09 November 2011

Observing Patients, Eleven at a Time

I keep having family and friends ask me what unit I work on at the hospital and what we do. As a brand-new, career-changing nurse, it's been a little hard to explain, even to myself. Now that I'm officially out of orientation and some (just some) of my naivety is gone, I figured I better know where I am and what I'm doing.

I didn't have the slightest clue as to what a hospital observation unit was when FGH hired me. I was just grateful for a job offer in a city that has one major university and several community colleges, all whom had just graduated their own gazillion nursing students who were looking for jobs in the Hattiesburg area at the same time I was. That, and I could finally move out of my parent's guest room and join my husband who had moved down to our new digs several weeks earlier.

No offense to mom and dad. It was a great time having mommy do my laundry again, but this 30-year-old was ready to move out of the proverbial basement and get on with her life.

Honestly, I was so proud of my title as "RN-Medical Oncology" back in Missouri. Caring for cancer patients? Totally worthy occupation. Outpatient Observation? It sounded weak at first, like I would be putting band-aids on boo-boos and sending my patients home with a lollipop.

Some days, I wish that's all I did.

I didn't really know what an observation unit was. I was like, do I just watch the patients and make sure they don't get worse? What are we observing for? Am I going to be bored to tears?

Today's Hospitalist explains observation units like this: "As Emergency Departments are increasingly stretched by capacity constraints and lack of specialist support, hospitals are turning to observation units, also known as clinical decision units, to fill those gaps without taking up inpatient beds. Patients admitted to observation units are expected to be evaluated and treated and rapidly improve within 24 hours."

“The setting is geared toward patients who require more management or attention than can be given in the traditional ED, but do not need the length or level of services provided in the inpatient setting,” says Russell Holman, M.D., senior vice president of Cogent Healthcare, a national hospitalist firm based in Irvine, Calif.

“Placing one patient in the observation unit frees up about three beds in the ED,” says Sandra Sieck, R.N., president of Sieck HealthCare Consulting, Mobile, Ala. "Observation units can help avoid unnecessary and costly inpatient admissions by aggressively diagnosing and treating patients’ symptoms, allowing them to go home in a timely manner."

Our unit works closely with the ER doctors - but when emergency department orders run out after eight hours, care is usually handed over to one of the on-call Hospitalists...which means a whole new set of orders to implement. In the meantime, the physicians and case managers are trying to determine - in less than 23 hours - whether the patient needs to be converted to inpatient status.

So it's very true we move at a rapid pace.

Yesterday alone, between transfers, discharges and admissions, I had 11 patients.

To give you a bigger picture, our unit is only 14 beds. I take seven, the other nurse on shift takes seven.

Seven beds. 11 patients.

Lots of coffee. And aspirin. And charting.

Our floor sees everything from sickle-cell crisis to cellulitis, COPD exacerbations to dehydration. Patients come from outside clinics for blood transfusions. We see a lot of patients with renal failure - I've gotten to know our nephrologists really well. We get a lot of funky wounds, and we also serve as a recovery floor for patients coming out of surgery.

PACU delivers us lap-chole patients, (seems like everyone and their second cousin has had their gallbladder removed lately) hernia repairs, thyroidectomies...just about any same-day surgery where the patient just needs to stay the night and be discharged in the morning. I call those my "eat solid food and drink with out throwing up, pee, walk the halls without passing out and be cleared to go home" patients. We've also had a run of PEG placements lately, and I feel like I can do tube feedings with my eyes closed.

(Which I once said to a co-worker, who told me she would hope I wouldn't. Southern people still don't get that when I say things like that, it's called sarcasm.)

A typical 12-hour patient rotation can look like this: a patient is admitted to the floor from post-surgery around noon, only to be discharged four hours later...who's room was rapidly cleaned and assigned to a new patient who arrives no less than 20 minutes after the previous patient was wheeled out the door.

Or a patient gets to the floor from the ER, and ten minutes later surgery is calling for them (no joke...this happened to me this week). To get a patient to surgery, you have to complete a whole checklist of items, have surgery consents signed - which you can't have the patient sign if they've taken narcotics (morphine, dilauded), which of course the ER gave them just ten minutes earlier - draw labs, make sure the patient has removed dentures/jewelry/glasses/clothes off/gown on, plus call surgery to give report on the patient you're sending them.

Giving report on a patient you've seen for a total of five seconds to the same-day surgery nurse who's been around the block a time or two is nuts. You better have your stuff together. Or at least make it sound like you have your stuff together.

And speaking of drawing labs, PCRMC spoiled me. We had phlebotomists who would come and do a simple stick for an H&H. Not so here. We grab our trays and tubes and trot off down the hall to play vampire.

PS: I love central lines and chest ports. The end.

It can get exhausting. Halfway through orientation I decided I didn't like the floor, it was too fast-paced and that I just couldn't get my day organized with all of the admission orders, discharge orders and general care orders going on in between. One patient coming in while another is going out...I seriously felt I was drowning trying to keep on top of everything. People wanting to be discharged want to go home NOW, not in 30 minutes...at the exact same time the PACU nurses are calling you into the room of the patient they just brought up because they need to hand off the chart and have lifting help from the stretcher to the bed. And then that new patient wants something to drink and their family is hovering and their IV is beeping and....

And people wonder why I'm still broken out in stress-related hives.

(Sarcasm again, my southern friends. But not really.)

Now that I've been on my own for two weeks, I'm realizing that I'm not as incapable as I first felt. I can do this.Yes, it's incredibly stressful. Yes, it's rapid work. But I feel like I know this floor now, I know where things are, and I know who to ask if I don't know something. I'm getting to know the doctors - most of whom are fairly approachable and easy to talk to.

I really like my co-workers and feel that we all work well together. They bring cake to celebrate birthdays, and I like cake.

This floor is growing on me. Once in awhile I still miss my cancer patients and the five-patient, steady, unchanging workload in Missouri, but honestly, this is now starting to feel like home. I don't want to bail ship and leave this unit anymore.

I get it now. I get the point and purpose of observation, and I'm proud to be an RN in the middle of it.

Oh, and my scrubs are cute too.

16 October 2011

Sunday, Sunday...

I did something today that I've never done before.

I wore shorts and a t-shirt in mid-October.

And went to the beach.*

This is about as far out as I'll go.

Things-in-the-ocean-that-will-eat-my-legs-phobia and all that.

"A message in a bottle!" I said.

"Nope," said M. "Just somebody's fo'ty."

So sorry, Missouri...I just didn't miss you that much today.

*I've actually been to the beach before, just not in mid-October. And just to clarify, we went after church. And lunch. And walking the apartment dogs who, we discovered, shredded a newspaper and some of M's student's homework while we were at church. Fabulous.

12 October 2011

Forget about the Blessings


You all know that I’m forever a student. I love to learn. Love love love books and taking notes and feeding into my OCD/list-taking/notebook/file folders/organization obsession.

I’m a nerdy-nerd, and I embrace that fact.

But do you know what’s hard for this little bookworm?

Re-learning and reprogramming my brain around a concept that I thought I had nailed down at one time.

From first grade.


Remember the song we all used to sing in Sunday School when we were six?

Seek ye first the kingdom of God
And all His righteousness
And all these things will be added unto you
Hallelu, Hallelujah!

Those lyrics are taken directly from Matthew 6:33. It’s based on the premise of trust…trust God to provide for your needs, don’t worry and try to relax. God will provide for you through his blessings.

“Can all your worries add a single moment to your life?...So don’t worry about these things, saying ‘what will we eat? What will we drink? What will we wear?’ These things dominate the thoughts of unbelievers, but your heavenly Father already knows all your needs. Seek the Kingdom of God above all else, and live righteously, and he will give you everything you need.” Matthew 6:27, 31-33 NLT

As a believer, this verse excites me. Sweet! Live a Christian life, do good things, seek God’s will for my life, and PRESTO! Blessings galore will be showered over me!! With sparkles and rainbows and unicorns!!!

Yes. I live in my own little (sparkly) world. Just ask my husband.

However, my little confetti-party got put on hold this past Sunday, when I heard a sermon – on this exact verse- that jumped up and slapped me upside the head.

My glitter headband was knocked askew, to say the least.

Pastor Parke: Forget about the blessings.

Me, thinking to myself, more than a little whiny: What?? Are you serious?? But God said…

Pastor Parke: Would you still be willing to give your life to Jesus if there was no such thing as blessings? Would you still be willing to follow him at all cost if there was no return on investment in it for you?

Oh. That’s hard. That’s really, really hard.

Pastor Parke: Don’t confuse the promises with the purpose. Don’t get greedy, doing things just for the promise of the blessings. Forget about the blessings.

How many times have I thought to myself, “Sure, I’ll donate this much money. God will bless me for it.” Or, “If I read my Bible every morning, God will bless me for it.” Or, “If I go to choir practice tonight instead of staying home to watch Game 3 of the NLCS, God will bless me for it.”

I’m not saying that God won’t bless you if you donate money or read your Bible or get your little self into church when the doors are open. God promises his blessings to us. He enjoys showering us with blessings – just one of the little perks of following him.

“See if I don't open up heaven itself to you and pour out blessings beyond your wildest dreams.” Malachi 3:8, The Message

“My cup overflows with blessings.” Psalm 23:5, NLT

“Yes, the Lord pours down his blessings.” Psalm 85:12, NLT

“Both are part of the same body, and both enjoy the promise of blessings because they belong to Christ Jesus.” Ephesians 3:6, NLT

Furthermore, God's idea of a blessing and my idea of a blessing can be two completely different things. In my mind, a blessing might come in the form of a dead president on a green and tan piece of paper. God's idea of a blessing might be just letting me take another breath or letting me get out of bed in the morning.

I’m just saying – why am I really reading my Bible? Is it because I expect God to shower his praises over me, or is it because I truly desire to know his heart and strengthen my relationship with him?

Forget about the blessings.

Why am I in choir? Is it because I want God to see me in front of the church every Sunday morning raising my hands to the sky and say, “Wow! She’s a Super-Christian!! I need to get her a cape!!” or is it because I want to return praise to my Jesus who extends his grace and forgiveness to me…even though he really didn’t have to?

How often do God’s blessings become a distraction – so much so that we forget who God really is and what he’s actually doing? Are the blessings becoming more important than the Giver of those blessings?

Forget about the blessings.

Don’t confuse the promises with the purpose.

Blessings are nice.

But focusing on God’s greater purpose is better.

09 October 2011

Knuke the Blue Fairy

First, let me say I have never, ever dressed our dogs up for Halloween.

It's not without lack of trying. It's because my husband thinks people clothes belong on people, and dogs are just fine and dandy with the fur God gave them.

But what fun is that?

What's fun is having ginormous dogs who don't fit into any dog costumes - even the XXL ones at PetsMart - and there is a Halloween pet costume contest three days away. Plus it's a fundraiser for the Susan G. Komen foundation, so this is a must...I mean, am I an advocate of oncology or what?

I chose Knuke as Contestant #1. He's the most laid-back of our dogs, and besides...M refused to let me dress up Suka. I was only allowed to send one dog to therapy after this.

So how to find an outfit that would fit?

Wal-mart toddler costume section to the rescue.

Only one problem.

All of the boy options are lame. I mean, what dog wants to show up as a spider or pirate? How original is that?

In a moment of creative glory, I decided to piece together the most wondrous of all costumes.

A blue fairy.

Knuke's official title on his entry form: Blue Fairy, Because it's Manly.

Wings, a tulle skirt, some birthday streamers and some creative stapling of elastic band and turquoise ribbon from Hobby Lobby, and you have yourself a manly dog Halloween costume.

M immediately started apologizing to Knuke.

What was a little frightening is that Knuke didn't seem to mind.

Saturday was the big day. Like I expected, it was mostly little teeny dogs prancing around as pumpkins and cheerleaders and banana splits.

I have absolutely nothing against little dogs dressed as pumpkins and cheerleaders and banana splits. I thought it was adorable.


Enter Knuke.

Gigantic, lumbering mass of a dog.

In a skirt.

Guess who won Best in Show? I was thrilled.

And if eye-rolling and groaning is any indication, M was thrilled as well.

29 August 2011

Baby, it's Hot Outside

I should have been born into one of those cultures that keep their women all wrapped up from head to toe.

Seriously. I love my long sleeve t's, my jeans, my fleece pants, my hoodies and sweaters. And let's not forget my fuzzy boots. Oh, the fuzzy, fuzzy boots.

So it keeps scaring me a little every time I hear someone down here say something along the lines of "Our seasons? Well, we have a really hot summer, then we go into a regular summer for a couple weeks, then it turns back into the really hot summer again."

And if by chance there is even a hint of a chance of snow flurries, schools are cancelled for weeks.

Not really.

Just days.

I'll miss you, fuzzy boots and hoodies.

Maybe I can convince M to retire to Alaska.

09 August 2011

Road Trip Weekend #1

Drive south 90 miles. Then you're in the land of debauchery and weird people and beautiful architecture and puffy little sugary pillows that I had been deprived of for 30 years.

New Orleans.

Yes, it's true. I've never been there. Unless you count the time my church youth group stopped on the way home from a mission trip in Texas just to get Hard Rock Cafe t-shirts while my youth pastor told of the evils of Bourbon Street.

Walking around the French Quarter on a 99 degree Saturday afternoon is quite a different experience. The place was packed. I'm the kind of person who likes to stop and look in store windows, take in the scenery and just take my time looking around. I quickly found out that that is next to impossible in the Big Easy. If you stop to look, you get trampled from the masses of people behind you on the sidewalk. Being short in a large, moving crowd isn't the best.

I lovelovelove the buildings. The balconies. The history.

But then we found it. The oasis in the middle of all of the hot, sticky, stinky inebriated bodies. It's green awning waving hello in the breeze. Powdered sugar dust coating the sidewalk in all four directions.

That's right. Cafe du Monde. Home of ridiculously thick black coffee and fried dough covered in powdered sugar.


Totally worth whatever time I will have to spend on the elliptical to minimize the damage.

I did the entire experience. The tiny little table crammed next to other tiny tables that can barely seat one person. The coffee that I could barely drink because, as my sister told me, it will put hair on my chest by morning, and the beignets. Oh, the beignets. Sigh.

Yes. I'm a naive little Midwestern girl, transplanted in the Deep South, enjoying every minute of it and not worrying if I look like a complete idiot tourist.

I need to quickly remind myself to say "ya'll" though. Every time I say "you guys" I get someone who asks me what part of the Yankee North I'm from. Fabulous.

Today I love: Fresh cut pineapple and Chocolate Truffle coffee.

26 July 2011

A Lot Can Happen in 60 Days. With a lot of Pictures.

So yes. In response to my last post (in MAY, for crying out loud), I did graduate from nursing school.

My adorable niece sent her congrats.

I took a hiatus from all things facebook/twitter/internet/life to study for my boards. I passed my boards. I'm officially an RN.

I started my new job as a medical oncology nurse and began the New Grad Residency program at the hospital. It was pretty cool. My preceptor was great. She taught me more in a month than I learned in an entire semester of nursing school.

Then, if graduation/boards/new job training wasn't enough going on in my life, my husband, my dear, sweet husband, decides to accept a new baseball coaching position in Hattiesburg, MS.

Roughly 536 miles away.

Did you all know that M was born and raised on the coast in Gulfport, MS? Yes. When I first met him, he had the sweetest little southern accent that was quickly decimated by the Missouri Ozarks twang that surrounded us. (He still teases me about my Yankee ability to put a "y" or "ie" sound in the middle of any word. Hi comes out as Hiiiieeee. Oil is oy-el. Etc.) He hates snow and ice, and I think the last couple winters of nothing but ice storms and snow days brought him to his breaking point. This position was just something he couldn't turn down - bigger school in a big city? With restaurants and movie theatres and a mall? And a Target?

Yes please.

So, I gave my notice at work, we packed up the house, and we moved. I've now been in Hattiesburg for one week. It's been a little bit of culture shock for this Midwestern Girl - namely, just now stinkin' nice everyone is. I'm not used to complete strangers coming up to me in the store to see if they can help me reach something on the very top shelf. If that happened in St. Louis, you make sure you have your mace handy. Actually, I wouldn't know, because no one ever took the time to stop to offer to help me before.

However, I'm sorry. I cannot put my groceries into something called a buggy - it's a shopping cart. A buggy is something you put a baby in to walk it around the block. I'm not throwing groceries on top of a baby.

I love where we live. We decided to rent our first year here just to scope out the area before we buy a house. Our apartment is sweet. All credit goes to M - he came down before we moved to look at several different apartments and secured this one for us. It is beautiful. Pool, fitness center, gated, and the best part - we are about five steps away from the Longleaf Trace, a 41 mile paved walking/jogging/biking trail. We get to have our dogs, and our apartment has it's own private entrance. Love.

See the lamppost in the middle of the picture? The door with the overhang right to the right of it is our front door:

View from the kitchen window:

My book nook! Knuke loves it.

Walking the dogs on the Trace.

Yes. We live two hours from NOLA. We also live one hour from the beach if you drive south towards Gulfport.

My new place of employment as of August 1. I'll be a post-surg RN.

I would show more pictures of the inside of the apartment, but we sold our furniture before we left Missouri, and Haverty's is supposed to be here today to deliver the new goods. If it's anything like waiting for the cable guy, I'm not going to hold my breath.

On a final note, southern humidity and my hair are not compatible. I look like I have the frizzy, puffy hair of my middle school days - not a good look for me. I really don't want to re-live that awkward time in my life, so any suggestions of anti-humidity/smoothing hair products would be greatly appreciated.

Today I love: Folgers Chocolate Truffle coffee and air conditioning.

16 May 2011

The End is the Beginning

So, what's everyone doing this Thursday?

I'm not doing much...just GRADUATING FROM NURSING SCHOOL!!

Not that I'm excited or anything.

This past year has been crazy. It's felt like a lifetime, but at the same time it's gone by so very fast. I know for a fact I've had more breakdowns and crying sessions this past year alone than in my entire 30 years of life combined.

Pathophysiology, I blame YOU for that.

So what's the next chapter in my life going to look like?

I start work at PCRMC Monday, May 23. I will be an oncology nurse. I am beyond proud of this.

I will also get to re-establish living in the same house as my husband.

To anyone who isn't familiar with our situation, it's fun to see the look on their face when I say that. No, we haven't separated. No, we haven't split up. No, he didn't see me have one of my famous Pathophysiology Meltdowns and decide I was too high maintenance (though he does tell me I'm high maintenance. But it's all in love. I hope.).

Living in STL for a year while going to school was difficult, but also sort of good for our marriage. Don't get me wrong - I wouldn't want to do this again any time soon. It's not ideal. I missed my heater-man against my cold feet at night. I missed being able to see him face-to-face when he walked in from work. I missed cooking him dinner and just hanging out on a Friday night. However, our communication skills were put to the test, and we actually had to talk to each other. None of this, "How was your day?" "Fine. How was yours?" "Fine." Then ESPN for the rest of the night. We had to have actual conversations. My night was always made complete with his "Goodnight, sweet dreams, I love you" sign-off. It was good. We learned how to talk (and text) to each other all over again, and I liked that.

M has been above-and-beyond supportive throughout this entire undertaking, and I seriously couldn't have done it without his encouragement and 100% belief that I could actually become a nurse. He kept me going when I wanted to (and did) fall apart. He told me I could do it when I didn't think I was able. Things would happen in our life - family things, work things, random things that just happened to fall upon us because it's us - and he would tell me that it wasn't my job to worry about it, it was my job to focus on school. Looking back, I can see so many things he sheltered me from just because he didn't want to distract me from school. What other guy would do that? He's amazing. And he's mine. I'm blessed beyond anything I deserve.

But he still won't let me practice starting an IV on him, even though he has the perfect veins for it. How's a girl supposed to learn?

Now, it's back to a routine. A job. A paycheck. Baseball games. Dinner. Feeding the dogs. Walking the dogs. Keeping the dogs from eating the couch. And I can't tell you how much I'm looking forward to getting back to a normal life. Seriously. I missed my house and family. And I'm tired of taking tests.

I do however have one more major test to go - NCLEX sometime in late June or early July. This might validate a couple more (or a hundred or a thousand) meltdowns - just warning you.

Then, I'll officially be AW: BA, BSN, RN, MBA.

I love letters at the end of my name.

07 April 2011


I met a woman today.

87 years old, she described in vivid detail the horrors of surviving an abusive marriage. She described being beaten, kicked, hit, slapped. She described the shotgun that was pointed at her when she was pregnant with her first child. She even described how her husband used to sleep with a hatchet under his side of the bed, and the many sleepless nights she spent just waiting for him to use the weapon on her.

87 years old, and she still remembers the terror just like it was yesterday.

But she was one of the lucky ones.

She escaped. She was brave enough to see through the many lies of “I’m sorry,” and “It will never happen again” and “I love you.”

Not many do.

Not many live to tell their stories.

On average, more than three women and one man are murdered by their intimate partners in this country every day.

One in four women (25%) has experienced domestic violence in her lifetime.

Nearly three out of four (74%) of Americans personally know someone who is or has been a victim of domestic violence.

I now personally know two.

Which, in my opinion, is two too many.

Take a minute to look around you. If you’re like me, you have it pretty well.

A warm bed. A car. Computer, TV, food in the fridge.

But most of all, the feeling of security.

How many times do I take my life for granted? How many times do I get wrapped up in my own little world, stressing about silly things that - in the long run - don’t truly matter at all? Why do I let myself get so wrapped up in inconsequential things? Ten years from now, will I really care? Will anyone else really care? Will it really have been the dramatics I made it out to be?


I need to stop focusing on myself. I need to stop focusing on how I will benefit from situations. How I will be treated by people.

Because honestly, I don’t matter. And I mean that in all sincerity.

Let me explain.

If I get myself out of the way, then that makes room for others. How can I claim to be a Christian and not have a servant’s heart? How can I possibly not want to put others first and see to their needs before I even start to care about my own?

Don’t be selfish; don’t try to impress others. Be humble, thinking of others as better than yourselves. (Philippians 2:3 NLT)

As much as my heart aches for those in my life who have suffered through and survived the nightmares of domestic abuse, I thank this courageous woman for sharing her story with me today. Not only did she make me want to champion the cause of domestic violence awareness, but she made me stop and reflect on my own life. My own hangups. My own selfishness.

So like I mentioned - if I have it pretty good, then I need to stop whining. Stop complaining. Stop focusing on me. What makes me think I’m so much better than someone else? Absolutely nothing. If only the world knew my struggles, they’d see why I’m so indebted, so in awe of the love and grace of Christ. I’m far from perfect.

Stop putting myself first. Start serving others.


02 February 2011

Let's Try This Again

Picture this:

Third week of school starts. (Sidebar: that’s why this blog hasn’t been updated in awhile...school started up again, therefore life has ended for awhile.) Lifespan test scheduled for 8am. I wake up at 4am wanting to scream in pain with...yep. Another round of kidney stones.

However, I don’t want to miss this test. I studied all weekend - I don’t want to waste that. So I took a couple Advil (or a million, I wasn’t really counting) and headed to class.

My professor took one look at me and said, “No. You’re not taking this test. I won’t let you get a bad grade because you can’t concentrate.” I argued that I was fine, she looked at me skeptically, I looked at her sheepishly, and she, sensing victory, called one of my other professors over to walk me to the ER.*

*The SLU nursing school is right across the street from the SLU hospital, and therefore the SLU ER. Very convenient when you want to roll on the ground in a ball from excruciating pain.

First of all, let me say how incredible our professors are. They actually take the time to care about us students. This is a major university with thousands upon thousands of students, yet little ole’ me got a personal escort with a professor who kept asking if I was ok, when did this start, what have I done to try to alleviate the pain, etc. (Sure, she’s also a nurse, but still. I appreciated the concern.)

The day progressed as you would imagine - hours in the ER waiting to see the doctor and get wheeled down to CT. I will say, however, this ER experience was MUCH better than my last ER experience. The Saint Louis University Hospital ER is WONDERFUL. No one made any mistakes with my IV, they put my armband on me, they repeatedly asked me my name and birthday before giving me meds...unlike the ER I went to a few weeks ago that didn’t do any of those things. Bad. Bad bad bad.

My friend Teri came to sit with me after she got done taking the test, and it was nice not to be alone - especially since the patient in the bay across from me was handcuffed and guarded by corrections officers.

I swear he kept staring at me when the curtain was open. Creepy.

And of course the day I have to be in the ER is the day the ice storm started. And of course I can’t drive home on morphine.

My wonderful, amazing and selfless cousin Gretchen dropped everything she was doing to come pick me up. In the ice storm. She didn’t even stop to think about it - she just ran straight to the ER and took charge - which was absolutely what I needed since the morphine had kicked in and I didn’t understand a single word the doctor was telling me. Plus, as a doctor’s wife, Gretchen knew the questions to ask. Plus, as a mom of three, Gretchen knew how to fuss over me which made me relax and not stress out so much.

Have I mentioned that Gretchen is wonderful and amazing?

The verdict: the ER doc said that he assumes it’s kidney stones, but the tests were inconclusive (of course - this is me we’re talking about), and I have to follow up with a urologist in a week.

Cause, you know, I have time for that.

When I called to schedule the appointment, the secretary didn’t understand why I couldn’t come in at 10am on Tuesday or Wednesday (clinicals and clinicals) or Friday at 11 (NCLEX pharmacology predictor test).

I’ve also discovered that it’s really hard (and exhausting) trying to explain my whole situation to people. Yes, I’m 30, but yes, I’m also a full-time student at SLU. No, I don’t have a primary doctor in the area, because my home is three hours away. But yes, I do live in the area during the week with my cousins. Yes, I’m married, but like I mentioned, my home - therefore my husband - is three hours away. Why? Because I’M A FULL TIME STUDENT AT SLU!!! For crying out loud.

I had to explain this over and over to the ER doc - is this really so difficult to understand? You are a doctor, right?

Anyway, we got out of the ER alive and made it home before the ice got really bad. And this storm might have been a blessing in disguise - clinicals were canceled yesterday and today.

The plan: Rest, pain meds and lots (and LOTS) of fluids, and looking up even more info about kidney stones and dietary restrictions (see previous post).

And lots of Audrey Hepburn. Breakfast at Tiffany’s makes everything better.

But now for something fun - Blizzard pictures! We took Cami-dog for a walk in the snow last night. Lesson learned? Blizzard snow HURTS when it hits your face.

Here’s me and Katie (she’s 12. And as tall as me. No fair). I was trying to stay upright on the ice - not easy when Cami likes to pull.

Believe it or not, this is all sleet and ice.

You can’t really see it in the picture, but the snow/sleet was blowing horizontal. That can’t be good.

This just in: my sister down in Houston, TX just informed me that they don’t have power: “How’s everything up there? No power here because our electric companies don’t know how to handle temps below 30. No power. No heat. No internet. Houston municipalities are so stupid!!!!"

Spoken like a true midwestern girl who grew up with snowstorms and a pastel pink snowsuit. She giggles when her neighbors don’t know what to do with a frost-covered windshield.

And according to my cousin Anne up near Chicago: “They have called a civil emergency in Lake county--all roads closed and you can be arrested if you do drive. I'm going to try to shovel out, call the police and get to the clinic later this am. This is not good!!” Poor Anne - today is also her birthday!

And let’s not forget my husband’s sentiments: “I’m moving to Jamaica.”

13 January 2011

The Great Health Manifesto


I did something really, really stupid.


Really. Stupid.


I was enjoying life as a vegetarian, saving the lives of innocent little animals and feeling like I was doing something good for my body. However, in the middle of finding myself back up to the weight I was at while at SBU in 2001 – no surprise since I’m back in school, sitting on my butt all day and stress-eating bags of sunchips and diet coke – and I had a moment of desperation. I know better. So what in the world was I thinking when I made this decision?


In a moment of pure insanity and desperation, I did something evil. Something really, really bad. I don’t even want to admit it. I’m embarrassed beyond anything.


I’m so ashamed about this...this awful, stupid decision to...ugh.


Fine. I’ll admit it.


I low-carbed it.


Ugh. Yes, that’s right. It was wonderful and disgusting all at the same time. I was dropping weight, but that was probably because I was sick to my stomach every time a fleshy piece of chicken or muscle-y piece of steak crossed my lips. The cheese – oh man. I could live on cheese alone. That part was wonderful. And salads and roasted veggies...that was all good.


But the meat. Oh, just the thought of it right now makes me want to throw up.


And now I find out that all that stupidity might be the reason why I got kidney stones again.


The ER doctor recommended that I talk with a dietician since this is my second time with the stones – the first time was on my honeymoon – and interestingly enough, I was on the low-carb wagon then too.


Hmmmm. There might be a connection here.


These stats kind of shocked me:


·         The younger a person is when they have their first kidney stone (I was 22) greatly increases the risk of having additional attacks. Peak stone formation is between the ages of 35-50.

·         There is an 80% chance of recurring stones ones a person suffers their first stone. There is a cumulative 10% chance each year (ex: 5 years = 50%).

·         60% of people who have experienced one kidney stone will likely develop another within seven years.


Guess what? Yep. It’s been seven years since my first stone.




So what did the dietician say?


First of all, she told me to knock off the low-carb mentality. Quick weight loss doesn’t equal healthy weight loss. Quick weight loss usually equals weight quickly coming back on. Which I know. I KNOW. I know that there are good carbs, good fats...I know the drill. I just don’t listen to myself very much, and I search for the next quick weight-loss option within my reach.


And look where it gets me.


Ugh. Fine. FINE. I surrender. I’m done.


We’ll do this the dietician’s way.


Here’s some info from my doctor, the dietician I talked to today, the Mayo Clinic and WebMD.


I like lots of sources.


So first of all, what are kidney stones?


Kidney stones form when there is a change in the normal balance of water, minerals, and other things found in urine. This can happen if you do not get enough fluids or if you eat too much of certain kinds of food, such as animal protein (!!!!). And, like previously mentioned, if you had kidney stones before, you are more likely to get them again.


My dietician said that by following the eating plan she suggests, I may be able to prevent new kidney stones. Here’s what she went over with me:


· It’s a common myth that a diet high in calcium contributes to kidney stones. Eat a moderate or high amount of calcium-rich foods, such as low-fat milk, yogurt and cheese. The calcium in the food you eat doesn't have an effect on your risk of kidney stones. Ask your doctor before taking calcium supplements, though, as these have been linked to an increased risk of kidney stones.


· Eat a balanced diet that is not too high in animal protein. This includes beef, chicken, pork, fish, and eggs. These foods contain a lot of protein, and too much protein may lead to kidney stones (No more low-carb stupid dieting for me!!). Choose non-animal protein sources, such as soy and legumes.


· Getting your recommended amounts of calcium, combined with a diet low in sodium and protein, may actually decrease your risk of kidney stones. (So, to summarize, increase calcium, decrease sodium and animal protein.)


· The number one way to prevent kidney stones is to drink plenty of water. The most common cause of kidney stones is not drinking enough fluids, especially water. Avoid tea, dark colas and limit coffee intake. (Um, crap. That might be a problem. I still haven’t found a way to break my four-cups-of-coffee-in-the-morning-and-diet-coke-afternoon-pick-me-up habit yet.)


· Avoid grapefruit juice. Grapefruit juice not only contributes to the formation of kidney stones, but it interacts with many medications as well. (True. Grapefruit juice and birth control do not mix.)


· Talk to your doctor if you take vitamins or supplements. He or she may want you to limit how much fish oil or calcium supplements you take. Also, do not take more than the recommended daily dose of vitamins C and D.


·  Increase how much fiber you eat. Fiber includes oat bran, beans, whole wheat breads, wheat cereals, etc.


·  Avoid pre-packaged foods that contain added sugars.


·  Avoid foods that are high in oxalate, such as dark leafy green vegetables, berries, nuts, and chocolate (!!!).  (Seriously? No more spinach?? What in the world??)


·  Try not to add salt when you cook or eat. Remove the salt shaker from your table, avoid eating canned soups, microwave meals and packaged foods that are high in sodium and limit fast-food intake.


So, that’s what the dietician and I talked about, and WebMD and the Mayo Clinic concur.


On one hand, it’s a great excuse to tell M that I’m not eating meat again.


On the other...life without chocolate? Even life with chocolate in limited amounts?  


But I’m willing to try anything at this point. I cannot even describe how painful this is...I do not want this to come back. I’ll do anything to prevent that from happening.


Anything. I’m miserable right now.


And just to clarify – the kidney stone prevention diet isn’t necessarily a weight-loss diet. It’s a “get your body back to its optimal health” diet – something I apparently need right now. We’ll worry about weight loss later. Right now I just need to focus on being healthy.


“To insure good health: Eat lightly, breathe deeply, live moderately, cultivate cheerfulness and maintain an interest in life.” ~ William Londen

12 January 2011

31 Days of Fitness and Kidney Stones

My 31 Days of Fitness reached Day 10 before it came to a screeching halt.
Kidney stones will do that to you.
Days 5-10 of Fitness consisted of walking 3.25 miles with my neighbors while alternating with JM's Yoga and Cardioblast at the Salem Fitness Center on Monday nights.
Day 10 ended with a trip to the ER at midnight in the middle of a snowstorm because I couldn't breathe due to the searing pain shooting through my left side. I was curled in the fetal position on the bathroom floor when M was like, "This looks exactly like when you had kidney stones on our honeymoon. We're going to the ER." So, we went to the ER.
After I changed out of my pajamas and put on deodorant and brushed my teeth, of course. I did wear my slippers though. Mostly because I couldn't bend over to tie my shoes, and also because we live in rural Missouri. On a normal day you'll see people wearing slippers in our local Walmart, so I figured I'd be forgiven in a hospital.  
Long story short - lots of fluids and painkillers as needed. Just like last time.
Now for something fun. M went out of town for a couple days to a baseball coach's conference, and I painted our bedroom!
We've been living in the dark dinginess of wood panelling for the past two years, and I've been wanting to paint it for, well, the past two years. But since we rent, we didn't want to put the money into it. Good thing our landlord owns the local hardware store...I went and asked permission to paint, and he practically threw the supplies at me. I offered to pay, but he said he was getting free labor out of it...and if I felt like painting any other rooms in the house to just let him know.
So I'm kinda guessing he didn't like the wood panelling either.

Oh yeah, and I rearranged the furniture too. Big surprise, huh? 

04 January 2011

31 Days of Fitness - Day 4

I honestly thought after last night's workout I wouldn't be able to get out of bed, but I guess that's what dogs are for.
7am. Wet nose on my chin. Three sets of eyes looking at me like, "If you don't get out of bed right now, you're not going to like the result."
I'm up.
It took a couple cups of coffee and an hour or so of the Today Show, but I did it. Day 4. I was going to do yoga, but I felt like after last night's workout (and the -3lbs lost on the scale this morning) to keep the heart rate as accelerated as possible.
I really, really love Jillian's Banish Fat, Boost Metabolism DVD. It's seriously one of the best cardio workouts I've done. I still want to try Bob Harper's, but...I'm nervous. I've heard it's ridiculously brutal.
Maybe tomorrow, if I'm feeling masochistic. 
Day 4 
Workout: Jillian Michaels Banish Fat, Boost Metabolism
Location: My living room
Equipment: Exercise mat, Garmin FR60 HR monitor
Start Time: 10:00am
Total Time: 55:00
Calories Burned: 602
Average HR: 158
Max HR: 190

Since I'm still on break and M's still on break, we're heading into Springfield today. Yay! We have absolutely no idea what we're going to do once we get there, but that's the fun of just running away for the day.
Speaking of running away, I had to pause my workout halfway through because I happened to glance outside to see UConn out in the front yard sunning herself near the ditch. Um...just 10 minutes earlier she was hooked in the BACK yard. I know she was, because I personally double-checked since she got loose yesterday. And the day before that. And the day before that...how in the world does this dog manage to escape so much?? I just can't figure out how she does it. 
As for today's quote, I love this one. It's hanging on the wall at the Salem Fitness Center, and it's fabulous:
"A man's health can be judged by which he takes two at a time - pills or stairs." ~ Joan Welsh 
How's that for motivation?

03 January 2011

31 Days of Fitness - Days 2-3

So I had a good, pure and holy reason all made up in my mind for why I didn't post my fitness results yesterday...something along the lines of "it's the Lord's day," or "honor the Sabbath day and keep it holy."
But I can't lie.
I was too involved in re-reading the entire Twilight series from start to finish. Start, being Saturday morning. Finish, being Sunday night.
Baz-inga! Four massive novels in two days. M keeps whispering "you're a freak" in my ear. And shouting it at me from the other room.
I love to read!! Nerdynerdynerd.
Anyway, I still made time to get Day 2 in.
Day 2 
Workout: Jillian Michaels Yoga Meltdown
Location: My living room
Equipment: Yoga mat, Garmin FR60 HR monitor
Start Time: 7:30am
Total Time: 35:00
Calories Burned: 208
Average HR: 118
Max HR: 168
And today's - which was BRUTAL. Susie Cahill, you kicked my butt. Actually, you killed my arms. I can't reach up to wash my hair. That's how bad I hurt. And I really, really need to wash my hair.
Day 3
Workout: Cardioblast Class
Location: Salem Fitness Center
Equipment: Exercise mat, Garmin FR60 HR monitor, 3lb weights, 5lb weights, step block
Start Time: 6:45pm
Total Time: 01:05:00
Calories Burned: 682
Average HR: 150
Max HR: 184

How are the rest of you doing so far? Any fun fitness ideas?
"Fitness to me itsn't about a crunch or a push up. It's about taking your power back." ~ Jillian Michaels

01 January 2011

31 Days of Fitness - Day 1

Happy New Year!
Know what that means??
31 Days of Fitness starts...now! Who's with me? That means doing some sort of workout every single day during the month of January - whether it's walking the dog around the block or pulling out an Insanity DVD. Mopping the kitchen with a little extra intensity, or training for a marathon.
Whatever gets you off the couch.
Confession: I'm bored to death with my Jillian Michaels 30 Day Shred DVD, and I wanted to try something new. So for Christmas, I was happy to open two more of her workouts - Banish Fat, Boost Metabolism and No More Trouble Zones. Along with that, I also got Bob Harper's Yoga for the Warrior and Cardio Conditioning DVDs that go along with his Body Rev series - think Insanity but with a way cuter instructor.
A little backstory: after hurting my knee during the Chicago Marathon and having a persistent right shin splint that refuses to go away, I was desperate to find a good workout that would allow me to build strength and tone without aggravating these nuisances.
I found it: Jillian's Yoga Meltdown.
Can you tell that I really, really like JM?
Plus, M got me a super-cute yoga mat and carrier from Gaiam for Christmas. It just begs you to workout on it:
After just two weeks of Yoga Meltdown, let me tell you - the stiffness in my quads and hamstrings are GONE. I can do toe touches and actually TOUCH my TOES. Amazing. My shin doesn't hurt - which is great because Jillian's Banish Fat DVD has some explosive moves, which is the reason why I stopped doing Insanity - those explosive plyometrics just about killed my knee and shin repeatedly.
So now it's time to get back in shape. Who's with me for the next 31 days? 30 minutes a day, 60 minutes a day, whatever you can do. It doesn't have to be complicated or difficult. Anything to get moving!
Here we go...
Day 1
Workout: Jillian Michaels Banish Fat, Boost Metabolism
Location: My living room
Equipment: Exercise mat, Garmin FR60 HR monitor
Start Time: 10:00am
Total Time: 55:00
Calories Burned: 598
Average HR: 160
Max HR: 189
What will you do today?
"I never regret it when I do it, but I always regret it if I don't." ~ Anonymous