The joys of sinus headaches

And yes, indeed, I do have a doozy, since the cold remainders are still hanging out in my upper respiratory system and sinuses. Laughing (or breathing just right) leads to coughing which leads to rattling the remaining junk...ugh!

Too many things to do today, so it's gotta go away.

Stay tuned...

Summertime's a comin'!

Signs of summer at the Hotel Rehab: certain characters call up with life-threatening "illnesses".

Here's what my travelling partner, the NP, told me today.

"You'll never guess who called me today?" she says.
"Who?", I ask
"It's the month of May. Who always calls in the month of May?" NP asks.
"I have no idea." I say
"Hint" she says, (squirrely voice) "I think I have sinus drainage that's green".
"OMG! Not again. Where's the hole now?" I say. (patient has a history of doing nearly ANYTHING to get admitted, including puncturing him/herself.)
"No hole. He/she just called and got a Z-pack." she says.
"Nice. I should have known" I said "It's air conditioning season again. Just wait. He/she will be back."

More to come...summer's on it's way!

Foul, smelly and otherwise crazy: update

I'm still finding words for what I saw and smelled recently.

We have a patient who's had an abdominal surgical procedure not once, not twice, but three times at the Hotel with us. He went to Washington, and I think every resident on that service must have worked on him/her. You'd think they'd get it right. Normally, this procedure is a slam dunk. It hasn't been lately for this patient.

Today, being a day after a holiday, is always a little weird. Things are done out of order since we have people still on vacation, meetings and bigwigs coming to visit. The unit goes from quiet one minute to absolute pandemonium all at once when you have 1) lunch trays showing up, 2) people moving around everywhere and 3) every motorized floor cleaner in our building rolling down the halls of the Hotel. It was not a pretty sight. I am so thankful I escaped with my feet unscathed.

The abdominal patient, seeing it was busy, and he/she didn't feel like moseying around early, decided to clean up after lunch. When I came back to pick up his/her stuff and dump a pan of water, I noticed the dressing and the towel he/she used was covered with tan drainage that seemed to ooze more fervently each time he/she pushed on the abdomen near the incision. By the time I ran to call the docs, he/she had an ABD pad soaking and a towel that was covered with lots of tan spots. MD and the trusty wound nurse were happy I called, because the stapled area of the incision did not seem to leak while they were in the room earlier.

For that dramatic, oozing display, said patient was whisked away to an emergency consult, where he/she was evaluated and then the specialists said, "Keep up the dressing changes. Bring him/her back next week and we'll re-evaluate it then."

The smelly: one of my patients with a newer colostomy can beat the nearest herd of cattle for methane production. If we could harness that gas, we could probably power the electric used in his/her TV everyday.

Finally, we just need a little crazy welcome back from a long holiday weekend...my brother's meds still aren't right. He's not happy, so he wins a trip to the unit where his psych actually is working now that he/she is not on vacation. I'm crossing my fingers that his regular doc can settle the issues once and for all.

And if that wasn't crazy enough, traveling partner and I are still dealing with the boss on various travel issues. Next time, I'll volunteer someone else to go to a conference with him instead.

More to come...stay tuned.

The colors of rehab

Yes, you'd see a lot of colors on our unit, and it's not just in the scrubs worn by the staff. There are colors in therapy--yellow, pink, blue Theraputty in those tubs. Next, you have the therabands in blue, green and red. The drugs even have pretty colors, too--the clear dark-red of guaifenesin, the fruity-smelling, clear with a gold tinge of liquid Neurontin, the neon yellow-green of Tygacil. Our patients have colorful equipment, too--the red, blue, black, silver, American flag print, green and even purple wheelchairs.

Also, if you didn't know it already, you see a lot of colors in the input and output for patients. The strangest thing I ever saw on a bed pad recently was an aqua-blue serous looking drainage. The patient never had it during the day, because I looked each time I turned him. I told the docs about it on Monday and everyone just said, "Oh well," and that was it.

So yesterday, I saved the pad after I cleaned him up and bluish dressing. The docs didn't figure it out right away, but the NPs took one look and they did. "Pseudomonas!", they chimed in chorus. "We have to get something to put on that dressing." MA ordered Iodaform gel, but we couldn't get it by the end of the day, so she gave me a new order to use Gentamicin cream with the dressing until the gel arrives. I fixed him up, fluffed, buffed and turned him and before I knew it, it was time to go home.

Outside, the sky was a brilliant, sun-filled blue with just a hint of the fall coolness to come and the end of another interesting day. More later!