girl in greenwood

I've been neglecting my poor blog! As my pathetic short posts have probably hinted, I've been just overwhelmed with everything that's been going on, both good and bad. So here's a quick update on several things in my life:

School. This is this first week of 6th quarter, which is my LAST quarter of nursing school. Graduation is scheduled for March 20. I have two courses with two clinicals - advanced med-surg and nursing management. For med-surg, I'm going to the big downtown location of my employer, which will be interesting. For management clinical, I'm going to a nursing home where half the week I will supervise first-quarter students during their first clinical, and the other half of the week I will manage care for the residents and also manage the staff (CNAs et al) who work there. I am scared to death about the management part - I feel like I don't know enough to tell other people what to do!

House. We're getting settled into the house. I rearranged the kitchen cabinets today, and found a place to plug in the dustbuster. One of our friends asked R* if we were happy in the house, and his answer was "Um... happier than at the apartment? We haven't lived at the house long enough to know." I concur. I think the house is going to be fine but I haven't been here long enough to be sure.

Apartment. I probably shouldn't talk too much about this, but suffice to say that we've found a lawyer and are investigating our options.

Health. Remember how I signed up with Weight Watchers October 1st? Yeah. I stuck to it just fine until the whole Sh*tland thing got underway. And when we were worrying about where we were going to sleep that night or whether we'd have poo in the bathtub, I didn't give a crap about what I ate. So I haven't lost any weight. At least I've managed not to gain any, either. I worked out today for the first time since we moved into the house... I am really out of shape. But it felt good.

Also, remember how I was having too much anxiety? I finally got my act together (and powered through my anxiety about making phone calls) and saw a psychiatric nurse practitioner who specializes in medication management and counseling. After discussing my symptoms and my family history, she agreed with me that I seem to have a biochemical issue that is probably genetic, and changed my medications. It's only been a few weeks and so far, so good.

Kitty. Our Kismet kitty has been such a trooper through all of this upheaval. She didn't like the night she spent in a hotel with us, but she was well-behaved. And she was downright cheerful about staying in the rental condo for a week, even though she didn't understand why we were bothered by her clawing the upholstered chair. (She doesn't do that at home!) Today I took her to the vet for her annual checkup, and the doctor told us she's perfectly healthy, but Kismet registered a complaint with the vet techs. I have never heard her hiss, growl, or yowl before, but she did all three while she was getting her nails trimmed. Goodness. She is a furry purring ball of love at home.

Car. The dealership service center patched my tire and charged me $19. And they vacuumed my floor mats and left me a new bottle of water. Awesome.

Books. I've read a lot of books during my time away from school. The kind you read for fun. You can read about the books I've read and what I thought about them on my shelf at Shelfari.

Las Vegas. R* and I went to Vegas for 3 days right before Christmas. We stayed at the Bellagio and saw 4 shows and ate lots of fantastic food and drank way too much and played slot machines for no apparent reason and generally had a great time. We pretty much avoided the skeevier parts of the Vegas experience altogether. I'm just a little bit bummed that I didn't see any Elvises. (Elvisi? Elvi? Elvoose?)

Christmas. We went to my parents' house and they made Christmas for us. They'd gotten a tree and decorated and put up lights and Mom even got stockings and stuff to put in them. We played games and cards and ate homemade food and took naps and went to see "The Golden Compass" and went for a walk in the snow and generally had a lovely family time. It was really good.

Leavenworth. Because I worked New Year's Day, I didn't want to do anything major on New Year's Eve, which turned out to be just fine since the Space Needle fireworks didn't go off as planned. At all. We had planned to spend the night in a hotel downtown with a view, but we cancelled it in advance. Thank goodness. It would've been a real letdown! So this past weekend before school started, R* took me to Leavenworth to see the winter wonderland. It was so snowy and beautiful! It's not like city snow - everything was covered in this thick puffy blanket of marshmallow cream snow. Because the town is so small, the snow doesn't get all dirty and gross from air pollution and lots of traffic. We went for a walk on the grounds at Sleeping Lady prior to having dinner there, and it was so neat. The snow was about waist deep and they dug out paths between all the buildings. I felt like a mouse in a burrow. The stars came out and they looked so huge and bright because we were out in the mountainy woods - so pretty!

Anyway. I've got to get to bed. I've got clinical orientation tomorrow, oh joy. Oh snore.

Labels: family, health, medical, nursing school, travel

# posted by girl_in_greenwood @ 9:25 PM 1 comments links to this post

I went to the eye dr yesterday and got new contacts. I also learned that the weird vision disturbance I've experienced a few times is called ocular migraine. I had never heard of such a thing before, and I'd never experienced it before last week. I was reading for school and noticed that there was a swimmy, blurry spot in my vision. My first thought was "oh no! my retina must be detaching!" but then I told myself not to panic. I took out my contacts and the spot was still there. It looked like oil on water, or heat waves around a fire, or that stupid Java "wave" effect that every other website had in 1999. So I intelligently decided that clearly I was exhausted and needed a nap. So I went to sleep for an hour and when I woke up it was gone. But I did have a yucky headache, which fortunately went away with the application of two ibuprofen.

Much the same thing happened two nights ago, except that I had been wearing my glasses all day, so it was clearly not contact-related. Since it was bedtime, though, I just went to sleep. Problem solved. And no residual headache afterward.

Anyway, this is a long and complicated way to say that I am not going to go blind. :)

Labels: medical

This post made me want to stand up and cheer!

http://ahyesmedschool.blogspot.com/2006/11/shande.html

Labels: ER, health insurance, medical

A selection of the health-care nonfiction I've read recently.

Cutting Remarks: Insights and Recollections of a Surgeon
by Sidney M. Schwab

Dr. Schwab is a well-known blogger who has written a book reflecting on his medical career. I checked out his book after I read someplace that he lives in Western Washington - which is a dumb reason to pick up a book, but I really enjoyed it, so I'm glad that the reason presented itself. There is a stereotype that all surgeons think they're God and are assholes to the nurses, the med students, etc... but either Dr. Schwab is an exception to the rule, or he's in deep denial. He writes about events in his career with a sense of wonder and humility. And he's had a lot of events, including a stint overseas during the Vietnam War. Best of all, the man is FUNNY. I really liked this book and am now a devoted reader of his blog, too!

Nursing America: One Year Behind the Nursing Stations of an Inner-City Hospital
by Sandy Balfour

I was excited to read this book based on the description - I haven't had any experience with the nitty-gritty of nursing in an inner-city hospital and so I'd like to learn about it. But while Balfour did a great job of portraying the personalities and convictions of the nurses he shadowed in Memphis, he shied away from the medical details. For example, I was intrigued by the burn unit nurse who said, "I love to clean a dirty burn!" but there was no following description of what she would actually DO. However, Balfour did hit on some very serious and pertinent issues in nursing in a public hospital, such as the constant budget strain, race relations, noncompliant patients, and the stress of working under all of those pressures and more.

Forensic Nurse: The New Role of the Nurse in Law Enforcement
by Serita Stevens

This book was informative, but I didn't think it was very well written. I did learn a lot about an area of nursing I had previously not been aware of - forensic nursing. Forensic nurses contribute to law enforcement by collecting evidence and testifying in court. For example, a forensic nurse might examine a rape victim and testify about the evidence that she found at trial. Or an FN might examine a child or vulnerable adult when abuse is suspected, or even examine a corpse for evidence of homicide. The case examples were very interesting and did a great job of clarifying the role of the forensic nurse. However, the book could have used a tighter edit - it was kind of repetitive and I was distracted by the "political" remarks that the author made. I don't mean political as in about government politics, I mean political as in airing complaints about different factions in the nursing community. I found that a bit jarring. Overall, though, this book is worth a skim if you're interested in learning more about the field of forensic nursing.

Labels: book reports, medical, nursing

Madhouse : A Tragic Tale of Megalomania and Modern Medicine
by Andrew Scull

This book is about a horrifying chapter in American medical history. Psychiatrist Henry Cotton practiced in the early 1900s and became convinced that mental illness was caused by infection in other parts of the body, such as the teeth, the colon, the tonsils, and the uterus, and therefore recommended removing some or all of these organs in order to reverse the mental illness. He believed this so strongly that he had all of his childrens' teeth pulled out to prevent them from going nuts later in life. It's quite shocking, especially when it becomes evident that many other doctors and administrators knew that Cotton's data (that supposedly showed that his technique was successful) was hopelessly flawed. It's a terrific argument for the vital importance of truth-telling and accountability in health care.

The Lobotomist: A Maverick Medical Genius and His Tragic Quest to Rid the World of Mental Illness
by Jack El-Hai

This book is a biography of Dr. Walter Freeman, the psychiatrist turned "psychosurgeon" who popularized the use in the US of the lobotomy as a treatment of last resort for patients with severe mental illness. It's a disturbing tale. While Freeman seemed to genuinely believe that he was helping people, even following up on his patients decades later, his own accounts said that fewer than half of the surgery subjects were improved. Many suffered negative side effects such as seizures and loss of cognitive ability, in addition to the (desired) personality changes. It is amazing to me that this surgery was still being done less than a generation ago - there are still plenty of lobotomy patients alive in our communities today. Can you imagine going to the doctor for severe depression and being told, "I want to jam an icepick through your eye socket into your brain, and then you'll feel much better"??

Labels: book reports, medical

All In My Head: An Epic Quest to Cure an Unrelenting, Totally Unreasonable, and Only Slightly Enlightening Headache
by Paula Kamen

This book is a memoir by Paula Kamen, a woman in her thirties who has suffered from a chronic headache since her early twenties. In this book, she chronicles the treatments she pursued in the quest to cure her headache, ranging from the traditional (painkillers, antidepressants, surgery) to the downright weird (craniosacral adjustments, guided visualization, strange diets) and everything inbetween (biofeedback, massage, chiropractic). Nothing cures her, although some things do seem to help a bit.

Interspersed with Kamen's own story are facts and statistics about chronic pain and its sufferers. I found that information fascinating. Kamen calls them the "Tired Girls" because chronic pain sufferers who have pain that is not from an obvious cause tend to be young-ish women with fibromyalgia, chronic headache or migraines, lupus, chronic fatigue syndrome, and so on. All of those disorders cause chronic, disabling pain and fatigue, but without any outward symptoms or foolproof diagnostic signs. So the people who have those disorders end up seeming like they are just lazy and wimpy, and that their problems are "all in their heads".

Even as someone who is sympathetic to the "Tired Girls" - my closest friend in college had fibromyalgia, and I never doubted that she was genuinely suffering, even though I couldn't see the source of her pain - I was taken aback by the callousness that the Western medical establishment, and Western society at large, show toward them. We would never say to a person with chest pain from heart disease, "Oh, quit your whining, if you stop thinking about the pain it will go away" or "if you just weren't so emotionally uptight you wouldn't be sick." Also, I think our medical culture still doesn't give enough consideration to the effects of chronic pain - it's demoralizing and depressing to be in constant pain, especially if you're told by your doctors that you're imagining it!

Finally, Kamen is a witty and funny writer, and really captures the absurdity of her situation. I didn't expect to laugh at a book about a headahce, but I did.

Labels: book reports, medical

Walk on Water: Inside an Elite Pediatric Surgical Unit
by Michael Ruhlman

The author of this book specializes in writing about people who are masters of their craft. Subjects of his previous books include builders of wooden boats and world-class chefs. I was prepared to be a little let down since the writer is not a medical professional, but I wasn't disappointed at all.

The book follows the practice of a renowned pediatric heart surgeon in a clinic in Cleveland, Ohio. Along the way, we learn a great deal about the history of heart surgery and the differences between congenital (birth defect) heart disease and acquired heart disease. I had never considered this before, but apparently doctors and hospital units who concentrate solely on congenital heart surgery have much more success that doctors who do both congenital and acquired.

The descriptions of the actual surgeries were quite technical - I was able to follow along because I've had classes in anatomy and physiology, but I imagine that a reader who didn't have an background in the subject would be completely lost.

The title refers to the giant-size egos that most cardiac surgeons reportedly have. After reading about what they do - holding life and death in their hands every day - I think perhaps they deserve to have high self-opinions!

Fascinating read.

Labels: book reports, medical

The Tennis Partner
by Abraham Verghese

Last year I read Dr. Verghese's My Own Countryabout his practice with rural AIDS patients in the 1980s. I found it tremendously powerful and thought Dr. Verghese was a terrific writer, in addition to a terrific doctor. So when I discovered that he'd written another book, I was excited to read it.

The Tennis Partner is about Dr. Verghese's friendship with an Australian medical student named David Smith. He discovers that Smith had played tennis professionally, and as a lifelong amateur devotee of the game, invites Smith to play with him. They develop a rapport on and off the tennis court, leading to Smith's confession that he is a cocaine addict in recovery. Verghese, who is himself going through a rough time as he separates from his wife, becomes Smith's confidante but is shocked and horrified when Smith begins using cocaine again. You can guess more or less what happens next from the subtitle of the book: "A Doctor's Story of Friendship and Loss."

Once again, Dr. Verghese has written a powerful book. I'm sure some of the tennis metaphor was lost on me, as I'm not a tennis player, but even so I could see that it was used to tie the whole book together. I eagerly await his next book.

Labels: book reports, medical

The Noonday Demon: An Atlas of Depression
by Andrew Solomon

I checked this out of the library after one of my imaginary friends in the computer recommended it. She said that she read it in an attempt to better understand her partner, who suffers from serious depression. I thought it sounded interesting, especially if it brought understanding to my friend, so I picked it up. It actually took me two tries to read the whole book.

I was first taken aback by the tone of the book - the author, himself a sufferer of depression, wrote in first person. While some of the book is personal in nature, dealing with his own breakdowns and recoveries, a lot of the material is factual in nature. For example, there's an entire chapter on the history of depression - it's fascinating, by the way, especially if you were forced to read a whole lot of 18th-century British romantic literature. (Little English major joke there.) Almost every chapter has several stories from people Solomon interviewed for the book about their own experiences with depression.

I'm glad I read the book - it was certainly informative and told me a great deal about the nature of severe depression. Mostly, though, I felt relieved that I am not that sick. I do struggle with depression, but for me, it manifests itself as anxiety and sadness - not abject fear or inability to get out of bed or suicidal ideation or self-mutilation. It may be a little perverse, but I took some joy out of being able to say, "Hey, I'm not very sick at all!"

Labels: book reports, depression, medical