Yes, it’s been months since I posted. I could make excuses about being busy with work, family, friends, and stuff like that. It’s all true, but the main reason is laziness. I’ve just not had the energy to sit down and post.
There’s nothing wrong with my physically or emotionally, I’ve just been distracted. I’m trying to combat that by starting to blog again. I can’t promise that there will be a lot of EMS content, because I’m not sure I have a lot to add after almost ten years of being out of active EMS. I read a lot of charts and see a lot of what is wrong with EMS these days.
Most of that I can’t do much about, but I can try at least to help individual and even entire agencies improve their care of patients. While the technology has advanced quite a bit over the decade since I retired, human anatomy and physiology are the same. Our understanding of it has improved, there are new medications and technology, but humans are still humans. I’ll blog more about that along the way.
On to 2021. Right after New Year I commented somewhat glumly that there is no reason to believe that the new year would be any better than 2020. I was more correct in that assumption than I could ever imagine.
The disaster that was the 2020 election continued in earnest when Joe Biden was inaugurated as President. Elections, even stolen ones, have consequences and we are seeing them in real time.
My work, such as it is, continued although I was doing almost all of it remotely. A couple of agencies opened up to outsiders so that I could meet with individuals in person, but for the most part it was all remote. Classes were difficult because at this point providers were confined to their bunk rooms when not on calls, so I had a dozen or so different people logged on to our Go To Meeting sessions. It was like talking into a void unless someone opted to reply to my questions.
Clearly suboptimal. By the end of the year all but one agency had opened up to me and generally I didn’t have to wear a mask. It was in some ways a return to normalcy.
One problem that I still haven’t totally resolved is that my quarterly reviews fell way behind. I’ve worked hard, with the cooperation to catch up on that. Part of that issue was that the medical directors I work with were buried with clinical hours, daily “COVID status updates”, and what one doctor I once knew called “Administrivia.” As a result it was often months before I could catch up with providers to do individual call reviews. That’s when they weren’t out on 10 quarantine because they’d come into contact with a COVID positive patient.
The end result was that I didn’t do the job nearly as well as I wanted.
There are still two medical directors for busy systems that are months behind on reviewing calls sent to them by our reviewers and then forwarding them to me.
Enough about work. Now on to the important stuff.
May 1 we had a yard sale planned at friends’ house. The day before I had brought a truck load of items over to their garage with the plan to come back early the next morning and set up. About 03:00 our boy cat Moe woke me up with a pathetic mewing sound. I took one look at him and knew that he was gravely ill. I didn’t wake Mrs. EMS Artifact up, but put him in the carrier and drove to the 24 hour Emergency Vet a few miles away. Due to COVID restrictions, I had to wait for someone to come out and bring him inside. I hated that, but had no other option.
I went back home and waited for an update phone call. That came around 07:00 and the news was bad. The very nice doctor gave me my options and I told her to go ahead and aggressively treat the little guy even though I knew it was likely going to be futile.
When my wife woke up I told her what had happened and she was miffed that I hadn’t woken her up. Maybe I should have, but I didn’t see the point then.
We would have cancelled the Yard Sale, but it was at our friends and they were expecting us.
We went and while selling stuff waited for the phone call we knew was coming, but dreaded. It came at 10:00 and a different doctor told us that Moe wasn’t responding. We did what we had to do and made arrangements for his cremation. Again, no option to come and say goodbye, which was perhaps the hardest part.
We were now down to one cat, our girl Minnie. They were a bonded pair that we’d had with us for just over sixteen years. Let no one ever tell you that cats (and dogs) don’t mourn when their partner dies. After Moe was gone, Minnie was confused and lonely for several weeks. She became more clingy and spent more time with both of us.
My mother in law turned 102 later that month and we had a nice lunch with her to celebrate. Despite her age, she was in very good shape. Mentally, as the saying goes she hadn’t lost anything off her fast ball.
The summer proceeded and times were happier when we drove south, picked up our grandkids, and took them to Dollywood. This was actually our second trip since we had done it in 2020 as well. This trip was much more enjoyable as the entire park was open, the rides were at full capacity, and no one was wearing stupid and useless masks. We had a great time realizing as we did that our grandkids were no longer babies and that in a few years would be teens and may not want to take long trips with their ancient grandparents.
We brought them back, stayed a couple of days to visit with my son and lovely daughter in law, then drove back home. The drive was nice even though it was Independence Day weekend and there was a lot of traffic. Some states still had COVID restrictions, but we ignored them as much as possible.
I’ll briefly mention that my best friend’s Dementia dramatically worsened over the course of the summer. All of the COVID restrictions meant that appointments were cancelled or postponed and I believe that he’d not have become as ill as soon if it hadn’t happened that way. It’s a terrible disease because the person is still there physically, but at best only there mentally now and again.
Summer passed and September rolled around. My mother in law developed a cold. Being her, she pretty much ignored it and treated it as she had every other cold she’d ever had. Only it wasn’t a cold and after five days she called my wife to take her to the hospital. No ambulance for her.
My wife took her to the ED, dropped her off, but couldn’t go inside. Sort of like the veterinarian.
She received a call from the hospital several hours later telling her that her mother had COVID and was being admitted. Not to the ICU or the step down unit, but to the regular COVID floor. Which was actually pretty good news. Of course no visits were allowed and getting phone updates was next to impossible. Even mother in laws primary care doctor couldn’t get accurate information and she was an attending physician at that hospital and chief of geriatric medicine.
That’s where working in EMS in that particular city for a long time came in handy. You get to know people and I knew a lot of them. I sent a text to a friend who was in management at that facility and said friend made some phone calls. I got a call back with her clinical condition, which was amazingly good for a patient her age. Not having diabetes, respiratory, or cardiac problems and not being obese, she was doing quite well. All of the nurses loved her and she was getting good care.
That went on for a week or so and then she was declared COVID free. Due to her age, they decided to send her to a rehab facility for a few days so that she could regain some strength. The good news was that she would be able to have visitors. She went over to the rehab late in the afternoon and we planned to see her the next day.
“The best laid schemes o’ mice an’ men. Gang aft a-gley”.
By the next morning she was unresponsive and having respiratory distress. The rehab called 9-1-1 and she was taken to the hospital across the street. Which was not the one she had been discharged from because that was too far away and she was sick.
I called the Emergency Department, but wasn’t able to get any information as she had just come in the door. So, I made a call to a friend who works EMS in that city and asked him to snoop around. He’s worked there for several years and knows people.
I got a quick call back and this time the news was very bad. Very bad. Everything possible was being done, but again she was 102 and at that age physiological reserves are pretty low. This time she was admitted to the ICU and we got very good daily updates. Good in the sense that they were timely, but bad in the news they contained.
At the end of the week my wife decided that it was time to go to Comfort Measures only and wait for the inevitable. Which was supposed to be 24-48 hours, but no one told my mother in law. She hung on for five days, which gave my daughter time to fly up from Texas to say goodbye.
I’ll spare you the rest of the family drama and only say that we had a lovely grave side funeral followed by a celebration of life back at our house. For 102 year old lady, she had a lot of people who came to say goodbye.
Interspersed with all of this our girl Minnie became ill. We took her to the emergency vet and again they gave us options. The right thing to do for her would be euthanize her, but how could I do that to my wife while she was dealing with her mother’s illness?
Since I recognized the symptoms earlier than I had with Moe, they were able to successfully treat her and we brought her home. I became what I called a “Catamedic” giving her medications, a daily fluid infusion, and lots of love. She hated the medicine, she hated the infusions, but she was still sleeping with us at night.
That brought us to October when she started to fail again. As a friend who has had many cats over the years told me, cats life span is about 17 years, but there kidneys are only good for about 15. So, we got an extra year of cat companionship.
This time we brought her to our regular vet and were able to go in with her. We couldn’t stay, but that was okay as the vet told us he’d call us when he knew what was going on. We drove around a bit, had lunch, then waited.
The call came and after a brief discussion, we knew it was time. This time we were able to say goodbye and be with her at the end. It wasn’t much better than with Moe, but it was better.
After we left Mrs. EMSArtifact said that she didn’t want to do that again because there was a chance at our age that the cats would outlive us and then they’d be orphans. Which is where it stands today.
They year ended without any more drama and 2022 dawned. So far it’s been a much better year, at least personally. The world seems to be going to shit, but personally we’ve had no drama as of yet.
This is has turned into a very long post and I probably should break it down into to posts, but I’m not going to.
If you didn’t read all of it, I understand. I think it’s more important that I wrote it than anyone ever read it.
