swimming

I passed the chemo test but I'm a bit disappointed with how I did on it. I should have done better and I messed up on a couple easy questions just by misreading them, I hate when I do that. Oh well.

In other news I've taken an ibuprofen and am getting ready to do my nightly ritual of biofreeze on my hips and thighs because they are aching. Why you might ask? Well because I've decided to start training for a triathlon. It's happening here in Pittsburgh in August so I'm giving myself almost three months to prepare for it. I started swimming again a couple of weeks ago, swimming I've missed you so much and I never remember getting this winded swimming as a child. Although when I was a kid I also wasn't swimming laps. I'm planning on signing up for a mini triathlon which will entail a 700 meter swim followed by a 12 mile bike ride, and a 5K run - why do they go back and forth between metric? I thought it was a 12K bike ride, my thighs are quivering just thinking about the extra distance. I also thought the swim was 600 meters not 700. Well I've been training doing blocks at the gym where I go from swimming to biking to running, which makes for a very sweaty and smelly me even though I shower after swimming so my hair won't be straw form the chlorine. I'm planning to buy a bike next month and get outdoors on some trails, I won't ride in the street what with the way people drive these days - yes I sound like a total curmudgeon, like I could be Ed Asner's character in Up. I'm hoping I don't make a fool of myself and drown in the swim part of the triathlon, that would be embarrassing. I really wanted to do it because I'm sick to death of doing the same old thing at the gym every day, especially when the hot guy has been MIA so long, well I've switched to the other gym location, where there's a pool, so I can focus on this triathlon goal. I've supplanted my eye candy fantasies with a goal, it's so healthy it's gross. I miss you hot guy.

In yet other news, on the romance front this time. I've joined match yet again. Third times a charm right? I'm thinking it's more like three strikes you're out and might as well depend on a battery operated toy for fun from now on. No. I don't know why I even signed up again. I have no free time to date. Really, if I'm not working I have the kids. I mean I have my days free right now but come summer that's gone so there's really no time to meet a potential match. After work you might say, well I'm basically an overtired, blathering idiot after 12 hours shifts, given to vitriolic diatribes on healthcare - not really gonna go over well on a first date. And my ideal match would be a doctor. Not because I want to be married to a doctor, and all the sort of social prestige that goes with that. No I want to get the MD through osmosis by being with a doctor, even if I know I won't really have an official MD. I just want to understand more parts of the massive puzzle that is medicine. Really healthcare is a such a huge part of my life now and I want to learn more so I want to date someone that I can learn more about medicine from, and who better to do that than a doctor, well at least a doctor that wants to talk about his job when he's not doing it, I don't know what percentage of doctors are like this (probably less than 5%?). Oh yeah and I need doctors that excel at their job, you know the outliers on the right side of the bell curve. I'm making the percentage of doctors who meet my criteria even smaller (<1%?). Oh yeah and they have to be compassionate, articulate and attracted to me. Now you see the seemingly impossible dilemma I face. In the interim I can reread Atul Gawande and dream.

But can I tell  you a friend, who doesn't know of this blog (not many people do know of this blog) who I knew liked me but, well, I'd told him a while ago, very clearly, that I didn't have romantic feelings for them. Well this friend wrote me a very long, very detailed letter about how he's liked me so much for so long and that I make him feel like a teenager, all very flattering stuff that was written to me. But what do I do, I do not feel that way about him at all. And I can't make myself feel that way. I wrote back right away explaining as much, because there's no way I'd ever leave anyone hanging after putting their heart out there that way (I mean I write back to everyone the writes me on match, even when I'm not interested to just say I don't think we're a match). It makes you very vulnerable putting yourself out like that, I get it and I wanted to acknowledge that while still staying true to my own feelings. So I wrote Thursday night when I saw the message and then again this morning (because recovering from work takes me days). And he won't write back. And I take it I won't hear from him and I guess he really wasn't a friend but just someone waiting for something more to happen between us? I mean I feel bad for him but I'm also sort of hurt, if I don't like you romantically then you won't interact with me? I know I'm not hurting as much a him but I guess it just makes me feel like I was almost lied to in a way. Like there was a duplicity beneath the friendship if he had an ulterior motive and won't be a friend unless that's fulfilled. Does that make sense to anyone?

I don't know why my romantic pursuits are so abysmal. Honestly the nicest, sanest, most normal boyfriend I ever had was probably the boy I lost my virginity to, my junior year of high school, he was ayounger man, a sophomore, a young born in August sophomore. A younger man who had an incredible five o'clock shadow at fifteen?! Eric was an absolute sweetheart of a boy and I fucking dropped him like a hot potato one drunken night and damned if I can find anyone that can hold a candle to that boy back in 1986.

Please don't misunderstand me and think I'm still carrying a torch for him. I've moved on and out of the eighties and he's a very lovely memory. I just wish I could meet someone I fit with so well who is also, well, solid, functional, emotionally healthy. I met a man I loved so dearly. Someone who was an incredibly good fit for me. He was what I always wanted in a man; someone equal parts funny, smart and kind. He was so loving and gentle and that was incredibly important to me during the point in my life that I met him. But it wasn't enough. His circumstances were, well convoluted might be the nicest way to phrase it. But I also realized after being with him that it's important that I'm with someone who's assertive (not aggressive). I also have to be with someone who is driven. Driven, to me, is passionate and I can't be with someone who is scared of living. I realize there are  people who might view me that way, as scared of living, based on my rather high strung nature but I actually face my fears head on pretty much constantly and doing that consistently has made me incredibly resilient, even if I don't necessarily present that way. I just need to find a kind, funny, smart, assertive doctor that is like tops in their field and thinks I'm the best, and I'm similarly smitten by him. How hard can that be? Until I happen upon Dr. Unrealistic I can fantasize about him while I'm swimming laps in the pool.

i've been remiss

I've got all these blog posts swirling around in my head but I haven't had a moment to type them out. Life is getting in the way, I'll butcher John Lennon's lovely quote 'life's what happens when your making plans' and say 'life's what happens when I'm thinking of blog posts' but the post are about life so it gets very meta? I don't know something that would have been masturbatorially discussed in one of my English theory classes in college. The endless litany of semiotics, signifier and signified and I just wanted to read and not let my love of reading be squashed with all the modernity bullshit.

Anyhoo, I've got big things to write about, not really BIG but the little big things of every day. But I can't do it tonight because I've got to take a chemo test in the morning so I'm chemo certified for hanging said cytotoxic agents.

But but but, I worked nights this weekend, trying to help out the team I switched from days because we were short staffed and let me tell you I had a moment on Sunday. I am no longer intimidated by the residents, in fact I had one arrogant son of a bitch resident that was giving me a hard time every time I paged him, which was often because I was having some issues with my patients. One patient told me they were hallucinating and I asked him to come up and assess her, 'What do you want me to do just sit with her? I can put in an order for Haldol.' No I told him I want you to come up and assess her before you decide to put in an order for Haldol. And I was firm without being bitchy. And he came up and wanted to give her Ativan, even though the nurse from the previous shift believed this medicine had caused her hallucinations. So I told him, no we're not giving her ativan. And then he's arguing with me that she can't possibly be hallucinating from Ativan and it must already be out of her system by now, blah blah blah I'm an MD. I agreed that it most likely wasn't the Ativan but the Ifosfamide that she had received as part of her chemo regimen (salvage ICE) because Ifosfamide can cause neurotoxicity. 'How do I treat that he asked?' Methylene blue I replied. And then he got mad because I had an answer for something he didn't know but I was quick to say, listen I'm new to this unit but I had a patient with Ifosfamide induced encephalopathy and he was treated with methylene blue, it's an MAOI strangely enough but does something very convoluted involving acronyms CAA & NADH that you can read about if you type methylene blue into wikipedia. I didn't tell him the bit about the CAA &  NADH and to look on wikipedia but everything else I did.

And then I called pharmacy, poor J- I was pestering him nonstop Sunday night, when he put in the Haldol order to find out just what the dose he put in was going to do to my patient, snow her which concerned me because then how would the morning residents, fellows, attending assess her for the neurotoxicity if she's out? I went in and she said she felt better and didn't want the Haldol so that solved that problem for me. But it's such a balancing act, nursing, ugh it's frustrating and annoying as hell sometimes. And I don't know if this patient's baseline was goofy (my euphemism for possible psych issues) to begin with, were there really hallucinations or was this attention seeking, maybe she needed a psych consult. And then there's the patient in another room that's had encephalopathy for how darn long and it still doesn't seem like it's being addressed, it was being blamed on acute kidney injury but that has since resolved but the patient, still very confused. And I'm thinking should I put a post it in the chart for the doctors to see saying 'Do you think an ammonia level might be a good idea?'. Because I don't have the patient right now but please they're testing for everything else maybe check to see if the ammonia is high, it could explain a lot. Well I've got to take my chemo test on the floor tomorrow at ten. Maybe I'll stick a note in there if I get a chance. They'd never know it was me and maybe that's the probably I could be the nurse equivalent of an elf, fixing things when others aren't looking. We'll see I've got to work on my math for this test first.

full

Totally wish I could go through life as exuberantly as my daughter does

Right now I'm typing with my belly so swollen and tight as a drum from having gorged on food as a way of stuffing down my myriad work related worries (and I'm off until Friday). I'm adjusting to work and it's getting easier but healthcare in general is a super duper stressful field, why else would there be signs for workplace counseling everywhere. I've gotten some very positive feedback but my mind is one that hones in on problems to fix, mine and system wide ones, which means I spend a great deal of time frustrated with things I think should be better. And then I'm attending to my patients needs, which I am happy to do. I haven't been getting so emotionally overwrought from a patient end because I can say with a clear conscience that I do the best I can for my patients in terms of care. This is when being a nervous, borderline OCD person works to my advantage. I am on top of my patients issues and make sure the doctors are aware of any problems too. I've become more confident talking to doctors (well the residents and fellows, I still fly under the radar with the attendings). But this line of nursing, while being incredibly rewarding, also sucks the marrow out of me, so then I feel bad and want to treat myself, even if it's ultimately detrimental for my health. I see so many overweight people in healthcare and now I truly get why they are overweight or smoke or become addicted to drugs or perhaps some combination of all three. I need to develop healthier coping strategies, and my car needs me to because my car seat looks like I'm incontinent of bowel and bladder with the many stains on the tan upholstered seats. The result of too many, cookies, brownies, or other chocolate treats and spilled caffeinated drinks marring the seat until it is now shamefully soiled, in a way no amount of OxyClean can remove.

So I'm an addict. I readily admit it, I'm a slave to sugar and chocolate. I've worn clothes from size 0 to size 12 and even when I'm my skinniest (at least with the sagacity of middle age I do realize, objectively, that I can get too skinny) I always feel and see myself at my heaviest. The fact that I eat in my car often enough to have destroyed my car upholstery, well it's a behavior overweight people do, shameful, 'closet' eating, although I know I'm not in the closet but metaphorically it's the same, in that it's sort of hidden in plain sight, but no one in the mile and a half drive notices how much I'm consuming. I hope to some day have a healthy relationship with food but I don't think I have since I was twelve. I peaked at twelve. I was cute and really very bright at that time. It was a brief sliver of time when my happiness far outweighed my worries. I spent all summer biking, swimming, playing gin rummy by the community pool, running around. I was on the diving team, eating huge lunches of cheeseburgers, fries and sodas and then having room for ice cream. I didn't think about what I ate or that amount, I just ate for pleasure or when I was hungry. And I physically was in the best shape of my life, my body was insanely fit, there wasn't an ounce of fat on me aside from my miniscule preteen boobs. I wore a string bikini and didn't think twice about it. That time was so idyllic for me but even back then I'd feel the worry nipping at my insides, I try to remember a time when that nipping wasn't there but I can't and that's not due to my memory being poor.

hipsta-love, posing in the sculpture garden on our walk to pirates game

I don't want to be a reactive eater but from the moment I wake up in the morning I'm thinking about food. Should I have coffee or try to wean myself off caffeine? Should I give up wheat and dairy because my eosinophil count is high and an allergist checked me but I have no allergies (really?) so could it be a sign that I'm intolerant of some food group? Should I try a juice fast for a few days and how would I survive said juice fast and work at the same time, it wouldn't be pretty. I'd been doing sprints up a hill in my neighborhood to try and strengthen my knees and hips in hopes of alleviating the back pain I've had for a year now, it's mild but it's always there and do you have any idea how annoying constant pain. It's more annoying than painful but that annoyance, well it's enervating. So I've been doing these sprints and feeling better until I decided to go to lulu lemon and try on the clothes there. Why I did this I can't explain since I really can't afford $82 work out pants and even if I could afford them, well it just seems wrong to buy stuff that pricey unless it makes me look like a goddess. But it didn't. The mirrors in that store were like some cellulite equivalent of a fun house mirror. I saw dimples places I didn't even know you could get cellulite, it was horrifying. I walked out and the sales girl asked if I was getting anything and I'm like hell no, I'm going to the gym that clothing session was thoroughly sobering. She said the lighting is awful there. Hmmm, lighting. 

my insane daughter looking like a muppet at the pirates game

I've gained ten pounds since starting work (3 1/2 months ago) and I know I need some 'get real' moment soon or I'll be heading towards a gastric bypass this time next year. My boobs and face look better fuller, everything else is looking not so good. And I feel awful. I'm so fucking tired. All the time. My vitamin D is low (12) so according to wikipedia (what did I do before wikipedia?) I'm falling into the rickets category or severe deficiency. Maybe this is why my back hurts. I don't know. I've got cod liver oil but I tend to forget to take it because I'm too tired in the morning or at night. The allergist was very serious and involved with me when I went to him, on my PCPs recommendation, because of my elevated eosinophil count (since March it's been twice the norm). But when he did the scratch test on my arms and I didn't react to anything, except the histamine control, which you're supposed to react to, well he couldn't explain why my count would be high, and then became dismissive, suggesting that maybe it meant nothing. 

Can I tell you how much I dislike doctors that become dismissive once they don't have an explanation for an aberrancy? Like they get mad at you that you and your problem won't fit into the expected norm for medicine? And maybe it's a result of starting Blink and reading about the fists or tiny slices that reveal a whole but I need a new Dr because when I'm explaining a problem that I'm dealing with all I feel is that this doctor doesn't want to take the time with me, like I'm the easy patient he can zone out on, or easily dismiss. My problem isn't a 'real' problem because I'm not hypertensive, obese and diabetic at 43. Because I present well and my issues are nonspecific there can't be anything seriously wrong with me, like it's normal to have a severe vitamin deficiency, have your eosinophil twice the norm, be in pain for a year and be exhausted. Sometimes I fucking loathe doctors. But I'm planning on healing myself for now, meaning I'm going to try really hard not to sweat the ten pound weight gain, with the window to weight gain (how I love The Simpsons) foods I've been eating with abandon I should be happy it's only ten pounds I've gained over the past three months. I'm going to exercise in ways I enjoy (aside from core strengthening, which I hate, but have to do for my back) and not solely from a I need to lose weight perspective. I'm going to try and listen to my body and feed it healthy foods, which in all honesty I don't think I've ever done. I've got my work cut out for me but I'm up for a challenge. I can look at it as my full body spring cleaning. I love to clean.

Living life so fully requires a lot of rest, asleep in my bed with her monkey

My daughter has nothing and everything to do with this post. Her personality is such the polar opposite of mine. I hope she never has these issues, that she continues to be so confident in herself. She's a very picky eater now, and she loves her sweets, but I don't think that means she's destined for food and /or body issues. I think many picky eaters grow out of it and are fine. I think food issues have much more to do with self esteem than pickiness. 

ilove

I am having major iphone love. One because it took me long enough to buy a smart phone and now after having one for less than a month I don't know how I managed before. And two because I finally figured out how ridiculously simple it is to sync my iphone with my macbook air through itunes and now I've got my icalendar synced to both and I am high off of organization fumes. I can quickly figure out the days I have free, when I'm working and schedule appointments without relying on my memory or my scribbles that I put on various bits of paper, which I then run around trying to find where they are or sometimes dumping my paper recycling to see if I inadvertently recycled them prematurely. This makes my life so much more manageable. And my third reason for loving the iphone, the camera, that was my main reason for buying it, and now my hipstamatic envy, well I no longer have to be envious although I do need a tuturial for the various lenses, I'm stuck in a green hued one. Now if I could only figure out what how to make the cute little black hearts on facebook. Or what pinging is.