Good afternoon, everyone! Hope you all are well. Yes, that is a very unusual title. Took me by surprise, too. I don’t know if I told everyone…or anyone outside of Facebook (good place to keep a secret) but I was diagnosed with breast cancer last year soon after I retired from hospital work. I was so caught up with getting things ready for retirement that I forgot about scheduling my mammogram so as soon as things settled down I went in for the mammo.
My heart sunk when I was told I needed more views of my right breast. After the tech took the pictures I knew an ultrasound and possibly a biopsy was in order (she let me look at the pictures. It didn’t look like a cyst). Well, after all was said and done it turned out that I had a 5 mm tumor…an estrogen feeding tumor that didn’t belong. Surgery was indicated followed by radiation treatments….more about that later. The surgery was a partial mastectomy or lumpectomy. “No problems,” they told me. “We didn’t do anything to your lymph nodes” they said. “Your chances of lymphedema are very slim” I was told so I went on my merry way.
I completed my radiation treatments early November, went up north to visit family for turkey day, then on to Haiti on a medical mission (which was awesome, BTW). Shortly after returning home I noticed swelling of my right boob along with discomfort and dull pain to the axilla (underarm) and around the nipple. I had doctor appointments coming up so I told the doctors about it. They passed it on….did I tell the other oncologist? (Like why would I? I am here!) I finally had enough and called the radiation nurse who said “It sounds like lymphedema.” WTH! My slim chances became 100%. I then called the lymphedema team at the VA.
What I do have is lymphatic congestion. It is not in my arm, just my right breast. I was taught how to do Lymphatic Massage Drainage (look it up on You Tube. No, you will not see my breast). I already had high impact sports bras (keep the girls in place with a bit of a squish) which helped. I also sleep in a compression t-shirt (Under Armor, short sleeve). I even bought an abdominal binder to really squish the boob and that helped a lot. Reminded me of the movie “Victor/Victoria” with James Garner and Julie Andrews where Julie Andrews played a woman who pretended to be a man who pretended to be a woman. She wore a binder. Kept the girls in place. Good idea.
Well, the congestion is still present but much better after help from my team at the Malcom Randall VAMC in Gainesville, FL so all is well, or better. And why am I telling everyone about this? you might ask. Because I was on Facebook the other night and noticed a post about similar symptoms. I can’t diagnose but I sure can tell her about my experience and use the blog to tell others, too. After all, one boob bigger than the other and holding about 4 pounds of water weight is not normal by any stretch.
Well, that’s all for now. Got to get back to posting patterns on Etsy. I have a bunch of new, uncuts ready to go….and some incredibly cool Hawaiian prints from, where else, Hawaii that I picked up my recent trip.
Love to everyone….and go get your mammogram done. And here is a quick shout out to Alice, the wonderful nurse at the North Florida Cancer Center. She is fabulous. Love my nurse!
Three weeks ago my littlest guy, Salty Dog, suffered a cardiac arrest. At first we didn't know what happened but after resuscitation (doggie CPR) and through his recovery, we were able to piece together that he suffered a cerebral vascular accident, CVA, more commonly known as a stroke. I posted updates on Facebook with pictures of his recovery but my friends said I should blog his story so others might learn from it. I broke the story into parts so it wouldn't be overwhelming. Throughout his recovery I found little on the web about dogs recovering from stroke or what to do so everything we did was by the seat of our pants. I hope it helps someone. By the way, we love our vet. We get lots of good advice and care but sometimes things happen after hours or on the weekend....and we live in the country, a bit of a distance from the big city so not everything is easily accessible. Sorry I have been away for a while but the last month has been a bit crazy. Between Salty having a stroke the day before having surgery for cancer removal (not a big cancer but the C word scares me) sort of had me a bit preoccupied. Day One:
The morning before the surgery I was a little on edge so I thought I would walk my dogs...at least 2 of them. Sammie, the boxer, and Fred, my bigger male poodle (he's not that big, 15 pounds but he thinks he is big) walk while Salty, the little toy poodle of the pack..7 pounds after he eats, runs to the garage to hang with the hubby in the man cave. That day was no different, Salty ran out of the yard as fast as he could to be with the hubby while I circled the drive with the other two.
When I got back to the house my hubby called me sounding a bit off. "Babe, could you come here a minute?" he said.
"What's up?" I said really thinking now what. "Salty's dead. He just died."
I thought of the little guy running so happily from the yard. "What happened? Did something fall on him?"
He just fell over dead. He's not breathing," was my hubby's response.
My husband was carrying Salty, cradling him in his arms. He had tears in his eyes and he sat on the ground next to a big oak. "Come on little guy. Come on Bud Bud. Don't leave me," he said.
The next thing I knew I saw my husband start mouth to snout CPR, resuscitation, on Salty. I assisted with compressions.
I wondered what could have caused a sudden cardiac arrest and thought it could have been one of two things, a heart attack with a fatal arrhythmia or a CVA, stroke. In Salty's case I didn't know what it could be. He had no signs or symptoms of major health problems that I was aware of. He'd been to the vet and had a clean bill of health.
After a few breaths and compressions Salty started to open his eyes. He didn't focus and his head flopped back. He couldn't move the left side of his body. His left legs stiffened and he couldn't control his head movement. It looked like he had a massive stroke. While supporting his head I carried him into the house. I gently bathed him at the kitchen sink talking to him and singing soft to him while supporting his head. I didn't know if those were his last moments and, if they were, I wanted him to hear a loving voice. I thought about taking him to the vet but thought there wasn't a whole lot they would offer a little old dog other than watch him. I also examined him while I bathed him. I noticed his pupils were equal, not blown, so I didn't think he had a hemorrhage. I also noticed it didn't seem like he could see if someone was on his left side, left-sided neglect. I noticed he couldn't bark or wag his tail and his tongue hung out of the left side of his mouth, like facial droop.
My husband and I talked about taking him to the vet. He was afraid he would need to be put down and he said he couldn't do it. To tell the truth, I couldn't either.
"I'm not taking him to the vet," I told my husband. "What will they tell us? Put him down? Leave him with us and we'll watch him? I'm not leaving him in a strange kennel with strangers. He won't know what's going on and he'll be scared. We can watch him here. If this is his last day on earth he's going to spend it with family." There was no way I would leave my little dog with strangers during his last hours on earth. Thankfully my husband agreed.
My husband and I held Salty for hours moving his legs and supporting his head while talking to him. We made sure to stand on his right side so he could see us...and we supported his head. I made a place for him on the pillow on the floor with a towel on it. He couldn't control his bladder. He just laid there and went to sleep. I remembered from stroke care that the sooner physical therapy is started on the affected limbs the better the recovery. It was then I started moving his legs, range of motion. My husband watched me and took turns doing it, too. I don't know how many times the hubby got up during the night to check Salty but I know I got up at least four times, each time expecting to find him gone. He amazed me, though. Even more, Sammie, the boxer, stood guard at his side watching him during the night. She laid down next to him and slept. Day 2 Salty was still there. He was able to lift his head but nothing else yet. I went for my skin cancer removal and straight home when it was through. When we arrived home Salty was still there and seemed to lift his head a little. Salty recognized us, me particularly, and would turn his head to my voice. He still couldn't drink or eat anything which worried my husband. I explained to him it was pretty dangerous to give him water by eye dropper especially since he couldn't bark yet. I was afraid of aspiration, water getting into the lungs, and thought we still had time to address it. The rest of the day was filled with holding, range of motion, and worry.
The hubby holding Salty so his head wouldn't flop around.
Day 3
Day 3 brought me a big surprise. Salty tried to get up for breakfast. I thought I should take him out like I usually do and he walked under his own power to pee. He walked in the yard about 10 feet then rested. He was pretty wobbly but he did it himself. A while later I made him walk again and he walked to the water bowl for a drink. It seemed like he was making up for all the water he couldn't drink over the last few days. Still not ready to eat, though. He wasn't ready to quit so we wouldn't, either. Hourly physical therapy that included walking, massages, lots of hugging, holding...and doggie dose aspirin.
I thought about how to treat Salty. In the hospital setting we use clot busters, like TPA, to restore blood flow after a CT scan to make sure there is no hemorrhage but we were home and I was treating by instinct. Since we didn't have a CT scan or TPA I thought about what other blood thinners could be used and remembered dogs can take aspirin. Aspirin is used commonly treat cardiac patients to decrease platelet aggregation, or clumping. I thought why not try it for Salty. I looked up "doggy dose aspirin" and found 5 mg per pound of body weight. Salty weighed 7 pounds. I split an enteric coated baby aspirin (81 mg) in half and gave him a half tablet. I started him on a half tablet twice a day, or every twelve hours.
The hubby holding Salty and Sammie, Salty's nurse, sitting close by.
To learn more about Doggie CPR there are several YouTube videos that demonstrate the technique. Here's one:
Dog Dose Aspirin:
"Most veterinarians recommend from 5 mg to 10 mg per pound of the dog's weight during a 12 hour period. (That is about 10-20 mg per kg weight). Going on the safe side, a recommended dosage of aspirin of about 5 mg/lb (10 mg/kg) seems to work well for most dogs." Giving Your Dog Aspirin by Ron Kurtus, November 11, 2008. http://www.school-for-champions.com/animalhealth/aspirin.htm#.Vwsb62N2fzI
Remember, do not use ibuprofen (Motrin) or acetaminophen (Tylenol) on dogs. Ever. And never use aspirin on cats. Never.
Post by Eileen from GoofingOff Sewing Nursing people and dogs.
Last night the hubby and I had a Saturday night date....pizza and a movie. We finally got to watch Captain Phillips...the movie about the tanker that was captured by Somalian pirates and its captain who was held hostage. Not a bad movie, pretty good, in fact. I did my usual, watching with one eye while the other eye kept track of my handiwork (which was crocheting a kippah for my Pomegranate Guild chapter).
I half followed along until the captain was rescued by the US Navy and safe aboard ship. He was in the sick bay and being examined by the nurse. The nurse's actions stopped me in mid-stitch. She was efficient, very smart, doing what she should do....except she was too efficient. The captain was just rescued and shaken up splattered with blood and brains from his captors. Every time she touched him he jumped. She very efficiently asked him if he was in pain, told him she was putting a sensor on his finger to measure his oxygenation....all the right things, but it was without caring. It wasn't until he asked her if the blood on him was his that she had any comfort or caring to her voice. She was well into the exam before she reached her caring moment.
It made me wonder if during the course of the day if I get so caught up in "getting it right" or being efficient that I delay the caring moment a patient needs. It also made me promise to myself to be sure to get into the caring moment as soon as possible. A soft voice and a kind word goes far, especially if the patient experienced a traumatic event....
"Our goal is go home" my patient's wife said. "I'm a nurse. I can handle the care." End of life care in their case. I often wondered how I would act if confronted with the problem she confronted. She joked a little. Laughed a little. Hugged her hubby a lot.
For him it started with a trip to the hospital for horrible back pain. Cancer wrapped itself around his spinal cord, crushing it and causing paralysis. He'd been battling melanoma and the cancer became metastatic attacking organs until breathing became difficult. Ugh.
I introduced myself and gave hime the call light.
"See this little symbol? Looks like me? Push this for your wonderful nurse, me." Later, when I checked his alertness level I asked him "And who am I?" "My wonderful nurse" he said and we laughed.
We are a nation of sun worshippers. Folks bake in little ovens..tanning salons as they are known...to get that beautiful bronze color. They even pay for the privilege. How often did I bake in the sun getting burnt thinking I looked good (I was young and stupid...now I am older, sometimes stupid, er, not so smart)? No sunscreen. I used baby oil!!??!!
I don't advocate staying indoors and avoiding the sun. I advocate using your brain...and sunscreen. Reduce your risk.
Live long and prosper.....(my Spock-love is showing).
I don't write too much about my nursing life. It's too personal...sometimes. I have these feelings about nursing....lots of them...it's my job. I do what I think is the right thing to do and it treats me well....food on the table, a roof over my head. It is what it is.
Last night my patient said "I bet you've seen a lot." Yup, good and bad, miracles and not-so-good. Some of what I see are non-compliant patients...those who fly straight into the face of the medical community and against medical advice (and sometimes common sense) to do what they want. It is frustrating to care for someone who doesn't want much done but doesn't want to leave the hospital, doesn't want to change their code status (they usually are full code but don't want anything done...sort of like hitting your hand with a hammer and not letting anyone take the hammer away), and doesn't want to....the list goes on and on.
We had a patient recently who not just fit the picture but posed for it, too. "NO, I don't want a PICC. NO, I don't want a foley." He was gruff and messy...and had crude language, too. Just the thing to make the hairs on the back of your neck to stand up.
I stopped in one day just to say hello. I told him I wasn't his nurse, wasn't there to stick him or do anything, just there to say hi and see how he was doing. He looked at me like I was crazy then relaxed and started talking. He told me how sick he was, how he was "easing on out." I asked why he changed his code status back to full code...full court press we sometimes call it....and he shrugged. It was then I realized this rough and tough guy was scared of dying. He told me he'd been all over, saw a lot and did a lot. "You know what you would like?" he asked. "Fishing in Montana. Watching the sun come up there and eating fresh fish." For that brief moment he left the hospital..I could see it on his face..then he asked why he felt so bad. I told him what I thought was happening and suggested he got back to bed to rest...which he did.
Not so mean, not so big and bad, not so gruff...just sick and scared. He had lived life on his terms and now it was coming to an end....out of his control.
I stopped in to see him before he transferred out of the unit. He took my hand and told me I was a good friend. I almost cried....almost.
I wonder how often we are non-compliant patients. I know I've been one. I'm good while I am sick but then there's other times.....My doctors would shake their heads when I'd tell them the things I did in spite of being told not to.
Today I'll be a good patient, take my pills, exercise, not eat too much. Not sure about tomorrow, though.
Post by Eileen Patterson
When I first became a nurse I was required to wear white. Everything was white from the cap on my head to the shoes on my feet and everything in between. I hated it. I looked like everyone else, not to mention the white stains from Mylanta. Every uniform had short sleeves (my arms were cold in the winter), the pockets not where I wanted them, and the tops just weren't my style were my main complaints. Besides, uniforms cost too much for a new nurse with a family to support. Finding uniform patterns was difficult so I adapted patterns that I liked to remake as uniforms. Finally my arms were warm and my uniforms were mine.
That worked for quite a while, that is, until I started working in critical care. I was issued scrub dresses, thin, flimsy dresses that had been washed a few thousand times. Once again I looked like everyone else. When the hospital's rules for dress changed I rejoiced. I could wear whatever color scrubs I liked. I didn't have to wear dresses and I didn't have to look like everyone else.
Fast forward another 20 years to today. Scrubs come in every color imaginable yet the styles are restricted to a few. Finding patterns to make something that looks different is as hard today as it was 30 years ago when I first became a nurse. The challenge is to take a pattern, modern or vintage, and make a scrub top that looks good, feels comfortable (12 hours is a long time to be uncomfortable), and suits the needs of the nurse.
The best pattern for use as a scrub top should have short or long sleeves. The sleeves shouldn't be too loose or wide but still allow for movement. The top should be hip length and not form-fitting. Form-fitted tops restrict movement and don't allow for full pockets. Nurses need pockets. We carry pens, scissors, hemostats, beepers, phones, and alcohol pads in our pockets so we need pockets. Still, a pattern that lacks pockets but meets all the other criteria shouldn't be counted out. Pockets can be added to a pattern.
Here are a few patterns that could be adapted for scrub top use.
The D variation could work well as a scrub. Just the right length, short sleeves, and loose enough to allow for movement. Add patch pockets in the front along the bottom and Voila! A scrub top is born.
At least three variations would work great for a scrub top. Perfect length, loose enough for comfort, just needs pockets. Plus Sized, too.
This one is a little more involved. The top in View B is cute. It needs to be cut shorter so it comes to the top of the hip. Add a little embroidery or cotton lace for softness if you like. The pattern also comes with elastic pants. Beautiful.
Wearing scrubs doesn't mean you have to lose your creativity or identity. Quite the contrary. Once you start sewing, you can be you.
Monday, December 14, 2009
Just about done with another class, Epidemiology, so I can get back to blogging about life. The class wasn't too bad with an awesome professor. A few more classes and I will be able to walk for my BSN diploma. It's been a journey for me but I am enjoying it. I wish I had done it sooner. I could blame putting it off on lots of things, kids, marriage, money, and those are all good reasons, partly true, but the real reason was me. Hard headed, I wanted to do more than nursing, something else besides nursing. I still do but that's O.K. A Bachelor's degree is a degree well-earned and I am working damned hard for it. I am going to walk with my head held high when I get that diploma. It's been a long time coming.
