Where the hell did that phrase come from? This is a complement on a girl's figure. A compliment. Comparing a supposedly lucious bod to a an outhouse in the most vulgar manner imaginable is an apparently logical function in the English language? No wonder the migrant workers here stick to Spanish. Damn. Double damn. Now I've got that awful Commodore's song running through my head.

Posted by: Jim at 12:00 PM | Comments (1) | Add Comment
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Lil Bro is a cultured enthusiast of the spiced delight and has not been able to get a decent wing for years (They do not exist in the North Left - there's some trade agreement between Starbucks and Microsoft that precludes them). Coming home late from Stone Mountain we decided to partake of dinner at a local eatery. This particular place is called Buffalos and they claim to have been made famous by their exceptional Buffalo Wings. They are foul and cretious liars. They do not love the wing. Lil Bro and I both ordered "Scorchin" wings. This is the level beyond "Hot". In a decent wing house in Buffalo an order of suicidal wings ("Suicidal" is the correct term. Their use of "Scorchin" should have clued me in right away that they were impostors.) would be remarkably close to my own handcrafted beauties. These were not suicidal. They were not scorchin. They were not hot or even medium-hot. They were barely medium. They were not crispy on the outside and delicately juicy on the inside. They were served with a profanity of vegetable matter assaulting them. They were served with "Bleu Cheese Dippin Sauce" that most closely resembled ranch dressing with black spotules in it. This uncouth offensive against my palate shall not go unrevenged. The karmic backlash alone should, at a minimum, result in the near destruction of their foul establishment.

Posted by: Jim at 11:59 AM | No Comments | Add Comment
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This is perplexing and worrying. Perplexing because I consumed better than a six pack last night in a span of only two hours. Perplexing because I was messed up enough to jump out of bed late for work and dive in the shower only to have Lovely Wife yell out an interrogation of my efforts as it was only 12:30 in the morning. Worrying because I'm not a drinker any more. Oh, I used to be. Back when I lived at E's place there was a keg fridge in the basement and we rotated those on a very regular basis. But since marriage and children happened, my semiregular bouts of debauchery have ceased. My once legendary tolerance for the amber potion has evaporated. In the past 4 days I've consumed more than I probably have in the past 4 years. By all rights I should have an explosive cranium today but all I have is an unquenchable thirst and drooping eyes from lack of sleep. Am I exceptionally lucky or is the bod returning to its party form? Hopefully its luck. I can't keep up with Jim of 5 years ago.

Posted by: Jim at 11:58 AM | No Comments | Add Comment
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Found a link to The Political Compass Quiz over at Ilyka's place. The idea behind the compass is to show another dimension of political ideography beyond Left/Right. Specifically it separates the traditional social metric from the traditional economical metric. As the site says:

A larger but less obvious problem with the quiz is that the questions lack weight. You may agree or disagree with a quiz statement or you may strongly agree or disagree. The quiz does not ask you how much that statement matters to you. Let me show you why. The four items in the following table are scored in the same manner as the ones on this political compass test.

I take this test and my answers are A,D,A,D. The results of my test indicate that I am dead center on both the social and economic scales. My agreements cancel out my disagreements leaving me at 0,0. But wait. I don't give a fig about the issue on question #1, I just strongly disagree with the statement. Now question #2 I am both strongly in agreement as well as passionate about the topic. If we can record this "weight" for each question we can reduce the effect of topics that don't matter (question #1) and increase the effect for topics that do matter (question #2). With the points weighted I'm suddenly a good distance to the right on the social metric.

Weighted polls like I describe have been going on for a long, long time. They have never really caught on because they are generally not needed - most polls are simply constructed to assign beans. "Will you vote for Bush? Yes/No". It doesn't matter how much you care about voting for Bush because you have one vote and it will either be cast for him or it won't. You can't half vote or 2/3 vote. They care only about the absolute values.

The poll/quiz they are using for this compass cannot work without weighting the questions as it is trying to determine relative values. As I illustrated in the example above it is far too possible for the results to skew without weights. So overall I don't put much stock in the results I got for my Political Compass but I like what they are trying to do here; the inclusion of a second major metric in political placement is absolutely necessary in my book. I'll wait impatiently for a proper quiz. In the meantime, go to the site, take the one that's there to see what it's all about and then place yourself on the graph where you feel you should be. It'll probably be more accurate than where the quiz places you.

By the way (in case you haven't guessed already from the post title) my results were Economic (Left/Right): 0.12 and Social (Libertarian/Authoritarian): -0.10. Those are on a scale of -10 to 10 so I'm about as dead stick stuck at the center as it's likely anybody could get.

Posted by: Jim at 03:21 PM | No Comments | Add Comment
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My Lovely Wife was born and raised in Germany and also spend a decade living in The Netherlands. This gives her a unique viewpoint on many of our staid American traditions and mores. One we discussed recently was underage drinking and I have to say that the Hollandaise solution seems quite superior to our own. Let's take a quick look at typical teen drinking in the USA:

1) Teens sneak into parents' liquor cabinet, steal booze, get blasted, get caught, get punished.
2) Teens are now cut off from parents'booze so the oldest looking one in their clique is now Mr. Beer and they buy illegally, get blasted, generally don't get caught so generally don't get punished.
3) Teens get blasted away from home in some "secret" location and have to get back. Maybe there's a designated driver, probably not.
4) Teens either die, get caught by cops and have their life screwed up or make it home safely , thereby reinforcing their belief in their natural immunity from all evils and encouraging them to do it again.

Not a pretty sight. Now let's look at your average late teen, twenty year old:

1) Drink illegally at a bar that doesn't care about their age. Sometimes they'll need to alter their license just enough so the bouncer can pretend he thinks they're 21.
2) Alternately, go drink at a friend's house.
3) Get blasted away from home and have to get back. Maybe there's a designated driver, probably not.
4) Either die, get caught by cops and have their life screwed up or make it home safely reinforcing their belief in their natural immunity from all evils and encouraging them to do it again.

The basic problem is that in the USA you are either a youth or you are an adult. There's no middle ground. If you are 20 years old plus 364 days you pretty much can't drink legally anywhere. This despite the fact that you've been old enough to elect the leadership of the country for 2 years and 364 days. O'er in the nordic lands they acknowledge that there is a middle ground when a maturing person is not an adult but wants to be one. They have a special classification for these tweeners that allows them some of the rights and privileges of an adult under greater supervision. Here's how Nederlander teens go partying:

1) Bus to the tweener club.
2) If you're 15 you can have some beer. If you're 17 you can have some actual alcohol.
3) You don't actually need to get drunk. You're at a club legally. No sneaking. No special thrill for breaking the rules. No need to drink everything you bought because there's nowhere to stash it until the next time your crew has a chance to get blasted. You actually learn to use alcohol responsibly and in moderation. Plus, the club is highly monitored. Mess up and you could get banned. You do NOT want to get banned from the club 'cause you can be damned sure that this would be the figurative end of your social life.
4) Bus back home at a reasonable hour because the club closes at a reasonable time. Maybe you caught a buzz, maybe not. You had a good time though so will likely do it again instead of trying to go the illegal route for a bender.

In the USA we cultivate an atmosphere that encourages teen drunkenness and violation of arbitrary laws. On the other side of the pond there is openness. No brick wall saying "Keep Out" that makes burdgeoning adults want more than anything to get in.

I put together a hypothetical situation and Lovely Wife has presented it to some of our friends with kids:

Your kid has been invited to a party. The parents there are buying beer for the kids. Both parents will be there the entire night supervising the festivities. Every effort will be made to prevent drunkenness and maintain a casual atmosphere. Keys are going to be collected at the door. Kids are welcome to spend the night. Those who do not spend the night may taxi home or may be brought home by one of the parents when the party is over.

Poll question:
Would you let your kids go to this party?

Results:
Yes: 42 (76%)
No: 12 (21%)
Maybe: 1 (1%)

So far three out of three that Lovely Wife spoke with would let their kid go. All three put in the proviso that we were the host parents. I can understand this as you can't really ask this question fairly, even hypothetically, without a bit of information on the hosts. What thinkest thou? Would you let your kids go? Comment and vote your opinion.

UPDATE:
Poll closed and results recorded above. This is excellent support. It should mean that there's a decent chance I won't get arrested when I throw one of these parties for Bear in a dozen years or so.

Posted by: Jim at 08:05 AM | No Comments | Add Comment
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Wasn't even going to post today as I'm in still recovering from my illness but I took a minute to peruse my favorite blogs and came across something that absolutely demands that I do so.

As you can tell by my archive depth I haven't been doing this very long. To tell the absolute truth I'm fairly new to the blogosphere even as an observer. In the relatively short time I've been here, and in the shallow corner that I've actually visited, I've encountered two of the most despicable actions of my life. In the first, the "Moxie" war, an inane online feud resulted in a woman losing her real life job. Now, a vindictive bastard has done it again. Some fucknut has taken an online disagreement and made it a real, human, personal attack. Some psychoanal addict has tried to screw with Kate in her real life. Not just with Kate, oh no. This scumball has tried to have her kids taken away from her.

HER KIDS!

They called Child Protective Services on her, claiming she is an abusive alcoholic. Exactly how evil does somebody have to be to do something like this? How fucked up do your thought processes have to be for this to seem like a rational thing to do? Can't people even think? Can't this fuck tell the difference between verbal argument or misunderstanding and what it means to totally fuck someone over? To try to strip kids from their family in order to "punish" somebody? I am totally fucking over the top pissed.

And I am unbelievably impressed by Kate. She is showing ungodly restraint. If somebody, anybody, ever tried to pull something like this on me - try to take my kids - I would be calling down the lighting on their soon to be sorrier than ever before in their lives ass. You attack me, fine. I've made myself a public target. But attacking my kids? Nothing this short of hell would protect you from me. Kate hasn't even stated who the argument is with. Kate's definitely a better person than me because at this point I would be slamming that name at every opportunity.

Whoever did this, I hope you understand how karma works and I wish to hell I could see you when this comes back at you. You suck and the world would be a better place without you.

Posted by: Jim at 06:36 PM | No Comments | Add Comment
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So we're at The Crick (see My Life Kicks Ass for the background) and Burger keeps running off. The candlemaker is across the way and he really, really wants to go in there. And Miss Katie's sideboard restaurant is right next to us. He wants to go in there even worse. And there's the long path down Crossroads that he can't resist running down. He'll be happily splashing in the water one second and then slyly look to see if Lovely Wife or I are watching. If at least one of us is occupied he trundles out of the crick and ambles toward his objective.

He gives a look over his shoulder every couple of steps to see if we're coming after him. When we do he giggles and takes off at top toddler speed, his 18 month old legs competing to keep him upright against the off kilter swinging of his little arms. Incredibly cute and just fast enough to make a parent jog to catch him. And he has a blast with the "Catch me if you can" routine.

But it started getting old. Lovely Wife has gone to the car for drinks and there were a couple other kids in the crick now. I had to actually watch the boys now. It's one thing if my own get crazy and whack each other, it's quite another when Bear plays Godzilla and scares the bejeezus out of some two year old little girl or Bacon starts Hulk jumping and lands on some tot.

Burger took off for the third time since Lovely Wife went on her errand, that's three times in under 5 minutes. Bacon and Bear were arguing about something and the spat was threatening to end in a push. My rational male mind was overloaded by the simultaneous need to handle two crises. I yelled at Bear and Bacon "Y'all knock that off!"

That's not so bad. I'm a willing user of "y'all" and its many derivatives. English has lost the plural posessive and as a lover of the language I was happy to adopt this elegant southern solution. No, my above statement is not the cause of my current self dismay. It's the one that followed.

With the Bear/Bacon problem solved I turned in Burger's direction and yelled out "Burger, git on ovah heah!"

Git on ovah heah? Unbelievable. Git on ovah heah! What the hell was that? It just came out, all natural like. I was floored. I couldn't believe I had just said that. An erudite yankee sunk into the contusive flow of southern jargon. I couldn't move. Couldn't think. I dimly recall Burger turning back and looking at me like I was some sort of alien. Fortunately Lovely Wife appeared at that point and gathered the errant child. She looked at me funny, probably because I was sitting there with my mouth open, self stunned by my own verbal bombshell. Though she hadn't heard my statement herself she sensed my distress and let me alone in my befuddled state to work out whatever my problem was.

What would be next? Maybe "How y'all doin'"? Possibly "Ain't nuthin' wrong witcher motor"? God forbid "Y'all come back now, y'heah".

Two and a half years in Atlanta and I've already been corrupted. Do I fight back? Do I make a concentrated effort to reclaim my fading grasp of scholarly diction? A concerted assault on this intrusive provincial vernacular?

Nah. T'ain't wurth th'effort.

Posted by: Jim at 09:20 AM | No Comments | Add Comment
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Note: This post got a bit long and rambly. So sue me, I was having fun writing. Anyway, you've been warned.

So I took Lovely Wife and the kids to Stone Mountain yesterday. We love this park. From the top of the mountain you can see clear to the Appalachian Mountains and you have a stunning view of the Georgia countryside. You get a very nice view of Atlanta too, especially on low smog days. The kids have a blast at the petting zoo and we never get tired of walking through the antebellum plantation. But I digress...

Lovely Wife has been feeling steadily better since her surgery so we decided on a trip to Stone Mountain since it would be my last day home (yes, I'm back at work today). It's close enough so we could return home quickly if she started ailing and we figured the fresh air and sun would be a nice change after being mostly cooped up in the house for a week.

We went on a nice trip around the mountain on the Stone Mountain Railroad. Our first time this year and Burger's first time ever (since evacuating the Momma belly anyway). Best part about going to the attractions on a weekday after school starts is no lines. Worst part is a lot of the actors and special stuff isn't there. Usually the train stops about a third of the way around for a comedy sketch of a train robbery. When we reached the spot where the stuff is usually set up for the robbery the train slowed down. Bear started getting excited - he remembered it from the last time we went on the ride. The train chugged past the spot and we saw all of the familiar props were gone. No cart full of TNT and nitro. No outhouse. No water tank. I was bummed. Bear got quiet and looked confused. The train continued to creep on and we saw a whole new area set up. There was the cart! The water tower! And a whole new little ghost town! Awesome! It got bigger and better! Bear got excited again. Bacon started to catch the fever too. Burger started wiggling on my lap and pointed at the Old Tyme buildings. But the train didn't stop. It just slowly chugged past and then picked up speed again. Double bummer.

After that dissapointment the rest of the ride was a bit subdued. It's always a nice ride, y'all, don't get me wrong. Beautiful scenery and very peaceful (once you filter out the train engine, anyway). There were hardly any people on the train and that was nice too. We were just a bit put out by the missing show.

After the train ride we figured we would walk over to the plantation so the kids could say hi to the animals at the petting zoo. We've been regulars for years and they know most of the animals. We started walking through Crossroads. This is supposedly a recreation of an 1870's southern town. I suppose it is, in the same manner as a mega mall is a recreation of a village green. There are lots of places to buy things and several of the things look like somebody could feasibly delude themselves into believing they resemble items from America's past. I'm sure Hello Kitty purses and Coca Cola trains were popular gifts in 1873. They do have a blacksmith, glass blower and candlemaker though and I get a kick out of watching them.

It's usually way crowded in Crossroads but seeing as it was a weekday with school in session there were only a handful of people walking around. We stopped at the fountain (it spits water at you - quite fun to watch tourists get nailed) so Bacon could throw in a penny he found. Burger bought a blast of agua right in the kisser. His expression was priceless. Where the hell did that come from? He looked around for the perpetrator. Lovely Wife got an accusing glare, as did Bacon. Bear and I apparently weren't considered criminal material 'cause we both got a pattented Burger smile.

So we continued our jaunt through Crossroads and came to...The Crick. The crick is a 25 foot or so span of running water designed for kids to get wet in relative safety. It's in the shade, smooth bottom, pool safe refiltered water. Normally you can't get near it but today it was completely empty. What to do? We have no swimsuits with us and only have a change of clothes for Burger. But this is not an opportunity to be missed. We give the orders of necessity: Shoes off. Wading only. No splashing. No jumping. Attack!

Bear walks in with his shoes on. Bacon rips his shoes off and jumps in. Burger waddles in, sits in the middle of the stream and starts splashing happily. Ah, well. The best intentions don't matter a hill of beans when you add kids to water. If you can't beat 'em, join 'em. Lovely Wife goes to the car to get her sandals. I deshoe myself and start splashing kids while she's gone. What a great time.

After the kids exhaust themselves in the crick we head for home. It's a miss on the petting zoo but there isn't too much complaint. The boys are tired and hungry so they just mutter some half hearted whines about the animals. On the ride home the shorter two fall asleep and Bear gazes out the window with a dreamy glaze to his eyes. I look over at Lovely Wife and see her eyes half closed and a smile of contentment on her face. I take her hand and kiss it. She turns to me and mouths "I love you".

It just doesn't get any better than this.

Posted by: Jim at 09:15 AM | No Comments | Add Comment
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Ryan has a problem with his buddy Marc. Rather, Marc has a problem and Ryan is concerned. You see, Marc is in an unhealthy relationship with a psychobitch and can't end it. This story is especially poignant to me because I used to be Marc. I was the nice guy with a codependency issue with a slut. My slut wasn't the bitch that Kelli is. There was never any physical abuse. There wasn't really any verbal abuse either. Just a manipulation that I was totally unfamiliar with and completely unable to recognize. I willingly jumped through hoops for her and played idiot doormat.

My term of exile was much shorter than Marc's - only about a year for me. After our breakup I did the same thing Marc is doing. Trying to hold on to the tattered remnants of the relationship because I still couldn't let go. She'd cheated on me, stolen from me, lied to me constantly. All of that was excusable to me so long as I could maintain my fantasy of a relationship.

I helped her pay her rent. I loaned her my car when hers broke down. I let her borrow my TV. I let her come to my apartment to use my computer when I was at work (hers sucked and she no longer had internet access). I adopted a puppy "with her". Whatever it took to keep her in my life.

It was a sick, sick time in my life. I knew what my family and friends thought of my continued contact with her and didn't really care about that either. It took time and the constant support of the people close to me to finally shake her off.

So here's my advice to Ryan. Make it clear that you don't like Kelli because of how she treats him. Make it very clear that you do not want to be lied to. If he is going to break a date with you to see her he should either tell the truth or say no comment. This is actually more important that you might think. He knows he is in an unhealthy relationship. He knows he is being foolish. Reminding him of that will not help at all. Even after the breakup I was still avoiding friends and family because it was a constant barrage of "why are you still talking to her", "why are you still seeing her", "when are you going to cut her off". When I could see the people who were important in my life without the misery of defending my undefendable position I started seeing more and more of them. That was the turning point. As I came out of my shell I started feeling better about me. I got back into my life and enjoyed myself away from her. I was then able to compare my life without her favorably to my life with her and that's when I cut the strings.

So tell Marc that you're his friend no matter what. Don't hound him about Kelli. If he brings her up (and he will eventually) you should either politely agree and offer support if he's in anti-Kelli mode or politely remind him that you are respecting his position by not ragging on her so he should respect yours by not forcing you to sit through a Kelli excuse session. He'll come around in time, just be patient.

Posted by: Jim at 08:04 AM | No Comments | Add Comment
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I don't have excellent dream recollection but I woke up last night with this one bright and steady in the ol' noggin. I jotted down the principle stuff and have been able to remember a good part of it.

The basic theme of the dream was fixing up a house. Not my house and not me fixing it up, I was just an observer. The guy fixing up the house was big and very mean. The house was already looking good because it was brand new but the components were all cheap and kept breaking so they had to be replaced or repaired. The overall condition of the house was getting worse and worse because this brand new stuff kept breaking faster than it could be fixed. The dream had a very strong feeling of inevitability and being overwhelmed.

So then there's a helper. A sexy brunette dressed up like a porn star trying to look like a French maid. Really long high heels. She's trying her best to clean but she's just as inevitably overwhelmed as the guy. He's angry that she can't clean fast enough so he smashes her with an axe and tosses out her body. Then he opens up his aluminum brief case and takes out a new, uninflated girl. She self inflates and is exactly the same as the first helper. She's more motivated but still can't keep up with the increasing mess.

She starts to get frantic 'cause she knows that if she can't clean everything up she's going to get the axe so she rushes and gets careless. She vacuums up the M&M Guys!! For some reason this was about the worst thing she could have done. The dream follows them through the tube system of the central vac system. They're making their dry, deadpan comments to each other through the entire trip. They make it to the collection bag at the end (it's a fine mesh bag instead of a vacuum canister).

Now they're in trouble. The M&M Guys are suffocating in the mesh bag. I'm now in the dream. It's just so urgent to save the M&M Guys that I have to be there. I start yelling and screaming for the guy. I can't actually touch anything so I'm powerless to do more to solve the plight of our candy heroes. He arrives and starts trying to rip open the bag. I'm telling him that it was an accident but he has to hurry. He gets more and more angry as he can't save the M&M Guys.

Here's where it gets wierd. I'm everybody now, in turn. One second I'm the red M&M, yelling that I'm suffocating and somebody better save me. The next I'm the chick, apologizing to the M&M guys for killing them. Then I'm the guy, absolutely furious and ready to kill, still unable to actually do anything constructive including saving the M&M Guys. Then I'm back as me, no longer a party to the dream but in my observer roll.

I'm the chick. The guy abandons his attempt to save the M&M Guys and turns toward me. He picks up his axe. I'm the yellow M&M. I can breath after all. I see the guy about to chop up the gal. I know that he's making a mistake since I'm okay after all but I don't yell for him to stop or anything. I'm the guy, swinging the axe. Time jump a couple seconds (I don't actually see the axe hit). I'm me as observer watching the guy take another deflated chick out of his aluminum briefcase. I know that he is very foolish. How long does he think he can get away with killing these girls? They're not just going to take it forever. I don't warn him though - I don't like him and I want the girl to win.

The girl self inflates (and is exactly the same as her departed sisters) and is terrified. She knows everything that happened to the other two. She picks up the axe and starts swinging at the guy. She's crying and not too effective. He's a big guy and he almost catches the axe. She does get him though and stands there crying and panting, covered in gross bits. She's probably hurt too cause I think he managed to land a few punches. The M&M Guys make one of their sarcastic deadpan comments.

I wake up.

How's that for vivid and freaky? Maybe I should send this one to The Dream Doctor.

Posted by: Jim at 08:05 AM | No Comments | Add Comment
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The following includes examples from Lovely Wife's recent surgery. Although this serves only as anecdotal evidence the theories espoused are well corroborated through other experiences of myself, Lovely Wife and Burger. In addition I have second hand knowledge from many colleagues, family members and aquaintances. If you, the reader, have had experience as a patient in a hospital setting there is a damn fine chance that you have experienced much of the same as it appears to be endemic to the industry.

In this article I'll give you a bit of background on me so you will know my perspective. I'll give you a brief explanation of Lovely Wife's condition and her diagnosis and prognosis. I'll then take you through each main portion of Lovely Wife's surgical procedure telling you what was supposed to happen and what actually happened. I'll occasionally expound on how poor performance affected us in an especially bad manner.

Background:

Although I am a software analyst by profession my scholastic training was in medicine. I spent eight years in the US Navy as a corpsman, operating room tech and fleet hospital corpsman. I have worked in Naval Hospital Balboa, Naval Hospital Portsmouth, Naval Hospital Oakland, Fleet Hospital San Diego in Camp Pendleton and Veterans Administration Hospital in Buffalo. I have had personal experience working in patient care, pre-operative care, surgical procedures, recovery and post-op. I know how the entire proces can and should work from front to back.

The Condition:

For several years Lovely Wife has had an acute recurring hyperthyroid condition. This means she would quite suddenly have a thyroid that suddenly and unpredictably put out way too much thyroid hormone. This causes nervousness, weight loss, heart arythmia, raised pulse, blood pressure problems, restlessness and exhaustion. The first couple times when it was noticeable enough to require medical attention were immediately or shortly post-partum. She has been diagnosed with Hashimoto's Thyroiditis, hashitoxicosis, hypothyroidism and post-partum hyperthyroidism. The reason for the many different (and sometimes contradictory) diagnoses was due to her returning each time after a few months to normal or borderline normal thyroid function.

She was problem free for over two years until about 5 months ago when it came back with a vengeance. She went from a thin but healthy weight of 135 pounds to just over 110. Her condition was finally pegged as Grave's Disease. The necessary treatment for this is destruction of the thyroid. This can be done with radiation that kills the thyroid tissue or with surgery to remove the thyroid. There is also a drug treatment that counteracts the overactive thyroid but there are possibly dangerous side effects to this drug therapy so it was eliminated as a course of treatment very quickly. The method we ended up with was surgical removal of the thyroid.

As a side note that won't be expounded upon here, the decision for surgery over the more common and generally safer radiation treatment was made necessary due to monetary considerations. Our insurance coverage made the cheaper radiation treatment too expensive for us to afford right now and her condition made waiting impossible. Yes, that's right. Our insurance pays almost everything for inpatient surgery but almost nothing for outpatient procedures. Sucks, doesn't it?

Pre-op:

Expected - Lovely Wife's surgery was scheduled for 9:30 AM. She was told to be at pre-op by 8:00 AM where she would be put in a pre-op room, an IV started and she would be given a shot to calm her down. The anesthesiologist and surgeon would both see her there to go over procedures again and answer any questions she had before she went in for the operation. Children under 12 would not be allowed. A maximum of 2 people would be allowed with her.

Actual - We arrived at 8:00 AM on the nose. We were told they were not ready for her. They would be ready at 8:30 AM. She was supposed to be there one hour before her surgery, not an hour and a half. We showed them her pre-op instruction sheet that told her to be there at 8:00 AM. Sorry, whoever filled that out made a mistake. We waited in the hallway until 8:30 AM when they took her into pre-op and I booked to the babysitter's to drop off the boys. She was nervous as hell but was not given the shot to calm her down as she had to see the anesthesiologist and surgeon before they could drug her. When she had finally seen them it was only 5 minutes before her surgery so it was way too late for it to be any benefit.

Special Problem - Our plan was to drop her off and I would take the boys to the sitter's. I would then be back in time to be with her for the last 45 minutes or so before she was taken to surgery. As she was not allowed into pre-op until 8:30 AM I barely had time to get them dropped off and get back in time. As there was a decent chance I would not be able to return before she was taken into surgery I had to take all of her personal effects with me. That meant that she spent almost her entire pre-op time with nobody with her and nothing to distract her except her own thoughts and worries.

Surgery:

Expected - The surgery would take approximately 4 hours. When the surgery was done the surgeon would come to me in the surgical waiting room and give me a report on how it went.

Actual - Exactly as expected. Lovely Wife's surgeon is very, very good and has an excellent rapport with his patients and their families. He explained everything clearly and concisely without using med-speak or talking down to me (and no, he was not aware that my background was medical/surgical).

Recovery:

Expected - Lovely Wife would spend about an hour in recovery and then would be taken to her room. One family member would be allowed to stay with her in recovery. Patients in recovery are in semi-private areas provided by rolling curtain partitions. The purpose of recovery is to monitor the patient for post surgical trauma and help them comfortably recover from the effects of anesthesia. Blood samples would be taken to start verification of her calcium baseline (this is a concern in a thryoidectomy as the glands that control calcium absorption in the body are directly behind the thyroid).

Actual - No family members, no visitors period, were permitted in recovery. There are privacy concerns with the other patients. Actual length of stay in recovery was three and a half hours. This was because there were no rooms ready for occupation. No rooms in the Short Stay Ward where they know precisely how long people are staying and exactly who will be coming to the ward days in advance. Lovely Wife witnessed a patient being wrestled down in order to remove his throat tube. She was denied a pillow after having her neck hyperextended for two hours during surgery. A volunteer found me in the waiting room and asked if I could go get her pillow because they didn't have any in recovery. She was ignored and then put off when she first came around and asked to go to the bathroom. They told her she could wait until she got to her room. Remember that she had been on constant IV fluids for almost 4 hours at this point. When you are on an IV you pee constantly and furiously. She was finally given a bed pan. She had never used a bed pan before and was still groggy from drugs and in pain from surgery with a neck that hurt furiously from 2 hours of hyperextension. She struggled into a sitting position by herslef and successfully used the bed pan. She then noticed that the privacy curtain hadn't been closed and she had just given a free show to the throat tube guy across the room. A lab tech came to take the blood sample. She asked him to take it from her right arm as the left was very sore from previous samples and a missed IV insertion. He said it had to be the left because her IV was in the right but he would take it from her hand to avoid the sore area. He took it from the sore area anyway, apparently forgetting in just a few seconds where his target was.

The Ward:

Expected - Lovely Wife would be in a private room with minimal disturbances. She would have the IV removed. Sleep was the most important factor for her getting over the surgery. A sample would be taken the next morning to check the calcium again. Me and the boys could visit.

Actual - She was in a private room but it was very far from disturbance free. For the first 4 hours she was woken hourly for vitals checks. She fell asleep shortly after getting to the room so I told the nurse that I was going to pick up our kids and to make sure that she knew that when she woke up. When she was woken up for vitals check the nurse said she didn't know where I was. She called me on my cell, crying because she thought I just up and left her. Shortly after she hung up with me the nurse gave her the message that I had left to get the boys. I arrived back with the boys and was informed that a maximum of 2 visitors were allowed at a time. I reminded them that the hospital policy said 4 visitors and walked by. We stayed for about an hour until the boys couldn't stay still anymore and Lovely Wife couldn't stay awake any more. The IV was not removed because she had not started drinking again. Remember that she was totally and completely infused with fluids from being on an IV for seven hours by this time. It also was very painful to drink as she had just had her throat operated on. They finally removed it when she told them to bring bandages because she was taking it out herself. She was woken up just before midnight for vitals. She was woken up at 4:00 AM by an incredible ass of a lab tech who was shouting her last name at her to wake her up. This was for the calcium test.

Special Problem - Lovely Wife has a slight curvature in her cervical spine (neck) and easily aggravated neck pain. In surgery the neck is hyperexted (head pulled back to expose the throat). She was in agony from this, far worse than the pains from the actual surgical procedure. No pillows in recovery? No ability to go get a damn pillow for someone who had neck surgery and is stuck on a gurney for hours? Since the surgery the main problem has been the neck pain. In fact, Lovely Wife is at her physician's office right now because of this incredible neck pain.

Post-op/Release:

Expected - The morning after the surgery Lovely Wife would be released from hospital so long as her calcium levels were sufficient. Her thyroid doc and surgeon would both see her before she left to give instructions.

Actual - As expected, with a twist. She was given verbal and printed instructions from 3 sources - her thyroid doc, her surgeon and the hospital itself (nurses). In each case the verbal instructions contradicted the written ones. The instructions from the hospital/nurses contradicted both the thryoid doc and the surgeon on several points.

Special Problem - The day after a surgery when the patient was under general anesthesia is not a good day for verbal instructions. How sharp are you after a night of frequently broken sleep? Add in the mother of all hangovers from the massive drugs that you were pumped up with. Add in that you are not familiar with the field being discussed. Also put out contradictory information from three separate primary sources. Fortunately I was there for the bulk of it and I am familiar with the field and didn't have an anesthesiology hangover.

Summary:

At each step of this surgical procedure we were given incorrect information. There was no evidence of efficient process and communication between the different groups involved. There was little to no consideration of Lovely Wife as a patient and customer, only as a job or commodity. (Exception to the last - both the surgeon and the thryroid doc had excellent bedside manner and both listened when we asked questions and answered clearly and concisely.)

Interpretation:

The advent of the health maintenance system and conglomeration of hospitals has completely changed the way patients are viewed. The patient is no longer the customer, the HMO is. Patient satisfaction doesn't matter because when the bill is sent out the hospital's client is still going to pay. Hospital administration has no incentive to make their hospital the best for patient care because no matter which one you go to in the area you are going to one of their hospitals. Taking care of patients in a manner that the patient wants costs money. More nurses, better training, more collaboration and communication. Our current system makes it less profitable for a hospital to take care of its patients in an acceptable and expectable fashion.

Epilogue:

How do we fix this? I honestly don't know and don't even have any major insights except to go look at the Naval Hospital system. We didn't have any of those problems in the Navy. Systems were worked out and implemented. Departments knew what was happening in other departments - they talked to each other. Scheduling was done on a macro scale with implementation on a micro scale. A Short Stay ward would never be overbooked causing a backup of scheduled surgery patients in the recovery room. The largest apparent difference is that the sole objective of a Naval Hospital command is to make sick people better. They have no concerns over cash flow or accounts receivable. So is socialized health care the answer? There is worldwide evidence that it not only doesn't work but is one of the first steps to a broken economy. So look one level deeper and you see other important differences. Organization, cooperation and the enforced belief that taking care of the patient is the primary goal make the real difference between my Naval experiences and what I've encountered in civilian medicine.

Tell me more:

I'd love to hear anecdotes from y'all. I'm not inviting a bitch session - good or bad, it's the experience that matters. Did you or a loved one have similar encounters with the medicinal kind? Tell me about it. Did you have a good experience with surgery or a hospital stay? Lemme know.

Posted by: Jim at 02:46 PM | Comments (2) | Add Comment
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Thank y'all for the kind emails. I appreciate it and Lovely Wife got a kick out of having virtual well wishers. Her surgery went just fine (but with enough hospital admin goofs to feed a scathing write-up later) and she'll be coming home today. I'll be blogging again by tomorrow.

Posted by: Jim at 07:23 AM | No Comments | Add Comment
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Lovely Wife will be having surgery to remove her thyroid tomorrow. Not sure how much I'll be posting in the next couple days as it's going to be a bit hectic with running the kids to various sitters and visiting with Lovely Wife to get her spirits up. Then again I've got a night or two with no Lovely Wife here so there's a good chance I'll be hanging on the computer to avoid insomnia. ;-)

Posted by: Jim at 10:02 PM | No Comments | Add Comment
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Stay with me on this one. Although it seems to be a long and meandering miscourse of disparate anecdotes (and, truth be told, that pretty much pegs it) there is a point in there.

I'm out of the dart tournament. Here at work there's an annual dart tournament (although this is my third year and this is the first one since I've been here). It's double elimination. I'm out after two games. My second loss was to a girl. A girl who sets her throw with her hand a good 8 inches from her head, off to the side. And kicks up her rear leg when she throws. I used to be good. No, check that. I used to be Damned good. I used to get on the board at the local pub and not get off until it was time for wings. What the hell happened? 7 years of not throwing darts happened. 7 years of not worrying about winning the next game to save a buck (loser/challenger pays and electronic Cricket was a buck a game) so there'd be another buck in the booze pool.

Since my ignominious elimination last week I've played at least a game each day at lunch and an occasional one in the morning. This morning, every mark closed ('cept bulls) in 5 rounds. Boo yah! The kid's still got it. Lemme back in the tourney! No dice. I'm a spectator until the next annual tournament (in 2006?).

Got a haircut. Short. Number 3 blade on the sides and back with a nice soft blend to the slightly longer top. Short hair has lots of advantages. First, it's hot in Atlanta. I'm outside a lot these days (3 kids will do that to you). With short hair you don't have massive sweat build up under the hat and when a breeze starts up you doff that sucker and feel the glory of natural air conditioning cool your brain. Ahhhh. Second, it's easy. Shower, towel, brush once each side. Done. Stays there all day without hair gunk. Lastly, the hairs stand a bit higher. Their numbers are not what they once were. Before they could lay in ambush, well camouflaged by their peers. Now my follicle army must rise and present their strength boldly to do battle with the encroaching Army of Forehead.

I've been teasing Pop about his ever increasing balditude pretty much since I could speak and realized that it pissed him off. Bear looked at me the other day and said he could see my head inside my hair. Soon it will begin. Karma sucks.

Thought about fighting it. There's a lot of options now. Plugs, transplants, Rogaine with Minoxidil, lots of new stuff you hear advertised lately. Maybe a nice rug? Maybe take the initiative and just go bald like Ryan did? Nah. The only one of those I could respect myself after implementing would be the ultimate shave treatment but I was in the Navy and I remember the trauma of seeing what I look like bald. Some guys look good totally bald. I am not one of those people. I'll resign battle and wait it out until I have a heavenly halo surrounding my pate, just like Pop has now. Then the two of us can sit back with a beer and laugh at Bear when he realizes that he's losing his hair. Sometimes Karma is okay.

There are two sorts of people. Those that masturbate and those that lie about it. My three boys fall firmly into the first category. I swear, as soon as the pants are off it's open season. Bacon is the worst offender. The other two will run around nekkid having a great time with an occasional grope to pacify them. Bacon's first priority is rolling the wurst and all other considerations are secondary. I was a bit concerned about all of this at first but Lovely Wife assured me it's normal and healthy behavior. Apparently it is. They don't do it when they have clothes on so there's no fear of the uneducated seeing this behavior and thinking that Lovely Wife and i are pervert child molesters or anything like that. So, what the hell. Let 'em go, I say. I mean really - I would give a lot for it to be socially acceptable for me to drop trou and choke the pope on a whim. You go boys! Enjoy it while you can.

Did a lot of running around yesterday. At Borders, little Burger had a blast yelling out his favorite new word. "Memo!" That's like Nemo, not the annoying things at work. In fact, it is supposed to be Nemo but he can't do "N" yet. That's Nemo the fish of course, not the star of the classic work of fiction. "Hey, Burger. Nemo!" Big smile on little face and "MEMO!" at the top of the little lungs. Daddy: "Nemo!" Burger: "MEMO!" Daddy: "Nemo!" Burger: "MEMO!" We attracted some disapproving looks but who gives a damn. When you can get a smile that big from an impromptu accapela round of "Nemo!" "MEMO!" nothing else much matters. You want to read your book for free go to the bloody library, jackbutt. (Due to parental considerations I've been replacing "ass" with "butt" lately. It works. My kids will grow up swearing in PG.)

At Petsmart Bacon walked off while I was distracted by Burger. ("Nemo!" "MEMO!" Man, that shit never gets old.) Lovely Wife was with Bear in the potty because some butthat had locked the men's room door as they left it. Anyway, I had an odd sensation when I realized that Bacon wasn't rifling through the cat toys anymore. It was a moment of stark terror possibly accompanied by a mild cardiac infarction. Burger got quiet immediately even though I hadn't said a thing. Kids know. Picked up the Burger and quickly (and calmly, I thought) walked down the aisle looking for my dwarven escapee. End of the aisle, no Bacon. Quick the other way to the fish tanks (he loves looking at fish). No Bacon. Very quickly (and no longer calmly) to the front entrance. Lovely Wife had relayed a story about how Bacon and Bear ran out of Walmart while she was at the register. Despite constant instruction Bacon still has no respect for parking lots. Streets, yes. He just refuses to accept that parking lots are just as bad, if not worse. I knew beyond a shadow of a doubt that he had just been hit by a car. There was no other solution. Except that somebody had taken him. He's a good looking kid. And smart. But way too friendly. I need to expose him to some mean people because he doesn't seem to grasp that there are mean people out there. There's people at the entrance. Oh, God. It was a car. Terror hits again just as a familiar voice yells out "Daddy! Want a penny!" And there he is next to the big offering jar for dog and cat shelters. Turns out he found a dime (all coins are still "pennies") and went to put it in the "piggy bank". And he wanted another penny to put in. If I had one I would have given it to him. As it was I took his hand and walked back towards the rest room to meet Lovely Wife and Bear. "MEMO!" Smile. Thanks, Burger.

Watched Without a Trace last night. It's a movie from '83 about a 6 year old kid who goes missing. Definitely dated but well done. I watched about a half hour and then went outside to smoke and read Harry Potter. Lovely Wife called me back in for some back rub action (her back, not mine). Watched another half hour or so then decided it was bedtime. It's almost over, why not finish it? Cause I know that the kid is going to be dead. It wasn't telegraphed in the movie but it didn't have to be. 1983. Kid missing movie. Not a comedy. There was not going to be a happy ending. Scare me with Freddy Kruger and Alien monsters. Keep this real terror away. Don't want it. Probably should have told Lovely Wife about Bacon and Petsmart.

My birthday was pretty cool. I know that birthdays aren't supposed to be special after 25 or so but I still want a fuss made over me. Lovely Wife sent me off with G to see Pirates of the Caribbean. Awesome movie. Best adventure since Indiana Jones. Based on a lowsy Disney ride. Oh, I don't think so. This appears to have had the Disney name slapped onto a previously fantastic screenplay. Don't put it past them. Check out the computer game. A great game with excellent reviews. It should be. It's the successor to a great game that got great reviews. You see, Pirates of the Caribbean the game is actually Sea Dogs 2. Late in the production cycle Disney gave Bethesda Software a bushel of money to put their name on it. I'm pretty sure they did the same thing with an excellently written pirate movie that had nothing to do with any Disney name or property.

Anyway (that's my favorite segue in case you haven't noticed yet), the movie was excellent and I had just as good a time as I ever have had in a movie except once (I don't remember what that other movie was but that's irrelevant because it was the activities of my movie watching partner that made the experience memorable). Got home and the house was festooned with balloons and banners and Bear launched into the Happy Birthday song. There were fudge brownie cupcakes and vanilla ice cream. There were pictures lovingly drawn by the kids that will soon be adorning the walls of my mega cube. There was playing of the Hulk video game as well as Yahtzee. There was much ado about the birthday from Lovely Wife. Life is good.

So, I promised that there was a point here, didn't I? It's a bit of an abstract but essentially it is this: I'm getting older and that's okay. It snuck up on me. I'm still not really ready to be 34 but I seem to be doing a pretty good job of it. I miss things from when I was younger but I find that most of them aren't really that important. Most of them are still here with me if I go looking for them and the ones that aren't recoverable are more than eclipsed by the things that have taken their place.

In other words, I'm going to have to fake my midlife crisis so I can get my sports car.

Posted by: Jim at 11:55 AM | Comments (3) | Add Comment
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