Thursday, January 21, 2010

Karen's views on health matters

I had a student when I was an Artist in Residence in Keyser W. Va. that took guitar from me. Her name was Karen Spots It seemed all the kids that were not following the road well traveled were attracted to that class. Karen was on of those.

She was, as I remember was energetic, not given to taking things at face value, and when she got hold of something, she went after it. She ended up going to U W Va and got a degree in music and on to some school of music in New York for a masters in voice and piano. She now works in Brookland NY (a far cry from Keyser W Va!) as a choir dierector and Organist/pianist for a small church..

Karen emailed me a year or so ago after 30 years, congratulating me for still being alive. She found me through the website, and after listening to the music cuts emailed. She's into oldtime and bluegrass music and still has the first guitar I sold her, an Ibanes acoustic from the mid 70's. She has upgraded to a Martin, so she's serious about this.

Karen was going to take my guitar class at Allegheny Echoes, a music camp I teach at in Marlington W Va, run by the Bing Brothers and John Blissard. She didn't make the camp last she explains here...I laughed till my sides hurt.

My stay in hospital yesterday caused me to reaquaint myself with this piece. I can't read it all now, it make my belly hurt.


This summer I went on a trip to the hospital compliments of Empire Blue Cross/Blue Shield and a consent form I signed trading a troublesome organ for a small yellow bag of morphine. It promised to be a new and life changing experience without all the hassle of peak season airport travel, but the brochure was just a come-on with the ‘Don’t eat anything that day’ and the ‘Don’t take any Advil’. It was woefully inadequate.

The following observations may help dispel some of the myths surrounding any Traveling On Opiates Via Major Surgery you may have planned for your next holiday. Although I learned a lot, I did not float above my body feeling the inner calm of another dimension but instead was too tired and nauseous to get out of my body and forgot where it was I wanted to go anyway.

Slicing open your lower abdomen, flipping your innards out of the way and cutting out a grapefruit shoved inside a marshmallow is going to cause you some discomfort. But there is no way to anticipate that substances designed to keep you from going into shock and dying from pain won’t actually keep you from being extremely unhappy and unbearably uncomfortable. I did not expect this.

When I have a headache, I take Advil. When I have a big headache I take Naprosyn. When I have a migraine headache I take Maxalt. When I am upset that I have a headache I take Valium. When I hate everyone because they are idiots who gave me a headache I take 2 Valium. When I hate everyone but have to eat dinner with them in public, I take 2 Valium, have a margarita and then make caustic remarks out loud that I should keep to myself but I know everyone is thinking anyway.

The point is, the success of self medication requires proper diagnosis and dosage. With good D&D you respect the strengths and boundaries of their powers and set up a win/win situation. And they need that success every bit as much as I need to calm the hell down before I flip the bird and cut off an inconsiderate driver with a pistola. Headaches suck almost as badly as stupid people, but nobody needs to die for them. So when I set up a drug to succeed I DO NOT ANTICIPATE FAILURE. Hospitals do not concern themselves with these details.

RECOVERY – Your Show of Shows
After major abdominal surgery, you feel very sick and so so tired, even though you are on morphine. Every minute you are awake is just another 60 seconds in which all you can think about is throwing up, so thank God there are special people there to take care of you. Curiously, the people there to take care of you are evil. Recovery nurses smile while they are hurting you, they sing to make mean things sound nice. ‘La La La! Wake up, sleepy head, you just gonna lay there and sleep all day! La La!’ while they poke-poke-poke you to make sure you’re still alive. And you just lay there full of self pity because you’re just too nauseous to sit up and say ‘Oh F*#% OFF you old hag’.

And the Recovery Room itself comes off as less of a professional venue and more of a crazed gobbledy-mish-mash not unlike a Phish concert: everyone is hallucinating, the noise is unbearable and you just keep praying for it all to end.

1st time I woke up: Annoying Relatives of Other People
Someone’s relative enters Recovery and passes out in the room seeing so many people passed out in the room. This seems to me not only dramatic and self centered but redundant. And honestly, they just don’t have the extra beds.

2nd time I woke up: Things only Jesus could do
An 11 year old girl arrives having had both legs broken by speeding Mercedes driven by an 18 year old boy. She is waking up after having pins placed in her legs and she begins screaming ‘Get me up, NOW’ and ‘I’m going home!’ Then the Dr, apparently having had 2 valium and a margarita, says out loud, ‘Let’s hope that kid’s family has some money. Booyah!’ But even that can’t resurrect her 2 broken legs and the family members grow silent staring at each other wondering ‘Which one of us has to stay home and listen to this shit for the next 3 months?’

The 3rd: The Circus is coming to town!
A large cage with a small hairless monkey is delivered to the recovery room. This is more like it! until the monkey wakes up screaming and they scramble for snacks. I make note to self for a research paper; Which will pierce an ear drum first, a toddler coming out of anesthesia in a strange cage or a monkey that just wants some jello. Send results to The Lancet.

Recovery nurses are also bad drivers, which explains who I have been flipping the bird at on the Belt Pkwy all these years. When they finally take you to your room they yell at everyone to get out of the way for show but smash into them anyway just for spite. Small beeping machines, elevator doors, other patients, they are all just competitors to be annihilated in the big stock car race to your room. And once they cross the finish line, they slam on the brakes, throw your chart on a chair and skedaddle so they can cram in a latte on the way back down to the Big Top.

At 4am, I feel pain. Not the regular pain of the last 15 hours, but a much heavier, burning pain. I press the morphine drip and it makes a whirring sound, beeps, and the pain doesn’t go away. I try it again like 47 times in the next 5 nano-seconds and still no relief. I call in the nurse and I tell her my morphine drip broken. She laughs, even though I’ve interrupted her solitaire game, and tells me ‘NO it isn’t! you just want more! And you can’t have more because you can only have what you’re allowed to have no matter how many times you push that button’. Silly me. I don’t even have to energy to ask why I have to press the button at all since the maximum is obviously not enough for a small mammal. Then I turn into a miniature schnauzer because 30 minutes later an uncomfortably pitched screaming alarm that apparently only I can hear begins. My nurse, not being a small dog, takes a while to come in, flicks on the overhead light full throttle followed by a nurse’s aid’s aid and they begin yelling.

What is beeping?
There’s something wrong with the morphine! *
Where’s the key? Go get me the key
I don’t know nothing about no keys
Kkkrrrrcchhhhh [Crunching plastic sound like they can’t figure out how to open the new Hoyle CD from the $1 bin at Circuit City so they just try and break the plastic case off]
Come on you’re stronger than me!
No get the key! Now!

*Morphine is locked in a box on your IV so that no one can steel your mojo, although by this point I am thinking if it’s that morphine feeling you want, why not just spin yourself around several times fast until you throw up? It’s certainly got to be easier than finding the key.

After finding they key, they realize they don’t know what’s wrong anyway since they don’t understand the secret code flashing on the box, which they could see all the while but the relentless alarm rendered them incapable of linear thought. Then I hear; ‘DEAD! The battery is dead because those evil nurses who can’t drive down in recovery always send up the boxes when the batteries are almost dead so they don’t have to change them then WE gotta change them’. While they send an aid to Siberia to get battery, I get to hear all about how this happens all the time and she can’t wait to go on her 3 day vacation later today while violently shaking the screaming pole attached to my arm. I can’t help wondering, if this happens all the time why don’t you get some batteries for stash, and if solitaire required the same battery wouldn’t you already have a whole bunch?

And 30 minutes later when it is finally all over and I have peace and quiet and morphine and darkness, all I can think of is ‘Crap, I forgot to say I told you so’.

There were some other new experiences on my morphine vacation. After surgery you must learn a magic trick and pee in a hat. It’s a plastic fedora on the outside and a measuring cup on the inside that they place in the toilet so they can measure your output but not have to touch it. You have to go every hour, which is a thoroughly exhausting trip requiring the stamina and concentration of the Dance of the Seven Veils, except you’ve only got the one veil and your crack is sticking out. It literally takes 20 minutes to go the 20 feet to your bathroom and back. First you have to sit up. Then you have to unplug the big re-inflating balloons from each of your shins that keep your blood circulating so you don’t form a life-threatening clot. Unfortunately it is too hard to unplug the wires so I had to take off the whole banana, which means 3 large sized Velcro straps on each leg designed to hold Hercules. Then you have to extricate yourself from the bed without them clinging on to your gown, each other, or worse yet to some part of you down there they left unshaved. Then move the 5 legged 6 ft tall pole out of the way without ripping out the IV in your hand and try to maneuver behind your bed to unplug it and wonder there and then if you should just pee the bed and make someone else clean it up. Then the IV spins round and round and gets caught in a really uncooperative curtain. When you are finally free you try to wheel through the pin ball course to the bathroom; hit the bed, hit the chair, hit the hazardous materials box, hit the chair, a little power boost to get over the door jamb and you’re in! Anyway, you just keeping peeing in the hat and then doing the same exhausting choreography back to your bed, your big ending being spinning yourself round and round the pole to make sure you have enough IV line to get back in bed without severing your own head, plug it in, get in the bed, put on the booties, try to find a way to get comfortable on all the wadded up sheets no one ever fixes and fall asleep before you throw up. You lay very still for 20 minutes thinking about throwing up, get 10 minutes of sleep, get your blood pressure taken for 10 minutes and then get up and do it all again and through it all you are just grateful you have a goal-oriented task at hand so you don’t waste the whole day.

Later when a nursing student asks if I’ve used the HEAD I wonder why she’s reverted to Navy-speak, but I play along because I am anxious to give my Science Fair Report. Full of the pride that only a hard won accomplishment can give you, I say ‘Yes and I filled it all the way up!’ but I’m disappointed because no one congratulates me. Then someone asks ‘What’s the head’? I say ‘The toilet, Ensign Pulver’, but because I am drugged I forget to say it out loud and the nurse says ‘blah blah – HAT – blah – URINE - blah’ and then I pass out because I am furious and no one can read my mind.

The rest is a fog as the morphine wears off. Although the nurses are sorry to wake you up every hour to take your blood pressure, after they check to make sure the machine is working properly because it’s frighteningly high and they tell you ‘You’re BP is frighteningly high’, they pretty much leave you alone to go off and frighten other patients and let you have your own stroke in peace.

Later, when you get to go home they ask you what you want: Vicodin? Demerol? Tylenol 4? Burned and bitter after the morphine, I say I’d like my uterus back and they laugh, she is such a kook! And the Vicodin that everyone thinks is so great is not so great when you are detoxing from morphine. It is a more or less what I imagine a blind date to be. Not a date with someone you’ve never met, but a date where you go to dinner after just having your eyes poked out; you can’t focus, you’re uncomfortable, you don’t care where you are or who you are with and everything tastes like you just grabbed the decorative wax candle. Nothing tastes good, nothing feels good and where’s the monkey in the plastic fedora who serves the drinks?

I told you this girl has a firm grasp of the obvious. Health care in Brooklyn seems to be more dangerous than being sick.

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