Painful Knives (continued)

So my surgeon tells me that those big lumps of clotted blood in my wounds just wouldn't do; it was off to the operating room to open up the surgical wounds then clean them out with the medical version of a squirt gun filled with "bug juice" or antibiotic-laced sterile water. I reported to the hospital like the dutiful little patient I am, got an IV started (eventually-my nurse wasn't so good at this task) then went to sleep anticipating another day of post-surgical mental haziness.

Morning came and I went to the OR as planned. The surgical wound-cleaning went well and soon I was back in my hospital bed feeling like shit. I had a PCA pump filled with dilaudid running, IV fluids flowing in, I couldn't pee, and my legs hurt. A PCA (patient controlled analgesia) pump has a large syringe of pain medicine hooked directly up to an IV line. Every time the patient presses the control button a small dose of pain medicine squirts into his veins. Now, I barf when I take two Vicodin and dilaudid is much more powerful. I had the nurse cut the dose I was getting in half hoping not to puke. No such luck; I puked like a champion anyway. I struggled with a urinal for hours trying to pee. Success finally came and I was a bit happier. If I couldn't pee within six hours or so post-op I might have had to had a catheter inserted and I sure didn't want that. The leg pain wasn't too bad but it was still there. Anyway, the night just seemed to last forever. I just couldn't get to sleep and my nausea wouldn't go away. I took some anti-nausea medicine but it didn't help. I just laid there all night writhing around trying to get comfortable without success.

Finally I fell asleep around 6:00 am. At 7:15 am the doctors woke me up to see if I were still alive. I found that they had left the leg wounds open with a full roll of kerlix soaked in bug juice stuffed inside the wound to keep it moist. A roll of kerlix is about the size of a roll of toilet paper that is 1/3 gone so they must have really had to jam that stuff into the wound to let it all fit. The plan was to leave the kerlix in for two days to let the swelling go down and the bleeding to stop then pull it out. By that time it would be fairly dry and probably stuck to my abused calf muscles and wound tissue. Getting it out promised to be pretty brutal.

I spent the next two days laying around in bed doing nothing. It truly sucked. The same crappy TV channels, the same crappy hospital food, the same crappy hospital bed. Fast forward past the boredom two days and one of the surgical interns comes by in the morning. He'll be returning soon with another intern and the attending surgeon (the guy I saw in the office and basically the big cheese.) He had the nurse give me five mg of valium to help out with the procedure and promised to make sure I got some pain medicine just before the kerlix came out. A half-hour later the trio of vascular surgeons reappear. The chief surgeon tells me that the interns are going to remove the kerlix and he was going to keep out of reach because "After this I won't be your friend anymore."

Though my legs look filthy, its just bruising and iodine staining the skin.

The interns unwrap the dressing on my legs and I start to feel like a mouse being played with by a particularly sadistic cat. They yank out the dried-up dressings and I'm feeling pretty miserable. I don't actually holler but If I had less pride I might have. For the next couple of days they nurses just pack in wet gauze to keep the wound from drying out then I go back to the OR to get the legs closed up for good.

The wound closing goes well and I'm discharged the next day with puffy, stitched-up legs. Hopefully they heal well and I'll be running in no time.

Painful running leads to painful knives

One day while sniveling to an orthopedic surgeon about how my calves would begin to tighten up progressing rapidly to excruciating pain and numbness after about five minutes of rugby or 1/2 mile of running I learned about Chronic Compartment Syndrome. He hooked me up with a local vascular surgeon who is an internationally recognized expert on this malady.

When I arrived in his office he took my history, asked questions; the usual thing. Then he brought out a little pressure meter with a big needle. He stuck the pointy end of the needle into the muscle on the front of the calf on each side and read off the internal pressures to the nurse assisting him. After a bit of discussion we set up a surgical date to repair the problem since the pressures were way out of line.

The day of surgery arrived and eventually I entered the oblivion that midazolam and fentanyl bring on. I awoke with sore calves and bandages from toes to knees. The surgeon had created a slit about four inches long running up and down on my calves then removed an oval piece of the fascia (inflexible connective tissue covering muscles) about that size. He then pried up the skin above and below that hole and gave the fascia a slit about 1-2 inches as well. Pretty straightforward. Another hole was created above the incision and a long drain tube was inserted into each wound running its entire length. The drain was connected to a little bulb to help pull out the inevitable post-op bleeding. I got a bottle of Vicodin, some dressing supplies, some care instructions, and an appointment to return to the clinic in a few days. Pretty old hat since I've been a nurse about twelve years now.

This is pretty uncomplicated surgery but its bugbear is bleeding. The surgeon told my family that the calves looked terrible; lots of inflammation, adhesions, etc. and that I had really needed this surgery years ago. Sure enough, my wounds just kept bleeding and hematomas (think big chunk of clotted blood) developed inside the wounds. The hematomas would eventually become scar tissue which would leave me worse off than before. I had to go back to the operating room for a little tune-up surgery. (to be continued)

Spending time in the hospital

I've been away from the console for some time now, spending some time in the hospital. What was supposed to be a quick 1/2 day outpatient surgery turned into a week in the hospital and three trips to the operating room. Stay tuned for some stories from The Wrong Side of the Hospital Bed.

London Calling

...London calling to the faraway towns

Now war is declared - and battle come down

London calling to the underworld

Come out of the cupboard, you boys and girls...

Out of context and years ago The Clash wrote that song. Just what does and what will the London terrorist attacks mean? As to damage and death the Underground and bus bombings were nothing more than a bad day in Bagdad. In terms of lives lost and physical damage the four bombings were strictly old news under the Iraqi standard but clearly the Iraq standard doesn't apply here. As to the meaning of why did the individual bombers do what they did, it appears that the bombers were firmly entrenched into the British middle class so economic opportunity or poverty aren't to blame. No danger of those men being compelled by a draft to go fight in Iraq or Afganistan so it isn't that.

What's left is ideology. An ideology that the four learned and expanded on while living in England which echos the sentiment shared by their brothers-in-arms who drive car bombs into crowds of children in Iraq for the crime of liking chocolate. I'll not expand on the ideology that drives radical elements of Islam; that has been covered so well by so many others, here for instance.

There appears to be no significant damage done to the war-fighting capability or political will of the UK; it appears that this attack was a failure on all fronts. Indeed, Europe's significant muslim population will likely see increased scrutiny of its radical elements. So, this is basically a loss for the European muslims and a gain for the various state's security apparatus.

(edited for style issues)

Is a new Cold War coming?

I’ve been hearing a lot lately about the coming cold war between the USA and China. Links here, here, and here. I see more reasons to believe in a possible trade war than a cold war but I’ll only discuss the cold war here. China and the USA have maintained somewhat an uneasy neutrality towards each other since the “end” of the Korean War. The Chinese sat out the cold war and were never very evangelistic about their communism while America’s attention was fixed firmly on Europe and the USSR. China was spared the crushing expense of trying to field advanced military hardware built with obsolete industrial technology. Instead, they built an industrial base that has become one of the most powerful in the world. If needed China could rapidly shift vast resources into defense production much as the USA did during WW2. I needn’t elaborate on the economic, industrial, and military might of America. Democracy and Communism have shared a mutual antipathy through much of the 20th century and continue to do so in a low-key sort of way. Conditions seem ripe for the rise of a new bipolar world power relationship.
But not so fast. Assume for a moment that a new cold war has sprung up. After WW2, the USSR was a very menacing neighbor indeed. Friendly European nations almost mortally weakened by a destructive general war. Buffer states occupied, fortified, and garrisoned by Soviet troops. Jingoistic rhetoric daily. Tanks poised at the border. Very scary. I just don’t see any of that in Asia right now. Sure, Taiwan feels insecure but they really were part of China before the revolution. Japan, South Korea, India, and other regional powers are militarily and economically strong enough to give any would-be attackers pause. Realistically, China’s domestic issues are enough for it just now. Invading neighboring nations just isn’t a viable option now. How about America? Is there any power bloc on earth that really wants the USA to build an even more capable and larger military force? Using two carrier battle groups (CVBGs) the USA could completely wipe out Europe’s entire navy and probably their air forces as well. America has twelve CVBGs at its disposal. America could cripple any nation’s military in a straight-up war. I cannot think of any nation who would encourage the American forces to get even more powerful.
Any new cold war with China and America opposing each other would end up looking a lot like Mutually Assured Destruction, that quintessential doctrine. Either both nations can prosper economically or they can destroy each other. China is heading for serious demographic problems as well as political upheaval as Chinese citizens clamor for more freedoms. It is in the best interest of all the principal players to help facilitate the Chinese transformation to a more mixed economy and democratic society.

Flag-burning

And more importantly, should laws be generated to outlaw it? I just can't get worked up over this. Criminalizing flag-burning seems like such a stretch. Mockery yes, but sending the long arm of the law is a bit much. If you really just have to burn a flag, please go ahead. Really. Go ahead and get it out of your system.

When I think of flag-burners I think of the semi-adolescent offspring of the American upper-middle class who populate our system of higher education. They try so hard to shock their parents with fresh tatoos, piercings, and socially unacceptable boyfriends that in the end there's no shock left. What's left is that which defines "tiresome." Kind of like Boy George. Oh sure, at some time in the distant past he was new and bold. Now, he's as fresh as dinosaur bones and as blissfully unaware. So, if you want to burn a flag go ahead and don't let the irony stop you.