Monday, January 31, 2011

It Is Almost Midnight.

In just a few minutes it will be a new month, February. I started this blog last year, in February. I suppose it is time for a retrospective. I know. I am late to the party. Most people do the assessment, resolution, betterment plan in late December. Or no later than Jan 3 (when the hangover is really, really gone and the bowl games are over). But, I am not really that way. The people who really know and love me get this about me, but only one person in my life has been able to put my "sarah-ish-ness" into words.

I took Modern European History when I was a senior in high school, at Chatham Hall in Virginia (girls' boarding school...awesome place. I still love it). Modern European History was NOT what I was expecting. Renaissance? Middle Ages? What did that have to do with MODERN?? Anyway, there were five of us in the class. Five. 5. Sooo....bluffing was not an option. Dr Reilly knew every single one of us flat out cold. Tests were several short answer questions and an essay. Rarely in college did I have exams that were that focused or that difficult. Rarely. I sweated those exams, probably as much as I should have. I was given a very narrow topic, one that would tax my knowledge of a subject, and I would have to deliver a well thought out argument.

Dr. Reilly, one day after handing us back our test results (to all 5 of us), had me stay after class. I had gotten an A on the exam, and he had never asked to talk to me after class before. It wasn't worrisome, it was just strange, odd. I looked at him, with his straight, dark, bowl-cut hair and his round glasses -- with his tweedy jacket with the worn elbow patches, incredibly intelligent and knowledgeable, but yet willing to teach teenagers -- and wondered what the hell he had to say to me.

That man captured the whole of me in a couple of sentences. He got me. He understood how I see things. His words to me, after class: "I always look forward to reading your essays. I know how everyone else in the class is going to answer the question, except for you. You always answer the question sideways." It wasn't a criticism, it was a compliment of the highest nature. A thinker who complimented a student on her thoughts. For almost 30 years I have carried that compliment with me. I have carried the knowledge that at least someone understood that i see things sideways, and that sideways isn't is interesting.

This year. The goal and the treat. Goal. I guess there are two. Buy a house (which will happen in the next few weeks...along with the flooring and yadda yadda),
get my knee well enough to do Dirt and run the Monkey. (notice I didn't mention time...that part is over for me. all good)

Treat. No brainer. A week in Sanibel, making Sanibel memories for the kids. What could be better than that?

Oh. I ran 5 miles today, with one water-stop. Slow, but steady, says the turtle. And I am walking pain-free tonight. HA.

Lola (December 2010)

Lola has been a resident of CVTU for nearly 4 months. She is one of the lingering remnants of the surgeon who should not have been. She is a fem-pop gone wrong, but gone wrong due as much to her own hyper-coagulation problems as to her surgical fiasco. She may have been kind of doomed from the start, but who knows?

Lola came into our ED with a cold right foot and intermittent claudication. She was dually assessed and it was determined that she needed to have the circulation restored to her leg by a femoral-popliteal artery bypass and graft. She came to my floor and struggled to heal. The bypass failed and not long after, Lola had a below-the-knee amputation of her right leg. Then, much of the re-vascularization of the upper leg was compromised, and Lola had her right thigh filleted open like a sturgeon. It was one of the biggest leg wounds I have ever seen, and one of the most painful. Wound care nurses changed the wound-vac M-W-F, and it took them close to 2 hours each time. Lola bled and bled. And bled more than that. She formed clots the size of softballs under the vac film. She got countless units of blood and blood product. And of course, with all this pain, she got addicted to dilaudid.

A couple of surgeries later, by the plastic surgery guy (nicest guy in the world...) and we thought Lola was going to be able to go home and get better. Then her amputation incision got necrotic. 3 surgeries and 2 months later, Lola has a nicely healing mid-thigh amputation. She is off all IV pain medication. She takes a high dose of oxycodone, but she takes much less than she used to. She like to stay up late, and sleep in. When she is in my team of patients, I don't wake her before 10am. There is nothing that Lola has to do before 10am, kinda like there is nothing College-Boy has to do in the morning when he is on break.

Lola moans and cries. When she is in pain, the entire floor knows it. She wants her Mommy to help her. But in these last 2 weeks, Lola doesn't cry anymore. She looks forward to going home. I was her nurse the day that the ortho guys told her that she was going to have an above the knee amputation, that she wasn't healing, and that her dreams of a certain kind of recovery of life weren't going to happen. That was a hard day. But, she is my age and she chose wisely for a woman my age. She chose to continue the battle.

I don't ever, ever, EVER get attached to patients. I learned the hard way more than once. I plan, God laughs. He gives me, no, he gives my floor, Lola. I took care of her this weekend. But at this point, I'm not her nurse anymore. I am her friend, and she is mine. Her fiance (oh yeah...he has hung in for all of this and that makes me just adore him) brought jelly beans, cause Lola had a craving. 'cept I ate most of them. It was a quiet weekend for me, and since I wasn't actively saving lives, I pulled up a chair in Lola's room and we watched TV together. Don't tell my manager. But those are the kind of moments that help a long-term patient recover. Those are the kinds of moments that help her nurses stay sane.

Well, Happy New Year. 2011. Geez.

Yeah, so I lasted posted about, oh, 2 years ago. Right around the time the Uber-Ortho drained my knee and life was good. (That lasted about a week. My knee and I, with the full-court press of 20ccs of fluid drained and some steroids infused felt fine and dandy for a week. Maybe 2 -- its Christmastide and I am feeling generous.)

The difference in strength in my quads was remarkable enough that the PT and the Uber-Ortho commented on it. Which kind of means nothing. But the muscle wasting in my right quad made cycling, well, interesting. The bike "skittered" underneath me. I am a novice rider, and a single rider. But I passed someone doing 22mph (not fast for most people), and I almost bought the farm. My bike skated on me. The more I rode, the more it did it. They tell me that it skates because one leg is so much stronger than the other. *sigh* I stopped cycling because my bike scares me now. I hate that. I really hate that.

So, 6-week follow up with Uber-Ortho. He says, looking not at me but at my MRI from the initial injury, that my PCL isn't an issue anymore. What I have is arthritis and some severe cartilage damage in my right knee. All my issues are related to that tissue damage. (Let me say that my knees never hurt me until I spilled from my bike. I said as much. His response was, "I didn't have any gray hair until I got my first gray hair.) He talks "when" not "if" about a knee replacement. When. Partial replacement. Perhaps not total. He says, not looking at me, only at the old MRI, that it is a kind of race between whether my "ticker" or my knee gives out first. Seriously? My heart or my knee. I don't have any cardiac issues, and am a healthy, active, middle-aged female. I have no concerns about my heart. Apparently, although we have talked about it before, he has forgotten that I am a cardiac nurse. But he is the ortho expert and talks about WHEN. When my knee gets replaced. He says that you only get so many stides, and that I have gone through mine. 20 minutes looking up and down and backwards and forwards though that scan. And you know what??? I am bone on bone in a small place in my right knee. But don't tell my knee, because she doesn't know it. Per the MRI, I am supposed to have a whole lotta pain going on. But. I. Don't.

I have seen those films. I have seen that cartilage loss. It is kind of impressive. It happened before I fell from my bike, and has never, ever bothered me when I run. Still, it is there. I think that if I am a WHEN and not an IF about a knee surgery, I am going to follow that slide in sideways philosophy. If I have to give it up, it will be on my terms. I have seen the MRI films. I know the score. I miss running. I miss it like the loss of a friend, or a lover. It is my decision. I choose to not go gently into that good night.

So. 1/1/11. 6+ miles. Ran more than I walked. Maybe 4 miles running, 2+ walking---mostly because I am not in shape to run. But, I did it. And, since it might be the LAST time I did it, I loved it. I loved the lake. I loved the birds, and I loved the people. I made sure to love this run/walk.

1/3/11. Slow, with walk breaks, mostly because I am so out of shape. I last really ran in September. Now I am running with a possibly delicate knee. Well, it is delicate. I just choose to ignore that.

1/3/11. Walked a bunch of miles in Epcot. I got some unexpected money for Christmas, and decided to do the Disney thing this year. We live in Florida, about an hour from Disney and never go. Not anymore. Smallest of All had a school field-trip to Epcot in December. She just adored it. A Princess Day anyway you slice it. So, Small One wanted to experience Epcot, too. Yay again! When I got home, I did some serious icing of my knee.


Happy New Year to Everyone!!!!!