The Fierce Cocker

MacKenzie and Georgie (the Cocker's current name) had a falling out over something, I'm not sure what. I wasn't home when they got into their disagreement, but it was obvious something had happened.

Normally, they get along fine, but when I got home they would growl if the other dog so much as looked in their direction. MacKenzie was missing a chunk of fur and skin just beneath her eye. Georgie had no injuries. They got into a fight and the tiny couch potato Cocker won against big athletic MacKenzie.

It took a couple of days and some intervention on my part, but they are friends again.

The Cocker got into another fight recently. He bit my sister-in-law on the nose at Thanksgiving. She put her face into his and he struck out at her. I rub my face against his all of the time and he just cuddles with me. Now, I'm going to have to warn everyone who sees the cute little Cocker not to approach him.

I don't really understand little dogs. Why do they attack for no good reason?

Can't I Have Just One More?

I have a reputation. That is why when someone in the hospital was looking to find a home for a dog, they were directed to me. The owner is dying and needs to find a home for his dog. It just breaks my heart.

The dog is a Saint Bernard mix, but is only about 60 pounds. He is sweet, housebroken and needs a new home. I want him, but can't have five dogs. Four is illegal and truthfully, is already a bit too much for me to handle. I can't do five.

I gave them the name of a local no-kill shelter. I also had them make a poster and hung copies around the hospital. They were grateful for that, but I wish I could have done more. Does anyone in the LA area want a sweet dog whose owner is dying?

Less Than Expected

Lacking anything better to do at work, I shopped on the Internet. We had more nurses than patients tonight.

Looking through comforter sets, I found some customer reviews posted on some of the sites. One person complained that although her duvet was lovely to look at, it was very thin. In fact, it was almost as thin as the sheets. She suggested putting a comforter under the duvet for warmth.

I have a better idea. How about putting the comforter inside of the duvet? A duvet is only as thick as the comforter that one stuffs inside.

Another person complained that the shams did not come stuffed. I could be wrong on this, but it's my understanding that if it comes already stuffed, it's called a pillow. If it needs to be stuffed, it's a sham. For businesses that believe the customer is always right, this must be frustrating.

On the subject of not getting what is expected, I finally got around to opening the care package my mom sent home with me after Thanksgiving. The foil contained nothing but turkey skin and small bits of dark meat. I was sad because I figured my mom had completely lost her mind. In her right mind, she would never give me something like that to eat.

There was a second container that appeared to hold the rest of the leftovers, like stuffing and potatoes. Inside there was sliced turkey breast. My mom hadn't lost her mind after all. She had sent home a treat for the dogs.

S.S.D.D.

Nothing especially unusual happened today. It was windy and Malibu was once again on fire. I could see the smoke off in the distance, but it was no threat to me.

I was outside watering my yard when I thought I smelled smoke. I asked Lindsay to come out and give a second opinion. It wasn't my imagination, he smelled it too. I walked all over the yard, up and down the street and even climbed on the roof. I could not see any smoke, other than Malibu. There was no unusual air traffic.

Perhaps the fire had just started and helicopters were on their way. Or maybe the fire was far in the distance and no threat. I was pacing like a trapped wild animal. I needed to leave for work soon and had to make a decision about what to do with the dogs.

Lindsay suggested that someone just had their fireplace going. It was possible, but seemed unlikely given that it was the middle of a sunny, warm day. I hated to do it, but I asked Lindsay if he would stay with the dogs after I left for work until it was safe. He didn't want to do that, but agreed to take my dogs home with him. We had a deal.

The air was getting smoky and the sun was changing color. That's never a good sign. The TV had Malibu fire coverage, but there was no mention of any other fires. Lindsay checked the fire department's web site, but it only mentioned the Malibu fire. Then he called the fire department for information. They said yeah, there was a fire in Agua Dulce, but it was almost out.

With that news, Lindsay was allowed to leave my house without my dogs and I was able to go to work. It's really time for the rainy season to start. This fire threat business is getting old.

Getting Old

I've been a little forgetful lately. I wanted to pour something from a bottle that had to be shaken first. I removed the top and shook it. Next, I wiped down the kitchen cabinets, counter and floor. And lastly, wiped the salad dressing off my hair and changed my top.

This is just the tip of the iceberg. You should see me at work.

Menopause isn't for wimps. It's turning me into an idiot. The doctor won't give me hormones yet, so I'm trying every snake oil remedy I can get my hands on. Even when the doctor lets me have hormones, it may increase my risk for dementia. A mind is a terrible thing to lose.

HIPAA Oops

I wrote up a doctor. I didn't want to. The house supervisor made me.

What happened is that an 18 year old guy used cocaine for the first time, according to him. As sometimes happens with illegal drugs, something bad happened. He vomited for a couple of days and had severe abdominal pain. He came to the ER and was found to also be in renal failure. He was admitted.


His symptoms could have been caused by cocaine, but we couldn't be sure without ruling out other possible problems. Over several days, he had one test after another. Everything came back normal, except for the blood tests showing failing kidneys. It had to be the cocaine.


His family was worried. They were constantly at his bedside and were becoming increasingly demanding in wanting to know what was wrong. We couldn't tell them because the patient is an adult and is entitled to his privacy and he was adamant that we not tell his parents. We just pretended that we didn't know what was wrong with him. It made us look like fools, but we're used to that.

Things began to go very badly on my shift. He began going into respiratory failure. We kept increasing the oxygen and he steadily worsened. The doctor decided to send him to ICU. He was going to need to be put on a vent if he continued the downward trend.

The patient's father demanded to know what was wrong. He went through the list of tests that had been done over the last several days and implied that we didn't know what we were doing. The doctor was indignant. He said of course we knew what's wrong with him; this was a side effect of cocaine.

The dad's face fell and he said what?!!! The patient just winced. I left the room. The damage was done.

The house supervisor was on the floor, so I told her what happened. Half-jokingly, I asked if we should call our lawyers now or wait until morning. She called our risk manager at home to discuss the HIPAA violation and told me that the risk manager wanted me to write up the doctor. I sure hope that he doesn't hold grudges.

When the doctor came out of the room, I did as instructed and told him that the patient was an adult and that he had violated HIPAA by telling the patient's family about the cocaine use. The doctor looked stricken. He said that the patient was a kid. I told him that the patient was 18 and that he was an adult. The doctor asked if the patient worked. I said that it didn't matter. At 18, he's an adult. We went back and forth until the doctor realized that he had screwed up. As instructed, I suggested that later when the patient was alone, he talk to the patient. The doctor agreed.

I feel sorry for the doctor. He was just the on call doctor and had no idea he was walking across a mine field. The doctor meant no harm, I'm sure. The patient's parents are furious with their son and they should be. I'm not sorry that they found out, but I do hope that we don't get sued.

One other thing, when the kid turned 18, he lost his health insurance and no one bought him another policy. He could have gone to a private college for what our bill is going to be. He'll be paying his bill for the next 10 or 20 years. When people complain about the cost of cocaine, they don't know the half of it.

A Wrong Turn

Today was chemo day. I should have known something was wrong when I didn't get my usual reminder call of the appointment. Once there, they said they had no record of my appointment. The best they could do was work me in three or four hours later in the day. It was such a long drive from my home that I didn't want to reschedule.

Although it wasn't the way I wanted to spend my day off, it was the perfect opportunity to Christmas shop. The vet's office kept Kelsey and gave me directions to the nearest shopping centers. Of course I went the wrong direction.

It was a long drive and the area kept getting rougher looking. It was also odd that so many people were on the sidewalks. You don't see that in the nicer areas of town. But the people weren't walking, they were just milling around. These also weren't women and children, but scary looking men. This was not a place for ladies. The street names sounded vaguely familiar, even though I was sure I had never been here before. Then it hit me. This was where the riot started.

LA is big and the areas I live, work and play in are nice. Other areas are dangerous and not a good place for anyone. Those are the areas that give LA a bad name and high homicide statistics. I had to get away from there and fast.

The streets were old and didn't have left turn lanes. I couldn't make a U turn without stopping traffic in my lane and didn't want to do anything to piss anyone off. People have been shot
for less. Instead, I made a right and went around the block.

The tidy homes were all Craftsmen style and showed pride in ownership, but every single window of every single home had bars on the windows. The people who live there must be scared. That is no way to live. There are no bars where I live, at least not on windows.

I escaped from the bad area without incident. Soon the streets had street trees again. The bars on windows disappeared. Sony Pictures was having catering by Wolfgang Puck. All was well with the world.

I found stores and went to work. I now have a red party dress, a new bed side dresser and a beaded black halter top. Oh and my Christmas shopping is pretty much done. Mission accomplished.

Kelsey is fine too. He's doing well with the chemo.

A Free Lunch?

My employer has a strict policy about not accepting any gifts from drug reps. We can't even take a cheap pen or pad of paper, so why is it that I got a nice Thai lunch today courtesy of a drug company? It's not that my boss didn't know about it because she sat next to me at lunch. She even arranged it.

We weren't told who was paying for the lunch, but I became suspicious when some man who looked like a salesman came in the room and started setting up some kind of presentation. The name of a drug was on display and when asked when he wanted to start his lecture, he said that he wanted to wait until we all had food in our mouths. Lunch was going to arrive in ten minutes.

Red flags were waiving. We can be fired for this kind of thing, not that I was worried about that happening with all of the big wigs partaking in the feast too.

I asked my boss if the drug company was paying for lunch. She said that they were. I asked, teasingly, if I was going to have to call the 24 hr. corporate compliance hot line to report this. She said that if I did, I would have to vomit to return what I was eating. She had a point.

My boss said that it was okay to accept this drug company gift because the drug was already on our formulary. We supposedly are only barred from accepting gifts from companies pushing selling drugs that we don't already prescribe.

The reason behind the rule is to avoid being influenced by drug company gifts. If you use a pen for several weeks with the name of a drug on it. It might have some effect, either consciously or subconsciously, on deciding what drug to prescribe. A good meal with a lecture explaining why a certain drug is better than a competitor's drug has the same effect of perhaps clouding independent judgment.

The drug rep was doing his best to explain why his drug was as good as the competitor's drug but for less money. He wanted us to prescribe his drug more often. I fail to see the distinction between what he was doing and a drug company trying to sell us a drug that we don't yet have on our formulary. It's all just selling and trying to influence our prescribing decisions.

It was a good lunch, but a waste of money for the drug company. Nurses don't prescribe drugs.

The Black Dog Of Death

One of my coworkers was laughing because her patient told her to get the dog out of her room. No, we don't have canine visits here, she was hallucinating. Or maybe not.

I asked my coworker what color the dog was. She didn't know and didn't care. I explained about the black dog of death. She had never heard of it. What kind of nurse is she? This is the black dog that some people see before they die. I've never had a patient complain about the black dog before, so I was a little excited. But, not excited enough to go in the room and ask the patient myself about the color of the dog.

Now, I may never know what color dog the patient saw. She went bad quickly and is now in ICU. There may be something to the legend of the black dog of death after all.

What Yelling?

Yeah, it was pretty bad. The old man kept shrieking, WHY, WHY WHY?!!! I DIDN'T DO ANYTHING! WHYYYYYY?!!! DADDY!

None us liked listening to that, but what could we do? Despite restraints, the patient managed to pull out his urinary catheter and was now lying in a pool of blood. Of course it hurt. He pulled out some of the lining of his penis and his bloody hands were rubbing his bleeding appendage.

His nurse tried inserting another catheter which resulted in more screaming. She couldn't get it in, so it was decided to just put a diaper on him and hope that he can pee. He may need to be seen by a urologist later.

Cleaning him up was not easy. He grabbed at us with his bloody hands as we washed him and changed his sheets. Yes, he was screaming like a banshee, but what could we do? He was given pain medication, but it takes time to work. He was too confused to understand our attempts to reassure him.

While this was going on, a visitor to another unit on the other side of the building walked to our front desk and in an officious manner asked for how long he had been screaming.

The secretary replied, "Who." Of course she knew who, she just didn't like what he was insinuating.

He replied, "You didn't even notice. How long has that man been screaming?"

She glared over her glasses at him and answered ,"Why?"

The visitor left without another word. He probably thinks that we are all barbarians who don't care or even notice if someone is screaming for help. We think he's a jerk for implying that. I hope that we don't hear about this on Monday.

Cocker Cleaner

One of the problems with Cockers is that they tend to get gooey stuff in the inside corner of their eyes which then runs down their face. Several times a day, I clean The Cocker's face. (No, he still doesn't have a name.)

Kelsey has discovered that he likes the taste of the gooey eye secretions, so he now licks The Cocker clean for me. He's such a good boy.

The Return

A few minutes prior to leaving for San Diego, I lost my only garage door opener. I was carrying it from one car to the other car and during the short walk between the two cars that are parked about 18 inches apart, I lost it. Running out of time, I left without it.

I needed to drop off three of the dogs at my parent's house. MacKenzie was left behind because the last time she visited my parent's house, she attacked their Cocker without provocation. I put down lots of food and water for her and figured that she would be upset, but okay for two nights alone. Of course I worried about her the whole trip.

Returning home after the trip, the first odd thing I noticed was that MacKenzie was upstairs and reluctant to come down. The hissing sound in the back yard was a clue to what had happened. The water supply line to the back yard had broken and in addition to the geyser, half of the yard was under water.

I was worried about the Koi. Chlorinated water will kill them and who knows how many days city water had been pouring in the pond. I wasn't even sure that the fish were still in the pond. They could have swam across the lawn. It was too dark to look for them, so that had to wait until morning.

I couldn't turn the valve to shut off the water only to the yard, so I shut off water to everything, including the house. I was thirsty, dirty and didn't have any water. It was going to be a long night.

MacKenzie was busy while I was gone. She got into the closets, pulled the clothes off the hangars and chewed off buttons. Just looking at the mess exhausts me. I still haven't done anything about it.

Not having water motivated me to try and fix the line in the dark. Wading out to it, I went to work. There was a problem with the valve that shut off the water. It didn't entirely stop the flow. Sprinkler cement only works on dry pipe, not that I didn't try using it on wet pipe. My efforts were met with another geyser explosion. Defeated, I went back in the house to sulk.

At some point, it occurred to me to try a wrench to close the valve just for the yard water. (I'm a little slow when it comes to home repairs.) The wrench worked and that valve completely stopped the flow of water. Once I bled the water from the line, I was able to glue the lines together. I also was able to turn the house water back on. Things were picking up.

The next morning, I found the fish alive and well in the pond. I also found the garage door opener. It was on the roof of the car that I had used to drive to my parent's house, Lindsay's house, back to my parent's house and then home. My car also sat on the street for a few days with the remote on the roof. I can't believe that it didn't fall off or get stolen.

So, that's it. All is well again, except that I need to sew on buttons in all of my free time. Oh, and one other thing. The sound to my computer no longer works. I have no idea what crazy sounds my computer is trying to make anymore.

A Wild Weekend

I just got home after spending the last three days in San Diego. There are many places to go there such as the San Diego Zoo, San Diego Wild Animal Park, Sea World and Lego Land. I just spent the long weekend at a Bat Mitzvah.

The ceremony itself only took an hour and a half, but there were three parties following it. I'm exhausted. Eating, drinking from open bars, eating, smiling, eating, talking and eating is hard work. I've never seen so much food.

I can't believe how much money people can spend on a kid party with 200 guests. The party was a beach theme with palm tree balloons and dolphin balloons against a back drop of surf boards sitting upright in the sand. A fish bowl with a live fish was on each table and the table linens were all in sea blues and greens. The people running the party dressed like lifeguards and carried the Bat Mitzvah girl into the event while she sat on a surf board.

It was all dramatic and interesting to watch at first. The first dance was the Hora which deteriorated into kids running as fast as possible around the circle. The adults started stepping back to get out of the way. There was one more dance where everyone had to dance back to back and then the adults had to leave the dance floor.

The party was for the hosts' daughter, so the kids played dancing party games on the dance floor with the "lifeguards" directing them. The adults were excluded and so just sat at their tables. The music was so deafening that conversation was impossible. That meant that the adults could only just sit and watch 13 year old kids running around and shrieking. I know that I'm 51, but I would have liked to play too.

I entertained myself by drinking. If it had been a buffet instead of a sit-down dinner, I would have eaten all evening instead. The next day at the last party, I heard the complaints about the adults being excluded from the fun. I guess I wasn't the only one who felt left out. I do understand the hosts thinking, though. They wanted their daughter to have a great time and for this to be her party, not just some adult event. In a couple of years, the hosts will have to do another party for their son. Where do people get that kind of money?

Sheet Surprise

In the middle of the night I heard Kelsey scratching at the door. He's forgotten how to use the doggy door, so I got up to let him out. Just as I reached the door, I felt warm gooey poop squish between my toes. I wasn't fast enough.

I hopped on one foot into the kitchen and washed my foot in freezing cold water while standing in the dark. That unpleasantness over with, I went back to bed.

That was almost a week ago. Last night I was brushing fur and dirt out of my bed and got down to the foot of the bed when I noticed dried poop all over the sheets. Let me clarify, the poop was inside the bed, where my feet go.

Washing my feet in the dark, I couldn't see that I didn't get all of the poop off, so I have been sleeping for several days with my feet surrounded by poopy sheets.

Pitiful Patients and Their Families

One of our patients is the mother of a movie producer. His movies are big and you are familiar with them, but I'm not allowed to say their names due to privacy rules. The producer thinks that his mom is special and should be in a place like Cedars, where movie stars and the elite go for medical care.

The problem is that his mom bought el cheapo HMO insurance and so is stuck with us. He could pay for Cedars out of pocket, but that is not going to happen. Instead, he talked to management and explained who he is why his mom deserves special treatment. They caved agreed and gave her a private room.

Another patient had his call light on so I went in to answer it. I asked him how I could help him and he said that he needed to go to the bathroom. I said that I would grab some gloves and disconnect him from his equipment. He said that he didn't need to be disconnected and was just going to catheterize himself where he was. (That's what he does at home due to prostate surgery.) I asked if he needed anything and he said that the only thing he needed was some privacy.

I could have asked WTF he used his call light for if he didn't want a nurse, but I just smiled, said okay and left. That was my second asshole of the night.

The third asshole was a patient's son who mentioned that he was going to be seeking help outside of our HMO because our doctors hadn't been able to help his mom's macular degeneration. I didn't say a word but I was thinking plenty of ill thoughts. If it were possible to reverse this kind of blindness we would certainly waive our magic wand and do so. Let him go elsewhere and see that we're neither withholding treatment nor incompetent.

I know the horror stories involving my employer, but if we were as bad as people think, we would have been shut-down years ago. Oddly enough, that is what my employer uses as one of its selling points.

My favorite patient was a druggie. Usually, there is nothing worse. He was completely covered in tattoos and had a recent history of addiction to opiates and meth. He was still a heavy smoker and was hepatitis C positive. I'm not being sarcastic when I say he was my favorite. He was the least of the evils. He liked his drugs and had a high drug tolerance, but at least he wasn't mean.

There was another patient, who although not mean, got on my nerves because she cried most of the evening. I tried my best to make her feel better, but she was just so unhappy. Why was she sad, you ask? It was because she didn't have a bowel movement today. She had one yesterday, but not today. No, she didn't have cramps, pain or discomfort. She was just so disappointed.

She had just had major surgery hours earlier, it went well and amazingly was having no pain and all she could think about was poop.