Lots of Adjustments and News Going On.

Most of it's extremely good news. I hope you'll forgive me for holding it close for a while. There've been some other changes too, and I've needed time to absorb it all.

--Walter is officially on Worker's Comp now. The local doctor he saw here declared: --No commercial driving.-- So he'll be allowed the time he needs to stay home and heal properly. YAY!!!

--The MRI of my hand showed no osteomyelitis - the bones are NOT infected. The doc said we'll get some new xrays just be sure, and it'll need time too - it can flare back up, we'll need to watch it for several weeks. But for now? No long-term IV antibiotics. YAY!!!

--It also showed a lot of RA and tenosynovitis in my left hand. Tenosynovitis is the autoimmune condition that partially crippled my right hand, that I had surgery for a couple years back. This is not good.

I've been trying to decrease my Prednisone. Right now I take 35 mg one day, 22 the next. When you alternate higher and lower dose days it helps keep the side effects down. But my immune system is ramping up so bad now, I may go back to the 35/25/35 dose that I've just decreased from, one mg at a time, for a month and a half each time. It's been excruciatingly painful to decrease even that slowly. I really wanted to get the dose as low as possible. But: If I let the RA and tenosynovitis get out of control, they'll cause more damage, and it's irreversible. So I'm considering going back up instead.

--I found an excellent endocrinologist for my suddenly out of control blood sugar. However, every time I call her number, I get a recording that says her voice mail box is full. Let's hope she's just on vacation for Memorial Day and not dead in her office, phone ringing in the silence...

A lot of Stuff has been going on. We've been talking and talking and making plans. I need Walter here, and I need him by me as I work through the hurricane claim and the mortgage and insurance and health issues.

Walter, for his part, admits he's not really able to drive any more, that it's not good for him, and he knows that. This is actually a great relief to me. He's so tough, and has been for so long, that I worried he wouldn't concede that point.

But he did. He's safe for now, waiting for his injury to heal. We'll find a good local orthopedist about that chronic rib inflammation too, and see if he's ready to go out on disability. To my mind, no law requires us to work ourselves to death, and that's what he'd be doing if he continued to drive much longer. He already landed back in Cardio ICU last fall. I don't want that to happen again.

The idea of having him here always, and not coming home half dead from driving, is so sublime a thought I can only let myself bask in it a little bit at a time.

I've spent my entire life being as independent as possible. It was my goal, from my earliest memories, to be on my own and taking care of myself. This was a more common paradigm back then, it seems. Certainly it struck me with full force. I treasure my independence.

This week, I told Walter I can't do this by myself any more. I need his help with everything in my life now.

And, being the very fine man he is, he instantly said he'd do everything he could.

Some of you have come to understand that I have a streak of ruthlessness in me, something that allows me to see things with a cold calm clarity. It's not a faculty for meanness or unfair behavior on my part; it's just an ability to set my emotions completely aside for a while. I can do this to the point of dissociating. I use it to think clearly and logically and make the best decisions possible - and to act on them efficiently and thoroughly.

Sometimes this shocks Walter with its brutal honesty.

Do you remember a few years back, when a hiker got his hand caught under a huge rock in an isolated canyon? There'd been a little landslide or such, and a 600 pound rock rolled onto his hand and trapped him.

Over a period of several days, realizing he would probably die if he didn't get free, he slowly disengaged himself from his hand. A little bit at a time: he broke one forearm bone one day, the other the next; then finally he cut off his hand and was free of the rock. He wandered back out, bloody but alive, and was found by a rescuer.

When we heard about that, Walter and I looked at each other and asked the same question many others were asking: Would you, could you, cut off your hand to save your life?

And we knew what each other's answers would be. Me? Sure. In a heartbeat. Walter? Nope.

So buckling down and admitting I can't go it alone any more, that ain't nuthin'. Not at all. It's not like cutting your hand off, right?

But I still had to call out my ruthless streak to do it.
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He's Here. He's Safe.

Walter got in around noon yesterday. Heaven only knows how, but I had the sudden energy to spend the morning in a fit of housekeeping. When I picked him up we embarked on a long, careful, tiring bout of shopping and getting prescriptions filled. We did extremely well on our available funds - oh, such excellent shopping we did! So much so, I even called the shot on splurging for some really superior shrimps at Sam's, 15 count wild caught monsters for less than $10 a pound.

We got home and rested on our laurels. Then around 10 PM I made the shrimp, which I can do most of sitting down. Here's a little example of Alternative Cooking for the feet-challenged. You know. Peel shallots - loads of them, like half a pound or more - and peel the shrimp. The rotini was boiling as I peeled.

I have to do a lot of my cooking with my feet elevated, and yesterday it was mandatory. Between some extreme and feet-intensive yard work last week, and all the housecleaning Saturday morning, then the shopping, even with Walter's help dropping me off right by the store scooters, it was way too much. Poor Mr. Foot! He was doing the muffin thing, where he gets so hugely swollen the top of the foot hangs down over the sides like a muffin. He almost went to his *Blue Cantaloupe* stage. And Ms. Foot wasn't far behind. So sitting in front of the computer to do my prep work was a must.

I've no idea if this dish has a particular name; I think I just sort of morphed it together one day long ago. Here's how the recipe went.

First: peeled and washed about 3/4# of shallots. I washed them with soap, because they got a bit of that black onion mold shallots are susceptible to, and it can be highly allergenic, that mold. Bought in bulk rather than those dainty little net bags, purple shallots run from $1.99 - $4.99 a pound down here. I got the organic ones, $4.99 at Whole Foods, because I didn't want to make yet another stop to save a buck a pound - and spend that much in fuel, and a hundred times that much in extra foot pain.

I peeled the shallots sitting in front of the computer with my feet way high, like usual. Then in the kitchen, after washing and thoroughly rinsing I chopped them fast and rough. They went in a large microwave glass bowl with extra light olive oil drizzled over them, a fair amount of it; then on into the nuker. Five minutes, stir, four minutes, stir, three minutes, stir, then wait for the shrimp.

Shrimp that huge I devein on both sides, top and bottom, and wash carefully, then dry on a paper towel. Everything but the washing and drying was done sitting down. Like any manual task, it goes fast once you've gotten some practice in.

I poured the olive oil from the shallots into a medium-heated frying pan, then gave it a dollop of whipped butter. The olive oil not only balances a cholesterol-lowering oil with the butter, it keeps the butter from burning. The olive oil I use has no flavor really, by preference, but the butter is yummy.

When the oils were hot, in went the shrimp. I turned them when they were barely pink on that first side, then dumped the almost-finished shallots on top. They got a sprinkle of salt and a much bigger sprinkle of turmeric. After the second side of the shrimp got barely pink, I started mixing it all, cooking a few minutes longer to let all the tastes blend.

The only other ingredient was scads of fresh-grated parmesan cheese. That's a very high-protein, relatively lower fat cheese. NOT *low fat* to be fashionable and find a great use for extra salt and chemicals, but lower fat because it's the way the recipe goes for making parmesan cheese. (So there, Dr. Idiot! 'Scuse please.)

I can grate 5 oz. of parmesan cheese in less than two minutes. The reason I notice the time on these tasks is because I simply can't stand up, even on a good day, for more than a minute or two before the pain starts to skyrocket. Walking's not so good either, but not as bad as standing.

Back to the food. Fresh raw veggies? You bet. Again, I'm lucky in my tastes: I eat this stuff because it's what I want. I make a salad of them, and almost never use any kind of lettuce. Spinach sometimes, yes. Usually, it's something like tomatoes, sweet onion, carrots, cucumbers. Peeled broccoli stems, black olives, spinach, kohlrabi, water chestnuts, hard boiled eggs or egg whites - depends upon my mood. Cheap Catalina Free dressing, too, in a nod to my diabetes. Walter loves cucumbers and tomatoes with ranch dressing for a *salad,* and I can feed him fresh raw spinach for a green leafy veg. (He's a challenge on the green leafies.)

I drained the rotini and put it in two bowls, way less for me than for Walter because there's your starchy carbs. The shrimp and shallots went on top. I also had a tiny side bowl of just rotini and whipped butter and a mound of the cheese. I like it plain like that, and I don't like the cheese on my shrimp and shallots, but Walter does.

We took our salads and shrimp and pasta dishes and ate like a king and queen, having a special *fancy* dinner for the grand total of about $15. Maybe $20 if you count the electricity to cook it, and the dollops of butter...So, say $10 each, to eat one of my pricier meals in the comfort of our own home? Not bad.

And this whole time, we talked and talked and talked and talked, from noon till midnight. He showed me some gorgeous pix he finally took with a digital camera, my gracious I had no idea he could take pix like that! We love to talk to each other, Walter and I. After all these years we still aren't tired of each other's company.

Tomorrow we have an intense day of strategic phone calls and letter writing and an MRI, and probably a need for a yard work fix to keep me on an even keel after the MRI.

But for today...ah, sleeping and lazing about, and surfing up how to cook this liver pudding ring he got at Penn Dutch yesterday, and fine long discussions of sausage - and giggling about how I had to stop surfing sausage info after reading about Tibetan lung sausage making, and that old saying about eating sausage vs. knowing how they make it - but Tibetans, I mean, who knew? Besides, I was looking for how to cook it, not how to make it in the first place.

I ended up sticking it in the lovely DeLonghi convection-toaster oven at 275 for an hour and a half, and Walter pronounced himself delighted. --How's that for a Don't Stand Up cooking procedure?,-- I asked him. Spray-oil a piece of aluminum foil, put it on the toaster oven pan, take the liver pudding ring out of its wrapper, place on tray, set oven for 275 for 90 minutes, go lay down and read Jane Austen. Ding! Rinse the (already clean enough) spinach, put in bowl, get bottle of salad dressing. Put some already cut-up cantaloupe in bowls for both of us. Sit by computer and listen contentedly to the sound of my guy eating something he really loves, knowing he might have bypassed the spinach part if left to his own devices.

And now the allergies are descending upon us like a sleepy but toxic warm bath, so off we go for another nap.

You see? Our lives have wonderful shares of pleasures, too.
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I'm Going to Get Some Icky Stuff Out of the Way.

Well. I need to dump a bit, so I shall. Then my other posts will push this sucker down the page, which will leave me - as Pepek so aptly put it - looking forward instead of back.

The latest developments in the ongoing sagas of:
-the odd infection on my leg that was recently biopsied
-Ms. Hand and her MRSA infection
-hurricane insurance
-mortgage issues
-etc. etc. are:

--The leg infection is mold. Yeah. Weird, huh? The great dermatologist, Dr. G, is short on staff by four people and still hasn't called in the special antifungal cream. I'm scheduled to get the whole thing taken out surgically on July 2.

--The *incident* that happened during that biopsy was that another doctor, a student who was leaning over the leg watching Dr.G at work, got exposed to my bodily fluids.

She got them in her left eye.

As he was injecting the novocaine, it came squirting back out. That's happened before with us, and we both went --Oh, a cyst!-- (they're hollow, and squirt your novocaine back out) a split second before we realized what happened to the other doctor. The poor lady maintained her composure beautifully as she inwardly freaked out and headed for an eye wash station. It's a long story, and perhaps I'll post the whole thing later. She's okay now. But it became an *Incident,* which needs to get reported or something and the room sealed off and sterilized, and my ID doc and others heard all about it, and they walk in the exam room and tell me, --I heard there was an *Incident* over at Dr. G's--...I did not see anyone in anthrax suits, but I almost expected to.

That happened in the morning of the day I started my search for a hand surgeon, and discovered they refused to treat me.

--The tiny drainage tunnel Ms. Hand made for me was kept open by ardent auto-surgery, every night before I went to bed. The wound itself was closing, but because it was still draining MRSA stuff from 3/8" deep, I had to keep it open. That self-cleaning business, there.

--Last Monday (5/12) I saw Dr. C, my ID doc. That was the first morning the wound had no drainage. That doctor is so fabulous, she almost has a sixth sense for these things: before she'd even finished walking in the door, she was assessing the hand. She had two immediate reactions. First? --Okay. You can let it close now.

The second thing was --We need an MRI. You may have osteomyelitis in this hand. See the swelling here and here? (I could, but most people would have had to look and compare my two hands for a long time.) --Is there pain in these joints and bone?-- --Oh yes. Intense, still.-- --If it's osteomyelitis, you'll need six weeks of IV antibiotics, okay?

--She mentioned hearing about the Incident at Dr. G's. And for the very first time since I started seeing her in 2004, when she examined my wounds this time, she put on gloves first.

I had to compartmentalize that.

--Dr. C said the outrage about the hand surgeons' refusal to debride the infection was NOT because of my MRSA, but because they're afraid of the liability. They get tired of getting sued, and I'm high risk. Their malpractice premiums go up and up and they get apathetic.

--Please note that of the 17 doctors on my doctor list, not a single one that I know of actually carries malpractice insurance. The State of Florida allows them to opt out. They do. I have to sign a paper saying I'm getting doctored at my own risk. I do.

I'm sure they have to prove financial responsibility of some sort, perhaps post a performance bond or such; but the *my premiums are too high!!!* argument carries little weight with me when they aren't actually paying malpractice insurance premiums at all.

--The MRI is scheduled for next Monday. That's a week after it was ordered. I have a little trouble sometimes understanding people's lack of any sense of urgency about this. If my bones are infected, a week's delay can make a big difference in the outcome. More apathy.

--Getting the MRI requires some blood tests, to see if my kidneys can take the contrast without injury. My kidneys are in great shape. I have this oddly good health under all my illnesses.

--My diabetes is suddenly so out of control I may have to go on insulin. My *fasting* blood sugar was 293 - except I wasn't fasting, they neglected to tell me to fast. Luckily, those tests were just my regular RA doc's requests. The ones my primary did for the MRI and my diabetes haven't come back yet - they were truly fasting, and will include my A1C.

But I know that when I wake up and take my own fasting sugar, it's often that high or higher. I've been having trouble with my vision, and sometimes the neuropathy in my feet is nearly unbearable. Lately I seem to get it in my arms too, from shoulders to fingertips. Heart palpitations, pounding and pounding. When the palpitations get bad I test my blood sugar. It's always either way high or way low when the palpitations come.

The urinalysis showed glucose of 3+ - sugar in the urine, which should read *negative* - and a trace of ketones, which should also be negative. The primary said this was Definitely Not Good.

I really don't want to have to go on insulin. Apparently my meds, and my need for copious sleep, are major factors - and neither one is in my control. I take those meds only because I really need to, and I sleep that much because I'm sick and really need a lot of sleep.

Long ago, Walter told me there was only one disease he'd have trouble dealing with, if I got it. Diabetes. His mother first went blind from it, then died from it.

The primary's office gave me three endocrinologist recommendations; I'll pick one out and we'll go from there.

--There've been several other underlying sagas in my life having to do with Chase Home Finance, which holds our mortgage; and with Citizens, who's supposedly processing the second half of my hurricane claim - what they call the *supplemental.* I submitted it to them on December 11, 2007, and they received it December 15, 2007. They're supposed to take two to three weeks to process it.

They fired the adjustor who came to inspect the place in January. He seemed so competent too...Perhaps he was drunk, because he submitted a report that was totally off the wall, erratic, full of odd errors and unanswered questions.

The new adjustor, who arrived here May 5 - oh no, wait, he showed up on my doorstep a week early, when I was totally unprepared, with the house a mess and me dreadfully ill in bed, insisting he had the date right and I was wrong - The new adjustor is incredibly dense. They've lost most of the package I sent them. The one that was put together with great care, full of the detail and photos they requested, and weighed almost two pounds.

Now: In today's mail, I was informed that Citizens just decided to non-renew our policy next December. Why? Because I haven't sent them proof that I've done the repairs...on the claim they haven't even finished processing, much less finished paying.

--Chase has revoked our *grace period* to make mortgage payments, and still hasn't answered my faxes requesting a breakdown of what those payments are for, what it would take to bring it current and get off the payment plan, and what that big initial *down payment* consisted of.

Recently, I discovered I can change my Social Security payment date. It arrives on the 3rd, and until I win the lottery and can get us $1500 ahead, I need that SSA to help pay the mortgage...3 days late. It must be *cash* or equivalent - Western Union Quick Collect, cashier's check, or money order. No phone payments! (Why not??? That's Instant Cleared Funds! This seems vindictive to me.) Mailing in my postal money orders to save the Western Union fees did not sit well with them. Frankly, it wasn't easy for me either; it required lots of walking.

I can change the SSA payment date to the last Thursday of the month. Hooray! Let's hope Chase doesn't send me a demand letter until Social Security fixes the date...which may take a month or longer.

It goes on and on and on like that. One day I'll fill you all in on all the gory details on those backstories. Rest assured, I'm doing all I can to whip my life back into shape.

Today, I just needed to vent. Dump the weird news and holler about some of my stressors, the things I deal with every day. My usual ordinary life.

I've been taking care of so much business I left neglected for too long. I work so hard. Now I neglect my need to blog and socialize instead...When I'm very lucky, I get to do my *treat* work: out in the yard with my plants.

Of course, right now most of that outside work is geared toward insurance stuff too. I've been force placed by Chase and non-renewed by Citizens and want to appeal my flood zone designation. I need to put my Rebuild and Repair plan together and get Inspectors out, which means painting the house and doing all sorts of other things to get it into shape, to make the best case I can for what I want to accomplish. There will be Company coming by, of all sorts of official, and not all of them will be on my side in these matters.

And since we ended up desperately broke again, I've been doing all sorts of sideline things to raise up money, which Walter courteously and properly explained he didn't want to hear about just yet. We agreed I'd tell him a year from now. So far, they're just starting to pay off. But that beginning payoff most certainly feels good. I'm sitting here looking at a smallish but most welcome bit of cash, that just came by as I was writing this.

And the real good news is: Walter's coming home.

End of rant. Thank you all so very much for your patience.
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He's FINALLY Doing Better

Sunday night, for the first time in what seemed like forever, Walter was talking to me again. I mean, almost like a normal person. He even laughed, more than once, and it didn't send him into agony when he did.

He said he might just go back to work, and see an orthopedist next time he came home. It's his decision, so I told him whatever he wanted to do, I'd support him. He said he'd sleep on it and see how he felt in the morning.

He decided to go back to work.

The seat belt is causing him problems, and I think he'll put in for home time so he can get here, and to a doctor, faster.

Part of me objects to this, so strongly. I know it's causing him pain to work, and it's hard to know that and not do anything to stop it. But his life is his own, as is true for us all; it's not for me to try to make him change this. It's not a matter of life and death this time.

Instead of thinking about his pain, I'll wrap myself in the gladness of how good he sounds on the phone now. Immerse myself in my yardwork, too.

Not to mention, getting paychecks again. Eating is good.
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WHAM!

I'm okay. I'm not in the hospital, and the fevers are steadily decreasing; the wound is still draining, but less all the time. I'm able to be active around every other day now. A deep MRSA infection knocks a person off their feet. That little nothing-looking bit of cellulitis will likely keep me sick for weeks to come. That's life.

No, this time it's Walter.

About ten days ago - a week ago Thursday - he was in Dallas making a delivery. It was a very windy day. As he entered the customer's office, the wind grabbed the door out of his hands and slammed it back into him. Right into his sternum. Right into his titanium mesh.

I tried and tried to get a good image of this sternum business for you, but couldn't. I did surf up a YouTube video of the sternum-cracking procedure used in his open heart surgery. I can see or discuss just about anything, medical-wise, but I found myself unable to watch that to the end. I did check, and it didn't seem to include the part where they bring the two cut halves of the sternum back together and tie it all up with the titanium.

Basically, the procedure leaves the two halves of the cracked-open sternum floating. They're connected with metal, but not necessarily with re-grown bone, even this year and a half later. Leaving the cut sternum flexible is done to allow the patient to breathe. Apparently if they completely close it back together, the act of breathing becomes too difficult as the inflated lungs press on the broken bone.

The door slammed into this delicately pulled together bone. It set off a chain reaction of medical and other events.

His heart, thank God, is fine. What he has is an orthopedic problem.

The bone was badly bruised. On top of that, it seems to have set off an inflammatory condition in his ribs. They're very tender even to touch, all the way around to his back.

If you've ever had a broken rib, even just a hairline fracture, you know how hard it gets to breathe. Every breath can feel like a knife stab, like pneumonia does. Now make it most of your ribs, from the front to the back, and toss in a broken sternum held together with wires, which had a big metal-framed door slammed into it with some force, making blood vessels burst and bleed into bruises.

Yeah. He still can't breathe or talk very well, and making him laugh is a mean thing to do.

Even before the injury, we'd had four short paychecks in a row. With this, we'll have at least two more. Add in that I paid the mortgage earlier than I'd like to have done, on dire threats from Chase, wiping out everything in the budget and some funds that weren't actually there yet. So Comcast, seeing their bill wasn't paid, rudely shut off my internet. Those of you who saw I was not only not posting but not commenting or answering my emails - I wasn't dead, just doing without internet access for a bit. I scraped a payment together, so I'm back.

Walter, though...This is not good. I have a sense it might be the end of his driving career.

The problem with driving once this sort of thing occurs is that basically, you can't. The steering wheel is huge and so is the gearshift; they require some force and stretching to work them. The seatbelt presses right into the damaged sternum as the driver moves or the truck lurches about. That doesn't help.

Surely we don't want a driver compromised this way to be handling a huge piece of heavy equipment like a big rig.

But the idiot doc at the worker's comp clinic had no conception of what goes into truck driving, and after a lot of hemming and hawing, said he thought it could be done. With *restrictions.*

The restrictions meant things like Walter not raising his hands higher than his shoulders, or using more than 10 pounds of force. This doesn't add up: You need to be able to do those in order to drive a rig. Oh - and he can't use the pain meds the same doctor prescribed.

But Walter said he'd try, and went back on the road. Why? Because the fact that the doc wouldn't get over his fascination with *driving but with restrictions* means that this was NOT considered a full Worker's Comp case.

Nope.

His medical bills are covered on Worker's Comp, but since he supposedly can drive a truck by magically not using force or raising his arms, there's no salary compensation. Having endured a day without food and ten days on low food because there was simply no money to buy food with, Walter didn't think living with no income was a such good idea.

The only reason I didn't pitch a huge fit is because his transmission is sort of *automatic.* It's not the same as in a car - he still has to work the gears to some extent - but it certainly helps cut down on his continuing damage.

I bet he'll half kill himself driving his current load to the New Orleans area, then give it up. All the healing that's taken place will be compromised by this drive.

Worse yet, that inflammatory condition won't necessarily stop at all. On a far lesser scale, it's been brewing in him as a chronic problem for some time. The cardiologist has been monitoring it. Walter hadn't made it to an orthopedist yet to see what can be done.

The underlying chronic inflammation may have helped *inspire* his immune system to ramp up into this new acute flare-up. Whether the flare-up is temporary or chronic, only time will tell.

Should he be unable to continue driving because of the pain, I made him promise to use his legal right to a second opinion by a doctor of his choosing. New Orleans has excellent medical care available; he should be able to find a good orthopedist. We'll see what happens from there.

Everything I've read and heard says it normally takes a month or so to heal just from the bone bruising injury he took. That's without having a broken sternum to begin with, and without that inflammatory condition. So if he can't drive, I'll go out and get him and bring him home.

Please excuse the worried tone of this post. I'm trying hard to look forward to a possible trip to New Orleans. I lived there for three years and I need to go back. I need to touch base with it, see it now, after the hurricane. Eat some real gumbo, some shrimp etouffee.

I'm trying to look forward to that, and stop looking over my shoulder for Trouble #3.
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Turning the Corner

There's a point in most any illness where you feel the change take place. The day before, you may be sort of wondering, am I starting to get better? - but you're not quite sure.

The next day you wake up and you know.

The fever's broken. It still creeps in here and there, but it's not knocking me off my feet any more. The wound is still draining, but it's also closing, from the inside. The safe way. The infected area is smaller, by far; it's pulling together into a localized infection instead of all spread out through the hand and fingers. The feelings in that hand have changed: the intense bone pain has lessened significantly, and the general tenderness and redness and swelling is down.

I stayed out of bed the entire day today, even worked around the house and outside some too. Grilled half of a ribeye, ate a small head of broccoli, a half an ear of corn, a caramelized onion, and a little red potato. Except for Lotus Chinese Kitchen, I can't remember the last time I ate any *real* food. And it seems to be staying down just fine.

Last Friday evening, after trying so hard for two days to see a hand surgeon, I called Walter and said: --There's nothing left to do. I'm out of options. On Monday I can try a couple back, but for now, there's absolutely nothing I can do except keep taking care of it myself. So I'm going to devote the weekend to staying calm and not thinking about it, maybe working my butt off in the yard if I can.

He agreed.

Another thing I decided to do was dispose of the poor, blown-engine Saturn.

Our excellent ex-neighbors, former employees, and friends, H and Danny, love cars. They feel about cars the same way I do about plants and animals. And they've been wonderful to us over the years. I sat on the front porch looking at the Saturn and thinking about H's face when I told him I was just going to junk it, that I didn't have it in me to mess around with getting a new used engine for it, cleaning it up, and selling it.

His face fell. He almost looked like he was going to cry. Oh no!!!

He looked, to me, exactly the same way I feel when I see people throwing away big beautiful plants that could very easily live. I do plant rescues. He wanted to rescue that car. He just lent us $7800, unasked, to buy the Isuzu. Part of what made him decide to do that, I think, was simply because it was a car, a very nice one at a very good price, just right for me. And I was without a car. This bothered him. A lot.

They have five cars between them, the father and son. That's why they park two over at our house. They live a block from the ocean, and their parking is limited - they just can't fit all their vehicles there. I certainly don't mind the extra cars; it makes it look like a bunch of burly Car Guys live here.

I didn't even want to go to the trouble of junking the poor thing. I just don't do cars.

So I asked H if I could give him the Saturn. I wasn't sure he wanted it.

But he did. So I signed the title over to him. The only thing I like about cars is that paperwork ceremony, that's fun, all solemn and significant. I told H I hoped he made a gazillion bucks on it, making it all nice again and finding it a good home.

OH, what a happy time! It was just great.

And I spent the weekend making serious progress clearing the yard. Early Monday morning I called to make the appointment with that hand surgeon - then I shattered, and was more or less not conscious again until Wednesday.

I didn't even have the strength to make my espresso. If you've been sick like that with a very bad flu or pneumonia or strep or so forth, you know what I mean. You hurt from head to toe, headachy and feverish and doing the sweats and chills, throwing off the covers then piling them back on, then pouring sweat and kicking them back off again, sleeping all the time but never feeling rested, and wondering what day it is and if that clock means 8 AM or 8 PM...

I love feeling better.

MRSA's Silver Lining

I have lost 10 pounds in 10 days.

It never fails.
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And the Treatment Plan?...Self-Cleaning It IS!

When the hand surgeon walked into the office, he held out his hand for me to shake it. I responded as I always do now: --I'm sorry, I don't shake hands any more.


This stops them in their tracks. Unfortunately, it also generally offends them. But I can't figure out how to say it in a nicer way.

He raised his eyebrows and left his hand in the air and said, --oooooKay. Why is that?

--Because I'm colonized with CA MRSA and I don't want to pass it to you. I'm also immunocompromised and don't want to pick up any germs.

--And who told you this?

Now it's my turn to be offended. It's an irritating question that could be put in a much nicer way on their part. I know they hate it when people *self-diagnose.* And I understand why. But good Lord, why ASSUME that's what I'm doing?!? Why not just say, --Okay, could you go through the history on that for me? That's a non-accusatory way to get the exact same response from the patient.

--Who told me? Well, lots of doctors, hospitals...The culture for this wound here came back positive for MRSA, it was cultured last Thursday. See this foot? (I flex Poor Mr. Foot.) The MRSA abscess in there was huge. They almost had to amputate. That was in 2004, and ever since then, I reinfect myself all the time. They culture the infections and they're MRSA. I scrub in Hibiclens, I did the Muciprin in the nose, I'm on permanent antibiotics, nothing helps. I can't seem to get rid of the germ.

--What's that bruising from? (My legs are all purple now.)

--Minocycline.

--Ah. Why are you on Minocycline?

--Uhhh...(WTF? I try not to sound like I'm talking to a two-year-old.) Because of the MRSA. And I'm immunocompromised, I get other germs too, they're hard to shake. My IgG is tanking now too.

By then he's reading the printed out Medical History I bring from home, and taking me seriously enough to put on some effing GLOVES. Finally.

This is particularly necessary because even though I washed in Hibiclens (microbe-killing surgical scrub soap) before I left home, the wound has cracked open and is draining again. I'm leaking germs on him. It made a nice little tunnel at one end of the wound.

Sounds like bad news? No! It's SUPERB news.

We want it to drain. We want all the germs out from under the skin before the wound seals shut and traps them inside, which can lead to making an abscess and further horrors.

If it drains on its own, it's self-cleaning.

See?

He looked at the wound and started poking around.

The pain is intense in the joints that connect the first two fingers to the hand, and down into the back of the hand.

--It doesn't look bad at all.

--Nope. Not any more. But it's still infected and still hurts like you would not believe. You should have seen it last week. It was gross. Draining MRSA pus non-stop, I'd mop it dry and it would pour out again.

--How do you know it was MRSA pus?

--Ummm...(WTF?!?!?) Because that's what they cultured. The stuff oozing out of the infected cut.

I no longer care if I sound like I'm talking to a two-year-old. I mean, come ON, how many times have I answered that by now?

He asks how I got the cut, when the infection set in, all that. Where it hurts. Why I'm on pain meds.

His attitude has changed, markedly.


Of all the many different kinds of doctors I see, the hand surgeons have the most wonderful office art, by far.

--Let's do some xrays, okay?

--Good. Thank you.

--But outside of that, I have to tell you, you need to go back to your ID doctor. He--

--She.

--Who?

--Dr. C.

--I don't know her. Out of what hospital?

--Holy Cross.

--Then if it does need surgery, she'll set it up inpatient there. The hand surgeons there will take care of it.

--But they aren't on my insurance plan.

--Doesn't matter. They're covered once you're in the hospital. And for a person with the complicated medical issues you have - The debridement itself my mother could do. (What? a joke? I'm shocked! He didn't seem to have it in him. I am gratified.) --But with you, it's really not the debridement that's the biggest issue. You have to get started on IV antibiotics and so forth, prepped, make sure you're supported against infection even before the debridement. The only proper way to do all that is usually inpatient. To start all over with a whole new medical team and put you in Broward General would be madness. Madness. Do you understand?

--Yes, I do. That makes sense. If I knew last Thursday what I know now, I probably wouldn't be here. But I was referred to a hand surgeon then on an urgent basis, and the ID doc was consulting on the phone with the dermatologist, so that's what I tried to do. Of the six hand surgeons on my plan, four refused to treat me. You weren't available until today. So here I am. And thank you for seeing me.

In other words, he's sending me straight back to Dr. C, my ID (Infectious Disease) doctor.

The dermatologist, with all the best intentions and sense, confused the issue by trying the (perfectly reasonable) approach of sending me straight to the proper surgeon.

Now I know better. And I called Walter and told him: --Next time I have any kind of infection issue, no matter what anyone says, make sure I go STRAIGHT to Dr. C, okay? I don't ever want to go through this kind of bullshit again. I mean, as horrible as it was to learn, now I know I'll get kicked to the curb by other doctors. I needed to know that. I just don't want to go through it again.


Check out this new xray developer. They put the plate in the top slot, and the xray pops out the bottom, like a photocopier.

The xrays seem clear. That means they checked to see if the infection had gotten into the bones - osteomyelitis, and a condition to be dreaded; it often means amputation. Unfortunately, as he said, osteomyelitis doesn't usually appear on xrays until it's pretty advanced.

And the fact that it's draining again is great. He said if he were to do the surgery himself, he'd probably wait at this point. (Meaning, we're going to see if it forms an abscess now.) --But try to keep it draining, keep it from closing. And keep it dressed, don't you dress it?!

--Sure, are you kidding? Of course. I live on Silvadene and Hibiclens. I only left it off so you could see it. I'll dress it again right now.

And the nice radiologist, who was sitting in at that point, offered me one of their bandaids as I got my Silvadene out of my purse. Yes, I don't leave home without it.

I have now gone in a big circle and arrived right back where I started. Sadder and wiser, and still with the threat of an abscess hanging over my head. But what I learned, this time, was of extraordinary importance.

I left a message for Dr. C, and now I'm going to decompress out in my yard.
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Emo k, Upon Leaving Home for the Hand Surgeon's Office...

see more crazy cat pics

It's MRSA.

Here's a little recap of my hunt for a hand surgeon last week. It started Thursday morning at the dermatologist's. I was there for a different thing, a biopsy. I showed him the hand. He cultured the draining fluid and referred me to a hand surgeon on an urgent basis, saying it needed evaluation and possible debridement. That's when they go in with tools and scrape it all out. Not pleasant. But most certainly better than the alternative.

Of the six hand surgeons on my insurance plan, three refused to operate on an infection. One told me it was because the surgical facility they use wouldn't allow it.

Another doc would have done the debridement, in an inpatient hospital setting; but after I faxed my medical history to his office, he changed his mind. This was a highly regarded surgeon, and the one my dermatologist specifically referred me to. After he changed his mind, I asked his staff member a certain question to pass on to the doc; there was something I wanted to know. Today I called for my answer. Would he see me for something else, a non-infection hand surgery? No.

Four refusals. Two docs were left on the plan. One seems new to the area; no one has any idea if he's any good or not. I'd prefer not to go to an unknown doc if I can help it. The other doc, a Dr. M., wouldn't see me until the next week.

So by Thursday afternoon, I could see this was a serious problem. At 3 PM I went to the ER at Holy Cross. Why? Because I'd learned, in my health adventures, that they'd refer me out to a hand surgeon that would have to treat me, and it wouldn't matter if that doc was on my insurance plan or not.

Good tactic, huh?

Except I didn't leave the ER until 5:24. The surgeon's office was closed. I didn't have him paged. Wrong decision.

I called early Friday morning, and he'd left for the airport only ten minutes before. He came in to do a couple urgent procedures before he left.

I called my old hand surgeon, Dr. G, who did the great job on my right hand - but isn't on my current insurance plan. He suggested some docs, said he'd make some calls if he could, but nothing helped. Same with my primary and my ID doc. They'd never heard of this *refusing treatment* business and were as outraged as I was.

But that great Dr. G? He would have refused it too. That makes five out of seven, folks.

I called Dr. M again. He was, at least, recommended by my primary. On Thursday, his staff member had told me - in a distracted, bored voice - that he didn't see people on a *walk-in* or urgent basis. She seemed a bit outraged that I'd even ask. Since it looks like he's closely affiliated with Broward General, which is our local Level 1 Trauma Center, this was a bit surprising.

Docs with dumb and/or attitudinal staff are to be avoided; and since he wouldn't see me urgently anyway, I turned my efforts elsewhere. I called again Friday. Same response.

By Monday morning, of course, I was out of options. I called Dr. M's office again. He can see me Wednesday. Tomorrow. My appointment's at 11 AM.

Only time will tell how this will play out. I don't know that this one-week delay in treatment is going to make any difference. But it certainly is a reasonable possibility. Debriding an infected wound before it closes is a very different procedure than doing so after it closes. Done afterwards, we may be talking about far more permanent damage to the nerves, tendons, tissues, blood vessels, and bone. We're also talking about a higher risk for amputation, septicemia and death. That's exactly how it went down with the huge MRSA abscess in my left foot in 2004. Why it's maimed.

The one-week delay, then, may well mean a worse outcome. In that case, aren't we looking at a violation of the Hippocratic Oath? The part that says, First, do no harm?

If nothing else, I must ask: Why are you a doctor in the first place? Why the hell are you refusing to treat someone because they're sick?

Say it all comes out fine. The infection clears, not much scarring or loss of function, we don't even need the debridement surgery, just antibiotics and time.

At the very least, this has become one of the more traumatic infection episodes I've had. The worst since the left leg got so bad in 2006. I HATE to be distressed over these things. I put a great deal of effort into staying calm, cool and collected. Peaceful. I do NOT like to be rattled by my health issues.

On Thursday, when the reality of the refusals hit me, my blood ran cold. The calm and reasonable fear this all caused has not stopped since then.

Now? Now I'm looking at the wave of the future. After trying so hard to get medical people to take MRSA seriously in the past, like at Holy Cross inpatient where they kept trying to put another patient in my room and wouldn't wash their hands after touching me, the pendulum seems to have swung the other way. I bet that recent study had something to do with it: the one that says MRSA kills at least 19,000 Americans each year. More than AIDS.

Logically? The patient they should fear the least is me. They know what I have and can take precautions. It's the unknown carriers that spread this, not people like me who know we're colonized and say so. But people are not always logical, not even the vaunted intelligent and educated members of the medical community.

The wave of the future? I'll continue to get more infections. One day I'll get a bad one. I'll be refused treatment again, over and over; and before I find someone who'll treat me, it will be too late. Septicemia will set in and I will die.

And yes - unfortunately, I was right. It's MRSA. The culture came back today.
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