Wednesday, August 27, 2008

Hey, EE!

Did your creepy guy (http://backboardsandbandaids.blogspot.com/2008/08/ugh.html) look like this?

Or did he look more like this?......



Tuesday, August 26, 2008

Different standards

Most of the time my hospice patients are in their own homes. Occasionally they're in a nursing home and rarely in a hospital, but most folks want to go home to die.

So, I've had occasion to go into other people's home frequently.

Let me interject this before I go any further: I am by no means the world's best housekeeper. My home isn't perfect - it's lived in, it's frequently untidy, occasionally messy, very rarely dirty and never gross and stomach turning. I'm not pretending to be perfect and I'm sure as hell not saying that my house always looks like something out of Better Homes and Gardens (it sometimes does. Rarely, but sometimes).

I have been in some beautiful homes, places where I've taken my shoes off before I stepped through the door and once inside, been afraid to move in case I disturbed something. I've been in some homes that are kept much like mine: things get done when they need doing but there isn't a 'must clean the bathroom EVERY DAY or else my world will simply fall apart' mentality behind the housekeeping methods. I've been in cluttered homes, places where you can't turn yourself around without knocking something over, let alone find the space to swing a cat, and I've been in grubby homes, places where the sink could use a scrub and the floors could have used swept, but they weren't really dirty.

I've also been in some dirty homes. DIRTY. Nasty. Places where I was afraid to accept anything to eat or to drink, even a soda still in the can.....where I was afraid to sit on the toilet because I was scared my butt would stick to it and even more afraid of what was on the seat that would CAUSE my arse to adhere to it. Homes that, when you walk in the door, you are nearly knocked backwards by the smell of urine (why do dirty houses always smell like pee, even if they don't have cats or dogs or other pets?) and rotting food, where you're attacked by fruit and house flies and other insects that have congregated - actually, I think that trapped is a far better word - therein.

I always consider myself fortunate to not get sick after visiting someone else's home who has questionable housekeeping standards. I try and take as much care as I can to protect myself - I'm not overly cautious, I just make sure I wash my hands or use hand sanitizer whilst I'm there and after I leave. I also try to find excuses to do a little housework ("Oh, Miss Irma, you look worn out! Why don't you sit right here and rest your bones a little while - I'll fetch you a glass of tea and take care of a little housework for you so you won't have to worry about it later. That way you can focus on being with your Louie and won't have those chores hanging over your head". It works most of the time) so that I'm leaving the place a little cleaner than I found it. Yes, I think I'm very lucky to not have come home with listeria or salmonella or common-or-garden food poisoning.

I think my good fortune may have run out, though.

Blech. (That's the sound of NinjaMedic hurling.)

Sunday, August 24, 2008

You SNORE!!!

Numbah Too 'lingthis morning: "Man, dad was snoring LOUD last night. I shut my bedroom door and turned my TV on but I could STILL hear him"

Future Trauma surgeon last week: "How in the hell do you manage to sleep with dad? Since you moved the head of your bed against my bedroom wall I have to move my pillows and stuff down to the other end of the bed or else I can't get any sleep!"

Me, every night at some point, usually more than once: "Dude, roll over. You're snoring. ROLL OVER!"

Urbaner, most every night: "No, I'm not. It's your imagination..."

As of this morning, though, he cannot deny it any longer.

I don't know which is going to be worse, though...him snoring, or the noise of a CPAP machine. :/

I beg your pardon?

I walked into a full but silent room at the nursing home. My patient was the skeletal figure laying on the low bed, mouth agape in the way only those near death display. I introduced myself to the assembled relatives: the wife, a nephew, a brother and the brother's wife.

"Hello...I'm NinjaMedic, and I'm with hospice....how are you all doing?"

His wife - small, grey and, as I was about to find out, incredibly difficult to deal with - sighed heavily.

"Well. you know, I'm not a well person. I'm really pretty ill and I don't know how much longer I can stand to be here. He's been like this for hours now. How much longer do you think it will be? I'm not a well person, y'know..."

Over the years I've worked for hospice, I've become pretty good at judging how close people are to death. There are signs: Kussmaul respirations, Cheyne-Stokes respirations, mottling of the extremities, livor mortis in the parts of the body making contact with the bed....but none of them are a sure-fire sign that death is imminent. I've been called out to people who have been Kussmauling away and who have been cold and a blotchy purple color but who have clung to life for another 12 hours. On the flip side of that, I've gone out to people who have been talking to me when I got there but who were dead 2 hours later. Everyone is different and there's no hard and fast way to tell when someones time is up.

"I really can't say, ma'am. What I'm going to do, though, is introduce myself to your husband and let him know who I am. Hearing is the last.."

"NO. NOBODY IS TO TALK TO HIM."

"Umm....can I ask why you feel that way?"

"IF PEOPLE TALK TO HIM HE'LL REALIZE HE'S STILL ALIVE AND WON'T DIE. NOBODY IS TO TALK TO HIM OR TOUCH HIM."

"Errr..."

"NOBODY."

"Ma'am, I think it's important that he know that we ARE here, especially..."

"FINE" and then she leaned over the bed and hollered in her husband's ear

"LOUIE, IT'S IRMA. I DON'T KNOW WHY YOU'RE HANGING ON, BUT YOU'RE NOT DEAD YET AND I'M GETTING TIRED AND I WANT TO GO HOME. I DON'T KNOW WHY YOU DON'T JUST GIVE IT UP AND DIE ALREADY."

Then, looking at me, she said "Why isn't he dying like he's supposed to?"

I was stunned. Truly speechless for a few seconds. That doesn't happen too often.

"Uhhh.....errr......I...err.....I beg your pardon?"

"He needs to just die. I'm tired."

(To myself) "Wow. WTF do I do now?"

The nursing staff and I ended up persuading Irma to take a nap in an empty room down the hallway. As soon as she left the room, the mood lightened by an incredible amount. I talked to the nephew and got some background of the saga of Louie and Irma: he'd been diagnosed with colon cancer a month prior and had expressed a wish to die at home. Hospice had provided equipment and nursing staff to come to their home and take care of him. Most people, when they have a loved one who has come home to die, put the bed in the living room or den. Not Irma. Nope, she had stuck Louie, his bed and gear in a poky, dark little bedroom and wouldn't let anyone go back there to see him - or go back there to sit with him herself. The day before he was admitted to the nursing home, Louie decided that he was tired of laying by himself in the dark and had tried to get up and walk into the living room to visit with his wife. In the process, he'd ripped out his Foley, his PEG tube and his IV port and had gotten into a physical confrontation with Irma when she tried to force him back into his bed. The police came, as did the nephew, and it was decided that Irma simply couldn't look after Louie at home (I was told that she said she didn't want to. I tend to believe that) and that he needed the 24 hour care of a nursing home.

So, Louie got admitted. He became unresponsive 12 hours later, and it was determined that his death was imminent. So, I got called in....

Almost immediately after Irma left the room, Louie's condition declined rapidly and he passed away 45 minutes later. He was waiting for her to leave, I think. He didn't want her there.

I didn't blame him at all.

Friday, August 22, 2008

Queen Turd of Poo Hill and Princess Attitude





This is what they were doing as I was shampooing my carpet......sitting on their 'throne', watching me. Actually, Gracie looks like she should be in a dog porn magazine, sitting with her legs like that and giving a 'come hither, boys!' wink.

Dog porn. Hahahah.

Wait.....I wonder if there is such a thing....?








Will this dog EVER get the message?


This is how Noodle Dawg is going to spend a lot of her day today. I swear to gawd this dawg is NEVER going to get the hang of potty training.
She started out strong and was doing great - we had a few wet spots on the carpet, but she was peeing outside the majority of the time. Recently, however....she WILL NOT PEE OUTSIDE. She seems to have confused the carpet in the living room with the grass in the back yard.
I've been mopping up pee, spraying it down with a vinegar and water solution and now my living room has an interesting odor. I have to shampoo the carpeting today - I was going to clean anyway but hadn't anticipated a job of that magnitude (our house is a good 1900 sq ft, half of which is an open plan living/dining and kitchen combination). I like to have a house that smells clean; I don't like to walk downstairs like I did this morning and have my olfactory nerves assaulted by the odor of dawg, vinegar and pee. It's gross, and I can't stand it.
Other news: I'm starting Urbaner's pirate fish hat today. He's been very patient but I think he thinks I'm never going to make it for him, so I'm going to surprise him with it. Ssssh, don't tell him....it's a secret. I'm going to knit it when he's not around and put it on his pillow when it's done.

Thursday, August 21, 2008

Asinine

I got a call from the plastic surgeon's office yesterday, telling me that my surgery has been approved. It's scheduled for the 17th of September.

They wanted me to go in for another office visit to get a pre surgery physical, but Tricare only authorized me for ONE visit pre surgery and ONE post.

That's fucking asinine. I need more than that; I'll need to have drains removed 48 hours post-op and then sutures removed a week later - that's a MINIMUM of 2 visits, and that's presuming I don't get an infection or a hemotoma or something.

So, I had to go ask my doctor to write me another referral for more office visits today. it blows my mind that Tricare authorize me to get a $50,000 surgery, but won't give me a $200 office visit beforehand/more than one afterwards. They're supposed to be 'medical professionals'; they're supposed to be familiar with the procedures they're authorizing. Pfffft. Yeah, right.

I got the referral. I'm having the surgery. I know that I'm lucky to have insurance that will cover it, believe me...I know I'm fortunate and I'm appreciative of that. I just don't believe I should have to be jumping through these particular hoops.

I also found out that I'm probably going to be a small C/large B when all's said and done. I'm ok with that. As long as I'm not a DDD or a DD or a D....actually, as long as they're smaller, I can maneuver and my back doesn't hurt I'll be happy.

Smaller boobies. *sigh* I'm scared, but I'm looking forward to it.

Friday, August 15, 2008

Things that have pissed me off already today and it's not even noon...

Ambien CR doesn't work for me anymore. I didn't sleep well, and when I did, I dreamt I was being chased.

School supply shopping and the retarded fucking school district I live in. One mom at the store was told her kindergartener need EIGHT fucking glue sticks, plus a bottle of glue. WTF?? What 5 year old needs 8 fucking glue sticks?! That kid'd best be coming home with elaborate collages EVERY fucking day to justify that kind of glue stick-usage. You know why he needs 8 glue sticks? Because they get dumped into a big ol' box and shared throughout the class - so some of his glue sticks are going to kids whose parents either can't afford to buy them (hmm...could that be because of the 'book rental fees' we're asked to pay?) or simply don't. I don't mind donating stuff like that to schools, but DO NOT tell me my child HAS to have to and then turn around and give it to someone else's child. ASK me to donate, please. Don't make it into something it isn't.

People at *gag* wal-mart, especially the lady at the door soliciting for donations for her church who told me that god loves me anyway when I said I don't give to religious causes.

People who smell bad due to a distinct lack of personal hygiene...and no, I'm not talking about homeless or morbidly obese folks. I'm talking about regular people who fail to see the need for WASH THEIR STANK ASSES and who go around assaulting others with their horrible body odor. It's not so much the stale body odor as it is a combination of that, the overwhelming smell of old urine and UNWASHED ASS CRACK AND SNATCH (before anyone starts asking how I know what unwashed ass crack and snatch smell like, let me direct you to the sidebar where I tell you what my job is and also inform you that I did private duty and long term care facility nursing for a few years before entering EMS. I KNOW what unwashed ass and snatch smell like, I've been up close and personal with it a few times - it never smelled that way after they became my patients, though. Ever.) that makes me gag. I sometimes want to go buy soap and deodorant and slip them into people's shopping bags as they make their way from the store....and if I KNEW that people would use them, I think I'd seriously make it a regular thing. However, as they saying goes, you can lead a STANK ASS to SOAP AND WATER but you cannot make them WASH.


Elderly drivers, especially the lady who nearly hit me when she failed to turn her head and LOOK BEHIND HER as she was backing out of her parking spot. I was already backed out and getting ready to put my car in first when she hit the gas and came awfully close (less than 1') to reverse t-boning me. Hello, people! LOOK BEHIND YOU! TURN YOUR HEADS! IF YOU CAN'T DO THAT BECAUSE OF SOME PHYSICAL AILMENT OR DISABILITY, TURN YOUR FUCKING DRIVER'S LICENSE IN BECAUSE YOU HAVE NO BUSINESS BEING IN CHARGE OF A VEHICLE!!!

GAH. I don't like people today.

(sorry for shouting. I'm having one of those days)

Wednesday, August 13, 2008

Things I learned today

I'm can't be reaching for things on the top shelves of the kitchen - at least not with my left arm - 'cause when I do, my shoulder subluxates and it really kinda hurts. So, I either have to move stuff to the lower shelves that I can reach (I'm short; 5'3") or get a step stool.

What I thought was a hormonal headache yesterday was probably a virus because I felt like shite most of today. Urbaner and Future Trauma Surgeon felt ill today too. So far, Davey-Boy and Wee Man haven't felt sick or rundown.

Teenage boys sound REALLY funny when their voices are about to break. Davey-Boy is almost 14 and is pubescent -got hair in his pits and on his legs and I don't want to think about where else he's sprouting fluff but that stuff on his top lip that he insists is a mustache is NOT a mustache, it's dark peach fuzz - and he raised his voice whilst playing 360 with his buddies this morning (he actually crawled out of his pit before noon today. I was stunned into silence) and all that came out was a screechy squeak. Funny, but sad at the same time...because he was my baby, my little chunk who literally tore me a new one when he was born and who threw up so much in the first few months of his life I swore I was going to drown in a sea of spit up and puke. He's not such a baby anymore, and that's kind of sad.

I still carry the memories of things that I've done and seen, even though I thought I was over them. When I was doing clinical rotations for EMT school, I witnessed and assisted with what was basically a miscarriage - a 17 or 18 week gestation fetus was delivered in the ER. He was alive when he was born, and he made respiratory effort and was really pretty active. He was the size of my hand.....eyelids fused shut still, and tiny. So tiny. He didn't live, obviously. Today I saw a photo on a stillbirth memorial site (I'll explain that another day) of a child that looked remarkably similar to the one I saw and held that day.
I thought I was over it. I was wrong.


I got sick of being blonde. It wasn't the color I wanted, and I swear I felt my IQ drop a few points every time I highlighted it. So, I went back to being a redhead.

That's Future Trauma Surgeon in the background, holding the infamous Noodle Dawg...who's looking pretty perky.

Noodle Dawg's personality has really come through recently. 'Feisty' and 'tenacious' are words that first come to mind when I think about how she is. She's also got one ear that sticks up higher than the other when she's on alert, which I think is hellaciously cute. She's almost big enough to make it on to the couch unassisted....but not quite.

Monday, August 11, 2008

Why?

Why do men from southwestern illinois think it's ok to ask a woman they've never met whether her 'carpets match the curtains'?

Why do aforementioned men get pissed off and call aforementioned woman a 'bitch' when she tells them they're fucking retards and to fuck right off?

Why does Noodle Dawg think it's ok to shit in the corner of the living room even though she knows she's supposed to go outside and does so consistently?

Why do I have an obsession with Paranormal State and let myself get frightened by it every Monday night, even though I don't believe in god, the supernatural, demons, angels ghosties and ghoulies and long leggedy beasties and things that go bump in the night?

Why do I have an obsession with Intervention and - never mind. I know the answer to that one.

Why haven't I heard of Dooce before now and why am I currently obsessed with reading her blog, right from the very beginning?

Why do I find Senor DrugMonkey so fucking hilarious? Actually, that's a dumb question. I know why he's hilarious. If somebody could promise me that I'd get to work with him all the time, I'd go to pharmacy tech school tomorrow.

Why can't I be satisfied with what I've got?

Why does it take weeks for my insurance company to approve my surgery? How is it that a respected surgeon (he's the head of the plastic and reconstructive surgery department at SLU, which is no small feat, imo) can say 'yes, she needs this done' but some peon at an insurance company who's probably never even BEEN in an OR to observe a surgery let alone done the cutting themselves has the final say on whether it gets approved or not?

Why am I such a bitch to people sometimes?

Why do I have such a low threshold for ignorance and stupidity?

Why does poor spelling aggrivate me so much?

How am I ever going to make it through another 4 months of unemployment without losing my fucking mind???

Sunday, August 10, 2008

why i do what i do

Someone told me this weekend that I chose 'intense' careers (hospice care and emergency medicine). I suppose that looking in from the outside things would seem that way, but I don't personally view them as such, especially the hospice gig.

I don't see what I do as being any more heroic or spectacular than the girl working the register at the grocery store. I saw a need, knew that I could fill that need - and not only could I fill it, I was GOOD at it - so I did what I thought was the responsible thing and went to work.

Not everyone can do what I do. I understand that. I understand how people would think that what I for hospice is morbid or horrible or a terribly emotional job. It is ALL of those things sometimes. Not every death is quiet and calm, not every death is peaceful and clean and pleasant. However, I do my utmost to MAKE every death as much of those things as it can possibly be. It's my job to help people die, and I try to do that to the best of my ability.

My job is not all about patient care, though. It's about family care too, and that's where the emotion comes in. Usually, people who are dying are somewhat resigned to it; they're not as upset about it as their kith and kin are. It's the family and those left behind that are the emotional ones. It's a normal, natural thing and I deal with it like anyone else would - I cry too.

Yes, I cry. I'm not emotionally stronger than anyone else, I'm not a superhero and things get to me and bother me. I've just learned how to deal with my emotions. I hold my pain tight and make myself feel it. I make myself hurt. Masochistic? Yeah. But it works for me. If I don't get rid of the emotion I've absorbed shortly after I've attended a death, it will fuck with me for days in more ways than I can list. It affects me physically and psychologically - I'll either sleep too much or not at all, I'll have no appetite or will eat everything in sight, I'll be hyperactive and talk to everyone or I'll be sluggish and not able to verbalize what I'm feeling. Once I went a week without really dealing with what I'd seen, heard and done. Mistake. I literally spent a whole 48 hours on the couch, unwashed and unfed, semi-catatonic. I was a mess, and it was the last time I made that mistake. Of course that particular death was...umm....yeah, I probably shouldn't say anything else. It was different, and that's all I have to say 'bout that.

I'm not a heroine. I'm not an angel. I've never felt anyone's soul leave their body, I've never felt a divine presence in the room as a patient lay dying. My personal beliefs don't play a part in the care I provide, though - I've even lead prayers with family members circled around a deathbed. I do what I think is necessary for my patient and their family, even if that means chasing nurses up and down hallways until they give my patient the pain medication our physician ordered for them, or praying with a family even though I'm an atheist.

I'm not a hero or an angel or even a very nice person some days. I'm just a girl who happens to be good at helping people die. And saving lives, but that's a story for another day.

I'm just me. That's all.

Saturday, August 9, 2008

Noodle Dawg

...sings.

Urbaner plays the harmonica and Punk Rock Grrr the Noodle Dawg 'sings'. Howls. Tips her wee little Jack Russell-y head back, purses her lips, and HOWLS.

Hail Mary full of Grace tries to join in, but what comes out of her big square head is more of a rumble than a howl.

It's noisy, but it's the sweetest thing I evah did see!

Thursday, August 7, 2008

Hooray for (smaller) boobies!

Surgeon said yes to smaller boobies.

Not THAT big, he said. But, big for me.

Can't guarrantee that it'll take care of all of you back pain, he said.

It's not just about the pain, I said. It's about function too. If I get minimal pain relief but I can run and swim and lay on my belly, if I can reach and stretch and not have them get in the way at work and wear nice bras and bikinis, I'll be a happy camper.

You're in, he said. I'll tell your insurance I want to do it, and I don't think there'll be too much of a problem. Haven't had a denial in years.

Cool beans, I said.

Smaller boobies for me! Yay!

Sunday, August 3, 2008

Little Beauties? Can someone please help me understand this?

I'm watching a show called 'Little Beauties' on VH1 and I am sickened.

Ever since Jon Benet Ramsey was murdered, the majority of America has been aware to some degree of the sick white underbelly of our culture that is the child 'beauty' pageant circuit.

There is a group of mothers (and I use that term in the loosest possible sense) who think that it's OK to sexualize their children at the age of 3 or 4 or 5 or 6. They think it's OK to tell them to "flirt with your eyes" and "shake the booty that gawd gave ya" and that it's OK to put more makeup on them than I, a full grown woman, would wear to a movie premiere. That it's OK to tease and curl their hair, to spray fake tan on them, to have 'flippers' made - fake teeth to cover up the gaps that are left when baby teeth fall out.

Don't even get me started on the clothes. We'll be here all day.

The sad thing is that the moms who are behind these little brats are ALL overweight. ALL of them. Personally, I'd be really interested to see the results of their MMPPI's; I think there'd be lots of narcissistic tendencies, borderline personality disorders and cyclothimias diagnosed. I have to wonder how many of the kids are up there on the stage because momma desired the fame and adulation as a kid and couldn't/didn't get it for whatever reason.

Here's something else I don't understand: the 'organizers' and MC's of all of these pageants, the people who make the rules and who run the shows....they're all GAY MEN!!!!!!!!!!!! TD?!?

I think all the mothers who have put their little girls up on the stage like this need a kick in their fat fucking asses and a smack upside their stupid heads.

You know what I think a beautiful child looks like? A kid with skinned knees and gappy teeth, sweaty from running at the playground or riding their bike. A kid who HATES getting their hair combed or their face washed and who isn't interested in getting dressed up for anything. THAT is a beautiful child, to me.

Gah. I think I'm going to go hurl.

Saturday, August 2, 2008

How NOT to get me to talk to you.

How NOT to get me to talk to you in a few easy steps:

1. Find my blog. See that I have a couple of photos of myself on my blog, photos that include my monroe piercing.

2. Go look at my profile, and find my yahoo IM ID.

3. IM me out of the blue, telling me that you have a 'fetish' for girls with facial piercings, and ask me to send you some more photos of my piercing, including pretty specific descriptions of what you'd like to see me doing in said pictures.

4. When I respond and tell you that no, I'm not going to do that and that I'm offended you even asked me, send me an offline IM that says 'fuck you and your attitude, bitch. you think your holier than thow. suck my dick bitch.' (spelling and grammatical errors are his, not mine).

That's how to get me to NOT talk to you.

The person in question was idiotic enough to not only post a photo of himself online, but was silly enough to be sporting his correctional officer uniform in said photo, dangling a pair of handcuffs from his pinky finger. He also listed the correctional facility he works at...which happens to be a women-only prison.

Mr Facial-Piercing Fetish:

I've archived the messages you sent me, and if you ever IM, email or otherwise attempt to contact me in any shape or form again, I won't hesitate to pass those messages on to the Warden of the facility you work at. If you're going to talk to a free, law-abiding citizen like that, I have some serious concerns about how you're treating the women under your watch. You think I'm a bitch now? You have no idea......

Love,

NinjaMedic.