In which Jo gets a disturbing differential.

My arm is fucked up. Seriously, majorly fucked up.

I woke up yesterday morning with the kind of muscle cramp in my left shoulder and back that made me actually wander around the house yelling and whimpering until the hot water bottle water boiled. It was miserable. I spent most of the day changing position every five minutes, trying to get comfy.

It was better today, so I trotted off to work. A buddy of mine rubbed the hell out of that shoulder and shoulder blade when I arrived, and it felt still better.

Then, at about 0930, my left arm stopped working. I still have grip and fine motor, but I couldn't raise it, quite suddenly, more than chest-high. And the pain came back.

So, handing off my soon-to-be-discharged patient to another nurse, I trotted off to the local doc-in-a-box, where they keep an outstanding nurse practitioner. He poked and prodded and rotated my arm, and kept asking if things hurt. "Dude," I replied, "everything hurts. I'm just one big ball of hurt."

The differential is this: either I have the mother of all muscle spasms, bad enough to affect the nerves running across my shoulder blade and down my arm, or I have a cervical spine nerve injury.

I'm full of steroids, both fast-acting and long-acting injectable, and muscle relaxants and antiinflammatories. I refused narcotics, on the grounds that they make me stupid and itchy, and I already feel like a retarded orangutan. I have orders not to bend, stretch, twist, lift, squat, or turn my head sharply for a minimum of five days. If I'm not better in three days, it's off to the spine surgeon I go (hi ho, hi ho) for an evaluation of my C5 disc.

There are a number of points arguing for muscle injury and against nerve injury, thank God, and only one cardinal for the nerve alone: the fact that I can't raise my arm without shrugging my shoulder up near my ear. *How* I would've injured a nerve in my neck so acutely is also in question, as the symptoms of C-spine nerve damage don't usually come on overnight.

Still, it's scary. And frustrating. I can't take out my own trash, or lift my own groceries, or do any sort of scrubbing or vacuuming or compost-pile turning or lawn-mowing.

Anybody who wants to come scoop the cat boxes is welcome. You can run the recycling out to the curb while you're at it. And peel me a grape, willya? I have a feeling this is going to be a long three days.

It's not all about the barbecue.

From We Band of Angels, Elizabeth M. Norman, Pocket Books, 1999:

"The Malinta Tunnel complex, organized into a series of narrow corridors, or catacombs, called "laterals," was like a small cramped city with sections for administration, supply, mess, ordinance, and a thousand-bed hospital staffed at first by the few dozen nurses originally stationed at Corregidor's post hospital above ground and, later, by the nurses evacuated from Bataan and some civilian volunteers. . .A main corridor 750 feet long, 25 feet wide, and 15 feet high served as a spine for the laterals. . .

The incessant [Japanese] bombing was concussive and some of the women developed severe earaches and headaches. Walls and ceilings trembled and shook, medicine bottles toppled out of cabinets, bunk beds bounced across the floor. The concussions increased the air pressure in the narrow laterals and caused the nurses' skirts to wrap tightly around their legs. . .

. . .The concussion was so colossal it slammed shut the tunnel's slatted iron entrance gate, and the laterals echoed with screams from the outside. Corpsmen and nurses in the nearby laterals sprinted toward the entrance to aid their comrades. When they arrived they had to pry open the iron gate, a grisly task, for jutting between the slats were body parts and pieces of torn and mangled flesh. . .

. . .almost every one of the seventy-seven Angels had dental and gum problems from three years of prison-camp food, diets dangerously low in calcium and vitamin D. . ."

From And if I Perish, Evelyn M. Monahan and Rosemary Neidel-Greenlee, Anchor Books, 2004

"...the sounds of bombs exploding in Anzio harbor had been rumbling through the hospital site for at least thirty minutes as Miernicke entered the postoperative tent and began her rounds. She had changed the dressing on one patient and was about to examine the bandage of the patient to her right when the roar of airplane engines vibrated through the tent. A moment later, the sound of machine-gun fire grew louder: a German and an American plane were engaged in a dogfight. As the two planes swept low across the hospital, Miernicke heard a whistling sound as a .50-caliber machine-gun bullets ripped through the canvas wall. Almost immediately, she heard a short, soft cry on her left. When Miernicke turned, she faced the soldier whose dressing she had changed only moments earlier. The young man was staring motionless up at her. . .he had been killed instantly."

"If anybody had a complete strap on their helmet, they had not been over there very long. The strap would fall off and get burned on the hot stove (while heating water for bathing). . ."

". . .I can still see him at times--whenever bad memories come to mind."

"If ever I come close to believing, it is when I hear 'Taps'." --Robert Heinlein

Atomic Batteries to power; Turbines to Speed!

Max has a Youthful Ward this week.

Her name is Molly, aka Good Golly, Miss Molly! Molly-Loo, Mollycoddles, and Mollywubbles.

Molly is eight months old and part border collie. The rest of her is either Corgi (judging by her ears) or speed freak (judging by her behavior). She has no clue how to be a dog, having lived her life to this point in the company of humans, specifically Nurse Ames and Her Lovely And Charming Husband.

Nurse Ames and LaCH are on one of those schwanky sailboat cruises through the Bahamas at the moment. Molly got here last night, right before they left.

This is Max being awesome. His youthful ward is just visible behind the big tree stump.

Molly, in full flight.

Max, wondering what the hell I've done here.

This is how awesome Max is: I gave both him and Molly pig's ears (thanks, Mom!) to chew on.
Molly had no clue what to do with the pig's ear. She sniffed it and was uninterested, so I gave Max his and dropped hers on the deck. She immediately went to see what Max was doing, and saw that he was chewing his pig's ear.

She ran back to hers, looked at it curiously, and ran back to Max. He didn't even lift a lip at her, and he's normally very posessive about food. Back to her pig's ear she went, then back to him. The lightbulb finally went on, and I left them on either side of the doghouse, both peacefully chewing their pig's ears.

She's already filthy muddy and covered with tree debris and she hasn't even been here twenty-four hours. Nurse Ames won't recognize her.

Sometimes, evil plans can come true.

I punched in for my first shift in the NCCU (two nurses, four beds, no waiting!) and the guy working with me, who handles most of the staffing for that unit, slung his arm around my shoulder.

"So, Jo," he said, "what sort of plans do you have for your unit?"

Er. Um. Aaahhhh.....gah.

The next day, one of the house managers grabbed me by both hands and started raving about how happy Manglement was that I'd taken on the job, that the unit really needed organization and efficiency, and how I was just the person to get all that done.

It would've been easier, and I would've preferred it, had nobody had any expectations. If I'd been able to do this under-the-radar, so to speak, there wouldn't be as much pressure.

I hate pressure. I am extremely pressure-averse, in the sense that planning and organizing something as big as this unit is going to be (and as fast as it's going to get big) are not my strong suits. Give me a couple of patients, both of whom are crumping in different ways, and I'm good: that sort of pressure is cool. *This* sort of pressure....well.

It's a challenge, right? It'll force me out of my comfort zone, right?

Right.

Other than getting bonked on the head by that Expectation Bat, things went remarkably smoothly. It's not dead-ass quiet, and it's not killingly busy--yet--so there's time to actually do nursing. There are problems, not the least of which is that we're working with borrowed equipment in a borrowed space, but the problems can mostly be fixed.

The two biggest problems-I-mean-challenges I see right now are these: The person who directs (well, supposedly directs; I'm not sure what he actually does other than wander in and complain about signage) the unit is someone with whom I have never gotten along and probably never will. How the hell we're supposed to get things done when his primary interpersonal-relations style is condescension with a side of bullying and a sprinkle of humiliation is beyond me. Seriously, this guy is such bad news that HR has been called in a number of times to set him straight about how not to manage people.

Oh, and nobody's really sure where we're supposed to be getting our supplies, like gauze and needles, but *shrug*. And there is no central monitoring capability in the unit. Yet. And we lack enough trash cans. Little things like that, you know?

It's going to be a bumpy six months. After that, it'll be an insanely busy year until we move into a new, dedicated space. And, since everybody seems to think that I really *can* do this, when what I'd planned was on-the-DL influence, I guess I'll start asking for stuff. Like trashcans and gauze.

Y'know what? I'm enjoying the hell out of this.

Ooo I had forgotten about this yes I had ooo.

Yeah, I don't feel so good.

Nightmares. As my brain switches from sleeping during one half of the day to sleeping during another. People getting locked out of the CCU, me not showing up on time to work, funeral corteges going past, people I know going missing.

MONDAY NIGHTMARE REMEDY!! That's what we need.

This is worth clicking, as embedding is disabled, and Robyn is the shizznit.

All you have to watch of this one is the first twenty seconds. In that time, you'll see staggering baby elephant running-times, and hear a tiny trumpet from a baby elephant schnozzle.

Later, I will make this pasta salad to take to work. Artichokes yum.

And that is all. Time to go lift heavy things.

Sunday Night Poetry: ee cummings

It may not always be so; and I say
That if your lips, which I have loved, should touch
Another's, and your dear strong fingers clutch
His heart, as mine in time not far away;
If on another's face your sweet hair lay
In such a silence as I know, or such
Great writhing words as, uttering overmuch,
Stand helplessly before the spirit at bay;

If this should be, I say if this should be --
You of my heart, send me a little word;
That I may go to him, and take his hands,
Saying, Accept all happiness from me.
Then I shall turn my face, and hear one bird
Sing terribly afar in the lost lands.

I hate nursing. Now what?

You're a nurse. You're paying off student loans with interest rates so high they make you dizzy. You're a new grad, probably working a crap shift in a crap unit, because that was the only job you could find. You're dealing with sick people every day, bullying coworkers, crazy family members, and inscrutable doctors.

And you hate it. You fucking hate it. Your life is a misery; you dread punching in. You lose sleep over having to return to work this weekend (because you've got the crap shifts). You obsess over how miserable you are, but you don't feel like you can quit.

Because of money. Because you've invested all this time. Because the loan guarantors are coming after you for payments, and it hasn't even been a year yet. Because you'll disappoint your family and your friends. And, most of all, because leaving a field that is widely seen as a Fulfilling, Sacred Calling That Only A Few People Are Suited For carries a huge stigma.

Y'know what?

It's okay to hate nursing.

Really.

It's okay to do something else with your life.

Sometimes *I* hate nursing, and I do it and think about it and blog about it and get quoted in books about it and sometimes lecture about it for pay and for free. The key, though, is that I only hate it sometimes. Most of the time, I'm as happy as a baby elephant in a kiddie pool. As messy as this job might be, it keeps me coming back, because it does something for me that nothing else does.

If you hate it all the time, it's time for a change.

I got a BA with a double major in music and sociology. I had no idea what I would do with it; write protest songs, maybe? I hated studying music. Hated it. I have a fair-to-middling voice with no real ability to act or interpret what I'm singing, and I barely scraped through on piano class because I hated screwing up so badly, I could barely practice. It cost my parents tens of thousands of dollars and untold worry to finance my degree, and I ended up doing everything from working in a bookstore to doing voiceovers and voice-mail mazes until that fateful day that I walked into a Planned Parenthood, asked for a job, and discovered what I'm really good at.

And you know what?

My folks, and my husband-at-the time, were baffled by my decision to go to nursing school. Not a one of them could figure it out. Not a one of them understood what it was that got me so het up over nursing, though they could appreciate that I was het up. My father finally said to me one day, "Johanne, I've figured out why you like nursing. You're the only one who was ever good at math."

The point of all this is, she says, taking another swig of Hardcore IPA (quite nice, by the by, if you like a fresh-hopped, dry, strong beer) is that you don't owe it to anybody to stay in a field you hate. Presumably you've done enough of it by now to understand what it is about it that makes you unhappy, and what it is about nursing that's a bad fit.

Eventually, the people who love you will realize that you're happier being a bank teller or a firefighter or an airline attendant, and everything will be fine.

I'll miss you. I'll throw you a huge party when you leave to go to firefighter school, and we'll keep in touch--and I'll be really proud that you decided to do what makes you happy.

Because, at the end of the day, you cannot compromise your own happiness for a paycheck (or to save face). You have to do what it is that you know in your gut will send you to work every day without feelings of dread and horror.

It's okay to hate nursing. Nurse Jo hereby gives you absolution, a blessing, and the help-wanted section of the local paper.

Holy Cats I Have Just Found The Best Blog Ever.

It's Always Something.

How did I not know about this before?

I have a new hero. Go read. NOW.

Muerte; Viva!

La Draculita esta muerta!

Viva La Rojita*!

(Yeah, I know that's a male redhead duck, but if you search on "female redhead" in Google Images, you've got to be prepared for a lot of NSFM [Not Safe For Mom] stuff. And don't even get started on how crappy my Spanish is [DAD...]; I speak medical Spanglish and that's it.)

I am DONE with the last night shift of this phase of my nursing career.

Next week I start as the first full-time day-shift neuro-exclusive nurse on the new neuro CCU.

If I do my job right, it'll mean greater autonomy for the NCCU. If I make a complete cock-up of it, it'll mean that it colors everything that will come after. No pressure, though.

The Pros: I'm very pushy about getting things done that are good for patients. I'm an experienced nurse, and I've worked with the attendings that'll be supervising the residents and nurses on the NCCU since one of them was a resident and the other was a new hire. I've seen things nobody has seen (primary meningeal melanoma, anybody?) in forty years, and taken care of a wide range of neuro patients for nearly a decade. I know what we need: a call list that's updated regularly and is dependable; a set of protocols for treatment of everything *but* occlusive strokes (that's the only thing they've gotten written yet); a set schedule for when to start everything from speech to physical to occupational therapy and beyond.

The Cons: I'm very pushy about getting things done that are good for patients. This tends to put the collective noses of the neurology residents out of joint, and for good reason: because of the lack of a dependable call schedule, one resident can find herself taking call for as many as two hundred patients stretching over three hospitals. Neuro*surgery* is more organized; they have three residents on call most days, and never fewer than two, even on holidays. The neuro intensivists just kinda figure it out as they go along, but as there are only four of them, it works out fine.

I'm on friendly terms with everybody from the housekeepers to the medical director for the hospital. This can be a bad thing, as brilliant ideas I mention as a one-off could conceivably get implemented without there being time to stop and think about them.

The attendings trust me. One of them told me, when I said I was moving to the NCCU, "Good. That means I can finally admit my patients there."

Uh. Um. Gah. Argh.

That means I can fuck up spectacularly if given the chance. And I will get the chance, I'm sure.

And, worst of all, my immediate Boss Lady offered me the job without really getting a chance to know me first. She thinks she's getting an experienced neuro nurse when what she's really letting loose onto the unit is a maniac with a crowbar and an attitude.

Because, by damn, what I want to build (even though nobody asked me to and will probably be pissed off that I took it upon myself) is a unit that *I* would want to be on when this aneurysm I'm surely cooking in my head blows.

I want a dedicated neuro unit. I want a comprehensive critical care plan that emphasizes the nurse's autonomy, and doubly-emphasizes the abilities that any patient has left. I want physical and occupational and speech therapy to start on the day of, or within twenty-four hours of, the patient's admission onto the unit. Being on a vent is no excuse; we can still do passive exercise with you so that you're not as weak as a kitten when you're extubated.

If you come in fifteen minutes past the limit after your last-known-well time with an occlusive stroke, I want the resident to be able to make the call that yes, you're still eligible for TPA. I want a protocol that allows an RN to order a stat head CT so that that scenario is possible. I want a protocol that allows an RN to start preparing a patient for that TPA after the negative CT, so that we don't lose any time.

Most importantly, I want to recapture what Sunnydale lost when it got bought out by Big Research and Academics, Inc. I want every single person who works in, gets brought to, empties the trash and scrubs the floor of, or calls the NCCU to be treated with more respect than they expect. I want "we can't do that" to be a not-uttered phrase. I want "we can't do any more" to be rarely said, and only when there are support systems in place for the people who are hearing it. I want chaplains, nurses, housekeepers, transporters, and residents on the same damn page for once, and treated with the same amount of decency and care.

Yeah. I want perfection. And I'm a dreaming socialist, with a poster of Karl Marx on the ceiling over my bed.

But, dammit, I want this unit to be the model for all the other units in Texas, not just the ones here in Bigtown.

*La Rojita sends big sloppy kisses to TGIL, who is doing some really cool stuff this weekend. You are awesome.

Friday One-More-Night Melody:

Things I will miss about the night shift

Yeah, I'll miss some things about working nights. Not enough to consider doing it for one minute longer than I have to (36 hours left! Only three shifts), but I'll still miss some things.

Like the weird confessional mood that strikes patients at four o'clock in the morning. I've had conversations with patients before that have gotten pretty deep, but it's different during the day: there's always a pager going off or a doctor that needs you. In the middle of the night, or near the beginning of the morning, people enter a mental space where reflection and expression meet.

I'll miss Bejweled and Bubbleshooter. I've actually gotten fairly good at them.

I'll miss the exhausted, underslept resident who comes in at three ack emma to admit a late transfer from Nowheresville, and the expression her face when I slip her a slice of home-made chocolate cake.

I'll miss Karen's coffee.

I'll miss the strange productivity of the hours between one and five. That's when everything happens in our CCU--labs get drawn, CTs and MRIs happen, baths get finished up. Even if eating steamed cauliflower at two makes my skin crawl, it's nice to know that my late lunch tops off a whole mess of work done early.

I'll miss the strange productivity of those hours at home, too. I have a load of laundry going, food for the week cooked and packaged up, and am blogging--at 3:10 a.m. No interruptions and no sunlight means your activity is concentrated.

I'll miss the feeling of being on call, yet not being called in. There's something satisfying about getting all ready for work save your scrubs and makeup, lying down on the couch, and waking up at four in the morning, knowing that nobody is going to call you in for the last three hours of the shift.

I'll also miss the on-call money. Holy crap, do they ever pay a lot for on-call. There were some nights I went in at the beginning of the shift and worked my ever-loving, rapidly-widening ass off, but other nights when I went in at nine p.m. and sat, earning nearly sixty bucks an hour, for eleven and a half hours, then handed off nothing to the oncoming nurse.

I'll miss Totti's delicious Filipino noodle dish, the name of which I cannot for the life of me remember, though I asked her to make it for our going-away party this week.

I'll miss the plummy accents of the BBC radio announcers I listen to on nights off. Nigel Astley-Astley-Nottingh'm announcing that it's twenty minutes past seven, GMT, and following with the shocking corker of the Chestwicksh'r cricket side in its match with Brustm'nsw'll always makes me giggle.

I'll miss the time. There was time to sit on nights, to hold the hand of somebody who needed their hand held, or to damn regulations and give a skin-to-skin touch to somebody who hadn't had one in months, and for whom it wouldn't hurt. There was time for the confessional mood to strike my colleagues. There was time to grill more-experienced nurses about the likely outcomes for our more complex patients, and thus be prepared for what would happen.

I will not miss the intestinal disturbances, the blood pressure that became labile enough to finally require a beta-blocker, the feeling that my life was just barely under control most of the time, the dirty car, the lonely dog who celebrates when I'm actually awake under the sun. I won't miss the difficulty of having a remotely normal life. I won't miss feeling like I'm walking into an alternate reality where weather and climate don't happen. I won't miss sleeping during the day, pillows covering my eyes. I won't miss most of the people. The two I'd miss most, Cheryl and Nurse Ames, are coming with me to days. So that's okay.

Only three more shifts. Only thirty-six hours. I can hold my breath, my urine, and my temper that long. By this time next week, I will be a day shift worker.

Whew.

I know it's been a heavy YouTube day, but I couldn't resist this:

THIS is why I love the Danes.

When was the last time your boss arranged a flashmob for your birthday?

More Tuneful Tuesday....

"Every now and then she offers me a lemon Now And Later" is a great lyric.

I hate the person who introduced me to Owl City (I'm lookin' at you, Dalai Llama).

The spaces between my fingers are right where yours fit perfectly.

Music: The What Day Is It, Again? Edition.

Two from Neko Case. If you have a Greyhound, pet it for her.

Mom, don't read this.

Good God, I need a keeper.

I went to class today (CEUs! Huzzah!) and, upon leaving Sunnydale, could not find my car in the parking garage. For twenty minutes. I walked around for twenty minutes, occasionally hitting the "lock" button on my key so my horn would beep, before realizing that I had parked in the exact same space I have parked in since beginning work at Sunnydale in June of 2002.

There were no groceries in the fridge when I got home, so lunch was Fritos and cheese sticks with a side of Torpedo Extra IPA. I would've had some black beans with that, but I realized when I pulled 'em out of the fridge that I couldn't remember actually cooking black beans at any point in the last, oh, year, so they probably weren't safe to eat.

I am misplacing my apostrophes.

And worst of all, I have lost all filters. When Annoying Former Manager Whom Everyone Despises asked me what the little widget on my badge was, I said, "A tiny horned toad." (I like horned toads. Sue me.) She replied, "That's gross." I said, with more of an edge than I normally allow into my voice, "Everybody else who's seen it thinks it's cute; what's wrong with you?"

Her reply? "I hate bugs." (cue giggles from everyone around us.)

My reply to her reply? "Oh, I see. You're stupid." (giggles turn into open laughter.)

I need a keeper. Just for the next month or so, until I get on to days and get used to them. Please. Come grocery shop and mow my lawn and cook me soup and potatoes, and I will pay you handsomely.

Also, I just shut the cat in the window. He did not make a single protest about being squeeshed; I realized it when the window refused to shut on the third try.

All applications welcome. No experience necessary.

"That was really dumb" and other wisdom from the Five Types of Nurse Blog Trolls

Ah, Spring. The birds are singing, the tomatoes are setting fruit, and the trolls have come out from their long winter hibernation to share their wisdom with the world.

Or, at least, with me.

Every year about this time there's an uptick in the number of silly, pointless, and just plain weird comments I get. Some years there's an uptick in the volume of abusive ones, too. Most years I get many, many more anonymous emails (both lovely and not) in the spring, as the pressure of class and graduation and job-finding Gets To Be Too Much for blog-readers.

So here, then, are the five commonest types of trolls Your Faithful Blogger encounters between, say, March and June:

1. The Okay....So? Troll.

Primary Characteristics: Harmless and pointless. Usually comments on a post that is quite old.

Primary Commenting Style: That was stupid and boring. Why did you post it?

Primary Response: Okay....so? Then I go back to picking my teeth.

2. The Auto-Troll.

Primary Characteristics: Posts multiple times on multiple blogs, thanks to the wonders of spidering. Includes dummy email address with each post.

Primary Commenting Style: Hello, dear Friend, I am sorry I could not find your email address to your blog, but this is a lovely blog. My late Father, the Commandant and Supreme Commander of the Backobeyondistan Home Forces, left me sixteen thousdadn dollars upon his demise, with which I have begun a small operation selling Fashionable and Quality Nursing Scrubs to fine people like yourselves. Etcetera.

Primary Response: Yes, I really do want to delete this forever, and I know it can't be undone.

3. The Concern Troll.

Primary Characteristics: Aggression and hostility disguised as concern. Multiple posts on the same or related subjects, usually going back years.

Primary Commenting Style: It seems to me that you have a lot of issues with anger directed at your patients. When I was in the hospital for the sixteenth time last year, with my Undiagnositis, I ran into a lot of nurses who seemed to have the same issues. Just because your work schedules suck and your (sic) forced to work with difficult populations doesn't mean you have the right to refuse me my pain medicine. Maybe you should get counselling.

Primary Response: .... .... .... .... ....I am. It's called a blog.

4. The Straight-Up Lunatic

Primary Characteristics: Straight-up lunacy.

Primary Commenting Style: FEMALE NURSES ARE THE MOST UNPROFESSIONAL BUNCH EVER TO COME DOWN THE PIKE AND ARE PROBABLY LIBERAL MUSLINS AND TERRORISTS BESIDES WHY DON'T YOU EVER TALK ABOUT THE WONDERFUL WORK THAT DOCTORS DO SAVING THE PLANET FROM CONTRAILS AND GOVERMENT PLANS FOR A NEW WORLD ORDER THE CURRENCY IS BEING DEVALUED OH AND BY THE WAY YOU'RE KIND OF UGLY AND YOU'RE PROBABLY FAT. (repeated, with variations, ad infinitum)

Primary Response: Giggling. Then I post it if it's really funny.

5. The Hysterical Shrieking Ninny (thanks, Abilene Rob, for the name!)

Primary Characteristics: Having never read a nursing blog before, and having little to no skill in the field of reading comprehension, this commenter gets really, really abusive and angry. She (it's usually a woman unless it's political) accuses me and other nurses of crimes against humanity. Sixty percent of the time they pull out the "For the CHILDREN" card, or suggest I get a new job. Women then recruit their friends, who threaten to find me and ruin my career. Men (on political posts) merely suggest that I be raped and beaten.

Primary Commenting Style: I can't believe you'd write such a cruel post on XYZ. When my son had XYZ, it was easily the most traumatic thing we'd ever undergone as a family, and led to many psychological problems for me down the line. He recovered fine, but it's no thanks to awful, horrible people like yourself. You make me sick. I'll find you, where-ever you are, and tell your boss about this blog and you'll lose your job, which is only fair, because you ought to find a new one FOR THE CHILDREN so that you're not around these helpless people any more when you're lacking compassion and caring and oh by the way you're sort of ugly and you're probably fat and maybe you ought to be raped and beaten. And I'm going to tell all of my friends so, so that they can write in with posts that exactly correspond to my writing style and typos and misspellings.

Primary Response: I used to try to reason with them. No more. Now it's Yes, I really do want to delete this forever, and I know it can't be undone.

Five ack emma musings.

Jo is grouchy.

It has been One Of Those Weeks.

It's been so much OOTW, in fact, that I skipped my workout with Attila today, because I simply felt like shit. Sore, underslept, stressed out through nearly missing a haircut appointment (other curly-haired people will testify that finding a stylist who can cut curly hair justifies walking through fire) thanks to construction that caused me to miss a turn and end up driving a surface street into Dallas, of all places. There needs to be a Ouidad salon closer to Littletown, is all I have to say.

There are flies all over my back yard and thus all over Max. I have emptied the two gallon-sized flytraps three times this week; I do not know where all these flies are coming from. Somebody is not cleaning his or her yard. My poor doggy is bleeding from fly bites; I finally gave up and covered him in children's OFF this afternoon. Cedar granules are next.

I have paid careful attention to both diet and exercise for the past two weeks, staying within my Weight Watcher's points and not freaking out on frozen pizza or beer. I have gained seven pounds in that time.

My shrink employs the flakiest office staff in the world. Getting through to them on the phone is an undertaking: I've been trying multiple times a day for a week and have yet to reach anything but an answering machine (messages are not returned). All I want is an appointment for a brain-drug refill.

It's been raining like crazy, which is great for the tomatoes and crap for my mood.

I have five more shifts to work at night. The thing that sucks about that is that not only do I have five more shifts (ie, two more weeks) on nights, but when I stop, I will no longer be able to have midnight chats with my bestest buddy ever, who also works nights.

On the other hand....

I did get that haircut. They were nice enough to wait for me, since the stylist had had a cancellation. It all worked out.

My pants and shirts are baggier this week than last, which leads me to believe that I'm doing something right, despite gaining seven pounds.

The neighbors are having a baby! This makes me so face-splitting-grinningly happy that I can't stand it. They're going to be great parents.

Max came in last night *just* as it was starting to rain and spent the night having what sounded like very complex, involved dreams on his bed next to mine. Human snoring and kicking drives me nuts; dog snoring and boofing and sleep-chasing sends me right to sleep.

Maybe it's not all bad. Maybe.

In honor of my neighbors, the Man of God and his Lovely Wife...

Ten things I know about babies:

1. Babies are remarkably resilient. You can drop them on their heads and they'll be fine. They're made out of rubber and springs, and can be handled like any other mostly-sleeping animal.

2. Sometimes babies hate breastfeeding. Ur NOT doin it wrong; it's simply a personal preference on the part of the baby. If said baby doesn't like the breast, bottlefeeding does not make you a bad mother. (Corollary: sometimes babies and toddlers are way too fond of boobies. I remember vividly the time an 18-month-old tried to breastfeed on me. Bras, after that, became a non-negotiable item in my wardrobe.)

3. Babies are messy.

4. Occasionally, babies can be surprisingly loud. Luckily, your tolerance for baby-produced noise grows with the lung-strength of said baby.

5. Babies require a lot of *stuff*. Diapers alone take up more space than you ever expected.

6. No baby can stay clean for more than two minutes (max) at a stretch.

7. If you need to, you *can* walk away from a baby, head into another room, and take some time off. Just make sure the baby is on the floor, in the middle of the bed, or in a crib: someplace said baby can't fall off of.

8. If it does fall off of whatever it's in or on, it's not the end of the world. See #1, above.

9. Babies are most easily washed in the kitchen sink, with the spray attachment to your faucet.

10. Babies should be kept far, far away from Auntie Jo, lest she teach them how to say "Dilapidated Motherfucker" at the age of two and give them trumpets and drum sets before they reach grade school.

TMOG and LW's baby is due mid-December. I wondered when I last saw her if she were indeed pregnant; I seem to have an innate Geiger-counter for breeding women. The crazy hippies across the street and I are planning a tie-dye-the-onesies baby shower/party for LW; we'll see how the baby does with eight gazillion people tryin' to raise it right.

The strange case of Bret Michaels

Good heavens.

I'm not talking about the eyeliner, or the hair(piece?), or the inexplicable popularity of Poison in the past. I'm talking about his subarachnoid hemorrhage the other week, the ones that doctors "couldn't determine the cause" of.

News flash: If you have a long history of alcohol and (alleged) drug use, the blood vessels in your body--and your brain especially, since there's more complexity there--are going to be weaker and more dilated than the average bear's.

Also, if you're a diabetic (as Michaels is), you're going to have weak-walled blood vessels.

Add that weakness and dilation to poor pressure regulation and you get an SAH. It was just bad luck that his happened near his brain stem.

As for not being able to find the source of the thing, well, that happens too. A number of times our Brain Boys have gone in with an angio setup and have been totally unable to find the source of a bleed. Sometimes they close up on their own. It doesn't always have to happen that a person has an obvious aneurysm that bleeds; sometimes arteries just do that.

What *I* don't understand, though, is this: Michaels, in his first interview after the hemorrhage, said he heard something "like a gunshot" in his ear right before the headache that sent him to the hospital started. I've never, ever heard a patient with a subarachnoid mention a gunshot noise, or any loud noise, prior to their headache. It's like, they get a headache, it's the worst ever, they vomit a couple of times or pass out, and boom, they wake up to me asking stupid questions about what day it is.

Oh, and that prop hitting him on the head? Or stage-dives gone wrong? More'n likely didn't lead to this.

There. Now I've said something about the Celebrity Brain Injury Du Jour and can ignore Poison's frontman and go back to listening to Faster Pussycat.