Cull the Herd

Hopefully the bulk of current healthcare-at-the-bedside workers  are with me on this: the Coronavirus poses a significant risk of shortening life expectancy. No matter where it originated from (which hardly matters in the ICU), it is a bad mofo. I believe that social-body-space distancing, mask wearing in public and hand washing, represent our best defense. This poem speaks to the folks who don't believe these recommendations, nor do they recognize the severe risk of death to themselves, and to their loved ones.

Cull the Herd

Herd immunity?
It will take at least three years,
Culling of the herd
Should be added to your fears,
If you're a big old fella
With diabetes or hypertension,
You better watch out boy;
You've got the Grim Reaper's attention.

Who do I speak to?
All the careless folk,
Who love to tell themselves
The Coronavirus joke,
How it's no worse than the Flu
Of which they already have immunity,
Coronavirus will cut them down
At the first opportunity.

Go ahead with your demonstrations
Shake hands, wear no mask and hug your brother,
Perhaps he will share the virus with you
Which will kill your mother,
But you frequently boast
"Well, ya gotta die sometime",
How about your eight year old daughter
Who caught it during lunchtime?

You will weep and moan
And smack the side of your head,
Realizing your foolish actions
Made them dead,
Or, maybe you won’t
You will blame it on the Democrats,
Deep state, Cabal, CNN
And mysterious Fat Cats.

You know the saying
You’re a part of the problem or the solution,
Will St. Peter or Beelzebub?
Offer absolution;
Stay tuned, old buddy
You get to choose,
Your survivability
But will your family lose?

At Home PCI Kit

In the April 9, 2020 Journal of American College of Cardiology, is an article reporting a reduction of admissions for STEMI during the recent COVID crisis. One assumption being proposed, is that patient's are afraid to come to the hospital, fearing they might catch the virus.

In my current state of being retired, I have a lot of time to imagine possible solutions. Here is my latest genius solution.

The Do It At Home PCI Kit

Here's the way I see it
And how the data was reported,
If you're having a STEMI at home
You need a hospital to thwart it,
Yet in these viral days of our lives
The hospital might seem too crazy,
We fix your heart, you catch the bug
You die and we look lazy.

A retired old Nurse
He worked in Cardiac Care,
All of the old and new ideas
Are in his brain somewhere,
He spends his retirement hours
Inventing Rube Goldberg devices,
A STEMI repair is just plumbing; and
You won’t believe the results and the prices.

You can do it at home with the PCI Kit
Assembled from household goods,
You will need a source of electricity
So you can’t do this out in the woods,
And it’s helpful to have an assistant
In case you pass out or you’re bleeding,
And not only that, if you work with a mirror
It will reverse the instructions you’re reading.

Call right now to Amazonabon
One kit delivered in an hour to you,
Review the supplies that you need
Not satisfied?, then nothing is due,
It’s advisable to examine the kit
And carefully read each instruction,
You might think it ought to be easy
But remember, this ain’t liposuction.

It’s important to have good lighting
A comfortable couch or a bed,
With a suitable selection of pillows
Under your feet and your head,
Having an assistant to aid you right then
Is like having a Musketeer,
Anxious? and you poke the wrong vessel
And the pipe cleaner comes out your ear.

Supplies found in the Kit
Dental floss - waxed
Ultrasonic toothbrush handle
Olive oil
Pipe cleaners
Disposable gloves
Merlot
Sewing needles-8,9 or 10
Stat-Seal Powder
6 Rare earth magnets

__ __ __ __ __ __ __ __ __

When You Are Ready:

Assemble the list of items: Place in order of use, on a clean towel at the bedside.

Wash your hands and wear a mask…………….if you don’t have one, just hold your breath during the times of puncturing.

Thread the two sewing needles with a five foot piece of dental floss (waxed is best) and lubricate with Extra Virgin Olive Oil (if there are no extra virgins available, no sweat)

Don your gloves (don’t ask me why it’s Don, if you like, use Dawn)

The usual site of puncture, if you’re old school, is the Femoral artery. You have to pull down your underwear to expose the area. Your assistant might be embarrassed at this point and run away. Therefore, it is better to be new-school and choose the Radial artery at your wrist, (and if you are alone) use your non-dominant arm for access.

Sterilize your intended puncture site: Hopefully, you have some alcohol on hand or some really good soap. Minimally, you can use the Merlot, which was included in the instructions.

You may have consumed a glass of Merlot already, to aid in the numbing of the puncture site. There is some disagreement about that, as the developing intoxication might alter your aim, but the jury is out on that detail. Suffice to say, the Radial artery is very superficial, and this writer assures you, (having done 5000 arterial punctures himself) if you can’t cannulate a radial artery, you don’t deserve to survive anyways.

Regardless of which arterial site you puncture, you may note a bright red sticky substance squirting out; that’s when you shout "Hurray, I hit the artery". At this point, I suggest you apply some digital pressure a little upstream from the puncture site to slow the leak. If you did use the (highly recommended) sewing needle with floss attached, you are finished with one of the most anxiety provoking moments, the gushing blood. Here you can apply some of the Stat-Seal powder to slow the gushing blood to a drip.

Now, take hold of the Ultrasonic (toothbrush) handle and turn it on. Your assistant will have several rare-earth magnets stacked together, and move them slowly up your arm, in the direction of your heart. The vibrating toothbrush handle needs to be moving in tandem, immediately next to those magnets. The vibratory ultrasonic wave will help to keep the needle in the middle of the artery. Slide up the arm, under the clavicle and then take a sharp turn down toward the heart. It gets a little tricky then, but if you just happen to have an iPhone with a visual Ultrasound attachment, then this will be a piece of cake. Otherwise, you just have to use the back and forth approach to hit the desired arterial take-off on the Coronary ostium; sooner or later, you’ll hit it. More than likely, if you send the needle down the wrong artery, you will actually have an upsurge in pain and symptoms, because you are now disrupting flow down one of the remaining open arteries.

The objective is to find the blockage and attack it a few times with your magnetically directed sewing needle and hopefully pass thru the fresh blood clot. When that happens, a little bit of fresh blood will pass the obstruction and the chest pain should be reduced immediately. At that point grab hold of the nearby tail of the dental floss, and with the help of your assistant, together you can floss the passageway through the previous blocked artery.

If it doesn’t seem like the flossing method is working well enough, pull it half-way back, cut the floss and tie in a long piece of pipe cleaner with a floss tail. Use the magnets again to navigate through the artery, pipe-clean with the same back-and-forth method.

Do realize that although this method has saved a number of lives, we CAN NOT guarantee success, because in the hospital they have machines that will blow your mind. However, you might catch COVID and never go home.

When it seems like the Elephant is no longer sitting on your chest, withdraw your tools. Apply direct pressure to the puncture site with more Stat-Seal, for at least fifteen minutes and wrap it tightly with a clean Scrunchie.

While finishing off the bottle of Merlot: Call your doctor and leave a short message; say something like this: Doc, this is Barney; you may not believe me, but I had a STEMI last night at home. Luckily, I ordered (1 hour shipping) from Amazonabon, the “You Can Do It (yourself) At Home PCI Kit With Common Household Items”.
Damn brother, this thing really worked! How come you never suggested it?