Global warming

Everyone has a theory as to why the earth is heating up but I know the truth.

The world is now hotter than it has been in the last 2000 years. Scientists have determined this fact from looking at the rings on old trees and by looking at samples of ice from the polar caps. Thank you John Stewart on the Daily Show for this information.

Why is it so warm?

Some blame the use of fossil fuels; others say that Gaia is just trying to shake us off, like when you get a fever to fight an infection.

That's not it.

The reason the Earth has gone tropical? It's all us Baby Booming Women hitting Menopause at the same time. It's just one great, big, global hotflash.

Now I used to think as you might (if you are one who has never had a hot flash) that women who complained about them were just wusses. So they feel warm, so what ?
Now, having undergone a medical menopause from chemo and radiation therapy, I gotta tell you, not only are these things personally devastating but they're cooking the whole planet.

If you have not personally experienced a flash I invite you to duplicate the experience. You will need Niacin (not the nonflush kind), a hot coffee, woolen long johns and a bathroom with a hot shower. Take the Niacin with the coffee, dress in the long johns and go clean the bathroom with the hot shower running. Instant hot flash. No you may not leave the bathroom until it is clean. Not funny any more huh?

Well if all these Red Hot Mamas are the cause, then what's the cure? Should we just shoot them and put them out of they're collective misery?

Why no! And trust me I'm not just saying that as a prospective shootee.

What we need to do is allow women of a certain age to just take it easy. Let them sit by the pool in the shade sipping caffeine free ice tea. When they feel a flash coming on they can take a quick dip to cool off. Let them have a year or ten off from work at full pay. We have Maternity Leave why not Menopausal Leave. Get some one to run their errands and do their chores. It's not asking too much is it?

We're talking about saving the planet here people!

little fairsCaPe happy again

It is so nice to be able to post again. It's like being able to breathe with the pillow off my face. I can visit and post. I can post at home. I toast posties. I sing to the mother blog universal. ( No I am not on drugs- I just don't get out much and these blogs have become my connection to the world.) So I am happy. Hello to all my blogfriends and hello to all you lurkers out there in blog land. I still haven't done the linky thing but I will one of these days when Hubby is not looking for a job or posting resumes and has time to guide me through the process. I have restored some of my bookmarks since switching to #2 son's aged laptop. When I think about the $5000.00 I spent on this when he started school... and now it's not worth much of anything. I guess computers lose value faster than cars. Oh well, I am having fun. Wheeeee.....

tracheostomy tubes

I guess I'm a dinosaur. I go back to the days of metal bedpans and bathbasins. When the patient left the unit we would scrub these things up, bag them, tape them with the special tape and send them back to central supply to be autoclaved. I also remember metal trach tubes. They were pretty awful. They'd get old and bent and the inner cannula wouldn't slide in and out of the outer cannula and the lock would wear out. What a difference when they started making plastic trachs out of PVC. They were great. It seemed like we were living in the space age at last . Sonnyboy came home with a PVC trach in place. We'd change it every week and just throw the old one away. We had to do "trach care" every day which involved removing the inner cannula , cleaning it with peroxide and a little brush, rinsing it in saline , drying it and replacing it into Sonnyboy's outer canula. All this had to be done with a sterile technique to prevent contaminating his airway and lungs with any new "bugs" and it had to be done quickly because Sonnyboy is on a vent and it's tubing only connects to the inner cannula.

The trach tube we were using was pretty rigid. One day last fall while the ENT docs were doing a change they put the whole thing right through the back of Sonnyboy's trachea into his esophagus. This was a bad thing to do. It took a few minutes for everyone to figure out why Sonnyboy was not able to breathe and we were close to that final curtain when somebody figured out what was wrong and removed and then reinserted the damn thing into the right part of Sonnyboy's anatomy. Sonnyboy spent the rest of the evening in the OR and the next month in the PICU.

It was pretty obvious that he needed a new kind of trach tube and after some investigating they came up with a custom made silicon Bivona . The silicon is soft and flexible, The airway is held open with a series of metal rings kind of like an imbeded spring. Also, the balloon that inflates to form a cuff to keep airway pressure in is filled with saline so its very soft and flexible. The tube is custom made and cost $350.00 to the old tubes $80.00 but it is made to the specific length that Sonnyboy needs. The biggest problem that the docs had was that it did not have an inner cannula and they worried a great deal that we would have problems with plugs of mucous.

It turns out that mucous just does not stick to silicon the way it sticks to PVC. We have followed in ENT clinic since discharge home last fall and the tube stayed clear with regular suctioning. Since it is long and since Sonnyboy is fragile inside we do use bronchial aspirating catheters, but even so the tube is great. Sonnyboy is comfy.No more hair raising weekly trach changes at home and no more daily inner cannula cleaning. The Bivona was changed last month when Sonnyboy was in the OR for his G Tube problem and the ENT docs are very happy with it.

Maybe now we are really in the space age.

Though the tube was initially quite expensive we are saving in the long run.
The price of weekly trach changes. The cost of daily trach care kits and saline and peroxide. The cost of regular suction set against the bronchial aspirators and sterile gloves. And the human cost in terms of stress and physical discomfort would make me choose on the side of the Bivona.

Most docs are going to use what they are comfortable with and what they are used to. But you know, there are hardly any more metal trach around these days...

Bed bath and Beyond.

Well let's see. I'm not at all sure what's up but we'll give this a try. Some thing else will probably shred apart but f- it, it's letting me blog and post. I promised PK a post about bed baths so here goes.

In order to give a good bed bath you have to keep a few things in mind. First of all you are doing this to make the bathee comfortable. Second you must live to bathe another day. Third, this is not going on your permanent record.That said we begin.

As in the take over of a small nation it is all in the planning. You must assemble the things you will need before you start. This will vary according to the individual but here is a good general list to get started with
disposable gloves (box)
towels (10) you may not use them all but have them handy
wash cloths (30) ditto
basins (2 or 3)one to keep everything in the others for wash and rinse
lotion- best if applied to damp skin
powder - best if applied to dry skin
deodorant- best if applied to clean skin
bath soap- I use No Rinse Body Bath
shampoo- I use No Rinse Shampoo
zip lock bags- it's easier and cleaner that putting the water directly in the basins
toothpaste/other mouthcare equip - Toothpaste on a gloved finger is better than nothing
gargage can with plastic liner- time to toss your diposables
baby wipes- nice and gentle for personal cleansing
water proof pads- protects the bed
bath blanket- keeps regular blanket dry and bathee warm
clean bed linens- whether it's time for a change or just in case
rolling cart- very convenient
hamper-better than throwing stuff on the floor
clean bedclothes and diaper etc if necessary
it's good to actually write yourself a list

on to the bath

take everything extra off the bed while you tell the bathee what you are planning
water proof pads under and bath blanket on top of bathee
wrap arms and legs in towels
start at the top
do one section at a time
don't use too much soap
offer to have bathee do their own personal cleansing other wise just do it
turn bathee on side wash and lotion back from neck to buttocks
clean bedclothes etc

this is a good time to socialize with bathee
it is also a good time to have a good look at their skin and check for bed sores
bedsores can develop overnight call your MD if you are concerned - don't wait

this is a good time to get the bathee up out of bed so you can change the sheets
otherwise , if the bathee can't get up you must dhange the bed with them in it

if you are taking care of someone in bed please protect your back and get a hospital bed if at all possibe
if you are going to be doing this for any lenth of time think about a solid surface floor
well I probably forgot a bunch of stuff but I am sure there are a lot of resources these days for this kind of information

please check with your MD if your loved one is to sick to take care of them selves

Well there it is PK, I've got it all worked out except the exit plan ...

pulmonetics 950 ltv

ltv=lap top vent

At 13 pounds it sure does come close to being a laptop. It's much easier to use though. I call it the vent for dummies. The fact that it's a life-sustaining piece of medical equipment is hard to get past. I guess you have to both lose and gain respect for it at the same time in order to take your kid home from the hospital on one. You have to lose respect in that if everything else looks good and the vent is putting up some scary shit you learn to go with everything looking good. Then of course you have to figure out why your numbers are screwy. There's often a reasonable explanation. It's hard though when you first come home not to get excited by all the flashing lights and alarms going off. It helps to have a good respiratory therapist from the start, you know, some one who can keep things simple for you and help to weed out real problems from mechanical glitches. You also have to gain respect for the vent and for your ability to take care of it properly.

Don't get me wrong, taking home a kid on a vent is no walk in the park. I've been an R.N. for over thirty years and I was scared shitless to bring Sonnyboy home. I had made Hubby PROMISE not to let them make us do it. In the end we did bring him home and while it has not been easy ( lots of crying and exhaustion at first) it has been worthwhile in a very personal way. For a time even after we came home we decided to try a respite facility. We found out there is no place like home. It is certainly worth it to try home care.

In order to gain respect for the vent there are some important things to know about the vent itself. Be sure they set you up in the hospital with the vent for at least a week before you go home. Get to know your home therapist. Have everyone in your family and all of your friends get to know the vent. Make sure you understand how to do a tubing (circuit) change and actually do it in the hospital before going home. Know how to set the vent up for home (wet) and for travel (dry). Find out how to clean the filters and have them give you extras. Get used to the alarms and learn how to turn them off and what they mean. Be aware that if the kid yawns or coughs or laughs the alarm is going to go off. Yes, kids on vents can and do laugh. Remember though to always check that your kid's airway is clear and that the tubing has not disconnected all the way from the kid's trach to the machine. This vent has a bad habit of popping apart at the point where the filter connects to the vent if you bump it , just be aware and push it back together. Another trouble spot is right at the trach but there are solutions using small pieces of extention tubing called omniflex and by using two different kinds of trach ties. Make sure you are comfortable with doing the trach care, changing the ties and doing the suctioning. Suctioning is scary because it looks uncomforable but if you ever talk to some one who has needed to be suctioned they will tell you it tickles and that it is a relief to have a clear airway. Be sure to be there when they do a trach change and then do at least two changes yourself before going home. One other silly thing the vent does is give out false readings if the tiny sensor tubings get water in them - there might be a better way to handle this problem but we have found that the best way to fix it is to just do a circuit change.

Taking someone home on mechanical ventilation is not easy, especially at first, but it does get easier. Like when you realize instead of fumbling for that extra breath button during suctioning you can just unlock the vent before you suction and dial up the rate by a few breaths per minute and then dial it down to the prescription rate after your finished and lock it again. Of course you would want to check that out with your doctor first. Every patient is different. Every family is different too. Not everyone can handle a vent patient at home. It can be done though. I didn't think we could do it but I am glad Hubby broke his PROMISE to me and let them make me take Sonnyboy home. There truly is no place like home.

Texas catheters

First, I can not believe how difficult it has been to post lately. I have no confidence this will ever actually be seen by anyone but me. I managed to get a poem up on fairsCaPe. At least I think I did. Oh well, log on and blog on I always say...

Todays topic is one you may or may not care for or ever have the opportunity to have need of information or actual wise. It is about the venerable texas catheter. We avoided using them on Sonnyboy for the longest time because our experience with them was limited to their improper use by hospital staff. Properly used they are really not bad. The trick to their proper usage is to remove them each time the patient voids and to thoroughly cleanse him. We use a gentle lotion and baby wipes because Sonnyboy is so fragile. The next important thing is to completely dry and powder the patient. We use Ammens medicated powder. Let the patient have a short "breathing " period before reaplying the catheter. Following manufacturers directions will mess you up. Always attach the catherter to the drainage tube before applying, then roll it on, then give it a friendly squeeze to set it in place. Use a fresh catheter each time. Washing and reusing is a false economy plagued with catheter failures and wet beds. Hopefully no one out there will need this info but if you have a frail elderly parent or grandparent it might be easier than changing diapers. Sonnyboy voids up to a liter/quart of urine at a time and the darn things hold on at least 80% of the time.

Blondes

I was born blond. Brother is blond, hubbies A+B blond, #1+#2 sons blond, Sonnyboy blond. Current Hubby is not blond, so not blond that if you wrapped him up in a turban and shot him the FBI would pay you whatever they're offering for Osama. Hubby hates it when I say this as he is adopted and who knows and he doesn't like being compared to mass murderers. People used to alternatively scream out Manson or Jesus at him as we walked along. He is actually quite beautiful. I am always having to throw buckets of cold water on gay guys who try to chat him up.
Anyways back to the blond thing. With age the blond thing has matured into what has variously been described as dark ash blond,dirty blond, mouse brown or light brown with blond highlights. Hubby says I have honey colored hair and is amazed at how if you look at each hair individually I have everything from platinum blond to black growing out of my head. Since I was a kid I wanted long straight black hair like a Polynesian Princess.
Blond people get a lot of bad press. Dumb blond jokes abound. Bleached blond remarks are unpleasant. It is just not a pretty stereotype. Why then, do so many women "go blond" and why are men so attracted to blond women? Is it some sort of Darwinian thing? Are blonds recognized a genetic recessives ready to be dominated ?

It's a blogs life

Blogs were born to sleep in the sun. -Snoopy

Oh well, why not, history rewrites itself,people are misquoted and all's fair in love and blogs.

I guess one "side effect" of getting older is that I am now able to blow off the remarks of people I used to take to heart. When I was younger I would be just mortified if I thought someone didn't like me. I am still not sure what the dynamics were but I guess I needed to feel I had the power over people to make them like me. I know now that I am powerless over other people . What a release. I no longer feel responsible for the way other people feel. I like that warm fuzzy feeling of consensual validation if some one writes something nice in the blog or agrees with me in the nonblog world. I find I don't value myself based on others' remarks anymore. It's not that I have tried to care less, its just that I have mellowed . Finally. Phew!