When one's doctor turns out, as mine has, to be a world-renowned specialist, the concept of "as soon as humanly possible" doesn't necessarily mean "soon."
In this case, we're waiting to see if he can squeeze me into his schedule for surgery as soon as next week, but that remains iffy. There has to be some pre-surgical workup done, of course, though I don't really know the precise nature of what needs to be done pre-op.
When I do go in for surgery, it might be as quick as just an overnight stay. The surgery itself, I'm told, is pretty simple, as such things go. Thirty minutes to an hour, I hear. One day of recovery time in the hospital, and then home.
When the prospect of a shunt was first raised, one of the questions I asked was, how much downtime will be required afterwards? In short, how soon can I go back to work? The first answer rocked me back on my metaphorical heels — six to eight weeks. Holy smokes.
I explained that not only do I work from home, but that my work consists mainly of looking at computer monitors and typing, with only the occasional phone call. Armed with this knowledge, the docs told me that I can estimate a week or two of downtime at home. I could, in theory, be walking by Thanksgiving.
That presupposes that I can actually get onto the surgery calendar sometime soon. Maybe they can wedge me in next week. I surely hope so; this has gone on long enough.
The phone rang earlier today, and I was surprised (to put it mildly) to hear my neurosurgeon on the other end of the line. He was in his office catching up after returning from the annual conference (Research Update in Neuroscience for Neurosurgeons) for which he was Director, and was making calls so his desk would be clear on Monday. After a minute or two of polite conversation, he got to the point.
Based on testing and on my symptoms, a shunt is not a sure thing for a 100% fix, but it will yield positive results. The thinking is that there are probably two separate things going on in my central nervous system, and that surgery will alleviate one of them, allowing the other to be looked for without the complication of hydrocephalus.
Thus the doc's recommendation is that I have the surgery to install a shunt. Any other condition notwithstanding, it will improve my physical capability.
It may be brain surgery, but the decision to have it is, for me, not exactly rocket science.
I think we'll be scheduling this to happen as soon as humanly possible.
Envy — Whoever gets to kick Ted Rall's ass for this, I envy.
Lust — Someone really really likes fire... in an entirely inappropriate way. Pity we don't use firing squads to deal with such.
Gluttony — They always want more, and they won't rest until they get it.
Greed — Illegals demand: "Gimme gimme gimme!"
Sloth — Too lazy to do due diligence in their reporting, TNR gets pwned by Bob Owens.
Wrath — Code Pink is mad... mad, as in "insane."
Pride — "I'm a reporter! Respect me!" Um... no. That syllogism just doesn't work.
While digging through 25 years worth of personal effects, looking to get rid of a lot of pointless junk that has accumulated over the course of my life (and without which I could really do), I found stacks of photos — hundreds of them — that I took while I was in the Army in Korea from 1988 to 1990.
Sorting them and identifying the people in the pictures will be an overwhelming task... but I think I might scan a few and post them here from time to time.
For now, a picture from October 1988, somewhere near the DMZ in South Korea, a much younger me takes a break to listen to a cassette and write home.
Wow. I used to have hair.
(Directed by Zack Snyder, starring Gerard Butler, Lena Headey, David Wenham and Dominic West)
Official tagline: Prepare for glory!
Better tagline: Putting the 'graphic' in 'graphic novel.'
If anyone else were to talk like this, family members would be shaking their heads and muttering about how maybe it was time to put grand-dad in a home.
But it's just a ranting loon Democrat congressman, so I guess it's par for the course.
On Hillary!'s propensity for gathering campaign funds:
The thing about donations from the Chinese is that no matter how much you get, you'll want more an hour later.The too-clever-for-his-own-good Frank J.
I believe the technical term for this is "making a silk purse out of a sow's ear."
Not, of course, that Limbaugh's comments that started the whole brouhaha could actually be classed as "sow's ear" by anyone who actually heard what he said at the outset.
Harry Reid, though, is just a self-serving opportunistic pig.
"Big Cat, Little Cat."
Mycah has been on a diet, and though it might not be obvious, she's slimmed down from her rotund maximum (almost 20 lbs when I got her) to a comparatively svelte 14 pounds.
Svelte? Rubenesque would probably be more accurate, in absolute terms. But having lost a few pounds, she is much livelier and more active than before. She still has a few pounds to go yet.
Complain though she may about not getting as much food as she wants, it's for the best. Her health comes first.
And she'll usually accept skritches in lieu of food... for a while, anyway.
Also this weekend: the Carnival of the Cats, at Bad Kitty Cats.
A word of advice: People who live in glass dunce caps shouldn't throw stones. Or, you know, those snub-nosed scissors gradeschoolers are always using.The inimitable (and I should know, I've tried) Jeff Goldstein
Via Tim Blair:
"They’re probably going to use it to commemorate the day they expelled Greenpeace from the town,” he added.That's something worth memorializing.
You might have noticed the button I've put up on the site.
And surely you're asking yourself, "why, in this day and age, would a person not have medical insurance to cover those costs?"
Long, convoluted story. Or maybe not so convoluted.
I'm a contract employee with no benefits; in the tech industry, this isn't altogether unusual. When my current medical crisis began, though, we all thought it was related to an old Army back injury, which would be covered by the Veterans Administration. Then last autumn, I was informed by my management that my employment status would be upgraded and converted to regular (benefitted) at the start of 2007.
In short, I had no need to buy insurance. I was covered for this. Then, two things happened.
First, the doctors changed their assessment of the cause of my medical problems. No longer could it be attributed to my VA-coverable injury, so naturally the VA will not cover my medical care. I don't begrudge them this at all; that's just the way things are. I checked this every which way; the only way I could receive treatment from the VA would be if I were unemployed and homeless, which isn't about to happen.
Second — and this is the irksome bit — someone at the VP level at my place of employment decided that the best way to make his budget numbers look good to his boss was to freeze all personnel actions. I'm not the only person who has been waiting since January to receive an overdue promotion or even conversion to "regular" status.
This, mind you, in an organization and at a company that professes to believe that its people are its most important asset. They sure have a funny way of showing it.
Me and a dozen of my coworkers have had our careers put on hold, just so a VP can maximize his annual bonus. I hope he chokes on it.
I'd have walked out the door to a new employer months ago, except for the inconvenient fact that I can't actually walk. As soon as I can walk, though, I will walk. But not before I visit the VP and leave him my crutches as a reminder that "personnel actions" have a human cost.
So that's where things stand. I'm at a job I can't afford to leave and at which I cannot afford to stay, and I can't get new employment until I can actually walk into a job interview.
Of course, I can't now get insurance to cover this now-preexisting condition. This is what is known as "slipping through the cracks." Or "bad luck." So be it. As I have noted before, if we had a Hillarycare-style system, I'd still be waiting to see a neurologist; indeed, it probably would have been illegal for me to get this far by paying cash.
In the meantime, I've run up tens of thousands of dollars in medical bills, all paid out of pocket. The total is likely to double before all this is over, however — especially if they're going to do this to me. My pockets only go so deep... and I've already reached the lint.
And that is why I've put the tipjar/begging bowl front and center, and right here:
Probably the brain surgery.
On my return home from the hospital Thursday, a box from Amazon.com was waiting for me. Inside: Steve Graham's latest literary endeavor, Keep Chewing Till It Stops Kicking.
Over the next few days, when I wasn't busy sleeping off the effects of my medical misadventures, I was reading... reading, and laughing.
This is a terrific book. A translation of the cave-wall diary of caveman "Hal," it details many aspects of his daily life and the society of five million years ago, give or take a week.
Hal tells of the problems faced by his contemporaries:
The main problem with early spearheads was, we still hadn't discovered the fully detached stick.We had nothing to attach the spearhead to, so instead of a spearhead, it was more like... a head. If you wanted to kill a mammoth, you had to run up to him, hold the spearhead against him, and push. And while you were doing that, he would usually wrap his trunk around one of your ankles and use you as a flyswatter.He also offers some wisdom which could only have been gained through experience:
Pretty much the only way to survive a velociraptor attack is to not be the slowest person in the area.Hard to argue with that.
With chapters such as "Clothing: Sometimes Back Hair Just Isn't Enough" or "Medicine: Trepanning And Ritual Mutilation For Dummies" there is going to be something everyone can relate to.
No, I have no personal reason for references to back hair and medical care. No reason at all.
For Steve's sake, I hope the book does very well. I also hope the Geico advertising people have either a sense of humor or a completely gecko-centric view of copyright infringement.
My only criticism would be that the book seems a bit short — not unusual for humor. This is the sort of thing that you want to make last... but at the same time, you don't want to put it down. Maybe I just read too quickly.
Keep Chewing Till It Stops Kicking gets my full endorsement.
I've been back from the hospital for about 32 hours now, and I think I've slept about 24 of those hours.
Part of that is the near total lack of sleep I had while actually an in-patient. Not only are those hospital beds terribly uncomfortable to begin with, but they have added inconveniences which maximize the discomfort for someone like me.
- They're too short. At 6'8", I am used to sleeping with my feet near or hanging off the end of the bed. I'm just used to it. Not so this week, though; the hospital rack had a footboard that constrained my feet, which is a serious obstacle to rest.
- The beds are also designed to force a person to slide down from the head end towards the foot. Any upward tilt of the head section leads to an inexorable involuntary migration towards the foot end. Perhaps this explains why they have a footboard. No hospital wants to be responsible for its patients slipping the long way off the bed onto the floor.
- Perhaps worst of all, though: the beds are designed with some sort of air compression system which is designed to reduce or eliminate the problem of bedsores by inflating sections of the bed and causing the patient to unconsciously shift his weight around to keep from falling out of bed. This would be fine, except that the air compression unit sounded approximately like a B-52 taxiing towards its runway. (Mom thought it was more like an F-15, but I'm not about to quibble.) It never stops, and you never get used to it.
That's just the bed. Have I mentioned what they actually did to me there?
I got to my room after about 4 hours of dithering. They said be at Admitting at 9am. OK, fair enough, we were... and then were kept waiting for about an hour, then another seemingly interminable wait for a wheelchair escort up to the room.
Once in the room, I met my day shift nurse, a real nice girl (indeed, the nicest thing about the entire stay there, named Melissa, very cute in a Shirley Temple sort of way — not The Littlest Rebel Shirley, more like Fort Apache Shirley) and then we commenced to wait for the Physical Therapist, so that I could be tested and a base level of neuromuscular performance could be set. 'Round about 3pm, that person showed up. So essentially, I could have slept an extra five or six hours instead of dragging my night-shift-working ass out of bed at 0630 that morning.
The PT testing complete, it was back to my room — a private room, thankfully — to wait for the lumbar puncture. An IV antibiotic was plugged into my right forearm, and then the attending neurologist, Torquemada by name, arrived and set to work with a will. A bit of topical anesthesia at the insertion site, and then....
Pain. Pain. PAIN.
Perhaps not the worst pain I've ever experienced, but the margin was small, and gout isn't voluntary. I mean, I didn't have to show up at the hospital. No one made me. I think they'd have stopped if I'd asked. There wasn't a prearranged safety word, though. Odd, that....
It would have been over quicker, but along with my being extremely tall, my bones, vertebrae included, are larger than a normal-sized person's. Consequently, it took that particular agent of the Spanish Inquisition longer than usual to get the tap into place; he had farther to go. And he had to use a bigger-than-usual needle to get the catheter into place in the spinal column. He didn't seem disappointed, if the chuckling was any indication. And I could feel every second of it, though oddly, I felt it in my hips rather than in my back. It went on and on and on and on for what seemed like hours, until... nothing. It was over.
Well, almost over. I had to be stitched to keep the catheter in place. The insertion had taken so long that the topical anesthetic had worn off. I felt the stitching... though compared to the tap insertion it was a sort of bliss. Sort of like the lesser agony marathoners describe as a "runner's high" — still miserable, but the endorphins must have kicked in.
The catheter having been inserted and the flock of Jesuits having departed, taking their branding irons and thumbscrews with them, I was left on my own. For the remainder of the day and well into Tuesday, the entirety of my role in the enterprise consisted of laying in place while leaking cerebro-spinal fluid into a bag and having the IV antibiotic (which worked on some sort of incendiary principle, given the burning sensation) changed every six hours.
Due to the aforementioned bed difficulties, this was not as easy a proposition as might be supposed. Compounding the problem was one of my primary symptoms: when I lay flat on my back, my legs spasm uncontrollably. I didn't sleep much.
The therapist came back for part two of the testing — the idea being that if my neuromuscular responses improved after the fluid in my brain was reduced, it would be a good indication that installing a shunt might be the solution. There was measured improvement, but not enough to satisfy the neurologist. I had to stay another night.
By that evening, the IV antibiotics had corroded the vein in my right arm, so it was relocated to the back of my left hand. They were apparently saving my left arm for blood withdrawal... a savings of which they made good use.
That morning my fluid levels were lower than ever. Having again had no sleep, I repeated the tests with the therapist. Despite the lack of sleep, there was more measurable improvement, but still not enough to satisfy my neurologist. So I had to stay yet another night. I was, to say the least, not thrilled at the prospect.
That night, I didn't even try to sleep. The night nurse came in just before midnight to plug in my dose of napalm (after relocating the IV yet again, to the back of my right hand) after which I passed out for maybe two hours. From 2am on, I read one of the books I'd brought with me and waited for the Thursday day crew to show up.
First thing in the morning, the therapist showed up to test me again; again there was improvement.
In rapid succession the attending neurologist (the doctor previously known as Torquemada) removed the drain from my back and stitched me up; my neurosurgeon's nurse came with a stack of papers to get me out of the hospital; a wheelchair showed up at my room, and I was whisked away. Fortunately, my ride (hi, Mom!) was already there with me, so I wasn't subjected to being unceremoniously dumped on the sidewalk in front of the hospital. Almost as soon as I got home, I collapsed on my bed and actually slept.
And that was that.
I'm still quite sore, and the improvement shown during the hospital testing has reversed itself now that my spinal fluid is not being actively drained.
I expect we'll have a recommendation from the neurologist and neurosurgeon next week. Pins and needles time, people.
You — yes, you! — can help.
It happens to be "Kid's Week" on Jeopardy. A bunch of snot-nosed juveniles competing for cash.
I'm pretty sure I could take any of them.
It might be easier to let them finish and then mug the winner.
I'm quite exhausted and extremely sore, but most importantly (for the moment, that is) I'm very much at home.
The lumbar puncture and draining is complete, having gone three days rather than the originally-anticipated 24 hours. The results seemed to me to be positive, but the final determination will, of course, be up to the neurologist and neurosurgeon.
I can definitely tell that my fluid levels are filling up again, though. The tests this morning showed definite improvement, but just 6 hours later now, my legs are again all but useless. Some of that can be ascribed to the fact that I've been off my feet and confined to a bed all week, but I think the fluid explains more.
I had no more than three hours sleep per night while I was in the hospital; as soon as I got home I slept for about two hours. Right now, I'm off for another date with my pillow.
(This entry brought to you by Russ' sister, via telephone)
There are many things worth taking one's time to enjoy. A spinal tap is not one of them.
On the plus side, at least I get another day's worth of hospital food.
Should be back tomorrow.
P.S. The beds here are so uncomfortable, they should ship a few dozen to Guantanamo. Then the International Red Cross would really have something to complain about. One does not so much sleep on them as pass out due to exhaustion.
Monday, bright and early, I head to Duke for a three-day hospital stay.
First I'll see the physical therapy folks, who will do some tests on me — setting benchmarks with actual numbers.
Then, I'll again undergo a lumbar puncture. This time, they'll hang a bucket on me and leave the drain open for 24 hours. Because the body can produce as much as a pint of cerebro-spinal fluid per day, they want to drain enough so that the effect of vastly-reduced CSF volume can be judged. I'll be staying overnight.
The next day, after the tap has been removed, it'll be another trip to see the PT people, who will repeat the initial tests on me, so as to compare the numbers with the previously-established benchmarks. The expectation is that my neuromuscular performance will be better after the draining.
And that should be the proof that hydrocephalus is the problem.
I'll then spend another 24 hours at the hospital, specifically to ensure that I don't get an infection and that the puncture site doesn't leak, which could have moderately dire consequences.
If the test results are as anticipated, we'll schedule surgery to install a shunt sometime in the following week or two. They tell me it's a 30-minute operation (which I rather doubt, but who am I to say otherwise?) followed by 24 hours as an in-patient, after which I can go home and spend between one and eight weeks recovering.
Yes, up to eight weeks. It's brain surgery. I just hope that they don't accidentally remove my math or language skills.
Improvement, however, should begin virtually immediately after surgery. I'm really looking forward to being able to walk again. Then there's physical therapy. There are more than a few muscles that have atrophied and are going to have to be worked pretty hard to get back up to speed after all these months.
That is, if this upcoming test gives a solid result. It had better.
I've begun having headaches pretty regularly.
If you're new to the story, you can read the entire tale of woe by going here, starting at the bottom, and scrolling up.
As an aside, I'll note that this entire thing has been horrifyingly expensive. Not so bad that I can't get the necessary medical care, but as a contractor at my workplace, I'm not blessed with insurance coverage. I've missed a somewhat substantial amount of work, with more absenteeism in the foreseeable future.
[No, I'm not interested in having a national healthcare system. If we had that, I'd still be waiting to see a neurologist.]
So, if you ever wanted to hit a tipjar, now might be a good time. I promise I won't pull an "Andrew Sullivan" on you and disappear for a month.
Whether or not that's a good thing remains to be seen.