Monday, August 3, 2009

Anger

I used to have a blog called Anger Management. Its subtitle was "Things That Piss me Off." I had great fun ranting about this or that outrage of, mosly, technological civilization. Blowing off steam there was a great cathartic.

I got pissed at a nurse today. Right after I saw my doc, he (the nurse) was giving me my meds. There is this unspeakably foul liquid they have been giving me to protect my kidneys. It seems that Metformin, my diabetes med, has a reaction with the contrast dye they use in the CT scan. The sulfurous swill is designed to help undo the consequences of this interaction. The doc had said I could discontinue it. But after he left, the nurse look at my chart and noticed that my creatinine level was elevated. Creatinine is an enzyme in the kidneys. Apparently elevated levels indicate stress to the kidneys if not outright damage. He suggested that I quaff the foul potion despite the doctor's reprieve. Well, I agreed. It all made sense. But then he wanted to give it to me in water instead of apple juice. The rationale here was that concentrated sweets like that shouldn't enter my body. This point was sharper because they had taken me off my metformin. But I refused to take it in water. (You have no idea how foul this stuff is.) So he said "OK, I'll give it to you in a little juice." I again demurred. I've had three doses of this slime so far. One was it a full gass of apple juice, one in a third of a glass and one in a full glass of orange juice. Guess which one nearly made me puke? So he gave me my full glass of apple juice, and I held my breath, pinched my nose and drank it down. Then without releasing my nose, I drank a full glass of water as a chaser. I got a good result. There was only a faint aftertaste of the full outhouse flavor.

OK, so next thing. They've had me on a carb controlled diet. That's fine, but what I really need is the intersection of the diabetic and cardiac diets. I mentioned this to them every day since my admission, and it only penetrated to the kitchen yesterday. Before that, they had switched me to the cardiac diet, ignoring the carb control. I finally got my first meal with the two intersected at lunch today. But before that, I had a cardiac diet breakfast, late because they had starved me last night in anticipation of the lovely TEE procedure. I was eating this breakfast as all this was going on. I mentioned that they had switched me to decaf coffee with the cardiac diet, but that it appeared I had high test on this breakfast. He said something to the effect that decaf wasn't a necessary part of the cardiac diet, but in my case he thought it was, since I had a rapid heart rate. He said "let me just go and tell them to hold the caffeine." I said "I wish you wouldn't." There followed a pissing match where he insisted I cut out the caffeine, and I averred that since it wasn't in the doctor's orders, I didn't have to take his (the nurse's) advice. What I didn't mention was that I had been off high test since the day before, and there was zip affect on my heart rate or arrhythmia. What I know about my body and caffeine is, if I have two cups of fully caffeinated espresso, then my heart reacts. If I keep the level a long way below that intake, I'm fine. Anyhow, I got angry because this situation pushed my reddest hot button. It looked to me like an arbitrary exercise of authority limiting my freedom of action. In fact, I think that's what it was, because I had insulted the guy at the outset by suggesting his medical advice wasn't worth taking, and that I wanted to appeal to my doctor. He was dismissive, deflecting every statement I made to the effect that I wanted to have my caffeine. I finally said. "Look buddy. If you keep this up, I'm going on strike! You will see a trouble-free cooperative patient become a real pain in the ass!" He just walked off shaking his head. But I got caffeinated coffee for lunch. At least I think I did :)

Of course, going on strike would have been self immolation. I wouldn't have kept it up. But short term, the first thing I would have done would have been to disconnect my heart monitor :)

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