Tag Archives: outfits inappropriate for work

by

No, really!

No, really! I am a mature adult! I swear! My inner child has grown up!

Well, maybe not at the end of October.

My friend P took the photographs with my phone in 2022.

For the Ragtag Daily Prompt: maturity.

by

Post Covid Sartorial Splendor

I dressed up in November for the Chamber of Commerce masquerade. This is a 1920s dress and I had to repair the lace around both arm openings. The underdress is rust colored silk and is beaded. The overdress is lace with the beaded and fringed flower with a tassel on the side. The lace is definitely see through and I wore a slip. The silk underdress has beaded squared off tags that hang outside the lace, which is a detail I haven’t seen before. I do not remember where I got this, second hand.

When the silk is nearly 100 years old, it wants to fall apart. I took a second dress just in case there was dancing. If I danced in this dress, it would probably disintegrate.

In other news, here is an article about the Post Covid exercise intolerance. It is a small sample size, but they biopsied skin and muscle in people who were still exercise intolerant one year out from Covid 19. These people all had Covid-19 in 2020, so unimmunized.

https://actaneurocomms.biomedcentral.com/articles/10.1186/s40478-023-01662-2

“Compared to two independent historical control cohorts, patients with post-COVID exertion intolerance had fewer capillaries, thicker capillary basement membranes and increased numbers of CD169+ macrophages. SARS-CoV-2 RNA could not be detected in the muscle tissues. In addition, complement system related proteins were more abundant in the serum of patients with PCS, matching observations on the transcriptomic level in the muscle tissue. We hypothesize that the initial viral infection may have caused immune-mediated structural changes of the microvasculature, potentially explaining the exercise-dependent fatigue and muscle pain.”

This is a big deal. More needs to be done to confirm this, but a talk earlier this year said that the muscles don’t get adequate blood flow and get hypoxic and that the fatigue is recovery afterwards, taking 1-3 days. That is the best hypothesis for why people have the activity “crashes” after exercise or doing a little bit more than usual. My chronic fatigue shuts my fast twitch muscles down when I have pneumonia. This time it was two years before I got them back and I still have to be careful. It’s weird when they won’t work. It’s like the muscles go on strike. They didn’t really hurt (ok, they burned like strep throat all over the two times I had systemic strep A) but it’s more like the muscles are screaming NO NO NO NO! at the brain. It is hard to describe. If I tried to push, it felt like dying. Perhaps the muscle cells really DO start dying if we push them too hard. Mine is annoying but it doesn’t confine me to bed. My slow twitch muscles were fine though this time I needed oxygen. I hope not to experience it again.

This is the mask I wore. Nice to be in a different sort of mask, but I masked at a concert last night and will mask for travel with an N95.

For the Ragtag Daily Prompt: sartorial choices.

by

Lose the chest strap

After my fourth pneumonia, I couldn’t stand the chest strap any more. Chest strap? say the guys. “What chest strap?” Dudes, bra, brassiere, whatever you want to call it.

It made my lungs hurt. My lungs already hurt. I thought, ok. I am 60 years old. I am “small” and don’t need any “support” unless I go running or something that really makes breasts jiggle. Don’t need a bra for dancing. And anyone who stares at my tits, well, gosh, thought you guys didn’t like “old” ladies. I don’t care.

Let’s think about that chest strap though. Guys, have you ever tried a bra on? What exactly is a bra for? Well, running or soccer or pole vault or football or all sorts of other heavy athletics, yeah, it can be really uncomfortable. Strap those babies down. But the day to day bra is to enhance support, stop jiggle and hide nipple action.

Uh, and meanwhile guys can take off their shirts in public. I think this is unfair. They have nipples too and breast tissue, just less.

Also, what is wrong with jiggle? The breast tissue drains in multiple directions, through lymphatics. I think some breast jiggle may be important to that drainage. Jiggle means slut to guys? Well, go suck a lemon, guys. And if you really stare at my breasts when I am talking to you, I might not sock your eye, but I sure as hell will lose all respect for you. All. And why are nipples evil in women but not in men? Because they are functional in women and men are jealous? Tit envy.

Now support. Yes, there are women who are so well endowed that they have back pain and may choose a breast reduction. This is covered by insurance if the clinician documents that pain over time. And breasts do change with time and age. But when is our culture going to accept and even celebrate aging! We do congratulate people turning 80 or 90 or 100, but otherwise older women are often ignored. I am delighted by the older actresses and musicians who are now finding parts and are still out there and dancing. Go Tina Turner, the legs go last!

I also think the chest strap is not nice for the lungs. Certainly not after four rounds of pneumonia, but bras have to be tight enough that they do have an effect on a deep breath. I’ve retired my bras. Ok, if I am in a Madonna mood and want to wear a lace see through white shirt, then I might pull out the scarlet one for the evening, but otherwise, no way. How good are bras for people with asthma, with emphysema, with post covid?

Lose that chest strap, ladies, and take a deep breath. Breathe free.

by

The witches out

The witches are out in the Halloween Parade downtown. Many are belly dancing.

The smallest children are not quite sure what to make of the witches. All of the monsters and demons and dinosaurs and witches are here replenishing the legends. The smallest children aren’t sure about me either.

One small child looks at me and says firmly, “Cwab.” Another one stares at my claws until he is led out of sight. I think he is wondering if humans can have claws for hands and WHY? Others are from the east coast: “LOBSTER!”

For the Ragtag Daily Prompt: replenish. A friend took the picture of me.

by

patriotic lobster

…because the pants alone aren’t loud enough.

Another in my Outfits Inappropriate For Work series. It is difficult to type wearing my claws. Also patients would get distracted if I wore something too weird. I can’t think why.

I got the claws at a church sale yesterday. I was told they went with a game, “You’ve Got Crabs!” Turns out they don’t, but maybe they should! I went looking vaguely for a CD case for my car and got two: however they came with CDs. Everything from Cake to Spongebob Favorites to Johnny Cash to Disney Favorites. I am SET.

So who wants to play “You’ve got crabs!”?

Do you have an Outfit Inappropriate For Work? Is a Silly Selfie a Silthie?

by

part time

I only dress like this part time.

#outfitsinappropriateforwork

A friend took this with my camera at my request. Thank you, friend!

For the Ragtag Daily Prompt part time.

by

Covid-19 and walking pneumonia

I wrote this essay in July 2017. Before Covid-19. It is clear that Covid-19 is also causing a walking pneumonia. People are exhausted when they get out of bed. No fever, they may not cough much, but if they get up, they can feel exhausted. The key to this is the heart rate, the pulse. If the pulse jumps 30 points faster or more, this implies lung swelling and reduced lung capacity. Right now, the only treatment we have is rest and time to heal. I should know, I’ve had really bad walking pneumonia four times: the first two times I was out for two months. The third time 6 months with 6 more months half days and chronic fatigue. The fourth time put me on oxygen.

I want to offer hope to the people with Long Covid-19. Having been through four bad pneumonias, with increasingly long recovery times, and now disabled for doing Family Medicine, I have experience to share. I will write more about that in the next essay.

From 2017: Walking pneumonia is changing.

The classic bugs are four “atypical bacteria”:

mycoplasma pneumonia
chlamydia pneumonia (this is not the STD chlamydia. Different one.)
legionella
pertussis (whooping cough)

However, streptococcus pneumonia can also be a walking pneumonia OR a lobar pneumonia. In a lobar pneumonia the person usually is short of breath, running a fever of 102-104, and they point to where it is: hurts in the right upper chest. On chest x-ray there will be consolidation: whited out from fluid or swelling instead of nice ribs and dark air. They are often tachycardic and hypoxic.

In walking pneumonia the person often has no or minimal fever, they just feel tired or short of breath when they do things, and the chest xray can be “clear”. It isn’t really “normal”, it’s just that the bacteria or virus affects the entire lungs and causes some swelling throughout and doesn’t white it out.

“Double” pneumonia is when the chest film is whiting out on both sides. We also see the lungs whiting out with ARDS — acute respiratory distress syndrome. So after trauma in a car wreck and lots of broken ribs, the lungs can be bruised too and white out. Ow. Influenza virus can cause lung swelling and in the 1917-1918 flu infected military recruits lungs were swelling shut. They would turn blue and die.

“My” strep that I’ve had pneumonia with twice is streptococcus A, not strep pneumonia. It causes strep throat mostly though it can invade and cause sepsis or pneumonia or cellulitis. There are currently 4000+ known strains of strep A, and some are resistant to antibiotics or can cause kidney damage or do all sorts of nasty things. I think that “my” strep is resistant to azithromycin.

The current guidelines say to treat walking pneumonia with azithromycin. However, a paper came out this year saying that resistance to azithromycin is rising among streptococcus pneumonia and that nearly 50% of strains tested were resistant. Uh-oh. That means that azithomycin doesn’t work and the person can get sicker and may die. I talked to a pulmonologist in Seattle when I needed help with someone. He said that he would have said there weren’t any resistant strep pneumo strains here in Washington except that he had one intubated and in the ICU right then. “I’m convinced now, ” he said.

A lobar pneumonia is easier to diagnose. Abnormal chest x-ray, reasonably healthy people run a high white blood cell count (so my frail folks, immunosupressed folks and 90 year olds don’t raise their white blood cell count), and a fever (ditto) and look sick. The walking pneumonia people come in saying they have been coughing for 3 weeks or 4 weeks or two months. I am doing more lab testing because of the resistance.

This winter I have seen 6 different causes of walking pneumonia here: influenza A, respiratory syncytial virus (In more than one person over 60. That is NOT who the books say it should affect. It’s supposed to mostly cause bronchiolitis in babies and preemies), pertussis, strep pneumococcus, strep A and none of the above. All looking pretty much the same, but with different treatment.

https://wwwnc.cdc.gov/eid/article/15/8/08-1187_article
https://www.cdc.gov/pneumonia/atypical/mycoplasma/index.html
http://www.medscape.com/viewarticle/820736
https://www.cdc.gov/drugresistance/threat-report-2013/pdf/ar-threats-2013-508.pdf#page=79
RSV: http://kidshealth.org/en/parents/rsv.html
Mycoplasma resistance to azithromycin has been reported too: http://erj.ersjournals.com/content/36/4/969