Wednesday, October 22, 2014

She's at it again....

My fave. Made with coconut milk. Found here

My friend Bev, that is.

I love this woman to death. You may recall a few of our previous adventures, the most recent involving her detonating a bear bomb in my car.

Yesterday, Bev picked me up bright and early, we grabbed a coffee, and headed into town. Bev was driving her trusty white mini-van. Gosh. I wonder how many hours we've spent together in that car over the years. Most of those hours were spent laughing, I'll bet. 

True to form, we sipped mochas and yakked as we maneuvered our way around town. And true to form, probably covered two or three times as many miles as necessary since we tend to wander a bit. Actually, we wander a LOT which usually is a good thing. We find the darndest things that way.

We did some shopping then decided to have lunch, so Bev pulled her van into a parking spot. One of those long low concrete barriers was at the head of the spot. We were hooting with laughter over something she had said, also true to form, so didn't hear that low, grinding, scraaaaaaaaaping sound...

Yeah.

So two hours later, after we had lingered over our meal and coffee and conversation,  Bev strapped herself in and put the van into reverse. This time the low, grinding, scraping sound was much much louder.

Yikes.

Oops.

Bev threw the thing into park and hopped out. She cautiously peeked around to the front of the car, stuck her hand under the bumper and retrieved a long black plastic chunk of something.

"Thank goodness. It's only this. Whatever this is." She tossed the thing into the back seat and we set off again.

SCRAAAAAAAAAAPPPPPEEEEEEEEEE crunch crunch crunch.

Um. Bev? I think there must be something else.....I stepped out of the car and buckled over with laughter as I saw fully half of her front bumper on. the. ground.

"Oh, man. Rick is SO buying me a new car!", was her response. Which made me laugh even harder.

Long story short: Bev had no one available to come and pick us up, so decided that we had to get the van home by hook or by crook. Which we accomplished by kicking the dragging bumper until it became lodged onto something on the frame of the van -- who knows what -- which kept it dangling just above street level. We creeped home avoiding bumps and potholes, which is quite a challenge if you've ever driven I-5...

Girl. Don't bother driving into my driveway, I told her as we approached my house.

"You're just worried this piece of junk will die right in front of your living room window!" she snorted and wiggled her fingers good-bye as she scraaaaaaaaaaaapped her way home.

The thing is, this is not a particularly funny story. But it's amazing how ordinary happenings can turn into extraordinary when shared with a friend, right?

Bev is an extraordinary friend. I'm lucky to have her. 

Tuesday, October 21, 2014

Diphenhydramine And Restless Leg Syndrome

The culprit. 

Did YOU know that Benadryl (diphenhydramine) can exacerbate restless leg symptoms?

I didn't. But now I do.

I have been taking Requip (ropinirole) for my RLS with good results, but over the few weeks my symptoms have been getting progressively worse. It seemed a vicious cycle: my legs would keep me awake, I would take something like TylenolPM which contains dipenhydramine, I'd conk out due to it's sedating effects, but the next night my RLS would feel even worse. And I wouldn't get any sleep. So I'd take the TylenolPM to knock me out, which would....well. You get the idea.

I just couldn't figure out why my Requip suddenly stopped working, so I did a bit of reading and came across this gem found on a Medscape article discussing treatment for restless leg syndrome:
Discontinuation, when possible, of medications that cause or exacerbate RLS, such as selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinepherine reuptake inhibitors (SNRIs), diphenhydramine, and dopamine antagonists.
Well, now. Made complete and total sense, and fortunately as soon as I quit taking products containing diphenhydramine, my symptoms receded and good old Requip was back on track once again.

Lesson learned.

Monday, October 20, 2014

Truth

Today's post courtesy of I'm not right in the head.


Yep. Sums it up nicely. See y'all tomorrow.

Sunday, October 19, 2014

Saturday we paint. Sunday we rest.

I helped just enough to get paint all over my fingers. 

When I was given a date for my laminectomy surgery, I immediately began making lists: stuff to buy, stuff to organize, and stuff to do. The stuff to buy item was the most fun on the list. And stuff to organize? Hm. Maybe I'll get around to that in the next few days....

The stuff to do was rather entertaining, especially since what this actually meant was stuff for John to do while Julia supervised.

Yesterday, I crossed one more item off my stuff to do list. I figured that there was a chance that I wouldn't be completely recovered by our annual Thanksgiving hoo-rah, so there were a few projects that I wanted completed before my surgery AND before the kids and guests began appearing during the holidays.

We built this house in 1996. And even though the rest of the house has been painted and repainted inside and out, only two lonely little rooms remained wearing their eighteen year old initial coat of paint. One is the laundry room, and pfft. That thing can continue waiting for awhile. But the guest bathroom upstairs was really overdue.

Lucky for John, I had everything ready: the paint, paintbrushes, the painter's tape, the drop cloths made from decades old holiday plastic tablecloths, and lots and lots of Julia brand advice. Lucky for ME, John was willing to dive into a Saturday painting project using most of the above items except my advice. Go fig.

But it turned out great, and was done in a snap. Thanks Hon. Let's see, now what's next on the list.....

Ah, yes. I'm guessing the last time this tablecloth last had plates sitting on it was back during the great Ham-o-rama from Easter '02. 

I documented the event.  

Lulu thinks we goobered paint on the floor. 

Saturday, October 18, 2014

Saturday Smile

I thought this was absolutely lovely:  Full Moon Silhouettes from Mark Gee on Vimeo.
Enjoy this -- and your weekend.



Friday, October 17, 2014

Impatience


I'm pretty good at crossing my eyes. Especially when I'm cranky. 

I cannot wait until my laminectomy.

Seriously.

I made that comment in a conversation a few days ago, and my friend laughed and said, "Oh, suuuuure you are.." rather skeptically.

No. Honestly. I really am!

She looked surprised. "Doesn't sound like much fun to me."

Well, yeah, surgery isn't going to be fun but neither is the pain and numbness and stumbling around which is why I'm having it.

Here's an example. I attempted to make a quick purchase in a craft store the other day. I knew approximately how much time and distance I could put in before the pain began and estimated that I could grab the stuff I needed and be back in the car without falling on my face. And it appeared that I planned correctly until I got to the check outs and saw the lengthy line of customers.

Drat. I didn't count on standing in line for an additional five minutes.

So as I stood there with my purse slung over my shoulder and my hands full of my purchases, I felt the pain begin in my hips and quickly progressed to burning numbness that stretched from my tailbone to my foot. Ow. After what seemed like forever, I was finally back in the car waiting for my leg and foot to wake up and the pain to subside, when a new and different thought occurred to me: that I should remember this incident and the pain. And how cranky I was. And how impatient I was just to have this all go away. That I should burn this memory indelibly into my brain.

Why?

Because when I am dealing with postoperative discomfort, I will need to remind myself why this surgery was necessary. The likelihood is high that I will complain frequently and at the top of my lungs (there's a warning for you, John honey..) that surgery was a really BAD IDEA. And that it's everyone else's fault that I literally have my butt in a sling.

Guys. I'm giving y'all an assignment. When I start writing about all the annoyances and aches and pains and wah-wah-wah-ing during my recovery, PLEASE remind me of this post. Tell me that there was a point in which I actually WANTED this. Be stern and firm: point out that I had proclaimed that surgery was my last option and that I would do anything -- anything at all -- in order to be able to walk more than one block before giving in to my stenosis symptoms. And that it was MY signature on those surgical consent forms.

Got that?

You will?

Awesome.

Thursday, October 16, 2014

Lulu Update



Several of y'all have asked how my plastic-biteguard-eating puppy is faring.

She's fine, thankfully.

I was concerned about her yesterday after she refused to eat, appeared lethargic, and I could hear her tummy rumbling quite loudly. So I called her veterinarian. After a lengthy discussion in which we discussed options for her care which included x-rays (which he didn't recommend because the type of guard I use is not radiopaque; meaning it wouldn't show up on the film), ultrasound, potentially scope and or surgery.

Yikes.

What IS it about my dogs that they seem to want to eat weirdo things? Remember when our previous schnauzer ate all those rocks?! We feed our pets really good pet food. Seriously.

Dr. F. and I decided on this plan: I would get some prescription soft dog food; I would monitor her for vomiting, diarrhea, or if she seemed to be in pain. Since we talked in the AM, we decided to follow up with a phone call or office visit in late afternoon.

I was consumed with guilt. Usually I put the dumb stupid night guard thing in it's case immediately upon taking it out of my mouth. Until Monday when I threw it on my bedside table. And of course, Lulu took the opportunity to gobble it up.

After hanging up the phone with the vet, I hopped into the car and headed over to pick up Lulu's new food. And, because I felt responsible for the poor little thing's distress, also motored over to the pet store and bought new toys. And treats. And....well, you get the idea.

Upon arriving back home, I took Lulu out for a very short walk and right on cue, she pooped halfway through our route. It's amazing what we pet owners will do, isn't it? I took a stick and poked around in the stinky stuff looking for plastic before tying it up in a doggy doo doo bag. Ewww.

Didn't find a thing.

Meanwhile, Lulu had perked up considerably and when presented with new toys and different food, began to eat and drink and play as though not a thing had happened. And today, she's just fine.

See?

video

She's frisking around the back yard barking at the kindergarteners coming home from school right now, being her naughty little doggie self, thank goodness.

Wednesday, October 15, 2014

Today's Challenge

Just look at this little furry face.


She looks all cute and innocent, doesn't she?

Pfffft.

I'm 99% certain that this critter ingested my plastic dental night guard. I'm wondering what will happen to the puppy's innards as it makes it's way through her.

Hopefully it makes it's way through her...

I'll keep y'all posted.

Tuesday, October 14, 2014

Kittens and Kids are Therapeutic

As promised yesterday:



C'mon. Sing along with me: "Kaaan u feel the luuuuuuv tonight...."

Monday, October 13, 2014

Ebola: No Easy Answers

image found here

So I've been sitting on my hands for the past few weeks, trying to restrain my urge to blog about the Ebola outbreak. But after the head of the CDC blamed a nurse for "protocol breach", I can't stand myself and as a result my blogging fingers have been unleashed.

You've been forewarned. .::Julia slaps on old, yellowed nursing cap::.

There's no ignoring the fact that the Ebola virus is the cause of a global public health crisis, especially after WHO Director-General Margaret Chan made this statement:
MANILA, Philippines (AP) — The World Health Organization called the Ebola outbreak "the most severe, acute health emergency seen in modern times" on Monday but also said that economic disruptions can be curbed if people are adequately informed to prevent irrational moves to dodge infection. Continue reading here
You can read more about the disease caused by the Ebola virus from the WHO here, and from the CDC here. In a nutshell this is a deadly disease which has an average fatality rate of 50%; this and other information about EVD was taken from a WHO fact sheet:

  • Ebola virus disease (EVD), formerly known as Ebola haemorrhagic fever, is a severe, often fatal illness in humans.
  • The virus is transmitted to people from wild animals and spreads in the human population through human-to-human transmission.
  • The average EVD case fatality rate is around 50%. Case fatality rates have varied from 25% to 90% in past outbreaks.
  • The first EVD outbreaks occurred in remote villages in Central Africa, near tropical rainforests, but the most recent outbreak in west Africa has involved major urban as well as rural areas.
  • Community engagement is key to successfully controlling outbreaks. Good outbreak control relies on applying a package of interventions, namely case management, surveillance and contact tracing, a good laboratory service, safe burials and social mobilisation.
  • Early supportive care with rehydration, symptomatic treatment improves survival. There is as yet no licensed treatment proven to neutralise the virus but a range of blood, immunological and drug therapies are under development.
  • There are currently no licensed Ebola vaccines but 2 potential candidates are undergoing evaluation.

I admire the health care workers from all disciplines who are willing to literally put their lives on the line in an effort to care for these patients and to work to contain the transmission of the disease. While I have had no experience in caring for patients with a virus in the same category as Ebola, there have definitely been times when I -- like millions of other health care workers -- knowingly and while wearing personal protective equipment, have put myself in extremely close proximity to dangerous disease pathogens. And came away unscathed and uninfected, I might add.

Thank you, God.

Back in the days before the hepatitis B vaccine, hepatitis was a serious problem especially for those people on dialysis. My first job as a dialysis nurse required that I work in a unit that contained both a hepatitis B positive and negative section. As I was oriented to my new job, I looked with dismay at a collection of photographs in the med room which were of the yellow eyes of all of the nurses who had contracted the disease as a result of working the hep pos unit. One of the nurses shrugged her shoulders and commented, "It's an occupational hazard." I was fortunate that the vaccine against hepatitis B began to be widely distributed. I was one of the first in line when it was offered to our department, ensuring that my eyeballs wouldn't be turning yellow as a result of hepatitis.

I  remember an incident back in the '80s when I was asked to draw a blood sample for a patient that had HIV/AIDS. What I recall most about this blood draw was not donning the mask and gloves, or the actual venipuncture. I was most struck with the "what if's" as I held that tube of blood in my hand after it was collected. I spent a few seconds just staring at the sample and wondered how many HIV viruses were zipping around in there. What if I tripped and fell while holding the tube and it shattered sending contaminated blood everywhere? What if I had tried to re-cap my draw needle and stuck my finger with that germy piece of metal? I looked back at the red sharps disposal box which was in the process of being double-bagged before being sent to biohazard disposal and imagined the potential disastrous outcome should that contaminated needle be mishandled. I thought about the implications for not only me, but for John and our children, should I become an AIDS victim.

That's a lot to think about. But I placed those dialysis needles and drew blood from AIDS patients because......If not me, then who? Who would care for these people if everyone refused?

I can identify with the staff members all around the world who are suiting up in protective gear to face the Ebola virus head and hands on. Which leads me (finally) to the topic of this rant post:

Don't be blaming health care workers for the spread of this or any disease.

Honestly.

As one who has strapped on more yellow paper gowns than I can count, I can tell you that the protocol mentioned by CDC director Dr. Thomas Frieden is front and center in the minds of anyone taking care of Ebola patients. That protocol is the only thing that protects those caregivers from serious illness. Mistakes can be made, it's true. But it would be a highly unlikely event given the gravity of the situation. Which leaves a few more important questions which have been asked by large numbers of doctors and nurses:

  • What exactly IS the protocol?  And how can this protocol, once defined, be effectively communicated to all staff members (read this)? How can staff technique for Ebola isolation be evaluated on an ongoing basis? The National Nurses United study reported, "Out of more than 1,900 nurses in 46 states and Washington D.C. who responded, 76 percent said their hospital still hadn't communicated to them an official policy on admitting potential patients with Ebola. And a whopping 85 percent said their hospital hadn't provided educational training sessions on Ebola in which nurses could interact and ask questions." Yikes. 
  • We are told that any hospital in the US should be capable of safely treating an Ebola patient, BUT how can a small country hospital duplicate the whiz-bang isolation equipment and procedures that are found in highly specialized units capable of biosecurity levels 4 and 5?  
  • And most importantly: Are we certain that all modes of transmission of the Ebola virus are known?

In a news conference today, Dr. Freiden  attempted to backtrack and clarify his comments. He apologized for implying any negative judgment on the nurse infected which was a very good thing; however he followed that statement by giving two conflicting messages: First, that we do not know exactly how this nurse was infected. And secondly, he is confident that current protocol correctly implemented will protect healthcare workers.

Wait. What? How could one possibly be confident of protocol that has yet to be determined without question to be completely effective?

Whew. Take a breath, Julia....

Sigh. See y'all tomorrow. I'm thinking I need to post some cute kitten videos......

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