It's getting crazy at work. I'm starting to feel like I'm living in a syfy movie.

[Laffy Kat]

At the clinic, we've gone from checking in patients for covid tests to now checking in very sick people who should have gone to the hospital to begin with. Ambulances are coming and going all day and there are teams of hazmat-like people dressed in green overalls everywhere. That's new. I am dreading the post-Thanksgiving rush.

I have good PPE and I'm using it; still, it's terrifying. I don't understand why we haven't shut down again or at least stopped doing elective minor procedures. I mean, do we really HAVE to be doing cataract surgeries and preventative colonoscopies right now? I don't understand.

[cilla4progress]

1. Bless you, Laffy -

stay safe! Holding you in my heart!!

[Laffy Kat]

3. Thanks, cila4progress. I'm not really worried about myself.

It's just that so many of the sick patients coming in are regulars that we've been seeing for years and they're older with comorbidities. Plus, I'm worried about my oldest son who works at the hospital next door that we are literally attached to. I have to stop worrying because it's not going to help. Fretful is my default.

[cilla4progress]

4. I hear you.

I am trying to make good choices and being cautious, but I also know there are risks if one isn't 100% quarantining!

Stay safe!

[KY_EnviroGuy]

2. Administrators don't want to lose the revenue right now.....

with hospital and clinic budgets in the red. That would be my guess based on articles I've read.

Let's hope our pending relief bill at least provides baseline support for all critical facilities so they can afford to delay non-critical procedures.

Thank you for your dedicated service, Laffy Kat.......

[Laffy Kat]

5. Thanks, KY_EnviroGuy

I understand about the lost revenue and we lost plenty when we shut down before, but we are a non-profit. Many of us would voluntarily take a furlough if management asked.

[Captain Zero]

54. Tele-visits would be good except for often the tech is flakey

I think my end is good it is the dr./hospital end that is flakey. Probably overloaded.

[KY_EnviroGuy]

57. Agree. Far too many citizens can't afford the technology, so....

tele-visit availability would biased toward the wealthy. I, for example, do not currently have that bandwidth capacity.

I just had the crazy thought that stores around the nation could install tele-visit cubicles (sort of like a fancy phone booth) that anyone could use, perhaps accessible using an access code acquired over the phone from a medical office.

They could be supplied with HEPA-filtered air and furnished with disinfectant wipes for cleaning prior to use.

Most stores would likely have the spare bandwidth in their Wifi or through a broadband cable connection.

KY

[Cha]

6. So Sorry you all have to go through

this crazy SciFY, Twilight Zone, Orwellian Shit 'cause of Maggots!

[Laffy Kat]

16. Yes, I have a lot of anger I'm trying to deal with.

We also have patients coming in complaining about having to mask-up, although there seems to be less of them now.

[mahina]

7. Thank you Laffy Kat for all you do

Last edited Fri Nov 20, 2020, 02:41 AM - Edit history (1)

Will hold you and your son in my prayers for continued good health. Aloha no.

[Laffy Kat]

15. Oh, thanks. I'm less worried about myself.

It's so surreal, though.

[catrose]

8. In late February I took a bad fall. Knee surgery was recommended

but there's no way I'd go into a hospital except under emergency conditions. I kept hoping things would get better...they get worse. So I hobble around and do physical therapy (at home, not on site).

I'm so grateful for the medical teams, and all I can do for you is to stay away and try to stay as healthy as possible. Here's hoping for miracles soon!

[Laffy Kat]

14. Oh, I am so sorry. Not sure I'd let it go that much longer.

Did you at least get an Xray?

[catrose]

18. Yes. Bad arthitis, knee replacement recommended. Fingers crossed.

[Ms. Toad]

43. I did PT for something else in a clinic that does mainly knees

My PT coincided with a whole bunch of folks going in for surgery - so I got to watch them all recover.

There was only one who made very little progress - the one who didn't keep working through the pain. She came in every week barely moving, wouldn't do the exercises they recommended, they'd revise them to make them easier, she wouldn't do those, and so on. Everyone else who had surgery the same day she did was in real pain at the beginning - but made rapid progress. The same was true of my relatively wimpy neighbor - who went back for replacement of her second knee.

It's no fun - but everyone I know who has had it is glad they did (aside from the one woman who had not graduated from therapy by the time I did, unlike her peers).

[Hekate]

28. I had total knee replacement in February; one of the last elective procedures in my hospital...

I asked a lot of questions about the hospital’s precautions, and was satisfied they were keeping the operating theater isolated. Also, our region was not in crisis at the time.

If you need it, you need it. I spent the year before being scarcely able to get out of a chair, much less walk. Recovery’s not fun, but I will say this: you have a lot of room to yourself at the rehab center thanks to COVID restrictions.

Best of all, I feel like I got my life back.

Best of luck to you when you are able to finally schedule it.

[Laffy Kat]

39. From what I understand, knee replacement rehab is one of the toughest.

And it takes a while. I've known people who have had bilateral knee replacements at the same time. I cannot imagine going through that.

[Hekate]

46. I can't imagine doing both at once!

I was scared, because of my late mother’s terrible experience. I tried to avoid the surgery as long as I could until kaboom, I could hardly move for the pain. The MRI and X-rays confirmed there was nothing left to work with in that knee.

Anyway, being afraid made the early home physical therapy harder. I had a setback and thought I’d done something all wrong, but the two PTs I had (trading off, not both at once) were very kind, corrected me, and firmly kept me going until I was ready for the PT center, where they were really really firm.

The pain meds are serious business, so I kept a chart of everything I was using, how often and how long they lasted before I needed another. Some people find they have to make themselves taper off at the end, but I think the chart helped by keeping me mindful. Definitely for sleep and before PT, but can’t remember how long now. Used an ice pack a lot. Definitely had hubby do the driving until I was able to stop using them before PT.

Initially, my mantra was, “Never again, please God make the other knee last,” but by the time I was recovered after several months, I said to myself, “Now that I know what to expect and how it goes, I can definitely do it again if I have to.” If I have to.

[certainot]

9. it's because we let 1500 putin radio stations declare it's a hoax to "push

the socialist agenda. it's really dumb. those radio stations are licensed to operate in the pub interest and dems ignore it because it hurts our heads to listen

[stopdiggin]

10. medicine, like everything else in the U.S., is a money game

want paychecks to go out to nurses and staff (and stockholders) -- gotta' have incoming revenue.

(of course, single payer -- sorta' like everyone else on the globe -- changes the formula somewhat)

[Laffy Kat]

13. We don't have stockholders but I get what you're saying.

It seems like in the long-run, though, it would be prudent to consolidate a few of our clinics for three or four weeks to reduce exposure.

[Heartstrings]

11. Thank you, Laffy Kat!

Safe vibes sent to you and your family!

Very scary Twilight Zone times, indeed!

[Laffy Kat]

12. Thanks. I appreciate the vibes.

[Nevilledog]

17. ...

[Warpy]

19. People are still getting sick and needing things fixed

and yes, people need that cataract surgery because I can tell you from current personal experience that going blind during a pandemic without any help and without any services is horrific. I've bought my cane and my braille overlays for the keyboard and I'm barely functioning, but trying to buy food is a nightmare when you can't see anything unless you are on top of it. Plus I'm terrified I'm going to step on somebody's kid. My eyes are that bad.

Also consider those colonoscopies can remove small cancers before they get to be big ones that require major surgery.

You're right that the period between now and mid January is going to be extremely bad. Extroverts look forward to these holidays all year unlike introverted misanthropes like me, so cases are going to skyrocket. At least this rotten virus is more of a known quantity than HIV was in the early 89s when it was called GRID and nobody knew how it was spreading, only that it was 100% fatal, usually within hours of diagnosis.

You have my permission to scream at any maskholes, chin guards, or dick noses who dare enter your clinic. Breaking the tension with a good scream can be beneficial and maybe the idiots will get tired of being screamed at and behave better.

[NJCher]

22. I loved cataract surgery

It was more like an insurance-covered psychedelic drug trip than a medical incident. I am on my iPad now but tomorrow i will write more.

[Warpy]

23. one was combined with a corneal transplant

and that's what I now need on the other eye. I dread it and there's no guarantee the vision will be much improved.

Keratoconus sucks.

[NJCher]

31. oh, well that's another story, then

Cataracts run in my family, so I wasn't surprised when I got them at a fairly young age. Having experienced the cloudiness, I very much empathize with how things are difficult for you. It is hard to try to get day to day activities done with this impairment.

So do I understand, then, that you have one eye where you already had cataract surgery?

[Laffy Kat]

25. Oh, I agree that the minor surgeries are needed, believe me.

They absolutely add to quality of life, and colonoscopies are vitally important to find polyps before they become cancer. Everything is necessary. I only want to postpone minors for a few weeks, so we don't put our patients at risk. Here in Colorado the first shut down significantly flattened the curve and I think we need to go that direction again.

[Warpy]

26. NM has been shut down for a week now and cases keep increasing

The shutdown is for 2 weeks, it remains to be seen if there is any effect next week. I honestly don't expect one, too many big extended families here think the shutdown doesn't apply to them, their families are safe, yanno.

I can see things like face lifts and boob jobs postponed indefinitely but just because surgeries are minor doesn't meant they're not absolutely vital to the patient. In any case, day surgeries don't seem to be a locus of transmission, it's more schools, churches and family events.

[BusyBeingBest]

20. The problem now is that many people put off appointments

or were simply unable to make them last spring or summer, how long are they supposed to wait on their health problems?

[ecstatic]

34. +1000. nt

[Laffy Kat]

37. I feel strongly that if you have a health problem you absolutely need to be seen!

Why did you think I wouldn't want people seen if they needed care? I'm a hundred and ten percent in favor of patient care.

[BusyBeingBest]

38. Just a rhetorical question--not really directing it at you, just the situation.

[Laffy Kat]

40. Oh, okay, sorry.

I just got home and am still decompressing. I am SO HAPPY to have two days off now.

[BusyBeingBest]

41. That's OK, enjoy your well-earned

weekend!

[Meowmee]

58. Yes true

I have put off the dentist, eye doc, gyn, colonoscopy, mammography, ultrasound, bone density and missed my 3 month endo and others, even though docs wanted to schedule them. I hope it is ok. On the other hand I have been doing pt for my back and now knee and other stuff, mostly related to post covid issues and injuries. And I got my flu shot. I am concerned that the eye doc uses the same eye drops for everyone, they really should not do that even in normal circumstances, same for the dentist with the nature of it. I don’t want to risk it until after a vaccine. If I have symptoms I will go.

[Hermit-The-Prog]

21. Please take care of yourself. Lots of people will need you after the vaccines.

[Laffy Kat]

36. Can't wait for the vaccine! I'd be first in line if possible.

A lot of my coworkers are afraid to take it, although I'd happily be a Guinea pig. I signed up for a clinical trial through the clinic where I work but have not been chosen, darn it.

[Hermit-The-Prog]

50. I will gladly wait for people "on the front lines" to get it first. Hermits don't get out much.

Truck drivers should be ahead of me. Ain't nobody depending on me for anything except those within my isolation bubble.

[speaknow]

24. No not a syfy movie

You have a nut job running the oval office, trying his best
to kill as many as he can before he leaves. Look ask
yourself where is FEMA, where is the Army Corps of
engineers? Didn't they build those quick hospitals last
spring, no where to be found right. The Govt you have
has failed the people they are suppose to protect. you're
on your own, do the best you can and hope for the
best. Stay safe.

[Hortensis]

27. Sorry, Laffy Kat. If you're really terrified, perhaps you should

get sick and return to work once they've stopped elective procedures. Not being facetious. We all have a right to take care of ourselves.

[Laffy Kat]

32. Oh, I don't want to do that. I feel like I need to be there.

Plus, we get 160 hours of covid time off if we get sick and I already used 24 hours in April when I had bronchitis and had to get tested before I returned to work. If I take off it will make it much harder for my coworkers. I'll stick it out with the rest of them.

[Hortensis]

59. :) Very glad to hear you have the strength, Laffy. That's such an

individual matter. Not all do, and it must be incredibly hard to have to leave the field in the middle of battle. Trauma on trauma for people who don't deserve it.

Stay well, of course.

[Hekate]

29. God, I am so sorry. Where are you? You're right, time for elective procedures to be postponed...

Stay safe, Laffy Kat.

[Laffy Kat]

33. I'm in Boulder County in Colorado.

Like most other states, Colorado has gone red with covid. We'll get through it, it's just so surreal.

[peggysue2]

30. I was surprised yesterday

During a telephone conversation with my brother-in-law, he told me he was scheduled for a colonoscopy during the first week of December. He lives in the Philadelphia suburbs. Philly is pushing through another set of partial public restrictions because of the Covid numbers. I would have thought elective surgeries would be on that list. Apparently not.

[Laffy Kat]

35. They may still, you never know.

I do think colonoscopies are one of the most important screening tests out there.

[peggysue2]

44. Oh, I agree. They are important screening tests

But for a routine scope (which is what my brother-in-law's would be) I'd think a reschedule would be a safer route. Particularly for my brother-in-law who has pretty serious lung issues requiring he tote around an oxygen canister.

Doesn't make sense to me.

[Ms. Toad]

42. I beg to differ - at least as to some of the preventative colonscopies.

My daughter has a disease that puts her at extreme risk for colon cancer - enough that at age 30 she is required to have colonoscopies every year (an MRCP annually, and ultrasound imaging annually in the alternate 6 months). (Same disease Jamie Redford, Robert Redoford's son just died from).

The ones that are every 5-10 year check-up can safely be delayed for a year. But those on a schedule like my daughter's cannot safely delay the scopes.

And, selfishly, I'm hoping to get past the 30th without a positive test for anyone in my family so that I can have minor surgery to remove a recurring lesion on my arm. Probably a benign recurrence - but it is rapidly changing and the original lesion had characteristics that may mean it was precancerous rather than benign - and about half of that small number with an original misdiagnosis die within a few years of even local metastasis. (Even though, objectively, it is likely just another benign regrowth which could easily be delayed until later.)

[peggysue2]

45. Your daughter's case is entirely different

And I think you're absolutely correct. If you're at risk and/or have a condition which requires close examination, then the colonoscopy wouldn't be considered an elective procedure. But the majority of patients who have colonoscopies are in that 5-6 year range. Not sure 6 months would make a huge difference. My brother-in-law's last scope was completely clean.

I'd say the same thing for the lesion on your arm. There are certain things you simply can't let go like a possible skin cancer. I had two skin cancers removed last year, one which required two corrective surgeries so I didn't look as if my ear had been partially chewed off.

It's all about weighing the risks. For instance, had we been in the middle of this pandemic, I could have waited on the cosmetic side of the surgery, just cover up my tattered ear with my hair. Until it was safe.

Best to you and your daughter.

[Ms. Toad]

49. Cosmetic side can definitely wait -

I've got a 1.5 inch scar with dog ears on both ends and a 1/2" diameter scar blob near one end of the scar. It was the first (or one of the first) such surgery for the resident tasked with removing it (hence the dog-ears). (Lots of coaching from the doctor I was officially seeing about how to stitch it up to avoid dog ears.) Then I had a histamine reaction that interfered with healing, requiring a punch biopsy hence the 1/2" scar blob. It's been 4 years since they created the scar . . . so not much worry I'll demand cosmetic surgery before the end of the pandemic.

Since the new lesion is parallel to the original one, I'm expecting to emerge from this one with a railroad track scar.

But this crazy thing has grown and the nodule has changed shape since I had it checked out about a week ago. I'm just afraid that my daughter (who was exposed to COVID 19 a week ago) will develop the disease and they will decide I have to postpone it because of my exposure to her - or they will halt all office procedures.

As to colonoscopies, my spouse is on the 5-year schedule for colonoscopies (she grows polyps). She had hers in the lull between the March pandemic blip and now. If hers was due now, we'd be waiting.

[peggysue2]

52. Wow. You've really been through it.

My surgeon, the one who did the corrective/cosmetic end of it, wanted to do another tweak. But I decided I'd had enough, plus I wasn't eager to go back into the hospital. Then he said he could actually do the last procedure in the office. I might consider that once the virus is under control. We'll see. I don't think the result is all that bad, a little puffy at the top and I have a strange divot in the cartilage at mid-ear. But as I told him, I think my modeling days are over. Plus, I rarely wear my hair behind my ears. So, who's going to see it beyond me and hubby?

I've decided it's a battle scar, the sort you get for living long enough.

As for the colonoscopies, my husband is like your spouse: grows polyps like dandelions. My husband is pretty good about going in for the regular scopes. Snipping those growths out early can avoid a lot of misery down the road. My father-in-law died with colon cancer. Anything you can do to avoid that is worth it. Not an easy way to go.

Take care.

[Ms. Toad]

53. That's actually only the tail end of the story -

I had to fight the original doctor to do a biopsy in the first place. (I have a brother with malignant melanoma & the spot on my met all of the ABC criteria for cancer.) Once he biopsied it, he ignored the yellow flags in the pathology report and refused to answer specific questions about it after I did my own research. I fired him pretty quickly - and had to make an appointment for a consultation with the pathologist in order to get the answers I needed. Talking with the pathologist was actually a lot of fun - since he let me see the slides, and it turns out the pathologist missed a few things the first time around: namely that the excision wasn't complete - and that it extended into the subcutis. The latter was one more yellow flag than appeared in the initial pathology report. The former made it regrow pretty quickly. This new thing is entirely (as near as we can tell by feel) in the subcutis.

I joked with my students that I was working up to a tattoo - a one hump bump, turned into a two hump bump, then into a gnarly scar - I was just making it ugly enough that I could justify a tattoo to cover it up. (I actually did contemplate a tattoo in connection with breast cancer a year or so later - but I'm not likely to get one on my arm.)

I've had visible battle scares since I was around 5 and got tangled up with some barbed wire. Country doctor aren't terribly good about thinking cosmetically when they repair wounds! Well into adult-hood I just assumed that I made big ugly scars . . . turns out it was the doc, not me.

Good luck with your ear - now that I'm wearing masks my ears are exposed a lot more of the time!

[Laffy Kat]

47. I wasn't referring to what your daughter needs.

Just to regular preventative screenings. I hope your daughter stays healthy.

[Ms. Toad]

51. So far -

her diseases are stable (as long as we keep spending $200,000 a year on medical care), and her overactive immune system seems to keep her relatively safe from external threats. One negative COVID test down (probably a bit too soon after exposure), and no symptoms.

[Laffy Kat]

55. Good lord. Please tell me you have good insurance!

[Ms. Toad]

60. She works at starbucks, and it is fantastic insurance -

Car better than mine at a public university.

Her out of pocket cost for all of that care is $3980 (which includes the premium). Earthfare was better before it went bankrupt.

Since she's working at starbucks (which doesn't pay bug bucks, we still have to kick in - and she's still living at home. But as a family, we a cover the costs.

[LuckyCharms]

48. I appreciate you.

[Laffy Kat]

56. Thanks, LC. I appreciate you, too.

You brighten up my days/nights!

[Hugin]

61. ...

Thank you.