I would like a little more precision in my doctor's language, plz.

We have a language problem here at the hospital. The nurses and doctors tell me, “You produced less bile yesterday,” and I’m like, “No, that’s not accurate. You recovered less bile yesterday. We don’t know how much I produced.”

The whole point of my hospitalization is to monitor how much bile they recover on a daily basis, on the assumption that as they recover less and less (and they claim they are, but more on that later), that my body is naturally processing it the way bodies are supposed to.

But there’s a catch: my feeding tube is currently broken. I’m getting all of my nutrition through an intravenous drip. My intestines are getting absolutely no stimulation at all. We saw a similar dip the first time my feeding tube was blocked, and once the feeding tube was restored I produced the usual 2400ccs/day (basically, the normal amount a healthy, well-fed and well-hydrated human body produces) I had when I first presented to the hospital.

So far as anyone knows, the current dip to 800ccs/day is not the result of my duodenum becoming unblocked (of both injury and feeding tube, note!), but of my not having any food at all in my guts. My intestines are a food desert. My microbiome is in a state of severe famine, whole villages of helpful symbiotic bacteria devastated. Their god has failed them.

I know I’m probably being persnickity about this, but I’m past the fear and reaching for the anger stage of my journey. I’m starving. I’m down 22 pounds from my original “healthy” weight, and I’m starting to forget what food is.

I hope the 800ccs/day figure is accurate, but I don’t think it is. And I really want to know one way or another. And we will not know until they can get a new feeding tube into me, one that stays in this time.

I am now the Training Patient Stunt Bottom

Yesterday, I got to be a Stunt Bottom Training Patient.

Back when I was doing BDSM regularly, back before COVID-19 when there was a lively BDSM community in Seattle, I enjoyed playing the role of “stunt bottom”; whenever there was a new person who wanted to learn to top, someone would attach themselves to them as a mentor. The community was quite good, on the whole, about warning newbies away from bad mentors. But once one was found, if the newbie wanted to top, who would they practice on?

Enter Elf, the stunt bottom. I endured bad floggings, wraps over shoulders and around waists, the occasionally over-delivered sting of the cane, because I was eager to show off and I really enjoyed helping people get into one of my favorite hobbies.

While I’m at the hospital, I’ve been trying hard to be a good patient. I’ve taking daily walks and publicly exercised (the equipment for angled push-ups is in the middle hallway with the “rehabilitation equipment”– and my gods, there are so many people in this hospital right now for gout. Fucking gout. I thought that was some kind of 19th century thing), so the nurses assume I’m sorta robust, at least physically, and emotionally too when I have some more say over my body. But I’ve also worked hard to preserve our respective dignities, to not flash anyone with my personal bits.

Which means that I’m now the Training Patient. It’s like being a stunt bottom, but for cute nurses fresh out of school.

Yesterday, one of the nurses came with her trainee. Now, they’re not that worried that I’m going to develop bedsores because I am self-mobile and self-motivated to get out of bed and move around, but because I am the Training Patient, this nurse decided I was the right person on which to practice placing a bedsore bandage.

A bedsore bandage is a heart-shaped band-aid with a mild adhesive, and it goes on your butt. So they had me stand up within the range of my tubes, opened the back of my gown, and I could hear the senior nurse saying, “Okay, after you take off the adhesive, you place it, with the point down, right here, just above the end of the tailbone. Start in the middle and leave some slack. Right, so now you have room to work it into the middle.”

Of course I can feel all this going on back there. It’s not anything but hands putting sticky padding on my buttocks. But I had make fun of the whole process: “Just like in the insurance commercial with the duck.”

“The what?” the senior nurse said.

“That insurance commericial. The one with the duck. You know.” I pitched my voice with a much sharper buzz. “Asscrack!”.

She just lost it. She laughed so hard she had to stand up and lean against the bed railing for a minute to collect herself.

They finished up and headed out.

The Old Elf Returns: What It's Been Like Being Off My ADHD Meds For Awhile

It has been fourteen days since I was last allowed to use my ADHD meds. I reassured the staff that I was still “somewhat functional” without them, and the sheer volume of text output over the past two weeks, plus writing TCDump and helping someone fix their Surface Pro 6 Camera Driver the old-skool way, shows pretty conclusively that I wasn’t kidding about the “somewhat functional” part.

I still feel pretty low. I couldn’t possibly work on anything big, like Scarlett or BFDLang, with my brain this addled with the drugs and the pain. Especially the pain. Every swallow is like being stabbed in the throat with a stiletto.

But it’s been interesting working without the medication. I find, oddly enough, that I have much more verbal output– my hypergraphia is in full swing now that I’m not on the medication. But it’s also very scattershot.

I use an older Unix window manager, one with “workspaces,” which is basically a full screen in which a single project can be held. You switch between them the way you do on a TV remote control– press an activate button (in my case, CTRL + ALT) and then use the Left or Right keys to go “up” or “down” a channel. And apparently, I must have learned to use this kind of manager years before I got treated, because it allows me to “channel surf” multiple projects at once, working a little on one until I get distracted, then going to another, then another. (In the course of writing this paragraph alone, I’ve checked Twitter, had a nurse come and give me vitamins, looked at my email, reviewed my “take” from my audio recorder last night, and called my mother.) Every once in a while I’ll just flip through the channels and go, “Oh, yeah, that. I should finish that.”

It doesn’t make for deep programming. I couldn’t concentrate for hours on an algorithm until I break it down and understand it deeply. Without my meds I’d never be capable of software architecture or the deeper mathematics that my current level of skill and training require. But it’s interesting, and it’s a bit like being The Old Elf, the guy who wrote a lot of stuff every day, because his brain had a lot to say.

Generation X is Starting to Suck, and I Know Why

One of the things I was able to do in the past year or so was hang out with my “brother-in-law.” He’s not really; my mother never married his father– they got really close to it when he developed Alzheimers and she spent his last years being his caretaker in exchange for which his family is taking care of her in her last years. Mom’s still sharp as a tack, though, and generally lives quite independently.

Election patterns

There’s been a lot of chatter recently about whether or not Gen-X is getting more conservative, taking on the same attitudes and beliefs as the Boomers before them, as they age. There is that old saying that you get more conservative as you get older although the truth is more disturbing: it’s that the wealthier you are the more conservative you become, and the wealthier you are the longer you live. Older people with liberal attitudes tend to be poorer, and therefore die younger. Eventually you end up with a population that’s nothing but decrepit, wealthy enough to afford decrepitude, and reactionary enough to any threats to that wealth to be nothing but “conservative.” Older liberals are simply dying off faster. (Although, to be honest, COVID-19 may reverse that trend.) Gen-X is showing that pattern more strongly than any other; Boomers, on the other hand, are starting to realize that, no really, the Republicans want to take away their Meedicare and Social Security.

So he and I are of the same age, and being with him and a couple of his friends, I’ve come to realize why. These are all wealthy men: lawyers, doctors, commercial real estate bigwigs at the top of their game. And to a man, they are done. They’ve made their money. They’ve played the game their whole lives. What they want now is the reward: they want reality to be unchanging between now and when Death comes to claim them. They earned their place in the reality they endured; now they want to enjoy it without having to do anything more. They don’t want any new apps on their phones; they don’t want to learn how to drive an electric car; they don’t want to have to memorize your pronouns or learn how to respect you if you don’t fit the categories they’ve understood their whole lives.

And that’s really it. They fought for a place near the top of the Great Chain of Being, completely unaware of how heritage and luck (and heritage is luck; they had the good fortune to be born to wealthy parents after all) played its role in putting them there. They think they deserve the world they have, and resent any idea that they would have to live in a newer, different, more complicated one.

I’m queer and neurodivergent. The first means I can never afford to be “done;” the world is still constantly working to figure out “why queer people and can they be ‘fixed,’ and if not, should they just be killed?” The latter means I don’t want to be “done;” the new world, the one coming, is still more interesting than the old one, still more beautiful, still full of interesting people, still alive, and I hope to keep it that way as long as possible.

Medical Update: Getting Food, but Also Getting Bad News

Well, the good news is that they got the feeding tube in this time, and this time I didn’t immediately cough the whole thing up in one giant, disgusting mess.

Having gotten the tube in, I met with a different dietician and we had a lovely, sparkling conversation about food and diet and all that, and she agreed to change the formula I’m “consuming” from Pivot to Osmolite. The difference is that Pivot is made entirely of molecules that are “pre-digested;” that is, they’re the molecules of protein, fat, and sugar that your digestive tract can absorb without any processing. Osmolite, on the other hand, is made of things like safflower oil, soy protein isolate, and maltodextrin– the chemicals from food that require some sort of processing by your digestive tract (mixed with stomach acid & bile, and handled by the bacteria in your microbiome) before your body can absorb them.

That was the good news.

The bad news is that we’re flying blind here. We have no idea if my duodenum has opened enough to process any bile, much less enough to process the Osmolite. The feeding tube is still in there, taking up some of the space, too. Worse, the “reduction in bile recovery” they were seeing earlier (you might recall my rant about precision in language from earlier) seems to have been an artifact of my being “nutritioned” intravenously: without stimulation in the digestive tract from the substances being pumped in by the feeding tube, my liver had little reason to produce as much bile as usual. Now that the feeding tube is active, it looks and feels like bile recovery is as high as it’s ever been, and there has been no change, no healing, in my duodenum at all.

The CT for tomorrow has been canceled. My lead surgeon came in today at around 8:00pm. I expressed surprise that he was here so late. “Oh, I had an operation that took longer than expected, and I figured I owed you an end-of-week visit.” He said the CT scan had been cancelled because they only do one if they think it’ll show something that will change the current course of action, and until they start to accurate bile recovery counts there’s no reason to suspect that it will. He tried to make it sound “chipper” by relating tales of people who ended up nil-by-mouth for the rest of their lives, but that only upset me more. He said, “I want to give it at least two months.” The last time I talked to him he said duodenal injuries like mine usually resolve “within two weeks.” I also said that my floor doctor had put into motion the idea of doing this waiting at home, with a cart for both the bile recovery and the feeding. “Never sent anyone home with both tubes in them. That stomach pump tube has to be replaced every four weeks anyway. And you’ve had so much trouble keeping the NJ [the feeding tube– Elf] unblocked. Not sure that’s a good idea. But it’s your call. You’re the patient.”

I’m not handling all his very well at all.

Omaha did show up today, and we held hands and took a walk and she helped me get undressed and chaperoned my taking a shower so a nurse didn’t have to. After I was dressed, the nurse came to hook me back up. She said, “I’ve never seen a couple quite like you two before. You’re so lively. Like, I hear you arguing, but it’s playful, it’s not like any other couple I’ve ever met. It’s really nice to see.”

I taught her the word biritululo, which means to “argue loudly over something trivial as a way of relieving tension,” and how Omaha and I use that word to make sure any arguing we have is really identified as utterly trivial compared to the love and affection we have for one another. She was surprised when I said that we’d been at this for 36 years, and I did say that the first few years were “rough” (and they were), but since we stuck it out (we’re both children of divorce, so I think we’re just too stubborn and committed to doing anything but making it work), but now we’re just… us, and happy to be together.

I spent an hour or so playing Dead Space. It runs surprisingly well on my Ubuntu Surface Pro Six. And I played a little of Tesla vs. Lovecraft, which is hilariously fun.

But I miss food. I miss being able to move in bed without pain. I miss my life. I miss being able to think clearly. I miss… everything that’s not this sucky, lousy, little world, this hospital bed, these tubes, these medications.

I miss living.