My Patients

I haven’t shared too much about my job here on the blog, but this is a story about my patients.

I can tell you that very often my patients are grumpy, or down right angry. They even cry uncontrollably and unexpected. Most of the time they sleep, right through my prodding them and talking to them. They don’t seem to find it especially important to thank me when I call them beautiful or compliment their long, dark hair and chubby cheeks. They do make interesting faces and most of them have the ability to go from a grimace to an angelic and peaceful repose within seconds.

I know that they wouldn’t want me to share that they burp quite often, or even have a tendency to gag and spit readily. Some just can’t help themselves and fart or poop while I’m with them. Sometimes stuff like that just happens, especially when you aren’t really adjusted to so many changes and hospital rules.

Even though they don’t have much to say I can always tell who is going to be totally bored with my visit, or just as easily the ones who are already wide-eyed and following my every move. I always think that those are the ones I have to watch out for, that those patients will be the ones to purposefully and obstinately refuse to listen. Then they surprise me and I find myself wishing I could spend more time with them as they dismiss me and settle in for sleep.

Some of them try to be helpful. They want so badly to help me detach sensors or ear hugs and it often takes a lot of explaining to them that no, I really do have to tuck their hands back inside their swaddle blankets, but I so very much appreciate all their efforts.

I really can’t tell, even anonymously, any funny or whimsical stories that I hear from my patients. Most of them are just trying to comprehend how their world has turned upside down and why they can’t go back where they came from just hours ago. They’ll have stories for sure, but I won’t be privileged to hear them. I would like to assume that they will be happy and bright and optimistic stories.

Those are the patients that I visit in a quiet room with their loved ones close by.

Some of my patients are alone. I meet them in a large, sometimes noisy, space. Their freedom is tested because they are attached to machines. Many of these patients rarely notice when I stop at their bedside. Of course they hear me remark on their beauty and strength just like all the others. Some will show their displeasure for me with the occasional frown or soft high-pitched cry, but I move forward with my work.

These patients are almost always asleep. If they aren’t they twitch, and appear jittery. I move them about, touch them only as much as is absolutely necessary and watch them startle over and over again. There are some that I come to visit and I have to stop. They tell me that it is too much, too soon and they begin to scream in pain. These are the patients that are telling me their stories over and over and I see at least one every day that I am at work. These are the patients that don’t get to go home wrapped in loving arms at 24 or 36 hours.

These are NAS patients. Rather in severe withdrawal, or on a monitoring hold, these patients were born to mothers who used opiates during pregnancy. Those in withdrawal are given morphine. I work in a small facility. Our NICU can house six patients routinely with overflow for 1-2 more. Very sick babies are transferred to a Level IV facility. Most NAS babies stay with us until they are well enough to go into foster care. Since I began work on September 1st, there has only been one of my shifts without an NAS patient.

The work that I do with most babies is rather routine, and predictable in many ways. However, it will never be routine for me to stand in the doorway of the NICU and see a baby, only hours old, being given another dose of morphine. I could never predict how much an infant can tremble, and twitch and startle, never seeming to find peace and quiet.

I can only wonder what these babies stories will be, what their future will hold. I will not be privileged to hear them. I would like to assume that they will be happy and bright and optimistic stories, because to assume otherwise is too painful.

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A Divorce Aftermath Story

It’s coming up on 4 months post divorce. I can honestly say that I have no regrets about my decision to end my marriage. My life continues to be consistent in many ways, with a sprinkling of new challenges tossed in here and there. Some aspects sorted themselves out almost without thought. Others have taken a little bit of time and more energy to accomplish. Not ironically, they all focus to some degree on finances, because in this divorce, that was going to be the major change I had to face.

I remember trying to imagine, during one of many sleepless nights pre-divorce, just how I was going to pay for healthcare coverage. I’d done my homework. I knew, at that time, what coverage costs might be and the range in price was overwhelming. A light began to appear at the end of that dark tunnel when I was told that I could likely get healthcare coverage through the military system thanks to my ex-spouse’s service. I was almost giddy knowing that coverage would only cost me about $25 per month.

On August 3, I applied. This process means that I had to acquire my own individual ID card within the military system prior to even beginning coverage. I waited. Two weeks, then 1 month, then 6 weeks. I reapplied. I waited some more. I had a very compassionate customer service person call me, wondering if I had been given an answer somewhere around the 10 week mark. I believe he went to bat for me once more, sending the information a 3rd time.

This morning, my email, just short of 13 weeks after my initial application, I found out that I don’t qualify for continued coverage. The military has a specific system for determining how and if an ex-spouse might still have benefits. I came up 2 years short of the required number of years.

I wasn’t too surprised really. I had assumed at about 2 months in that a process taking this long couldn’t end in a positive way. In fact, just a few days ago, I actually sat down and begin researching plans and costs for healthcare coverage, being 90% sure that I was going to become one of the masses entering into the health insurance circus.

I found a plan, affordable enough with the tax credit that I will receive, although it is definitely well above the anticipated cost of military coverage. The deductible is high, but most of them are unless you can pay $800 per month for coverage. I am fortunate now. I don’t see a physician often. Routine checkups are the norm and then I go about my life. I will pay the $122 premium each month for preventative care because I want to have a clear picture of where my health is and monitor any issues. The key now is keeping myself healthy.

I will also readily admit that in many ways I had a laissez faire attitude when it came to paying attention to healthcare issues. It was easier… much easier, to assume that those problems wouldn’t be my problems. Sometimes we need a good whack to the side of our head to make us aware that those problems are everyone’s problems – regardless.

A Heartfelt Reminder

This is Cece Mae. She turned 2 on Thurdsay.

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On Friday night, instead of playing with her new toys, she was admitted to the Pediatric Intensive Care Unit to be monitored for 24 hours.

Cece found a pill on the floor, inadvertently dropped by a visitor to her house. That pill, a diabetes medication used to control blood sugar, was chewed and swallowed before anyone could stop Cece.

Her big sister tried. At 5 years old, Miss G knows that pills are not candy. Pills and medicines that are not given by mom or dad do not go in your mouth. Pills that aren’t meant for you can hurt you. Miss G tried to get Cece to spit out the pill, but it was too late. Miss G ran to tell her mom and dad what Cece had done.

Cece and her family will be back home tonight, thanks in part to Miss G’s fast thinking and her parents fast response. Had Miss G not seen what the pill looked like and also reported to her mom and dad immediately what had happened then Cece, on her way to bed, without anyone’s knowledge of what she chewed up… well, we are all thankful that we didn’t have to face that what if.

Besides the IV in her arm, and the hourly finger sticks to test her blood sugar, Cece is taking this whole experience like a trooper. We imagine that she won’t even remember the past 24 hours.

So readers, my plea to all of you, especially if you take medications, vitamins, herbal supplements and happen to be in the home of a small child-

Never assume that your medicine is not of interest to a small child.

Never assume that a child will not find, look for or make attempts to reach that interesting bottle or gummy-style looking “candy.”

Never assume, no matter how many times you say not to, that a child will remember not to put anything into it’s mouth, no matter their age.

Never, ever assume that all your pills actually make it into your mouth when you take your dosage, especially if you are one of those people who can, and do, swallow multiple pills at one time.

If you are in a home with small children, always check the area where you just took your medication. Counters, beds, tables, the floor. Any place a child can see and reach may have a harmful surprise waiting for little hands to find it.

And finally, if an accident happens with a medication, please know what to do, right away. Call your Poison Control help line, or if your community doesn’t have one, call 911. It is imperative if you know a child has ingested anything that you do not wait.

 

Revelation

Nothing major, but something that has been growing on me since about mid-September.

I like my job.

I cannot honestly say that I remember the last time I said that. Likely it was years ago when I was teaching childbirth classes. I loved that job. That job felt right. I probably used the word like a few times during my dental assisting career as well, although I suspect that I liked the doing of the actual job more than I ever really liked where I worked.

I also don’t really know why this admission strikes me as rather incongruous. I suspect that we can all find something about our work to complain about. The commute, a co-worker- or two or three, overtime, workplace drama, etc. I would be surprised to find anyone who would say that their career, and the inherent aspects that surround doing that career, is perfect, but I do assume that many/most of us like the path we have chosen or the career we have ended up in. Yet again today, as I spent time educating a father about what I was doing and why, the revelation popped quietly into my head: I really like this job.

Those extra shifts that I picked up when we lost one of our screeners haven’t been a burden at all. I could literally do this job five days a week. I don’t remember feeling this way when I worked at the same job five years ago. Just like the dental career, I liked the doing, but the place and people- no connection, no sense of belonging.

New parents haven’t changed. I meet them when they are bleary-eyed, sleep deprived but high as the sky eager and anxious and terrified humans contemplating the new person in their lives.

Babies certainly haven’t changed. The babies are the most predictable aspects of my job in so many ways…most of the time…until they aren’t. Babies will surprise you when you least expect it. They will force you to adapt and to think on your feet. Their job is to challenge and I am finding that amazing and humbling.

The job really hasn’t changed with the exception of a few procedural differences. Autonomy, self control and responsibility, the aspects that I craved last time around, still give me a sense of purpose, and self-worth, and feelings of capability and ownership in my work.

So with so much the same I wonder why I am so much in like with my job. Could it be because the facility is smaller with a calmer atmosphere, or that the staff is simply more welcoming and so I feel more grounded; more of a team member; perhaps even more valued. I remember always feeling intimidated when I had to enter the NICU to check on or screen a baby. Now, with my desk just 4 feet from the NICU, I am building a rapport with the nursing staff who feel like colleagues rather than strangers. I am greeted regularly by the housekeeping staff and nutrition staff delivering breakfast. I even got a physician (maybe anesthesiologist) who is always there on my shift, to finally smile and tip his head in greeting.

I’m sure that all of this is a factor, but I also wonder what’s different this time around with me. Five years ago I had just ended my career in dentistry because of arthritis. Five years ago I was beginning my role as grandma. Five years ago I knew that my marriage was over, although I had no idea that I would actually come to the decision of divorce. Five years ago it was difficult to take a job that had me working weekend evenings, even though I was beginning to welcome being out of the house more and more. I think in some ways guilt led me to take that job five years ago. I felt a need to still contribute, maybe even to prove something about my place in a marriage where it was becoming clear that my not working was frowned upon, and the reason I stopped working was implausible in the mind of my ex-husband.

Today, I hold this job for myself. I still feel a need to contribute, but the contribution is to my own sense of self, my own well-being, my own desire to learn from and interact with other adults. Of course, I am also contributing to my finances, and I won’t deny that the extra money every 2 weeks is a bonus! Selfish reasons maybe, but there is no burden of proof that is owed to anyone anymore. I get up and go to work on Saturday and Sunday mornings because I want to. Because I like to. Because it is necessary for me to forge a sense of ownership about myself. Because I do not have to think of how my days and nights are, or are not, making someone else happy or content.

I do this job for me, and that makes all the difference.

 

 

Electrical Anxiety Syndrome

Hold on a minute, no need to run to Google to look this up. It’s not a real thing. At least I don’t think it is. I just invented it, and will now, moving forward in this post, refer to it as EAS because I love acronyms.

Living in a brick apartment building during the summer of 90+ degree days was actually tolerable. I told myself the brick helped to insulate from the heat. Does it? I don’t know, but the idea sounded plausible. Never had an inkling of EAS during August or September. I just kept my blinds closed when not home and never had to even think about turning on any heat.

Living in a brick apartment building during the autumn and coming winter may be another story as it relates to insulation, but again I must look at the idea that if brick insulates well in the heat then conversely it would stand to reason to insulate against the cold… wouldn’t it? If my reasoning here is way off base please excuse me. I leaned much more heavily to biological sciences rather than climate science. Honestly, I’m not really ready to blame the brick for my EAS. I think I need to put the blame squarely on really old single pane windows, two of which don’t seem to make sufficient contact with the aforementioned brick, and god-awful zone heating- aka: individually operated base-board heaters.

What is she talking about, you ask. In lay terms: I think that I’m going to freeze this winter and in the process run up a large electric bill. Thus the creation of my electrical anxiety syndrome (EAS) after a summer of almost non-existent heating bills.

My heaters are designed to be turned on when needed for the room I am occupying at the time. If I leave that room and go to another room, say the bedroom for some reason, I will likely encounter temperatures much, much, much colder. Energy efficiency is not a hallmark of this type of heater, and if you have these heaters in your own home you know that they are typically put in under the windows. Mine sit squarely under my woefully inadequate single pane windows with those blinds that do nothing more than keep the neighbors from glaring at me when they walk down the sidewalk.

As I have no control over changing either the windows or the heaters I have tried to take measures that will help to insulate the inside and prevent losing tons of heat to the outside. I purchased and hung thermal curtains. Pulling them during the day means living in cave-like darkness. I’m having a hard time with this as it’s autumn, the days are sunny, but not warm, and quite frankly I need to SEE OUTSIDE. Cave dwelling isn’t high on my list of fun activities. I also have those door draft snake things stuffed along the windowsills where the cracks are.

As long as I dress warmly during the day when I’m home (that means long sleeves, sometimes even a sweater, heavy-ish socks, or light socks with slippers, then I’m okay. The heaters may be turned on for a time at night, and I heat up my bedroom prior to going to bed.

“So Deb, why don’t you just turn the damn heaters on and live like a normal person?”

Great question.

The reason I am not simply just turning the heaters on and watching my meter wheel turn willy-nilly is that I have no basis for just how much electricity these things use. My local power company, in every newsletter they put online, describes these heaters as energy wasters, or as I think of them- the root cause of my EAS. I have no experience with these things, coming as I did from a natural gas/forced air furnace set-up over the past 24 years.

But I have a plan. I always have a plan. October is my test-out-the-energy-usage-of-these-crappy-old-heaters month. I can run these babies for a time each day while trying to keep the EAS at bay and then see what my bill runs at the end of the month. I can use some not very scientific calculations based on temps now versus expected temps in the coming months plus some hefty algebraic formulas that will allow me to calculate things like HRT (heater run time) / OTV (outside temperature variation) / WPA (weather pattern analysis) against more impractical options such as STSR (sock to slipper ratio) / EB&QC (extra blanket & quilt costs) / and UOOAH (use of oven as heater).

Simple right? I think so.

Or I could just get up, move around to warm up my body and find a better use for my time than filling blog posts with silly acronyms.

*Seriously though, helpful readers- if you have any experience with this type of heating system I am all ears and would love to here what works, suggestions, heartbreak versus triumph over these things…whatever you’ve got. Many thanks!

How we do autumn in my house

The mini pumpkins have taken their place on my outdoor window sill. They get to overlook part of my new garden planter. I have a matching set on the other sill, but I think you get the idea.

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The very first pan of vegetables is ready to roast. I’ve been waiting all summer to get back into the roast veggie routine. This tray was supposed to include some red skin potatoes as well, but I let them go a bit too long. They now have a place at the bottom of the garbage pail.

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There was spicy, Market Spice tea a bit earlier, but I missed taking a photo of that so you have to settle for the generic view.

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and, finally…

I have pulled out the first of the pumpkin scented candles. This one is Pumpkin Cider

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We’ve had on and off rain showers today as well. That’s a sure sign of autumn in the Pacific Northwest.

What about you? How are you doing autumn around your home?