May. 15th, 2013 @ 12:01 pm
Out of hospital already yaaaay.|
My roommate was non-annoying!
My knee is Not Too Bad (tm). I currently have very mild pain (sitting on the couch, no weight on it) but then the Panadol will have worn off - it's worth noting that my pain is currently manageable even when walking on mere paracetemol.
It also no longer makes crackling sounds when it bends, which pleases me and which the surgeon said was a good sign.
Apparently there was some developed roughness under my patella, so they shaved that off all smooth or something. Then they did the "lateral release".
I am tired, due to not sleeping that well in hospital, although more than I did last time due to non-annoying roommmate (although someone a couple of rooms down needs to see someone about his sleep apnoea) and also having had velithya and myfyr bring my pillow from home to sleep on. My pillow is nice, I'm used to it, it's the right firmness and the right thickness, it smells right and not of hospital laundry, and also, isn't plastic.
(The pillows at StJoG Subi are decent, for hospital pillows, at a good point between soft and firm, etc, but they still have plastic casings because otherwise they'd have to burn them after single-patient use due to risk of infection transmission. So their nice, soft cotton pillowcases are still nice, soft cotton over plastic, which is never, ever going to be as pleasant to sleep on as My Pillow.)
So I managed to get actual sleep, despite things like being woken at 2am to have my blood pressure checked.
(The saga of my b.p. during my stay: Slightly high for the first few, then 124/87, then something like 120/57, and then I was released. >.>)
I'm not necessarily going to succeed at catching up for another few days at least. On Tuesday I'm having surgery on my knee. It turns out my kneecap is in the wrong place and needs to be moved.
... way behind on reading journals. I was keeping up, but there was a whole thing, that upset me, and I was all journal-aversion again for a while. If I loved you before, I totally still love you.|
I had an MRI last week. It was distinctly painful, because the problem being investigated is my knee, and a major symptom of the problem with my knee is that I can't lie on my back with my leg straight, it makes my knee hurt, and the MRI was 20 minutes of lying on my back with my leg straight and a sandbag on my shin to hold it still. Which also means it was not even just straight, probably, it will have been bending slightly backwards, because I am mildly hypermobile and my knees bend slightly backwards and always have.
And I had to pay $95. After pension discount etc.
After the MRI I had a pelvic x-ray. The tech asked if this was checking on my hip replacement(s). I'm 32. (Also, the initial setup was done by a trainee, who was very nice, but I had to tell her that no, I didn't mind if she pressed more firmly locating my bones, because her carefully gentle touches tickled. She had made sure it was okay to touch me at all first, that was fine, but I hate being tickled and also it kinda makes it hard to hold still.)
"Crepitus". That is, apparently, the technical term for "joints making noise".|
It's on the report I got with the knee x-rays I had taken yesterday. Since I regained walking after breaking my leg last year, my left knee has tended to make a crackling sound when I bend my left leg with weight on it (e.g. when I go down stairs). It also is rather hurty. My right knee is silent under bending, and only gets hurty under compensation strain occasionally.
I've had a referral for an x-ray for a while, but what kinda prompted me to actually get around to doing it is a) a doctor's appointment tomorrow and b) the discovery that taking up regular walks to strengthen all my muscles does not, in fact, improve my knee pain, but rather worsens it considerably.
Most of the report on the x-rays is largely incomprehensible to me. With the aid of Google I've determined the following:
- The fracture of my fibula, last year, has healed up with "cortical bony thickening". I'm pretty sure this is normal. My fibula is STRONGER and MORE BADASS now.
- There's a cyst on my patella, apparently? This is somewhere on a spectrum from "no big deal" to "hey good thing we caught this cancer so early".
- There is fluid on Hoffa's fat. Obvs I am looking this up, but I kind of want to just be all WHO IS HOFFA AND WHY IS HE LEAVING HIS FAT IN MY KNEE. MY KNEE IS NOT FOR OTHER PEOPLE'S FAT.
So, I've started making a proper effort at getting back into something resembling shape.|
It's really driving home to me how self-reinforcing injury can be.
For three months, I couldn't put weight on one leg at all, and being on my other foot moving around represented a high-risk scenario for serious further injury, so I avoided it as much as possible.
I got back to the point where I could walk around the house, somewhat, but then I sort of stalled. Getting sick here and there didn't help, depression doesn't help, but ultimately it boils down to this: spend enough time immobile, and standing, walking, anything, becomes incredibly difficult and painful.
I feel shame to admit this, but at the moment, I literally can't stand up for more than a couple of minutes, tops, without something to lean against. I start experiencing pain all over - my back, my abdomen, and my ankle are the worst.
I can walk on a flat surface barefoot, but wearing shoes, or walking on any kind of slope, gives me ankle pain within a few steps, generally. Which makes me want to avoid it, which means... it doesn't change.
So I'm working on it. I've started going for walks with my housemates - short walks, so far, but walks, outside, where the street outside has a slope enough to work the muscles that a flat floor doesn't. I'm making a point to stay on my feet a little extra, any time I get up, to work on all my standing-up muscles.
It's harder than it should be. And it's sometimes disconcerting. Take standing on tiptoe, a not-at-all weird activity I didn't think twice about before I broke my ankle. On my right foot, which retained all the strength plus some thanks to doing the work of two for several months, it doesn't cause me any issues. I can stand on my toes, even on one foot, until I either overbalance or my calf starts to cramp. (Static muscle work is still static muscle work, after all.)
On my left foot? Not only does it still feel like effort, but I get *out of breath*. That is a weird and disconcerting thing, because it just feels like it shouldn't happen. I don't feel like "standing on my toes" should qualify as that much exertion, and yet, for my left ankle, it totally does.
But the point is, it's a start. I will get back to the point where so long as I can maintain my natural pace, I can walk all day without a problem. I will get back to the point where the limit to how long I can comfortably stand around is defined by when my feet get tired, not by when the rest of my body gets tired of supporting itself.
Hell, I will get back to the point where I can walk at my natural pace, where the muscles in my left leg and ankle can support the stride I once had. I still walk timidly, taking careful steps half the length of what my steps used to be.
I WILL WALK LIKE A GROWNUP AGAIN.
So, earlier this morning I was looking at options for renting a motorcycle for the few days I'll be on my own in the US in October - contemplating getting a bike and seeing some of America that way.|
However, I've come to realise that that's just not a good plan, for one simple reason:
Bikes have a higher chance of an accident, or at least a higher chance that in the event of an accident, you'll be injured.
And the thing is? While I've been injured before, and even injured in motorcycle accidents, and I could handle it, those incidents all happened in Australia. Not only did this mean that I had my family and/or friends to help me deal with recovery, it meant that any professional intervention I required happened in Australia, too.
I truly dread the prospect of having to deal with the American health care "system". Yes, I'm getting travel insurance - because you can't guarantee you *won't* need health care - but I just can't take the risk on a bike.
I'll save my Amazing Motorcycle Holiday Dream Journey for Tasmania or New Zealand, still. Because I pretty much trust Medicare - my badly-broken leg was treated excellently - and New Zealand's system is relatively similar to Australia's. (Plus New Zealand is near enough that it is conceptually feasible that if I were injured there, I could still make it home again even while I was still recovering.)
I have a sense of breakability I didn't used to have, since 27/12/11 marked the first time my body actually, truly broke - always before I'd been injured, but largely structurally intact. That had nothing to do with bikes, but I'm aware that I *can* be hurt that badly on a more visceral level than I used to be.
Nothing I've ever heard about the health care experience in the USA suggests that, really, any part of the process of treatment and recovery I went through would have been handled even close to as well as it was handled here.
And even if the medical staff were exactly as kind, exactly as pleasant, and exactly as competent, even if somehow the astronomically-higher medical costs were handled by the insurance without being stressful for me (which I doubt) and didn't cost me anything out-of-pocket (ditto), I think it would be vastly more stressful and unpleasant and difficult to deal with just because I'd be in a foreign country, which has to it an inherent level of alienation.
Here, I got treated by people with familiar accents and familiar cultural preconceptions, and while I was in hospital I was visited daily by family and friends.
Somehow I don't think as many of my most beloveds would make it to my bedside on another continent.
So. Bikes are too high-risk for tourism outside of Oceania. I have decided.
This morning, I bought a pair of roller skates! My first pair of new skates since my eleventh birthday, if I remember rightly - when I grew out of them and went to replace them, I got rollerblades, which, frankly, I regret to this day. I was never as comfortable in them, the buckles never seem to make them as secure on feet, etc - I prefer skates. (But skates were hard to find, for a while, because suddenly it was all about rollerblades.)|
But this morning, in conversation, velithya discovered I love rollerskating (and the idea of doing it again makes my face light up with joy and delight), and I discovered that velithya really likes rollerblading and has been wanting someone to do it with.
So we went and I bought a pair of skates. Also kneepads and wristguards, because I'm unbelievably out of practice, and I'm also 31, and on the hefty side, and so I'm less likely to bounce back from falling over as readily as I did when I was a child regardless - and I already have a slightly dodgy knee from past injury aggravated by getting wrenched around and then strained with heavy casts when I broke my leg.
Add to that: When I did a little run on the skates to see if they fit nicely and so on, I felt really, really nervous and unsteady. Partly that's being so out of practice, and partly I was terrified of falling and landing on my knees, because it would hurt like crazy. Kneepads will let me overcome that fear.
I got proper boot skates. These days it seems you can get below-the-ankle ones, basically sneakers with wheels, but I'm not willing to risk skating without ankle support. Bending and rotating my ankle can be painful - twisting it would be agony. Definitely boots.
Five or so minutes on skates had my ankle muscles aching, but pretty much in the good way. This should be a good way to build up my strength and fitness again. And it just felt so good to be on skates again.
The guy where we bought them recommended I take lessons. I felt super-weird about it. Rollerskating lessons are some of my earliest memories, and I loved them, but now the idea gives me this kind of offended pride feeling. Like rollerskating lessons are beneath me, I've been rollerskating as long as I've been walking I mean how dare you, and yet... probably actually a good idea.
I just took the dressing off my ankle (the doctor told me to leave it there until Saturday).|
I'm pretty pleased with it! There was some dried blood on the pad, but not that much, and the incision looks good - healing well, and even smaller than I'd expected. There's only two stitches!
A week and a half until the stitches are due to come out, and then I'll offically be done with direct medical procedures on my ankle. WHEE!
Since I just realised I hadn't made a post in like two and a half weeks:|
The broken leg is healing well. I'm now allowed to put *some* weight on it, but I still have to wear the broken-leg-boot and use the walking frame.
I'm discovering the degree to which I prefer to be snacky about food - since I can't, for example, carry anything while walking, velithya leaves my lunch and some snacks by the couch for me before she leaves for work.
I've developed a tendency to eat half my lunch mid-morning, and the other half at actual lunchtime. Which is actually optimal, without the hypoglycaemia thing, but usually I forget to go and get food until I'm waaay too hungry and low on blood sugar, which, you know, bad.
Stonefruit season is starting. Dean also got me some plums and nectarines which are in a bowl near the couch now, too. Yum.
Yay, SOPA/PIPA are dead for now! That's awesome.|
Imagine how much better life in America could be if the good people of the country could be stirred to speak up this way about trivial issues like health care reform, as well as vital matters like internet access?
I'm not saying that SOPA/PIPA weren't important, by the way. But America's current health care "system" is literally killing people, and metaphorically killing the American economy in very real ways.
I'm not going to go into details about that, but what I am going to do is talk about my recent experiences with the Australian health care system, and invite Americans to compare this tale with their own experiences and expectations in the USA.
On the 27th of December, I slipped on the stairs and, it turns out, broke my leg in three places.
We went off to Sir Charles Gairdner Hospital, I think the biggest emergency (and teaching) hospital in the city. (The other major one is Royal Perth; there are smaller hospitals dotted around the suburbs, of course, but those are the big ones. (Charlie's is the one nearest our house.))
We arrived at the emergency room at around 8:30 or 9am, I think. There were one or two people in the waiting room, but after a brief interview at the triage window, I was taken inside for examination, having been designated Fast Track.
Fast Track means your case is not critical, but *is* simple; when there's a free spot, you're taken to another room, inside, where doctors treat you promptly. From the times I've been there, usually everyone in Fast Track has some kind of painful, yet not life-threatening injury. If your case is likely to be more complex, you go to Observation, where there are many more doctors, and many more beds, and they're going to work out what exactly is up and how to treat it. (If you've arrived with a broken bone, or anything similar, there is a well-established protocol for how they're going to treat it.)
There's a big poster in the waiting room about their targets: the designated performance target for the Emergency Department is to have 85% of patients either admitted to the hospital or discharged from Emergency within four hours of arrival. Underneath, they write in how they're doing; when last I saw the board, they were at something like 76% overall, with 96% of patients who weren't admitted to hospital being released within four hours.
So. If you turn up at the busiest emergency room in the city, if your problem doesn't require hospitalisation, you've got a 96% chance of getting to leave inside four hours. If you do require admission, you've still got a 76% chance of being out of Emergency and in the hospital proper within those four hours, even taking into account time they may spend observing you and whatnot to make that decision.
Note that this does not mean that, if you require serious medical care, you are denied it - it just means that if it's not something that can be treated quickly and turfed out, the patient should be admitted to the hospital proper.
This is what happened to me. X-rays of my leg showed that I had snapped both my tibia and fibula just above the ankle joint, and the fibula again just below the knee. This qualified my injury as an "unstable fracture", which would require surgery to treat. A visit from the orthopaedic registrar followed. The ortho reg explained the surgery to me, and I signed some paper formally acknowledging my informed consent to the process, and I was wheeled out of Emergency to the fifth floor.
Sadly, I didn't get a private room - the hospital was under a fair amount of pressure for beds, as the private hospitals to which many private patients might have been transferred were all largely closed for the Christmas holidays.
Still, I was put into a room, a Jones Pillow was fetched to hold my ankle well elevated, and there I was in hospital.
It was three days before I had surgery - an ORIF procedure can't be done before the swelling has gone down, because you need enough loose skin to be able to close the incisions again. During those three days I was given gluten-free food that was really quite edible, and a steady supply of pain relief medication from friendly and pleasant nurses.
While I was waiting, I had a visit from a lovely woman from Occupational Therapy. She was there to discuss my equipment needs - what I'd require to be able to go home, and live my life safely. Around Thursday, I think it was, someone from OT went to my house to survey the situation - measuring distances, herself hopping from toilet to sink to couch, and suchlike, to calculate how exhausting it would be and what would be necessary in a given day.
Several of the people who passed through stays in my room were from outside the city - they'd been injured in deeply rural areas, and flown to Perth for treatment.
On the Friday I had surgery. I was wheeled to the OR's anteroom. Surgeons came over to introduce themselves, then the anaesthetists - two qualified doctors and a bashful-looking student. A few minutes later, I was taken into the OR itself, where more people introduced themselves - nurses, from the surgical an anaesthetic teams, mostly, giving me a sense of who this crowd of strangers was.
There were friendly, reassuring comments at my visible nervousness, people warmly telling me that it was okay, they did this every day, they knew this was strange and scary for me but it was totally normal for them, I'd be fine.
And then I was put under, and I woke up back in my room on the fifth floor.
Back there, the nurses supplied me with more painkillers, through the initial phase of post-surgical pain, than I would have thought possible. I had slow-release oxycodone, quick-release oxycodone, paracetemol, ibuprofen, and some tablets that I don't know what they were that you put under your tongue and wait to dissolve. They taste horrible, but they take effect really quickly, and are on a separate cooldown from the rest.
Thanks to this raft of medication, I was almost never in very much pain at all. Most of the time my freshly-drilled-into bones were a faint, easily-ignored ache in the distance.
On Sunday, it was decided by the doctors that I could go home. But, as the woman from hospital administration who came to see me explained, the physiotherapists and Occupational Therapy were refusing to sign off on my discharge.
"Yes, they talked to me about that yesterday," I said. "They want to make sure I'll be safe. They're coming later this morning to make sure I have the equipment for home, and the physio is going to be making sure I'm able to move around like I need to."
And so they did. The OT and physio brought a mobile wooden platform, so that I could, with assistance and supervision in the hospital setting, practice using a walking frame to hop up a low step - because there is a low step to be navigated in order to enter my house. Once I'd managed that properly, they assembled the equipment I was being assigned to take home with me.
- a seat with rails and so on to go over the toilet
- a shower chair
- a walking frame
The only thing they weren't supplying was a wheelchair. The hospital only provides those if you can't move without one at all, because they don't really have enough to do otherwise.
After that, all that was left was to wait for my medication bag. This was a plastic bag the size of a small pillow, containing a sharps container, thirty Clexane needles, and boxes of my anti-inflammatories and various painkillers.
Once that arrived, I was officially discharged. An orderly came to wheel me down to the hospital doors, while Dean, who had come to collect me, pushed the trolley loaded with the equipment and my bags, and so on.
A couple of days later a letter arrived, giving me the date of my next appointment at the orthopaedic clinic. I went to that, and got my stitches removed and a shiny new cast applied. In a few weeks I go back again, and get the temporary screw removed.
All of which amounts to a really quite excellent standard of care, I'm sure you'll agree. But would it bankrupt me? How much did I pay for all of that, you might wonder?
The answer: Absolutely nothing.
Not a cent. I was not presented with a bill, in person or by mail. Not even for the bag of medications to take away with me. No-one asked for anything except my name, my date of birth and my Medicare number.
And if you're American, don't be mistaken about what it means to have Medicare here. Medicare is not some special subset of care for old people, or poor people, or whatever it is there. In Australia, everyone has Medicare. Everyone. If you are a citizen or permanent resident of this country, you have Medicare. (If you're a tourist, the emergency room will take care of you anyway, by the way.)
How is it funded? Easily enough - when additional money was needed to pay for Medicare costs, the government introduced the Medicare Levy, which is paid alongside income tax, but is separate, because the Medicare Levy is only paid at all once you get above a certain income threshold. Effectively, the wealthy, who can afford and often have private health insurance, subsidise health care for the poor.
When this was introduced, the general reaction of the Australian population amounted to: "... That's fair."
The fact that the Australian government has a vested interest in health care costs has a raft of added advantages. Various medications that are sometimes necessary for people's survival, but which are very expensive, are subsidised by the Pharmaceutical Benefits Scheme; there are drugs which cost thousands of dollars a month, but which Australian patients will pay perhaps thirty dollars a month for - or less, if they have a pension or low-income Health Care Card. (Most of my meds are covered by the PBS; now that I'm on a pension, they're three or four dollars a month, where before they were over thirty.)
So if, for example, you're unemployed, the government further subsidises any health care costs you may be incurring.
Meanwhile, Medicare has a heavy market power with which to negotiate drug prices with the companies that manufacture them, which helps keep the costs down in the first place.
As of the latest statistics I can find, as a percentage of GDP, Australia spends 9.5% to America's 14.6%. Per capita, we also spend much less money in straight dollar costs. And our costs aren't rising as fast.
I'm not really reading my reading list at the moment, mostly because I'm spending a lot of time being really grumpy and I fear saying something I'll regret when I'm not.|
I'm grumpy, of course, because of ongoing pain and inconvenience due to having a broken leg, as well as all my Hilarious Cast Adventures.
Put it this way - I broke my leg less than a month ago, and I'm on my sixth cast.
( Hilarious Cast Adventures, explained. )
Number six is doing okay so far, thankfully - but I'll be getting number seven on Thursday, at my next ortho clinic appointment. It's projected to last a few weeks before it has to come off too. After that, though, I should get a "removable boot", which will be awesome, because the prospect of being able to have a shower, a proper shower, without having to worry about keeping a cast dry is thoroughly appealing.
Not as appealing as the prospect of being able to stand on two feet or walk again, but that's much further away, and too depressing to think about. On the bright side, the muscles in my arms and my right leg have strengthened enough now that moving about as needed is no longer so painful and exhausting. (I'm not as fit as I'd like to be, but I don't really count it against my fitness levels that my muscles did not appreciate the radical changes to my methods of locomotion in the last few weeks - I was never going to be accustomed to hopping and/or holding my weight on my arms this much.)
This experience has brought home to me, mind you, the notion that the "not disabled" are better referred to as the "not yet disabled". I wasn't significantly physically disabled, but right now, I am, and it is, in fact, incredibly frustrating to deal with even when everyone around you pretty much couldn't be nicer, which I've been lucky enough that they have been. And it really is awfully easy to find yourself abruptly shunted into the Disabled category.
Accordingly, "poor wheelchair accessability" has become an issue about which I no longer am concerned with in the "Strongly, But Somewhat Impersonally" sense, but rather in the "No, Really, And With Personal Anger And Rage" sense. Because I used to just think it was important on moral and ethical and justice-type grounds, but now I have experienced the nature of life when a one-inch-high step that, walking, I wouldn't even notice, is actually a source of pain, exhausting effort and massive inconvenience, and really, it does make it all a lot more visceral.
I now feel, just a little bit, that anyone who gets pissy about providing proper wheelchair access to things should be provided with an unstable ankle fracture. Once you're a few days past surgery, they're not that painful - most of my pain now is muscle, knee and tendon-related, and a carefully administered break could avoid wrenching everything as badly as my fall did, and also avoid the extra broken bone I collected - and you don't get to walk for months.
I think it would serve as an excellent demonstration injury. Obviously, it doesn't cover anything *like* the full scale of what wheelchair-prompting disability can entail. After all, you can still move pretty well otherwise, and you have one working leg which makes a lot of things much, much easier. For example, I can get up off my wheelchair, using my working leg, and swivel around to get onto a toilet that has no lateral transfer access. I imagine that this is making my life vastly, inexpressably easier than if I couldn't.
Nonetheless, I do feel that it would do much to convey the point.
I was going to go on to the post I want to make about health care systems, but all this has gone on long enough that I think the other one needs to be a separate post. (I always prefer to make posts about Serious Topics separate from personal ones, in case people get linked to them.)
Especially posts in which I have been advocating the deliberate injuring of annoying people.
Just below this, in the cut tag for this post, there is going to be a warning. I cannot stress enough how much I mean it, so I'm also going to say it in the actual post:|
If you are squeamish, particularly about injuries, bruises, cuts, stitches, or anything like that at all, I advise against looking at the photos in this post. At all. Just don't do it, you don't want to see it. I used my phone to take pictures of my broken leg when the cast and stitches were removed, and they are pretty appalling, as far as legs go.
However, if you are not squeamish, and are interested in looking at the effects on the outward appearance of a human leg caused by breaking bones and surgical repair, then click away.
( No really I mean it if you are squeamish do not look at the contents of this cut. I'm serious. Don't. )
I now have another cast, a proper all-the-way-around one with the higher grade of plaster. It's even blue. I keep this cast for a month, and then it gets removed, everything gets checked, and then I get some kind of boot cast that's even removable so I can wash my leg and stuff. In the meantime, I'm to keep my foot elevated, so... yeah, I still live on the couch.
E-mail of choice for today:|
Subject: I have a message from my giant death robot
He wanted me to tell you something...
What was it?
( Context, if you really must. )
In not unrelated news, I'm not sure using a Giant Death Robot to attack Tokyo will ever not be hilarious.
GAMERA WILL NOT SAVE YOU NOW
Anyway, I've been quiet for the last week or two because, as it turns out, I was in fact very very sick. Sick enough that, when I started to recover, the answer to how I was feeling started with "lucid", because for several days, I really wasn't lucid at all. (Hence this post.) My delirium was odd, because it wasn't based on a fever as far as we could tell. Checking with an actual thermometer even revealed my temperature was up *maybe* half a degree from what I could recall was normal - and definitely not very high, given I didn't even break 37.
In a new category for Weirdest Symptom Ever - that hasn't quite cleared up - this illness also made my teeth hurt. I was, for a bit, mildly worried that I'd developed my first ever cavity or something, and this was actually the proverbial toothache, but then I decided that toothache from tooth decay probably didn't come and go at random points all over one's jaw. I have 29 teeth*. At various points over the last couple of weeks, every single one of them has hurt, singly or in groups.
* - Yes, I know the nominal tooth count for adults is 32. I have 29. Three molars were removed because there wasn't room for them. There's no spare space in my mouth. I don't have the faintest idea where Nature thought three more teeth could fit.
I just found out how thoroughly my body had taken the "encyst the fucker" approach to my spider bite:|
It just fell out.
There's a divot on my hand. Pink scarring below, and a DIVOT on my HAND.
Apparently a small piece of me just got jettisoned.
So, on Saturday I spent most of the day at the Emergency Department, accompanied by my awesome buddy Dean.|
Obviously, this sucked, especially since neither of us ate between breakfast and when we got home just before 5pm. Dean was a trooper, though, even braving the isolation room to hold my hand while I had a pelvic examination, despite the fact that - all other considerations aside - this cost her all blood flow to that hand for the duration.
Anyway, I'm just about okay now, although I still get lightheaded if I stand up too fast, too long, or exert myself; all consequences of some apparent issues with blood pressure drops, assumed to be connected to my having lost thoroughly disconcerting amounts of blood over the course of four or five days via womanly pathways.
So. Highlights of the trip:
1) Woman in next bed in the ED processing room explaining her troubles, using the phrase "volcano of the stomach". Dean and I were both sleep-deprived, low on blood sugar, and dehydrated by this point; suddenly we were twelve and trying hard not to snicker audibly.
2) Volcano Woman was replaced by... a guy with something stuck in his butt. SERIOUSLY I AM NOT KIDDING. I had just had someone poking my cervix and I still found this inappropriately funny.
3) Discharge time, I was desperate to go home. Dean and I had come straight from the GP who recommended I go to Emergency, and I was hungry, thirsty, and in dire need of ADHD medication and things to do.
The nice doctor came back to see me. "Do you need to go to the toilet before you leave?"
Me: "Not really..."
Her: "Do you want to try? I know you said you're not sexually active, but we have to do a pregnancy test before you go anyway."
Her: "We only need a tiny amount..."
We went home, and I took my ADHD meds, and, to a degree that I had never before experienced, I could feel them kicking in. It was like the whole world decelerated sharply and came into focus, all at once. It was really, really odd.
So, this morning I was supposed to start a new daily course of therapy stuff.|
Instead, I woke up at 6am with agonising abdominal pain, and ended up spending the morning at the Emergency Department, where the conclusion is that I have crazy cyst action blowing up my ovaries.
Fun Times also messing up my attempts to get my life in order.
WTF moment of the day: Discovering that the registration clerk had entered my name as Tami, so all the paperwork (including my prescription) were written out for Tami, when she was taking my name and address details off my driver's licence, which says, in clear, Western Australian Government-approved font, that my name is Sami.
She read the rest just fine, but... no. Tami. They're not even near each other on the keyboard.
Meanwhile, I've been playing Nier lately. I got it late Friday (Chas picked it up for me in town), and have been playing it a lot ever since. I really like it, actually.
I was looking for some commentary on it to link to, specifically the unusual element that it's a video game with a character who is not exactly cisgendered, but so far everything I've found is from people who haven't played the game and are making an awful lot of suppositions that I wouldn't say are particularly supported by the game. (Including that she has no clear gender identify preference; I think she's pretty firmly presenting as female, to start with, and then you have the part where Grimoire Weiss makes many, many comments about her being a horrible hussy and all sorts of other comments that are dependent on her femininity, and Kainé has no trouble whatsoever voicing her displeasure when Weiss pisses her off, so I think she'd probably say something. Especially at the point when she still totally hates him.)
I'd warn for spoilers, but, seriously, when you load the game, before you start playing, before the intro movie even rolls, you get a splash screen with audio playing over it that is Kainé yelling at Weiss. In which she calls him names, mocks him for being a little bitch (in so many words), and then yells at him some more. It totally doesn't count as spoilers to tell you that Kainé and Weiss have some personality conflict happening.
So, I went to the gym today. I, a fat fat fattie female, went to the gym. Alone.|
And it was an awesome, positive, incredibly rewarding experience.
Everyone I spoke to was really nice, including the personal trainer who came along to do an induction round with me - she listened when I explained my injury and mobility issues, and worked out what I could do that would help to build up the muscles I need to work on. She was really encouraging getting me through sets with a given exercise, and extremely encouraging when she had me on the cross-trainer, encouraging me to keep going - but only up to a point.
The cross-trainer turns out to be perfect for me, because it's a good cardiovascular exercise that doesn't actually strain my semi-functional leg joints too much. The trainer was very encouraging as I was on it, saying that a lot of people struggle with the co-ordination of it and to keep going more than thirty seconds, but I was doing really really well...
... but she stopped me at five minutes, because overdoing it is also very bad.
She also complimented me on clearly knowing what I was doing with some of the machines - she was busy with some other women when I arrived, and she saw me doing some things, and said I was doing them perfectly.
Mind you, this includes leg presses, where I was in the position that if I did them carefully and right they'd be really helpful, and if I did them at all wrong they would wreck my knee hideously. My bad knee can not take inappropriate strain right now.
The effects of long-term injury can be very apparent at the gym, like when your left arm breezes through sitting row pulls with 20kg weights and your right arm can just barely manage to do the exact same thing with 2.5kg.
But I feel really, really good. The satisfying feeling of having used my muscles, got my blood pumping, breathed hard enough to really open up my lungs - it's great.
The thing to remember, next time, is to have a snack slightly earlier than I did, because I got to the end of my workout and was starting to feel like hell, and it was getting rapidly worse, and I suddenly realised oh bollocks low blood sugar and had to stagger to the locker room, find the snack in my bag, and eat it past the feeling of acute nausea. (Then I was fine.)
My body shall work again!
... ahahaha, this is hilarious: I'd taken a pair of Skechers runners I have to work out in, but found them uncomfortable and switched back to the shoes I think of as my walking boots.
Apparently, these are technically supposed to be cross trainers.
I GUESS THEY'RE FINE FOR THE GYM THEN, especially since, at the moment, my regular-footwear boots are my waterproof hiking boots I got for the UK. I was planning to take them on my trip, they can be my shoes if I stop at gyms in Britain.
Conclusion re: dog sledding: I can handle it just fine, I think, as it turns out.
So, one of the most hilarious ways to end up struggling more with mental health issues: have an appointment with your psychiatrist that leaves you feeling a myriad range of badnesses.|
( Griping on that topic. )
Meanwhile, I'm planning to take the amazing step of going to the gym tomorrow, if I'm up to it.
I've reached the point in recovery from my various physical injuries where I feel like I can start expanding my range of deliberate physical exertion. It's been almost three years since The Accident, and finally, finally the pain has subsided to the point where I can start getting my body back.
I've always been overweight, but the thing is, three years ago my body did what I wanted it to, more or less - I wasn't as fit as I wanted to be, but I wasn't actually particularly unhealthy in a muscle tone and cardiovascular sense. (Anyone who is not yet aware that body size and physical fitness are not equivalent, please go look it up before you argue.) I could walk for hours, I'm pretty sure I could even do things like break into a jog or a run, although it's hard to remember how that even works, nearly three years since the last time I could do those things without agony.
While I am all of three years older, I think my recent susceptibility to joint injuries and pain and so on may well be linked to the loss of muscle tone that has accompanied forced inactivity.
My usual forms of exercise of yore - long, brisk walks, swimming, judo, that sort of thing - are still beyond me. I'm not physically capable of a lot of that stuff.
But I'm not sure I can *become* capable if I can't work on rebuilding my muscles - in a controlled way, so I can balance it, and can also work around those parts of me which are still injured.
I probably should have started several months ago, but I didn't think of it. What prompted the idea that I should go to a gym, and do gym things, was in fact my holiday planning, when I came across the recommended exercise routine for preparing for week-long dog-sledding safaris: rowing machines.
I'm not planning to go for a week, or do any of the "challenging" routes, but I do want to learn to drive a dog team, if I can, and do a short trip. I can't do that much serious muscle-building in the next month, especially since for a fair chunk of that time I'll be travelling (although you never know, I might find ways to fit in a stop-off at a gym a few times a week).
What I can do is get my muscles past that initial strain point, the border between inactive and active that causes serious pain once you've crossed it.
I used to be an athlete; I was never a gifted athlete, at all; my ball skills are terrible and I'm a slow runner, but I worked hard and was a moderately competent martial artist.
I remember all too well the fitness boundaries, or at least the fitness boundaries *my* body has. The transition from not-doing to doing is hard, but my body feels vastly better for it. Regular activity, it feels fine, feels easy - I forget how much above the inactive standard I'm running, until I have a minor injury, or catch cold, and miss a week of training.
Judo, as an athletic activity, is a whole-body thing. Every muscle gets used intensely.
Which means that if you miss a week of training - or, my worst experience of this ever, six weeks with a cracked collarbone - when you go back, the training itself is fine - a little more tiring, but you sail through easily...
... until the next morning, when your muscles have had time overnight to think things over and voice an opinion, and you wake up, and your brain says "sit up" and your body says "as if". It takes a minute to muster your muscles to activity, and then you groan as you do it, because every single muscle in your body is aching.
The worst is generally the abs, because abdominal muscles are weird for this. On the one hand, we don't use them with any real intensity in normal life, so they lose real tone quite readily. On the other hand, there is nonetheless very little that we do in life that doesn't involve some low-grade participation from the abdominal muscles (as my mother, who has had a number of rounds of major abdominal surgery, could tell you), and so if your abs are feeling strained, you spend a whole day moving with awkward stiffness, trying to do things without them.
So there's the curve of regret, and I want to be riding the happy middle when I try to drive a dog sled - not to mention, I want to see how well my muscles are faring, because I don't want to find out I can't sustain the effort when I'm halfway out. Better to do some preparation now, when I can be testing my muscles on a gym pass at Lord's, where reaching my limits just means I take a break.
I'm watching a basketball game. Cleveland Cavaliers vs Orlando Magic. I am developing a preference for the Magic in this series, because:
1) Orlando Magic wear consistent uniforms that look fine. Cleveland Cavaliers... I've watched three games between these teams. First game, Cavaliers wore a really nice blue. I rooted for them that game, and that may be why. Second game, they wore a dark red I disliked, I found myself preferring the Magic. This game, they're wearing navy blue with red stripes. PICK A COLOUR.
2) Orlando Magic do not have Lebron James, who a) seems like kind of a jerk b) keeps getting bad decisions in his favour because he's a STAR c) okay, this one isn't his fault, but seriously, one of the commentators is totally doodling MR LEBRON JAMES in the margins of his notebook, because he can not shut up with the OMG Lebron James is so awesome he's the dreamiest OMG OMG.
3) The Orlando Magic's coach is kind of adorable. He's so wee! He's short even compared to normal people, let alone the basketball players, so standing amid the basketball players he looks like a moustached, shouty munchkin. So tiny! So shouty!
Watching American sports, I have very little personal stake in what's going on, but I like having a side I vaguely want to win. So I pick a side on an incredibly arbitrary basis.
There's a commercial for Maltesers that comes up periodically. My brother-out-law Chas observed yesterday: "That ad always makes you smile." I hadn't realised, but it's true, I do really like it. It's 'Rollers', for Maltesers, which the YouTube blurb claims was so successful Mars had to build a whole new factory to cope with the demand. (The version we see has been dubbed with voices in Australian accents, but the dialogue is all the same.)
The thing is, it's a genuinely good ad. It doesn't treat eating chocolate as a "guilty pleasure", or some kind of overwhelming experience that's just stupidly unrealistic, or anything like that... it's, hey, chocolate is nice. And the friend's reaction of "I can see what you're doing!" and the fact that this is a cause for laughter, not any kind of why-would-people-do-that argument based on getting overly invested in a bag of chocolates, that's... nice. And the way the song on the radio gets to a cool bit and they both join in singing.
It's the kind of thing that, for me, is just... hey, this is friendship. I've had those moments. You're driving with a friend, you're laughing, being a little silly, including being silly about something like a pack of snacks, where the point isn't exactly eating the snacks (although they're tasty), it's also the game of sneaking them and getting caught and both of you finding it funny. A good song comes on, you both interrupt the conversation to sing along. These are the little, mundane moments of love and laughter that, in a very literal sense, I live for.
So yeah, that commercial makes me smile. Because it's a commercial that speaks to everyday joy - not pretending Maltesers are anything other than, you know, chocolate snacks.
Honestly, if Maltesers were gluten-free, I would probably have been buying them more since I saw this ad, because I like the taste, and it would make me think of happy, random moments with my friends.
Advertising: Just for a change, you're doing it right.
Something that's come up in my head recently:
I've been reading a lot of blogging (from the science-based, pro-vaccination side) about anti-vaccination activism.
I've also been reminded by various events that my own immunisations are either coming up to due for boosters, or possibly way overdue.
When I see my new doctor next week, I'm going to mention this, in the expectation that she will send me on to the clinic nurse to shoot me up with something, and give relevant instructions on how slowly I need to get everything done.
The site of the tetanus shot I got on Saturday is still red and puffy, but I showed it to Dr Paula on Monday, and she said it was a normal localised reaction, and the inflammation was a small enough area not to be concerned (and demonstrated what WOULD be cause for concern). I have reasonable faith in Dr Paula, so I'm not worried.
Faith because: Seriously, she's awesome. She listens, she doesn't tell me all my problems would be solved if I lost weight, when I went in near-fainting from fear about getting a pap smear she listened and she was sympathetic and very, very gentle. I had this localised skin problem. Doctor before her, Doctor D, when I said, look, I've got this, and my previous doctor told me it was a fungal thing, so I've been using anti-fungal cream for nearly a month now and it's just not getting better, glanced at it, said, "That's a fungal infection." like I didn't have any idea that was a possibility and told me to get a different anti-fungal cream.
Doctor Paula's reaction, to my telling her that that one hadn't worked either? "Well, it's probably not fungal, then." *writes prescription for steroid cream* "Try that." Visible improvement by the following morning.
Doctor Paula is awesome because when I tell her something, she listens, and integrates that into her plans for my treatment. I tell her, look, this is really scary for me, because X, she's gentle and reassuring and sympathetic and promises me that if it's too hard, we can stop, and we'll work out another way to do this.
Also, Doctor Paula is at the uni medical centre, which bulk-bills students, so it doesn't cost me money to see her, which seeing Doctor Peter, who's been my family doctor since I was about three, does. He recently moved to a new practice that's actually bothersomely expensive.
Explanation for non-Australians: Medicare pays a set fee for doctor's visits. Doctors are not required to charge that amount for their services, and most charge more. Usual practice is that the doctor will charge the fee for their services to the patient, who can claim a rebate from Medicare. However, if the doctor only charges the Medicare-refunded fee, what they will usually do is skip charging the patient altogether. Instead, the patient signs a form, and the practice bills Medicare directly. This is known as bulk-billing, because they bill Medicare in bulk. The university medical centre charges a fee for university staff and local community members who use their services, but bulk-bills students.
I keep meaning to learn more about proposed systems for American health care reform. ( Cut for lengthy digression. )
So we have multiple payers, and the system is far from perfect, but... for the most part, it copes.
I have invented a new form of insomnia. It involves going to sleep fine, but waking up ever-earlier and being unable to get back to sleep. Then, because I'm tired, I go to bed earlier, and my bedtime winds backwards. But if I nap, I can't sleep at night, and my psychiatrist has forbidden napping.|
On the bright side, this morning I have invented a superior method of putting ointment up my nose.
I somehow injured the inside of my left nostril several weeks ago; it's been refusing to heal, not least, I think, because every time I bumped my nose or blew it less than flawlessly, it broke open and started bleeding again. Yesterday I saw my doctor, and her recommendation? Savlon. In my nose. Thrice daily.
On the one hand, it already seems to be helping. On the other hand, putting antiseptic ointment in your nose fills the world with The Smell Of Antiseptic. I have a reasonably sensitive nose. This is very hard to get used to. Also, putting my finger in my ouchy nostril to apply ointment both hurt and felt really weird. (Even weirder than having ointment in my nose feels generally, which is Very - it feels like I really, really need to blow my nose properly.)
Solution: Using a cotton tip. (Q-tip, for some of you.) Apply ointment to cotton tip, insert in nose (ignoring the bolded allcaps on my box of cotton tips that says CAUTION: TIPS SHOULD NOT BE INSERTED INTO EAR OR NOSE CANALS because I am a rebel and they can't tell me what to do), rub hurty places, resist urge to shudder violently at sensations this causes, resign self to everything smelling (and, therefore, tasting) of antiseptic for several hours.
I'd already had breakfast, but I keep thinking that my water glass is contaminated. If housemate.Dave decides in the next week that it's time to make his transition from Such A Quiet, Good-Humoured Fellow to And Yet, Also A Serial Killer by poisoning me, I'm so very much not going to notice.