at the place, came and looked on him, and passed by on the other side.33 But a certain aSamaritan, as he journeyed, came where he was: and when he saw him, he had bcompassion on him,34 And went to him, and bound up his wounds, pouring in oil and wine, and set him on his own beast, and brought him to an inn, and took acare of him.35 And on the morrow when he departed, he took out two pence, and gave them to the ahost, and said unto him, Take care of him; and whatsoever thou spendest more, when I come again, I will repay thee.
Now ask yourself if Dave Reichert -- absent a camera trained on him -- would stop and take care of someone at risk to his own reputation. Question answers itself.
Darcy Burner is the real deal.
She is thoughtful, careful, considerate, and takes care of people.
All you have to do is watch the video and compare how she answers the question, with how Dave Reichert is rude and arrogant.
Beyond the issue of Congressman Reichert's believing it's fine for a pharmacist to not sell birth control pills -- not emergency contraception; birth control -- to a woman, simply because the pharmacist opposes birth control, just watch how rude Dave Reichert is. From interrupting, to forgetting the question (demonstrating he either isn't listening or that he's trying to dominate), and then instead of explaining himself and his answer to the people who elected him, he just says "No."
Reichert's answer belongs to someone who simply doesn't think, isn't smart, whose morality is all about looking good to a particular base group so that they'll vote for him, un-grounded in any genuine religious or moral conviction of his own. He is a man who clearly doesn't give a damn who he leaves dying by the side of the road, just so long as he gets his.
In short, he is a George Bush Republican.
I was privileged to interview Darcy a few months ago:
Darcy Burner*smiles*
There are five basic principles that form the basis for every political decision I'll make:
1. Government should treat everyone fairly.
2. Hard work should be rewarded.
3. Government should stay out of people's private lives.
4. We should keep our promises.
5. We should take care of our children, and leave them a better world than the one we found.
That's not the only way to slice it, of course, but it's one way, and that's how I slice it.
At some basic level, though, I think it comes down to what my father told me over and over again when I was growing up: "You're no better than them, and they're no better than you." The founding principle of our democracy is the idea that all persons are created equal*. And the fight at the moment comes down to whether that's actually true.
The other side believes, deep down, that a wealthy CEO is a *better person* than the woman who cleans my office at night.
I do not.
* I know, I know, women still don't have a guarantee of equality under our Constitution, and it was initially only white male landowners. But while we have lagged in execution, that principle has been our guide, and we make progress when we move closer to that ideal.
This is what I'm talking about.
We have to elect better, smarter Democrats.
She's one.
Please join with me this Holiday season by spreading a little cheer Darcy's way. She's really that good.
Thank you.
Previous Darcy posts:
How to Reach Darcy:
- Darcy Burner for Congress
- Help elect Darcy Burner to Congress by contributing. (Please add $0.13.)
- Feel free to send me an email letting me know.
And if you missed it in our last Darcy post (Part 3), make sure you watch her campaign video with music by the Squirrel Nut Zippers & Rickie Lee Jones.
Note: Edited at noon to fix my not paying attention to the bible verse when I modernized who was who. Thanks to the readers who pointed this out. There's more...
Sunday, December 9, 2007
Krauthammer-ed!
You Just Got Knocked The Fuck Out!!! Maaaaaaan!!!
As I've got friends and family toiling in the pharmaceutical industry, I'm tempted sometimes to do with them what folks often do with me when we become close and they find out that I work in the publishing and entertainment industries—pitch 'em “product” ideas.
I hope that my brainstorm will be something akin to the next “Viagra”, or “Lunesta”, or “Enablex” or something else that sounds like a Marvel Avengers villain's name, but reels in hundreds of millions of dollars from jittery, hypochondriacs everywhere.
I've mulled pitching cures for tinglefoot, and underarm deodorant-clumping. But I think I have the one panacea that could rake in countless millions of pharma-dollars, enabling me to finally be able to afford that immortal, Insta-fuckwit-endorsed robot body to download my consciousness into.
I would call that miracle dream drug...Preemalex.
It would be a combination barbiturate/muscle relaxant that would act on the brain—specifically the triumphaloid gland and the still-mysterious nyah-nyahicus blusterex section of the brain, while also anesthetizing wildly hyperactive jaw muscles.
I've even got a target market demographic that desperately needs the drug—Premature victory ejaculating wingnut pundits. The marketing folks could come up with all the scary, “Do you have these symptoms?” copy that a reassuring voice-over artist could sonorously read off.
“Preemalex... (Sound of a rooster crowing) ...for when the cock crows too soon.”
Karl Rove's a sufferer. (“I have THE MATH!”—Nov. 3, 2006) So's his Libertarian, non-conservative, rope-belted tenure-baby pal Instapundit (“Okay, I'm officially declaring the Plame scandal bogus”—December 3, 2003), shillhistorian Victor Davis Hanson (“We're winning the war!”—Spring, 2005), and skipping over about 7,594 examples since that time, we now have the sniffy, condescending Charles Krauthammer.
Charlie's a tough one to take. He's NOT dumb. And when the subject is a non-political one, I have occasionally found him to be thoughtful, enjoyable...and even, witty. But let the conversation turn to politics and it's “Moe! Larry! The cheese!”, and he's off his rocker, swinging madly at everyone in the arena. And to and to cap it all off, when arguing for wingnut causes, he tends to veer towards the realm of angry, disingenuous jerk.
If you didn't know, Krauthammer is disabled—paralyzed due to a diving accident during his undergraduate years in college. One might assume that dealing with that issue, and as a reknowned member of the medical community, (his work as a psychiatrist is heavily cited in many medical journals) he could conceivably be a receptive ear, and perhaps a strong voice for the myriad potential benefits of stem cell research. More specifically, government funding for embryonic stem cell research—stem cells that are incinerated anyway as the leavings of in-vitro fertilizations of couples that have successfully brought a child to term, or have given up trying—cryogenically frozen remnants left at medical storage facilities.
One might assume that research using those embryos—in lieu of throwing them out—to aid in the cure of various ailments such as Parkinson's and Alzheimer's Diseases, or even finding a way to repair nerve damage in the paralyzed would be something that this medical professional would consider beneficial, without the silly rancor and talking points of a mocker of the disabled, like Rush Limbaugh.
But you all know what happens when you assume, right? 'Cause apparently Charles didn't. (Via Daily Kos:)
(KRAUTHAMMER:) A decade ago, Thomson was the first to isolate human embryonic stem cells. Last week, he (and Japan's Shinya Yamanaka) announced one of the great scientific breakthroughs since the discovery of DNA: an embryo-free way to produce genetically matched stem cells.
(KOS DIARIST DARKSYDE:) Except that one likely way to say ‘embryo free way to produce genetically matched stem cells" in light of current procedures is ’cloned.’ Which plenty of ignorant, mostly conservative politicians also oppose. But this sucker gets worse, much worse. Steel yourselves:(KRAUTHAMMER:) The embryonic stem cell debate is over. Which allows a bit of reflection on the storm that has raged ever since the August 2001 announcement of President Bush's stem cell policy. The verdict is clear: Rarely has a president -- so vilified for a moral stance -- been so thoroughly vindicated.
( DARKSYDE:) And that's the tone for the rest of the article more or less: George Bush is a genius -- one could almost read savior in the editorial -- because his unpopular policy forced those lazy scientists to do without embryonic stem cells. Of course, the real moral objection to Bush’s ban on Federally Funded lines is that the blastocysts used to produced them are slated for destruction anyway. A few could be saved for ESC research. Preventing that in anyway won’t 'save them,' quite the opposite in fact.
So Charlie got all fired up and triumphant, letting his mania for screaming winger talking points like an air raid klaxon with an unconscious Tor Johnson sprawled across the “on” button get the best of him.
“Oh noez! You are the loosrz! LMFAO&ROTFL!”
This otherwise intelligent man blew the whistle and wanted to call the game over after a scoreless drive where his team moved the ball thirteen yards.
What happened next? You guessed it—he got 56 unanswered points thrown up on him before he could say Roman-fucking-Gabriel, via a stern rebuttal in the same paper five days later...
A new way to trick skin cells into acting like embryos changes both everything and nothing at all. Being able to reprogram skin cells into multipurpose stem cells without harming embryos launches an exciting new line of research. It's important to remember, though, that we're at square one, uncertain at this early stage whether souped-up skin cells hold the same promise as their embryonic cousins do.
Far from vindicating the current U.S. policy of withholding federal funds from many of those working to develop potentially lifesaving embryonic stem cells, recent papers in the journals Science and Cell described a breakthrough achieved despite political restrictions. In fact, work by both the U.S. and Japanese teams that reprogrammed skin cells depended entirely on previous embryonic stem cell research.
-----------------------------------------------
While commendable, these efforts remain preliminary, and none so far has suggested a magic bullet. In the same way, the recent tandem advances in the United States and by Shinya Yamanaka's team in Japan are far from being a Holy Grail, as Charles Krauthammer