Insufficiently Adrenalized

The End

2009-03-19T13:33:00.000-07:00

It's been quite a while since I posted anything...sorry in advance for the morbidity of this post.

Anyway, after some recent experience in the Intensive Care Unit I would just like to make my own personal end of life preferences known, so here goes.

If at some point I am no longer able to make decisions for myself please consider the quality of my life over the quantity of life I have left. Specifically, if I am mentally incapacitated but my body could be kept alive with the help of artificial measures, I do not wish to continuing living. That is why I am an organ and tissue donor. No death could give me more honor than to give the gift of life to others with my own passing.

I feel the same way even if my organs and tissues are of no use to anyone, if my quality of life is greatly diminished please, let me go!

Know that I would prefer to die when my body or mind can no longer function and would choose not to be kept alive by unnatural means if the likely hood of recovery was minimal or my quality of life were greatly diminished.

I have no problem with the use of measures that will bring me comfort, even if they might hasten my death.

What I really want you to know is that I have no regrets, even if I were to die tomorrow I have lived an amazingly full and wonderful life. I am not afraid of what is to come next so please don't delay my next adventure when I can no longer enjoy this one. I promise that it really is OK to let me go.

It is often a great burden on the loved ones of the ill to make these end of life choices. Please make your wishes known to your families and friends so that they are not forced to bear the weight of making and living out the reality of these difficult choices.

PUT YOUR KNEES TOGETHER!!

2008-12-01T11:47:00.000-08:00

1. Write a blog about an experience you had in either peds or Women's health rotation that you felt strongly about.
2. Did the situation change your views about nursing, about people, about anything?

3. If you could change something (within reason) about the situation, what would you change? 4.What type of nursing do you think you want to do when you are done?

I just wanna start by saying that Women's health is a powerful division of nursing to begin with and, I feel pretty strongly about almost all of the experiences I had there. Come on we're talkn' bringing new life into the world. An odyssey that brings both mother and child just a stones throw from death. The atmosphere in this ward of the hospital is somewhat like being in the eye of a hurricane, calm but with an undercurrent fear and exhilaration.

It is hard for me to choose a story to tell you because there are so many that I feel strongly about. There were the methadone babies, mothers so young we weren't even sure if they were teenagers yet, arguments, epidurals, shaky handed catheter insertions, injections, episiotomies, c-sections, and circumcisions. I could go on and on, but don't worry, I'll spare you.

So anyway, about midway through this rotation after I'd had seen several vaginal births, most of which were induced or had at least labored for several hours in the sleepy haze of an epidural and Stadol, a screaming mother was wheeled through the doors by two paramedics. Well let me tell you, when you are screaming bloody murder in the hallway, attention is not something you have to worry about getting enough of.

So as the paramedics rolled her down the hallway on a stretcher, nurses began asking all the pertinent questions like:

How far along are you?

Who's your doctor?

How far apart are the contractions?

Has your water broken?

Do you want us to call anyone for you?

When the answers were respectively:

AAAAAAAAAAAAAAAAAAAAHHHHHHHHHHHHH!!!!!!!!

IT HURTS, I WANT TO PUSH!!!!

AAAAAAAAAAHHHHHHHHH!!!!!!!!

I DON'T KNOW, I DON'T HAVE A DOCTOR.

AAAAAAAAHHHHHHHHHHHHHH!!!!!!!!!!

After those answers the tension in the air was thicker than the humidity in August.

Turns out this young woman had not had any prenatal care, had labored all night at home alone and was 10 cm dilated. Oh and did I mention she was pushing!

Talk about some scrambling. Nurses and residents came flooding in, respiratory and the nursery were called. Student's ran for warm blankets, towels and whatever else anyone yelled for.

Meanwhile the mother was screaming and pushing and the residents were yelling:

"PUT YOUR KNEES TOGETHER, DON'T PUSH, BLOW IT OUT, HE HE HEW, HE HE HEW!"

In a matter of moments the room was set to go and was practically overflowing with medical personnel. A few pushes later the residents decided that an episiotomy would be necessary. Unfortunately, (for both the resident and the mother) the sterilized scissors they used to cut it with were not exactly what you would call, sharp.

Oh the horror.

I know you've experienced it before trying to cut through something with a dull pair of scissors, you know just sawing away. WELL I BET YOU WEREN'T TRYING TO CUT THROUGH HUMAN FLESH, WERE YOU??? I digress.

A minute later a child was born. About an hour after that it was given up for adoption.

So while it makes an interesting story, I did find the whole situation quite sad. The thought of going through an entire pregnancy without prenatal care just seems absurd. The idea of laboring at home, completely alone seems terrifying. That this child who clearly did not have the benefit of a mother who knew enough to take care of herself while pregnant, will still have a chance to be loved by someone who wants nothing more that to raise a child, seems like a miracle. While this experience didn't really change my view of people or nursing, it was interesting to see another side of the birth experience. Perhaps the polar opposite of mothers and families that plan and prepare, who are overjoyed to see the life they have created. Just another example of yin and yang one cannot exist without the other, or how would we tell the difference.

If I could change one thing I would rain condoms from the skies into the hands of every horny teen. What's that? Can't be done, we must teach abstinence instead. FINE, that's worked great so far by the way!

If I could change one thing I would teach young mothers the importance of prenatal care, perhaps a pop up book in every pregnancy test with lots of pictures and small words.

Ok, ok, if I could change one thing I would give the resident a sharp pair of scissors with which to cut the episiotomy.

I'm not sure why but I am definitely drawn to the field of women's health. Maybe it's the excitement, maybe it's the beauty of new life. Maybe it's because pregnancy isn't contagious...just kidding.

Home remedies shmemedies fee fi femadies

2008-10-17T07:39:00.000-07:00

You will write a blog in your blog space about the following topic.

1. Describe a folk remedy or a home remedy that you know of. Mention the source where you heard it from. 2. Is there any truth to it or is there evidence to disclaim it? Find an article and tell us whether the current research supports the "old-wives" tale or disclaims it. 3. Post the reference at the end of your blog in APA format.4. Do you disagree with using "home-remedies" like the one you posted or not? Do they cause more harm than good ? or do they serve a purpose?5. Would you recommend the one you described to a patient?

I am a Floridian not by birth, I'm a transplant from Pennsylvania, but I've lived here the majority of my life so I consider myself a Florida girl. This was made painfully obvious to me when I moved to Michigan a couple years ago and didn't own any winter boots, gloves, hat, or a real winter jacket and proceeded to freeze my bum off, but I digress.

Since I've lived in Florida a long time and I am blessed with fair skin I've had the unfortunate opportunity to experience several sunburns. This is not from a lack of wearing sunscreen but rather it's from a combination of easily burnt skin, the inability to reach every portion of my back by myself, and a lack of either reapplication of sunscreen at the right interval or after swimming, sweating or a water balloon fight. To a certain extent it is also probably from a lack of the good judgment that would have kept me out or gotten me out of the frickin' sun in the first place. But who wants to sit inside when all the fun's outside? You only live once, and tomorrow is never guaranteed.

Anyways, everybody probably knows how bad sunburns hurt and if you don't, you're the lucky one. I've tried all kinds of things to alleviate the pain of a sunburn like applying Aloe Vera both the bottled kind and right from the plant, oatmeal baths, hot showers, cold showers but the thing that has worked the best was a home remedy that my Mom and probably my Grandma used on me as a kid. It has worked reasonably well for me, but it does have the side effect of making you smell like a pickle. Pour vinegar (white vinegar or apple cider vinegar will work, I don't recommend balsamic) on a cloth and apply it to the burnt areas of skin, you can also add it to your bath water. I have found that it helps take the sting out.

I would recommend this home remedy to my friends or family, however, since current research says that we don't have enough research to say one way or the other how or if it works I probably wouldn't tell patients to use it for fear of being sued. That is probably one of the saddest parts of medicine that I've seen. Fear of being sued changing how and if nurses and other medical practitioners decide to help people and, just gonna be honest here, I think it's total crap. However, it is the world or probably more accurately the country we live in, so for now I'm just gonna have to suck it up.

I think that home remedies serve a huge purpose in peoples lives because it gives them a feeling of control. Illness and accidents are scary, and most people can't, won't, and shouldn't go running to the doctor every time something happens to them. Wait, I forgot I'm in America so strike that. You should see a medical practitioner for everything that ails you, and if you don't have one, or don't have insurance, can't get an appointment, or just can't afford an office visit: please proceed directly to your local emergency room.

However, if you aren't gonna sue me then I think for the most part home remedies are pretty safe and even if they don't work at all having some kind of treatment that can be done at home gives people a little bit of control. Not to say that there aren't remedies that are dangerous, because they're out there, but I don't think that the vast majority pose a huge threat to people's safety. I'd also like to mention that I believe in the placebo effect and the power of the mind over many physiological processes, and I don't care how much stock scientific research is currently putting into those ideas, so there!

I think that even if the "remedy" isn't effective if the person receiving it believes that it will help it probably will do more good than harm even if "it's only in their head." I'm gonna back that up by mentioning how bad stress is on the body and how stress alone can alter physiologic processes that were working just fine before. So even if home remedies only helped by alleviating stress and giving people something that they think is helping, home remedies serve an important purpose. If you don't believe me just ask my Grandma.

Reference

Herbal plant therapies: Apple cider vinegar. (February, 2008). Retrieved October 16, 2008, from the University of Texas, M.D. Anderson Cancer Center: http://www.mdanderson.org/departments/cimer/display.cfm?id=9e8f94b3-b637-4a3e-bf43a1dce39b9be3&method=displayfull&pn=6eb86a59-ebd9-11d4-810100508b603a14

Birthdays are the best days!!!!!

2008-10-16T15:07:00.000-07:00

So today happens to be my sisters birthday, and I am so happy that I have her in my life and I am totally excited to celebrate the day of her birth, even if she isn't really feeln' it this year. Also, today I was in the labor and delivery ward and I got to see another baby come into this world and it took me back just a little cause I was all, this is the same day my sister was born, if I was sent back in time this could be her, except she was this beautiful pink petite wonder of a baby and the baby I saw today was well... BIG and also a boy, but that's not the point. Today marks the day that my only sister was brought into the world and that is worth celebrating!!! So I'm sending out the happy energy I feel today, I'm celebrating thanksgiving a little early because I'm so grateful that on today's date not that long ago at all, a wonderful, smart, talented, creative, amazing woman came into this world and I got her as my sister! Happy birthday sis, hope you live it up!!!

Stress the sixth vital sign.

2008-09-29T08:26:00.000-07:00

So my sister is stressed about turning 30, and I am stressed that "if everything goes to plan" I will still be in school when I turn 30. Just goes to show that it doesn't matter what your problems are, worrying about things that are out of your control, will still take up the same percentage of your life. Awesome.

Semantics

2008-09-22T10:28:00.000-07:00

Disillusionment: the act of freeing from an illusion, or the state of being freed therefrom.

Sounds pretty good, in fact I think I could use sumothat. I think almost everybody could use some. After all who wants to walk around with some illuuuuuusion of how things really are? Doesn't everybody want to see the world as it really is? Know the truth.

Now here is where it gets interesting, it's like that scene in the Matrix, where Morpheus gives Neo the choice of two pills. The red pill will open Neo's eyes to what the Matrix truely is. In other words the red pill is a big ol dose of disillusionment. Of course there is the option of the blue pill, take the blue pill and go back to life as you know it, nothing changes. Ho hum, just keep livin' the same ol way you have been. Keep those blinders on and relish in the illuuuuuusions that are your current perspectives.

Well, when you put it like that, don't you think everybody would want the red pill?

Now listen to this definition of disillusionment: a feeling of disappointment resulting from the discovery that something is not as good as one believed it to be

Well CRAP, crappity crap ola, crapadoodle doo, open up a box of crapper jacks. You better hope you have a sensitive gag reflex cause baby, I don't know anyone who wants that red pill now.

Awe, what's that?

It's too late.

Pity.

Soooooo, now that you've gone tumbling down the rabbit hole what are you gonna do?
tick, tick, tick, tick, tick, tick, tick, tick, tick, tick
That's the sound of your life slipping away while you wallow in your own misery.

So I heard this quote on some movie the other day: "every minute is another chance to turn it all around."

Got it? Now that you have had your moment/month of self pity, it's time to suck it up! Roll your sleeves up, shake it off, play the theme song to Rocky if you have to and get to work figuring out how to "turn it all around." Be like Neo, go and kick the machine's proverbial a*#!

No need to thank me, I'm doing this as a public service.

So how was your day? Wait, don't answer that.

2008-09-21T07:41:00.000-07:00

Hospitals make me want to drink. I mean that in the best possible way, because I think that all the red wine is probably awesome for my heart and I am going to live forever now.

So Friday night I was driving home and my boyfriend called:

BF: "Hey babe, how was your day?"

Me: "Peachy, do we have any wine?"

BF: "Umm, let me check....uh no I guess we're out"

Me: "Well I'm not coming home then."

BF: "What?"

Me: "Sorry what I ment was, do you want anything from the liquor store?"

Student Nurse Thought For The Day!

2008-09-14T16:20:00.001-07:00

I find that if I lower my standards I am much less disappointed, and I am able to find the silver lining no matter how small it may be. Take for example the administration of an enema. . . at least I wasn't on the receiving end.

Pppsstt are you asleep?

2008-09-06T13:30:00.000-07:00

This week's assignment: post a blog in the blogspot you have created for yourself describing your experience or your families with OTC or prescription medications. Did the medication do what it was supposed to?
So my experience with OTC (over the counter) drugs is pretty typical. For the most part I try to avoid pills and pharmaceuticals except for a multi-vitamin and an Advil every now and then. Recently though I have been having an unusually hard time sleeping. Wait, let me preface that with a little history. I have always had a hard time going to sleep. Always being, ever since I can remember. When I was little sometimes I used to sleep in my sister's bed and since I also suffer from scotophobia, I would ask her to "stay awake until I fall asleep." Well that was virtually impossible because my sister had the exact opposite problem. Once her head hit the pillow she could not stay awake even if she tried, even if there was noise or people moving about, or the lights were on, or the T.V. was playing, or a hurricane was roaring overhead she still had almost no trouble dropping off to sleep. Or at least she didn't when we were young, I can't speak for her now. I on the other hand would lie awake for hours tossing and turning and every time I thought she had fallen asleep I would whisper really loud "pppssstttt are you asleep?" You can only imagine how annoying this must have been to my sister, being roused by wiggling and whispering every time you've dosed off. So you know why it wasn't very often that I was allowed to sleep in her big canopy bed.
On and on I have had this problem, I go to bed exhausted and then my mind will just not shut down. I start to worry about things, mostly stuff I have no control over, I feel slightly overwhelmed and by then there is almost no possibility of sleep. So I do some deep breathing, try my best to clear my head, let things go, forget about what's bothering me and in a couple of hours I fall asleep. Then just as I am entering what feels like the deepest most enjoyable restorative phase of sleep my alarm goes off. This seems to happen no matter how early I go to bed at night. Night after night until it feels normal and I don't even think about it anymore.

So now that you know a little family history hopefully you have a better appreciation when I tell you that I've been having some trouble sleeping lately. In the past I've tried things like NyQuil, Tylenol PM, and Benadryl I've even taken prescription drugs like Ambien but most of the time they make me feel fuzzy in the morning and if you think I have a hard time sleeping at night you should see me trying to wake up. My mom and sister used to flip a coin for who had to do it, it was that bad.
Recently this sleeping problem has frustrated me to the point of trying some new OTC remedy so I went CVS and wandered up and down the sleep-aid isle and decided to purchase an herbal remedy. I picked Alluna which is composed of 500mg valerian root extract and 150mg hops extract. Don't ask me what the hops is about maybe the makers also have a brewery or something.
I tried it the first night and didn't really feel any effects, still had the same hard time getting to sleep. Tried it the next night, still no results. I gave it a third try, still nothing. Well crap! There's nothing like wasting your money especially when you have very little of it to begin with. So I pretty much gave up taking this herbal remedy until last night. I'm not gonna lie, I was freakn out a little after clinicals. Doing some heavy thinking about choosing the nursing profession. Wondering what the heck I'd got myself into. I mean some serious reconsideration of my plan in life. Lets just call it a Genesis moment, and I mean that with a whole lot of respect for a very sweet, smart girl but like her I was really wondering "if my heart was still in this."
So,I came home showered, really tried to scrub away not only anything that might be infectious but kinda tried to scrub the whole day off. Like if I got the water hot enough and used enough soap and exfoliated every millimeter (by the way there are 10 of these in a centimeter) of my body maybe I could erase the day I'd just had. It didn't work, but I digress.
I had dinner and two big glasses of Merlot and then since one dose of Alluna didn't seem to do anything I decided to take two. Now please do not think I'm some suicidal maniac. I was in no way trying to overdose, and a glass or two of Merlot is pretty usual for me so all in all I was following my regular routine except I took 1000 mg of this natural sleep remedy instead of 500 mg. To tell you the truth it seems like it might just be the right combination for me because for the first time in several weeks I actually slept. I laid my exhausted body down into my snuggly soft bed and despite the fact that the day was weighting heavy on my mind I went right to sleep. I slept all the way through the night and woke up at 8a.m. feeling pretty refreshed.
After a big cup of coffee and two skydives my outlook seems a bit brighter and I'm feeling like I might just figure out a way to keep my sanity. Now if I could only find a way to bottle the feeling skydiving gives me and get some pharmaceutical company to pay me royalties. . .

Almost the second.

2008-08-25T12:12:00.000-07:00

So here it is folks, in all it's glittering Internet glory, like a shining Olympic medal gleaming on the neck of Michael Phelps . . . my very first blog. Crap . . . I already used the "F" word and I'm only on the second sentence. Settle, just settle down now, it's not what you think. Really. Where I come from, no it's not another planet, but I am probably weird enough to make you wonder, and with a name like Amahra, oh never mind. What I'm trying to explain is that the "F" word is really the word meaning: that thing that comes before the second time you do something. As I was saying, where I come from which is specifically a place so full of freaks and misfits that it makes me look pretty darn good, which of course you have already observed just by viewing my profile picture. The word "first" is something that is avoided like dog doo in the yard. It is something that people are guilty of. Something that you never want to admit to, never, but just like stepping in dog doo, people tend to sniff it out like a hot stinking wet. . . well, you smell what I'm steppin' in.
There is a very good reason why the people in my social circles avoid the "F" word as I have defined it above. They don't want to admit to being a novice. Admit that they have never tried something before. After all, who wants to own up to the fear that we all experience when doing something for the first time, which is of course, the fear of the unknown and probably most of all they don't want to have to buy a case of adult soda as is the tradition for anyone who utters the "F" word at a DZ.
This tradition being what it is, leads to a mentality of "fake it till you make it." Which brings me to the point I was really trying to illustrate. The real enemy here is another "F" word: fear. Everyone has experienced it, the paralyzing, mind numbing, sweat inducing, stomach churning, nail biting, leg giggling, emotion, sensation, physiologic response that is fear. The real trouble isn't just that we experience fear, it's that it prevents us from thinking and acting with a calm mind in situations that need clear, controlled, logical thought. As a skydiver and adrenalin junkie in general, I have had the opportunity to hone a skill that many others do not even know exists or is possible: staying calm in the face of fear when clearly you would be more inclined to panic.
I'm not telling you this to brag, because I have been chased from the calm crystal clear waters of my grandparents swimming pool on countless beautiful sunny days by my sister singing the daaaa naaaa, daaa naaa, daa naa, da na, danadnadanadaDANADANADANADANA of the Jaws theme song. So clearly I haven't always had a handle on this beast. I'm telling you because if I can do it there's no reason why you shouldn't be able to do it too. All you have to do to start, is fake it.
That's right, faking confidence and being able to relax your body, face and eventually your mind is the best way to fool your body into believing that it isn't scared stiff. I could elaborate but instead I'm going to send you to a great website whose author is much more eloquent and whose techniques I use to overcome my own fear. Believe me, even if you don't jump from perfectly good airplanes, plunge at speeds over 120 mph toward the earth and then deploy bits of fabric and string to save yourself from becoming a lawn dart, you can still utilize these techniques in your everyday life to transcend fear.