Dave: Oh My Pretty, you've been playing in the flour again!
Me: But Daddy, how did you Know?
Dave: The floor, the walls, the cabinet....your nose.
ON THE WORK FRONT: At work we've noticed a run on Aortic Aneurysms. We've had those of the dissecting variety (NOT GOOD), the bulging awaiting repair, and the newly repaired back with higher dissection and need of further intervention. These people won't be on a balloon pump, because, no matter how bad the heart...can't risk blowing the aneurysm...that's usually instant death or pretty close to it.
One elderly gent, who also had an MI and is not a surgical candidate...due to age and other factors....family made a DNR....I guess they thinks that means he will die right away. Actually, he is doing pretty good, and can probably live for years with his condition, if he doesn't do anything strenuous. He's got a few knots on his head from falling...syncope...and they've been doing a lot of adjusting to the BP meds to keep him in the low 100 systolic range. He's is cute as a bug....he only speaks a few words of English....but who can not love somebody who tells you how pretty you are .... every time you go into his room.... in English and in Spanish? Who cares if he has dementia...I like his touch of dementia...it made my day!
My other patient, an elderly lady, had a humongous AAA, not dissecting, but bulging...and found by ACCIDENT on a CT for something else. Imagine coming in for some relatively non-urgent testing and finding out you have a time-bomb literally ... tick tick ticking...with each and every heart-beat....scary as hell. I saw the sucker on the CT scan...and as you scrolled down it got bigger and Bigger and BIGGER....her only symptom...claudication (pain in the legs when walking)! Another case of really tight blood pressure control. The bad thing was that they did an aortagram/angiogram it check her heart out and she had multivessel disease. She had to have open heart surgery. I could not be for certain that she really understood the implications...she could die ... on the table, her prognosis was not good. I asked her about family, and she only had a sibling that lived far away...for HIPPA purposes I'll hit a couple of states away, in the Kentucky, Virgina, Carolina neck of the woods. She had called her sis...who was older than her, and sis was driving down, because she could not afford to fly. Sis was coming ALONE because she was widowed. It was going to take her three days to get there, because she would need to stop and rest. The morning I left she was going to surgery, they came and got her at the butt crack of dawn....I was still there...I went in, and held her hand, and told her I'd pray for her and check on her later in the day. She had tears in her eyes, and she held my hand so tight! I couldn't hardly sleep (that was the day the telephone pole was on fire and we had no electricity). Before I went to sleep around noon, I called CVR and checked on her. She had made it through surgery and was doing good. Praise God! Anyway, when I worked my last shift she was back to the floor and getting ready to go home, after she recovers from this she will be back for the aneurysm repair.
Well, going to put the last sheet of cookies in...and make a run to the neighbor's with all the goodies is tow.