I try, when I can, to make the hour drive to Johns Hopkins Hospital when I think I’m having a medical emergency. However, on October 12th, I thought I might be having a heart event of some sort, and realized that I needed to get to the closest ER possible. This meant driving 10 minutes to the Meritus Hospital ER, which turned out to be the worst choice I have made, medically, since having surgery with Dr. WLS.
Over the week prior, I had reoccurring headaches, and increasing pain/weakness in my right arm. On my birthday, October 11th, the pain had become severe, and had spread to the right side of my torso, including over my sternum area. I really didn’t want to go to the hospital on my birthday, and I kept telling myself that it was the “wrong arm” (as, stereotypically, heart events cause pain in the left arm). However, by 3am I was having a hard time taking deep breaths, and the pain in my chest was pretty significant. I woke Rave up and told her I thought I should get checked out, even if it’s just to rule out a heart event.
I had other reasons to worry: I’ve had a bunch of irregular tests lately when it comes to my blood, my blood pressure, and my doctor was suggesting a statin because my HDL was a little (but only a little) high. My blood sugars have been high regularly, and it had been hard to regulate it because I kept having to go off my Metformin due to CT scans and other tests. (Metformin raises your body’s sensitivity to insulin, which helps a diabetic use less insulin – or none at all – to regular their blood sugar numbers.) And the pain I was feeling was pretty damn severe, especially in my right arm. In fact, the reason it’s taken me this long to write about this is because my right arm is still in severe pain – 7 out of 10 pain on a good day – and my hand and fingers have had some weakness as well, which has made it hard to type at all.
So Rave woke up and we drove down to the Meritus Hospital. I’d been there once before, for what turned out to be a superficial blood clot. I wasn’t very impressed then, but it wasn’t awful.
When we arrived, I was pleased to see that there weren’t many other people in the waiting room. One of my biggest reasons for being hesitant about going to the ER is the fact that often, we have to wait hours upon hours before anything significant happens, and I feel bad that the person who brings me there has to stay up all night (or longer) just so I can find out it’s no big deal. Also, ER waiting rooms tend to fill quickly starting on Friday night and lasting through the weekend, since people can’t call their regular doctors for less emergent stuff – or they wait until the end of the work week to seek treatment, so they don’t have to miss work.
The ER has big signs as you enter that say something like “If you are experiencing CHEST PAIN or SHORTNESS OF BREATH, please inform the registration desk immediately”. Since they were both happening to me, I rolled up to the desk and pointed to the sign and said, “That’s me.” I waited about five minutes before a triage nurse came out and led me directly to a EEG machine to determine if I was having a heart attack right then. Things looked a little abnormal, but not “OMG” abnormal, so they walked me through the rest of triage and then brought me back.
That was the end of anything that made sense for the rest of my visit.
A doctor came and saw me about 30 minutes after I was brought back, which seemed like a little too long for someone who might be having some sort of heart event. After listening to my lungs and asking me some questions, he decides I need a breathing treatment. I look at him and ask how that would help my heart problem, and he said, “Well, this will help us rule out something like an asthma attack”. “How about the fact that I don’t asthma?” Anyway, we had to wait for a respiratory nurse to come and administer the treatment, maybe another half hour. As soon as I was hooked up to the mask, other nurses came and tried to take me to CT and X Ray, and were told to come back when I was done. The breathing treatment did nothing for me but make me feel high and unfocused, which was not conducive to me answering the hundreds of questions nurses and doctors and techs had for me over the next two hours.
When I told the CT tech that I have had over 20 CTs in the last year, she freaked out a bit. “We usually recommend no more than 6″, she says. So I ask her, “Do you think this CT is absolutely necessary?” …and of course she says, “Yes.” I’ve asked that question every time I am asked to have a CT, and never ever has a doctor said, ‘Oh, well, now that I think of it, maybe we can do something else.”
When I got back, the IV ordeal began. The first tech poked me three times before she gave up, even though I showed her where most phlebotimists have had good success getting a vein. Then the doctor came back with an ultrasound machine, so he could visualize the vein before poking. Even with that, it took him three different tries to get a good line. This did not instill any confidence in me whatsoever. After that, I was given a small amount of pain meds – that did jack shit – and sat waiting for almost two hours. Also, after I witnessed my doctor put the needle in, then reach to a shelf with the same glove (thus contaminating the shelf) in a very habitual manner (which means this has happened before, with other patients), I asked him to change his gloves before he proceeded. In every other medical situation I’ve ever experienced, a request to wash hands or change gloves has been met with immediate compliance and no questioning. This doctor, on the other hand, looked confused and angry, and tried to explain to my why it wasn’t necessary. When I tried to point out how he was wrong, he copped an attitude and stripped the gloves off in a way that clearly communicated “I totally don’t want to do this, and I’m angry you asked”.
After this, a brand new doctor comes to see me – maybe because of the glove issue, since I saw the first doctor still there. This part is going to make me seem less PC, but I hate doctors who can’t speak English well enough to be understood. This new doctor was some flavor of Asian, and I couldn’t understand her at all. I had to have her repeat herself three or four times, and then I would try to restate what she said to make sure I got it right. I was told I had a PE, or pulmatory embolism, which is a pretty fucking big deal, life and death stuff. She told me I would be admitted for observation and for further testing. I didn’t feel I had a choice, since I had a PE, so I agreed.
One of the big things about Meritus that makes it a bad hospital is that the ER is the nicest part of the hospital. Once you get admitted, you’re shown through hallways and rooms that are old, dirty, not well kept, and feel depressing. Not that I’m usually overjoyed about being in the hospital, but many decorate the rooms so it seems a little less like you’re in a prison. This fact was made sadder when I found out that the hospital had been completely renovated only a few years ago. I was put on the “observation floor”, and considering how little actual “observation” I recieved, this misnomer should probably be changed.
I was brought a meal I couldn’t eat much of, and then the nurse chastised me for not eating more. When I explained to her I had food sensitivities that made most of this inedible, she told me that she would talk to someone in dietary to come up and discuss better food choices. Not only was it inedible because of my diet, but it was also completely unappetizing. I am pretty sure their miniscule portion of scrambled eggs were from a powder, having eaten my fair share of powdered eggs in my time. The only thing I was given to drink was coffee, which I can’t have because I am sensitive to caffiene.
During the intake, I was never asked about what meds I take. However, I was grilled at length about every single personal item I had brought with me. From my glasses to my underwear and my wallet to my Nook. I stopped at one point and asked the nurse “Is there a lot of theft in this hospital that makes this necessary?” She looked sheepish and said, “Oh, no, no.” But it did come across as though they were much, much more worried about someone stealing my phone than knowing what meds I take or what medical conditions I have. (Which no one ever asked me except at triage, and that was from a set list, which didn’t include many conditions I have.)
Then I spent hours just sitting around. No tests, no doctor visits, no pain or nausea meds, nothing. Finally, Rave started chasing doctors and nurses down to find out what was going on or to ask if I could have more meds. This is when we both directly observed hospital personnel, on several occasions, sitting around talking amongst themselves about non-medical subjects (at least twice we saw really obvious sexual/romantic flirting going on).
Also, there are signs on the walls everywhere that informs you that personnel have smartphones, but “rest assured they are not being used for personal use, but to enable communication in the hospital”. Although I applaud hospitals experimenting with new tech to facilitate better care, these were the most annoying thing in the world. The problem was not the phones themselves, but that caregivers (at every level, from techs to doctors) would always answer them. No matter if they were in the middle of administering a test (like the CT), or explaining your health status, or while you were trying to explain what you were feeling so they could treat you. It’s like all of the bad habits of smart phone usage in the general public in a condensed form. It was so frustrating.
When I asked about my home med schedule, I was informed that I should take them from my own supply (which I always bring with me to the hospital, but not everyone does). Later on, a nurse or doctor (I was never clear on who was who, since no one introduced themselves to me, ever) flipped out about this, and demanded me to both list every med I took, and that I have Rave bring my med bag home at the first chance. Since they never gave me any of my maintenance meds while I was there, I’m glad we didn’t. It took forever to get any meds from the nurses, and every instance was treated as though I was being totally unreasonable for wanting nausea or pain meds. There are big posters that proclaim that they have a committment to treating pain, but my experience was the exact opposite. And this wasn’t the typical, “Wow Del, you’re on a really high home regimen of pain meds, so we don’t want to give you any more”, because I am on (comparatively) much, much less pain meds than I was a year ago.
Finally, after waiting over 6 hours for the cardiologist to come (even though the other doctor said everything about my heart looked just fine, which was suspect in itself since I have heart problems they never asked about, like an enlarged heart), having been assuaged that I was next in line at 9am and it was now 3pm, the hospitalist came in and I asked her if there was any reason for me to stay in the hospital if everything looked good. At some point, the fact that I was told I definitely had a PE kinda went away, as no one else had heard this when we asked. Also, the fact that I had been told I was to be given a diruetic since my legs were swollen never happened either. So at this point, I see no effing reason why I needed to stay any longer. The hospitalist actually agreed with me, but asked me to wait a little longer so the cardiologist could sign off on my discharge.
The hospitalist came back about 3 minutes later and said, “Oh, he won’t be able to get to you for a while, so you can just go home.” She took out my IV and told me she’d be back in a minute with my discharge papers. 10 minutes pass. 20. Then I decided to put on my clothes to make it clear I was leaving. A phlebotomy tech comes in and tells me I need another blood test. I tell her I was told, definitely, that I was only waiting for papers to be discharged. She, very confused, went and talked to the doctor, the exchange of which happened right outside of my door. The phlebotomist was clearly of the attitude that I was just being beligerent, even thought I had been calm and collected (no matter how angry I was at this whole fiasco) when talking to her. The doctor comes in and says, “Oh, you need to do this test before you can be released”. I said, “No. You said I could go home now, and the only thing in the way was getting the discharge papers. I’m holding you to that.” She shrugs and says, “well, we don’t really need it anyway.”
As one last “Fuck you, Del”, as I signed my discharge papers, the nurse pulls out a “Against Medical Advice” (or AMA) document. This is what you have to sign if you leave a hospital when the doctors have clearly told you you shouldn’t. She tries to quickly explain that because I refused to stay for another test, I had to sign myself out AMA.
“Bullshit.” Was my answer. I refused to sign. This means that if I ever go back to that hospital, I will be marked as a non-compliant patient, which definitely affects the care you receive. But you couldn’t drag me back there if my life literally depended on it.
There was one moment of levity, though. At one point, a tech came to put on the EEG machine and started using masculine pronouns. The nurse or doctor who came in heard this and tried to correct the tech. The tech looked at me and my only answer was “I chose a gender-neutral name for a reason!” For the rest of the exchange, the tech used male pronouns while the doctor/nurse used female ones. It was amusing.
But not amusing enough to make me ever want to go back there. Or send anyone I care there if they need more than stitches. I will find a better local hospital, or I will endure the drive to JH.
I get a lot of odd search terms (what people put into a search engine and find my blogs). But one of my all time favorites has been “If I eat a crow, will I get sick?” I mean, it’s a good idea to check before diving into strange meat to see if there are any standard precautions, y’know, like not eating raw chicken. And honestly, I’ve never done the homework to find out the answer to that time-old question. I mean, I figure any source of meat, if thoroughly cooked, is probably edible.
But that’s not what I wanted to write about today. It is, however, a someone apt title for my newest and most amusing symptom.
I know it’s been a long time since I’ve updated you guys on my medical situation, and part of that is because I’m in a state of limbo; a brand new, completely different, confounding medical problem has become the star attraction. I’m wary to say too much right now, because it’s in that stage where my new PCP just spouted a lot of guesses based on what they saw in my bloodwork and some of the things are game-changers. I’ll put it this way: the person who accompanied me to the appointment disagreed with my remembering of what the doctor said, so to be extra clear that I wasn’t worrying over nothing, I emailed her and got some clarification (I was right, if that matters.)
So the new issue is my blood. There is something funky with both my red blood cells and my white blood cells. The only white blood cell disease that has been ruled out is leukemia. The red blood cell problem is likely just anemia; but the biggest symptom is what I want to write about because I find it so damn funny.
Pica is a disorder I’ve found endlessly facinating since I was a child. I have even devoured every episode of “Strange Addiction”, as most follow a formula of “Person who does weird thing” followed by “Person who eats a nonfood substance” (like toilet paper, bathroom cleaner, or cornstarch). I once even asked a friend about a trend on the show, where African-American women were in the majority of the latter-half segments. She told me that, indeed, pica is common in African-American women (as the wikipedia article says), and that she herself had tried eating a non-food item after an errant craving.
My pica snuck up on me. Normally, when I’m at home, I don’t use ice in my drinks unless, for some reason, I have to drink water. (I really dislike water unless it is very cold.) But as the dog days of August came in, I started filling up my ice tea tumbler with ice cubes before adding the tea. Once the iced tea was gone, I would suck on a few ice cubes and maybe bite them so they would break into smaller pieces (making them easier to suck). As time wore on, I was putting less and less iced tea into the cup, and just filling it with ice so I could eat the ice. I didn’t think of this as “eating ice”, though; I still thought I was drinking iced tea.
It got to a point where I could no longer deny that I was now skipping the iced tea entirely and just eating huge cups of ice. I would wake up in the middle of the night because my craving for ice was so strong. Instead of pouring myself something to drink with meals, I would just pop an ice cube in my mouth every once in a while. Finally, Rave noticed the trend and decided a) this is a “thing” now, and b) we needed to get smaller ice cube trays so I didn’t break my teeth or hurt my jaw.
It seemed pretty harmless. I figured that it was, at the very least, upping my water intake. Almost every time I’ve been to the hospital or ER, I’ve been dehydrated. The last trip, in August, I was so dehydrated my urine was reddish orange. When I get in pain, I stop drinking. I don’t know why, but I do. And when I am super nauseous, the only liquid intake I can handle is ice, or water with a lot of ice.
It became such a habit that I would fill a mug with ice before going to bed, both so if I awoke wanting ice it would be there and so I could use the water in the morning to take my pills. Rave now makes sure I have a cup of ice at hand most of the time she is home.
I saw the doctor last week and I first brought up the restless legs. It is a symptom I get any time I go into opiate withdrawal, but I am currently on a low dose oxycontin regimen and have no withdrawal symptoms other than the RLS. It’s so bad that there are full nights I’ve lost sleep because every time I laid down I would reflexively start rocking my legs. Even when I’m sitting up, I get this crawly energy that runs up my calves. Nothing else relieves the sensation but moving my legs. I do use my foot bike when the feelings are overwhelming, and the fact that is has a backup motor (so if I don’t have the power to push the peddles against resistance, my legs will still go in circles) is super helpful in those times, especially at 3am when I’m exhausted and just want to go to sleep.
Between my odd bloodwork numbers and the RLS, she was already thinking that something is up. When I told her about the ice, it clinched it. I basically have all of the markers of iron deficiency. So that’s in the works.
However, the pica has “grown”, I guess. It’s hard for me to admit this, but I am trying to keep a lighthearted sense of humor about it because otherwise I would probably freak out to the point of uselessness. In the past two weeks, I’ve had cravings for dirt (another classic pica symptom), cigarette butts, and wanting to chew on wood. I have not given into any of these for obvious reasons, and when I get the odder cravings I just get more ice and eat that until it passes.
I am not at all concerned about this being some sort of mental health issue, because if there’s any disorder I know for certain I do not have, it is OCD. I am not autistic, nor am I eating ice in some odd way of getting attention. In fact, I prefer to eat my ice in my room alone.
I also learned that pica gets its name from the Magpie (another reason why the Crow thing seemed appropriate) because people observed that magpies will eat just about anything.
So there it is. Maybe this is some odd coincidence, since I’ve always been fascinated with pica. I had a dog with pica when I was a kid, who ate all sorts of nonfood things. Now I know what she was going through, I guess.
I should know more about the blood issues in a week or two. Longer, of course, if they turn out to be more serious and require further testing.
…and the diagnoses are the spaghetti.
Still at Johns Hopkins, and it looks like this trip is going to end very unsatisfactory. After being absolutely certain that the problem lied in my kidneys, they have now ruled that out completely. I don’t really understand how, as some of my symptoms are unmistakeably kidney related, but the doctors assure me my kidneys are just fine, other than the small stone that is “in a place I shouldn’t be able to feel it”.
So today’s crazy noodle is some sort of lung issue combined with neuropathic pain. The chest x-ray they took showed that part of my right lung is not getting as much oxygen as it should. Of course, this could easily be explained by the fact that I’ve been having crippling flank pain for over a week now, forcing me to take shallow breaths, but of course that would be too easy.
From what the doctors said, it looks like their plan is to run a few more tests, let a few test results come back from the lab, but otherwise begin the transition towards discharge. They’ve already lowered my pain meds; normally I’d be cool with that, except around dinnertime I got another giant stabbing, burning pain in my flank and now nothing the nurses can give me helps at all. I spent most of the night sitting still in the chair, trying hard to find a position that doesn’t make me cry. Gah.
What really upsets me though, is that the doctors are already talking about how I should chase this problem down as an outpatient. However, and it’s not their fault, but I can barely keep up with all the doctor’s appointments I have now. Between not having a regular driver who can bring me from Hagerstown to Baltimore, not feeling well enough to leave the house, not having the money to fill any more prescriptions or other medical shite thrown in my direction, I don’t know what the hell I’m going to do to chase this down. They’re talking about attempting an MRI again, although this doc says she knows of a few machines that might accommodate me better than the one here. The intern stopped by this evening and asked me a bunch of questions that were dancing around the idea I might have MS: this is one of the most bandied about diagnoses I’ve heard since this all began, but the diagnostic criteria are either a) spinal or brain lesions on an MRI or b) ruling every other disease on the planet out first. I might actually be getting close to the latter, these days…
But I have to say, this hospital stay has been exceptionally hard on me. It’s a combination of factors: I’ve been alone more; every time I feel like I understand what’s happening with, and to, me the rules change; I’m in the “historic” building this time (if you think the 1970′s were “historic”) and the room isn’t as cheerfully appointed; I haven’t been able to eat or sleep like a normal human being in more than a week; oh, and let’s not forget Dr. Laing’s shenanigans. I can’t recall if I’ve ever secretly planned to sneak out of a hospital AMA before.
I also am feeling this crushing weight on my heart because, for so many years, loved ones were pressuring me hard to seek out Johns Hopkins in hopes they would be able to solve the greater Del mysteries. Now that I’m here and in the reality of it, people are constantly asking me why. Or why I haven’t moved on to somewhere else. Here’s the truth of it: it’s really not that easy for someone like me to up and move all of his health care around. I mean, I’ve been in Hagerstown for just about a year and I still have at least one doctor in Germantown I have yet to find a counterpart for. Getting my pain management shit transferred was a big deal (although, another benefit of having suffered through the wean is that if I don’t like what his next move is, I can likely find another pain management doctor fairly easily now), and now I have a huge amount of data here referring to my abscess adventures.
In fact, I debated going to the Hagerstown ER when the flank pain didn’t get better. I figured any hospital worth it’s weight should be able to heal a kidney infection, right? But the more I thought about it, the more complicated it got. We’d have to get all the office info for my JH doctors; they wouldn’t have any of the information about the abscesses; they would have to get all my CT results so they could compare now with before; and of course now that we know it isn’t a kidney infection but something more difficult, I’m glad I didn’t.
I have decided, however, that I am using the next few weeks as a time of omens. There are some big questions on my plate that I have been very slowly compiling data on, and depending on how this plays out some of those questions will be easier to answer. For example, if one of the doctors decides to go gung ho on finding MS or something like it, I would be more likely to invest and take the long route. And that’s all the hint you’re going to get.
But for now, I have to figure out how to sleep when my back and side on are fire.
This is going to be difficult to write. I almost never use trigger headings (warning people about potential upsetting topics), but this post deserves one: Trigger Warning: discussion of sexual assault, abuse of power.
There is also an anatomical image of a vaginal opening further down.
I’ve posted to Facebook my frustration over the way doctors have been tossing potential diagnoses at me left and right. At various points in time, I’ve “had” a kidney infection, an abscess on the kidney, a blood borne infection, another abdominal abscess, kidney stone(s), a pelvic infection, etc, etc.
In the course of this, I am being seen by an intern, Dr. Laing. (I am guessing on the spelling. Please note that I rarely use doctors’ real names on this blog, but for him I am making an exception.) At the time, I do not know that this is only his second day on this rotation (although he’s done it once before). He is a charismatic young doctor who looks like he’d make an excellent background character in a college library or Revenge of the Nerds movie.
Dr. Laing stops in and begins to ask me some sexual history questions. As y’all know, this doesn’t phase me at all. He is vague at first, when I ask him how this could be related to my problem. Then he tells me I am getting a pelvic exam to rule out STIs, and other problems with my magina area.
As someone who has experienced real, documented trauma at the hands of a crappy gynecologist, as well as someone who has psychological issues with strangers mucking with his bits, I start to feel a little panicky. I take a deep breath and start trying to make the situation as comfortable and “safe” as I can.
I start by asking for a female doctor to do the exam. It’s not that I have issues with male GYNs, really. I find informing a female GYN of past trauma translates into a much more compassionate and gentle experience. Dr. Laing says he will look into it; a few minutes later he returns to say he couldn’t find one but that there will be two female nurses in the room. I am unhappy (especially since it felt like he only spent a minute looking for a female gynecologist before giving up) but shake my head and accept that the intern will do my exam.
It helps the story to remember at this time that my chief complaint is severe pain in and around the kidney area on my back and side. Dr. Laing informs me we’re going to do the exam in my room, and I am surprised. I ask why we aren’t going to an exam room with, y’know, stirrups and shit. He assures me it’s going to be quick so there’s no need. He is, in fact, surprised that I am surprised.
I should have known something was going awry when he asked a nurse to get all the necessary tools, and when she arrived with them she had to give him a rundown as to what was there. I had requested he use a pediatric speculum, since we weren’t doing a pap smear or anything requiring more than a glance at my cervix. This, too, he pretends to accommodate, by leaving the room for a minute and returning empty handed. I happen to know that JH has an extensive pediatric unit, and I would bet something large that it has at least one peds speculum.
Finally, I carefully lay down, yelping at the pain in my side. Keep in mind, I hadn’t slept in 3 days because laying down was uncomfortable no matter what position – and he knows this. He decides to use an upturned bedpan to raise my hips a little, which digs into the most painful area on my back.
People are probably wondering why I haven’t refused to continue at this point. Again, I mention that the doctor is very charming, and I am honestly afraid that if I really stand up for myself I will get substandard treatment. Also, it bears mentioning that I have been the victim of sexual assaults, one of them perpetrated by a doctor. So being in this situation has already flipped me out emotionally and so I focused on being physically compliant as I could.
I lay down with the bedpan digging into my lower back. We mess around with the positioning of my legs. I am making a constant stream of pain noises and am trying not to squirm. He informs me we’re going to start with the speculum. This is not the tack I would take with such an exam; those of you who have played with vaginas know that it’s better to start with something small and work your way up, rather than the opposite. I accept my fate with a sigh.
This is when things start going downhill fast. He parts my labia and immediately pushes the speculum against my urethra.
As you can see, that’s like aiming for Manhattan and ending up in Staten Island. They’re connected, but not the same thing. Because I am in a fair amount of pain already, I just flinch away and try to close my legs. He takes this as skittishness and tries to relax me. I am somewhat non-verbal, which is exacerbating the issue. He attempts again, and this time I feel him trying to open the speculum as it is resting painfully on top of my urethra.
I react again, and this time he decides that this isn’t working so he’s going to skip to the manual exam. He says his objective is to palpate my ovaries. I tell him that many GYNs have tried to palpate me in this matter and have been unsuccessful. (My ovaries happen to be hiding in an area of my body with a lot of fat tissue.) He asks me to give it/him a try, so I sigh and nod.
Unshockingly, he takes two fingers and presses them against my urethra. At this point, I say something like, “That’s my urethra you’re trying to penetrate.” He apologizes, withdraws his hand, and then returns to push painfully against my…clitoris. That’s right, this newly minted MD thinks the vaginal opening is above the urethra rather than below it.
Let’s just skip ahead. He fails to palpate my ovariesm (not for lack of trying!), and by the time he’s done I think he knows he’s fucked up. He leaves without saying anything to me, which was good since I was crying. Both nurses who were there were shaking and holding their tongues until he left. It was validating to see and hear that the nurses were as concerned and frustrated as I was. One nurse in particular, who was my assigned nurse, went to great lengths both immediately after, and for the rest of her shift, to comfort me. We sat and talked about our lives, she brought me super secret nurse treats, and she let Rave and I go for a walk for half an hour.
Later that evening, the attending (Dr. Laing’s bosses’ boss) and the resident (Dr. Laing’s boss) came in to hear my story. I stressed that this was not a “OMG gyno exams are hurty” complaint, but a “he really should have known the difference between an urethra and a vaginal vestibule” sort of complaint. It turns out that Dr. Laing assured his attending that he had done several pelvics before; the attending wanted Dr. Laing to have another doctor assist him, but Dr. Laing went rove and did it on his own. The attending assured me that I would not see Laing again, ever, and that the attending would take a special interest in my case.
He also gave me the lowdown on what’s been going on. As I’ve written before, it seems like possible diagnoses are spaghetti strands and I’m the fucking fridge. I might or might not have had or currently have:
- a kidney infection, otherwise known as pyleonephritis
- one or more kidney stones
- an abscess on my kidney
- a third reoccurance of an abdominal abscess
- a peritoneal infection
- an STI or other reproductive issue
- ovarian cysts
- any two of these in combination
The attending assured me that we were only looking in two directions now: we can actually see the kidney stone, but it’s resting on the bottom of my kidney where it should hurt the least. However, I’m not acting like a kidney stone patient. Second, there have been a ton of white blood cells in my urine, which screams “INFECTION”; the current thought was that I had an infection of the bladder.
This meant that right after I had come to peace with the pelvic-from-hell, I had to let yet another stranger muck about in my cuntal region (or is that “cuntle”?) and do something painful. I tried to advocate doing it the next morning, but the doctor really wanted the results tout suite. (heh.)
Anyway, back to the conversation with the attending about Dr. Laing. We agreed I would never have to see Dr. Laing or deal with him in the future, and I further pushed that if I saw him again, I would scream and shout. This ultimatum, in addition to a bevy of other complaints, served me well. I haggled over pain meds in my negotiation about the exam for my bladder and won. I decided to push my luck one final time, and asked him for a standing order for a little extra pain meds when I was particularly hurty. (Otherwise, the process is kinda long: I have to complain to a nurse, who then has to call the on-call service doc and explain the situation, and sometimes that doc has to call my actual doc to verify that whatever I’m asking for won’t mess anything up. This can take up to several hours.)
So a few hours later, three very kind but nervous nurses came in to do the straight catheter. See, when you pee in a cup, sometimes you leave behind skin, hair, or other contaminants in there too. Getting a urine sample straight from the source eliminates a lot of that cross contamination. I know I have friends who get cathed for fun, but I am not one of them. Maybe my urethra is too narrow, or I just don’t enjoy penetration in that way. I was shaking the whole time, but my awesomesauce nurse held my hand and told me funny stories fro her life to distract me.
So that was yesterday. Today’s song is in a different key, a different time signature, a different genre.
From what I understand, we have definitively identified the following diagnoses as being accurate and applicable:
- one kidney stone, resting in the bottom of my kidney
- an infection, somewhere in my abdomen
- severe dehydration, and even IV fluids aren’t doing much to fix that
- severe pain in my right flank, that is very sensitive to touch?
However, I have symptoms that are not explained by any of that. So now comes the oddball testing, starting with an echocardiogram this afternoon. I’ve been assured there were be no more pelvics, though.
I’m trying very hard to ignore the fact that three different phlebotomists have tried to take enough blood for a blood culture and failed. One couldn’t find any veins, so he walked away without playing Bingo! first. The second got a good vein, but it was pushing very slowly and meekly, so they only got enough for the little-bottle tests, not the catheter test (knowing the name would likely help).
I keep trying to explain to my doctors that my medical situation, whether it be short term or permanent (anything in between is more likely), is never black-and-white. Now he can order those wacky tests the hospital wants to try out. My nurse keeps telling me I’m scheduled for an echo (which I’m pretty sure is a heart test) this afternoon.
There has been some upsides: The nurse I had yesterday when all this went down, she and I bonded a lot. We sat and talked about my separation, and my relationship with Rave, and teaching adults about sexuality; she talked about some of her past struggles and what it’s like serving the homeless population in East Baltimore.
Um. There has to be more upsides. I have my own room? (in the dingey, “historic” building) Well, I do like my ID doc – who is actually the boss of the ID doc I am seeing at their clinic. I like the resident and attending of Dr. Laing, who are caring and considerate when touching me. I am pleased that they’re taking my pain seriously, and not dismissing it outright when their theories on what’s causing it don’t pan out.
People have been asking how long I’m going to be here. The only clue I’ve been given is that the attending would be happy if I wasn’t here when he gets back on Sunday. However, some of the tests they are doing today take two to three days to finish, so something tells me I will still be here Sunday. How much longer after that, I have no idea.
Hey, I’m allowed a painful pun, as I am hopped up on the goofballs.
What I mean by that is, I am currently in Johns Hopkins emergency department, waiting for a bed to open up so I can be admitted.
This starts about eight days ago. I started peeing a lot – like 10-15 times an hour – and then the nausea hit. I was getting very little sleep, like 3 or less hours a night. Then my kidneys started to hurt, and I decided it was time to get thee to an ER.
Long story short, they debated admitting me then, due to my history with infections, but decided against it. They gave me a new-to-me antibiotic and antiemetic and turfed me. I mean, I am not a fan of being a patient, but it did muddy the waters some.
I was scheduled to make a work-related trip, 10 hours by car from home. If the docs told me it was no big deal, I could go without worry. If they admitted me, there was little I could do about it. But telling me that the infection *usually* merits a stay, and then setting me free, made things tough. I felt pretty crappy, but this trip was extremely important for both professional and personal reasons. Even so, I was totally looking for some external source to give me permission to cancel. I asked for and received three forms of divination, hoping to be told I could stay home.
In the end, I decided to pray. As the trip was partially in service to two of my most important gods (Loki and Hel), I prayed to them. Send me a sign, a nudge, a way to know what you want. If you want me to go, give me the spoons and energy to get packed and be ready for the trip by the time we need to leave.
The first thing that happened was, I felt an overwhelming urge to shave my head. I had been growing it out for some time and it was actually getting pretty long. But if it were up to Loki, I would be bald all the time. At first, I thought this was him taking advantage of my weakened state, but as the hair started to come off, I realized for the first time how much I felt literally weighed down by my hair. It was stringy and frequently damp from my night sweats. And I wasn’t particularly happy with it.
I also realized right away that my God phone was in much better working order. This helped me understand Hel’s point of view on the matter – that sometimes, you have to choose the riskier path to make life worth living. frequently, I make choices that rock my boat the least.
So even though I had no idea what would happen, I got my shit together and made it to MA in one piece, more or less.
While I was there, I was keenly aware of not feeling well, but had much bigger shit to think about. My wonderful boyfriend and devoted girl did everything within their power to help me get through it.
We knew there was a price to be paid as soon as we set sail for home. My symptoms went haywire. BY Monday, I was puking up my meds again. So after some discussion with some of my doctors – who, by the way, were pretty damn pissed I didn’t get admitted the first time – I limped back to John Hopkins ER.
after a grueling 6 hour wait, I was brought back and immediately shit got real. They’re sure I have a kidney infection but it’s obviously worse than first thought. now they’re doing additional tests, because some of my symptoms aren’t quite what they expected, and now they’re hunting to see if I haven’t developed an abscess on or around my kidney. yeah, that’s what I said.
So here I am, alone in JH ER waiting for a bed to open up so I can be admitted. The plan is, at the least, high test IV antibiotics (since I can’t keep my meds down) and aggressive abscess hunting. The hard part is that I’m alone. Rave spent all available time off to go to MA,and then stayed awake all night with me here. I’m waiting for a friend to come help me – I get confused and distracted in hospitals.
I do. Not. Regret my choice to go. I just, as Winter put it, can’t catch a fucking break.
This is not the blog post I’m supposed to be writing.
You may have noticed that I haven’t been as active online as usual – less blog post, no inane facebook replies, not even a “like” on a picture on Fetlife. My Gods put a giant smackdown on my head, and until I’m ready to compose This Great Entry that is, mostly, entirely their idea, I’m to keep my nose out of the Internet. I can give short email responses to timely matters if it is necessary, but everything that can wait, will wait.
I got a writ for this entry, because something somewhat major happened today in terms of my health and well being, and well, this blog originally was a way for me to tell large swathes of people about that sort of thing, so here I am.
The title is two-fold: one, “the jig” being my only slightly explained Internet silence, and the second “jig”, well…is frustrating and good in turns.
You may remember that at the end of my last hospitalization, I ended up with some terrible miscommunication between my pain management doc and the hospitalists. By the time I went to the pain doc to get meds, they had decided that they didn’t want to write scripts that matched what the hospitalists had decided, and ushered me out of the office with even less than a “see ya!”, as the doctor only communicated the end of our five-or-six year relationship via a nurse. I was not allowed to speak to him directly, at all.
Luckily, as I was leaving JH, I had asked my surgeon for a referral into JH’s pain management program, so I only had to find a month’s worth of meds until I was seen there; the surgeon begrudgingly supplied these. Then I had my new patient appointment at JH Pain Management, and I decided that Mistress Poppy had it out for me something bad.
At the first appointment, about a month ago, I was told that they would be reducing my opiates slowly over time. This made sense, as they had reached somewhat ridiculous levels when I was discharged from the hospital; however, my assumption was “reducing to a more normal amount”. (More on this later.) I was then informed that I would have to see a weight loss doctor (but not a surgeon, thank something), and agreeing to that was a non-negotiable point. I tried to explain that I had seen several weight loss doctors in my lifetime, and any time I’ve lost a significant amount of weight I have developed more health and pain problems, but it fell on deaf ears. Finally, I was told that the pain management office wouldn’t actually be writing my scripts – they’d give me a month’s worth, but no more – and it was impinged upon me that I had to find a local Primary Care Physician (PCP – what most people think of as “the doctor”) who would write the scripts for me. Oh, the JH Pain docs would still meet with me and decide the dosages and schedule, but the PCP would be actually doing the writing. I was pretty suspicious of this, but I was assured that they have plenty of PCPs who go along with this scheme, and I should have no problem finding one. (I did ask if they had a list of doctors who “played along”, and was denied.)
Well, it doesn’t take a medical genius to see why this is beyond stupid. The DEA doesn’t give a shit who decided how much opiates someone gets, they care about the doctor who actually wrote the scripts. We called over 20 PCPs both in Hagerstown and in Frederick, and of the ones who actually were taking new patients, and could see me before the month’s deadline was up, only one agreed to undertake this unholy arrangement, but when I showed up in his office he, too, decided against it. He referred me to a different pain management doctor, who wouldn’t even take my call after he found out I was already on opiates.
So my drugs ran out. Slowly, as I have learned over many years to skip a dose here and there if you can help it, should something exactly like this happen. I started calling the JH Pain doc’s office about 8 days before the deadline, and got no response from them at all. It was only when my medical advocate demanded to speak to the practice manager that I was finally, begrudgingly, granted an appointment – in a week. So you were spared a week of me posting self-succoring Facebook statuses about how crappy I felt on practically no pain meds whatsoever.
I get to the appointment today and I am pretty bad off.* This is likely how it didn’t hit me right away when my pain doctor lets me know that we’ve – I’m pretty sure this “we” does not include me – have decided to wean me off of opiates entirely, in the span of one month. I was so focused on please gimme something for the pain and the rocking, doc that I’m pretty sure I totally misunderstood him at first.
But no, that’s exactly what he said. And I guess “we” agreed. So although I was lucky to get scripts – this office has a weird habit of constantly reminding you that at no point are they contractually obligated to write a prescription for you, I guess so you feel doubly grateful when they do – I got the most complicated effing scripts in the history of prescriptions. The instructions on each bottle are a paragraph in themselves. Where a normal prescription bottle may say, “Take two pills every eight hours for pain” or whatever, these say, “Take four pills every eight hours for the first week, then two pills every eight hours the second, then two pills in the morning and one at night on the third…”
I had only enough wits about me, after my weaning-off-Fentanyl experience, to splork the words “Ativan” and “Clonodine” – two meds I’ve been given in the past to treat withdrawal symptoms. With the calmest demeanor ever, my JH pain doc explained that he’s “moved away” from prescribing benzodiazapines, although I could feel free to ask my PCP to write for them.** He did, however, agree to the Clonidine, mostly because it’s primarily a blood pressure medicine that no one would ever use recreationally, ever.
If this wasn’t enough for my poor, withdrawal-riddled brain to wrap itself around, I am now on a mysterious “list” for an “in-patient pain program”. I tried to explain that I don’t have the kind of life where I can just hop off to the hospital for an unknown amount of time, but the odd assurance I received was that this wasn’t happening today, as the waiting list is very long. (Of course, this means that not only will I get no notice on when I will be going to the hospital, but that it could be anytime starting tomorrow until 2020.) The concept is actually kinda cool, in a way that unfortunately reminds me too much of a psych admit: they wean you off everything you’re on, then put you in the program and with a team of pain docs, physical therapists, counselors, occupational therapists, and others. Together they figure out a long-term strategy for dealing with your pain. There is some, but not much, focus on what’s actually causing your pain (as most un-Del like people know that sort of thing), but it might lead to some diagnostic testing, at least.
So where does that leave me?
Well, the last time I detoxed from opiates was, oh, the worst thing that ever happened to me physically. It was done over three months instead of one, with the idea of taking very gradual steps. This time, I have 30 days to go from “holy crap I didn’t know they made a pill with that many milligrams” to “here, take some Tylenol”. At least when I did this last time, I had a different opiate at a steady level. What that meant, was that although the withdrawal sucked really bad, my pain was under some modicum of control. Not so this time. By the end of August, I will be taking Mobic, which is an NSAID, and little else. If this past week was any sort of guide to what life will be like on way less medication, not only did my arms and legs hurt so bad that there were times I seriously thought about wetting the bed rather than having to walk to the bathroom, but my still-healing surgical wound burned so deeply I couldn’t eat. (Which I guess helped the first problem in its own way).
There is an upside, even though it is very difficult for me to see now. Many specialists have turned me away, or blamed my symptoms, on the opiates. In fact, the reason the JH pain doc is doing this, even though I’m dubious that it actually applies to me, is valid. His reasoning is that there is a condition called hyperalgia, where your brain gets so used to opiate medication that the medications start causing more pain, and not treating it. As I still get relief from my meds, I am more than a lot skeptical that this actually applies to me, but even if it doesn’t I’m sure my opiate receptors could use a vacation. Most people who need chronic pain meds take a “vacation” now and again, so their tolerance can lower closer to normal people’s. It’s helpful for people like me, who seem to need a lot of surgery, because there does come a time when they just can’t use opiates at all to treat pain, and there’s not a lot of other options. So by taking a “vacation”, I am future-banking a lower tolerance to pain medication, so any future surgeries will not need the amounts that make each nurse, every shift, look at my file and go, “Um, what?”
And honestly, if there is an answer out there for my pain that isn’t opiates, I’m all ears. I’m not a fan of being on them, and going off of them could open up something very important – the ability to drive. I don’t drive for a variety of reasons, but the first and foremost is that if I were ever pulled over and they thought to run a blood test, I’d be a fucking goner. And there are times when I know my reaction time is slowed down from the meds, and I’m infinitely distracted. So resetting the system may allow me to drive my own car, which I haven’t done for many years.
That all being said, I’m still displeased that this was sprung on me when I was actively in withdrawal. If something goes awry – which it can, which is why many people undergo this sort of thing as an inpatient – I could very well argue lack of informed consent. I probably wouldn’t win, unless my judge has experienced what it is like to be in active withdrawal and a ridiculous amount of physical pain, but I don’t think I’d be laughed out of court, either.
It is very likely that between The Entry They Want and the terrible withdrawal and pain I have to look forward to, I’ll either be on the Internet every fucking second I can, bitching about how terrible my life sucks; or you’ll hear from me some time in September.
*Those who know me intimately will attest to this: I have a collection of pill bottles with one pill in them. In the same way that I hate reading the last chapter of a series of books because the world will cease to exist in my head, I hold onto those pills, telling myself that someday it will be that bad and I will be pleased that present-me saved the damn pill for future-me. This week drained every resource I had, and when I told Rave I had thrown out several now-empty pill bottles, the blood drained from her face. She knows how long I’ve stowed away some of these “last resort” meds, and I spent every single one of them this past week.
**You know, the imaginary PCP I’ve found who will play this stupid game. Well, in all honesty, I do have an appointment at the end of August for a PCP whose practice is under the JH umbrella, so there’s a chance this may work out, but not until after I’ve detoxed from my meds.
Today was pretty much that – just a no good, very bad day.
I had my first appointment with Johns Hopkins Pain Management department. I don’t remember if I told this story to you yet, faithful readers, so I apologize if this is old news. When I was released from the hospital in April, the Acute Pain team increased my opiates to help with the pretty intense surgical pain I was dealing with – remember, I was going home with a large open wound – and I made it abundantly clear that it was vital that they communicate and get clearance from my pain doctor. They told me they had, and I called his office to verify and was told I was clear to go home. The hospital gave me a week’s worth of meds and I was to follow up with the pain doc right away. Well, when I went to his office, I was informed that no, he had not agreed to this regimen, and he was refusing to write more scripts at that level. I never got to speak to him directly, and was sent home empty handed. I lived on my secret stash of extra meds until I was able to persuade my surgeon to write a month’s worth, to cover me until today.
And keep in mind, when I was released from the hospital, the plan to switch to JH’s pain clinic was already in place. So I stupidly assumed that there wouldn’t be a problem getting, if not the same regimen, a slightly stepped down version now that the wound is closer to healed.
The appointment was made for me without my consultation, and was scheduled during an event I attend every year without fail. I called every week, sometimes twice, in hopes of a cancellation so I could be seen sooner. This did not occur, so I had to limit my attendance of the event to just the weekend, much to my sadness.
I first met with an intake doctor, who got to hear the short version of my six year struggle with chronic pain. It was she who informed me that it was up to the doctor if he would write scripts for anything, and I started having an internal panic attack. I was literally down to my last few pills, having gone through most of my extras waiting for the surgeon. I had not even imagined such an outcome, and would have made different choices if I had known.
The doctor came in, and the highlight was that he was a genuinely nice, engaged doctor. He seemed actively interested in me and what I had to say, which is not a given these days. However, even though his tone of voice was pleasant, he had some pretty terrible things to say.
The biggest surprise is that their pain clinic doesn’t actually prescribe opiates. He informed me that the way they work is in conjunction with a patient’s primary care doctor (PCP); they send the PCP a list of what to prescribe, and the PCP writes the scripts. Their theory is that it is best if the majority of your medications are all prescribed by the same physician, which holds merit. However, since my current PCP had worked to get me into the first pain program I was in specifically because he was uncomfortable writing me a maintenance opiate regimen, I knew this would not end well. They did, in fact, call him and ask if he would play ball, and unsurprisingly he said no. Before they called, they had stressed that I really needed to find a PCP closer to where I live now (I haven’t changed PCPs since the separation), and now I have to.
Tell me: How likely do you think it is, that I can find a new PCP who is a) covered by my insurance, and b) can see me in the next month, and c) is willing to write opiate scripts that are managed by another doctor?
Because that’s exactly what I have to do. He did agree to give me a month’s worth of scripts (including a new med called Mobic, which supposedly potentiates opiates better, and a large increase in my tricyclic), but it was dependant on me committing to making this happen. I even shared with him that I had looked for a local PCP a few months ago, specifically looking for one that participated under the JH umbrella, and none of them had new patient appointments in the next three months, if at all. His assistant did give me a little hope: she said if I find one and the only block is not being able to see me in a timely manner, their office will call and push the issue on my behalf.
If that was the only commitment I had to make in order to get my meds, I would have been stressed but accepting. The next item was a hard swallow, and readers of this blog will totally understand why.
I have to meet with a weight loss specialist; one that he has worked with in the past, at JH.
Now, the upside is that she isn’t a surgeon nor does she advocate WLS. (I reiterated that part of my history, including and stressing the part where at least three neuros have said that the rapid weight loss program Dr. WLS put me on may have caused and/or triggered my chronic illness to start with!) But no amount of hemming and hawing would change his mind: no weight loss doc, no meds. He stressed that she works via physical therapy and “appropriate exercise”, whatever that means, and nutrition counseling. I told him I was already on a antiinflammatory diet that is very healthy, but no dice.
I am not pleased. But a chronically ill pain patient has to do what a chronically ill pain patient has to do, I guess.
As a final fuck you, they wrote my oxycontin prescription with smaller doses of immediate release pills instead of the larger extended release doses, merely because their automatic system didn’t have my dose as an option. So instead of four pills a day, I have to take 12, in two groups of 6, at different times. I am not looking forward to figuring out if I’m actually going to have to set an alarm for the middle of the night to take a pill, or if my metabolism of the med will let me sleep through the night.
I had to race from that appointment to my surgeon’s office on another floor, even though I made it clear to the pain people I had another appointment to make. The surgeon’s appointment was in the last time slot of the day, so there was a chance that if I were too late he’d have left for the day.
I arrived a few minutes late, but I had called them from the pain clinic to let them know I was coming. They told me if I were more than 15 min late, I might be SOL. In hindsight, I should have taken the chance to laugh.
I waited for over an hour to see the surgeon. My companion/driver took the opportunity to run my scripts to the in-house pharmacy. The receptionist hinted that something had gone awry, but gave no details. Finally, I was called back.
The reason I was seeing him is because my home health nurse had a freak out. On Monday, she was measuring the depth of my wound (which she does every time she changes the bandage), and something odd happened. We know it’s been 11cm or thereabout lately, but this time she met resistance after 5 or so. She pushed gently, and something gave way, leaking a large amount of fluid – some of it looked infected. She had originally wanted me to go to the ER, but eventually we agreed that I would make an emergency appointment to see the surgeon instead.
I told him this story. He didn’t even pull the gauze out of my wound, but stuck the cotton-tipped applicator (looks like a super long q-tip) in about 4-5cm, and saw no problem. I tried to explain to him that it was likely he was meeting the same “resistance” that the nurse had, but it was obvious he was rushed. He saw no obvious signs of infection or any other concerns, so he advised me to tell the nurse to make sure she’s getting the sponge all the way into the wound (pushing lightly against any pressure). He asked after my writing, and I told him I had seen a few search hits that used his last name. (I honestly can’t remember if I had used it before or not.) He was surprised that I blogged about him, and told me he’d be googling my name and his to see if he found it. (Hi, there, Dr. Sacks, if you or one of your residents are reading this!)
To add insult to injury, even though they had the scripts for almost two hours (half an hour longer than they had told my companion they’d be ready), I still had to wait for another 30-40 minutes before we could finally leave. All of this waiting meant that we had to negotiate Baltimore’s Inner Harbor on a Orioles’ game day, which is no picnic.
When I got home, Rave had already returned from work. After my companion left, she informed me that the landlord had been to the apartment on Wednesday while I was at a different doctor’s appointment. He had come to fix our hot water pressure, as it was down to a trickle. However, it seems he decided to tour the entire apartment, including both our bedrooms and bathrooms (completely out of the way from the kitchen) and is not pleased with our housekeeping.
Our apartment is disorganized, which we both totally own. We’re still figuring out where everything goes, and there are wound VAC and other medical supplies in boxes in the living room, where the nurse does my bandage changes. However, the important distinction (to me, anyway), is that our place is clean. The carpets had been vacuumed, the kitchen floor had been mopped a few days prior, the dishes were in the dishwasher, etc.
Either this distinction didn’t matter to him, or he is a harsher critic than we, but he had sent Rave an angry email informing her that he considers the state of our place in violation of our lease, which we are going to reread forthwith. He has given us 30 days to straighten up or he will consider the lease broken.
Rave and I came up with a game plan of three parts. I am going to write a very calm and polite letter to the landlord, reminding him that he had been informed prior to the lease signing that one of us is disabled and was just about to have major surgery; there is only so much I can personally do to keep the clutter down to a minimum, and the medical supplies in the living room must stay there in some form or fashion. (I’m not thrilled with the idea of having the nurse work in my bedroom.)
Secondly, Rave, and to what extent I am able, I, will focus our efforts on making things look more organized. He also specifically complained about our garage (calling it a fire hazard), because we have chosen to use it for storage rather than for a car. There is a large, clear walkway from the garage door to the door into the house, but obviously this is not enough. We may have to find a more permanent storage facility to store some of our things in, and/or decide to chuck some of our stuff towards a Goodwill or something (even though we’ve already significantly paired down our belongings, the AEU is much smaller than where we were living before, and we both have a lot of “stuff”, like my lunch box collection, that there just isn’t room for in the house).
The third part of the plan is to eek together enough money for a maid service to come in and do an overall cleaning a day or two before his inspection. Not only does this allow us to focus our limited time and spoons on organization, but if he claims that we fail muster again, we will have some form of proof that we made an effort to make the place cleaner.
This situation is hard for me in a lot of ways. I have some deep triggers around my living space being dirty, which I see as something different from cluttered. I’m not a fan of either, but clutter I give into because I just don’t have enough spoons to care. But Rave cleans both bathrooms once a week unless we’re away for the weekend, we both keep the kitchen counters wiped down and the dishes from getting out of control, and generally we keep surfaces clean because I have a large open wound and a propensity for infection. I am also really not okay with the landlord, who is basically a stranger, poking around in my bedroom. He had to have walked all the way through to look at my bathroom, which means he could also be masking a reaction to the rather large Death altar in there. (Our other altars can pass for curio collections, but the Death altar is pretty blatant.) There was also some…ahem…adult items out in plain view.
But this may be a blessing in disguise. As I wrote in my last essay, we love the layout of the AEU, and the neighborhood is nice and quiet, but neither of us is in love with Hagerstown. It would make my life a million times easier if we lived closer to Baltimore, but we nixed that due to Rave’s commute. Rave hates her job pretty hard, and it looks like the feeling may be somewhat mutual, as they’ve taken her off the floor and out her back in training. It’s also draconian about taking time off, even when it’s been for things like “my partner needs to go to the ER” or “I told you two months ago my partner was having surgery that day”. She really needs a job with a little (not much) more flexibility, and one where her coworkers are at least more polite about not liking her and purposefully excluding her.
So if the landlord decides to be a dick and evict us, it would just give us more reason to take a closer look at Baltimore, and possibly in getting Rave a better job in the bargain. We’re not happy about the possibility of moving again so soon, but if our landlord is going to threaten to evict us over a little clutter, it’s best we learn this now and not, say, when we can’t do anything about it.
So that was my no good, very bad day. Tomorrow, I get to jaunt off to Pagan camp and see most of my Bear family. Of course, my STBX and his new poly family are there too, but these days, that’s the least of my concerns.