Aaaaaaargh!

My beloved third born.

Was in the studio lab at school the other day. That would be Saturday.

She'd just inserted a brand new exacto blade ,into her exacto knife, and was making the final adjustments to her model. (Due on Monday.)

And, she didn't use her safety skills.

Instead of sitting, with her legs under the desk as she cut?

She stood. And pulled down - HARD- on that new-bladed exacto knife.

And, as she concentrated on outlining her model? The knife slipped on and out...into her thigh. (She must've had alot of pressure behind the knife.) Kind of when you're cutting a slice of thick, hard bread, (and then all of a sudden it slips through, the knife,that is), and you're thanking your lucky stars that the knife didn't go through *you.* Turns out Amanda's laceration to her thigh? It was 7 inches long, and 2 inches deep.

Her studio mates were freaking awesome. A guy took off his T-shirt, and tightly wrapped her leg. Other kids lay her down and elevated her legs. She was definitely shocky. They called 911. (Aussie readers: would that be 000? It's been too long for me to remember how to dial an ambulance..)

We eventually got a call from the ambulance people. They'd bandaged the wound, done orthostatic BP's, deemed her safe to get a ride with friends to the hospital vs. an $800 ambulance trip.

I called our insurance company...they okey'd the ER visit.

Off she went and 31 internal and external stitches later? She was discharged.

Our dearest girl....she sent us phone photos of the laceration. I have to be honest. The first one? The one of the open wound? Made me feel sick. And I'm a seasoned nurse for the love of god. I have seen blood and gore that would make your hair fall out. But the picture of my girl's laceration? Oy! Bring me the bucket.

Now? She's sending daily photos of the healing.(Per doctor daddy's request.) And she'll see a follow-up doc on Thursday for a wound check.

Do you know what? If that knife had gone 3" higher? It would have severed her femoral artery.

Facts like this?...Keep me awake at night in a perpetual state of insomnia.

My beautiful third born. Could've been removed from us in a heart beat.

Impossible to get my head around.

Get Over Yourself, Sadsack!

So, I dunno....10 days ago? 3 weeks ago? 3 months ago? A year ago? It *feels* like forever..

I've had the tendency to wander around wallowing (in my head) about life's (mine) injustices. On the outside? Its all just fine. On the inside...Oh, so much questioning, debating, deciding.. blah, blah, blah. (yawn...)

I combat this inner turmoil pretty well...I work hard, at home and at work(s)...smile alot, but feel all the usual things people feel when they're troubled by sh*t, but try to 'make nice' on the outside.'

And then...came the wake up call.

As in. Get. Over. Yourself.

S....The 16 year old daughter of J and S has died. Suddenly. And the autopsy doesn't know why.

She was the only, beloved daughter of our friends, J and S...and I honestly cannot get my mind around her death. Her daddy and mommy are, well...you can only imagine. Paralyzed? That would be a good adjective.


We went to her funeral....hundreds of people there...hundreds....And we saw a mommy and daddy having to sit on the pews in the school chapel, hugging all hundreds of us, as we said our lame .... "I'm so terribly sorrys", and our," I just cannot believe this has happened."


How can they possibly stand it? Their only little person. Their only little person who made their lives shiny and optimistic and fun and worthwhile? And now..nothing. A huge void. How will they do this now? This getting up in the morning thing, and, you know, functioning. In a quiet, empty house. With no beautiful S. to love, and encourage, and just...be with.


Because..that was the kind of kid she was...Bursting with energy...a gorgeous kid. I remember seeing her playing 'Annie' in Annie.. In this little rural community where there is a tiny theater...she shone, and, even at nine had a beautiful voice which she used to belt out the songs from the musical. She's been in countless school plays..she's raised money for the hospital that her dad is affiliated with...and..she's gone.

I remember meeting her for the first time..She was sitting as an infant, in a cart at Costco,...gorgeous little baby girl..with a mom and dad who were smitten. Their 'smitten-ness' was palpable. S. blossomed into the most beautiful young woman you could imagine.

And she's gone. We don't know why. But get this people... I am so f*cking over myself. No more wallowing. Enough already.

Bullet points, anyone?

I've been a slack poster of late. Plenty of excuses. Won't bore you with them. Decided to do the bullet point thing... until I have a chance to write a decent post..

. Went to Maui to learn how to do a new extremely important, (shut up Melissa..it *was* important), process on the computer for my HMO job. The didactics were unbelievably unclear...but I wrote everything down verbatum, and am (hopefully) doing the new 'census ,log thing' appropriately. Who knows? I send my stats into the 'never-never', (aka..the ether of cyberland) and hope for the best. One can only hope that I'm doing the right thing. I'm sure I'll hear about it if I'm not.

. Going to Maui for the day was bliss. Getting off this island (the Big Island) was joy, uninterrupted. They fed us lunch at the training. Oh yes they did. It was free, man. At the end of the day? I got to the airport to go home in time to enjoy a glass of wine pre-flight. Awesome.

. Amanda is loving school. That is a joy in itself. Her first year in college was touch and go. Leaving rural Hawaii for the city life in Honolulu was a huge adjustment. She knows the drill now. The sirens all night still bother her, but the lifestyle in general is palatable.

Matt is also loving school. He's working full-time and schooling part-time. He is goal-oriented and determined. Bonus: He has an incredibly wonderful girlfriend, Mandy, and he is the happiest I think I've ever known him. This particular fact makes a mother's heart sing. Mandy came to Hawaii a few months ago (to get together with her best friend who lives on our island) and we got together. She loves my boy. She's awesome, and lovely, and wise beyond her years. I look forward to someday being her mom in law. (And being the grandma of her and Matt's kids.)

. Jessie is back from deployment (Navy)...and in school herself ... and she's loving it too. My kids seem to be enjoying academics. Late bloomers? (The older two?) They take after their mother. I graduated from nursing school at the grand old age of 29.... Its hard being a mum, a wife, a part-time worker, and a full-time student..it took me forever.. but I did it. My kids will too.

. How happy am I? Very glad that my kids are enjoying life and working toward their degrees.

. On the social front? Mey...not much. I have 2 jobs (HMO RN and Hospice RN on the weekends,) so our social life is pretty limited. Stewart is working his a*s off. I actually feel very removed from my friends because of our intense work schedules. My new goal is to reconnect with our friends and hopefully do stuff beyond working. When? On the weekends that I'm not working. Where? At our house where I can cook and host some dinners. It feels very isolating to get up, go to work, come home, cook dinner, go to bed, then get up and rinse and repeat. For months and months on end. Unhealthy? Yes.

. Some positives:

Our kids are doing well. (HUGE bonus) Our dogs Cody (3) and Bean-Elizabeth (1) keep us unbelievably entertained. They are way better than television.

. Stewart is planning a trip to Costa Rica this coming January. An awesome country to hang in. A respite from practising medicine on his own, in a rural environment with limited resources.

. Next summer? I'm going to visit my beloved Jess and her fiance Channing in Ca, and I will then drive to Oregon to visit Matt and Mandy. Stewart may, or may not come with me. Depends on the situation with his practice. It is very hard to be a doctor in private practice, in Hawaii.

So..there it is. A long overdue update. Hope all of you reading this are doing well and enjoying life to its fullest. xx

My Insane Security Experience at LAX

It was insane, returning to the States from England this summer, and going through security.

Because I travelled on frequent flyer miles, I had an odd flight schedule and flew on several different airlines. The first leg of my route home was London to Vancouver. I spent the night in Vancouver and left the next day for LA and then on to my final destination, Hawaii.

Going through customs in Vancouver was quite an experience. (Remember the potential bomb-carrying terrorists who have come into the country from Canada in recent years?) Yeah, those guys. They have made the security process rigorous. It wasn’t too taxing…but there was a lot of waiting around to go through four security points.

Once I made my way through, I perused the shops and found a bottle of lotion that looked really good. (I am a sucker for all things lotion, potion, aromatic or soapy.)
Then I did my favorite thing – I went to the gate and settled in for some good people watching.

On arrival in LA, I had to go through security again. My bag was routed directly to Kona, so it was just me and my backpack. Imagine my surprise when I was waved into a small holding area by 3 inspectors. I’m middle aged, and I dress pretty conservatively. I don’t *think* I look dangerous, but apparently I must’ve been giving off some sort of vibe, (waving hands vaguely), that made them want to take an extra special ‘look see.’

First off, they asked me if I’d like my inspection to be in a private room. "No thank you", I said. It was scary enough to be in the high-walled cordoned off area. I didn’t want to be ‘private’ one bit.

A woman began the inspection by waving an electronic wand all over me. No biggie. Then, she reached into my hair (which was in a loose bun) and dug around for a good bit, touching and maneuvering each bobby pin , feeling deep into the hair to touch my scalp. Ugh. What a job.

She went on to my neck, arms, under my arms and then moved on to my boobs. OMG. Every cubic centimeter of my boobs was examined (not gently) to the point that I almost quipped, “did you feel any lumps or bumps that I should know about?” I remained silent of course, because by now I was feeling somewhat freaked out. No wonder they had suggested a private room. On she went to my torso and lower abdomen. She didn’t touch the lady parts (that came later), but the buttocks were not spared. Lastly came the legs and feet.


Next, a male guard told me to stand diagonally with my feet two feet apart and my arms held up and out. He approached me with a different kind of wand and proceeded to scan my entire body. Again. After scanning the upper areas, he bent down and moved the wand from my right foot, up the inside of my leg, then dragged the wand across that deep, sacred place from which my first and third born emerged, before continuing down the inside of my left leg. (Aside: the second born chose a more circuitous route, exiting via an incision in my lower abdomen. Always a dare devil that one! Anything for a bit of excitement, my Matt :)

So I'm all....*that* was repulsive. What on earth are they thinking? That I have a metal canister of cocaine shoved up there? Something that will make the wand go off with an alarming trill?

I was told to change position to the opposite diagonal direction, and the guy did it all over again, this time starting with my left foot, dragging the wand across the sacred place, and then down to my right foot. By now, I felt scared and violated.

Told sharply to sit down, I obliged while they went slowly and thoroughly through my back pack. Everything was looked at in minute detail. A tube of lipstick was opened and closed. Several times. Chapstick. All the bottles with less than 3oz of fluid in them in a baggie. Toothpaste was squeezed out. Pill bottles examined meticulously. "Oh" said one..."I see you have two passports", upon which there was a discourse about my various citizenships. "Huh" said the other, "so this is what they saw on the monitor!"

He pulled out my newly purchased bottle of lotion as if it were a prize and excitedly announced that he'd have to discard it. It weighed over three ounces. I told them that I'd bought it in the secured area at the Vancouver airport. My luggage had already gone through, hence its place in my pack. That didn't work. He discarded it and continued on.

A few minutes later, the guy who discarded my lotion turned to me and said, " I really like your outfit."

Thud!

The hell? Is this what they teach them in 'How to Spot a Terrorist' school? Are they taught to say nice things as they frisk you and your stuff to make you relax and spill the beans? I was so taken aback it took me a moment to respond. "Where did you get it?" he asked. I'm all wtf?? but told him where I'd bought it. As if he could have cared.

Eventually, I was released into the chaos of the terminal building and made my way to the gate. Honestly, I was more than a little shaken. And so glad to be heading home.

On Call

I worked as a full time rural hospice nurse for 14.5 years. I'd take call every other night and every other weekend. Exhausting? Yep.

So, after 14.5 years, I chose to take another job during the week, and now I 'do' hospice call 1 weekend per month, plus holidays. In total, I've been with hospice for 17 years.

Some weekends, mey, they're ok. Others? Can run you ragged.

This weekend? Has been one of the raggedy ones. 13 patients spread over 410 square miles. 4 of whom are very close to death. It has been really, really, busy. Why am I on the net? I should be documenting. There have been so many families I've come face to face with this weekend, with bucket loads of anguish and grief and sorrow.

Today a (really lovely) family, refused to sign on to hospice. Basically it was because of their religious beliefs. Truth is, they could really use the help. What do you do in situations like that? When religious beliefs come before giving a patient the gift of pain and symptom management? Especially,in this case, the pain management. She (my potential patient) was "up all night last night clutching a hot water bottle to her abdomen..".....Oh yeah, to the nurses who read my blog....black tarry stools for 2 weeks, with severe epigastric pain. It could be anything from an ulcer to cancer. Oh...and they pointed out a "sore" on her leg..rapidly growing...an obvious squamous call carcinoma ..it is bigger than um, a 50cent coin. Much bigger.

I've learned over the years not to talk anyone into anything. You accept people for their beliefs and for who they are. Dogmatism does not have a place in hospice nursing.

Yet when I left this particular pt's home today (after they refused hospice,) I just had to take a minute or 10, to come to terms with her situation. How effing brave is she to put up with her relentless pain? Yet... if she chose treatment? Who knows? She could be just fine, out of pain, and pursuing a normal life. (Assuming this is a non-malignant thing.) I did (major coup) get the husband to agree to take my patient to a doctor tomorrow, (the doctor is someone he plays tennis with on the weekends) for a 'look see' and some blood work. The husband couldn't promise me that his wife would consent to blood work, or xrays.

Will he actually go through with it? Given their religion? I don't know. I just hope so for her sake. Sigh. These patients are the ones who keep me up at night.

Their son (incredibly nice guy in his 60's) had flown over from another island to be with them this weekend. He also follows their religion, but not to his parents' degree of stoicism. He was excruciatingly polite, and kind, and offered to carry all the crap that I carry around with me when I go from car to house and back...but, when I mentioned that the doc could provide them with morphine for the pain tonite? He was decidedly against it too. Amazing.

I cannot torment myself with this. Acceptance is the key. But still yet........

Intimacy, and a Stranger

When I went to Scotland this summer, I knew I had an arduous air trip ahead of me. Five and a half hours to Los Angeles from home…with an immediate connection (we’re talking people already boarding the plane when I arrived) to Chicago….(that was several hours of flight), followed by a 5 hour layover, and then a seven and a half hour flight to London. Good thing I love travelling. And being an inveterate 'people watcher', I don’t mind layovers at all. Not to mention window shopping and so on.

I was more than a tad worried about jet lag though. Discounting 4 travel days, I had only 5 days to 'do' Scotland and 1.5 days to 'do' London. I tried very hard to sleep on my flights to avoid that impossible fatigue one gets after long flights, crossing countless time zones.

As I waited in Chicago to board the flight to London I was standing next to a Muslim man. I remember noticing what a beautiful, deep red color his turban was. It was a mixture of pomegranate and brick red. He was wearing a suit, and was probably about my age. He made a hilarious comment to me about the slowness of our boarding, and I laughed and we exchanged a few words.

Imagine my surprise, when we were seated, to find that I was on 1 aisle of 5 seats, and he was on the other ….and there were no seats taken in between us. Calculating quickly, I realized that we could each have 2.5 seats to lie down on, which would encourage sleep. I was mulling around in my brain the possibility of taking the plunge and suggesting to him that we shared the empty seats. (I had noticed him too, looking at the empty seats with a certain longing.)

My main considerations were...Would he mind if I suggested it? Would that be uncomfortable for him, us sharing the space? Him being Muslim and all...would it be seriously maladroit of me to even suggest such a thing?

Then I thought, f*ck it. This was going to be a long trip, and sleep was definitely a priority. Imagine my surprise when I suggested us sharing and his face lit up into a beautiful, relieved smile and he absolutely ok'd my proposition.

Neither of us ate dinner. We lay down head to head...having 2.5 seats to share, it was possible to tuck one's legs up and go into a fetal position, but being a nurse I knew better (thromboembolism etc) so I lay down, but with my legs stretched out under the seat in front of me. Not the best, but certainly better than sitting up all night.

I smiled as I went to sleep. Because I thought that, you know, even though these were extremely intimate circumstances, it would be kind of nice just to hold hands , as Stewart and I do when we go to sleep. It is a comforting thing. (As I'm sure he and his wife/partner probably do also.) Don't worry, I didn't go there! But a girl can imagine. (Steve, (my brother), if you're reading this and it bothers you? Just click off right here ok? :)

I woke up at one point during the flight and the top of our heads were touching. I was really surprised at the 'hardness' of his turban. It made me wonder if this was the sort of turban you could buy say, as a 'hat', already pre-wrapped, or if he spent 5 minutes every morning wrapping it around his head. It felt more 'hat-ish' to me.

I awoke again to use the bathroom, and when I walked back, imagine my, well, irritation, I suppose you could call it, to find that in my absence he had stretched out, in his sleep, just as if he was in his own bed at home...and was taking up all the vacant seats! Oh no! 3 more hours of flying time and now I have the choice of either waking him up and asking him to move, or just sitting up in my own seat, and trying to sleep.

He looked so utterly peaceful. His face was tranquil...lips slightly open,(no snoring, thank god), one arm flung over the back of his head...Once I sat down, the top of his turban was grazing my thigh. It was hard to resist not reaching out to touch and hold his shoulder...as I would touch Stewart under the same circumstances. How could I possibly wake him out of a dead sleep? It would be cruel. Mercifully, once buckled back into my seat, I went back to sleep.

About an hour before landing, the flight attendants came around with breakfast. He woke up and omg.. Poor guy! He was horrified that he had 'stolen' the seats (kind of like when your spouse/partner steals the blankets on a cold winter's night and in the morning they feel like sh*t for doing so..) In fact he started apologising and I just said..."Its ok mate, don't worry...I slept well, no probs!"...You could tell he was absolutely mortified.

Breakfast was marginal. Or maybe I was so jet lagged, I didn't have an appetite. I thought, in order to make him feel less awkward, I'd offer him my yoghurt, and a few other unappetising things from my tray. At first he refused, but he looked hungry. I offered it again and he took it and smiled, and it was all good.

I love thinking back on this part of my Scotland/England journey. It was such an intimate time, yet there we were, complete strangers. I hope he looks back fondly, (hopefully not with too much embarrassment) on our Chicago to London trip.

An unusually funny event in nursing life...

Today I went to a discharge planning meeting at our local nursing home for one of my patients (92 years old) who is about to complete her 100 days of SNF care (skilled nursing care) and is about to return home. This particular case (my patient and her family) is *full* of intricacies, and emotions, and ...well... its going to be a difficult transition when she goes home..to live with her daughter, her son in law, and her 14 yo granddaughter.

Before the meeting, I went to buy a soda in the nursing lounge, but before I got there? I noticed a coffee bar...complete with those delicious half and half creamers with fake 'irish coffee' tastes and, well, I just couldn't resist.

As I filled my paper cup and added creamer after creamer... I noticed an elderly guy in a wheelchair just watching me. I smiled and said hi, and just kept on doing my coffee thing.

When my cup was filled I turned around to leave and he said..."you can sit in my lap if you want to."

Aha. Pregnant pause. In my head I was thinking.. omg... I am at least twice your weight, and sitting in your lap would crush your femurs.... what I did in actuality was just smile, and I went on to my meeting. I couldn't stop giggling... this poor old bloke who wanted middle -aged me to sit in his osteoporotic lap.

Hey... my nurse friends who read me.. I know you can get the humor:)... In nursing? Where it is often so tough? We have to take our laughs when we get them.