And the thunder rolls...

No, no Garth Brooks meanings here.
It started last night with a big flash and a distant rumble.
Then another noticeable rumble at about 4 am.
Now, 7 am brings a flash so bright I see it with my eyes closed.
Puppette is uneasy, Bugsy barks and Poni could care less as the thunder rolls over the house like a breaking wave.
The flood gates open and the rain hits the bathroom skylight like a small drum with an irregular rhythm to start my day.
Up and out with the dogs into the wet morning. I try to keep the umbrella over Poni. No, not to spoil her, I can't find her rain coat and she won't pee if she feels rain on her ass. Would you?
We come back in and I start to exercise a little, get the bones moving. the rain is a gray mist outside, it falls so hard. the drum in the bathroom is loud enough to be heard over my work out music. I see day light pale flashes of lightning and count the seconds.
I read it is 5 seconds per mile, not three per mile as I was taught as a kid. Either way the storm is coming closer.
The lights flicker, Poni decided to bark her defiance at Odin's hammer being thrown about upstairs. I sweat out the aerobic part of my movements and count seconds to distract me from the burn in my legs, shoulders.
I love a good storm.
I wrote my very first short story about a thunder storm.
How cyclic.
I am going to watch the lightning.

C

Patients

No, I typed that correctly.
I have debated with my self if I should ever write about any of the patients I have worked with over the years.
The Federal Government (sorry for using such an ugly word, people, but you gotta call things by their rightful names) in its highly questionable wisdom passed the HIPPA law. This is the Health Information Privacy Protection Act. It was passed to help protect health care information from falling into the unscrupulous hands of the unscrupulous. ( I just love that word...)
I have been reading other blogs of health care workers and of Waiterrant and see how they white wash people to make them as anonymous as possible.
That being said, I thought I'd share a story from the start of my career. Some of you have heard it, so just bear with me.

The patient came into the extended care facility (the better word for nursing home) responsive to pain only. This person had been hit by a car.
I was with the patient 5 days a week for about six weeks.
You start out moving the person, passive range of motion in all joints, so muscle shortening does not limit their ability to move. Then you advance to rolling stomach to back and return them. Next you, and another therapist get them from stomach to on all fours, then up to kneeling. We advanced to standing with three people in support, long leg braces on both lower legs so the knees do not buckle. Them you progress to walking, again with three people in support and long leg braces.
I learned about head injuries. How a person can appear normal but then have out bursts of word salad where not one word makes any sense, inappropriate responses to stimuli. This person was sitting in a room one day with many of the other residents and proclaimed ( I am not making this up) "You are probably all wondering why I called you here tonight.) It was a therapeutic recreation show where, if I remember, people were coming in to dance and sing for every one's entertainment.

I was not there the day of discharge. I missed saying good by to the family which I had gotten to know well with two 45 minute treatments a day for a month and a half.

I saw this patient six months later walking through the mall parking lot. The gait was still off in some clinical ways, but look good overall. Holding on to each hand was a grand child. There were smiles all around.
In that moment, tears in my eyes. I felt more satisfied with the world, myself, all things, than I had since I was a young kid with no greater care than which toy to play with.
In that moment, all the hell and hard work I put in to graduate was paid in full.
The Patient and spouse came back to the facility after a year. I walked up and introduced my self. The spouse remembered me, with a big smile. he patient apologized and said they had no recollection of me.
I learned then that this is not unusual. Head injured patients, patients you treat in ICU/CCU some times have no memory of the staff that help them. It is nothing personal, ever. It is a chemical mix up in the healing body and brain.

Taking the exam reminded me of what I get out of this investment.
Paid in full.

C

It is done.

I woke up with K.
Kinda hard not to when 2 out of 3 dogs wake up and pace, shake, scratch, yawn loudly (Bugsy) and walk on your face licking up your nose and over your eye lids (Bugsy again). Poni would not be stirred. They needed to go out into the deep freeze to relieve themselves.
I made a safe breakfast and had some tea. It is a one hour drive to the town where the test center is.
The time to leave rolls around. I bundle the dox in their new coats and take them out into 7 degree, -2 degree with wind chill, weather to give them one last pee before they are boxed for the day.
I make three false starts. I forgot my passport for ID. I forgot the GPS navigational device. I forgot the letter from the FSBPT. (do not worry about that last acronym, it really is not important)
I go to start my truck and get three very low sluggish whirs and then the dreaded rapid fire click. The cold has turned my oil to sludge and the poor 9 year old truck battery, unaccustomed to such frigid abuse, has not enough "crankin' amps".
There is no room for panic. I just will not allow it today. I must stay calm and focussed.
I drive a stick shift and I live on a hill. Problem solved.
No difficulties following the navigation thingy to my destination. The LIE (Long Island Expressway) is blocked with an overturned semi just past my exit so the traffic slow down does not affect me.
I had planned to eat a nice salmon lunch at a nice restaurant. The navigator tells me the restaurant is 20 minutes away. OOOPS. So I pick a nice looking little diner and they have Norwegian salmon. OK. The waitress asks me how I am and I tell her tired and on a schedule. I tell her about the test and she takes very good care of me. She even asks if I want a refill on my water or if I am afraid it will make me need to pee during my test. I tipped her well.
K calls as I leave the restaurant, so does my sister. Each ask how I am and wish me luck. As my sister goes to sign off, her two boys, my oldest nephews, start singing the Olympic Fanfare for me loudly. How can one not smile.
The testing center is quiet, security is very high. I am thumb printed and they use biometrics to assure I do not leave and a stooly takes my place. The man signing my in to the test area responds to mention of "Fizzbin" and we talk Star Trek trivia while we perform the legalities and necessaries. Always nice to find a fellow Trekkie.
I took the test and felt good about it.
I am under legal agreement to not mention any part of the test or its contents. That is fine.
Another test taker was leaving as I was and I asked him to jump start my truck. He was great and did so with a smile and wishes of good luck.
I have to wait for the FSBPT to score my test. Then they send the results to the state License board, then the State will tell me my score.
So I wait.

I had forgotten how much I know.
It is almost a compliment to take such a test because I can prove I know this. My brother told me to enjoy this because it is not often one gets to take such an exam. In some ways he is very right and to think of it as a rare happening, it shifts you out of fear, anxiety and apprehension.
I am knowledgeable about so many areas. I can think through the tough questions. I had shot in the dark answers on about 10 questions out of 200.
It is a relief to be done.

More on this another time.

Be well all.

C

A secret

Many of you know Puppette.
For those that don't, Puppette is a highly trained, very social, amazingly intelligent golden retriever that has been my work partner in the Hospital for 6 years.
I never taught her when to get involved with the terminal patient's spouse who is sobbing on the roll away bed in the ICU. I could never have taught her to sit at the side of a wheelchair being still so they could pet her and then stand and act normally for an able bodied person. She taught me that when she was done in a patient's room, she would turn her back on me and face the door, inching a step closer to the exit every minute I lingered talking to a patient or their family.
I did train her to come on command, to lie down and stay until told other wise.
She can hold a down stay outside a room on the insanely busy cardiac care unit or outside a room on the critical care unit while I work in the room, out of her sight, for up to 45 minutes and she will not move. We have a working vocabulary of over one hundred words and over twenty commands.
People always ask me if she is a normal dog, does she do doggy things. Is she happy?

OK, time for a secret a few of you know intimately.
My dog is a ham.
No, really, a thinking buffoon.
We walk out the door to the yard. She sits down and looks around for a minute and then flops over backward to wriggle on the grass, all four big blond feet up in the air, waiving like rabid fans at a sports event. Then she stops, holds the 4 legs up position, snorts LOUDLY, and gets up as if nothing happened. The other day I look out of the corner of my eye, keeping tabs on the wieners, and she was chasing her tail. I have tried to get pictures of this. But I swear when she sees me looking, she stops.
So this beautiful, brilliant, lovely girl of my heart topped herself last night.
We went out for the last pee before bed, all dogs should have a bowel and bladder schedule, makes life a bit easier, believe me. She stops in her tracks and I hear her growl. This mop has let a 6 year old boy fall asleep on her tummy, has sat in bed with patients hooked up to so many machines, has been calm when rushing gurneys, industrial carpet cleaners and massive portable x-ray machines rumble by in the busy halls of a hospital.
She growled.
Being such an uncommon noise, I looked at her, not verifying if Poni was peeing or not, and saw her hackles were up. ( I had a Maglite flashlight so I could see just fine, thank you) Looking across the street, I tried to see what had her up in a tizzy.
Back in November, just after Thanksgiving, our across the street neighbors put up their Christmas lights and decorations. On their lawn, near a tree, is a lighted white frame reindeer with a red velvet bow around its neck.
Puppette bobbed to her left and growled, letting it mature into a low bark/howl sound.
I stopped her at once, it was 11:30 after all, and got ehr under control. She was circling, just getting ready to go to the bathroom and she saw this minion of hell , in the same place it has been for a month, and decided it was here to end our days. She elevated us to red terror alert, defcon 4, Osama had brought jihad to Puppette's 'hood.
Poni peed and I brought my brood back in to the house. Puppette's hackles were still up when we got to the bed room.
I did the only thing I could do.
I told her that she was a good dog and that we were sufficiently warned to the danger and thank you for keeping us safe.
She sniffed loudly , jumped up on the bed and turned her back to me, sighing loudly.
My dog is the greatest.
My dog is a goof.
I love my dog.

Peace
C

Holiday Wrap up

For many years, K and I really have not celebrated Christmas. We both volunteered to work at the Hospital so someone with kids could stay home and make merry memories for themselves.
And, neither of us has spent Christmas with family in a very long time.
So why was it different this year?
It seems just a bit strange to me but this year I was homesick and wanted to be near my family.
It came to mind that it is distance.
Have you ever bought a book, or a tool, or pieces for a project thinking that "some day" you would have time to do it? It is the potential for possibility, I think. When I was closer to family, I knew I could get to Mom of a brother in hours, a sister by hours in an airplane. So it was the potential ease that was comforting.
This year it is thousands of miles and many hours to get to them.
We spent a wonderful Christmas day with K's family and her in-law's family. There was only one melt down when oldest nephew got mad that some one else was playing with one of his toys first and made it do it's special thing before he got to. He crashed for a nap and the adults and the baby nephew just enjoyed a calm evening.
K was sick with some gawd awful sinus crap that made her tired and made her head hurt.
In bigger families, and parties, I do not have much experience. It has always been smaller groups for me. So present opening was scattered and personal on a one to one basis, but not what I was used to. It was not, by any means, a bad thing, just different. Vive la difference, but I need some more known routine just now.
K worked New year's eve and New Year's day, I am at home, studying because I sit my License exam on Thursday.
I really do not care what the average range is for blood pressure for a one month old infant is, and had never heard of Brunstrom! What the hell is a de-rotational brace and how many test questions do they need to ask about anterior cruciate ligament rehab?
So I continue to look at the practice exams and wonder if I ever knew some of these trivial facts... Today I need to re-familiarize myself with the bones of the wrist, specifically the carpals, and know what other bones they articulate with, I need to brush up on enervations and dermatomes and memorize Brunstrom's stages of recovery. I need the rule of nines and gait patterns with device. AAARRRGGHHHHHHHHH!!! Did you ever see Shawshank Redemption where Andy's student lost his cool taking the test? That is where I feel I am at.
Breathe... just breathe.....

So, go forth, in this new year, so young and innocent in its infancy.
May the very best day of 2007 be your worst day in 2008.

Peace.
C

A gem...

Yesterday, I was poked, prodded, bled, stuck and processed.
I thought the hiring was tough at the last hospital I worked at.
Here, I had to give multiple forms of ID, proof I had actually graduated from an accredited college, and then sign my life away.
Then, after a physical, paper work and three nice people telling me "welcome" to the Hospital, I went to the basement.
Phlebotomy, the drawing of blood, has never bothered me. I do not like pain, but the stick of a needle is necessary, so I have never minded it. But to put it in the basement does not help the idea of bloodletting.
When I reveal to people that I am new to the area, they keep asking: "What do you think of New York?"
I have never been overly diplomatic, and I am told I have all the tact of black on white ( or white on black, what ever). But I am careful in my answer.
So the wonderful phlebotomist, a young, grey haired woman named L asked me what I thought of New Yorkers.
She was taking three large vials of my blood for titer tests or some such.
What I have found, I have stated before in previous posts.
She agreed with my findings and we talked a bit more.
She told me that people here do not look up or down but usually straight ahead. At this, she held up her gloved hands and put them around her eyes like goggles. She then confided that she takes her kids out into the yard, has them all lie on their backs and stare up at the sky. Her tone and word choices made me think that this is not all that common of an experience out this way.
How can you live in the Pacific NW and not look up at mountains, eagles, seagulls, crows, racing clouds, vintage airplanes, jet airliners whisking people off to adventures in a rumbling roar...
My comment to her, after making my usual disclaimer that I was not being offensive (look I am not intentionally offensive, just tactless and blunt) that New York, so far, did not appear to be a place for enlightened people.
I am not talking sitting cross legged at the top of a mountain as an aesthetic. I mean some one who has at least discerned that there is more to life than one foot in front of the other-keep-up-with-the-Joneses scurry through the maze rat lab.
She readily agreed.
I found her to be a jewel. A jewel is usually found among common dirt, gravel, rock and sediment. I found that to be an appropriate analogy here.
I am not calling the people that are in the rat maze dirt, not in the slightest. But I have moved my freaking cheese thousands of miles and started new with K and the animals. I am certainly not going to look only ahead, keeping up with the Joneses. I am going to look up down left right and side ways to find gems, jewels.

I signed up to take my license exam in January. I am so tired of taking the practice tests and seeing what I have forgotten and what they have changed in the last decade or so since I graduated.

Be well, my friends.
More when I take breaks and have a moment.

C

Random Thoughts, again

A wiener in the snow!

The Golden One sitting on snow. OK, I know, she is weird.
Profile.
One short legged boy really wants to go inside.

A wink and a nod. She loves the snow!

More soon. As always.

C
More snow today that turned into a type of sleet. Interesting.