Friday, August 24, 2007

Warning: agraphia ahead.

Agraphia ahoy!

I'm moving on Thursday, so posting will be nonexistent until I get moved in and the bathroom finished.

Ah, yes. The bathroom.

It is not going well.

In fact, it's a hole. There are joists and studs and bare pipes and nothing else. You can fall into the crawlspace quite easily, something I almost did the other day. I was saved by a complicated and entirely instinctive movement reminiscent of something out of the Matrix series, if the Matrix series had been populated by flailing, screeching people holding prybars.

The good news is that everything else is pretty much done. I have to paint the woodwork in what will be my bedroom, but that's pretty minor. I scrubbed the kitchen down today, yuck, and am already moving things in.

Brother Bruce's Bargain Brain Barn is its usual exciting and gratifying self. Word from the carpeted areas is that charges for insurance will go up somewhere in the neighborhood of twelve percent starting in September. This is a no-big-deal thing for those of us without spouses or children, but a very big deal for those with, as their insurance actually costs them money. Us bitter, barren, lonely extras at the dinner table have everything covered. That's one benefit to being bitter and barren, I guess.

The dude with the huge glioma in his left temporal lobe? Turned out not to have a huge glioma, which is good. He instead has some wacky viral infection there, which is bad, but not as bad as a glioma. After a couple of weeks on some IV antiviral I'd never heard of and can't remember the name of now, he bounced right back and is fine and dandy.

Also, the young kid with the exploding AVM is talking, walking, and generally getting on people's nerves. That's a plus, since she was doing the staring, drooling thing last time I saw her, which was three weeks ago.

Speaking of getting on people's nerves, or maybe of staring and drooling, I may have to have A Chat with one of our resident brain cowboys.

He stares. At the nurses. Not in a smouldering, McDreamy way (as if; have you ever seen a bunch of real-life neurosurgeons?), nor in an intimidating, you-oughta-be-in-a-hajib-mindset way, but in a vaguely clinical, oddly disturbing way, as if he's wondering the best way to get to our hypothalami. He stares mostly at me, which is beginning to bug me. And will likely get him an entirely new digestive system if, after I point it out to him, he continues to do it.

He is, like all neurosurgery residents, totally socially inept. And he stares.

If you'd like something new to stare at, check out this week's Change of Shift. It's over at Nurse Ratched's. It's a Western theme, which is pretty darn cute.

I'll see you guys in ten days or so.

Tuesday, August 14, 2007


Goodness gracious. I just checked out Blogdorf Goodman for the first time and am amazed. One of the bloggers there did a whole series on makeup brushes. A series. On makeup brushes. With photos and a discussion on natural versus synthetic bristles.

I wonder if a series on catheters would grab as much attention.

In Work News, it's Christmas in August. Seems like every third person is opening his or her stocking and finding a wonderful gift: a glioblastoma! On your left temporal lobe! A meningioma! In your occipital lobe! Oh, boy! Lookit this, Mom! It's my very own spinal tumor!

Temporal lobe tumors are generally a bitch because, as you know if you're a disciple of the brain, they can cause seizures. Depending on which side they're on, they can also rob you of speech and understanding, memory, and the ability to make change.

One of my patients this week had the memory-loss and seizure problem. The memory loss is harder on us than it is on him; he keeps forgetting that what he has is a cancer that is going to kill him, nastily, so he keeps asking. And his family has to keep telling him. The seizures he has are manifested in a really weird way--sudden bursts of uncontrollable anxiety. Panic attacks, basically. I'd never seen that before, though I knew theoretically that it could happen. We put him on Keppra (a kinder, gentler anti-seizure drug) and problem solved, but still.

In House News, the bathroom walls are down. And oh my Frog, what a mess it is.

When the bathtub enclosure was built lo these many years ago, the builders installed a cabinet above the tub. Keep in mind that showers weren't standard equipment in the late 1940's, so it made sense. Need a towel? It's right there. Genius!

Except that somebody installed a shower. And did it badly. So badly, in fact, that I have a hard time believing that the thing actually worked for as long as it did.

See, when you install plumbing, it's important to make sure everything matches up. If you have cast-iron supply pipes, as I do, it's a good idea to get the proper connectors to extend piping up a wall (say) rather than jimmying something together with PVC, copper connectors, glue, caulk, and a prayer. What'll happen if you jimmy and pooky everything together is that the created joint will split and leak and take out the backside of the wall it's running up.

This was brought home to Chef Boy and me when I tapped on the wall with a pry bar (okay, banged on the wall) and the wall came down. Except for the bit surrounding the fixtures, which were glued/sweated/caulked on to the supply lines and thus have to be cut off with a hacksaw. I now have a lovely space just above the bathtub that communicates with one of the kitchen cabinets. Chef Boy suggested that we leave it as is and pass crystal decanters of bourbon and Scotch through the hole so that we can drink while bathing. For a minute, that seemed like a really, really good idea.

Today Chef Boy will install cutoffs on the sink supply lines and we'll take out the toilet, and then I'll go to work on the last wall (and probably the floor as well) with the marvelous pry bar. Later on in the week the cement board and tile will go on. The Evil Secrets of Bad Plumbing will be walled up again.

Maybe the bathroom won't smell so strongly of mouse and mold when it's done.

Saturday, August 04, 2007

House Blog, Part 2

Oh, my.

I'm sure the people who lived in the house before me were marvelous folks. I'm sure they were kind to animals, fine parents, socially conscious, and committed recyclers. I'm sure they were all those things and more.

However, they lived like pigs.

I cleaned the bigger bedroom the other day; it took me fifteen gallons of cleaning solution just to do the lower half of the walls. One wall alone took nine gallons of solution. It experience.

Let's not even talk about the kitchen. Suffice to say that I am looking at new stoves rather than clean the one that's in the house. I don't think it'd be possible to get it into usable condition. Thank God they didn't leave the fridge.

So today, when the numbers on the clock are bigger, I'm heading over there with more gloves, more sponges, and more cleaning solution. Today I'll clean, period, and worry about painting tomorrow.


In other news, a simple tip for the family members of patients: The way to get noticed and get your questions answered is not to assault a nurse. You'll get noticed if you do, of course, but it's not the kind of notice you're likely to want to attract. Let's face it: If you kick a nurse, or take a swing at him, you're going to face security guards from countries where genocide is a way of life. They know many, many more dirty tricks than you do.

*** *** *** *** ***

I finally quantified what it is about my nursing style that makes the crazies love me.

When we say "crazies" at work, we don't mean people who believe that aliens live among us or that Star Jones really lost all that weight with diet and exercise. We mean people who are so stressed, or so anxious, or so overwhelmed that the conventional modes of behavior fly out the window.

Everybody who's worked in any kind of health care knows that there are some folks whose behavior becomes unacceptable, impolite, and sometimes downright dangerous in stressful situations. When every other nurse has been fired by a patient or a patient's family, when security's been called, when the doctors refuse to go in to the room, they assign me that patient.

And invariably--I say this not to boast, but in amazement--those patients end up asking for me again the next time I work. And we get along.

I've had several patients in that situation over the last couple of weeks. In most cases, the patients themselves have a handle on what's going on; it's their family members who have lost it. What every situation had in common was this:

I explained what was going on, in English, from start to finish, and didn't assume that the patient or the husband/wife/sister/whatever knew what had been happening prior to that day. If it took re-explaining three or four times during the course of the day, or going back to Page One and going straight through to the end, that's what happened.

It's not that our docs and nurses and therapy folks don't tell people what's going on: they do. In terms of communication and keeping people in the loop, we do very well as a team. I think the assumption is, though, that people in a stressful situation are going to remember the conversation you had with them last night. This is hardly ever true; they have so much going on internally that they often forget to, you know, eat. We do this every day; they've done this exactly zero times before, and so the stress level is huge.

All of this seems really obvious now that I look at it logically. Still, it's the only commonality I can come up with over the course of several years of being the Nut Wrangler. Explain, explain, explain. Warn, reassure, explain.

And, if all else fails, Xanax works wonders.

*** *** *** *** ***

Trivia Treat: Turns out one of our surgeons (not in our department, sadly, but still) used to fight in cage matches to make extra money.

How cool is that? "Twoooo goooo iiiinnnn....ONE coooommmmes ooouuut!" (/announcer voice)

Which explains a lot about this particular surgeon.