Archive for January, 2010
Among the many things I have been dreaming about it technicolor, I dreamt that I killed my patient. Not due to negligence but it was a Dr. Kevorkian moment. Very strange and incredibly emotional for me. I woke up in rare form with tears running down my face, out of breath from sobbing.
On a non- Kevorkian note, when the patient in my dream was taking his last breath he looked strickingly similar to my Grandfather. The reality of that was probably the reason that I was so upset. It was a mixture of memory, worst fear and a Greys Anatomy episode all wrapped into one dream moment.
Needless to say I woke up feeling less than rested. I just wanted to close my eyes again but I was too afraid that I would be brought back into that dream again.
Do you remember your dreams?
Im so excited! In just a couple weeks the Hubby and I will be celebrating our First Wedding Anniversary!
Some days it feels like we have been married for 10 years, especially when you think of everything we’ve done and been through. Other dayd I cant believe its already been a year.
Ive been told that the first year is the hardest, so if that was that hard part then I cant wait to see what the easy stuff is.
Our first year of marriage survived Iraq, family deaths, orders that kept us apart, traveling abroad, and a second set of orders keeping us on separate side of the US. Not to mention Nursing school.
Nursing school alone makes marriage more difficult. The time constraints that studying, clinicals and lecture cause dont leave very much time for romance or being spontaneous. But we manage.
And now here we are, almost a year in and I have to say that I am even more in love with him than I ever.
What did you do for your first anniversary?
Working in just about any type of clinical facility you are likely to run into alcoholics and those who are going through withdrawal symptoms. I never really realized how dangerous withdrawal can be. It can be deadly. Amazingly the booze can kill you but so can discontinuing drinking abruptly.
I was talking with a Nurse on the unit today about a withdrawal patient and she was telling me about it is imperitive to ask patients if they drink and how often. And if it sounds like they drink frequently to push for how long it has been since their last drink. She said that sometimes she will even warn them about the importance by telling them that they can go into seizures and die if they go into withdrawal without the proper precautions inplace.
I knew a person a few years ago who was embarassed by his drinking and therefore lied to the doctors and nurses about how long it had been since his last drink. Sadly after 10 hours in the ER for an issue unrelated to ETOH and then being admitted and on the floor it had been about 20 hours since his last drink and he had a grand Mal seizure.
This poor guy wound up in Status Epilepticus secondary to alcohol withdrawal. Status Epilepticus is a serious medical condition that can be fatal.
Long story short, it is important as nurses not to pass judgement and to find a way to gain the trust and establish a relationship quickly with your patient so that they are willing to share this type of information. Never judge a book by its cover, just because the patient isnt a 50 year old homeless man with rotten teeth and booze breath doesnt mean that they arent possible alcoholics. Ask everyone. It can save a life.
And for those non medical folks, it is very important not to lie to your Nurses and Doctors. The information that they ask for is not because they are curious, it has a valid place in preventing serious complications.
And now, I step down from my soap box.
Happy Tuesday Everyone.
So remember the other day when I said I was going to stick with the family practice doctor because I was treated so badly by the receptionist in OB?
Its amazing how quickly things change. After I made the appointment to speak with the CO of the hospital, suddenly on Monday everyone who had treated me badly (I havent had the appointment yet BTW) start calling me to see what they can do to make my experience less stressful. Seriously.
Suddenly, the complicated OB Doc (the one whose receptionist said wouldnt see me until 10 weeks) has an appointment available for me for this afternoon. Suddenly the radiology department (the same one whose tech verbally assaulted me a few weeks ago) has appointments this week to recheck Baby Bean for a heart beat, even though last week they were booked until the middle of February. Its amazing, huh?
I have to say that the stubborn part of me wanted to tell them to “shove it” and just continue with my current plan. But the responsible person who is choosing the best for me and my baby knows that I need to see the complicated OB doctor. So I conceded and accepted the appointments.
That brings me to today. This afternoon I attended my Nurse intake appointment and filled out all of my health information. I got the information, handouts and consents for the NT scan. I had nearly all my blood sucked out into 7 little vials. I was weighed, measured and told to continue doing what I am doing.
I see the complicated OB doctor on Tuesday, where I will get my physical, an ultrasound and he and I will discuss the future plans for this pregnancy, assuming that Little Bean has a heartbeat.
Now I dont mean to get too pessimistic about this, but I know that there is a chance there wont be one. I know that in my brain. But my heart prays that Little Beans heart is beating away as fast as a nearly 8 week fetus’s heart should (relatively 130-190 beats per minute (BPM)). Im praying, because Little Bean has my heart already in love with his (hers).
I had my moment today. I hope that saying it doesnt jinx it, but I had the moment where I really thought about how amazing it will be to bring home Little Bean. I thought about being a Mom to him here on Earth. I started fantasizing about nursery gear and diapering and breastfeeding and labor. Those are forbidden things. Scary things. Those things allow me to venture into creating memories with this baby that can be broken if something bad happens.
But I wont think about that today. Today I am pregnant and I love my baby. And I am thankful for the 7 weeks that I have had with Him. I am praying for another lifetime of memories, but for now I am happy with my 7 weeks and counting.
How far along? 7 weeks
Total weight gain/loss: -1.0lbs, -2.5lbs so far
Maternity clothes?: Still wearing the sleep bra, and I love one of my pairs of maternity pants. With the new weight loss I am easily wearing my old pants again. Amazing what 2lbs will do for the bloat.
Stretch marks? Still no new ones….
Sleep: Im exhausted, but cant sleep more than two hours straight because of potty breaks.
Best moment this week: This week hasnt been the best week. Im so ready to be onto week 7.
Movement: Still have alot of cramping.
Food cravings/aversions: Rather than Morning sickness, I have horrible food aversions. I will go to eat something and I can feel it in my bones not to take another bite, if I push that then I will vomit. Otherwise the only food Ive been interested in in Pineapple. I went three days eating nothing but a little pineapple.
Belly Button in or out?: In and will be for awhile.
What I miss: This week I food alot. I just couldnt eat. I wanted to eat but couldnt. God I missed food this week.
What I am looking forward to: Starting with the new doctor and consulting with the High Risk OB doctor.
Weekly Wisdom: Pregnant until proven otherwise.
Milestones: This week baby has working kidneys! And is developing a tongue and mouth. The arm and legs are budding too!
Symptoms: Exhaustion, moody, crying spells, repulsion of all things with smells, spending the day gagging, and this week on top of everything else I have a cold. So that is making me feel miserable.
On to a new week! Grow baby Grow!
So, Im coughing my lungs out. I sound like an old smoker, and since I havent smoked since that one time when I was ten Im guessing my lungs are cruddy from that. Its just the crap thats going around.
I cough a couple of times a minute, no runny nose, no other symptoms. Ive been fighting a fever on and off for the last 24 hours and trying to keep tylenol in my system. I have no energy, AT ALL.
As for eating, nada, nilche, nothing. Ive been consistently consuming between 300-500 cals per day and that is mostly fluid calories. Nothing wants to stay down, and those things that “might” stay down arent appealing to me. Im eating a ton of pineapple, craving it like you wouldnt believe!
Ive been having weird dreams about the next ultrasound. I had a dream last night about the doctor finding triplets and all had strong healthy heartbeats. The other night I had a dream that there was no heartbeat during my ultrasound. And strangely I had a dream last week about the ultrasound, and in that dream they found that there were puppies in my uterus. I know, Im a spaz.
Needless to say I am getting nervous about the ultrasound. It is scheduled for right around week 9. That is important because it is diagnostically ominous if there is no heartbeat on the 9 week ultrasound. Basically, no heartbeat then and it means end game. I hate to think that way, but I have to be serious and I have to know that it is always a possibility.
Im not feeling very positive today, can you tell? Being sick has taken it out of me.
Today I am pregnant and I love my baby. And I am pregnant until proven otherwise. Grow baby Grow!
Slurpees taste really good!!
Side note#2- slurpees hurt like hell to throw up.
There are some things that just suck beyond belief, and one of them is being sick while in Nursing school. It is so hard to stay home and take care of yourself because you really cant afford to miss any of the classes. On the other hand, you dont want to go to school and contaminate the entire class room.
I have a low grade fever, cough, runy nose, congestion, upset stomach, and I am just exhausted. I would love to stay home but I have a presentation to do today for my Ethics class. Today is my long day of classes, a really long day. I hope I can make it through.
The second part of this that is annoying is that with being pregnant, there is almost nothing that I can take (ok there is, but it doesnt work). So I have to tough it out. And Im gonna whine about it. Alot.
It was brought to my attention that I frequently use abbreviations in my postings that not everyone is familiar with. So here are a list of ones I frequently use:
CO- Commanding officer (military person in charge)
LMP- Last menstrual period
EDC- Estimated date of confinement (Due date)
DPO- Days post ovulation
HCG- Human Choriono Gonadotropin (Pregnancy hormone)
Quants- Test that measures HCG
Are there any others that I use?
School is wonderful, I am just loving clinicals so very much. I am loving that the Nurses I work with are interested in teaching and that I have been blessed with happy nurses so far.
I worked on the Renal floor the other day and I have to say that I think Dialysis is magic! Seriously magic!
Now I need to get back to studying for my Neuro exam and finish getting ready for my Ethics presentation.
Off I go.
So I promised to ellaborate on my controversial health care decision. And so I will.
If you have been reading for any length of time and recently, you may have noticed that I am pregnant and have had a miserable time with my healthcare trying to get appointments.
That being said, I needed to make a decision that would be the best for me and my anxiety level and one that would relieve some of my stress. I opted to stay in family practice and have my PCP be my OB doctor. In my hospital it is not unusual for Family practice to be used as OB care for the lower risk population. I am still planning on going to see the high risk OB for a consultation and I will express my discontent with the OB department then.
Why would I decide to do this? Well….after calling for an appointment I was soured by the support staffs general attitude. And I walked away feeling like my pregnancy had somehow incovienced the OB department. One conversation was enough for me to want to just walk away from any type of prenatal care (it was my gut reaction and not a choice I would truly make).
Here is the conversation that caused me to come to my decision:
I called OB to make my appointment (refferal is in place I just needed to schedule). I gave the receptionist my name, SSN, DOB, and EDC. She looked up my referral and said that I needed to be seen by DR. Keepmepreg (fake name obviously) and that his first available wasnt for 3 weeks. I would be nearly 9 weeks pregnant by then. I agreed to the appointment and hung up. Then it occured to me that I had seen flyers around the hospital stating that the first prenatal appointments are done at 6-8 weeks, so I called back. JoAnne (the bitchy receptionist) answered my question and confirmed that in a healthy normal pregnancy the first appointment is at 6-8 weeks, but that I would not be being seen until 9 weeks. When I asked why, since that doesnt seem to make sense to me. SHE stated “Well, lets make sure you are still pregnant by then before we give you an appointment”
I would love to say that I am exaggerating, and that all of my recent experiences with Tricare have been all in my head, but Im not. This is totally serious.
Due to all that I have been through and all the hassle and stress that this has caused I needed to make the best decision for me. One that would leave me feeling secure and stress free.
I have an appointment in 1.5 weeks with the CO (commanding officer) of the Naval Hospital to discuss the ongoing issues that have come up in just the last couple short weeks. This will also be my meeting to try and get the ultrasound tech removed from her job, a plight that I have not given up on.
So there you have it. What type of doctor did you use for your pregnancies? Family practice, OB/GYN, MidWife, Birthing center, hospital birth, or home birth?
Clinicals yesterday were fabulous. I love being a Nurse! There werent any real hiccups and I worked with a pretty darn fabulous nurse!
Funny things from yesterday.
•i was told that I looked like a “good Catholic girl” and asked to join a family and their priest in prayer. (I did not mention that I was raised LDS)
• I had an 80 year old dementia patient grope me. Apparently if you ask a patient “how they feel” you should be aware of the feeling they are
Going to demonstrate.
•Between the two run in with the Dildo cam and the Groper, I hardly notice that my husband is gone. (Just kidding, of course)
•I made a controversial decision about my healthcare. I will discuss this in a post tomorrow.
• Sleep has graced me with its presence again. So happy!
Now time to go start my patient care.
Today is the first day of clinicals, and we are back to the Med/surg clinicals. This means that I am back at the Hospital with the sick people. No more fun OB patients, No cute peds patients. People are sick, very sick.
After going through the Renal portion of the lecture and hearing about End Stage Renal Disease, I can say that it is seriously awful when there is a kidney issue. Everything goes wrong when the kidneys go bad. I really never realized how important they were/are.
Strangely, this week Sweet Pea’s kidneys are formed and in just a few weeks time they will be functional. Its just kinda weird that we were covering the Kidney during the same week that this is the milestone. Crazy, huh?
Im posting a quick cell pic of Sweet Pea, but I will post a real scanned picture later.
Today I am 6 weeks and the ultrasound showed a gestational sac and yolk sac and the start of a fetal pole. I had some quants redrawn just for safety sake and will probably have another ultrasound next week.
The reason that seeing a heartbeat is so important is because it changes the babies survival rate to 70-90% chance! For now we are right on track. Hopefully Sweet Pea continies to stay sticky!
How far along? 6 weeks
Total weight gain/loss: +0.5lb, -1.5lbs so far
Maternity clothes?: A sleep bra, and added two pairs of maternity pants. Though those are for comfort and not neccessity. The baby bloat is killer in the afternoon! Life is too short to be uncomfortable!
Stretch marks? Still no new ones….
Sleep: Now I just cant get enough sleep. It doesnt matter if I slept 6 hours or 12, I still need a nap. Making a human is hard work!
Best moment this week: Seeing something on the ultrasound. Although it wasnt for the best reason, I was so nervous that I was thrilled, nay ecstatic that there was a little gestational sac on the screen!
Movement: Way too early for baby movement, but now I have lots of twinges in the cervix area, and tons of cramping.
Food cravings/aversions: Still nothing Orange. And now the “morning sickness” has absolutely no rhyme or reason. Some mornings I have it, other times in the afternoon, sometimes all day, and then there were a few days with NONE!
Belly Button in or out? In still for many months to come!
What I miss: This week I missed my Latte a LOT! I actually cried in line at Starbucks when I ordered a decaf tea instead of my latte.
What I am looking forward to: Ultrasound today and hoping to see a heartbeat!
Weekly Wisdom: Im growing a human, thats why Im tired and its ok to take a nap.
Milestones: Baby has a gestational sac and a yolk sac!
Symptoms: Heart burn, horrible awful heart burn at all times of the day and night. General feeling of fatigue and exhaustion. Scatter brained, I guess they call this pregnancy brain.
With Renal on my brain for todays exam I have to say that my increased micturation rate has left me thinking about renal about 22 times a day (I wish I was kidding).
I can only imagine how much worse this will get once the baby gets bigger! Instead I am left thinking more seriously, like there are not enough potty breaks planned into the nursing program. We get an hourly stretch and bathroom break, but I seem to need to go every 30ish minutes. This makes things very interesting!
Studying was very difficult this weekend as my brain was somewhere else and my attention span is that of a flea. Where I used to be able to sit and study for hours at a time with no breaks, I am now only able to read for 15 minute spans of time before I have to stop for either a bathroom break, or because I have been reading the same sentence over and over again and still dont know what it says.
I read about Angiotensin II for over an hour and I am still kinda foggy. I finally understand about Acute renal failure and Chronic Renal failure. And I have a very good understanding of UTI’s and Renal Calculi. Its the dialysis that I am totally stuck, there are a couple types and I have a feeling that I could read about it for weeks and still not get it completely.
This morning I have my exam in Renal, and since it is the first exam of the quarter I imagine that the score will leave much to be imagined. I always start the terms out with low scores, always. I think it takes one test and the fear of failing to get my arse in gear. So here is to hoping that I can score an 80% or better and that the extra brain cells in my uterus are able to help me retain some of the information!
In the news today there an article about a hospital in Tennesee that is going to stop hiring tobacco users as part of their committment to health.
I am absolutely thrilled about this! There are very few things that bother me more than smokers. I despised working with the ones that smell like cigs. I was envious of their hourly smoke breaks and hated carrying their workload while they polluted the air.
How do you feel about this? Would you want your work to become smoke free?
Just wishing everyone a happy Martin Luther King Day. And hoping that today everyone can try to do one act of service.
Im not sure what act of service I will do…perhaps donate to the relief fund for Haiti. I strongly encourage everyone to do something! Share here what all you did!
Dont be embarassed if you cant see it, I had to be educated and now I see a bubble.
Last night I had some unusual bleed and cramping and was worried that something was wrong, so off to the ER we went. I am fully aware that there would be nothing that they could do if there was something wrong, but I needed to know one way or the other.
I got to the ER and was fully prepared for a long wait, but things went smoothly. After blood work and an ultrasound they sent me home as “Threatened Miscarriage”. My Hcg was 11,451. The ultrasound did show a little blood in my uterus, so I am hoping that it is nothing to be worried about.
The tech was phenomenal! She was able to visualize the gestational sac and a yolk sac. She did not see a fetal pole or heartbeat but said that it may just be a couple days early.
All in all, its just a wait and see game. Grow baby Grow. I have a follow up ultrasound (my original ultrasound) is on Wednesday. So hopefully we will have a heart beat then and my chances of this babies survival will go from 50-50 to 70-90% chance.
When was your first ultrasound? And what did you see?
Reading the news today I see the article about the federal government who is trying to make a decision about whether this group of girls who sent naked photos of themselves through text messages should be charged with distributing child pornography.
My first question is, where were the parents? The second is, what type of
Punishment did the children get from the parents?
Do I think that this is distributing child porn? No. Do I think that the government shoul be getting involved? No.
If this happened during school hours, then those girls should be expelled. I think they should have their rights to cell phones removed until they are 18. But I dont think that they should be charged with kiddie porn nor should they have to register as sex offenders.
What do you think?
Lets start with the simple facts, I have an ultasound next week on Wednesday. The reason for this ultrasound is so that I can get in to see the OB doctor early and get some additional workup to try and keep this pregnancy. Makes sense, right?
So I get a phone call from OB today, and they want to schedule me for an appointment for Feb 2 to talk with the OB doc. Thats not too bad. But then I ask, how soon do they usually start the Ob visits? And this just blows me away. The lady says that they like to have the first visit between 6-8 weeks. So I mention to her that I will be 8 weeks already by that time and then she says “Well this appointment isnt for your first OB visit, you will have to schedule that a different time, this is just a visit to discuss your history of loss.”
SO let me get this straight, I am higher risk and therefore you are going to give me an appointment LATER than the average pregnancy? WTF? What is wrong with people? Is this making any sense to anyone else?
Im trying to keep my cool, because it seems that no one seems to understand whats going on. At this point I think the only thing on my side is prayer, and thats because the doctors and staff arent doing their jobs.
Here’s to praying that the ultrasound goes well and that all this was nothing but a speed bump.
My nursing pogram has gotten really into using the hybrid classes this quarter. This all actually startedast quarter but has become predominant now.
When I started Nursing school the instructors would leisurely post paperwork on Blackboard for us to print before classes. Some professors used it, others didnt, but basically there was no consistency with even the ones who did use it.
This quarter is totally different. All the classes are hybrid, meaning lecture time in class and quizes are done at home online. On top of this they switched to a new system, Angel.
Now I found Blackboard to be unorganized and difficult to manuever. Angel seems so much better except tht it prefers firefox over the regular internet.
Does anyone else have any experience with these hybrid syle classes?
I love the online aspect! And it make me so excited to start the next leg of my degree!!
There has been no hiding the fact that for the last week I have not been able to sleep…at al! Not at naps, and definitly not at bed time. Ive tried everything. I have not had caffiene, I dont eat right before bed, im not working out before bed, I dont watch anything exciting or overly stimulating before bed either. And yet…. No sleep.
Yesterdau was the last straw, a hormonal, tired Me is not a happy or functional me. So I decided to implement a little prebed routine. On top of my already very exciting regular activities (brushing teeth, combing hair, washing face, etc) I decided to use a little lavendar lotion and put on some soothing music and I laid in bed and talked to my little orange seed for a few minutes. And… It worked!
I slept a glorious 7 hours last night! With only hourly visits to the bathroom, it was excellent!
In other news I finally got my lab tests back from last week. All negative! So I dont have antiphospholipid antibody syndrome, no clotting or bleeding disorders and nothing else that seemed to pop up as suspicious. This is all fantastic!
I also finally got my 12dpo progesterone level back at 12.89. The normal range for the first trimester is huge 9-47 is considered normal. And since I was not even 4 weeks pregnant when I got those labs I am quite impressed.
Im am a tad disapointed in my doctors staff and cant wait until I can be transferred to the OB. His RN was giving me some shady advice that made me really think that the information wasnt coming from the doctor. Maybe I am jist being overly sensitive?
5 days until the ultrasound! Grow baby grow!