He was ALL RIGHT!

So, you all remember my student, STUDENT!, right? Well, my little student has grown up, and now has been earning her own paycheck for over a year and a half now. My how the time does fly!

Anyway, last night she wrote this post about having learned that she likes working in the ICU and it reminded me of why I also like(d) working in the ICU. It's why working in the LTAC (long term acute care, a specialty hospital where people who are incredibly ill will stay hospitalized for a longer than normal time because they're too sick to be transferred anywhere else) with Jeaner's crew was my favorite work, patient-care wise ('cause Jeaner will tell you that some of the crew was more than a little batty), and solitude is one of the reasons why I am so dearly loving home health. I joke around all the time about my job description. If you ask Jeaner or CL, they can tell you what I've said for years when people ask me what I "do"...

"I'm doing God's work, stamping out physical disability one patient at a time right here in (enter whatever town I happened to be in at the time, now southcentral VA) Monday through Friday. I handle plague and pestilence on the weekends."

Now, obviously, part of that is a joke, but part of that is very near and dear to me. I REALLY BELIEVE that physical therapy should be done in a one to one setting. Just because the law, or your insurance company, may allow for a PT to treat more than one patient at a time, it does not mean that's what SHOULD be done. I need to pay attention. I need to watch, touch, hear (noises), and LISTEN to everything, absolutely everything the patient can tell me. A lot of times, listening has to be done with more than the ears, because patients either can't talk or won't or can't tell me, for whatever reason, what's wrong. So I love working in a setting where I only have one patient at a time, with no pressure to double or triple up, and don't have to worry about having patients in multiple areas where I can't see them. I love the solitude of the ICU, the LTAC, and now, being in a patient's home. I work only with my hands, my brain, and my patient. It's great. Getting to know my patients, gaining their trust, making them smile and laugh, that's where I get my enjoyment.

So, Student's story reminded me of one from when I worked with Jeaner at the LTAC.

We had a patient who'd had a stroke and it had left him terribly affected. Initially, he could not speak, he couldn't move his left side at all, and it was clear he couldn't understand what we were telling him. He must have been terrified. His children were very supportive and were with him every day, taking turns sitting with him so he would seldom be alone with people he didn't recognize. As it happened, the first few times I went in to work with him, nobody from his family was there. I talked the whole time, believing that even if he didn't understand me right then, it was better to hear a reassuring sounding voice, than to hear nothing and just have things done to you. So I talked, and I smiled, and held his hand, and moved his body, and talked some more. Around the 3rd day one of his sons was there and told me that though I was using his correct given name, nobody really called him that, they all called him Wilbur. "Well, no wonder you never answered," I exclaimed, "you didn't know I was talking to you!" Wilbur smiled a lop-sided smile.

Over the next few weeks, as he continued recovering from his stroke, Wilbur started understanding a lot of what we said. He started mumbling, then whispering some words mixed with gobbledy-gook, then sentences. Before he did more than mumble, we could tell he was trying to tell jokes. He would mumble a bunch of stuff, then giggle and giggle. I would laugh right along with him. I never got the punchline, but I got the joy that telling it was giving him. Wilbur's voice never really recovered beyond a coarse whisper, but he was able to express himself, and returned to being a jokester. I asked his son once if his dad had always been a quiet man. William thought about it for a few seconds then said, "Well, I think he went through a really loud phase when I was a teenager." I cracked up.

One day before Wilbur was well enough to finally transfer to a nursing home rehab unit, I walked into the room to do his physical therapy session with him. While he had recovered the use of his voice, and lots of his language skills, his left side was still limp and useless.

Wilbur: Tiff, did you hear the one about the guy who had a stroke and couldn't move the left side of his body?

Me: No Wilbur, I don't think I've heard that one. (Shaking my head in disbelief)

Wilbur: He was ALL RIGHT.

Me: Oh my, Wilbur, that's terrible!

Wilbur: Do you get it? ALL RIGHT? 'Cause I can't move on the left!

Me: Yes, Wilbur, I get it. I think you're all right, alright.

It still makes me laugh.

Aaaaaaaaaaaaawwwwwwwwww, nuts!

This is a true story. Which has now been edited to make you understand why it's even funnier than when I first wrote it. You have to understand that the man in this story is over 90 years old, and has, perhaps, the worst stutter I've heard in years. So when you hear him say MOST words, they drag out at least 8-12 beats before he gets going. The result? "L-l-l-l-l-l-l-l-l-lady, it p-p-p-p-p-p-p-p-p-p-p-p-pinches m-m-m-m-m-m-m-m-m-m-m-m-m-m-my b-b-b-b-b-b-b-b-b-b-b-b-b-b-b-b-b-b-balls!" Go ahead, read the story now and see why it's even funnier!

I went to see a patient today, not to do any therapy, per se, but because he was having a problem with some of his, um, equipment. We're waiting on him to get his new prosthesis (false leg), and while we wait, no therapy. I had ordered him a commode seat where the arm drops down so he can transfer from his wheelchair without having to stand. When he first got the "drop arm" commode chair, I worked my ass off to get it adjusted perfectly, positioned just right, and teach him how to get on and off correctly. Everything was a go.

He was supposed to get his prosthesis yesterday, so I called this morning. Unfortunately, his new leg was not ready yesterday (and the prosthetist is going on vacation, so he won't get it for another two weeks, son of a bitch!), so no need for me to visit, "unless you can fix this toilet seat." Uh, what's wrong with the toilet seat? (Fixing this equipment is not exactly in my job description, but sometimes it's not actually the seat that's the problem. Sometimes you just need to change how you're moving, and that is in my job description.)

Him: It pinches me.

Me: It pinches you?

Him: It pinches me. Every time I get off the pot, it pinches me. I get hung up in it!

Me: Ummmm, so, your nether-regions are being pinched?

Him: Lady, I don't know what the medical word is for it, but that seat is pinchin' my balls!

Me: Okay sir, I'll figure out how to fix it, and I'll be by today.

So I thought about the, well, mechanical issues of the potty chair, and the physics of, well, the balls, and the interaction of the two. One trip to WalMart later, and I was armed with KrazyGlue, foam pipe insulators, foam window stripping, and scissors. Oh, and two gallons of water.

In less than 30 minutes, I had stopped the seat from shifting, padded the edges, filled the holes, and my patient was able to get on and off the pot without getting his balls pinched. He proclaimed me a genius. This dude just could not believe that I had understood the problem, thought up a solution, and come to fix his potty chair the same day (needless to say, with the impending ice/snow/sleet storm headed this way, nobody expects anything to get done for at least 6 months.) I told him that just because I didn't have the, a-hem, equipment, didn't mean I didn't understand his problem! He thanked me profusely, but insisted that I not tell PB what I'd had to come do for him. He's worried that PB is a jealous man and wouldn't like it that I'd had to discuss such a delicate matter with a black man (of 90+ years, mind you). I promised, but told him not to worry, that I thought PB would be proud of me for saving any man from that kind of pain (as I imagine any male reader has been cringing the whole time, if not throwing up in your mouth just a little).

I did run home and tell PB (but I won't tell my patient I did), and he is proud. I imagine my Big Poppy will be, too. I mean, who else would know about using foam pipe insulators? I learned stuff like that from the Big Guy.

The water? That's for him and his wife just in case the power goes out this weekend. You know, with them calling for a storm that could bring anything from a few inches of sleet and snow to snow up to my tits, we'd better be ready to lose power for at least a few hours.

Soon you can stop beholding my leather. I promise. Soon. But first I must stamp out physical disability one patient at a time. Or stomp. Don't you judge me.

Peta can suck it.

Behold. My leather.
Le sigh.
Let the decorating commence. Or finish. Whatever.
(Peta can suck it because I probably already ate the cows that made up the furniture.)

Dear Internets,

Yesterday was good. I'm sure tomorrow will be fine. But today was my birthday and it kind of sucked.

Boooooooooooooooo.

Two of my coworkers raise German Shepards. They're crazy bitches, but they can be helpful when it comes to things like Pooh King's recent illness. They've brought me additives for his food to help with digestion, given me hints and tips for feeding to help keep him from yacking, etc. So yesterday morning when they asked how he'd been doing, I told them. He'd been fine since the vet's visit, then all of the sudden one puke incident Sunday morning. They ask more questions about quantity, consistency, etc. Then one looks at me and says, "Well, it sounds like he's dying."

WTF?

When we were at the vet's office his blood work was fine, his x-rays were clear. I'm pretty sure my vet would have told me if his death was imminent.

I told her she has the tact of a bulldozer.

Well, after a trip to the vet's office on Monday, Pooh King got some anti-nausea medicine, a bland diet, and the right to give me the finger whenever I fed him. He did really well until today, and apparently whatever gave him the stomach upset is back. I'm not sure what to do next. The vet can scope his throat and stomach at the cost of my wedding, but I'm not sure it will actually give us information that will lead us to treatment. So, I'm also looking online for some food additives that will calm his stomach. One of my coworkers swears by pumpkin, and I'm going to give that a try. Anyone else have ideas?

In the wedding planning world, there seems to be some progress. I found a cool location that I think will work. We're still going to look at another one, but I have to say I'm pretty stoked about the place I saw this week and its potential for unlimited fun. Like seriously, there are no neighbors to bother, and no reason we'd have to shut down except that our legs give out from all the dancing. Good times.

There was something funny I was going to tell you, but Pooh's telling me he's got to puke again, so I've kind of got to go.

Oh, Pooh King...

One woman should not have to clean up so much vomit. I don't know if Pooh King ate something yucky in the woods (no matter how many times I've warned him not eat things off the ground, he insists), or if there was a problem at the other end, but there was a horrible problem in Pooh King's stomach last night. It made the problem with peanut butter scooby snacks seem tiny.

I came home from spending the evening with PB and The Force to find that Pooh King had blown the contents of his stomach all over the house. 2 floors worth of redecorating the flooring. Great.

Thank goodness for the steam cleaner, because you KNOW my dog has to puke on carpet. Which means I have to clean the carpet. And when Pooh King is too uncomfortable to sleep, I can't sleep. So we were up until 4am, walking and whining, whining and walking, taking turns with the whining and walking. He finally settled down and was able to sleep after that (thank you sweet baby Jesus).

I got up at 11, which would explain these pajamas and the bathrobe I'm still wearing.

Farts can save the day

Last night I got to ride out the end of a full-blown temper tantrum turned nuclear meltdown over bed time. Usually, The Force is pretty good about going to bed for PB. There's a little fussing over wanting to keep playing at first, but then it's over, and off to bed he goes. But last night? Holy shitballs, Batman. The bottom lip came out, the tears rolled, and we were off. PB kept his cool for a good 40+ minutes during wailing, rolling of eyes, nashing of teeth, thrashing of arms and legs, pleading, holding and rocking... then rinse and repeat... at least 3 times. And when the final turn came around, he was ready to lose his shit. He came out of The Force's room and said he couldn't go back in there without losing his mind.

I figured I'd give it a go, since The Force has proven in the past to be true to his name, and is a force of nature when it comes to being able to maintain the momentum of a tantrum. We're talking HOURS here, folks.

I went in and sat next to The Force's bed, talking to him while he sobbed and wailed, kicked his legs and pouting, begging for Daddy. I told him Daddy was too upset to be in there, and that he had to show Daddy that he could be quiet for a little while before he would come back in. No deal. We basically just kept talking in circles until he started winding down. And that's when it happened.

The force FARTED.

Then he giggled. I said, "Is that what the trouble was? You had a toot stuck all the way up your butt and it wouldn't come out? Do you feel better now?" He couldn't decide whether to keep giggling or crying, so he did both for a few seconds, then he belched. Then he hiccupped.

Meltdown officially over. Commence giggling. Then he had trouble lying still. When I told him he needed to be still, he said, "T, this is as good as I can do!"

When I left the room he was still awake, but happy, and knew Daddy would come back in as soon as he was asleep. PB reports he woke up in a good mood this morning, none the worse for wear.

I just hope he doesn't get anything else stuck up his butt. :)

Welcome back Mr. Myiagi

Well, I FINALLY have my computer back! Or, at least for a few minutes... the backlight on the LCD screen burned out, and after trying 2 different replacement screens, I learned that my computer has to have a specific type of screen and can't use a generic replacement (thanks a lot Dell). But my trusty computer guy, Chris, (actually one of PB's best buds) got the proper one in place and working, so tonight, wa-la! I've spent about 2 hours trying to catch up on the blogs I haven't been able to see from my phone. Boy howdy, I've missed you guys!

I'll be back tomorrow to tell some stories. Tonight I have to go to bed so I can try to get to work on the early side tomorrow. There's lots to do, including 2 more visits to the car doctor for George Jetson. Sheesh.

Okay, people, I was just kidding about working 3% less! Our caseload was really low this week, so I got to enjoy my third 3 day weekend in a row. That's right... a low census day on Friday. Fun for me, but not so good for the budget. PB and I ran around a little on Friday then had dinner with friends. Yesterday we hit the gym, saw "Sherlock Holmes" (which is awesome) and had pizza and beer at our friends' new house. Lots of fun! Today I'm doing housework-type stuff, and more hitting of the gym. Blech. At least I have a new book to keep me occupied on the runner, "Such a Pretty Fat: One Narcissist's Quest to Discover If Her Life Makes Her Ass Look Big, or, Why Pie Is Not the Answer". I can't wait!

And happy birthday to my SIL Erin!

I'm not getting the 2% cost of living raise the hospital has given everyone else. Apparently when our little hospital merged with the big hospital system, the big system decided I make too much money and therefore would not be giving me an annual raise. Gee, thanks. Not getting the cost of living adjustment that everyone else gets is tantamount to receiving a paycut. Dirty rat bastards. Chris pointed out that I should not work 3% harder. I think I'll work 3% less.

Happy Birthday Seester!

Dear Seester,
Happy birthday! I made bluberry pancakes, so please come right over and get yours while they're hot. I'll make you any kind of pie you'd like for dessert.
Love, Your Seester

Dear Mom,
I've made you a cup of tea to go along with your blueberry pancakes. Thanks for pushing my Seester out all those years ago. Now, hurry along or it will all get cold.
Love, T

Dear Dad and Ryan,
Thanks for putting up with the 3 of us girls all these years. I know it was sometimes hard to swim in the estrogen ocean, but you did well. I've got pancakes for you and a pot of extra strong coffee. Oh, and I'll put on Rambo, or some other movie where a lot of shit gets blown up and Mom won't want to watch.
Love, T-Bo

Dear Shawn, Erin, and Jason,
You haven't put in near as much time in The Circus as the rest of us, but thanks for running away with us, if not sometimes from us. Wse love having you along for the ride. Now, hurry to the table 'cause I'm going to have to start a 2nd batch. Oh, Shawn, kill something on the way over so we can have sausage or something with all the pancakes. Please and thank you.
Love,
Tiff

Computer still down. Now having car trouble. Happy birthday Pooh King and happy new year to you!