crazy miracle called * life *

Hold my heart

2009-11-06T12:50:28+00:00

How long must I pray, must I pray to You?
How long must I wait, must I wait for You?
How long 'til I see Your face,
see You shining through?
I'm on my knees, begging
You to notice me.
I'm on my knees,
Father will You turn to me?

One tear in the driving rain,
One voice in a sea of pain
Could the maker of the stars
Hear the sound of my breaking heart?
One life, that's all I am
Right now I can barely stand
If You're everything You say You are
Would You come close and hold my heart

I've been so afraid, afraid to close my eyes
So much can slip away before I say goodbye.
But if there's no other way, I'm done asking why.
I'm on my knees, begging You to turn to me
I'm on my knees, Father will You run to me?

So many questions without answers,
Your promises remain
I can't see but I'll take my chances
To hear You call my name
To hear You call my name

Hold my heart, could you hold my heart?
Hold my heart.

tenth avenue north

Witnessing a Miracle :: N30010 Clinical Journal Entry #22

2009-10-31T20:54:31+00:00

I never thought OB nursing would be fun.

I had an open mind, but I doubted I'd enjoy checking cervixes, analyzing fetal monitors, teaching breastfeeding, and watching women push watermelons out of tiny little spaces, yet I cannot even begin to tell you what I learned and experienced yesterday.

I'll give you a hint... it revoled around this:

Friday was pretty interesting. Our instructor is great, but she's a little scatterbrained so she sent out an email a few days earlier to ask what time she told us to get to the hospital on Friday. None of us really knew - she said 7:30am, but some of us (okay, myself only) thought the schedule had us there at 7am, so we all got there at different times. I was the first student there, and Instructor told me if I hurried, there were 2 or 3 births happening right then.

On this unit, we wear the hospital-issued scrubs (all of the nurses on the floor do, too, probably because there is a high risk of squirting, splurting, splashing, and umm getting attacked by about 10 kinds of bodily fluids) so I changed really fast, and then she told me where I'd be for the day since originally, I was scheduled to be on postpartum. It turned out one of the births we were "hurrying" for had already happened and the other involved a mom who did not want a student, so Instructor gave me a patient who was thought to deliver soon. Not the case, but it gave me something to do, so it worked out okay.

Mom was 20 years old, a primapara, and had come in late the night before with contractions after losing her mucous plug earlier in the day. She had a relatively healthy pregnancy, and we were planning on a normal vaginal birth. Around 4am, her membranes ruptured and she had an epidural. It slowed her progress a little, but she managed to be dilated to 6-7cm by around 8am, and 9-10cm by around 10 or 11am. There was one little problem though - she had something called an anterior lip where 1-2" of her cervix was holding the baby's head in. The RN I was with had me feel it, and my instructor later told me that she has never had a student who was (what she called) "privileged" enough to do a vaginal exam on a mom. She said it wasn't our job, and most RNs don't trust students with it anyways. Well, I assumed it's what we had to do in the class, so thinking nothing of it, I just felt around as my nurse told me what I was feeling. The weirdest feeling in the world was to feel the baby's head in there - it was so distinct, and when the nurse told me to feel for the baby's fontanels, I felt them so easily. I had never thought about it before but sure enough, I had no problem blindly feeling what I had only felt on a live, visual baby before. I was able to feel the anterior lip, too, which in itself was also distinct. It felt solid and small, yet I could tell it was holding the baby's head in. We made Mom comfortable and helped her get into more of a 90* sitting position (rather than lying down) so gravity could help push the baby onto the cervix. And that was that.

A couple hours later, my RN suggested we see if the baby had moved at all or if the cervical lip had softened to the point of moving.We figured labor was progressing on it's own though when we saw that the baby was starting to go into early decelerations (on the fetal monitor, it shows up as a transient decrease in Baby's heart rate just as Mom's contraction starts, usually because Baby's head is compressed in the later stages of labor) If the cervical lip hadn't improved, the nurse said she would try to maneuver the baby and the cervix a little so we could get the baby out. RN had Mom do a small push just to see if the baby could pass by the cervix she thought had moved out of the way, and sure enough, the baby was on her way out. Since Mom was only a few pushes away from having her baby, we really didn't have time for much of anything. RN had me hit the call light while we all but delivered the baby before anyone else even came in to help. 2 residents barely made it in on time, but they were able to finish up the delivery and remove the placenta. We got a nurse into the room about 5 minutes after the birth, and she took over the baby while my RN worked with Mom. Then there was the OBGYN who came trailing in pretty late, only to find out there was nothing for him to do. I just helped Mom and the 2 nurses, and the residents showed me all the "features" of the placenta. (Which, by the way, is the most disgusting part of birth as far as I'm concerned, and if I never see a placenta for the rest of my life, I will be more than fine.) The umbilical cord was wrapped around the baby's shoulders, and she came out with too much fluid in her lungs, but by 5-10 minutes, she was doing fine. The nurses on the unit are so experienced, and my nurse knew to give Baby her Vitamin K shot early to help initiate her crying. She said typically, the injection is given a little longer after birth, but she knew in this case, the baby needed to cry and get the fluid out of her lungs, so she gave it right away. It worked, and with some O2 and suctioning, we were able to get Baby in healthy respiratory shape by her 10 minute Apgar score. It was an interesting experience how the RNs and myself knew the baby wasn't completely okay, but I followed their cues and didn't let on at all to Mom and family. In the end, I saw how they knew Baby would be okay in a short amount of time, and that's why they were able to help Baby while not freaking Mom out. (If Baby wasn't going to be okay in the end, I doubt they would have covered it up so well.) The nurses on the floor can be kind of snappy to students, but most of them have been on the floor for literally decades and know their stuff inside and out. During labor and delivery, they know what they're going to do, and they do so seamlessly and gracefully without showing any signs of fear, shock, or stress. A few times over the course of the day, my RN would answer a question with, "Not now," and yes, that might sound mean to some, but she would always gladly answer any question I had after we were out of the room or out of that circumstance. She knew the timing of the events and the signs of certain progressions of labor, so I trusted her and saved my questions for later, even when I didn't realize until later why she was having me wait. I can't wait until the day comes where I am happily on a certain floor for that long and can have a routine down pat to that extent. Must be nice to have the skills and intuition only experience can provide.

My patient's birth kept me pretty busy for the rest of the day, but I do want to share another experience I managed to squeeze in. A little something that, like the placenta, I really don't care to see or experience ever again in my life.

We have 2 groups from our school on the labor & delivery, postpartum, nursery, etc. floors every Friday. A student in the other group mentioned to me his patient was going to have an epidural. That sounded pretty interesting to watch, and I was momentarily bored, so we asked the patient if I could observe, too, and she was fine with that. Picture the most freaked-out-Mom TV birth you've ever seen, and that's kind of how this woman was. She was screaming and going crazy at every contraction, and after waiting maybe 20 minutes for an epidural without any signs of an anesthesiologist, she decided she was going to get nasty. (To be fair, I will say that she did apologize later once her epidural had kicked in.) She was screaming obscenities and yelling at the anesthesiologists once they arrived... it really was quite interesting. We have nurse anesthetists on the floor, too, and the whole anesthesia team really does try to make sure the entire floor is medicated to each patient's requests, but it was a very busy day on the unit, so she had to wait maybe a half hour or so. Anyways, the anesthesiologist later told the patient he really didn't think she could sit still enough in the certain position required to get an epidural to actually get an epidural, but surprising us all, she calmed down once he came into the room and began the "procedure." First, he kicked everyone out, including the husband/baby-daddy/whatever he was. I later asked about it, and his reasoning was "too much distraction." Okay, buddy, but if you were having a baby I think you'd want your spouse with you while you got a ginormous needle jabbed into your spine. Just saying. Anyways, once everyone but the patient, anesthesiologist, RN, myself, and the other student were gone, the doctor set up sterile field, went crazy applying Betadine, and numbed the area on the patient's lower spine with an injection. Then he picked up this needle that looked more like a drill and inserted it into the patient's back for what seemed to be about 6 inches, but what I know could not possibly have been that far. Once it was in, he threaded a thin catheter through the needle, pulled the needle out, and secured the catheter into her back with adhesive. Then he cleaned up his mess of wrappers, fluids, and needles, and he was off. And I was extremely disturbed by this poor woman enduring a needle being inserted about 10 feet into her spine (again, exaggeration, but it looked like he was putting it so far in it would come out her stomach!) all alone and without her husband, mother, sister, friend... all the nice people the anesthesiologist kicked out. After my entire day, I will say that my patient having her baby looked much less painful than the epidural, but who knows. I'm really not qualified to make such a statement since I have experienced neither. Just save the epidurals and the placentas for someone else. Both make me want to vomit.

Other than that, I had more fun in my first OB clinical day than I ever thought I'd have! It's messy and kind of eliminates any recollection of the term "personal space," but it's what millions of healthcare professionals deal with every single day, and it's an experience billions of women have gone through since the beginning of time.

Somehow, though, I think what my clinical instructor said on orientation day will always be true. She said that obstetric nursing makes you forget it's medicine and science. It makes you call the same experience you've been through thousands of times, a miracle. When you think of the few life-changing "events" individuals experience throughout the lifespan, having a baby is one of them. OB nurses experience these huge, amazing events with a handful of patients each shift, while most other jobs can't provide anything even close. Kind of crazy...

Seriously, Cavs?

2009-10-28T03:16:44+00:00

Ahh... tonight, my boy Mo Williams couldn't even save the Cavs. I knowingly got ripped off in a desperate attempt to attend the Cavs season opener game (lol) but I donned my new Mo Williams jersey and went to Cleveland with the fiance to see the Cavs take on the Boston Celtics only to LOSE 89, 95. Come onnnn. We have LeBron, Shaq, and of course, my boy Mo Williams! No excuses, guys. Absolutely pathetic. We started out the game completely on fire and then it got pretty intense... until we lost. :( Well, at least my hot dog was delish, I had a night with my fiance, and it was free t-shirt night! Ohhh, and I looked pretty schhhweet in my new Mo Williams #2 jersey!! :)

Here's a few movies from the night, mostly the beginning like intros, tip-off, etc.

I have lots of pictures, too, but I'm having issues with my new camera... they will be up soon. :)

And the next unit is… :: N30010 Clinical Journal Entry #21

2009-10-24T18:07:01+00:00

... labor & delivery! Not sure if this is a good thing or a bad thing, but at least it's not peds.

I absolutely hated my pediatric rotation. Hated. Dreaded. (Yet I LOVE pediatrics... get that.) Peds was miserable. First of all, the low patient census and the fact that (I recently learned) the Cleveland Clinic is just not a large pediatric center, made our instructor overly eager to pair 2 of us up with 1 patient. Patient sharing is good for maybe your first one or two days in clinical (as in, ever) and that's it. We didn't get much experience doing anything, and if we wanted to learn, it took extra effort on our part. Our instructor was a far better lecturer than clinical instructor, the drive to clinical was too long and too early, and well, I could go on. Then there was the fact that our instructor failed some of our papers for no good reason at all. She have me a 16.75 out of 30 because she didn't like the order of my headings, and I made a couple tiny APA errors. I questioned her about it (politely!) and she said I didn't include half of the points listed on the paper description on the syllabus, to which I got even more upset seeing how I went over it a zillion times and checked each point off as I put it into the paper. Then, when I didn't do so well on our proficiency tests, she told me I "didn't even try." Right. Funny how I came to her for help after taking the practice proficiency tests, and she had nothing to do or say. I talked to some of the other students who had her for clinical, and they told me she did the same to them, too. Out of the 5 or 6 clinical instructors we could have had, we got her. Partially thanks to her, I hated peds, and totally thanks to her, my final grade in the course dropped from a high B to 1 point below a B. Did she take a calculator to figure out the exact grade she could give my paper to drop my course grade an entire level? They say nursing professors can be vicious, and unfortunately, I just experienced my first one who was truly, completely unreasonable. I asked her if I could come in during office hours to talk to her about my paper so I could learn to do better, and told me she didn't have anything to tell me other than to go ask for help at the library. What?!?! The library staff would have probably told me I had a good paper. Seriously... I rarely can't stand certain people but I'll have to say I really can't stand this professor and am thanking God I don't ever have to talk to or see her again.

So Tuesday was our pediatric final, and Friday began our Parent and Newborn Nursing rotation. Until the end of the semester in mid-December, we will be working on the Labor & Delivery, Postpartum, and Nursery units of our local city hospital. (Only a 20 minute drive, hooray!) Our clinical instructor seems really nice and fair (a little free-spirited, has a lot of rules but doesn't seem like she's good at enforcing them), but we only got to see her for a few hours yesterday because she went home sick with H1N1. (Or that's what she thought it was...) So we got a half day off, which was nice. I spent the extra time getting my H1N1 vaccine since my doctors office finally got them in. All of the local hospitals ran out of vaccines, and it just so happened my PCP had them in when I called to check on Friday. Then I went thrifting (because I love thrift store shopping!) for a little before coming home and getting started on our OB/L&D worksheets. (Using our very graphic textbook of course. The picture of the placenta makes me want to vomit!)

As I said, I'm not sure about OB... let me have more than a few hours of orientation, and I'll get back to you. I was assigned postpartum/nursery for the next 2 weeks, followed by 2 weeks in labor & delivery. Then for the remaining weeks, our instructor said she will try to put us on units where we haven't gotten experience. (eg, if we didn't get to see a C-section, she will try to get us on labor & delivery with a patient who may be getting a C-section)

So that's that.

Then there's my little girls on Wednesday. I took L Bug to the pumpkin patch on Wednesday while Mom kept Baby S. (Mom's still on maternity leave.) They had a petting zoo, a little kids train, pumpkins (of course!), a corn maze, etc. I'll have to post a picture or two... we had so much fun! I love Wednesdays. I think even after I graduate, I'll stay with this family until the girls are both in school and don't need a nanny anymore. It's only 1 day a week (Mom works from home except for 2 days - 1 of which I have, the other which Grandma has) and I absolutely love the family. So, so fun.

This week, we have our first OB lecture and clinical of course, tomorrow I go see my liver specialist and a new pain therapist, Tuesday I'm getting my hair done and going to see the Cavs season opening game (!!!) with Jonathan, Wednesday I have my girls, and Thursday I have a genetics exam. Big week. It doesn't ever end.

I want to get married, graduate and get a job, have our babies, live in a nice little condo, you know, be a grown up. But still, it's just living day-to-day. I think that's what it'll be like for the next year and a half, but you know what? I believe everything happens for a reason, even things that seem wrong, messed up, confusing, or just plain "not part of the plan." I think we just need to fight hard, love harder, and let life happen... and be grateful for every minute of it. ♥

Never alone

2009-10-19T18:40:58+00:00

words by the fabulous audrey hepburn, art by the fabulous vol. 25!

Dreams and visions

2009-10-17T23:48:47+00:00

Yesterday I was dreaming on the highway. It was around 6:30am and I envisioned myself side-swiping the truck next to me. When I got home about 12 hours later, I realized it wasn't a dream. Go look at my car if you don't believe me.

Tonight I had my girls so Mom and Dad could go to a charity function. My tiniest (10 weeks) decided she wasn't going to go to sleep, so I rocked her back and forth, back and forth. Seconds turned to minutes, minutes turned to hours, back and forth, back and forth. Then, as my heart was breaking deeper and deeper, all of a sudden, it happened again.

The dreaming, I mean.

This same nursery was all of a sudden in my own home. A beautiful wood crib, a dresser, a sweet little lamp, and those coos that can stop you dead in your tracks. There was a baby here. Finally.

I closed my eyes, and I was in the suede/microfiber rocking chair and ottoman set that I have in my basement all ready for when this life finally happens.

Back and forth, back and forth.

The door was ajar, the tiniest bit of light peeking through. It widened, and I looked up.

Jonathan came in.

I looked down into my arms at this precious manifestation of love, hope, and sheer miracle, and then my eyes met the ones I loved first. He kissed me softly before peering down at our daughter and kissing her forehead. He didn't have to speak a word. His eyes said every feeling in his heart.

And that was it.

Then my heart was ripped out again as I realized that dream may never be reality. Sure, I can dream of getting hit on the highway and that will come true, but the most honest, purest of things? I can dream it every single night, and yet I'm still here alone, yearning, grieving.

A long time ago, many different people told a pained, confused little girl that Jesus loved the little children, all the children of the world. Their eyes looked so sure. Maybe they were. Or maybe the little girl was still too naive to know any different.

It didn't take long for her to realize that those children grow up. And then what? Are they lonely like me? Why?

How Much Farther Must I Go? :: N30020 Clinical Journal Entry #20

2009-10-16T20:16:41+00:00

I guess I'm not going to write about clinical today. Everything that could wrong, did. My health problems surfaced and, technically, you could say I got into 2 car accidents on the way to clinical this dark, frigid morning. Every day I doubt my intent more and more, and well, I just don't feel like talking abot it right now. It was, however, our last day of peds. I just have to make up a pediatric proficiency test (long story - I missed it because I was home in bed crying), take the final on Tuesday, and then I'm off to Labor & Delivery.

I am still trying to get my bearings from doing something I'm pretty positive I can't. I know that's a terrible attitude to have, and I know this is the path I'm suposed to be on, so maybe that's why it's so hard. Lately I've been hanging on to these two songs by Christian artist FFH and last night, was blessed to be able to see them in concert the second time this year. They live what they sing, and they have an amazing story to share.

Happy Weekend, Friends

How much farther must I go?
Until you say that I'm broken.
How much heartache must I know?
For you to say enough's enough.
How many teardrops have to fall?
For you to see that I'm empty.
Is the reason for this all
So I'll admit I'm not so tough?

So come and stop the bleeding
I think I finally understand
So come and stop the bleeding
If you can

How much desert must I cross?
Till I come to the Jordan
I am thirsty and I'm lost
My heart is weak and emptied out

So come and stop the bleeding
I think I finally understand
So come and stop the bleeding
I've tried to fix this but I can't
So come and bring the healing
I think I've had all I can stand
So come and stop the bleeding
If you can

Last night, Jeromy told us his story (which I love hearing each and every time)

Anyways, moved to Africa... One of the pastors of the local church of about 200 people asked me if I would come consider coming back and sort of doing some worship leader training and spending some time there, and I said I would love to, but for man, six months? I said I'd have to do some checking on that. I went home and talked to Jennifer about it. And Jennifer, you have to know she has been open to whatever the lord's will is ever since I can remmeber and ever since she was a kid, she has always told God, I will go whevere you want me to go Lord, I am yours, I lay it down, I'll go anywhere .... Except Africa.

So I got home and I said, "Hey, umm, I think we need to go back there." and she said, "I already knew. I knew when you called me you were trying to manipulate me into moving there."

So 6 months later we end up there moving back into our little cottage. No heat, not air conditioning, had running water but no cable television, no land line phone, no high speed internet unless we pirated it from the people next door which we could do if we were like in this one part of our bedroom... No Starbucks. And it was hard at first, not just 'cause of the stuff we were living without, but because the South African culture, the African culture in general is difficult to get used to. It's very relational. Everything is about each other. We seriously, in the first week or so there, we had people show up in the middle of the day that we didn't know, people from the church that just wanted to make us feel welcome. And they didn't know us; they just showed up for tea in the middle of the afternoon, and they werwe coming in no matter what. They didn't call first - they didn't let us know they were coming. They just showed up. If you were in your underwear, it didn't matter - they were coming in! They wanted to make us feel welcome but they made us fel weird. And then we were out of all the things we were used to having. It was culture detox for a while.

But we started to love it - the importance of relationships grew on us and grew on us until about halfway through, we bought onto the whole thing. We were excited to get back here. It was a planned 6 months, and we missed home. We missed our country. We love it. We do so many things right here. But there's some things we missed. And one of those things is the imporance of time with each other, not time with each other watching TV, time with each other. Loking at each other. Staring at each other in the eye. Watching the sunset with each other, something that we did for six straight months that we thought while we were doing it, "Man I wanna go home," but we came home and we thought, "Man I wanna go back."

We had to go the whole way to Africa to learn what relationships look like to God.
We had to go the whole way to Africa to start to feel like we were comimg home.

After spending six months away, the first time spending six months at the same church every Sunday... you know we had been on a tour bus for the first 10 years of our marriage, some 200 days of the year on a bus, sleeping on different bunks. And it was so nice to be there and just be alone and together and to rest. My last journal entry coming back sounded sort of like this 'Lord, I can't go back to my old life. I feel so different and it just doesn't feel right.' And we were sure, and when you say positive, that the Lord was moving us into someting else. We were sure that we weren't going back into FFH. And we got home and expected the Lord to tell us what was next, but he was completely silent, which was so frustrating. Becuse here we had just waited and rested and been alone with God and detoxed for 6 months and it was like, come, hit the ground running.... and we didn't. We prayed and we saught, but God said nothing. And now that may sound lazy, but for me, tht was torture. I am not the kind of person who is bent to just do nothing. My parents used to tell me to just get up and do something, justify your existence. And that somehow stuck in my mind, and for me, busyness meant success. So just doing nothing was impossible. It was hard.

Jennifer was pregnant when we got back from South Africa. Sadie Claire, we got back in the spring and she was due in the fall and Jennifer and I really liked the doctor she was with, so halfway through the pregnancy, we said forget about doing anything else, let's just sit here and hang tight... We were staying put for a while. We were waiting some more. It took until December of 2008 till the Lord started to put it back on our heart to go back to this again. At first, we were like Really? Surely you don't mean that God? And he said Yes. And we knew it together. And it was not like an almost.

And you have to know when we were in Africa, we sort of had this list, we never wrote of down, of things that God would have to do for us to be confinced he was pushing us back into the life of treaveling and touring and singing. We were so much loving enjoying being a familing and having some normalcy. One of those things though was that we'd get to take our kids, too, with us wherever we went. And especially with Sadie coming, we didn't want to have this dual life....this life we had at home that no one understood It just didn't work. So we said, it we said if we ever do this again, our kids are ocming too. We started back in Februrary and our kids haven't missed a show.

Sadie was born in November, in August I was diagnosed with MS after having strange and debilitating at times neurological symptoms which started even before we stopped our FFH tour for awhile. I couldn't figure out what it was. We went to doctors and was misdiagnosed a couple of times. It was like both extremes - One neurosurgeon said 'You you know, you have maybe MS, looks more to me like an inoperable tumor' while the other guy says, 'This looks nothing more than like injury to me.' I was poked and prodded, and it was like 'Why can't I use my arm?' It was horrible for me, and horrible for my family because I was so depressed. I was in a lot of fear because confusion leads to fear and fear leads to confusion - they sort of go hand in hand. I was such a mess.

In Africa I was such a mess. Jennifer was like, "God, you got to get ahold of yourself." Then we came back and I got diagnosed.

Diagnosis was a relief of sorts because it wasn't a tumor, but it did mean I was going to live my life this disease. You don't die from MS, but you do live with it. And if you don't sort of get it in check, it can be debilitating. Doctor looked at me in our first real appointment after the diagnosis, and he said, 'Man, you guys are going to need to prepare yourselves for disabiliity. I don't want to candy-coat this for you. You have 7 normal years left.' I wasn't satisfied with that, but I also was relieved there was a timeframe. During that visit, the doctor gave me a chance to get into a clinical trial for a new MS medication, and I opted for it. It's 4x better than anything available, but I was sort of a guinea pig. He put, at the time, 5 people in it. It's chemo once a year and it's working great. I feel great. My prognosis is way better than it used to be. My MS numbers are way down, and most days, the only time I think about MS is when somebody else askes about it or I'm taking my pills, so I'm thankful for that. I've had 3 relapses but have been in remission for over a year.

One of the things I've discovered in being given this gift is that God does this to you. I know that's hard for some of us to swallow because I've had friends try to talk me out of that theology, but Jesus says I don't have to. We've Jesus and I have sort of worked this out together, and in the Bible, He says 'I bring calamaty', and he also says 'I have wounded you so I may heal you'. If I feel like God knows the future and He can change it and didn't, then he gave this to me as a gift. Sometimes it doesn't feel like a gift, but sometimes it has because nothing would have slowed me down except for the Lord taking away my health. I would muscle through anything else. Come hell or high water I was going to make it on my own until I couldn't.

Look, don't get to the point to where you're missing so much that God has to sit you down physically, to get you see your wives, men, and to get you to rub your hand through your kids' hair, and kiss 'em, to look 'em in their eyes and hold 'em when a lot of other things seem important.

The lesson that he taught me in this is rest. I know it seeem like such a simple thing especially since my message from the stage has always been evangelism - come to Jesus. But my message now is rest. It's what the Lord gave me for this time. And rest is not as sort of an option for me but rest as in one of the 10 commandments. Be still and know that He is God. Be busy, and you won't.

That's how it was for me. I thank God for this gift because it's made me different. The Lord took my family over the past three years, two years, literally into the desert. And we hated it at first. I know some of you are shaking your head - it's because you're going, 'I'm there and it is not fun.' We hated it at first because it was so uncertain - it's like you close the blinds to the future and the past, 'Here's your sand. Walk on it.' But then we started to love it beccause it was the wide open space with Jesus. Does that make sense?

And it wouldn't happen without MS. Without going back to Africa. Without all this slowing down time. The Lord taught us a lesson, getting away with Him. And I don't mean a 10-minute kind of a deal with your Bible study. That's all good but I'm talking about disconnection like Jeremiah 6.16 says 'Follow me each into paths of Sabbath rest.'

You know that word for the "Be still and know that I am God" verse? That word is still is Rapha. It's the same word in the Hebrew as healing. Be still, Rapha. God calls himself Jehovah Rapha, the Lord that healeth thee. And in the busyness of Chrsitian life, church life, what would it be like if we were just still? No sermon [pause] Would it feel weird at first like it just was then? But then it would become home. And when you're still, you can feel yourself breathe. And when you breathe, God takes dead air and turns it into life, the same way he took dead dust and turned it into Adam.

Can we just be quiet... and lisen. Do you know God can talk to you?

I'm still sorting it out myself, but I know there's something to that, and I believe if we lived that way, we wouldn't have to tell people about Jesus. They'd be like, 'Whatever that guy has, whatever that lady has, I've gotta have that.'

So this is what it feels like to walk the wilderness
This is what it feels like to come undone
So this is what it feels like to lose my confidence
Unsure of anything or anyone.

Do this is what it feels like to wlak the desert sand
This is what it feels like to hear my name
And to be scared to death because I'm all alone
But feel love and peace just the same.

And this may not be the road I would choose for me
But it still feels right somehow
'Cause I have never felt you as close to me
As I do right now
This is what it feels like to be led.

So this is what it feels like to have it fall apart
To be totally unglued
And find out if I accept my brokenness
That I get more of me, I get all of you
But this is what it feels like to be on shaky ground
Careful of every step I take
Realizing as I stop to look around, I look around and see everything
A different way.

And this may not be the road I would choose for me
But it still feels right somehow
'Cause I have never felt you as close to me
As I do right now
This is what it feels like to be led.

This is what it feels like to be led.

So this is what it feels like to just walk away
From every thing I thought kept me safe
To depend just on you for every meal
And find it's better this way
Oh, it's better this way.

And this may not be the road I would choose for me
But it still feels right somehow
'Cause I have never felt you as close to me
As I do right now
This is what it feels like to be led.

Taylor Swift : This love is difficult, but it’s real… It’s a love story, Baby just say yes!

2009-10-14T23:17:39+00:00

I absolutely splurged and bought floor tickets to Taylor Swift's 10/3 concert at the Q for my little sister's 20th birthday. (Man, doesn't 20 sound so old?? She used to be 2 you know...)

The concert was much better than I thought it'd be, and the seats were way better than I had ever imagined.

Gloriana opened for Taylor, and they were really great. We knew them from their single, "Wild at Heart." Here they are...

Then came Kellie Pickler who seems like so much fun in real life! She was wearing super-high-heels absolutely covered in glitter and had a matching microphone. So fun!

When she sang "Red High Heels," someone actually held a red high heel on stage, which she of course autographed. It was so cute.

Then, among a screaming, cheering crowd and posters of Kanye West with his head crossed off and saying things like "Why'd you have to be so heartless?" Taylor came out to to begin her show.

Completely amazing...

I have a string of YouTubes, too, but this one, you absolutely must see. Taylor is even more humble than she looks to be on TV, and Cleveland, well, we obviously love Taylor! Check out this video!! (Oh, and keep it on because White Horse is afterwards - one of my faves!)

Here's a playlist of all my my YouTube concert videos... scroll down for the set of Taylor. I have Kellie Pickler and Gloriana on there, too. They were great!

I hope my little sister enjoyed herself at my wallet-breaking concert! ;-) She seemed to have a great time which was all that matters.

Happy Early Birthday, Nikki!!!

Oncology Day :: N30020 Clinical Journal Entry #19

2009-10-11T02:48:14+00:00

Did you know that a child's leukemia takes 3 years to treat, maybe a little longer if the child is a male? Did you know that every day, all over the country, kids pile into outpatient oncology offices to see doctors and nurse practitioners or to receive chemo or blood transfusions? Or how about the safe "dosage" of any blood product? (It's 15-20mL/kg.)

Those are just a few things I learned and experienced on Friday when I got to leave our clinical floor for an "alternate experience" at the hospital's outpatient pediatric oncology (aka "hemonc") unit ...

For 8 of our clinical hours, I experienced a field of nursing that has always seemed interesting to me. I think it all started a few years ago when my grandfather died after several weeks of fighting in the hospital, after several weeks of our entire family practically living on the oncology floor. I spent my entire spring break and most of my time out-of-classes there with them, and I marveled at the compassion of the nurses and the strength of the other families there. Grandpa died there, and the experience was absolutely excruciating, but the nurses helped us through every step. I've worked enough on different floors as a student and nurse technician to know that I need a floor where I can join other nurses to care and use our hearts every minute of the day. Most floors just aren't like that, but the oncology floor was. And then, I've wanted to work with kids ever since I wanted to be a nurse, but at times I've wondered if I was strong enough because of my past and also because I really think if any nurse would get compassion fatigue, it would definitely be me. I do everything with every single piece of me - I can't help it. I have a problem "leaving it at work," and I take it on as a personal job to make sure every single patient I encounter is treated like the best person in the world with everything I can find to give. But Friday taught me that I really feel I want to go into pediatric oncology.

First thing in the morning, every single day, around 7 or 8 doctors and nurse practitioners and a handful of nurses join a psychologist, social worker, secretary, and child life specialist to discuss the day's planned children and where they are in their treatments, what their latest tests have revealed, what they were coming in for (chemo, consolidation, blood, visit, tests...) etc. It's an amazing 45 minutes where every person is completely in tune to what's going on so they can cater their speciality to the kiddos as best as they can. Knowledge is power, and these meetings really displayed that. The unit just exudes cohesion. Everyone is on the same page.

After the AM meeting, the patients started rolling in. For each new folder we'd see in the "inbox," we'd walk to the waiting room and call the child's name. The nurses all know the kids inside and out, so usually it's more of a, "Hi, Amber, how are you doing? Wow, I love your coat!! How was school this week? How is your new puppy?" Then came vitals, and we'd do a height, weight, BP, and temp on each child before bringing them into a room. After a normal run-down of questions, each child would get a blood test (CBC, CMP, differentials, type and screen) either peripherally or through the ports in their chests. I learned that the "Mediports" are like Hickmans, not Broviacs, and I learned the pros and cons of each. Most of these kids have Mediports, so I handled an extra the nurses keep for an example, and I was able understand the idea of them so much better. They can be challenging to draw blood from, but they make life a little easier for the kids. We had to use a sterile field to draw the blood, and we wore masks so we didn't risk getting any germs into the port since these kids are so immunocompromised.

Anyways, after we had our blood, we would flip the flags above the door to signal the doctor or nurse practitioner that their patient was ready, and then we'd send their vials to the lab to be analyzed. After seeing their practitioner, each child would hang out until their lab results returned. If their counts were low, they would have to stay an extra few hours to get a blood transfusion. If their counts were good, they could go home. Some kids had chemo treatments scheduled for after their office visit, and they would go get started on chemo and sometimes receive blood later on. Oh, and we monitored each kid on a big list the nurses made to make sure everyone has had their flu shot!

Chemo is a crazy thing. To hang it, we had to put special gowns and gloves on, and before we gave it, the kids would often get IV Zofran to prevent nausea and vomiting. The kids and their parents would each get their own room where they could watch TV, play games, watch movies, eat lunch, do whatever they wanted, and there was also a bigger room with a bunch of activities if a child wanted to go play with other kiddos. They would hang out all day until their chemo and blood (and sometimes IVIG) were transfused, and then, exhausted, they'd go home. For some of these kids, this is their routine 3 days a week, for others, 1 time a week.

I'm not sure if all peds outpatient oncology units do this, but at least for here, the doctors work closely with an organization called the Childrens Oncology Group, or COG. COG, from what I understand, is an organization comprised of doctors, nurses, researchers, scientists, etc., and they work on maintaining very, very specific (down to the day) treatments for each kind of cancer, also dependent on the child's age. Their treatment plans are called "roadmaps," and for example, it will say for ____ type of cancer, the child must get ____ kind of chemotherapy on day 35 of treatment. Of course, each child's doctor could modify theirs if they wanted to, but outside of unusual circumstances, they don't. Then, if the child and their family agree to be in the "study," the doctor would continually send in each child's progress on the treatment, samples of tissue if they get any kind of tumor removed, etc. COG takes all of their patients on each of their treatment plans into account and will modify treatments if they "discover" something revolutionary or even just realize something isn't as successful as another option would be. The plans are up-to-date and completely cutting-edge, and it's really amazing how this system works together. One of the nurses told me COG is the reason pediatric patients recover from cancer at a much higher rate than adults. Parents of kids with cancer are desperate to help out other parents, to help progress the study of pediatric cancer so that someday, it won't hit families like it hit theirs. They are in this for their child, and they want to do everything they can to make sure this doesn't happen to any other children ever again.

There were three patients who really made an impact on me during the day. L, R, and N. L was a 10 year old who hadn't been to school in months because of her leukemia-stricken immune system. She was in for blood and chemo, and one thing she was really dreading - 4 injections of a drug called asparaginase. It's a form of chemo that has to be injected, 2 shots in each thigh. To make it as bearable as possible, 4 nurses injected it at the exact same second after counting to three. They're deep shots, but the drug itself is what makes it so painful. L had EMLA cream applied before hand, and she also treated each thigh with ice before the injections. L told me it just stings incredibly bad, and the sensation took awhile to go away. This was her third dose of the "4 shots", and she only had one more left after that. I told her how amazing she did - I would have been bawling! Not her. These kids are strong.

Next, R was in his early-20s (if you begin in pediatrics, you can stay there for your course of treatment) and he was deaf. He was so inquisitive, and using his mom as an interpreter, he asked me several questions since I was a "new face." He kept flipping through a magazine extremely fast, not even reading, barely looking at pictures. I asked his mom if he liked to read, and she said yes, but it's frustrating for him so he doesn't know many of the words. Anytime he got to a word that was new to him, he would stop and look it up and then figure out how to sign it. She said he would spend more time doing that than actually reading the book, so eventually it would frustrate him too bad. I had a few questions about it, and Mom explained something to me that I have never even thought about. People who are born deaf only know the words they have learned how to sign. So if a deaf person tries to read a normal book, it's likely that he or she will not recognize many words. Who signs "thoroughly," "enormous," "periwinkle" or all of the fancy, long adjectives we've put into the English language that are only synonyms for simple words like "very," "huge," or "purple"? That concept was just amazing to me.

Then N. When we called her from the waiting room, I knew I recognized her. She was absolutely beautiful with long, blond hair and pretty eyes. She was with a guy I assumed to be her boyfriend, and the more I saw her, the more I tried to remember how I knew her. Every time my eyes met hers, I recognized the deepness of them and how exhausted, scared, and just how world-turned-upside-down she was. She seemed so accustomed to her terrible routine, keenly aware it wasn't what other girls her age were used to. She seemed like each visit to this office was just as hard as the first. My heart felt hers, and it was so sad. When the nurse was confirming her current medications, I was surprised to realize her "list" was similar to the portion of my "list" that falls under my car wreck pain and fibromyalgia. Gabapentin. Percocet. A few others. Then I learned she was coming in because she was experiencing pain in a new area. Cancer patients are in significant pain, sometimes the worst of all.

Once we left the room, I asked the nurse what N had - I deducted that she was in pain, but there were no chemo meds, and her hair was long and perfect. So apparently, she's terminal, but she's had cancer for several years now. I guess they're not actively treating it at the moment or something, but her prognosis isn't good. Then the nurse told me a story that made me realize why I recognized N's face. A few years ago, her picture was all over the local news and MSNBC for getting a wish from Make A Wish that was quite different yet so heartwarming. N was in love with the guy she knew she wanted to spend forever with, yet her time could run out at any moment. She wanted to marry him, but she knew she would fall off of her parent's insurance, making her unable to get treatment. So it was love or healthcare coverage. Make A Wish decided she shouldn't have to choose between those two things, so they granted her wish of wanting a "commitment ceremony." Instead of a traditional wedding and marriage license and losing her healthcare coverage, they had a formal ceremony with a minister, and he moved in with her and her mother. Make A Wish paid for the wedding, reception, and honeymoon.

It broke my heart to remember the story I'd long forgotten about because N was in the same situation as Jonathan and I are in... marriage or health insurance. It's a terrible, awful thing what kids like us have to deal with, to choose between. Crazy world.

So for the entire day, I worked closely with the nurses, spent time with the patients, brushed up my IV connections/machine/hanging skills (since I haven't gotten any practice with the patients I've had this semester) and just really took so many things in during my day. I wasn't ever bored, and I really enjoyed the pace. It got busy at times, but not stressful-busy. I felt like I belonged. I even ate lunch with the nurse practitioners and asked them the paths each of them took to get to the jobs they have now. You can learn so much from successful nurses who have been in their fields for awhile.

You won't though, learn as much as you'll learn from the patients, from the precious kiddos who are fighting something most adults can't even find the strength to get through. Yes, this floor could be hard at times, but on the other hand? The kids - each and every one of them - are so full of hope and strength. There's an amazing air of hope on the unit, even in the rooms of the kids you know aren't going to make it. We had one teen who was literally at the edge of death, yet enormous efforts were still going on to fight the cancer we could, and of course, to make him as comfortable as possible. What if one dose of chemo, a few units of blood, could give him just one more day with his family and his friends? Would it be worth it? We believe it would be. And so that's how it goes. Then the kids who are just starting, in the middle of, or wrapping up their chemo? There's so much hope. Hope that this is working. Hope that the cancer is going away with every new treatment. Hope that all this fighting is going for something. Hope that the family will get through this. Hope that this is just a really hard time but it will end soon. Hope that tomorrow will be just a tiny bit better.

It's a good floor. A good field. The best nurses I've ever talked with, and the best, most courageous families.

Friday changed my life, and I loved it. Absolutely loved it.

Monday Randoms

2009-10-05T15:16:34+00:00

I cannot stop watching this video and wishing I was there! Nikki emailed it to me. :) We're a mildly obsessed with Disney World and the Magic Kingdom.

Next up, do you realize Christmas is less than 12 weeks away? I have no idea how I'm going to pull it off this year, you know, while I'm busting my butt in nursing school and trying to even just barely maintain sanity. I have a feeling lots of you are feeling the same way, and I'm loving Simple Mom who has a plan. 12 Weeks to a Peaceful Christmas. (Yeah I laughed too at first, but I think she's onto something!) First up, Week 12: Prepare Your Holiday Budget and great topics each week until Christmas. She has plans and downloads, and I think I might just be able to pull it off. I love you, Simple Mom!

For some cute pictures of pets in Halloween costumes, you have to check out Good Housekeeping's 3rd Annual Halloween Pet Costume contest. I won't enter Haylie seeing how much she loathes any form of clothing, but I wish I could! She was a ballerina one year, a pumpkin another... but she just hated it so much. People like my cousin (Hi Heather!) will love this site so check it out. A great time waster too. You know, when you have a huge nursing exam in the morning... yeah, perfect for that! ;-)

Well last week was nuts, this weekend was packed (I took Nikki to the Taylor Swift concert - got floor tickets for her birthday), and this week is going to be no calmer! I'm excited though because on Friday at clinical, instead of working on the floor I get my "alternate experience" which is outpatient oncology. That means I get to hang out with the nurses there all day and see what I can learn. It should be really fun, and I'm excited about it. Then the following week is our last week of peds! The remainder of the semester is Maternal-Newborn Nursing, which honestly, I'm not looking forward to. But we'll see, maybe it will be better than I think. Hopefully so. So today I'm studying, tomorrow is class and an exam, my first experience with acupuncture (not even kidding), and then Wednesday I have my girls. Their mom made L Bug's 2 year old and Baby's 1 month appointment to be at the same time which means double shots, double screaming, double the fun. Good thing I have Thursday to recover, wait, scratch that, I have Thursday to finish my 12 page nursing paper which is due the following week. The fun doesn't end!

Have a great, chilly, autumny week! :)