IT: RTFM. HEALTHCARE: PATFQ

(Read The Freaking Manual)(Please Answer The Freaking Question)

TINS, TIWFDASL some time ago, and I interviewed this soul.  

(Me) “How long have you been sick?”

(Them) “Well, all my kids were sick last week.”

(Me) “So, how long have you been sick?”

(Them) “I guess it was going around the school, last week.”

(Me) “So, how long have you been sick?”

(Them) “My (wife)(husband) was sick all last week.”

(Me) “So, how long have you been sick?”

(Them) “ Oh- do you mean, how long have I been sick?”

(Me) “So, how long have you been sick?”

(Them) “Uh, around 3 days.”

Ermagherd! 

“It’s Natural!”

Long ago, and far away, I was working in a clinic, and my partner had the opportunity to chat with a soul who reported vomiting several times a day, for several weeks. During her interview, she determined that her friend reported that he had been smoking marijuana for, lo, these many years. He reported an abundance of marijuana intake every day.

As an aside, let us recall that there is this thing, known as “cannabis hyperemesis syndrome”. While the folklore of marijuana asserts that it is useful for nausea and vomiting, excessive use can elicit vomiting. Similarly, overuse of Tylenol or Motrin for headache, can elicit headaches.

So, my friend, knowing this, counseled this soul that ceasing marijuana use would resolve his vomiting.

He was not seeing it. He asserted that he had been using marijuana, multiple times a day, for years and years, and had never had a problem with nausea or vomiting.

She replied that this problem develops after some duration of frequent use.

Her correspondent replied, “That cannot be true. Marijuana is natural! It grows out of the ground!”

I observed that poison ivy is natural, it, also, grows out of the ground. I speculated that, should I roll him a blunt of poison ivy, would he consider firing it up, and breathing the resultant fumes?

Should he consider such, I would encourage that he wait for me to exit the room and seal the door, before he put fire to paper.

Please.

Weather Spotting-At Home- Part 2

Here is another Skywarn/ Weather Spotter class deja-vu’.

So, TINS (This Is No Shit), TIWFDASL (There I Was, Fighting Disease And Saving Lives), at work as a day shift ER RN in BFE Community Hospital. This was years and years ago-decades, really- and TDW and our (at that time) two kids were in town, and she stopped by to visit briefly.

The clerk told me that they were here, and I strolled out into the parking lot to say hello. Once there, I observed that the skies over our little rural town were a sickly shade of green. Not good. Very not good.

I shepherded my wife and kids into the hospital, and directed TDW to take the kids into the bathroom, conveniently located across the hallway from the department, and, for bonus points, was removed by a storage room from the outside wall.

Just about the time I got my family situated, our direct line to sheriff dispatch rang, informing us that there was a tornado warning, and we-all of us, staff, patients, guests and all- needed to take shelter immediately.

Our charge nurse paged the warning overhead to the rest of the hospital, and the rest of us notified the waiting room denizens to stay put, and away from the windows and doors. We were blessed that the ER had no windows, and did have solid cinder block construction.

Once the all clear was called, I retrieved my family from the bathroom, and walked them out to TDW’s vehicle.

When I got home that evening, she regaled me with her observations. Along the route that we all took every time we went to town, there was a full sized barn, that the storm had moved off it’s foundations.

Contemplate what those winds would have done to a sedan with a woman and two children inside.

A bit farther out into the county, a mobile home dealer had several of his display models rolled over onto their sides. One wound up in the roadway.

Contemplate, oh, let’s say, a sedan with a woman and two children, re-enacting the house-on-the-witch scene from The Wizard of Oz.

I found that prospect to be, let us term it, “unappealing”.

Another stroke of good fortune lay in the fact that OUR mobile home came through unscathed.

Am I paranoid if I react as if Fate was plotting to get me? Or my family?

Weather Spotting- At Home!

Today, TDW-Mark II and I took a refresher Skywarn/weather spotter course. She and I are both amateur radio operators (“Hams”), and weather spot as a way to serve our communities.

That class reminded me of a couple of stories, that I have not, yet, told.

A long, long time ago, I was working midnights as an ER RN, some 25-30 miles west of my home. On one particular night, the weather forecast predicted thunderstorms. Since it was summer, this was unsurprising.

Many hours into my 12 hour shift, we had cleared the house, and completed our housework. I was idly staring out of the window into the parking lot, from our waiting room, and noticed that it appeared to be kind of windy.

That was resolved, as it became very windy. Then, it became exceedingly windy, and our sign indicating that patients should park over thataway, was blown clean over.

I suspected that this indicated winds much stronger than our baseline, and, seeing the waiting room TV flash an alert of some sort across the screen, noted that there was a high wind warning in place, indicating that the winds were moving from west to east. Winds were reported to around 100 mph to my west.

Hmm. That meant that my family was downwind of this event, and, since a couple of my children slept in a bunk bed in front of a window, suggested that I ought to awaken my wife and have her move the children, gosh, away from the window which might well become shrapnel in a serious, no-crap hurricane force wind.

So, I phoned home. This was pre cell phone, so I rang the house phone. No answer.

I called again. No answer.

I called again. My oldest son, 13 years old at this point, had a paper route, and got up way before the crack of dawn to get his papers organized. I directed him to awaken his mother, right now.

He demurred, citing the fact that it was way, way early, and his mother likely anticipated awakening after, oh, gosh, 8 am. And it was not quite 0600 as we spoke.

I directed him to STFU, get his mother RFN, and stop screwing around. (I might have phrased that last just a leeetle bit differently, and in my summation paid homage to generations of sailors, longshoremen, and drill instructors and their collective contribution to The English Language.)

Once I had TDW-Mark I on the line, I summarized the foregoing, and directed her to move the kids, right stat like.

She glanced out of the window, and observed that it was “a little windy outside”.

I suggested that, should she desire to see “really freaking breezy”, just wait a few minutes, but MOVE THE GODDAM KIDS first.

Once I got home, a journey complicated by downed trees, downed power (and other) lines, and assorted firefighters, officers and utility workers guarding multiple downed lines, I observed, thankfully, that TDW’s vehicle appeared undamaged, all our windows appeared intact, and all the kids were eating breakfast in the kitchen, excitedly chattering about the storm winds that had passed them by.

Odd Conversations

A long, long time ago, in a un-named fly over state not so very far from here, I was dating a young woman, let us denominate her as “Elsa”, who was a nurse in one of the emergency departments into which we would run.

As things developed, she had such a lapse of judgment that she moved in to live with me.

One time, my partner and I were hanging out at her hospital, chatting in the parking lot, when another medic approached me.

“Do you know Elsa?” was his question, after initial greetings.

I replied, “Yeah, I guess I do, sort of.”

“Do you know her well?” asked my interlocutor.

I attempted to deflect him. “How well does anybody really know somebody else?”

He was not having it. “Do you know if she is seeing anybody?”

I was trying. Really, I was trying to gently deflect him, but I failed, with my answer, “I guess she is seeing somebody. At least, that is what I hear.”

My partner, who knew very well that Elsa and I were An Item, attempted to stifle his grin.

The inquisitive fellow persisted. “Do you know if she is seeing anybody, steadily?”

I answered, “Yeah, I suppose it is kind of steady.”

Powering straight ahead, he asked, “Well, is it serious?”

I was done with subtle. “Serious? Well, we like to think that it is serious!”

Today’s Tangents

Yes, today I actually counseled a two year old that he should not run around my exam room.

It was every bit as helpful as you would imagine.

ON ANOTHER TOPIC: A long, long time ago, I nursed in an ICU, on nights. It happened that many of my colleagues smoked. Most of them smoked several times a night, heralded by the question, “Would you watch my patient(s) for a few minutes for me, while I go out to smoke?”

What followed was that the nurse in question would exit the department, only to return on the order of 20 minutes later.

This would repeat nearly every hour. It progressed to the point that several of us who were non smokers, suggested that we ought to take up smoking in order to have a 20 minute break every hour.

One time I was speaking with the department manager, and suggested that, should hospitals never hire smokers, the units would find that their productivity would rise around 30%.

Learning Is Exciting

The other day, the conservation club to which I belong had a rifle shoot, something along the lines of “It’s Sunny And Sixty, And Winter Has Been Long And Grey, So Let’s Get Out And Shoot!”

With a shorter title.

One of the guys had brought along a borescope, and offered to give me a look at my bore.

Oops! Learning time! There was an abundance of collected stuff, along with what appeared to be rust.

My cleaning regimen had, for a couple of years, been to employ a ropelike cleaning product, which featured bristles as well as a fabric cleaning area, running same down my bore several times, and calling it good.

Which, evidently, it very much was NOT! So, after that meet, in which I both sucked berramuch as well as learned other things that need further attention by me, I took my rifle home and gave it a diligently cleaning employing a bore brush, cleaning jag, and MULTIPLE patches, and MULTIPLE rounds of same, repeated the next day, only to find today, Day Three, the above.

The top patch is my first solvent soaked patch of the day. The second is the dry patch, immediately after the first, and the bottom patch is the second solvent soaked patch.

I see that I have my work cut out for me. I also see that the rope-bristle-swab thingie is for field cleaning only, and no longer to be confused with, ya know, real CLEANING of my bore.

Kitty Parkour

Since we live in The Un Named Flyover State, said state laying in the
northern tier of states, we have this particular meteorological
phenomenon, I believe the locals call it “winter”, every year.
The sky turns cloudy, the air gets cold, and generally the
sunbathing-and-picnicing-season, is over.
In order to moderate the percentage of my paycheck I must send off to
The Utility Company, TDW-Mark II and I place plastic film over our
windows. I am disappointed at the amount of billowing that this film
does, once we have “sealed” each window.
We have noted slices in this film, lately. Since our Cat Ranch has had
surgical removal of the front claws (what with me being a
anticoagulated geezer, that seemed prudent), we were puzzled at how
this transpired.

Until today. TDW observed that one of our cats, whose “spirit animal”
is Dart, had graced her with a display of Kitty Parkour, involving
sprinting about the house, a graceful leap over the couch, and a
springlike rebound from the (film covered) window, leading to another
dash to points unknown.

The film suffered in that encounter, subsequently demonstrating slices
identical to the last several repairs that we had effected.

A more definitive solution is as yet undetermined.

Cat Triage

(From the left:  Max, Dynamite, Oliver, Sully (in the foreground), Trixie, smiling for the photograph, and Olivia next to TDW) (Missing:  Momma Kitty, Henrietta and Frankie)(left, background:  Penny T. Corgi.)

So, TINS, I was NOT FDASL (fighting Disease And Saving Lives), but was recovering from some flavor of Creeping Crud which developed on the way home from vacation. Since TDW had been cooped up with me in the vehicle, well, of course, she developed it as well, although, since she HAS to be an overachiever, she developed a 101.3 fever that I had not. 

So, she felt poorly. The cats kept watch while I did the housework and generally tried to clean up from our trip. I noticed that she had 6 of our 9 cats hovering over her, which was reminiscent of a previous experience. 

I had thought that I had written about it, but, I searched and searched, and  could not find a previous post.  (Peculiar, because it is one of the stories in my frequent rotation “playlist”). So, I'll tell THAT story, so I can tell this story. 

Several months after I had had a cardiac cath and stents, I was feeling poorly.  I shrugged it off (guy stuff, amirite?), yet, to my surprise, I kept feeling sicker, and sicker.  It developed that I would get dizzy and my heart rate would accelerate each time I would sit upright.  

TDW commented upon the fact that both dogs, and every cat, would perch on the bed, staring at me, as if on duty and I was the patient. “They only leave, one at a time, and that one comes right  back!  It's kind of weird!”. 

Soon, I gave up, she took me to ED, and the doc there (whom I had worked with many, many times in years past) found that I had lost around half my blood volume.  Being a geezer, being a cardiac patient, well, I bought an overnight (well, a coupla overnights) stay in the hospital, along with a blood transfusion. 

Oh, joy!

After the fact, TDW and I determined that, should all the animals keep watch, we were going to stop dithering, and call EMS. (might be difficult to explain to dispatch. “Yep, I said that the need for EMS was because every animal is sitting on the bed.  That's what I said.  Yeah, I know that is not in your medical priority dispatch book, please, just take my word for it this one time...”)

So, back to today's story:  TDW took note of her multiple furry shift nurses, and commented, “Jeez!  I don't feel all THAT awful!”

A couple of days of acetaminophen, fluids, and bedrest, and she awakened today reporting that she was starting to feel better. 

The cats apparently agreed with her assessment, because she is back to 3-4 cat supervision, presently, which is pretty much her/their baseline. 

Things That Make Me Wonder…

Recently returned from a cruise. Had a good time, soaked up some sun, got a bunch of recreational reading done, spent time with The Darling Wife-Mark II. Saw some things that left me puzzled.

First off, it is surprising to me how many folks go on a cruise, and, in the midst of blue skies, sunshine, beautiful and novel scenery, STILL have their faces in their phones.

So, TINS (“This is no Shit…”), TIWFDASL (There I Was, Fighting Disease, And Saving Lives)…well, OK: There I was, lazing away and soaking up sunshine, and I repeatedly noted individuals (or, perhaps, “in-duh-vid-uals”) who were, head in the phone, gibbering away to person or persons evidently at the other end of their cell phone connection. NOT being present in the moment, in the Caribbean sunshine.

I did (and do) not get it. In my view, a vacation is an opportunity to do different stuff, at a different pace, and separate oneself from the daily thing. Clearly, this is not a universally shared worldview.

Similarly, in yet another different-world-view exemplar, several times TDW and I noted folks demonstrably intoxicated. I do not mean, as KJP (Karine Jean Pierre) would say, requiring a subtlety of assessment that requires a physician’s expertise, rather, something on the order of subtlety associated with a “dermatologic fracture” (which is a fracture of such overwhelming obviousness that, should a dermatologist wander past and see the x ray image from the corner of his/her eye, s/he would come to a halt, and comment, “Dude! That looks broke as hell!”) As is uncoordinated gait, slurred speech, wobbly stance, and the rest.

The different world view part arises when TDW observed, “Ya know, if I had spent as much money on a cruise, as I know these folks spent, I sure as heck would want to be alert, and able to notice it, as well as enjoy it, as well as remember it!”

Again, some folks have different priorities in their lives, and they therefore elect different choices than I do. Or would. Met some interesting folks. One soul was wandering about, wearing a shirt proclaiming “7.62×39”. (I’m sympathetic, but am starting to wonder if 5.56×45 is a superior choice. I may transition in that direction, one of these days)

Another gentleman was reading a book entitled “Breaking Biden”, by Alex Marlowe. Another cruisers asked him about it, and the reader waxed eloquent about Mr. Biden’s failings, in his (the reader’s) view.

Another fellow had a “Sig” shirt on. (for those not Of The Order Of The Gun, Sig is a brand of firearm. For a while the Michigan State Police issued Sig 229 pistols to their officers)

It was interesting to feel as if I was in the midst of Like Minded Individuals.

And, should Miguel (or JKb) be reading (from Gun Free Zone)(Howdy, Miguel! G’day, JKb! Howthehellareya!), when we set out for the cruise port, a no stool gun free zone, I secured my sidearm (and TDW’s as well) in a concealed, locked gun safe secured to the frame of my vehicle) (Tuffy brand. No swag, simply a paying customer.)