Thursday, July 31, 2008
Understanding Your Chronic Pain-Fibromyalgia
Oddly enough, just a day after I wrote on keeping a pain journal, my inbox was full of the usual mail, and then from WEB MD was a great article about seeing your pain doctor, and it touches on some good ideas that include a type of journal that you can keep before seeing your doctor to help them in a diagnosis. It is an interesting read. Mainly covers the topic of Fibromyalgia Pain. Hope you enjoy it!!
Wednesday, July 30, 2008
Digg - Home Care Nurses Drive More Each Week Than UPS Drivers
Digg - Home Care Nurses Drive More Each Week Than UPS Drivers
medicalnewstoday.com — In this article from the site: http://www.nahc.org, which is the National Association of Home Care and Hospice; it is noted that the nurses out making house calls cover more miles per week than a UPS driver! I found this so fascinating because I worked as a Hospice Nurse for years and used to put 120 miles/day some days I was on call. Nuts!
medicalnewstoday.com — In this article from the site: http://www.nahc.org, which is the National Association of Home Care and Hospice; it is noted that the nurses out making house calls cover more miles per week than a UPS driver! I found this so fascinating because I worked as a Hospice Nurse for years and used to put 120 miles/day some days I was on call. Nuts!
Keeping Your Pain Journal
I want to always have a record of my pain levels. Having this Pain Journal with me when I see my pain doc is valuable information that I could not recall easily or at all when I visit him without it.
Think of one day in your life. The ups and downs of your pain levels can vary by the minute. The peaks and valleys must be recorded, all of that information will be so helpful when you visit any doctor, especially the one that manages your pain. Your symptoms may speak specifically of one issue, and help with a doctor's diagnosis.
What spikes your pain? How long does it take after a certain activity for the pain to get bothersome? What do you take for your pain medicinally, and how long does it take for that medicine to be effective?
What helps your pain? Are there specific exercises that your doctor has approved for you? Stretching, swimming, etc.? Do they really help?
What other modalities do you use that have been effective/non effective for your pain? Heating pads, ice packs, Thermacares (Activated by air-heated charcoal), for on the go heat; Icy Hot Packs, tinted with Menthol for a cooling feeling in a to go pad also. Capsicum patches are made from hot pepper and this is for some helpful. Cramps? Try some Thermacares for Menstrual Cramps. Very effective. The heat in Thermacares last for 8 hours up to 12. Great for hurting backs at work or out doing something we probably are pushing ourselves to do! Chart all of this. Remember, just a few jotted down notes is all you need to do.
Your daily Pain Journal should consist of your pain levels, when and possibly why they were exacerbated, what helped, what did not, how long it took for relief, and all this with times of the day written in. It may sound tedious, yet after you get used to doing it, you will feel odd when you don't 'chart' for the day!
A small notebook but with enough room for your extra notes works fine, as does a specifically-made pain journal. I have one from the American Pain Foundation. It was a few years ago, and I found it to actually be more tedious to follow their way of charting it. I feel more comfy just noting it down in a notebook and keep it by my bed. Kind of like a dream journal!!
Each day, make a note of your pain level when awakening. If the day goes by without anything out of range happening , or not much unusual in what is normal for you pain wise, note that; and happily!!! If the day begins to take a turn for the worst, start by noting the time, your symptoms, what you were doing prior to the pain, and what action you take. Then make a note of if your action was effective.
Do whatever works for you! When you have your next doctor appointment and you bring that journal, you will have with you many moments out of the month or two months since you've seen the doc, that are significant and important for her/him to know. And when you look at a month's worth of moments, you will realize there is no way you could have remembered each of them to tell the doc. Many have a tendency to go with the most recent pain levels in their mind, they may have had a basically good month, but not connecting that every time the dog poop is picked up, or a drive longer than an hour escalates pain levels. If these seemingly small events, but so important in our lives as Chronic Pain/Illness sufferers because they cause pain; are not noted down ever, the connection may not be made, and there is another reason for pain flare-ups that could have been identified. Even standing while washing dishes for me is HUGE. The use of my arms at Thoracic level and standing flares up my pain fast.
We all know, as the patients, what things make our pain worse. The obvious things. The ones we can connect immediately to pain. Then there are the days that we feel good enough to do 'some things' around the house, work a little extra, drive a little further, stay a little longer. We know that the next day, we are likely to 'pay' for our over doings. Today I am in a lot of pain and need to get out of the computer chair and my positioning, and go sit using the heating pad with my legs up. It doesn't take a smart one to look at the fact I vacuumed last night, something my doc and other docs have told me not to do. I even did the attachment thingy and started on the couches. Of course I had to stop before I would have liked to, but I knew I was going to hurt last night, and today very bad-- if I didn't stop. And I do. :-(
So, I overdid it. But what about the day I worked on the computer, and emptied the dishwasher? Why did my pain level rise so quickly? Which of those events caused the spike? I was able to narrow it down to the computer time, having made a note for that day when I came home what my pain level was. I was going to attribute it to the computer chair, but I have a really great ergonomic chair, and then I must look at the position of my hands that starts to put my back into spasm. And what do you know? Aside from standing, it is just like doing dishes to my back. Thoracic level, arms working, holding them away from my body, reaching out.
Identifying your triggers are an excellent thing to jot down in your journal too. I put my list of triggers in the front and seriously have to look at them when I am in pain, but have things to do staring at me, like wash, (oh, just the word hurts,) to remind myself of the things I just can not do at that time. Oh well, who said a heating pad, an old Rosalind Russell film, and a diet coke is not too bad of a deal when I have the time to rest and do some self-care. Or, (this is for Jeanne & Mckay) , when I make the time to rest!
Duly Noted!!
Think of one day in your life. The ups and downs of your pain levels can vary by the minute. The peaks and valleys must be recorded, all of that information will be so helpful when you visit any doctor, especially the one that manages your pain. Your symptoms may speak specifically of one issue, and help with a doctor's diagnosis.
What spikes your pain? How long does it take after a certain activity for the pain to get bothersome? What do you take for your pain medicinally, and how long does it take for that medicine to be effective?
What helps your pain? Are there specific exercises that your doctor has approved for you? Stretching, swimming, etc.? Do they really help?
What other modalities do you use that have been effective/non effective for your pain? Heating pads, ice packs, Thermacares (Activated by air-heated charcoal), for on the go heat; Icy Hot Packs, tinted with Menthol for a cooling feeling in a to go pad also. Capsicum patches are made from hot pepper and this is for some helpful. Cramps? Try some Thermacares for Menstrual Cramps. Very effective. The heat in Thermacares last for 8 hours up to 12. Great for hurting backs at work or out doing something we probably are pushing ourselves to do! Chart all of this. Remember, just a few jotted down notes is all you need to do.
Your daily Pain Journal should consist of your pain levels, when and possibly why they were exacerbated, what helped, what did not, how long it took for relief, and all this with times of the day written in. It may sound tedious, yet after you get used to doing it, you will feel odd when you don't 'chart' for the day!
A small notebook but with enough room for your extra notes works fine, as does a specifically-made pain journal. I have one from the American Pain Foundation. It was a few years ago, and I found it to actually be more tedious to follow their way of charting it. I feel more comfy just noting it down in a notebook and keep it by my bed. Kind of like a dream journal!!
Each day, make a note of your pain level when awakening. If the day goes by without anything out of range happening , or not much unusual in what is normal for you pain wise, note that; and happily!!! If the day begins to take a turn for the worst, start by noting the time, your symptoms, what you were doing prior to the pain, and what action you take. Then make a note of if your action was effective.
Do whatever works for you! When you have your next doctor appointment and you bring that journal, you will have with you many moments out of the month or two months since you've seen the doc, that are significant and important for her/him to know. And when you look at a month's worth of moments, you will realize there is no way you could have remembered each of them to tell the doc. Many have a tendency to go with the most recent pain levels in their mind, they may have had a basically good month, but not connecting that every time the dog poop is picked up, or a drive longer than an hour escalates pain levels. If these seemingly small events, but so important in our lives as Chronic Pain/Illness sufferers because they cause pain; are not noted down ever, the connection may not be made, and there is another reason for pain flare-ups that could have been identified. Even standing while washing dishes for me is HUGE. The use of my arms at Thoracic level and standing flares up my pain fast.
We all know, as the patients, what things make our pain worse. The obvious things. The ones we can connect immediately to pain. Then there are the days that we feel good enough to do 'some things' around the house, work a little extra, drive a little further, stay a little longer. We know that the next day, we are likely to 'pay' for our over doings. Today I am in a lot of pain and need to get out of the computer chair and my positioning, and go sit using the heating pad with my legs up. It doesn't take a smart one to look at the fact I vacuumed last night, something my doc and other docs have told me not to do. I even did the attachment thingy and started on the couches. Of course I had to stop before I would have liked to, but I knew I was going to hurt last night, and today very bad-- if I didn't stop. And I do. :-(
So, I overdid it. But what about the day I worked on the computer, and emptied the dishwasher? Why did my pain level rise so quickly? Which of those events caused the spike? I was able to narrow it down to the computer time, having made a note for that day when I came home what my pain level was. I was going to attribute it to the computer chair, but I have a really great ergonomic chair, and then I must look at the position of my hands that starts to put my back into spasm. And what do you know? Aside from standing, it is just like doing dishes to my back. Thoracic level, arms working, holding them away from my body, reaching out.
Identifying your triggers are an excellent thing to jot down in your journal too. I put my list of triggers in the front and seriously have to look at them when I am in pain, but have things to do staring at me, like wash, (oh, just the word hurts,) to remind myself of the things I just can not do at that time. Oh well, who said a heating pad, an old Rosalind Russell film, and a diet coke is not too bad of a deal when I have the time to rest and do some self-care. Or, (this is for Jeanne & Mckay) , when I make the time to rest!
Duly Noted!!
Sunday, July 27, 2008
This Day Went By Too Fast!
Today has me in an odd way of thought. This day has gone by way too fast! I have gotten so much done, and now my brain is on 'relax' mode. Tried to study Lifespan Developmental Psychology but wasn't interested in the repetitive information I was being fed. Tried to apply it to my own life; (suggested for study,) yet I had no interest in my zygotes, prenatal care, or delivery of a baby and their APGAR score. Ah, the United States Educational System....I have always believed that so much time is wasted in this country on the amount of time that goes by before someone is considered "done." We all know education never ends, yet what I have seen from living in other countries, and having lived with a man from Mexico; I am informed well on the topic of countries that graduate their HS students with the ability to go out and work at a career, not just a job. He was teaching Biology in Mexico the year after graduating High School. Of course higher education was encouraged, and utilized; and these new possible college students were able to make the choice of staying in what they specialized in while in HS; and not continue their education, or, as they are going to school, they can work if they have to, and not always at a mindless job!
Here, our kids are lost. It's not easy to find 3 other guys and a house, all splitting it, that would not be affordable unless they all are working straight from school, for hours at minimum wage just to make some money; of course leaving no study time. It is so expensive to live in Southern California, the rents alone are astronomical, and unrealistic for most college students. We Americans spend 12 years in school, and come out with a Diploma. No specializations, just general studies and a piece of paper that at that time, makes no difference really. I took 2 years of ROP in HS, of course it was Medical Occupations....my dreams then of being a surgeon...watching people almost die from gunshots in the ER, chaotic scenes there--at a hospital that of course is now no longer called what it was---Orange County has gone from citrus trees to losing the old 'institutions' I remember learning in. And won't forget one heart wrenching scene.
In the Medical Library at the Hospital, I saw an old book with a picture of a man with no lower mandible. Straight on throat only photo. I took one look at that book and kept it for the whole year, mesmerized by the pictures of disfigured people inside that were helped in appearance through prosthesis's and surgery. (Of course I DID return the book at the end of the year!) I knew since I was 12 I wanted to be in the medical field, and as soon as I could, I was IN some kind of program that put me in the actual life I had dreamed of. I spent time and interest in that program, ROP was something our HS's had: Regional Occupational Programs. The guys took car shop, or electrical; some girls took secretarial, I went straight for the Medical field. I wonder...it would be very nice had I been able to graduate with something like: 'A High School Diploma with major in Medical Occupations.' Why not? The classes became just words on a report card, eventually making their way onto transcripts, (that are even asked for now!) my they are old! LOL
Just a few thoughts this odd day. Even as I work on my Bachelors, I see books full of previous knowledge from my nearly 2 decades of being a nurse. Oh how the rules and regs work for this one! OY! Oh well...what can I do?
.......maybe I'll be in the mood for some zygotes later on. zzzzzzzzzzzzzzzzzzzzzzz
Here, our kids are lost. It's not easy to find 3 other guys and a house, all splitting it, that would not be affordable unless they all are working straight from school, for hours at minimum wage just to make some money; of course leaving no study time. It is so expensive to live in Southern California, the rents alone are astronomical, and unrealistic for most college students. We Americans spend 12 years in school, and come out with a Diploma. No specializations, just general studies and a piece of paper that at that time, makes no difference really. I took 2 years of ROP in HS, of course it was Medical Occupations....my dreams then of being a surgeon...watching people almost die from gunshots in the ER, chaotic scenes there--at a hospital that of course is now no longer called what it was---Orange County has gone from citrus trees to losing the old 'institutions' I remember learning in. And won't forget one heart wrenching scene.
In the Medical Library at the Hospital, I saw an old book with a picture of a man with no lower mandible. Straight on throat only photo. I took one look at that book and kept it for the whole year, mesmerized by the pictures of disfigured people inside that were helped in appearance through prosthesis's and surgery. (Of course I DID return the book at the end of the year!) I knew since I was 12 I wanted to be in the medical field, and as soon as I could, I was IN some kind of program that put me in the actual life I had dreamed of. I spent time and interest in that program, ROP was something our HS's had: Regional Occupational Programs. The guys took car shop, or electrical; some girls took secretarial, I went straight for the Medical field. I wonder...it would be very nice had I been able to graduate with something like: 'A High School Diploma with major in Medical Occupations.' Why not? The classes became just words on a report card, eventually making their way onto transcripts, (that are even asked for now!) my they are old! LOL
Just a few thoughts this odd day. Even as I work on my Bachelors, I see books full of previous knowledge from my nearly 2 decades of being a nurse. Oh how the rules and regs work for this one! OY! Oh well...what can I do?
.......maybe I'll be in the mood for some zygotes later on. zzzzzzzzzzzzzzzzzzzzzzz
Sunday, July 20, 2008
Taiwan Years
I had the pure pleasure of having the opportunity of leaving the U.S. to live in Taiwan. Those four years held the most pain, emotionally, that I had ever had to endure; yet it also gave me the ability to see how the other parts of the world lived, and this was a gift I will hold close to my heart forever.
In the mid-80's, boarding the plane to meet my then-fiancee; saying goodbye to my mom was really tough for us both. She was my best friend and I hers. I did my best to stop crying and find my way to the seat. The next 14 hours gave me not only lunch, dinner, and breakfast, but a scene I would not soon forget. This leg of many plane flights to come was just the beginning of a set of norms that I would come to know well, be able to ignore, and also use myself.
Staring, is not considered rude in the Chinese culture. In an elevator for instance, the person on either side of me would have their heads turned totally to the side to stare at me. After all, a taller than most on the elevator blond and green-eyed Caucasian lady, was a sure-fire reason (although there was never one necessary,) for the staring to occur. After I began modeling there, and my face was recognized, wow, was it wild!
Since I was living there, not staying for a few days on a tour; I needed to learn how to converse with the Chinese-speaking public. For me to shop, go to the open markets, to pick out the best fish for dinner, to ask our houseboy to fix something. This was my life for 4 years. My hubby decided he would just let his secretary translate for him, and set up all the utilities for us. He had no interest in learning the language. I, on the other hand, was in it for the entire experience. Heck if I was going to wait for a translator, or be one of those that used a dictionary but had no idea of how to put the words together kind of foreigner!
Most of us ex patriots were viewed as slightly spoiled, never really trying at anything much, using the driver and car the companies provided for their Overseas workers type of people. Little did I know that soon I'd be squatting with the rest of the shop I was in, bargaining with the best of them, all in Chinese! I still can sit like that, although with needing my 3rd knee surgery and arthritis in the other, possibly more, I opt for the standing position thank you.
Taiwan gave me many things. My marriage. We flew back to the beach to get married. Another 14 hour trip with my wedding dress that was designed for me in Taiwan, and it was the latest design, that I saw maybe a year or more later in the states. We had access to the European designs way before the states even started putting them in their windows. I modeled dresses once for Chloe, that were one of a kind. I was so startled when the designer saw how much I loved one piece that was going to go for production there in Taiwan, and gave me the piece. I wore it to my 10th High School reunion, I wore it till it started really showing it's age!
My dress that clear day of my wedding, was truly a show-stopper, the headdress with many pearls that were coming towards my face, on pieces of translucent wire. Very different than the U.S.'s traditional veils of that time. Having our wedding night full of returning his son to the airport an hour away, (I know, why couldn't THAT have been pushed back one more day?) I only wanted to sleep! Luckily, so did my hubby! We had about 2 days alone at the beach, fully jet-lagged, then packing up to go back home. Quite the whirlwind wedding! We never had a honeymoon until the first of many times we HAD to leave the Island, for visa purposes, to our favorite destination--Hong Kong!!
There in Hong Kong was the chance to really relax and let others come to us! In the hotel we came to stay in nearly every time we stayed in HK, we had personal attendants for each room, which overlooked Hong Kong Harbor, greeting us with a plate of fresh fruit and orchids, champagne and an offer to ring them anytime we needed anything. We had the lovely chance to see one Chinese New Year's celebration, and the amazing fireworks blasting over the Harbor, ships docked everywhere, those ships that could find a place, had an awesome view too.
Sitting in the elaborate lobby, with bellhops paging anyone with a message, with a name written on a chalboard they would carry around with bells on it, the carrier not saying a thing, it being our responsibility to raise a head if you heard the bells. Once, when we were in a silly mood and there with our best friends from Taiwan, we girls got the idea to make the men laugh--we paged them as "Senator (my hubby)", and "Ambassador (her hubby)". It did get a laugh from them, but a few curious looks from those around them.
I have so much to write abut those years. I did mention Taiwan gave me many things I hold close to my heart. The one holding the top spot and always has, is my son.
In the mid-80's, boarding the plane to meet my then-fiancee; saying goodbye to my mom was really tough for us both. She was my best friend and I hers. I did my best to stop crying and find my way to the seat. The next 14 hours gave me not only lunch, dinner, and breakfast, but a scene I would not soon forget. This leg of many plane flights to come was just the beginning of a set of norms that I would come to know well, be able to ignore, and also use myself.
Staring, is not considered rude in the Chinese culture. In an elevator for instance, the person on either side of me would have their heads turned totally to the side to stare at me. After all, a taller than most on the elevator blond and green-eyed Caucasian lady, was a sure-fire reason (although there was never one necessary,) for the staring to occur. After I began modeling there, and my face was recognized, wow, was it wild!
Since I was living there, not staying for a few days on a tour; I needed to learn how to converse with the Chinese-speaking public. For me to shop, go to the open markets, to pick out the best fish for dinner, to ask our houseboy to fix something. This was my life for 4 years. My hubby decided he would just let his secretary translate for him, and set up all the utilities for us. He had no interest in learning the language. I, on the other hand, was in it for the entire experience. Heck if I was going to wait for a translator, or be one of those that used a dictionary but had no idea of how to put the words together kind of foreigner!
Most of us ex patriots were viewed as slightly spoiled, never really trying at anything much, using the driver and car the companies provided for their Overseas workers type of people. Little did I know that soon I'd be squatting with the rest of the shop I was in, bargaining with the best of them, all in Chinese! I still can sit like that, although with needing my 3rd knee surgery and arthritis in the other, possibly more, I opt for the standing position thank you.
Taiwan gave me many things. My marriage. We flew back to the beach to get married. Another 14 hour trip with my wedding dress that was designed for me in Taiwan, and it was the latest design, that I saw maybe a year or more later in the states. We had access to the European designs way before the states even started putting them in their windows. I modeled dresses once for Chloe, that were one of a kind. I was so startled when the designer saw how much I loved one piece that was going to go for production there in Taiwan, and gave me the piece. I wore it to my 10th High School reunion, I wore it till it started really showing it's age!
My dress that clear day of my wedding, was truly a show-stopper, the headdress with many pearls that were coming towards my face, on pieces of translucent wire. Very different than the U.S.'s traditional veils of that time. Having our wedding night full of returning his son to the airport an hour away, (I know, why couldn't THAT have been pushed back one more day?) I only wanted to sleep! Luckily, so did my hubby! We had about 2 days alone at the beach, fully jet-lagged, then packing up to go back home. Quite the whirlwind wedding! We never had a honeymoon until the first of many times we HAD to leave the Island, for visa purposes, to our favorite destination--Hong Kong!!
There in Hong Kong was the chance to really relax and let others come to us! In the hotel we came to stay in nearly every time we stayed in HK, we had personal attendants for each room, which overlooked Hong Kong Harbor, greeting us with a plate of fresh fruit and orchids, champagne and an offer to ring them anytime we needed anything. We had the lovely chance to see one Chinese New Year's celebration, and the amazing fireworks blasting over the Harbor, ships docked everywhere, those ships that could find a place, had an awesome view too.
Sitting in the elaborate lobby, with bellhops paging anyone with a message, with a name written on a chalboard they would carry around with bells on it, the carrier not saying a thing, it being our responsibility to raise a head if you heard the bells. Once, when we were in a silly mood and there with our best friends from Taiwan, we girls got the idea to make the men laugh--we paged them as "Senator (my hubby)", and "Ambassador (her hubby)". It did get a laugh from them, but a few curious looks from those around them.
I have so much to write abut those years. I did mention Taiwan gave me many things I hold close to my heart. The one holding the top spot and always has, is my son.
Tuesday, July 15, 2008
My Chronic Pain is Showing
I suppose for as many of us that understand every day pain, there are just as many that have either no idea what it is, or many in my life that have no idea that I deal with it daily. Or at all.
I must realize that I do not wear a sign on my forehead and one on my back that says, "I suffer from Chronic Pain." The other nurses I work with have no idea unless I TELL THEM! I also realize that again I, and others that fight this battle of pain, are being judged on our outside. Remember the old, "But You LOOK Good!" comment, and way of thinking. If I am walking into work with a smile as I usually do, am dressed nicely, hair out of the way for work, fixed up well, and a hint of makeup so I don't scare anyone away, why would anyone even have the word 'pain' associated with me? So again, it takes those of us that experience pain, to tell and educate those around us that are in our lives, what chronic pain is like. What it does to me. At home, at work, on a date. It is all my life, my hours, my minutes. Living in a world that no one knows of until they are told. I have let go of all expectations in my life. My years here have taught me that!
How are we to inform everyone that crosses our path for more than a few moments, that I am hurting? That I cannot bend over to look at that one patient's back, take that one blood sugar sample, that one 'ouchie' that needs to be looked at. I am not a lazy nurse. I have bent, squatted, and cried later in private as the pain comes surging back; or cried because the pain has not left. Yet. And may not leave that one day. I have written before that on my days off, I am hit by pain 100% harder than the days I work. Is it truly distraction only? Is the pain there but just not noticed because I have been handed 12 follow-ups from the am shift and I need to call 5 doctors before their offices close? I have 2 hours to fit a days worth of calls into. Most of the time, I get out of rounds with the nurse leaving, get report from them, and handle all the CNA's that are either there with questions or deal with call offs. All this while the minutes tick away and the docs get closer and closer to leaving their offices.
Having lived with one of our docs for a decade, I know the docs side of things. The calls that would come from the exact place I work, at the oddest hours, and with the stupidest things. Not that any report to a doc is stupid, but cmon, a lab result that is not that high or low at midnight? We've been in bed trying to get some sleep as his pager would go off, I'd hear the call and who had called, as he'd return the call, only to be told something that truly could have waited till the morning. This is what I try and pass to the nurses now, that I have seen the other side, very very close, and I know the docs are not going to answer the calls I am asked to make. And I have now gone off my main topic a bit!
My pain is showing. I have been offered another position at work, passing the meds; yet I can not push the cart without pain. I have wanted to push the carts around when I got a minute at work, but that minute has never come, and I've yet to try it out. Since my DON knows about my pain, and hired me knowing about it, she now needs me to get a note from my pain doc saying I can push, pull or lift a certain amount of pounds. I know myself that the carts are not going to be the answer. It is how can I make them adapt to my pain that is the true answer. Pull a stool along with me is one idea, in case I need to check blood sugar, requiring most just to stand and bend to the patient's height in bed, while I could try using the stool. I may need to sit down for a few minutes if that is even possible, while many patients wait for their pain pills, some putting on their lights to ask for them when I would not be in their area with the meds yet. Which requires stopping what I am doing, and preparing the meds, walking them to the patient. I do not know if that is my answer at work. The desk has been good for my pain, although it has reared it's ugly head a few days at work, not responding to my meds, or the distraction of work.
Can I adapt? Can I keep the ball rolling? Can I keep my job? Of course I can keep it. It is how I can make my job adaptable to my shortcomings physically that is my biggest problem right now. I will think of anything that is going to help me be more flexible in my job. Oh, to be 30 again. To go back to the days before the surgeries and procedures started. The days when I had yet to really feel the Osteophytes. Before I had total Spinal Stenosis. Before the bone growths had gone into my spinal cord in several different levels of my Thoracic Spine. But those days are past. I will not look back and wish. It is time to figure out a few interesting adaptations for my job.
I'm a strong-willed person. And I love my profession. It is the times I see myself in my patients that really scares me. When I feel that I could easily be in that bed, awaiting pain medications, yet knowing it is not my time, I know that I must tap into my will. I have done it all my pain-filled life.
And I will not give in now.
I must realize that I do not wear a sign on my forehead and one on my back that says, "I suffer from Chronic Pain." The other nurses I work with have no idea unless I TELL THEM! I also realize that again I, and others that fight this battle of pain, are being judged on our outside. Remember the old, "But You LOOK Good!" comment, and way of thinking. If I am walking into work with a smile as I usually do, am dressed nicely, hair out of the way for work, fixed up well, and a hint of makeup so I don't scare anyone away, why would anyone even have the word 'pain' associated with me? So again, it takes those of us that experience pain, to tell and educate those around us that are in our lives, what chronic pain is like. What it does to me. At home, at work, on a date. It is all my life, my hours, my minutes. Living in a world that no one knows of until they are told. I have let go of all expectations in my life. My years here have taught me that!
How are we to inform everyone that crosses our path for more than a few moments, that I am hurting? That I cannot bend over to look at that one patient's back, take that one blood sugar sample, that one 'ouchie' that needs to be looked at. I am not a lazy nurse. I have bent, squatted, and cried later in private as the pain comes surging back; or cried because the pain has not left. Yet. And may not leave that one day. I have written before that on my days off, I am hit by pain 100% harder than the days I work. Is it truly distraction only? Is the pain there but just not noticed because I have been handed 12 follow-ups from the am shift and I need to call 5 doctors before their offices close? I have 2 hours to fit a days worth of calls into. Most of the time, I get out of rounds with the nurse leaving, get report from them, and handle all the CNA's that are either there with questions or deal with call offs. All this while the minutes tick away and the docs get closer and closer to leaving their offices.
Having lived with one of our docs for a decade, I know the docs side of things. The calls that would come from the exact place I work, at the oddest hours, and with the stupidest things. Not that any report to a doc is stupid, but cmon, a lab result that is not that high or low at midnight? We've been in bed trying to get some sleep as his pager would go off, I'd hear the call and who had called, as he'd return the call, only to be told something that truly could have waited till the morning. This is what I try and pass to the nurses now, that I have seen the other side, very very close, and I know the docs are not going to answer the calls I am asked to make. And I have now gone off my main topic a bit!
My pain is showing. I have been offered another position at work, passing the meds; yet I can not push the cart without pain. I have wanted to push the carts around when I got a minute at work, but that minute has never come, and I've yet to try it out. Since my DON knows about my pain, and hired me knowing about it, she now needs me to get a note from my pain doc saying I can push, pull or lift a certain amount of pounds. I know myself that the carts are not going to be the answer. It is how can I make them adapt to my pain that is the true answer. Pull a stool along with me is one idea, in case I need to check blood sugar, requiring most just to stand and bend to the patient's height in bed, while I could try using the stool. I may need to sit down for a few minutes if that is even possible, while many patients wait for their pain pills, some putting on their lights to ask for them when I would not be in their area with the meds yet. Which requires stopping what I am doing, and preparing the meds, walking them to the patient. I do not know if that is my answer at work. The desk has been good for my pain, although it has reared it's ugly head a few days at work, not responding to my meds, or the distraction of work.
Can I adapt? Can I keep the ball rolling? Can I keep my job? Of course I can keep it. It is how I can make my job adaptable to my shortcomings physically that is my biggest problem right now. I will think of anything that is going to help me be more flexible in my job. Oh, to be 30 again. To go back to the days before the surgeries and procedures started. The days when I had yet to really feel the Osteophytes. Before I had total Spinal Stenosis. Before the bone growths had gone into my spinal cord in several different levels of my Thoracic Spine. But those days are past. I will not look back and wish. It is time to figure out a few interesting adaptations for my job.
I'm a strong-willed person. And I love my profession. It is the times I see myself in my patients that really scares me. When I feel that I could easily be in that bed, awaiting pain medications, yet knowing it is not my time, I know that I must tap into my will. I have done it all my pain-filled life.
And I will not give in now.
Wednesday, July 9, 2008
Days Off Work
I thought the week would never end! My first 5 straight days work week in quite awhile. Funny, but I find my pain is worse on the days I have off! Also being sleep deprived, the first day off was all about catching up on sleep. Must be a nurse thing, because every nurse I work with sleeps the first day of their off days. 
Then, it's time to do all my errands, wash, do manual work on my car, (nothing huge, just adding coolant and cleaner for the front windshield,) and hope the beeping stops as my car loudly tells me about every 5 minutes that I need to add wash fluid, like it is some emergency or something!! lol Also cleaning the house, picking up needed items at the store, and finally shopping today for new scrubs and new nursing shoes!! Then back to work.
My pain doc told me that distraction is one of the best ways to not focus on my pain. Ergo the fact that most days I have worked, my back has done really well. A few days it's been quite high in pain levels, and that is when I just have to deal with it. Work in pain. I'm already getting used to it! Work has definitely helped in my focus on being busy and that I am every day at work. Being the charge nurse of a wing is a lot of responsibility. I'm the one that everyone comes to when there is a problem--family members, the hard-working CNA's, the other nurses. Taking all the doctor's calls, and also calling them for orders, to let them know how a patient is doing; from lab results to need for antibiotics when we see a UTI, or get back a result of MRSA. That was a real drag to see on the board when I got back after 2 days off, that this certain patient had contracted MRSA in her wound. What is MRSA? Methicillin-Resistant-Staphylococcus-Aureus. Why was I not happy to see this?
If a wound is resistant to Methicillin and all the 'cillins', it needs to be cultured to find out what type of antibiotic can be effectively used. It is now known as the 'super bug', because it has become resistant to many antibiotics. The germs are winning in this one. And they continue to be resistant to more and more of the antibiotics. It is something that needs to be addressed quickly and efficiently. Isolation is used, and anyone entering the area and anyone touching the patient must be gowned, gloved, and mask worn. I just don't want to see that strain in any other patient in our facility.
Hey, I was writing about my days off, and here I am going to nursing again!
oops.
So, today I am off to the doctor to see what he can do for a blister on my leg that is about 4 inches long and 2 inches wide, 1 inch high. How did I get it? I have NO IDEA! Every nurse that saw it said "That's a burn!" But I didn't burn myself! I did nothing that I know of to that area, especially burning such a large amount of skin, I would remember that! So, I have a mystery 'blister', although I will wait for the doc's diagnosis. It needs to be drained, as since Sun. morning when I went to get coffee, and felt something hurting when my jammies rubbed against my leg, and I looked and almost fell over when I saw this 'thing', I've been waiting for the holiday weekend to be over, and the doc to have a spot for me. If I could get a picture on here, you would know why I am so flipped out that it is even there, and it is BIG.
After that visit, I am very excited to know I will be getting my first paycheck tomorrow, and I'll jump the gun by one day and shop for some new scrubs. The ones I have date back to my days working in '94-'01. I wore street clothes with a lab coat for the next 3 years in Hospice. Since those days, the style has really changed. Guess they follow the styles of clothing. The scrub pants are lower rise now, just like the jeans, and the tops are not big, billowy things that make me look quite a bit bigger than I am! The tops have gotten much tighter, not unable to work in of course, just nicer to the figure. And shoes...oh my nursing shoes are gone...gone in a move, who knows? I wore running shoes for years, and now the shoes are also much lighter, also the clogs are popular and comfortable. Makes my running shoes feel bulky and heavy. So that will make me feel much more pulled together at work to have some new, fresh scrubs and shoes.
Working Hospice, I wore street clothes and a lab coat. Now I'm back to nursing 'clothes'!
Time for me to get ready for the rest of the day. I wish for you all a low or no pain day, and if you have a day off, I suggest a little extra sleep.
Then, it's time to do all my errands, wash, do manual work on my car, (nothing huge, just adding coolant and cleaner for the front windshield,) and hope the beeping stops as my car loudly tells me about every 5 minutes that I need to add wash fluid, like it is some emergency or something!! lol Also cleaning the house, picking up needed items at the store, and finally shopping today for new scrubs and new nursing shoes!! Then back to work. My pain doc told me that distraction is one of the best ways to not focus on my pain. Ergo the fact that most days I have worked, my back has done really well. A few days it's been quite high in pain levels, and that is when I just have to deal with it. Work in pain. I'm already getting used to it! Work has definitely helped in my focus on being busy and that I am every day at work. Being the charge nurse of a wing is a lot of responsibility. I'm the one that everyone comes to when there is a problem--family members, the hard-working CNA's, the other nurses. Taking all the doctor's calls, and also calling them for orders, to let them know how a patient is doing; from lab results to need for antibiotics when we see a UTI, or get back a result of MRSA. That was a real drag to see on the board when I got back after 2 days off, that this certain patient had contracted MRSA in her wound. What is MRSA? Methicillin-Resistant-Staphylococcus-Aureus. Why was I not happy to see this?
If a wound is resistant to Methicillin and all the 'cillins', it needs to be cultured to find out what type of antibiotic can be effectively used. It is now known as the 'super bug', because it has become resistant to many antibiotics. The germs are winning in this one. And they continue to be resistant to more and more of the antibiotics. It is something that needs to be addressed quickly and efficiently. Isolation is used, and anyone entering the area and anyone touching the patient must be gowned, gloved, and mask worn. I just don't want to see that strain in any other patient in our facility.
Hey, I was writing about my days off, and here I am going to nursing again!
oops.So, today I am off to the doctor to see what he can do for a blister on my leg that is about 4 inches long and 2 inches wide, 1 inch high. How did I get it? I have NO IDEA! Every nurse that saw it said "That's a burn!" But I didn't burn myself! I did nothing that I know of to that area, especially burning such a large amount of skin, I would remember that! So, I have a mystery 'blister', although I will wait for the doc's diagnosis. It needs to be drained, as since Sun. morning when I went to get coffee, and felt something hurting when my jammies rubbed against my leg, and I looked and almost fell over when I saw this 'thing', I've been waiting for the holiday weekend to be over, and the doc to have a spot for me. If I could get a picture on here, you would know why I am so flipped out that it is even there, and it is BIG.
After that visit, I am very excited to know I will be getting my first paycheck tomorrow, and I'll jump the gun by one day and shop for some new scrubs. The ones I have date back to my days working in '94-'01. I wore street clothes with a lab coat for the next 3 years in Hospice. Since those days, the style has really changed. Guess they follow the styles of clothing. The scrub pants are lower rise now, just like the jeans, and the tops are not big, billowy things that make me look quite a bit bigger than I am! The tops have gotten much tighter, not unable to work in of course, just nicer to the figure. And shoes...oh my nursing shoes are gone...gone in a move, who knows? I wore running shoes for years, and now the shoes are also much lighter, also the clogs are popular and comfortable. Makes my running shoes feel bulky and heavy. So that will make me feel much more pulled together at work to have some new, fresh scrubs and shoes.
Working Hospice, I wore street clothes and a lab coat. Now I'm back to nursing 'clothes'! Time for me to get ready for the rest of the day. I wish for you all a low or no pain day, and if you have a day off, I suggest a little extra sleep.
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