Say WHAT?

I truly do admire people who devote their lives to medicine.  From nursing tech to the most highly skilled surgeon, they have chosen an exacting field requiring in depth education and a dedication far beyond most other jobs.  But I’ve come to realize many of them missed a critical class, or maybe that class is just not offered.  It would be called something like Communication 101.  As in saying things so everyone understands what you’re saying.

And it’s not just the upper echelon of surgeon and charge nurse.  Early in our hospital experience a Case Manager told me the husband would be going to a Snoof.  “What’s a Snoof?” I had to ask, and she explained it was a place he would go to learn how to deal with any disabilities resulting from long term hospital care, and where his body would be brought back to self sufficiency.  I asked a tech later, who told me the Case Manager was wrong, it was Sniff.  Eventually I learned it was a Skilled Nursing Facility.  Ah, that made much  more sense!

This has continued off and on for the two plus months we’ve been moved from floor to floor, from ICU (Intensive Care) to Step Down (Intermediate Care) to the various nursing floors, back to ICU then to LTAC (Long Term Acute Care) which is actually not the same level of care as the hospital would give but addressed different needs.  Then he developed a slight infection in his incision, which drained and sent him back to ICU at the hospital, since those sort of holes are a huge deal for stomach surgery patients.

Once he’d been there long enough to be poked and prodded and after several visits to I/R which is Interventional Radiology but that unit is nice enough to put X-Ray under their door sign, I had a discussion with his doctor.  I was informed they had thought he had a fistula, but came to the realization it was an “abnormal connection between skin and intestines.”  Now, I have a pretty good vocabulary and can usually follow conversations.  But this one took a minute.  Abnormal connection between skin and intestines?   “Ah,” I said.  “You mean his HOLE.  It’s okay, I can understand the idea of a HOLE.”

What could have been a huge issue became a fortunate incident.  He’d been scheduled for a feeding tube replacement anyway, but first they studied where the hole led, which was nowhere dangerous, and then where the feeding tube was ending up, which was where it really shouldn’t have been.  I tell you, this guy’s going to glow in the dark even more than I did when I worked in Purchasing for ANPP (That would be Arizona Nuclear Power Plant).

He’d been under severe infectious condition restrictions, which meant glove and gown before you went into the room, and leave them in the room along with his germs.  Until yesterday when he came up clear for C-Dif (a nasty germ he’d been fighting) and negative for MRSA (Methicillin-resistant Staphylococcus Aureus, AKA the band leader in the Ugly Bug Ball).  Then he could finally feel fingers on his arm, and not gloves.  They’re moving him back to Intermediate Care and this time we just might keep that onward and upward path going OUT of the hospital and HOME.  And we can go back to our own world of BoB, BoS (dog jargon), various specialty watercolor inks, and the sub-genres of the writing world.

We can’t wait

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It’s all about timing

This is a somewhat self indulgent post, maybe because I’m working on a rather nice New Mexico red.  Or maybe because I’m seeing that light at the end of the very long, very dark tunnel

Last Friday the husband started to come back to life and respond to the world around him.  He’s still got that long road ahead, but he’s starting to take more steps forward than back. Unfortunately he can be impatient.  Last night he fell out of bed, I think trying to get home.  Oops.  No harm done but he’s just not the patient sort of patient.

I’m not exactly patient myself and I was SO glad to hear from my wonderful editor at Black Opal Books that My Killer My Love will be releasing in paperback a whole month early.  Right now the link says September 10, but I’m assured it will be August 10.  http://blackopalbooks.com/index.php/en/component/content/article/21

I’d like to think the timetable for healing would also be moved up but more likely he’ll be pushed down the road to an intensive rehab by then, and maybe be home by September.  We can dream, can’t we?

In the meantime it’s definitely time to stop lolly gagging around and get back to work on editing the story of a young woman who has to learn how to trust after her childhood was ruined.  Working title is “Teach Me to Forget.”  So I’ll be blogging about the husband and hospitals, and also about books and writing.  We all need our relief valves.

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A LONG Road

Pre surgery, a good doctor will go over every step of what’s going to happen.  They’ll lay out the statistics on the surgery, give you a prognosis based on your specific condition and they’ll explain, generally with illustrations, what they’re going to do while inside your body.  After the surgery, they’ll let your “people” know how the surgery went, and what to expect in the next few days.

We had this information from my husband’s surgeon.  He gave us the statistics (grim) and the prognosis (guarded).  After surgery, he gave us his report (semi positive).  The anesthesiologist said we still had a long road ahead of us.  What an understatement that was!

Depending on the severity of a surgery, the body must recover not only from the insult of being cut open and sewn back together, but also from the drugs used to sedate during surgery.  Long term bed rest compounds this insult.  And any stay in ICU on a respirator requires even more sedation.  At some point, your body and your mind will say ENOUGH and will try to shut down for recovery.

This is where good nursing is so critical, and where those sitting bedside must be ever vigilant.  Nurses and doctors have great education but they have multiple patients.  You the relative, the caregiver, the one most worried, have ONE patient.  It’s up to YOU to remind them about potential blocked catheters, what certain gestures mean, and in some cases what sort of surgery was performed.  It’s also up to YOU to reach out to the patient, even if they seem to be shutting themselves off from you.  Rub their feet, stroke their hands, and talk about nonsense, just to give them something for their minds to connect to. It never hurts to bring in cookies for the staff.

If you do feel there is a problem with care, speak up.  If Physical Therapy was scheduled for the day before, did it happen?  If the patient is supposed to use breathing implements, has that happened as scheduled whether you’re in the room or not?  Is everything as clean as it should be and if tests are being done, WHAT are the tests, and WHAT were the results.  If you feel no progress is being made, ask why.  You might not like the answers but far better to know than to wonder.

A good hospital will let you know when they feel it’s time to pass the patient on to another facility where they can get different care.  Sometimes the care is more intense, sometimes its just another step along that long long road to recovery.  After severe surgeries, such as the Whipple, there can be a longer than usual stay in the surgical hospital, then more time in a rehab center where the patient gains strength.  Sometimes the move is more lateral, to an acute care facility where more attention can be given to recovery.

All of this sounds kind of clinical and distant – I wanted to get information out without getting too emotional.  The husband wasn’t recovering in his surgical hospital, I did go to the nurse, the case manager, to the floor doctor, and ask WHY???  We all agreed he would do better in what is called LTAC – Long Term Acute Care.  A smaller hospital, where they are aggressive about getting patients well, and have the staff to get the job done.  I also needed a facility where the staff had the time to communicate.

The move was made earlier this month.  It hasn’t been a stroll through the garden, more like climbing a mountain in the rain.  Hauling up over craggy rocks, sliding back from time to time.  We celebrated our 24th anniversary on one of his worst days.  Then the next day his eyes were clear and he was not only answering questions but initiating conversations.  For the first time he was able to see the proof copy of My Killer My Love.  He went into the hospital about the time it was released digitally (May 22) and with the help of a great hospital staff and a lot of work on his part, will be home before it releases in hard copy (September 10).   I’ve found a great buy on some large frames for his next watercolors.  We have a lot of life still to live.

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But it’s a DRY Heat

My brother in law Larry has been here for about a month, helping out around the property and spending a fair amount of time at the hospital with Tom.  This has taken a huge hunk out of his Southern California life, and has been a great help.  But it’s not likely he’ll be thinking about relocating.

I’ve been informed we’re the equivalent of an Army desert outpost, with killer winds and high temperatures.  I kept telling him it’s a DRY heat, and that makes all the difference. Only to be told it’s hotter than a popcorn fart, and hot is hot. Not to mention our lives revolve around the dogs and not around antique cars.  In spite of his grumbling, the Salukis have wormed their way into his heart, if snuck cookies mean anything, and he now has pet  names for his favorites.  “Garbage Disposal” is a term of endearment, isn’t it?

In spite of adverse weather conditions he’s managed to help with all the changes needed to make a more welcome environment for Tom’s return.  We’ve added fences and shade areas separate from the dogs, since Salukis can be a bit too enthusiastic for someone not quite healed, and I’ll finally be painting the dog room instead of leaving it “natural” – since Tom’s not here to say otherwise.  Oops, should I have mentioned that?  Fortunately there’s no computer in his ICU room.

Though I haven’t done much writing on books, the imagination took over one day and I came up with the Whipple procedure from the POV of the digestive tract, something I don’t think has been considered in the past, so I took a stab at it:

http://occsliceoforange.blogspot.com/search?q=monica+stoner

Yeah, I’m silly sometimes!

 

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Hospitals — a world of stories

Writing is a solitary endeavor.  Even when spending vast amounts of time with people comes easily, the actual writing is done one on one, writer with paper or screen.  And so many writers are solitary people by  nature, spending much of their lives in worlds of their own creation.

Hospitals are filled with people.  All kinds of people.  Sick people, well people, strange people and hard working people.  People with hard jobs and great responsibilities, people bearing burdens they’re not quite ready to share.  Mix writers with hospitals, and you have an overload of ideas and characters waiting to be woven into a story.  There might not be enough energy to spend more than a few minutes at one time in front of the computer, but the stories take root and grow behind the scenes.

Sleep deprivation is a classic form of torture, often experienced by patients in ICU.  The nurses have a name for it: ICU Delusions.  Blinking lights and the constant noise of machines keeps patients from deep sleep, and they can fall into a fantasy world of their own creation but beyond their control.  In this world the people in the hallways are enemies, ready to sneak up and attack.  Patient’s thoughts turn to defense and escape, and they might call their family demanding protection and immediate removal from the hospital, or at least that particular ward.  Fortunately once they have been moved to a quieter, darker area they have little memory of their demands.

And there are the nurses.  Nurses can be very good,not so good, or any level in between.  The very good ones are phenomenal, the not so good ones are still pretty darned amazing.  Chocolate chip cookies are a great bribe, and all of them appreciate a thank you from time to time.  They work under great pressure, faced with intense emotions and demands.  It’s not a job I could do.

After more than a month watching people in the hospital while visiting with my husband and talking to doctors, it looks like the story gathering days will soon be over.  Having beaten the odds on the Whipple procedure, then overcoming pneumonia when he aspirated bile, it looks like my husband will be leaving ICU for the second time and, we hope, moving from the hospital to a rehab facility where he will relearn how to stand up and walk around.   I don’t know that I would ever write a story about hospitals, but I can write about hope, and about the power of thinking only positive thoughts.

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It’s a Long Long Road

I’ve been wrapped up in life and haven’t shared for more than a week.  In that time, my husband’s blockage was identified as a tumor, and we were given options, none of which sounded pleasant.  The days of doctors patting your hand and not explaining what’s really going on are long past.  Our options were do nothing, with an obvious negative outcome, use chemo, with the same outcome but painful, or take a chance on what’s called a Whipple procedure, where the tumor is removed along with a portion of the pancreas and intestines, then everything is reconnected.  We were given statistics of survival, and potential reasons for failure.  As I pointed out to the surgeon, there wasn’t one person in the hospital who wouldn’t die at some point, and if the options were failure or limited success, we couldn’t see much of a choice.  My husband decided in the beginning to fight, and as long as he felt that way, we’d do whatever it took.

My husband reconnected with his brother, who flew in to help the day we called him, and was there on surgery day.  With three of us there in pre-op, it was a tag team comedy act right up until they wheeled him away, and the waiting started.  Seven hours later the surgeon came out to tell us he felt good about the surgery, and reminded us about the potential road blocks to recovery.  The anesthesiologist reminded us that road to recovery was going to be long and difficult.

In the past several days we’ve learned about the complexities of modern medicine, and the value of a great nursing staff.  We can’t say enough good things about this hospital and about his two nurses, both very experienced in this procedure, and both generous with their time and knowledge.  We’ve learned about ICU delusions, which seem so very real to the patient trying to reconnect with his world and establish some kind of control over his life.  Most of all, we’ve learned the value of friendships shared without strings.

Yes, it’s a long, long road but that’s far better than a road block

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The Left Hand Taketh Away

Coming into June after the madness of May, I’m not sure what to say.  Tom, my wonderful talented irritating artist husband has been in the hospital for more than a week.  He’s on a first name basis with the techs who draw blood and with the great people down in Nuclear Medicine.  If he hadn’t been glowing from the jaundice he would be from the x-rays.  They’ve established he has a blockage, they just haven’t identified it.  At this rate we’re going to be declaring it as a dependent.

I’ve found I’m not one of those driven people who can write no matter what.  I try, and I’ve been getting down scenes and plots but nowhere near the output I had before.  The house is just too darned quiet.  I’ve finished up my blog tour with a visit to the Book Boost, which will be up a bit later.  Tom reminds his nurses his wife has written a book, and hands out cards with the cover and links to order.  “My Killer, My Love” is doing well even when I can’t steal time to promote it.

Whatever the diagnosis we can deal with it.  Ranting, raving, hair pulling is non productive and has never cured the common cold much less anything else.  Certainly this, along with the natural disasters around the world, has brought so much into perspective.   It’s not how many times you’re knocked down, it’s how many times you get up and keep moving forward.

I can’t say enough good about the support system we have developed for each other as writers of relationship books.   We dance in joy for each other and we all join in virtual hugs.  We just rock

 

 

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The Right Hand Giveth

Since February 22, when Black Opal Books asked if I wanted them to publish My Killer My Love, life has been a roller coaster.  Incredible highs. Deplorable lows.  And I wondered whatever happened to my former  ordinary life.  Well, as ordinary as a life spent in a whirlwind of club activities, traveling, going to dog shows can be.

In the midst of edits, cover art, promotion and all things new book, I jumped in on the deep end with writing sprints, on line classes, and contest judging.  Life was manic but life was wonderful.  One of our favored dogs sired a lovely litter, my husband had more recognition for his artwork, and we had some really nice wins at dog shows.  Mountaintop highs.

Then last Saturday I noticed a new glow to my husband’s face, and by late Sunday he was beginning to look like an extra for the Simpsons.  Jaundice.  Since he is diabetic with some pretty severe kidney issues, we pay a lot of attention to these kind of symptoms, and he was calling his diabetes doctor early Monday morning. Deep valley lows.

Last week was spent going to doctors, to labs, to clinics where he could be poked and prodded and scanned.  He got progressively brighter and progressively weaker, and we finally got him admitted to the hospital yesterday.  Seems we had to see a specialist who wasn’t available right away.  When we finally got in, they said – “He’s really sick”  YA THINK???  They made noises about doing the necessary extra tests on an outpatient basis but then agreed he needed to be somewhere with a fluid drip in his arm.

Yesterday, while sitting by his bed in the emergency room willing the drip to go into his arm faster, I heard him telling the lab tech “My wife’s book is coming out this week.”  Which was the brightest light in the gloom.

At this point his condition is serious but not dire though I’m told recovery won’t be immediate.  While we were getting through last week, I was more involved in making sure he drank water frequently, in small amounts, than checking on whether or not my name had appeared on Amazon.  Since this doesn’t happen until your book is released, and my release wasn’t for several days, it was just a silly game. Until this morning, when I typed in Mona(space) Kar and saw the last two letter fill in.  I thought my cover was pretty before, it ROCKS on a bookshelf, virtual or not.

It looks like I’m outed all over the place.

http://www.blackopalbooks.com/index.php/my-killer-my-love

https://www.allromanceebooks.com/product-mykillermylove-549448-173.html

https://www.smashwords.com/books/view/61404

http://search.barnesandnoble.com/My-Killer-My-Love/Mona-Karel/e/2940012506559

http://www.amazon.com/My-Killer-Love-ebook/dp/B00529AJ6Y/ref=sr_1_1?ie=UTF8&m=AG56TWVU5XWC2&s=digital-text&qid=1306249150&sr=1-1

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Looking our best for the signings

Martha Doster replied to the earlier post mentioning her lotions and potions. I’m going to put her answer in here so more people can see it.  We spend so much time rushing around, cramming our time with word counts and day to day life, we forget about skin care until it’s time to leave the house.  Living in a dry climate makes it even worse!  So here’s Martha to the rescue. Again.

Hi, Mona – thanks so much for your kind words about me! I love the idea of using all resources at hand as inspiration for your craft. I am in awe of anyone who deftly puts pen to paper.
Just a few words if I may re: quick tips for getting your skin to be radiant for your oh-so-popular book-signings –
*no harsh soaps – use softer glycerin soaps with added complexion savers like Shea butter, milk, oatmeal, or liquid cleansers without alcohol (have you tried the White Tea Shower Lotion?)http://marthasbodybueno.com/Shop/index.php?main_page=index&cPath=5&sort=20a&page=3;
*use all-natural ingredients for moisturizing – NO mineral oil derivitives. I know you love my pure Unrefined Avocado Oil, & it is the perfect all-in-one product when hurried, but stop using the Extreme Foot Butter on your hands! My new Extreme Gardener’s Hand Cream is similar but lighter for working (read typing) hands.
Let me know if you’d like more tips!
*p.s. as for the “naughty wink-wink” section of my website (http://marthasbodybueno.com/Shop/index.php?main_page=index&cPath=12&zenid=8a985c69b4cebe82417559d2158722e6), if any of your readers want further info on specific items, just direct me as to how to do that!

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Welcome to Rebecca Forster

Rebecca Forster is joining us today from sunny California, where they don’t have snow storms on the first of May, to talk about her decision to go from a USA Today Best Selling Author to self publishing, and why this has been the best choice for her.  Rebecca’s “Before Her Eyes” is one of the strongest most intelligent books I’ve had the privilege to read in a long time.  And I can’t wait to read the next in the “Witness” series.  Josie defines the modern woman I like to read about.

Monica: The question all writers are asking is whether to self-publish or not. After a 26 year career why are you now self-publishing?
Rebecca: First, thanks for that great introduction. I love Before Her Eyes – for a lot of reasons but mainly because I pushed the ‘craft’ boundaries a bit. When New York balked, I didn’t want this book to languish. My writer’s gut told me it was viable and thankfully readers have really liked it. Sales have been great and the response to both the format and the characters has really made me realize that, sometimes, an author should take matters into their own hands.
Monica: You took your entire back list digital. Are you planning on publishing through New York again?
Rebecca: I’m not going to rule it out but the last year and a half has been focused on making my books available for digital access. Amazon, Smashwords. com, Barnes & Noble are making it easy for authors to post their work and begin building an audience.
Monica: What’s the drawback to taking this route?
Rebecca: First, new writers must realize that digital readers are as discerning as traditional readers – in fact, most of them continue to be traditional readers. They are expecting quality books even though the self-published do not have the advantages of New York’s editors, marketers, cover artists etc.  I work with a freelance editor because I know my self-published work needs to be of the same quality as my traditionally published. Also, marketing is difficult. No one is quite sure how to go about getting their name out there. Social media is critical to this step so it’s not just enough to write a book, an author needs to have the social media set-up to promote it.
Monica: Do you advise new writers not to approach New York?
Rebecca: No, definitely not. Who doesn’t want to hold their book in their hand? Plus, there is no training ground better than working with a New York editor. For me, the consideration was that digital seems to be the way of the future and I did not want to sign away my digital rights. I would caution new writers to look at their traditional contracts and see what the publisher is asking for in terms of digital rights. I understand the contracts have questionable benefits for the author in terms of e-rights. The other thing that struck me was that bookstores are becoming few and far between. Borders is in bankruptcy, independents have gone by the wayside. Distribution channels are drying up. So I had to ask what is best for my career. For me, the digital route seemed appropriate but there are times I would kill to get a call from my agent, pop in to see my editor, walk into a bookstore and see my book. I say go-for it with traditional publishing but keep your eyes wide open. Not only are times changing – they are changing by the minute!
Monica: What projects are on the table now?
Rebecca: I have one script, a romantic comedy, in development and we are still looking for a couple of ‘angels’ to round out the funding but we have incredible talent already signed. I also have a request for a script based on one of my thrillers and I’m working on Expert Witness, the fourth book in the Witness series.

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