Sunday, December 31, 2006

Happy New Year! Happy New Year! Happy New Year!

I guess you can tell we're not out partying for New Year's Eve.

I used to call this Amateur Night.

Sometimes I stay up late to watch the Times Square ball drop. Sometimes I don't.

Like on the 4th of July, I'm tempted to be a killjoy on the subject of illegal fireworks and shooting the moon. So I think I'll stay away from all that, for now.

And just wish the world joy, instead.

An end.

New beginnings.

Friday, December 29, 2006

Home Free


 Posted by Picasa

Togetherness

Of course, as we just saw in the article below, it isn't always easy to get along in close quarters.

When you're together by choice instead of incarceration, you have, at least, Options.

Walter needs to get some staples removed. Most of his stitches are the dissolving kind: the classic Open Heart Surgery railroad track up his chest; the slash on his left shoulder where his pacemaker now sits; the three long horrible inflamed sections on his legs where they took veins to use in his heart bypasses. He had two chest tubes in below his sternum, with one big old cloth stitch each. They yielded to my home surgical scissors with gratifying ease.

That leaves the unusually large gash where they put the heart catheter in his femoral artery.

His new local cardiac doc was quite puzzled at that one. It's generally just a little hole. Walter's is two inches long and held together with six nasty staples.

They did NOT yield to my pliers.

Not without a big old loud yelp from Walter, anyway.

So, I've been gently pummeling him to go get them out ever since.

We didn't want to go back to the primary who took over from my old doc. He gave Walter a thorough physical, pronouncing him in excellent health, a few weeks before he almost died from massive coronary artery disease.

I haven't been too happy with him either.

So apparently, unless your family doc is able and willing, you can't get just anyone to take out your stitches and staples these days. This complicated procedure requires an emergency room or a walk-in urgent care facility.

Since Walter's been wearing himself out sleeping and trying to eat healthy foods, and k's been wearing herself out rocking Walter to sleep and buying and cooking healthy foods for him, we just didn't make it to the ER.

He needed a chest xray too, because his chest pain is worse now than after his surgery. I mean, on the same pain meds. He figures that cross-country drive home had something to do with it. Sounds logical to me.

And! That annoying right arm MRSA didn't respond to the minocycline as well as usual. In fact, even though I went with the Miami doc's instructions and stayed on it for longer than Dr. C said to do - last night, it flared up bad.

Voila!

A His and Hers trip to the ER.

When we came to Holy Cross to check in, the nice lady who generally oversees things there told us we were the second couple coming together today. Ha! Would I could hear what brought them here. But, of course, that rude HIPPA thing made me not even want to ask. Even as nosy as I am, and I could have promised and said cross my heart hope to die stick a needle in my eye...but no. I was a good girl.

It was a long wait this time. Luckily, we advance planned enough to have books for both of us, plus Walter's computer.

His is the one with the Everywhere Wireless.

Which means, finally, I am really and truly liveblogging from the ER.

They would NOT put us in the same room no matter how we begged and pleaded. Oh, protocol!

Well! Here he is, staple-free! He had to bash some heads to get in to my room.

I'm sitting here waiting for my papers, greatly relieved that we have one last oral antibiotic to try. See, without Clindamycin, I'd have to be incarcerated here for a Vancomycin drip. But the smart doc went over this - that - and I explained about my printout, my list of allergies and meds and docs, and he said okay let's look, and said, Hey! Can you take Clindamycin? and I said, Well yes, so far so good!

Now I'm a free woman, ready to go home, and Walter's ready, and in two shakes we're outta here.

Oh, Walter says they used some special tool to take out his staples. He didn't even feel it.

Guess that's why my pliers didn't work.

heh!

Wednesday, December 27, 2006

Just Because I Ain't No Crapblogger...

Flatulence Allegedly Sparks Jail Fight
By Associated Press

NORTH PLATTE, Neb. - Brian Bruggeman caused a stink at the Lincoln County Jail earlier this month and will now have to answer for it in court. Another inmate, Jesse Dorris, alleges that Bruggeman's flatulence, passed in close proximity to Dorris, sparked a Dec. 14 fight between the two at the jail.

Now Bruggeman, 38, faces a Jan. 11 preliminary hearing on the state's complaint of assault by a confined person. It's a felony punishable by up to five years in prison.

Bruggeman is accused of injuring Dorris, his cellmate, when he pushed him into cell bars. Dorris, 26, was not charged.

The two began scuffling, County Attorney Jeff Meyer said Tuesday, because Dorris was fed up with Bruggeman's flatulence.

Jail fights are common, Meyer said, but the cause of this one was rather uncommon.

"It's usually about someone hogging the newspaper or someone not happy about what's on TV," he said.

Bruggeman, of Hershey, is serving a 90-day sentence for violating a protection order.

"He compounded his problems," Meyer said.

Dorris, of North Platte, is awaiting a January trial on a charge of aiding and abetting robbery.

Brad Dawson, Bruggeman's attorney, did not immediately return a phone message left at his office.

Sheriff Jerome Kramer said the incident was a result of overcrowding. The jail was built in 1933 and has a capacity of 23 inmates, according to 2006 standards, Kramer said. As many as 65 inmates have been lodged at the jail in recent days, he said.

"You just can't get a reprieve from one another," Kramer said. "When you've got a guy causing problems passing gas, there's no way to get away from the smell."


http://www.comcast.net/news/strange/index.jsp?cat=STRANGE&fn=/2006/12/26/549523.html
Copyright 2006 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

Monday, December 25, 2006

Merry Christmas!

Yes, we're still here! And we're doing fine and Walter is recovering nicely.

He's sleeping a lot. This is good for him, especially considering how he's been hacked to pieces from head to toe.

Thing is, he sleeps much better if I lay down with him. I find this makes for scanty blogging, lately.

When the cats were with us it was such a treat to tell them: ohhh KITTuns! LET'S go to BED!

Oh BOY! those little tails and heads would pop up in the air, and they'd bounce around all joyous, oh BOY!!! A Nice Nap! oh BOY!!!

heh!

Not many creatures can appreciate a nap quite as well as a cat.

I feel them around so much lately. Babycat was a Doctor Cat, and took his role as a healer very seriously. He's been hanging around keeping a careful eye on Walter lately. And little April too, waving her gorgeous tortoise-shell long haired tail slowly back and forth, nuzzling and kneading our heads at night, kind of like little Jasmine with DC.

It's been an interesting Christmas. We both feel we have so much to celebrate - we feel so very Christmasy. Yet it's the first time ever that we've had no tree, no gifts, none of the outward trappings of the season. It just wasn't in the cards this year - but truly, it's all right. I have my guy, he's alive against all odds, we're here together and whatever in the world could be a better present than that?

One neighbor came by a couple days ago with a small but very sweet gift: homemade chocolate chip cookies, tied up in a tin Christmas cookie box with ribbons and everything. It was the one single holiday-ish thing we had in the house, this perfect little wonder from some newer neighbors. They come by walking their dog, alone or together, and stop and talk for a while if I'm up and around. If I'm not they'll quietly walk my front yard sometimes just for the simple pleasure it brings them. They love the park-like feel of it, and this means a great deal to me.

I hear you all out there. We'll catch up soon. Until then, we wish you all the peace and joy of the season, everything good to you and yours.

Tuesday, December 19, 2006

Man Sorry for Taking Handicapped Spot

WELL! And he should be. But hey. I forgive him. He really does seem contrite.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Man Sorry for Taking Handicapped Spot
By Associated Press

Sat Dec 16, 7:35 AM

UNION, S.C. - A man who parked illegally in a space reserved for handicapped drivers was sentenced to stand outside the store with a sign telling everyone about his crime.

Ragheem Smith, 29, stood in front of a Bi-Lo grocery store Thursday with a handmade sign that read "I am not handicapped. I just parked there, sorry."

Magistrate Jeff Bailey imposed the sentence. "I figured he needed to apologize in a public way," Bailey said.

Smith told Bailey he didn't have the money and couldn't afford the time away from work that a
jail sentence would require. He could have been sentenced to 30 days in jail or fined $325.

"That was better than having to pay a lot of money," Smith said of his punishment. "I know I won't do it no more."

http://www.comcast.net/news/strange/index.jsp?cat=STRANGE&fn=/2006/12/16/543298.html&cvqh=twisted_handicapped
Copyright 2006 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

Wednesday, December 13, 2006

Tuesday, December 12, 2006

He's Home

Home and safe.

Goodnight.

Sunday, December 10, 2006

Released. Released, and Homeward Bound.

The hospital was ever so eager to let him go.

At least, that's what they'd been telling him.

His cardio surgeon made it very clear that when Walter was released, he would be safe from my germs - and I would be safe from his. Statements like that told me a lot about the caliber of his caregivers. See, I never talked to the surgeon. He deduced or was told, and remembered, that I'm immunocompromised and have far more to fear from others than they do from me. He took that into account when he decided on Walter's release day.

The surgeon told Walter that if he started smoking again, he'd come after him. Hunt him down. I told Walter, --Yes indeed. Tell him he can call me anytime and I'll rat fink on you. I'll give you up to him if you start again.

But Walter had already decided he's done with smoking. Since smoking poses as big a risk to his heart as bad diet does, if he can stay off cigarettes, he's instantly overcome a highly significant risk factor.

I used to smoke, heavily, and I know full well how terrible an addiction it can be. They had him on nicotine patches in ICU, which certainly help, but an unplanned cold turkey stop is really rough. After the bypass surgery they couldn't even give him the patches; as the nurse put it, his veins would have had a fit.

He's made it through the worst of the withdrawal symptoms by now. And I have a sense he's very determined to become a healthy person again. He's made decisions and changes that are radically different from the man of only two weeks ago.

Walter did so well on his cardio rehab, which seems to consist of jumping out of bed and running up and down the halls in ICU, that they decided he didn't need any more PT than he was already doing on his own. That's why they released him straight from the hospital to home.

His MRSA cultures came out negative. Yes, negative: he is NOT colonized with my nasty germs.

Oh, hallelujah! Every time I remember that I break my face grinning.

Still, they kept pumping him full of Vancomycin. They told him Friday would be his last dose. Then they changed their minds and gave him an even bigger dose Saturday. And this morning? They nabbed him again.

All that pushing him out the door, and he was still doing blood tests and paperwork today, Sunday. The doctor didn't show up until after lunch, and you don't get out till the doc says Yes.

Then here come Horacio and Danny to save the day! They swooped in and grabbed him and tossed him in their big beautiful giant show truck.

Free at last.

This odyssey to retrieve Walter and get him safely home is taking all four of us back to the time we worked together in our shipping company. He's precious cargo, the most precious ever.

Back in the day, I used to send the drivers out on their long delivery runs with an itinerary and a sheaf of maps printed out from Microsoft Streets & Trips. I'd plug in their stops, plan their route, and show different map views including very tight close-ups for tricky places. When I could I'd print them in color.

The itinerary would have every contact name and phone number they could possibly need. Customer at home, work, cell; spouse, other family sometimes; the furniture vendor and salesman. Doorman. Building manager or security for authority to bring a truck to a New York City high-rise. I'd always get directions from the customer, too, and transcribe them. I spent a lot of time on the phone with customers, before, during, and after the delivery. Communicate, communicate, communicate.

So when Horacio and Danny asked if I would have maps for them, I jumped all over that. You want maps, guys? You got maps. You betcha.

Except...the printer wasn't printing.

That's the sort of thing I'd rather not even look at. It's amazing how much computer related stuff can wait till Walter gets home.

Not this time.

So...me the phobe, I figured it out, all by myself.

heh!

I went online, downloaded the PDF manual, realized it not only had a weird paper jam, but wanted new color inks. Okay.

I did it. All by myself.

So Friday afternoon I was ready. I must have printed fifteen maps for them. Nice pretty color ones. I did the whole route, some other overviews, and details for every time they had to change highways or do a bypass. I had close-ups maps of the hospital area and the towing company that had Walter's big rig.

The cover page had full directions to the hospital and towyard, their phone numbers, and contact names and notes for the tow company too. Including one that says, --They're open 24/7 but please call first before you go there.

After they got Walter out of the hospital, Danny called me and wanted to know how to get to the towyard.

I said, Do you still have that paper I printed out with the directions? They're on that. Phone number too, they said come anytime, but please call first.

Sometimes the guys would forget to read the whole page. That took me back, too. ;-)

They got to the rig, and cleared out Walter's things. This took a few hours. It's like moving house. They packed up his clothes and bedding and cooler and cooking things and food and microwave and lots of regular books and books on CD and tools and radios and antennas and, and all that. It filled up the entire bed of the big giant pickup truck.

Understand, this truck does NOT go places and do things like a work truck does. No. This is an Art Truck.

But it's a working truck today.

After the late release, then all that loading work, they even got 100 miles under their belts. Now they're stopped for the night. I'd hammered on them all to go SLOW. No reason to rush. Take all the time you need, take days and days if you want. Be gentle with my guy.

And they are. Extremely. He has two dedicated buddies guarding his well being like a pair of eagles. Fierce and strong and loving and determined.

Saturday, December 09, 2006

A Long Road


This is just a part of the long journey from the parking lot to the great doc's office, down in Miami.

I forgot to start at the very beginning: once you actually enter the building and get your pass, the doc's at the very end of a very long hallway.

Being slow on the uptake this day, I started the pix at the front entrance, as I was leaving to go back home.

To my left is the valet parking stand. I can't use that: I can't survive their lingering allergenic scents in my car. I need mental clarity to drive. Neither do I want any germ exchanges going on.

So I've just exited the building, and I'm looking up the first of two long sloping walkways.

I cranked the scooter and zipped on up. Hung a right, got more pix, and zipped on up again.

So far this hasn't even gotten me out of Cedars and into the parking garage.

This shorter passage gets me there.

Posted by PicasaAnyone who parks in the garage has to come to this 3rd floor passage to get to Cedars East. So there's a lot of foot traffic through the yellow lined areas.

The elevator bank is at the other side of the gargage.

I scooter on...

Posted by Picasa And there they are. Finally!

Here's the view looking back where I just came from.

This lady in white is making her way toward Cedars East. See her cane? She was very slow and very lurchy.

Last time I was there, that's exactly how I walked in. Except two canes not one.



Check it out! Isn't that cute? All perched up on its platform, tied down with two ratchet straps, ready for the notoriously terrible commute back to Ft. Lauderdale.

Posted by PicasaAnd making my way back to I-95, I saw another fun license plate:
NO CHNCE

I bet there's a story behind that one.

I Ducked Good

So as I sat soaking in Hibiclens in the tub yesterday morning, I had this feeling of being called out for a Command Performance.

I really couldn't think of a reason to go back to the ID doc's office so soon except for that smoke signal effect.

Well, that's all right. We're all only human.

But on the other hand, I did something I almost never do any more: I was 15 minutes late.

The appointment was for 10:15 not 10:30.

Ooops.

When I got there, the waiting room was empty. The office wasn't hugely staffed either. Very quiet all around, almost deserted.

I asked if I had a minute to go back downstairs to lock my car. --Sure, go ahead.

Scootered down, did the deed, scootered back up.

And waited.

I called Walter on my cell phone. We talked and talked. Just after I hung up the phone, D came for me. She's the ID doc's medical assistant and I really enjoy visiting with her.

Good thing too. Cause we had some time to do that.

D has been with her guy for five years now, and off and on for two years before that. Now he's getting really serious about getting married. And she had kind of gotten off that track and more focused on her career and so forth, and time went by like it does...and SHE had wanted to be the one who said, HEY, guy, come ON now, time to do it RIGHT!!! we get MARRIED!, and all that.

Instead it's him, not her. And just about every day now he's saying the B word, as in, Babies.

HMMMM.

She says it's making her a little nervous. But she seems pleased, too. And it sounds to me like a man taking that kind of interest is bound to be a very good father.

This conversation came about because we were talking about Walter, she'd asked how he was doing. See, when I saw her on Monday, Walter was still in his triple bypass surgery. She said she was thinking about what it would be like to suddenly be alone, if her man unexpectedly died, and how you have to change everything about your life, your sense of security gone, the person you always turn to isn't there any more.

I told her I found out Walter had not one but two heart stops on Tuesday. One was nine seconds. He doesn't know how long the other one lasted.

For nine seconds he was dead.

We thought about that for a while. And we are both way glad we have our guys still with us.

Then we talked about MRSA, and finally the doc came by.

That was a little after 11 am.

She did seem just a tiny bit...steamed. Very quietly so.

--Why wouldn't he biopsy?

--He felt it was too dangerous.

--Dangerous? I don't think this is MRSA.

--Oh! he's absolutely convinced.

(slight pause)

--It looks better already. Are you on antibiotics?

--Yes.

--How much?

--He asked me how much you usually prescribed, and I told him 100mg BIC. Is that right?

--Yes. (slightly mollified, perhaps?)

--But you don't need it for 30 days. 10 days then stop. All I ever prescribe is 10-14 days for MRSA.

--Okay. Just out of curiosity, could you explain the different times to me? I mean, are you concerned about keeping me from getting sensitized?

--No no no. That's all I ever do. The eight months, before? That was because of the other infection in your arm, that looked like a mycobacteria.

--Okay. And I have no doubt it was an infection of some sort, culture or no, because it was only after you did that that the lumps stopped spreading. Before, they were both growing and making more lumps, and they only stopped and then reversed after you did the long-term minocycline. They seem to be pretty much gone now.--

I told her I was going to try to decolonize again, too.

So...I think what I saw today was this: Ever so gently, we drew our little lines in the sand. Made sure each of us knew where the other one stood. Tacitly agreed to disagree and move on.

*Whew.*

While I had to pay another $30 copay unexpectedly, OTOH she said I didn't need to come back for this one, so my appointment on the 18th with her is cancelled, and it's a wash.

Yay!

Now I have a prescription for a month of minocycline, and a doc who says I don't need to take it all. My feeling is it's safer to take it for longer. That's always been true for me anyway, I've needed longer antibiotic courses than other folks since at least my early teens.

I'll probably take all but a few day's worth. There are certain meds I have no qualms about hoarding any more. Silvadene, minocycline, the topical numbing agents like lidocaine and cetacaine I use on the skinless blistered places in my mouth. I'd run out of my stash of minocycline and I'll be glad to have a bit in reserve once again.

MRSA or no, it was clearly a bacterial infection: it had all the signs, and it's responding fast to antibiotics. The little points of contention between the two docs - me in the middle, keeping my head low - are not relevant to me. I simply don't care about that aspect of it: my goal is to clear this infection.

So yeah. I'm a happy camper on the infection front today.

It's Aaaaaaaalll Good

Walter's coming home.

I sent Horacio and Danny off tonight on their journey to go get Walter. It's 1040 miles away, and they'll probably arrive tomorrow night. They can stay in the hospital itself for $30, or at any number of reasonable motels close by.

On Sunday they'll swoop in and grab my guy, and all go out to the rig. Danny and Horacio will empty it out and load Walter's things into their big giant pickup truck.

And bring him and his stuff on home.

With any luck, I'll see him Monday night. And every night after that for the next three months.

Me, I'm fine. It was a long and tiring day. I feel a little sickish and fevery but the antibiotics are already doing their job, and the redness is going down a bit.

The largest chunk of logistics is over. Walter didn't need any intermediate rehab facility, so he's going straight from discharge to home. Yesterday they pulled his last two tubes, chest tubes, and that was extremely unpleasant for him. See, they were supposed to do it on Wednesday during the pacemaker surgery. But they forgot. So he had them pulled without benefit of all the novocaine and such he was full of on Wednesday.

Poor guy. Those suckers hurt. This was the only screwup I've heard about, so I'll forgive them. Of course, it's not my chest tubes that got so rudely yanked.

That's all for now. Time to rest, and I'll fill you in on all the gory details asap.

Thursday, December 07, 2006

Biopsis Interruptus

Not one single biopsy!

I got down to Cedars, where the Great Doc resides. The journey from the parking lot to the doc's office is a long and arduous one. Going there on my scooter really hit home to me that I had decided against more appointments with this doc simply because I couldn't get in there very well.

So, I gleefully - smugly - oh, contentedly! - scootered my way to the office and the waiting room. My scooter can easily hold both my canes, my purse, and my laptop. I wanted to show off my pix from the 10/19/06 leg infection.

When I first met this doc around a year ago, I had laid out photos of Poor Mr. Foot, showing the progress of the 2004 infection and abscess. I did this after surfing the doc's name showed not only his fine qualifications as a dermatology MD/scientist, he'd also published at least one article on MRSA.

I read his article. He made some good observations, including the striking comparison between the often less than dramatic appearance of the infection, and its extreme pain.

That first visit, I'd laid out the series of 2004 pix on the countertop in the exam room. He walked in the door and immediately gravitated toward those pix, and spent some time reviewing them. The 2004 photos, now, they are dramatic. It's the sort of thing that can help one's medicos take one's case seriously.

To my surprise, he recalled that first visit and the pix quite clearly.

This time, as he trooped in followed by a couple med students and a nurse, I had the laptop open and the Friday-Saturday-Sunday leg pix up on the screen. All three docs had a fine time looking.

Next, of course, we came to the purpose of the visit: the arm.

I noticed that both med students were doing Giant Step Backwards on me. The male student doc never came near, deliberately hiding behind one of the other docs the whole time. Thinking he was invisible? Definitely skittish. Showing the whites of his eyes any time I glanced his way.

The female student doc was hesitant too, but she determinedly gloved up and examined my arm. She was the one who kindly wrote down the name of my elbow thing for me.

To the Great Doc, it looked like it was a MRSA infection in four lymph nodes and possibly the vessel too. He also thought it had gone to more areas of my arm than I'd identified. This made sense, because when I posted the pix of the arm, I realized the rest of the forearm had reddish patches more visible to the camera than to my eyes. He spotted those exact same areas.

It looks like it's traveled up the back of my arm too, past the elbow toward the shoulder. Laying my right arm down on the worksurface is often when I feel these things first.

With the infection in such a state, he refused to do a biopsy. Cutting into that stuff can send loose germs running around in one's bloodstream and lymphatics and such, and he refused to do a procedure he considered unsafe. Good.

He put me on a month of minocycline, and also mupirocin cream to try to decolonize me. I said we'd tried that over and over again, but I'd try 18 million times if there was a chance it might work.

He was puzzled about why the ID doc didn't already have me on antibiotics, too.

See, she thought the first big red lump in my arm wasn't anything at all. And that, my friends, was where she and I first disagreed on Monday. The lack of antibiotics was another.

Before that? While the 10 days of minocycline appears to have killed off the primary infection in the left leg, still, MRSA's well known to hang around long after a *normal* course of antibiotics. So we also disagreed about that. I didn't say so at the time. Now I'll ask her more about it. It could very well be she's trying to keep me from sensitizing to more antibiotics. But me, I think leaving unkilled germs behind is worse.

So I feel much safer being on a whole month of minocycline.

There was no wound or other entry point for the arm infection. From some things kdad explained to me, I'm guessing this may have started from germs circulating around, unkilled after the leg infection, and setting up camp in that lymph node for reasons they'll never disclose. Once they settle into one lymph node, they often travel up the lymphatic vessel and infect other nodes on the way. It's what happened with my very first cellulitis in September, 2001. That was also in my right arm.

But not having any biopsy, no way to prove what I believe about this infection? ARGH!

I did get a little more info on other lumps:
-The watery bubbly bump on the end of the elbow is called *olecranon bursitis.* An excellent addition to The Collection of Stuff Gone Wrong.
-The big hard lump a couple inches from the elbow is probably just a calcified lump of inflammation.
-The other lumps they thought were from mycobacteria could also just be due to inflammation, from more of the autoimmune process that's eating me alive.

Now: Remember when I sicced the CIC doc on the cardiac surgeon to make sure Walter stayed put for his surgery?

Docs can get into serious pissing contests. When this happens, if you're the patient sitting in the middle, best thing to do is duck.

They're not shooting at you. They're shooting at each other. No point getting caught in the crossfire.

So when I called the ID doc's to say there was no biopsy, and there was a month of minocycline, I was expecting smoke signals.

I got 'em too.

Her medical assistant called back and left a message: Dr. C wants to see you Friday, the 8th; call the office for an appointment time.

Ha!

Okay. 10:30.

This will be interesting.

Good thing I used to work for the government, huh? I really did learn how to duck.

Wednesday, December 06, 2006

Heartstopping

Yesterday, Walter had another Cardiac Incident.

His heart stopped beating for 9 seconds.

That's a pretty long time.

So now they're going to put in a pacemaker.

After my initial reaction - that I didn't like it one bit - I mulled it over for a few hours. Talked to kdad. Heard that the doc said we don't want Walter passing out whilst driving that rig. Heard from kdad that these days, putting in a pacemaker is a 15 minute procedure, and the most time is spent on making sure the thing is set correctly. They adjust it from the outside, using a computer. The pacemaker goes in just under the skin and is about the size of a watch. Tuck a couple leads in a vein or so, up to the heart, and you're done.

After a while I came to like the idea. I want Walter's heart to keep going, and if it stutters, to get a kick.

After a while longer, I actually developed a fondness for the little sucker.

So...I guess it's all right. They put it in him tomorrow at 1 pm.

Meanwhile, he's running laps around the cardiac floor. They had to hold him back today and make him rest first when he wanted to do his therapy walk. After a nice nap they let him go.

He walked unassisted, at a normal walking pace, around the entire floor. Twice.

After dinner he did it again.

Understand, this is Wednesday, and he had a triple bypass Monday. Two days ago. They cut through your sternum. Crack open your ribs. Stop your heart and put you on a heart-lung machine. They go in your leg and strip out a big long vein, long enough to do three bypass veins. All that stuff hurts.

Surgery was Monday. The next day, Tuesday, he was sick from all the surgery and was barfing from the pain meds. His heart stopped beating for nine seconds. When the machine went off and the nurse came in, he thought it was just a little skip in his heartbeat. He thought the anxiety he felt - that classic heart attack fear - was just a panic attack from laying down on his back. Like it put him in the same place, mentally, as when he had his heart attack in the truck.

No. His heart was stopped. That'll scare most anyone.

That same day he also walked twelve steps, unassisted.

Today he did two laps around the entire floor, two times.

When I talk to various people at the hospital - the insurance folks, finance department, rehab coordinators - they all know exactly who he is and how he's doing. Part of that is because they are very, very good out there, and they take an interest in all their patients.

But the rest is because they're seeing what kind of person this man is.

Tuesday, December 05, 2006

Twelve Steps

That's what he walked today.

Unassisted.

The nurse was next to him the whole time, ready to catch him. But he made it on his own.

He got bathed and changed and had his tubes pulled. My, that sounds naughty! Let me rephrase: The only plastic tubing still stuck in him is his chest drain. That one will be there for a while.

I talked to him three times. The nice people there moved him into a room with good cell phone reception, just so he could talk to me.

Between all that activity, and getting a bit barfy from the pain meds, my poor guy is all wore out.

But I am so proud of him.

He's doing great. They didn't expect him to be able to walk that much by himself.

I've been hanging by the phones all day. Polishing the silver. Seemed like the thing to do, ya know? And in between polishings and crime shows, calling his employer's Benefits Coordinator, and his insurance company, and the hospital about getting him an intermediate care room when he's released on Saturday or so, and calling the hospital's financial folks about making payment arrangements for the big ol' bill we're gonna get, and back to the Benefits Coordinator to untangle the complicated web of deductibles, maxouts, and coinsurance (it's a PPO), and then his short-term disability insurance, which should kick in on 12/7 if we counted our days right, and how we keep his insurance premiums current since neither they nor payroll taxes are deducted from the disability payments. Which are capped at $500/week.

And calling my own insurance company and two vendors and then my primary's office to shake loose some effing test strips and lancets I ran out of last week, which no one but me has felt the slightest urgency about getting replaced, even though it turns out it's a 2-minute process to order them: the primary's office writes a script, puts k's phone number on it, and faxes it to the vendor's diabetes supplies fax number. Yup. A caveman could do it.

Since the idiots at the primary's office whose paid job it is to know and do all this FOR me couldn't get it together in a whole WEEK, and don't have the sense to hire any cavemen, I learned their job. I provided them with the instructions and the toll-free fax number to fax that script.

The second time I called, I mean. That was after the first call, where they had me on hold for 7 minutes and I hung up? And then I called back. And didn't ask for anyone in particular this time, just said, --Hi. This is k. I need my diabetes supplies I ran out of last week. Got a pen? Okay. Write a script for strips and lancets, I test 3x/day, write my phone number on it, and fax it toll free to this number. Okay? And write a little note or call them to explain that I've been out for a week and can no longer wait 3-5 days for the UPS delivery, so now this needs to get overnighted. Because if it isn't, then something really bad could happen. I have some really serious health complications here and not testing could mean an outcome that would cause a great deal of trouble.--

I don't think for one minute they'll overnight it. But at least they may effing attempt to send a fax now, if it doesn't kill the last three brain cells they can collectively call their own. Between the eleven of them.

Okay. That was just taking care of business. I like taking care of business.

I like this even better: Now I'll sit back for a bit and think about my Walter walking around. There's a very fine image for me.

Ahhh.

And pour myself into bed.

The MRSA Slow Crawl


IF this one's even MRSA, that is.

I'm thinking yes, but not 100% sure this time. The foot, I knew it was. This may be some other kind of infection. I'd put way high probability on something like, bacterial infection in the big red lymph node, progressing up a lymphatic vessel and into three other lymph nodes. Lymphangitis and lymphadenitis, those are called.

But...maybe not MRSA. Maybe a strep infection instead of a staph infection, something like that.

It grew so little overnight that only one of the three small lumps went outside the pen line.

That's not a flash. Not like the foot, moving throughout the entire left leg in less than 48 hours.

This here's just a slow crawl.
Posted by Picasa
Exactly what I was hoping for.

So tomorrow, I go to the research scientist for *a* biopsy. I have maybe 5 different kinds of lumps in that arm, so if I catch him in the right mood, maybe I can get him to biopsy all of them. He did one type before, and cultured it for mycobacteria. Those are notoriously difficult to grow. He got nothing. Hopefully that means it's not a myco after all - since that could be something awful like tuberculosis or leprosy.

--But!-- you protest. If not a myco...what is it? (play some mystery music here.)

It's something not boring.

Maybe I can get an answer or two from this episode. If it flashes and I have to run out to the ER, the chances of an answer are actually much less. The ER people don't do biopsies.

So I'm quite pleased with my own health stuff today.

Okay! I'm done. Now back to Walter.

Good Night, Sleep Tight

Tonight I even got to talk to him a little!

Mom called me this afternoon when she finally saw him after the post-op recovery. He swam back up out of the meds for a minute and she went to him and told him, --k is very happy to hear you're okay. You're doing just fine, the surgery went beautifully.

She said he opened one eye and kind of smiled at her and tried to say something, and went out again.

Much later, he was awake again and wanted to tell her something.

He was groggy and hoarse but he wanted to be sure to talk to me for a few minutes. Swimming in and out of sedation, he got my mom to understand what he wanted. He was by a phone, and kmom asked me to call it. Cell phone reception isn't so good there.

So I did and I talked to him for a little while.

He said he was fine, his chest hurt some but they had him on lots of pain meds. Tomorrow he thinks he'll be more awake and we can talk more. I told him he did great, the blockage was really bad so we're all very glad he was so lucky. He said that's good, we can talk about all that tomorrow. Now he had to go back to sleep again. Okay, I said; you rest, baby, just rest and sleep.

This was one of the finest conversations in my entire life.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Jean tells me Blogger is having one of its intermittent *Comment Fits,* so don't anyone worry if you can't comment. I'll try to keep you updated as best I can. For a while I just figured every blogger in blogdom was out Christmas shopping at the same time.

The ID doc wants me off antibiotics until my new arm lumps get biopsied on Wednesday. This is one of the few times I disagree with her. She's not sure it's MRSA. I wasn't convinced myself, really, but a few hours after I left her office I was. I think I'm just getting too good at catching it quick.

Not that I'll ever, ever, complain about developing that skill, huh?

If I hold out till Wednesday I can get it done at the world class dermatologist's down in Miami. I'd like that. But I think it may spread too fast. It started as a barely red lump in my right arm, then I felt three small bumps under the skin. To me it seemed like a lymph node, then MRSA spreading up the lymph vessel, where it tends to set off more lumps as it creeps into more lymph nodes.

Would I have preferred to wait on another infection until I was sure Walter was okay?

Hell yes.

But you know something? It sure is fine to just sit back here tonight, feet up in front of the computer like usual, and think how wonderful he sounded on the phone.

He made it. He made it through.

Monday, December 04, 2006

He Made It

He's out of surgery and he's doing very very very well.

That, per kmom, who is not given to superlatives.

So he's really doing great, then.

I can't believe how fast this went. It really was around 3 hours after all.

kmom says Walter was very very very lucky, too. He was a step away from a major heart attack.

Major. That one artery was effectively closed off. Just a tiny hair of an opening remained for any blood to get through. The other two were not much better. It sounds like they were in worse shape than the CP doc had thought from the heart cath test.

That major heart attack would probably have killed him, and killed him quick.

Finally, finally, now he has good blood flow again.

He is strong and healthy in other ways, so this surgery won't wear him down too bad.

I'm so relieved.

I've been waiting for him to have a *heart event* since I knew him, really. It runs in his family. They've had more than one baby born with major heart defects, and plenty of early fatal heart attacks on one side of his family. The other side lives forever, like mine do.

He smokes, and eats all that sausage and stuff, and since he became a driver in 2003 - as opposed to driving plus delivering furniture - he's been pretty sedentary.

OTOH? If he'd still been pushing armoires up 2 flights of stairs every other day, he probably would have had that bad heart attack by now.

He was telling me yesterday how he's lost his taste for greasy foods since knowing me. That's actually true. Oh, he used to cry at me as I skimmed the fat off the top of my soups and stews and goulashes...trimmed it out of the meats I roast...ha!

So of course, I said, --Yeah. You have, you don't love grease any more. And you like my cooking anyway! :-0 !!!

He laughed: -Yeah. I really do.

Oh, he's okay, he's going to be fine, better than he's felt in a long time I bet. Got blood again. Got a good heart again. They found the bad pipes and fixed 'em.

So Far So Good

Walter went in right on time, a little before 9am my time.

Last night I used my CPAP machine, first night ever.

And slept so soundly I didn't wake up until after he went in for surgery.

AAAUUUGGGHHH!!!

I woke up to hear the sweetest message from him.

--Hi honey, it's Walter. It's 6:35 local time. I'm doing fine, into surgery in 10 minutes so if I don't talk to you good luck today. And you don't be upset or nervous, it doesn't seem like a big deal. So I'll talk to you when I'm able to, and if not, just call your mom and she can give you all kind of progress reports. Okay honey, bye.--

I just got one of those progress reports. Yesterday Walter said the surgery would take about 3 hours. This seemed way too little time, to me anyway. OTOH after hearing everything else that's amazing me about modern open heart surgery, maybe it was just what they do, these days.

kdad thinks he was being a little optimistic on the time, there. Not that they didn't say *3 hours* about something, but maybe it was out of context.

Anyway.

kmom told me they just sent a nurse or someone down to talk to her. Everything's going fine but it'll be a few more hours until they're done.

So even though that doubles the estimated time for surgery, kmom and kdad said there's nothing wrong with it at all, not to worry, doesn't mean a thing.

Okay.

I'm fine.

Now that Walter can't get to a computer, I can also say this: The ID doc is squeezing me in at 1:30 today. It looks like I've got another internal MRSA infection, this one in my right arm. I'm guessing it's a lymph node and it's going up the lymphatic vessel because it's popping more little lumps up my arm. It started Friday night. It always likes to pull shit over the weekend so I can't get it taken care of in a more timely manner.

My ID doc's office hours are on Monday, Wednesday and Friday. I can't hold off until Wednesday. So today it must be done.

Of all days.

Well. It'll help me pass the time.

Good to Go

Walter's scheduled for surgery at 7:45 am. Central time, I think. Evansville, Indiana. In Indiana you never could tell what time zone you were in, and now I hear they went and fixed it, and I still have no idea what time zone it's in.

They tell him he'll be in surgery for around 3 hours. On Saturday he'll be released.

That fast.

The problem is, his incision won't be healed yet. In fact he'll still have a drainage tube in.

Meaning he should not be around any MRSA carriers.

We'll be checking into a few things to take care of that. There are some recovery rooms there for people who are released from the hospital, but still not really ready to go home. Maybe his insurance will cover it, maybe not.

The four docs working on him are:

-Cardiologist In Charge - I don't know what formal names they give the team rankings. I also don't know what the guy's position in the facility is. What matters is, he's the lead guy, the boss, in Walter's case. Dr. S. I'll call him *CIC.*

-Cardio Partner, Dr. P - He did the heart cath. Say, *CP.*

-Surgeon - Don't know his name yet. You've maybe heard surgeons referred to as *mechanics* by other doctors. It's not that they disrespect surgeons really, no more than you'd disrespect a good mechanic. They still can look down their noses at a mechanic, and in the hierarchy of medicine, non-surgeon docs often sneer a bit at surgeons. They may enjoy putting them in their place if said surgeons are perceived as overstepping their bounds.

-ID Doc - Since I took care to inform and re-inform them of my own MRSA, and Walter's got a good chance of being a carrier now too, they assigned him an Infectious Disease (ID) doctor. Thank you thank you thank you.

I talked to Dr. CIC on...Friday? Anyway, he was in a hurry to move on but took a minute on the phone with me anyway.

For kdad especially, I wanted some precise information on Walter's blockages. Here it is:

-90% blockage in the right descending coronary artery prior to branching to posterier
-70-80% in circumflex (CX)
-60-70% in LAD.

I've no idea what all that actually means, except that if it were my house plumbing, I'd want to throw away the pipes too.

kdad says that they usually don't do a bypass unless there's at least 90% blockage in one vessel. So as shocking as the actual percentages sound, hearing the word *bypass* means a minimum of 90% anyway.

When I talked to CIC, Walter still wanted to come home for the surgery and I was worried. I told CIC that the surgeon had acted like it was no big deal if Walter left.

CIC's response? --I don't care. He's just a surgeon. No. I'm not releasing Walter before the surgery. He's not going anywhere until then. I'm the one in charge here. Not the surgeon.--

Quietly and absolutely firm. Brick wall time. I mean CIC is a ROCK on this issue!

YESSSSSS!!!

Huge relief.

I'd already told one nurse about my MRSA. I checked with CIC and he hadn't been told yet. It's probably in the chart but so what.

I explained: --I'm colonized and constantly reinfect myself. After I got home from the hospital in 2004 Walter had three separate skin infections that looked like MRSA to me. I wouldn't be surprised if he's colonized too. Also I had a severe reinfection through my entire left leg six weeks ago, and Walter came home over Thanksgiving. So he's been very recently exposed to a heavy germ load from me. I don't know if you'd do a nasal swab to check on him or whatever, I just want to be sure you know so you guys and Walter are all safe.

CIC's immediate response? --Okay. We'll get an ID doc on him right away.

And don't come here.--

So I'm officially banned from setting foot in Deaconess.

Which is a good thing.

Walter told me CIC was already late for his next appointment and trying to get out the door. Being perfectly selfish - and unabashed - about Walter's health, I couldn't care less. Except to be thankful that CIC took the time to talk to me anyway. Very decent of him.

They swabbed Walter's nose, armpits, and groin to test for colonized MRSA germs. Walter's now doing antibacterial nasal swipes twice a day, too. Good good good. He may get a load of the toxic antibiotics during his surgery, just in case.

For today he got a special decontamination bath to sterilize his body for surgery. Not that it'll get him truly sterile. Pure sterility is almost impossible to achieve. The focus is on killing all the germs you can, to work on percentages rather than aim for complete sterilization.

And what did they use for his scrub soap? Hibiclens. Same as mine. A little taste of home, there.

I asked if he was nervous. Some anxiety, sure, he says. But he's much more concerned about after the surgery than the act itself. He and I are the opposite that way: I figure if I survive the surgery, I can handle the post-op. Him? He has no fear of death. The first two or three weeks after the surgery will drive him nuts instead.

The success rate for bypass surgery these days is over 99%. Phenomenal. Comforting.

kmom got there okay and spent an hour visiting. She took his laptop back to her hotel room for safekeeping. I know she'll be there tomorrow morning too. Even though he said not to trouble herself!

At 3:30 am they started poking and prodding and medicating and harassing him again. Change his nitro patch, get a blood thinner shot in the belly, take some pills, do the antibiotic nose swipes. More xrays. Take all the monitor leads off, take a Hibiclens bath, change all the clothes and things, put the monitor leads back on. They never let you rest in those damn places. Finally he got a nap this afternoon.

At least he doesn't have an IV drip any more. The lead is in him for shots of stuff but it's not hooked up to a bag any more.

The monitor? It's wifi.

He has leads glued on him, but they aren't attached to wires to the machine. He can walk around.

ha!

That place trips me out.

He's in good hands, there.

Sunday, December 03, 2006

Me? *I'M* Ready for His Surgery. Walter?...

He's still ready to go home.

But he made his decision to stay, and it's all set up. If everything comes together as planned, he gets his bypass Monday morning.

He told me yesterday he hadn't changed his mind about coming home for the surgery. When he saw how upset I got, thinking about him trying to get home, he decided to stay in Indiana not for his sake - but for mine.

I am grateful.

He was feeling much better yesterday. They're still giving him all sorts of meds, but he's off the morphine because his chest pain is gone. The nurses keep checking his incision site where they put in the heart catheter. This was done through the femoral artery, in the groin, and of course you want that to heal up right.

So he appreciated Livey's offer of nekkid lady pix. But considering the amount of time those nurses are spending checking out his guy parts? He asked me to tell Livey it's probably not a good idea just now.

heh!

If he wants a good boobie story he can check this out:
http://www.chromedcurses.com2006/12/02/ninnies/#comments

He said they're starving him. Then he found out he could order as much food as he wanted, as long as he didn't exceed his salt or fat restrictions. I hope this means he finally got enough lunch.

They woke him at six am yesterday for xrays and more blood tests, and then gave him a big ol' shot of something in the belly. That, he didn't like.

Plus he's all aggravated that he feels fine now but he's stuck in a hospital room. Yeah. That can wear on ya.

After lunch he went to sleep. He woke up to find his express mail had arrived, hooray! The first thing he did was plug in his cell phone and call me.

Can you tell he's feeling better? I sure can.

Such a strange and serendipitous coming together of events we've had. Desert Cat and Company schemed and plotted and created the Scooter Brigade at the exact same time that Walter unexpectedly got routed home for Thanksgiving. Walter used up his last energy on scooter shopping with me and getting the hitch and platform installed in the Saturn so I can take the scooter around doing errands.

I couldn't have gotten my mobility back without the Scooter Brigade and Walter, both.

Without the scooter, I would be seriously hampered now. There's a great deal to do to get this place ready for a person recovering from open heart surgery.

More than one of you has suggested he waited to have his heart attack until the scooter was all set up.

When I told Walter this he laughed.

Notice, though, he did not deny it.

After that? He could easily have had a fatal first heart attack. Instead, the heart attack is so mild it causes little damage to his heart.

And where he has that heart attack really does look like the middle of nowhere.

Yet as it happens, some 20 miles away is a top-notch facility for...cardiac emergencies and surgery. Yup.

It's so very good that people come from hundreds of miles in all directions to get their heart surgery done there.

So. How's all that for a smooth and pretty unfolding of events?

deaconess Gateway Hospital. Right off the bat, Cindi guessed it. kdad the MD went and surfed up info on the facility and the cardiologists treating Walter. kdad does not impress easily. He sounded pretty impressed with the place to me.

The docs have excellent backgrounds and no negatives he could find, no complaints, nothing. The facility is part of a larger hospital complex, takes care of serious emergency situations including cardiac care, and was only built a year or two ago.

The rooms are all private rooms, large and comfortable. That flat-screen TV! Walter is quite happy with his room.

Surely that helps, huh?

He has a big binder full of Useful Info he's supposed to read. It tells about the whole process, before and during and after the surgery. They'll put him on a heart-lung machine. He thinks he'll be released as soon as Friday.

This amazes me.

While talking to him yesterday afternoon, he was holding a pillow. It's specially made by a volunteer group that does nice things to take care of the cardiac patients. After his surgery he's supposed to hug this heart pillow to ease the pain of the incision.

Why does hearing that break my heart?

Friday, December 01, 2006

He's Staying Put

Thank you all for your concern and good wishes and comments. Hearing how many people have had heart attacks and stents and bypasses really surprised me. The results all sound positive, too. I think about other blogs where people are having back trouble, and they get a lot of comments about how the shots or the surgery or whatever didn't help them, or sometimes that it made them worse.

We've talked him into staying there for the surgery. kmom actually got a ticket change, leaving here tomorrow evening instead of Tuesday evening, and they didn't even charge for the ticket change! Walter's scheduled for surgery Monday morning. kmom will drive out there on Sunday and stay until after the surgery is over.

yay!

He has his laptop back now too. One of the other company drivers came out to move the rig, and I think it was him who brought Walter his computer.

Just now, I sent off an express mail package to him: it had his cell phone charger, the one for the wall rather than cig lighter. He left so quickly after Thanksgiving, he not only forgot his turkey and other food supplies, he forgot his cell phone charger. That means he can't call out. The phone in his room doesn't go out long distance, so we can only talk to him when we call him. Drives him nuts.

I included six romance books I just got at the thrift store. Walter likes reading those romance novels. Probably tomorrow he'll be a happier camper.

More details tomorrow too I think. Right how I'm falling on my face with exhaustion.

But things are definitely looking up.