ProfessorTomoe

My white blood cell count is down, from 15.2 to 11.9. I'm going home today, barring any last minute screwups. End of line.

Well, smeg. I'm stuck in the hospital for another night. Saw my podiatrist this evening and learned that my white blood cell count had jumped from 12 to 15 overnight. He's keeping me to see if it goes down in the morning. If it does, he'll let me go home. If not...well, we'll come to that if it happens. I also learned that family Christmas has been temporarily postponed due to illness of several of the hosting family members. Looks like I'm not the only one sick, although I am the only one in the hospital. It'll be rescheduled soon.

In the latest twist to the osteomyelitis saga, it looks like I might get to go home today after all. I've still got to get a PICC line inserted while I'm unconscious, have IV drugs delivered to my house, and figure out who's going to be doing what and going where over the next few days. I may be riding down to Austin with a tennis ball full of cefepime infusing into me en route. Stay tuned.

I've finally met with the infectious disease doctor, and there has been a bit of a revision to the story. Here goes. Once the bone biopsy sample decalcified, parts of it were sent to two different labs - pathology and microbiology. Pathology studied it under the microscope and determined that it had been subjected to acute osteomyelitis. Microbiology tried to grow cultures from it, but since I'd been on antibiotics for over 5 days already, nothing new grew, so they were unable to determine exactly what kind of organism was causing the osteomyelitis. As a result, I'm going to have to remain on the two broad-spectrum IV antibiotics I'm already on...for 6 weeks. I'm not going home any time soon. I'll most likely be sent to another Skilled Nursing Center, LTAC, or something similar. I'm pretty sure of the place I'll go - I've been there twice before. So much for family Christmas. Sigh.

I have been told by my hospital doctor this morning that my bone biopsy has shown signs of growth in the medium. In short, I have osteomyelitis. How this is going to affect my schedule is uncertain right now. They still don't know what kind of infection I have in my bone, but in any case it's going to require IV antibiotics. I might be able to go home with them, but it's doubtful. I'll find out more when I see the infectious diseases doctor later today. No idea how this is going to affect family Christmas yet. Sigh.

Surgery went well, and the bone biopsy is still cooking in the lab. So far, nothing has grown. Meanwhile, the 1-2 punch of vancomycin and cefepime appears to be knocking back the infection in my leg and knocking out the infection in my foot. I've been advised that, if nothing grows off of the bone biopsy sample, I could be sent home as early as Thursday with just oral antibiotics. That would please Mrs. Prof to no end, since it would allow her to take me down to the Austin area for her family's Christmas get-together on Saturday. Only time will tell.

The "jaunty" Horn Sextet is, I believe, finished, more or less. I'm not quite sure about how the last note sounds - it might not be beefy enough. I would appreciate your collective opinion on the matter. Please click on the following private link to listen to it: https://on.soundcloud.com/9SbVq Thank you for your help.

My surgery is scheduled for 7am Sunday morning. It's now just past 12:20 a.m., and I'm on NPO (nothing by mouth) until the surgery. I'm scheduled to take my pain pills at 5am, so there'll be a slight exception for that, I hope. Otherwise, some shouting will occur.

I'm in the queue for more surgery, Sunday morning. The podiatrist isn't happy with the pain I'm still having and thinks there may still be hidden abscesses, so he's going to go in and find out. He'll check out the bottom of my foot, and the inner side of my big toe. I'm hoping he cleans out whatever he finds.

Life in a hospital is hell. With its daily Lovenox shots to the stomach, the horrible food, the uncomfortable sleeping arrangements, the unusable toilet seats blocked by a malplaced toilet paper dispenser, to the obligatory guy (or girl) shouting "HELP!" all through the night. It downright sucks. I keep forgetting how terrible this place can be.

Okay, that last communique was a bit incoherent. Sorry. I've been in the hospital since Tuesday night with an infected foot, and now, an infected right leg. They've been giving me vancomycin for the infection, but it hasn't knocked out everything. An infectious disease specialist came in today and added Cefepime to my IV antibiotics. We'll see if anything else gets caught in its web. He also may order a nuclear bone scan to see if I've got osteomyelitis again. Wouldn't that be just lovely. So, I'm sitting here, trying to break out of a writer's block on a French Horn sextet for a competition, while drains get backed up at home. Such joy.

I spent Tuesday night and Wednesday morning in the ER =, being treated for the infection in my right foot while alone in the room. She brought my computer back up to me this evening. This is the first chance I've had to communicate to the outside world since..Sorry.

What makes things worse is that my surgery will probably be pushed off into 2024, when the deductible count resets. I'd met my catastrophic out of pocket deductible for 2023, so the surgery *was* going to be free. Not any more. Sigh.

Saw the podiatrist. My foot is badly swollen and warm to the touch. The swelling and warmth are moving up my leg. The doctor prescribed clindamycin and told me to come back Thursday. If it hasn't cleared, I'm going into the hospital for IV antibiotics. The shoulder surgery has been postponed until further notice. Damn it all to hell.

According to my wife, my right foot has started swelling up on me. I can't see the swelling, but I can feel pain when I walk on it, in the area where the sesamoidectomy was performed. Something could be going wrong in there. Shiat. This could force me to postpone my shoulder surgery if it's infected. Damn it to hell and back. I have an appointment with the podiatrist in a couple of hours. We shall see what's going on.

Mrs. Prof has a stash of Cymbalta of her own. We will live on that until my prescription can be filled on the 13th.

I have run out of Cymbalta (a.k.a. Duloxetine), and I am suffering from withdrawal symptoms. Electric shocks to the head, jitters, coldness, and others. I'm not enjoying this, especially since Mrs. Prof didn't tell me I was completely out (she does my pills every week).

I had leftover biscuit (singular - wasn't terribly hungry) and gravy tonight. Added a touch of extra salt to the gravy, since as I said, I didn't put enough salt into the original batch Friday morning. Wound up tasting better than any gravy I've ever made, ever. Seriously. A couple of the factors that helped in the original batch: 1. Corn oil. You wouldn't think it made much of a difference, but unless you're using pan drippings from something like bacon, sausage patties, or chicken fried steak, you're not going to get a better fat for the gravy. It's pretty much made solely for use in hot foods, according to one of the major cooking sites (either America's Test Kitchen, Cook's Country, or Bon Appetit - can't remember where I read it). Don't use it for cold foods (foods that will be served cold) like salads, cakes, and so on, they said, but for hot served foods, it's perfect. I agree. 2. Mixing cream and whole milk. This brought the fat content up in the milk side of the equation (roux + milk + spices = gravy), making the end result more silky. More cream might have been better, or it might have been overkill - some experimentation would be needed in order to tell. A factor where it could have been improved: 1. Flour. I used something called Wondra flour (https://www.goldmedalflour.com/our-flour/wondra-quick-mixing-all-purpose-flour/). It's a pre-cooked and dried flour, supposedly, which allows it to blend into gravies with amazing alacrity. The end result is a near-perfect smoothness almost all the time, but at what cost? There could be some flavor lost in the roux-making process by using a pre-cooked flour. One could probably improve the roux by using a regular all-purpose flour that has been sifted to remove all lumps first, if you're skittish, or just gently added and very quickly whisked, if you're more trusting in your cooking skills (I'm not). Now, why the hell am I going on and on about something so mundane as gravy? Because I was raised on the stuff by by grandparents and relatives (not my mother, unfortunately - her cooking left something to be desired except for spaghetti w/meat sauce). They made fantastic gravy, and it's been my life goal to replicate their efforts. I've finally accomplished that task. My relatives did not share their recipe nor their techniques with me. I have resolved not to be so secretive with my discoveries. Besides, hell, I'm a longstanding Native Texan who lives on cream gravy, not one of these newcomer MAGA types who couldn't spell gravy if you filled a fountain pen with the stuff. It's my duty to learn how to make it, and my duty to pass down the recipe (my relatives were sorely remiss in their duties in that area). I've got to go on and on about it, it's my job.

I made canned biscuits with homemade from-scratch cream gravy for Mrs. Prof this morning. Okay, it was part cream, part Fairlife whole milk. Came out great. My only gripe is that I didn't put in enough salt, but I'd rather have that gripe than the alternative (too much salt). Mrs. Prof was happy with the whole shooting match. I am therefore pleased. If anyone wants the gravy recipe, here 'tis. It's not easy, nor quick: 3 Tbsp. corn oil (corn oil works best, but substitute as you like) 3 Tbsp. flour (I use Wondra flour, since it doesn't clump) 1 cup heavy cream 2 cups whole milk (I use Fairlife, since it's lactose-free, but anything works since you're cooking it) Salt to taste Pepper to taste Rubbed Sage to taste Thyme to taste Before you start, combine your milk and cream in a container, preferably with a pour spout of some kind. Stir with a metal spoon so that they're well mixed. Clean off the spoon and keep it handy for later. Heat a large saucepan (3 quart) or a large skillet/frying pan over medium heat until hot, but not smoking. Add oil and heat until it shimmers. While whisking with a wire whisk appropriate for your pan, add your flour to the oil. Whisk until coated, then continue whisking until the flour turns light brown, around 6-8 minutes (I'm guessing - it may take longer). Do not let it smoke!!! Turn down the heat if it gets too hot. Once your flour is at an acceptable shade of brown (not quite peanut butter brown), pour the cream/milk mix into the pan while whisking, gradually at first, then faster until everything is whisked in. Adjust the heat under your pan to medium, and start whisking at an easy speed, making sure you scrape the entirety of the bottom of the pan. Keep whisking until the liquid starts steaming and begins to look somewhat thick and shiny. Put down your whisk for a few seconds and get your metal spoon from earlier. Dip it into the (now potential) gravy and remove it, then look at the back. Blow on the back to cool it down, then draw your finger across it. This is the old, "Does it coat the back of a spoon?" test. If your finger leaves a clean, non-grainy trail, your gravy is pretty close to being ready. Now, use the spoon to dip out some (potential) gravy and let it pour back into the pan. If it's the thickness you want, declare it as official gravy and pull it off the heat. Serve with hot biscuits, bread, or any number of other things that just need some good cream gravy.

Cold, leftover tortilla chips.

I don't remember if I posted anything about this here, but I think I did. Anyway, I've arranged a Beethoven Piano Sonata, specifically Sonata #18, Opus 31, No. 3, for Woodwind Quartet. I finished this quite some while ago - a few months, in fact - and I'm just now getting around to submitting it for publication to E. C. Schirmer. The Score and the MP3s went online last night. One thing I didn't do in the past was post the arrangement with a good rendition to SoundCloud. I have now rectified that problem. If you would like to listen to a damn fine Beethoven piano sonata, being played by a woodwind quartet, please click on the following link: https://on.soundcloud.com/Rjqc6 I would appreciate your opinion of the arrangement. Thank you very much.

I'm not going to surround this with spoiler tags, because Bob Gammage, this needs to be out in the open. I've been gathering stuff in preparation for next week's rotator cuff repair surgery (it's got me so nervous I can't even spell it properly). So far, I've got a lifting recliner chair, a left-handed ergonomic mouse (to mirror the right-handed one I have now), and one or two other things. I'm nowhere near ready. One of the things that I do need, and which I just ordered from Amazon, is something euphemistically titled a "Toilet Aid." It's an 18-inch-long wand of sorts with a handle at one end and a gripping flap at the other end that locks. You insert your toilet paper into the flap, grip it and lock it into place, then make use of it. When done, there's a button on the handle that unlocks the flap and releases the paper into the water, completing the cycle. Repeat as necessary. This *is* necessary, because I will only have one working arm (my left one) after the operation, and I'll only have very slight use of my right hand to either grasp the wand or insert the paper, one or the other (haven't figured that out yet). The post-use hygienics are still in question as well, but will probably involve a small bucket of bleach-treated water and another dry bucket. I've got to think about this stuff, man! I'm going to have to live with it for a good six weeks while my right arm is in a sling. I don't like it one bit, but I prefer putting up with this crap to putting up with the pain in my shoulder that I have now. I mean, today I've had to max out and take the two-pill dose of my Dilaudid. That's 16 milligrams a dose, and I'm still feeling pain!!! If someone tells me I can permanently get rid of this pain by having to wipe my butt with a wand for six weeks, I'm making that deal. Case closed.

Norman Lear is dead. He was 101. https://variety.com/2023/tv/news/norman-lear-dead-dies-tv-legend-all-in-the-family-1235823995/

Boston-creme-pie-flavored Pop Tarts.

Ah, that's a low-moisture mozzarella, if memory do serve. Very popular with the kiddiewinkies and their lunch boxen.