Sunday, November 27, 2011

Trigger Warning: Nightmares

Webster's Dictionary defines a nightmare as...

Definition of NIGHTMARE

: an evil spirit formerly thought to oppress people during sleep
: a frightening dream that usually awakens the sleeper
: something (as an experience, situation, or object) having the monstrous character of a nightmare or producing a feeling of anxiety or terror

What Webster's dictionary doesn't mention is that nightmares suck and can really leave a person traumatized.

I had a nightmare last night that has totally messed me up. (I think I had a migraine in my sleep to top it all off because I woke up with shoulder pain, stiffness, and weakness in my right arm/side of my body), and I dreamed that I was in jail. I was dressed in an orange prison jumpsuit, but instead of a cell, I had to crawl in a cave where I couldn't do anything but lay down. It was a very narrow space. If I sat up, I would have hit my head. There was no loo in the cave, and the officers laughed when I asked where the loo was. (They weren't called "officers" they were called "Amministratores" which I found odd. I looked did a search on that word, it's Italian for officer.) So I would lay there, close to tears. My husband and other family members would come to visit me, and officers would come and get me out of this cave so I could visit. I kept asking the warden what I did. He eluded to me being a bad person, even eluded to the fact that I told someone off and punched them dead in the face, but he wouldn't tell me why I was in jail. I met my cellmate, a man who was literally insane. He thought he was a woman. He brought in for rape. I was scared. I didn't want that man in the cave with me. He talked like he was mentally challenged and was telling me that we were going to have so much fun together. I cringed. I was sent back to the cave. The man was being processed, then he would come down there with me.
Awesome Fantasy Art by Elena Dudina

I decided to ask for a reduced sentence. The cave was scary. It would fill up with water when he rained. I didn't have a loo to use. The Amministratore decided to reduce my sentence, but still refused to tell me what I did to get arrested in the first place. (They also played "Good Cop/Bad Cop" with me.) They reduced my sentence, but they didn't let me go. They just put me in a regular cell.

Rosie Hardy Plagiarism

The whole dream was really freaky, and I woke up, wondering how I got out of jail. Did I break out? Did my husband sneak me out? Did I serve my time? I had to spend twenty minutes telling myself that none of it ever happened, because I realized why I was thrown in jail, in the cave...

I had escaped from a concentration camp...

Thursday, November 24, 2011

Happy Thanksgiving!

And this is just around the corner...

I hope everyone had a peaceful Thanksgiving day surrounded by loved ones, be it family or friends...



Tuesday, November 15, 2011

Bruce Wayne's Medical File.

Bruce Wayne as seen in 1989-1990.

Patient BW, DOB 2/16/1971


[By special request]

Patient: Wayne, Bruce

DOB: 2/16/1971

Occupation: Industrialist

Insurance: Self-pay

Emergency Contact: Dick Grayson, XXX-269-9637

Interval History: Patient was seen for his last annual physical approximately one year ago. Since that time he has had numerous visits for acute illnesses or injuries, generally accompanied either by his companion Mr. Grayson or Alfred, a senior member of his household staff. These recent maladies appear to be in keeping with the pattern that has emerged over the past several years, in which significant medical problems are associated with odd or incongruous explanations. Most recently, patient was seen for numerous areas of lower extremity cutaneous blistering, erythema and thickening, consistent with moderate to severe frostbite. Patient had reportedly gotten lost while camping in the mountains, but could not account for how he had sustained these injuries in mid-August.

Past Medical History: As stated, patient has a somewhat lengthy and complicated medical history, best summarized by system –

Orthopedic: By far the greatest contributor to patient’s ongoing morbidity are his multiple and seemingly ceaseless musculoskeletal injuries. The most significant of these was sustained several years ago, when he was rushed to GCGH with several fractures of his lumbar vertebrae, reportedly after falling while rappelling. Skeletal series obtained at that time revealed numerous (>20) areas of orthopedic injury in various states of healing, which could not be fully explained by recent fall, including areas of all extremities and many ribs; confirmatory bone scan similarly showed many areas of increased uptake. Patient’s robust stature is not consistent with osteogenesis imperfecta, and skin biopsy was negative for abnormal collagen and P3H1 or CRTAP genetic defects. Malignancy was suspected, but eventually ruled out following oncology consultation. Patient explained most of these (and most subsequent) injuries as being the result of membership in a private and apparently quite intense mixed martial arts club. Patient has denied being the victim of domestic abuse by Mr. Grayson following indirect and direct questioning on numerous occasions.

Neurologic: Patient has been evaluated numerous times over the past several years with complaints of headache, blurry vision, memory deficits, nausea and emotional lability. As with above injuries, most of these symptoms occur following some blow to the head during MMA sparring or competition, and were diagnosed as consistent with concussion. (Patient reports that the club frowns upon protective headgear, a stand with which he seemingly complies despite numerous exhortations to do otherwise.) Following the third such episode, patient was referred to neurology due to significant concern about second-impact syndrome. While no gray matter changes in the cingulate gyrus or white matter hyperintensities were noted on magnetic resonance imaging, given history and known risk factors neurology has recommended MRI to be repeated every two years, and they are arranging for diffusion tensor imaging in the near future.

Allergic: Earlier this year, patient was again rushed to GCGH for what appeared to be severe anaphylaxis, with marked angioedema of the face and hands, and widespread urticaria. After administration of high-dose IV Solu-Medrol, patient’s angioedema resolved sufficiently for him to report “tripping into a bunch of weeds” while hiking, and he eventually left the emergency department against medical advice. On outpatient follow-up, patient was referred for urgent allergy testing given the severity of his reaction. Skin-prick testing was negative for all food allergies, but was markedly and instantly positive in reaction to all plant allergens, such that a dose of IM Decadron was administered by allergist in the office. Despite was appears to be an extraordinary hypersensitivity to phytochemicals, patient has had no further symptoms following the one episode.

Psychiatric: During most visits, patient displays a somewhat somber and flat affect. Numerous inquiries into his mood yield answers that it is “just fine,” followed by requests to change the topic of questioning. While dysthymia or frank depression is suspected (particularly considering patient’s voluntary participation in flagrantly harmful recreational activities), patient seems to have avoided any major depressive episodes. More worrisome was an episode about a year and a half ago, during which patient appeared to have a psychotic break. On arrival at GCGH, patient was found to be suffering from vivid, terrifying hallucinations, rendering him essentially incoherent and requiring high doses of both benzodiazepines and haloperidol to abate. After regaining consciousness several hours later, patient stated that the “stress of [his] job” had gotten to him. He vehemently refused evaluation by Arkham consulting psychiatrist, and eventually left the ED AMA.

Social History: Patient denies smoking, drinking or taking any illegal controlled substances. He resides with Mr. Grayson, reportedly without romantic involvement. Diet consists largely of meals prepared by private household cooking staff. He reports serially monogamous sexual relationships with female partners. When asked, he states that he “usually has proper equipment,” which is interpreted to mean that condoms are used for contraception and STI prevention.

Family History: Both parents deceased (homicide). Generally assumed to be non-contributory

Physical exam:

Temp 98.7, HR 60, RR 12, BP 113/68

General – well-nourished, well-appearing adult male in NAD; alert, oriented, cooperative

Skin – confluent, symmetrical, faintly erythematous rash extending from anterior hairline onto malar region (“from the hazmat mask they make me wear when I visit the lab”); four linear, well-healed lacerations on left pectoral (“fencing accident”). Numerous ecchymotic areas in various stages of healing

HEENT – small area of firm edema on the left occiput, c/w contusion. PERRLA, EOMI. TMs grossly intact bilat. Nares patent. Oropharynx normal. Good dentition, with evidence of repaired trauma

Chest – CTAB

CV – RRR without murmur. Radial, femoral pulses +2/4

Abd – soft, NTND, no HSM, + BS x 4.

Ext – well-defined (borderline hypertrophic) musculature. Limited active ROM in shoulders, elbows, wrists, knees, ankles, consistent with healing contusion/sprain or overuse injuries in numerous joints. Normal tone, strength UE/LE bilat.

Neuro – CN 2-12 grossly intact. ? faint resting tremor. FTN intact, no dysdiadokinesia. DTR +2/4 at patella, Achilles. Gait normal. Refuses MMS exam (“I have an aversion to riddles.”)

Psych – well-groomed, pleasant and conversational. A & O x3. Affect somewhat flat (baseline, as stated above)

Assessment/Plan — 40-year-old male with complicated past medical history as noted. Generally normal exam, excepting the following:

Rash — Patient advised that mask seems to be causing an irritant rash, and advised him to have lab personnel fit him with another, less occlusive size.

Resting tremor — Given risk factors stated above, there is some concern about early Parkinsonism. Will contact patient’s neurologist to have next follow-up appointment moved up.

Joint stiffness — As with previous visits, patient was advised to consider recreational activities that carry less risk of ongoing physical injury, or at very least allow himself to heal fully from previous trauma before returning to participation. Given the apparently quite aggressive tendencies of patient’s MMA club, advised him that almost any other activity he might choose is likely to confer less risk of ongoing morbidity (or even mortality). Patient responded to this advice with his usual polite indifference.

Looking more globally, there is some concern that there is an underlying illness that accounts for some of patient’s extensive symptomatology. Discussed with patient that there may be some obscure syndrome that includes brittle bones, but also propensity for severe hypersensitivity, psychiatric symptoms and skin damage. Advised him that many journals publish reports of puzzling cases, which may allow other physicians to comment helpfully about treatments or diagnoses that might be pertinent. Patient politely but emphatically refuses consent for such publication at this time.

Advised patient to limit stress, continue with (hopefully more benign form of) physical activity, continue with healthy diet. Flu shot administered. Planned follow-up in one year, sooner as needed.

(Note to clerical staff — please exclude the following note if there are future record requests. An alternate explanation, more plausible than the histories associated with many of patient’s injuries, is a series of industrial mishaps. As head of Wayne Enterprises, patient presumably takes a very active role in the company’s various subsidiary R&D departments. These subsidiaries include biotech, chemical and numerous other firms that traffic in hazardous materials. One might infer that some of patient’s more extreme medical problems stem from exposure to these hazards while taking a hands-on approach to running his company. There are a few understandable reasons that patient might wish to keep the true nature of his injuries private, despite assurances of medical confidentiality given that leaks of this information might undermine confidence in his company’s governance or alternatively might jeopardize secret government contracts. While it is somewhat regrettable that patient does not feel comfortable revealing the true nature of these injuries and exposures, it is nevertheless understandable.)

Blog Broken. See Title Below.

It's one of those days. The destroyer arrived last evening, bringing with it manky feelings, pain, nausea, migraines, insane cravings of salt licks covered in chocolate, and violent mood swings. (HELP!) I was up all night with a migraine complete with photophobia and phonophobia. (I'm still experiencing photophobia.) I had to go out for a little bit, but I'm home and in comfy clothes. I consumed a small chili with crackers and hot sauce, which really hit the spot. I had a tiny chocolate frosty. (It's a frosty and it's tiny!) Now I'm sipping on gin and juice, I mean Coca~Cola, and I'm about to escape into the lovely world in my book before my body eventually renders me unconscious and I run away to my metaphorical Fortress of Solitude that is the bedroom. (Dale Gribble: I'll be eight feet under in my metaphorical grave...the basement.) The Moo Bear is nestled on my pillows that I have to sit on when I use my computer in the living room because even at its lowest setting, the desk is quite tall and it's easier to reach on pillows. Trinity (who usually sleeps on top of the cable box in the entertainment center) has ran off somewhere. (I would get a picture of her on top of the cable box, but where she's mostly black, you may not be able to see her.) Probably going to listen to a little television. Just a peaceful day in the Townsend House, well, for now...

To all of my readers, I hope you're having a peaceful day!

Monday, November 14, 2011

My Apology For Emotionally Honking

I wanted to apologize for the sound emotional honking I put my readers through. I just had enough and some things needed to be said, and I still have seven months worth of things to say, but I'm not sure if they should be said or not, because they're to one particular person who has put me through so much crap lately, but I digress.

As my way of making things up to everyone, I am going to post some beautiful pictures to start your afternoon/evening out right. Enjoy them and accept my apology.

Neuschwanstein Castle in Fall

Nice, France

Budapest, Hungary

Le chateau de Monjardin, Belgium

Perigueux, France

Edinburgh, Scotland

Loch Leven Moorings, Scotland

Rhodope Mountains, Bulgaria

Belgrade, Serbia

Rheineck, Switzerland

Rye, Sussex, England

Rocamadour, France

Tilt-shift, Paris

Flemish Brabant, Belgium (Winter)

Flemish Brabant, Belgium (Fall)

Coton Manor, England

Bilbao, Spain

Gardens of Pavlovsk Palace, Russia

Latvia, Riga

Beaufort, France

Salzburg, Austria

Chateau de Laussel, France

Fireworks in London

Clovelly Devon, England

Brasov, Romania

Welcome to the Fairytale-Aargua, Switzerland

Konigstein Fortress, Germany

Coventry, UK

Channels of Monschau, Germany

Le Mont-Saint-Michel, France

Cordes-sur-Ciel, France

Staverden, Netherlands

Maribor, Slovenia

Kew Gardens, London

Corricella, Italy

Brugge, Belgium "That's where Daddy's from," Dr. Evil said to Mini Me.

Switzerland (My favorite picture so far...Fall & Winter at the same time!)

Reims Champagne-Ardenne, France

Callan Kilkenny, Ireland

Calton Hill, Edinburgh, Scotland

Galleria Umberto 1, Naples, France

St. Gallen, Switzerland

Berlin Cathedral, Germany

Burg Eltz, Germany

Bukovel, Ukraine

Saint Basil's Cathedral, Moscow

Copenhagen, Denmark

Valladolid, Spain

Mist Forest-Gorj, Romania

Deauville, France

Chatsworth House, England

Eiffel Tower

Bremen, Germany

Devin Castle, Slovakia

St. Peters Basilica and the Tiber River, Rome, Italy

Malcesine, Italy

St. Vitus from Charles Bridge, Prague

Winchester Cathedral in the Freezing Fog

Rijksmuseum, Amsterdam

Pavlovsk, Russia

Trevarno, Cornwall, England

In the Hardagenfjord, Norway

St. Isaac's Cathedral, St. Petersburg, Russia

A magical Fall afternoon over Paris

La grand place, Brussels

Grangemouth, Scotland

Val di Fonda, Italy

Nidarosdomen, Trondheim, Norway

Sjavarborg, Iceland

Bilbao, Spain

Place de Furstenburg, Paris

Herfst, Netherlands

Burgos Cathedral, Spain

Bridge of Sighs, Venice, Italy

Copenhagen, Denmark

The Royal Palace, Madrid, Spain

Brianza, Italy

The Colosseum, Rome

Edinburgh, Scotland

Kariskrona, Sweden


Emilia Romagna, Italy

Montparnasse, Paris

St. Paul's Cathedral, London

Hendaye, France

Park Kasprowicza, Szczecin, Poland