Monday, October 03, 2005
Google ads
Oh well. I am currently cooking some of my favorite addictive substance -- boiled peanuts. I have a huge pot on the stove, filling my whole house with the wondrous aroma of the luscious legumes. That is one of the best things about fall in the south -- freshly harvested peanuts. "Green peanuts" as they are called, though they aren't green at all. I am indulging in a bit of pity for any who have never had the pleasure of this delicacy. (I wonder what kind of ad the mention of boiled peanuts will get me?)
I have been reading a really fun blog recently: celebritysmack.blogspot.com. I first found it when my favorite online magazine - Salon - mentioned something about Jude Law's naked penis having been published all over the internet, and mention was made that surely everyone had seen it by that time. Well, I hadn't, and I hate to be left out, so I went searching for it, and found it in celebritysmack. Plus a ton of other pictures and gossip. Total timewasters, and who cares anyway? But SUCH fun! Check it out... Oh, as for Jude's penis... NBD. Much was made about how small it was, but from my vast experience (as a health care professional!!!!) it is very average. For a white boy. LOL.
It really kills me how much importance is attached to penile size. Even though many women will go to great lengths to increase their breast size, there are some of us who will actually undergo surgery to REDUCE the size of our breasts. I don't think I've ever heard of a man willingly reducing the size of his penis. Cut it off, maybe, but reduce the size? Never! Can you imagine a man saying "gee, I wish I had a nice, compact penis. This dangly thing just gets in my way. And I hate when my SO rolls over on it and squishes it... " No, you aren't ever going to hear that.
Speaking of breasts... There are some really awful ones out there. AwfulPlasticSurgery.com has some great pictures. I do not, and will NEVER, understand the appeal of breasts that look like bolted-on halves of some huge round object. They all look exactly alike. No surprise. I love breasts that are as individual as their owners, with all the various shapes and sizes that human diversity can provide. It is entrancing to watch a bra come off and breasts' true shapes and contours be revealed. I guess I am an old-fashioned lesbian. But I dread the day when everyone looks just alike with chiclet teeth, cheek implants, straight noses, hair extensions, half-globe breasts, lipo-ed bellies and thighs, and butt implants. Goddess preserve us.
I saw a movie yesterday which starred Isabella Rosellini. She is so incredibly beautiful... and then she SMILES -- and oh my god. Those imperfect teeth somehow ENHANCE her beauty. It is amazing. I am so happy she never had them braced or veneered or altered. Her beauty wouldn't be nearly as awe-inspiring without that touch of strangeness to make it uniquely hers.
So maybe the whole world won't go crazy and end up with everyone looking alike. There will always be some beautiful people with sense enough to keep their own beauty instead of trying to be some bland, copy-cat kind of appearance.
And of course, there will always be those of us too poor to indulge in trying to surgically perfect ourselves!
Wednesday, August 31, 2005
4:15 am blues
Wanted to blog a bit, but am awfully tired. Awake because the dog needed to go out. Now she is sleeping blissfully at my side, and I am wide awake. Damn dog. Good thing I love her, else I'd give her to one of those ethnic restaurants reputed to cook those of her kind. .
And now back to seeking sweet, elusive sleep.
And now back to seeking sweet, elusive sleep.
aiiii... I was evil last week. That'll teach me to try to stop my antidepressant medication. I really know better. I have done it before and it never works out for me. So, last week before I resumed my medication, I had this patient who was REALLY pissing me off. I honestly don't often get pissed off by patients. I don't. I love my patients, and I try to do my best by them. But this guy... well, first of all, I could smell him from the other end of the building. He likes cheap, loud cologne. I hate it passionately. So I was pissed immediately, just from his swirling miasma. I have even told him how offensive I find his cologne. It makes me sneeze, makes my eyes water and generally makes me unhappy. So the mere fact that he wore it when he had an appointment with me was clearly an affront.
I enter the room and Bubba, as we'll call him here, was in a rare good humor. He has reasons not to be. He has insulin dependent diabetes with all the nasty things that go along with it - poor vision, nerve damage that causes pain in his feet and legs, heart damage, early kidney failure.... the list goes on, but you get the idea. He comes here for pain management mostly. And he does have pain, no doubt about it. But geez.... he has gradually worked Doc until he is on oxycontin 80 mg twice a day along with which he gets 180 hydrocodone tablets (eg, vicodin, lorcet) a month for his breakthrough pain. Eighty milligrams of oxycontin is equivalent to 8 of the highest strength percodans, and he takes two of them a day -- which is like taking SIXTEEN percodan a DAY. Plus 6 lorcet a day in case the oxycontin doesn't do it. Well, he's a big man, and he and Doc settled on his pain medicine regimen. None of my business.
Except Doc wasn't there that day, and I had to see Bubba. Bubba had last gotten his medicines 19 days prior to this particular day. He was there to see me for two reasons. He was out of his lorcet already (ONE HUNDRED AND EIGHTY of them!!) not to mention that he had on one of his brother's fentanyl patches, and he liked it and wanted some of them too! (Fentanyl is a high-power synthetic narcotic delivered through the skin.... or IV in the operating room. It is easily as strong as the oxycontin, if not stronger.) He wanted more lorcet, since he was out.
Hence the good mood, I suppose. I mean, I don't know how he walked. Or stood, or even spoke. If he indeed took all his prescribed meds, (and lord knows, he may have been selling most of them and still had enough left to be high as a kite all the time), it is a wonder the added fentanyl that he decided on his own to use didn't kill him.
I chastised him for doing that. I told him it was against the law, and indeed was a felony, both for him to take it and for his brother to have given it to him. Not to mention it could have killed him, considering all the other narcotics he was taking. He became surly. He let a tear drip down his cheek. He started whining (oh gawd how I hate whining, especially from grown men!) about how severe his pain was, how I didn't understand how often he lay awake at night crying, and about how much he wanted to be dead. Yes, he emphasized to me, he just really wanted to be dead more than anything.
Oh dear. He shouldn't have said that. It was so calculated to make me just go all soft and buttery and sympathetic. I gave him the cold fish-eye and said, Bubba, you are a grown man. If you really wanted to be dead you COULD be. I went from there into a rant: You sure have plenty of drugs to do it with! And I bet you have at least 16 guns in your house! (here he interjected sadly that someone had stolen all but 3 of his guns -- which I ignored and continued) You are willing to risk not only your life and health taking all these drugs, but you are risking MY license! How dare you? I wouldn't risk my license for someone I liked, I SURE wouldn't risk it for YOU! I ranted on in that vein for probably ten minutes.
When I stopped to take a breath, he asked me, Does that mean you aren't going to give me any more lorcet today?
I was spent. I shook my head and left the room. I could still hear him complaining that he was out of lorcet and really needed more.
I am better this week. I haven't ranted at a single patient.
And finally, a warm and personal HI! to a special girl out there. :)
I enter the room and Bubba, as we'll call him here, was in a rare good humor. He has reasons not to be. He has insulin dependent diabetes with all the nasty things that go along with it - poor vision, nerve damage that causes pain in his feet and legs, heart damage, early kidney failure.... the list goes on, but you get the idea. He comes here for pain management mostly. And he does have pain, no doubt about it. But geez.... he has gradually worked Doc until he is on oxycontin 80 mg twice a day along with which he gets 180 hydrocodone tablets (eg, vicodin, lorcet) a month for his breakthrough pain. Eighty milligrams of oxycontin is equivalent to 8 of the highest strength percodans, and he takes two of them a day -- which is like taking SIXTEEN percodan a DAY. Plus 6 lorcet a day in case the oxycontin doesn't do it. Well, he's a big man, and he and Doc settled on his pain medicine regimen. None of my business.
Except Doc wasn't there that day, and I had to see Bubba. Bubba had last gotten his medicines 19 days prior to this particular day. He was there to see me for two reasons. He was out of his lorcet already (ONE HUNDRED AND EIGHTY of them!!) not to mention that he had on one of his brother's fentanyl patches, and he liked it and wanted some of them too! (Fentanyl is a high-power synthetic narcotic delivered through the skin.... or IV in the operating room. It is easily as strong as the oxycontin, if not stronger.) He wanted more lorcet, since he was out.
Hence the good mood, I suppose. I mean, I don't know how he walked. Or stood, or even spoke. If he indeed took all his prescribed meds, (and lord knows, he may have been selling most of them and still had enough left to be high as a kite all the time), it is a wonder the added fentanyl that he decided on his own to use didn't kill him.
I chastised him for doing that. I told him it was against the law, and indeed was a felony, both for him to take it and for his brother to have given it to him. Not to mention it could have killed him, considering all the other narcotics he was taking. He became surly. He let a tear drip down his cheek. He started whining (oh gawd how I hate whining, especially from grown men!) about how severe his pain was, how I didn't understand how often he lay awake at night crying, and about how much he wanted to be dead. Yes, he emphasized to me, he just really wanted to be dead more than anything.
Oh dear. He shouldn't have said that. It was so calculated to make me just go all soft and buttery and sympathetic. I gave him the cold fish-eye and said, Bubba, you are a grown man. If you really wanted to be dead you COULD be. I went from there into a rant: You sure have plenty of drugs to do it with! And I bet you have at least 16 guns in your house! (here he interjected sadly that someone had stolen all but 3 of his guns -- which I ignored and continued) You are willing to risk not only your life and health taking all these drugs, but you are risking MY license! How dare you? I wouldn't risk my license for someone I liked, I SURE wouldn't risk it for YOU! I ranted on in that vein for probably ten minutes.
When I stopped to take a breath, he asked me, Does that mean you aren't going to give me any more lorcet today?
I was spent. I shook my head and left the room. I could still hear him complaining that he was out of lorcet and really needed more.
I am better this week. I haven't ranted at a single patient.
And finally, a warm and personal HI! to a special girl out there. :)
Sunday, June 12, 2005
Health Care for All
I have come to the conclusion that if you need health care and can't get it any other way, (i.e., you have no insurance, you have no money, you have no credit cards....) you go to a small town or country doctor. Many people have caught on to this. I don't know quite how... maybe it is word of mouth from their country cousins. All I know is that the small rural practice where I work has recently been flooded with new patients -- from the nearby big city.
It struck me as odd from the beginning. The nearby big city is full of health care providers of every ilk and specialty. They have several large hospitals to which they may refer extremely ill patients. They have excellent reputations (well, some of them, anyway.) It blew my mind to see a patient with several serious, non-routine diagnoses in my office recently. I am not even a doctor, I am a nurse practitioner. Not to belittle my expertise in any way, but hey, I know my limits! The woman listed the names of her specialists for her various conditions. I sat there bemused, and finally asked her, "Why did you come here? You were getting the best of care." Her answer? Money, of course. She had lost her insurance when she was laid off from her job. She couldn't afford the specialists' fees. She couldn't afford her medications. She had heard that we would see patients on a sliding fee basis, and that we would help them get free medicine.
So I got out my books, and with her knowledge of her own condition, what I was able to look up, and her list of her current meds, we were able to map out a care plan for her. She was stable on her meds. I had forms from the companies that made them so that we could apply for free or reduced cost medicines. I did a physical exam and documented her current condition so we could be alert for changes. I looked up what labs to order and ordered them.
She fully understands that I have no expertise in her conditions. I fully understand that she is stuck with me because her financial situation won't pay for the specialists she needs. Perhaps I should refuse to take on the care of a patient so complex, but surely I am better than nothing.
But I deeply resent out current system in which patients must utilize care that is less than optimal. Yes, I'll do my best for her. But she deserves better.
It struck me as odd from the beginning. The nearby big city is full of health care providers of every ilk and specialty. They have several large hospitals to which they may refer extremely ill patients. They have excellent reputations (well, some of them, anyway.) It blew my mind to see a patient with several serious, non-routine diagnoses in my office recently. I am not even a doctor, I am a nurse practitioner. Not to belittle my expertise in any way, but hey, I know my limits! The woman listed the names of her specialists for her various conditions. I sat there bemused, and finally asked her, "Why did you come here? You were getting the best of care." Her answer? Money, of course. She had lost her insurance when she was laid off from her job. She couldn't afford the specialists' fees. She couldn't afford her medications. She had heard that we would see patients on a sliding fee basis, and that we would help them get free medicine.
So I got out my books, and with her knowledge of her own condition, what I was able to look up, and her list of her current meds, we were able to map out a care plan for her. She was stable on her meds. I had forms from the companies that made them so that we could apply for free or reduced cost medicines. I did a physical exam and documented her current condition so we could be alert for changes. I looked up what labs to order and ordered them.
She fully understands that I have no expertise in her conditions. I fully understand that she is stuck with me because her financial situation won't pay for the specialists she needs. Perhaps I should refuse to take on the care of a patient so complex, but surely I am better than nothing.
But I deeply resent out current system in which patients must utilize care that is less than optimal. Yes, I'll do my best for her. But she deserves better.
Sunday, June 05, 2005
Subscribe to:
Posts (Atom)