Wednesday, April 13, 2005

It seemed like a good idea at the time.

He couldn't bend over easily, due to a combination of spinal arthritis and a frontal-lobe glioblastoma multiforme that had made it harder for him to coordinate what he was hearing with what he wanted to do. Unfortunately, bending over, or rolling up into a ball, or sitting slumped forward was exactly what we needed him to do, since we had to get a cerebrospinal fluid sample to figure out why he'd suddenly gotten so weak.

So I balanced him on the edge of the bed with his toes barely touching the floor. If his feet touched completely, he would try to stand up. Then I braced his knees against mine and wrapped my arms around his shoulders, pulling his upper body against my shoulder. Then I went into a half-crouch and supported 150 pounds of dead weight as the neurosurgeon tried to get the spinal tap needle into his back.

I stayed in that position for twenty minutes. By the end of it, I was alternately cursing my idiocy and thanking God that I'd been taking the stairs for six weeks. This morning my butt and legs are tight, my shoulders hurt, and my abdominals feel like I've done an hour of Pilates. But the patient didn't fall, we got the lumbar puncture done, collected the CSF, and everybody is happy. Especially the neurosurgeon. She thanked me repeatedly, then said, "I had no idea that you were that strong."

Neither did I, frankly. I did *not* take the stairs up to my car yesterday evening.

In other news, I had another Hospital Hobbyist yesterday for eight hours. She decided around noon that she didn't like her nurse, given that he wouldn't shoot her full of Dilaudid as often as she would've liked. She's been on our floor for a month, getting four milligrams of Dilaudid (a very strong painkiller, highly addictive) every hour. That's a bolus on top of her patient-controlled anesthesia pump, which delivers a milligram of Dilaudid every ten minutes. We're not sure what's wrong with her; general consensus is that she must have nudie pictures of the neurosurgery team stashed somewhere to stay as long as she has. Of course, since she hasn't worked in fifteen years (on "disability", probably because of her Dilaudid preference), she has plenty of time to spend in the hospital.

Your tax dollars at work, people.

On the other side of the coin, I got to tell a marvelous man that no, he'd have to go to the Veterans' Administration hospital to get the medicine he so desperately needed, since there are no community programs in place to help him. He has insurance. He even has prescription drug coverage. Unfortunately, the job he's had for ten years pays so little that, after taking out what he needs to support three other people, he can't afford the deductible or co-pay for his prescriptions.

He's just had brain surgery, is newly-diagnosed as hypertensive, and has bad blood sugar control.

I won't bother to point out the contrast between my two patients.

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