Category Archives: specialists

(Knee) Joint Ventures


by Lillian Csernica on February 13, 2017

k17796865

Finally scheduled the physical therapy for my sprained knee. Here is yet another excellent example of “Be careful what you wish for.”

Those of you who have had physical therapy will know what happens first, especially with a joint problem. The physical therapist (PT) works the joint to see where the mobility issues are and just how serious your discomfort levels may be. In short, you spend the first fifteen minutes being tortured while your PT gets the lay of the land, so to speak.

2141038325-the_20devil_20supplier_20of_20ligaments

My PT explained and demonstrated the exercises she wanted me to do in order to help heal the ligaments and get the knee cap realigned. No problem there. One exercise involves a rolling pin. That one I really must use in a story somewhere.

Now for the weird part. A nice young man wheeled in a machine on par with a fast food cash register that included an ultrasound gadget and one for infra red light. Ultrasound can break up scar tissue. I had no idea. The infra red light promotes healing. Don’t you just love science?

stock-photo-tens-electrodes-positioned-for-knee-pain-treatment-in-physical-therapy-376434412

For me, they brought out the electrodes. One pair above my knee, one pair just below. This is where my anxiety spiked. I know what those kind of electrodes do, and I wasn’t looking forward to it. As much as the tech assured me this procedure was designed to reduce my pain level, I wasn’t buying it. Sure enough, Step One would be “adjusting the level to suit my needs.”

Translation: Finding out how much I could take before my muscles spasmed and I started swearing.

Ever seen Showdown in Little Tokyo? Dolph Lundgren, Brandon Lee, Cary-Hiroyuki Tagawa, and Tia Carrere. WARNING: Our Heroes do start swearing.

You see where I’m going with this, right?

It got even weirder when my PT wrapped my knee in an ice pack. So first it feels like I’ve got all these little needles jabbing me, then the ice pack helped numb the area. Even so, when the tech tinkered with the voltage I freaked out, laughing like a maniac. It TICKLED. Sounds funny? It wasn’t. I kept doubling up, working my non-existent six-pack, laughing until I thought I’d have an asthma attack.

My PT said to the tech, “I think she’ll be low level.” Gosh, ya think so?

g7098

The tech adjusted the voltage, then set the timer for about ten minutes. My PT told me to yell if I needed anything.  Then the tech offered me this silly piece of comfort:

“Now remember, this machine cannot hurt you.”

Really? Tickle torture, muscle spasms, and making it hard to breathe? All that didn’t count as “hurting” me?

I survived the ten minutes without too much discomfort. To be fair, for the rest of the evening my knee did feel better. My PT said she expects to see improvement in six weeks, so I’ve got six more sessions. I confess I’m hoping I can do without the electrodes VERY soon!

electrode-clipart-frankensteins_monster_standing_in_front_pair_electrodes_100926-162956-469060

 

2 Comments

Filed under bad movies, doctors, frustration, Goals, hospital, Lillian Csernica, specialists, therapy

Five Reasons Why Today Is Wonderful


by Lillian Csernica on January 24, 2017

women-drinking-coffee-clipart-a_pregnant_woman_sitting_with_her_feet_up_holding_a_hot_drink_royalty_free_clipart_picture_100607-033672-616053

One: The rain has stopped. The sun is out! The creek that runs along our property is back to a reasonable level. The wild stormy weekend made the creek rise several feet, biting off chunks of our back yard. All the trees  that fell, fell away from our house.

This is a huge relief.

k4613943

Two: Today I saw my cardiologist. Thanks to my brief period of radioactivity during my previous appointment, my doctor is now satisfied that no plaque is lurking in my veins waiting to cause me a serious problem. This means no angiogram!  Another serious relief.

13658397_1871759493051525_1918115958_n

Three: I’ve been having problems with my CPAP equipment. I stopped by SleepQuest today for some troubleshooting. Turns out the 90 days have passed and my insurance covers a fresh set of equipment. The tech on duty (a delightful lady) set me up with everything I needed.

trader_joes_flyer_logo

Four: By this time hunger pangs set in. On my weight loss program I have to make sure I don’t let myself get too hungry. If my blood sugar drops, I tend to stand around staring at things and I can’t make decisions quickly. Given that my drive home meant going over Hwy 17, lunch became a serious priority. Trader Joe’s to the rescue! I spotted one and discovered a number of tasty items on my You Are Allowed To Eat Very Little Of This list.

pothole-sign-traffic-indicating-season-us-38495877

Five: I made it home before the after school rush, thank God. Between the clean up after the latest storm, the road crews filling in all the potholes, and everybody getting out into the sunshine, driving was hectic enough without all the grade school parents picking up their kids and all the teenagers with cars spilling out of the high school.

Here I sit, preparing to edit a fresh short story. The hardest part of this weight loss program is giving up chocolate during the first stage. I sincerely believe chocolate fuels the imagination. Oh well. I seem to be surviving without my usual Mocha Coconut Frappuccino from Starbucks. If I can write without caffeine, I shall be a new woman!

canstock21672830

3 Comments

Filed under chocolate, doctors, Family, Food, Goals, Lillian Csernica, nature, Self-image, specialists, worry, Writing

My Stress Managment is Too Stressful


by Lillian Csernica on June 30, 2016

canstock20091684

How do I manage my stress?

  • At the end of the day, I watch TV
  • I go to the library and write in my journal or my work notebook.
  • I get out in the sun and enjoy Nature.
  • I play with my cats.
  • I see my physical and mental health care professionals.

stress

How do these activities increase my stress?

woman-watching-tv-free-clip-art

  • Are you familiar with the term “binge watching”? There are a number of TV and cable shows available on Netflix, Hulu, et al. Some of my favorites include “Person of Interest,” “Once Upon A Time,” various Food network shows, and a few that try to document paranormal activity. One episode is just like one potato chip. One is never enough. Even though it’s summer, I still have to get up at 6:30 a.m. for Michael’s morning routine.  If I stay up too late watching TV (and I do), I don’t get enough sleep. Less sleep = more stress.

0511-0902-0801-4559_woman_thinking_in_a_library_clipart_image

  • Libraries are no longer the Sacred Sites of Silence. I often find a remote corner, depending on the time of day, but even so, noise travels. Shrieking toddlers, teenagers with no concept of muting their phones and themselves, and the endless clicking of everybody’s laptop keyboards. Makes me crazy. If it’s a bad time of day, I retreat to Denny’s. Yes, it’s noisy, but in Tourist Season, I’m OK with that.

stock-photo-santa-cruz-california-usa-july-large-crowds-of-people-flock-to-the-santa-cruz-beach-347851250

  • Santa Cruz County is full of beaches and national parks and redwoods. We’ve got artist colonies and museums and aquariums. And yes, this means we’ve also got Tourist Season. Generally speaking, I like tourists. I can take a stroll down the Boardwalk and hear three or four foreign languages being spoken. What stresses me out is the traffic. People who don’t know Hwy 17, Hwy 9, and the major artery streets can get confused, which means they slow down. Then there are the people who insist on going insanely fast no matter where they are.

il_214x170-894676489_p2m3

  • It’s summer. I have three cats who are all shedding. One is a black longhair who decided to hack up the mother of all hairballs on the stairway landing some time last night. The last thing I want to see first thing in the morning is some big furry disgusting mess on my stairs, especially when there’s a good chance it might be alive. I live in a somewhat more civilized area than I have in the past two towns where I’ve lived, but we still have all kinds of flora and fauna that can and do take me by surprise.

stock-vector-paroxysm-of-ventricular-tachycardia-in-sinus-rhythm-background-vector-professional-information-91857905

  • Now we come to the big issue of the moment. I’m having trouble with my heart. Arrhythmia, which is no big deal. At least I hope not. I had an attack today that lasted long enough to make me consider going to Urgent Care. I made an appointment with my doctor. The thing is, my general practitioner is over the hill in San Jose. That means I’ll be driving Hwy 17 tomorrow. Tomorrow is the Friday of the 4th of July Weekend. That means on my way home I will be dealing with everybody on the face of this part of the planet who wants to spend the holiday weekend at the beach. On a slow day Hwy 17 is a nightmare. Just thinking about it stresses me out. I didn’t realize the logistics of the drive until after I’d made the appointment. Doesn’t matter. I have to see my doctor. This is one of those things that just can’t wait.

heartbeat-clipart-heartbeat

4 Comments

Filed under doctors, Family, frustration, hospital, Lillian Csernica, nature, reality TV, research, specialists, therapy, worry, Writing

In Need of Nurses


by Lillian Csernica on June 18, 2016

vector-of-a-super-hero-wonder-nurse-with-a-rope-by-ron-leishman-26097

I’ve been meaning to write more frequent blog posts.  Life has gotten in the way in the form of being seriously short staffed where Michael is concerned.  Right now I have two R.N.s and my sister, who does have experience with hospital and in-home care.  With Michael out of school, we’re running two eight hour shifts per day.  This means I have to pitch in as well.  I’ve had to take four of the eight hour shifts, three 6:30 a.m to 2:30 p.m. and one 2:30 p.m. to 10:30 p.m.

Michael takes seven different medications.  He needs at least two breathing treatments per day which include nebulizer treatment followed by three timed sessions with a percussive therapy vest.  Diaper changes can be quite laborious depending on the nature and quantity of his output.  Michael is twenty years old, close to six feet tall, and weighs 145 lb.  He’s on the gangly side, so rolling him from one side to the other requires considerable effort.

In the morning I fully expect to need Naproxen, if not my carefully hoarded stash of Vicodin.  I’m hoping the Vicodin won’t be necessary because I have an hour’s drive ahead of me in order to attend a writer’s group meeting.

medications-02

Adding to my joy this week is a breakdown in communications with the supplier of my antidepressant medications.  I did get an interim prescription for one of them from my doctor, but there’s been more difficulties with the other prescription.  Tomorrow will be Day 3 without Pristiq.  I will either be what some people might consider manic, or I will have no patience with obstacles and no filters in place to moderate my reactions to such obstacles.

Not really the best frame of mind for giving critiques in a writer’s group setting.

On Sunday we interview yet another R.N.  I’m really hoping she turns out to be a keeper.  We’re stretched mighty thin.  Summer school starts next week, but we still need a third R.N. to take some of the load off of my sister.

All of this leads me to think about what we’ll be facing once Michael is no longer in school.  He has two years left in the County program.  Then we’ll have to find other ways to get him out of the house and keep him occupied so he doesn’t languish in bed for the majority of his day.  That’s not good for his mental or physical health.

Doesn’t do a whole lot for mine, either.

fatigue-clipart-a_tired_woman_with_curlers_in_her_hair_looking_in_the_mirror_royalty_free_clipart_picture_090807-033118-029053

 

 

2 Comments

Filed under Baclofen pump, Depression, doctors, Family, frustration, Goals, hospital, Lillian Csernica, mother, parenting, perspective, Special needs, specialists, therapy, Writing

Here I Go Again


by Lillian Csernica on March 16, 2016

f26f7751dfaa7622dc4b0425a358201c

I know.  I said I wouldn’t do it anymore.  I’ve learned my lesson.

Then somebody came along and made me an offer that brings with it a lot of benefits.

I’m going to join a writer’s group.

In the past I’ve had some unfortunate experiences.  Personality conflicts.  Hidden agendas.  The gap in experience between some of the writers was so great that we couldn’t do each other that much good.  In some cases it was a matter of logistics that just didn’t work out.

Online writer’s groups don’t really appeal to me because the biggest plus that comes with participating in a group is the brainstorming, plot twists and bigger stakes and stronger motivations for the characters.  We bounce ideas off each other and the person whose work we’re discussing makes lots of notes, to be sorted out later at home.

lady-writer

 

In this group, which meets this coming Saturday, there will be three people I’ve known for over twenty years.  I have collaborated with two of them on separate projects.  With the one, I’ve sold three stories.  With the other, two stories and a novel series that is still a work in progress.  One member is new to me, but I’m told he writes in genres where I have more experience than the other three, so we should all be able to do each other some kind of good.

I confess I let myself get talked into this by the member of the group whose advice about writing has led to many improvements in quite a few of my stories as well as my novels.  I have packaged up the first fifty pages of Sword Master, Flower Maiden and emailed it to all of them.  I’ve been reading through the ms as I prepare a new synopsis for query purposes.  The book needs more tinkering in terms of pace and the use of Japanese language.  We’ll see what my fellow scribes have to say.  We’re all history addicts, so that makes for a happy foundation.

a_secretary_sorting_papers_and_tossing_them_in_the_air_royalty_free_clipart_picture_110215-138178-509053

If I can just get up to speed on the projects of two members, prep my comments, and be ready to participate by Saturday, I shall enter into this group situation with fingers crossed and notebook at the ready.  I’m hoping I come out of it with the help I need to get my work to a better level of quality that will sell to better markets for better prices.  We’ll see.

I’m a fan of ’80s rock, those glorious days of the Hair Metal bands.  Bon Jovi remains my favorite, but in this particular instance, Whitesnake provides my theme song.

8 Comments

Filed under creativity, editing, Fiction, Goals, historical fiction, Lillian Csernica, publication, romance, specialists, Uncategorized, Writing

Another Hospital Stay, Part 2


by Lillian Csernica on August 1, 2015

I’ve been MIA because I’ve spent most of the past ten days at the hospital with Michael, and most of those days in the ICU.

The Baclofen pump replacement went well.  No redness, swelling, etc. at the incision site.  No problems in the Recovery room.

Then matters started to get complicated.  Instead of sending Michael to the Surgical floor, somebody in his or her infinite wisdom sent him to the Rehab floor.  The reasoning?  The staff on the Surgical floor weren’t as familiar with the Ketogenic Diet, and besides, the kids with Baclofen pumps all go to the Rehab floor.

Michael developed an infection.  Other bad things happened, but let me just say his left lung took a hit.  That’s his most vulnerable area.  His breathing was compromised, and sure enough, it looked like pneumonia.  I don’t want to hear the P-word.  That has been Michael’s #1 enemy for most of his life.

After two days on the Rehab floor, I had a polite, even-tempered, but very firm hissy fit.  Michael needed more aggressive care.  He should be sent to the ICU immediately.  The charge nurse agreed with me and called the ICU.  One of their attending physicians came to evaluate Michael.  The doctor asked me a few key questions about Michael’s history, then told the team of Pediatric M.D.s on the Rehab floor Michael did indeed need to be in the ICU.

This is why I work so hard to be calm and polite when I’m dealing with the medics.  I know when to get angry, and I know when to panic.  I also know how to make these feelings clear without actually taking them out on people such as the R.N.s who are always busting their butts, or the respiratory therapists, or the other People Who Aren’t Doctors.  Oakland Children’s Hospital is a teaching hospital, so there are teams of residents under the supervision of the attending physicians.  They do things a certain way in teaching hospitals, and that’s important to bear in mind.  I really liked the Pediatric residents who took care of Michael.  He’s just a complicated guy and needed what can be done better in the ICU.

Two days ago Michael’s kidneys and liver shut down.  Chris and I were living in absolute terror that Michael would need a liver transplant.  The liver specialist explained the whole evaluation process to us, the waiting list, the length of the surgery, and even what would happen if Michael rejected the transplant or was considered a bad transplant risk.  He would not survive more than a week.

I don’t EVER want to have this kind of conversation with a doctor again.

The good news is Michael is on dialysis right now and that’s helping matters.  His breathing is much better, with less equipment strapped to his face to help him breathe.  The kidneys and liver are amazing organs capable of considerable recovery.  Michael seems to be on his way to getting over all this, but we still have to be cautious.  Another infection, another fever, and all this progress would be lost.

I want to say a loud public thank you to my parish priest, Archpriest Basil Rhodes of St. Nicholas Russian Orthodox Church in Saratoga, CA.  He called a number of priests who reside in or near Oakland.  Fr. Ninos Oshaana was the first to arrive.  He said a molieben over Michael and anointed him with Holy Unction.  Fr. Ninos moved so quickly he got there before Michael was taken into surgery for the implantation of the dialysis catheter.  God bless you, Fr. Ninos!

I go back to the hospital tomorrow, suitcase in hand, to stay there or at the Family House nearby until Michael comes home.  Please keep us in your prayers.

11 Comments

Filed under Baclofen pump, Depression, doctors, Eastern Orthodox Christianity, Family, frustration, hospital, mother, Special needs, specialists, surgery, worry, Writing

Shift Change at the Doctor’s Office


by Lillian Csernica on June 5, 2015

http://www.cartoonstock.com

My son Michael is 19 now.  Still a teenager, although he is legally an adult.  Last year my husband and I had to file the appropriate papers and meet with the state officials who oversee the process of the appointment of a legal guardian for medically fragile, nonverbal people such as my son.  We are now not just his parents but his legal guardians as well.

That process brought home to me the fact that my son is moving on.  I have lived most of my adult life in the world of pediatric medical care.  Hospitals, doctors, nurses, therapists, caseworkers, counselors, and the vendors for all the equipment and supplies.  Bright colors, scrubs with cartoon characters, aquariums in the waiting rooms.  Environments meant to soothe and entertain children who are facing the frightening prospect of yet another doctor visit.

Yesterday my husband and I took Michael to the Oakland Children’s Hospital.  That’s a two hour drive, and our appointment was in the afternoon, so my husband had to take the day off from work.  “Family medical leave” is the category, rather than burning a vacation day.  Finding parking for our van was a real problem because the van’s roof is higher than the parking structure clearance.  We made it to the doctor’s office on time, but only because we know enough to leave a wide margin of extra time for traffic and the whole parking issue.

My son has a Baclofen pump, which is a medication pump implanted in his abdomen with a catheter than runs under the skin around his ribs to his spinal column.  Baclofen helps ease the spasticity in his muscles due to the cerebral palsy.  The battery in the pump is nearing the end of its charge, so it’s time to schedule the replacement surgery.  When the pump was implanted, I stayed with Michael for the five days he was in the hospital.  The replacement surgery is much simpler, so his stay won’t be as long.  Every surgery has its risks, but this doctor is a recognized expert in the procedure.

What disturbed me the most about this appointment happened when the doctor pointed out that soon Michael would need to see a doctor in this same field of medicine who treats adults.  On one hand, this isn’t a cause for anxiety because it makes perfect sense.  Our present surgeon is a specialist in pediatric cases.  My son has almost reached the legal drinking age.  Of course he would no longer see a children’s doctor.

On the other hand, as this thought sank in, I realized that the same will be true for all of Michael’s specialists:

The pediatrician.

The neurologist.

The gastroenterologist.

The pulmonologist.

The ophthamologist.

The orthopedic surgeon who put the Harrington rods in to correct Michael’s scoliosis.

Each of these doctors represents almost twenty years of expertise in the treatment of my son’s particular combination of medical problems.  The idea of having to leave the team that has helped us keep Michael healthy and strong through so many crises really upsets me.  No doubt we will be referred to doctors in whom our current team has confidence, but still.  Reading Michael’s chart in the context of one particular aspect of his care will not give each of these new specialists a real grasp of the complexity of Michael’s circumstances.

So much about the future frightens me.  Climate change.  Water rationing.  The increasing frequency of earthquakes (I live in California).  Making sure we have everything in place to provide both of my sons with a safe, healthy adulthood.  The movie “San Andreas” just opened.  I can’t go see it, no matter how good the reviews say it is.  I know that at some point I will freak out and have to leave the theater.

New doctors.  New names, new faces, new locations, new phone numbers, new logistics.  Finding out how they communicate, if they’re willing to listen, how much they’re willing to let me participate in planning Michael’s care.  We’ve been very fortunate with the pediatric physicians we’ve known.  People who go into pediatric medicine generally like children and make an effort to be pleasant and nonthreatening.  As we move into the world of adult care, where we’re all expected to act like “grown-ups,” I wonder about the people who will become responsible for maintaining Michael’s health.

7 Comments

Filed under Depression, doctors, Family, frustration, Special needs, specialists