The Greatest Generation...and then some

I wish I had had a tape recorder (er, do they make tape recorders anymore?), or some sort of recording device going at work today.  I have a fun group of patients getting their cardiac rehab on right now.  Somedays I try to teach them a thing or two, and then somedays they teach me a thing or two.

I happened to have three war veterans in the room today swapping stories of their days in the service.  Some stories were hilariously funny, some sweaty armpit scary, but all were pretty inspiring.  I can't imagine doing what they did.  I can't really fathom war to any extent that they experienced it.  These days, it seems like we have so much more knowledge and technology at our fingertips - but I guess that makes the weapons that much more complex too.

I mentioned in an earlier post that I had recently read the book "Unbroken" by Laura Hillenbrand. She wrote "Seabiscuit" a few years back and I love loved that book, so when I saw "Unbroken" sitting there on the library shelf, even though not my typical read, I thought I would check it out.  Literally. It was monumental - or some other inadequate adjective. The book follows Louis Zamperini's life, from an incoragible trouble-maker, to Olympian and WWII bombadier whose plane went down in the Pacific.  He survived in a lifeboat for 47 days only to be captured by the Japanese and held as a POW until the end of the war.  The recounting of these events illicits a physical response.  It was definitely hard to read at times - almost making me sick. 

The wonderful thing is the hope and forgiveness with which the book ends. One of my favorite photos in the book is a 81 year old Zamperini skateboarding.   Who skateboards at 81?  Louie Zamperini is still alive today at the spry old age of 93. 

So I get a little awestruck when I hear the guys telling their stories. On one hand, I don't think they think anything of it.  They just did what they were asked to do. They are national treasures, and we really owe them a lot.  Much more than could ever be repaid, I suspect.  I'm glad I get to hear their stories, and I'm glad they are here to tell it.

Have Christmas...Will Travel

We have always had to be a little creative with  the time and date of celebrating Christmas with my side of the family.  This event took place on Sunday, the 20th. You would think that with all of us living in the same small town this would be a simple task.  It is always more complicated than it first appears.  Add a pilot and a nurse and the various extended families to the mix and we just take what we can get.

This year we had to be a little creative with the venue as well.  Dad was in the hospital.  Couldn't do Christmas without him.  Since he couldn't come home to be with us, we moved the party over to him.  Have you ever celebrated Christmas at your local hospital in the cardiac rehab department?  As you will soon see, it makes for some pretty interesting pictures.

It all started traditionally enough.

Adult table.

Kids table.  Yes, we like it like that.

Adults partaking.

Kids partaking.

Kleyton partaking all by himself.  Kleyton takes a little longer to partake than the rest of the kids.

We also had the toddler in the traditional velvet Christmas dress.

Hi Lizzy.

Don't you look just like your momma?  Beautiful.

From there we moved the party, and an awful lot of presents to the cardiac rehab room at the hospital.  Otherwise known to me as "work".

Sheesh.  Think there are enough presents? And look, Charlie Brown forgot his tree again.

Here's the man of the hour! Hi Dad!  Glad we could join you!  That's my older brother Don.  We used to tell people we were twins and they would believe us.  I think we could still get away with that.

Here's the gang.  Like I said, it makes for an interesting picture with a crash cart and treadmill in the background.  We told the kids that if they didn't behave we would get out the defibrillator or make them run a mile on the treadmill.

See?

Everyone had to tow the line.  Even toddlers in velvet Christmas dresses.

What is up with these two?  Feeling the Christmas love?  We are marking the date on our calendar and will check back with Nate and Tanya in 9 months....

Even after 12 years, The Captain still wonders what he got himself into.

Actually, he got himself into a wicked game of Twister.

You are in big trouble, Honey!

And Nate, so are you... that left foot on red will get you every time.

May not be your traditional Christmas in some ways, but yet in many ways it was.  We were together for a few hours, we took a break from our crazy busy lives just to hang out over some good food and a couple games of Twister.  And Dad was there.  Dad was there.  Words cannot express.

All this because (excuse the cheesiness) two people fell in love.

Merry Christmas!

How to Save a Life

I opened up my Google home page this morning and noticed the "how to" for the day was this. How appropriate. A couple weeks ago it was "How to land an Airplane". The Captain and I are covered.

I have to maintain certain certifications as a nurse, and in a small town hospital, you need to maintain many more. I am certified in Basic Life Support, Pediatric Advanced Life Support, Adult Cardiac Life Support, and the Neonatal Resuscitation Program, and have recently added ACLS instuctor. It is exhausting. AND most of the nurses I work with have more certifications than that! Usually these re-certifications come up every two years - and folks, this is my year. I have practiced resuscitating "Annie" (adult manikin), "Junior" (child manikin) and "Baby" (you got it). I have had my share of simulated chest compressions.

It's a good thing to know. And for those of you (myself included) who get the heebie-geebies thinking about giving actual "mouth to potentially bloody, smelly, dirty, emesis filled mouth" - I wouldn't worry about it too much. It's all about the compressions, Baby* (or Annie or Junior) and the AED (automated external defibrillator). So you want to give good high quality CPR. Here are a few songs to put on your CPR playlist.


or if you are one of those glass half empty people....



I think I like Staying Alive. But I do like the guy getting groovy with it in the gray pants right in the middle of the screen on the last video. Not sure that is proper technique - but think it should be. : ) So, go forth and save... or not? Seriously, watch the "how to" video, or go take a class - you just never know.

*By the way, with neonates, ventilation is key to successful resuscitation. Patty taught me that. Thanks Patty!

Where Have I Been All My Life...

...or at least these last couple weeks. Whew! Double Whew! (not to be confused with "W"). I feel like I can finally take a deeeeeep breath.

So here's a recap from most recent to most recent past. Today, regular work day. No prob. Took care of Sweet Lizzy. (she can patty cake now - I am in love) Again no prob. Dance recital pictures. Prob. Ugh!! I so thought I had everything organized, but didn't. We made it though. The girls looked really sweet - even though their mother got a bit snappish. What is up with their mother anyway?

Yesterday, it was Mommy and Maren day. Maren has been out of preschool for the past week. Sewer back up at the brand spanking new preschool. Can you say how nasty is that? E-coli and salmonella, and shigella just kicking up their heels at preschool. Makes even a nurse cringe. (They are replacing all carpet and flooring but I am taking my petri dishes along on Monday and taking samples just to be sure.) Anyhow, I was way too busy doing mani-pedis, going to the park AND the library and playing Barbies to blog. I did some Spring cleaning in our bedroom though. Do you think it is bad to need 2.7 Swiffers to adequately clean my blinds? Those petri dishes sure do come in handy. So do Swiffers. Why couldn't I have invented Swiffers? Then I would be lying on my own beach somewhere with a margarita in my hand instead of a Swiffer.

Last Tuesday, I got my Advanced Cardiac Life Support Instructor certificate. Now I can officially teach people how to save a life. The Fray has it all wrong.

Saturday, I worked in Babyland for a bit. Do you have any idea how fun is to take dismissal pictures of new babies and their families as they are discharged from the hospital? Do you know the hospital actually PAID me for this? Too fun, too cute. Proud papas, wide-eyed big brothers and sisters, and mommas in that weird transition phase of being proud and satisfied of a job well done, yet knowing the real work is just beginning. What a glorious and terrifying thing to be a new mom.

Thursday I worked the cardiovascular clinic. We did have a surprise cardioversion added to the schedule. I was not in charge of the "button". Amazingly enough, we got Bob and Dr. Wanner out the door on time for once.

Every other day between was just a normal work day, but I have had lots of new people. I really love my job in cardiac rehab. I think only the coolest people have heart attacks. If you are a nerd or an inconsiderate dork, you are in the clear, because I have yet to have one walk through my door.

Oh, I forgot to mention last Wednesday was my last VP3 class. I will miss the people I have met there horribly. Oh, I will still see them in church, maybe around town, but hopefully not in rehab, because the are all REALLY cool. Even John F. who use to scare me a bit. But the context of why and how and the reason for us being in that place at that time will be missing - and there were some God moments let me tell you. It seemed like every week at 6:30 -8:00 at Trinity church, there might be another chance to witness one. I will miss that. That does lead me to the question, and the title for this blog post. Where have I been all my life? I sometimes feel I am so busy "doing" life that I am not really "in" it. I sometimes feel I know OF God, but don't really "know" Him. If I took anything away from this class, I want and need to be more present in my life - and look for Him there too. If you ever get a chance to do a VP3 class, go for it.

That about takes me back to Easter, which was so very bloggable. Hold that thought...

Cardio-aversion

Last week was a busy week. One of the things that made me busy was the fact the I had somewhat reluctantly given in to helping out with an elective cardioversion at work. Thursdays are usually my day off. The cardiology clinic is on Thursday and therefore the only time cardioversions are done electively. Therefore I was working on Thursday. (And therefore all my laundry caught up and passed me in the final turn for the weekend.)

Don't get me wrong - I don't mind helping out with the cardiology clinic. I usually learn a lot and think it is helpful to maintain a presence with the cardiologists that eventually make referrals for my real job of cardiac rehab nurse. I don't mind getting ready for the cardioversion itself. Don't mind getting the paperwork filled out, the consent signed, the lab run, the orders noted. Don't mind the clinical stuff of shaving the chest (if male - although I am sure they curse my name in about a week or so when all their hair starts growing back really itchy like and stuff - so I usually let Patty do that so they can curse her name) placing the defibrillator pads, starting the IV, taking the vitals, or getting the EKG to verify that they actually still are in atrial fib and really do need said cardioversion. Don't mind it a bit.

See, if a patient goes into the funky heart rhythm of either atrial fib or flutter, it's nice to get it converted back to a normal sinus rhythm. There is much debate about whether it is better to rate control (by medication)or rhythm control atrial fib- although I think the latter is preferred - otherwise why cardiovert? In atrial fib or flutter the upper part of the heart (atria) are sort of doing their own thing flopping around up there and the ventricles (lower, more powerful part) have a hard time following along and just start doing their own thing - which is good at least they are doing something - but the heart really loses a good part of its punch when the two aren't working together.



So last Thursday we wanted to get our patient back into normal sinus rhythm. The patient with advice from his physician made an informed decision to do an elective cardioversion. That is all well and good, but the part that makes me a bit nervous is having to push "the button". As the nurse helping out, I am in charge of "the button". Yep, that button. It goes something like this.

Dr. Wanner: "Are we ready?"
CRNA: "Yep." (he is sorta cocky like that)
Patient: SNORES LOUDLY- he is already under from the versed and propofol
IA Pilot Nurse: "Yes sir! Anything you say, sir!" (Nah, I usually say "yep" too - I like to pretend I am a bit more cocky than I feel)
Dr. Wanner: "Charge to 50 Joules."
IA Pilot Nurse: " Charging to 50 Joules. " (not even pretending to be cocky at this point and I select the right amount of joules on the Lifepak and charge away)
Dr. Wanner: "All clear?" (everyone scoots away from the patient - not wanted to have their own unelective cardioversion)
IA Pilot Nurse: "All Clear." (that's an affirmative)
Dr. Wanner: "...and shock."
IA Pilot Nurse presses "the button" and holds her breath.

Because what is worse than running "the button" is the one to two second pause after the shock. Any number of things go racing through my head in those one to two seconds of flatline. Really fast like this...

"where is the nearest code button, wow I really should have used the restroom before all this started, what is the ACLS algorithm for asystole again?, what is taking so long - man that pause is taking forever, is that a P wave I see - oh please let it be a P wave, speaking of P, I really do need to use the restroom, oh my, they may not be able to have an open casket funeral because I just shaved his chest, is a precordial thump good or bad these days? - I'll just let Wanner take care of that - he's got the better angle and oh please .... ahhh that was a p wave followed by a normal and lovely QRS, followed by another and another and another.



Normal sinus rhythm is a beautiful and wonderful thing after an elective cardioversion. And I'd like to say I helped - just a little.

And sort of like the A-Team of my youth... I do love it when a plan comes together.

These Three Queens...

I really have the coolest job. Sometimes you find God in the most unexpected places and today He came to work with me. Over the past year and a half I have gotten to know these three special ladies quite well. I'd like to share a little bit about them.

The Lovely Ms. E: Ms. E came into rehab today without her wig. After a year of chemo, tears, anxiety, a double mastectomy, and should we say a wig that had seen it's better days, she left it at home. And she did look lovely. Her hair had grown back in a nice soft swirl of curly silvery gray and Ms. E shone like an angel. It was more than just an opportunity to stuff her slightly matted, slightly singed, ( that's a story) completely uncomfortable wig into the nether-regions of a storage closet, but a gold medal victory over the the considerable opponent of breast cancer.

The Formidable Ms. N: There ain't no stopping Ms. N! She just keeps coming back for more. This sixty something young lady rides the stationary bike (for an hour) in rehab on M-W-F, does yoga and swimming on T- TH and tops it all off with a 4 mile walk on Saturday. This past year she has faced a heart attack, a near fatal brush with a ruptured appendix, and the death of her dear mother whom she had taken care of in her home over the past few years. After putting her 60 minutes in on the bike she was off and running to the Omaha airport to spent Christmas with her family in Phoenix, AZ. Her beaming smile rivaled the Iowa sun on fresh winter snow.

The Divine Ms. G: Ms. G. is 90 years old. She is my most consistent customer in cardiac rehab. Come hell or high water, on Mondays and Wednesdays at 9am she is on the the bike- seat at position 1, RPM 40-50, 15 minutes, BP 102/60, HR 66, weight 167 pounds - for the past 8 years. Last month Ms. G's heart rate irregularly jumped to 125 and they have been adjusting her meds to try to get it slowed down and regular again. Last night, while in the hospital it stopped. Completely. The nurses were able to get her back and this morning when I went to see her, after she complained of a sore chest from the CPR, she grabbed my hand and said, " I miss you in rehab, but it's okay if I don't come back." She lost her husband this past year also, and had taken care of him at home for a number of years after he suffered a stroke that left him paralyzed on one side. Won't they be a sight when they meet in Heaven again? Pete will probably walk out to meet her and maybe Ms G. will ride her bike through those pearly gates.


I hope I am half as strong as these women someday. I have a really cool job, don't I?