Monday, September 24, 2012

From the Files of a Nursing Student: Blue

It was kind of a lax weekend, and by "lax"...I mean that there were no looming tests on Monday. Not that this means that they're giving us a breather, because there's a paper due today. (fortunately for me, I have one from the previous attempt at this course, that was never graded & in my eyes, legit for round #2) Hubby is away on a business trip for 9 days, so it's me & the baby. Baby plus keeping up with this place (cats, laundry, etc.) has me so busy I'm really grateful that there isn't another test till next Monday.

Four weeks down. Four to go. On Thursday, after I took my hubby to the airport & ran to the grocery store & went home, a brief GI virus sidelined me for the rest of the day & I wasn't sure that I could drag myself around on Friday,but I felt marginally better by then. Took my cardio test & sat through 5 hours of GI lectures. I did very,very badly on the cardio test (but my average is still ok...still there's no excuse for it). I think it was a combo of feeling sub-par plus not being able to "think" it out plus total brain deadness on the math questions. I studied, I REALLY studied. Cardio is supposed to be the worst test though (other then the final) so I just need to concentrate on getting stellar grades for the 2 tests before the final. My mom is coming up to help me out for a few days this week, so that will be really helpful. (try lifesaving...she cooks me food,cleans,shops,helps with the baby. I don't know how she does it all,but she had six kids so I'm sure this is just minimal compared to back in the day) That comes with its own particular brand of stress,as she's of the opinion that the first few years of a child's life should be exclusively day-care free..let's just say that we disagree on that point. I don't think I'm emotionally scarring my child for life,& I do my best for my baby.(and I enjoy doing it,he's a good baby) He is happy,healthy, & loves people(everyone..not just his momma)in some respects I feel like the interaction is good for him as well.

Four weeks to go. (have I said that yet?feels like I've been in this course for-ev-er. At the end of this course, there's a break until Jan. because of a weird quirk in what course plan,cannot take a 3rd semester course right after a 2nd semester) I've discovered why the hospital freaks the sams hill out whenever there's a glucose value like say, 53 (or 284)...those values require follow up by the nurse & possible notification of the doctor. And if you're a tired OB, a blood glucose of 284 is likely to majorly annoy you.(especially if you have no clue how swing-ish a type 1's blood glucose can be, post-pregnancy(or pretty much any time) Their goal is to
ensure that there are no surgery complications and discharge you as soon as possible. (and diabetes kind of throws a wrench in that process)
I really think they go overkill on it,as a type 1 I do not need to see a diabetes educator every time my blood glucose goes outside of the range...but it's all very much CYA. But you've got to remember that the vast majority of PWD are type 2...and have stabl-er blood glucoses then type 1's. They often do well on sliding scales,& have residual insulin production to keep their bgs lower. However, that doesn't help me in figuring out what type they are if they are older,perhaps overweight,already have some complications,and are exclusively on insulin but were just diagnosed. (because that info isn't in the charts)Doesn't this information MATTER? (well,it does to me...apparently not to anyone else) Couldn't they try type 2 meds, or has there been any screening bloodwork for antibodies,and shouldn't they get education on counting carbs etc.etc.etc...when it comes to diabetes, I wish I had a clearer clinical picture then the one I get.

A FB friend of mine passed away last night, she was 31 years old, type 1, and had just had surgery. (we used to chat on a diabetes chat) It's so sad when things like this happen out of the blue,& the family is left to grieve. (so much of that around the DOC lately) 31 is too young to die. 40 is too young to die. Please keep those families in your thoughts & prayers. I guess I've just been going through a mini-midlife crises, one in which I've been learning (in depth) about hospitals (and the million & one things that can go wrong post surgery...clots & DVT's, heart attacks, strokes,etc) and being in my 30's, it's been a jolting realization that yes, young people have these problems too...especially PWD. Waiting till I'm 45 & in the CCU with a massive MI isn't going to do me any good,I really need to start improving my diet & exercise NOW. (regardless of cholesterol, people have heart attacks from other things) And women, especially young women, do not have a good prognosis post-heart attack. I don't want to leave behind my family just yet, I want my baby to have a mother & my hubby to have a wife. (for a good long while) Life doesn't feel very fair sometimes but its a heck of a lot fairer then to die of a complication, too young. That complication isn't always "D" related...blood clots can be a complication of any surgery, regardless of the diabetes. You can do your best to lead a healthy life with D..but things can still happen, outside of your control. I just wish there was a cure for diabetes though,because it breaks my heart every time I see a blue candle.

Friday, September 14, 2012

The Nursing School Diaries: Day #2

It was all about the choices.
Choice A: turn around,go home,whisk my forgotten iBaby off the charger, & speed madly towards the hospital,praying that the traffic gods would be kind to me & that I'd be able to get to the right (yes,top) floor of the deserted parking garage (yes,they particularly hate students,they make us park as far away as humanly possible) & my butt across the grounds to the 5th floor of Obscure Building X before 6:45 am. Forgetting your phone is a crime punishable by death...because you need your phone to look up the 1,001 things you don't know.(thing have to sneak off to the bathroom to do it,because should someone see you & think you are "texting" you are in big,serious trouble) Yes,our instructors encourage us to sneak off to the bathroom to do "questionable" practices. (or,should we need to text/find them...because the unit is so darn huge) Being late also means a Plan for Success..but if your instructor is lax on the "lateness" definition(or,is late herself,which some are) sometimes you just gotta take that risk & turn around,grab your phone,& go back. So forgetting your phone is a definite no-no while being slightly late just might be forgivable.

Such was the position I found myself in, one morning this week. I made it to the hospital by 6:40 & rushed over to the assigned meeting place,making sure I hadn't forgotten my backpack/purse/food/car lockup/permit displayed...& was there before my instructor, so everything was great.It was a busy day,as we acclimated to the computer system/healthcare setting/patient load etc...but by 9:30 I figured it was time to check my bg & grab a bite to eat.

Yep,I'd forgotten my PDM/meter/backup insulin vials/syringes in my car. I was also starving to death,but with no way to check my bg/bolus I didn't dare eat. Figured I needed something though so I ate a banana. There is a fate worse then ketoacidosis, & it's called "Plan for Success"...I didn't dare tell my instructor that my meter was out in my car,lest she write me up for not being prepared. In the meantime, my Dex crept up steadily towards 300 & I tried to just focus on making it to lunch,when I could go out & grab my meter/bolus myself into euro glycemic bliss once more.

12:30 came,I went out & checked..only 267. Felt more like 500,what with ketones slugging away through my circulation but I corrected,bolused for lunch,walked back to the rest of the group, & tanked up on fluids.(my insulin was fried..good thing my infusion pod was perfectly ok or I probably would have been in DKA)
Made it through the day,picked up the baby, spent the evening attempting to get my blood sugars straight & the ketones cleared. It's hard when you can't take care of yourself because no one else is allowed to do "X" slack cut unless you are dying.(& in that case, you'd be "relieved" of your clinical duties." I clearly have much to this crazy juggling (school,diabetes,family)life.

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