Wednesday, May 30, 2012

Lucky fin update

I went to the orthopaedic witch-doctor yesterday for the two-week roentgenogram. Turns out that I haven't broken a metacarpal after all.

I've broken two.

*sigh*

Not only did I fracture the fifth metacarpal, but also the fourth.

To add insult to injury, I also dislocated both the fourth and third where they connect to the wrist.

Doc peered at the screen for a long time, then asked, "Are you sure you didn't hit a wall, or the floor, or something?"

"Positive, doc."

"Maybe missed and tagged a long bone, or the skull?"

"Nope."

"Wow." Long contemplation. "Use a stick next time."

*snort*

Five more weeks until they cut this damned thing off. It may survive until then.

LawDog

Monday, May 28, 2012



Never Forget.

LawDog

Sunday, May 27, 2012

Mental note: Let's not do that again.

I have a routine I follow when I know that things are about to get ... dynamic.

I take a slow breath through my nose until my lungs are full down past my belly -- and a little more -- and hold it for a slow count of five. Then I let it out slowly through my nose until my lungs are empty. Repeat twice more.

When I was taught this, I was told that it would help me shoot more accurately, hit harder and think clearer.

While I can't prove that -- and have no real desire to find out -- I'm of the impression that when I have time for this I don't get tunnel vision; the adrenaline shakes aren't as bad, and -- most importantly -- when I breathe like this the panic monster stays shackled.

As a Pavlovian side-effect of doing this before hopping off of choppers, going through doors, climbing into rings, and other assorted adrenaline-events is that when I do the breathing ritual, my body seems to start dumping endorphins pretty much immediately.

I have discovered that this comes in handy when I'm knackered. I do the breathing and it's like a double-shot of espresso -- the world clears and I can focus on whatever needs doing.

This has gotten me through more than one 72- or 96- hour ARTEP, but I've slept for a day or two afterwards.

One of the things that disturbs me the worst about this pericarditis episode is the fact that I'm only good for about four hours, then I'm exhausted.

Well, today Herself, AEPilotJim and I went out to do some errands for the upcoming PhlegmPhest and I hit my four-hour limit. Not even really thinking about it, I took a deep breath, held it, let it out; lather, rinse, repeat X2.

Voila!

I was myself! I was awake! I had energy!

For about twelve minutes. Then I augered-in, we got home, and I slept for two hours. And I'm still wiped-out.

Yeah. We won't be doing that again for a while.

LawDog

Friday, May 25, 2012

Part, the Second

So. There I am, in the back of The Big White Taxi, my blood pressure is 116/68, pulse is 72, mood is grouchy.

The paramedic, bless his heart, has agreed with me that I am not -- as a matter-of-fact -- having a heart attack. He has run another 12-lead using his EKG and has shown me a strip which shows mild ST elevation on just about every lead, and is busily trying to find a vein.

As he is rooting around, he asks, "Don't like hospitals?"

"I had this exact same pain last year. I thought I was having a heart attack, so I had my lady drive me to the ER -- did you know that the ER doctor association at Big City Hospital doesn't accept County insurance? -- spent four hours in the ER, to find out that it was pleurisy, given steroids, anti-biotic, Aleve and a bill that I finally got paid off this past month."

"Ah," he grunts.

"I've got a really good vein in the back of my right hand. Everyone hits it. Pop that cast right off, and you'll be able to see it from orbit."

He gives me Ye Olde Hairy Eyeball and keeps checking my left arm.

"Since then I've had about six or seven flare-ups. Same type of pain, same location, just not nearly as bad. The first time I hied meself over to Big City Urgent Care, waited for four hours and was told I was having esophaegeal spasms, told to take Aleve, and if I had further episodes, that I might need anti-anxiety meds."

I wave my cast at the paramedic, who still seems to have not found a vein to his liking. He starts eyeing it speculatively.

"The second time, I went back to Urgent, got the same answer. And did you know that the labs that Urgent uses don't take County insurance? Yeah, me neither. I also got the distinct impression that even though I don't like pain meds and frequently refuse to take prescribed pain meds, that the folks at Urgent were suspecting me for fishing for an opiate scrip."

My bad luck, the paramedic hits the vein above the cast first try.

"So the next two times, I went over to Bugscuffle Clinic and Tyre. The doc over there diagnosed it -- both times -- as 'chest wall spasms', suggested Ativan the first time, and Xanax the second, along with a gentle noodge to make an appointment to see the travelling psych doc. So. I double-dose on OTC Aleve for three to five days, it gets better, no muss, no fuss."

And we pull up to Big City ER, the first person I see is the charge nurse.

"'Dog," sayeth that worthy, "What the hell?"

"Not a heart attack," I snip, for the umpteenth time, as the paramedic says, "Called to Bugscuffle Clinic and Tyre for AMI." We go through the Standard Report, and next thing I know I'm in an ER cubicle with Charge Nurse and a padawan. Introductions are made, and then Charge Nurse says, "Remember what I said about 'Special Needs' patients?"

Padawan nods her head enthusiastically, "They're iron-assed, bull-headed, and mule-stubborn; too [deleted]ing ornery for their own good, and too [deleted]ing stupid to go to a hospital instead of dying."

"Yes. And this is their king."

"Hey!"

"Given the history, and the presentation, what do you think we have here?"

Padawan frowns at me, "Umm ... pericarditis?"

"Very good. Here's the ECG strip, see the ST ..." The two of them wander off, leaving me to my ownsome until Chris shows up, followed shortly by my lieutenant, AEPilotJim and my lady love.

Long story short, some time later a doctor wanders in, announces that there have "Been changes" to my EKG since the Great Pleurisy Incident of 2011; that a heart attack "Cannot be ruled out" and I'm chucked into a bed in the brand-new Cardiac Care Unit.

Several hours later everyone has gone home, I'm working my way up to "Irritated" from "Peevish" and I open my eyes to find a stranger sitting beside my bed. At midnight. In a hospital. Figuring someone had wandered into the wrong room, I cock an eyebrow at him.

"Oh. Hello," sez he, "I'm your cardiologist."

"I don't have a cardiologist." I reply, somewhat snippily, I admit.

He grins, "You do now."

We size each other up for a moment, and I announce, "I am not having a heart attack."

"Nope," he replies, with a great deal of relish, and more than a touch of confidence, "You are not."

"Great! So I can go home?"

"Charge Nurse called me. We had a long talk, and I'll make a deal with you: You let me do one quick check to verify the pericarditis, and if you feel up to it when I'm done, you can walk out of here with my blessing. Deal?"

I figure, what the heck, nod in assent and my new cardiologist puts the flat of his hand against the left side of my sternum and pushes towards my right shoulder-blade.

The world goes grey, shot through with red flashes. I really, really want to scream, but it hurts too bad to breathe. It feels for all the world that I've just been kicked in the chest by a bus, and the damned thing has parked a tyre on my shoulder blade and is spinning out.

When everything comes back into focus the doc says, "I don't think you've ever had pleurisy. I think you've been fighting pericarditis for the last year. I don't like hospitals either, but you're 45, diabetic, and your heart is pissed-off at you. Spend a night or two here, we'll get you started on colchicine, echo your ticker to see if there's any damage, and send you home. Deal?"

You know, I really couldn't argue with that.

LawDog

Pericarditis, and you

The pericardium is a double-walled sack around your heart. It is slicker than greased weasel snot, and is usually lubricated with a small amount of pericardial fluid. During the normal course of your day, the two membranes and the cardiac muscle slip past each other with nary a care in the world.

Other times ...

Several nights ago -- just before the "Hey, I just broke my hand on a critter" day, matter-of-fact -- I was yanked out of a sound night's sleep by the somewhat unique sensation of getting hammered through my chest to just under my left shoulder blade by what can be best described as an ice-cream head-ache with troll genetics, a lead slapper, and a grudge.

I staggered out of bed, into the bathroom and assessed the situation: There was chest pain, but it didn't have a "heavy" sensation; it got worse if I bent forward, laid on my back, or took a deep breath; I was sweating, but not clammy; and there was a feeling of general pissed-off, rather than fatalism or anything else.

Ergo, I thought to my self, pleurisy. Again.

So, I downed two naproxen sodium and held my breath in the recliner until the pain subsided enough that I could doze back off.

Last April, AEPilotJim was visiting, and we were enjoying something dead and not very burned at a local eatery when this exact same thing happened. At that time, Herself and AEPilotJim rushed me to the ER where it was determined (after one metric butt-ton of very expensive tests) that the sensation I was not enjoying was not a heart-attack, but "probably" pleurisy.

I was given a prescription for steroid horse-pills, non-OTC naproxen sodium, and a anti-biotic; and advised to take a couple of days off.

While the pain did go away, every once in a while since then I've been getting a somewhat-less-agonizing repeat -- each of which has been diagnosed as "chest-wall spasms" or "esophaegeal spasms" or other ailments which seem to be primarily treated by a regular dose of anti-anxiety meds.

Well, bugger that for a lark. I figured the pleurisy had left a weak spot over a lung, and each time I'd take naproxen for a week, it'd get better, and voila!

Fast forward to now. AEPilotJim had arrived in town for a visit a couple of days ago. As is tradition, we went to the same eatery, and the next day at the office I was assigned to work a rather warm control room. About 90 minutes into my shift the nagging pain of my pleurisy episode had increased, but the alarming thing was the fact that it was slowly getting harder to breathe.

I gave myself the rest of the day off, and -- since my lady tends to fret about my health -- I decided I would go by Bugscuffle Clinic & Bait and have them take a picture of my lungs so I could reassure her that I wasn't having pneumonia. Again.

"Hello!" chirped the alarmingly cheerful receptionist. I marshaled my thoughts -- there were so many ways that what I was about to say could go very bad, medically-speaking -- then said, very gently and with all of the confidence I could muster: "Yes. I've a touch of pleurisy. I've had it before. I just need a chest x-ray to make sure nothing dramatic is going on."

Low key, right?

So, I'm led back to a cubicle where a Nurse Practioner is already waiting, and the first question out of his mouth isn't so bad: "Soooo ... pleurisy?"

"Yep," sayeth I, "I've had it --" The next question cuts me off mid-speech, and I know I should have gone on home. "Sooo ... your chest is hurting?"

I look at the eager young eyes, and something in the back of my mind sighs, pulls a Migraine Salute and whispers, "Don't bother. The path from here is preordained", but I try anyway.

"Yes, I have chest pain, but it is positional. It is worse when I lie down or bend over. It gets worse when I breathe in, but exertion does not make it worse. I've had this exact same pain, in the exact same place, before and it was pleurisy," I look at another nurse who is busy pumping on my arm, "Look, my blood pressure is 120/76. I'm willing to bet large amounts of money that my pulse is strong and steady at between 60 to 80. I am NOT having a heart attack."

"You are over forty, past history of diabetes, hypertension and hyperlipidaemia?"

"Yes, but X plus Y plus Z doesn't necessarily equal 'Acute Myocardial Infarc', either. I just need a chest x-ray to make sure I've not got pneumonia and that my lungs are still where they should be, give me some NSAIDs and send me home."

He adopts the soothing tone instilled in nursing school and I know I'm screwed, "I checked your file, and you don't have a baseline EKG in there. That's something we like to maintain, so why don't we go ahead and knock that out while you're here. Okay?"

I figure, what the hell, get the EKG out of the way, only a little bit of extra time, then home, right?

When the tech ran out of the EKG room so fast that her crocs were smoking, EKG strip clenched in one paw, I started to get peevish.

Of course, this was followed by the NP bounding into the room, EKG clenched in one paw like the Six Lost Commandments, and announcing, "You! Are having a heart attack!"

I heroically resisted saying the first thing that came to mind, instead stating -- rather firmly, I admit -- "No. I'm not."

"You are! Right now! Here, swallow this aspirin! Good, slip this under your tongue! Now, see this EKG? This part! You don't understand it, but trust me! This is your heart dying! Denial does not change fact!"

I glare at him, grab me cell-phone and call Chris, "Chris, Bugscuffle Clinic & Bait is saying I'm having a heart attack ..." and then that little voice in the back of my head says, "Oy. Sub-lingual? That's nitro. But my blood pressure was 120/ ... Weasels! Popcorn! Bretty putterflippthbb, ppthhbb, ppthbb*"

I wake up several minutes later, in screaming agony because I'm flat on my back, and the first thing I see are the softball-sized eyes of a good friend in his Bugscuffle PD uniform. Then I notice that the entire room is full of Bugscuffle Volunteer Firemen. And that Nurse Practioner is rubbing two cardioverter paddles together with the sort of beatific look on his face that tells me that I have just made all that schooling, testing, time and money worthwhile.

I roll to one side, then push myself to a sitting position BECAUSE THE PAIN FROM THE PLEURISY IS BLOODY WELL KILLING ME, and snarl, "I am not having a sodding heart attack, so don't even think of coming near me with that ... oh, bugger. You called the ambulance, didn't you?"

Sure enough, wading through the horde of First Responders with a reassuring air of humour and cynicism is a set of paramedics from Big City. One of them kneels next to me, "Hey, sport. How are you doing?"

I look at him, "How do you feel about listening to your patients?"

"Makes my job easier."

"Condescension?"

"Pisses me right off."

"We're going to get along just fine. I have chest pain. It is positional, and gets worse when I take a deep breath, or lay flat on my back. I've had this exact pain, in this exact location before, and it was pleurisy. I am not in denial, and I am NOT having a heart attack."

"Nope. You're not. But your EKG isn't right, either. Let's go ahead and take you into Big City Memorial, let someone with a lot of letters after their name make sure this isn't going to go south on you."

I take a breath and he leans forward, and says, sotto voce, "I broke my Edison cherry a long time ago, and I'm not jonesing for a chance to kink your curlies. Be safer in the Big White Taxi."

"Load me up."

Part 2 to follow.

LawDog

Monday, May 14, 2012

Well bugger.

It seems that I have broken my right hand.

More specifically, it seems that I have broken the fifth metacarpal in my right hand, a/k/a the bone connected to my little finger.

It says something about me that the next question is answered by: "Rabbit punches."

Why, yes, I am a dirty fighter.

Over the years my fighting style has (semi)unconsciously moved from a really vicious and dirty straight-out-of-the-gutter striking discipline to a judo/sambo-based grappling style. While the transition is mostly due to my being inside the jail where knuckle-dragging back-up is always within eye-sight, the officers are the only ones with boots, and everything is under the unblinking eye of cameras (To a camera, a dropping hip-throw looks ever so much kinder than a shovel hook to the liver. The recipient may beg to differ -- landing on a concrete floor with 170-pounds of me using his rib-cage as a cushion seems to engender a sudden belief in the mercy and benevolence of Insert Major Organised Religious Figure Here -- but the recipient's opinion on the matter doesn't count)

[note from Phlegmmy- he's been typing this with his brace off. I told him if he was meant to remove the brace for typing, the folks at the hospital would have told him, "Keep this brace on except when you want to type something." What do YOU think? *exasperation* I say if half the planet can type one-handed, then he can muster, too. I'm told it's quite common on the Intarw3bs.]

I would be remiss, however, if I didn't admit that getting older has no small influence on the shift. Punching and kicking, and the slipping of same, is really a young man's game. A two-hour work-out on the focus-mitts, the heavy bag, and sparring leaves me downing Tylenol like candy and requiring assistance to get out of bed the next morning.

Two hours of judo practice, on the other paw, leaves me with the slight "good" ache that usually goes away before supper.

Unfortunately, in cases of sudden, unplanned dynamic social interaction I tend to default to the gutter and the Glasgow kisses, ear slaps, fish-hooks, gouges, rabbit-punches, knee shots to the groin, elbows into the eye-brow, kidney shots, liver shots, floating rib shots and all the other goodness that is the result of a childhood in the overseas oilfield staffed by multi-national veterans of wars ranging from World in scope down to the nasty little bush wars of the 60's and 70's.

*sigh*

Ah, well. I see the orthopaedist tomorrow. In the mean-time, it's a deuced inconvenience.

LawDog

Wednesday, May 02, 2012

Beltane

In the Wheel of the Year, May 1 is fairly important.

To some, it is Beltane, when the bonfires should be lit on hilltops to drive away the remnants of Winter, to welcome Summer and to recharge the hearth-fires.

To others, it is Walpurgis Night, a time to have one rollicking party around a bonfire -- dancing, drinking, laughing, doing the other inevitable stuff what happens when you combine drink, dancing, mixed company and a bloody huge fire.

In Finnland and Sweden, they do the same -- only more partying -- and they call their fire-festivals Vappu and Valborg.

May 1 is also a fertility festival, involving picnics, (ahem) Maypoles and the dancing around same (winkwinknudge), general dancing, placing of roses by maidens, choosing and crowning a May Queen, Morris dancing, and for the Catholics out there, the acknowledgement of Mary as the Queen of Heaven and the Mother of God -- usually involving adorning an image of Mary with flowers.

Since most of the homelands of our ancestors celebrate May 1 with fire, flowers, fire, dancing, fire, drinking, fire, badly-camouflaged fertility rites -- and fire -- of course the stodgy, Puritan United States has ...

... Loyalty Day.

*sigh*

Public Law 85-529, found in Title 36, Chapter 1, paragraph 115, penned by the Congress of the United States on July 18, 1958; and signed into law by President Eisenhower who then issued the first proclamation designating May 1, 1959 as the first Loyalty Day*.

Every sitting President since that day -- following the mandate of Public law 85-529 -- has, on each year, proclaimed May 1 to be Loyalty Day.

Personally, I think Loyalty Day should follow in the footsteps of our ancestors and involve fire. A Big Fire. A Big Fire in front of various State and Federal Capitals, and involving the ceremonial burning of effigies. Dancing and flowers mandatory; drinking and partying encouraged; and fertility rites optional.

To my mind I'm thinking that watching papier maiche versions of themselves burned at the stake every year would go a nice way towards reminding various political critters of where their loyalties better damn-well stay.

But that's just me.

LawDog

*We read history books, Gentle Readers, we do not eat them.