Here goes...

This is gonna be a long post - so sit back & relax...lol.  Sunday night I had a patient that also works at the hospital.  I don't normally like to take care of people I know or that work at the same place I do.  It's just awkward not to mention sort of a test.  I mean this is someone that is capable of telling others how you are as a nurse.  Luckily by the second night, she was praising me & by the fourth night, she was filling out positive comment cards.  Whew!  That's the nice thing about working continuous days in a row - you tend to get the same patients back & can build up a good rapport. 

I'm not going to go into details with each & every patient I've had - that would take way too long and in all serious, their conditions were not all that interesting.  Instead, I will give you my version of "General Hospital" as it has been a dramatic week at work between my patients and their families. 

I had a young man in his early 20's that came in with nausea & vomiting due to stress.  The first night I had him, he was wiped out - like sleeping the entire night.  The report I get from the day shift nurse is that he had a fight with his roommates and the stress had gotten to him.  I get a phone call from his mother wanting to know everything that's going on.  Thanks to the privacy act, I tell her that until he's alert enough to set up a password, I can't give her any information.  99% of the time, this does not go over well with someone on the phone.  She yells "I AM HIS MOTHER."  Ok, well, anyone can call & tell me that, but it doesn't matter - he's an adult, he gets to pick & choose who he wants to hear his medical information & until he is awake, it's not gonna happen.  She insists I transfer the call to his room.  Well, ok...but he's sleeping & probably not gonna say much.  A couple hours later, his fiancee shows up after a 2 hr drive.  She was easy to get along with.  She went in to visit him & he woke up just enough to set up a password so that I could share info with her & she in turn, shared it with his mother.  Everyone's happy, right?  Nope.  He has a step-father that can't stand the mother or the fiancee & he doesn't want them having any contact with the patient.  Ummm, sorry, that's not how a hospital works.  He is an adult, HE gets to choose who he wants to communicate with.  The step-father insists (over the phone) that he wants the fiancee out of the room by 8:30 pm.  Nope, that doesn't fly with me.  If he enjoys her being there & she is the only one that I saw visiting with him the entire time I was there...then she can stay past visiting hours for a little while.  I also got to meet the grandmother who started to share with me the drama & I instantly got myself out of that by cutting her off & telling her if she wants to see him - to go do it now.  I don't have time for all this family dynamics.

I had another patient that came in with chest pain after fighting with his wife or ex-wife or soon to be ex-wife.  I get a call in the middle of the night from his out of town girlfriend telling me to not allow the wife to see him.  Ok, again, this man is an adult, HE can say who he wants or doesn't want to visit him.  We're all thinking that it's just anxiety that caused his chest pain...but surprise, surprise...he was having a heart attack.  See what stress can do!

There was another patient on the floor - somewhat confused to start.  By the time the lab girl came in to draw blood, it got out of control.  This woman was scratching, kicking & spitting.  Ugh, spitting is the worst.  It's just so disgusting.  We ended up putting a mask over her face in which she continued to spit - guess she couldn't figure out that the only person she was spitting on was herself.  Restraints were also applied, but not before she kicked the lab girl in the head.  As if this wasn't enough, a couple of hours later she started screaming - very loudly.  She woke up the entire floor.  I don't think I've ever heard anyone scream as loud as she did.  Quick fix, close the door & leave her nurse inside the room with her...lol.

Gina had a "fun" patient also.  A frequent flyer/drug seeker.  She would complain that she was having excruciating chest pain & within 30 seconds, she'd be sleeping - snoring away.  Then she'd wake up & moan loudly about all the pain she was having & right back to sleep she would go.  She had been in the room for quite a few hours & we figured she had to go to the bathroom even though she was saying she didn't have to.  So Gina tells her she can't give her anymore pain medication until she goes to the bathroom.  We have never seen anyone get up so quickly to use the bedside commode as this woman.  It was actually comical.  I also noticed how she had like 8 bottles of flavored bottled water with her.  Who brings bottled water with them to the hospital while they are having chest pain?  She had a whole bag packed...hmmm...usually chest pain comes on suddenly & you don't really have time to prepare.  Not this lady - she looked like she had packed enough to stay awhile.  As if she was going on vacation...lol.  I'm glad she was Gina's patient & not mine.  :)

There was another family member of some other patient that whenever she got on her cell phone....whoa...the language coming out of her mouth was beyond foul.  We just sat & watched her - it really was like watching a live taping of General Hospital.  Although you couldn't write this stuff out - it was all just natural...lol.

I had another patient in which half his family lives here, the other half in South Carolina & the battle was brewing over where he would go into a nursing home - it was like the Hatfields vs. the McCoys.  It wasn't enough that they were fighting amongst each other, they tried to drag the nursing staff into it also.  Not me, I wasn't getting involved.  After they finally left, the patient was telling me a little about it.  I asked him "Where is it that YOU want to go, because that is all that really matters."  The poor guy felt bad letting either side of his family down if he were to make the choice.  He ended up going to South Carolina.  He was a sweetheart, kept asking me for my address.  I have no idea why, I gave him a copy of the hospital address with my name.  I know his family is going to be like "Why in the world did that nurse give you her name?"  And he probably isn't going to remember asking.  Oh well. 

It was a fun week.  A few of us on the nursing staff had fun picking on one another.  It makes work more bearable.  That's one of the few things I like about that place...the staff.  Most of them are easy to get along with & make working with one another fun.  It's actually the reason I have yet to leave.  I really doubt that anywhere I go will it be this good amongst the staff.  I'm still inching my way towards agency or travel nursing.  Slowly but surely.

I think I'll wrap things up.  I have my niece Elizabeth for a few days.  We're gonna go see "Monster House" & hang out at Chili's today.  Fun, fun!

 

 

 

Ahhhh

What a week it's been!  I have to admit though...my patients were pretty easy to care for.  I had one mishap that actually turned out to be a blessing in disguise.  I had given my normally alert & oriented patient some Ambien because earlier that night he had been given some bad news regarding the fact that he has colon cancer.  He was feeling a little restless & requested some sleep medication.  Ok, no problem...until later.  The thing with sleep medications - you never really know how they are going to affect the elderly.  He told me he takes it at home, but for some reason, it made him confused.  So confused that he somehow ended up on the floor next to his bed sitting up...with his central line (it's basically an IV in his jugular vein) pulled out.  He had just been started on TPN (basically nutrition via the central line) a few hours earlier because he had surgery about 5 days ago.  That's dripping all over the floor since his central line is pulled out of his neck.  I was so thankful that his neck was not bleeding at all.  We got him back in bed, got some IV's started and I placed some calls to his surgeon and the primary doctor.  The surgeon didn't seem to care, he advanced him to a full liquid diet, discontinued the TPN.  We sent him for x-rays, everything was negative...thankfully. 

This gentleman was such a sweetheart.  I had told him the first night I had him that I was going to take him from room to room to show people how to have a great attitude while in the hospital.  He was very thankful & always giving compliments about everyone taking care of him.  Anyways, needless to say...he went pretty quickly from liquids to a regular diet & he was discharged ahead of schedule...pretty much all because he got confused & fell out of bed.  Otherwise that TPN would have probably run for a day or two & then the diet orders would be slowly advanced.  I was happy he got to go home & that he wasn't hurt.  Hopefully he'll be able to deal with the cancer.  The doctor said it was more of a watch & see rather than sending him for chemo. 

I have a lot more to tell, but I'm getting sleepy - so I will resume this later.  Hope everyone is having a great weekend!

I must be crazy

I only have a minute because I'm going to work - again.  This will be my sixth shift in a row.  I must be crazy!!!!  But I will be taking all of next week off...something to look forward to.  I'll catch up soon.  Peace, everyone!!!

Travel Nursing

I've been asked what the benefits of travel nursing are...Linda...just for you...here's the info!!!

Free Furnished Private Housing - on every assignment. Subsidy available.
Double Time for Overtime - on most assignments
Travel Allowance - $400 to $600 per assignment. Paid again if you extend!
Day 1…Free Health and Dental Insurance – No Deduct.
Immediate $20,000 Life Insurance Policy
Immediate 401K Enrollment – with a company match of 50%
License Reimbursement – 100% for each new license required
Immediate Direct Deposit
Vacation Pay
CEU Reimbursement - plus 30 free CEU’s per year
Income Revenue Saver - our Tax Advantage program- $210 per week tax free                                                                                          And the hourly pay rate is usually somewhere between $30-50/hr.

Can you see why I'm looking forward to it?  On top of all those benefits...you pretty much can choose whatever location you want to travel to & you can change locations every 2 to 3 months if you want!

Medication Reconciliation

Guess who's at my hospital this week...JCAHO...ooohh, scary words in healthcare...lol.  JCAHO is the Joint Commission of Healthcare Organizations (or something like that).  We've been preparing for months for them to show up & they are finally here.  They follow you around, watch what is going on, ask questions...anyone working in the hospital is fair game...even doctors.  If they find something out of sorts, expect a large fine to follow.  We've heard all kinds of rumors...such as a doctor not knowing what to do in the event of a fire & the hospital was fined $75,000 or not being able to unlock a bathroom door quickly which brought about another huge fine.  Basically...they are people I don't want to be around.  Because I know for me....I know the information as long as no one is directly asking.  As soon as someone says "What is so & so?"...I go blank.  It's like this also when I go to Blockbuster or a music store.  I will have the movie or cd that I want memorized in my head, but as soon as I walk through the door...it's gone.  What did I come in here for???  Sooooo, lucky for me, I'm not scheduled this week & I plan to leave it that way.  I've been enjoying my time off anyways.  I'll make up for it next week.

I'm sitting here reading Advance for Nurses...which is a pretty good little magazine (if you want a free subscription...go here...http://nursing.advanceweb.com/ & follow the link for a free subscription.  There is an article in here regarding Medication Reconciliation.  This is something new we've been doing at our hospital for quite a few months.  I've been fighting it the entire way because it is too confusing, too frustrating & the patients don't understand it either.  I think a lot of the nurses I work with were/are resistant to it...mostly because the doctors aren't very cooperative & the forms aren't really people friendly.  It's getting better though because I think we all are starting to understand the importance of it. 

And that's why I'm passing it on to all of you...basically the purpose of Medication Reconciliation is so that patients AND their families are well aware of what medications they are taking & the dosages, routes, how often, etc.  What I'm passing on to anyone reading my journal is this...if you &/or your family members, friends, relatives, etc are on medications....write down the name, dosage, how often it's taken & make copies of it.  Put one in your car, in your purse, give copies to your family members, friends...anyone that would most likely be at your side should you end up in the ER or admitted to the hospital.  Because again, if you're anything like me, this important information is erased from my memory as soon as someone directly asks me.  I've seen many patients end up admitted not having any clue what medication they take.  They always seem to describe it as "a little white pill that I take twice a day."  Ok, there are zillions of little white pills...it helps to know which one specifically. 

So I'm putting it out there to save you or your family members the frustration, embarrassment or even worse....having important medications automatically stopped simply because no one knows what they are on to begin with.  Write it down, put it in a good spot & don't forget where that good spot is (like I sometimes do...lol).  :)

Merely babysitting?

It's raining, it's pouring....good ol Florida summers.  I don't mind the rain - as long as I'm not out driving in it.  I'm glad I'm home because I was planning on going to Sea World this afternoon/evening.  I postponed it until tomorrow...I hope it's not going to be raining like this tomorrow. 

Work was a breeze this week...all stable, alert & oriented patients...well, almost all, I received one patient last night around 11 pm that was confused, but he slept nearly the entire night...as did my other patients.  Nights like those I feel like I'm merely babysitting the older generation. 

I think my thyroid condition is improving since I've been taking my medication on a normal daily basis.  I definitely don't seem to need as much sleep as I had in the past.  Like even today...I took a 2 1/2 hour nap after work & I'm wide awake now.  Usually I would sleep until 5 or 6 just to catch up on my sleep. 

I found out last night that I'm getting a raise in August.  Woo hoo!  I love more money.  I've actually had quite an increase in pay over the last 18 months....over a $3/hr increase since when I was hired.  It's not as much as what I'd make in other states, but then again...we don't have a state income tax...so I think it washes out.  I'm still looking forward to the income that travel nurses make...soon, real soon.  I do need to start working on getting all the paperwork completed for travel nursing & agency nursing.  It's such a pain...showing proof of immunizations & titers & a zillion other things.  Oh well, gotta get it done sometime. 

I just renewed my nursing license...I can't believe it's that time already.  It has gone by quickly.  We have a new person in charge of our department...she's really friendly & approachable.  She was asking me how I like it at the hospital.  I said all good things & she replied "I think we need to make you the ambassador to speak to all of the new hires."  Eeekkk...nooooooooo. 

We are getting closer & closer to going computerized...I start training at the end of August & I believe October 22nd is our "go live" date.  I'm curious to see how much of an improvement it is...because I can't imagine it being any worse than all of the handwritten charting we are doing now.  It takes hours to chart on our patients.  Watch though...they'll probably increase our patient ratio if this is truly effective with time managment...grrr.  We shall see!!!!!!

My niece is coming over tonight...time to spoil her...yet again.  :)

I just knew

I started looking in the obituaries yesterday...it's something us nurses do to see if we recognize any names.  I just knew my patient from Monday night would be in there...and he was.  He passed away on Tuesday, July 4th.  I don't know if it was during the day or at night.  I hope his family was at bedside or the nurse or someone.  No one should have to die alone.

Go Steve Go

Some real good news this week...my friend Steve is now to be referred to as Steve, RN.  He passed his boards!!! 

CONGRATULATIONS STEVE!!!

Oops...I mean STEVE, RN!!!

A first time for everything

I went to work Monday night hoping for an easy night...and I sort of got my wish fulfilled.  Physically - it was a very easy night.  Emotionally - well, that's another story.  I started out the night with only two patients & only got one admit...two of which were med/surg status, which "usually" means they aren't as guarded or critical as PCU patients.  Unfortunately for one of my patient's..."usually" wasn't accurate that night.

To quote the patient's doctor..."I don't think he'll make it through the night."  Huh?  That doesn't sound good.  Don't say stuff like that.  I've had plenty of sick patients...even some that have gone on to die...but never have I had one in which the doctor was predicting the amount of hours he had left.  This gentleman was in his mid-70's & had suffered a CVA (stroke).  I was reading back through the nursing notes since he had been in the hospital for nearly a week.  He came in agitated, swearing, pulling out his NG tube...he had to be restrained.  By the time I got him, he was non-responsive, couldn't even open his eyes...I don't know if he even knew anyone was there with him.  His wife and daughter were at bedside, I could tell they had been crying...a lot.  I would be too if that was my dad.  The doctor had discussed with them quite a few times over the past week about this patient's grave prognosis.  They were in denial, hoping for a miracle.  I can't blame them.  I'd be doing the same.  Hospice had been consulted twice, the family just wasn't ready to give in & let go.  He had seemed content, non-responsive, but content...until the day he was my patient.  During the day he had difficulty breathing, his oxygen was increased from 3 liters to 5 liters.  It helped his O2 sat (98%), but it did not change the agonal breathing pattern he had developed.  I don't believe I've ever had a patient with agonal breathing...it's something I won't soon forget.  Basically, he looked like he was trying his best to breathe...sometimes it would be multiple, shallow respirations mixed in with this slower, somewhat gasping noise...I can't even really describe it.  If that isn't enough to convince his family that it's time to get out of denial & start making decisions, I don't know what is.  I hope that doesn't sound mean...cause I'm not brutal like that.  I really felt for them & tried to provide them with answers to their questions...but there comes a time when you have to look at his condition & see that what he needs is medication to ease the pain while at the same time, stopping other medications that are not necessary (IV fluids, tube feedings...things that are just overloading his already tired out body). 

The wife kept asking me to give him medication to help him breathe easier...I tried to explain to her that there was nothing we could give him to improve his breathing pattern.  At this point, all we can do is provide comfort care.  She asked what was available on his medication sheet...all I had to relax him was Ativan IV.  I gave him 2 mg and did not see any difference in him, although his wife swears he seemed more relaxed.  The breathing was no different.  She began to ask me about hospice...what do they do to make him more comfortable?  Not realizing she had already had two consults in the past week with Hospice nurses...I told her more than likely he would probably receive morphine.  I truly didn't know the answers though other than knowing they do provide medication to ease suffering.  I've never had a patient that needed hospice.  So rather than continuing to guess, I brought in my clinical leader since she was an experienced ICU nurse also.  She pretty much said the same stuff I did.  It was then that we discovered that the wife knew exactly what Hospice would provide & it was the same information we were giving her.  Later, my clinical leader told me that the wife was probably hoping for a different answer...some type of hope.  It breaks my heart.  The wife then asks if I can get the doctor to order morphine for her husband.  We got the order as well as an order to turn off the fluids for the night.  He was already having a difficult time breathing & he's a dialysis patient, no reason to overload him with fluids.  I alternated through the night of giving him Morphine & Ativan.  I could see that he was more relaxed, his breathing didn't appear so labored, he wasn't making those grunting noises that he had been making earlier.  His wife told me he was all sweaty & she didn't know why.  He didn't have a temperature...I told herhe was sweating because he was having a hard time breathing...his body was working hard to get oxygen. 

His wife wanted to stay the night, which I totally understood...I know if it were my parent or loved one, there is no way anyone is kicking me out of that room simply because they have a "family cannot stay over" rule.  Luckily, our floor was pretty empty (the other bed in the room wasn't occupied) & I got the approval from my clinical leader & the charge nurse.  They weren't happy about it, but I really don't see how anyone would have the heart to go in there & tell her she had to go home because of our stupid rule.  I made sure to find her a recliner & she spent the night at his bedside...holding his hand.  I heard her earlier in the night make a comment to her daughter about how she wished she could lay down next to him.  I was hoping she wouldn't because I know that wouldn't go over too well, but at the same time...I could understand why she would want to. 

She got up around 5:30 am as I was hanging an antibiotic IV.  She told me she was going to go home for a few hours...that this is the time of day when she usually would get out of bed & leave him to sleep a little longer.  She smiled, but I can't imagine the pain she's feeling.  I tried to clean him up the best I could, straightened up the room, put the flowers he had received on display so you saw them when you walked into the room.  The respiratory therapist came in to give him a breathing treatment...it was then when we discoved his O2 sat was only 77%...most likely a combination of him getting tired out with that labored breathing and the medications relaxing him...especially Morphine - one side effect is that it can decrease respirations.  The respiratory therapist decided he needed a non-rebreather mask...she started him out at 35% & predicted that by noon it would have to be up to 100%.  He didn't have much time left.  I stood & watched him for a little while...when that mask was put on him, he began those grunting noises again...like he was gasping for air. 

A first time for everything & I'm sure it won't be my last.  I haven't stopped thinking about him since I left work.  During my workout, before falling asleep, upon waking up & through the night...I kept wondering if he was still alive.  I haven't decided if I'm going to work tonight or not...I'll decide later.  For now, I'm gonna go do my 60 min work out again & be thankful that I have a choice when it comes to labored breathing...unfortunately, my patient does not.  :(

What a great weekend!

Look at the time...yes...it's after 4 a.m. & I'm wide awake.  So much for having my sleep schedule straightened out, right?  I fell asleep for about an hour earlier tonight watching the Pepsi 400 Daytona race....just enough of a nap to re-energize me.  It works out though since I'm working later tonight...I'll just stay up until morning & then sleep all day. 

Speaking of the Pepsi 400.....did everyone see who won???  Hmmmm.....my man TONY STEWART!!!  Add to it that Friday night Dale Jr. won the Busch race & it makes it a great weekend since they are my two favorite drivers.  I'm happy!

I've been reading a little about Graves Disease & hypothyroidism & cholesterol.  I did not realize just how rare Graves Disease is in children.  I mean I know when I was younger that the doctors didn't know exactly how to treat me because they had never seen it before in a child...but now that I'm older...I can't believe just how rare it is.  They say something like 0.02% develop it as a child.  I also have Pernicious Anemia...which basically means my body doesn't absorb B12 orally so I have to give myself an injection monthly.  I have no idea how I ended up with that either as it's not really supposed to affect younger people (I've had it for 10 yrs) - it's usually when people are elderly & their body doesn't work as good as it used to....or people that have had abdominal surgeries.  I had my gallbladder out, but I don't think that caused it.  I wonder if it's connected to the thyroid problem...I mean they both are autoimmune diseases.  I'll investigate it later. 

Anywayssssss...I read that one of the symptoms of hypothyroidism can be elevated cholesterol levels...so I'm wondering if maybe that's the reason my cholesterol is higher than usual.  It will be interesting to compare when I get labs done again in a few months & see if anything has changed once I get my thyroid back under control.  I'm like a science experiment waiting to happen...lol. 

Also, as I read the other symptoms of hypothyroidism...I suddenly feel like I have every single one of them...lol.  Actually...I have felt more forgetful & scatterbrained lately, but I thought it was just the aging process (I'm writing as though I'm 85).  In fact...just as an example...referring back to Gina's patient with the low blood sugar.  When the lab called, they told me the patient's name & room number.  Before finding Gina, I went in to assess the patient.  He was responsive, talking to me, answering appropriately.  I asked him if he would drink some milk & eat some crackers...he told me he would even though he wasn't hungry or thirsty.  So I left to go get some milk & ran into Gina...handed her the milk carton & told her the guy seemed ok.  A few minutes later, she comes back to the nurses station & says "he's not responding to me."  I was like "What?  He was talking to me just fine."  So as she's looking at his medication list to see if he has any D50 ordered, I go back into the patient's room & sure enough, he's talking to me.  I yell to Gina that he's fine, he can eat & drink.  I come out of the room & she's like "That's not my patient."  Ooopppsss!  Her patient was in the next room!!!!!  That first guy must have thought I was insane to wake him up at 5 am to see if he would drink some milk....lol.  So I have been a little absent-minded on occasion.  Hopefully I can blame it all on my thyroid.  :)

I'm looking at a scrubs catalog.  If anyone wants a good deal on scrubs...try www.uniformcity.com.  I really like what they offer.  I'm disappointed though...the scrub pants I like were discontinued - not that it matters right now as I have plenty of scrubs, but I'm hoping that style comes back.  They are kind of stretchy....they have some spandex in the material.  It's just really comfortable..especially when you have to bend down to empty a foley or pick up something off the floor. 

Ok, time for me to play the latest game I'm addicted to on www.pogo.com which is Word Whomp.  Thanks for listening to me ramble. Byeeeeee!!!

Dr. PCT

Why do days off go by so quickly?  I can't figure it out.  I only worked on Mon & Tues nights this week...had the rest of the week off, yet I'm sitting here thinking "I have to go back to work tomorrow night!"  I'm only scheduled for Sunday & Monday night.  Not sure if I'll pick up more days or not...as usual...I'll just wait & see, play it day by day.  I love the flexibility of truly working when I want to work.  I am considered part-time status which allows me this flexibility.  The thought of committing to at least 3 days every single week is just too much.  I know when I get into travel nursing, I'll have to commit...but for now, I will enjoy the freedom. 

It was a piece of cake this week at work.  The first night I thought was going to be a disaster.  We started the shift with 10 patients & 3 nurses.....knowing full well we'd probably be hit with admits through the night.  Then 2 minutes later at the beginning of the shift, our 3rd nurse is sent upstairs because someone didn't show up.  So it's just Gina & I plus 10 patients.  Luckily we had a patient care tech...that makes it so much better. 

My only main issue that night was a patient's family member that wanted to stay the night with her mother.  I totally understood & supported her staying 100%, but our department says no family can stay overnight in semi-private rooms.  This patient had alzheimer's & dementia, plus she was different than any other confused patient I've ever had.  She just seemed so nervous & that was even with sedation medication from the MRI they tried to do.  So I refused to kick the patient's daughter out.  The patient was much calmer having someone she knew there.  I told my clinical leader that if she wanted her to leave, she'd have to talk to her.  So she talked to the daughter & the daughter refused to leave also.  We could have made a big scene, but luckily that didn't happen.  The next day, the day nurse got a doctor's order to allow the family member to stay.  I was glad to see that. 

There's really nothing to say about my patients or their conditions...nothing really stood out.  I will tell you about one of Gina's patients though...or at least a situation with one of them.  It was a man in his 40's in with diabetic ketoacidosis.  I think his blood sugar was in the 800 or 900 range when he first came in.  He was in ICU & she got him that night as a transfer.  Fastforward to about 5 am & I got a call from the lab saying "patient so & so has a blood sugar of 36."  Ok....as I was on my way to let Gina know, I asked our new PCT to get a blood sugar on patient so & so.  A little while later, I hear the PCT talking to the patient so I go in to observe.  He's trying to coax the patient into drinking orange juice - the patient was really out of it, barely responding, but was semi-awake.  As I'm watching & listening to this PCT encourage the patient, I say to Gina "He should be a nurse."  She replies "He's a doctor."  Eh???  What???  Dr. PCT???  Later she tells me that he is from Russia & over there he was an endocrinologist.  I'm thinking "Then why is he a PCT here?"  I go back into the patient's room & sure enough, this PCT is explaining to me all about insulin & it's effects on the body, blah, blah, blah.  I was impressed.  I don't know if he's planning to become a doctor here or not, but it's nice having him around.  The patient eventually came back around & was fine. 

My sleep schedule has been all messed up....taking naps in the afternoon & staying up late at night.  I finally got it turned around today...but of course I go back to work tomorrow.  Oh well! 

I got my lab results this past week...come to find out I am "severely hypothyroid."  It's my own fault.  I haven't exactly been 100% compliant with my medication.  I have had Graves disease since I was a little kid & eventually had the radioactive iodine treatment when I was around 16.  Since then I've been on synthroid or a form of synthroid.  Since working nights, I always get mixed up as to when to take the medication.  You're supposed to take it on an empty stomach...2 or 3 hours before or after a meal.  Well, that's not so easy to do with the mixed up schedule that I have.  Anyways...my TSH result is 35.9 & it should be below 3.0.  I've learned my lesson...regardless of time, I will take my pill on a regular daily basis regardless of whether I've already had something to eat or not.  I really didn't feel like I had any of the symptoms of being hypothyroid except for the weight gain.  I figured it was just me getting older & my metabolism slowing down.  I had gained like 25 lbs in the last year yet didn't really change my eating habits.  However, I have been working out on a regular basis since March & managed to lose almost 20 of those pounds.  Still have a long way to go to lose this extra weight, but it's a start.  I'm curious to see if I will have more energy or be able to lose weight faster once my TSH level improves. 

My cholesterol isn't the greatest either.  My doctor wants me to go on cholesterol meds, but I really don't want to.  Partly because I don't like that your body become reliant on them....once you start, you can't go off of them.  Plus I don't like the risk of damaging my liver...although I know there is a risk of heart disease related to cholesterol level.  I guess right now the main reason is that the meds boldly say that if you're planning to become pregnant, you should not take these meds.  Not that I'm planning to right now or even in the near future...but it's still a possibility.  I know I'm getting older, but I think I still have a few more years to make that decision & I don't want to be on a medication that will cause any problems if I do choose to one day have a child.  So for now, I refuse to be on any meds.  Gina told me to eat oatmeal & to take certain vitamins.  I'm not sure what they are...but I'll check it out.  Anyone else have any advice? 

I had my niece stay over last night.  Her mother (my ex-sister-in-law) had a baby yesterday.  A big baby girl...9 lbs, 7 oz.  Mom & baby are doing well.  It was weird today...my brother was here as were my niece & nephew when we got a call from the ex saying her bf/fiancee was coming over to pick up the kids to bring them to the hospital.  What was weird is this...this bf/fiancee is someone my brother had beaten up really badly a few years ago because my brother was still married to the ex at the time.  I can't imagine how he feels now...a few years later having this guy come pick up his kids to go celebrate the arrival of the bf's baby with my brother's ex-wife.  Am I making sense?  It's just thoughts going through my head....they don't always make sense.  :)

Oh yeah...update on the critter situation.  I officially declared my house critter free on Friday.  I thru away some of the traps (still left some in the attic), but we have not caught anymore since the original two.  I'm confident there are no more...feeling comfortable in my own home once again.  Thanks to Steve...after reading this story, I am thankful it's not my house...

AOL News - 1,300 Pet Rats Overwhelm Man's Home  or

http://articles.news.aol.com/news/_a/1300-pet-rats-overwhelm-mans-home/20060629225509990007

Have a great weekend!