Blowin' in the wind

Yes, it does seem like answers lately ARE doing that. It's been extremely windy here in RehabLand lately. From the "dirty fronts" to the Alberta Clipper, the winds are blowing.

The winds of change are also coming soon to RehabLand. We know it because it's leaking out of the management suite slowly, but surely. Our manglement finally GETS what I do in the SU, and they know realize how woefully executed my programs are (due to lack of cooperation from manglement, staff, etc.)

Some folks are even seeing cryptic messages in the media. They are slow on some things, but may be smart on others.

I'm having flashbacks to my other life before nursing. And some of them ain't pretty.

How to tell when change is in the wind (my $0.02)

1. Headquarters hires a new boss from outside who has a reputation for "cleaning house" in a Fortune 500 company. 

Some of our armchair pundits at the Hotel may have missed the hint when he/she said, "Some folks won't be with us on the journey." in that welcome e-mail.

Translation: If we can fire you, we will. If we can downsize/rightsize or RIF (reduction in force) you, we will.

2. Said head honcho gets permission to bring in a bunch of high-powered consultants with whom you can sit in a meeting (where you're supposed to be asked about your job) and they will grill you like your at Nuremberg. 

The grilling will have very little relevance in relation to you or your job or the reason why they (Manglement) asked you to come in the first place.

My favorite part: watching one of the old doctors (not a consultant, but an "expert") nod off during your session. The runner up was the grilling they gave the education chief. Best description: deer in the headlights. This was scary.

Translation: We're already paid for our time, so this is just a foregone conclusion, but we're trying to figure out how we can get more work "analyzing" your organization.

3. Head honcho publishes a "manifesto for change".

Believe it or not, the Hotel is in it. People like that at work because it makes them feel "safe".

Translation: You'd better believe the Hotel is going to change. Don't feel too comfortable just yet.

Should be interesting to see what happens...

Interesting rehab conference in June

If you rehab cancer patients on your rehab unit,  you may want to check it out. This is going to be free and located at the NIH in Bethesda, MD.

I may have to see if I can escape to go!

That is all...super busy week. Lots more stories on tap, but will have to sit down long enough to process, then tell them.

The doctor IS right

I've been following Dr. Val for a while, and I have to say, part of the reason is that I get her. I get what's she's talking about because I work in rehab.

Physiatrists get rehab, since they train in a specialty known as Physical Medicine and Rehabilitation. I happen to work with wonderful physiatrists who have years of experience.

And I have thought the same thing when I have read and seen certain specialists, like Eric Topol  in the media. It would be nice to sum up everything we do into a little smartphone app, but it will never happen in this lifetime. Disclaimer: My work actually includes a whole lot of technological interventions.

If we ever get to smartphone-only health care, I fear for everyone who does get a diagnosis, like spinal cord injury, that can benefit from a rehab program by specially trained staff, just like ours at the Hotel.

Cheap is one thing, and quality is another. You can have both to a certain degree; however, we do have to be careful what we wish for. It may not be good enough after all, cheap or no.

Stay tuned....

State of the union

I missed the actual address because I've been busy with Bubba, the birthday boy, the last couple of days. No wonder I fell asleep early!

Stay tuned...

It's beautiful outside, but it's sad

This past week's been a doozy. I'm hoping I never repeat some of it again.

Work was work. We had our yearly inspection and I survived. The inspection team had some new and some old folks, so it was interesting to watch them.

Outside of that, one of my mother's in-laws died. I hadn't seen her (or any of her kids) in ages. I like this family, so it was pleasant. The crazy relative didn't show up for the wake. Still don't know if he/she is alive or dead. 

I was just getting ready to go to bed when another relative called me. Her son didn't answer calls as usual that day, so she went to the apartment complex where he lived near her. No one answered when she knocked and one of the neighbor's let her know she could see inside the apartment from outside, since Max left the curtains open when he worked from home. (He had a job that could be done remotely, and hadn't worked in an office in years.)

When they looked in, Max appeared hunched over his desk. My relative watched, but Max didn't move. She knew Max was probably dead. While it wasn't a surprise (Max had problems), it was sudden.

So, since Max's family (girlfriend and teen child) was out of town and she didn't have a key, she had to call the police to break down the door. She found Max dead. He was in his early 50s. It was sort of a circus arranging the apartment, having the police roaming around, lots of questions, and waiting. Happily, things calmed down before I could get dressed and leave.

Now, we're just waiting for Max's family to get back to complete the arrangements, and for the medical examiner to do his/her part.

Stay tuned...

Read this

Several years ago, I was sleeping when I was suddenly awakened around 3AM. I went to work and found out one of my patients coded around the same time I woke up.

I thought of him when I read this post on the American Journal of Nursing's blog, Off the Charts today.

And I, too, thought of those family members who aren't around anymore. The pain subsides, but some of it never goes away.

Love, however, goes on.

Winter in RehabLand

If deep cold wasn't enough, we got a reprieve. The last two days have been above freezing (32F). Now the weather people are predicting freezing rain.I don't care. I have everything stocked up and gassed up the car. From the looks of the stores, it was mild panic.

Just let the light and heat stay on and I'm good.

Do your thing, Mother Nature. I hope I'm ready. If not, I'll just keep reading all this interesting stuff while I wait.

Stay tuned...

My patient gig is up...for now

Recently, I got to go on the other side of the fence. I had a sleep study in a sleep lab, after my two home studies looked funny.

I got basic prep over the phone, but I still had to call to make sure it was okay to take my meds in advance, etc. Preparing Dahey and Bubba was fun, too. They are always wanting instant communication when I am gone, so I had to let them know I was going to spend most of my time there sleeping. Translation: Don't call and send me a bunch of text messages. 

To keep the environment quiet, I had to turn off my cell phone and all my electronic devices since I was going to be wired up in bed. They budget 45 minutes to do this. My tech was great. I got wires on my head, which seemed to involve sandpaper, to make sure the electrodes and the goop got a good seal. I also got belts around my chest and waist. For good measure, I even had some leg electrodes with weights (kind of like those used when fishing). All the leg ones were attached with a good amount of goop and sealed with Medipore tape.

My room looked just like a hotel: heavenly bed type setup with a million pillows, flat screen TV and there was even a very nice leather recliner. Since I hadn't had any caffeine all day, I was ready to go to sleep when I got there.

Lights out were at 9PM for me. It took me about another hour to fall asleep. Then the fun started. My cannulas came off, not once, but twice. My room got hot, so the tech had to come in and cool it down. She warned me of this earlier, because if you sweat, the electrodes can come loose. (No way I was going to do this one twice!) Finally, the room got cooler (I think the duvet and the pillow top on the bed made me hot, but not sure.) I slept, but it was not quality sleep. I could hear trucks going down the road outside.

Miraculously, I woke up and it was nearly the wake up time we discussed when I started. I had to take all the wires in the bathroom with me, but when I got back, she took them all off. Relief!

The PhD who interprets the labs was in before I left, so I got a report. Yes, I have periods of apnea, but since none was severe enough for CPAP during the night, I probably won't get one. (My best sleep is on my side, so he recommended that). I just missed the score for a CPAP (barely). What does this mean? I will have to discuss with my doctor and see what he can wrangle with the insurance company.

As Dr. X, the pulmonologist told me, the PhD said he'd just put me on one, too. A borderline score shouldn't be an eliminator, but since insurance companies look at the almighty dollar, it is. CMS even has guidelines on this for Medicare. There are alternatives which I will have to check.

Now, I just have to wait until my next appointment to see what the verdict is.

And if cold weren't enough...

Now we have snow too.  Thankfully, it's light, fluffy, and can be swept away easily with a broom.

I can't wait to go to work on a day like today. This is when I really wish I could telework. Somehow, I don't think we'll have too many people go AMA today.

Off to warm up the car and remove my own personal icicles.

More to come.

Brrr!

Curses! The Arctic Blast is back. In a crazy week with a full moon, quirky coworkers and several threatened AMAs, you just need something else to keep you busy.

I think I'll just close my door all day tomorrow and hibernate in place.

That is all...

Bad luck? Perhaps

As we sent one rehab patient to hospice recently, I read this article from the BBC with much chagrin.

Could our patient Mr. Z really have just had bad luck? Could that mutation have been stopped before it metastasized all over and sent him to rehab?

One commenter said, "Mutations get all the bad press."

Fine time they should!  Lifestyle changes are important, but as the saying goes, sometimes you do everything right, and something goes wrong. I have a litany of relatives who've been burdened with these cancers by fluke, food and lifestyle. Horrible disfigurement and shortened lives make for a story, but try telling that to kids growing up without parents, families suffering from impenetrable sadness and loss.

Knowing we got him on his way, no matter how long our little bit lasted, with a little more dignity, is a very good thing.

Stay tuned...

The merriest of all

Dahey brought home some caramels his coworker's wife made for us. They melt in your mouth and are simply smooth and scrumptious.

Since I didn't get my sparkling wine last night (due to a spill), I'm having it now with these caramels.

It is a wonderful dessert. I hope the rest of 2015 is this smooth and sweet.

More later...