Thursday, October 18, 2018

And the week goes on.

Jeremy is home!  Everything feels better when he's home. 

******

Beautiful running day today.  I think I hurt my feet today which is kind of unusual.  I'd normally be worried about not being able to run, but now I'm worried I won't be able to work on the hospital floor.  Hopefully tomorrow my little injury will be better.

Untitled

Taco night.

Untitled

Edda made a brownie beetle at camp.

Untitled

Monday, October 15, 2018

To bed early.

Jeremy is in California now, he texted me when he boarded the plane at BWI and just now texted me again when he touched ground in Oakland.  He's off doing his work thing.   He's doing me a favor by compressing his travel schedule these days, turning down trips that he feels are not necessary, timing them so he can leave after the morning school routine or coming home in time for dinner.  I appreciate all of this.  I came home today and Vince asked - so Dad is gone?  Where did he go?  I said he's in California.  Vince was like - did he drive to California?  The van is gone.  I laughed - no Dad did not drive to California, he only drove to BWI.  I'm on the edge of exhaustion - you know, when you can't quite tell if you are tired or sick, I'm hoping to go to bed by 8:30 tonight.  I think I wear myself out more with my emotions than with any actual physical work.  Though sometimes I think it's good to be emotional (for me at least) because oftentimes, I think I can be a little bit unfeeling & unsympathetic.

Sunday, October 14, 2018

Game of life, stitches, physics.

It's been an emotional weekend for me.  I can't shake the feeling from my last two shifts.  And not only that, I'm getting unusually stuck on the national news and some of Edda's issues, just perseverating on the same crappy thing over and over again in my head.  Usually, I'm only a forward anxious person.  I get anxious for things that might happen in the future.  I'm very rarely a backwards anxious person - I usually get over things that happen in the past, quickly shrugging off bad experiences.  But somehow not today.  I can't quite figure out why. I've certainly had patients yell at me before and I've always have known I would have difficult patients, but this one stuck.  Jeremy thinks it's because he's leaving on a business trip in the morning for 4 days and certainly that might be it, but it doesn't mean that I can rationalize myself out of a gloomy mood. 

******

I played two games of Life with my friend Rory.  The game of Life has changed a lot over the last time I've played it.  We made up a lot of new rules.  It was fun.

Untitled

******

Christine tried to take out Gene's stitches at Sunday night dinner.

Untitled

******

Vince & Jeremy working on physics homework.  Projectile motion problems with sin and cosine.  Thank goodness for youtube, you can basically find a person doing any problem that you have on youtube!

Untitled

Saturday, October 13, 2018

tough week.

Hello loves!  It's been a long week. Jeremy & I both had challenges this week at work.  For Jeremy, it was annual review time , which as a both an employee and manager Jeremy never, ever finds enjoyable.  Does anyone love annual review time?  I'm not sure it is possible for anyone to love it. 

*******

On Thursday, after a week of being pretty sick, Vince rallied to go to school to justify attending the Denzel Curry concert at the Filmore in Silver Spring.  He went with a pal and it was decided among three of the four parents that we couldn't get the kids to Silver Spring in the late afternoon/early evening (all us working at work), so we agreed that the kids would take the crosstown bus which went straight from the Rockville metro to downtown Silver Spring and that would be totally fine and that Jeremy would pick them up late after the concert ended.  It was raining that day and the fourth parent came home unexpectedly early from a business trip (and thus missed out on the public transit discussion) and found the boys after school trying to figure out the bus schedule and called them a Lyft.  I was like - oh no! What is more of a teenage experience than waiting in the rain for a bus to go to the other side of town to go see a concert?   Vince loved the concert.  There was a lot of moshing.  There was the feeling of being 16 and out on school night and surrounded by everyone else at the concert seemed to be in their 20s.  So exciting!  Remember when you used to think someone who was 23 was old?  Hahaha.

******

On Friday, I was at the hospital and just losing it.  I will now say that I lose it everyday at 5:15 pm.  I never work three shifts in a row, but most of the time, I work two days in a row and that 2nd day just kills me.  The first day of two-in-a-row, at least I come in fresh from a day off and feel well rested, but that 2nd day, whatever reserves I had to manage whatever crap I am dealing with is just depleted.  It is really, really hard to have a difficult patient.  On Thursday and Friday both, I had a patient (the same both days) who yelled at me the entire 12 hours.  A very complicated patient who needed many, many, many medications, so I needed to be in his room a lot.  He tried to fire me on Friday, though no one took him seriously.  It was bad enough that the patient in the next room was concerned for me because they could hear him yelling my name down the hall.  OK, so that's going on for 12 hours or 24 hours if you count the two shifts, but besides that, it is like death by 10,000 papercuts.  I will give you only a small, small, percentage of what I'm working with.  I try to print out a label for a stool sample, the printer doesn't work from my computer station when I complete the task.  I call the lab to force print a new label to the printer.  The force print works, but the ink is misaligned so that only half the bar code prints out.  I have no idea how to realign the ink and I'm like - do I send the sample with half the bar code - is there enough information for them to accept the sample?  Do I call the lab again and force print on the printer all the way on the other side of the unit?  Or will I send it and then they'll reject it and then I'll have to figure out how to get another sample?  I'm trying to infuse albumin through an IV line.  Albumin is a thick substance (think egg white) and the IV line is a small bore.  The night nurse had to hang a bag at night and she said that it was constantly clogging and that she needed to flush it every 15 minutes.  I walk into the room to see that the old bag of albumin is still struggling to be infused.  So of course, it does the same for me and I'm like - how the (*&$ am I supposed to get 100 mL of this into this poor patient.  I had to rejigger the IV lines in a weird way to dilute the albumin, so that something that was suppose to be done at 9:30 am is finally complete at 1 pm.  The pharmacy never answers the phone promptly.  I had two patients on Friday that needed, I swear, 8 medications every 2-4 hours.  Without fail, 2 of medications would be missing from the medication machine and I'd have to call the pharmacy to replace the medications, but they won't pick up the phone, or else they will transfer me to someone "covering my unit" and then accidentally hang up on me.  Someone needs IV dilaudid because they are in severe pain, I go to med dispenser to get the dilaudid and because it's a narcotic, you have to count how many are in the drawer to keep the count accurate.  The top of the compartment flips open and, I swear, there are 37 loose syringes in the drawer that you have to count before you can pull one - a special kind of torture because if you do the count wrong too many times, it guess it locks you out?  It is like this all day, every minute.  I'm assured, by many people, that this feeling will go away, but it doesn't mean that it isn't extremely painful right now.  While I was being yelled at by my patient, my male nursing assistant was standing right outside the door making sure that I was alright and wouldn't get hurt.  My charge nurse checked in on me all day and helped me out when I needed it.  I've given up on not crying anymore, so I cry and someone usually gives me a hug in the medication room (not a patient! yet.).  On the floor yesterday, there were 5 nurses covering 30 patients (usually there are 6, but one of the nurses puked in front of the elevators and went home early) and 3 of us (3!) had fewer than two months experience.  Honestly, the thing that usually sends me over the edge is someone asking me - do you think they have more lime jello/freezer popsicle icees in the cafeteria? or I think I left my phone charger in the ICU, could you get it back for me? or can you change this medication from a pill to liquid? or the ever popular - when do you think the doctor will come see me?  these simple questions drive me batty.  You think I could answer all these questions/solve these problems in 30 seconds, but really, they are extremely complicated to execute. 

******

My parents were in town for a hot second.  I saw them Friday night.

Untitled

Here's my dad trying to buy Vince's friends some late night pizza.

Untitled

Wednesday, October 10, 2018

Vince home sick.

Untitled

Picked up V from school early because he's still pretty sick.  I'm glad I was home today to be able to do this. 

Tuesday, October 9, 2018

IEP, I'm from Baltimore, Vince is sick.

Untitled

We went to Edda's IEP meeting this morning.  This was the first meeting with her new team at the high school.  These folks have been working with Edda for about 5-6 weeks now, so they are learning about Edda's strengths and quirks.  (She hates art.) We signed a piece of paper which said that Edda was not going to get a high school diploma, rather she was going to get a certificate of completion, the form also said that she would get modified standard assessments.  Both of those were fine, I'm at peace with not getting a high school diploma.  They crossed out the two other options on the form, one was consenting to the use of restraints and the other was the use of isolation.  You know, Rett Syndrome sucks and everything would be so much better if Edda didn't have Rett Syndrome, but it's also kind of like - oh, thank goodness we are not in the restraint/isolation-procedures-at-school territory.  They tried to cut some services, we (meaning Jeremy) gently held our ground.  At the end of the meeting, the transition specialist came to talk to us about adult services.  Edda's going to be able to go to high school until she's 21.  And then we enter the world of adult services - something that is daunting, but will happen as sure as time marches on.  They are trying to help us along, even though I don't want to think about it at all.  The transition person said that our goal for the next couple of years should be to just go to various community meetings that discuss DDA services and financial planning and other things (demystifying Medicaid! exciting.) offered by various organizations and not really do anything else, so by the time you've heard it 3-4 times, one will be over the denial and ready to do something.

******

Ever since I lived in Austin, I have a soft spot in my heart for country music.  I've been liking this song recently.



******

Do you know how many times a day I'm asked at the hospital where I'm from?  Like 17,000.  Hey Doris - where are you from?  Usually it's a patient, but sometimes it's staff.  I know lots of Asian people hate this question, but really, I don't mind if it's asked with the right tone and usually it is.  Though I do like messing with them.  I first tell them "I was born in Baltimore." which is true but entirely unsatisfying to the question asker.  Then they look at me, head tilted trying to figure out how to rephrase the question (but I like to stop them before they ask, no, I mean where are you really from? To which the true answer would be - "I'm really from Rockville", which probably is even more unsatisfying than the Baltimore line) and then I say, "you know, I'm consider myself American, but my parents were born in China.  And then they say, ahh, China!  I hope I represent all of China well.

******

Vince stayed home sick today.  He's congested and everything.  Booo.  Tomorrow is the PSATs.  He will have to go into it at less than 100%.   I've been trying to get Vince to read more NYT articles out loud to me to bring his youtube dominated youth experience up to SAT level reading (with spotty success).  He gets to pick the article.  So we skip over all the political articles and head on over to the articles about the pot-smoking dad or animals freed from animal cracker jail.  The other day, he read an article about the Instant Pot and came across this line: "After the rice and shrimp had cooked for a mere three minutes, Ms. Ram twisted the vent, which sent forth a rush of spicy vapor with a companionable whoosh."  Vince totally stopped at that line (after stumbling over "mere" and "companionable") and declared it was too pretentious to continue.   It's about the Instant Pot, a completely non-pretentious thing and turned it into something it's not.  I'm like- the NYTimes is nothing if not pretentious, keep going!   By the way, we did get an Instant Pot the other day after our slow cooker died, and I took it on it's maiden voyage where I managed to not only cook the frozen block of chicken, but accidentally managed to pressure cook the weird absorbent pad is often stuck to the bottom of a package of frozen chicken thighs.  Whoops, hopefully not too much polymer ingested.

Sunday, October 7, 2018

C & O.

Untitled

The boys hiked an unexpected 14 miles on Saturday.  The day involved: impassable roads from a landslide, a blocked parking lot, a weird encounter with a couple who provided parking at their house, mosquitos, a marathon, chafing and then, finally, no water at the Saturday night campsite which meant that they aborted the mission and all came home Saturday night.

Untitled

It was nice to have them all home on Saturday night.

Untitled