Wednesday, September 19, 2007

Even Cowboy Doctors Get The Blues....


The days of wine and roses,

Laugh and run away,

Like a child at play,

Through a meadowland,

Toward a closing door,

A door marked "nevermore"

that wasn't there before...


("Days of Wine and Roses", Henry Mancini")



Last week was just a bad week all around. It was like we all fell apart at once.

The first thing that happened was that I caught Belinda crying at her desk one early morning before anybody else had arrived at the office. And it was about her mother again.

As I've explained previously, Belinda's mother is (and has always been) very seriously mentally ill. She frequently forgets to take her meds, which results in a worsening of her symptoms. And even when she is taking her meds properly, she "isn't right", according to Belinda.

Belinda's mother is so paranoid and fearful most of the time that she calls Belinda on her cell phone constantly, all day long. She also wants to have lunch with Belinda every single day. Belinda tries in vain to explain to her mother that she doesn't always have the time or the money to go to lunch during her busy workday, but her mother simply doesn't understand.

The morning I caught Belinda crying, I sat down nearby and asked her what was wrong. Belinda sniffed and blew her nose into a Kleenex as she told me: "I just feel so guilty about the fact that I wish my mother was "normal". I mean, it's not her fault that she's mentally ill---and I feel like a bad person for getting impatient or annoyed with her."

"Feeling sad and frustrated doesn't make you a bad person," I stated. "You have a heavy burden to bear--- and I know it's not easy. And I also know that you love your mother very much. If you want to know my opinion, I think you're a great daughter--- because I'll bet there's not very many daughters who could take such good care of their mothers as you have."

And then she looked at me very seriously and stated: "And... I just wish so much that she could be normal, you know? So that she and I could talk to each other about every day mother-daughter stuff..... But yet, each year, she only gets worse instead of better. And now I know that she isn't ever going to be normal....ever."

I just sat there with her, quietly, waiting in case she wanted to talk some more. But she kept silent and then began stoically wiping the corners of her eyes with the Kleenex in order to ensure that her eye makeup wasn't smeared. After a minute or two, she got herself together and said: "I'll be okay."

I gave her the "thumbs up" sign and replied: "Let me know if you need anything. If your mother wants you to eat lunch with her today, don't worry about it. I'll do a couple of your visits to free up some of your time if you like."

"Thanks," she said, smiling her brave little smile.

I turned to walk over to my desk--- hiding the tears that were threatening to form in my own eyes.

And we went on with our day.

Seeing my best friend crying hurts me deep.....deep down inside.....

* * * * *

The next bad thing that happened was that Bonnie arrived at work looking slightly disheveled, her face resembling that of a wild-eyed lunatic who was angry enough to snatch somebody bald.

And not only that, but she slammed her purse down on her desk while muttering the F-word---which is the first time in history that I've ever heard timid Bonnie say a cussword. I mean, she's such a good Christian that she never curses----and what's more, she simply can't ever bring herself to lie---not even a tiny little fib.

In fact, one day Jane-Anne (who can be very competitive---a trait which I have yet to successfully whup out of her sassy young butt) taunted Bonnie about one of Bonnie's patient visits, predicting rudely that Bonnie wouldn't be able to successfully get a blood sample out of one of our patients, a lady who is a particularly "difficult stick". For some reason, Jane-Anne thought that because she'd once gotten that lady's blood herself, that she had suddenly become the world's champeen blood-drawer.

Later that day, Bonnie called me on the cell phone and told me that Jane-Anne's taunting had "psyched her out" and that she, indeed, had not been able to get the lady's blood---and she wanted me to come over and try my hand at it. So I detoured off my own patient route of the day and went out to where Bonnie was.

When I arrived, I tried my hand and was lucky enough to get the lady's blood. As a dejected Bonnie packed the blood samples into the blood-carrier for the trip to the lab, I told her: "Look, Bonnie. You don't have to take Jane-Anne's shit. Simply don't tell her that I was the one who got the dang blood. You act like YOU got it, okay? I'll never tell."

"No," Bonnie replied dejectedly. "I can't do it. I just can't lie and take credit for something that you did."

I rolled my eyes in impatience because I knew it was the truth---she would never lie. But then... a lightbulb of a great idea went off over my head.

Slyly, I stated: "Okay, Bonnie, if that idgity Jane-Anne doesn't ASK you about the blood, then you won't be put into the position of having to tell her that it wasn't actually YOU who got the blood, right? It isn't a lie if she doesn't ASK you, right? And then you don't volunteer any information, okay??"

Bonnie looked at me with a little brighter expression on her face, the logic of my trick dawning upon her previous shameful mood, and she said quietly: "Yes, I believe that would be okay..."

And to this day I'll bet that Jane-Anne has no damn idea why I became so helpless that afternoon, dragging her over to a couple of my patient visits to "help me hold somebody's legs apart for a urinary catheterization" or else to help me roll someone over in bed so that I could change a wound dressing on their backside....

...and ONLY me and Bonnie will ever know that idgity ole Jane-Anne damn well didn't have ANY time to ask ANYBODY about ANYTHING that day, HEH!

Anyway, where was I?

Oh yes, Bonnie came into work looking like she wanted to snatch someone bald.

After talking with her, Belinda and I found out that Bonnie's 20-year old daughter and worthless son-in-law (and their child, Bonnie's beloved grandchild) had all moved in with Bonnie's family over the weekend because they had been evicted from their own place.

Bonnie already has one son living at home--- and a husband to boot. So now Bonnie's house is a chaotic mess with 6 people crammed in a small, two-bedroom house. The situation has practically dashed all of Bonnie's hopes of getting time to study for the online course that she just paid thousands of dollars for----a course which will allow her to make the transition from an LVN to an RN. But because of her daughter's family moving in, Bonnie now says she doesn't know how in the world she'll ever get any quiet time to study. I've never seen her so sad and frustrated.

* * * * *

And then the week just kept getting worse. And what happened next was what we have all been secretly afraid of for months....

It's Jane-Anne.

Remember that Jane-Anne is a very brittle Type 1 diabetic?---and that she had been sternly advised by two doctors to NOT get pregnant? But then the stubborn little mule got pregnant anyway?

The other day she came to work----and she looked awful. Her face looked puffy. I thought she'd been crying or something.

"What's wrong?" I asked her. "You look all puffed up. Have you been crying?"

"No," she replied dismally. "I'm just puffed all over. And my legs are the worst---they've been puffing up for a couple of weeks now----and now my face is finally puffing up, too."

"Your legs?" I asked with a quiet dread. "Uh...pull up your scrubpant-legs. I want to look."

She pulled them up----and I paled.

Both of Jane-Anne's legs were so swollen with fluid, from her toes to her knees, that you could literally poke your finger into her leg and make a dent an inch deep. Her toes looked like sausages.

"Give me my stethoscope, Bonnie," I said fearfully.

I took Jane-Anne's blood pressure. It was 184/106.

Horrified, I threw my stethoscope down on the floor and hollered: "Jane-Anne! Get your butt on the phone to your doctor right this minute!"

"But what if she wants me to come to Dallas?" Jane-Anne whined. "My husband's at work and only Mee-Maw's available to drive me----and she practically got us all killed when she tried to drive us to the Dairy Queen last Friday. And I've hardly got money for the gas, anyway!"

"Call the damn doctor!" I demanded. "Because if you don't, I'm just this far from dragging your ass down to the ER. You are most likely pre-eclamptic or very near so!"

Sure enough, when she got on the phone with her doctor she was instructed to get herself to Dallas just as fast as she could.

And she's there now, in a Dallas hospital----and sure enough, she's pre-eclamptic.

She's on strict bedrest and they're watching her closely. The doctor's trying to allow the baby to develop as much as possible before they induce labor. Because although the baby is already as big as a full-term baby (6 lbs), it's not full term internally---Jane-Anne's real due date isn't until the 1st of November. Thus, the baby's lungs may not yet be developed properly.

And so, we're all doing the waiting game---hoping like hell that the pregnancy doesn't ruin Jane-Anne's already strained kidneys and cardiovascular system----and hoping like hell that both Jane-Anne and her baby will be alright....

* * * * * * * * *


And then there's me......

Well, let's just say that last week wasn't the greatest week of my life. The way it happened was this:

I had been tired for a long time---at least several months. And I couldn't figure out WHY I was so dang tired. I mean, my job isn't THAT stressful. And each week, as I sank deeper and deeper into an all-encompassing fatigue, where I was so tired that I could barely put one foot in front of the other, I kept trying to puzzle it all out in my head.

Did I need vitamins? Was it the Texan heat? Was I anemic? What the heck WAS this strange fatigue?

And it got worse and worse. In fact, it got so bad that there were some days that I truly believed that I might not be able to make it through the work-day. I felt like I was walking in wet sand.

And then one week I began having....some other symptoms.

But I put the rationale for those symptoms right out of my head. I refused to consider their origin. I knew that it couldn't be THAT. Nooooooo, I was too young. I didn't fit the "criteria" for that problem. It simply couldn't be THAT, no sirree....

But finally, one day last week, I arrived home after work at about 4:45 pm, and I was so tired that I went straight to my bed right then. And I didn't get up till the next morning.

But I still didn't feel any better....

So I dragged my tired self into the office and sat down across from Bonnie, who was already at her desk preparing her day's paperwork. Belinda had just called me on her cell phone to ask if I wanted anything before she arrived, and I had asked her to bring me a "sweet tea" from McDonalds. And then I turned to Bonnie---to ask a question, the answer of which I had been dreading for weeks....

"Bonnie," I said in a trembling voice. "I...uh...haven't felt very well for a few weeks. And I know I didn't say anything to you guys about it, but....well...I guess... you had better check my blood sugar...."

Bonnie lifted her head from her paperwork and looked at me. She started to say something---but something in my expression caused her to stay silent, a similar dread forming on her own face.

She reached into her nearby nurse bag and pulled out her glucometer. Still silent, she "loaded" the glucometer with a "strip", swiped my finger with alcohol, and then stuck one of my fingers with a lancet. She placed the ensuing blood droplet onto the strip in the glucometer---and we each waited, holding our breaths, for the result to appear on the face of the little machine.

A human being's normal blood sugar is around 60 to 120.

The machine beeped it's results---and my blood sugar result appeared suddenly on the glucometer's screen....

It read "600".

Bonnie's and my horrified gasps could have been heard down to the fire station. Hearing us, Belinda (who had just arrived with my sweet tea) and the secretary both ran into the room to see what was wrong with Bonnie and me----and when they realized what was going on, Belinda dropped the sweet tea and they both paled. They were both completely and utterly appalled at the number which blazed from the glucometer's screen--- as were Bonnie and I---- and we all stood there like idiots, staring at that glucometer. The fear and mortification in that room was so thick that it was palpable.


"Oh MY GOD!" Belinda suddenly screamed. And then she quickly came to her senses when she realized that I was near tears, scared, and so confused that I didn't know what to do. "Bo, call your doctor IMMEDIATELY!" she hollered. "And I mean right now!"

So, in a daze, I called my doctor. And I was told in no uncertain terms to get myself to the Emergency Room right away.

So off to the ER I went, for the second damn time in two months, and I couldn't have been more miserable. I figured my life must be over for sure. A blood sugar of 600? I'd never even had a home care patient with a sugar that high! How could this be? How? I didn't fit the criteria I kept telling myself.

After I arrived at the ER and was rushed to an exam room, the doctor blew in like a tornado.

"Goddamn it, Bo!" he yelled. "Didn't I save your life once already this year? Have you been drinking again?"

"No!" I yelled back. "But my damn blood sugar is sky high! Bonnie's glucometer said 600! How could that be? I mean, I thought you had to be a lot older than I am to get adult-onset diabetes. And I thought you had to be overweight to get it--- and I'm skinny!"

"I don't know why," he replied, frowning. But then he brightened. "But at least I get another chance to see your tattoos..."

But then I interrupted him.

"DAMMIT, I REFUSE TO BE A DIABETIC!" I hollered at him. "Can't you just fix it?"

"Oh yeah, baby," he told me ruefully. "I've done this a few times before. And I've fixed you before, Bo, and I'll fix you again. So you just lay your little self back and let Super Doctor do the fixin'. And I don't want some stupid glucometer's results. I want some real bloodwork from you. So in a minute the nurse is going to start an IV on you and draw some blood."

And so it was. After the nurse made me give her a pee sample, she made me lay back down on the guerney, covered me with a blanket, and then pulled the room's swivel TV set over my guerney, presumably to distract me while they did their work.

And they did go to work on me.

She started an IV on me, then a lab person drew my blood--- and then the nurse hung some sort of IV solution up and started running it into me at a rather rapid rate. I just lay there, stupidly staring at the TV, not even comprehending what television program was playing, as I wondered what in the hell had happened to me.

After a little while the nurse rushed back in with a different IV solution bag in her hand.

"We've got to give you a different IV solution," she explained hurriedly. "We got your lab results back and your sugar is actually 624. And your potassium is all wrong so we've got to give you some in your IV. And your urine shows that you're spilling ketones at a level of 'greater than 1000', which is considered critical...."

The doctor came in again and I started my protesting a second time.

"I just can't be a diabetic!" I told him balefully. "I don't fit the damn criteria! I'm too thin! And besides, I think I'm too young!" I was starting to bawl.

"Has anybody in your family ever had adult-onset diabetes?" he asked gently, sitting beside me while putting his arm around my shoulders, as if to lessen the terrible blow of the upcoming truth.

"Well..." I muttered. And then I remembered. "Yes---as a matter of fact, my father did get it. And he was only in his thirties if I remember correctly."

And then he started asking me a bunch more questions about my family history, about how long I had had certain symptoms, and on and on----but again I interrupted him to say: "Look, I told you that I REFUSE to be a dang diabetic! And..."

But he didn't let me finish my sentence.

He stood up, took my face in his strong hands and looked me right in the eyeballs from about two inches away from my face----and he stated very emphatically: "I'll tell you what, Bo----you're just about two damn steps away from the ICU, do you understand me?"

That shut me up and so I cooperated and let them do their thing.

Between the doctor and the nurses doing all kinds of things with the IV solutions and lots of units of Regular Insulin, they finally got my blood sugar down to an acceptable level. The doctor came back and told me that my blood sugar was down to 235. He looked visibly relieved.

"We've got to stop meeting like this, Bo," he said with a mischevious smile. "People will talk..."

My ER doctor---my hero....

* * * * * * *


But there it is.

I'm a diabetic.

A diabetic.

I have to keep saying it to myself in order to believe it.

My company's owners gave me a brand new glucometer for which I was grateful.

But then, a deep---and I mean a DEEP-----determination rose up in me like a runaway fire. And I knew what I would have to do.

I will check my blood sugar. I will take their medicine---it's only two pills a day. And I will maintain their strict diabetic diet to control my sugar. And I'll work out until I turn every ounce of tissue of my body into healthy muscle.

Because, By God, I am going to get my blood sugar back to normal, no matter what it takes. I WILL get it under control.

Because I sure as hell didn't battle alcoholism for the last 10 years only to let diabetes kill me....

* * * * *


That was last week. This week I saw my regular primary doctor for a check-up.

Between my strict diabetic diet and the medicine I've been taking, I had gotten my sugars down to normal. I hadn't cheated on my diet once---NOT ONCE. (By God, when I say I'm going to beat something, I'm going to beat it, dammit.)

And I feel so much better. And I have more energy. And some of my spunk returned.

"Mark my words," I sassed my primary doctor, poking him in the chest with my pointin' finger. "I told Buck down in the ER and now I'm telling you---that I absolutely REFUSE to be a diabetic. I am going to beat this thing."

He started chuckling at me but I kept on ranting. "I hate it when you laugh at me. And I can tell that you don't believe that I can beat it. But you just watch me, Mister, because one year from now I will be OFF this dang medicine and will be HEALTHY AS A HORSE---just you wait and see!"

He laughed a little more. And then he did the exact thing that I had been afraid he would do. He suddenly stopped laughing and looked me very seriously in the eyes---- and he said: "Bo, what did I tell you the last time you were here?"

Oh Lord Jesus and Elijah's Chariot, I thought. I had almost gotten out of there without it---THE lecture. But I was wrong.

Sure enough, he continued: "I told you last time that you were here that you need to get a job with insurance."

"But I like my damn job!" I argued. "I work with my best friends in the whole wide world! We've come through thick and thin together. I don't want to leave them!"

He stared at me for a minute, and then he said quietly: "I want to see you back here in a month."

And then he walked me to his office manager's desk and handed her my exam bill. I thanked him and said goodbye as he walked off to see his next patient. And then I turned back to the office manager, pulling out my billfold to pay for the labwork and the doctor visit. I knew it was all going to be very expensive since I didn't have any health insurance---and I knew that I'd cringe painfully when she announced the bill's total amount.

I resolutely pulled out my credit card and tried to hand it to her---and then I noticed that she was staring at my exam bill with a puzzled look on her face.

And after a minute she finally looked up at me and declared plainly: "He's only charging you half of the regular price for his visit and the bloodwork..."

My primary doctor---- my hero....

* * * * *


Later that day, when I returned to the office after my doctor visit, I found Belinda and Bonnie sitting at their desks---and Belinda was laughing her head off. Bonnie was just shaking her head in shame.

"What?" I asked. "What in the hell is so funny? And what the hell is wrong with you, Bonnie?"

Belinda kept laughing but was finally able to say between snorts and chuckles: "You won't believe what Bonnie did!"

I looked at Bonnie quizzically. She sighed and replied: "Well...I was pretty worried about you when I went out to see Mr. Strickner. And you know what a grouchy old complainer he is."

Belinda was still laughing loudly and so Bonnie said: "Would you just SHUT UP and let me tell her what happened?"

"Yeah, you tell her what happened!" Belinda replied, practically choking from laughing so hard.

So Bonnie continued. "Okay, so I got there to do my visit on him and I took his blood sugar like always. And it was up---it was 232. So he started bellowing at me like an old wall-eyed bull, saying stuff like 'you dang nurses NEVER come here when my blood sugar is down to normal---noooooo, you only come when it's up to the 200's--- and then you have the dang nerve to bitch at me about what I eat!"

"And here come's the good part," Belinda interjected, still laughing.

Bonnie sighed heavily---and then told the rest of the story. "I don't know what possessed me, Bo, I swear I don't. But I hollered right BACK at that ole coot! May God forgive me, Bo, but I blasted him with something like 'dammit, you wanna hear about high blood sugars? Well you ain't got nothing on poor little Bo----she just got out of the damn hospital with a blood sugar of 624!! So now just WHAT do you think of your 232 after that?!"

Belinda and I practically fell on the floor laughing at the thought of shy, timid Bonnie getting mad enough to holler at a patient (which was a double black mark on her behavior since she'd already besmirched her ladylike reputation by saying the F-word earlier that week). The whole situation was so ludicrous to us that Belinda and I kept laughing until tears ran down both our faces. And then finally, Bonnie started to laugh, too. And then we all laughed till we finally got tired.

"I need a Fresca," I said. "Fresca doesn't have any sugar in it."

"You did apologize to Mr. Strickner, didn't you?" Belinda asked Bonnie.

"Yes, I apologized," Bonnie replied. "But I wasn't too worried about him staying mad at me. Because he knows dang well that if he gets too ugly with me that I won't pick his tomatoes for him like I always do."

* * * * * *

And so, the three of us sat there, in our shabby little office, chattering with each other, wondering aloud about what we were going to do about all of our various troubles---and then I thought of something and spoke up.

"Listen, you two," I stated. "We shouldn't worry so much about all our troubles. Haven't we always come through our problems together? Haven't we always triumphed over evil?"

"Triumphed over evil?" Belinda retorted. "What are we, Jedi Knights in 'Star Wars' or something?"

"Very funny, Smarty-Pants," I replied sarcastically. "You know what I meant. I just threw that phrase in for 'effect'".

Bonnie giggled and exclaimed "No, we're not Jedi Knights---we're the Three Musketeers! One for all and all for one!!!"

We all laughed until I looked at the clock.

"Hey, it's quitting time," I said. "Let's go to Bubba's Bar-Be-Que and get some cold drinks. They have Fresca there...."

And the other two yelled in unisom "...AND FRESCA DOESN'T HAVE ANY SUGAR IN IT!!!!"

And so we went.

One for all and all for one, indeed....

* * * * * *


So if you're ever driving on a Texan Interstate Highway---and if by chance you stop at a little tiny town called Podunk----and if you notice three giggly, idgity nurses sipping cold drinks at the back picnic table behind Bubba's Bar-Be-Que---

It's just us Three Musketeers....



Jane-Anne is still in the Dallas hospital.

And, with the medicine and a strict diet's help, my blood sugar is now down to normal.

(And I still want to be a Jedi Knight, dammit.)



Anonymous said...

And I thought the nursing staff threw a hissy-fit when my ex-husband (the scumbag) tested at 427! You win the prize.

Seriously, Bo, I'm glad you found out and are ornery enough to do something about it. As you know, diabetes is insidious, and only dedicated, strong, Jedi Knights have a chance of beating it! LOL

Duckie said...

I think here in Alberta we have a different way of testing blood sugar, because my dad has diabetes, and he has one of those sugar testing machines (glucometer-thingy)..well anyways, if you're lower than 4 thats bad, and higher than.. lets say 10-12 then thats bad. My Dad had a blood sugar level of about 23 when he was diagnosed (which I guess is crazy high). ANYWAYS, this is my roundabout way of saying that I think diabetes is a cruel disease (no sugar?! NOO!) and that I think you're a trooper!

Warrior Knitter said...

The Force is strong with these three.

danielle said...

G'friend...they say that we are not given more than we can keep on laughing and keep on sharing the burden by sharing your stories....I am praying for all of you - daughter and mom, mom-to-be and new baby...and you! And praising the fact that there are some doctors out there that truly live up to their professional creed!! And dont just fall into the Greed Pit!if I lived close enough, I would refer everyone I knew to your doc...

Anonymous said...

Sending up prayers for Jane-Ann and the baby ...

Abd we'll be cheering you on as you fight diabetis, too, if need be, woman ...

poody said...

Girl, good golly! You are always having some sort of crisis Bo! You really do need to get yourself some insurance! I am glad you are not letting this hateful disease overpower you! Just remember the reason most of our pts. who are diabetic do so poorly is because they become complacent! No immediate gratification for their hard work. Just being normal is the only reward they get and this is just not enough! Take care sis!

Taueret said...

get better, Bo. Also get "dr bernstein's diabetes solution" (book- if you can't afford it I will buy it for you).

Katherine said...

So glad you are on the road to recovery (yes, I believe you can beat this). Prayers going up for you and Jane ann.

mielikki said...

You have the knowlege to control that Diabetes, and NOT let it control you. It sounds like your doing a fine job of it.
I'll keep my fingers crossed for Jane Anne as well. . . .

Anonymous said...

Oh, thank heavens, Bo.

When you wrote last, I was afraid of something like a brain tumor or something else with a bad prognosis. Diabetes can be bad, but it can also be controlled.

And I have faith in you. When you have a tangible enemy (those lousy -ose molecules), you are an excellent fighter. Even I have managed to keep my diabetes under control, at a weight of 240 pounds (it was lower, till I started hobbling around with a broken foot and put on 20 pounds in four months while waiting for foot surgery).

So, although it is totally unfair, and you really don't need another aggrevation, I have total faith in you controlling it - and you can holler about it anytime you want to and I'll listen. aj

Cyndy said...

Feel the force, Bo.....

Lordy, What a time you all have had! You are all lucky to have each other ;0)