Nurse Carlos and Mrs. P

I am joining Six Sentence Stories for the first time. The prompt word is skip. I just realize it is more challenging to write a story in only six sentences. For my son, who would type 1.5 pages out of required 2 for a high school assignment, this would have been a breeze. :)

Anyway, I am writing another story of a fictional character, Carlos, RN. My first one is here.  With similarities to my experience with patients, this stories will give you a glimpse of what a shift in intensive care unit looks like. It is gross a lot of times, and not for the squeamish. I apologize.

It is another day. I am once again assigned to Mrs. P who had bleeding on two areas in her esophagus. The areas where embolized yesterday, and she has been stable ever since. She did not throw up any more blood. There is no need to keep her intubated.

We were about to extubate her (remove breathing tube and take off ventilator support)  when bright red blood started coming out of her mouth like water from a hose. 

F! I almost said the word but I just thought it in my mind. 

Immediately, I got her head to the side so she does not aspirate any of it. I  suctioned her mouth with a Yankeur. It is like one of those aspirators they use in the dental office.

We are skipping extubation this morning for sure.

Hours later, after more blood transfusions I rapidly administered, and another endoscopy and interventional-radiology-guided procedures, more spots of her esophagus are coiled and embolized to stop her bleeding.  

Poor Mrs. P. I am sure when she finally fully recovers, she will never take mega home doses of Advil ever again.


I keep her calm and sedated. I hope she stays stable. At least, she made it through my shift without any more blood gushing out of her mouth . .  . yet.

The Great Outdoors

What am I thankful for?

There are many as before

As I head out my door

I had a chance to explore

I hiked with my nurse friends

It was a great time to spend

Just talking and walking

I did not want it to end

Oh, and last fourth of July

I hung out with my guy

We just looked up in the sky

Watching a show of fireworks up high

And then my last day in Cali

That I spent with my family

Walking by the beach merrily

And dipping in the pool lazily

Nurse Carlos

festival

together

wore

only

poems 

fruit

walked

favorite

wine

listened

before

shades 

I am joining Sunday Whirligig today, using the some of the word prompts assigned. I am writing a short story inspired by my experience as a nurse. This is my first try.

It's been slow in intensive care unit this week but not today. It is Thursday. I knew it even before hitting my floor as the employee parking lot is almost full.

"Carlos, I am giving you this patient with GI bleed (gastrointestinal bleed).

Immediately, I admitted Mrs. P from the emergency department (ED) to an ICU (intensive care unit) bed. Her blood count is normal but per her report, she started throwing up blood several times since she took 600 mg of Advil six times in a day four days ago for left arm pain.

From the ED, she received liters of normal saline through her intervenous access (IV) and the first blood just got started.

The GI lab nurse called me. "Can we come up at 11 to start setting  up for endoscopy in the (ICU) room."

"You can come up now." It was 10:30 am.

"But we don't want to get in the way of your admission."

Admitting a patient takes time. We have to take history, ask pages and pages of questions,  enter the data in the system, assess the patient, et ce te ra.

"That is OK. Patient's needs come first." She is not critical but I thought, heck, the GI team is ready. I would take them when I can.

Mrs. P  started as stable to very unstable before our eyes.

Two hours of long endoscopy, and more administration of liters of saline and units of blood, the team gave up as they could not see the source of bleed. They were suctioning blood, alright, but the exact source could not be scoped. Her blood pressure stayed low. She required intubation. We are going to the interventional radiology (IR) to look for the bleeding source.

I left her there with respiratory therapist and the whole interventional radiology team. It is now 4:30 pm. Starving, I  walk back to my unit. I can finally take my overdue break.

The nurse's lounge has Panera cookies and fresh fruit bouquet waiting just for me. OK, they are not just for me but they look great.

It is late. This is more like supper. My arms and legs feel weak.

I had great desserts to end my break with pork chops I brought from home.

Shortly, the IR team comes wheeling Mrs. P back to ICU. They found two small arteries in her esophagus that needed to be embolized. They fixed them and she is now stable.

My charge nurse reported that Mrs. P's ex-husband called during my break and complained to her that I did not call back to give an update. Apparently, he brought her to the ED, and he wants to be called at home for an update.

"He called? I did not get the message and Mrs. P said (when she was still able to talk) that her son is her only main contact. The residents have phoned this son  about the recent events."

Soon, her son came and visited just in time for the good news. He knew up to the point that his mother was brought to the IR but that was all.

I am sorry my patient's ex-husband was not notified but Mrs. P is doing better now. It must be stressful waiting at home wondering what is happening. I cannot help but wonder, though, what is he doing at home?

 Back in the room,  Mrs. P's son expressed a lot of gratitude to me and the team. This is the picture I want to take home.

 It feels great to go home and know that my patient is finally stable (for now). I hit my goal for my shift. Tonight, I don't have to drink my favorite wine.

Zippy

Meet my hiking partner, Velvet, in this zestful open space.

The letter of the week from ABC Wednesday is the letter Z.

I choose the word zippy.


I belong to a Facebook group on body transformation where each member defines his or own transformation. Whether the goal is to lose weight, shape your body, add bulk, etc, we all want to work on our goals with eating and exercise.

We talk about, among other things, what gives us energy or motivation to exercise and go to the gym.

What makes me zippy and energetic? I tell them my secrets of having the energy to exercise or workout.

1. A breakfast with 20 or more grams of protein makes a difference. It gives me this satisfied feeling and not feel hungry for hours. When I go to the gym, I do not think about hunger or food because I am not hungry. How do I get 20+ grams of protein? I cheat by adding protein powder to my green smoothie. I eat yogurt or eggs or ham in the morning.
2. I drink lots of water. By the time I hit the door leaving the house to go to the gym, I would already drink 4 cups of water and then two more in the gym. I am well hydrated. In the past, before I get conscious about my water intake, I get so thirsty and get a headache while exercising. I reach my maximum heart rate according to my age within minutes of walking in the treadmill. I think I was dehydrated, that was why. In 15 minutes, I was so tired and could barely continue.
3. Caffeine also keeps me going. I feel a bit hyper after 1 cup of coffee and 2 cups of matcha tea. I pour this energy in cardio and weight machines. It works. It extends my stamina. No need for me to use expensive pre-workout out supplements.
4. Meditation and yoga, I think, helps my mind and helps me to think about positive things too so my mind does not wander too much and I could concentrate on what I want to do--exercise, read, or work.
5. My dog Velvet, keeps me going as we walk outside. She is so fun to be with on a hike. To see her happy motivates me to go further.
6. A good quality sleep. To me, it can be anywhere from six to nine hours with a good amount of deep sleep. I use my Fitbit blaze to track my sleep and I notice, the more I spend time in deep sleep, the better I feel throughout the day.

How about you? What gives you energy? How do you motivate yourself to move?

Family Time in California

1. We flew to and drive through California to visit my teens' relatives from both sides. We met at like the In N' Out burger with its fresh burger and fries. It is a joint we don't have in Colorado and one that my young nephews and niece like. I also saw my cousin who just arrived from the Philippines with her new husband.
2. For my hyperactive son, we went to John's arcade with all-you-can-eat pizza, salad, and dessert. He spent a good two hours playing football and basketball there. He had a great upper body workout for two hours. My sister and I hit the food bar of course. I also went for a virtual ride with my daughter a couple of times with its moving seat and fan going and played bowling with one of my nephews.
3. I get to pick calamansi fruits in my sister's backyard in Bakersfield. It is a citrus fruit sweeter than lemon that is common in the Philippines. I also enjoyed the early morning walk with her in their quiet neighborhood. There was nobody walking outside but us.
4. I posed with my former roommate in her restaurant. She is wearing the orange top. She has a Filipino restaurant and gave us a big treat with her very good food just as we ordered. She never lets me pay though.
5. As if the Filipino lunch was not enough that day, we had dinner in another Filipino restaurant to meet more relatives. My teens spend time with their older step twin-sisters. It has been three years since their last meeting. My son ordered the same thing in this restaurant--Kare-kare (peanut based beef stew). I guess he did it to compare. He liked them both.
6. While in Northern Cali, we stayed in an inn half a block from the beach. It was cold but it still makes a nice view from our room window. I liked the sea breeze smell.
7. We also met up with their cousins, grandmother, and father. We ate together and the boys bonded while playing basketball in the rec center. Of course, we had Filipino food--Dinuguan (chocolate meat) with steamed rice. Their grandma brought it to share. She does not drive and took the bus herself to meet up at a relative's house. She got there before we did. She is so sweet.
8. I am so thankful that their dad showed up sober, unlike the last time. I am very happy for my kids that they get to see their dad like this.
9. I get to spend time with my aunt who has chronic renal failure. Although I did not like to see her so thin I am glad to see her and get to talk to her.\
10. My son did not wander this trip unlike three years ago. Never did I spend time calling him or tracking him with his phone wondering where he was. I like him better 18 than 15! Look at him even stopping to eat so I could take a picture. The bowl in front of him is his favorite Kare-kare, of course.

I felt bad my kids did not see their one aunt and two cousins. They were not available 3 years ago as well because of her work. It has been 10 years since my kids saw them. 

I am still thankful we saw the rest of the relatives we expected to see. 

I thought a month notice was good enough and being told (us) that they could not make it the day before we meet because of a week-long viewing does not make a 100% sense to me. 

Anyway, I use this moment to reflect on myself and teach my teens that it is a great importance to spend time with our loved ones while we are alive. Time is precious. And no matter what, we should try to make the most of what we have and show our love. 

To the friends and family who made time to see us, I truly appreciate them.

A Welcoming Happy June

Hey, hey, hey. It is still June and I am posting my second list of gratitude post of the month. I do better this month already than the previous, I think.

I cannot fail to mention Father's Day. I special mention, Paul, who's been a great father: a tennis dad to a varsity teen who won doubles for the state of Colorado, a basketball dad to his son playing varsity this summer for his school, a math tutor, a life skills coach, and the sole financial provider to two lucky kids. Look at him enjoying his Margarita on his night. I thought he would order something hard but with just a lady's drink he had a smile from ear to ear.

I thank the thoughtful people who brought cupcakes and cookies in the nurse's lounge one day. I don't even know who brought them. Sometimes, I'd see a card or a sign who the treats are from. But on days we are so busy on the floor to take a coffee break, my hungry tummy, sure, is glad to find quick snacks I can stuff in my sugar hungry mouth, and run back to the busy floor. 

I found this free app on iOs (also available on Android) called Text to Jesus. I write a word or two about what I am thinking about. And then it responds in a form of a short reading from the bible. One time I sent the screenshot of the reading to my teens. I did not get any response but maybe a picture is worth a thousand words? Oh well, I sent this, 

Do to others as you would have them do to you," Luke 6:31. 

No text back from my teens. But I am thinking, it is not me nagging at them. These are words from the Bible so maybe they would listen. This app is for me as well. If I need an inspiration or a reading, I use the app. Half of the times, it is right on and it eases my mind. I don't carry a Bible around but my phone, I carry most of the times. The app comes handy.

My city had a ten-day art fest. My daughter and I participated in painting a mural to be displayed later. Look at her posing proud in front of the piece.

I finished a 5K on a 100-degree weather. The fact that I finished it is an accomplishment on its own, never mind my speed. Heck, I still earned a medal even though I walked all the shady areas. When I said, "I walked," I slowly walked. A friendly dog on my way gave me a slobbery lick on my hand. Maybe it thought I could use some hydration. Anyway, I helped raise funds for heart and stroke patients. It is a good sacrifice to make.

My family discovered a nearby Mexican restaurant that was pretty good. We passed it by many times before but it is away from the road that we did not notice it until I read the reviews in Yelp. We will eat there again.

Snowball looks like he posed for the picture but my poodle was just resting on a hard medicine ball. I don't know why of all places he rested there but he looks so cute.

And lastly but the greatest gratitude of all--my son loved the Welcome Home cake we got for him from being away for high school for a year. He is back home full time. The cake is Tres Leches cake which is a light, wet-whipped-creamy cake we all enjoyed. It is a sweet ending to the sort-of-boot-camp-high-school of one year. He is 18 now and I realize his move may not last a long time. I am hoping he'd go to college but he may move out of our home before then as he is working a lot these days and saving up for a car and an apartment. No matter what, I wish him happiness and self sufficiency.

And that concludes my post for the month. Next time I will write about our vacation to California. 

Have a good rest of the month, my friends.

Click the picture to read more gratitude posts by my blog friends.

Growing Teens This Spring

A month has passed, and I have not posted anything! Did you miss me? LOL. I am alive and doing great.

Here are my gratitude list and the reasons why I am occupied.

1. My first born just graduated from high school. Two years ago, I did not even imagine this is possible as he was skipping days and sometimes months of school. He turned around and took extra credits to graduate on time on top of working full time as a new young manager at a pizza chain.
2. He requested to eat at Red Lobster. Where we are, I was not too impressed with their lobster and shrimp, but this night, it was awesome. The seafood including mussels was fresh, we had a blast for his graduation dinner. He even apologized that the meals were expensive. I was like, where did this teen come from? It was his graduation night.
3. My house got hit hard by golfball-sized hail last month. It is not to be thankful for. My siding and roof are damaged, but I just got my first check from my insurance yesterday to pay my contractor for replacement.
4. My son, yes the one who's behaving so differently got me a mother's day card with his artsy work all over it. He even thanked me for being his mother and father. I was so touched. His dad is almost non-existent, especially after our divorce. I feel so appreciated.
5. Look at my handsome son in his senior picture!
6. Paul has to be silly in our dinner picture, of course.
7. My son on his graduation gown makes it more real that he really did graduate. LOL.
8. He gave me a long-stemmed rose for the first time on Mother's day. It also marks my 18th year of being a mom. The only other time he gave me a flower was when he was six. He was so proud to give me a dandelion. I reminded this to him, and he just laughed.
9. What's more from my son? He gave me a Teddy bear for Mother's day!
10. My daughter, of course, as sweet as she is, gave me a gift and a card for Mother's day. This is the first Mother's day we were all together in the last few years. It was indeed very special. I think the used-to-be defiant teens left the house for good.  I have my teens and my home back!

Read more gratitude post through TToT blog.