Archive for May 2012

Welcome to The Age of Austerity! Stay healthy or die.

As many of you know (especially if you are already on this site), California is looking at nearly 1 billion dollars worth of cuts to Medi-Cal, IHSS and various other important programs.  Many childcare and adult day care programs have lost all of their funding, forcing them to close with no follow-up or placement help for the recipients.  Also, a “pilot program” for turning Medi-Cal over to managed care (meaning a huge HMO) is in effect all over the state, with San Diego as one of the first stops on the march towards total healthcare privatization.  And, no, they didn’t feel any need to allow the taxpayers and recipients of said care to collectively decide this.  Now, I am sure we all know that the money sure isn’t going towards education either, considering that here in just San Diego over 1600 pink slips were given out just recently.  Overall, pretty grim circumstances.

Not that the rest of the country is faring much better.  I was curious and typed “healthcare cuts” into a Google search and the parade of headlines mentioned what seemed like at least half of the Lower 48 states are experiencing serious budget crisis and making immediate cuts to, what else, healthcare and education.   Illinois, Florida, Maine, Pennsylvania, Virginia, Texas, Washington….the list goes on.  There have been hospitals, doctors, nurses and recipients protesting their state’s cuts all over the country.  The social safety net for hundreds of millions of people is being unraveled in an economy that refuses to recover for the majority of us.  Topping that off, our nations leaders are looking at cutting over a third of Medicare funding.  In California, there are nearly 5 million Medicare recipients.  They are looking at massive cuts to their national AND state health coverage.  Meaning?  Well, it means that millions will likely be removed from the rolls (enrollment rosters) of one of these or possibly both.  Patients will be forced into nursing homes (that have a huge lobby and are run for profit) where the quality and length of their lives decreases significantly.  Necessary equipment, meds, nursing and companion care and the ability to even see a doctor will be compromised greatly, if not completely taken away.  Again, pretty grim.

Yet, not all is hopeless.  Why?  Resistance!  Patients, recipients, doctors, nurses, caregivers and families are saying “Hell NO!” to these budgetary machete jobs. I didn’t become a nurse to watch conditions for people become so dire and to see my own employment opportunities, pay and benefits disappear.  Here in San Diego, we have had a loud, persistent voice in the campaign to save Raul Carranza’s medical nursing hours (a struggle you can easily follow on this page).  Do the health care cuts google search, and you will see link after link talking about these cuts mainly in the terms of the fight against them.  I was delighted to see that the cuts to Medicare are not happening quietly either!  The message getting out is not just about the medical consequences but highlighting that this is a civil rights issue.  Taking disabled people out of their homes and away from their employment and lives flies directly against the concept of liberty for all.  The rights of family members, who get paid (very little, I might add) to care for their loved ones will be trampled on as well.  Unions are jumping in this fight too.  Here in California, United Domestic Workers (UDW) is trying to head off the proposed 20% cuts to IHSS.  There are voices rising, more every day, against the chorus of politicians who are scapegoating all of us for their terrible budgetary management and lop-sided taxation.  From the persistent months-long tenacity of the Occupy movement to the recent upheavals against the cuts, people are sounding off and demanding answers.  
We are all frustrated, overworked and living what seems like isolated and solitary lives.  I feel it too.  The pressure is mounting, and around the World we are all seeing the pressure cookers explode with protests, government changes and calls for justice.  Change is really in the air everywhere and the best change possible is where we take our power back and hold these allegedly representative politicians and corporate shills accountable to our demands. None of us is alone and, when we fight together, we really are unstoppable.  I believe this and I see our collective asses are all in trouble if we don’t speak up and speak out…LOUD!  And I hope to hear your voice in the fight, however you can, because I want the roar to be deafening!

El Dubz, Nurse Extraordinaire is a home health nurse with a deep affection for resistance, animals, nursing and equality.

More in this video: College Essay

I Almost Died… Again

Going to the hospital is always an adventure. I had made the decision to go to the ER because I had been having trouble breathing for upwards of two weeks. I would wake up with a dry throat, dry mouth and hacking up a lung. It gets especially bad on Sundays, when it’s only my mom or dad with me and my brother for 16 hours of the day. Usually, my brother has a day nurse, but he was running low on hours so he won’t get her back until next week. At that time, however, all I knew was that something was wrong and I needed to find out what it was before it got worse.

When I’m home, I get to make all the decisions. If I need suction, I just ask for it. If something hurts, I ask for medicine. I have complete control over everything that has to do with my body. It’s not like that at a hospital. At least not for me. They’re not used to dealing with someone, in my condition, that’s completely in charge of their care. So they assume that I’m not capable, that I don’t know what’s going on.

“Has he fallen in the last month?” They ask my mom as they admit me. Now, I understand that they have paperwork to do and that they have to adhere to certain procedures, but the least they could do is acknowledge that I’m capable of answering that question. But they don’t. They repeatedly asked my mom questions without even looking at me. It didn’t matter how many times I spoke up they almost always looked at my mom. After about the fifth basic question I gave up and decided to just let my mom answer everything. I figured, it was just easier to let them do what they want to do. After all, they couldn’t fuck up too bad, right?

“All right, we opened up a bed for him. We’re going to move him up to the ICU”. Said the ER nurse as she walked in. If you have never been escorted from the ER to the ICU, let me tell you what it’s like. You have a team of nurses and respiratory therapists hauling you and all your life sustaining equipment down a corridor. They take you on a humongous medical elevator only to let you out at another long corridor. The lights are all fluorescent and there’s a distinct lack of windows. It doesn’t matter what time of the day you came in because time is irrelevant. The only context in which time matters is what time you have to get your medicine. At the end of this long corridor are two remotely operated double doors that make a loud clicking noise every time they open. To open them, you have to pick up a phone that’s mounted on the wall and identify yourself to the nurse inside. I don’t think it is an exaggeration to say that it feels like you’re walking on death row.

Once you’re inside, all you hear is the constant beeping of heart and oxygen monitors. They don’t go silent based on what time of day it is. To the monitors, the sun and the moon don’t exist. All that exists is your beating heart and your vital signs.

There’s a nurses station right in the middle of the floor, but you rarely see the nurses in it. They’re always going from room to room giving medicine or checking vital signs. All that matters to them is that their patients vital signs are okay and that there’s nothing visibly wrong with them because, to be fair, that’s all they have time to worry about.

“We will take it from here” says the ICU nurse to the ER nurse. Immediately, I’m surrounded by a gaggle of people ready to transfer me from my chair to the bed. They ask my mom what the best way to do it is. When she tells them that she just needs help carrying me their eyes widen, “Are you sure?”

“Yeah” she says nonchalantly. They’re not sure what to make of it, but they figure she knows what she’s talking about, at least about that. They got me on their bed and shoved my mom aside so that they could do what they do.

“I need to turn you to look at your back, okaaaaaaaaaaaay?” Said the extremely tiny nurse in her most condescending voice. The reason they wanted to turn me was to check for bed sores on my back. They assume that I can’t feel anything so they have to check in order to cover their asses.

Now, before I go any further I need to explain something to you. There are two kinds of trach’s: cuffed and uncuffed. When a trach is cuffed it has a little balloon inside of it that helps keep it in place. Doctors and hospitals like it because it’s generally safer for the patient. The problem with them is that it makes it almost impossible to talk. Because of that, I like to keep mine uncuffed. It’s a little riskier because there is a higher probability of it getting pulled out, but, as long as you’re careful it will stay in. It’s a fair trade off for me: make sure that people are mindful of the trach and keep the ability to talk. The problem is that hospitals don’t usually deal with uncuffed trachs.

I’m not exactly sure how to describe what happened next. I know they turned me and I know that I could immediately tell that they hadn’t given my trach enough slack. I can also say that I could tell right away that the trach had come out. I wasn’t getting any air and I watched the young nurse on my right look around, confused. It was obvious that he knew something was wrong, but he couldn’t quite figure out what. The tiny nurse on my left was dutifully inspecting my back and it wasn’t until the other nurse started yelling for help that she noticed anything wrong. I watched as everyone around me panicked. All they had to do was put the trach back in. My mom knew as much and started trying to push everyone out of the way.

It’s weird, everyone around me was panicking. There was lots of screaming. Lots of, “We need some help over here”’s. I was turning blue and my oxygen was dropping. I knew I was in trouble, but… I wasn’t scared. It felt as if I was outside of the situation, just watching everyone panic. It was… cathartic. I know what you’re thinking, “You almost died and you say it was cathartic?” Short answer?Yeah. For a few seconds, I could just sit back and watch the unmitigated chaos around me. Everyone was reduced to their most primal instincts. The mother, trying desperately to save her son. The young rookie nurse, who’s really just a kid my age, screaming for help. His hands shaking as he tries to put the trach back in. He really shouldn’t be there, but he is, so he’s dealing with it as best he can. He doesn’t realize how much we have in common. The tiny, mild mannered nurse pushed aside by my mom… desperately trying to figure out what to do. And then me, just calm as a cow. Not worrying about anything but watching it all unfold. Everyone was playing the role they were supposed to, and, just for a brief second, everything seemed okay.

I don’t remember who put it back in or how it happened. All I remember is my mom hugging me tight and asking me if I was okay. I looked at her with furrowed brows as if to say, of course I’m okay… why wouldn’t I be?

Just Breathe

I was supposed to blog about managed care today, but I’m not going to do that. Instead, I want to tell you about my Saturday.

Due to the cuts that I had to make to my nursing care, the only person with me that day was my dad. The problem with this is that my brother and I are in different rooms. That means that my dad has to run between rooms when one of us needs something. So we set up a system. When I need something, I call the house phone using skype, if it’s a real emergency, Otherwise, I speak into a baby monitor that he puts on my shoulder.

Like everyone else, I have good days and bad days. Normally, when I have bad days, I have nurses that can help me get through it. I can tell them what I need and they’ll do it. But because my dad was taking care of both of us, I had to limit what I asked for.

It started with a very loud wheezing around 6pm. Phlegm was blocking my airway. I could tell it was in my airway because of the distinct vibrations I felt every time I took a breath. I could also tell the exact position of the phlegm and I knew that suctioning (taking a catheter, sticking it down my trach and sucking the phlegm out) wasn’t going to help. The path the catheter had to take was such that it bypassed the actual position of the phlegm, which was on the bottom left side of the trach. It didn’t matter how many times my dad suctioned me (it was 6, I counted), he was never going to get the phlegm out. What I needed to do was change the trach all together. The problem was that my dad was the only person there, you need to two people to change the trach.

“Let me suction you again.” He anxiously watched the oxygen saturation monitor every time he pulled the catheter out. It fluctuated between 96% and 92%. A healthy person has an oxygen saturation of 98-100. Dipping below 95 is dangerous, as it causes a decrease in brain function. I had been dipping below 95 since 8pm. It was now 10pm and I wasn’t getting any better.

“Wait ’til eleven, then change my trach when the nurse gets here.”

“Let me change it right now “

“No, I can wait.” I knew that if he did it by himself it had the potential to turn worse. If, for some reason, something went wrong, there would have been no one there to help him. Waiting one more hour was a risky decision, but it was one that I had to make.

I don’t know how many of you know what it’s like to not have the ability to breathe properly for an extended period of time, so let me tell you. Imagine that you’re breathing through a straw. All the air that you breathe has to go through that little opening at the bottom of the straw. Now, what if that opening is blocked and you can only get half the air that you were getting before? Naturally, you are going to struggle, but there’s nothing you can do. You just have to wait it out and hope that it doesn’t get any worse. So that’s what I did. I sat, in my bed, wheezing and intently staring at the clock. It was 10:50 pm, but it might as well have been 8 pm again. It felt like it’d never end. I watched as the clock turned from 10:58 to 10:59 and finally to 11:00.

“Are you ready to do this?” said my nurse as he walked in. My dad had told him what was going on as he frantically collected the supplies to change the trach. They laid me flat and I watched as huge chunk of phlegm came out with the trach. I was instantly better, and felt a twinge of pride for having made it through.

“Quick, take a picture.”


Raul Carranza is a full-time activist and college student (when he has the nursing hours).  When he is not blogging about the evils of budget cuts and private insurance, he competes in Strongman bouts and is a tactical planner for the A-Team.


Last week I had to let one of my nurses, Laura, go. We both saw it coming, just… not this soon. We had a plan that would have had me covered until June and would have allowed her to stay. Needless to say, that plan backfired and now I’m down a nurse. I’m not going to go into details as to why, mainly because it doesn’t really matter now. What matters is that, what I’ve been talking about for months, has finally happened. My nursing have been cut. But that’s not what I want to talk about. Instead, I’d like to talk about what Laura did for me, not only as a nurse, but as a friend.

Laura worked the 3-11pm shift. I remember when I first came back from UCLA and she was working with my brother. At first it didn’t seem like we’d get along well, at least not to me. The agency had sent a different nurse, but the prospect of training another nurse from scratch was not appealing since I had just gotten home from LA where I had gone through a carousel of nurses. So I made a deal with my brother: You take the new quiet, shy nurse and I’ll take the one that doesn’t shut up about politics and Battlestar Galactica.* She had been working with my brother, so she already knew the basics of how to take care of me.

During the course of your life you make a lot of decisions. Sometimes those decisions seem small and sometimes they seem huge. The funny thing is that, every now and then, the decisions that don’t feel like a huge deal at the time turn out to be completely life altering.

“I’ve never seen anything like it before!” Laura said one day, her eyes wide with excitement and hands wildly waving around her head. “There’s so many people! All over the country. It’s amazing. ” That was the first time I’d ever heard about the Occupy movement. I’d never seen her so excited.

I admit, I wasn’t really very political before Occupy. Sure, I had my views and opinions, but I didn’t really care for politics. I didn’t see the point in getting involved. But there was something about the way she talked about it that intrigued me. Maybe it was just the right idea at the right time, maybe it fed into my anti-authoritarian streak. Whatever it was, I knew I wanted to be a part of it.

“Are you sure you want to go today?”


“But it’s raining.”

“I can see that.”

“Okay…” She said as she opened the car door.. I’d come to know that ‘Okay…’ quite well. It usually said, ‘I can’t believe I’m doing this right now’. This time, though… this time it said, ‘I’m going to walk three blocks, in the rain, to an organizational meeting for an international movement that has yet to start… with a person in an electric wheelchair that depends on an electrical machine to survive’. The ridiculousness of the situation was not lost on me, but a little water never hurt anyone (my equipment is very well protected) and I hadn’t showered that day anyway.

The challenge for me in the rain is not the actual rain itself, but the cold that comes with it. Because my body generates less heat than the average person (due to less movement), I’m extremely sensitive to the cold. It stiffens my muscles and makes it impossible to move my thumb, which I use to control my chair.

No thumb = no chair = no moving = stuck downtown in the rain.

Still, I felt confident in our ability to get down to the meeting. And we did. It took us a little longer than most, but we got there. We were soaking wet, cranky and sat through a meeting where people argued for 3 hours about when to have more meetings and how to decide when to have more meetings. But the point is she got me there.

As frustrating as that meeting was it still piqued my curiosity. My curiosity led to this, which led to this and then this.

Looking back, I can’t believe she actually did that. Any other person would have told me to fuck off and, you know what? I would not have blamed them for it. Laura consistently went above and beyond the call. She didn’t do it for for the money, because the money was shit. She did it because she cared. She did it because she wanted to see me happy. That’s a rare fucking quality in this world.

I don’t think we’re going to work together again. Not that I wouldn’t love to have her back, because I would. But even if I do get my hours back, it feels like she’s moving on. That isn’t necessarily a bad thing, it’s just the way it is. She’ll obviously still be part of my life, a big part, she just won’t be here everyday.

* To be completely fair though, the reason she was talking about Battlestar Galactica was because I was also talking about it.


Raul Carranza is a full-time activist and a college student (when he has the nursing hours).  When he is not blogging about the evils of budget cuts and private insurance, he competes in Strongman bouts and is a tactical planner for the A-Team.

An Open Letter to Glenn Beck: I’m Disabled and I Support Assisted Suicide

Dear Glenn Beck,

I’m disabled and I think you’re hilariously wrong, as usual. Let me tell you why.

You recently did a segment on your radio show about assisted suicide. In it, you lambasted a mother that went on Dr. Phil and talked about wanting to euthanize her two mentally disabled children.

Now, I don’t know the circumstances of this case, I don’t know what kind of condition they’re in or how much they’re suffering, so I can’t comment on that situation. What I can comment on is the stand you took against assisted suicide. You said, “Suicide is never an option”. Yes, it is.

I’m in a wheelchair. I can’t breathe on my own, I can’t move and I can’t do much of anything without assistance (I’m writing this using my right thumb and a virtual keyboard). What I have to go through in my daily life is beyond your comprehension. Yes, you have a disabled daughter and yes, she faces great challenges too, but you personally have never experienced the challenges that we have.

Our medical benefits are being slashed at an alarming rate. Mine have already been cut to the point where I can’t live a life independent from my family. Everyday is a struggle to have decent life. You are telling me that, should I ever decide my quality of life was not acceptable and didn’t see it getting better, that I can’t decide to end my suffering. You are telling me that, because it offends your sensibilities, I can’t exercise the only power I have? Sorry, that just won’t fly.

You don’t get to make that decision.

You tried to frame this as the government trying to euthanize the disabled, but it’s simply not. This is about the government giving people the freedom to do what they want with their bodies. Yes, sometimes this involves decisions that you don’t agree with , but that’s freedom and that’s democracy. As long it doesn’t infringe on your rights you’re just going to have to deal with it. Life is full of tough and ugly choices. People like myself have to make them everyday. You might not agree with those choices, but to deny us that option is inhumane.


Raul Carranza is a full-time activist and a college student (when he has the nursing hours).  When he is not blogging about the evils of budget cuts and private insurance, he competes in Strongman bouts and is a tactical planner for the A-Team.