Jan 16 2014

Cookie-Cutter Tiny Houses

You know it’s a first world problem when your efforts to curb consumption are co-opted by copycats:

Are tiny houses becoming too “cookie-cutter”?

That’s the fear of Phoenix Vo-Dinh, a tiny-house renter who fears the rise of “miniature McMansions.” And she knows from McMansions: Before her current home, she lived in a Maryland house 10 times its size. The Maryland house had four bedrooms and four bathrooms in its 3,500 square feet, with seven entry doors.

Vo-Dinh now lives with her 24-year-old son, Christopher Lollar, in what she calls a “witch’s cottage” in Portland, Oregon. Its interior walls are papered over with Trader Joe’s grocery bags and pinto bean and flour sacks (coated in linseed oil); the exterior makes use of a local pizzeria’s tomato-sauce cans; and flowerboxes are made from discarded stove hoods turned upside down and poked with drainage holes.

~~~~

 “In Maryland,” she says, “the size of the house — it was too big! It was a big house with no hiding places in it! It was the weirdest thing. I didn’t know that would happen.

“And this is huge. This is 364 square feet.”

No hiding places. Now that makes me wonder about Ms. Vo-Dinh. And everybody else who thinks tiny houses are the “it” thing. Didn’t they have playhouses or the imagination to create one from blankets and a table when they were children? And just where does she think she’s going to hide from her son in that tiny, though chic and fashionable space?

And what the hell is her son thinking? Perhaps… “Well, Mom is a bit nutty, but she still controls the purse strings. And the apron strings.”


Jun 30 2012

Linkables

Feline of the Damned

Just frickin’ frack it

Is it worth the trouble? For Swedish meatballs, yes. Here’s AVI’s suggested recipe.

I’m way behind on my allotted conspiracy theories.

The Conspiracy Meme

The origin of hippies. (via Assistant Village Idiot)

What? Germs don’t come from Germany?

Everything old is new again, sort of. How Instapundit is like Paul Harvey. (via Instapundit, of course) Here’s an example of how Instapundit doesn’t even try to be like Paul Harvey.

Does Justice Roberts have the Judgment of Solomon? Alas, probably not.

A visit to a small Texas town honoring a local born celebrity — Conan the Barbarian. How could anyone not want to go a festival named “Barbarian Days”?

“…don’t treat a fever.  Avoid perplexed sclerosis. And breathe normally my friends.


Apr 21 2012

Breasts, Testicles, Prostates, Men, Women, Pain, Politics

OK, I didn’t have a good title for this post. That one got copied right into the tags field. Trolling for traffic? You betcha.

One of the bad things following the passage of Obamacare and Sarah Palin’s invocation of “death panels” is that now it’s considered necessary by some (certainly not all) conservatives and libertarians to automatically assume that any research finding that might also reduce costs is automatically some variant of “rationing” or on the slippery slope to a “death panel”.

To wit – this one by Althouse, linked last week by Instapundit following a link to Dr. Helen’s rather innocuous post on rates of prostate screenings.

No matter how I look at it, I can’t see the relationship between the rates of prostate screening, pain research, pap smears, expense, fairness, and the Buffett-rule that Glenn Reynolds apparently finds obvious. So now I’m wondering about him falling for or into mere drama where anything can be taken to be “rationing”. Or a precursor of a “death panel”.

Is stretching an idea, meme, partisan point, etc., to the breaking point the same as jumping the shark? If not, it should be!


Feb 05 2012

Overheard

Tag: health,stupidity,wordsDonna B. @ 5:49 pm

Heard by my husband while he’s face down waiting for a lumbar puncture. As the radiologist approached him, she commented to the nurse: “I didn’t want to do this  procedure today. I asked them to find someone else… I am so nervous.”

He was not reassured.


May 08 2011

Here’s What I’ve Read Online This Week

Best Mothers of the Animal Kingdom - I’m really glad I’m not an octopus.

The Beauty and the Bartender - a dating service tale with a heart-warming twist.

How to make cheap wine taste better  – knowledge is free.

A lost girl remembered - an excerpt and follow-up from The Poisoner’s Handbook.

The Costs of Not Vaccinating - the story of a 2008 measles outbreak in Tucson.  

Parasites, boogers, and garlic - oh, and don’t scratch.

Are Talking Heads Blowing Hot Air - Yes, mostly. The literature review beginning on p. 5 of the pdf names a book I now want to read – Expert Political Judgment. The best part of the study begins on page 17 with descriptions of the 26 columnists and types of predictions they made. While the numbers make some of them look good, the descriptions lead me right back to the hot air conclusion.

Ten Peeves About Greenies


May 06 2011

I’m Still Here

Tag: brains,healthDonna B. @ 9:05 pm

You know the old saying about when it rains it pours. It’s been pouring around here for a while. And you can bet your sweet bippy I’m not about to ask what else can go wrong!

Most of what’s gone wrong has resolved or is well on its way to being resolved. One issue (that I’m not going to write about) I’ve simply shoved away for a time.

One issue I will write about is my worry that my husband was developing a dementia of some sort on top of his numerous well-documented (and mostly well-treated) physical problems. Finally, I get the courage and impetus to broach the subject with him and we see his doctor.

Sure ‘nuf, he flunks the mini-test warranting further exploration. The first thing done is an MRI to rule out stuff. One of the things to be ruled out is normal pressure hydrocephalus. And the MRI indicates that might be the problem – but before we get those results back, he passes out and falls hitting his face on our metal trash can.

I hear the crash and find him conscious, but not coherent at all. I call 911 and refuse his requests to help him up. I’ve got to compliment the Shreveport Fire Department and EMS people. They got here quick and they were as compassionate and helpful with my panic as they were my husband’s disorientation.

So we’re off to the ER and find out about the implications of the MRI and that other causes of fainting now have to be ruled out also. Then we experience the horror of being hospitalized over the weekend.

It took approximately 6 hours for my husband to return to “normal”. It was very much like being with someone coming out of anesthesia, though maybe a bit slower. We were told by various representatives of specialists that several tests needed to be done. The first was 24 hour heart monitoring. By the time that was finished, we were told (on a Saturday morning) that the other tests couldn’t be done until Monday or later.

Now… there’s nothing worse than being in the hospital when you feel as good as you ever do… or “fine” if that’s the word to use. The remainder of these tests — a specialized MRI, EEG, ECG, tilt table test for orthostatic hypotension, etc., are all tests that can be and are routinely done on an outpatient basis.

So… perhaps we were wrong insisting on going home. However, I’m not sure that these tests would have been done sooner had he stayed in the hospital.

After leaving the hospital (not against doctor’s advice btw) I ran into more trouble than I’ve ever had before scheduling these various tests. One of the problems turns out to be that the hospitalist intern was now acting (or trying to act) as primary care doc – and he would certainly not be the doc of our choice. Another problem was that the consulting cardiologist in the hospital was also not the cardiologist who has been treating my husband for over 15 years.

Then there was the crazy neurologist. Yes, crazy. My husband and I had both been referred to this neurologist a few years ago and the best way to describe his diagnostic technique is that he refuses to diagnose. So… we were not thrilled, but also felt we had no choice but to try to use him.

There’s a lot of appointment making strangeness, but I’ll not go into that right now.

As it stands now, my husband is having a cardiac cath done next week because he failed the stress test needed to clear him for surgery to install a shunt to treat the normal pressure hydrocephalus.

Of course during all this, I get my annual cold which turns into bronchitis and am pretty much out of commission for a few weeks.

We have an appointment with a second neurosurgeon also. As of now, the main differences between the two neurosurgeons is the brand of programmable shunt they use, the ease of interacting with their staffs, and the location of the operating room… and, of course, their reputations.

One of them is the chief of neurosurgery at LSU medical school and hospital. He practices with a group of neurosurgeons that has managed to not renew the practice’s domain name, has an indescribably poor telephone system that makes making an appointment next to impossible, and… includes the neurosurgeon that scared the hell out of me a few years ago about my meningioma.

I do not think that the neurosurgeon that I rejected a few years ago reflects on the skills of the chief of the department. But I have to ask why the department continues to allow a doctor whose physical impairments quite clearly portray an inability to operate to continue doing so.

The other doctor is one who just might have what I think could be an unethical relationship with a medical device manufacturer. This is merely a suspicion… and I do NOT think that doctors who look to the manufacturer of devices for training are necessarily unethical.

Regardless which surgeon we choose, this is a no guarantees procedure. First, there’s no way of knowing whether his dementia symptoms are caused by the normal pressure hydrocephalus. And there’s also the possibility that some are and others are not. The surgery itself is sort of a test to determine cause.

It’s also a step that I think must be taken. The possibility that this surgery can stop the dementia symptoms where they are now (mild) cannot be discounted. The possibility that the surgery could reduce the symptoms cannot be overlooked, even though that is not likely.

Of course, he could have Alzheimer’s or some other dementia as well as having normal pressure hydrocephalus dementia. I can’t say that is a reason to not have the surgery. One cause seems better than two, doesn’t it?

So… we wait. We’ll see.

Next up – what’s with this shortage of drugs?


Nov 08 2010

If Only It Were Just A Pain In The Ass

Tag: health,whiningDonna B. @ 7:22 pm

As I mentioned a couple of weeks ago, I caught a cold and it morphed into a sinus infection and bronchitis and I got drugs to make the trip to S. Carolina possible.

What I got was pack of methylprednisone. I knew it wasn’t a cure, but I also knew it would help stop the spiral of the bronchitis coughing (I had bronchitis really really bad several years ago and the coughing seems to be partly due to inflammation… caused by coughing!)

And I knew it would make me feel better. That along with a nasal spray to help drain my sinuses would make the trip possible.

What I didn’t expect was how good I felt by the 2nd day on the methylprednisone. I had an energy level I hadn’t experienced in maybe 10 years and my body ceased to hurt everywhere. I realized that I’d forgotten what a pain free day felt like.

In addition to some fairly severe injuries to knees and ankles (no one ever accused me of being graceful) during youth and as a young adult, I am also dealing with the family tendency toward severe osteoarthritis, carpal tunnel (from hand-sewing more than keyboard use), ulnar nerve entrapment in both elbows, odd little irritants possibly due to a meningioma, and the general physical insults of aging.

None of these things are really serious. I’m actually quite healthy and would be more so if moving were not literally such a pain everywhere but in the ass. I generally do OK with acetaminophen and/or naproxen.

Or so I thought. I realize now that I’ve learned to accept a certain level of pain as “normal”.  In a way, I hate the reminder of what pain free feels like though I enjoyed it immensely.

I had a bit of a rebound effect from the steroid. This past Friday and Saturday were horrible. I took all the acetaminophen and naproxen I thought was safe and it didn’t make a dent in the whole body (excepting the ass) pain.

That’s over and I’m back to my normally accepted level of pain now… but I remember fondly my pain free week.


Sep 17 2010

Dust And Cobwebs

Tag: grandchildren,health,my familyDonna B. @ 7:06 pm

I’ve let this place go, haven’t I?

Usually when I do this it’s because I’m vacationing in the comments on other blogs, but that’s not the case this time. I’ve actually been away from home for 10 of the 20 days since my last post. It’s not that I’ve lacked a connection to the internet, but that I really really am not flexible when it comes to using laptops or other people’s computer setups.

Oh yes, I am spoiled by my messy, but convenient for me, little office space.

I’ve also read four novels recently. Don’t worry; nothing particularly uplifting or literary. It’s just that for the last 10 years or so, I’ve read mostly non-fiction and a lot of that could be considered educational. That was a major change from my previous habit of consuming 3 or 4 novels a week.

I spent the Labor Day weekend with two of my grandchildren. It’s so very, very nice to have them only a 3 hour drive away instead of 20 hours. The 5 month old is just the sweetest baby. She’s fun and easy to care for. When she’s awake, she’s constantly cooing, laughing, or enjoying her new found manual dexterity.

The 3 year is not so easy, but she’s definitely fun. The theme of the visit was words beginning with P. She put together a 24 piece puzzle by herself. Her parents didn’t believe that I didn’t help her beyond verbal suggestions, but they should have. Did they really think *I* was going to actually get down on the floor with her? HAHA!

The other words were Papa, pizza, and piano. She has a little notebook that she wrote all those words in. There’s still a little work to be done in always pointing the z in the proper direction. I like the notebook because I found out that chalk dust really does a number on my nose and throat. She tends to erase her work with enthusiasm.

I was home for a few days and got word that my father was in the ICU with pneumonia. He’s 87 and a two-year lung cancer survivor, so that was scary news. I thought my step-mother would need help caring for him when he got home because he seemed really weak in the hospital.

Well, she didn’t because by the 2nd day he was home he had pretty much resumed his normal activities. Though the bug he got knocked him down quickly, modern antibiotics knocked it out almost as fast.

One of his current normal activities is running for mayor of his small town. I stayed another two days caught up in those discussions and helping a little with the campaign.   

That reminded me that my husband and I have to get absentee ballots this year because we’ve got a wedding in S Carolina to attend the weekend before the election.


Jul 29 2010

Links That Spur Questions And Thought

When theory and fact fail to intersect – Bookworm Room. Political lessons from buildings.

Who Goes Nazi? – The Anchoress, via Assistant Village Idiot. Suggested further reading: The True Believer: Thoughts on the Nature of Mass Movements.

Masterminds or Muddlers? - the glittering eye.

The prototype for a mastermind would be Napoleon, someone who with a combination of brilliance, insight, savvy, guile, and the urge to power was able to bring complicated plans with many moving parts to fruition.

Letting Go: What should medicine do when it can’t save your life? — The New Yorker, by Atul Gawande. And… as I see it, a complete misunderstanding of that article by Megan McArdle and most of her commentariat. That misunderstanding is further displayed in this McArdle post:  Does Medicaid Kill? Though not easy to identify, there are multiple points where medicine becomes harmful rather than helpful. Part of this has to do with the way we evaluate drugs — by choosing an endpoint (ie, blood pressure reduction) without evaluating whether that leads to longer life, much less the quality of that life.

That’s enough deep thought for a while. I will now return to my regularly scheduled whining, ranting, silliness, and non-blogging.


Jul 14 2010

Critical Thinking Failure

Tag: food & drink,healthDonna B. @ 5:12 pm

Dustbury links to this Reuters story: Consumer group targets mcDonald’s Happy Meal toys. It starts off:

“Tempting kids with toys is unfair and deceptive, both to kids who don’t understand the concept of advertising, and to their parents, who have to put up with their nagging children,” said Michael Jacobson, executive director of the Center for Science in the Public Interest.

An even more disturbingly paranoid view of McDonald’s as a corporation (and ultimately demeaning to parents) is this from the Center’s website:

“McDonald’s is the stranger in the playground handing out candy to children,” said CSPI litigation director Stephen Gardner. “McDonald’s use of toys undercuts parental authority and exploits young children’s developmental immaturity—all this to induce children to prefer foods that may harm their health. It’s a creepy and predatory practice that warrants an injunction.”

Such a view of corporations requires one to think that all corporations are run by Lex Luthor clones. To what nefarious end do corporations do this? According to these types, it’s the evil bottom line.

And they are using evil mind rays to control all of us and what they really want is for all of us to live unhealthy short lives. Because in magical thinking land that improves the bottom line. Somehow.


Jun 23 2010

How I Ended Up Without A Primary Care Physician And The Worst Hospital I’ve Ever Been In

I haven’t yet posted why my original 3-4 week Arizona vacation turned into a 6 week plus adventure.

There’s some backstory here that needs ‘splaining. First of all, let’s get the planned itinerary out of the way. I left on Mar 28th and arrived on Mar 29th. On Mar 25th, I got notice from my insurance (Tricare Prime) that I needed to find a new primary care doctor by April 1. The letter was dated several weeks earlier. 

This pissed me off because on March 22, I’d seen my primary care doc and got a bunch of blood tests done pertaining to a chronic problem. Had I known I was about to be “dumped” from treatment at the MTF (which I’d been coerced into 4 years before) I would not have bothered.

Anyway… with little more than five days notice, I have to find another primary care physician. First, I contact the physician my husband has used for years. That’s a no go. Then I find the largest group practicing near my home and affiliated with the hospital nearest my home. I contact them and am told that each physician decides whether to accept new patients and their insurance. After a few denials from specific physicians in that group, I’m finally informed that none of the 13 will take me on.

By this time, I’m in Arizona. So, I search again and this time find a physician who will take me. I fill out the paperwork and am informed by Tricare that if the paperwork is received before the 2oth of April, the assignment to the new PCP will be valid on May 1.

That’s wonderful and I make an appointment with the new doc for May 6. I plan to be home on April 28th… exactly a month after I left. Except for the perhaps wasteful blood tests, everything is good.

Except… on April 25th, I am running a fever and have stomach pain. Monday, April 26th, the pain is worse, the fever a bit higher. Since I don’t think I have a primary care physician to call for a referral to an urgent care clinic, I call Tricare directly. I am informed that since April 17th when I submitted my request (that I was told would be effective May 1) I do have a PCP and that I must get any referrals from her.

Unfortunately, she hasn’t seen me before and ethically can’t make any referrals. (This is another topic…) and therefore I can’t get a referral from anyone. I am advised that since this is the case I should go to the ER since that doesn’t require a referral. However, it’s been pounded into me that using the ER for routine care is a bad, bad, wasteful thing and that Tricare might not cover it. Since I don’t think my problem is an emergency, I’m not that thrilled with that advice. But I’m also worried that I won’t feel like driving 1200 miles unless I get feeling better.

So I go to the nearest ER which is less than a mile from my daughter’s house. Why I should have chosen an ER much further away may be the subject of another post. Let’s just say that the close hospital didn’t have a great reputation. But… I was only going to probably get a prescription for an antibiotic and a suggestion I follow up with my PCP when I get home, right?

Continue reading “How I Ended Up Without A Primary Care Physician And The Worst Hospital I’ve Ever Been In”


Jun 08 2010

Dumb Questions And Crocs With Socks

Tag: healthDonna B. @ 3:18 am

Oh yes there are dumb questions. Like the one my husband asked me yesterday: Why don’t you wear high heels?

Huh? We’ve been married 20 years and I can guarantee you that he has never seen me wear a pair of high heels. Never. Unless a 1 1/2″ heel fits that definition. I think it was 2004 I last wore anything that high.

Pretty shoes and my feet just don’t get along. I envy women who can wear pretty shoes and I wish I could wear high heels. I’ve tried and the pain is unbearable. This is probably because of injuries to my feet, none of which were caused by high heels. You see, I’m a klutz. Clumsy. Awkward.

I’ve injured my left foot and ankle five times seriously enough to have to use crutches before I was 35. Now that I’m just a tad bit older and dealing with arthritis on top of old injuries, comfort and support in a pair of shoes is the primary goal. I really don’t care what they look like.

So… yes, I wear Crocs. And sometimes Skechers. And even worse, I wear them with socks!


Feb 05 2010

Emergency Room Fun

Tag: bariatric surgery,healthDonna B. @ 2:40 am

There’s not much that’s more exciting than spending six or more hours in an ER when you’re pretty sure you don’t need to be there. This is especially true when the ER staff discerns that you don’t need to be there either, but they can’t let you go until they get permission/instructions from a doctor.

Thanks to the internet and my knowledge of my past medical history*, I was 94% sure the radiating chest pain I’d been experiencing was not due to any cardiac problem.

Six percent lingering doubt is enough for a primary care physician to send one to the ER to rule out an emergent condition.

Blood tests, EKG, and chest x-ray ruled out the heart as the cause of my pain as I was almost sure it would do. I knew the pain was more than ordinary acid reflux and, after much reading, decided esophageal spasm was the best fit to my symptoms.

Yet… the chest pain I was experiencing didn’t involve difficulty swallowing, correlate to eating, position, or exercise, or involve regurgitation or a “sour taste” in my mouth. Then again, I didn’t have any nausea, vomiting, or shortness of breath that might be associated with a cardiac problem. 

Thus the doubt and the need to rule out a problem requiring some action more proactive than taking a pill.

All I had was a recurring, intermittent, and sometimes severe chest pain that radiated to both arms and almost into my jaw.  Yep, that’s “all”. It is scary to hurt that bad in that part of your body and I don’t blame my PCP for sending me to the ER. As she stated on the phone, “We can’t do an EKG and our lab can’t do cardiac enzymes.”

What annoyed me the most about my ER visit is that a cardiac problem was ruled out within an hour of my arrival. The tests had been run and all returned normal. The next five hours was waiting for someone with the title and authority to tell the ER to dismiss me.

When that guy finally showed up (and I realize I was not high on his priority list because he also knew I wasn’t in danger of having a heart attack) he assured me that my heart was almost positively A-OK. 

I’d had a cardiac cath in mid 2006 which showed zero blockage and he told me that a blockage developing in 3 1/2 years severe enough to cause symptoms was highly unlikely.

(I am overweight and have high blood pressure, so was required to take a stress test to join a fitness center… and I failed. The docs said that it was probably boob size that caused the failing reading, but the only way to make sure was cardiac cath.)

He was more than happy to write me a 3 month prescription for Nexium — which is what I intended to ask my PCP for when I was lucky enough to get an appointment with her.  So…

Is all well that ends well? This time, for me, certainly.  

*my past medical history includes banded gastroplasty, which always creates gastro problems while not even close to always resulting in weight loss… but that’s an entire blog’s worth of rants that I don’t really feel like going into right now, especially on this blog.


Nov 24 2009

News From The Neuro-Urology Department

Tag: brains,health,stimulusDonna B. @ 5:01 pm

The most amazing news to me is there’s such a specialty as neuro-urology. This is like life imitating a dirty joke. The author of Shocking Treatment Helps Erectile Dysfunction, and perhaps even the researchers just can’t seem to help themselves, even though the treatment sounds exciting, er… I mean interesting.

I admire the way researcher Yoram Vardi describes the parameters of the strength of the shockwaves in language the average layman can understand:

“These are very, very low energy shock waves,” Vardi said. Each shockwave applied roughly 100 bar of pressure — some 20 times the air pressure in a bottle of champagne, but less than the pressure exerted by a woman in stiletto heels who weighs 132 lbs. (60 kg). 

“This sort of energy is completely different from what you would get in a massage, although everyone can do what they want,” Vardi said.

This is just perfect material for a Neurotopia Friday Weird Science post.  

 


Sep 09 2009

Not-So-Fun Activities Of The Last Two Weeks

Tag: health,my familyDonna B. @ 11:47 pm

My husband had his first treatment for bladder cancer yesterday. This is his third primary cancer and, of course, he has asked, “Where next?”

Two biopsies were performed, but neither got enough muscle wall tissue to rule out the spread of the cancer there. It was a transitional papillary tumor at the top of the bladder which makes it more difficult to get a “good” muscle wall sample. Location, location, location.

His options were to assume that the cancer had not spread to the muscle wall or to assume that it had. After talking it over with his doctor, he chose to assume it had not. Removal of the bladder is still an option, but hopefully it won’t have to be done.

What is fascinating to me is the treatment when the assumption is that the tumor has not spread to the muscle wall. It consists not of chemotherapy, but of immunotherapy. In a nutshell, BCG (Bacille Calmette-Guerin), a tuberculosis vaccine is inserted into the bladder to “call” the immune system to battle the cancer.

See: Bladder cancer, Treatment and Drugs, Mayo Clinic. Also, NCCN Clinical Practice Guidelines. Registration is required, but it’s free.

Because the biopsies were inconclusive, my husband was faced with the choice of trying the immunotherapy or with surgical removal of his bladder. Surgical removal is sort of a guaranteed cure, but it is also a drastic cure. My husband chose the less drastic, but less certain treatment.

We shall see.


Aug 21 2009

Cultural Changes And Health

Tag: health,HistoryDonna B. @ 9:03 pm

Finally, the appendix gets respect.

And we learn that a system that sees its need reduced just might cause problems. It’s odd to think that because we have learned sanitation techniques that we are underutilizing our immune system so that it attacks something else that it would have ignored previously because something more dangerous was there.

This is just so interesting on so many levels and analogies can just fly off the shelf.

But it makes sense. Haven’t we all read about the absolutely horrific (to our modern standards) sanitation was hundreds of years ago? I have often wondered how anyone survived. Now it’s possible to think their appendix was doing great things for them.

Now I’m wondering just what benefits I’m not receiving from not having a gallbladder and tonsils that were removed because they “might” cause me trouble rather than because they were.


Aug 16 2009

Complexity For Complexity’s Sake

Tag: health,health care/insurance reform,legislationDonna B. @ 6:40 pm

It is designed for ambiguity.

“It will be of little avail to the people, that the laws are made by men of their own choice, if the laws be so voluminous that they cannot be read, or so incoherent that they cannot be understood…” – The Federalist #62, James Madison (a founding father, the primary author of the Constitution, and a founder of the Democratic Party)

The topic is HR 3200, the proposed health care/insurance reform bill under discussion at numerous locations across the nation.

Dr. Rich’s explanation is better than any I can come up with and it illustrates my concerns accurately. Read it, please.


Aug 07 2009

A Happy Hospital Story

Tag: health,my family,ResponsibilityDonna B. @ 4:38 pm

For background, see here, here, and here

This morning, my father, brother, and I met with several St. Michael’s staff, including the director of the medical staff and the director of the nursing staff. It was a very cordial and informative meeting for me, and I hope it was for everyone else. We all left the room on the same side, so I’d call that success.

Of course, one thing that helped from our point of view was that the St. Michael’s staff was obviously very upset that such things had happened and were anxious to tell of us ways they’d already worked on to prevent such in the future. This, basically, is what we wanted.

The nursing supervisor on duty when my step-mom fell was devastated that something like that had happened on her watch.

We, as patients, learned a lot about how some hospital systems work. For example, we learned that when we need to call a nurse to be sure to say what we need, as they can get the message to the right person more quickly.

The director of medical staff explained some of the problems they were having implementing a hospitalist program and contracting with a separate firm for ER physicians. It was quite honest of him to say that these two groups of physicians do not always cooperate in a timely manner and explained how the hospital was working on this problem.

When we asked whether charges for the x-ray after the fall would be included in the bill, we were told it didn’t matter whether they were or not. Now this was upsetting at first – it seemed like the hospital was not taking responsibility for something they admitted was their fault.

But we were oh so wrong. That’s not it at all. My step-mom has Medicare and no matter what tests or procedures or how long she was in the hospital, they were going to paid the same, based on her problem at admission. To my way of thinking, that just ain’t right.

The final conclusion I have come to is that if the hospital staff had all got together and planned to have my father and step-mom treated as they were, they could not have planned it to be quite as bad as it was. These episodes are likely random ones and we were the unlucky family that lost the coin flip twice in a row.


Aug 05 2009

What To Think, What To Do

Tag: bariatric surgery,brains,healthDonna B. @ 3:10 am

My symptoms.

I’m not even sure the site linked above is a reliable one. The design sucks, but that’s not an infallible indicator of bad information. Nor is bad spelling and grammar, but it makes one wonder.

However… dammit, except for PTSD, every one of those things is happening or has happened to me. I had VBG – vertical banded gastroplasty about 16 years ago. Oh yeah, I lost weight at first, but now I weigh about 5 lbs less than when I had the surgery.

Until recently, I didn’t even consider that any of my health problems were related to that surgery. I was diagnosed with fibromyalgia before the surgery, but tended not to say anything about that to anyone because it was not really accepted as a “real” problem at the time.

Several years after the surgery, I found I had a small meningioma which finally grew much larger. It was treated with radiation when it got larger. Many of the symptoms listed in that link, I attributed to the tumor.

I’ve seen neurologists, neurosurgeons, gastroenterologists, psychiatrists, rheumatologists, and… of course, my primary care docs. I recently had a hernia repaired which was due to the incision made by the VBG surgery. Ever since then, the diarrhea is much worse.

Honestly, I don’t know what to do. None of these symptoms alone are serious enough to worry about or cause much trouble, but taken together, they do cause problems. And they’ve become much worse over the past 3-4 years. But how am I — or a doctor — to know what causes what?

I also had a bad fall about 3 years ago. Both knees were injured, but my right knee has never been “right” since then. It was x-rayed and nothing is broken, but it is still very tender and painful at times. My left knee is “unreliable”. Sometimes it just doesn’t work, but it was that way before I fell. It’s just worse now.

Though I’ve joked about losing 25 IQ points, it’s really not funny. I am blessed that even with that loss, I’ve still got at least an “average” IQ and supposedly can express myself well.

Well, not as well I once did and not as well as I want to. I hate the inability to concentrate. Once upon a time, I read two books a week, now it’s a book a month, at best. This is a serious blow to my sense of well-being.

One of the main reasons I have this blog is to try to keep my mind as sharp as I can. It’s also why I read certain blogs daily. But frankly, sometimes I’m a little bit frightened that I can’t communicate the way I want to, whether in a post here or a comment elsewhere.


Jul 31 2009

Another Sad Hospital Story

Tag: health,my familyDonna B. @ 3:30 pm

See update here

A few weeks ago I wrote about an excruciating and medically scary 24 hour adventure my father experienced in an unnamed hospital. Read here and here, for that background. It’s time to name the hospital now:

Christus St. Michael in Texarkana TX.

I mentioned in that story that my step-mom was in the same hospital that my Dad was transported to. She’d had a hip replacement and was in rehab. She got out of rehab a few days after the ER fiasco and was doing pretty good getting around the house with a walker.

One morning a little over a week ago, she woke up with chest pains and too dizzy to stand. At the ER, it’s discovered she’s got a blood clot in her leg. It takes hours and hours (just like with my Dad) after the decision to admit her to actually get her admitted and out of the ER.

When she’s in her room and settled, my father goes home. Talking to him a few times that day, I chuckled at the thought that he was having some very mild PTSD symptoms from memories of his recent visit.

My step-mom is, of course, labeled a fall risk and she’s instructed by the doctor (not the same one my Dad had) to not try to get out of bed herself. Later that evening she has to go pee and presses her buzzer for assistance. And presses it and presses it and nobody answers.

She’s soon faced with a decision: Do I wet the bed or do I try to get up by myself? I don’t think anyone will be surprised that she decided to get up. And she fell. Fortunately, she wasn’t injured worse than a nasty bruise on her shoulder, but the hospital did x-ray her shoulder to make sure.

And then they addressed the issue of why no one answered when she buzzed. It was simple to fix — all they had to do was plug the buzzer in. The initial neglect in not making sure it worked when my step-mom was moved to the room is bad enough, but it was fixed now so there should be no problem, right?

When I wrote about my Dad’s experience, I made sure to compliment all the staff except the arrogant doctor and the maintenance people who didn’t show up in a timely manner. Now I don’t know whether my Dad was really lucky or whether my step-mom was just really unlucky. She didn’t get the same quality of care from the staff. Nowhere near it.

You’d think that after her falling the first night there, that the staff on that floor might have been a little extra-vigilant about answering her buzzer and responding to her requests to go to the bathroom. But that wasn’t the case. The buzzer was answered and she was told somebody would be there, but often no one showed up in what could be called a timely manner and sometimes no one showed up at all.

This hospital uses a blackboard to note patient information. In addition to noting she’s a fall risk, there’s a notation about warm packs to be placed on her legs three times a day and this was not ever done during her week long stay. Perhaps the doctor changed his mind, but the blackboard was never updated.

Shortly after coumadin was started, my step-mom started having stomach pains. She described her stomach as being on fire. Four days later, this pain was finally addressed and eased. I can’t imagine what took so long.

For two days, she and Dad pointed out to nurses that her IV was no longer working. While they all looked at it, no one did anything to fix it.

I’m not quite sure what all the problems with her bed were, but it was not comfortable. She used multiple folded blankets to try to make it better, but finally got to the point where she demanded a new bed. She got it and was then given medication to help her sleep. Or, as my Dad suspects, to “knock her out and make her shut up.”

Anyway, they tried to use the IV she’d been telling them wasn’t working for this medication, but of course it wasn’t working. They crushed a pill and gave her the medication orally. I don’t know what it was and am wondering why it needed to be crushed. She’d been taking other medications by mouth.

Ah… wait. Let’s back up a little bit. Before demanding a new bed last night, my Dad called the customer service representative that we (my sister and I) have emailed and talked with concerning the problems my Dad had while he was there. He got voice mail, of course, and left a message requesting she call him or come up to the room and talk with them.

She called him back a short time ago, approximate 20 hours after his request and five hours after my step-mom was released.

This morning when the doctor told my step-mom that her coumadin levels were good enough to be released, my Dad packed up her stuff and took them to their car. He got a wheel chair on his way back to her room and told the nurse she could mail the release paper work to them. She asked him to wait and talk to her supervisor about their problems. A half hour later, the supervisor got there and listened to their complaints and said the problems would be addressed. By that time the paper work was done and they left.

So, maybe we should just drop this right now, but we’re not. One reason is that my parents (and many many other folks) rely on this hospital. They’ve been going there for years and the problems seem to be getting worse.

My father had a stent inserted there (I’m guessing) 8 years ago. While I was sitting with him, his monitor started flashing bright colors and beeping. I looked at it and noticed his blood pressure was low. It went back up a little and the beeping stopped. But it started again soon and didn’t stop. The door to his room was open and his bed was less than 10 feet from the nurses station where his nurse was chatting with her co-workers.  I had to walk up to her to get her attention, and could clearly hear the beeping while standing beside her.

Frankly there are many other little incidents I could post about, enough to make me wonder if there’s a “systemic” problem with patient care there. Enough to make me want it further investigated before any more of my relatives are hospitalized there.


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