Admitting Procrastination

I'm currently in the throes of studying for the NCLEX-RN.... or procrastinating. Yep, I admit it. This is pretty much  me....

I have to constantly keep myself on track or else I'm trying to do other things - check out allnurses, look for what might be better ways to study, hell even trying to find other blogs to start reading. Yo, any new blogs out there? Shoot me a line, I'll come check them out!!!! It seems that lately none of my usual blogs are writing anything that I can use as a way to procrastinate with - wth?! Guess it's God's way of telling me to keep my eye on the prize or something!

So this meme is also me while studying. Geeze my ADHD is kicking me in the head. It's been hard to keep on track and keep focused. I don't know whether the way I'm studying is the way I'm supposed to be but hey, that's the way I'm doing it. Now when we moved to this new house, I pretty much got rid of ALLLLL my notes and books (lots of my books but not all) - but all my notes for sure - cuz I wasn't thinking about the NCLEX and so this meme is definately me =>

The expression on that person's face (bottom) is pretty much mine at the moment. I am SO done and yet I still have a bunch of days left that I have to use to study. So I guess that expression will be mine for the next two weeks.

Just hope that I can hold on to some kind of motivation to actually study and retain information. I need to get through questions and information as well as remediate on information I got wrong. But geeze, it's difficult when hubby is gone too and he was my kick in the butt. Even though he annoyed me to high heaven, he did it for the best of intention and for the betterment of me. I miss him already and he's only been gone for a day! hahahaha

Anxiety ridden

I'm studying for the NCLEX - taking the NCSBN program in effort to be prepared. When we were looking into how best to get prepared, we heard that that was one of the best ways.

But I'm just so anxious about this because I'm not the fastest of readers. It somewhat has to do with my ADHD. I can't read in total silence but I do understand that having my tv shows on does slow me down as well. UGH!

So I'm working extra hard, staying up twice as long in order to get the info read. Plus I'm also copy & pasting info that I know I want to flag and re-read later that I feel that I don't know enough about or that I need to remember later, reference at a later time. Such as cranial nerves, OB/L&D info, growth & dev't... you get the drift I'm sure.

I'm not sure whether I should be doing it this way or whether I should be doing a massive amount of questions. I know that when I did my NCLEX-PN, I just did a butt load of questions, but I have such an enormous amount riding on this result that I can't just wing it and hope I pass. I need to do anything and everything I can to ensure that I do.

I actually talked to US job-based recruiter about some stuff. They wanted to know about when I was taking my NCLEX. At that point I didn't have my ATT so I couldn't tell them when my date to write would be. But I did talk to them about when I planned to move. When I noted that I was thinking about coming after the first week in February I was advised against this as I was expected to begin onboarding preparations before a certain date way before my start date. Before I was meaning to go, really.

But I'm nervous about the NCLEX. I know everyone is. But this year they're combining the US & Canada, which means that this year's test will be even harder than usual. So yes, I'm afraid of failure. I'm nervous that the knowledge that I know that I have won't translate to the test and result in a successful attempt.

Goodness I'm nervous. I'm nothing but nerves and anxiety. I can't wait for it to be over but I also know that I need every spare second I can get to study.

Making it come together

I always wanted to have the opportunity to decorate my grad cap but because we went to graduation the day before and only had the chance to pick up the cap and gown just prior to the actual commencement ceremony. So hubby and I talked about still doing that since being back.

Even better, I'm going to do a shadow box!What's that you ask? Well I'm going to use the nursing top that my uni made us buy/wear which I'll use as most of the background and I have my name tag that I used in clinical.... then I have my pinning ceremony booklet as well as my pin.... then I have my graduation cap (once I have it completely decorated) and my commencement booklet. Plus I figure once we have a few of the photos developed from the ceremonies, then I can put them into the display as well.

I want to put a saying here and there as well such as....

“I always dreamed of success, now I’ve achieved it”

“It always seems impossible until it’s done”
We'll see how inspirational I am for the sayings or what I can find on the internet (fyi, I found those somewhere there!).

However, this stuff may have to sit on the back burner a little bit as I've already received my ATT!!!! And with that I've already scheduled my boards. I'm nervous as heck. I'm afraid of failure. I'm afraid of diappointment. I have a LOT riding on my boards! For those who don't know, if you fail your boards, you have to wait another FORTY FIVE DAYS in order to sit for them again!!! By that point my residency will have begun already! But I can't push my board back because I have to go through license verification and visa crap in order to get my shit together for the residency! So like I said, a LOT is riding on getting my stuff done right the first time! But boy does this pressure do something terrible to my head. For the last day I've been fighting a nasty headache/migraine. It's no fun! I can't wait until I can just kinda skate through life again! hahahaha.... the way my life is, I don't see that happening for a long long long long time!!! So wish me luck on getting this done successfully the first time!

what could go wrong you ask

I graduated Saturdayday! 14 years after I set out to obtain my BSN degree - but only three years after actually starting my core courses (after the four pre-req's that I procrastinated on - which took me a year while I was working and raising an infant). After all the obstacles that I've had to overcome to get to this point, it seems surreal.... it seems so ordinary now to be sitting again on my couch again.

From the point of the night before our trip, anything and everything that could go wrong DID GO WRONG!!!! And I'm not exagerating either.....

#1 - we decided that since I hate ironing that I would take hubby's clothing (two pairs of dress pants and one of his shirts - the one colored shirt that matches my uni's color) to the dry cleaners who did their stuff in-house because it would get done faster and stuff wouldn't get lost..... well when I returned the night before (at the time directed), they could find only his pants and lost his shirt.... we went through the entire line looking for the shirt and couldn't find it. I was so overwhelmed I didn't know whether I should cry or vomit... The woman was perplexed as to where the shirt could have gone. She "suggested" that I come in in the morning to see if the shirt could be found - which I explained that would be VERY difficult considering we were leaving at 3am!!! So she said that if we got to our location and bought another shirt, to keep the receipt, that they would reimburse us for the shirt.... yep, we'll see.

#2 - Hubby suggested that we put the nursing pin in my luggage to keep it safe. And he didn't realize that our luggage could be taken as a carry on and he did it as a checked baggage. He figured that since we had a connecting flight that that would make this easier that lugging it around everywhere. Made sense at the time. Problem was that that pin was vital for the pinning ceremony that was due to occur several hours after we landed!!!! I'm sure you can imgaine what happened next.... yep our baggage somehow does not land at our destination with us but seems to go to the next.... and must do a back track at a time cost to us of approx. 2 hrs!!! This causes major emotional trauma to me because when they said they didn't even know where the bag was at first and whether they could get the bag back in time, I PANICKED!!!!!!! I called the chair of my program to see if they had extra pins in case MY pin didn't arrive in time. Plus, we still had travel time that had to occur. So ya, talk about stressed out!

Thankfully the bag does arrive and we get on the road and arrive and get ready. Too bad my husband doesn't listen to me and wears whatever he wants to wear and so I think I'm going to be disappointed with the picture that occurs. But I'm very happy with the ceremony. There were 44 nursing students there. There were only 5 distance LPN-BSN students - from our 16 graduating class that showed up, so disappointing in my opinion. Hell, I'm from Canada and I showed up, and another was from Maryland and she showed up - and we had to go all the way to Indiana to have this pinning and graduation! I figure, with the amount of time, money and dedication that I and we have put into it, I would think that they would make every effort to attend. But that's just me - my opinion.

So during the pinning ceremony the dean of the nursing program recognized the members of Sigma Theta Tau (Nursing Honor Society) to which I was the only one in our program and one of only fourteen of the 44 that were there. I felt special in that moment. Especially considering I knew that I wouldn't be recognized in our graduation for getting honors, all because I was a "transfer" student and hadn't stepped foot on the university. It didn't seem fair. Hell, I've paid $75,000 (no lie or exageration!) to this university, it really doesn't seem fair that I get jipped because I wasn't able to step foot on this university.

#3 - I preordered my gown and cap - yep not there. So then we had to scramble to see if we could find one that would fit. Thankfully we did. Too bad there's not enough time that I can decorate it :( That part really does make me sad. While we were there we did some purchasing of uni-related items to wear for times to come or items to use from this point on. Things to remember that I put in the time and effort and I made it!

#4 - So we are told that we have name cards that we fill out and we have to tell the speakers out to say our names phonetically and then hold on to until we get to the front of the line just before we get onto the stage and are to hand it to the speakers. No problem! We're told that when we get to our seats in the auditorium that there are booklets that we get to keep and while we're bored during the commencement that we could look through the booklet and keep ourself occupied. Ok, sounds great. Well I was seated with three others from my class and one other of my class we hit it off and were chatting it up and so I put my name card into my booklet because just before it was our turn to stand up and go to get our fake degrees, we figured that we would make sure that our caps were on straight and our tassel was on the right and well her cap was definately not on straight so I gave her my booklet to hold for a sec so I could give her a hand.

When she handed it back to me, it was time for us to go and when I went to find my card, it wasn't there. We went page by page, we shook the damn booklet.... we looked around. I was so friggin panicked! The rest of my row was just walking away!!!! Well one of my professors (alumni) turned around, ripped a page out of his booklet, gave me his pencil and told me to write my name on it and tell them how to say my name and I would be good to go.... Thank God for him! And yes, I was. They said my entire name correctly. I was soooo flustered that I wasn't quite paying attention and I tried to shaked hands with a person I wasn't supposed to, and I didn't get the chance to really savor the moment. That's what makes it sad for me.

The other bit that makes me sad is that when they announce the name is that after the name they say whether they received honors (sigma cum laude, cum laude, etc...) and because of the issue of not setting foot on step on my uni, I'm not eligible for even though my grades are high enough! Makes me so sad. But I have to remember that at least I'm receiving my degree and that's what's important.

#5 - My damn shoes gave me blisters on my baby toes and on my heels - pretty crappy considering I chose flats! I should have chosen the heels I was going to go with but I didn't want to worry about "tripping and falling" like most of us ladies do.

#6 - When we go to leave for Canada we get to the airport at 3:45am for our flight at 6:25am. Our airline was Aircanada and they had ONE kiosk with ONE lady manning the damn desk. Unfortunately, the people in front of us were on student visas in the US and were connecting through Canada on their way home to China and were having MAJOR issues. so by the time that we got up to the front it was like 5am and figured that we were good to go.

We were Canadians, travelling on Candian passports (no visas or anything). Usually if we have problems, we have it when we travel INTO the US not Canada!!!! Hubby has a name that raises flags and causes delays and they usually have to call TSA because hubby doesn't have a middle name to differentiate him from all those other people who do the terrible, potentially dangerous things and so it always causes the agents to have to make LONG calls to people who eventually tell them that he's ok to get on the damn plane.

Weeeellllllllll this time it took them over two hours and many many many tries to get his passport to go through on their system. When they would try, it would just say no. Not declined or call so and so. Just no. It was so frustrating! And of course hubby was getting frustrated. So because of hubby's issues it held the line up too..... and so they had to hold the flight up.... but low and behold, the flight was held up anyway because the heater on the plane broke because the temp had dropped so quickly overnight that the plane couldn't adapt and so it broke and it needed to be repaired first.

So the kiosk lady told me to go on through security/customs and head to boarding. When I got there that's when I had found out about the heater being broken. But when I arrived I greeted the lady there thinking that the rest of the people were already on the plane and such. Nope, we were still to wait around. So I had a few minutes to get myself situated and calm again. I told her about myself and hubby's situation and told her his name and when I was done telling her that the pilot and crew showed up. Well low and behold it was a female pilot!!!! Awesome!

I greeted her, telling her about how wonderful it was to see a woman pilot and that it was great to see her stick with it through what I'm sure was a difficult education and getting into a male dominated field. She indicated that she appreciated that acknowledgement because so often most people look down upon female pilots and think less of them. I indicated to her where I was from, and she had said that she was very familiar with it and had flown into it numerous times. I told her about how when I was in school there and saw female pilot students (in my hometown there's a pilot school program in the college there), I would encourage their perseverence because I'm sure it's not easy, even now.... She said that when she was in school she was absolutely looked down upon by other pilot-to-be's and that she would put them in their places because she figured that she had just as much right to be there as they did! I really liked that about her. Thats the sort of personality that I have. But back to my story...

I saw that the pilot and one of the crew had a starbuck's in their hands and asked where they found it because the starbucks in the main area wasn't open and I hadn't seen another one, so they gave me directions. I asked if I had time before we boarded and the crew member indicated that she believed so if I hurried so off I went, because I figured that if the heater wasn't quite up to par, the plane was probably going to be quite chilly and the drink would probably keep me and my hands warm! So off I went!!! I got my white hot chocolate (they didn't have the toasted pecan flavor shot unfortunately so it wasn't quite as yummy) and made just in time to get onto the plane. Before boarding, I asked if my husband made the flight. She said she didn't know, but she said that they were waiting on one more person. Boy did I pray that it would be him!!!

So I'm sitting in my seat, saying a silent prayer and looking out the window and everyone had boarded the plane. The crew member has handed out the declaration cards (that are usually handed out in mid-air) because she has the time now to do it! and counts heads. It seems like she's about to close the door, the plane sounds as though it's revving up and getting ready and everything. And the lady from the desk inside comes onto the plane, seeks out my field of vision and tells me that hubby didn't make the flight, that he would be catching the one at 2:40pm - I was so sad! Oh the thoughts that were going through my head!!!

So I'm sitting there sipping my hot chocolate and filling out my declaration card and MY HUSBAND SHOWS UP!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! WTH?! Well it turns out that when the lady made the new reservation for hubby for the 2:40pm flight, that's when the passport went through! How stupid right?! So she radio'd through, telling them that she was sending him, and told hm to hurry through customs/security and he raced through and then pounded on the door like 5 times to get their attention in order to get on the flight!

#7 - We get to Toronto and we're supposed to be picked up by our car. Problem is is that the night before, we got freezing rain and no one bothered to check the car our and see if it was frozen over. Therefore, they had to turn our car on, leave it there and pick us up in their own car (a car service) and then bring us to our car which was semi unfrozen. So then we had to use our scraper as a pick axe to break up the ice and try to get it off our car. Yep fun times!

Finally we got home and crawled into bed and made up on the sleep the I was deprived of while we were away. I was very thankful that I went but boy I couldn't believe what happened while we went!

Of course I'm the 1%

So when I last saw my immunologist he said he wanted  me to see a dermatologist because I showed him my cheset that had pimples/sores all over it (but not under my breasts or under my axillas) and he was all concerned because he was sending me to a different hospital in big city.... I figured what's the difference, big city hospitals are all the same. I figured I would be getting a good Dr either way, so I agreed.

So I saw the Dr.... or actually I saw the resident who took my history and prettty much had me disrobe and checked me out from hide to hare, from tip to top... you get my drift - really, I don't get why they even gave me a hospital gown! Hahaha

So when the dermatologist came in and asked the resident what he thought I had, the resident confidently stated - hidradenitis suppurativa.... a condition that affects ONE, yes ONE percent of the population!!!!!!!!!!!!!!!!  Let that friggin sink in!!!!!!!!  Holy shit bat man.

Go figure... It doesn't really surprise me that I''m the one diagnosed with this! It seems to me that with everything that's been happening that I would be diagnosed with something that is rarer than rare.

So you want to know what it is I'm sure... well it's essentially where my body is attacking the hair follicles and oil glands and it's overly inflammed and such - so it's creating little pockets of abcesses of pimple looking things. And sometimes it can create fistulas - like what happened to my bottom - yep....  he thinks that my bum issues are related to this condition!!!

An answer!!!!

Once they checked my skin and told me how severe it was, the dermatologist asked the resident what medication I should be started on.... she suggested clindamycin and rifampin, but those meds interfere with my insomia meds - amitriptyline & quetiapine - and so have to go to the next highest level which happens to be the highest level - Humira (Adalimumab) which is super expensive - think $3000 per dose - which will be $21,000 for the first month alone and then $12,000 there after!!! Crazy right!

So the doctor's office contacted the medication company to start the process who then contacted me to get the process started on that front - then we contacted my insurance company who indicated that in order to be covered it had to be "preapproved" and so my derm's office had to send info to the insurance company with info about this and then the medication company will be contacted to say that it has been approved and then they will contact my pharmacy to order the med and then will inform me as to where I can go to do my first injection because the first one has to be observed in case I have an anaphylaxtic reaction - which I doubt but still.

For my condition and med It's liquid medication that must be injected subcutaneously like insulin and so I've chosen a pen system, just like an insulin pen. For my first dosage I have to inject FOUR doses!!! Crazy right! It's essentially to shut off my immune system. What that means for my immune system I don't quite know, because as you know (if you've read any of my history), I''ve gotten a TON of infections - and weird ones, one after another..... I know I have several right now actually. But whatever.

Tomorrow I have to see my primary physician to get some antibiotics to deal with the infections because if we turn off what immune system I currently have, I'm going to be screwed! So I'm sure that tomorrow I'm going to be put on IV antibiotics.... or at least that's what I'll be pushing my Dr for. I think that's the best option if we're going to be dealing with the issues at hand. I know that I have a resp infection - I think I should do a sputum culture - and I know that I have a UTI (cloudy yucky urine with intermittent lower back pain) - I figure if he puts me on Erterpanem then that will deal with the UTI..... for the sputum resp issue I think possibly a Z-pack and wait for the culture to come back for sensitivity and I think that since I'll be taking all these antibiotics I'll suggest Flagyl as a precautionary thing so that I don't end up with C-diff! Cuz really, we're talking about me here, I'm the 1%, I'll end up with c-diff!!!

A tad bit backwards

I've said it before but I'll say it again, I'm Canadian.

I complete my US based BSN program in just over two weeks - WOW! Shocking consdering the hoops I've had to jump over to get to this point.

That being said, I still have hoops upon hoops to jump through. I have a job waiting for me - pretty much my dream position!

In order to get said position I have to get a US license in the state that I need to. HOWEVER, said state won't even let me write the NCLEX because I don't have a social security number (SSN) but I can't get that until I have my NCLEX written and receive my visa.... so how in the WORLD am I expected to get this license then you ask? Well I have to write my NCLEX in another state and then get my visa in order to request endorsement from the state that I actually want to work in.

Ass backwards isn't it all?!

Yesterday I called said state I want to work in because they require that I get a background check and fingerprinting done - but that I am supposed to request endorsement FIRST.

Problem is is that because I graduate in December, everywhere closes over the holidays and thus I lose valuable weeks in getting my authorization to test (ATT)... then I have to actually TAKE the exam, get my results (hopefully a pass on the 1st try) then get my visa - so that I can have the SSN in order to even apply for endorsement..... all before the beginning of February!!!

Oh ya, and to top this all off, the stupid visa ppl say that they need how many hours of clinical I have done in certain areas or else they won't give me the visa - so now I have to contact the school I went to before for my practical nursing and where I did the most of my BSN previously. When I talked to them last they said that it would take 8-10 WEEKS (Like WTH?! It doesn't take long to look through a few course outlines and make calculations to fill out the required paperwork - 8-10 DAYS I would think would be more than sufficient). If it seriously took them that long I'm going to be screwed for getting my job started when I'm supposed to.

Geeze why must it be so complicated?! Can't anything in my life be straightforward and simple???

I did forget to mention that I had contacted the other BON to see if I could get the background check and fingerprinting package sent me now so that I could get this done and have it waiting for the endorsement and then when I'm ready, I don't have to wait for the package to be sent to me, me to get it done and then to have it sent back to them.... which of course would take time I just do NOT have.... and thank GOD he was listening and this person actually agreed to it!!!! So this person is sending it to me so that I can get it done (hopefully while I'm in the US for my grad cuz everything has to be done in the US - which I do not currently live in!) and it won't delay things later on.... we shall see.

They all want a piece of me

On Friday I got an email.... at 9:30 at night. Ya, I know, we all get emails at all hours of the day and night, big whoop! But this email stood out among the rest. Do you want to know why?!

Well as I've said before, I've applied to several nurse residency programs and everyone that I applied to I was asked to have an interview with. Yep, I have a fabulous resume (that I did by MYSELF and did not use a professional resume service [yes those exist]) and a pretty awesome cover letter (if I did say so myself!) and I even put together a pretty darn good letter of intent for a couple of programs.

For those of you who read more than just one post and go away (ya I don't blame ya, I can be quite boring - though stupid shit happens to me frequently so if you want to continiue reading about it all, read some more!), you know that I was already asked into a nurse residency program already and accepted said program.

Well I got another email from one of the residencies that I applied to - Vanderbilt, asking me into one of their programs. If you know anything about programs, you will know that this program is prestigious and so LOTS of applicants. And I actually beat some people to be asked!

Now for the bad part, I have to turn them down. I'm sure you'll wonder why I would ever do that but the thing is is that the one I already accepted is in the field that I want to go further for education - neonatal nurse practitioner. The Vanderbilt program has asked me into the operating/post op program - not where I want to go. If I wanted to be working on a med-surg unit I would just stay in Canada!!!!

I'm not quite sure how I turn them down though. I certainly don't want to burn professional bridges after all. Plus, I don't think I can change their minds about which program to put me into. Geeze, sure do with I could though!

Always negative and holy hell am I awesome!

I'm so frustrated with my husband. We've decided that we aren't going to Pakistan to attend his brother's wedding because we just can't make the finances swing or take on that debt. Because there is no way that I'm going to go there and not actually experience a million different things and not buy a TON of stuff. So we'll send little tyke in our place (again!). Seems to be the story of our lives!

So I approached hubby about his vacation time because work was allowing him to carry over two weeks but thought that he could talk to his boss about still being able to carry over whatever he could get and come move me to the US to be able to start the nurse residency program.

No surprise he wasn't thrilled about the idea. Seems that he always talks about the negative. He can't look into the good - like in ONE MONTH I will be walking across the stage to get my DEGREE!!! However, he would NOT really talk about graduation and such until after my graduation was guaranteed (passing the stupid ATI comprehensive test). Now he's doing the same thing about starting the residency program. He won't talk about it until after I have my boards passed and my visa in hand. It's incredibly infuriating.

Then I pushed back about how hard I've worked this semester both in school and in getting an offer for a nurse residency. It's not exactly easy for this to occur because I have to show how superior I am to others. He agreed but wouldn't give in. I talked to him about how the visa should happen easily because I have a job offer and I'm doing anything I can to try to ensure victory on the boards. He softened some. I told him that I didn't expect any over the top gesture, but that he would simply agree to talking to his boss about carrying at least a week over and taking that time to come with me and help me settle into my new digs and get all set up to start the residency.

He finally relented and said that he would see what he could do. I mean, I'm not asking a lot from him, just to take the time to look forward to our future and to think positively about it, even if it's not completely set in stone yet.

Hell, we've jumped sooooooo many hurdles to even get to this point, so have a little faith that God has a plan and that just possibly that may be us moving to the US.

Post immunologist

I saw him and reviewed the bloodwork. Nothing too abnormal, my IgG subclass 1 is still low but it's higher than the last time. The total IgG was normal though so nothing will do anything about it. He was perplexed why one of the tests that he really wanted done - the oxidative burst assay - wasn't done when I had all that bloodwork, or at least he didn't get any results and of course the physician that okays this test (or something like that), is not available for another two weeks. My Dr sent an email but also told me to contact him in two weeks to see whether he got results or whether I have to do this test all over again. Sooooooo frustrating!

BUT at least I have to go see my surgeon in two weeks so I figure that I can do the blood work then if I find out that it wasn't gone before. UGH!!!

I also asked him whether he knows what's wrong with me and why my immune system is crap and I keep getting sick and so forth. Surprisingly he said that he has "no idea". Nice to actually hear a Dr tell me the truth!

I also told him that I intend to move to the US - he asked when I was returning, I simply responded "umm never" hahahaha I am supposed to see him one last time in January so I'll get my records then so that when I move to the US, I'll be able to find my own immunologist.

Oh and on a different subject, I got the result back for the paper that I lost a friend over - 370/375!!! I hope she feels that it was worth it.

And my nursing pin came in - I can't wait for this semester to be over with and to be pinned and receive my fake degree - to walk across the stage and celebrate the ending of my BSN education. Goodness I can't wait for these moments!

Round and round we go

So my hospital won't employ me because my neurologist won't complete paperwork or answer their damn phone. Their doctor said that he would help me get to a new neurologist in the big city, but I haven't heard from him (big surprise right). Story of my life! I see my immunologist in two days, doubt that he'll do anything or give me an official diagnosis. Who knows, I suppose I could always get surprised, but not likely.

There's only a month left in school, this thought is so shocking to me. I never thought I would get to this point. I've come against so many hurdles that I thought it would be impossible for me to surmount them all. But here we are, a month left.

My mom said her boss won't give her the time off. I found a way around this where she'll fly the day of my grad, come to it and then the same day fly back. I knew based on how she was acting/saying when I gave her this solution that she wouldn't take me up on this. Sure enough, that's exactly what happened. She didn't care that she was hurting my feelings. She said that she was too "scared" to do that all in the winter. I'm calling bullshit but who am I to judge. Whatever, I've come to expect that she'll disappoint me.

I went looking into housing for moving to my southern city, things are affordable. Heck, I can even get a small house. But hubby pissed (I was going to say rain but he was harsh and mean and difficult to talk to abou this) all over this. He just wants to put money into someone else's pocket. It's frustrating to me. Don't know how we're going to come to a mutual point of understanding and agreement. It seems we're oceans apart.

Last evening my DD was in the bathtub and my BIL was visiting and kept asking where DD was even though I'd already told her where she was. She then got all huffy that she wasn't out yet because she needed to "practice" her religious reading with her before she read with her teacher (which I don't understand why we pay her if my MIL is the one doing the practice with my DIL) and said that if my DD needed to get out then she should go tell my DD to get out of the tub. Well my BIL said that it was my "duty" to go do this. For the reasons list above, I said to him and I also put it out there that if I was to leave DD behind while I move south (which is what I'm intending to do - hubby is being left behind as well) then she will have to step up and be an authority figure (which thus far she has sucked at). But of course he argues with me and then my MIL goes upstairs and actually gets her out of the tub (after me giving her the notion that she could literally pull the plug in order to get her out) so that she could practice. Should be interesting when things come to fruition.

A paper is worth more than friendship

For the last two weeks I've been undertaking a paper for school.... with a friend that I've been doing this whole thing with since the beginning. We didn't start out knowing each other, but became friends at the beginning of this journey. I learned that we were strong academically and so when this last course came up, we asked if we could partner up for the papers that we have to do.

BIG MISTAKE!!!

This most recent paper she did her parts quickly. And expecting the same of me. Problem is is that with my IIH, things take me a bit longer. Plus our sleep schedules are opposite and she expected things done on her timeline. She expected updates and work to be done even though I was still in the prep part.

So this upset her and she went to the teacher and threw me under the bus. She chose the paper over our friendship. When I responded I was so shocked. I explained what was going on and thankfully the prof saw what was real. I even stated about how there was still 10 days left before the paper was due, she didn't need to freak out because the paper wasn't complete.

I couldn't believe that this happened.

So now I'm left to pick up the pieces and pretty much just do my part and get this over with. I am so hurt that she did this. She knows what I've been going through and that still didn't matter.

I guess I finish this journey alone.

New Graduate Residency (NGR)/Nurse Residency Program (NRP)

So I got an email yesterday from the NRP human resources (HR) personnel indicating that they were trying to reach me and had left me several voicemails. On friday I had received an email that gave me an idea that they might be giving me some good news sometime soon - at least thats what I was hoping for.

But I had completely forgotten that our cellphone broke just last week and didn't think about the fact that I didn't have access to voicemails and that ppl would be trying to reach me. Additionally, the HR person and I had always emailed one another and so I didn't think that she would try to reach me by phone - such a blonde moment!

So I emailed the HR person and explained what happened with the phone and gave an alternative number. But in the evening I questioned hubby about whether we could retrieve the voicemails - so we were able to get that to work and I heard what was said.... not much other than that they had "good news" for me and wanted to talk to me about it on the phone. Well while we were listening to them I then had an epiphany about whether we could forward the cellphone to another phone ***without using the cellphone because it was broken and wouldn't even turn on. We contacted our phone provider who helped us through that and now it's forwarded.

This morning the HR person called me and offered me a position with a brand new NGR with their pediatric/PICU!!!! And they're also going to put me through L&D/post partum and NICU so that I can do shifts in this area if need be!!! OMG I'm ecstatic. I NEVER thought in a MILLION years that they would consider me for that area because I don't have extensive clinical experience in peds and no experience in PICU - only through the ER and so I never thought that they would offer me this NGR. I'm so excited I can't even explain it.

When I did my interview, they asked what area I was interested in. I told them that I was pulled in two - one way being my passion and hearts desire to work in peds/NICU/PICU which I had PERSONAL experience with but little to no clinical experience in these areas, but felt that I wanted to work in those because I could relate a bit to what parents are going through when you expect a healthy baby and they end up in the NICU instead and then the flip side where I have the clincal and work experience in adult care which lends well to the critical care NGR. After this the interview continuued on like it normally would - but the questions were generic in nature and didn't ask me to talk about how my peds/ER experience would lend well to the NRP I got offered. Either way, doesn't matter anymore, my hard work and perseverence is paying off big!

Now that I've been offered this, I have to get my butt in gear and finish my program off as strong as I can and get prepared to write the NCLEX ASAP!

3 wks out of the game

A lot has happened, which is why I've been MIA.

Last night I had my MASSIVELY IMPORTANT ATI test - the comprehensive predictor test - the one test in my ENTIRE nursing education that matters. If I don't pass it, I fail my course (if I fail the second attempt that is) and have to repeat the course, which would then push my graduation date and would screw up my current GPA of 3.5!

So I've been busy studying for that thing - which I PASSED!!!!!!  OMG what a weight has been lifted! And because I passed this, arrangements can FINALLY be made for us to get there for the pinning ceremony (evening before) and graduation. My husband has purposely not allowed him nor I to get excited about the upcoming graduation because this one test would decide my future. Now that I've passed it, you bet I'm being ecstatic and seriously want to scream it from the tip top of this new house.

Oh ya, did I mention that we moved into a new house? Probably not, considering I've been a bit busy. But never the less, we moved. I don't really like the new house. I wasn't consulted before an offer went in. I hate that there isn't two separate living room areas that are enclosed somehow so that the sound from one won't interfere with the other. It's incredibly frustrating. Plus I was promised my own bathroom with a shower. Ya, didn't get that one either! I got a sink and a toilet and a shower I am told I can't use because the glass isn't installed yet. But my wants and desires are always put on the back burner in this family so who am I to say anything!

On a different note. I've applied for a bunch of nursing residencies. For every one that I applied to I've been contacted for an interview for. And for two I've been asked to go to their hospitals for interviews/match day. And for the one that I was actually able to go to for an in-person interview. Then just the other day I received an email from the one place I did the in-person interview with that attached an "employee benefits package"!!! So I'm hoping that this is a great clue that I'll be getting an offer very soon!!!

I really, really hope that it's critical care; even better would be NICU, but I doubt it. Either way, I would still take this position though, it would be quite the experience. This one hospital alone has SIX, count em six ICUs!!! Plus they have 5 other hospitals that I can transfer into after the fact. Perhaps I can get into PICU or NICU afterwards.

As great as these parts of my life have been my work life has suffered BIG time. So my IIH is still a major issue. Whenever I work I either end up with a migraine during the shift or the next day. Friggin sucked! And considering I'm not going to work while on narcotics, I needed to have my shifts spread out. So I couldn't work the "required" weekend like my collective agreement states I need to be doing every other weekend. So my physician noted that I need to have at least two days between my work days. But otherwise, I can work the required jobs that a nurse does. But when my Occupational health person got my medical documents and talked with my manager who indicated that that wasn't an option on our unit. SUCH BULLSHIT!!!! The other unit my manager is responsible is closed now due to renovations and such and so all the nurses from there are transferring into our unit - so it's not like there's a shortage of nurses or anything - ones who would be able to work those shifts that I can't!!! So I'm off work now because my manager won't agree to me working what my medical documentation indicates I need to. Plus, the Oc Health Dr wants to meet with me to discuss my IIH and how I'm impacted from it (assuming so since I don't actually know). So now I have a meeting with this Dr on thursday. Kinda pissed that I have to go through this kind of BULLSHIT.

Another piece of BS that I had to deal with was trying to get my daughter started at her new school. OMG such a process!!!! They need documentation that you bought a house in their district, but also require a bill in our name (which we wouldn't have received for another 3 wks!!!) - but won't take house insurance!!!! I wanted to scream at that about the idiocy of their policy. After a bunch of "going over the heads of the lower ppl to get to the ones who make the decisions" we finally got her started. Then on Friday I was told to come pick her up early from school because she had head lice - AGAIN!!!! So I treated her before even seeing if she was infested but when I combed out her hair with the little brush, there were NO nits or lice. So ya, kinda pissed about that. And they also make you go to your physician to get cleared and get documentation that there's no infestation or they can't go back to school!!!! So guess what I have to do in the morning?!

So ya, I've had a lot going on these past couple of weeks. I'll try to remember to tell you all about my nurse residency adventures. My life, as always, is never boring.

Working hard

I started back at work. Yaaaay! Only 7 mos away! Geeze it took a long time.

My first day back I worked alongside a co worker => ended up with a migraine half way through! Thankfully my migraine med worked and I didn't have to leave work because I needed to take morphine to relieve the pain.

My next shift I was kicked to fend for myself. And WOW what a shift!

At first it flowed well. I had a flow down. Plus there were some nursing students that were paired with ME who I could delegate some tasks to. Too bad they were only there until noon. ARG all by myself. Goodness I thought I was falling out of the nest and having to learn to fly while falling 50 ft to the ground. I felt inept for sure.

Then of course the shit hit the fan after one of my patients (who got thrown on me because a nurse called in sick! - go figure) had physicians coming out of the wood work, popping up and saying that all these stat things needed to occur.

A little back story: my patient ended up at our house because my patient was found by family with what was thought coffee ground emesis and so EMS brought her to MY hospital. Oh ya, and her GCS was 7. But for who knows what they were thinking, did not think stroke considering all signs pointed to stroke.... who knows why though. Since our sister hospital is the regional stroke hospital she should have gone there and not ended up under my watchful eye.

So when I had this patient I was definately thinking stroke - pt was COMPLETELY obtunded with a GCS of 4 - she only responded to pain and certainly couldn't obey commands. She was posturing. Every sign pointed to stroke. But she hadn't been diagnosed with having had a stroke.

The head CT that they did didn't show a stroke - a bleed anyways, which would have shown up on the head CT but if it was a thrombotic stroke, it sometimes takes up to 24 hours to show up.

Back to my story...
So GI came to the unit to see the patient, did quick questioning to the daughter who was there and of me and what I have observed while caring for her. So he decided almost immediately and said "ok, I'm going to take her to scope her in ten minutes if that's alright with you" - the daughter of course said yes... then not TWO minutes later did a porter come in the room saying that she was picking her up. I was completely shocked and thought that she was going to surgery. And when I made a comment in regards to that the porter indicated that she was taking her to CT.... which perplexed me because I hadn't heard this in report and hadn't seen a physician so I had no idea what was going on.

Of course I helped transfer her onto the stretcher then asked the porter to wait at the nursing station while I figured out where exactly she was to go to first. I headed straight to the charge nurse to find out what they knew about this all. Well turns out some physician had decided to order a stat head CT - but this patient also needed to have things figured out and needed to be scoped because she had certainly bled out of her mouth and I had provided extensive mouth care and didn't see a cut to the mouth to account for how it looked. But she also really needed this head CT. So it was decided that she would go to be scoped first then to CT and back to us.

Before the patient got back the neurologist showed up and questioned me about the patient. I indicated that I was a neurology nurse for five years and thought that she had suffered a stroke. But told him that it would be good for him to lay eyes on her himself and asked that I contact him. I asked if there was a way to get a hold of him in particular and he actually gave me his pager number. Surprising considering most physicians say to just call locating and contact him that way. Of course he's gone like 5 minutes and the patient returns. So away I went and paged him and he came so quickly!

Once he laid eyes eyes on her, he completely agreed and even said that he thought that it was possibly be a brain stem infarct because of the posturing - the oddity being the fact that her legs looked like this:

The patient had the first position, which is supposedly a indication of brainstem infarct. So he wanted a stat MRI because the head CT didn't show anything.

Of course while this is all going on I'm having to discharge one patient, deal with another patient who had massive wound issues and the wound care nurse needed me to go with her to do it. Plus another pt that I had to manage - who needed bladder scans q4hrs which of course meant doing In&Outs 3 times in my shift. Not included this is the regular duties - meds, bathing, etc...

So when this all went down I was up the crick without a paddle. Thank goodness for my buddy who offered to take a few things off my shoulders so that I could take a break and decompress a bit.

Crazy thing about all this..... MRI did NOT show an infarct anywhere in her brain, or brainstem for that matter. So nothing to account for her neurological status and clinical symptoms. But where I stand - I know that I did all I coud to keep her alive and well. Who knows if it stays that way, I hope it does, I know that it would destroy her family if that changes.

I'm in pain

So for the last two days I've been dealing with a pretty bad migraine. My meds don't seem to be helping either and so I've been struggling. It's hard to get stuff done when the pain is like this - when my head feels like it's being squeezed it's hard to concentrate on what I need to get done for school.

I have a "ways of knowing" paper, I'm about 3/4 of the ways done but my brain isn't really computing because the pain is so bad. I just feel like sleeping a whole lot - it's kinda how my body deals with pain. I tend to sleep quite a bit so that I'm not experiencing the pain.

I'm just thankful that little tyke started school again so that's been keeping her happy, if not a little bit more tired. Her first day you could tell that she was exhausted but by golly she would not go to bed any earlier than 9pm - come hell or high water! Surprisingly she made it to then and then completely crashed! I only wish every day was like that. Unfortunately, I know that won't last, give it another week and she'll be used to getting up early and the energy expenditure that occurs when you're at school with your friends. Bonus is that little tyke has said that she loves her teacher. Hopefully that means that she'll have a good month because with the move that means that she's switching schools and therefore will receive another teacher. So we'll see how well she copes.

With this migraine I really don't want to be staring at a computer screen any longer than absolutely necessary - so I guess it's nap time for me.

Trying my best

It's been a little over a week since I had my surgery. It has its good moments and bad - times when I think I may have an infection but then I'm unsure about what color discharge should be seen considering where the surgery was. I have follow-up on the surgery in a couple of weeks so we'll see.

I've been trying to not aggravate the area so I've pretty much been reclining or laying on the couch and getting my school work done. Boy I can't wait for this semester to be over, and it only just began last week!

Our prof has us doing our NCLEX prep stuff differently than what is normally done in which you study and then take the tests/quizzes. Well she has us doing the quizzes/tests without any studying so that we find out where we're weak and therefore need to spend our time studying THAT stuff. Her way makes sense, just wish she would have explained this at the very beginning. Oh well, c'est la vie!

I'm below where I need to be for the HESI but I know that I can get to where I need to by going through this process. I certainly know I have a bunch to relearn/remember from the paeds and OB course that were tested out of like 4 years ago!!! So it's not like the information is fresh in my mind or anything. I also suck at remembering cardiac stuff (Lt vs. Rt heart failure) or all the values for cardiac stuff (cardiac output, atrial pressures, etc...) or ventilatory settings - the norms and what you would do when they are off and such. I also suck at remember cranial nerves  - even tho that's where I worked for like 4 years!!! So bad!!! I also have to go back and remember developmental milestones & stages as well as immunization schedule (FYI they're different for Canada vs. the US!) so I guess I'm going to have study study and study some more. But at least I know where my sucky areas are.

This week and next week I have major papers due for the other course so I'm going to be busy plugging away at those. Nice this is that little tyke starts back up in school in 2 days time which means she'll be in a regular routine and I can stay awake all night long like I normally do without feeling bad that I have to sleep at some point during the day - at least while she's in school she's away and doesn't care that I'm sleeping.  Yay for little kids schooling!!!! Now back to studying....

It's done

I had my surgery yesterday. I was quite nervous for it actually. I didn't know what would happen until I was under general anesthetic and could be examined that it would be decided upon.

We did the pre-op and it took FOUR HOURS!!!!  Goodness that was the longest pre-op process that I have ever been through. I would have expected that from the hospital in my hometown but not at this major city's hospital. It was ridiculous.

First I had to see a nurse and tell her what I was having done. Then she decided that I needed to have blood work and because of one of my IIH meds (diamox) I needed to have a ECG -> which showed that at one point I may have had a heart attack so then once I had those done I had to see a physician (after sitting around for somewhere like an hour and a half) and he kept asking me whether I have any chest pain or whether I can go up two flights of stairs without huffing and puffing. I indicated that I could and it seemed like they didn't quite believe it because they asked the questions just in a different manner. Plus I had to repeat all the same info I had told the nurse which I understand why they do it but I don't see why they don't just verify the information and ask if anything was missed or forgotten. He also asked about my IIH and I had to sign a release of information for them to get the neurologist's last progress note. So then I went and waited for another hour+ to see the next person.

Then I had to see an anethetist and repeat ALLLLLL the information all over again. And surprisingly enough they had the neurologist's note and so I had to discuss how I learned about that. Then I learned something new....
Succinylcholine (Sux) increases intracranial  pressure and should therefore indicate that it needs to be avoided. So I asked whether there was a chance that she would be my anethetist.... which she gafaughed and said "well there's 38 of us so it would be surprising if you do".... well guess what?!

I got the same anethetist!!! Rather shocking. Said that instead of Sux she would be using rocuronium (rock). She also had a teachling who said that once on the table she would give me some ativan - yay!

But HEEELLLLLLLL I woke up with a MASSIVE migraine!!!!!!!! Geeze my head hurt. But surprisingly my butt didn't! I was told that I received a fistulotomy. That it went smooth and exactly as planned. It was the first time in THREE years that my butt didn't hurt (well it was about 2/10 pain wise which for me is no pain really). I was sooo impressed that my butt wasn't the main bit that hurt.

Then I was given morphine on an empty stomach (bad idea!!!) and after I was out of PACU they wanted me to go pee which was harder than you think! They wouldn't let me go until I peed. However, I was extremely nauseous and just after I washed my hands I vomitted into the sink - OMG I couldn't believe it. I was so caught off guard, I couldn't even make it to the toilet 2 ft away!!! Thankfully when I exited the bathroom they had a basin that I could take with me back to my little corner and vomit along the way and lay down into my bed. Ugh I was so nauseous. So my nurse gave me a med to try to help me not vomit. But it didn't help. So I pretty much told my nurse that since I was out of options for meds to take to control the vomiting, I opted to be discharged so at least I could vomit in the privacy of my own home.

I came home, took a couple of my own meds (like zofran) so that I could feel better. Then went straight to bed and slept a whole whack load of hours. And when I woke up I wasn't nauseous OR in pain. It was glorious!!! Now for the healing part. I hope it goes accordingly so that I can go back to work and life and be able to exercise again!

Getting ready

Next week is my surgery. On tuesday I have pre-op, then I'll learn what time I have surgery. I'm kinda nervous about it all. Going into this surgery I don't know what I'll come out of at the end of it. I'm sure hoping that this time next week I'll be over and done with.

And while I want to be optomistic, I've seen firsthand that that's not the way it always works out. I had a patient last year whose buttocks were a mine field of fistulas... I'm worried that I'm dipping my toes into a puddle I don't know the depth of which I'm getting into.

I'm just hopeful that I heal properly and that I don't have to worry about this issue any further.

And next week I also start the 'final' semester (good lord I sure hope that it's the final) - I'm getting a running start at it b/c the prof opened up the course already. It's going to be a doozy of a semester too. The other course is all about ATI, NCLEX and Kaplan - holy heck it's going to be a lot to keep my head above water. Plus I'm supposed to go back to work after I heal from this surgery.

Then we're supposed to move in the beginning of october. Hubby just asked me the other day what day I want to  move on. Problem is that I have a major paper & presentation due that week and so there's no way that it can be done that week - or it won't be a lot that I'm involved in. Good thing is that we're going to be in possession of both houses and so it doesn't really matter when exactly we move either than the fact that we're supposed to cut the utilities and internet here to move it to the new house. Unfortunately, I need the internet in order to submit my stuff so I don't know how we're going to work that.

Plus I'm sure that moving will add stress to my already stressfull life. Hopefully I can handle it all.

What is yet to come

I've moaned and groaned on here that a bigger house is needed.... been saying that for YEAAAAARS.

Now that I'm set to graduate and we can afford to actually move out of the hell hole, the in-laws have finally decided that they agree... no thanks to my BIL who is to be getting married in January and now that he wants a bigger area for his new bride, a brand new home is in order.

Move in date is October.

I graduate in December (God willing!) - and I just really want to move. But just in case that isn't the case, things will have to be done about this new house if we are to live with the inlaws still.

First off, there's only 4 bedrooms - the master bedroom is for my inlaws

then there's one room for my other BIL - the youngest one.

then another bedroom for my BIL who is getting married - he saw the house with my in-laws and I did not and supposedly he claimed this room..... I'll comment on this in a sec. It has a bathroom attached to it - sort of like a secondary masters bedroom.

Then the last bedroom is supposed to be for little tyke BUT

Hubby and I have been relegated to the basement (again!) and in this new house, the basement isn't finished - not even the studs! SO I said FORGET IT!!!! And I claimed the bedroom upstairs with the bathroom attached. I really don't give a crap about my BILs desires b/c this house was clearly bought with the intent for what HE needed, not what hubby, nor I or little tyke needed! 

PLUS - if I take the room upstairs, I'm certain that the basement will get done sooner! Plus I've made it clear that I don't want to live in the basement like I have to now. I know what I want done and until it is, I'm not moving out of that bedroom unless I get a nurse residency and then by golly, I'm gone!

So what must I have you ask?!

1. A full bathroom - beautiful shower, a nice vanity & sink, plus of course I toilet - BUT there must be a door leading to my bedroom AND one that everyone else could use (I don't want ppl going thru my bedroom to use the toilet).

2. Hard wood floors

3. Oh and while they're at it - put up the walls, cuz right now the basement doesn't even have the studs in!

4. At least one bedroom, two would be great.

5. A large window in the living room area since I actually like sunlight while I'm awake.

6. I would like a full fridge (right now I only have one of those small ones that kids take to college) and would like a hot plate and a microwave - so some cupboards would be good!

IMO I think I'm going to be upstairs for a long while. The unfortunate thing is that little tyke doesn't get a bedroom to herself until the basement gets done. I feel bad for her, but not enough that I would for go it all. 

Personally, I would rather just move away and get a residency. But we'll see what life and God has in store for me!

Seeing it was amazing

So.... up next is another clinical experience....

The BIG case we had was a patient who was brought by ambulance as a stroke alert which means that CT tech is notified so that by the time that the patient arrives, they are at the hospital and the CT scanner is ready for the patient to be scanned. 

When the patient arrived, she could barely wiggle her left toes, had trouble lifting her left arm and sensation was drastically affected on her left side. Her pupil on the left side was sluggish as well. Her facial expressions were asymmetrical and she had a slight slur (ambulance personnel said that it was quite pronounced when then arrived) and grip was unequal bilaterally (less on left side). 

I immediately put her onto telemetry which showed A- fib (every other VS was within defined limits)– however the physician wasn’t concerned. I was baffled. I don’t understand why no one is ever concerned when they see this. I put in two large bore IVs (one in the AC and the other in the hand; on the same arm) and drew labs. 

Then she went to CT. It was clear which meant that she did not have a hemorrhagic stroke and if she had an ischemic stroke there was no evidence of that at this point. By the time that she had returned from CT her condition had changed, she was starting to be able to move her left side more freely. She was able to life her left arm almost entirely and slowly, but steadily she was able to raise/move her left leg & toes. Her left pupil was now reacting briskly. 

Upon return from the CT I did her EKG which still showed A-fib, however the physician struck this out and wrote out stable rhythm with occasional PVCs which I don’t agree with considering the A-fib was also showing on the strip rhythm. But as a student I don’t feel comfortable speaking up and disagreeing with a physician. I asked my preceptor about it and she said that she didn’t understand it but didn’t do anything further about it. 

We switched gears a bit to get the paperwork in order to give to the new hospital, give report but also still take care of our patient who thankfully every time we did another assessment was improving. By the time we transferred her to a stroke hospital, she was able to move all her limbs, her grips were strong and equal, her eyes were PERRLA, and expressions were symmetrical. 

I spent a lot of time with her and the family alleviating their fears and explaining things after the physician as well as answering many questions.  What I learned had to do with the last one. It was amazing to see a person with a stroke (a TIA is how the physician was classifying it given that her symptoms were dissolving right in front of our very eyes) and to see how the symptoms of it were evaporating slowly but surely, little by little. 

It was hard for me to reserve not telling this family that this event probably occurred because of her A-fib and that this physician simply ignoring this fact and not telling the family about it. I just wanted to yell it out loud!!!!!  Ugh so frustrating. 

I loved being there for this patient and for the family though through such a difficult time in their life. I could absolutely work in the ER and enjoy it for the rest of my life if I dealt with situations like this day in and day out!

It was also neat to see a stroke patient at that point and watch the symptoms disappear b/c coming from a neurology unit where we see the patients AFTER their symptoms have resolved or when their symptoms are more permanent. Frankly I thought it was awesome to see her symptoms resolve little by little. 

I think if I could do pediatric ER that would be awesome!!!! But we'll see how things pan out.

Clinical experiences

Liike I've said before, once my semester finished I would let you know about what I experienced - cuz it was AWESOME!!!

The first that really comes to mind is a guy who was on his FIRST date with a girl and wanted to impress her and they were on a swing set and tried to do a a back flip off it. Ya, bad choice! Obviously he didn't make it and put his arms back instead of falling on his butt. Again, bad choice!

When he walked into the ER all calm and stoic, just holding his arm (actually he looks like he had his arms crossed across his chest and so didn't think much of it) - we had no idea what brought him in.

Once we heard his story it was hard not to laugh at his antics. Of course not to his face! Nah, we went to the nurses station first. Ha!

We figured that we would be doing something requiring massive amounts of pain relief, I put in his IV and drew labs off it (we figured that the Dr would probably want to check his alcohol level!). So once that was in we got the order for pain meds - gave that to him thru the IV I put in and off he went to x-ray. Sure enough - dislocation - kinda nasty actually.

Doc told us that we would be doing a conscious sedation on the guy - boy did THAT make me excited!!!! My first time and I anticipated actually being able to participate in this. So I helped my preceptor get everything ready. Ensured that our guy was hooked up to telemetry and hooked up his IV to fluids.

Then we went to town and gave this guy a great show of support - the manager of the nursing department/ER picked up this shift because another nurse was sick (I'll tell you that story another time - it's interesting to say the least!) and so she volunteered to help the Doc pull the arm back into alignment. I was responsible for ensuring his airway and monitoring his sats & heart rhythm. My preceptor was the one who instilled the meds. It took about a min for the meds to kick in - but holy moly did he fight the meds!!!

It didn't take long or much pulling - but I ended up having to help hold the patient because the manager was having trouble keeping the reverse pull on the arm/shoulder. In the end it worked out. He barely even moaned - all he kept saying was "nooooo, nooo, no - don't do that" - and then when the meds started to wear off, he started to get all flirty with different staff members - heck when the x-ray tech came to do the x-ray after setting the elbow, he was REALLY flirting with her. It was actually quite hilarious and no one was able to keep the giggles in.

The great thing was that when he fully came through the haze, he asked "when are we going to do it" - I told him "dude, it's already done" - he didn't believe it, had a hard time accepting that but was completely ok with what we told him. He was so relaxed and cool. It was easy treating him.

Another day I'll let you know what else I was privy to. Completely blew my mind!

Anything less than boring around here

Well I called it... I put it out to the universe that I needed to stay healthy - like that term really means anything with regard to me. I feel like I'm in a holding pattern of stability - ill but not seriously so.

Last week I had to get paperwork to my family Dr so that I could start the process to go back to work. But work needed the Dr to fill out the forms and so I had to go see him. I was up til really late (~4am) and I noticed what I thought were hives - 2 of them - n my chest. Midline and slightly lower than the left sternal notch. I didn't think much of them - they were kinda burning and so I put some hydrocortisone on it and took a couple of benedryl and went to bed. When I went into the Dr's the next day (~3pm) we were about to wrap things up and I made the remark to him "hey, can you take a look at these, they're kinda burning - I thought that they were hives but what do you think"

His response - ya you have SHINGLES!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

So for those layman folk out there, that's the chicken pox virus that rears it's ugly head when you're older - as in mostly those who are ELDERLY!!! I realise that I got it because my immunity isn't what it's supposed to be, but geeeeeeze I feel like I finally get up on my feet and then get knocked down again.

I couldn't believe it and I had no filter at the time and said "are you fucking KIDDDING me?!!!!!"

Ya, he wasn't. To which he replied that that meant that I wasn't going to be going to work as planned. So he filled out my paperwork and off I go to give the pharmacy the script for antiviral meds & cream. I get there about 4:30 and tell them I'll be back to pick it up.

Well the pharmacy ppl didn't bother to say ANYTHING to me about the fact that they were closing in 30 min - b/c of the fact that it was actually a holiday here. Grrrrrr - I was rather irritated and hubby said that he would pick it up first thing in the morning after his night shift. Well I ended up being awake all night (doing that paper I told u guys about) and so I went with him to get the med - complained to the manager there that I should have been notified at least considering what kind of med it was for!

Anyways - so I take the first dose and put the cream on - OMG that cream was awesome! Totally took away the burning feeling!

So because it was now after the holiday weekend, Dr's were back in offices and so I figured that I would call the surgeon.... the one who said that I would have surgery by the end of May!!!!!! I got a hold of them immediately and they indicated that they were waiting on MRI reports that they had requested (which I completely understand that they needed) - but these were requested in FEBRUARY!!!!! So I tried to be VERY nice to the receptionist and was more than frustrated. I inquired as to why I hadn't been put on the schedule once they received them and she bypassed this with offering me the next available time slot - just over a week away.

Ok, sign me up!!! But I also told the receptionist that she needed to let the surgeon know that I was diagnosed with shingles and told her what medication I was on (I knew the surgeon would want to know) and left it at that. Wellllllllll..... it turns out that the surgeon didn't want me on the table that soon after having them and now I have to have it on the 24th - the day AFTER my LAST semester begins. UGGGGGHHHHHHH

I realize I need this surgery, hopefully it can be done in one fell swoop and I'll be good to go after that. Unfortunately, knowing my luck, I'll have to wait another six wks after this surgery to have the actual surgery to make everything right. Not encouraging!

I also called the immunologist office b/c I'm sick of being sick. I inquired about blood work and whether the receptionist can get the Dr to fax a requisition to my family Dr and hopefully I can get the necessary blood work done so when I see him he'll see just how crappy my immune system is and POSSIBLY he might actually do something about it! At this point, if he doesn't I'm going to ask for a second opinion b/c I think with everything I've been dealing with this past year, I need all the help I can get and if a Dr isn't going to help me, I need to find one that is!!!

So..... just as I was ready to go back to work, I develop shingles which delays things and then I find out that in the 3rd wk of the month I'll have surgery..... so at this point I have no hope of getting back to work until the middle of september I figure - and that's IF I don't have to have more surgery. Like I said, my life is ever far from boring!

Goodness it's done

AAAAAAAaaaaaaaa I finally finished this stupid paper for my course. All 27 pages of it!!!

For the course we were expected to develop a "tool" and implement it then evaluate it. What I did was develop a family presence during resuscitation policy.... single handedly!

And holy moly was it more complicated than originally thought. Plus I had to make it aesthetically pleasing. So I ended up trying to figure out footnotes that were APA even though they're technically MLA.

We're seriously counting down the courses. Provided I pass this course (which I expect I will - just have to see how good the mark is), I will have 1  1/2 classes left.

My new prof sent me the syllabus today and the course looks intense. The last two courses I've had to come up with projects that require a boat load of research. Unfortunately, it seems like I have to develop another project. Oh my gosh I hate this!

I think I'm going to be up to my eyeballs in articles in this new class. Plus of course all the busy work. I don't think I'm going to have much time to devote to anything but this course, work, and possibly my family. But at least it's the last one (I hope!) and so I understand if it's intense, I wouldn't expect anything less.

I'm just thankful to have this last course over and done with. It was stressful at the end! Plus it didn't help that I've been fairly ill with my IIH and trying to get things even enough for me to be able to do the paper. I had to have an extension of an extra week after the course ended to finish the paper, I was having debilitating migraines everyday and it seems to have passed (thankfully!). I just hope that the medication I'm on makes it so that I can continue to function. I can't ask for an extension with this last course because it would cut into graduation and therefore I wouldn't actually be allowed to graduate. Sooooo.... I need to make sure that I stay healthy.

I think I can, I think I can, I think I can

My title I took is from the book "The little engine that could" because that's where I feel I'm at right now.

This week is the last week for my class, but I'm still working on my paper. My IIH has made it difficult to write like a 4th year - especially when you add uber amounts of stress and it's triggering migraines which make writing even that more difficult.

So I asked for an extension 4 days before my paper was due and my prof and I emailed back and forth - she asked for a note from my physician, which I got quite easily because my family Dr is AWESOME and completely understands my condition and trusts me when I say how bad I feel I'm doing. He also doubled my migraine med, which was nice.

I emailed it to my prof and she asked when I wanted the extension until and I told her but then didn't hear back from her. I figured that I was in good straights and so I continued to struggle on with the paper. But then 5 days later I got my weekly update mark back and she gave me zero and noted that she hadn't received a difinative date for the extension and so she pretty much told me that I would have to complete THE ENTIRE CLASS OVER!!!!!!!!!!!

I internally flipped out but then hubby suggested I wait until the morning to email me so that my state of mind & emotions didn't rub off into the email. So I did... I forwarded her the email that I sent her previously, which clearly indicated what day I had sent it, as well as me noting a difinative date for extension. Well.... she emailed me back saying I now had to speak with the director of the program to ask for the extension from them. OOOOOOO that infuriated me! It was HER fault and I was being punished for it. Goodness I was frustrated. So off I go contacting this third party, explaining my position on it all. And thankfully she stated that she was alright with the extension so long as I kept to it. Ok, no problem!

HOWEVER (isn't there always that with me?!) she's to be my prof for this next course (the director of the program will be the prof) and stated that she was concerned that my health will impact my ability to keep up in the next course and suggested that I take a semester off in order to "get my health in order" - AAAARRRRRGGGGGG - see what my friggin current prof started?! Ugh I was so irritated by this all.  I emailed her back indicating that I was able to keep up with all the course work and such for this entire course and that I have only struggled with this paper. I haven't received anything back from her. I don't want to take a semester off, this next semester is supposed to be my LAST semester, I just want it all over and done with!!!! Plus, I figure that if we can get the migraines under control, things will be alright. It's the tricky bit really.

So my plan for next semester will be to contact the prof early on if we have a larger paper and get started on it immediately so that the stress of it all won't be so severe and I shouldn't experience the migraines like I have been (I hope!) - plus we're playing around with meds & dosages so I'm hoping that we can find something that works. The increased dosage of the med I have been on seems to work sometimes but other times it only takes the edge off.

Having IIH there are MANY (almost all) migraine meds (incl preventative ones) that I can't take because the SE is increase intracranial pressure.... and while normal folk this is alright, with me, this is particularly troublesome considering mine's already increased! So I don't know what I'm going to do. I know that my neurologist said that he was going to refer me to the headache specialist but I haven't heard high nor hair from them so I may have to call my  neurologist's office and inquire about this.

Once this course is done I'll tell you all about clinical and trying to get back to work - life is never boring I can honestly say.... I would like a bit more boredom!

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!

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!!!

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....