Sunday, July 17, 2016

ATI pharmacology scared me

So I had to take this stupid test as part of my course that I'm taking right now - which is done in just about 2 wks time!

So, what you ask had me so scared about this test? Well.... it's JUST regarding medication... and if you know anything about health care, you know that there are a SHIT LOAD of medications out there, so how the HELL are you expected to know about all the side effects, adverse effects or which lab tests to monitor for EVERY medication???!!!

I don't really know what you tell you about that one.  There were many medications on that test that I had no idea and took educated guesses. I couldn't believe I got 78% when I was finished.

Plus, they ask you to determine values - calculate the amount of medication that the patient would receive - or (what I bombed) how many mL/hr to give to the patient and they give you the drop factor - I absolutely froze on that one because when I was preparing for this test I wasn't thinking medication calculations and so I had filled my head with medications and pushed out the calculation formulas. A couple of them I fumbled my way through and seemed to have gleaned the correct information so yay for that one!

What I hate about that test is that they expect you to know medications from areas that (I feel) are for more specialized areas - such as oncology and L&D - so I just had to take guesses with some of these things, but other ones I remembered reading once upon a time and so I took my best shot at it.

Others were more familiar and I knew immediately. The saying "you know what you know and you know what you don't know" - well that's certainly the case here.

I can't wait to be done with stupid ATI. I've hated it from the get go and don't feel that it adequately prepares you. Additionally, I don't think that their educational material helps prepare you for their tests. Therefore, find other pharmacology texts to help prepare you.

Now I have to write a massive paper that is worth 1/3 of my mark for my course! Wish me luck - I'm doing it on family presence during resuscitation - and I have to actually write a policy & procedure! And, if you're anything like me - someone who is at the bedside and does NOT actually have any part to play in those being written, it feels like a massive undertaking - and I have a week to write it AND the paper component. Yep, not really looking forward to this. I'll be buried up to my ears with this. I'm slightly stressed about this. Plus I'm such a procrastinator when I get anxious and let me tell you, I'm VERY anxious about this all because this teacher is soooooo critical and I want such a good mark for this.

But once I get it done, I'll be able to tell you a couple of stories from clinical and my personal life - things have been busy!

Tuesday, July 5, 2016

Every time I get excited

Let me preface this by stating that about 4 yrs ago my in-laws agreed to look for a house that was big enough to house us all comfortably in - which would include a proper bedroom for little tyke and another proper bedroom for hubby & I... I really bought into it - full blown! And then they pulled the rug out from under me because my BIL decided it didn't work for him and so it was pulled away from me and now that he needs it because he's due to get married in January and will need proper living compartments for him and his new bride - yep, selfishness wins.... but whatever. However, ALL and I mean ALL the houses that we have found that work for what we need, we've put offers in on and we have lost EACH and EVERY time.... that includes the time that we went $55,000 OVER asking and we STILL lost. UGH, I feel so defeated.

Then - we are starting to look into stuff for the wedding and subsequent trip to Pakistan and just this past weekend we started to look into when to leave and thus the flights and also stop-overs. Hubby asked me if I wanted to fly all the way or if I wanted a lay over at all. I told him I wouldn't be opposed to it, especially if that gave us a chance to check out a place we wouldn't normally be able to. So hubby checked things out and said - ok we'll have a stop over in Brussels (Belgium) - problem is that we would be flying into there on Christmas Day and considering it's predominantly a Catholic country, I figured that it would be closed (stores and restaurants) - which hubby went about trying to prove me wrong and found out that I was actually right - hahahaha!

So then we thought that we would have a stop over in Dubai (United Arab Emirates) and still fly in on Christmas Day - but this country is predominantly Islamic so majority of things should be open. And we then went to figure out what to do on the way back.... and it was to be Dublin (Ireland) - Yay, I've always wanted to go to Ireland and the stop over is ~8hrs so that would give us a bit of a chance!

BUT, and THIS is a MAJOR BUT - I spoke to my manager today (cuz I'm lookin at going back to work in about a week and a half) to indicate that I was at the point where I may just actually be coming back to work but that I needed to talk to her about this extended period of time that I would need off. Now.... (in her words) we have to go by what the unions stipulates and you must either work Christmas OR New Years  - so because I need New Years off, I HAVE to stay and work at LEAST Dec. 24 & 25 - (ARRRRRRRRRRRRRRG) and even more than that, we have to go according to seniority and that I have to wait at least several weeks to even know if it's feasible.

So AGAIN when I become excited about going to Pakistan - the stop over in Dubai (we were going to go for 2 days) and then continue on our merry way to Pakistan to meet up with family there - meet up with my MIL, one of my BILs and little tyke (she's going on ahead of us) and get to do a bit of sight seeing and lots of shopping (we're flying into the major textile city in Pakistan), then I get to see where my hubby grew up, where he went to school, etc... So much excitement!

BUT this two days before we can leave (and we probably wouldn't be leaving until the 26th so that's 3 days) - means that we can't have the stop over in Dubai now. And because my manager can't confirm that I can have Christmas, I can't make flight confirmations either so now everything is up in the air.

It seems like every time I get excited the rug gets pulled out from under me and I get sorely disappointed. Seems like this keeps happening. I wish this would stop!!!

Sunday, July 3, 2016

Hearing I'm doing well

Had a follow-up appt with the neurologist - first I had to see his nurse practitioner and tell her all the hoop-la that's happened since January - though I'm not sure I've really even put it all on here - so it took a few minutes and so when the neurologist came strolling through the door and started talking to the NP I was a bit irked - it's MY life, MY health, MY condition and so I COMPLETELY took over.... told him how after he sent me to the neuro opthamologist I only saw the fellow who determined that because I don't have papilledema (swollen optic nerves) that I don't have IIH (Ideopathic Intracranial Hypertension) - and how the ACTUAL neuro opthamologist wasn't even IN the office to speak with about this all - and the neurologist piped up saying 20.-30% of IIH patient's don't have this symptom - which I already knew.... but this stupid person sent a letter to my family Dr indicating that I didn't fit the criteria and not to prescribe me my IIH meds - and so 3 wks later I ended up in the hospital for 11 days with an LP opening pressure of 36 (remember that it should be 5-15) and then suffered with metabolic acidosis because my body can't handle more than 250mg twice daily - frustrating for me!

I told him how while admitted that they started me on Topamax at such an increased dosage that I felt absolutely stupid and so (with the every ready guidance of my family physician) that we decreased it to a dose that we feel comfortable with - only 25mg twice daily.

But that I ended up in an ER with a pretty severe headache and pain across my shoulders and up my spine and when they did the OP it was 20.5.... when I asked him (MY neurologist) if this was elevated given the fact that I was on TWO medications that's supposed to LOWER my CSF, he agreed (nice to hear that he agreed with me and disagreed with the other neurologist that I saw that day who said that number isn't increased) - more with the fact that I'm on the Diamox and to a very small degree the Topamax.

I explained that I was satisfied with being maintained on what we had figured out as of November of last year - Diamox 250mg twice daily and Lyrica 150mg twice daily - and then there's also the topamax which he said I should come off of (because the other neurologist that I saw when my OP was 20.5 sent a letter to MY neurologist stating I shouldn't be on the topamax and diamox simutaneously because it increases the risk of developing calculi - kidney stones) the diamox OR topamax.... so I chose => I choose to stay on Diamox because that works for me, not at increased dosages mind you, but my brain seems to prefer Diamox as compared to topamax.

He asked me if I had a follow up with the neuro opthamologist (wish I didn't to be honest, not exactly THRILLED with how they treated me considering they're supposed to be the foremost EXPERTS on this friggin condition!) - which I do mid July - and he actually asked me to call HIM after having the appt to tell him how that appt went and what they had to tell me - which kinda threw me for a loop... I wasn't sure what exactly he meant by that so I'm sure I looked like an idiot with this stare while my brain was running through exactly what that could mean. So instead of trying to figure it out, I just tried to clarify (because this Dr ALWAYS has a milleau of ppl surrounding him and running after him so I certainly wasn't expecting him to come to the phone or for his receptionist to put me through to him!!!) - so what he wants is for me to give the information to his receptionist and she'll somehow get the information to him. And he'll somehow get a hold of me after that to let me know when I will have follow up with him. So ya, I now have NO idea when I see my neurologist next. This isn't too disconcerting since a lot of my care is generally between me and my family physician anyways.

The neurologist did believe that there was migraine aspect to my IIH and so because I had stopped all tylenol and advil since January and I've only been taking statex (morphine), that he's referring me to a headache specialist in the major city that's about an hour away. This is exactly what I want so I''m happy about this. I was able to ask him about the migraine medication that my family physician ordered for me (Maxalt) and whether this was a good one to use considering I have IIH - he gave his thumbs up - so I'm quite pleased about this. Unfortunately this headache Dr has an UBER long waiting list so I don't expect to see this Dr for a long while. Hopefully we can keep them under wraps. I have found though that rain seems to be a trigger for migraines and putting me out of commission for a couple of days.

So now I have to see my family Dr on monday to relay this information and get him to fill out the necessary paperwork so that I can try to go back to work. Hope the ride is smooth sailing.

Oh in good news - my parents and my brother, sister in law and nephew came for a visit and we went to the amusement park together. SO MUCH FUN!!!! I was soooooo nervous given my IIH and going on the roller coasters or the centrifical force of some of the rides and loops in the coasters that it would spark a migraine. Thankfully this was for naught and I lucked out and enjoyed myself thoroughly. Unfortunately my mom tried to make unilateral decisions for the group and it sparked a minor disagreement between her and I - I was trying to discuss it nicely and she stormed off in a huff and puff. ERGGGG. I hate when my mom is like that to be honest but hey she's my mom and you can't choose blood, so you put up and shut up. Too bad my feet didn't have as much fun - my feet were blistered to high heaven since we walked 11 km in 12 hours!!!!!!!!!!!!!!!  The best part of my visit was watching and hearing my almost 60 year old dad GIGGLE while on a ride. It was awesome. It's something I will treasure. I wish I had caught it on camera but that just ain't possible when you're whipping around in mid air!!! It was fun, we all had fun - completely enjoyed myself.

Now I have to put my nose to the grind stone for school since this course is finished at the end of the month.

And we're also planning for the trip to Pakistan in December-January - 3 wks long.... first time. Hubby's first time back since leaving. My first time there. Boy I can't wait to go there. We're trying to figure out a layover - maybe Brussels or Dubai.... problem is that this layover would be around Christmas time so it would be a bit tricky since things close down in predominantly Catholic countries and I really don't want a layover that I can't anything with! I think Dubai would be interesting though!!! Some investigations and research needs to be had....

Friday, June 3, 2016

I got the worst news from my mom

Ok, maybe not THE worst news, but pretty darn close

I called my mama yesterday, not unusual - we talk often enough. Plus her and dad (plus my brother & SIL and nephew) are supposed to come visit in a couple of weeks so we had a bit to talk about.

Well we were talking and I was like "hey, I just got my mark back on my last class - a B+!"

her - "well done - so do you want to hear some bad news?"

me - "not really, but what's up"

her - "well we're not going to be coming to your graduation"

me - "omg - I'm going to cry" - then the phone hung up.... and my husband came up from behind me (he WAS downstairs while I was talking to her, because when I was talking to her I was making the  meat stuff for hamburgers for dinner and thought he was still down there) and said

hubby - "it's ok, it'll be ok" and I started to just break down

I couldn't believe that finally graduating and my mom isn't going to be to see me get my degree. Ya'll don't understand how supportive my  mom had been of me getting my educaation. When I was trying to get my degree the first time and Big boy was really little, she would watch him so that I could go to clinical. If I had a big paper/assignment and needed time to focus on that, nana and papa would babysit him.

I called her back, still crying and thanked her for telling me. I'm certain it wasn't easy for her to tell me or to listen to me cry over the phone. At least I have another six months for this news to really sink in and I hope I'm not as devestated by the fact that my parents won't see me get my nursing degree.

Sunday, May 29, 2016

A new day

I've been ok - my IIH has been stable, my headaches have been relatively low - I've only had one in the last week or so that I've had to medicate. This includes pain across my shoulders.

I've been to clinical - that was fun! We had a patient come in with a possible stroke - and I saw before my eyes as her symptoms started to ease up.... so she was declared a TIA.... on telemetry it was showing A-fib - no doubt that's what caused her symptoms. Unfortunately, I couldn't tell her this. We shipped her to a stroke-appropriate hospital for further testing and management.

Then there was a patient who went to walk home from the community club through the woods and fell - breaking their ankle and spent the entire night in the woods crawling out of it to reach someone to get help. Plus it had rained overnight!

There was a couple of other things but suffice it to say, this time was interesting and fun so I really enjoyed myself. Plus I love my preceptor so it makes it even that much more enjoyable.

School is pretty good too - I've gotten my assignment done from last semester and I've been working on the assignments for the new class - with this new class we are all reflective and la ti da - so in touch with our emotions and what not. It's a bunch of BS but I'm pretty good at it so we'll see how I do! The other aspect of this class is pharmacology - this is one area that's a bit trickier because there is a TON of medications ya'all!!!!! I hope I can pass that part with good results, I really want a good mark in this class!

Last week marked EIGHT years that I've been married - WOW! Considering what we've been through I'm surprised that we've made it to this point. Living with his family has NOT been easy, major understatement! If I had known that things would be like this I certainily wouldn't have agreed to this - it's been really difficult on our marriage living here. But if things work out, I graduate in December! Then we're going to Pakistan for my BILs wedding - that should be interesting! After that we plan to move... so lots of changes to come. Now to just get through this class and onto the LAST class of my BSN!!!!

Tuesday, May 17, 2016

Going no where fast

Last friday I had to see my primary care physician - mandated by my Oc health person to have some paper work completed. But it just happened to be that I was in serious amounts of pain and my left arm was going numb and tingly as well. It was a weird sensation.

My neck hurt something fierce, as did my shoulders. It felt like there was fluid there and it was creating a pressure on the tissues. Oh my goodness did it hurt. It hurt to turn my my neck to look over shoulder - if someone would enter a room and you would go to absently look, it would send joltingly amounts of pain to my brain. Wow it is disturbing how painful that was (and still is). This area also limited the range of movement of my left arm in particular (more so) but has been starting to affect my right lately. I can't seem to get better. 

The headache is wicked strong. I've lost days. DAYS. I've stayed in bed pretty much because I can't live overwise. The pain is too extreme. 

I went to the ER on friday. I saw a neurologist. He did a LP - my opening pressure (OP) was 21.5 - his words were "ok, so it's normal".... dude, that's NOT normal..... I'm on TWO meds that are supposed to make that NORMAL..... normal is supposed to be between 5-15!!!!  Now for those who don't know brains..... brains don't like it when pressure is anywhere over 18.... mine is OVER that..... UGHHHHHHHHHHHHH........ 

So I don't know what to do because it's not like we have that many places to go around here. So I just curl up into a tiny little ball in my bed and have waited for 4 days to pass in pure hell in the hopes that my body will go back to normal functioning!

My new semester started today, yay for me -- I'm so fucking screwed!

Friday, May 13, 2016

What am I going to do

Have to see the Dr tomorrow - I've had an increase in the # of headaches I've been having, plus I've been feeling like crap - more fatigue and exhaustion. Also my pain levels have increased - I'm having pain across my shoulders and up my spine.... so I had my VBG (venous blood gas) checked today to see if I can increase my meds or perhaps I need to make a trip to the hospital tomorrow to have a spinal tap (LP) to see what my pressure is.... who knows, maybe my pressure is low. I mean it IS completely possible that it is low but not likely!

My occupational health lady is coming off vacation and is expecting me to go back to work - and so is my husband - hell I really want to go back to work, I would love to be ABLE to go back to work but I don't know if that's possible at this point. Perhaps if we change my area and hours? I don't know. I guess we would have to have a conversation together about this.

I'm in the middle of writing my last paper of my course - it's not flowing like I need it to.  Geeze I wish it would! I can see the end in sight but holy frig I need this paper to be completed! I guess I'm just procrastinating. I'm such a procrastinator! UGH UGH Ugh!!!!!!!! Guess I better get back to the grind because the faster I get that done the faster I can get to starting this next semester that starts MONDAY!!!!! Sweet bloody hell I feel like the rug is being pulled out from under me. I feel like I'm always running after everything, like I'm never on top of everything because of these damn health issues.

The only good thing about this new semester starting is that my clinical site is AWESOME!!!! OMG I can't wait to start there. I get the same preceptor I had when I was at the ER previously and we've been talking and she's just as excited to have me get started as well. YAAAAY!!!! Awwww I love her! Now I just need to get this stupid paper done (it's all about epidemiology and other crappy health stuff that's difficult to write about).