Friday, January 29, 2016

Visiting my primary physician turns up something interesting

Went for follow up with my primary doc about my wound culture results to find something interesting:

E-coli (not that surprising considering the wound culture is a perianal abcess) but the interesting part is that it's HIGHLY resistant to antibiotics... the only thing it's sensitive to is Gentamicin. Thing is, current literature states that you don't want to really give Gent now a days because of the connection to hearing loss plus it is harsh on the gut and will increase the chances of developing C-diff.

The other thing that turned up is Group C Strep which I was surprised about. Thankfully it's sensitive to penicillin so my doc easily gave me a script to cover that.

But now the conundrum about what to do about the Gent.... considering this is like my 4th abcess, it's important that we use the correct antibiotics if we hope to get rid of it once and for all. So my doc consulted an infectious disease doc but because it was 3pm on a friday didn't reach them so now we wait til we hear back from said person - probably monday.

For now I will take my Amoxil and at least treat the Strep. And perhaps I will take some lactobacillus to ensure that my gut still has some healthy bacteria when we're done sorting all this out! Wish me luck!!!

Not what I thought it would be

Had the follow up with the neurologist today - all he could talk about was how I need to get off any NSAIDs or tylenol products and how I MUST be off them for 4 months minimum. What a load of bullshit. He wouldn't even refer me to a specialist in IIH until this occurs. The only thing he would do was refer me to a neuro opthamologist and that likely won't happen for another 6 months at least.

Today was pretty good in terms of movement. I was able to get a hold on the constipation (thank the lord!) and have many bowel movements. I rewarded myself with a trip to the mall with hubby. HA! I think hubby was feeling pretty bad about what I've been going through because he was cool with me spending $75 on premium tea!!! Mmmmm yummy tea.... one that tastes like strawberries, another like blueberries and the last is one that smells (and tastes) like peanut butter cups! Goodness they're yummy.

My home care nurse says my bum is healing well, even if it's hurting quite a bit. So I'm hoping next month the specialist can do something once and for all about my butt issues.

Wednesday, January 27, 2016

On the mend.... maybe?

The nurse saw my bum and agreed that it was inflamed but didn't think it was inflammed because of infection. Plus there wasn't an increase in exudate or a change in exudate appearance. So he cleansed it really well, put some providine on it and packed the wound with providine soaked packing and thankfully today the inflammation was signficantly reduced - as was my pain!

Now if only I could get a handle on the constipation! I try to increase my fluid intake, take my senna/colace and increase my fiber intake - to no avail.... stupid diamox! Makes me dehydrated which makes my situation even more dire

Speaking of diamox - I have my follow-up appt with the neurologist tomorrow. I doubt that he's going to say anything. For the most part I'm doing well in terms of headaches/migraines. I think I can tell when my pressures get high because the pain starts right behind my right eye. I normally take an extra diamox and hit the hay for a couple of hours. Normallly that's enough to stave off a migraine due to high pressures. I count myself lucky that I don't have near the complications that others have with IIH - I feel guilty a bit that mine is a seemingly mild case - and for that I am also severely thankful for. I know how bad it can be and how lucky I am to have what I have.

That being said, these things make going to school rather difficult. Concentrating has been difficult at best. I've gotten very little school work accomplished this last week and a half. I seriously need some things to go in the right direction so that I don't lose my semester.

So I suppose I should get a good night's sleep and call it a night so that I can go to the neurologist tomorrow and then get started back on all this school work!

Tuesday, January 26, 2016

I don't know what to do

The pain has been significant, so I've been taking my statex like I need to (~twice per day at this point) and because of the constipating consequence of this narcotic I have become quite bunged (ya I know, not quite a term) up and have tried to counteract this by taking senna & colace.

However, said medication isn't working very well and I've been struggling with constipation. The other problem is that this damn abcess is next to my rectum and thus I have the dressing that's next to and sometimes covering the rectum - which makes having a bowel movement rather tricky.  

Of course, having a bowel movement is important and this I was able to do. Problem is is that it feels like I have other abcesses - hard, painful bumps where there shouldn't be any - it should be smooth.

So now I don't know what to do.... I think I may just wait to see what the homecare nurse says considering they've been doing this dressing on my bum for several days now and who knows, it coulld be changed.

If things have changed and they're still there tomorrow, then I guess I'm heading back to the hospital tomorrow.

Monday, January 25, 2016

Emergency surgery

So I had to do corporate orientation this week. 2nd day in and my bum started to hurt. Not overly so but certainly noticeable. 3rd day in and my ass was KILLING me! So much so that I went to the ER.

And got bitched out by the surgeon about why didn't I go to the hospital where I had the other butt surgeries done and where my own surgeon is and such. He complained that he didn't have access to the diagnostic images that I had had done nor the operative reports - as if it would take a million years for a fax to have been received.

Then he mad handled my ass to do his exam - making me cry. So I begged the nurse for some pain medication - to be told by her that the surgeon wouldn't permit her to give me more pain meds because he would be taking me for surgery "soon". Whatever the hell THAT meant!

SO I had the surgery - was in recovery and asked what he ordered me for pain meds.... tylenol (which I'm allergic to - fucking idiot!) and morphine => 1-2mg q1hr.... the q1hr was good but the 1-2mg is bullshit considering I take 10mg orally.... the math certainly doesn't add up. So when my pain went up at about 3am, I asked for the max dose (which I received) then clock watched til 4am because the 2mg certainly did NOTHING for my pain!!! I got the max dose again and thankfully that was enough to take the edge off.

Then my bladder was telling me that it needed to relieve itself so here I was in the bathroom with the water on and nothing is happening. My bladder is screaming at me telling me it needs to come out and I was certainly relaxed enough for things to happen but then NOTHING. I let the nurse know about this and so she kindly bladder scanned me and I had 350mL sitting there (I think I had more but she didn't scan me quite right but I wasn't about to complain)... so I went back to bed and tried again another 3 times before being able to FINALLY pee. Geeze that felt good!

At about 6am the surgeon comes in to ask how I'm doing - doesn't check my ass out or anything and goes to leave. I told him that I needed a sick note and told me that I needed to get the paperwork to him - as in the ones that oc health requires. It didn't matter that I also needed one for school. Just off he goes.

Later when the nurse goes to get my paperwork ready, she realizes that the surgeon didn't write me a prescription for ANYTHING.... no pain meds, no antibiotics.... NOTHING. Nor did the surgeon take a fucking culture - from an abcess!!!!!!!!!!

So off she goes to page the surgeon to find out that that was intentional - that because of my "many" allergies to pain meds (tylenol, codeine, demerol, percocet) - that he told the nurse I should just take "advil". His words, not mine! Unbelievable! I had told him going into the surgery that I took statex (morphine sulphate) 10mg when this sort of thing occured and that I had enough for ~5 doses. Clearly this surgeon has NO idea how painful it is to have an abcess cut open on your ass!

So I literally left the hospital to go straight to my family doc to get culture swabs so that when homecare came to pack my ass that they could take a proper swab that should have been done in the first place by the surgeon. I also got a prescription for more statex so that I can get through this rough period. I am so unbelievably thankful to my family doc for being so wonderful and understanding. He couldn't believe that I'm going through this AGAIN. Frankly, so am I! So here we go again....

Monday, January 18, 2016

My 2015 by pictures (mostly) - kids version

When we got back from Christmas vacation it was time for little tyke to begin Quran lessons - here my MIL is helping out with certain verses

Little tyke invades our bed frequently and these two are always the first to fall asleep

Little tyke just before her 6th birthday shows me how she can hang upside down and gets hung up by her boot

Little tyke hangs out with her BFF Hussan and little tyke is able to swing without assistance now

Little tyke turns SIX and my parents and my auntie Bev comes to visit to celebrate it

Lt to Rt: Mom, Auntie Bev, SIL Sidra (married to hubby's brother Hammad)
Both of my moms
Lt to Rt: Hubby, my Dad, my BIL Hammad and my FIL

Lt to Rt: my FIL then on the floor is SIL's sister and her parents are on the couch
Three generations
Little tyke about to blow out the candles at her birthday at Chuck E Cheese
Lt to Rt: Leah, Teagan, little tyke, Hailee, Hussan
First time riding the birthday bike - getting a bit of help from daddy
Our newest family addition: a rescued bunny Millie
Hubby and I celebrated our 7 yr annivery
June 18th little tyke broke her arm in half
In high spirits even though she broke a major bone

Graduation for the big boy
Big boy's favorite subject as you can tell

He got the award for highest mark in geography

Family photo June 2015

Seriously bonding with the bunny

Trip to our nation's capitol: Ottawa
Aug 2015 - we got to see the change of the guard
I'm bad at centering selfies - our trip to the Agricultural center and visiting the cows
Little tyke cleaning one of the cows
Getting a chance to pet them
Petting the cow right to sleep - I can do this with babies too!
The wave pool 

Hubby helping her jump the waves - she squeeled with delight after each of these
She got the gist of what to do so we figured we'd go shallower and let her do some herself

First day of Grade ONE

First trip anywhere for little tyke and I'm sending her away for 6 wks with this woman - my M IL

Off she goes on an adventure

Time for a swim in the community watering hole - the weather was 40 degrees Celsius = HOT HOT HOT

And returned fully safe and sound - fully fluent in Punjabi and Urdu - she's amazing.

Then I got sick and was hospitalized. Got a new job and left the old one. And spent Christmas with family - mom and dad and my two brothers (and their respective spouses and child(ren)].

Saturday, January 16, 2016

I got a hot chocolate for all the stress

I met with the person from the hospital to discuss the incident....

It appears that I'm in the clear thank God. I told her my version of the incident from start to finish. I talked about what kind of processes were missed or missing. I talked about how I had the physician paged MULTIPLE times - which records back me up for. My co workers also backed me up in talking about how this person was a CONSTANT caller but that night at that time did not.

I also brought my shift paper and showed that I had done vitals, even if I hadn't put them in the chart. I talked about how because this person had appeared like they had finally fallen asleep that I didn't want to wake them up.

I also talked about how this was my third shift by myself and that I was still learning the lay of the land and time management in terms of charting - about how the physical act of writing narritively takes up a lot of time.

I also talked about how this person had wrapped a blanket around them because they had taken off their gown and obviously didn't want to walk to the bathroom naked. About how they could very well have tripped on their blanket and fallen.

I also talked about how earlier in the shift another nurse had given an antihypertensive when they shouldn't have because this person had had hemodialysis that day and the order was to hold the medication on days when they had it - because this person would go hypOtensive because of them both - so who's to say that this person didn't have a syncopal episode because of the previous nurse giving medication when they weren't supposed to?!

So I don't really know where I sit but the hospital person made it sound as though my actions were supported by my coworkers and such. I think she felt bad for how stressed out I was about the whole thing because when we were done she bought me a hot chocolate. She said the results of the investigation and suggestions for improvement should be out within two months. Hopefully it isn't too harsh.

Thursday, January 14, 2016

Protecting others at my detriment

That patient that fell, they died - and now it's a coroner's case. Thing is, my charting was lacking in direct time frames and I didn't put in there about the fact that the Dr was paged multiple times over a couple of hours.

Plus, I didn't fill out stupid rounding sheets - they weren't part of the chart and aren't legal or anything and I was so busy that I didn't have time to fill them out like they're supposed to be.

I had another pt that was detoxing from alcohol, very needy and requiring Valium frequently. Around the time of this other person's death I was with the other person who started to complain of chest pain - I was with her, assessing to make sure she wasn't having a heart attack. Problem is is that I didn't chart this, I only passed it on because I didn't want to stay late after work. Now I totally wish that I had. Fully regret this.

The other thing is that this hospital doesn't do bedside reporting so we don't know whether this pt would have been alive and somoething could have been done had we done it. UGHHHHH!!!!!

The other kicker is that our unit doesn't have bed alarms or alarm pads that can be put on the bed that would alarm when someone was getting out of bed that shouldn't be.

This pt got out of bed while I was on break but I was in the room across the hall when this pt got out of bed without assistance or calling for assistance and I heard the hollering and went across the hall to find this pt on the floor. When I talked to my manager about this - she commented about how this pt did not get out of bed ever before and made it sound like it was so unbelievable that this pt would get out of bed by themself. UGH

Now I have to meet with some big wigs on Friday and my manager and my union rep to talk through this case. I hope they have my back, I need someone to!!!!

Sunday, January 10, 2016

Losing my shit

Title is two fold -

On one fold is work where on the unit we have two pts that call ALLLLLLL the time. One pt is able to get up on their own and yet they will call to tell a nurse that they need to be "boosted" in bed. Same pt told me I needed to turn up the temp in the room because they won''t put another blanket on. Thing is, they aren't in a private room by themselves and there is another pt to think of. Yep they don't give a shit. It's all about them. Ya, I don't roll with that one! I turned the heat up a little bit but the pt still complained the temp wasn't high enough - I told this pt that we aren't a hotel, that we're in the HOSPITAL and we are there to take care of pt, not to cater to them! They made a HUGE fuss - ya I walked away on that BS!

The other pt picks their nose to the point of it bleeding and making a MASSIVE mess - and throwing everything on the floor. EWWWWWW nasty! I've even said to the pt that they wouldn't do that in their own home and therefore shouldn't do it at the hospital. Ya they don't care - still it occurs. UGH! Then the other nite when I worked the night the pt got up by themself while I was on break and fell in the bathroom. So then I had to do an incident report because this pt got up without calling for my counterpart when they were supposed to. UGH!!!! Then of course they hurt themselves and screamed bloody murder in a WARD room -----> which means 3 other pts in the room ----> at 2 in the morning!!!!!!!!!!!!!!!!!!!!!!!!!! Nothing seemed to help - pain meds didn't seem to help for about 3 hours. Of course this pt falls asleep just as I'm about to be leaving. Wishing I don't have this pt again or that they go elsewhere before I go back to work.

The two fold part is that the new semester starting is just around the corner. The new nursing course is community health - something I know very very little about. To be quite honest I'm not really looking forward to it. And to make matters more complicated I have an elective this semester - an english course. I AM looking forward to the clinical course because I'm required to read a couple of interesting books - like The Hunger Games & Bridget Jones's Diary - for this english class. What an english class eh?! I hope it isn't too challenging. I hope that I can cope well with taking the two classes and working at the new place. I can't believe we're down to the last three semesters - down to the last couple of courses. I love that this is the last year (god willing!). I've heard that this community health course is rather difficult but I'm hoping that I can cope and that I can understand the concepts being taught. I can't wait until this year is finished and I can say I FINALLY did it - that I finally have a BSN to put at the end of my name. It's been quite the journey, I'm just hoping that I'm about at the finish line...

Monday, January 4, 2016

What will next year bring

Last day of 2015 (when I actually wrote this - but since then I've been brutally sick s it's up late) and I'm being reflective - 2015 has been an interesting year - I decided that I would leave neurology in pursuit of bigger and better things - get hired on a surgical unit and just after accepting that position I get another interview for a different job at a different hospital on a new unit - a medical-surgical unit. Accept that position over the surgical unit and begin on the med-surg unit.

I also got diagnosed with a new illness - Idiopathic Intracranial Hypertension (IIH)- long story short, I make too much Cerebro Spinal Fluid (CSF) - this was found when I had a nasty headache that when I wasn't suffering that I was super nauseous. Hubby got to the end of his rope of me complaining and said that I needed to stop or go to the hospital so off I went. Several lumbar punctures (LPs) later, and I have a diagnosis. Now to learn how to cope with the crappy effects by medicating the crap out of myself (which I always forget to take the meds, so it's been interesting!)

I've gotten through another year of nursing school successfully - not as successfully as I would have liked, but at least I made it through it! This last course was a killer but was shocked when I made it through with a solid 'B' mark.

I have also gotten the privilege of watching little tyke (and helping along the way) learn how to read... she's struggled so much but it seems that she's making up for this in leaps and bounds so I'm excited to see what this new year will hold in regards to this avenue.

Now onto what this year could possibly hold...

Little tyke may actually be able to read ME a book instead of me doing all the reading! Just the other day she actually wrote a whole sentence by HERSELF!!! Wow what a proud moment for me!

When it comes to the job - I'm hoping that it all comes together because my shifts into this new year have been terrible! My first night shift (my second shift off orientation) had me having TWO admissions on top of 3 other patients. This would be alright if I was actually good with the new systems and everything but on nights you have to do EVERYTHING because there is no clerk there to do part of the admission. But as they say, "nursing is 24 hrs" and so things got pushed onto day shift. In the end the saying "it is what it is" is what holds true.

I'm also VERY excited that this is my last year of my bachelors. I'm VERY nervous that this is my last year and what this means. There are four nursing courses and one elective standing in my way. I feel like I have the support to get this done. Boy can I not WAIT until I am standing on the graduation stage to get this damn diploma that I have been chasing for more than a decade!

I'm hoping that this year will be a healthier year. I have struggled so much in the last couple of years in this avenue so I'm really hoping that this will be an area of improvement. Clearly I'm not starting out this year very good, I'm already sick - a bloody nasty cold that I'm hoping won't turn into pneumonia or a sinus infection. As the saying goes for spring "comes in like a lion, goes out like a lamb" - boy am I hoping that this is the way this year goes!

Now on to the show!

Saturday, January 2, 2016

The blows keep coming

I was woken up yesterday to be told by Oc Health (OH) of the new job that I am NOT immune to mumps and either rubella or measles (remember, I was woken from my slumber - the brain wasn't moving high enough to process and remember everything - and the last two would suck to get if pregnant at the time!) - no surprise there.... we knew that I lose my immunity, but what would OH say about this mess? Because I've seen an immunologist and can demonstrate that although I've been immunized MANY times it cannot be sustained and have documentation regarding this, OH was ok with this as long as I sent it to them.

The other blow came from work itself.... I've lost my first patient - during my shift - about 2 hrs into it actually. The good thing was was at least the pt was DNR with an order for "nurse to pronounce". The blow isn't soo much that I am no longer a death virgin but that the poor pt had just decided on Monday that they would agree to go to hospice (they were dying from cancer) and on Wednesday had caught a virus that did this person in.