Senior Moment No. 6 : Sunday in the ER with Greg

     New and soon-to-be parents often daydream about all the things they will experience with their children as they grow.  They imagine trips to the zoo, to museums, family vacations to Disney World and the Grand Canyon.  I'll bet somewhere a mom-to-be is at this moment planning her baby's first birthday party.  A new mom is feeding her infant and wondering what he will be like when he's 17.  I know I did.  One experience I can guarantee those new parents are not dreaming about is a trip to the Emergency Room. 

     And yet, that's one eventuality that every parent should plan for, because it will happen.  If you're really, really lucky, you'll visit the ER only once during your child's growing up years.  But I can tell you that your odds of winning the $48 million powerball are much better.  So far we have made a total of seven trips to the ER with Greg.  I say "so far" because he's still a minor (if only for 6 more months), but, even after he turns 18, he'll still be on our health insurance plan (we hope).  Parental concern aside, we'll have to accompany him to the ER if only because we have to sign the treatment consent form as the "responsible party."

     Which brings me to our most recent visit to the Olathe Medical Center's emergency care area.  That would be today.  Greg spent most of the day Saturday vomiting, the unhappy victim of a particularly nasty stomach virus that hit him hard.  By 9:00 am, after his eighth run to the bathroom, I decided we needed to get him to a doctor.  Well, as everyone knows, primary care physicians' offices are rarely open on Sundays.  The walk-in clinic didn't open until noon.  Considering the paleness of Greg's skin and the dryness of his lips, I figured the walk-in staff would just send him to OMC anyway.  So, hey, by 17 years old, he knows the drill.  We skipped the middle man and made a beeline for the ER.

     It was most definitely the right call.  Yes, he was dehydrated.  They hooked him up to an IV and gave him anti-nausea medications.  We were there for most of three hours while they gave him two full bags of fluids.  When he was able to keep down fluids sipped from a cup as well as some crackers, they sent him home, where he has been asleep ever since. 

     This was, by my count, our 7th visit to the ER -- not including his birth, which took place in an OR in the maternity ward.  I had the easiest of pregnancies -- no morning sickness, no nausea, no complications.  But, by the middle of my third trimester, I had developed preeclampsia, which resulted in a c-section and a nightmarish recovery.  Preeclampsia is characterized by high fever, high blood pressure, a drop in platelet counts, and fluid retention (which puts the patient's kidneys in danger of shutting down).  I experienced all of that; in fact, I've never been sicker in my whole life.  For me, the possibility that I could have a recurrence with a subsequent pregnancy was enough to make the decision to stop with one child.  In fact, it turns out that preeclampsia runs in families.  My mother had it while pregnant with me, and my sister showed signs of it in her own pregnancies.  Suffice to say, I have never regretted that decision.

     Still, it didn't occur to me as a new mom that I would become a frequent buyer of OMC's emergency services.  Maybe it's because my only visit to the ER as a child was to accompany my sister who had cut her forehead on the bedrail of my bed in an unsuccessful attempt to jump from her bed to mine.  The cut required stitches.  It was excruciating!  It took so long; the whole ordeal was extremely painful and uncomfortable.  And that was just sitting in the waiting room!  I'm sure it wasn't much fun for my sister, either.  Yes, I was one of those blessedly sedentary kids who spent more time reading a book than doing something physical, thereby greatly reducing the risk of injury.  I didn't really get the full benefit of the ER experience until adulthood.  Now I consider myself sort of an expert.

     I had some time to reflect on this while I was sitting in the room this morning waiting for Greg to rehydrate.  Some of those visits turned out to be inconsequential -- nothing more than an inner ear infection.  But, when your toddler is obviously in pain and sobbing uncontrollably at 2:00 in the morning, what else do you do?  Some of those visits, however, were more memorable.  Here, then, are some of the highlights:

Why You Shouldn't Run With Sharp Objects (Or, Why You Can Never Completely Child-proof Your House No Matter How Hard You Try)

     Scene :  Early evening, summertime.  I suggested to 2-year-old Greg that we go out for ice cream (Steve was at a gig).  While I was collecting my purse and car keys, Greg ran outside.  Within seconds I heard a blood curdling scream followed by hysterical crying.  Unbeknownst to me, Greg had a pencil in his hand when he ran outside.  You guessed it -- he dropped the pencil, then promptly tripped and fell on it.  The pencil left a long, nasty-looking abrasion across his cheek; it stopped mere centimeters from his eye -- this is what your mother meant when she yelled, "You could put your eye out!"  The cool part, though, was literally watching the abrasion heal, right before my own eyes.  Young children's cells are constantly dividing and new ones growing; you can actually watch the regeneration in real time.  Pretty amazing.

We Told You to Leave the Poor Cat Alone!

     Scene:  December, 1996.  Our 10-year-old cat, Goblin, was dying of cancer.  He had a tumor on his tongue, which made it very difficult for him to eat.  He had lost a lot of weight and was very weak.  Yet, 4-year-old Greg persisted in tormenting the poor cat -- chasing him, grabbing his tail, trying to pick him up.  Finally, Goblin resorted to the only defense he had:  he bit Greg on the hand.  We cleaned the wound and treated it with Neosporin and a bandaid.  But cat bites can be tricky.  Even healthy cats have bacteria in their saliva that can cause infection.  Sure enough, in the wee hours of the  morning, Greg awoke feverish and crying, his hand swollen from a developing infection. 

     The ER visit included X-rays of the injury (to make sure there was no tendon damage), a tetanus shot, and a vigorous course of antibiotics.  The follow-up activities included an appointment the following day with a hand surgeon (in case there was damage to Greg's hand -- he could possibly lose all or partial use of it!) . . . and a 3:00 am home visit from an Animal Control Officer.  Note to pet owners with small children:  If your pet bites your child and he is treated in the ER, the ER staff are required by law to report the bite to Animal Control.  An officer will then come to collect the animal in question for a 10-day quarantine to watch for signs of rabies.  Even if the animal has recently been vaccinated for rabies, as Goblin was.  However, they are not equipped to take a terminally ill pet, as there is no veterinarian on staff.  In that case, the pet must be quarantined at your vet's clinic at your expense.  Hopefully your vet is like ours -- wise, compassionate, and sensible -- and he will convince the officer that the cat would be much more comfortable being quarantined at home.  Goblin passed away six weeks later.  Greg's hand sustained no damage, thus no surgery was required.  And he learned to be much nicer to the cats.

If, After Falling Off a Trampoline on Your Arm, You Feel Shooting Pain, Tingling, and/or Numbness -- For Pete's Sake, GO TO THE HOSPITAL!

     Okay, the title pretty much says it all, but let me fill in the details.  16-year-old Greg was at a friend's house jumping on a trampoline.  No spotters, not much thought given to safety, as evidenced by the fact that Greg decided to dismount by jumping off.  He jumped at an odd angle and put his arm out to catch his fall.  Landing on his arm with his full body weight resulted in a great deal of pain, tingling, and even numbness.  He treated the injured arm by going inside the house and lying on the couch.  Two hours later, his arm hurting worse, he decided to drive home.  Minutes from home, Greg called on his cell phone to say that he was on his way home, and, oh-by-the-way, he hurt his arm jumping off a trampoline -- "probably just a sprain."  When he arrived home, it was obvious this was a little more serious than a sprain.  The X-ray at the ER confirmed it:  hairline fracture just below the elbow.  Two weeks in a cast, another week with the arm in a sling.  Greg's lucky it was only three weeks; it could have been much worse and much longer.  Still, it was his right arm that was injured, and he's right-handed.  Three weeks of not being able to write or eat (it's hard to hold a pen or a fork very well when your entire lower arm is immobilized) taught him a lesson. We think.

     Comparatively, today's visit was pretty tame.  Knowing he would probably be there for awhile, I brought a book.  Greg dozed while the fluids dripped into his veins through the IV; I read The World is Flat by Thomas Friedman.  In fact, we had been in this particular situation before.  Fifteen years ago, Steve was hospitalized for dehydration brought on by a similar illness.  I brought a wide-eyed Greg to the hospital to visit his dad.  Taking note of the tubes running in and out of Steve's arm, Greg, then 3 years old, earnestly asked him, "Do you have fluids and liquids?"  Today it was Greg's turn to get the "fluids and liquids."  He winced a little when the nurse stuck the IV needle in his arm, but it was really no big deal.  After all, he's a pro.

Above photo:  Greg, age 4 or 5, in front of our house in the snow.

You Say You Want a Resolution

Q.  Which of the following poses the greatest threat to heavy people?

(A)  Heart disease

(B)  Diabetes

(C)  Cancer

(D)  Photography

Answer:  (D)

Yes, when you're overweight, the most terrifying thing you can experience is someone snapping your picture, especially before you have the opportunity to look around for something to hide behind.  Some of us have become very adept -- even creative -- at finding ways to camouflage our girth in a photo.  The above picture is a good example.  It was taken nearly ten years ago on the Plaza.  We took Greg out for his birthday, which naturally meant taking some pictures.  The "cow exhibit" was in place at that time, which made for several entertaining photo ops.  In this photo, I'm not only strategically hiding all but my face behind the "shuttlecock cow," I have the added benefit of my cute and precocious son posing in the foreground, drawing attention away from his heavy mom.  Ingenious, if I do say so myself!
     Nowadays, I could go even further and photoshop myself thinner.  Anyone who has seen the Dove ad in which a perfectly lovely model is photographed and photoshopped to look "even better" knows what I'm talking about.  The ad is meant to show how artificial the ideal of beauty is in this country  In fact, it doesn't exist . . . except in retouched photographs.  Unfortunately, we can't "retouch" or "photoshop" ourselves in real life.  We can hide behind objects and jockey for position so that our heaviness doesn't show in the photo. Believe me, I've done it myself, almost pushing people out of the way so I could be on the back row (now that I think about it, it almost seems like an oxymoron)!  We can have the photos cropped, edited, grey-scaled -- anything to alter our true appearance.  We can wear dark colors and baggy clothes in the mistaken belief that they will somehow make us look slimmer.

     But we can't hide the damage that lugging that weight around does to our bodies.  We all know about the increased risks of heart disease, stroke, diabetes, cancer, and a host of other serious medical problems -- but what about the risk of getting poor health care or even no health care at all?  A jaw-dropping article in the January/February 2010 issue of Health reports that overweight women "have a harder time getting health insurance (or pay higher premiums for their insurance); are at higher risk of being misdiagnosed or receiving inaccurate dosages of drugs; are less likely to find a fertility doctor; and are less likely to have cancer detected early and get effective treatment for it."  And that's just for starters.  Health magazine also reports a chilling find:  many doctors are biased towards overweight women.  In one survey some doctors admitted that seeing heavy patients was a waste of time:
      University of Pennsylvania researchers found that more than 50 percent of primary care physicians viewed obese patients as awkward, unattractive, and noncompliant; one third said they were weak-willed, sloppy, and lazy.  In addition, researchers at Rice University and the University of Texas School of Public Health in Houston found that as patient BMI increased doctors reported liking their jobs less and having less patience and desire to help the patient. 
     The article points out that overweight women who feel stigmatized may turn to food for comfort as a result of the stress from the stigma, thereby making the problem worse.  Overweight women are also more likely to delay doctors' appointments and preventive care -- including screening for cancer -- rather than face criticism.  More alarming, overweight women are less likely to receive heart catheterization procedures as well as organ transplants because of greater risk of complications.  Even routine screening procedures like pap smears, CT scans, and ultrasounds are made more difficult by the extra weight.  In one study, obese women were more likely to have false-positive results from mammograms, which can lead to unnecessary biopsies and anxiety. 
     I'm very lucky to have a kind, compassionate doctor who listens to me -- and who hasn't given up on me because of my weight.  To the contrary -- she stresses to me over and over her desire to see me lose the weight and improve my health.  I know that she has my best interests in mind, but, until I read this article, it hadn't really occurred to me that I could make her job easier -- and the quality of my care better -- by losing weight. 
     Losing weight isn't exactly a New Year's resolution for me -- it's an ongoing resolution, one that I've been working on in earnest since October.  As I stated in a previous posting, my ultimate goal is to lose 100 lbs by my 50th birthday.  That birthday is 11 months away.  I know -- 100 lbs is a pretty tall order in less than a year.  But even if I lose only half that much, I will have accomplished a lot.  That's my long term goal; my short term goal is to see my doctor smile at my next appointment.  Then maybe I'll have my picture taken -- standing next to a large object rather than behind it.  I'll keep you posted.

Snow Stories

     Take a look at the photo to the left.  That's my street, looking west.  You might expect that I took this photo today.  Nope.  It was taken on December 26, 2009.  Last month.  Last year.  Almost exactly two weeks ago.  And two weeks later, my street still looks like that, except there are 4-foot piles of snow lining the curbs where the snow plows have made a pass.  Oh, and that bit of pavement visible in the middle of the street?  Long since covered over.  We've had two more significant snows since Christmas Eve, adding more layers. Not only that, a plunge into single digit temperatures plus wind chills in the negative double digits has kept the snow in  place.

     I realize this is nothing compared to what folks are dealing with in the Upper Midwest, or, for that matter, what folks in the Northeast and mountain regions deal with every winter.  But for the same snow to stay on the ground for two weeks (and counting) in Kansas City -- not to mention the frigid temperatures and dangerous wind chills -- well, it's unusual to say the least. 

     As my husband's mother used to say, "It's real winter out there."  Real winter, indeed.  In the nearly forty years I've lived in Kansas, I don't recall another Christmas Eve blizzard like we had this year, and I can't remember snow lasting this long without a thaw.  But, despite the fairly mild winters we've had over the last decade, it's not unheard of to experience this much snow and an Arctic cold snap here in the middle of the country.  So, having been driven indoors by the blowing snow and bone-chilling air, I've had plenty of time to reminisce about other "real winters" in my life. 

     It's an old cliche:  In my day, we walked two miles to school through the snow -- uphill . . . both ways!  While it may be a bit of an exaggeration (okay, it's a myth), I would like to point out to the young people in my life that yes, they do in fact have it easier than we did!  Nowadays school districts cancel classes at the drop of a snowflake, it seems.  Certainly, this past week all school districts in metro Kansas City were forced to close due to several factors:  icy streets, bitter temperatures, and, I suspect, fear of lawsuits if anyone got hurt trying to get to school.  I'm not being critical -- it makes perfect sense.  Obviously school officials have learned over time that it's better to be safe than sorry.  I wish it had been so when I was in school.

     I remember one winter day my sophomore year in high school when a heavy snow was falling and blowing into drifts in the roads.  Was school cancelled?  Of course not!  Nobody cancelled school in the 70s -- for shame!  I lived at Ft. Leavenworth at the time and attended Leavenworth High, which was several miles from the post.  The bus was late arriving to pick us up (no surprise, given the road conditions); I recall waiting 25 minutes in the bitter cold.  Finally, the bus arrived.  We made one more pickup after my stop, then headed into town toward the school.  The usual route took us up a steep hill.  Now, taking into consideration there were no more stops along the way, plus the slick road conditions -- with snow blowing and drifting across the street -- you would think the bus driver would choose a different route, at least one a little more traveled.  You would be wrong.  The driver gamely headed up the hill as everyone on the bus nervously watched.  Halfway up the hill the bus slid off the road . . . and into a ditch.  We waited more than 30 minutes for another bus to come and pick us up.  When it arrived, it stopped at the top of the hill; the driver had been instructed to stay there rather than take a chance sliding downhill and getting stuck.  You guessed it -- all of us students were told to get off the bus and hike up the hill to the waiting bus.  So, when I say I walked uphill in the snow and bitter cold to school . . . I'm not kidding!
     Or how about driving over 200 miles in the snow to school?  I did that, too.  Well, technically, I was driving home from college through the snow.  I had driven a flute buddy and myself back to Manhattan, Kansas over Winter Break to play in the pep band for a K-State basketball game.  After we arrived in Manhattan, it started to snow; by the end of the game, travel was treacherous.  We decided to spend the night in Manhattan and drive back to Kansas City the next day. 
     The following day we headed east on I-70, which, due to blowing snow, was patchy at best.  Somewhere in the desolate No-Man's-Land of the Flint Hills, between Wamego and Topeka, we slid off the highway into the snow-filled median.  There were no exits, no buildings, no rest stops, not even any other traffic on the highway.  If I had been driving any other vehicle, we would have been stuck there for days (remember, kids, this was B.C. -- Before Cell phones).  But, as luck would have it, I was driving my parents' 1975 Oldsmobile Regency -- the only custom-built "luxury" car they ever owned.  It was silver gray with a plush velour interior, power steering, power brakes, power windows, and power seats.  By 1970s standards, it was just about the classiest car you could buy, short of a BMW.  It was very long and roomy, almost like being inside a limo.  It was a little like driving a limo, too -- the hood seemed to stretch all the way to the horizon. 
     By the early 80s, its glamour days were over, but the thing was built like a Sherman tank.  A few years later, my future husband would dub it the "S.S. Coble."  So, summoning my Army brat wits from a childhood spent in the military (having seen the movie "Patton" didn't hurt, either), I drove the S.S. Coble forward, slow and steady,  straight up the median until I found a relatively clear spot to re-enter the highway.  I gingerly steered onto I-70 and headed home.  Whenever I see an SUV spun out in the snow along the highway, I remember that day.  The S.S. Coble was a great big, clunky gas guzzler, but damn -- it sure could handle snow! 
     Fast forward to December, 1987.  I was a grad student at the University of Kansas, working toward my master's degree in music education.  Just my luck -- the day I had two major finals, it started snowing in the wee hours of the morning.  As dawn broke, the snow intensified, which is how I found myself driving to Lawrence at 7:30 am in blizzard-like conditions.  What was normally a 35-minute drive took nearly two hours as I drove no faster than 25 mph on westbound K-10, peering through the blinding snow -- visibility no more than about 30 feet -- all the while trying to keep my Toyota Tercel steady in the whipping wind.  My first final began at 9:00 am; I arrived at 9:15.  Dr. Radocy's jaw dropped when I walked in.  "I did not expect to see you here!  Now that's dedication!" he exclaimed.  But there I was, so he gave me a copy of the test.  I pulled out my blue book and ballpoint pen.  The final exam for his class was an essay test.  As I began to write, my hand wobbled; I struggled to hold the darned pen.  I realized that I had been gripping the steering wheel so hard during my torturous drive, my hand was shaking from the tension!  Somehow, I managed to write, and I even finished the exam 10 minutes early.  My handwriting looked pretty sloppy, but it must have been legible -- Dr. Radocy gave me an A!
     So there you have it -- the snow stories of my youth.  All of us "old folks" love to tell them.  They aren't cautionary tales so much as validation -- and proof of survival.  The advantage of age is that we've "been there, done that" and lived to tell about it.  And we lived to tell about it because we learned something from the experience.  Wisdom gained, which we can now pass along to the younger generation from safe inside our warm homes by the fire, with a cup of hot tea in our hands. 
     Because, kids, the point is this:  I already walked up that snowpacked hill in -10 wind chills to school -- now it's your turn!  What?  You say they cancelled school?  Another snow day? What a bunch of wimps!  What stories will you have to tell your grandkids?  Tell you what, get me another cup of tea, and I'll let you borrow one of mine.