Tuesday, March 29, 2005

The Dead Pool

I am addicted to news, specifically, late-breaking news.

News radio in Anchorage is sadly limited to either dreadfully boring Public Radio or hateful right-wing diatribe and info-tainment stations, so television and the internet are my main sources of news. The internet is actually my favorite source since it combines the immediacy of instant posting with the thoroughness of a written story but usually television will have quicker updates than internet sites.

I'm not all that impressed with the CNNs so that leaves me with MSNBC or FOX News, both of which will interrupt their own screaming diatribe shows to “go live” to breaking news. Between those two, I can usually get decent pictures and facts. Whenever there is a pause in the flow of incoming news and the ‘anchors’ start babbling or calling on screaming pundits for reactions, I can flip to the opposite station.

During the last week Terri Schiavo has been in the news with increasing frequency. Mrs. Schiavo has either been in a vegetative state for the last fifteen years or she is one hell of a lazy woman. Either way, her husband successfully gained permission to remove her feeding tube 11 days ago. Mrs. Shiavo’s parents, who are Evangelical Christians and take their ‘Right to Life’ bumper stickers very seriously, had fought an unsuccessful custody battle for her daughter and are organizing (or at least encouraging) protesters who have held a vigil outside Mrs. Schiavo’s hospice.

Consequently, the news stations are having something of a “death countdown” for Terri Schiavo. Unless something miraculous happens, her death should occur before the week is out. The news stations can do updates hourly about her condition, will get several hours of “breaking news” out of her death, and can probably milk a week or two of blather about her afterward.

But while Mrs. Schiavo is the front-runner in the race toward the afterlife, there are two celebrities who are still in the race. Probably running second at this moment is Prince Rainier of Monaco. Coming up on the outside is the Pontiff, Pope John Paul II.

And Holy Crap! As I sit here writing this, I flipped over to IWON news to check the spelling of “Rainier” the race has been won. And, pardon the horrible pun, by a dark horse.

Johnnie Cochran, lawyer to the oppressed and, oh yeah, O.J. Simpson, died of a brain tumor at 11:30 am Alaska time. Breaking news, wahoo! Sad and horrible for the Cochran family, to be sure, but he won the pool. And before I posted the line-up.

So the race is really for third. Cochran won.

Onto the next few.

In an ironic twist due to his position on keeping Terri Schiavo hooked up to her feeding tube, the Pope is being considered for a feeding tube of his own.

Price Rainier has multiple organ failures so he is probably on his last legs as well.

And there is always Chief Justice of the Supreme Court of the United States, William Rehnquist, who has cancer and is probably not feeling so hot these days either.

Television Evangelist and creator of the Moral Majority, Jerry Falwell is on a respirator going through a rough bout of pneumonia.

So the race for second odds are currently:

“Skinny Schiavo” 3-2

“Grace’s Ex” 2-1

"It's Hard to Breathe With a Chest Full of Hypocrisy Falwell" 5-1

“Pope at the end of his Rope” 10-1

“Chief Willie” 20-1

Not that I'm a bettin’ man.

But news this week should be breaking out all over. The fact that I'm excited about it probably is a sad commentary on me. The fact that the news channels will be ALL over it probably is a sad commentary on the nation.

But I'm not going to dwell on that.

If you are looking for me, I’ll be tuning into Deathwatch 2005.


Monday, March 28, 2005

Life Lessons

At 10:23pm on Sunday March 12th, 2000, my recruit and I got a call from the First Care walk-in clinic on Huffman Road. They had a male patient with head lacerations. He wasn’t very forthcoming about how he got the injuries but after repeated questioning by the doctor he said that, after a verbal argument with his wife, he hit himself three times in the head with a bedpost.

My recruit was puzzled about how to put this in the computer: was it a suicide attempt? an assault? Perhaps I’m a bit cynical but this would be the first person I’d ever heard of that had attempted suicide by bedpost. We have had lots of folks jumping off of buildings or taking pills or shooting themselves. Once in a while we’ll have a hanging. A bedpost would be stinkin’ creative. And anyway, I’m thinking his soon-to-be-ex wife was responsible for putting the guy under the influence of a bedpost, but that’s just me.

Lesson: well… that whole “don’t go to bed angry” rule seems to apply here.

A couple of weeks later (and I’ll confess, not on my shift, but I’ve got the paperwork to prove that it really happened) we got a call from an Anchorage Refuse garbage truck driver.

First let me paint a little picture for you: Garbage trucks have a ladder that runs from the front bumper up to the front lip of the trash area, just about dead center so it’s not a big obstruction to the driver’s line of sight.

The caller was doing his nightly rounds emptying Dumpsters™ when, as he’s driving alone down the street in the middle of the night, a guy climbs down the ladder face-first from the top. Scares the bejeezus out of garbage man. Think about it: Even if you were getting a bit sleepy or distracted by loud Tom Waits music, you’d probably make a trash deposit of your own in your coveralls if you saw a guy climb DOWN YOUR WINDSHIELD as you are driving down the street in the middle of the night. So the driver slams on the brakes and calls on his radio for his dispatcher to call the police.

A quick investigation revealed that the subject (who took several years off the life of our friend the garbage man by making his grand entrance) had been sleeping in a Dumpster™ and had been dumped into the truck without the driver noticing (not hard, I’m sure).

Sadly, he hadn’t JUST been dumped into the truck. He’d been dumped at least four Dumpsters™ before and the driver had turned on the compactor at least three times. Three times! The guy was in pretty bad shape (had at least one broken arm, a broken leg, and a broken collarbone) but he was darn lucky to be alive. God watches over those sleeping in the trash too, apparently.

Lesson: don’t sleep in Dumpsters™... ever. Better to smack yourself in the head with a bedpost a couple of times. Then you’ll at least go to the hospital in a more comfortable vehicle.


Easter At The Hospital

I sometimes tell folks an amusing story about a lunch I had with my grandmother. Well, it’s amusing to me.

A couple of years ago I was at my grandmother’s condo for our weekly lunch (it’s been less than weekly lately, but I digress) and my grandmother’s best friend, Joanne Brant, was visiting. My parents lived in Washington state when I was four or five years old and Joanne served as my de facto grandmother so it’s always a joy to see her.

We were eating lunch when my grandmother, having come back from the kitchen and standing near her seat at the table, made a weak coughing sound and gave the universal sign for choking. Joanne asked, “Are you okay?” My grandmother shook her head. Joanne asked “Do you need help?” My grandmother nodded her head. Joanne turned her head to me as if to say: you are the guy who works for 911, this is right up your alley.

At that moment I knew I had to do one of two things:

a) Explain to Joanne that, while I am indeed a 911 call-taker and police dispatcher, the only thing I do for medical emergencies is transfer the call to the fire department for the paramedic dispatchers to give emergency instructions. Besides, Joanne was sitting closer to my grandmother so perhaps she should step up.


b) Rush in and give the Heimlich maneuver, which I had been trained to do while working at the Hotel Captain Cook but had never done in an actual emergency.

The fact which tipped the scales toward jumping in and Heimliching my grandmother (which is illegal in several southern states) was that it would take too long to explain to Joanne all the things in plan a).

So I performed an amateur and very undramatic Heimlich, my grandmother successfully cleared her airway of a piece of apple, and we continued lunch as if nothing interesting had happened.

While I always expect that I will react quickly in an emergency, I cannot assume that I will. I get plenty of calls from otherwise very competent citizens who seem to lose their wits during emergencies and I try to remember that I’m not immune from that kind of reaction.

Luckily, during today’s excitement I performed as well as I could have hoped.

After getting the third of four weekly iron infusions to battle a bout of anemia, my grandmother went with my mother back to my parent’s house for an Easter brunch of homemade pork carnitas. On her way up the stairs from entryway to the living room, my grandmother became extremely weak and dizzy. My mother helped her up the stairs where my father met them both and picked my grandmother up and gently placed her on the couch.

Shortly afterward, Kelli and I arrived to find her reclining on the couch nibbling on chips and feeling weak but otherwise fine. About thirty minutes later, and before my mother started sautéing the onions and peppers to accompany the carnitas, my grandmother decided she needed to visit the bathroom.

She got up and had taken a few steps when she became very dizzy and weak once again. Kelli thought she might be leaning over to see around the corner for a light under the bathroom door to see if it was occupied but she was actually performing a graceful slow-motion leaf-falling-from-a-tree type of plunge to the carpet. My mom asked if she was okay and her response was a weak “no.”

I was closest to her so I quickly slid behind her and grabbed her under the arms to prevent her from doing a face-plant on the carpet (always embarrassing and potentially expensive and painful if the plant-ee is wearing eyeglasses).

My grandmother was still conscious at this point but very weak. My mother aptly described it later as “boneless.” I helped my grandmother up and we took a few more steps then she went limp again. By the third time she had collapsed we were in the bathroom. I let her sit on the floor for probably thirty seconds before she requested being sat up on the toilet (cover down, like a chair). I helped her up half-way, she again did the boneless chicken routine, so I picked her up and placed her on the toilet.

All the while I talked to her very calmly as if mimicking invertebrate poultry was a traditional Easter custom in our family.

Then the real excitement began. When I got her sitting upright on the toilet my grandmother totally lost consciousness and did the deep breathing one might expect from a heavily sleeping person. Then again, I thought, it could be agonal breathing* (the death-rattle I have heard over the phone but never in person, God forbid ptooey ptooey**).

I don’t remember what I said but Kelli heard a very calm “Someone needs to call 911, can someone call 911 right now please.” I remembered a Stephen King story*** where a med student woke up a person who had fainted by pinching her earlobe really hard. So I did. And it worked to a certain extent. My grandmother looked up, her eyes opened, and she gave me a look as if to say “hey, what was that for?” then she dropped off again.

At this point, and I wish my grandmother was conscious and alert enough to witness it because it would have made her proud, the five of us did a kind of ballet.

My mother called 911 very calmly and, from what I heard, she was the perfect caller. She described the situation clearly and calmly and told the paramedic dispatcher that, no she was not standing near the patient but her son was a police dispatcher and was with the patient and could shout answers to all of their questions.

Kelli heard me tell my grandmother that I was going to lay her on the floor and saw how difficult it was going to be for me. Kelli called my dad to help me. Kelli then asked for the keys so she could move our SUV out of the driveway so the paramedics could drive right up to the door.

My dad assisted me get my grandmother laid flat then helped direct the paramedic, firefighter, and police traffic through the house. It turns out I knew the main paramedic (Ken Craver, paramedic God) and the responding officer (Doug Fifer, the funniest officer on the force), although neither Ken nor I recognized each other until later and I never saw Doug, who was in the other room.

By the time she was flat on the floor, Grandma had regained consciousness and was weak but mostly lucid. In the couple of minutes it took for the paramedics to arrive she had regained full lucidity and was able to answer all of their questions (and add that, for their information, she was on Medicare and she had AARP supplemental insurance!).

There was no question about whether the medics would transport; she was going to the hospital, like it or not. My mom got to ride along in the front seat of the ambulance. Kelli and I followed shortly thereafter and my dad (who probably has a case of pneumonia right now but was too stubborn to cancel his Easter carnitas just because he could hardly breathe) held the fort at home, made calls to my brothers, and awaited further instructions.

The rest of the day was boring. The emergency room did some blood and urine tests which were inconclusive but suggested that she probably had a reaction to the infusion medication as well as may have been dehydrated. They checked her heart and lungs, ruled out a cardiac incident or a stroke, and pronounced her well enough to go home unless we wanted her admitted for observation (although the doctor suggested that infections or other diseases caught while in the hospital would be a lot worse than what she went in for).

I volunteered to spend the night with my grandmother at her condo to make sure she did not have any further difficulties. (Bless my wife, who was not consulted about this but was fully supportive when I told her).

And that’s where I am now, getting ready to go to bed on the pull-out couch. Grandma seems fit as a fiddle, although a little weak. Tomorrow I’ll take her to an appointment with one of her doctors which will hopefully shed a little more light.

I’m blessed to have such a great family and I’m proud to have been a part of our little “Medical Emergency Ballet.” Perhaps we could get music written to it and have ourselves a hit on Broadway.

Or maybe not.

Happy Easter,


* From a tiny amount of research on the internet, I found that dyspnea (shortness of breath) can be caused by anemia. Obviously I had not heard ataxic (agonal) breathing but instead probably Cheyne-Stokes breathing, a type of dyspnea which is sometimes normal for someone who is asleep but is abnormal for someone who is conscious.

** Robin Hartlieb (aka Shaindlin), who was my recruit for a couple of months prior to her going into observation and being cut loose as a dispatcher (thank you very much) probably taught me as much about being a Jewish grandmother as I taught her about being a dispatcher. Saying “God forbid, ptooey ptooey” after mentioning any ailment or catastrophe so as not to cause it to happen to one’s self is probably my favorite Jewish grandmother mannerism.

*** The story is called “The Raft” from Stephen King’s collection of short stories “Skeleton Crew.” While this is not one of the stories that Robin’s dad, Herb, read to his audience over the radio back in my formative years, it was Herb who piqued my interest in Mr. King’s work by reading “Quitters, Inc.” in his inimitably chilling voice.

Friday, March 25, 2005

Just desserts

LOS ANGELES (Reuters) - "American Idol" television star Paula Abdul on Thursday was fined $300 and sentenced to two years probation for swiping a car on a Los Angeles freeway then fleeing the scene, a city official said.
The former Los Angeles Lakers cheerleader, who rose to fame in the late 1980s as a pop singer of hits such as "Straight Up," pleaded no contest to one misdemeanor count of hit-and-run driving.
She faced a maximum fine of $1,000 and up to two years in prison if convicted, said Frank Mateljan, a spokesman for the Los Angeles City Attorney's office.
Mateljan said the accident occurred in December, but it took time for California Highway Patrol officers to conduct a full investigation and track Abdul from a photograph of her car's license plate taken with a cell phone camera.
She was formally charged Thursday morning, and her attorney made the plea this afternoon. With penalties tacked on, Abdul paid close to $900 and another $775 in restitution to the victims, Mateljan said.
Abdul's probation is "informal," meaning she does not have to report to a probation officer, but if she breaks any further laws, she could face the higher fine and jail sentence.
Mateljan said the official investigation found that Abdul was attempting to change lanes on a local freeway when she hit the other car. She failed to pull over, and exchange information with the other driver.
Witnesses wrote down her license tag and snapped the cellular phone photo, then notified police, he said.
I had nothing against Paula Abdul until I read about this incident (in fact, she's my favorite 80's artist who danced with a cartoon in a video) but this story proves she's a criminal. I'm not saying she's Ted Bundy, but if you do $800 damage to another vehicle and flee the scene then you are a criminal.
Martha Stewart: out of touch at least but maybe a scape goat
Paula Abdul: Straight Up criminal (caught in a hit and run, for you lyric fans)
I had also thought that camera phones were pretty silly until I read this story. They take such low resolution pictures (great to share with your friends' phones but you could buy a nice digital camera with lots of extra features for less money). I have to admit that snapping a picture of a fleeing hit and run driver was quick thinking and better evidence than witnesses (who are notoriously unreliable).
So score this one: Citizens 1, Celebrities 0
And a special note to Paula: if your way of dealing with stress is to go shopping, perhaps you should not invite a certain Ms Ryder to tag along.

Wednesday, March 23, 2005

Her Goals, My Goals, Our Goals

At Kelli’s weigh-in today, she had lost exactly twenty pounds. 20 ! Woo-hoo indeed.

She should continue to spiral downward until she plateaus, hopefully close to her ideal weight but probably a bit higher – most Roux-En-Y gastric bypass patients report lose about 75% of the excess weight the first year and tend to stay at that level or bump up a bit from then on if they don’t concentrate on exercise afterward.

I'm on day three of the South Beach Diet, round two. The first time I was on the SBD I lost probably about 20 pounds then went completely crazy (probably unrelated). I was pretty weak today but I hear that’s normal. It might have been a good idea to have started this while I was off work after all (although work tended to distract me from being hungry at least while I was there).

The BMI charts show that I should weigh 115-155 ideally. 115 is absurd but I wonder how close I can get to 155. At this point I’d be thrilled with being under 200lbs for the first time since Junior High. We’ll see.

I’ve intentionally left off our starting weights but when my number gets a little lower I’ll be more proud of how far I’ve come and less ashamed about how wildly out of control it was to begin with (at least for me).

We’re both going for a walk with the dogs now, so that’s a start.

Staying strong.


G Tubes and Surgical Complications Explained

Kelli got her G tube out today with no pain whatsoever (she was worried it would really hurt). I found out that the G tube had been inserted into the bypassed stomach to drain stomach acids and gunk out. My current understanding is that, since food will no longer enter it, only a minimum of stomach juices will be produced and they get dumped downstream (where there is still a connection to the intestines). The ‘pouch’ which is left to digest the food produces the appropriate amount of acid relative to its size.

We asked Dr Bogojavlensky (who assisted Dr Todd during the second surgery and was the one who took Kelli’s tube out) what exactly did they find during the second surgery. I did not explain to Dr Bog (pronounced ‘boge’ – everyone calls him that) that my understanding was that one of Kelli’s drain tubes was clogged and the end was broken plus there was a hematoma (a mass of blood) in the abdominal cavity. Dr Bog explained that when they went in for the second surgery they found a mass of blood, yes, but it was from bleeding along the staple line of the stomach. He did say that the bleeding had stopped prior to their going in.

He expressed that this was a scary complication, one that makes a surgeon question their own surgical ability, but was likely the result of the anti-coagulants that they use to prevent a possibly fatal complication: pulmonary embolism.

Dr Todd had previously mentioned they had replaced the broken G tube with a slightly larger one, so that part of my understanding of the situation remains intact.

So all’s well that ends well.

I found it interesting that, while everyone was very up-front about the possible complications before she underwent her surgery, once there WAS a complication – no one really explained what had happened. They assured us that everything was okay but did not go into any detail.

At the time this was all I needed. I was very worried (to the point of tears when she was wheeled away for the second surgery) that my wife was going to die. Upon hearing that she was going to be fine, I was satisfied. But everyone from the nurses to the doctors avoided saying anything specific about what had required her to undergo that second surgery other than the fact that since she was in pain they wanted to check. Even Dr Todd said nothing more specific except the “hematoma” which meant very little to me at the time. I imagine this was for liability reasons but it was nice for Dr Bog to take the time to explain the situation and admit the gravity of that situation.

While Kelli still is not recommending the surgery to anyone (due the sheer amount of pain she had), I think we are both satisfied that she’s on the road to a slimmer, trimmer new Special K.


Kelli's G tube comes out today

My wife Kelli goes to see Dr Todd, her bariatric surgeon, to get her G tube taken out. She also gets the first official weigh-in since her gastric bypass surgery. Will post the results later but we expect about a 20 pound loss in her first week. Woo hoo!

She's my angel

Tuesday, March 22, 2005

The beginning of a great adventure

This is my first foray into the bloggosphere. There will be bigger and better posts soon but this first one is just a test. What do I want from my blog? Well, it's just going to be random brain doodles from yours truly, perhaps a place to post some original song lyrics or stories. Whatever topics that spring to mind leading whereever they lead. Great stuff? Maybe. We'll see.