Monthly Archives: March 2020

Diagnosis: Insanity

There is being cautious in the time of danger, and there is complete overreaction. This is the latter. We have lost our collective minds.

We have had Ebola, SARS, Swine Flu, the regular flu, and Lord knows what else in my lifetime. There is a new, unknown threat every two years (conveniently consistent with election years.) This is the first one that has canceled events, shuttered businesses and locked everyone in their houses, wearing masks and hoarding toilet paper.

What has changed? A number of critical issues, which I believe over time have weakened society.

Overprotection is Bad

We’ve had a full generation that grew up over-protected, and now they’re freaking out.

Think back to when you grew up. Were you driven to a school that was three blocks from your house? I rode my bike or walked the mile to school until I switched to a school fifteen miles from my house and rode the school bus. Did you have to wear a helmet to ride a bike? I didn’t. Did you need knee pads to wear skates? Could you go beyond the end of the block without your parents reporting you missing or calling you on a walkie-talkie? Did you get told to “walk it off” at least once? Did you lose games?

If not, you were probably raised overprotected. We have an entire generation or more who never experienced the basic pains of childhood – which is not really that bad. It’s a learning experience. Fall down the spillway, you learn not to walk there. (I didn’t, I fell down twice – the second time, showing where I fell the first time.) Fall off a bike, you learn to pay better attention. Walk to school, you learn independence. Blow out a knee in soccer, you learn to play better. Get some stitches, have a cool scar to build a better story around in old age.

Common Sense is Missing

How have we gotten to the point where we have to tell people, “If you’re sick, stay home?” and “Wash your hands”? Really? Really? Didn’t your parents teach you that?

As an aside, I am basically an hourly worker at this point, even if I’m called an “employee”, so going to all the doctors appointments for my broken ankle and foot recovery, the two days in the hospital recovering from the failed nerve blocker after the surgery, and anything else I do during the day that is not in front of my computer costs me money. I’m pretty sure I’ve used up most of my earned vacation at this point, because I really don’t have sick time. So, I get it. Being sick costs money.

That said, if you’re sick, stay home is not about you. Its for the protection of others. That’s where we have completely failed as a society. We are more concerned about ourselves and our needs than the community at large. This is a major issue.

The other example of the “Me” society is hoarding … anything. You don’t need sixty rolls of toilet paper. You don’t need dozens of masks. You don’t. This is why ERs will be overrun with people who are not sick. Me. Me. Me.

Think It Through

All schools are closed. Except for meals.” DISD has decided to continue providing food to students in need. There will be more than 500 students in the school, but served in the classrooms so they are smaller groups. Uh, if they’re in the classrooms, why not teach them? If these children are from homes that can’t afford food, how are they affording high-speed WiFi to do homeschooling for the rest of the year?

I’m going into isolation. I will just call for food delivery.” Who delivers your food? Oh, yes, drivers on minimum wage and tips. Remember, “if you’re sick, stay home?” That would be the target group for that message.

I’ll wear a mask 24×7 to protect me.” A face mask is for people who are ill, not for people who are well. This is according to the CDC and WHO. Don’t wear a mask if you are well. You look like a putz and you’re keeping a mask from someone who needs it.

I need six hundred rolls of toilet paper.” Review the CDC’s advice on caring for a COVID-19 patient at home. Amazingly, it doesn’t ever say, “Wipe their ass every sixteen seconds.”

My kids are home from school. Guess we’ll go to the mall.” Do you understand what self-isolation means?

I heard garlic can prevent coronavirus.” Uh, Italy?

Keep It In Perspective

I am not saying the spread of COVID-19 is not bad. I’m just saying, there is worse. Visit https://www.cdc.gov/flu/about/burden/preliminary-in-season-estimates.htm and you will see there is an estimate of 22,000 to 55,000 deaths from seasonal flu in the US. This happens every year. Every fucking year. Just in the US. This is even with everyone able to get a flu shot at pretty much any corner drug store. COVID-19 has 4,613 deaths worldwide, per the WHO.

Why does the US not shut down for six months every year during seasonal flu season? We could save thousands of lives.

I have seen estimates that COVD-19 has about 80% mild cases. So, yes, if everyone in the US was infected, we would potentially lose 20% of our population. What are the chances of that actually happening?

If you are not in the high risk groups, much of the time, COVID-19 will be like a mild flu – stay at home and self-treat. The press never seems to mention most cases are “stay at home, self-treat.” You don’t need ICU time. You don’t need to be on a respirator. You need rest and chicken soup.

Information, Not Hysteria

Ever since CNN went on the air in 1980, there has been a need for constant news. When I was growing up, TV stations went off the air at night, and there was peace and quiet for a few hours. With CNN, there is no escape. Then, they got competition. Now, we have wall-to-wall coverage of crap we never would have known about years ago, as long as it fits their model and the biases of their owners and staff. It is relentless.

So, COVID-19, a disease with a very high survivability rate outside a few high-risk groups (which are generally high-risk for any respiratory disease), is suddenly a “deadly pandemic scourge which cannot be stopped.”

The annual flu is deadly. Car wrecks are deadly. Smoking is deadly. Chicago shootings are deadly. Most probably cause more deaths than COVID-19 has. Not a lot of coverage.

The World Health Organization has information. The CDC has information. Everything else is noise, and most of it is designed for ratings and not to actually help anyone. The more you panic, the higher the ratings. Just turn it off.

Proportionate Response

It’s a pandemic!” Once an epidemic (a rapid spread of a disease within a given population) occurs in multiple countries, it’s a pandemic. That’s the definition. It is a loaded word now, but it quite literally means as soon as there were cases in China, Italy and anywhere else, it was a pandemic. Don’t let a medical term panic you. AIDS is still a pandemic and you don’t hear a lot about it anymore, because it’s mainstream.

Our emergency rooms can’t handle everyone being sick!” This is probably true if everyone goes to the ER at the same time and needs constant care. Also, does everyone with seasonal flu go to the ER? There seems to be more of them.

People will be treated in the hallways!” Here’s a fun fact – that happened before COVID-19 ever erupted. My wife went to the ER in Pennsylvania with chest pains in 2018 and they had marked spaces in the hall for beds. They would bring a curtain when she changed or was examined. This was on a Monday. So, some ERs are already overrun on a regular basis. It’s not news. So, here’s a thought – if you have a cough or a runny nose, go to urgent care or better yet, your doctor. If you have a gunshot wound or a bone sticking out, go to the ER. If you don’t have symptoms, you might not really need a test on day one. Stay home and enjoy your mounds of toilet tissue.

One of the reasons The Hitchhiker’s Guide to the Galaxy was popular was because on the cover, it said “Don’t Panic.” Wise words.

Broken Dreams

This report has been a long time coming. Still, better late than never, I suppose.

On January 10th, I was going to let the dogs out for a pee break. I was annoyed, which is not a good way to be when traversing tight areas. I caught the corner of the dog ramp with my foot, and tripped. As I fell, I considered my options: fall on the wooden ramp itself, fall forward and hit a glass coffee table, fall sideways and hit a wire dog crate, fall right and hit a brick fireplace. Eventually, I just collapsed on the floor.

The first (sad) thing to admit is that I had tripped over this particular ramp before. Every time I did, my Spousal Unit mentioned we should get rid of it, but she never will. Even now, it’s just blocking the other side of the couch.

The second thing is that this time, it really hurt. I couldn’t even consider getting up for a couple of minutes. I just lay on the floor, wondering what to do, and thinking I could soon be the second person in this house Dallas Fire Rescue might have to come lift up (RIP my Mom-in-law.)

Finally, I got up and struggled back to the couch. I never twisted my ankle this badly, but I assumed I could “walk it off.” However, unlike other falls, it wasn’t getting better.

By morning, it was worse, so it was off to urgent care. I would have gone to the emergency room, but didn’t want to waste an entire day on a sprained ankle.

The urgent care by us said on the website that they did x-rays and handled minor broken bones. This was useful, even though I was sure it wasn’t broken, because I had never broken a bone in my life.

The website lied. They had the equipment but nobody there who could use it. The physician’s assistant on duty was useless, but she seemed to confirm it wasn’t a break, so I just figured “Suck it up, Buttercup” and get on with life. Since the PA was an idiot, we decided to just get an appointment with my orthopedic practice. We could have driven across town for a x-ray, but the specialists always do their own, even if you walk in with them, so why waste the time and money? Besides, the PA said it probably wasn’t broken (she didn’t see bones sticking out), so even though she was an idiot, that confirmed my lifelong failure to break a bone, so that was good enough.

On Monday, we managed to get an appointment on Wednesday to see the orthopedist. Those guys are busy. So, I just hopped around in the meantime. The PA didn’t think I needed a boot, so I just limped around in my flip-flops, since I couldn’t fit into a shoe.

Wednesday morning, we saw the orthopedist. They sent me for x-rays before he came in, so I got to limp the entire length of their offices to the x-ray room (and back.)

The doctor looked at the x-rays and said I had broken my foot … and my ankle.

Broken, I believe

He asked why we had waited to come in, and we said we went to urgent care on Saturday, and they didn’t think it was broken. “Didn’t they do x-rays?” So, that was that story, again. My wife is always happy to trash one practice to another. “They didn’t put you in a boot?” More trashing.

Urgent care’s care did not look good.

That afternoon, I had a CT scan which also said I had broken the crap out of both my foot and ankle. From tripping over a dog ramp.

As they got me a boot, we started discussing surgery options. It was January 15th. We had an anniversary cruise on February 9th. Nothing major, February 11th was just our 20th wedding anniversary. The doctor said we could go, no big deal, it I wasn’t like I was going to do any more damage, but the idea of a cruise on a new ship with no snorkeling, actually no beach time, and getting around on a scooter wasn’t very appealing.

We canceled the cruise in the 100% penalty period. Always buy insurance! The checks are in the mail.

We scheduled surgery for January 21st. I had to go to the hospital the day before for a surgical pre-check, since there wasn’t time for my family doctor to do it. Luckily, I passed.

Surgery was thankfully not at the crack of dawn. We got to the hospital (well, the day surgery facility) and got checked in. I got my bed and my gown. It almost fit.

The anesthesiologist came in and said he was going to administer two nerve blockers to help get ahead of the pain. After that, it was general anesthesia, as well.

The doctor came in and autographed my foot so he would remember that the one amazingly larger than the other was the broken one.

Off to the OR. I’m traditionally a good patient who has recovered faster than average. This was going to be my first set of metal plates. The doctor said he would probably leave the ankle alone unless he saw something he didn’t like. He saw it. So, one plate in the foot, one plate in the ankle.

I woke up in the recovery room in the worst pain I have ever experienced. I couldn’t focus, it was so bad. Apparently, my body has alternate nerve paths to my foot which didn’t get blocked.

Unfortunately, since I had the nerve blocker, I wasn’t given any painkillers after surgery. So, after I couldn’t cope, the staff gave me Fentanyl and not much happened. They gave me hydrocodone, and that started to help, but I couldn’t get ahead of the pain. They finally admitted me.

After a while in the room, somebody gave me morphine, and that knocked the pain down. After that, it was hydrocodone every four hours.

As usual, the doctors successfully downplayed the possible pain aspects of recovery. They managed to have me never consider what cutting my foot open and screwing stainless steel plates into multiple bones might feel like after I woke up. Well played.

Overnight, my wife discovered the order for hydrocodone was “as needed” and not “every four damn hours so he doesn’t die”, so I had a dose an hour late, and the pain came back. An hour or so after that, I asked for more morphine, and it settled back down. From then on, we asked for hydrocodone a bit early, just in case.

The whole “drugs working slowly” was new for me. A nurse would give me something, and say, “You’ll feel better in a half-hour or so.” It would take an hour or more. So, getting meds on time became critical.

Here’s a funny thing I learned – anesthesia can put your bladder to sleep. Then, you can’t pee. Joy. Of course, trying to pee off the side of a bed into a handheld urinal while two nurses and your wife are discussing your ability to pee three feet away is difficult, anyway.

So, now they had to manage my pain and try to awaken my bladder. Day two in the hospital – the day facility not really designed for overnight guests. You know you’ve overstayed your welcome when they stop comping you’re wife’s meals.

I do have to say, the staff was great. The nurses managed to keep my wife calm and me medicated. I can’t ask for more than that.

Here’s a fun way to start an unexpected day in the hospital – physical therapy. As a new cripple, I had to learn to transfer from bed to a walker, from a walker to a knee scooter and from either to a potty chair. The physical therapist was very insistent that I do this all within about twenty minutes. I was a heavily-drugged patient who had no sleep. It was interesting.

I did enough transferring to get the physical therapist to leave me alone, and tried to get some sleep. However, they still wanted my bladder awake.

Have you ever heard of a catheter? It’s a small tube that goes into your bladder to help drain urine when you can’t pee it out on your own.

Actually, it’s a glass rod a nurse inserts into a body part you had once promised to reserve for your wife. “Small” may be true, but the opening it is going into is even smaller. It hurts like hell, but then it’s in. Don’t move too much, and it’s fine. Well, less painful.

Here’s a tip – drain your bladder for all your worth when the catheter is inserted. Otherwise, the staff will decide you need a more permanent catheter, which means pulling one pipe out of your manhood and replacing it with another one.

You know, a nurse handling a guy’s business is a key part of a lot of porn films (I’ve heard.) I doubt the hot nurses in those movies had catheters in their other hand. That would be a horror movie.

Here’s the interesting part of having a catheter in – you pee without knowing it. At one point, the nurse asked me if I knew when I peed, and I said, “No.” She said, “You’re peeing now.” Three women’s (two nurses and a wife) heads all did the “puppy tilt” to watch the tube running out of me.

Thursday, I got the catheter removed. A while later, I finally peed. I transferred to the potty chair to do so, which made physical therapy happy. I’m pretty sure one motivation was avoiding having the catheter replaced. Since I successfully emptied my bladder on my own (they measured it), I was allowed to go home. I would have run for the door, but … broken foot and ankle.

In Tuesday, out Thursday. For day surgery. I’m losing my touch.

The hydrocodone continued for a few days after I got home. In truth, I would never get addicted to it, but I was afraid to stop taking it. I don’t want the pain back. I finally started dropping the dose, and then spreading them out, and then it was gone.

The main problem with losing a foot temporarily is learning to walk without it. The technical term is “non-weight-bearing.” In other words, I can’t let my right foot hit the ground. I could hop for six to eight weeks, but that’s probably not feasible.

The solution is reams of equipment. When my wife had Achilles surgery years ago, all the equipment was so expensive, you had to get the insurance company to find someone to provide it. Now, you get it from Amazon.

Here’s the foot support gear:

  • Wheel chair (rented)
  • Walker (hospital)
  • Boot (doctor’s office, pre-op)
  • Knee Scooter (Amazon, two tries, sent one back)
  • Potty chair (hospital)
  • Bath transfer bench (Amazon)
  • Bath chair (Amazon, as backup)

I have been living in my wife’s recliner since the operation. The dogs are very confused. If there is a laptop in front of me, I’m at work. If there’s food, I’m on a break. If I’m reclined all the way, I’m sleeping. It’s two shuffle steps to the bathroom, two shuffle steps back. I hate it. My wife lived in this chair after her shoulder surgeries and I don’t know how she did it.

The first two weeks after surgery, I was in a splint, waiting for the swelling to go down.

After two weeks, the splint was replaced by a cast. Before the cast went on, I had more x-rays. This time, I was taken in a wheelchair because it was broken. Then, the cast went on. My first cast.

My first cast (with Graham Gnome)

Three weeks later, the cast came off, and was replaced by the boot. The boot I was given the first day at the orthopedist, after they realized that urgent care didn’t give me one.

My last week in the cast, I moved back to bed at night, because I couldn’t take the recliner any longer. I vaguely remember “just going to bed.” Now, it’s getting the knee scooter to get down the hall, falling sideways into bed, moving the scooter so my wife can put the potty next to the bed, and then go to sleep. It’s still better than the recliner.

The longest challenge is taking a shower. I have a foot and ankle that can’t get wet. So, down the hall on the knee scooter into the bathroom. Do a 180 (harder than it sounds in a narrow room.) Slide onto the transfer bench. Scoot into the tub, sticking the boot out, so the boot can be replaced by a cast cover (waterproof, self-sealing). Into the shower. By this point, I’m exhausted. Luckily, it amuses the dogs. After the shower, everything is done in reverse, drying everything carefully to keep the foot and ankle dry.

I’m very glad I’m home-officed. I can work without much effort other than getting my laptop out and logging into the systems. My team is spread out all over the world, so time zones are a challenge but nobody is missing me in the office.

The only other concern is that the top of my foot isn’t healing as well as the doctor would like. So, he’s keeping an eye on it. Apparently, there’s not much skin on top of the foot. I’m a bit concerned they will be debriding it – which is a polite term for “cutting off a bunch of dead skin.”

It’s going to be an interesting scar. Well, scars.

On March 4th, I can put “some weight” on the foot. I need to ask what that really means. I’m thinking running a marathon is probably out.

On March 11 (a month after our anniversary), I may be able to walk again. Then, starts physical therapy. Two months or so since I tripped and couldn’t fall properly.

I’m hoping to be fully functional by my 60th birthday in April. Yes, this was going to be a year of landmarks without adding “first broken bone.”