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Sunday, July 19, 2015

Communication - the Art of Misunderstanding and Stubbornness - the Art of Rebellion

Wow - how time flies when you're having fun!


Let me just summarize by saying the last 5 days of my life have been the most frustrating, angering and painful of my life.

And, much like the Incredible Hulk, I have learned from years of dealing with the Beast Inside, I have to say...

"Please don't make me angry..... You won't like me when I'm angry!"

In a nutshell, the last few days went something like this.....

I  went in for knee surgery last Tuesday morning.  I had reviewed the procedure in detail with the doctor. Pretty simple.... make a 1 to 1-1/2" incision on the inside of my left knee, move some muscle and tendons out of the way to get access to a 3/4" long bone spur on the back inside of my left knee and shave that sucker off and exit the scene.  Last thing I asked him at the consult was..... How long is the recovery?

And he says, "Ah.... you'll be walking in 3 days and be back at 100% in 3 - 4 weeks". 

Hmmmm...... Walking in 3 days.... Remember that.

So in the preoperative "check-in", the Texas Orthopedic Hospital admitting nurse is doing the standard questionnaire from a laptop at bedside and she describes the procedure as an "arthroscopy"....  which is a totally different procedure that accesses the inside of the knee joint through very small "incisions" or holes.

I said - No - I am not having an arhthroscopy - he will make an incision - a big incision.

And the nurse said - Oh.... yes, that's what the written order says - this is the hardcopy she was holding in her hand.


The Surgical Procedure type in the computer system was different from the hardcopy procedure that was obviously from some other source.

So.... that bothered me.... cause I knew there was likely a slew of information tied to the erroneous procedure.

But I let it slide.....

MISTAKE #2.....

I should have cried "Foul" right there and had them change the procedure in the computer system.

Anyway.... to make a long story into Gone with the's what happened.

I wake up from the procedure... have 2 cups of coffee, a Coke and some Crackers.... they start handing me instructions and Discharge documents and the Doctor comes by and says.... Everything went well.... Now take it easy the next few days.

I look at the illustrated instructions in my hand which right off say....

Perform these 6 leg exercises - stiff legged leg raises, heel drags, quad muscle flex, etc - starting TODAY! and do them for so many reps however many times a day....

So I figure...they want me to exercise my leg from the get-go.

But the Doctor tells me Take it Easy.... which to me means Don't do any CrossFit workouts and don't ride my bike.... that sort of thing..... I'm kidding.... but the point is what they wanted me to do and what I understood I was supposed to do..... you get the picture.

Which is the beginning of Miscommunication..... cause what you mean by Take it Easy and what I mean by Take it Easy....

May be 2 totally different things.

And the written instructions for an arthroscopic procedure recovery involving soft tissue repair may be different from a "cut the side of the knee open" procedure involving chopping off a piece of bone from the outside of the knee.

Which turned out to be the case.

So the afternoon of the day of the surgery.... the anesthesia and procedure meds are wearing off....

And I'm starting to hurt.... so I'm taking the Pain Meds - 2 Tylenol 3's every 3 - 4 hours..... just like the Rx said.

And the Pain is overwhelming the meds....

And I am hurting so bad I can't sit still.

And I'm trying to do these fucking leg exercises that the discharge instructions tell me to do.

And I've taken off this huge Ace bandage and gauze covering the massive incision (at least 3" - what happened to that 1 to 1-1/2" incision) and I'm icing my knee.... which is what the illlustrated instructions given me at discharge tell me to do.

I finally gave up on the exercises... cause I couldn't even move my knee without it feeling like somebody was driving a railroad spike into my knee joint with a 12# sledge.

At 8:00 am the next day, Wednesday, I called the Doctor's office and talk to Dr Woods head nurse who is about like talking to a wall, in terms of bedside manner, and I tell her the pain is at Defcon 2 level and we are about to start global nuclear warfare on my left knee.  She says to call back at 11 am and talk to the good doctor.

At 10:55 am, the Doc calls me back and I tell him pain level is too high and the meds aren't cutting the pain and he says I can't give you anything stronger but you can double up on frequency going to 2 Tylenol 3's every 2 hours vs every 4 hours.

I also asked him about the exercises and told him I couldn't do them - hell, I couldn't even straighten my leg - and he says "No, don't do any exercises.  Do nothing, just rest".  And put the gauze dressing and Ace Bandage back on and ice the knee through this Ace bandage - which was about an 1" thick once it was all wrapped up..... Ice through that.... Yeah right.

Ok.... that's all new news.... I've gone through 24 hours of Hell.... with bad data.... and now I'm supposed to Do Nothing.  Just rest....

Got it.

So I up the pain meds and after about the 3rd 2 hour frequency dosage.... lo and behold....  the pain starts slowly subsiding.  Funny how that works.... take more pain meds and the pain is less.

I go to bed Wednesday night early at 7:00 pm after just taking a round of T-3's and I wake up at 10:30 pm and

SHAZAM..... the knee isn't throbbing anymore.

I get up Thursday morning and the knee feels much better.... no more deep bone pain anymore..... still painful.... but manageable.

But there's another problem....

My whole lower leg below the left knee was swollen and bloated.... I mean so much that it looked like I had blown it up....

I'm used to looking at my skinny left calf and ankle..... Now all I saw was a big bloated swollen limb.

So naturally, being the Communicator that I am, I call the Good Doctor's office to report this latest development.

I get a different nurse on the phone.... one I hadn't talked to before... and that seemed to be a new nurse.... so this is Nurse #2.

She takes the information and says someone from the doctor's office would be back with me shortly.

My knee is feeling much better.... so I am moving around on my crutches more.

I am amazed at this miraculous turnaround.  Maybe I will be walking in 3 days.... like the good Doctor told me.

Since the pain has subsided, I realize something else is wrong....

I haven't shit since Monday morning.

Holy Shit!  or Holy No Shit!

And if you knew how much I normally shit every morning...... you would have to wonder...... after 4 days of No Shit....

Reminds me of an old Crystal Gayle song.... Don't it make my Brown Eyes Blue..... except the opposite of that....

Cause my Blue Eyes are turning Brown.

Houston - we have a problem.

I get up Thursday morning, No Shit, Swollen lower left leg (which I called the Doctor's office about 24 hours earlier - Are you keeping up?), but knee feels better.... like I can get up and do something.... which I haven't done much of for 3 days.... and anybody knows that knows me....

Me not doing anything for 3 days.....

Is not a good thing!

Because exercise and activity is my  Lease on a Healthy and Happy Life.

I don't exercise.... I'm not Happy.

I'm not Happy.... I get negative.... I get negative.... I'm a Bitch to be around.

Pretty simple chain of events.

So anyway, I get up Thursday morning, and I decide I'm gonna go buy some groceries.... No big deal.

I got it planned out.... I crutch to may car.... drive my car 3 minutes to the HEB in Angleton which is literally down the block take a right and you're there.

I pull into the Parking Lot and I see the blue Handicapped sign at the head of the parking spot right at the front of the HEB store and I think....

For the first time in my life, I'm gonna park in (and actually use for what it was intended).... a Handicapped Parking Spot.

I take about 2 minutes gingerly lifting my left leg out of the deep recesses of the Mustang floorboard and over the door sill - which incidentally was the hardest part of the whole trip  - exit the Stang on 2 crutches like a crippled person which I am at the time.... and grab a shopping basket and slow roll into the Produce section of the Angleton HEB.

I got a list.... so I ain't shopping.... I'm buying.... meaning I'm not walking up and down every aisle.... just getting the stuff I need and checking out.

I thought I did pretty good....No hits, No runs, No falling down...

I get everything loaded including me.... drive back to my sister's house.... and start to unload the groceries.

Phone rings.... and it's the doctor's office.... this is a 3rd nurse I've never talked to before.... Nurse 3.

Remember, Communication effectiveness decreases by the reciprocal of the number of people in the Communication chain.

So that means we now have 1/3 of the effectiveness.... Tough Math I know.... if you don't get it... look it up on the Internet or blame your 4th grade teacher.

This nurse..... we'll call her Nurse T for short.... says she's calling me back.... from my call on Thursday morning....

And this is Friday morning.... 24 hours later..... I guess my concern about the swollen left leg wasn't much of a concern....cause the doctor's office waited a whole day to call me back.

So we talk a little bit about the swollen lower left leg and the fact that I can't shit and this lady is laughing and giggling at all my stupid jokes....

She asked me a couple of questions related to the swollen lower leg.... Is it painful?  Am I running a fever?  No and No.

And then she says You need to be doing nothing but laying down with your leg elevated.

And that's about when my Stubbornness comes out.....

I told her "T, I don't know how y'all expect someone to go belly up 24 hours a day for several days cause that's not realistic. I got things to do.... I've got to set at my computer and work (at least 2 hours a day - I know that's shameful but somebody's got to do it).... I've got 2 online meetings today.... and I gotta go pee about 10 times a day.... so your expectations are not realistic".

So I get all my work done and meetings taken care of on  Friday and I'm looking at my left Calf and Ankle and Foot and the SonofaBitch looks like it's twice as big as the right one.

Fine.Wages of Sin I guess.

Until about 4:30 pm Friday.... when Nurse T calls me back.... and asks how I'm doing....

And I said "Well I'm still concerned about this swollen left leg".

I told her I felt like I was running a low temp but the lower leg wasn't painful.....

And the next thing she says is...

"You need to go to an Emergency Room immediately and be tested for a BLOOD CLOT in your leg".


I think my Blood Pressure went from 0 - 60 in 2.2 seconds.

I hadn't had this kind of a reaction since Who flung the Chunk, a Coon's age... a long time.

I mean I came fucking unglued - inside..... I mean I was a Mad Mo Fo.

I kept it pretty well contained when I said.....

I'll think about it.

I think that pissed her off.

Nurse T comes back and says the wrong thing.....

"Well, I'm gonna note on your chart that I advised you to go to the Emergency Room".

Oh.... so you're gonna play the Legal ese - CYA - card on me huh?

Ok.... you went down that road so let's just go a littler further.....

I let the dogs loose.....

I told her....

"Oh.... you're gonna note that on my charts?  Ok.... well you better also note that I called you people 36 hours ago about my swollen lower leg and you never even mentioned that a blood clot was a possibility and now.... 36 hours later, you call me at 4:30 on a Friday evening and tell me I need to rush to the Emergency Room.... and on top of that, you gave me the wrong discharge instructions which had me exercising my left leg the same day as the surgery when I should have been keeping the leg totally immobile".

After that little rebuttal,  I calmed down a little bit and told her....

"So tell me a little bit about this blood clot thing.... what's the mechanism....  what are the list of symptoms and is there anything else that would make my leg swollen like this."

She didn't give me any more information on blood clots other than the emergency room would do an ultrasound on  my leg to look for the blood clot.

She also told me that the swelling could be caused by over activity and not keeping immobile and elevated.

Hmmm.... sounds like a likely candidate to me.

Then she says "You told me you went shopping this morning" and I said "Yeah, I just drove my car to the HEB and crutched down a couple of aisles, bought a few things and came back home".

She says "Well, I live in Lake Jackson and I know you can't do that at the mall." 

Whoa Nelly!

Now you're telling me what I did.....and how I did it.

That's pretty much where I just shut it down.

Thanks for the call.... 

So I get off the phone with the Good Ship Lollipop and do an Internet search on leg blood clot symptoms.

Turns out here are the symptoms of a lower leg blood clot:
  • Swelling - Check
  • Pain in the Lower Leg - Nope
  • Discoloration in the Lower Leg - Nope
  • Low Grade Fever - I took my temp and it was normal - so Nope
  • Cool feel to the skin (normally felt at the site below the clot) - Nope
This was the type of data-oriented info I had asked Nurse T for....but she was so fucking busy trying to cover her ass - that she wouldn't give it to me.... or didn't know it.... Whatever.

So I made the decision not to go to the Emergency Room.... and I jacked my leg up in the air and went Dead Bug.

Everybody happy now?

And here it is Sunday morning.... and the left lower leg is back to normal.

So.... that's my adventure for the week.

Whose fault was all this?


Nearly 100%.  

It was a calamity of errors but I could have broken the Uh Oh Chain at many points along the way.

Basically, the Doctor's office did not know or understand how to communicate or deal with someone like me.... Who is used to being intensely active every day.  And their expectations for immobility were unrealistic and unattainable for someone like me.  They should've known that... I explained who I was, how I am and what I did  in a "normal day" to them in the Consult and the Pre-Op interview.

Am I mad?  or Am I angry?  What's the diff?  Well.... one is crazy and....Never mind.... Only Crazy people understand crazy people.... and you're perfectly sane....  which is why you're reading this madness.

I was mad AND angry... but I got over it.

Just call it temporary insanity with a prejudice of malice.... that would sound good on a sentence.... or in a sentence.

Has this been pleasant?

Nope - just about the worst, most frustrating and painful experience of my life.  I think I already said that.

Was it worth it?

I don't know.... at this point, my answer is No.... If I knew what I know now, I wouldn't have had the procedure.

Maybe Time will change that perspective.

Did I overreact to this whole misadventure?


But that's OK.... that's who I am....

Sometimes you have to fall off the Wall.... 

And put Humpty Dumpty back together again.

I thought I had the Beast under Control but this experience left me....

Despite all the Controversy and Negativity, I am still eating good.

And all the Pain and Suffering and getting pissed off sees me down 2# this week to 169.5.

Prep'g the proteins for the week to come.  Figured I better prep what I bought at the mall....

When in doubt, have a Good Cigar and just kick back and say F it!

And listen to some good Korn Radio.

There's a Rebellious Streak in me a mile wide....

I just don't do good when you tell me to sit still....

In fact, my response will likely be....

Well what it was this week....

In the grand scheme this was just a speck of sand on the Beach of Human Experience.

For me....

It was just another week of.....


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