elfs | Entries tagged with covid

I really should stop talking about my COVID-19 hospitalization in spaces with normal people. When someone asks me why I mask so routinely, I sometimes explain that the first time I caught COVID it sent me to the hospital twice, for a total of a month, including short-term disability, because my “recovery” the first time was a mirage that hid the real damage that damned virus did to my insides.

The explanation is counter-productive, because they’ll just nod sagely and say, maybe not in so many words, “Ah. That explains it. You’ve been through something horrible and are afraid to experience it again. That explains why you’re not willing to be free and share the air with the rest of us. You’re trapped in your trauma.”

As if there was something irrational about wanting to avoid a disease that

lowers your IQ by an average three points every time you get it

quadruples the risk of urinary incontinence in men my age

can cause erectile dysfunction, loss of testosterone, and “direct testicular damage”

destroys the body’s ability to respond postively to exercise

destroys your ability to fight other infections

can cause brain inflammation leading to mental illness

doubles your risk of developing diabetes

significantly raises your risk of heart attack and stroke

does progressive damage with every re-infection

is seventeen times more deadly than influenza

… and yet, somehow, I’m the one who needs pity and understanding because I’m not willing to risk what’s left of my life and my health after nearly dying of it the first time. As if I’m the one who need accomodation.

Just fuck off, the lot of you.

Current Mood: angry
Current Location: Norwescon '46

Being in the hospital, you start to realize just how much even high-end of medicine is a kind of voodoo. The surgeons and other doctors rely mostly on their own experiences, trying to find similarities between your case and things they’ve seen before.

Unfortunately my case is unlike any they’ve ever seen before, so the only thing they can do is really guess. I’m sure the gastro-intestinal people have seen a lot of collapsed duodenums and collapsed intestines over the years, but this particular reason, this particular set of circumstances that caused the collapse, they have not seen. Hematomas are not common in the location where mine occurred. The question is still: will it resolve? And when it resolves, when it dissolves enough that it’s no longer putting pressure on the intestine, will the intestine have been damaged to an extent that the bypass is still necessary?

These people have no answers. They just don’t know, not in my case. So they’re guessing and they’re guessing as conservatively as possible. They don’t want to go in and cut while there’s still information that would just make it worse, and they don’t want to go in and cut because in their experience the fluid buildup in the abdomen resolves itself if the body is well cared-for.

I feel like I’m being well cared for here, or at least I’m being medically cared for, which I guess is sort of a different thing.

Current Mood: cynical
Current Location: Hospitalized

As always, this includes some medical details that probably constitute TMI (Too Much Information).

Yesterday, I merely endured, with the help of an extremely powerful drug, ketarolac. Ketarolac is an NSAID, a drug in the same family as ibuprofen, aspirin, and naproxen sodium, but it is so strong it has a black box warning about the risks of kidney failure and related conditions. They’re allowing me to take it because my bloodwork indicates my kidneys and liver can handle it. In less than 48 hours, I will be forbidden from taking any more. I’m genuinely terrified of when that happens, because my pain without it is quite severe.

But NSAIDs are pain relievers second. What they are first is anti-inflammatory drugs. When I spoke to my surgeon, he said that the blood mass had shrunk to something about the size of his thumb, but the location on the CT scan says to him that it might even have been in the outer lining of my duodenum (which is why there’s no bleeding inside my intestine) and its location may be causing irritation and inflammation.

As 10 Tuesday night approached, I asked the nurse for the volume of bile recovered and the interval. She said it was 300ml. “Really?” I said. “When was it last emptied?” She looked it up and said the computer recorded the last emptying at 3pm.

The human body produces approximately 100ml/hr of bile. At my highest output, I was producing a superhuman 145ml/hr as my body desperately sought to find any way to start digesting food again. Over the past 16 days, I have consistenly been producing that 100ml/hr, only to have all of it recovered by the stomach pump, and none of it getting into my actual digestive tract where it belongs.

The rate and interval the nurse gave calculates out to a recovery rate of 42ml/hour.

That is a huge drop. And it indicates that maybe, just maybe, I’m healing inside. That I’m finally clearing the blood mass and have reduced the inflammation to the point where the fluids my body produces to digest food are being reabsorbed and processed naturally by the kidneys. An indicator of that is also that I’m having to piss much more often, and in greater volumes.

I had trouble sleeping after that. My brain wouldn’t shut up, wouldn’t slow down; the day nurse I had that day was the same one who clogged my feeding tube several days prior, and my faith in her is low. Maybe she had missed recording an emptying of the recovery jar, and the data was faulty? I had hope, and I had anxiety, and then from the other end of the floor I heard shouting, an angry voice, a man not happy with where he was or how he was being treated. There was paging for security. I wanted to sleep without drugs, but I finally asked for some lorazepam, hoping it would switch my brain from “spin cycle” to “warm delicates.”

Over the nine hours since waking this morning at 6am, the rate of recovery has been 55ml/hr. That’s entirely in the wrong direction, but it does indicate that the 42ml/hr reading may not have been a fluke. I hope it’s not an indicator that once again I’ve seen a false light at the end of the tunnel. It’s still half what it’s been for the past two weeks, though! My surgeon says that he’ll consider withdrawing the stomach pump only if the recovery rate drops to 25ml/hour and stays there; that will mean I have enough passthrough that I could probably handle all of my own bile production without mechanical assistance.

Hope… hope is a fragile thing. I’ve been despondent, and now I’m terrified of losing ketarolac as my lifeline to a relatively pain-free day. The good news on that front is that my doctor says in these circumstances there’s no “rebound inflammation;” if the ketarolac is knocking the inflammation down, it’ll stay down. I don’t know what’s going to happen over the next 24 hours, but I hope the numbers start to trend in the right direction, because if they don’t, I’m gonna need a lot of lorazepam to sleep, and I’m gonna need opiods just to survive the day, and I don’t want either of those. Sleepy and stupid is not me, and it’s not for me.

I also have this maddening suspicion that if the powerful anti-inflammatory they’ve had me on for the past two days was the secret all along, we could have hurried the healing process along with a drip of prednisone after the second CT scan. I hope the surgeon comes by today; I’d like to ask him about that.

Omaha visited yesteday and today. Yesterday, she snuck– fully clothed, sadly– into my hospital bed and, despite the three sets of tubes connecting my body to life support equipment, we managed to snuggle for almost a half hour before a “low supply” warning required she get up and let me call a nurse.

I was awakened at 6am by the phlebotomy technician, who took my vitals and my blood. She was young and inexperienced, and sometimes being a Training Patient is no fun. She brought in the sampling kit they hang on a hook outside my door, put the tourniquet on my left arm, and then proceeded to set up her whole rig: collection vial, butterfly needle, bandages. My arm throbbed painfully for two minutes before she was ready. When she was done, I gently pointed out her mistake, and said, “Never forget that while you’re going through your checklist, there’s a patient here. Don’t involve the patient until you’re ready to start the procedure.” She promised she would remember.

I asked about the shouty patient. “Oh, that. He was unhappy. Now he’s not.” That’s all she said. It sounded kinda creepy, the way she said it.

Today, Omaha’s visit coincided with my mother calling, so we had a family conversation. Omaha and I walked my laps around the halls, getting me the exercise I need, and then she chaperoned my bathing so I could wash my hair. My scalp is so dry in this utterly purified air.

Current Location: Hospitalized

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.

Current Mood: chipper
Current Location: Hospitalized

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.

Current Mood: annoyed
Current Location: Hospitalized
Current Music: Ayreon, The Human Equation, Day 4: Mystery

Today has been a small disappointment, a modest success, and a huge disappointment, in that order.

Yesterday one of the nurses saw that on the list of assignments I was supposed to be getting zinc, so she took two zinc tablets, put them in warm water, and tried to crush them as well as she could before putting them into the narrow feeding tube. She failed so the tube ended up blocked by the tablet. By the end of the evening I was back on intravenous feeding: saline, glucose, potassium, andh electrolytes, with daily additions of micronutrients. My insides are now completely deprived of food.

I was scheduled for a return to Interventionist Radiology to try and unblock the tube. At 1:30pm today they came and wheeled my down there and we went through the same procedure as the time before. Unfortunately, this there was no success. Lacking additional time or consent to sedate, we had to reschedule, again, for the procedure be attempted once more later that afternoon by a more experienced physician and with my consent to sedate me and replace the tube if necessary.

When I get back from the procedure, I ask the nurse if I can take a walk before she hooks me back up again. She agrees, so today I did eight laps around the floor (about 1600 steps, total), plus two sets of 6 high-angled push-ups (just enough to wake up the muscles in my arms), two sets of 12 calf-raises each, and one set of 12 squats. Still hard to find ways to do hinge or pull exercises. My nurse says “You weren’t kidding, were you?”

“Nope,” I said. “And it’s nice to remind my body that I’m coming to put it back into shape once I break out of this place.”

So at 3:30 a “transport assistant” comes and wheels me down to surgical prep, where I wait in a very cold room while we go through what will be different this time. I sign the consent form for a big dose of anti-anxiety medication to handle how I’ll feel if they have to replace the tube.

The new doc goes through the same process as the previous one and with the same results. After three or four tries with different kinds of, basically, drain snakes, he gives up and says, “Okay, we’re gonna replace the tube.” Since I’m not technically going to be “sedated,” just relaxed, a nurse anesthesiolgist administers a big dose of anti-anxiety medication which, to my surprise, works quite well. I can feel everything going on but I just kinda sorta don’t care that much. He pulls the entire old tube out, the most traumatic part of which was disconnecting the “sinus bridle,” a silicone thing that’s actually wrapped all the way up and around the nasal bone to come out both nostrils and provide a secure mount point for the hose.

And then he puts the new one in. It’s uncomfortable, but as I said the medication makes it so that I don’t really care. I make the appropriate noises, reminding him that “If I feel something is really wrong I’ll let you know in clear English.” I’m clear-headed and communicative but I’m able to handle this disgusting, sinus-and-palate-beating experience without too much concern.

All seems well and they wheel me into recovery. I have only the TV for company and it seems like every channel is half advertising. I’m sick of having my attention span shattered by shit like that.

Everything seems fine for about half and hour and then, suddenly, I start to feel nauseous. I sit up hard in the bed and bend over and begin dry heaving. Nothing is coming up– I haven’t had food in days, the bile pump had been hooked up during the procedure, I was as empty as Liz Truss’s economic plans.

Then suddenly, I cough hard, gag, and the entire feeding tube comes out of my mouth. I hit the panic button and the nurse comes running. They immediately grasp what’s happening and call the gastrointestinal surgeon who put it in. Realizing the problem instantly, he agrees to cut the tube where it exits my mouth, frees it from the bridle, and we pull the last 20cms back through my sinuses.

The procedure is a failure. My body rejected the implant.

Because the “procedures” were so widely scheduled, I didn’t have any visitors today. No sense since nobody could know when I was going to be available. The bridle is left in place in case we try again tomorrow. I’m back on the intravenous nutrition thing again.

Today has been a real thrice-damned disappointment, let me tell you.

Current Mood: distressed
Current Location: Hospitalized

Today, I had a major breakdown, a kind of panic attack. I awake for the first time in ages after 7am, and I was feeling pretty good. The stomach has an orientation; sleeping on your right side elevates the esophageal valve and submerges the pyloric valve; this is the correct posture you want if you want food (and medicine) to be processed as quickly as possible into your intestines. I’d been a lifelong right-side sleeper for just this reason, but when I blew out my rotator cuff last October, and especially after the surgery in May, I was unable to sleep on that side anymore.

Last night, I slept on my right side anyway, using a lidocaine patch to suppress the pain response. It made a huge difference; I processed much of the vile rather than having to have it pumped out of my gut, and I slept much, much better.

Or so I thought.

About three hours after I awoke, Omaha arrived to find me in absolute meltdown, tears running down my cheeks. I don’t know how my body interpreted that sleep, but suddenly the initial stages of bile reflux disease vomiting were manifesting hard– uncontrollable drooling, massive phlegm production, nausea, anything my body could do to convince me to throw up the mass that couldn’t possibly be in my stomach with all the pumping going on. The tubes in my throat were so sore it was like I was being stabbed in the neck, and it hurt, oh it hurt. I couldn’t stop crying. They gave me a large dose of pain relievers and Ativan and I fell back asleep. Omaha, goddess keep her, stayed until I was out, then went to get lunch.

When I came to around 3pm, Omaha was still there. We talked and caught up, and then played a few rounds of card games before she headed out.

Around 5, a nurse came in with a small medicine cup with pills in it. “It’s your vitamins,” she said. She crushed them– poorly– with the back of a syringe, and then tried to force the mix through my feeding tube. Which ended up being completely blocked. And then she tried to blame me for “kinking the tube” with all my flailing about during the panic attack. No, you either get it in liquid form, or you put it in the stomach pump tube, flush it down, and let me right-side present for 20 minutes to get as much of it as I can past the duodenal damage.

So my nutritional needs have been “reassessed” and I’m being fed intravenously again. This utterly, utterly sucketh the bong water of the most diseased. In the meantime, I’m going to be scheduled for Interventional Radiology again tomorrow, where I get to make more Bugs Bunny sounds, again.

I’m stable enough again to write this, at any rate. Mad as hell. Forced to take more of it. But stable. Tired again, too. Tired of everything.

Current Mood: aggravated
Current Location: Hospitalized

When I was hospitalized and declared NPO (nil per os, “nothing by mouth”), they hooked me up to a feeding machine that supplied 1500kCals of low-residue pap.

Early Thursday morning, they switched me from intravenous hydration to hydration through the feeding tube, which delivers nutrition past the constriction in my upper intestine, and I could already tell it wasn’t enough. I complained about it. I told them about it. The nurses were sympathetic, and they said, “We’ll talk to the dietician, but this is the amount of water a 56 year old man of your weight and profile should be getting.”

On Tuesday, I was able to walk four laps around the floor. On Wednesday, the same. On Thursday, Omaha was escorting me around the floor for my laps, and I made it halfway around the floor before I collapsed to the ground, exhausted. I knew these symptoms. I was dehydrated. I told them.

The dietician came and assured me I was getting enough. “No, I’m not. I am not a couch potato. I am an amateur athlete with a strong hydration game. I need more water.” My blood pressure was dropping fast and my heart rate was sky high. I demanded a lab draw for dehydration and hypovolemia. She consented.

“Oh, she also ordered 1500ccs of water, double rate, immediately,” like it was the most casual thing in the world to admit that they had pushed me into hypovolemia by a liter and a half.

About two hours later, the nurse comes in and casually says, “So, the dietician says we need to double the amount of water we’re giving you.” And she plays with the feeding machine to set it. Then she starts futzing with my intravenous line. I ask her what that’s for. “Oh, she also ordered 1500ccs of water, double rate, immediately,” like it was the most casual thing in the world to admit that they had pushed me into hypovolemia (not enough fluid in my body) by a liter and a half.

One thing I later learned was that my condition had not been correctly explained to the dietician. She understood that I had an intestinal blockage, but it had not been clearly explained in my chart that meant I had bile reflux disease, and that the stomach pump was removing one to two liters of digestive fluid that had nowhere else to go. Her water recommendation had not accounted for that artificial removal.

The intravenous water was chilly. When you go to sleep, your body’s core temperature drops to preserve metabolic resources during the cool hours of the night, and apparently deliberately lowering your core temperature signals your body that you’re sleepy. I fell asleep quickly and napped for three hours.

When I came to, I was feeling much better. I finally had enough water in me. I was partially human again. My blood pressure immediately returned to a very normal 120/80 and my waking heart rate dropped below 100 for the first time in three days. As one of my mutuals on Twitter put it, “Doctor, you’re a valuable and appreciated consultant, but as the sole occupant of this particular body for the last 50+ years, I happen to have a little bit of accumulated expertise on it myself. Heed me.” Indeed.

Now I look forward to being well-watered every two hours. I feel a little queasy when it’s done– it’s a lot of water in a short period of time– but it lets me stay conscious, and today I was able to complete one lap around the floor twice in the same day.

Now, to be fair, they had a valid concern. Most men my age would develop swelling and edema in their calves, because their calves are weak and underpowered, with that much water in them. But my calves are built out of years of hiking and bicycling, and I will start developing that risk if I don’t get out of here soon and get back on the bike and the calf lifts and all that. But grief, it shouldn’t have taking friggin’ begging and a dramatic collapse in the hallway to convince them the problem was real.

Current Mood: cheerful
Current Location: Hospitalized
Current Music: The Anguish of the Mariners/Astros Game

I’m stuck in the hospital again with very little to do, so I’m Very Very Online now, going through Twitter, and there’s been a spate of COVID denialism and or “The COVID emergency is overblown.” And I really want them to come say that to my exploded abdomen, lacerated face, and broken intestines.

And the worst is that “How did you get a lacerated face from COVID?” I explained that I developed “Covid-induced retroperitoneal hemorrhaging.” The blood loss caused me to pass out, smashing my face onto the floor. The resulting blood mass in my abdomen is pressing against my duodenum, making it impossible for me to digest food.

“Ah, so COVID didn’t lacerate your face.”

If you’re sitting at a traffic light and some drunk douchebag slams into you from behind at 35 miles per hour and pushes you half over the car in front of you and you land into the left lane which is oncoming traffic and the oncoming car there hits you hard enough that through the deflating airbag you still fracture your nose against the steering wheel, you don’t blame the steering wheel, or the guy in the oncoming car, or the car you careened over, for fracturing your nose. No. You blame the douchebag who set the whole accident in motion.

This is common sense logic that any mature adult understands. So, yeah, by this common sense logic, my lacerated face is “from COVID,” not “with COVID.”

Current Mood: angry
Current Location: Hospitalized

While I was hospitalized with COVID, the good thing about the hospital was the immediate staff, the people I saw every day. Most of the nurses were cheerful, kind, and competent; a few were of the brusque variety, and the only one about whom I have questions was somehow the white guy.

The white guy was my second nurse, the one on my floor Thursday night. I asked for some earplugs and he said, “I don’t think we have any of those.” I was disappointed, but soon thereafter Omaha showed up with my custom-fitted ones and I managed to get some sleep despite the very loud HVAC system. I say he was a disappointment because the next night one of the nurses saw I was using a t-shirt as a sleep mask and brought me a little bags with earplugs and a real sleep mask. I asked where she got them from, and she said, “Oh, we keep these in a cabinet.” I said to her, "Good. Could you please tell Ian^* where they are because he said you didn’t have any."

I had to take sponge baths, which could be humiliating for someone with more body shame than I have, but the nurses and I worked to maintain our respective dignities. One nurse said, “It’s fine,” but I said I didn’t want to be abusive or a creep because nurses, like hotel housekeepers, get way too much of those. “You’re fine, you’re not of those,” she said. “I can tell.” I’m glad she can; some days, I’m not sure I can.

The attending doctor and trauma surgeon need to up their communication game a bit because neither was very clear on whose responsibility it was to discharge me toward the end; it turned out both of them had to sign, and that was efficient enough.

Overall, every nurse was a goddamn saint. They all deserve to be canonized, but more than that, they deserve to be paid a hell of a lot more, and they deserve better hours, and they deserve more support.

Hospitals like this must be a nightmare for white supremacists. The vast majority of the staff are POC. The CAT scan guy was Nicaraguan, my oral surgeon was Ethiopian, my admitting nurse was Jamaican (and really cute!), and the rest of the staff was almost entirely POCs. The other physicians, the attending and trauma docs, were white; funny how only the Ethiopian one seemed to care about my well-being, the rest treated me like a component on an assembly line.

And, y’know, the food wasn’t that bad at all. People mythologize how bad hospital food is. My one deserved complaint is that it was loaded with too much sugar. Every tray had jello, fruit juice and soda. By the time my side table had three ginger ales on it, one nurse said, “You don’t want the soda pop?” I said, “I’m a savory fellow. Please bring me more hot tea and hot broth.” And blissfully, she brought me a lot more tea. Lipton, but I was in no place to complain; it was tea, dammit, and that meant I would survive.

I did learn never to try eating an orange off the rind when you have a lacerated lip. Ouch! And I bet every time Julia Child was due to be hospitalized she snuck a small bottle of salt in her purse.

So the people were great. The policies… not so much.

“Skipping doses or starting and stopping an antiviral medicine can allow a virus to change/adapt so that the antiviral is no longer effective. This is antiviral resistance.”

First and most egregious stupidity of all: after taking three doses of Paxlovid (night, morning, night), they confiscated the rest of the box and didn’t let me have more. You do not interrupt a course of antivirals! Do you want nastier variants? Because that’s how you fucking get nastier variants! It’s just the same as with antibiotics!

You know what they gave me instead? Vitamin C and Zinc. That was their “Covid prophylaxis protocol.” Vitamin C and Zinc. I was in the friggin’ dark ages.

The selections on the TV were terrible, with far too many religious shows.

And the hospital is already breaking down, with the halls filled with patients who have no beds, beds that are well past their lifetimes and don’t work well anymore, patchwork plumbing and HVAC. If that’s more representative of hospitals elsewhere in this country, I’m very afraid of what the next decade will bring in healthcare.

^* Any names changed to protect the various.

Current Mood: worried
Current Music: Rocket Scientists, It's Over

During my COVID isolation in a three-star hotel in Fort Lauderdale, I found myself doing something I do not ever do. I found myself watching television. Premium mediocre television, but still, television. I watched a few movies on HBO and Cinemax, and even some on commercial television.

Later, I was hospitalized with that COVID. While I was in the hospital I noticed that my roommate perpetually watched the television. He was up all night long, watching the television. My next roommate did the same. They never turned the television off. And when I described that behavior to my mother, she said that she had the television on all day long.

I never turned my TV on; it was broadcast only, taking even the “premium” out of its mediocrity. Omaha was beautiful and brought me my laptop, e-reader, phone, and notebook (and all the relevant chargers, too!). I spent my time reading, researching, and yeah, bragging about my survival and my brief fame as The Bed Whisperer.

Due to circumstances beyond our control, Omaha and I were authorized to fly on different days. So I got home Sunday night, and Omaha was to fly home Monday night. I… I pushed myself waaaaaay too hard Monday night, probably did extra microembolism damage inside my peritoneal cavity, but in some ways it might have actually been worth it. Only my future self will be able to make that judgement.

But in that time, I found myself watching television again. Well, a movie, the last Bond film. And as I did, I asked myself why I was watching television. And the answer was simple: My alters, The Council and the Stable were as sick and fatigued as the rest of me, and none of us could really think well. We were all quiet. Tired.

We don’t want to be lonely.

Omaha and I are still watching television over other activities. It’s fine and passive, and it means we don’t have to move much, risking inflammation. She’s a huge fan of her childhood favorites and we ended up watching Barney Miller, the comedy that, I believe, bridges the gap between Steve McGarret of Hawaii Five-O (a “perfect cop”) and Norman Buntz of Hill Street Blues (a “corrupt cop”). After a few episodes, I realized that over half the “cases” dealt with by Barney Miller and the rest of the 12th Precinct were about lonely people dealing with their loneliness in inappropriate ways.

Some of us cherish our time alone, but none of us want to feel lonely. For those who have no one, television fills the hours with a kind of companionship, a sense that humanity is happening, at least somewhere, and letting you in on it, at least a little bit. I’ve spent a lifetime learning to live with myself, create personas for the thoughts (not really “voices,” not as I understand it) in my head (if they are “voices” as other experience them, mine are all very friendly and helpful, but I cultivated them to be so).

I’m eager to get back to full health, to be capable again, to have Girl Scout, Muse, Code Fairy, DJ Earworm and the rest back at their respective helms (do they have helms? I should ask Muse; she would know). And true to my sages, I must find, now, how to manage the interior loneliness that will come as I get older.

No silence today. There’s always a silence tomorrow. What? Look, somebody’s got to have some damn perspective around here! Silence.

Current Mood: tired

To the nurses, I am the bed whisperer!

Unfortunately, Not like that. But it’s still cool.

During my recent hospitalization, I was stranded on a hospital bed. Since I had fainted due to blood loss, I wasn’t allowed to get out of bed without an attendent. They even had frickin’s lasers watching and if the lasers sensed both feet on the floor an alarm would go off.

Nurse’s panel

Worse, the beds were broken. But, as someone else said recently, “I have ADHD, an internet connection, excellent research skills and poor self-regulation.” I took photos of the nurse’s side panel and underside to identify the make and model, downloaded the manual, discovered that it was no help at all, but ultimately found MedWrench, where nursing home technicians exchange gripes, complaints, and potential solutions. They hate this particular bed, but it’s popular because it’s cheap. Quelle surprise.

At one point, the nurse was struggling to make the bed go up. “Let me,” I said. “I’m the bed whisperer.” I reached through the handle, pressed the Global Lock + All Lift Locks buttons simultaneously, then pressed the specific lift she was looking for (raising the head of the bed).

“You are the bed whisperer! How did you do that?” She looked incredulous.

I explained, and I said I didn’t know how long that hack would last before the bed failed entirely. MedWrench says after that, you have to dig a panel open and re-seat a chip on the control board; it’s poorly held in and falls out if you move the bed too often. The most approved technique is to drill an 8mm hole at a location shown in various images and push the chip back in with a pencil eraser.

A little later, a nurse was checking on my roommate. She shuffled over to me and said, “Can you show me how to unlock the bed. The other nurse said you know how.”

“I can’t unlock it if that’s not working. But I can show you how to override the lock while you’re using the bed.” I showed her the trick (Hmm, two in the front, one in the back… I should nickname it The Shocker!), she went to the other patient, I heard the whirring and she shouted, “It worked! Thank you!”

Pretty much by the end of the day the nurses had all taught that trick to each other.

As I said, I have excellent research skills. But I refuse to believe that an entire hospital full of professional nurses had no one with curiosity and mediocre research skills to relieve a serious, ongoing problem. It boggles my mind that no one at that hospital had done what I’d done– downloaded the manual for a thing they use every day, then looked further when the instructions in the manual didn’t work!

A friend of mine suggested I have a programmer’s mindset– we get libraries and toolkits with crappy documentation and are used to supporting each other by giving out tips and tricks when we ask. But surely that’s not unique to my profession? Are we the last bastion of problem solvers in our species? No, I don’t believe that at all. But what to make of the fact that a patient had to solve one of their most commonplace irritations?

Current Mood: bitchy
Current Location: The Villa Sternberg, isolating with Covid
Current Music: Mad Max Fury Road OST, Water

“Wow. That is a lot of blood.”

Now, to be honest, this may have been a masturbation-related injury.

I caught COVID-19. I had traveled to Florida and family convinced me to go to Disney. I had all four shots: initial Pfizer, Pfizer first booster, Moderna second booster. I tried to mask reliably, but one still has to eat, and I felt safer outdoors; I shouldn’t have, but I did, so I took it off when outside. There were still too many people, too many crowds.

And so I caught it, probably BA.5 or BA.2.75. I isolated in my hotel room, now in Fort Lauderdale, and got a prescription for Paxlovid, and was doing okay. Not great– every swallow felt like I was gargling broken glass mixed with thumb tacks– but okay. Omaha had gotten another room to isolate away from me, and the hotel was being more than accomodating. The morning desk person was terrible, tried to kick me out even though Omaha had negotiated with the manager for the extension; but after calling the manager not only did we get the extension, but they left us plastic bags of their complimentary Continental breakfast (oranges and four cups of yogurt) at our door. So everything seemed under control.

But I was bored. And you know, when a healthy man is bored, and there’s nothing on TV, he, er, takes to stroking his, er, boredom away. So I did. And I hadn’t gotten anywhere yet when I felt this sharp pain in my gut. So, I stopped. Awhile later (like, a whole movie later– Free Guy, great film, I want to watch it again as I missed the first 45 minutes or so), I realized I hadn’t had much food or water that day, and the disease makes you sweat like Alex Jones facing judgment, so I got up and filled my one-liter bottle from the tap. I drank about a quarter of it, still didn’t feel great, got into the shower since showers are my go-to source of warmth, isolation, and white noise comfort. I realized that wasn’t making me feel any better, so I turned off the shower.

You know those 80s video games, the arcade ones where the display’s memory is just part of all the memory on the motherboard? When the game boots up, it needs that memory for other things, so the screen is scrambly and weird until it hooks into position zero of the game’s program counter and behaves correctly. I was suddenly kinda like that.

My mind was a very dark grey, almost black, the threads of thought random and colored dark red. The narrative that is Elf started to cohere, the threads grew thicker and bundled together, and I opened my eyes. I don’t remember questioning why I was on the floor. But it was wet and cold, and I moved to turn over and my hand splashed in… red.

Blood?

“Wow. That is a lot of blood.”

I stood up– pulled myself up, using the countertop, really– looked at myself in the bathroom mirror. I knew where I was and who I was, but that guy in the mirror had the widest staring eyes I’ve ever had. There was blood in my hair and all down the right side of my face. There was blood on my chest. I was naked, wet, and cold. “Wow,” I said. “That is a lot of blood.” I looked under the counter and, yeah, there was a lot of blood, a puddle at least 30cm in diameter, ringed in water from my wet body. Naked and bloody, I stumbled into the bedroom, found the phone, realized I couldn’t read the instructions, stumbled to the bed, found my glasses, got back to the phone. “Hi, uh, I just woke up in a pool of my own blood. Could you call me an ambulance?”

“Oh! Uh, yeah, sure. Room 511, right?”

“Yeah.” I hung up, then found my cell phone and called Omaha. “Honey? I just asked the front desk to call me an ambulance. I just woke up in a pool of my own blood.”

“I’m coming over there!”

She did. She found me on the bed. She answered the phone, and took advice from the paramedic on the way about how to stop my nose from bleeding so much. The paramedics arrived and began asking me questions, which I answered competently. I knew my name, date of birth, address of record, and so forth. I could still quote Shakespeare. (It’s Marvel canon that whenever Tony Stark suffers from a concussion, he recites the ending of Hamlet, Act 2, Scene 2, that whole “For the Devil hath power to assume pleasing shape…” speech, to make sure his brain is still in working order.) Sheriffs arrived and determined it was not a crime scene. The paramedic asked, “Do you want to go to the hospital?”

“Hell, yes.”

“Let’s go.”

A reconstruction of the incident now includes one relevant detail: I was on that floor, unconscious, for an hour and eleven minutes. That’s what the Fitbit says; I was still and unmoving from 5:39pm until 6:50pm. I count myself lucky to be alive, to have come to at all.

One hour, 11 minutes

While we were at the hospital, I was seen by another sheriff who wanted to check the story. When I got to the point about not masking when outdoors at Disney, he snorted and said, “You gotta live your life.” My life is sexy, academic, athletic, and somewhat internal. I live a lot in my own head. Disney was a high risk, and I shouldn’t have done it. There’s not even a viable Truvada for COVID.

At the hospital there were no trauma rooms, so I was left on a gurney in a hallway. I complained about neck pain and was immediately put into a neck brace. Annoying. I met my admitting nurse, who was relentlessly cheerful, Jamaican, adorably hot, and competent as hell. She sent me to a CAT scan, where…

We discovered that I had hemorrhaging and blood in my peritoneal cavity, but my temperature was stable so there wasn’t peritonitis or sepsis. That pain I had felt was COVID shattering blood vessels in my abdomen. Not only was there a lot of my blood loose on the hotel bathroom floor, there was a lot of blood loose and sloshing around in the space around my intestines. I was immediately admitted and a battery of tests were conducted.

The good news, such as it was, is that my hemoglobin levels stabilized almost immediately; my body had recognized the damage and clotted quickly, starting the healing process.

I probed: A cut on my scalp, but very small. The left nostril had been bleeding freely, the right less so. The most damage was a laceration on the inside of my lip, a deep and wide self-inflicted bite wound when I fell. A doctor showed up and gave me very painful injections of lidocaine in the lip, followed by three stitches that he said “Have to be looser than normal so the wound drains properly. The mouth has the most germs of any place, even your backside.” Somehow (“Somehow?” C’mon, Elf) I knew that already. But he was both kind and hella competent, and sewed me right up. As he did, someone in the ER started playing “When the Saints Go Marching In” on a harmonica and… it was kinda nice, actually?

The ER Trauma surgeon, one of those tall, thin, early 30-somethings that

I am more than okay with born psychopaths being surgeons. They get to be well-paid, lauded as heroes, love the challenges, and have no hesitation to cut into people to show off those hard-earned skills.

radiates with health and competence, listened to my story, shook his head with a little smile, said “Fucking COVID” as if it had brought him fascinating new problems, and then gave that little laugh only born psychopaths are capable of. I’ve known a few. This guy was totally in the mold.

Battered, bruised, bleeding internally, happy to be alive.

Somewhere in there, Omaha arrived at the hospital, I took photos of my wrecked face, and we waited for the admissions process to move forward. She liked the nurse as much as I did.

I was put into an ER room, and Omaha went back to her hotel, utterly freaked out, as emotionally wrecked as I was. Eventually I was moved to a standard hospital bedroom, where I had a roommate and a very loud (65dB according to the sketchy sound meter on my phone) Corsi-Rosenthall box. And it was friggin’ cold, but viral infections always wreck my ability to manage my internal temperature. He also kept the TV on all night long, and he stims; I can’t see him through the curtain separating our spaces, but he claps, he slaps himself, he whoops, he randomly outbursts in laughter or just random words, like a light case of Tourette’s syndrome.

And I was here for just “observation.” They would take my blood every 12 hours to make sure the hemoglobin levels stayed the same.

And I settled in for boredom. My beloved Omaha brought me my bag the next day with my books, my laptop, my chargers, my headphones, and my earlplugs! I was equipped for a long intellectual dry spell. Blood was drawn, meals were delivered.

Early on, there was some discussion as to whether or not the damage to my insides was caused by the fall or by COVID directly. The new trauma doctor, a no-nonsense woman of the highly competent stripe, told me that the trauma team had concluded it was a COVID complication. Again, research skills, ADHD and an internet connection, and I found a case study that matches mine: Unexpected tendency to bleeding in COVID-19 patients: A case of spontaneous retroperitoneal hematoma. Healthy woman, no comorbidities, no suspect medications, 47 years old. I had tenderness in the left anterior abdomen, hers was in her back. I caught mine earlier than she did, so I did not need a transfusion. It took three months for her body to clear all that blood out of her peritoneal cavity.

More to come…

Current Mood: tired
Current Location: Home, and Isolating
Current Music: Rocket Scientists, Rainy Days and Pastoral Grays

There was something that happened repeatedly on the hiking trails this past week that bugged the hell out of me: People wore masks on the trails.

SAR-COV-2 is a scary virus. It’s killed a lot of people, and it’s probably going to kill many more before this whole thing is over. Its infection profile is now fairly well-established and incidental encounters, outdoors, is not one of the vectors. There are exactly zero cases of SAR-COV-2 being transmitted by fleeting encounters with strangers.

Zero.

In over 1,200 cases of documented spread events, there is exactly one case of outdoor transmission, a jogger gave it to his running partner. It’s impossible to know how long they were in the same space, and how much they shared the same air. Another 40 happened at indoor/outdoor venues, where “it happened outdoors” could not be ruled out by investigators. 99.91% of all documented transmission cases outside of family or hospital settings happened indoors, in poorly ventilated locations. There is not a single case of transmission between strangers in a fleeting outdoor encounter.

I wear my masks all the time; I wore them long before Omaha accepted their necessity. I wear them reliably in any indoor setting: gas station, grocery store, wherever I have to be with other people. While camping, there was a flush bathroom with three stalls and I always put on my mask before entering.

But almost every time we were within ten meters of another group, they would mask up. One of the people I spoke with said “It’s about respecting the other person.”

But it’s not. Not in that setting.

In that setting, it says, “I think the world is out to kill me.”

SAR-COV-2 is not “in the air.” It’s in very specific locations– those inhabited by people in the early stages of infection, usually in enclosed venues with poor ventilation where people are vocalizing loudly. (“Venue, Ventilation, Vocalization.”) And yes, that means it can be transmitted from one person to another in that location, in that time, if you’re exposed to it long enough for the virus to overwhelm your lungs’ first-line defenses.

We are human beings, and we use each other’s faces and expressions through which to judge trustworthiness, value, and friendliness. I’ve never met anyone hostile on the trail; some taciturn and wanting to be left alone, but that’s not hostility. Some friendly and wanting to talk. The great outdoors, in a literal sense, is the one place where we can continue to be that so long as we stay apart and the breeze is fresh. To mask up in that environment is to mis-judge the nature of the beast, and to constrain yourself unnecessarily.

But more than that, it communicates not respect, but fear. Fear that the very air is out to kill you. We need to get past that, to understand the risks better, and to communicate those risks clearly. Indoors, mask up always. Outdoors in a crowd, mask up. Outdoors, ten feet apart or brushing past one another on a hiking trail, exposed to the sun and wind? It’s not necessary, and it shows ignorance and fear.