June 1, 2017

And the megacode was....

Ventricular tachycardia.  First with a pulse, then after cardioversion, it went pulseless.   Great...I figured I was going to go 0 for 5 and prepared for my inevitable asystole (CPR, push epi, CPR, push epi, H's & T's, CPR, push epi, call it and offer condolences).

It didn't happen.  Did. Not. Happen.

For the first time in 5 ACLS classes, my patient lived...well, lived long enough for me to transfer him out to the CICU.  But the patient was alive when I was done with him!

May 23, 2017

It's that time again...

ACLS renewal time.  Time to get the latest guidelines out and remind myself what third-degree heart block looks like.

I am 0 for 4 on my patient surviving megacodes, because I am 4 for 4 on getting the asystole megacode.  Something about me must tell the instructor, "give this one the flat liner." Perhaps it's because I'm usually the only psych nurse in the class, probably the only one they see all year.

I am a pro on the asystole megacode.  The problem is that most patients are not pros at surviving asystole.

I did get a chance to run a second megacode during one renewal--it was supraventricular tachycardia, and that patient did make it.  But as it was after my official (asystole) megacode for the class, and the instructor did it to give other students a chance to perform in different roles, it doesn't really count.  Though since it wasn't asystole, I wasn't used to the fact that my patient was actually responding to treatment, and it kind of threw me...so it wasn't my smoothest megacode performance to date.

Anyhow, here's hoping I get a megacode with a shockable heart rhythm this year.   Then again, being 5 for 5 on getting asystole megacodes is kind of a bragging right in itself.

May 22, 2017

Surgery stuff

Recovery will be up 2 weeks, so that's what I'm putting in for.  This is going to run into the Labor Day holiday, but I can't help that.   I would like to try to be back on Labor Day so I can get a day of holiday pay, but that's up to the MD.  I have to get the paperwork in June and get the process started.

May 15, 2017

The bane of my existence...

In the last week, I attempted 23 IV starts.  The one I managed to get in was later determined by the MD to be not good enough for his purposes...so essentially, I batted .000.  I did get one successfully started the week before, and on a psychotic hallucinating patient, no less.  So for the whole month, I'm 1 for 24, or 4.166% percent successful.

My IV skills are not improving despite hell AND high water.

I decided that it's time I broke down and took a LVN IV Therapy course.  So I went to the BVNPT website and found local approved course providers, and messaged them for more information.  I suppose since I'm not going for BVNPT certification, I could take a course that wasn't approved by them.  But I consider the fact that a course has BVNPT approval as meaning that the course content is up to snuff.

That is the downside to working in psych:  we almost rarely start IVs.   Psych-medical sees more IVs than the rest, but even then, it's nowhere as many as you'd see on your typical med-surg floor.

IMs are no problem:  I can give an IM to a patient under pretty much any conditions.  And have.

So while I wait to hear back from the courses about enrollment, I'll be pulling out all my IV books and reading them...again.   I wish they sold an IV practice kit that didn't involve a human body part.

May 4, 2017

Typing this while wearing high heels

I have a social event to go to in a few days, so I finally bought a new pair of party shoes.  The last pair of high heel shoes I have is more than 20 years old--they're still in good condition since I wear them so infrequently.  I just can't find them, so I decided to get a new pair.  I'm currently wearing them over a pair of red wool socks to break them in.  The following day after the social event is a work day, and I want to minimize the inevitable blisters.

I don't usually wear high heels as gracefulness is not one of my strong suits.  That, and wearing high heels puts me into the "rather tall female" category.  I also don't usually wear dresses but I will be that day, and I am now debating whether to get some Dermablend to conceal the leg ink.  I'm not ashamed of my ink, but I also don't want to commit a social faux-pas.

24 pounds down.  Some of our long-term patients have commented that I've been losing weight.

I don't really see it, though.  I mean, I can tell from the fit of my clothing that there's less of me.  In fact, I had to break down and order some smaller scrub pants, since a lot of the ones I own were unable to be cinched tight enough at the waist (I'm all about the drawstring) to prevent them from dragging on the floor.  But I don't look at myself and say, "you know what, I do look thinner!"  I guess because I look at my face and body every single day so I'm not noticing the subtle changes.

Anyhow, this loss means I'll have 22 pounds to go before I hit my minimum ideal weight--27 until I hit my maximum.  145-150 looks good on me; any less, and I start to look ill.

I'm hoping to lose the rest, or at least most of it, before the eye surgery in August...yes, a date has been set.  Late August.  I have already informed my manager that I will be having some minor surgery (didn't say for what) and will be off work for up to 10 days.   I asked if I should put in for time off now, or just wait and see.  No response yet and it's been a couple of weeks...I think I need to remind them that I will be off for surgery starting on that day regardless of what they say.

April 22, 2017

My weight loss stalled.  I'm not gaining though, which is a good thing.  But I'm holding steady at the 20-21 lb mark.  My shift in sleeping schedule--and thus my shift in and laxity of intermittent fasting and what I'm eating--is probably the reason behind it.   Plus Easter chocolates.  I've improved on the wake-up bag of Doritos though I did have one this afternoon...I was a charge nurse last night, it was a wild night, what can I say?  My soul craved Salsa Verde.

I'm sure once I'm back on my usual schedule and meal plan, the loss will resume.  I need to get back into exercising as well.

Work has been...work.  I thought about calling out tonight or at least requesting a cancellation.  But given that both the little one and I will have various medical expenses coming up, it's better if I work and get my full pay with weekend diffs than just the PTO at my base rate.

I successfully started 2 IVs in the last couple of weeks, bringing my EVAA (estimated vascular access average) up to around .300.

Acuity has been high on every unit since before the full moon.  There are lots of little changes going on to help prepare us for various site visits.   New staff are going to be starting soon, including a new grad (someone who wanted into psych, no less!), so there's been some shuffling around of who is working what unit, who will be doing what, and what schedules will be changing.

Come to think of it, that shuffling has been happening for a while.  It seems like TPTB are into floating staff around and people are working where they usually don't.  I think part of this is due to new staff coming on board, as well as the budget--they want to fill in the coverage gaps so they don't have to pay people to stay late or come in on OT.

I'm eyeing all of this with a little apprehension and concern.  I thoroughly enjoy where I work and I don't have plans to leave anytime soon.  I'm glad to have new staff come on board.  It'll be nice to have staff more evenly spread so there's fewer gaps.  I'm excited we have a new grad that appears to be want to be here and not just wanting to get their mandatory first year over with to leave for more medical pastures.

But I also wonder with all this shuffling, where I will fit in.  Yes, I know some of this is my well-known (well-known if you've read this blog anyway) anxiety/insecurity.  I know the union means they can't just fire me without cause.  I know they can't change my schedule without my consent.  But I'm hardly on my home unit as it is, so I wonder where I'm going to be stashed with all of these changes...especially since some of this new staff is coming to my home unit.

I'm trying to be Zen about it and take a "wait and see" approach.  See what's going to happen to me--if anything--before I make my concerns known to the TPTB.   It could be that I'm getting rattled over nothing, and everything will be the same as before or better.  Or not.

April 20, 2017


The little ones are on Spring Break, which means I've had to adjust my sleeping schedule.  I now sleep in the evenings, go to work, then stay awake to do things with them.  It's been working out so far...its a nice change to stay up after work, and I'll admit that it's easier to fall asleep when it's starting to get darker out as opposed to brighter.  But this won't work when they're back in school, so in a couple of days, I need to return to my regular schedule.  I may shift back to this in the summer, we'll see.

I've been enjoying the last few days off.  I've caught up on sleep.  I'm spending time with the family.  I've turned down requests for work.  I'm just recharging the batteries, getting ready to once again tackle all of the Axis II that seems to have infiltrated the patient population.

The tough thing about personality disorders is that they are how a patient is wired, meaning that nothing is going to cure it.  Sometimes I do wish it was like psychosis, where a shot of Haldol will make the pink elephants go away...at least for a while.  Alas, it's not.  Medications may help them manage their symptoms, but the patients need some good old-fashioned therapy--usually CBT or DBT--to change how they think and respond.  But because they are wired this way, it's also incredibly hard to effect change.

All the Axis II can wear a nurse out after a while.

I'm debating if dealing with Axis II disorders is more exhausting than working with patients in mania.  Both can be challenging, frustrating, and have medications end up with little to no result.

But a manic patient with Axis II...now THAT'S a hurricane!

April 12, 2017

The mystery of the insurance auth has been solved

The ptosis repair--for both eyes!--was approved.  Clearly, my ophthalmologist's UR office is good.

My ophthalmologist only does surgery on Wednesdays.  Also, Wednesdays is the only day that the surgery scheduling team schedules surgeries.  I called and just missed them.  So I have to wait a whole week before they call me.  Well, I've had this eye issue for this long, what's another week?  And it's not as though surgery will be the week after I call them anyway.

I also need to remind them that if they are going to twilight sedate me, that diazepam will make me turn bright red.  They may decide to use something else.

I'm not sure how to deal with this at work.  I have the sick time accrued for a week off...actually, I have a TON of time off accrued because I never really take it.   I'll only need 7 days off for this.  Maybe 8.

When I schedule the surgery, do I tell work now that I've scheduled it so they can plan around my absence, or do I call them the day of surgery and tell them I won't be around a week per doctor's orders?  I'm guessing the former.  But I'll wait until I schedule the surgery first before I say anything.

April 8, 2017

So I received an automated message from my medical insurance plan, stating that my "requested services" were approved and to call my PCP.   I'm guessing it may have been the eyelid repair.  Or it could have been the testing for Graves' disease.  I got the call at 1800 on Friday.  So I'll have to wait until Monday to call and find out what it is.

In other news, I worked my first double at my current facility.  I ended up being so overtired that I felt wide awake.  I didn't fall asleep until I had been awake about 27 hours, and even then, it took pharmaceutical help to bring sleep about.

April 5, 2017

Back on the wagon

So the theme for the last three days has been Doritos.  Massive amounts of Doritos.  All flavors of Doritos (BTW, whoever invented Tapatío Doritos has my eternal adoration).  Doritos for breakfast, lunch, dinner, and bedtime snack.

OK, not that many Doritos.  But a lot of Doritos nonetheless.  More than usual.

That plus lax eating for the last three days...I'm scared to step on the scale.  The last time I weighed in a few days ago, I hit the "23 lb lost" mark.  I know I'm not going to have gained 10 lb in those three days...but still, I think I'll wait until the weekend--and a few days of intermittent fasting--before I weigh in again.

I just felt like going off the rails these last three days, what can I say?

March 30, 2017

It's not painless

In 2014, someone that I cared about very much committed suicide.  Good friend, all around good guy.  The last time I had talked to him was when I went back East for a visit.  We were attempting to make plans to meet and catch up, but for various reasons, the plans fell through.   I figured it was just bad timing on our parts, and that there'd be another visit out there--or him visiting out here as he had family in the area--and we'd try it again.

I regret that now.

Another friend messaged me with the news.   A family member found him.  There really wasn't any warning, any clues, anything, that he was so depressed that suicide was about to happen.   He also worked in psych--that's where I met him--and you'd kind of figure that those of us in the trenches would know to ask for the help.  I guess not.

What I remember about that day--that whole weekend, actually--was that everything outside seemed so crisp, so still, so quiet.  Almost as though it wasn't real.  It definitely didn't seem real.

That day was also another close friend's birthday--she did not know him.  Normally, she would be the one I would have turned to to process what I was feeling.  But I couldn't burden her with that on her birthday.  She would have listened, she would have understood, she would have been supportive of me...but I would have felt like I was ruining things for her.  "Hey, happy birthday, sorry I'm kind of down, found out a friend killed themselves today.  So what do you have planned for your special day?"  Way too macabre.

I was off work that weekend and didn't have anything to distract me. The better half wasn't around that weekend--I think it was because of his work.   I did have to explain to little one why I was crying but I kept it simple.  I also didn't want to burden a young child's mind with this.  Littler one was an infant, so I talked to him about it.   He probably didn't care as long as he was attached to a boob.  It was the longest three days of my entire life.

The family didn't want flowers but asked for donations to NAMI in his name, so of course I made one.   I couldn't go back East for anything but friends told me about the memorial service, and I got to see a few video clips from it.

A few weeks later, I received a card from the family.  I haven't opened it.  I can't bring myself to open it yet.  It sits in a folder on my dresser.   I will open it one day.  Just not now.

For a long time, I couldn't listen to Def Leppard.  About a year or so...I can now, though some songs still sting a little.  He did have great taste in music.

I never wrote about it here--I just checked the entries for the month of his death and I didn't mention it.  So why am I mentioning it now?

This week, another friend received a phone call from her mother.  Her father killed himself.   He was diagnosed with depression but had been getting treatment...things were up and down but they thought he was doing all right.  So this--like my friend's--was a bolt out of the blue to them.


While I've lost a good friend to suicide, I can't even begin to imagine the pain of losing a family member to it.  A parent, a child, a spouse...any family.  As far as I know, no one in my family has ever committed suicide, though there have been a few who attempted.  Losing my father to health issues was painful enough.  I can't even begin to fathom how it would have felt had he killed himself.

Go here if you feel things are that getting that bad that you're thinking about ending your life.  Or if you're worried about someone who is thinking, talking, attempting it.  Or if you're surviving the loss.  I'll be there for a while today myself.

Yes, I know preventing suicide isn't as easy/simple as clicking on a link.  It takes a lot to ask for help.  Hell, I can't even open that card yet and that's small change compared to someone struggling in crisis. But educating ourselves and others about suicide can help.

March 21, 2017

Grandma Meriwhen

Well, to two pet rocks anyway.  Little One the Elder introduced me to them today.  They're both boys, named Joe and Bob.  Well, Joe was going to be Ben, but he didn't think the rock really felt like a Ben.  And Bob would have been Brian, but little one has always had a soft spot for Bob the Builder.

And there would have been a Meriwhen...yes, the little one wanted to name one after me, except that both rocks were male.

"And how did you know the rocks were boys," I asked.

"I looked at their bottoms," he replied.

"OK."  I couldn't bring myself to ask what he was looking for.

So that's rock-sexing 101.

Speaking of grandparenthood, I saw on social media that one of the neighborhood kids I grew up with became a grandmother.  She is a few years younger than I.  That means she had to have had her own child at about age 20 or therabouts, and this child then became a parent at age 20 or thereabouts.  She's 40 or so and already has a grandchild.

At age 20, I was in college, still deciding what I wanted to do in life.  At 40, I was still deciding what I wanted to in life, but at least had a general direction at that point.

So she now has a granddaughter--a darn cute kid too.  Meanwhile, I'm sitting here as Little One the Younger, toddler, is tracing an outline of my body with Post-Its.  His main squeeze--besides me, that is, as he's still in the "want to marry Mommy" stage--is a stuffed Shaun the Sheep doll.

And Little One the Elder, pre-teen, is holed up in the office playing video games.  He's expressed no interest in dating, and I'm not about to encourage it.  I don't think I'm ready for it.  Puberty has started setting in on him, and I'm having a hard time dealing with the soon-to-be loss of my little boy as it is.  He already is as tall as my nose, and I'm tall to begin with.

But no grandchildren from either son will be on the radar any time soon.

Just two grandrocks.  And possibly a sheep-in-law.

I broke 20

21 lb lost to be precise.  But today, I'm back across in the high 19s, but I did have barbecue for dinner:  a French Dip sandwich.  And that au jus is seriously a liquid salt lick.

I had a patient yell at me for most of my last shift.  Reason:  I existed.

They started in on me, in full-on oppositional form and at the top of their lungs.  After a couple of attempts at reality orientation--which they were not receptive to--I told them, "OK, whatever you say" and went about my business with my poker face on.   I learned early on in psych nursing not to argue with actively psychotic patients because it's an exercise in futility.   They're going to believe what they want to believe, and no amount of discussion is going to convince them otherwise.

Said patient didn't really like that I was not standing there being a willing target, that they weren't getting a visible reaction, and that most of my responses were "whatever you say" or other blandness.  They tried bating me by calling me a few choice names, but that didn't work either...after several years in psych, I've already been called every name in the book plus a few new ones.  So if you want to offend me by calling me names, just be aware that the bar is set really really high.

Said patient kept ranting on until they found another person or object to briefly distract them, then returned their attention to me.  They were also manic, so their energy didn't wear down.  They kept it up until the moment I left.  Something about me must have touched a nerve with them, I guess.

Funny thing was, they weren't even my patient.  I just happened to be on the floor that shift.

Just a typical day at work.

March 15, 2017

Of acetylcholine receptors and vanity

So I contacted my ophthalmologist's office and asked them to check if the ptosis surgery will be covered by my insurance, and if so, how much.  They're going to check the cost of fixing the affected eye by itself, and fixing the affected eye along with addressing the issues of the other eye.  Depending on what the numbers are, I'll be moving forward with this.

I talked to my sister about the procedure.  I learned that she is as squeamish about all things eye as I am, so that was comforting.  Even so, she's miles more solid with blood and gore than the better half, who once almost passed out during a labor and delivery video.  She agreed to drive me to and from the procedure.

And being the immunologist she is, she wants me to ask my PCP for a blood test to check for acetylcholine antibodies.  She's thinking myasthenia gravis is the cause.   And who knows, she may be right.  I don't think it is, as its rather rare and the only symptom I have from the list is the drooping eyelid.  But I do fit the "at risk" profile, being a female over 40 and being on a beta-blocker for the long-term.  I have my annual physical next week and it couldn't hurt to ask about it.

Here, read up on the disease if you're unfamiliar:  http://www.healthline.com/health/myasthenia-gravis.  I had to refresh myself on it as well.

My research did turn up that ptosis isn't a cause, but a symptom of some underlying problem, be it myasthenia gravis or some other issue.  Fix the problem and the ptosis could go away.  Or not.  But it's not as though they can schedule the surgery next week.  It'll be several months before it would happen, so that gives me plenty of time to do more research and rule out potential causes.  I know that if I don't treat it one way or another, the ptosis is only going to get worse.  It's not going to magically resolve on its own.

I admit that I also want to get this fixed for aesthetic reasons.

While the ptotic (yes, it is a word!) eye is giving me physical grief, I am--or feel like I am--starting to notice the ptosis more.  I feel like it's become glaringly obvious in every picture I take.  I'm wondering if other people notice it.  I'm wondering how to ask other people if they notice it AND get an honest answer from them, with none of the "it's not that bad!" crap.

I feel weird that I'm considering the aesthetic along with the medical.  I feel like I'm getting an eyelift.   Well, technically I would be, as it's pretty much a similar procedure.  I personally have no objection to plastic surgery.  If it makes a person feel better about themselves, then fine.  If it fixes a problem, even better.  And yet, even though I have a valid medical reason on my hands...er, face, for having this done, I can't help but feel like I'm being vain in doing this.

And is feeling that way necessarily right...or wrong?


March 12, 2017

Is it wrong of me to want to be able to eat a bag of Doritos without interruption?

And without having to lock myself in the bathroom to do so?

I believe not.

Yet the little ones will not let me do that.  But then I realized how I could make it possible.

So on my way home this morning, I stopped at the local 7-11 and got a small bag of Salsa Verde flavored Doritos.  I took it and a Diet Dr. Pepper into the bedroom with me.  Then I turned on my sound machine and went to sleep.

When I woke up, I got the bag of Doritos and the soda, and feasted before I turned the sound machine off.  The family knows that when the sound machine is on, they can only enter if there's a fire or copious amounts of blood are involved.  So I knew I would not be interrupted unless the house was burning down or the little ones got into a playroom brawl.

I have no regrets and I do not feel guilty.  Not. One. Bit.

I'm also almost 20 lb. down since starting the intermittent fasting in the middle of October.   19.75 to be specific.  The fact that I don't eat for 16 hours out of each work day (on days off, I scale it back to 12 hours) lets me eat whatever I want--within reason--during the other 8.

March 9, 2017


I went to get my taxes done today.  I don't do them myself anymore.  The Meriwhen Estate is rather complicated and requires a lot of itemization and the use of many extra forms.  It is worth paying a professional to do them.  It might be expensive, but to me, it's worth every single penny.

If you itemize, here is a handy tip:  get a folder, label it "Taxes."  Throw any and every work-related receipt in there:  purchasing scrubs, renewing licensure, CEU payments, etc.  Also throw in donations, medical bills, anything that you plan to write off come tax time.  It's a lot easier to do that than to spend the first few weeks in January trying to find and print receipts, or doing a best guess estimate of what you spent without paperwork to back it up, and then hoping that you won't get audited.

Despite doing that every year, I still spend about 3 hours printing, cataloging and organizing all the tax paperwork.


I used to strive for a gigantic refund every year, until I realized that I'm basically loaning money to the government interest-free.  And I could be using that money now, not later.  I do itemize and claim all the deductions I can, but I also tweak my withholding so that I come out close to $0.   I won't complain if I do get a refund though, but I'm no longer in the "big bucks, big bucks, no whammy, stop!" mindset.  I just don't expect a large refund.

This year, I owe the government a little bit.  It's much less than I thought it would be, given the income shift between the better half and I, plus the fact that I didn't update the multiple W4s until the middle of the year to follow those changes.  So we had too little taxes taken out...though if I hadn't changed the W4s, it could have been a lot worse.  Next year, we should hit the sweet spot.  But this year, I mail a check in the morning.

I got the state withholding right:  a $30 refund...which, in California, is taxable income for the following year.  Which is an even better reason for me to get my refund as close to $0 as possible:  not only would a refund mean I'm letting California borrow money from me at no charge to them, I then have to pay California for the privilege of getting back money that was rightfully mine to begin with.

It took two hours and two tax preparers to figure it all out.  But they did it a lot faster and probably more accurately than I ever could...so again, worth every penny.

March 7, 2017

Last day at Job #3

I received my final paycheck from Job #3 in the mail.  They actually had it ready to give to me at my last day, except they didn't know where they put it.  So I told them to mail it to me.

I never did tell you about how the last day went, did I?

It was mixed.  I know that by resigning, I was making the right decision.  At the same time, I was going to miss my coworkers.  I had already said some goodbyes in person a couple of weeks prior.  On the final day, I messaged those who I couldn't get to see before I left that I was going, and gave my contact info in case they wanted to get in touch.  I cleaned out my e-mail and message boxes, and removed any personal files...there weren't many left as I started doing that once I decided to resign.

The nurse manager/my friend brought me flowers--which are actually still in great shape a week later--and food, which was sweet of her.  The administrator told me that I would be missed and that I would be welcome back.  And you never know--things in my life might change and I end up going back down the road.

I made one last pharmacy haul to use my 25% employee discount.  Stocked up on diphenhydramine, as I use 100mg for sleep on work nights.

Work itself was kind of slow.  There was a nursing inservice that day and I was invited to go along even though it was my last day.   I was hesitant at first since it was my last day, but I'm glad I did decide to go, as some of my coworkers that I didn't get to see before I went were there, so I got to say goodbye in person.  The presentation was about substance abuse and managing withdrawal.  Not only did I get to spend 1.5 hours discussing a topic I love, I got paid and picked up some CEUs as well.

Not long after that, I had to see nurse manager/friend to turn my stuff in.  That was sad but we had to laugh about how small the nursing world is, as this is the second workplace we've been together at, and a number of staff from our first shared workplace came over to this workplace as well.  And that we've probably both find ourselves together at a future workplace.  Then I left.

I decided that I needed In-N-Out Burger to soothe my wounded soul, so I took the long way home to stop at the one two towns over.   One Double-Double (no veg) later, I felt a little better.

And that's it, really.  It was a fairly low-key day, which suited me as I prefer to leave quietly in the night from such things.

It took a little getting used to being employed at only one organization.  I've always had the safety net of multiple jobs at the same time, so if I felt unhappy at one I could spend more time at one of the others.   Now, all my eggs are in one basket, so to speak.  But there are plenty of opportunities for extra work, and they're even willing to pay overtime if that's what it takes.

And the committee that I'm now involved in guarantees me several hours a month.  But that's a story for another post.

March 3, 2017

In which Meriwhen learns she was never meant to go into ophthalmology, and other important life lessons

Lesson #1:  Never schedule an eye appointment after working night shift.

Especially when the night is long and the psych acuity is high.  It was all I could do to stay awake once I got off of work.  I usually sleep immediately or thereabouts after getting home.  But not today.

I went home, showered, ate breakfast (Jack in the Box, how I love thee), and then drove the 45 minute to my ophthalmologist (Blogger autocorrect, how I love thee).

My eye doctor is located in a very affluent part of the entire state.  Not just an affluent area in my city--it's one of the top in the state.   So my little SUV is a bit out of place among the Audis, BMWs and other luxury cars.  I also feel a bit of place there too, as I show up right out of work, in my sandals, old jeans, and AN.com jacket, while both staff and patients walk around in business suits or designer label swag.  Everyone else is (or appears) slim, young and beautiful.

Then after the appointment, I drove the 45 minutes home and had lunch.  And then I tried to pass out...and was unable to fall asleep.  So I ended up staying awake for a full 24 hours.

Lesson #2:  Eye doctors have access to the best toys.

The eye doctor has the most beautiful green eyes...so beautiful and fairy princess-like.  There's no way THEY could have been natural.   But minding my manners, I did not ask.  And it goes without saying that all the vision techs and nurses had long, luxurious lashes...me thinks Latisse is at work.

And nary a wrinkle in sight on anyone.

Lesson #3:  Ptosis is not what I thought it was.

I told her that my right eye had the issues with drooping...she was focused on my left.  Then she took measurements, went over the test results, and I learned that what I assumed was a drooping eyelid was not actually a drooping eyelid.  And what I assumed was the normal eyelid was in fact the drooping eyelid.  It's the left eye that had the ptosis.

That being said, the right eye still has its own issues, so I'm not entirely insane.

The cure for both of these issues is minor outpatient surgery with a week's downtime.  It's not critical--it's more of a quality of life issue.  If I never got the procedure done, no big deal.  But she warned me that given the aging process, both eye issues are not going to get any better on their own.  And I'm also apparently at the border where the procedure would be covered my insurance for medical reasons, instead of not being covered as a cosmetic procedure...at least for the left eye, since my vision is apparently being impaired by it.  The right eye, they'd have to apply for specific approval to fix this problem, as apparently my vision is fine in the right eye.

I say "apparently" because during the vision field test, the right eye was far more uncomfortable during testing than the left.  So naturally, I assumed that it was as I originally thought--the right eye was the issue.  Guess I was wrong.

But we agreed on a conservative "wait and see" approach for now because...

Lesson #4:  I have no stomach for anything involving eye surgery.

She started describing the procedure and I began twitching.  It was all I could do to not go squeamish and pass out on her.  Even recalling the conversation as I type this several days later is making my stomach churn and my body shudder.

We decided that, even though the surgery is a minor procedure and I could drive myself home afterwards, it would probably be best if she put me out for it.

Then there's the scheduling issue.  A week of time off will be needed until the stitches can come out.  The bruising will take longer to heal, but I don't mind going in all bruised up.  I could camouflage most of it with makeup, I imagine.  And if not, it'll have the potential for helping me spin entertaining tales for my patients.

I got home and filled in the better half who agreed on the "wait and see" approach (he's got a much weaker stomach than I).  I follow up in 6 months or sooner if it worsens.  I'm probably going to schedule the surgery for the end of the year.

And of course, not having slept in 24 hours plus all this about eye surgery--the procedure is essentially an eye lift--made me start thinking...

Lesson #5:  I need to embrace aging.  Not necessarily without a fight though.

Mentally, I don't feel my age at all.  I feel years younger than I am.  I know I'm not a teenager or in my 20s, so I don't act or dress like one.  But I refuse to mentally-tack on "middle-age" to anything I say, think or do.

Thanks to a lot of sunblock plus great skincare, I'm fortunate to look 10 years younger than I actually am.  My skin has never looked this good in the last decade.  I'm also steadily losing weight and starting next week, I'm getting back into exercise (my excuse for not starting now is that I have a half-marathon that in this weekend, and I don't want to be sore).   I don't have any greys...though to be fair, I've been coloring my hair since age 19 so if there is grey beyond the random hair or two, I wouldn't really know about it.  So overall, I'm on the upswing.

The fact is, I have to accept that my body has been on the road for 40+ years now and with life happening to it, it's inevitable that there will be some wear-and-tear (tare?).   I'm never going to have the face or body of a 25 year old again.  And even though I'm ahead of the game with the religious sunblock use, I admit to feeling some regret that I didn't take even better care of my face and body (watched my weight, dealt with skin issues, etc.) so that perhaps I wouldn't have felt so insecure in my teens and 20s.  I could have enjoyed them more.

But I am what I am.  I should embrace it.  That doesn't mean letting myself go and not putting up any fight, though.   If I can improve something a little bit, I shall.  But let me be realistic about what I am and what I can achieve.  Nothing is going to bring me back to age 25 nor should I try.  But at least I can look and feel damn good for a 40-something year old.

February 25, 2017

Housekeeping note

I've noticed that as of late, this blog is getting a lot of traffic from a hookup website.  Curious, especially since I've never used one and don't have any plans to.  So if you are on such a website (no judgment here, just a FYI) and you see anyone linking to this blog, rest assured that it's not me.

Health woes

Tuesday and Wednesday's dental work has meant a world of pain on Thursday and Friday.  I must have looked like I was in a black mood the last two nights at work, but that was I was waiting for the Motrin to kick in.

Well, I also was--am--in a black mood as of late for another reason, but that's a story for another post.    

Today, the pain is much better.  The rest of the dental work is next week, then I'm off the hook for six months.  

Meanwhile, the vision field exam went...weird.  I have ptosis in one eye.  Most days it's manageable, other days it's like someone's trying to keep my eye shut for me.  I finally got fed up with it, and now that I have decent medical insurance, I decided to see what could be done for it.  

I had to go for a preliminary vision exam so they can see how it's affecting me.  I drive up 45 minutes--in the rain, of course--to the vision tech.  For some reason, all the specialists I need to see for whatever reason are located at this specific office 45 minutes away from me, and they are all scheduled on days that it's raining or about to rain.  Then I spend another 45 minutes staring at little lights, either trying to keep the eyelid just so or having to have the eyelid taped in various positions to keep my eye open.

You know the movie A Clockwork Orange?  Kind of like that, but without the aversion therapy.

I don't know how I did, other than the fact that it was a lot harder for my affected eye to do what they wanted, than for my normal eye to do the same.  I'll find out Tuesday when I meet the eye doctor...in that same location 45 minutes away from me.  Any guesses as to what Tuesday's weather will be?

I did a little preliminary Dr. Googling on ptosis.  It's not always a medical problem in itself, but usually a symptom of another underlying medical problem.  So the best cure is to determine what that underlying medical problem is and fix it.  Or they can do surgery, but that would depend on what the underlying medical problem is.  Or I can just learn to live with it if it's determined that there's no major underlying medical problem.

As of late, the eyelid hasn't been too bad, so I'm hopeful that whatever is causing it is minor.  I'd rather not have surgery if I can help it.

Of course, between the dental work, the eye issues and the unspecified cause of my black mood, I'm not sleeping well at all.  It's come to the point that I've had to blow the dust off my bottle of alprazolam and take 1-2 tabs of that in addition to my regular HS meds, just so I could fall asleep.  Staying asleep isn't happening either, but when that happens I don't take any more meds:  I just do my best to doze off again.  That doesn't always work.

If this doesn't improve, I think a call to my psych NP is in order, as I don't want to be relying on alprazolam in this way.

On the brighter side, I'm down 17 lbs.  I finally broke the 180 barrier this afternoon.  20-30 lb more to go.

February 22, 2017

I thought I had a relaxing few days off ahead of me. Nope. Two dental appointments, one eye appointment, the final day of work at job #3 and most importantly, the littler one's birthday.

First, dental appointment #1. It was there that it was determined I needed a second and third. Nothing critical; mostly maintenance work and fixing a few minor problems.

 The birthday was early in the week. I can't believe where the time has gone. He was a tiny little baby; now he's a hulking toddler.

 Today is the second (of three!) dental and the eye appointment, back-to-back. The eye appointment is first, thank God, so at least I don't have to go through it with sore gums. However, the appointments are not in the same part of town: I have to drive 45 minutes--in the rain, no less--to the place where the eye appointment is. That's at 0900. Then afterwards, I have to drive back to my hometown for the dental appointment at 1100. If everything runs on time at the eye doctor, I should make it back to the dentist with time to spare.

There will be needles involved in this second appointment. Fortunately, I have a supply of ramen on hand, thanks to some recent ramen cravings. I haven't had ramen in years, but last week I felt compelled to have large quantities (no, not pregnant. I'm out of the gene pool, remember?) so I went to the Asian section of the market and stocked up.

Then the final day at job #3 tomorrow. I'm both sad and relieved.  Sad because I will miss a lot of people there, and even the job itself--it's not what I'd want to do forever, but I did learn a lot from it. Relieved because I no longer have to stress about my schedule and meeting the scheduling requirement.

February 10, 2017

Two weeks' notice (official) and adventures in reading

I officially submitted my notice at Job #3.  My department head was understanding, thanked me for my service and wished me well.  The nurses at the site I was at were rather upset that I was going.  They made me lay down on their new therapeutic cot (I guess one too many patients have come over all faint in there) and I basically told them the details while lying on my back and with my shoes off.  First time I ever resigned from a job while in the supine position.

Truth be told, I'm kind of upset about leaving these nurses.  Actually, of all the locations I have to go to on Job #3, the one I was at today is by far my favorite.  I'm really going to miss the nurses, doctors, staff, pretty much everyone there, really.  They are some of the most laid-back people in psych nursing that I know.  Unfortunately, I have no more shifts scheduled at that site...but I told them they can always stalk me on social media. 

So I left the site with sadness...though not before hitting the pharmacy on the way out the door and taking advantage of my 25% employee discount one last time.  Don't knock these perks--they add up in the long run.


Regular readers know I have a habit of randomly requesting books from the library, usually because I get interested in something and want to read all I can about it.  Often, the holds take some time to make it to my tiny (really, it's only one room) branch of the public library, so when I go to pick them up, I'm often surprised at what I had requested.  The librarians are no longer shocked at what I get.  They are also tolerant of my requests, especially since I tend to forget to return books on time and have to pay fines.  I'm good for a couple of dollars a month, at least.

These requests usually occur late at night, when I'm in bed reading and/or surfing on my Kindle.  When I used to do this after a glass or two of wine, I'd apparently request the most random stuff.  Now that I am not drinking...I still apparently request the most random stuff. 

So I go to pick up the latest haul.  In it, there is:
  • A collection of novels by Richard Bachman, a.k.a. Stephen King.  I didn't remember why I wanted this one until I saw that The Running Man was one of the stories.  Yes, the book that the movie is based on.  Seriously, did you know that Stephen King of all people wrote that?  I certainly didn't...though now that I know, it makes sense.
  • A book on borderline personality disorder.  Given my area of nursing, that is no surprise.
  • A book on North Korea.  Also not surprising.  North Korea fascinates me.  I have no desire to visit there though as I'd probably never be let out, but I'll read all I can about it.
  • A biography of one of the Ramones.  I think that was due to a discussion that I had with a coworker--we're both fans.  I don't remember which Ramone it was offhand.  Joey?
  • And five (!) books on the Vestal Virgins.  Now THIS one, I'm trying to figure out.
Five books on the Vestal Virgins...really.  I should check my Kindle's browsing history to see where I was surfing that got me so intrigued to get my virgin knowledge on.

So yeah, I have a lot of literature to keep me occupied for the next 6 weeks. 

February 8, 2017

Two weeks' notice...almost

Tomorrow, I officially give notice at Job #3.  My friend/manager took my e-mail well and was understanding.  She reassured me that I would always be welcome back whenever I wanted to, which was nice.  I have two more assignments there:  tomorrow and in two weeks.  After that, it is finished, and I am down to only one job.  That's going to take some getting used to.

February 1, 2017

High anxiety, you win...

I'm a Mel Brooks fan.  I couldn't find History of the World Part I to watch, but I did find High Anxiety, so I put that on instead.  It's a fun way to spend the night when you can't sleep.

My father actually took me and my sister to see that movie when it first came out in the theaters in the 1980s.  I'm sure the theater staff thought he was crazy, but our family has always has a warped sense of humor.  We didn't get all the jokes but we never asked Dad to explain them....and I don't think he would have anyway.  It wasn't until many, many years later, that I fully understood every single thing in the movie.

I do remember my sister and I spent the rest of the day singing "The Inquisition."  I still do sing it at times.

My father also took us to see Monty Python's The Meaning of Life in the theaters.  But singing "Every Sperm is Sacred" doesn't go over well when you're in Catholic school.

Moving on to nursing news...

I'm still working on that Job #3 resignation plan.  The letter is pretty much done.  I've stop accepting any work requests using a variety of creative but true excuses.  I'm back there next week so that's when I can make the resignation official.  The immediate next step is the hardest:  calling my friend/manager to let her know I'm leaving before I actually do it.  I know she's going to try to talk me into staying...again:  she was successful in doing that once before.  She's going to be disappointed.  But I need to let this job go, for my own sanity.  I need to think about that first and foremost and resist.

Maybe I'll do it by e-mail instead.  I know, I'm a non-confrontational wuss.

Whatever way I decide to do it, I need to do it really soon because I swore to myself come Hell or high water, I was resigning the next time I went in.

Work anxiety, you win...

January 30, 2017

In which Meriwhen shrinks, and crafts a resignation to boot

Since November, I've lost about 15 lb.  I decided to try intermittent fasting...well, the Leangains method, since the idea of going 24 hours without any sort of food is inconceivable to me.  Well, except that time I had my tonsils removed:  I lived on ginger ale for a whole month because it was too painful to eat anything at all.  I lost 30 lb. that month, but I don't recommend tonsillectomies as a weight loss method.

The all-the-ice-cream-you-can-eat thing is a myth, BTW.  And if you can, get the tonsils out when you're a kid.  I was 21 when I had mine removed.  I'm still traumatized from the experience.

So Leangains....you fast 16 hours, eat 8 hours.  So I don't eat at work and go right to sleep when I get home.  I wake up and then I have 8 hours to eat what I want.  I still try to eat sensibly though, but I do feel less deprived doing it this way than I would if I was counting calories and looking at forbidden foods.

So 15 lb done.  20+ to go.  I'll be happy if I hit the low 160s.  I'm tall, so I can carry 160s well.


I officially decided to resign from Job #3.  You know I've been on the fence about it for a while, and I was going to do it in November until my new supervisor happened to be a former coworker/friend who didn't want to see me go.  So I held off and held on.  I wasn't scheduled there at all in December, which made me realize how much I've been missing my days off.  And the better half and little ones loved having me around more instead of hauling off to the day job after a full week of working nights.

Then I was a no-call/no-show at Job #3 in January.

I'm very meticulous with my work schedules, and often know them better than the schedulers.   For some reason, the day I was scheduled for this month escaped me and my calendar.  I didn't realize what happened until the scheduler called me to make sure I was alive (that's how meticulous I am--if I don't show up for work without calling off, they automatically assume I'm dead or on the way to death).  I reassured her that I still had a pulse (74 bpm), then checked my e-mails...and found the one where I agreed to work that specific day.  Still don't know how it got away from me.

But you know what?  After finding out I was a no-call/no-show...I was strangely apathetic.  I didn't seem bothered about missing work itself.  I was more bothered that I didn't keep the calendar up.  But as for not being there...I sometimes feel guilty calling off when sick and holding a doctor's note in hand.  But I didn't feel guilty about this.

And so I realized that perhaps, it's time to let Job #3 go.

The problem is that I actually have to resign in person...well, via company intranet.  So I have to wait until my next scheduled day in February (and yes, the calendar was triple-checked), and then go resign.  I'm working on my letter that I'll fax over with the computer resignation explaining why I'm going.  The official reason--and actually, the honest reason--will be that I am taking on more responsibilities at Job #1 and that I will no longer have the extra time to meet the PRN requirements.  That is a story for another post.

I called Human Resources at Job #3.  I only have to give 72 hours notice (really!).  I plan give 3 weeks and work all the days I have scheduled in February.  I will talk to my friend/supervisor first, to give her a heads-up so she's not blind-sided.

January 4, 2017

Happy 2017

New Year's Eve at work was calm.  We got to see the ball drop on television, and we all enjoyed our pot luck and complementary sparkling cider.  Then I had to go give multiple IMs to a patient who decided to get undressed and completely lose it...right after we had finally gotten all the manic patients to fall asleep.  Of course, that woke them up.

The following night, same unit, but much better.  Only one IM needed, and it was requested by the same patient before things got out of control.

It wouldn't be a holiday without some excitement, now would it?