Sunday, April 29, 2012

Tick, Tick, Tick

The mild (read: nonexistent) winter of 2012 has resulted in warnings about a prolific season for insects and critters  from people who know about and monitor such things. It never got cold enough to kill off, well, anything. Heck, it was the first winter in quite possibly my entire life when I didn't even pull on a pair of gloves. The absence of a solid winter freeze meant a spring of wretched  allergies for everyone, and even though it's only April, the ticks and mosquitoes are already out in full force.  I've been sneezing, personally responsible for a spike in tissue sales, and scratching at bug bites like a monkey for what feels like forever but is probably closer to a month. Good times.

While generally annoyed by any biting creature that leaves behind an itchy reminder of its bloodsucking infiltration of my person, I've been thoroughly skeeved out about ticks since back in the last century. In the mid-1990s I met Meg just after she'd contracted Lyme Disease from a tick bite while gardening in her yard on Cape Cod. She was pregnant at the time and endured partial facial paralysis for several months from Bell's Palsy, which lasted until she delivered the baby. As a kid who never much cared for bugs, dirt or sweating, I reached adulthood backed by years of solid experience of summers invested in hiding indoors reading books to avoid insects and life in general. This methodology proved highly effective until the summer of 2008 when the stray cat I coaxed into my house and life converted my bug-free sanctuary into a flea-ridden hellhole. Daily routines expanded to include obsessive vacuuming coupled with frequent use of a lint roller and the wearing of Deep Woods insect repellant on the feet and ankles while indoors. Two failed home bug bombs led to the contracting of the services of a professional exterminator, a relationship that has endured for four years. During the period of flea infestation I became highly adept at sensing abnormalities (such as a lone flea) upon my flesh and could run the lint roller over all surfaces to collect fleas and their larvae with the speed of a Marvel Comics superhero.

Fortunately (and probably in large part due to my extensive avoidance techniques), I enjoyed minimal personal contact with ticks. There was the two-week archeological dig  at Land Between the Lakes back in October 2003 or so, when I sprayed liberally with Deep Woods eau de DEET, kept pant legs and shirt tucked in and still found a tick on my stomach one night after returning home. One tick over a two-week period spent daily in the woods felt like success. After performing at City of Clarksville's 2010 Riverfest along the Cumberland River, I felt an itch, and upon removing my belly dance costume, dealt with the glorious task of removing a tick that was busily burrowing into my bosom.  

The spring of 2012, however, is proving to be a record breaker.

In the space of one week in late April, I had already removed a tick from each dog, both of which seemed to be already expired and interpreted by me to mean the flea and tick solution is working. Then, sensing something unusual and tickly on my own skin, examined the situation and found a tiny, orangish dot with little crawly legs traversing the expanse of milky skin between my lady pillows. The next night, again sensing something amiss, I discovered a larger, darker reddish brown demon burrowing into my inner thigh, thus triggering a new, near-permanent state of high alert. I can now detect an eyelash or a dust mote on my skin the instant it lands, which, with my new hyper-acute sense of awareness carry the weight of a log or a boulder.

And that brings us to today, a day spent schlepping material possessions from the confines of the basement and inner sanctum of my home out to the front lawn -- and in the case of much of it, back from whence it came -- in the home retail ritual known as a Yard Sale. The rigors of dragging an ottoman, various chairs, boxes of  books, coffee mugs and other assorted housewares out to the front yard to be arranged on tables previously trotted up the driveway to the yard, and then unwinding the whole operation seven hours later, left me feeling thoroughly spent and in need of a lovely nap. It's cheaper and more convenient than going to a gym, but by the end of it, the leg that was broken six months ago was throbbing and aching (except for the parts that are still numb), and the leg that is doing the bulk of the work of transporting me around was even more fatigued than usual. My lower back hurt and my shoulders and neck were screaming with exertion and tension. The couch beckoned for a nap or to watch a movie (or a combination of the two).  We settled in -- Moose nestled into the pillows by my shoulder, and Winston down by my feet.

As I usually do when they are laying against me (or completely on me), I was petting my fur babies.  I felt a little bump on Moose's belly which turned out to be a tick. I disrupted our scene of domestic tranquility to fetch the now specially designated tick removing tweezers and pull the thing off. Like the one on him the other day, this one seemed less than alive.

Exhausted from moving heavy stuff in 80+ degree heat while now simultaneously harboring a refreshed state of tick high alert, I thought I felt something on my own stomach. Bingo! It was a tick, but unlike the one just removed from Moose, mine was still scuttling around and attempting to become one with my flesh. The tweezers came back out and so did the tick, which was entrapped on a piece of tape like his compatriot from Moose. By now, the idea of napping was nothing more than one of those flimsy morning dreams that evaporate with the bleat of the alarm clock. When the dogs rotated positions, it was Winston's turn for petting and tick inspection, which revealed one in the crease where his leg joins his body.  A banner day -- everybody gets a tick.

The calm of an evening featuring two hours of  Big Bang Theory episodes in syndication and a Lifetime network movie starring Lindsey Lohan, fueled by a supremely satisfying supper of double portobello veggie burgers with Provolone cheese and lettuce on an everything bagel accompanied by a Sam Adams Boston Lager, was interrupted by intrusive thoughts of ticks. The tranquility destroyers were two thoughts recurring to the point of obsession -- What will happen when I find a tick in a place I can't reach to remove it? And what if there is already a tick lodged in such a location and I just haven't found it yet? As I was shoving these ideas aside for the umpteenth time, I was snapped to attention by a poking feeling beyond my side and more around towards my back. The first assumption was the mandatory care tag in my new summer camisole, but contortions and yoga twists revealed it to be another freeking tick -- the second such discovery in an hour or two.

It's feeling out of control. Is it safe to use heavy duty repellant all over, every day like body lotion? Is there a body lotion with DEET that desn't smell like insect repellant and make my nose become stuffy? Does canine Frontline work on people? I sense a new research project in my immediate future, but it's probably just another tick. I'll tackle those new questions right after trying to memorize the symptoms of tick-borne illnesses like Rocky Mountain Spotted Fever and Lyme disease. With four ticks removed from myself in one week's time, I am quickly losing faith in my odds. It's making my skin crawl.

Saturday, April 21, 2012

Firsts and Such

The final Red River Sirens Roller Derby event for 2011 was a stunning personal finale.

Some people succumb to mid-life crisis by buying flashy sports cars and/or flashy jewelry. Some get divorces. Others take up overeating or drinking or religion. Some fight it with flat-out denial. Case in point -- I bought a pair of Reidells, learned to roller skate at age 49 and helped grow a roller derby team. I took the name 'shades deville' and focused on hydrating, stretching, endurance drills, technical skills, and attempting to cultivate and channel my aggression to help my team. After a year and a half of training and practicing, questioning myself, feeling like a misfit in a sport with a reputation for being dominated by misfits, and skating on the roster for a few bouts against other teams, things were finally beginning to gel for me. I was beginning to trust my skates more and second-guess myself less. I felt, for the first time, like maybe I could, with lots of focus and lots more practice, someday be good, and not just good 'for my age.'

About 45 minutes into the season-ending Zombies versus Commandos intra-league bout, I was propelled into a cannonball maneuver (I was the cannonball) at turn two that went not-quite-right, followed by a tangle or a Tango or something that resulted in me on the floor. I hit the floor a lot, and prided myself on getting up quickly, but this time was different. I felt my left lower leg snap, sort of like breaking a stick. This was not the usual spill, and my blood was spilling into a pool on the track.

Those few seconds resulted in a triumvirate of firsts in my personal and medical history. Spiral fractures of my tibia and fibula at the precocious age of 51-going-on-30 (or 12, depending upon whom is asked) marked my first documented broken bone(s). (The odd configuration of my 90-degree tailbone detected in January 2011 is still an unknown physical situation of unknown origin.) The multiple fractures required my first surgery (unless wisdom teeth removal counts, in which case my weekend of monumental firsts is minimized by approximately 33.3 percent). It was also my first overnight hospital stay (undisputed – and three nights!). The EMTs and hospital staff were incredulous that someone half a century old had not previously been broken and hospitalized, which had me feeling like some sort of freak. My camouflage patterned boys size 16 boxer briefs worn over fishnet tights and camo paint on my face only exacerbated the freak feeling. Out of context, commando derby attire is kind of, well, odd. I couldn't wait to wash the green and brown makeup off my face.

My first hospital food had me curious as to whether it would live up -- or down -- to the infamous reputation ascribed to it. It looked good on paper -- a visually appealing, professionally designed menu featuring breakfast, lunch, dinner, and "available all day" selections. At least twice (and possibly every time), the person on the other end of the food hotline asked, "Is that all?" after hearing my order for a scrambled egg and orange juice, or grilled cheese and tomato soup. Evidently, they are accustomed to feeding heartier appetites.

Even though it was delivered from a place called "Room Service," and arrived on a plate under a fancy lid on a tray carried by a person wearing a white shirt, black pants and black vest, (been there ... not a first) the trappings and presentation could not disguise the fact that the food was still mostly yucky. It turned out the flavor was directly improved, not by the tiny salt and pepper packets included with the napkin, but by activating the pain management button prior to, and while eating. It seems that Morphine makes food taste better. Each time my "Fresh Fruit Cup" contained cantaloupe, it required conscious and deliberate effort to block out the memories of the flood of news coverage of the recent spate of deaths from lysteria-tainted fruit. (Those were probably the times my blood pressure approached anything above super-low.) The veggie burger sounded promising but turned out to be an overcooked, sponge-like disc that was too spicy for even my spice loving palate -- another first. I choked down two bites before I gave up on it. The linguini with pesto, overcooked and mushy to the point of not requiring chewing, became another two-bite meal. The french toast was barely toasty and served with gross margarine spread. The scrambled eggs were actually edible. The clear winner of first prize in hospital Room Service roulette was the tomato soup and grilled cheese, but the overall winner for best meal during my stay was pizza from Michael's Pizza, prepared at a legitimate food supplier and delivered by a derby teammate. Perhaps Michael's could get a food concession at the Medical Center and perform a huge service to weak, hungry patients.

Gateway claims to practice Hourly Rounding, whereby nursing staff visit the patients every hour. They promote this in an informative brochure titled "Hourly Rounding and What it Means for You." There were clocks with movable hands opposite each bed in the luxury suite in which I was lodged (Room 4228). When the staff visits, explained in the brochure as hourly during the day and every two hours overnight, the clock hands are moved to the time of the most recent visit. Many of the visits included the recording of vital signs -- temperature, blood pressure and pulse. The staff almost always had to do my blood pressure twice -- the cuff on the portable equipment cart was too large and a reading couldn't be done successfully until they got "the small cuff." Eventually, someone left a small cuff attached to the rail of my bed so they could stop searching and commence with the reading and recording. Staff usually marveled at the low, low readings on my blood pressure. Perhaps the pool of blood left on the derby track had not been replenished yet, taking my usually low blood pressure to new lows.

Hourly rounding was great. It was predictable. As a 'guest,' I appreciated knowing when to expect the staff to show up to do vitals. It meant if I needed to use the bedside commode, I knew when someone would be around next, and might be able to avoid a call to the nurse station for help. On Sunday, Hourly Rounding worked like, well, clockwork. On Monday the system was just a fond memory and the place turned into a totally different hospital. It was anyone's guess when (or if) medical staff would be stopping by. Several times I had to buzz the nurse station because the IV machine to which I was attached was beeping frantically, which is rather unnerving and quite loud. When someone finally arrived, they'd casually comment, "Oh, that one is getting low," which probably would have been noticed with those regular, hourly visits.

When the same night nurse arrived Monday night that I had on Sunday, she asked how things were going. I said "Great," then asked if Hourly Rounds were just a weekend thing. When I pointed to my clock displaying "7" and said that was not from an hour ago, but from that morning -- 13 hours ago, she mentioned I was not the first patient to mention that in the hour since she'd arrived. Then she said she was going to speak with the supervisor, because the Hourly Rounding system was a quality mandate of the hospital, and supposed to be followed consistently.

On Tuesday I was discharged, which led to another day of surprises in the absence of information provided. I was told early in the day I would be discharged and that was the extent of the helpful nuggets of knowledge. Umm.... any idea what time this may be happening? Should I order another fabulous lunch from Room Service? I needed to arrange for a ride and a time frame would be helpful, unless that ambulance crew that delivered me on Saturday was planning to drop me off somewhere. I was handed two sheets of paper and two prescriptions, which required a line of questioning worthy of Judge Judy to learn that no, this hospital does not have a pharmacy on-site. (Maybe the tradeoff was between the lobby Starbucks or pharmacy?)

One sheet of paper was an official permission slip to leave. The other was a yellow carbon sheet bearing the previous day's date and a one sentence instruction to "Follow up with doctor on Wednesday, Oct 26." There were no written instructions about keeping my lower leg elevated for the next three days, as told during the surgeon's bedside visit. There was none of the timeline information I thought I remembered mentioned in my pre-surgery drugged state (when I was certain I felt the warmth of sunshine, beach breezes and sounds of the ocean) about stitch removal and putting weight on the affected limb. No info about keeping it dry. No doctor's name. No phone number to call to set up the aforementioned follow-up appointment. No helpful info whatsoever. This was becoming a mystery worthy of Nancy Drew. At least the Doctor's name was on the prescriptions. When we arrived at her house after a cross-town jaunt to the pharmacy, my gal pal Wendy conducted an Internet search to find the basic contact info required to call and schedule the follow-up, which, according to the office staff, was supposed to be Friday, not Wednesday. So the one concrete instruction I left with was not even correct. I had the feeling this was not a first-time occurrence for the establishment in which I was recently a guest.