Hello...?

UGH. Blog. Wha cain't I quit yew?

I mean I do quit this blog. On the reg. But every time I come here thinking to delete it, I think maybe I'll give it another shot. A year ago (or longer, really) I thought it seemed like a good way to document the goings-on with my move and my new start out here, but that lasted about a month. Honestly I wish I would have written (...typed) more things down as last year proved to be one for the books. It was a huge year of travel - London, multiple trips to Austin, Dallas, and Houston, Italy, France, Croatia, Napa Valley, San Francisco, New York. I watched my dad become sicker than I ever want to see him get, only to re-emerge back to his normal life within one year. I got ENGAGED to my best friend in the presence of my sweet family.

I mean really. You'd think I would want to write down some of these things.

But I'm not here to re-cap the entire past year and a half. That's a big task. I'm not here for any reason really, except to say hi, does anyone still read this? Lora, I'm lookin' at you! I like the idea of blogs. I love to read them - friends' blogs, recipe blogs, lifestyle blogs... I'm convinced that if I had even this - much knowledge of htmlwhateverwhatever to make this shit look super awesome, I'd be more committed. It's also easy to just rely on Facebook (and Facebook photos) to tell your story of the day, but it is nice to have a real written memory of important (or insignificant!) days and how you felt at a moment in time. But then again, I kind of cringe when I read old posts. It's like hearing your own voice recorded - awful. Do I really sound like that? I was so deer-in-the-headlights nervous/excited about work when I started out here that it's painful to re-read. Now if I were to tell you about work I think I'd just be complaining, and no one likes a whiner. ;)

Just kidding. Mostly. There are tons of things I like about my job, but no job is perfect.

So with that, I'm never going to be the next Pioneer Woman (who sucks on TV, can I just say? What a mistake), but maybe I'll try harder to write down a few things this year. Maybe. I guess I'll end this with a current event to "stamp" this post with something going on - Obama re-elected! People acting like the world will end! People who shout and cry and offend everyone around them to make their presidential vote known, and then will continue to do nothing to participate in local/state government on issues that they supposedly care about. Yawn. The president isn't the do-all end-all of the government people. Ever heard of congress? I digress.

XOXO

A is for:

This post is brought to you by the letter "A"!
A for Adorable as usual:

A for Airplane:

A for the acute cause of Amyloidosis that I was stricken with causing my call-in to work for Friday's shift and forcing me all the way to Houston.
(There really is a lack of illnesses and diseases that start with the letter "A." My second-in-line was going to be Aortic dissection, but the likelihood of my blogging during this aortic dissection would be slim to none)
All lies aside, Kori already had plans to go see Dad this past weekend, and I got a last-minute flight to do the same. I worked Monday/Tuesday, and, aside from the shift I was supposed to work Friday, I don't have to be back until tomorrow. Enter: sick call-in. Bye bye PTO. Hello family, food, and 100 degree temperatures.
I am tempted to delete my most recent post as it no longer applies. The situation described in that post actually would have been the best-case scenario (as far as bad scenarios go, I mean), and now we're looking at a different picture. If I were to give other people advice in this situation, it would probably be to take it at face value and not let their (my) minds embellish the information in either direction on the spectrum until there are facts to support such embellishments. That's the plan: to have no plan. But I won't pretend that the lack of plan is a comforting plan, ya feel me?
Anyway, that's not what this is about. This post is brought to us by the letter "A," and the weekend must go on!
First, Abdominal pain. Delicious, delicious abdominal pain:

The weekend was basically a big food fest, and my oh my it was good. Burgers, BBQ, brunch, Mexican food. When we waddled inside the house in Lupe Tortilla comas Kori said "What a way to end it. I ate like I was never going to eat again." Amen sister.
Appropriately Analytical wall art (at Gatlin's BBQ no less.)

Kori and Adam's first wedding Anniversary (I'm so pleased his name fits into the "A" theme!). They have bed-and-breakfast plans in Fredericksburg this upcoming weekend, so they were okay with Kori spending the day in Houston this year.

Don't worry, Adam, distance makes the heart grow fonder and more full of candy and slim jims. A fiesta awaits you!
Ayiyiyiyiyi!
And now, that's All folks, Adieu, Adios, Alveterzane... that's all I got.

I am a wound-up ball of emotion this weekend; you've been warned. Not necessarily in a negative way, though not necessarily always positive either.

My cup is overflowing with the positive: we had beautiful weather this weekend. We spent some time outside browsing the Reston town center and watching Andrew's frisbee game yesterday morning. We tried a new Indian food restaurant near the apartment on Friday night and absolutely loved it. There has been ice cream x 2, epic Harry Potter movie 3D imax (what what!) x 1, and hugs x.... a lot. Right now I have eggs and milk coming to room temperature on the counter so I can make Sunday pancakes when Andrew wakes up.

Did you know that tip about pancakes? There is lots of technique to pancakes. I digress.

On the other end of the emotional spectrum, I'm not very big on mass public disclosure. But, because I don't publicly link to this blog on the ol' F-book anymore, I feel comfortable getting serious for a hot minute with the handful of you that keep the link to this blog.

My dad has had a lucky streak of dodging some bullets in the oncological world in the past few years. I didn't have a very good feeling about it when he called last week with reports of not feeling well lately and something questionable on a CT scan, but there seemed to be reasonable evidence that it might just be nothing. He got his biopsy results quicker than expected, and he said it is a recurrence of a previous testicular cancer. I asked him what the plan was, and he cheerfully responded "chemo!"

Dad will always deliver his worst news in his most positive fashion. Honestly I knew he must have had bad news when he called because of the way he was joking and chatting with Andrew before I could get to the phone. I suppose it's something about being a parent that I might understand some day.

Chemo? Something that, as a nurse who's given it, I know too much about. On one hand the extra knowledge is comforting as the concept of "chemotherapy" isn't as terrifyingly foreign as it would have been a few years ago. I know not all chemo drugs are even close to being the same. I know which ones are more harsh than others. I know what questions I want to ask. I know what I could warn him about. I know what precautions he needs to take after he starts. I know warning signs he needs to look out for.

But this is my dad, and I don't want any of those things for him.


And that's really the bottom line isn't it? I'm his daughter, not his nurse. There is a lot optimism in the fact that this cancer usually responds very well to treatment. I could spit out some numbers and statistics for you.

But talking about "odds" at all is not something that settles in my stomach very well. I don't care what they are. And I guess that's where I'm at this weekend. There really aren't more details at this point other than what I've shared, which I suppose I'm fine with considering the details at hand just don't fit.

"Well, because this happens to other people, not our people." I think Mom did a good job summing it up.

America!!

[heck] yeah!

(I can't drop the F bomb on the blog, it just feels wrong.)

We had a fun 4th of July in our nation's cap-i-tol (channeling F. Gump).

We had brunch at our current (only) fave brunch spot in DC - Founding Farmers - and then we were off to see what there was to see. We caught a part of a super lame parade whose participants looked absolutely miserable (and who can blame them? It was HOT!), and then we walked all the way to the Jefferson memorial since it was Independence Day and such. Between the trek to Jefferson, back to Lincoln, to nowhere, back to Lincoln, to the national mall - WOOF! Andrew mapped it later, and we probably covered about 9 miles on foot. In flip flops.

To say I had back pain at work the past 2 days would be an understatement. Oh the joys of being old and crooked.

The firework show at night was AMAZING - best I've ever seen. And honestly? The rush back to the metro was not that bad, and the 15 minutes of squishing uncomfortably close to a bunch of strangers on the train was not enough to turn us off to the whole thing. Everyone told me "HA! Good luck" when I told them we were going into DC for the 4th, but I didn't think the crowds were anything to write home about!

Oh, and I made pie.

I thought using frozen puff pastry (Dufour brand - worth every penny! Amazing) would make this an easy process, but I was wrong. Maybe I'll give a rundown of the recipe later.

Other news: Harry Potter and Winnie the Pooh both come out next weekend. WE. ARE. THRILLED! I don't think we're doing the midnight premier, but we'll be getting in on the HP action next Friday or Saturday.

Other other news: I'm thankful to live with someone who willingly gives excellent back (and foot!) massages when I need it. I was so tired after 3-in-a-row at work last week that I cried at the pressure to decide where we were going to eat. Who am I?! I get a little wacky when I'm tired and starving.

I'm halfway through my orientation at work, which is kind of terrifying. Time flies! I've gotten comfortable taking 2 easier patients and keeping up with all the workload and documentation, but now we need to start getting sicker patients with more complication, more drips, whatever. I know there will be tons of things I won't get exposed to during orientation, and that makes me really nervous for the day I'm on my own. Everyone helps each other so much, so that won't be an issue, but YIKES! Some of these people are so, so unbelievably sick, I don't want to miss something. My preceptor continues to be ultra supportive - she is even switching her schedule around to go with me for my nightshifts coming up. My hired schedule is 50% days 50% nights, but I only have to do like two weeks of nights during orientation - the first two nights being next week! I'm glad that she'll be making the switch with me - it helps having consistency. Being with somebody else sets me back for half the day because of their tendency to take over before they know where I'm at.

BUT, regardless of all my worrying, I really like being in the ICU. I like being able to focus on two people and having so much information about them at my fingertips, and I like learning how to take care of people that are, essentially, trying their hardest to die.

That's all for now friends. I have a blind girl-date tomorrow with a friend of Pat's from law school. I miss all you girls back in Austin - still working on meeting people out here! I hope all is well in yall's worlds!

If you'll excuse me...

I'll be back after a few more days of this.

The Happy Hap

I think I would be more motivated to update my blog if I knew how to make it look pretty.

Just thought I'd let you know.

I can't believe I've been out here for 2 months. I've settled into more of a routine, Andrew has officially moved in, and it's been full-force at work for a few weeks now.

Needless to say, the Bug has settled in just fine as well.

Andrew moved in last weekend in the middle of my work marathon. If I'm working multiple days in a row, there's not much time between getting home and going to bed to repeat the long day again (especially now that I've got the 20-30 minute commute). That's nothing new, but my short time (awake) at home is so much nicer with him here to spend it with! Even on nights that I'm computer-ing and he's in the other room video game-ing, I think we both are enjoying each other's company.

And drinking wine out of a dinosaur glass.

And metro-ing into DC.

And purchasing flirtatious printers.

Tomorrow night we might go to a Nationals game, and Saturday (if the weather holds up) is our first game in our frisbee league.

...Wait. WHAT? I know. Do I know how to play ultimate frisbee? No. Can I throw a frisbee? Sometimes. Andrew's always loved playing pick-up frisbee games even when I knew him in high school, and he convinced me to join the "just for fun" summer league. He tells me it will be acceptable in this league to not have any coordination, talent, etc, so here goes nothin'! 

In the working world:

My new job is challenging me a lot, and it brings back a lot of nerves similar to being a new nurse. At this "phase" in my orientation, my preceptor Windy and I are supposed to be assigned 2 "stable" patients so I can get some of the basics down before taking on the really sick patients. Unfortunately, at this point, "stable" patients in the Neuro ICU are still incredibly un-stable according to my comfort zone, not to mention it's frustrating me that I am so slow at everything. I miss being able to pull out meds or chart assessments or troubleshoot equipment quickly without having to think so much about it. And with assessments/charting/flowsheets that need to be updated hourly, sometimes I feel like I'm barely treading water with the tasks of "easy" patients. <--- not to mention that it irritates me that I am reverting back to the new-nurse-curse of being too task-oriented. At this point, though, I know I need to be focusing on some of these tasks. If i don't get it down now, I won't be able to do it quickly when it really counts. I'm told that everybody feels this way at the beginning, and that I'm doing fine so far.

...But man, I look at my co-workers managing these patients who are trying to die - intubated, sedated, cooled, septic, bolted, on CRRT, whatever - and it's hard to imagine that I'll be able to take care of 2 of them while keeping up with the documentation of all this craziness on my own in a few months. During one of our crazier days last week we got a new SAH patient that needed to be intubated early in our shift. It was the first time I've gotten my hands on what it's like to take a patient who starts out on nothing but Normal Saline and, within the hour, ends up with multiple fluid boluses, electrolytes, propofol, versed, nicardipine, fentanyl, and a ventilator to account for. It was challenging enough for me to keep track of each drug's amount and volume on the flowsheet - some of them pushed, some of them drips, some of them alternating between the two - much less managing the patient himself, who now has nasty secretions, moments of trying to wake up despite all the drugs, and whacked out vital signs.

Oh, and then we had to take this whole mess to CT scan and IR. Gone are the days that I get a break when a patient goes to a test - now I go with them. And their drips. And their vent. And their likelihood to code in the elevator.

(And with my wonderful, amazing, understanding, crazy smart preceptor. Thank the Lord for her!)

I think I can I think I can I think I can...

Honeymooning

Holy EVD, I love my new job.

I keep bracing myself for the first nightmare-ish day that is bound to be in my near future, but for now, I'm honeymooning.

I've only had 2 shifts on the unit, and everyone has already made me feel so comfortable. My preceptor Windy is fantastic, and I'll be with her throughout my entire fellowship. She explains everything without hesitation, and she even brought in one of her textbooks to start going over some of the advanced patho that I haven't had to be responsible for yet. I've just been shocked (and grateful) at the initiative everybody has taken to help me hit the ground running. They definitely have a strong team going there - help is constantly being offered from all directions, whether it's for quick turns, stat labs, meds, recording q1h vitals, signing off orders, whatever. Since quitting at Brack I've been worried that my next job might not come with great co-workers, and I'm so relieved that, in fact, it does!

As for new stuff? Yyyyeah. Lots. I'm starting to catch on to soooome of the "normals" in terms of common orders/treatments - tight BP control with pressors or antihypertensives, tight sodium level control with 3% NS drips and/or boluses to keep swelling down in the brain, etc etc. I got a little practice with EVDs/A-lines/vents. One of our patient's A-lines wasn't reading well, and the doctor came in the afternoon and placed a new one at the bedside. I was completely worthless and unable to assist him in any way besides plugging in the ultrasound machine, but it was good to watch Windy do it so I can try to flub my way through next time.

Weirdest moment was looking at the code buttons on the wall - "MSET" is what they call their code blue,  and there's another button for "rapid response" - and I asked if you would push rapid response if a patient was on his way to coding but not quite there yet. Windy said "well, I guess, but we are the rapid response team. It would probably be faster to just shout for help."

We are the rapid response. Geez. So much to learn. I can't wait until I feel like I know what I'm doing, whenever that will be.

Worst part of the day? Drop of blood on my cute work tennies, dangit.

Best non-work part of the day? I pulled into the garage and noticed almost all the empty boxes had been cleared out, and some of my boxes of Christmas stuff had been moved into the garage. YAY Andrew! He offered to make me a salad or get my food together while I got in the shower. Where am I?! I am so not used to anyone being home when I get back from work, and I gotta say it was nice.

And bless him for listening to all my work ramblings today as well as all the ramblings he will tolerate in the future. Amen.

And now we sleep.