Wednesday, May 25, 2011

Random, and updates.

Dr. Crane emailed me on Tuesday with a single line: "MRI looks good. No tumor."

That was fucking amazing, guys. I wasn't aware that anybody was even looking for a tumor. I just thought they were, you know, getting a baseline for my new skull configuration.

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If you wake up from your afternoon nap totally blind, it's probably not a good idea to wait a full twenty-four hours before you go to the emergency room.

On the upside, though, it gives me a chance to see a really nice case of cortical blindness in action, along with temporal lobe edge-sensing and a lack of confabulation. The patient's hypothalamus got hit in the stroke as well, with the effect that they seem to be unable to regulate body temperature.

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Likewise, if your spouse has had a stroke, it is not a good idea to allow them to drive. Home. From the hospital. Just. Sayin'.

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And finally, let me make this perfectly clear:

We Can Tell If You Are Cray-to-the-Cray.

If you insist (par example) that you have to have an MRI because of some whacked-out set of symptoms that correspond to no possible hit in your brain to me, then insist that you *can't* have that MRI because of some whacked-out implant that nobody has ever heard of to the doctor, we will treat your case with what's known as a "high level of suspicion."

I still do not know, nearly ten years later, why people think faking neurological symptoms will somehow fool neurologists and neuroscience nurses. We have seen it all before, including things that hadn't been described before we saw them. I, personally, me, Little Jo The Neuro Nerd, have seen two things that weren't named before the patients showed up on our doorstep, and one additional thing that our most experienced neurologist had never seen, but only read about. He told me I could retire happy after that one.

You can't get past us. We are the Cerebrus of the medical system. Just give up, already.

Please note that here I am not describing conversion syndrome, which is a positively hellish disorder in which your body basically takes over your brain. I am talking about hydromorphone-craving malingerers. Dilaudid's a great trip; I'll give you that. But it's not worth four days in a CCU, with me standing over you like an angel of Hell.

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In other, more personal news, my GYN thanked me today for being the easiest, least emotional, most logical and productive surgery consult she'd ever had.

Yes, Animal is being evicted. On July 7th. I have yet to tell my boss.

My GYN, whom I'd thought was seven feet tall and as impressive as Michelle Obama, actually turned out to be a rather short, fragile-looking woman with huge eyes and a ready grin. It's amazing how one's perspective changes when there's no speculum involved.

Animal is roughly the size of, oh, I dunno, a starling's egg? A robin's egg? Say, four cee-em one way and three cee-em the other? And, thankfully, there was no indication of malignancy on this super-de-duper microsonic amazo-sonogram. Teeth and hair and possibly some waxy substance (me thinking "WAXY BUILDUP" from the commercials), yes, but not anything scary.

So not big, but big enough to torque, which would be a fucking emergency. So we're going to take it out. Not that there was any question, mind you: as long as I'm still relatively young and healthy, and have met my deductible, why not go in for another $13,000 nap?

It'll be laparoscopic and will involve four band-aids to my belly. Worst-case scenario, which neither Dr. Impressive nor I think is likely, would involve the ONC/GYN staff coming in to do a lavage of my belly and take out both uterus and tubes. More'n likely I'll get out in under an hour.

My recovery nurse, whom I've already lined up, is named Tiffany. So is my surgeon. All I need now is a gashog with the same name and we'll be set.

Remember when we all were kids, and we were told "Girls can do anything they want!"? That time is now. I'm a middle-aged woman going under the knife with a female, black surgeon and a female recovery nurse, and probably a female anesthesiologist.

Wow. Things sure have changed since the 70's.


Rosanna said...

So, Lady Jo, it's "Out, damn'd" ............ (~#12 square centimeters of assorted teeth/hair/wax lumpiness) ............ "spot!! Out, I say!!" ??

'Very glad to hear that it will indeed be taken *OUT* for you on July 7th, i.e., too worrisome, (for both you and us), not to!!

Nurse Philosopher said...

On your female Animal-Napper Team, we consider it a victory for us women everywhere.

Husband and I laughed our way through another of your stellar posts. Despite the shocked silence from my daughter & husband (Donnie and Marie) on your equally hilarious post, "Well That Hasn't Happened in Awhile" we here at Li'l Old County General think you're The Best!

Blessings for Patient and Team in the upcoming surgery.


Albinoblackbear said...

Great news about the MRI!

My WV is "dentedis"...seems like a fitting last name for Animal. :)

Hope the lap goes off without a hitch, sounds like you are in great hands.

Peny@nursing scrubs said...

Whew! That is called the empowerment of women. But seriously, I'm hoping for the best when you go under the knife, eh. And I love the story of the patient with cortical blindness, who waited for 24 hours before going to the hospital. Oh, boy what a wait (in fact it could be waiting in vain). Nice post. :)

jimbo26 said...

Hope everything goes Ok . :)

messymimi said...

Glad the MRI is good, and will pray for an easy surgery and quick recovery.

Allison said...

Hope it stays laproscopic and it's all good. Good luck to you with this one.

terri c said...

I'm thrilled with the all-female team, thrilled that Animal is being evicted, and thrilled with the no-tumor state of the MRI. Somehow I think that when a doc HAS seen a tumor, then the absence of same will always be noted on any scan, of whatever type, of the area where it once was. It's a variant of the "If the only tool you have is a hammer" law. Will be holding thumbs for you through the eviction. You rock.

Allison said...

I was re-reading your blog, because I'm where TV is not in English and any more BBC will finish me off, and was wondering what is a recovery nurse? I'm not familiar with that term. Does she stay with you at home or what?

Jo said...

AM, a recovery nurse is the person who makes sure you wake up from anesthesia okay. Normally you're extubated in the operating room, then taken to a post-anesthesia unit, where the recovery nurses are. From there you either go to a hospital room or home (the latter is what I fully intend to do).

Dr. Alice said...

Congrats on getting the surgery scheduled, and that your MRI is okay! Excellent news. I agree, Animal needs to be evicted. Best of luck.

Somali-Swedish Nurse said...

Like your blog // nurse student

Anonymous said...

Jo, best of luck to you! I had my own "animal" evicted 10 years ago, and the neighbors have been thrilled ever since!!! Bye-Bye dysplagia, periods like Stage 2 labor, and crazeeeeness that my hubby and sons had to endure!

It is gonna be great, I promise!! I snicker as I breeze past the feminine products aisle. Neener-neener-neener, Tampax and Midol. So long Maxi-Pads with wings!!

And best of all??? ALL your undies can be your "good" undies!!!

Pattie, RN get some high waisted white cotton granny-panties a size LARGER than you usually wear for post-op. You can burn them in six weeks and get lovely new bits of satin and lace!