Friday, May 29, 2009

How could you not love a face like this?




Some might say it's a face only a mama can love, but I disagree. Then again, I AM her mama (hoomin mama) so I'm biased.

Both the photos are kinda blurry because she doesn't sit still for very long when she's awake. Someone left a comment on a previous article and said that when he bought his second Boxer home there was non-stop play for 5 days....and that's pretty much how it's been here. When she's awake, she's either eating or playing.

I gotta tell ya, she's got me wrapped around her paw already. She's just so CUTE....she hasn't quite grown into her legs yet so she's got the clumsy, klutzy gait that just makes me giggle every time I see it, and she's interested in EVERYTHING. Everything is an adventure for her, and I love to watch her explore.

She's been pretty good about not tiddling on the rug (peed and pooped either outside, on her training pads or the tiled kitchen floor), is getting the hang of sitting on command (as long as there's a snack involved, she's all over it), is learning quickly what "NO" means and that shoes are not for chewing on, but you wanna know the absolute best part?
She's been sleeping in the crate with Grace, and she hasn't howled at night. At all. Not once. How awesome is that? It's FREAKIN' awesome, that's how awesome it is!!

SHE'S awesome. She really is.

GUILTY

http://www.rapidcityjournal.com/articles/2009/05/29/news/top/doc4a1ee36613f50546773144.txt?show_comments=true#commentdiv


It took a jury of 10 men and 2 women 2 hours to find Frank Ashley guilty of ALL of the charges leveled against him.

His daughter testified against him. Her half-sister testified against him and said she was abused by him too. His former girlfriend testified that she found his daughter in his bed three times and each time Frank tried to persuade her that she was sleepwalking or scared.

Sentencing will take place at a later date, but he's looking at 135 years....the rest of his life.

I'm glad it's over, but I will never forget how I exposed my children to him. He has shown them that monsters don't always appear monstrous and that you cannot trust anyone, not even a police officer.

Thanks, Frank - but don't let your narcissism run away with you and get all warm and fuzzy, thinking that I like you all of a sudden because I said that. I detest you and everything about you. It pisses me off that you breathe the same air as me, and it pisses me off even more that you called my home BEFORE your trial, telling my husband "I love you, bro" and saying how you miss us, but when it became obvious that we were not getting involved and had no useful information for your defence, you failed to call again. That's you all over, Francis. A manipulator who uses people for what he wants and when he has no use for them, he moves on.

By the way, now that you're convicted, I can hang the title of 'Pedophile' on you...because that's what you are. You garnered sexual gratification from your DAUGHTERS, Frank. That, pal, qualifies you to be called 'pedophile' and 'child molester' and even 'sick fuck'. Get used to hearing those words, because where you're going you're gonna hear them a lot.....hopefully as some big corn fed fucker with an anger problem and a hair trigger is shoving his cock down your throat or up your ass to show you EXACTLY how it feels to be someone else's sexual plaything.

I hate you for what you did, and I hate you for how you make me feel about you.

I'm glad it's over.

Wednesday, May 27, 2009

Ruby Tuesday

A little while ago, Noodle Dawg had to go live with another family. She had this digging fetish which the gub'mint wasn't going to like, and as she got older she got more and more territorial. She snapped at me one day, and I can't have that.....because if she's going to snap at me, the hand that feeds and loves her, she'll snap at other people. Like my kids. Or other people's kids. I couldn't live with myself if that happened. So, she went off to live with other people who have no children and lots of room to run.

I was sad. Noods was my pal, my compadre...she licked my tears when I cried and kept me company when I was recuperating from surgery. Grace did too, but she's Urbaner's dawg, not mine.

My 40th birthday is coming up soon, and Urbaner asked me what I wanted. I said a dawg, preferably a Boxer. We've had such a good experience with Grace and really like the breed, so I said I wanted a puppy for my b'day.

I searched and searched the classified ads for a breeder and couldn't find many that I thought were a) reasonably priced and b) NOT a puppy mill. I'm sorry, but I'm not paying $500 plus for a pet and I don't want a puppy from a bitch who's whelped 3 times in 2 years and who doesn't ever get to run on grass and just be a dawg for a while.

I had all but given up hope....until this morning. I saw an ad in the local paper for pups priced very reasonably, but being as it was 6am I thought it best to wait to call. As I was washing my hair this morning I mentioned to Urbaner that "wouldn't it be cool if I call this number and it's the same breeder we got Grace from?"

I called at 8am, apologized for the hour, and asked where they were located. When she said "Marissa, IL" I knew that it was indeed the same breeder. We arranged to meet in a couple of hours, and off I went to look at her pups.

Within 3 seconds of walking in the door Cupid's arrow had struck and I knew I would be leaving with a dawg. The one I chose is a brindle female out of the same dam as Grace (different sire). She is 12 weeks old and she is not only cute as all get out, she's got a great temperament too. This was the breeder's last litter of pups, so we were lucky to get this dawg. I paid the money, and loaded up the pup in the car. 2 miles down the street she hurled into the center console cup holder, but that's ok. I cleaned it up - no harm done. I know now that she doesn't do well in cars.

I thought that Daisy Mae was a good name for a Boxer until I saw her. She just doesn't look like a Daisy, you know? On the way out there, I was listening to the Rolling Stones 'Ruby Tuesday', and to me, she just looked like a Ruby. Add to that the fact that she's my 40th birthday gift, and that the 40th wedding anniversary is traditionally the Ruby anniversary....well, I think you can see my train of thought there. So, Ruby is her name. Ruby Tuesday will be part of her AKC kennel name, but I still have to figure the rest of it out.

I haven't been able to get a decent photo of her yet, but I'll work on that this evening and will post one tomorrow for sure. She's adorable, y'all. Really. And, she's a good girl too. She's getting along great with her sister (literally) and she sure does love her food. It's a good thing I believe in putting puppies on a schedule and not leaving food down all day every day, or I think she'd devour an entire bag of chow in pretty short order.

So welcome, Ruby Tuesday NinjaMedic. Please try not to howl tonight...not too much, anyway.

How my garden grows!

I did some planting a couple of weeks ago, and I have to say that I am incredibly pleased with the results.

First, we have the plant I am most proud of: my tomato!


It's a patio container hybrid (I have named it Eloise. Yes, I name my plants. No, I don't know why), and it produces small cherry fruit. As you can sort of see, there's a little green tomato on the bush there, and hiding behind it is another, smaller one. There are flowers all over the top of the plant, so I'm expecting a nice crop of love apples this year.

Next, we have FTS's eggplant that she has named 'Bernado':
She said that choosing it was akin to adopting a child: you have to make sure you can provide the plant with the conditions it needs in thrive. This one needs a fair amount of sunlight, and our patio is the perfect place for that. It gets sun in the morning and late afternoon/evening, but is shaded when the sun is at it's harshest in the middle of the day. I don't know why FTS is growing an eggplant because she doesn't really care for them, but I'll eat them if she doesn't.

Here we have Enid the sweet pepper plant:
Yes, that's a soda bottle in her pot with her. It's my DIY drip irrigation system. You take an empty plastic bottle with a screw top on it (that's important) and poke a few holes in the bottom with a pin (I used a safety pin I heated with a lighter). Fill the bottle with water - yes, the water will run out the holes your poked in the bottom pretty swiftly at first, but when you screw the lid on it'll slow down to a drip. Dig a shallow hole in the soil next to your plant, and put the bottle hole side down in the dirt. Replace the dirt and voila! You've got yourself a drip irrigation system. I fill mine in the morning and sometimes in the evening too, depending on how hot it's been during the day.

Here we have Bizzy Lizzy the Impatiens:

They were just little green plants with no flowers or buds when I planted them in this hanging basket. As you can see, they're blooming now! I call them Bizzy Lizzy because that's what my dad always called them when I was a kid. They were one of his favorite flowers in plant in the yard.

Last but by no means least, we have my fuschia (I have another but it's not blooming yet. I'll post a photo of it when it's got a few flowers):


Flossie is a red and pink fuschia who is hanging from a shepherds crook in the back yard. The gub'mint doesn't like us to dig up the yard, so all of my plants are in containers - besides, I think that fuschias look better in hanging baskets. It gives them a chance to really show off their flowers. As you can see, Flossie has her own drip irrigation system too...and it's working well for her!

I have a family of swallows who have set up camp by the front door and are busily building a nest and dive bombing anyone who dares to use that entrance, so we're all coming in through the garage or the back door. Yeah, it's inconvienient for now, but seeing the birds build and eventually have babies right outside our living room? It's SO going to be worth it!

Tuesday, May 26, 2009

Unexpected

One of my patients died, and it's thrown me for a little bit of a loop.

But NM, I hear you say, you work in a rehab facility, a long term care facility, and for a hospice. You expect your patients to die!

And you're right, I DO expect them to die.....but of all the people I've cared for recently, this person was NOT on my radar as 'death imminent' or even 'death in the next few days'. They were independent and cared for themselves; they just needed a little help here and there with medications and appliances and the like. They were with it mentally and I had more than a few interesting conversations with them. I came to regard them more as a friend than someone I was being paid to take care of.

They were prior military and retired at the rank my husband just attained. That stings a little.

One day when I was taking care of some things for them they looked at me and said "why are you here?". I paused for a moment, not sure of what to say, and I think they saw the confusion on my face and said "I mean, what are you doing wasting yourself like this? You're smarter than this; I know it and you know it. Don't waste a whole lot more time, young lady. Life's too short to waste time."

They were right. A few days later, they were dead.

I read about their death in the newspaper. It's a habit of mine to read the obituaries every few days to see who has departed this life. Sometimes seeing a name I recognize is a cause for me to rejoice - not in a 'Yay! That asshole is dead!' way, but in a 'I'm so glad their pain has come to an end' way. Not this time, though. Apparently I wailed 'OH NO!!!!!!!!!!!NO!!!!!!" loud enough to cause Urbaner to come downstairs to see what was wrong.

Sometimes I think death takes the wrong person with him when he makes a visit. There are many more people in that facility who are suffering terribly, either because they're in pain or are incapacitated in some way and who just don't want to be here anymore. Why death decided to take my friend with him and not one of those other people, I don't know. Why my friend's heart quit beating but someone else's, someone who is far sicker than they ever were continues to beat, I don't know. I don't know why some people who are horribly damaged manage to live whilst others who are seemingly fine and relatively healthy just up and die.....I just don't know.

I DO know that my friend was a fine person and that I am sad they are gone. I don't do well at funerals, but theirs is one that I would consider attending.

Goodbye, Telly. You will be missed, and remembered fondly.

Sunday, May 24, 2009

Time to reassess

I had another doctor's appointment on Wednesday, and saw the occupational therapist on Thursday.

My biceps tendon is really very thickened and inflammed, and certain motions cause it to roll right out of it's groove (which creates a sick snapping sound and really kinda hurts). I have an MRI scheduled in a couple of weeks to see just how bad the damage is, and I've been warned I might be looking at another surgery.

I also have supraspinatus tendinopathy because I've been compensating, so I'm having bi-weekly ionophoresis treatments with corticosteroids to treat that.

The OT asked me what I did for a living and then said I may want to consider another career choice.

I think she's right. Clearly, EMS isn't going to work for me long term. Not because I don't like it, not because I'm not good at it, and not because I'm not enthusiastic about it.....but the car accident and the resulting injuries are making it difficult for me to continue on this career path.

Right now, I'm banned from lifting anything with my left arm. I have some range of motion exercises to do so I won't end up with a frozen shoulder and I'm allowed to do some light resistance work, but I can't lift anything. The bicepitus tendon is already weakened and the fear is that lifting too much will cause a complete rupture.....which would mean another surgery for sure.

I'm going to have to quit my job this week. I don't want to, but I don't have much of a choice. I don't know if my arm is ever going to be up to my lifting people day in and day out, whether I have surgery or not.

I don't want to NOT be in medicine, so my idea about going into the PA program has become more important than ever.

I love my job, and being an EMT is a big part of my identity. Not being able to do that anymore is quite a blow and is going to take some time to get used to....

Wednesday, May 20, 2009

Part II

The nurse standing next to me murmured 'dang, girl! you like yo job much? But you know whut? I'm glad you said it. Needed to be said. That mofo cusses at us all the dang time and I'm sick of it...'

"What the hell is going on in here?!" The PA from fast track had heard the doc shouting and cussing and had come to investigate.

"NM told the doc off and he left" said the charge nurse.

*remember that the patient is still undermedicated and in the brief moments between seizure activity she's trying to fight the ET tube*

"You what? What the fuck are you thinking?!"

"I didn't tell him off, exactly" I retorted "He was cussing at the nurses about this kid being tachy and telling them they were fucking stupid and couldn't take a pulse right, but he'd given her Atropine....I just reminded him of that and told him I had my hand on her carotid and that the pulse rate IS that high."

"...and he left you in the lurch here?"

"Uh huh. He also refused to retract her tube even though I told him I couldn't hear breath sounds on the left. I think it's in her right mainstem...it would explain the O2 sats. But hey, I'm just an EMT....what do I know?!"

"Gimme your 'scope" the PA said. "I'll listen"

He listened to her left chest for a few seconds, ripped the scope out of his ears and said "retract that damn tube a coupla inches; it's in too far. Why is she still seizing? How much Versed has she had? What kind of clusterfuck code is this, anyway? Christ.....how far out is that chopper?"

Right on cue we heard the distinctive whub-whub of the medevac helicopter from Big City Pediatric Hospital. A couple of moments later the crew walked in with their gurney and bags. They got report from the charge nurse, checked over their patient, MEDICATED HER ADEQUATELY, and off they went. The nurses, PA and I were left in a room littered with the detritus of a code....gauze pads, tegaderm backings, empty packages from the sterile equipment. I stripped off my gloves and wondered aloud what I was supposed to do now.

"I guess I'll start clean.."

"Was that the chopper I heard?" The doc appeared in the doorway. Everyone looked at their shoes, me included.

"Yeah," said the PA. "She's gone off with them.....and that ET tube WAS in too far. I had to retract it."

"Oh.....NM, I need you to come with me. Now, please."

My heart was in my shoes again as I followed him down the hallway to the doctor's lounge, and when he asked me to close the door behind me I made a mental note of thelocation of the nearest trashcan. Nausea was already washing over me and I was sure I'd hurl at some point.

He rubbed his face with his hands and sighed. "I hate working on kids, y'know. I mean I HATE it. There's always this added drama and.....well, I detest it. You know, I could have you fired for what you said to me..."

I had gone in there with the intention of being contrite and apologetic, but what I perceived to be a somewhat veiled threat caused a fire of fury in my belly.

"Excuse me? For reminding you that you gave a medication that can induce tachycardia and for sticking up for the nurses?"

"You questioned my authority!"

"No, I reminded you of something I thought you could have forgotten, and I did so because I was concerned for my patient. I was as polite as possible; I didn't cuss - unlike you, who dropped the 'F' bomb gawd knows how many times and told the skilled nurses they're stupid and dumb! You know, I came in here thinking I was going to apologize and be all demure and repentent, but you know what? I changed my mind. I'm not sorry for what I said, not at all. I had the welfare of OUR patient in mind, and I didn't do anything wrong.....so if you're gonna fire me or get me fired, just fucking do it, dude. I know I did the right thing and I'll be able to sleep at night. Don't threaten me, just do it."

"Are you done, little Miss KNOW-IT-ALL-EMT?" he raised his voice and scowled......and then he smiled.

"I'm not going to fire you or have you fired. I'm not even going to write you up. I can't fault you for caring about your patient.....if I'm honest with myself I can't even fault you for saying what you said. I didn't - I DON'T - like it, but I can't condem you for it. Don't think for a second that I'm condoning it, though, because I'm not. You got lucky this time....now get back out there and clean that shit up, and act like I scolded you good whilst you're doing it. I have a reputation as a crotchety old bastard in this ER and I'm not about to let you fuck that up, too."

"Whatever. I suppose you expect me to thank you?"

"No, I expect you to go do your job. I like that you're not afraid of me, NM, but don't let that attitude get out of hand. It'll get you into bigger trouble than you can handle one of these days. Now GO!"

When I got back to the trauma room the mess was all but cleaned up. I grabbed a pair of gloves and the disinfectant spray and started spraying down the stretcher.

"So....do you still have a job? A license??" The charge nurse asked.

"Barely" I said. "I really don't want to talk about it. That guy....."

"...is an ass" someone else said. "A prime grade A ass. Nobody likes him...I told my husband that if I ever got seriously hurt or was really ill he's to take me somewheres else if that ass is working here. I wouldn't trust him to work on my worst enemy. Girl, we're about done here. Go on and get yourself a soda and take a break for a bit. You deserve it....and thanks for making a stand like that. Nobody else is gonna say it, but I will."


I don't make a habit out of back talking and second guessing physicians. I realize that my medical education is rudimentary at best when compared to theirs and I respect what they've done to get to where they are. However, just like every other profession, there are a few doctors who make me wonder if they went through medical school and internship by proxy; if they didn't pay someone else to do the work for them because their medical knowledge is so horribly bad. Those are the docs that I struggle to keep my mouth shut around. Luckily I don't encounter them too often.

As for our patient that night....they spent almost a week in the hospital under the neurologist's care. It took a little tweaking to get their epilepsy under control, but with the help of a couple of medications they made a full recovery. Thank gawd for that.

Tuesday, May 19, 2009

Eejit doctor

There is a mindset among some people, particularly older members of society, that doctors are demigods.

Their word is law, their instructions divine. They are not to be doubted or crossed, no matter how assinine or impractical their advice is.

I am not one of those people. I have seen enough physicians at work to understand that they are human and that some are better than others...and some are, to be blunt, farkin eejits. Usually the eejits are weeded out during residency and aren't practicing in my particular field, but some slip through the cracks and could even be working in an ER near you (Dr Bloody Gloves, I'm thinking of you in particular here).

It was my great misfortune to see one of those eejits in action.

I was working Inner City Ghetto ER. We had just had an almost-pulseless and apneic 2 year old with a complete airway obstruction choppered out to Big City Pediatric Hospital (removed the chunk of food he was choking on and resussitated him successfully, thankyouverymuch). We had cleaned up the trauma room and were standing at the nurses station dissecting the events when I hear a "SOMEBODY SAVE MY BAYBEEEE!" and turn to see a very large man carrying a toddle who was clearly in status epilepticus. He shoved her off into my arms, and I turned and headed into the trauma room with her as fast as my little feet would let me.

She was 18 months old, he said. No previous medical problems, he said. Not medicated for anything, he said. Not allergic to anything. My heart in my shoes and 'not again' running through my head, I laid her down on the gurney and started taking her clothes off. The nurses were around me in an instant, telling me to take her clothes off and help start an IV.

The doctor in the ER that night was not educated in the US or the UK.... and he was not known for his bedside manner. He had made it known that he was not comfortable working on kids....yet here we were, working on the second pediatric near-code in a row. It just wasn't his night, I guess.

He came in the room, rolling his eyes, and ordered RSI drugs....in amounts appropriate for a 6 month old. One of the nurses asked if he wanted Versed first instead, and he said no. Another nurse had broken out an ET tube and the accompanying Broslow tape and mentioned that the appropriate dosing for a child her size was quite a bit higher than what he had ordered. The doc just grunted and said that he didn't go to medical school to be told by some piece of paper how much to give and repeated the dosages he wanted to be given. All this time, the child is still seizing.

He assembled the laryngoscope, looked me in the eye and told me to hold her head whilst he intubated. The nurse pushed the RSI drugs in,but instead of the patient becoming still she carried right on seizing. I glanced up at the charge nurse as if to say 'is this guy fucking serious???' and she just nodded at me and shrugged her shoulders. So, I tilted her head and did my best to hold it still whilst the doc shoved the 'scope down her throat.

Once he was in, he asked me to check for breath sounds. I listened and heard them on the right - but they were absent on the left, and reported those findings to the doc.

"It's in right, you just don't know how to listen" he said.

"no, really, I'm no.....owwwww!!" I began, but shut up quickly when the nurse next to me delivered a swift kick to my shin.

"Umm...she's still seizing. DO you want to give Versed? Ativan? Valium?" the charge nurse timidly piped up.

"Who's the doctor here?" he snapped. "You think I need you to tell me my job??"

There was silence in the room.

"Give her some Versed..." and he walked out.

"How much?" asked the nurse.

"I don't know, however much you think. Perhaps you can consult your Oracle tape..." and he waved his hand dismissively before sitting down at the nurse's station.

The nurse rolled her eyes, drew up the meds and pushed them into one of the two IV's we had running. The seizing didn't stop, but it did slow significantly. However, her O2 sats were at 89% and dropping and her pulse rate was slowing. The nurse reported this to the doc, who ordered Atropine.

Once the Atropine was in, her pulse rate came up - to over 200 bpm's. Her sats were still in the low 90's, but she was now tachycardic - and dangerously so. The nurse yelled out to the doc that she was tachy, and he grunted back that the monitors were wrong. I was at her head, bagging, so I placed 2 fingers or her carotid and counted her pulse rate manually. The doc asked for a pulse rate again, and the nurse told him what it was - over 200.

When he heard, he got pissed. He stood up, face red and creased with anger, and told the nurses he didn't know what they were talking about and that they were all fucking wrong and too fucking stupid to know what they were doing, that it couldn't be over 200 with the O2 sats she had.

There was silence in the room, save for the beeping of the cardiac monitor and the hiss as I squeezed the Ambu-bag. Every nurse looked down at their shoes, silent.....

...but I wasn't quiet. I had had enough. Enough of seeing this child seize, enough of seeing her sats drop because he wouldn't let anyone retract her tube, enough of his 'I am the DOCTOR, don't you DARE question me" attitude...just enough. Of him. Of everything that was going on this this kid.

"it's NOT wrong; I have my hand on her carotid and it IS that high. You gave her Atropine, remember??!!!"

To use the cliche, if looks could've killed I'd have been dead before I hit the floor. His face turned purple, he gritted his teeth, and I heard a murmered "oh shit....I hope you don't like your license much'' from someone in the room.

"Oh really, Miss Know-It-All? Well, how about you run the fucking show seeing as you know so much? I'm done here".....and he walked away down the hallway.


To be continued....

Saturday, May 16, 2009

Doggy Blog

Hi, dis is Gracie. I never wroted on dis compooter before, but I seed mai sister Noodle do it all the time so I figgered I cud do it too.

Mai Momma sez I am a gud gurl, the bestest gurl in the whole wurld. I shore hope I am. I know that mai sister gets yelled at a whole lot cuz she is a nawty dawg. She tiddles on the rug and poops in the laundry room where she finks nobody will notice. My Big Guy wented in dere the other day and he trod rite in sum poop Noods had done in there. He wuz not happee. Noods had to go to her room and she didn't liek dat either.

One of Mai Kids gotten sum fings dey call 'Rats". I fink that dey gotted them for me to watch, cuz they shore are interesting. They hav long tails and I am qwite jellus of dem cuz I don't gots no tail. I just gots a little nub. I don't fink I was borned dat way, but I doan know whut happened to mai tail. Praps it got shutted in the door or sumfing. Dat happened to Mai Tall Girl, she shutted her fumb in da car door and Mai Momma had to take her to dis place called a mergency rum. When she camed back she had her fumb all bandaged up and Mai Momma sed she had 'a partial avulsion of the tip of her thumb and a distal fracture'. I doan reely know whut that meens, but I fink it really hurted cuz Tall Girl shore wuz maeking a lot of noise when it happened. She wuz quiet when she camed back and she acted reel funny, like Mai Momma or The Big Guy do when they have been drinking beers. Tehn she frewed up on da kitshun floor. It smelled reel interesting so me an Noods went over there to smell it. Noods wondered if it wud taste as good as it smelled, so she stucked her tung in it. Mai Momma yelled at her and sed 'geddaway from that, dog! That's gross!' and she putted me and Noods in our room so she cud kleen it up. The Tall Girl is better nao. I like that. I still doan know whut happened to mai tail.

Every morning I have a routine. I have to lick mai kids so I can see how their flavur is. I can tell if they are not feeling gud frum their flavur. They doan like it much and they say they just took a shower and doan want to smell liek dawg so I gots to stop it. I doan liek showers. Or baffs. Mai Momma and Tall Girl make me get baffs alldatime. Mai Momma sez 'Gracie, you smell dog-y. You need a baff' wich I doan unnderstand cuz I AM a dawg and I'm spposed to smell dawgy. Whut else am I spposed to smell like?

Mai peoples are coming downstairs, so I gots to get off her nao. It was reel nice talking to yew and Im gunna maek shore I come back and talk sum more.

Love,

Gracie.

Friday, May 15, 2009

I wish I'd never had it done.

I'm starting to wish I'd never had my shoulder capsule reconstructed.

I had the surgery because my shoulder dislocated and subluxated frequently. I did some research before I made the decision and thought I was well informed, but looking back on it I think I should have asked more questions.

The first clue I got about it being a pain of recovery was when the anesthesiologist mentioned something about shoulder surgeries being incredibly painful as he was placing an interscalene block in my neck. The next clue I got was when the nerve block started wearing off and the pain set in.

It was a difficult recovery to say the least, and I have been left with two other medical conditions as a result of the surgery and recovery: a duodenal ulcer and now bicipital tendinitis.

My arm has hurt on and off since the surgery. The surgeon said it was normal and that it would go away. It didn't, and since I've been working things have gotten worse. My elbow started aching last week and I started to ask for help lifting patients because it hurt so bad to do it myself and I was afraid I'd drop them. This morning, flexing my biceps brought tears to my eyes.

So, I saw my doctor. She said I have bicipital tendinitis and that the arthrogram report pre-surgery mentioned tendinopathy, so I've had it for a while. I'm off work for the immediate future and have to see the occupational therapist next Thursday. Because of the ulcer I cannot take ANY NSAIDs or steroids, so I'm on Ultram and tylenol. I don't know when I can go back to work - or if I can go back at all. This tends to be a chronic problem, apparently. I don't know when it's going to get better and I sure as hell don't want to do anything to make it worse.


I don't like being out of work; I really enjoy it and I enjoy the paychecks that accompany it. I can't go back to school full time until Urbie sews on MSgt, so that leaves me with nothing to do but sit at home and play housewife. Some of you might think that's a great deal, but I've been doing that since September of last year and I am really, really tired of it - not to mention bored and frustrated.

This kind of sucks. Had I known then what I know now I don't know that I'd have had the surgery. It's caused more problems than it's solved.

Thursday, May 14, 2009

At what point?

I care for some patients who are where they are (in a rehab facility/nursing home) soley because of their weight. They have a multitude of medical problems and are unable to do much of anything for themselves. I've been wondering at what point does a person say to themselves "Hmm, my weight is the cause of all of this. Maybe I should do something about it...?"

Is it when you get breathless walking from your car to the grocery store - where you have to use a motorized cart because you can't cope with walking around the aisles?

When you are on disability because you can't work?

When you have to live downstairs in your own home because you can't walk up the stairs?

Or when you can't fit into a seat at the movie theater?

How about having to buy 2 seats on an airplane because you can't fit into one?

How about when your doc tells you you have diabetes?

When your legs are constantly purple and ulcerated - and it's not because of the diabetes?

Or when your joints fail you because the human skeleton is only designed to carry so much weight and you have surpassed it's max capacity about 100lbs ago?

Is it when you have to sleep with a CPAP machine because your fat collapses your airway when you sleep?

When you can't lie flat on your back because your own weight impairs your breathing?

When you have to use a wheelchair - an OVERSIZED wheelchair because walking stresses your heart out too much?

When you have to use a motorized wheelchair because pushing yourself around in a regular chair stresses your heart too much?

When it takes 3 or 4 nurses to get you rolled over in your bed?

When those nurses have to use a hydraulic lift to move you from bed to chair, chair to commode, commode to bed etc?

When you can't use a bedpan because you'll crush it flat?

When your skin is so stretched that it cannot maintain it's integrity and it splits, and you leak lymophatic fluid all over yourself and your bed?

When you have constant raging fungal infection in some of your flesh folds because your lack of mobility makes it nearly impossible to keep them dry?

Perhaps losing coins, combs, and even a TV remote in those flesh folds is the motivation?

Or does being in your 40's but having to live in a facility with 80 and 90 year olds who have demetia because you simply cannot care for yourself at home?

When?


When does your size become enough of a problem for you to make you want to do something about it?

A couple of years ago, my weight got out of control. I never broke 200lbs, but I was up there in the high 180's. I decided that I needed to do something about it when I found myself avoiding going upstairs in my own home because doing so made me breathless. That was what did it for me.

I started watching what I eat, being more active and generally trying to live a little healthier. It took me 18 months, but I lost over 50lbs. It wasn't easy, there was a lot of denying myself things that I really liked and times when I went to bed hungry.

When I tell that story to people, the most common question I am immediately asked is "Did you have the surgery?" followed by "Oh, you must've used Alli" when I tell them no, I didn't have any procedures. They're equally disappointed when I tell them no, no Alli or Hydroxycut or anything (as an aside, the latest Alli commercial pisses me off. The woman touting tells people they can eat what they like and still lose weight as long as they take that pill, which isn't the way to lose the weight healthily and more importantly, KEEP it off). I did it the hard way; I ate less and exercised more. Less calories in + more calories out = weight loss.

I'll ask again: at what point does your weight become enough of a problem/interference in your life that you decide you MUST do something about it?

He did it!

My husband tested for Master Sgt in February this year. He got the results today..

...he made it!
These are the stripes he'll be wearing!

Congratulations, babe. I love you, and I'm incredibly proud of you. This has been a hell of a month for you; first you made Raven and now you're joining the ranks of the Senior NCO.

OOh, we're eligible to move house now, too! We can apply to go live in senior NCO housing, away from the hooligans and fucking 'tards on this street! Even better!

We had talked about it a couple of days ago, and this promotion is going to mean a new way of life for us. Along with the extra stripe comes a pay raise - a significant one - which means that we'll be able to afford me going back to school full time. It might mean that my dream of being a PA will become a reality.

I am SO incredibly proud of you, babe. Really. You're awesome, and I love you!

Wednesday, May 13, 2009

I want what I want and I want it NOW.

Last night at work was a bit rough.

I had 10 patients I was responsible for, some of whom were able bodied and just needed a little assistance. However, I had a few people who are significantly impaired both physically and mentally and I try to make them my priority.

Most of my able bodied people are really very patient and understanding, but a couple of them want what they want when they want it and they want it NOW, and if I don't get to them NOW they get upset. Last night was one of those nights when that attitude seemed prevalent. I had to explain two of three times that I cannot and will not leave someone who can't change or bathe themselves laying in a soiled bed or half naked directly before/after a shower so that I can adjust the fan in their room or turn the light off - things that they are perfectly capable of doing themselves, btw.

When I'm in a patient's room, not matter what their level of function, I make that patient my priority, no matter how much time it takes. I may not look like I'm doing much when I'm standing next to someone's bed, holding their hands, stroking their hair or just talking to them, but I AM doing something. One of my patients last night Sundowns pretty badly, so I made sure to take a little time getting her settled and off to sleep instead of just throwing her in bed and running off to the next patient. Another patient came and interrupted me two or three times, which upset the woman I was caring for and put me right back at square one when it came to getting her settled.

When I was taking care of the patient who had interrupted me, I tried to explain my philosophy about making the patient a priority.

"I'm in your room now, so YOU are my priority."

"Well, I should be your priority ALL the time. That's what you're here for, to look after me."

"That's partially true, yes, but I also look after 9 other people. Sometimes I have to prioritize and sometimes there are going to be more important things for me to do than adjust your fan or turn your light off. If you had soiled your bed, wouldn't you want me to come take care of you?"

"I don't wet my bed! I never have! If I did, you'd better be in here to change me, I'm not gonna lie in a wet bed! That's wrong!"

"Exactly. Now do you understand a little better?"

"I have rights, you know!"

"Yes, you do, and so does every other patient in this facility."

"well, they shouldn't. Some of them don't even know what day it is..."

I could see that this conversation was going nowhere fast, so I took care of what the patient needed and asked them if there was anything else I could help them with. They said no, so I left the room and went to prepare one of my more impaired patients for bed. Not 30 seconds after I left the room, the call light went on. I answered it immediately.

"How can I help you?"

"Oh, I don't want anything. I just wanted to see how fast you'd come. I'm glad that you've learned that I am to be the priority here. That's good. You can go now."


Gah.

Tuesday, May 12, 2009

Venting

*This is just me venting. I may not actually mean any of the things I say; I'm just saying them to get them off my chest. Please bear that in mind*

Being a military spouse, I've learned to spend holidays, anniversaries and birthdays alone. It usually doesn't bother me and I don't make a big deal out of it.

However, this year is different. I turn 40 in a few weeks. That's a milestone for me...it's a big deal. I had planned to go out with Urbaner, eat a nice dinner and have more than a few drinks to celebrate. I'd asked for the day off work so we could make this plan a reality.

Urbie called this morning to tell me he's leaving ON my birthday for a week or so, coming back for a few days, then leaving again at the very start of July for over 3 weeks.

*sigh*

I want to tell you I'm not upset, but I can't. I am upset. The one birthday I really wanted him to be here for, and he's going to be gone....not to mention that he's going to be gone pretty much the whole month after that.

Part of Numbah Two's issues was his father being gone. He's really close to his dad and takes him leaving, even if it's only for a few days, pretty hard. He's just coming out of a crisis situation, and here his dad is leaving AGAIN.....I'm worried about that, and about just how the fuck I'm going to handle it. I'm tough and I can handle a lot of stuff, but I am also human and have a breaking point.

I'm starting to feel like a single parent again, and I don't like it. I know that I was aware of all of this when I got married to an active duty military guy, but....I've sacrificed dreams and plans for the last 15 years and not really batted an eyelid over it, but this time....I'm starting to feel resentful, and I hate that. I hate that I feel that way, because the sane, rational part of me tells me that this is what Urbaner does for a living, it's what pays the majority of our bills and puts food on the table and a roof over our heads and that I should just put up and shut up. And, for the vast majority of our marriage and his career, I have. I do. I make do, I compensate, I put things off, I play mom AND dad, I try to make up for him not being here, I do everything I can to provide my family with as normal, stable a life as possible. It's just.....well, this birthday is the first time we've planned anything for me this far in advance, and it really hurts that we're going to have to cancel plans now. Coming on the heels of a shitty mother's day, I'm feeling neglected and unloved and generally left out and not cared about.

When is it going to be my turn? When am I going to get a fair shake? When can I be selfish?

Monday, May 11, 2009

Future?

I've been thinking and talking to Urbaner about what I should do for a career in the future.

I had thought that finishing nursing school was what I wanted to do, but the more I think about it, the more I realize that whilst it might be good for a short term goal, I don't think I'd be happy in the long term. I LOVE EMS, but physically it's a taxing job - as is nursing - and given that I'm already a broken toy, I don't know how long my career span would be. But I’m sure I’d choose nursing over being a medical coder, even though the medical coding salary isn’t too shabby

So, I'm researching PA programs around here. I know of two, and they're both BSc programs rather than post-grad. The AF has started a program where the active duty member can share his GI bill benefits with his spouse and children, so I'm thinking I should take advantage of that.

When I was a teenager I wanted to go to medical school and started out my college career with that in mind. However, life got in the way and medical school fell by the wayside. Could I still do it? Probably. I wouldn't be practicing medicine until I was 50-ish, though. Do I really want to spend that long in school, and can we afford it? Again, probably, but I don't know that I want to. I think that being a PA is a better fit for me.

If anyone reading this has any advice for me, please don't hesitate to leave me a comment or email me. I'll take all the help I can get!

Sunday, May 10, 2009

Numbah Two saves the day

Remember in my last post I was saying how hand made things from my kids mean more to me than any store bought gift, and how I was hurt and disappointed that the eldest and littlest didn't do anything for me for Mother's Day?

Well, Numbah Two saved the day for me.

I went to visit him in the hospital today - he's doing wonderfully, btw. I can see real progression in him and his mood and attitude. Anyway, I digress - he had gone to the nurses station to ask for some construction paper and crayons and he had made me a card. I have his permission to blog it, so...

On the front there is a big ol' daisy with 'aint it perty?!' written underneath it. On the inside left, it says "it matters not how strait the gate, how charged with punishments the scroll, I am the master of my fate, I am the captain of my soul" and he's written "So TRUE!!" underneath it. It's the last stanza from 'Invictus', my favorite poem. I'm awed that he remembered it.

On the right side, he's written something that brings me to tears each time I look at it. It says:
"This may not mean much, but even though we aren't together all of the time, and I may not act like I care, I would be lost without you. The whole family would be. It just needs to be said once in a while. Happy Mothers Day. Every boy needs his mother, Love Numbah Two.
Post Script: Thank you for taking time out of your life to pay attention to me.
Post Post Script:I mean that!"

And, on the back he's written a disclaimer: "This card was meant to be 100% serious. How anyone else takes it is simply a matter of opinion and is entirely up to them".

My gawd, I love that kid. I'm so glad he's still here and is getting better.

That simple handmade card has made my day.

So much for Mother's Day

I don't expect much on Mother's Day. I've never been a big fan of brunches and I know from experience that lunches on M Day are crazy, so I never ask to be taken out to eat. I'm happier staying at home, to be honest.

I don't want my kids to wait on me hand and foot, and I don't want them to spend a fortune on me.

I really don't expect much.

But this year....I'm so disappointed.

I got a card that they left on the kitchen counter for 3 days. Neither of the two that are home wished me a happy Mother's Day or volunteered to make me a cup of coffee...nothing. They got up and proceeded to play XBox. LL wished me a Happy Mother's Day after his dad prompted him, but FTS didn't say anything.

I thought that perhaps they had made plans for something later in the day, but FTS is going to her BF's house and LL is hanging out with his friends, so clearly they're not planning anything.

I told them a few days ago that I keep all of the pictures and cards that they made for me for M Day when they were little, that those things are more meaningful to me than any store bought card or gift.

We have markers, crayons, paints, paper, glue, glitter...all kinds of art supplies.

They didn't make me anything.

I'm so disappointed - and hurt, too.

I don't expect much, but I expected more than this.

Thursday, May 7, 2009

Highs and Lows

I talked with my kid's psychiatrist this morning.

We have a tentative diagnosis of Bipolar Disorder. He's going to add a mood stabilizing medication in addition to the increased dosage of Celexa and we're going to see what happens.

I should have seen this coming. Really. When Numbah Two was little, we had him assessed for Oppositional Defiant Disorder...which can be the way BD manifests itself in little kids. He's always been moody and prone to swings from one end of the spectrum to the other: either vivacious, the life of the party, always wanting to be out with friends and able to talk to everyone or cranky, downright spiteful, agressive, isolated and pessimistic. I know that some of that is normal teenage behaviour, but NT seems to go through phases.


When I went to see him last night, he was very 'up'...he wouldn't stop talking, couldn't be interrupted, bounced from one subject to another without really focusing on any one thing, had all these ideas about what he was going to do when he got out of the hospital. He said he hasn't been able to sleep for 4 or so days, and the staff reported that yes, he was very agitated all day and had had difficulty sleeping the night before. Compared to how he was when he was admitted for the first time - pessemistic, feeling isolated, sad, talking about suicide, cutting himself, using drugs and alcohol - well, it's the other extreme. Obviously, there's some stress and anxiety involved because of where he is, but I've seen this kid stressed out before and this behaviour is different. Very different.

The more I think about his childhood, his behaviour throughout it and our family history, the more I think that yeah, Bipolar disorder fits all the symptoms he's exhibiting (and has exhibited).
I can cope with whatever the diagnosis is; with whatever his disorder is. I'm not afraid anymore, I just want my child to be stable and I'll do whatever I need to do to help him achieve that. I say 'help him' because I honestly think that this is something he has to do for himself. I can't do it for him - I WON'T do it for him. He's going to have to learn to be accountable for his condition and his behaviour, I'm not going to let him go down the 'I've got bipolar disorder/depression so I'm not responsible for what I do' road. I'll help him as much as I can, but...I'm not going to do all the work for him.

I know it's not all my fault, too. I know that it's not the way he was raised...this is an organic brain chemistry thing; it's nature rather than nurture. That takes some of the sting out, but it still smarts. It still hurts.

Tuesday, May 5, 2009

*insert appropriate title here*

I readmitted my son to the adolescent psych unit again today.

I can sleep better knowing that he's safe, but I feel like a failure as a parent. Logically, I know that there is an organic cause for his issues that isn't my fault, but there is this wretched part of me that whispers in my ear "What the fuck is wrong with you? What is it in your DNA that made him this way? What did you do wrong? What could you have done better? What DIDN'T you do for him?"

I think that he's going to have his medication tweaked, and I now that he's not going to be in there for a short stay this time. I warned the staff this time to not let him bullshit them this time.

I'm going back to work next week. I'd taken some time off to try and deal with this stuff, but I need some normality in my life....so I'm going back to work on Monday. I also went to my littlest 'ling's baseball practice this evening. I'm going again Thursday....I'm the beer source this week. I NEED things like that, I NEED the mundane and the routine. If I don't have those things, I feel like I'm simply lurching from one crisis to another. That's not a good thing - not now and not any time, really.

I want to tell you that it doesn't hurt. I can't. It does. It hurts like a motherfucker. But, I'm handling it.

He's safe, and he's getting help. I find great comfort in that.

Invictus

Out of the night that covers me
Black as the pit from pole to pole
I thank whatever gods may be
For my unconquerable soul.

In the fell clutch of circumstance
I have not winced nor cried aloud
Under the bludgeonings of chance
My head is bloody, but unbow'd

Beyond this place of wrath and tears
Looms but the horror of the shade
And yet the menace of the years
Finds, and shall find me, unafraid.

It matters not how strait the gate
How charged with punishments the scroll
I am the Master of my fate
I am the Captain of my soul.

'Invictus', W.E. Henley.

I will not give in. I will not crumble. I will not succumb.

I am invictus.

Wait, let me gaze into my crystal ball....

I took my son to his annual dental exam yesterday. His regular dentist left for pastures new, so I had to make him an appointment with a new guy.

We went to his office and were given paperwork to fill out. One of the forms was an agreement that we (the parents) would pay $25 per every 15 minutes of appointment missed that we gave less than 48 hours notice for.

I didn't sign it. I wanted to talk to the receptionist about it. Apparently she was busy, because the dentist himself came out.

"I have a question about this 'agreement'" I said "I have a slight issue with it; I think it unrealistic for me to consistently be able to give you 48 hours notice that my child will not be able to make their appointment...I mean, I can't predict when they're going to be ill"

"In that case, you need a doctor's note excusing them" he said.

"Excuse me? That's even more unrealistic. I'm not going to take them to the doctor every time they've got a virus...even the school doesn't require me to do that. And I'm a little concerned that you want sick kids in here spreading their bacteria and viruses all over the place so that other people get infected."

"If they're not sick enough to go to the doctor, they're not sick enough to miss my appointment"

"Ok, I have a REAL issue with that. I'm in the medical profession and I know a little bit about basic healthcare..."

"Oh, really?" he sneered " and what it is that you do, exactly..?"

"I'm an EMT and a nursing student, in addition to being a mom of three teenagers..."

"...oh...." he seemed a little crestfallen "...well, then you know about false calls. You get called out for people who aren't ill and they still have to pay."

"No, I don't deal with anything like that. I deal with people who receive treatment from me, regardless of whether their illness is 'false' or not...and I am telling you that I can't always give you 48 hours notice, that it's not realistic, and tha..."

"..But that doesn't happen often, now does it? Not very freq..."

"Actually, he almost didn't make it today because he had a doctor's appointment this morning" Urbaner interjected from across the waiting room "Tell you what, just give us the paperwork back and we'll go somewhere else"

He gave us all the forms back EXCEPT the insurance claim form I'd already signed. So, I called the insurance company this morning to warn them what he'd done. There is no reason to keep that claim form unless he intends on submitting a claim for services we DID NOT receive, and I'm not about to let that happen. I also passed on my concerns about his having kids who are ill come into his office and spread their viral wealth, so to speak.

I can understand his reasoning. He's probably been burned in the past and has felt the need to protect himself....but I also need to protect myself, my bank account and my kids, and I did that by refusing to sign his ridiculous agreement.

12 hours notice, absolutely. 24, even. But 48? COME ON. I may be a parent and a EMT, but I'm not psychic.

Sunday, May 3, 2009

New Ink

Mine:




His:


The infinity symbol (lemniscate) on his wrist is an exact copy of one I have on my left deltoid, and we both got the same Roman numerals: I . XXI. MCMXCIV . It's the date we got married.

Did it hurt? Yeah. Was it bad? No, not really BAD...it was an interesting sensation, though. Urbaner said the same thing about the lemniscate on his wrist. Would I do it again? Oh yeah. In fact....

....I have been talking for many years about getting a whole sleeve on the left. I got one at the top, now I have one at the bottom. Now all I have to do is fill in the blank....right? ;-)

Dear Anon,

Dear Anonymous Commenter,

Thank you SO much or stopping by my little blog and leaving a comment! I very much appreciate your readership!

I imagine that you thought you were being very clever by NOT using an ID and leaving your somewhat inflammatory and altogether ill-informed comment under an 'anonymous' tag. However, I must inform you that you are very, very wrong about that.

You probably don't realize it, but I have a stat tracker on my blog. That tracker tells me who came here, where they came from, and even gives me their ISP addy. I put it on here for a reason; I wanted to encourage people who don't have ID's to leave comments.....much like you did. I want to encourage freedom of speech, no matter how fucked up, retarded, moronic or inflammatory that speech may be. However, because this is MY blog and it's sorta like MY house, I have a couple of other little tools that nobody else knows about that let me see who's coming from where and what they're doing here.

I don't check my stat tracker very often. I don't HAVE to.

Nobody that comes here is truly anonymous. Ever. Please try to remember that the next time you leave a comment.

Oh, and one more thing: You were NOT there. I was. I was in the middle of it for years. I am NOT relying on what the media is reporting...in fact, I'll let you into a secret: I AM THE SOURCE OF HALF OF WHAT YOU READ IN THE NEWSPAPERS ABOUT THOSE EVENTS. Yeah, I'm a media informant. I was confidential, but there went that cover.

I also have access to information that the media does NOT, and no, I haven't passed on that information. It'll all come out at trial, and that's good enough for me.
See how pathetic your comment is now? I sure hope so.

When I said one more thing, I lied...but this truly IS the last thing: anyone who believes that a TRULY innocent person who has NO incriminating evidence against them can be extradited from one state to another and then held in a county jail for 10 MONTHS whilst awaiting trial is either incredibly misinformed or a fucking 'tard.

The truth will out, and that process will start in approximately 3 weeks.

Love,

NinjaMedic.

Friday, May 1, 2009

Coming home

My Phoenix Raven will be home tonight. I already have butterflies in my tummy and still have a few hours to go yet before I leave to go get him.

I haven't seen him in three weeks. That's not very long, comparatively, but a lot of stuff has happened since he left. It feels like a lifetime.

Some things have changed for the worse - deaths of family members, for example, but some things have changed for the better. Like my love for him. Being apart from someone you love can make you acutely aware of just how important they are to you; how you take for granted the daily interactions you have with them. I know from experience that we tend to idolize the people we love when we are separated from them; we put them on a pedestal and only remember the good things. Living with them again can be difficult because we are forced to see every aspect of their personality, not just the great stuff we love. However, after 15 years and many, many deployments, TDY's and missions, I've come to understand how reunions work.

They're hard work. It doesn't matter how long we've been apart for, whether it's days or over a year (did that once. That was REALLY sucky), reunions still require effort on both our parts.

So, I'm preparing myself. I talked to him this morning, and he's preparing himself. I've tried really hard not to buckle under pressure recently, but the cracks are starting to show and I have a horrible feeling that sometime over the next few days I'm going to have a meltdown. The best thing I can do is recognize it for what it is - a normal reaction to some pretty serious stress - and work through it when it happens. Urbaner is feeling the same way; he's had to swallow all the emotion he's felt about things that have happened in order to focus on the task at hand. Neither of us has been in a place where we could release the things we were feeling.

So, today is not only reunion day, it's the start of a healing process for both of us.