Caring Time

Today, we had a boatload of patients, procedures and recoveries. We were super busy, procedures were delayed, it was hard to find beds and we "closers" worked 14 hours total. What made it a good day, was how many good visitors we had, paying attention to their friends and loved ones. Thanks, all.

Families and friends
Who hang out for the waiting,
Are the best that can be
And I'm not overstating,
The appreciation we have
For their vigil with Bob,
Whether they are dressed to the nines
Or just a casual slob.

It's best if they talk
Ordinary conversation,
Perhaps share a tv program
Or a radio station,
I don't like it when visitors
Focus on their gadget-gear,
They might as well go to Starbucks
Because they're not really here.

Being a supportive family / friend
Showing care for Billy-Bob,
Is far more than any kind
Of lazy, boring job,
You are giving of yourself
Unselfish caring time,
Thank you, to everyone
You help everything rhyme.

1/31/15

Drought Solution

Where is all the water? I realized where a good portion of it is, after seeing a response to Lasix the other day. Perhaps our end-of-times drought wouldn't exist, if those perpetrators of Heart Failure, would PLEASE return the water!

A brilliant solution presented itself
After a standard dose of Furosemide,
In California, we're in a massive drought
The plants, and aquifiers and lakes have all dried,
The patient in the spotlight had fluid overload
Short of breath and feeling chest pain,
In the next two hours, I hereby witnessed
Two liters of urine go down the drain.

How many persons in California with Heart Failure?
Holding on to our water, in the midst of a drought,
There ought to be an ordinance, a fine, or citation
Breaking a natural law, there is no doubt,
Wildfires rage with dry tinder conditions
Fish species in danger, when they can't spawn,
And most of you with Heart Failure
Are probably still watering your lawns.

Sure, a little off the track, I will admit
But Lasix and Bumex
Just might do the trick,
To solve our water crisis
In our severe time of need,
Let Go Of Your Water
It's time everyone peed.

1/30/15

Bed Theory

After 31 years of Nursing, I stake my claim, and publish emperic, evidence-based, scientific research.

Even though our new "HIPPA" compliant, one occupant , get-ready and recover rooms are the cats meow, they are small. They are designed for a gurney, but those things are just rolling torture tables. Our 2015 idea, is to have a real bed in there, for those patients who might be with us for more than 4 hours. The following mini-research proves, that providing a comfy bed, does not guarantee patient happiness.

Bed Theory

We theorized the following:
Sometimes our patients have a long wait
For a Cardiac Cath date,
If they had a bed, instead of a gurney,
They might be less inclined
To call an attorney.

A common supposition stated
Bed, compared to gurney, might be rated,
Higher on the satisfaction scale
But still, our patients moan and wail,
Because laying on one, uncompared to the other
They don't know the difference, and the crux of it brother,
What they really want, is nicotine and food
Bed Theorem debunked, hence their bad mood.

1/27/15

Hollywood Star

This old gent was determined to need an Aortic Valve Replacement, secondary to reduction in Valve area and calcification. He had a pile of tests to support the suspected Diagnosis, and eventually qualified for TAVR. Transcatheter Aortic Valve Replacement. If you don't know; at this time, it is reserved for those persons deemed too risky for open heart / sternotomy approach. This is most often as a result of comorbidities, frailty, old-age and the like.

So, he passed all of the prep tests and today was the day of the big event...................except, he didn't really need it after all.

They thought he needed a TAVR
But it just wasn't so,
He had 14 preparatory tests
And it was all systems go,
Coming in at 5 a.m....
When you're 91, that's a cinch,
And when they started his IV
He didn't even flinch.

Transported to the Hybrid Room
Anesthesia induction, was smooth as expected,
Every monitor known to modern surgery
Insured that he was protected,
From collapsing vital signs and hypothermia
Arrhythmia's, bleeding and more,
His Femoral arteries and veins were cannulated
With everything the Surgeons had in the store.

And then it was time, for the last Aortic measurements
Before they would load that valve on a wire,
Three or four Doctors, scratched their heads and wondered
How did we get to this place, where we call a ceasefire?
And admit to ourselves, that this fellow doesn't need it
The best thing to do, is to send him home today,
Let his family celebrate, wondrous good fortune
And pray to the heavens, there isn't a Copay.

A six hour recovery, that's all he needed
Sleeping the whole time, till he walked to the car,
At 91 years of age, this was another adventure
I think he just earned his Hollywood Star.

1/25/15

Bumped Off

A couple of times a year, I find myself bumping against things to the side of me, as if my radar is busted. It's as irritating as those days, when I have hiccups about 7 times.

It's the middle of my shift
Suddenly, pain in my thumb,
I can barely bend that sucker
I wonder, what's that from?
And then I remember
Bumping the metal door,
Also, caught a finger
Pushing the handle, man, my finger is sore,
And to top it all off
Smacked my other hand,
Against a non-moving bed
I assure you, none of this was planned.

I think my proprioceptors
Are not properly tuned,
If I start bumping my knees
I might be marooned,
Trapped in the hospital
Too lame to go home,
And we don't stock toothbrushes
Not even a comb.

New Stuff Learned

I love going to Medical Education events, because I like to learn new stuff. Also, it's a great place to get ideas for jokes and new poems. I went to a little meal and eat at the country-club, back in October, and my table-mates and I learned about Neurological Disorders, specifically regarding Parkinsons and Tremor. My new pal (yes, you) likes joking around too, and here is what we came up with. Silly cocktail humor.

Chorea: A country near Japan

Leva-Dopa: When the Taxi-driver drops off the dopehead.

Bezel Ganglia - Jewelers Neurons

Parking Sons: A motor vehicle parking business.

Pre-Cursor: Middle schooler who hasn't yet learned to curse.

Vascular Insult: "Your varicose veins, are WAY ugly!"

Blood vessel to Fat guy: "Hey, lighten up, will ya?!? I can't supply all this fat!"

Parkinsonian Features: Short films, just before the Main feature, at the Parkinson Theater.

Stepwives: Exercise Program @ 24 Hour Fitness

Cardinal Rigidity: A high member of the church, and his "little" problem.

Sleep Disorder: Acting out while sleeping.

My Charge-Nurse has executive function dysfunction.

Motor-State: Detroit, Michigan

Are you moody about your anxiety, or Anxious about your moodiness?

A dancing disease vs. Advancing disease.

Don't look at me funny, that's how I manage to stay awake after drinking two glasses of country club wine. 

Smoking and Choking

I will admit, that I like ye olde fireplace fire........but now, I don't like the smoke in the air when it feels like I have Asthma.

And here in the Capitol of Californication, it hardly ever gets cold enough to freeze anything.............so, a lot of people probably don't really need to light the fire...........it's just a warm living-room homey thing.

As soon as I got to work today, I smelled wood smoke coming from the ventilation duct. As the day progressed, I was coughing more and more. Talking with coworkers later on, they too, commented they were coughing, and had burning eyes. My partner called someone in Engineering, and he dropped by.........probably thinking we were talking about burned popcorn.

Engineer of the Night, wasn't very sympathetic to our complaints of things making us cough, sneeze and burning eyes........because after all, "No one else has complained yet".


We got a heckuva response
From the Engineering dude.
If it had been Mark
He would never have been so rude,
When we called about the smoke
Piped in by our new ventilation piping,
The dude said, "It would be too expensive
And no one else complained, only you are griping".

I said, "Well, we are the healthy ones
What about those who can't complain?
Asthmatics, with C.O.P.D.
Respiratory Failure
Just struggling to operate their brain",
No, Engineering dude, once again stated
"I'm sorry, no one else has lodged a complaint",
Denouncing our legitimate concerns
Oh, I held myself back with some restraint.

I guess, maybe he is a perfect example
Of someone, who takes his job easy,
Don't rock the boat, ruffle the edges
Maybe he gets queasy,
Afraid to pose
Questions of impropriety,
Like piping in particulate-matter smoke
Intolerable to most of our society.

He talked about charcoal filters
Although, I dont know if that's a viable solution,
And anyway, Engineer said it would be too expensive
And "no one else" complained about the air pollution,
Then I begin to wonder, how much do you want to breathe
Is it as important to you, as Valet Parking?
Go find your car later, without much help
Or listen to your loved one, wheezing and barking.

Your Nurses too, are coughing
Like infected banshees, on the roam,
Where, in reality, they are suffering
From neighborhood households, burning loam,
And really folks, do you want
Your caregivers, coughing like deathrow survivors?,
Coming up from the deep-blue sea
Like gasping, deep-sea divers?

But night-time Engineer said
"Well, no one else complained",
I guess he's the wise man in the bunch;
Let's have him Ordained.

1-2-15

Some Data  regarding Smoke Air Pollution:

http://www.baaqmd.gov/Divisions/Communications-and-Outreach/Air-Quality-in-the-Bay-Area/Wood-Burning/Wood-Burning-Rule-Information.aspx

http://www.sparetheair.org/~/media/Files/Communications and Outreach/RedWoodSmoke.ashx?la=en

http://www.epa.gov/airquality/community/details/i-woodstoves_addl_info.html#activity2

http://www.cleanairplus.com/blog/activated-carbon-filters-air-purifiers.html

Our Engineers are in complete support, apparently.