Tuesday, April 26, 2011

The Night Bill Monroe Came to Town

Ronald Reagan was our president
A diet coke would run you twenty-five cent
I was just a kid, hair flaxen-brown
On the night Bill Monroe came to town.

The Golden Girls were reigning on tv
(Not that it was something I could see)
Bluegrass was the hit, the biggest sound
On the night Bill Monroe came to town.

Momma scrubbed my face, and packed us in the van
Yeah, we were all going-the whole entire clan
Once all the shoes and socks had all been found
On the night Bill Monroe came to town.

Five hundred people screaming in the gym
The passion in their voices no mere whim
To let it out, in yet another round
On the night Bill Monroe came to town.

On and on went Billy and his band
"Dark Hollow" "Feudin' Banjo's" "Freeborn Man"
We're getting up, we're getting wild, we're getting down
On the night Bill Monroe came to town.

Thronging fans besiged him, to get his autograph
That a little kid could get one, was more then crazy daft
From that mass of people hanging 'round
On the night Bill Monroe came to town.

Cheeks and arms and papers, all were signed and blessed
With the pen of Bill Monroe, his official scrawing crest
It was still a night of being quite profound
I won't forget the night he came to town.

Saturday, April 23, 2011

Ten Years Pumping: A Pictorial Odyssey

On this date in history, my life changed, for the better.

(yes, it sounds cliche-ish, but its all true. I hated the imposed schedule of the 2-shot-a-day regimen. I was about 35 lbs overweight because all I ever did was feed the insulin.Pumping helped me to lose most of that.)

If I had to pick a favorite, well, I wouldn't. (they all have their good points, except perhaps that mid 80's Disetronic) But one thing I know, I don't think I'd ever go back to a Medtronic pump.(they & I had a major falling out,& I don't think much of their products.Your opinion may vary,& I respect that)I want to do a more detailed vlog about the differences.(when I have the time)

But today, is a day for cupcakes & ice cream, to celebrate the freedom that the pump brings.Diabetes is so much easier with a pump.

Thursday, April 21, 2011

Thoughts From the 3rd-4th Week

1.One week,you're on top of the game-the next,you do something unspeakable (or non-HIPAA compatible) & on top of feeling horrible about it,you then get to tell your instructor,the shadowing Masters Degree student,& the RN charge nurse.(the patient is fine) You then get to fill out your very first Incident Report on why the thing you did was a bad idea & burst into tears,well,just because the situation is not awkward enough.Mistakes happen,I know that(it's the sheer amount of authority figures that sent me over the edge). Live & learn.(I haven't been kicked out of the program yet,so that's a positive.)

2. I got to see a cataract operation(video from a guest lecturing ophthalmologist) as well as ten zillion pictures of the Diabetic Eye. It was both fascinating and made me want to throw up,as it seems that the winning combination of diabetes,nearsightedness,cataract surgeries,strabismus surgery,and optic neuritis spells a
near certain dearth for my left eye.(glaucoma,retinal detachment,macular degeneration,pick your poison)I really would like to keep it 'round as long as possible.(renewed vow to get myself to the optho this summer) I think that the clouding on my L.lens has progressed,I don't see as well at night(it seems to have really gone to town in the past 2 years...is it something about that 10 year post-surgeries mark? I think lasaring is in the cards for the near future which is kind of scary to think about. I hope it doesn't A.hurt or B. have any other visual side effects.I've known the day would come that I'd need lasar,it's just hard to remain calm when its an eye(s) you're talking about.

3.150 years ago last week,the Civil War began. iTunes has an incredible app called The Civil War Today which gives you a daily update through the 4 years of war. (it's an iPad app though) It's in newspaper format,& has video clips,journal accounts,quotes,trivia,photographs, etc. & really makes it come alive...it's a pretty cool app.If you love history and have an iPad,I suggest you check it out!

4.Cancelled my Endo appt,rescheduled for May 3.Hopefully my a1c won't be so off-the-charts high by then.

5. Freestyle strips without the Butterfly are becoming next to impossible to try and find. The bad thing is,both kinds have the same UPC so it's impossible for a pharmacy to know what they're getting.It's largely hit & miss trying to obtain any.(at all)
1.In the Event of a Fire Alarm,make darn sure you grab your meter & sugar,because you won't get back in that building for a good 45 minutes. This is not a time to go low.
2. Working in a nursing home is like working in the psych ward..one day everything is "normal", the next, the patient is wheeling all over the cafeteria,& attempting to slug you when you try to prevent disaster from occurring. (while the rest of the population looks on) I guess it's not that bad when the patient is not physically capable of hurting anything,but it was just so,so,so bizarre & the Easter Bunny was not exactly helping me in what I was expected to do in said situation.(me & Easter Bunny in room full of patients,& I couldn't leave because I was monitoring somebody else) HELPPP.(just about ready to be committed to a mental institution myself,I was not supposed to be monitoring the whole entire room) Next time, a little help, Easter Bunny?
3. Forget tiredness, I've progressed to dead. But next week,there is no homework/care plans due(Monday,Test 4) and Wed/Thurs we'll be caring for two patients EACH & then,that's the end to clinicals. Following week,we have our big Patient Presentations & the week after that,evaluations & the cumulative Final Exam and the big Nursing Convocation Dept. "party" and then it's all done! (time flies when you're having fun) I need it to be summer.
4. You may cross "morbidly obese patients" and "chemo/radiation patients" off the list of future career choices.Someone needs to do it,it just won't be me. I can't even find a pulse(anywhere) let alone formulate a good plan. I feel like whatever skills I may have acquired up to this point have not gotten me really far (in terms of a morbidly obese individual)
5.One week & 12 hours till the royal wedding! (I'm sure you're all just dying NOT to know)

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Sunday, April 17, 2011

YouTube: A Royal Wedding

Love this clip...(and yes, I will be waking up at 5 AM (April 29) to watch the real thing!)

Wednesday, April 13, 2011

Circle of Trust

Trust. It's a tricky thing,and for a PWD,the question of ultimate trust boils down to a little red box.

In 12 years, I had only asked the question of ultimate trust one time (to a non-family member-family members have given me some,& my husband does know how to give one) It was directed to my then-EMT boyfriend(my blood sugar was under 10 mg/dl, & I was hysterically convinced that I would soon die) and he said no.Who knows why...nerves,perhaps.Or the legality of the situation.It did not matter,I was both annoyed(to the nth degree) and scared & crushed,that question of trust had been thrown back into my face & ultimately,that helped in the breakup.If you cannot trust someone completely,you have no business being together.(and I used to be an EMT & in my section of the universe,heck yes they give them.I know he knew how)

So when I asked my clinical instructor if she would be willing to administer "the shot", it was with a great deal of fear & trepidation. She said yes.(she's an ER nurse,heck yeah she knows what to do in an emergency) I ran through the basics,& what I'd be like(in such a situation). But then a dept wide email circulated RE school policy in such a situation & it was advised just to call 911,not to get involved.

Crushed,that's what I was. I dunno why it feels so important that I have someone on my side,but it felt like that trust I'd just given out for the 2nd time in 12.5 years didn't mean squat,again.Of course my clinical instructor was sympathetic but she couldn't go against dept policy. So back I went to talk to the dept head,& she said in actuality,the instructor could do as they wished-call 911 or give the shot/call 911,the schools liability insurance would cover either way. I wouldn't ever sue but there is liability insurance for everything,these days.

I am relieved..so,so relieved. I thought the school really didn't care if I lived or died,& I don't have the attitude that it's anyone's responsibility to do this..only someone I think would care enough to do so. When my clinical instructor said sure,I thought that to be the case.(she's pretty great) I have worked a retail job & in 7.5 years,never trusted anyone there (even good friends) with that burden.(said person has to be somewhat knowledgeable about medical matters) I think part of the deal here lately has to do with the lability of my blood sugars,& my desire to stay closer to 100 then to the 250's of yesteryears. A blood sugar monitor is also not always handy..like it was at my old job. You can't very well crack the meter open in the middle of a procedure.(plus you have to wash your hands a billion times a day)

I hope to never need it(on the job)but it's so wonderful to have that piece of mind.(Bgs have been all over the map lately & it may come to pass,that I need one) I need to feel safe,& more then anything else,this decision has greatly influenced that. I don't think I'm going to be having this conversation with all my clinical professors but in this rotation,I never needed that reassurance more.(nursing home in the middle of nowhere)

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Tuesday, April 12, 2011

A Blue Shield Comparison

It's four months into the year, and I have mixed feelings about our newest insurance plan(Blue Shield/Blue Choice). (previously, we had Blue Cross/Blue Shield)Can't escape them Blues.

- no test strip copay when I went and filled my rx at the local pharmacy..I can't remember the last time THAT happened.(age 21, perhaps)
- 100% coverage on the several emergency magnesium infusions(I have a plan in place for that..it's done at an outpatient infusion center) Is it fun, no, but the nurses there can get blood from a stone(they're very skilled) It also takes about half the time then at an Emergency Room. At $2,000 a pop(if not covered),even under the old insurance the copay was just horrendous. I have standing orders there.(fortunately these days my mag levels are doing pretty well but when things go south,I know it)
-diagnostic tests are covered, 100%. Lab tests appear to be covered 100% as well.

-no mail order pharmacy, I have to order things directly from the manufacturer.And both pump supplies and Dexcom sensors are a chunk of change significantly higher then what I payed under the last plan.
-Test strips I have to get directly from the pharmacy. I miss getting all my D supplies (strips,insulin,pump supplies) in one fell swoop, at the same time, every 3 months.
- Insulin I haven't attempted to get filled yet,but I fully expect Apidra not be covered(Novolog is apparently the med of choice)or some outrageous copay & I will have to go through a lengthy appeal process. I try to use up my vials to the last drop,& therefore go through them pretty slowly but eventually I will have to face the music & go to war with the insurance company. I just don't have the energy/time to do that right now.
-regular drugs (aka synthroid,etc.) are slightly more expensive then they were with the old plan.
-dr office copays are the same...
-ER copays are $100 a pop,about 2x of the old plan. Now I really don't want to go there.(I need a tattoo that says "Do Not Take to ER" on my forehead)If I were to have a bad low, I think I'd want the IV glucose & then refuse transport.(assuming I were in that state of mind) ER's are money suckers.
-I have to get preauthorization on EVERYTHING,which is a pain in the wazoo. Preauthorization can take days, to months.(cannot begin process right before I'm about to run out of something critical)

Bottom line is...most insurance plans have problems, you're always going to be shelling out for something. I'm just glad to have insurance.(that covers as well as it does) I'm not sure yet if I like it better/worse then the old plan..they both have their advantages. I'll probably have more of a opinion later on in the year, when it becomes obvious just how much has been shelled out in comparison to under the old plan.(for mostly the same stuff)

Saturday, April 09, 2011

Thoughts from the Second Week

1. Sleep? What's that?

2. See above.

3. See above.

4. I need to grow longer fingernails...there is no other way of getting into some medication packets.

5. I caught a medication error this week,& felt really good about it. I guess I wasn't that surprised that in the 4 proceeding months,no one else had.As nursing homes go,this one is ok but of course none of them are going to question the all-knowing pharmacy's RX's.I don't have a very high opinion of nursing homes' care.(in general,if you know of a great one,I will stand corrected) And it is better for the patient that is was caught,but in the grand scheme of the Universe when one has many,many other medical issues I'm not sure how much good it actually ends up doing.

6. Sometimes I need to keep my mouth shut...no one gives two cents about the nursing student's needs. I was under the impression that they did,but administrative policy trumps all.Reality is the bitterest of pills to swallow.
7. Weekends without looming tests are a good thing.And as I've been a test every Monday since Feb(barring the Spring Break) it feels indescribably wonderful NOT to have to study/cram this weekend.I'm still upset about this week anyway.

8. Starbucks is essential for those incredibly early morning risings.

9. There's no way I'll be able to get off an hour early for my would-be Endo appt. next week,you have to be dead.(dying doesn't cut it,according to my clinical instructor) Which is stupid,because all we do that time of day is sit around,talk,& write care plans. I will have to reschedule for July,my Endo will be upset, & I'm already there X 1,000,000.

10. Is it May yet? I need to get out of this semester.

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Friday, April 01, 2011

The Top Ten Ways to Drop Your Blood Glucose(part 1)

The Top Ten Ways To Drop Your BG-Au Naturale






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