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To Iraq and Back: Living Wills, Immunizations Gone Bad and More Sleepless Nights

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This is another installment of my To Iraq and Back series which tells of my deployment to Iraq with RP1 Nelson Lebron in 2007 and 2008.

One of the sobering things as you get ready to go to war are administrative issues that deal directly with your mortality. They are mundane actions when we do them in peacetime but chilling when you put them in context of going to war.

In our society in which people do all they can to push back even thinking about death discussing the issues that deal with your possible dismemberment, disability or your death are taboo. The month before I deployed  Iraq Judy had me take out an additional life insurance policy that doubled what the military would provide in the event of my demise.  At that point Iraq was a cauldron, hundreds of casualties each month and I was going to the heart of the action in Al Anbar province.

Part of our processing to go to combat was a will and power of attorney update.  We had not updated our wills since well before coming to the Hampton Roads area so I took advantage of this time to get it done.  The will itself was pretty easy since we have no children and have not been married to anyone else.  That was the easy part.

The next part was dealing with various powers of attorney, a general power of attorney and a medical power of attorney. The medical power of attorney is something that I routinely deal with at the hospital. I have dealt with them before in other places.  At the same time they become somewhat disconcerting when you are getting to go into a combat zone where there is heavy fighting going on. For most that is disconcerting enough, but chaplains go into action unarmed.

Sometimes when I fill out one of these I pray that I don’t end up like Karen Anne Quinlan or Terri Shaivo.  When I did it this time all I could think about was me being so badly wounded that it would be like the movie The Naked Gun.  I someone telling Judy “Doctors say that Dundas has a 50/50 chance of living, though there’s only a 10 percent chance of that.” While this is going on I could just see me unable to respond trying to say “give me one more at bat skip, just one more chance…please.”  This may not seem like the most spiritual thing for a Priest to be saying but I don’t want to be in the afterlife before my time. It would be bad form.

Legal matters finished we had to get our immunizations. When you deploy the military always ensures that you are vaccinated against about everything imaginable. These include typhoid, anthrax, smallpox, malaria, yellow fever, certain regional diseases and probably others that I have forgotten.

I had received many of these before at various times. This included my first Anthrax vaccine. On this second occasion something happened and ti had a reaction to it.  My bicep felt like someone had shoved a baseball in it and the sucker hurt like hell. By the next morning I knew that my reaction was not “normal” because the first one I had did not do this.

I thought back to the Anthrax scare right after September 11th 2001 and I didn’t want to take any chances regarding something that the media said could be dangerous. What if they had messed up and given me a bad batch of the vaccine. Hell, just because I’m paranoid doesn’t mean that they are not out to get me. Besides if I was going to die for my country I didn’t want it to be from a reaction to a vaccine and not something heroic.

So I went back to the immunization section. Like a typical officer I simply “excused” my way past the queue of sailors waiting to get PPDs read and went to the desk. I figured that I wasn’t going to wait in line behind people with routine stuff when things looked like they were getting sporty for me.I call it “self-triage.”

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The Corpsman at the desk was polite and asked what he could do.  I told him that “I think I’m having a reaction to the Anthrax vaccine.”  He gave me a funny look and asked which one in the series this shot was. It was the second and since I figured that the next question would be “did you have a reaction the first time?” I continued “This didn’t happen the first time.”

The Corpsman looked at my arm and said “Obviously sir the first time you had no antibodies to Anthrax so it had nothing to react to….”  I was thinking “no shit Sherlock” when the young man went to get his Chief. The Chief came in, looked at my arm and said: “Gee sir it looks like you are having a reaction to the shot.”

I was thinking well no shit but didn’t say it. So the Chief took me back to his office and started having me checked to make sure that I didn’t have a fever or a number of other things, like if I was dizzy or was having trouble breathing. No I was neither dizzy nor experiencing breathing difficulties but was simply in pain, a bit scared and really pissed.

After his battery of questions and a couple of phone calls asked me “do you think that you are safe to drive?”

At that point I would have said anything to get the hell out of there and get on with what I needed to do to make sure that I wasn’t going to die.  So I said “of course I am.”

He asked if I was sure and I reaffirmed this to him in a convincing enough manner for him to send me over to Portsmouth by ambulance.

Portsmouth Naval Medical has a small office manned by a couple of nurses whose job it is to report bad vaccine reactions up to the FDA and God only knows who else. These ladies were very pleasant and when they got a look at my arm they were impressed.  Once again I heard “Yes sir you are having a reaction.”

I got to answer yet another battery of questions and they took a couple of pictures of the baseball sized knot on my left bicep.  One of them made a couple of phone calls and a few minutes later I was told that I would be okay. The explanation was that the subcutaneous injection had caused the vaccine to be encapsulated in my arm rather than doing what it needed to be doing. I was told to inform whoever gave me my next shot in the series to make sure that they got in the muscle. I was told to take some Motrin for the pain and swelling and do a lot of push-ups, pull-ups and massage the bicep to help the swelling dissipate faster. My fears eased and I left the hospital and reported back to the processing site where all of my fellow sailors had already left for the day.

I spent another tense and sleepless night with Judy, the emotional distance still there.  We talked about various things but nothing serious. I don’t think that either of us was able to vocalize well what we were feeling.

Even Molly seemed differed, I’m sure that she sensed that something was going on as I had continued to pack and re-pack my gear from EOD. Molly does not like it when either of us pack as it usually means that one or both of us is leaving.

The next morning I repeated my “Groundhog Day” trek back to Norfolk Naval Station fighting the idiots driving to work on the I-264, I-64 and I-564 battle zone where matching wits with the witless I safely picked my way through traffic while drinking my black coffee.

This was our next to last day of processing and we checked and re-checked paperwork, received our signed wills, living wills and powers of attorney. That morning I met with Father Pat Finn a mobilized reservist and Episcopal Priest from South Carolina and we had a nice chat where we were joined by Fr Steve Powers a retired Navy Chaplain and Rector of St. Brides Episcopal Church in Chesapeake.

Following that I was asked to assist with a sailor who was having some personal difficulties getting ready for the deployment.  These tasks completed I went back to muster with the others and sat down next to Nelson. Following this we went out where the Storekeepers and other supply staff had our gear.

We gathered outside where we lined up and given a sea bag in which to put our issue.  There were boxes of stuff everywhere and a couple of civilians and sailors stood by to ensure that we got what we were going to get.  Uniforms with all of our name tapes rank insignia and qualification pins sewn on were there as well as more socks, t-shirts and other assorted gear.

Our stash was a bit lighter than the others as we already had much of what was being issued. When this was done and we were released. I told Nelson to go home as his family was coming into town from New York.  Taking the newly issued gear home I again went about packing and repacking and took Judy out to dinner after which we spent our time alone together pondering the future.

Peace,

Padre Steve+

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Filed under iraq,afghanistan, Military, ministry, to iraq and back, Tour in Iraq

Oh the Pain…Padre Steve’s Kidney Stone Naming Contest

Getting set to pass the stone

Well I spent a good part of the last night and early this morning with the Abbess visiting my friends in the Naval Medical Center Portsmouth Emergency Room.  I had been in pretty bad pain most of the day and even went with the Abbess to visit a retired chaplain friend and his wife as he has been a patient at our medic al center for the past week.  As we visited I continued to be in pain and when we went home I had the Abbess drop me off at home while she went to Gordon Biersch.  Anyone who knows me knows that I have to be feeling really bad not to go out and have a beer with the Abbess and or Stein Club friends on Saturday night.  The Abbess was convinced when we left the hospital that I would be back but being that I have a rather high threshold for pain compared to most people as well as a typical career military man view of pain and illness I thought that I would feel better and ride it out.  I did not expect a kidney stone and thinking it was something gastric went hope to vegetate and hope that with some chicken soup and some anti-gas meds that it would go away.  Wrong answer padre…

As I sat on the couch trying to get comfortable with pain waxing and waning and Molly doing her best to “will” me into feeling better I continued to feel worse.  The Abbess came home and pronounced that if I was still feeling this way at midnight we were going to the hospital whether I wanted to or not.  At about 11 PM I cried uncle and she drove me to the hospital.  Every freaking bump on the road was misery and when we got to the ER I got out of the car and limped into the ER. I could barely walk and was doubled over in pain, which when the triage nurse asked what level on a scale of 1 to 10 I said 5 to 6 because though it hurt it was not the worst pain that I have ever had which can only be reserved for the “undead tooth of terror.” (See Killing off the Undead Tooth of Terror)

One of the good things about playing on the home field is that people recognize you, of course for some this can be good or bad but thankfully for me it was good as I like the folks down in ER and the only thing that could make my affection for them be greater was if we were a trauma center.  What can I say? I did my residency at Parkland Memorial Hospital as the Trauma and Surgery Department Chaplain and served as an ER Department Chaplain at another regional trauma center.  None the less I know a good number of the staff, especially the ER residents as well as the surgery, internal medicine, psychiatry and other residents who see patients in the ER.  Last night was only different in the fact that I was not making rounds or being called to the ER but was a patient, something that I have little patience at being.

After a relatively short but uncomfortable wait in the waiting room I was taken back to a bay with a curtain as a partition given a gown and put on a monitor which as I observed that my vital signs, despite my pain were very good. My conditioning program is paying off.  I knew the ER attending, the RN and the Hospital Corpsmen that attended to me and other staff members who know me took time to visit.  Dr Ventura told me that he thought that it was likely a kidney stone and both he and the RN asked me about the color of my urine which I compared to a cloudy Keller Beer or Hefe-Weizen. How else can you describe urine when it does not have the clarity or effervescence of a Pilsner? I was sent to get a CT scan which was pretty cool. CT’s have come a long way since my residency, what used to be a 20-30 minute procedure only took about 2-3 minutes and I didn’t even have to take my San Francisco Giants baseball hat off.

So anyway, after being discharged from the ER and saying good bye to all my friends we went up to get the myriad of drugs from our pharmacy including pain meds like Vicodin as well as meds to help the stone pass and other meds.  I think the bag of meds weighed a couple of pounds.  So since the Abbess was really worn out I drove us home which meant that I did not hit the rough spots in the road beacus I know where they are.  After dropping her off and getting a sweet greeting from Molly I went over to our 24 hour super Wal-Mart and picked my way around the stockers to pick up a few things including the Minute Maid Lemonade that the staff told me would help me pass the stone.

Now kidney stones can take anywhere from 3 to 30 days to pass and if they don’t they may have to be removed. Approximately 80 percent of these stones contain calcium, as either calcium oxalate, calcium phosphate or a combination. Another 10 to 15 percent are composed of magnesium ammonium phosphate, s0metimes  known as struvite, while only 5 to 10 percent are uric acid stones. Fewer than 1 percent of stones are cystine.  Now for people like me this is interesting I don’t know too many people who laying on an ER bed think all the technical details of their illness.

Finally home I got to bed just before 0600 and got up just before noon.  Since getting up I have eaten light and drank a lot of fluids, like tons of fluids and since I need to try to capture the stone have a wire mesh coffee filter with a little handle which makes it like a bucket to piss into.  This will of course be consigned to oblivion once the stone is passed as there is no way, even with high tech sterilization gear available that anything that has had urine pass through it will ever be used to filter something that will pass through my lips.  If you remember the Seinfeld where Jerry’s girlfriend’s toothbrush fell in the toilet you will understand completely.

So now I wait.  I have been doing everything that I have been told to do but it seems that the stone has gone into hiding.  I haven’t passed it but it is still in me.  The choice for it is to come out on its own or be blasted into kidney stone oblivion or should either of those measures fail be surgically removed.  I guess with choices like that I would prefer the natural birth even though it stands to be painful.  I do hope and pray that that if this is the case that the stone will come out on the 4mm side and not the 7mm side, otherwise I will be like Kramer in the Seinfeld episode where he passes a kidney stone. I just hope when this happens I am nowhere near anyone whose life is depending on something.   http://www.strimoo.com/video/13214541/kramer-gets-a-kidney-stone-Dailymotion.html

So my challenge now is to figure out what to name this.  My friend Greg who is a Priest and Navy Chaplain says that I need to capture and keep it in case I am ever considered for canonization as a Saint.  However I wonder who the hell would want that kind of relic but realize after visiting various diocesan museums in Europe I know that anything can wind up as a relic.  So my question to my readers is what to name this stone.  I am leading to Adolf since he was a pain to remove during the Second World War.  Friends on Facebook have suggested other names and it will be interesting to see if any consensus builds as to what to name this bad boy.  So feel free to comment here or on my Facebook page as what you think this stone should be named.  Like the undead tooth of terror I will keep you apprised of this health issue as well as try to keep a humorous perspective on this.  Again thanks to all my friends in the ER and blessings to all. Pray for me a sinner.

Peace,

Steve+

Post Script: While in the ER it came to me that the doctor who called me to the ER back in December to administer the last rites to a dying retired military doctor was Eric Inge.  He was a key part of my Christmas miracle and I will not forget him, see

Doubt and Faith: My Crisis in Faith and Why I am Still a Christian an Advent Meditation

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Going to War: Wills, Living Wills, Immunizations Gone Bad and Christmas in July

This is part three in my “Going to War” series. Previous parts are noted here:

Part One:Going to War: Reflections on My Journey to Iraq and Back- Part One

Past Two: Going to War: Interlude July 4th 2007

One of the sobering things as you get ready to go to war is issues that deal with your possible dismemberment, disability or yes even your death.  In the month or so before going to Iraq Judy had me take out an additional life insurance policy that doubled what the military would provide in the event of my demise.  Part of our processing to go to combat was a will and power of attorney update.  We had not updated our wills since well before coming to the Hampton Roads area so I took advantage of this time to get it done.  The will itself was pretty easy since we have no children and have not been married to anyone else.  That was the easy part. The next part was dealing with power of attorney.  We did a couple of them, a General for most stuff and a couple of specific POAs for various things.  I also had to do a medical power of attorney.  The medical power of attorney is something that I routinely deal with at the hospital.  I have dealt with them before in other places.  At the same time they become somewhat disconcerting when you are getting to go into a combat zone where there is heavy fighting going on and that you know that you will be in places that the enemy likes to attack and by the way, you are as a chaplain unarmed.

When doing a Medical Power of Attorney I am always reminded of the episode of Seinfeld where Kramer sees part of a movie called The Other Side of Darkness which supposedly is about a lady who ends up in a coma.  Since Kramer doesn’t want to be in a coma he makes his own Power of Attorney for Jerry to be his representative.  Jerry refuses and Kramer gets Elaine to go to a lawyer played by Ben Stein to get his “living will” done.  Without going into too much detail the interview with the Ben Stein is funny as hell as in his monotone voice he asks Kramer what he would want to do if….and Kramer turns to Elaine and asks “what should I do?”  Of course after Kramer makes this out he sees the rest of the movie only to find out that the lady in the coma comes out of it.

I digress, but anyway sometimes when you fill one of these out you pray that you get it right so no one offs you before your time, but also so you don’t end up like Karen Anne Quinlan or Terri Shaivo.  All I could think of when doing this was me being so badly wounded that people were telling Judy that there was only a fifty- fifty chance of me living but only a ten percent chance of that and did she want to pull the plug.  While this is going on I could just see me unable to respond trying to say “give me one more at bat skip, just one more chance…please.”  This may not seem like the most spiritual thing for a Priest to be saying but I don’t want to be with Jesus or in Purgatory before my time.

Legal matters finished we had matters of health and preventive medicine to accomplish.  As always when you deploy the military ensures that you are vaccinated against about everything imaginable including typhoid, anthrax, smallpox, malaria, yellow fever, certain regional diseases and probably some that I have forgotten.  Many I had received at different times, including my first Anthrax vaccine which I  injection was done into my muscle. This time the corpsmen given the shot did it sub-cutaneous which means just below the skin.  Well something happened and the little reaction area became a big one that night.  My bicep felt like someone had shoved a baseball in it and the sucker hurt like hell.   By the next morning I knew that my reaction was not “normal” being that the first one I had did not do this. I thought back to the Anthrax scare right after September 11th 2001 and I didn’t want to take any chances regarding something that the media said could be dangerous.  Who knows, what if they had messed up and given me a bad batch or even a weaponized form of the vaccine.  Hell, just because I’m paranoid doesn’t mean that they are not out to get me.  If I was going to die for my country I didn’t want it to be from a reaction to a vaccine and not something heroic that would actually matter to someone and maybe even get a ship named after me.  So I went back to the immunization section, excusing my way past the queue of sailors waiting to get PPD’s read I went to the desk.  I figured that I wasn’t going to wait in line behind people with routine stuff when things looked like they were getting sporty for me. It’s called triage. The Corpsman at the desk was polite and asked what he could do.  I told him that “I think I’m having a reaction to the Anthrax vaccine.”  He gave me a funny look and asked whoch one in the series this shot was.  It was the second and I said.  “This didn’t happen the first time.”  He told e to show him my arm and then with a look of surprise on his face said: “Obviously sir the first time you had no antibodies to Anthrax so it had nothing to react to….”  I was thinking “no shit Sherlock” when the young man went to get his Chief.  The Chief came in, looked at my arm and said: “Gee sir it looks like you are having a reaction to the shot.” Wow, he could have floored me with that bit of news.  So he took me back to his office and started having me checked to make sure that I didn’t have a fever or a number of other things, like if I was dizzy or was having trouble breathing.   No I was neither dizzy nor experiencing breathing difficulties but was simply in pain, a bit scared and a lot pissed.   After his battery of questions and the phone calls asked me “do you think that you are safe to drive?”   At that point I would have said anything to get the hell out of there and get on with what I needed to do to make sure that I wasn’t going to die.  So I said “of course I am.”  He asked if I was sure and I reaffirmed this to him in a convincing enough manner for him to send me over to Portsmouth.  Now Portsmouth Naval Medical has a small office manned by a couple of nurses whose job it is to report bad vaccine reactions up to the FDA and God only knows who else.  These ladies were very pleasant and when they got a look at my arm they were impressed.  Once again I heard Yes sir you are having a reaction.”  Once and I got another battery of questions and they took a couple of pictures of the baseball sized knot on my left bicep.  Another couple of phone calls later I was told that I would be okay.  I was told by the ladies that he next shot of the series would have to go into the muscle as this batch had encapsulated itself in my arm instead of going to the rest of my body.  I was then told to take some Motrin for the pain and swelling and do a lot of push-ups, pull-ups and massage to help the area dissipate faster. My fears eased and I left the hospital and reported back to the processing site where all of my fellow sailors had already left for the day.

Another tense and sleepless night was spent with Judy and I with the emotional distance still there.  We talked about various things but nothing serious as I don’t think that either of us was able to vocalize well what we were feeling.  Even Molly seemed differed, I’m sure that she sensed that something was going on as I had continued to pack and re-pack my gear from EOD.  Molly does not like it when either of us pack as it usually means that one or both of us is leaving her employee for a time, we being the well treated and loved hired help.  So the next morning I repeated my “Groundhog Day” trek back to Norfolk Naval Station fighting the idiots driving to work on the I-264, I-64 and I-564 battle zone where matching wits with the witless I safely picked my way through traffic while drinking my black coffee.

Arriving for our next to last day of processing we checked and re-checked paperwork, received our signed wills, living wills and powers of attorney.  That morning I met with Father Pat Finn a mobilized reservist and Episcopal Priest from South Carolina and we had a nice chat where we were joined by Fr Steve Powers retired Navy Chaplain and Rector of St. Brides Episcopal Church in Chesapeake.   Following that I was asked to assist with a sailor who was having some personal difficulties getting ready for the deployment.  These tasks completed I went back to muster with the others and sat down next to Nelson my ever faithful assistant and body guard extraordinaire.  We were then told that we would collect the gear that we were being issued.  We gathered outside where we lined up and were given a sea bag in which to put our issue.  There were boxes of stuff everywhere and a couple of civilians and sailors stood by to ensure that we got what we were going to get.  Uniforms with all of our name tapes rank insignia and qualification pins sewn on as well as more socks, t-shirts and other assorted gear.  Our stash was a bit lighter than the others as we already had much of what was being issued and did not need the issue boots having already been issued non-issue boots courtesy of EOD.  When this was done and we were released I told Nelson to go home as his family was coming into town from New York.  Taking the newly issued gear home I again went to packing and repacking and took Judy out to dinner after which we spent our time alone together pondering the future.

Peace, Steve+

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