03 September 2015

A note to me old man regarding health

The dark spots on on the donor site are blisters from boxer shorts chafing.  I have good sensitivity over 90% plus of the graft area, and note daily improvement.  I'm returning the wheelchair to the supplier, and am trying to arrange for the donation of the walker and WoundVac supplies to the St Dominic Hospice which cares for, I guess the word is "retired" nuns and priests, as well as laity.  Vincent Worley's grandmother, who largely raised him, also lived out her last months there. Hortense was a sweet old biddy, and it would make me feel good to make the donation there.

I'm using one crutch rather than the usual two.  Crutch under right armpit, 'cause the injury is to the left foot.  I was told I could start wearing a shoe on the left foot.  The resident was amused when I asked where I could get one size 10 right foot shoe and a size 15 left foot shoe.  My left foot has no discernible arch, and is very nearly four inches thick.  This, I am assured, is due to soft tissue trauma, and not fluid retention, so I was advised to discontinue Lasic.  "Time will take care of that" said my attending resident, displaying considerable wisdom for a person less than half my age. (I saw a tee shirt on the internet the other day reading: "I'm not 55! I'm 18 with 37 years of experience!".  You may consider that a birthday gift suggestion.)

The issue of walking on the foot was raised and approved under limited circumstances.  Having lost all the callous on the left foot due to swelling, I was issued a quite stylish sandal, but only one, which makes it rather less stylish.  I'm hoping to find a good-looking walking cane (a friend of mine in Porter has promised to try to bring along a stash she inherited from a long-ago uncle.  She's 6'2", so I'm hoping some may be long enough). This is enough to allow me to make much-needed walks to the laundry room and the trash bins, for which my neighbors are suitably grateful. It would have been nice had they been that helpful, but the only offer I got was from a neighbor upstairs, who is in a pelvis to jawbone spinal brace, who wished he could help but (flailing gesture at steel, spandex, and velcro).  I need to offer him a hand.  He let me watch the Super Bowl at his place, after all, and we have some mutual friends.

My medical records now list me as being 6'1".  I explained to the recording nurse that at six foot, I was being issued stuff for someone 5'10", which is too damn short. I am now issued crutches listed for "5'10" to 6'6".  Much better.  They've also distributed a xerox giving the conversion factor of "stone" to "pounds" and "kilograms". I suspect they cribbed it from the VA, but what can I say?  Multiculturalism!  (I actually had one Nursing Assistant say "15 stone, um, 210 pound, 95 kilos, WITHOUT BLINKING.  Cuba to Jamaica to US.  Underutilized potential.  BTW, Nurse Nickey says hi.).

James has an interview with Kroger, but is unsure of the location to which he may be assigned, likewise the hours.  JOseph is doint PT (Physical Training) with his recruiting Sgt, but the Reductions In Force (RIFs) indicate that he may have to wait until this coming June for Boot.  He can take the Oath [(induction) when he qualifies from PT, which means in emergency he can be called in for Boot.  But when he takes the Oath he's a Marine].  He is quite set in his decision, although he has not declared it a career objective.  The USMC is much less bigoted against "mavericks" (enlisted men hising through ranks to officer corps) than the other services.  Chesty Puller (https://en.wikipedia.org/wiki/Chesty_Puller) is still, and will forever be, an icon. He tells me that if he can get some friends (and he has a list) to enlist with him, he can be breveted to Lance Corporal automatically after 9 months, with possibility of NCO School shortly thereafter.

I suggested that he speak with the brother of my friend Liz, whose brother did his 20 in the USN, retiring at the equivelent of Major, with the sevice paying for all his (BA, MS, PhD) schooling while on Active Reserve status. Something not to be sneezed at.  Mortality rate of active US servicemen is roughly comparable to mortality rate of young men from car wrecks.  My suggestion that he strive to become the best chaplain's assistant the Corps has ever seen were not appreciated. I suspect that his intelligence and learning ability will suit him for something other than 0311, but every Marine is a Rifleman.  Wanna take him to the range sometime with a rifle rather than a handgun.

It's his life, he's a grown man (legally, at least), and I respect his decision.  He's also offered to help me work out when I am fully ambulatory, and that I really appreciate. It's goining to take a good year for my muscle tone to recover, and probably longer for my left leg.  The first metatarsal is knitting, but at an odd angle (at least so far as I could tell from the films they let me see).  Ben Taub is concerned (first) with the screws installed to immobilize a relatively trivial fracture, and (second) with the progress of the graft.  I have seen  no close films of the foot - those details are seemingly not of interest to orthopaedic surgeons, who dream of living at the base of ski slopes.  (Yeah, I remember you and Bruce Hinkley talking about that!) That's Podiatry, which is (ahem) below them.  I may go for a referral to LBJ, which does do Podiatric Medicine, but my phone calls indicate that there's a 1 to 3 year wait.  So call me Hopalong, call me gimp, just don't call me late for dinner.

I really can't complain about the treatment at Ben Taub.  I realize that it's a teaching hospital, and that the staff is going to change, and that I'm a case that other students/interns/residents should see.  It is difficult not having a staff physician on call to do things like say "yes, dilaudid.  Not Norco!  What is that, some kind of breakfast cereal!"  The guy in Trauma, I think his name is Paul Sun (ethnic Chinese from Canada, but Montreal, not Vancouver) did an excellent job in debriding the woujd, removing obviously moribund tisue, and suturing.  The first care nurse (whose name I did not catch, but gets a big wet kiss from me) who went and pushed 2 units of Dilaudid right before the cop came to take my statement did a faultless first stick for the IV (I'm usually an easy stick,I've been giving blood for decades, but a shocky patient will have decreased BP) and timed it so that I could tell the cop "Sorry, I cannot make a statement right now.  Drugs, y'know".

Now here's a problem I do have with modern hospitals in general. Everybody wear scrubs.  I understand that there may be a color coding, but I was not issued the secret decoder ring.  Senior consulting physician shows up wearing what he wants to, MDs wear short kinda lab coats, residents wear long lab coats, green scrubs are for folks who do stuff in the operating rooms, blue scrubs are RNs, purple scrubs are RNAs, red scrubs are who knows what but I saw a lot of black scrubs and I do sincerely hope that they are not ninjas.

Does anyone who doesn't follw deviant porn recognize this?  Classic nurse uniforms

Nurses are supposed to look like that.  Not like someone who just broke out of jail with the aid of some grape jelly.

prison aug details special prison have status of call mcnamee

Dye the orange purple, leave with the medics.

I've worn scrubs.  I don't like scrubs. I tend to rip the backs of the shirts, and the pants fall off my ass.

Here's an idea.  Doctors dress like professionals.  In the uK they're no longer allowed to wear neckties, but they can tuck them into the shirt. The stethoscope goes into the inside breast pocket, folded,  not into a gin and tonic.  (Damn, they can be COLD).  Wear clothing like a professional - lawyer, CPA - unless coming directly from OR, in which case bllod spots are required

Residents get the long lab coats.  Like graduation gowns, but stethoscope goes around the neck, with end in breast pocket. May wear scrubs beneath.

Interns, short coat, but same stethoscope protocol. Scrubs OK

Nurses, look like professional nurses.  Whites, headgear, stethoscope end carried inside warming area. Unless scrub nurse directly from OR, scrubs not OK.

It's a pain in the ass trying to discern if the person coming into your room is there to take your blood pressure or remove your dinner tray.

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