Tuesday, October 6, 2009

Sick or Faking?

Did you ever fake being sick so you could stay home from school?

Did you pass down this wonderful trait to your own children?

When I was a kid, I would plot this out the night before. I would lay in bed and plan the whole decietful lie that would get me out of school.

First it would be a headache, however I knew that this would not be good enough, then my stomach would hurt. I would pull out my best sick, whinny voice and complain of the pounding in my head and the cramping in my belly. Mom would then put her hand on my forehead and check for a fever.

"Nope, cool as a cucumber. Now get up and get dressed you have to go to school today. ", She would say.

Ok, so this led me to more plotting. I had to figure out how to fake a fever. But until I got that figured out, I would work my magic at school. By 3rd period, I would make myself late to class, I would pinch my cheeks to make them red, splash a little water on my face and tell the teacher I was late because I was in the bathroom thowing up. She would send me to the nurse where I would get to rest for about 45 minutes. I would continue to complain of achy skin, upset stomach and such. She would take my temperature. . . NORMAL!!! Back to class it was for me.

Then one day I had it figured out. When I complained to mom before school, I would still be in bed. I had a waterbed, WITH a heater!!! I would get my hands really warm and rub my face making it a little warm too. When she came in to get me up, yep. . . no more "cool as a cucumber" for me. Off she would go to get the thermometer. She would put it in my mouth, you remember those old mercury thermometers, and then she'd go back to the bathroom to finish getting ready for work. While she was gone I would put the thermometer against the warm mattress of the water bed. Up it would go. But that didn't get it warm enough to get me out of school. So, I would rub it really fast against the blanket on my bed. Yep, 100.2! That should do it.

Next thing I know she is on the phone to the school and I am snug in my nice warm bed. After she would leave for work, I would take my blanket and pillow and find my spot on the couch. . . for the rest of the day!!!!

This rubbing the thermometer trick worked really good to get me out of class when there were missed assignments or tests I wasn't ready for. I would use the same technique as above to get me out of class and in the nurses office. She would have me lay on one of the beds in her office. Lucky for me there were curtains around each bed. After she had given me the thermometer, I would rub it against my jeans. Sure enough, my dad was there to pick me up within the half hour.

I will never forget the day it backfired. I was in my bed, trying with all my might to be sick. I had to get the themometer up there quick because mom was running late. I rubbed and rubbed really fast. Then I heard her coming. I didn't have time to check it. I quickly put it back into my mouth just before she got to my bedroom door. When she checked it it was 104!!!!

Yep, you guessed it. . . I went to school. BUSTED!!!!

What did you do to get out of school???

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Monday, October 5, 2009

14 and pregant. . .

When I was doing my OB clinical rotation while still in nursing school, I remember this 14 year old girl coming into the ER after giving birth to a very premature baby boy. She delivered this baby at home in the toilet.

She told the doctors she didn't know she was pregnant. She was dieting because she couldn't figure out why she was gaining weight. Then she was hurting pretty bad and went to the bathroom. Low and behold, she lost all that weight she had gained, right into the toilet!!!

She ended up being fine, the baby went to the NICU and never went home with his 14 year old mother. Instead he went home with a foster family after living in the hospital for about a month. He had no one except for the nursing staff and doctors for the first month of his life. What happened to him after that I will never know. I just have to trust that he is still alive, happy and healthy and with a forever family who loves him as their own.

What concerns me is that this 14 year old girl was pregnant and her mother didn't have a clue. What are we teaching our kids these days? Are we talking to them or are they learning by our actions? How can things like this happen?

I know it is not all that uncommon anymore for a young girl this age to be pregnant but are we doing anything to stop it from happening? These kids aren't ready to be raising kids. They can't even take care of themselves let alone be responsible for another life. Who is teaching them to respect themselves? Where was this baby's daddy?

My heart breaks each time I think of this situation. It has been 6 years since this incident happened. Where is this baby now? He would be in school already. Does he know someone loves him?

My heart breaks that we don't pay enough attention to our children to let them be children. . . to teach them what is right. . . .to give them what they need and deserve.


Saturday, October 3, 2009

Are you educated?

She was 25 years old came into the ER with a bad cough and trouble breathing. By the time I had seen her she had been in the hospital already for about 2 weeks.

She had a bad case of pneumonia. However it was not just pneumonia she had. While inpatient they discovered she was not just HIV+, she had AIDS. This was very difficult for her to believe, as she stated she was NOT a drug user and had not had sex in 6 years. Not since her son was born.

Nonetheless, it was in fact AIDS. She was angry, almost hateful even. She was not very nice to the staff, and would not even talk to the social services people who were trying to help her. She was convinced it was not AIDS. There must be some mistake. She was sure she didn't have what they said she had. She demanded those words not even be said in her precense.

After being in the hospital a total of about a month and a half and after many tests, many new medications, many procedures, she went home. She went home with home health to care for her. She went home to spend what time she had left with her son, who during this hospital stay also learned that he was HIV+ as well.

How can a person live that long and look so frail and sickly and never learn the fate that is set before them. Did she not go to the doctor? Did she not have the financial means to get there? Did they not test her while she was pregnant? There are so many questions here.

Where did our healthcare system fail this family? Will it ever get better?

What can we do to ensure that each person has the health care they need and the education that is so important?

I am seeing this all too often. People come into the ER for what they think is something so simple. However they don't have a family doctor because they can't afford one. They come to the ER and probably don't even have the money to pay that bill and the hospital ends up writing it off. Then while they are in our ER, they learn that because of lack of healthcare, they now have a very serious illness. One that will now take their lives because they did not have proper preventative care. Now they have to live what life they have left with AIDS, lung cancer, breast cancer, an inoperable brain tumor. . . .

Our country as a whole needs to be focusing on education. People need educated!!! It is not just the middle or lower income people who are having this issue. It is also the higher income people. Those who just think they will live forever. Don't have time, don't want to spend the money to go to the doctor. Or maybe they have the attitude that, "It won't happen to me".

Let me assure you, it can happen to any of us at any time. These terminal illnesses do not discriminate. They don't care who you are, who your parents are, how much money you have or how important you think your life is. If you don't take care of yourself and have regular check ups with your doctor you could be that person that finds yourself in the ER with what you think is an easy fix, just to learn that it's not that easy.

Ladies, go see your OB at least once a year. Teach your daughters about annual exams, and how to do a self breast exam.

Gentleman, have your yearly check ups as well. You are not exempt. Teach your sons how to do testicular exams. Did you know that men can get breast cancer too??

When you become of age for colonoscopies and mammograms, GET THEM!!! Early detection is the key!!!

If you have questions, make an appointment to see your doctor. Don't let these things go!! Love yourself and your family enough to take care of your body.

There is a young man who will now grow up without his mother. There is a mother, who will miss out on the majority of her son's life. She will probably not live to even see his 8th birthday. Could this have been changed if she had been having regular annual check ups with her doctor? Who knows. There would have at least been a better chance of them catching it earlier and prolonging her life.

Educate yourself and the ones you love!!!


Tuesday, September 1, 2009

Ovarian Cancer Awareness Month

In honor of September being Ovarian Cancer Awareness month, I thought I would do a little education. All information below can be found here.

Ovarian cancer is the 5th leading cause of cancer-related deaths in women ages 35-74. It is estimated that 1 out of 58 women will develop ovarian cancer during her lifetime.

If diagnosed and treated early, and the cancer is confined to the ovary, the 5-year survival rate is over 90%. However, because the symptoms are not specific and because of lack of early detection only about 19% of all cases are found at that early stage. Like many other cancers, the survival rate decreases, when it is caught in later stages.

According to the National Ovarian Cancer Coalition, there are more than 30 different types of ovarian cancer. This type is determined by the type of cell they start from.

For more information on the types of ovarian cancer and the stages, click here.

Symptoms of Ovarian Cancer

  • Bloating
  • Pelvic or abdominal pain
  • Trouble eating or feeling full quickly
  • Feeling the need to urinate urgently or often
  • Fatigue
  • Upset stomach or heartburn
  • Back pain
  • Pain during sex
  • Constipation
  • Menstrual changes

These are vary vague symptoms, many of which women deal with on a regular monthly basis. However, when the symptoms persist and do not subside with normal intervention, it is IMPERATIVE to see your physician.

Screening tests are available and should be discussed with your physician, especially if you have a family history of ovarian, breast or colon cancer. You are also at risk if you are over age 35 and/or have undesired infertility. A pap test DOES not detect ovarian cancer, it detects cervical cancer.

Screening tests for ovarian cancer include:

  • Pelvic Exam
  • Transvaginal Ultrasound
  • CA-125 Test

If you or someone you know is at risk, please click here and learn more about detection, stages, treatment, risk factors, and prevention of Ovarian Cancer.

You can also contact the National Ovarian Cancer Coalition Helpline (1-888-682-7426) to get more information or to find support services in your area.

Don't take your health for granite, make regular visists to your GYN!!!


Tuesday, August 25, 2009

Acute Confusion

She laid in her bed yelling out. "Daddy. . .! ", "Oh, my God, what's happening to me?" , "Brian!"

I think she was yelling out the names of her children. Daddy was refering to her husband of more than 60 years. Each time she yelled out a name, it was a long drawn out cry. It was breaking my heart. It was making the rest of the nurses and other patients crazy.
I kept hearing those famous words, "Can't you give her something?"

At 83 yrs old, Mrs. Springer was experience a nightmare within her mind. The only problem, she wasn't sleeping. I couldn't wake her up from this. I was in her room about every 5 minutes. Trying everything to distract her, reassure her, listen to her. Nothing was working. I was at my wits end. The nurses who cared for her the last two days said this was her behavior for 2 days straight. They had given her everything and nothing was working. They had tried Ativan, Haldol, Dilaudid and nothing was making a difference. They were not even helping her sleep.

She had a recent joint replacement and had returned to the hospital with a Soduim level of 119. She had pulled out a foley catheter, and 3 IV's. She was refusing food, and at times combative. I believe all of these behaviors were due to the fear she was feeling, which was in turn caused by the confusion, caused by the low sodium. A domino kind of effect.

Finally I got her to be quiet enough to hear me ask if she was in pain. She just let the tears flow and nodded her head yes. I repositioned her in bed, gave her alot of pillows and tried to make her comfortable, put her TV on the music channel and let her listen to very soft, quiet music. Then I gave her 1mg of Dilaudid through her IV. It took about 30 minutes and she was fast asleep. This was about 9pm. At 5:30am I hesitated to wake her because she had slept all night without waking up. But I had to draw her labs. I had waited as long as I could.

She was very cooperative during the lab draw, however it didn't take but 20 minutes for her to start yelling again. I thought about giving her more Dilaudid, but the last dose had her alseep for so long. It was almost morning and I didn't want her to sleep the whole day. She didn't really have anything else I could give. I offered her a drink, fed her some pudding, and went to my next blood draw of the morning.

Ringing down the hallway was the sounds of a crying, weak voice. . .
"What's wrong with me?"
"Where am I?"
"I've lost it. . . . I've lost it!"

Over and over she yelled "I've lost it, Oh my God, I've lost it!"

I went back to Mrs. Springer's bedside to try to talk to her again.

Me: "Mrs. Springer, what is wrong? Are you hurting?"

Her: "NO! I've lost it!!"

Me: "Lost what?"

Her: "My mind, it's gone, what's wrong with me?"

Me: "Mrs. Springer, you are not well right now. Your sodium level is low, that is why you are
feeling this way. We are working to make it better. You will be your old self before you
know it."

Her: "Oh my God! I've lost it! Just call the patty wagon! I'm done for!"

Me: (doing all I can to not laugh!) Now Mrs. Springer, I promise you we are working on it. The doctor will be here to see you soon. Your levels are improving it is just taking some time.

This was obviously doing no good. She continued to yell, and cry. There was no consoling her. I called the doctor and got an order for Ativan. She only gave me an order for 0.5mg IV ONCE.

Yep, it worked until shift change. Imagine day shift coming in to this poor lady yelling. That was all they needed to hear to go ahead and come to the conclusion it was going to be a terrible day. I assured them the doc had told me he would be making rounds early. They could expect him within the next hour. The look of horror on their faces didn't change.

I worried about her all the way home. Praying that she was able to find some peace within her mind. That they could find a medication that would calm her at least long enough to stop the torment she must have been experiencing.

Lessons to be learned here:
  • Low sodium causes major acute confusion
  • Confusion causes torment
  • Tormented patients who are confused need a patient nurse
  • Nurse has to be someone who knows how to pray for peace
  • Peace may not come for days for the patient or the nurse


Back from a blogging sabbatical

I have to say, I have missed blogging! I have been one busy nurse, but after a short sabbatical from the blog world I am back. I probably won't be posting daily, maybe not even every other day, but I will try to keep up.

I have stories to that need to be told. I have stories that I need to document, because I don't ever want to forget them. I have stories, I tell you!

I have to commend all you bloggers who can post religously every day, follow hundreds of blogs and make comments and be a great blogger. I tell you, I will try. That is the best I can do right now!!

Let the stories. . . . .resume!!!


Thursday, July 2, 2009

Did Somebody Say Chocolate?

Everyone loves chocolate!! I am not sure I have ever met a woman who does not at least like chocolate. Many of us love chocolate to the point of not being able to go a day without at least a little taste. Some of us only really crave it once a month.

Ever wonder why women have an intense craving for chocolate around the time of their menstural cycle? There has not been alot of research on this but what I did learn was:

Chocolate is very high in magnesium. A Magnesium deficiency can exacerbate PMS. PMS for most women start 7-14 days prior to their period. It is not really known what exactly causes PMS but there is much known about helping to control the symptoms of PMS. Some of those include staying away from caffeine, taking B6, calcium and magnesium supplements, among other things.

Here is how it relates to chocolate. Before menstruation the levels of the hormone progesterone are high. This promotes fat storage preventing its use as fuel. This in turn may cause a craving for fatty foods. One study stated that 91% of chocolate cravings that were associated with the menstrual cycle occured between the time of ovulation and the actual start of menstruation. These cravings were most intense in the late afternoon and early evening.

This timing made sense to me because if it is a craving for those fatty foods, those are the times when your body would be needing more energy to get through the rest of the day.

Chocolate also generally makes us feel good. Especially if you are a "chocolate person" to begin with. You crave chocolate when you are depressed, lonely, feeling blue, etc. The sugar in chocolate causes a release of serotonin. The brain uses serotonin to reduce depressive or anxious feelings. Chocolate also causes a release of several other chemicals (tryptophan, anandamide, phenylethylamine) in the brain that can give a person a mental boost, increase the heart rate, stimulate the nervous system and produce feelings of euphoria. These chemicals effect serotonin as well as dopamine in the brain. Both serotonin and dopamine are used in antidepressants and antianxiety medications that help make us feel "happy" and/or "relaxed".

So, now you know! When you are feeling blue. . . take the plunge. Eat a piece of chocolate maybe eat two. But remember, all things are good in moderation!! Don't overindulge, you will be more blue later if you do. Especially after you step on the scale and see that extra pound or two because you ate a whole box of chocolates!