Of Dogs and Their Tricks

I recently started working again after 14 years away from hospital nursing. My job is at an urban hospital that is a Level 1 trauma center. It is a teaching hospital, so the place is crawling with all manner of students. I work night shifts, though, so I see very few of them. What I do see is a lot of patients who range from not ill at all to catastrophically ill with all type of diseases. 

Many of my patients are the ones that are prone to being shunned in our society. I have cared for those who are addicted to drugs, those who are experiencing homelessness, those who are withdrawing from alcohol, those with a wide assortment of sexually transmitted diseases, those with disabling mental health diseases, etc. This is life in a hospital that takes the sickest patients of its city. 

I was also offered a job at a suburban hospital, but declined it. It would have been less hours, more money, and closer to home. But I didn't take it because I would have had to give chemotherapy, the manager offered me the position because I "seemed nice," and it just isn't what I do. I chose the harder path. But it is the path that stirs up the better parts of me. 

This awakening of the bedside nurse has combined with other influences to compel me to write again. The other sources of inspiration are Mary Oliver, Makoto Fujimura, and The Scrappy Farmer. Mary Oliver's poems remind me who I am and who I hope to be. She invites me to slow down, breath deeply, and seriously embrace my joy. Her writing calls to my long-neglected poet within. She is an older sister: mirroring, beckoning, encouraging me. 

Makoto Fujimura's paintings and words shift and sift what is within me. His paintings have long captured my imagination. His recent book, Art and Faith: A Theology of Making is paradigm shattering and permission to rest and recognize redeeming broken things as art. 

The Scrappy Farmer is a fabric artist, creating extraordinary works out of bits of cotton. I have the privilege of knowing her personally and I have no greater cheerleader for my writing. Anytime Scrappy Farmer can encourage me to write, she does so.

This month marks 20 years since I graduated nursing school. In the healthcare context, that makes me a very old dog. My extended break from working in a hospital setting made it difficult for me to re-enter the workforce. Most facilities think a nurse who hasn't worked in a hospital within the past year is lacking basic competencies. Not working for fourteen years? No travel agency would accept me. The hospital I work for made me go through a fellowship program, to be sure I am a safe provider. In short, the nursing profession thinks it is incredibly hard to teach an old dog new tricks.

My transition back has been very smooth, though. The biggest hurdle has been computerized charting. When I left bedside nursing I was still using paper charts. But because I am familiar with how computers work, and I already knew how to chart, it really hasn't been that difficult to learn. Many of the "new" drugs aren't new to me because I have kept up with continuing education, even beyond my state board of nursing's requirements. Because I have spent the years in between hospital gigs learning and taking care of medically complex children, I have been continuously learning new tricks.

Perhaps the problem isn't the age of the dog (or nurse), but how long it has been since it learned its last trick. Once you quit learning, it can be difficult to start again. I'm glad I didn't stop learning how computers work, how to communicate in English, what new therapies and medications are available, about genetic disorders, etc. I have no idea how long I will work as a clinical nurse. I can't predict how long I will write. But I do know that I am proof that you actually can teach an old dog new tricks. It's just much easier if the dog has been continuously adding stunts. 

Keep learning. 

And don't do drugs!!

copyright (c) Elizabeth, Bug's Beef. All rights reserved

Mobile Changing Tables

Today I want to share my idea for changing someone who can not use commercial changing tables.

I'm including photos of the supplies I use, as well as a video. 

All of this hinges on owning a van, or other vehicle, with a hatch back. There are ways it could be adapted for other vehicles, too, but those are not included in this tutorial. 

To be quick, I set up a table in the back of my van, then put a curtain around the trunk to maintain privacy. 

This is the table I use. It has legs with adjustable height and folds in half for easy storage. I found it at both local warehouse stores for around $38.

 These are the mega clips I use to hold my curtains shut. I purchased them at my local office supply store.

 These magnetic clips are the ones I use to secure the curtains to the trunk and side of my van. These work for all fabric types, but can be difficult to find ones strong enough to hold your material.

 Another option for magnets are these hooks. They are super strong, but only work for curtains that have holes for the holding of the hooks. If you get these, make sure they don't attach to each other. It takes a great deal of prayer, cussing and sweat to separate the magnets again.

Here it is with the table set up, and a portion of the privacy curtain in place. 

This is what it looks like from the outside when fully set up.

 This is the view from inside when set up.

Here is the video, showing it all coming together:

copyright (c) Elizabeth, Bug's Beef. All rights reserved

Regarding Stress

Three months ago my husband, four kids, and new dog piled in the van to return home via 550 miles of highway. We had gone to visit my extended family, including a beloved aunt who was terminally ill. As we settled in for the night at our first stop my phone alerted me of tornadoes at home. A Midwest upbringing left me unafraid, but still appropriately concerned. I texted my neighbor to be assured of her family's safety. When she replied that their ears were popping as they huddled in the basement I knew we were being hit.

The next day the six remaining hours of the journey seemed double their length. Every bit of van not filled with kids, dog or luggage was stuffed with bottled water and a generator, purchased along the way home. I called the police to figure out which roads were open. I watched the news on my phone and got text updates from friends and prepared my kids for a home that was going to look very different.

Each morning of the first week I woke up, put on work clothes, and pulled my hair back. The remains of our shade trees were toppled, chopped and hauled. The debris was collected; there were five types of siding in our yard. Kids were tended, the roof was tarped, the refrigerator was emptied into the trash, calls were made from cell phones charging in the van.

I eventually noticed that when I pulled my hair back, I had bald patches at my temples. It was a similar pattern from my post-baby days. But I hadn't had a baby. I thought perhaps it was from pulling my hair back so much.  I mentioned it to my hairdresser when I was at my appointment recently. She looked at my temples and said she would guess the hair had actually come out four months prior, based on the regrowth. It had not been broken, or ripped, but had fallen out. She frequently saw the hair loss pattern with stress. Had anything stressful happened four months prior? I counted my months backwards quickly and knew exactly when I had lost my hair.

At T's well visit last Fall the pediatrician was concerned about one tonsil suddenly being larger than the other. We got worked in to an ENT, not our own, who could see us immediately. He interrupted me, grew inpatient with T for having a developmental disability, and disregarded the pediatrician's note that this was a significant change. He blew us off. In December T's tonsil was still enlarged and other physicians agreed it wasn't improving. The pediatrician put in a consult again, I called to beg our regular ENT to get him in quickly.  She did see him and when she did, she said the tonsils needed to come out. But first we needed to try antibiotics. If the antibiotics didn't decrease his tonsils, T would need surgery. She was concerned about lymphoma.

Lymphoma.

Cancer.

However bad you imagine it is, being told your kid might have cancer, it's worse.

Anytime my mind would start to drift toward life with lymphoma in my kid my chest would grow heavy and tight. I pushed it aside, told myself to mourn when I had a reason to. I told my husband, but he didn't hear me. He didn't know we had a death threat hanging over our heads. I dwelt under the cloud by myself. I didn't want to tell anyone else, didn't want to share unnecessary burdens, but it leaked out in a phone call with my sister one day. Saying the words out loud to her triggered my first tears. I cried for a minute, then pushed them aside. I would cry when I had reason to. Tucker's teacher asked me a direct question, that for a variety of broken reasons I felt compelled to answer. I felt bad for dragging her down into the worry. I pushed that aside, too, though. I refused to let fear, or guilt, or possible suffering and death ruin our upcoming holidays.

When we got to my sister's house for Christams, 600 miles away, I realized I had left the antibiotics in the previous hotel's refrigerator. I hated myself, but couldn't slow down to feel bad. I called the on-call ENT and asked for more antibiotics. I didn't want to get to our follow-up appointment and find out that missing days 9 and 10 of antibiotcs was grounds for restarting the process. Meanwhile, T's appetite started decreasing, his throat hurting too bad to inspire him to eat. We saw other people in December who were unwilling to honor my requests to meet T's needs. I wanted to scream at them that he may have cancer, but swallowed it down. I fantasized about my son having cancer and them realizing they made everything worse by their jackassery. They would feel guilty and I would feel sainted.

At the follow-up appointment the doctor said, "Those need to come out. I want the surgery scheduled within 2-3 weeks. The scheduler will call you tomorrow." When two tomorrows passed, I started calling the scheduler. She treated me like a hysterical pain in the ass for believing the physician's timeline, then took a day off work. T still wasn't eating much. One week later she finally got the surgery scheduled for five weeks in the future. I wanted to cuss, or throw something, but instead made a phone call to the nurse to see if the doctor was aware of the delay in his surgery.  I felt everything within me tense, but kept my voice calm. The doctor knew, she was fine with it. Each person I talked to was forcefully cheerful, trying to deescalate my frustration with a chipper voice, rather than competence. I tensed with every call I made, but could not go on the attack. I had to stay calm, but persistent with the medical team. I couldn't get those tonsils out of my kid's head without them. It had been two months since I was told the doctor was worried about lymphoma, four months since my pediatrician first sounded the alarm.

Surgery finally came.

Recovery was a horror. T was in so much pain. Oxycodone is the only thing that kept us from being readmitted to the hospital. We alternated Tylenol and Ibuprofen around the clock, setting our alarms to wake him in the night. He would only eat ice chips when his oxycodone was working at full force. He refused all the jello, ice cream and popsicles I had stocked up on. He slept in our bed with us, assuring the worst quality of sleep for his parents.

I kept my cell phone on me, waiting for the biopsy results. A week later I called them. "They're negative!" When I checked the online chart later I found that they had had the results for five days, but didn't bother to tell me.

You would think benign results, after 2.5 months of being worried about cancer, would bring about the largest sigh of relief. Instead, all the stress that I had been pushing off came crashing in. Later that week my neck began to hurt. I thought I slept wrong. Then the headaches came; 800mg of Ibuprofen only took the edge off so I could function. I caught myself tensing my jaw, gritting my teeth, something I have never done before. Eventually the pain spread to the front of my neck. I felt like I was being strangled. Only with the culmination of symptoms did I realize I was combating stress, not a misaligned pillow. My man all but shoved me onto a masseuses's table. The masseuse had never felt a scalp as tight as mine. I didn't know scalps could be tense. She marveled at the knots in my neck, head and shoulders.

And apparently, my hair fell out. But I didn't notice until a tornado hit my house and I started utilizing pony tails on a daily basis.

I can't imagine what happened to my cardiovascular health during the Winter of Deferred Worry. Or my endocrine health. Or neurologic.

There is not such thing as "just stress." When you next grapple with stress, please learn from me. Go to a counselor, go for a walk, participate in a prayer group, join a kickboxing class. Don't push it off. It can not be held off forever. And when it builds enough strength, it will come crashing in, taking your health and hair with it.

copyright (c) Elizabeth, Bug's Beef. All rights reserved

T-Man Update, 2017

Seven years ago, I filled my October days by completing adoption paperwork and preparing a gender-neutral nursery for whichever baby was entrusted to us.

Six years ago, I filled my October days and nights by recovering from childbirth, muscling my way through breastfeeding, and marveling at the most extraordinary human*.

Five years ago, I filled my October by reading labels, relearning to cook in the face of multiple food allergies, laughing at my baby’s wonky crawl and adjusting to apartment living.

Four years ago, I filled my October by crying, worrying, researching and otherwise hunting for the breath that had been knocked from me when the pediatrician said, “That’s a language delay.”

Three years ago, I filled my October by watching for problems in a twice-sutured surgical site, fighting off the many shoving us toward public school special education and attending therapy no less than six times per week.  

Two years ago, I filled my October by growing to love T’s preschool teachers and taking naps as Baby N wrecked first-trimester-havoc.

One year ago, I filled my October by wondering if we were pushing T too hard, chafing at the constraints of a small house and laughing at my fabulous five.

This year, I filled my October by marveling at my extraordinary humans, laughing at my fabulous five, and packing moving boxes.

My Extraordinary Humans, At Whom I Laugh:

T

I thought I was a whole person until I met T. Holding him for the first time six years ago I felt more alive, more capable of love, prettier, smarter, calmer, altogether more “me” than I ever had before. It’s the same today. I am the best expression of myself when I am holding my son.

What’s really amazing, is T seems to have that effect on many people. Those who pour their hearts and knowledge and energy into him get it returned to them many times over. The place this is easiest to see is school. I cried on the last day of preschool last spring, dreading the leap to elementary school. By some mysterious mystery, some blessed blessing, T has had a flawless transition to kindergarten. Not everyone knows him yet, but those that do, love him and work hard to keep him safe and push him towards excellence. Getting to watch other people love my son is such a gift.

So, the update on T is he’s doing great. He loves school; school loves him. He isn’t always impressed with my lunch-making-skills, though. The first week of school he informed his teacher that the snap peas I sent were actually trash.

Big N

My refining fire, this boy continues to grow into the most unexpected keeper of zeal. He loves dinosaurs, his best friend, war, cooking, sharks, his stuffed bear, baseball, God, history, family, and extra sharp cheddar. He is still homeschooled, because he is flourishing. He plays rec-league soccer and baseball; this winter he’ll add on basketball. He’s as cute as can be, even while pushing every button I possess.

AB

My girl. She loves purple, kitties and going to preschool. She regularly points out other students and says, “That’s my best friend!” Her teacher is T’s very first teacher, so I know she’s in good hands. She has discovered the thrill of headbands. AB prefers tutus and her brother’s old yellow rain boots. She is wild, compassionate, silly, smart, argumentative and tender. She knows that being strong is great and can be found flexing as often as she twirls.

Baby N

This boy has reached the age of absolute bliss. My favorite age range is 15-18 months. Baby N fills my days with laughter, hugs and raspberries as he explores his world. His run, mischievous eyes, laugh, destructive intrigue, blankie toting, words and babbles are the things that dreams are made of. Hollywood has no fairytale as magnificent as the one I’m living as I parent this stinker.

Packing Moving Boxes:

Whoop Whoop! Yes, you read that right! No more chafing at a small house that I can’t decorate to make my own. We are, after five years here, going to have our own home. I’ve been trying to hold off dancing until we close. I think one of the first things I’ll do when we get the keys is cut a rug in that new space. And pour out prayers of gratitude. Then, actually cut that rug. Because it’s lovely, but carpet and children who eat aren’t a good combination.

Bonus update:

My man, while still being infuriatingly man-ish, is marvelous. He’s in a job where he can be fully himself. The kids rush out the door to greet him everyday. His wife finds his laugh lines charming and his muscles exquisite.

*My husband peeked over my shoulder and provided unrequested editorial advice. He felt that my statement excluded all others and had hurtful implications to the other kids (and him.) One of the more astounding parts of being a parent is being able to see and know each one as my very best, yet not my only. T really is the most extraordinary. And so are his siblings. They take turns being the cutest thing I’ve ever seen, the funniest person I’ve ever met and the one kid I would pick to be mine if I had the whole world to choose from. Just this morning I stopped and stared in the face of the most enchanting child I’ve ever met, absorbed in her beauty, captivated.  So. I’m ignoring the editor.

Me: Guys, sit at the end of the bed so I can get your picture together.

Them:

copyright (c) Elizabeth, Bug's Beef. All rights reserved.

Why We Lie

Three months ago T Man had a routine, follow up appointment. At the beginning of our time I answered a series of questions on a tablet. I can't remember the details, but the questions focused on support for our family. Had anyone directed us to community resources? Had anyone ever asked us how we were impacted by our diagnosis? My answers were overwhelmingly negative. The implication was that those things should have happened. It was an affirmation that we had been very alone through our journey with disability. The questions triggered some grief in me.

Five years ago, the week we moved to our new state, T had his first anaphylactic reaction. Since then we have bounced from one mishap to the next. At each new physician, on each new intake form, with each meeting we are asked if we have a support network.  I lie. I say, "Yes, we have a few friends in the area and out of town family that is willing to travel in times of emergency." Today I was reminded why I lie.

Most days, life just is what it is. Some days, though, the stress wears thin my soul. I've had a number of overtaxing days lately and have thought of those painful questions. I want to read them again, at my leisure, in the privacy of my home, and process through the loneliness. Today I finally called the doctor's office to see if they could release the questions to me. Unfortunately, when the nurse called me back I cried on the phone. I stared at the ceiling and bit the sides of my tongue, but still I cried. I cried AND I told the truth. I told her those questions, by some magic, left me feeling more alone than I did before I answered them. I said I just wanted a copy of the questions so I could process my grief on my own. She asked me if I needed a social worker to let me know what resources are available. I told her no, what we needed was people. She said she would have a social worker call me.

Then she called back. Fortunately, my experience as a nurse helped me brace for the crap to come. She told me to call my primary, that they could help me. She wanted to make sure I wasn't in crisis, to be sure I wasn't at risk of harming myself or anyone else. She wanted to be able to chart that she had intervened in my pain and prevented disaster. I let her. I told her, using my cheerful voice, that I would call my primary. I went the extra mile to point out why that was such a good idea. I lied. She assured me again the social worker would call later. "Okay, sounds good!" I lied.

When I told M that I briefly lost my mind and told a healthcare provider the truth about our lack of social support he shook his head side to side. As healthcare providers we both know what folly that is. You see, the healthcare team doesn't actually want to know. Because they don't really want to help. They don't know how, and they don't want to learn how to. So, they ask the questions to make themselves feel better. But they don't want to know when you're weary. If you do confess to having more responsibilities than resources they turf you to social work. Social work adds to your responsibilities by giving you a long list of places to call and forms to fill out. No one quietly listens, allowing you to share your pain. No one says, "I'll take care of this for you." No one cares. So we lie.

In addition to the seven appointments that I'm going to navigate with four children next week, I'll have to answer a phone call from a social worker and tell her everything she wants to hear. If not, she'll flag me as unstable, or give me more work to do. She won't listen to my pain. She won't believe me that all I need is a copy of those damn questions. She won't give me the one thing I asked for. She'll give me more questions, more forms, more calls and threaten me with more appointments.

This is why we lie.


copyright (c) Elizabeth, Bug's Beef. All rights reserved.

Baseball

I don't recall when I started to hate baseball. Perhaps it was gym class when the horrid boys would criticize and hog the field. It's possible that being made to listen to games on the radio caused the thrill to leave. At some point in junior high I began to despise the sport. I watched my stepdad mow the lawn while listening to the game through headphones. My teenage disdain for anything adult-related helped seal the deal. It was a slow, boring game that I didn't like.

When I was in elementary school my family moved to a town that had neither friends nor family in it. Our first home was a townhouse with hardwood floors and 800 square feet of living space. Our part of the complex was built as a square at the end of a lane, with a parking lot filling the square. Sitting on the front porch, which faced south, we could see something like twenty doors. One of them had a family behind it that would prove to be friends.

The family consisted of a husband, a wife, and their two sons. The first summer we lived there, our days of school-free independence were marked by crossing the parking lot to be kept alive by the husband of that family.  Now as I reflect back, I don't know why he was available to watch his boys, plus us three girls, all summer long. Was he unemployed? On temporary disability from an injury? Did he work for the schools? Hmm.

Bruce (the husband/dad) gets credit for first teaching me baseball. He loved the Chicago Cubs, who were not the home team. Anytime the Cubs played, the TV was on. It felt like the Cubs played every single day of that summer. I quickly learned to love baseball. When we weren't watching the Cubs with Bruce, we were looking at his sons' baseball cards, or making fun of the sports cups they left lying around. Their front door should have been painted white with red stitching on it.

When my husband and I were newlyweds, we visited his old stomping grounds on the east coast. My father-in-law arranged a softball game while we were there. My job was to cheer for my man. They were a player short. I was recruited. No sports bra or baseball refresher course were included in my hiring contract. I'm sure I didn't spend the whole game at the plate, but that's all I can remember now. I couldn't hit a fair ball to save my skin. I begged my father-in-law to just call me out. He wouldn't. Toss, clink, sprint halfway to first, turn, walk back, pick up the bat; repeat, repeat, repeat. The horrid boys didn't verbally criticize but their patience wore visibly thin.

A few years later God gave us a little boy, Big N. The first sport he played was soccer. Ah, soccer. No making up games that were cancelled for weather, no sitting around picking at the grass. We all loved soccer. Then the Kansas City Royals made it to the World Series. We watched together. He got hooked. The Royals won the World Series. He fell in love. I tried my level best to dissuade him. It's boring, it's played in the hottest season, you have to make up missed games, and on and on. He was immovable.

So I waddled or dragged myself out to baseball diamonds over and over last summer. I had baby N in the midst of baseball season. There was a snack kerfuffle, it was blazing hot and Big N lost his hat. Baseball cards and sports cups litter my house.

My father-in-law brought us a documentary about baseball. In it, a surprisingly young Bob Costas explains that the slow pace is part of the charm of baseball. I had already figured that out. Being a soccer mom raises my blood pressure; being a baseball mom mellows it out. Big N and I watch clips on YouTube of amazing baseball plays, marveling together at the athleticism on display. He turns the living room into a baseball diamond and executes the most astounding unassisted triple plays you could ever imagine.

Last week I went on a solo road trip and listened to the Cubs game on the radio until I lost the station signal. Tonight I took my son to baseball practice and reveled in it. He encouraged his team mates, he played with the grass, he took counsel on adjusting his swing, he smeared dirt on himself, and he had the time of his life. I love how baseball brings out the best in my son. I like an excuse to get an hour and a half of fresh air three times per week. I love baseball again.

copyright (c) Elizabeth, Bug's Beef. All rights reserved.

My Hand

Google has forced my hand; I am writing a short update. I have been attaching a copyright statement to the end of all my blog posts. As I updated, some of the posts republished. It's rather irritating that my blog is out of order now, but I don't have the spare brains to attempt to fix it.

The reason why I was adding copyright statements to the end of each post is I am wanting to try my hand at writing fiction. A story exploded within me a few months ago. It bounced around in my mind long enough that I started taking notes and writing down the attributes of its various characters. I researched details of the main character's job. I checked out books on how to write fiction. I planned on publishing it a chapter at a time on my blog.

As I have further contemplated the story that must be told, I have pushed it back for a time. Most everyone on the planet agrees that an author's first work is crap. If I'm going to churn out sewage I don't want it to splash on the important story.

In the coming months I hope to craft another story, to get the junk out of the way. If I do, I will publish it here. Though everything is *supposed* to be copyright protected already,  I want to put extra reminders out there for my three readers. Ya know, in case they are asked to write the dumbest sentence they can think of. I want them to come up with their own stupid crap, and not copy mine. ;-)

copyright (c) Elizabeth, Bug's Beef. All rights reserved.