Naomi – The Worst Day Yet
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Two days after the surgery to replace her prosthetic hip, Naomi suffered through the most painful and difficult day recovering from any of her surgeries. After having remained in bed continuously for two days, since the surgery, the physios and Naomi both wanted her to get out of bed to move around a little. Due to the almost complete blocking of sensation due to the epidural, the physio wanted to take Naomi off the drug, so that she would have some sensation in her legs when she stood up. Unfortunately, it seems it was too soon to cut this pain relief, and as a result, transferring from the bed to a chair and back was equal to the most painful thing Naomi had ever felt. Even sitting in the chair was so painful, Naomi could only manage it for 40 minutes, in agony the whole time.
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After a brief sit out of bed (top), Naomi transfers back to her bed, assisted by a frame and two nurses, the pain clearly visible on her face.
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Moving around and exerting herself partially opened up the approximately 33cm (13in) wound, requiring additional bandaging.
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Even after returning to bed and being given high doses of oral painkillers, the pain was too severe for Naomi to tolerate. Mercifully, the nurses resumed the powerful epidural drug that completely blocked all pain from the lower back down. The change in Naomi’s disposition was like night and day, within a mere 10 minutes of the reinstatement of the epidural. Seen here at the lower left is the patch and bandage on Naomi’s back where the epidural enters her spine, to deliver the drugs. The bloody bandage at upper right covers the surgery wound.
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The following day, the epidural had to come out permanently, or risk infection. Fortunately a good alternative was available. Naomi was given a PCA (patient controlled analgesia), an IV painkiller that Naomi can control herself with a button whenever the pain becomes too severe. There is a limit of one dosage every five minutes. Naomi was using it to its limit, but was gaining significantly better pain control than the previous day – though not quite enough for comfort.
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Due to her immobility and the swelling in her right leg, Naomi is required to wear a “TED” stocking, to help prevent the occurrence of a deep vein thrombosis, or DVT.
Fortunately, and to our great relief, Naomi’s condition today (day 4) is much improved on the days described above. With an extra day’s healing, a doubling of the dosage given via the PCA and a short but very productive physiotherapy session today, Naomi’s pain is at a much more manageable level and she is actually able to enjoy some measure of comfort. I plan to visit Naomi earlier in the day tomorrow to hopefully photograph her doing a physiotherapy session.
Naomi’s Portacath is Flushed by Nurse
During her home recovery from her recent hospital stay, Naomi had daily visits from the Hospital in the Home nurses. During these visits, the nurses would observe Naomi’s vital statistics, such as blood pressure, and change the bag of antibiotic fluid that was being automatically being delivered into Naomi 24/7 by the pump to which she was attached.
In these following photos, which were taken three weeks ago, the nurse also flushed Naomi’s Portacath. This is a small valve implanted in Naomi’s chest, below the skin, with a pipe leading directly into an artery near her heart. This was implanted to allow the nurses easy access to her bloodstream while she was participating in a drug trial. Every month a bag of the trial drug would be given to Naomi through the port, and would allow for blood samples to be easily taken. Part of the care for the port included flushing it monthly with saline solution to keep it clear of blockages.
Since Naomi has been in hospital fighting the infection, she has come off the trial. The port remains, however, while Naomi and her specialist decide what the best new treatment for her will be. Part of the Hospital in the Home nurses’ duties then, was to flush the port when needed.
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Naomi has since completed her IV antibiotics course, and is now free of the pump and doesn’t need the inconvenient daily nurse visits. This has been a great relief for both of us! As of today, Naomi is doing well, but is starting to suffer from the effects of the deteriorating prosthetic knee joints which will both need to be replaced early in the new year.
Naomi Update – Ok, So Maybe the Knee Can Stay!
Just a quick update on Nomi while I take a break from my Manifest preparation.
Good news! The surgeons and orthopedics (not osteopaths as I mistakenly said yesterday) people had their meeting, and have decided on a compromise. The options Naomi was given initially were replacing the prosthetic knee twice, with a course of anti-biotics in between, or being on antibiotics for the rest of her life. Both of those are very serious propositions. So the surgeons are instead going to open up her knee, and thoroughly clean and flush the joint out. This is an attempt to remove all of the bacteria which are expected to have formed a protective biofilm against the metal of the joint, where they could hide from antibiotics.
This compromise solution will still require a large incision, probably 15-20cm, into Naomi’s knee, and will require a moderately long recovery. She will be unable to bear weight for 5-7 days, and will need to remain on IV antibiotics continuously for a month. However they feel this is a treatment which has a good chance of removing the infection, without having to go to the extent of replacing the whole joint – twice!
I want to apologise if I worried anyone with yesterday’s blog entry. All of what I said was true, and not exaggerated, but given the despairing mood I was in, I used a tone of voice that may have alarmed some of you. Particularly my comment about scanning Naomi’s heart for the bacteria. On this particular issue, it’s not as serious as it might sound – from my understanding. Apparently the scan is precautionary. It has also been postponed a couple of times, so they are apparently not concerned about it being a pressing issue. Also, if anything of concern WAS found, the treatment would probably be what Naomi is already receiving: strong antibiotics.
So far Naomi hasn’t had this scan, and there’s no set date for it as yet, so we’re just not going to worry about it for the time being. More pressing is the scheduled time for Naomi’s surgery – 3pm tomorrow. This is coincidentally exactly the time I will be photographing one of the costume competitions at Manifest! I hope I’ll be able to keep my concentration.
Tomorrow is going to be a very stressful day for us both, but the day is also an important step forward for us both, paving the way for a brighter future. Naomi will be taking a big step forward to returning to her normal health, and I will be starting my first big professional event photo shoot.
Please wish us both luck! :)
Naomi Update – The Knee Has To Go
Moderately graphic images below, view at your discression.
Today has been a very rough day. I was planning to spend the day shopping and preparing for Manifest after visiting Naomi in hospital first. When I arrived however, Naomi had been given some bad news, so I stayed the day with her.
Unfortunately, upon further investigation and after allowing the bacteria found in the samples taken from Naomi’s knee and blood to grow, it was determined that the abscess on the knee was actually infected. The infection was also found in the joint itself, and in Naomi’s blood. The infection bacteria is Staphylococcus epidermidis
After lots of visits from doctors and specialists from Infectious Diseases and Rheumetology, Naomi was offered a choice: a double knee joint replacement which would result in approximately 12 weeks of recovery, or to be on anti-biotics for life. The surgery seems to be the obvious better choice, but we have to wait to see the result of a big meeting planned tomorrow morning with the Osteopathy department and the surgeons. They will determine what they think is the best course of action for Naomi, given that they are the ones who will have to perform the surgery and look after Naomi. It’s possible that they will determine that surgery isn’t the better choice.
Naomi is also scheduled for an echo cardiogram to check to make sure the infection hasn’t spread to her heart – the organ most at risk due to the fact that all blood passes through it, now that the bacteria has been found in her blood.
Interestingly, the rheumetologist suggested, without actually saying, that the drug trial that Naomi has been on for the last three years may have had an important contributing factor in the infection. The trial, which gave Naomi initially wonderful results in the first year, then increasingly less so in the last two, is an immuno-suppressant. Arthritis is a disease where the body’s own immune system attacks the joints. This trial drug, and all others like it, suppress the immune system to give the body a break. Unfortunately it also lowers it effectiveness at fighting off infection. The doctor suggested that Naomi may not have had as much trouble fighting off the infection herself if she wasn’t in trial. Damned if you do, damned if you don’t.
I’ll let you know how the meeting goes.
Photos below – do not scroll down if you do not want to see moderately graphic images.
Here’s a couple of photos of the nurse changing Naomi’s dressing. After the surgery to drain the abscess, a large hole, about 2cm across, was left in Naomi’s knee. To help the healing process, the hole to the void once filled by the abscess has been packed with about 50cm of gauze. That’s what you can see sticking out of Naomi’s knee in the photos below.
Cosplayers: How to Help Photographers Get the Best Pics of You
- At September 18, 2008
- By Neil Creek
- In Tutorial
1
The Melbourne Anime Festival is just around the corner, and all around the world there are conventions throughout the year. As a photographer, I love cosplayers. The outfits are interesting to look at, the people are usually outgoing and happy to be photographed, and at conventions, there are so many photo opportunities. Cosplay competitions are especially great, as you get a parade of fantastic costumes to photograph, all standing in the same spot!
If you are a cosplayer, you’ve put a lot of work into your outfit, and you’ll want to have great photos of them. I’ve compiled a list of tips and suggestions for you to follow if you want to help photographers get the best possible photos of your work. Some of these tips apply specifically to the cosplay competition, but many are helpful wherever you are in your costume.
Tips for Cosplayers
- Dress to Impress – Colourful and intricate costumes will make me go “wow” every time. The huge Soul Calibur group at Manifest last year took my breath away! The stage was glittering and shining with lots of colour and movement. I couldn’t shoot fast enough!
- Bland is Bad – On the other hand, simple or bland costumes are far less fun to look at. I’m not a fan of Bleach cosplays simply because they all look so simple and similar. If I’d seen Bleach I’m sure I’d enjoy it more, but from a costume perspective only, I find them bland.
- Get Expressive – If the character you love does has a simple outfit, you can compensate for that by being very expressive with your movements. Think theatrically. Exaggerate your movements and expressions. Go for physical comedy if it suits your character. Even the simplest ‘anime school girl’ costume will be memorable and photogenic if you know how to pose.
- Know How to Pose – There are few things more frustrating than when a cosplayer has made a gorgeous costume, but doesn’t show it off enough. Some first time cosplayers are so timid, it seems like they can’t get off stage fast enough. Others strike a pose, and hold it rock steady for the whole time they’re on stage. If you happen to be standing side-on to me, I can’t get a good photo of your costume unless you move! Please have at least two, preferably three different poses, and change your angle so we can see the hard work you put into your costume.
- Hold It – On the topic of poses, when you strike one, please hold it for at least three to five seconds. Some poses are great, but if you only stay like that for less than a second, it’s very easy to miss getting that shot.
- On Your Mark – Please try to stay near to the mark on the stage. I understand you need to move around for your skit, and that’s fine, but if half the action occurs behind the speaker or podium, I’m not gonna get any photos of that.
- Go Wireless – For the last couple of years at Manifest there has been a wireless mic available. That makes me very happy, because a mic cord, or worse, mic stand, can ruin an otherwise great photo. If you are offered the wireless mic, please take it.
- Lose the Mic – Regarding mic use, if you need it for your skit, please pass it back before you do your poses. A mic in shot isn’t as nice as one without the mic.
- Pose After a Skit – IF you have time after your skit, please take a few seconds to take a few poses for us. Skits often move so fast it’s impossible to get a clear photo. Allowing us the time to get those photos will make us very happy, and probably make it easier for the judges to see your work, thus improving your chances of getting a good score.
These tips are obviously from my personal perspective, but many many people watching the cosplay comp are taking photos, and all photographers will appreciate it. I’m sure that you also want to have good photos of yourself in the competition as well, so helping photographers out also helps you to get the best photos possible.
I’ll follow up this post with another one with tips for photographers, revived from the archives.
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