Bright Spot, Black Note

Tumors and races

2009-10-05T13:06:00.001-04:00

My 5k is on Saturday! Less than a week away! Although I still have a long way to go, I see my body being transformed by running.

Wait.

Scratch that qualifier, "although I still have a long way to go". Adina has practically spent our whole relationship trying to get me to say nice things about myself without throwing in a backhanded insult in the same breath. There's no need to bring myself down here. I guess when I do that I want people to know that I don't think I am immodest or delusional. Like if I say my body is transforming, maybe somebody will think that I believe I look like Uta Pippig, the winner of the Boston Marathon, who incidentally crapped herself during the race. HAHAHAHAHAHA!!!!! Yep, take a moment to laugh.

So, anyway.

I have a new "primary" patient at work. That means that whenever I work I have him. We've been taking on more patients lately who have residual disease or active disease, and my patient D's tumor keeps growing even while he is getting his Busulfan prep (a chemo to kill the bone marrow). It's actively strangling him. He is only 27 years old. I am hopeful that when he gets the Cytoxan part of his prep, which is another chemo with strong anti-cancer properties, he will feel better quickly. His father is his bone marrow donor, which means that once D gets the transplant, his dad's immune system will be fighting against D's aggressive tumor forever. It's like the ultimate gift. I imagine little dad immune cells dressed up like knights at the Renaissance Faire with swords, and they are all lined up ready to charge at these big globby cancer cells. What more could you ask for when you look at your sick child, when most parents would feel helpless, and know that a part of you will live inside your child, circulate in their bloodstream, and defend against sickness and pain. It is so beautiful.

-- Posted from my iPhone

Completion

2009-09-18T11:54:00.000-04:00

I also considered titling this post "Hallelujah", but mostly because I was listening to that song by Leonard Cohen. Both titles speak to the same feeling that I am carrying at the moment. There are tears behind my heart about seeing my family this week. A contemplative, quiet exuberance fills me and, oops, guess those tears are more in front than I realized. So much healing has happened and I do feel like a whole person now. My mom and stepdad actually enjoy spending time with Adina and me, and the simple act of laughing with them, all of us laughing and enjoying each others' company, did more to bond us than any serious conversation could have.

Reuniting with my sister has ignited tinder in me that I was not aware of. I feel so much love for her!!! I keep thinking of fun things we could do together.
I feel like mama hen in a way, which maybe I don't have the right to feel, but I just wanna wuv her and hug her and be weird with her forever and ever!

-- Posted from my iPhone

I have a past and a family!

2009-09-15T12:05:00.003-04:00

What to say. I met my family for the first time in 11 years this weekend. I was expecting a great deal of tension and weirdness but actually things have so far melted into place. Adina and I have so far spent two days with them and we are headed into a third day today for a latke extravaganza. I had not cried until Sunday, when my sister Danika and I had a lengthy walk'n'talk. I think it was weirdest for me to see her, since we had had no contact with each other since I left. She said she did not remember me really, which was hard to hear. I like her though. She seems reserved, although I totally get the need to keep yourself reserved in the presence of a dominating personality. I definitely was reserved at home, and I think that's why I went a little crazy at the end of high school and the start of college (see: smoking pot, pumpkin burning, burnt peep curtain, etc.). I am really excited to get to know her better and I hope she wants to learn things about me as well.

I have had countless dreams about meeting her over the past decade, most of which involve a variation on that awful theme of having to go back to high school to complete some class or another that I forgot to take. In those dreams, I disrupt classroom after classroom looking for her, but since I don't know what she looks like, I cannot find her. Two months ago, I never would have imagined that Adina and I would be picking her up from school and hanging out, all with the blessing of mom and Pete. I feel like I am floating in a dream.

I can't wait to post pictures of some of Pete's artwork that he gave Adina and me. It is really awesome and I hope he starts to sell it on Etsy.com.

Anyone want to help me determine the difference between a creed and a credo? Thanks!

-- Posted from my iPhone

A pox upon me

2009-09-02T19:58:00.001-04:00

I feel diseased. My fellow staff members and even our resident back away in fear and disgust. My leprosy has made me an outcast in the only place I belong.

Actually, my cultures are negative so far, but my patient today had shingles and her culture didn't come back positive until 10 days out. I prolly wouldn't care except I have a new yuckster on my arm and I'd like to know if I should be out of work again. I called my hookup in derm and she said it didn't sound like anything to worry about.

My patient today is intubated and she asked me for some funny hospital stories/drama/gossip. The best I could come up with was to tell her about The Don, who was her "doctor" for a while. She was cracking up and told me that she did not like him because he kept waking her up at zero:dark:thirty and "manhandling" her, so she told him never to touch her again. HA! And yet, she said, he was still her doctor but would just talk to her from the door and never examine her. Niiiiiice.

Picture of my cat.

-- Post From My iPhone

Back from the dead

2009-08-28T11:04:00.000-04:00

Well I am at the doctors office again, having my pox looked at. The past 5 times or so that I have been here I have had to wait for over an hour to be seen. My doctor is a friend of mine and is also an old family friend, but Adina says I should switch over to her doctor since she never has to wait. Is it wrong to switch doctors because of administrative problems? Take my poll and let me know what you think.

-- Post From My iPhone

Meatwad

2009-01-24T17:44:00.003-05:00

Gawsh it has been ages since I blogged. I am at work, of course. I have this patient who has HIV-related lymphoma and is the gayest little thing I have seen in a while. And he is the kind of guy that you see last because you know he will keep you in there for as long as you'll take. I mean, not once has he said that he is done with me today. I have always had to find an out, usually after he says something crazy and inappropriate and I laugh, back away, and say, "that's it, I'm out!" And when I say, ok, I gotta go see my other patients, which is a lie because my trainee has the other patients, he says, "where you goin'?" He dragged me in there to watch cartoons with him earlier.

He spent a long time talking about God today, and how God had delivered him from himself and all this stuff, and he got all teary-eyed with joy about God and I wish that stuff like that permeated me more. It is nice to have a patient that leaves you with a smile and a positive feeling, even if he is a PITA.

Untitled no. 2

2008-11-24T22:15:00.005-05:00

I don't know where to start. What I can say is that I find myself being bored with stability. I mean, my life circumstances are in flux, there is a great deal of uncertainty about my medium and long term future, and so on. But my internal life has been relatively calm for about a month or so, maybe more. I find that I yearn for the ups and downs that I am used to. I am not accustomed to this kind of predictability. It scares me sometimes. I am definitely able to have a range of emotion, but sometimes I worry that I am not feeling enough.

Part of this blog project is compiling information about my feelings and experiences so that I can write a book. I also am working on getting these feelings and experiences into words, sentences, and complete thoughts. Often I find it difficult to do so. I remember the experience of writing when I was younger; my best work was borne of turbulence, I often would write a lot in a storm of passion and rarely edited what I produced. Of course, I would guess that teenage and early adult writing in a many cases comes from a place of emotional drama. Now when I want to put down a thought, I have to first get over this wall of vapor that siphons my thoughts and feelings away the moment I decide to give them voice. That sometimes happens when I just start writing stuff. Often I can't cross that wall.

Poll Addendum

2008-10-26T16:45:00.002-04:00

The operational definition of "first clear memory" is a memory that you can "see" in your mind. The image must be vivid enough to be describable. It can be a very short period of time, like a clear memory of your mother's face the first time she yelled at you or something.

From the trailer park to Congress

2008-10-24T12:00:00.001-04:00

First, I will say one thing and get it out of the way...

If you are using google reader or something to read my blog, please click on my page because I am getting few responses to my polls and the small sample size is skewing my results. Also I like to get hits on my page counter.

Anyway,

As an absentee voter, I had the privilege of looking up the candidates as I was voting. It was excellent because in TN they do not list third-party candidates by their party names, they are all listed as independent, which I did not know. Because I could look everyone up, I was able to vote Green for one office.

In the process of researching the candidates, I came across a man running as an independent who calls himself Jon "Trailer Park" Jackson.

Only in Tennessee, baby. Would you ever vote for a fringe candidate?

Shamless copy from another blog

2008-10-23T13:14:00.002-04:00

I owe this question to The Dutchess Of Kickball.

Let's say you found a genie in a bottle and instead of the typical three wishes you were granted only two, but with a stipulation. You could have anything you wanted completely selfish no matter what, but only if your other wish was for something completely selfless. What would you wish for? And of course, no wishing for more wishes.

Random picture of the day:

Silly tag thing

2008-10-20T11:47:00.002-04:00

I normally hate this kind of thing but since there are only 5 things and I get to pick them out, I suppose I can manage the effort.

This is a virtual game of tag. Beth tagged me, and these are the instructions:

1-Link to your tagger and list the rules

2-List 5 random facts about yourself

3-Tag 5 people

4-If you’re tagged, play along and pass it on!

1. When I was a kid I was OBSESSED with those pencils with the little toppers, not the kind you can take off but the kind that are attached and the pencils would have a little saying on them. Like I had some with those little felt teddy bears like this little guy or like these . I totally had the globe one and the merry-go-round one. :)

2. My dad and I lived in a little loft area of a friend's storage shed for a while when I was younger.

3. I don't usually shower every day.

4. I hate scrimshaw, any mealy or sweet apple, and the smell of fresh dog turd.

5. I am obsessed with batteries and tape. I always think we are running out and need more.

I decided just now I ain't gonna tag anyone. SO THERE!! But if you want to do it, make a comment to this entry and link to your blog.

Untitled no. 1

2008-10-11T20:47:00.010-04:00

Happy thing number one: For my friends who ran in the Baltimore marathon today, congratulations. And I am glad that the sloppy fortune that I thought befell you did not happen. You know of what I speak.

Happy #2: I got to leave work at quarter to 5 today! Booie picked me up and we ran errands, and bought some stuff from the Linens N' Things store closing sale, and got ice cream, all by the time I would just be leaving work.

Happy #3: You guys, this is why I am a nurse. Adina and I were eating at Atwaters this afternoon, and this balding but cute-ish young-ish looking guy came up to our table, and said, "excuse me". He looked familiar to me... but I was also wary of him too, cuz weirdos always want something from me. He said, "I'm Brian xxx, I was a patient of yours at Johns Hopkins a few years ago." I looked at him in complete shock; here was one of those patients that really stuck with me in my heart when I cared for him three years ago. I took care of him quite frequently, and I remember even having dreams about being his nurse at home. He had Burkitts Lymphoma, an extremely rapid-growing cancer that can doube in size in a matter of days. Some Burkitts patients can even see the tumors growing before them. It takes a LOT of high-dose chemo to attain shrinkage, which initially can be pretty easy but in the long run it often relapses and the effects of the chemo itself can be lethal.

It is the curse of an inpatient nurse to not know what happens to your patients when they leave. We honestly thought Brian was going to die on our unit. But he left, and except for some occasional readmissions early on, we did not know what happened to him. But here he was, looking like a normal guy, good coloring, filled out, smiling, eating with his wife and 2 small children. He said, "You saved my life." He called to his kids and pointed to me and said, "This is one the the people that saved daddy's life when daddy was very sick." My heart fell to the floor. He told me that he was completely cured, no evidence of disease after 3 years.

Cure is a word we almost never hear on my floor. Disease control, hopefully. Prolongation of life, if we are lucky. But rarely is the word cure used, because it is rarely found. When he went back to his table, I looked at Adina and started to get teary. I made a real difference in Brian's life. I connected with him at the time, and he remembers me years later as someone who saved his life. He paid for our dinner, and said, "This and a million dollars and maybe we'll be even." I gave him a big hug.

I truly believe that I was meant to get out of work early and go to Atwaters and see him. Sometimes it is easy to forget that people do get through this crap. I felt to proud to do what I do and to be who I am.

Which brings me to my last point:

Please register to become a marrow donor with the National Marrow Donor Program. They will send you a cheek swab kit that you send back. You could save a life, too. Click the link below to get more information.

Late breaking blog post

2008-10-08T16:43:00.003-04:00

Adina went to take a shower after I was done, and noticed that there were these strange white things that seemed to be moving around. They were LARVAE and OMG I really thought that they came from my body until I saw one drop out of the bathroom fan onto the floor. I feel like I am going to vomit. Fortunately we have bug spray in the house.

WOMAN vs. MACHINE

2008-10-08T12:18:00.006-04:00

Is a light fixture a machine, you ask? Adina asked the same question. Fortunately for me, I had the complete set of the Charlie Brown Encyclopedias, where I learned that a machine is any device that reduces the amount of force needed to perform work. So, there. (Don't give me any B.S. about this, Andrew, just roll with it.) It took me many hours to get this D-A-M-N light fixture working; it was a seemingly simple task of putting a new cord up and attaching a new socket. The cord would not fit through the threaded nipple (yes, that is what it is called) and it took about an hour just to figure this out, when Adina suggested I strip the whole cord and replace the insulation with a thin layer of electrical tape. Hm, not the safest thing, but heck, it worked.

When will I be declared an American hero? Dammit!

The brightest spot ever

2008-10-06T09:25:00.005-04:00

The spot in MY HEART!! hahaha. You know what I would really enjoy right now? For pharmacy to send me my chemo on time, for once. Cuz then I can, you know, give it on time. Which is nice for everyone.

The patient that I had four days in a row last week, my critical patient, died the morning after I left. Yup. One of my coworkers joked that he died as a result of poor nursing care the previous four days. Ha. The strange thing is, he was doing so well... I had weaned him off his Versed drip, he was on trach collar most of the day, etc. (For you non-nurses out there, those are very good things). And the nurse told me today that he just suddenly dropped his heart rate and they could never bring him back! Totally strange. It is kinda a blessing though, I mean, he was never gonna get better, probably. So might as well go quickly.

Does this seem crass to you non-nurses out there? I feel like nobody but a nurse could understand a nurse's attitude toward death.

I just found out that my little 20 year old patient with sickle cell anemia lost his graft- basically what that means is that he had a bone marrow transplant and the transplant didn't take- his body took it over and his sickle cell anemia is back. He doesn't even have any family in the room. I went in there and spent a little bit of time with him, asked him if he wanted to talk to me about it. Surprisingly enough, he removed his headphones and a small tear ran down his brown little cheek. "I don't know what is going to happen to me," he mumbled. I wish I had something to say to him, but what can you say? I told him it was OK to grieve over this; he has experienced a great loss and it's OK to let yourself cry about it. It's all part of the dirt and grime of life that I am lucky to be a part of.

PILLOW!!!

2008-10-03T23:32:00.003-04:00

Like, OMG! I finished this pillow for my uncle's wedding present... uh... his wedding was a few months ago... but you have a year to give a gift, right? Right? Anyway, I have been working on this thing for a LAWNG time and it feels good to see the end product. Anyone who is on Ravelry can see this pattern and my other fine works under my name: gratefulsned.

And, I have recently become aware that one of my readers has made a comment on this blog while actively toileting. Yes, that's right. Which one of you is it? Let the suspicions swirl until you, my readers, become a maddened mob with murder on your minds. God I love alliteration.

Myopic

2008-09-30T09:45:00.004-04:00

There is an Ansel Adams photograph of a really cool-looking tree in my patient's room. I rarely ever notice the artwork in my patient's rooms. Isn't it strange how one can become oblivious to one's surroundings? I mean, this photo is right next to my drip titration guideline sheet and has been here since the building was built. And yet, I am only really looking at it for the first time.

This photo was taken at Yosemite. I have always wanted to go there. There are so many places in America that I would like to visit. This is part of the appeal of travel nursing: you can make a ton of dough and then take a few months off to do whatever. Also, of course, you could travel somewhere cool and work there. I really need to spend more time in the West. I have never been to the Northwest or the Rockies. Look at those mountains. I am enjoying looking at this photo and thinking about traveling while I am in this isolated hospital setting.

Hip-Hop gospel

2008-09-29T10:53:00.006-04:00

I am sitting in my patient's room; he is intubated and sedated, but his family brought in a bunch of CDs of modern gospel music and I like to play music or movies for my patients. The CD I have playing right now is WOW gospel 2007. Now, when I think of gospel, I think, you know, like traditional gospel. But this is just like stuff you hear on hip-hop and R&B stations, and you can barely tell what they are saying, and when you can, it is so loosely based on gospel themes that I would be hard-pressed to identify it as Christ-centered music. It reminds me a lot of the new Christian rock music, with lyrics like "I just want to get close to you, oooohh yeah I don't want to let you go" and stuff. I guess, though, that is you like that style of music and you are gonna listen to it anyway, you might as well be absorbing somewhat positive themes.

I find that in my old age, I am getting more conservative about stuff, especially regarding clothing for young girls. I think it is totally gross the way young girls are dressing like mini-whores. Granted, I used to bring an alternate outfit in my school bag and change at my friend's house before loading on the bus, and change back when I got off the bus. But I hardly think I dressed whorish. I am sure I made some awful clothing choices but not in that regard. I remember I had a couple outfits that I would rotate all the time, including a black above-the-knee skirt (scandalous) and this grey tunic top that really accentuated the bosoms, but was unattractive in every other way.

Man... my 10-year reunion is coming up. I am considering going, but am alse terrified of the thought. Plus, is it worth it to drive up to Cape Cod and spend all that dough for a probably-lame reunion at the conference hall at the Holiday Inn in Hyannis? James, are you going?

1

2008-09-27T03:09:00.003-04:00

So tonight I have 4 patients, which is a busy assignment for my floor. One of my young patients has recurrent disease progression despite bone marrow transplant, and is pretty darn sick. Her oncologist came in to see her and her family today, and told her that there is nothing else we can do to help her. I was there during the discussion- I watched her face as she began to realize that what he is telling her is that she is going to die, and it was heartbreaking. It is the kind of critical life-moment that only a few people experience with the patient, and the way it is handled can affect how well the patient accepts their mortality. I was really impressed with the way the doctor handled the conversation; he kneeled down by her bed and was stroking her face as she was crying. It was truly beautiful.

I have this fascination/curiosity about what it feels like to have the certainty that you are going to die, either imminently or in the near future. Sometimes I try to put myself in that mindset to see what it might feel like. The part that scares me most about the prospect of dying is the potential pain involved. Sure, the doctors would like to tell you that your pain will be controlled, but sometimes it is not. I also have this fear that maybe, just maybe, there is an afterlife... and maybe it doesn't look so good for me. Fortunately, these are all distant questions for me and I don't have to deal with them in my life right now.

Her family told her that she would never be alone... then left for the night! Ha ha. So I went in there a while ago because I had some extra time, and I asked her if she wanted some company. She said yes, and I held her hand and sat with her for 30 minutes. She fell asleep, and I prayed, in the way I do which isn't really verbal prayer, and who knows what that is about but at least I was able to just BE with her, and it seemed to be a comfort to her. I felt really lucky to have the unique opportunity to just be a presence with my patient. It made me smile.

Breakfast at 2:51 PM

2008-09-26T14:50:00.005-04:00

I get mighty tired of rotating days and nights. How on earth am I supposed to keep myself in a normal rhythm psychologically when I am forcing my body to operate in the most arrhythmical of conditions? I just woke up, by the way... I am eating cereal. Now I get to go to a doctor's appointment, then... go to work again!!!

Opening Act

2008-09-26T05:02:00.000-04:00

You can expect the following things from this blog:

1. Honesty about many aspects of my internal and external life.
2. Periods of absence and presence.
3. Odd pictures of my head, and probably of the cats too.

I have decided to restart a blog because of the roaring global demand that I increase my online presence. Because I belong to many sites, I thought I would have a better chance of increasing my presence if I do it in the laziest way possible, meaning, streamline all my blog interests into one blog. Hey, you gotta know yourself.

I would like to start by saying that there is no way I will ever get this first pair of socks knitted if I can't find my size 2 DPNs in time for work tomorrow. Don't you wish you got paid to knit? I tried knitting them on the toothpicks Andrew and Chad gave me but they got all splintery and are also the wrong size.

Anyway, wanted to get this show started, but I have to chart and tape report now. Ah, the trials of a night shift nurse.