Cruise

Cindy & Donnie on the ship

Great Stirrup Cay International Airport?

Atlantis Resort

Donnie and I celebrated our 10th wedding anniversary (a little late, since we were married in July) by going on a cruise to the Bahamas. Check out all of our pictures @http://www.ritzpix.com/net/Albums/ListImagesTV1.aspx. I think my favorite part was snorkeling at Norweigan's private island. It was amazing!! We also enjoyed visiting the Atlantis Resort. It has the hugest aquarium I've ever seen. I'd love to go back and vacation there, but... maybe another day.

Dolphin Show - Atlantis

What Bugs Me the Most in Health Care

Noncompliance, system abuse, stupidity. There are lots of words for it, but what absolutely drives me crazy in health care are the cases of people who go out and purposely abuse their bodies, knowing full well based on numerous warnings in the past, that they shouldn't do it, and then come to the hospital expecting us to fix their problems.

I'm not talking about the skier who has broken his leg again, or even the diabetic who has been told to loose weight to help her disease. I'm talking about the 30 year old who has the heart of a 130 year old from years of cocaine abuse. He has a biventricular pacemaker/defibrilator paid for by his Medicaid/Medicare. He takes multiple heart medications to help his limping heart along (again paid for by my taxes and yours). And he shows up to the hospital with chest pain after a weekend Coke binge. It becomes my job to fix the problem, and I wonder why.

I'm clearly not the first person to ponder these things. Check out these clips from the movie Bringing Out the Dead.

Donnie's Dad Passed Away

Donald Marshall Taylor, Sr., 72, died Saturday, June 28, 2008.

The funeral service will be held at 2:30 p.m., Tuesday, July 1, 2008 at Fuquay-Varina United Methodist Church with burial to follow at Montlawn Memorial Park, Raleigh.

Mr. Taylor was a loving husband, father, grandfather and uncle who inspired all with his courage and strength during his illnesses. It was his trust and faith in the Lord that sustained him throughout his life.

He is survived by his wife of 52 years, Edithe Taylor; children, Debbie, Deidre and Donnie, Jr.; sister, Jackie Fowler; seven grandchildren; one great-grandchild; 12 nieces and nephews; and his very special friends from the Cary Imps Club of the 50's.

The family will receive friends from 6:00-8:00 p.m., Monday, June 30, 2008 , at Thomas Funeral Home, 401 N. Ennis Street, Fuquay-Varina.

The family would like to express their deep appreciation to Dr. John Kelley, Dr. George Hamrick and Dr. Philip Ashburn and their nursing staff for their excellent care and going the extra mile in Mr. Taylor's care.

Memorial contributions may be made to the Fuquay-Varina United Methodist Church Building Fund, 100 Judd Parkway SE, Fuquay-Varina, NC 27526.

Published in The News & Observer on 6/30/2008.

Nut Grass Driving Me Nutty!

My flower garden has an infestation... of nut grass. Actually it's official name is Cyperus esculentus. I have tried everything without success. I should have looked it up on the internet, because a quick look at any site, including Wikipedia would have told me, "It is extremely difficult to remove permanently when it is considered to be an intrusive weed in lawns and gardens. This is due to the plant having a stratified and layered root system, with tubers and roots being interconnected to each other to a depth of 50 cm or more. The tubers are connected by fragile roots that are extremely prone to snapping when pulled on, making the plant extremely difficult to remove with its entire root system intact, and the plant can quickly regenerate if even a single tuber is left in place."

Since I didn't know this, the first summer I tried...

1. Pulling it out. It doesn't work. The roots break, leaving the little tubers in place to sprout new plants.

2. Next I tried spraying it with roundup and then covering it with newspaper and mulch. Didn't work.

3. This season, I am digging about 12 inches deep, and screening all of the soil. I am trashing all of the tubers, roots, and any wood chips that get caught in the screen. It is tedious and time consuming, but I am bound and determined to save my flower bed.

If that doesn't work, there's a herbacide called "Manage" that's supposed to work, but it's $150 a bottle!!

Anybody want to come and help me play in my dirt?

Snoring

It's not very lady-like, but for the past few years, I have been bothering my husband with my snoring. He's tried everything from nudging me, rolling me over, to donning ear plugs. Nothing worked. Two years ago, I underwent a sleep study to see if I had sleep apnea. I did not, but I still continued to snore. Last month, I finally got this problem fixed. I underwent palatoplasty. It was a short office procedure lasting only 30 minutes. That was the easy part, though. After the lidocaine wore off, which happened before we even got home to fill the prescription for pain medication, my throat starting hurting.

Now, the doctor warned me I would have a severe sore throat. He didn't tell me that it would feel like I'd descended into the 7th circle of hell.

I settled down to a routine of pain pills and soft foods. I was supposed to be better in 1 week. Unfortunately, a week went by, and my throat still felt like it was on fire. The back of my throat was one big swollen scab. And swallowing anything, including water, felt as if I were drinking molton lava.

So I called the doctor and took another round of solumedrol to control the swelling. I am feeling better now, but I still can't eat anything more solid than soup or scrambled eggs.

Would I recommend the procedure to others? I'm not sure. The good news is that in the past 2 weeks I've lost 11 pounds, and my snoring has also decreased significantly. I'm hoping that once all of the swelling goes down, the snoring will stop completely. But the jury is still out on whether it was all worth it. I'll keep you posted...

Firefighting

It has always been a goal/dream of mine to be a firefighter. I have now been on the Cleveland Volunteer Fire Department for about 20 months. Let me tell you that it has been an eye opening experience so far.

I have been around the fire service indirectly for the past 22 years (ironically that is how long I've been in EMS). The level of comeraderie in the fire service is remarkable! There is a definite element of "Brotherhood" that does not exist in any other profession. Thus far I have spent many days/nights in training, most to obtain my FirefighterI/and II certifications. There is a lot to this job. It is the 5th most dangerous job in the world. Back in July, I found out just how dangerous it really is.

We were called to a reported house fire at 01:20 hours. As the apparatus leaves the station, all personnel are donning their protective gear. This stuff is hot and heavy before you even get near the fire. We can see fire through the roof of the house as well pull on scene. A quick size up confirms that all occupants are safely out of the house. The officer in charge does a walk around as myself and another firefighter pulls a 2" diameter hose line off the engine. We flake out the line and stop at the door to mask up and begin breathing precious air from our SCBA.

We then make entry through the front door. There is intense heat and dark smoke. You can see about 1 foot in front of you so you rely on your sense of feel. Then there is the fire area. We begin to put water on the fire. After a few minutes, a section of the ceiling falls in on me; this is followed by a rush of flames and heat. I actually pondered for a few seconds if I was going to be able to get out of this precarious situation. My training kicked in and I swept the nozzle up over my shoulder and turned the nozzle to a wide pattern to get the flames off of me and my partner. They always say that in a crunch situation you get superhuman strength. Well that is true because my adernaline was flowing, and I then lifted the section of roof of of my and threw it to the side.

We knocked the fire down and then came out for rehab. As I removed my gear and sat in a chair, I was replaying the events in my head. It was so exciting but at the same time was pretty scary too. There isn't much time for resting; soon I was back in my gear and inside the house performing what we call overhaul and salvage. This is where we clean up the mess and try to save any items not destroyed by fire, smoke or water.

I am hooked for life!!! Take care out there and be safe in all your journeys.

Nurse or Party Planner?

Bob commented on my last post that nursing seems like hard work. It is, but the terminal diagnoses are few and far between. Most of the time I find myself being a strange kind of event/appointment coordinator. It's sort of a combination between a party planner, personal assistant and drug dealer.

My day goes something like this...

We'll send you first thing in the morning to cardiovascular testing for your stress test. You'll be there sometime between 1 and 4 hours. Please sign here on this consent form. Consider it like a kind of RSVP.

You have a blood draw due in 30 minutes, and then radiology would like to squeeze you in for a chest x-ray. After that you have an appointment with physical therapy (Oh, by the way, even though I don't know exactly when they're coming, I need to give you pain medication 30 minutes prior to your therapy.)

For lunch you'll have a choice between the house specialty, "Nothing per oral" or better known as 'NPO'" or "Starvation for the sake of testing." Actually, not allowing patients to eat isn't really for the purposes of testing. It's actually a hidden plot to make the patients think that hospital food actually tastes good once we finally allow you to eat. But I digress...

Did I mention that CT and Respiratory Therapy would both like to see you at the same time? They both claim that they are very backed up, and now is the only time they can see you. Even though you're in severe pain, and starving, would you mind splitting yourself in two so that you can be in two places at once?

By the way, your wife called, but due to HIPAA laws I couldn't tell her if you were dead or alive... Maybe she'll call back later. Of course you'll probably be out for another test, and I still won't be allowed to talk to her...

After your testing is complete, you'll have to wait around for hours for your meeting with your doctor. Sorry that I can't tell you exactly what time that will be, but I only have nominal control over your schedule, and absolute none over his.

I hope you enjoy your stay at Le Hospital de Americana. Please don't call me when you get the bill; I only do scheduling, and I'm not allowed to give health care advise over the phone.

Death, Dying and Nursing

It's my first year as a nurse, and while there have been many challenges, one of the greatest has been helping patients who have just received a fatal diagnosis. We were taught about this in school: how to handle end of life issues, the 5 stages of grief, etc. With 8 years as a paramedic, I thought I was ready to deal with death, but what I forgot is that dying is very different from death.

I work on an observation unit of a hospital. Most of our patients come in for less than 24 hrs. They are either waiting for some test (which usually comes out negative), or they have just had surgery, and need a little time to recuperate before they go home. Sometimes, when there is no room elsewhere in the hospital, we keep patients that will be staying in the hospital for a long time until another bed becomes available. As a result, it is rare that my patients are VERY sick. Most of the time my patients are not expecting a bad diagnosis.

When a bad diagnosis does come, it is usually a surprise. I see these patients on the first or second day after their diagnosis, and I only see the denial stage. Even that stage presents with different varieties. I've seen patients ignore the diagnosis, and continue on as if they had been told nothing. They laugh and joke with the staff as if they don't have a care in the world. As a nurse, I wonder if I should let them have these last few moments of carefree joy (as false as it is) or if I should try to gently bring them back to reality. I've had patients who are completely saddened by the diagnosis to the point where it paralyzes them; they can do nothing. They make no decisions, do not want the doctors to do anything about their condition. It is as if ignoring the problem will make it go away.

As many different patients and diagnosis there are as many different forms of denial. Some are more difficult to deal with than others. One night I had a patient who hit her call bell constantly. She had a litany of requests: move me up in the bed 2 inches, add a little water to my apple juice, move the pillow under my knees a little to the left, etc. I must have walked to her room a dozen times per hour. It was truly getting on my nerves, and I was quickly losing patience. While trying to find my compassion, I realized that this woman had just lost control over everything that was important in her life. The doctors had given her no choices but surgery and little hope for survival. The only things she still had control over were where she was sitting in bed and the temperature of her drinks. Once I realized that, it was a little easier to find my compassion and meet that patient's needs. True to form in an observation unit, a bed came available in the hospital, and she was moved. Once again, my patient and I never got past denial, and from time to time, I've wondered how she's coping.

Sometimes nurses forget that we have another set of patients: the family. Helping them cope with a fatal diagnosis is another part of nursing. It is equally important, but often requires a different approach. Families don't always have the same reaction that the patient does. Saying goodbye to a loved one is a very difficult process.

I've wondered recently if how we deal with life affects how we deal with death. Recently my dad sent me a link to a very interesting video that addresses how we live our lives. It's crossed my mind several times recently to question how well I'd deal with a fatal diagnosis. I've wondered if the more content we our with our lives, if that makes us more capable of dealing with our own death.

I don't really have any answers to these questions. I just keep contemplating them as I care for my patients: those who are trying to live well and those who are trying to die well.