Thursday, September 29, 2011

Okay, this is ridiculous. And it doesn't change my view on having WILD FUCKING ANIMALS as pets. . .but.

When I watch this, even though they're two different species, I know what he means, because I live in this place with Max every day:

Max was feral when we found him. He was skeletal at 37 kilos/81 lbs and was perfectly able and willing to attack anything that looked like food. For months he would not come near me, no matter how non-aggressive I tried to be when I approached him. He would either shy or snarl; neither option was comfortable.

Yeah, he's not a half-ton grizzly bear, but he's certainly able to kill the cats. He won't do that, though, because he recognizes that cats have Sharp Pointy Bits at the end of their paws. He respects the cats, and the cats respect him.

He's also capable of killing *me*. You don't ever live with a hundred-pound animal without having that somewhere in the back of your mind. The reason he doesn't get obnoxious when we're irritated with each other, I think, is that he understands that I respect him and recognize his autonomy. I never give him a command without reason, but at the same time, if he disobeys the command (like "sit/stay"), he knows I'll take a second look at the situation. One hundred percent of the time, so far, I've deferred to his judgement.

Yeah, no. He's not a bear. But I kind of understand what this is like, to rearrange your life a bit so that a critter can have Thanksgivings in your house (although Max doesn't care for turkey; instead, he gets his own plate of pumpkin pie).

He's a good boy. A good boy. And he eats birthday cake just like the grizzly does.


Had a bad day? Have a cub-'n-bucket.


Tomorrow, the State Fair starts in Yeehawton.

And dammit, I am going to drive and drive and drive sometime in the next twenty-four days and go to the State Fair. Because two years ago, I was too busy being heartbroken and stood up to go, and last year, I was too busy bein' all cancery and shit. I want me some fried food.

In the meantime, I have advice for the Minions: Don't get an autoimmune disease that affects your nervous system.

The patient in question is a normal, boring guy who went on his normal, boring, noiseless way until the day when he suddenly seized. Multiple times, in the presence of his family, and then multiple times in the presence of the emergency department peeps.

Then, while he was hospitalized, he got confused and combative. Then he got really weird and stopped breathing on his own. Then he ended up with us and did nothing but twitch and seize for four months.

Six months after he first had a headache that turned into Hell, this dude is waking up. Turns out he has a weird autoimmune situation going on: nearly all the people who get his particular syndrome are female; the ones who aren't have tumors on their thymus gland. Less than a tenth of a percent of folks develop this thing with the hard-to-pronounce name on their own, in the absence of triggering factors.

This guy is, of course, one of those perfectly inoffensive, perfectly boring people who had nothing at all wrong with them, who went on to develop an autoimmune disorder so rare that even Wikipedia doesn't have more than a stub on it. It's the autoimmune fuckup version of my cancer, basically, but without the good drugs and the pleasant outcome.

HOWEVER! He has, statistically speaking, a good chance of recovering. From what we can tell, if you wake up at all, you're pretty much guaranteed a happy ending. It just takes a while.

In the meantime--and this is why I would advise against getting any weird, obscure disease--we've tested him for everything from viral infection of the central nervous system to heavy metal poisoning to parasitic infestation. He's had so much blood drawn over the last four months that he's required two transfusions. For a while, we had a drain in his back to draw off CSF, just because it was easier than doing repeated lumbar punctures.

Now that he's kind of sometimes a little bit following some commands, I'm sending him off tomorrow to a long-term intensive rehab program. There, he'll learn how to swallow and talk and walk and tie his shoes again. If he's lucky he won't remember a damn thing about the last half-year. If he's really lucky, he can hit the State Fair along with the rest of us next year.

And if I see him there, you can be sure I will buy that man a Shiner and a corndog.

Wednesday, September 28, 2011

Whiskey-soaked donuts, Tornado Taters, unicycle, eight small rubber balls.

Or, the title of this post has nothing to do with the post itself.

I got the Definitive Obturator fitted today. There was no speech bulb attached; that'll come on October 6th, after Dr. Elf has a chance to mold the thing off of this current obturator, which works great both in terms of speech and of snot drainage.

You guys, I am *so* excited.

Remember how much I hated the first obturator? Remember how I got used to the second obturator, but kind of didn't like it because it fell down in the back and was heavy and made it harder to talk?

This one is. . .well.

It's shiny, shiny silver metal. I have no clue what the metal is; it looks like that cheap stuff they make adjustable rings out of--the kind you get out of the gumball machine. It's got integrated tooth hooks, which means they're much less likely to break off. And it's got this loop on the back which'll hold the speech bulb, and *that* means that the shape and size of the bulb can be changed as needed without as much effort.

I'll post comparison pictures after I get the D.O., but for now, imagine a retainer. You know how retainers have that plastic part that covers up your entire palate? That's what I've got now. The D.O.'s palatal widget is about a third the thickness of the plastic one, and it doesn't cover the area just behind my front teeth. That means that not only is it lighter and easier to put in, but it also doesn't change the way I talk. I've learned that the speech bulb is only part of the equation: good enunciation requires tongue contact with the backs of your front teeth.

(This is especially important for singing, for reasons I don't completely understand but have experienced. I talk fine but I lisp when I sing.)

When Dr. Elf put the D.O. in, it was like wearing nothing. I'm not kidding: the feeling was as close to having a normal mouth as I've experienced in nearly a year. It was. . .comfortable. Not just comfortable, it was unnoticeable. I could tell the difference even without the speech bulb.

There are two pieces of bad news: first, I will no longer be fully protected from Dorito Abrasions and Pizza Burns. I'll have to re-learn how to eat like a normal person. The second bit of bad news is that Dr. Elf had to grind down several teeth to get the occlusion right; there's only so much grinding you can do on tiny metal hooks before you weaken them. My tooth enamel had to be slightly sacrificed in two places to get my bite correct. Tooth enamel ain't no thang, y'all; it's totally worth it to have this new widget work.

The upside to the tooth grinding is this: When the first obturator was being fitted, Dr. E. had to grind off bits of the posterior edge of the anterior side of my eyeteeth. Given that *this* grinding of teeth involved the anterior edge of whatever tooth is behind the eyetooth, I now have even more prominent fangs than I used to. When I smile a certain way, I look like a vampire. This is a look I really, really dig: it's body mods with a medical excuse.

In sum, this new obturator/speech bulb combo is going to be bad-ASS. It's gonna be Terminator Mouth from here on out. I think that this might actually be an improvement on the normal human mouth, in fact: it'll cover most of the area of my palate that used to get burned from too-enthusiastic hot-food consumption, yet not impede my speech.

Okay, enough of that. Thank you, all of you who sent reassuring emails and posted reassuring comments after The Twerpacle (the minor debacle involving That Guy I Was Dating). In a surprising demonstration of Good Timing, the Universe decided to make my pal and coworker Dame Hammet (points for those who got the Brother Cadfael reference) want to introduce me to her cute friend who's tall and skinny and funny. Pray for me this Sunday, around 7:30 pm Central time.

***I should mention here that TGIWD isn't actually a twerp. His behavior was twerpy (and so was mine), but he's a hell of a person, and any woman who is able to sort through his various issues is getting a massive catch. (Feed him up, girl. Them elbows is sharp.)***

And yes, I've already picked out my outfit. And my shoes. And my eyeliner. Not that I'm nervous, or excited, or anything.

This "dating" stuff is fun. Who knew? Now that I've gotten over the Fear Of The Obturator Causing Uncomfortable Conversations (take it or leave it, buddy), I'm kinda enjoying myself.

Coming Up: Why you should try to avoid autoimmune diseases!

Sunday, September 25, 2011

Nursing stuff later this week. For now, *sigh*.

That Guy I'm Dating is now That Guy I Was Dating.

Because, after six weeks, he still hadn't figured out whether or not he liked me. I mean, really? All the signs were there, dude: You brought me an LED mod for my mini-Maglite, you wanted to hang out whenever, all that other stuff, and you weren't sure whether. . .you. . .liked. . .me?

Getting upset over this would be like getting upset because I can't communicate with somebody who speaks only Russian. Abilene Rob, being the sort of stand-up guy he is, and a very good friend besides, was exasperated on my behalf. I think he said something like, "He had your boobs right there and he didn't know what to do with them? What kind of idiot is he?"

Ah, Rob. Always there to pick up a girl's self-esteem.

Anyway, this has led to my re-reading the profiles of those poor fools deluded enough to check me out on A Famous Online Dating Site. From my perusal, I have determined the following:

1. Every man in Central Texas describes himself as laid-back. This explains the droves of horizontal men lining the streets.

2. Few men in Central Texas can spell, punctuate, or put together a sentence. There were at least half-a-dozen guys whose profiles left me all, "What? What?"

3. If a man is six-three and three hundred pounds with a bad goatee, he wants somebody at least ten years younger with a slim or athletic build.

4. I am too old for forty-one-year-old men. (Yes, one of them actually *told* me this after I'd emailed him, my rockin' profile notwithstanding.)

5. Every guy around here is looking for a mother for his children. Most also have few to no teeth, and one in six admits freely that his mother thinks he's gay and that he's looking to change that.

I could have the problems Stoya has, though: Within 24 hours of getting an account on A Famous Online Dating Site, she had over fourteen hundred "winks." That's one thousand four hundred, or a one followed by a four and two zeros. There is such a thing as having too many choices. Stoya is about to just pull the plug and spend the rest of her life in her apartment, cowering under the bed.

I, on the other hand, would like to dissect That Guy I Was Dating, and find out what he uses in place of a brain.

Please, nobody suggest I start dating musicians. This place is as full of musicians as a fleabag hotel is of fleas, and you know the old joke: What do you call a musician without a girlfriend?


See? I have a sense of humor! Call me!

Home again, home again, etcetera.

I could happily live the rest of my life in central California, near the coast, provided I didn't have to do anything to earn a living. Could somebody please invent a time machine so that I could invest in Microsoft stock early? Thank you.

Pens the Lotion Slut and I keep emailing and texting each other with the words "Best Vacation EVER" and "CONDORS."

We ("we" being Pens and me) arrived late in the morning Sunday at San Jose and were whisked, as much as a bus can whisk, off to the CalTran station near the airport. There's some wonky stuff going on with construction there that would've made it impossible for Beloved Sis to pick us up, so we just rode the bus through town, with Pens asking things like "What's that vine?" and "Is it always so gorgeous here?" (Answers: Bougainvellia and Yes.)

Beloved Sister and Brother-In-Law have a little place in Monterey--and by little, I mean little--with a guest house/studio out back. Pens and Beloved Sis and I installed ourselves there and proceeded to eat lots of bread and hummus and snackages, complete with thyme-infused olive oil. Then B.S. and B.I.L. made us ravioli and butternut squash puree with sage butter and perfectly sauteed zucchini with the sweetest bell peppers ever. I should've known at that very moment that it's nearly impossible to get a bad meal in central California.

Seriously? Had I posted during the past week, this would be the Head Food and Condor blog. Because we saw CONDORS. But before that, I saw HUMPBACKED WHALES. And before that, I sprained my knee.

On Monday, Pens and I went to see whales on the Monterey Bay Whale Watch tour. We took the Sea Wolf II from the wharf at 0900 sharp. It was during the boarding (boarding? Embarking? Getting-on-the-boat?) that the boat went *wibble* and my left knee went *gronk* and I stumbled, practically into the arms of the handsome man who was charged with getting my landlubber ass onto and off of the boat in one piece. Sadly, I caught myself and sadly, my knee swelled to the size of a small grapefruit during the trip.

But I saw three humpbacked whales: a mother and calf and a big male lazily doing the flipper-slap on the surface. And dozens of Risso's dolphins pacing the boat and breaching, and several sea lions (distinguishable from harbor seals by their longer flippers) scamming for scraps. Penny ended up belowdecks in the cabin, green and sweaty from seasickness. At least I won the genetic lottery *somehow*: Penny could be mistaken for a European fashion model, but *I* got the steady cerebellum that allowed me to stand at the bow of the boat and go whooping over the waves while eating a sandwich and ignoring the groans of the dying.

It was, truly, one of the best moments of my life.

Then we went to Cambria. If you ever have to go to Cambria, stay at the White Water Inn. They have cookies! And, if you go straight across the street, dozens of ground squirrels will meet you on the boardwalk and beg for food. I have pictures; they are forthcoming.

Also, if you ever have to go to Cambria (and poor you, having to go to one of the most gorgeous spots on this earth), you should eat at JJ's Pizza. I'm not sure why it got only three and a half stars on Yelp; it's seriously the best pizza I have ever eaten, and close to if not the best hamburger. Plus, the dude who couldn't work the bottle opener for my Sierra Nevada IPA was both charming and handsome.

When you go to Cambria, you have to do two things: See the Hearst Castle and eat at Indigo Moon. The tours at the Castle have been cut to 45 minutes, which is just enough that your head doesn't *quite* explode from the beauty of the place. I kept walking past medieval tapestries and triptychs and saying, "Wait. . .I saw that in a book."

Indigo Moon is that sort of experience, but in food form. Beloved Sis had a risotto that made me determined to learn how to make risotto, with a cheese that I will be ordering in bulk. Pens had a tomato-basil soup that (and I will not lie, here) I was unreasonably proud of already having the recipe for. I had seafood fettucine that will live forever in my memory. Get the Harmony Wineries Riesling: it's the only Riesling I have ever liked. It's superb.

I've been so caught up in the food that I haven't even mentioned the condors. So, CONDORS: As we were driving along Highway 1, a route that is fucking lousy with vistas, we passed a low stone wall with two large, ugly birds sitting on it. One had a nasty pink head; the other had a less-nasty grey-feathered head. The dialogue in the car went something like this:

Pens: Vultures?

Me: Too big.

Beloved Sis: TAGS.

Beloved Sis and Me, together: HOLY SHIT CONDORS.

So we screeched to a halt and walked back to get within ten feet of two California Condors in all their impressive, irrepressable ugliness, and take pictures. Other people were hopping out of their cars and grinning maniacally at us.

Penny mentioned, being the bird-person that she is, that number four looked like she was getting a bit agitated, and what happened? Everybody moved back and let the birds calm down.

Then we saw two more condors soaring over a cliff. Protip: They look a lot like vultures, but marked differently and WAY bigger than vultures.

AND I spotted a purple-freckled starfish and several anemones and a hermit crab in a tidepool, AND Beloved Sis has great pictures of a bright-orange starfish in another tidepool, AND we saw a sunfish at the aquarium, AND Pens is Beloved Sis-and-Brother-In-Law's favorite person ever, AND there were many cuddles with my pit-bull nephew sweetums snuggums Bones, and we all slept eight hours a night at least without nightmares or insomnia.

I'm so glad I took a vacation I could not afford to a place I had left, the last time I was there, with loathing and disgust. I want to do this every week. Tell me, those of you who live in California: do you ever get tired of being surrounded by Nature that isn't trying to kill you?

Saturday, September 17, 2011

Say nice things about me, 'cause I'm gone. . .

Tomorrow I leave for California, where I will be spending a week in the lap of near-luxury, if not outright dissipation, in the company of Beloved Sister and Friend Pens The Lotion Slut.

Beloved Sis has been emailing all week with details about the tiny goats'-milk soap she's wrapped in Japanese printed paper and arranged lovingly in tiny straw baskets in the guest-house bathroom. Pens said today on the phone, "It just makes me feel bad to think that we're going to be using up all her toothpaste and stuff, you know?" To which I replied, "Beloved Sis will be like a pig in a wallow, knowing that she can go out and buy new Vetiver soaps and wrap them in delicate paper with flower-petal inclusions. GET OVER IT ALREADY."

There is whale-watching scheduled. And wine-tasting. And pedicures and facials and a B & B in Cambria after the tour of the Hearst Castle. I am taking a pair of leggings on this trip, bought special today at Target: that's how you know I'm serious about being in Northern California.

What this means for you, the devoted minions of Head Nurse: I will not, unless circumstances permit, which I certainly hope they don't, be posting. I'll update you on the Hospital Follies du jour when I get back. You're on your own.

There may be pictures, too.

PS: Thanks for the good wishes and prayers; my house is on the other side of Bigton from the fires, which are now mostly-contained. If y'all want to donate money or clothing or household goods to the folks in Central Texas who lost fucking everything, please talk to your local Red Cross chapter. We need animal chow, too--everything from cat food to horse feed. Thank you.

Saturday, September 10, 2011

Friday, September 09, 2011

Pens The Lotion Slut emailed me this morning

To point out that it's been a year.

I hadn't even thought about it until I got her email. I wasn't sure what to feel or think this morning, and I'm still not this afternoon. I had to go back and check the blog entries for this time last year to be sure.

A year ago I had, though I didn't know it for sure yet, cancer. Not a nasty sort of cancer, not an invasive sort, but cancer. Amanda The Amazing had found it during my routine tooth cleaning and had looked very solemn about it. So had the dentist, and the receptionist, and everybody else.

I remember feeling as though I'd been walking along on a treadmill that had suddenly sped up. I was barely keeping up, keeping my feet under me, as other people made phone calls and tried to find an oral surgeon that would accept an emergency appointment within a few days.

The next few weeks were like that all the time. I went from one oral surgeon to another to an ENT to CT and MRI and PET scans and had a lymph node biopsy (just thinking about it makes the right side of my neck hurt again) without really being aware of what was going on. I remember eating lunch with Nurse Ames, high on Valium, after the PET scan. I remember Abilene Rob coming to town the day that the biopsy came back positive, and trying to eat dinner with him. I watched him clean his plate--you have never met anybody who can eat like Rob can--while still feeling like I was in a film that had been speeded-up.

I remember it was the most beautiful fall I'd seen in years.

Today is a beautiful day, too. The quality of the light's the same, and the trees--those of them that are still green--are up against a perfect blue sky the same way that they were last year. Things have quit burning down to the extent that it's eerily familiar outside.

Max is still here. Pens and my Beloved Sister and Parents are still here, Rob is still here, my Brother In Beer is still here. The cats are still here. I yelled at Notamus today for stabbing me with one of his claws, a thing he knows he's not supposed to do, then felt bad for yelling at him, then felt incredibly grateful that things are normal enough that I can yell at him.

Part of my mouth is gone forever. It got cut out with a bone saw and ended up on a pathologist's counter, cut into frozen sections and analyzed. Somewhere at Dr. Elf's there's a mold of what used to be in my mouth, including a dent that marks the mirror image of where the tumor used to be. ("That's the tumor," he said, showing me the hollow on the alginate mold.)

I have three new friends, all "cancer buddies"--Lara, whose general pissed-offed-ness at the whole Cancer Mess made it okay for me to be pissed off too; Tashi, who provided comfort and love and concern even in the middle of her own hell; and Nikki, who didn't come along until after everything was over, but who provides some of the best on-going one-liners ever.

I have a lot more patience than I used to. I have a better understanding of what it means to be on the other side of my job--how little you remember from moment to moment when you're terrified, how huge even simple things seem, how hard it can be to get the hell out of bed. I missed a lot of work between diagnosis and surgery because, most days, it was just too damn hard to get out of bed.

Now, if something is going to hurt, I can tell my patients that honestly. I can also recommend Dilaudid wholeheartedly and without reservation. I know firsthand where to put an IV, how it feels to get up the first time after surgery, and what "tired" really means. I never want to see pureed anything ever again.

I have a lot of debts I can never pay. Lola and T-Bird, Carolita and James, Nick and Aud, Nurse Ames and Stoya and The Manhandler--all the nurses who took care of me inside the hospital and out--I want to buy them all dinner every night for a year. Beloved Sister made me a communication board because we didn't know if I'd be able to talk after surgery, and some of the magnets from it are still on my fridge, because they're hilarious. My folks were about as non-strange as it's possible for parents to be in that situation. My Uncle Jon came down and played housewife for a week, making it possible for me to go back to work. The Man of God and His Lovely Wife fed me, Beth and Matt buzzed my hair. . .I'd have to start a whole new blog just to say thanks.

And you guys: When I needed information, you sent me loads. When I doubled back and asked you please not to any more, you sent pictures of kittens instead. I got prayers and outpourings of love and good, solid ass-kicks when it was appropriate.

Some things have changed. Some things haven't. Some things changed for a while, then went back to the way they'd always been. It's been--and it seems weird to say this--a good year.

Wednesday, September 07, 2011

This picture is copyrighted by Deanna Roy

Austin skyline today.

I get all excited about the weather, and then everything catches fire.

I may be rather scarce for the next couple of days. The fires aren't near Casa Jo, but the air is horrible--smoky, hazy, awful--and I'm staying glued to the fire maps on the Innerwebs.

Pray for rain, Peeps. We need it, bad. It was enough that every stock tank was dry; now they're dry and ON FIRE.

Sunday, September 04, 2011

OMG. It's supposed to be 80 here tomorrow.

And the low?

In the fifties.

I might just live long enough to go to California with Pens The Lotion Slut and see Beloved Sister.

In the meantime, the Universe reminded me that there's something worse than having a chunk gone out of your head: Joint Commission survey prep.

For those of you who are lucky enough never to have heard of the Joint Commission (the Joint Commission on Accreditation of Healthcare Organizations, aka "TJC," aka "JCAHO," aka "Our Benevolent Overlords"), it's a not-for-profit organization that sends out "Surveyors" every so often to your local hospital to determine whether or not people are charting, washing their hands, sterilizing instruments and changing lightbulbs--all the stuff that goes into running a hospital.

Surveys are usually unannounced. You can be sure that the middle manglement of every hospital in every city across this great land is on speed-dial to every other hospital the minute TJC shows up, to warn everybody that The Beast Is In The House. You don't want to be caught unprepared, without liners in your trashcans or with mops in the corners of the utility closets.

Accreditation is bullshit. When a survey's expected, the management of a hospital decrees that every chart will be audited for errors and omissions. Every bit of equipment that normally languishes in the hallways between uses gets taken away and stored somewhere. Things that are normally unlocked, like syringe drawers and storage room doors, are locked by the housekeeping staff, who usually have the only keys. Nurses are subject to surprise searches to be sure nobody's carrying meds in their pockets. Floors get polished and bathrooms get cleaned.

And then, once TJC has either not come or has come and gone, things go back to their usual comfortable, vaguely disorganized state. About the only thing that Joint Commission accreditation tells you is whether or not the management of a facility can handle having a bag of rabid weasels thrown into their midst unexpectedly, because that's what it looks like.

Prep is horrible. Everybody who shows more intelligence than your average turnip is handed a stack of charts to audit--in other words, you go back from day one of a patient's stay and look at everything everybody has written--and correct. Correction means hunting down the folks who made an error and sitting on them until they fix the error (or omission). Given that we move patients between Sunnydale and Holy Kamole all the time, chart prep means hours and hours of soul-destroying fiddly work, followed by the opportunity to have doctors and nurses from two hospitals and all the associated clinics pissed off at you, the auditor.

My job this week was auditing, along with precepting a new experienced nurse for the unit. Thankfully the nurse was sharp and with-it, or else I would've leapt out the window by nine ack emma. Chart audits are the worst thing I can think of to do at work.

But we're prepared! For the survey! And it'll be great!

Never mind that another hospital in Bigton got surveyed a couple of years ago and won accolades from the JC folks, only to return to having potato chips show up in supposedly-sterilized surgical kits. I'll bet their trash bin liners looked fantastic.