My patient gig is up...for now

Recently, I got to go on the other side of the fence. I had a sleep study in a sleep lab, after my two home studies looked funny.

I got basic prep over the phone, but I still had to call to make sure it was okay to take my meds in advance, etc. Preparing Dahey and Bubba was fun, too. They are always wanting instant communication when I am gone, so I had to let them know I was going to spend most of my time there sleeping. Translation: Don't call and send me a bunch of text messages. 

To keep the environment quiet, I had to turn off my cell phone and all my electronic devices since I was going to be wired up in bed. They budget 45 minutes to do this. My tech was great. I got wires on my head, which seemed to involve sandpaper, to make sure the electrodes and the goop got a good seal. I also got belts around my chest and waist. For good measure, I even had some leg electrodes with weights (kind of like those used when fishing). All the leg ones were attached with a good amount of goop and sealed with Medipore tape.

My room looked just like a hotel: heavenly bed type setup with a million pillows, flat screen TV and there was even a very nice leather recliner. Since I hadn't had any caffeine all day, I was ready to go to sleep when I got there.

Lights out were at 9PM for me. It took me about another hour to fall asleep. Then the fun started. My cannulas came off, not once, but twice. My room got hot, so the tech had to come in and cool it down. She warned me of this earlier, because if you sweat, the electrodes can come loose. (No way I was going to do this one twice!) Finally, the room got cooler (I think the duvet and the pillow top on the bed made me hot, but not sure.) I slept, but it was not quality sleep. I could hear trucks going down the road outside.

Miraculously, I woke up and it was nearly the wake up time we discussed when I started. I had to take all the wires in the bathroom with me, but when I got back, she took them all off. Relief!

The PhD who interprets the labs was in before I left, so I got a report. Yes, I have periods of apnea, but since none was severe enough for CPAP during the night, I probably won't get one. (My best sleep is on my side, so he recommended that). I just missed the score for a CPAP (barely). What does this mean? I will have to discuss with my doctor and see what he can wrangle with the insurance company.

As Dr. X, the pulmonologist told me, the PhD said he'd just put me on one, too. A borderline score shouldn't be an eliminator, but since insurance companies look at the almighty dollar, it is. CMS even has guidelines on this for Medicare. There are alternatives which I will have to check.

Now, I just have to wait until my next appointment to see what the verdict is.

This is going to be a bad Monday

How do you know?

1. Your kid is sick with this (when you were hoping it was just a migraine).

2. Your town is experiencing an ice storm. (even better reason to be trapped with all these germs inside). My Lysol fumigation continues...

3. You planned a busy day while kiddo was off school (doctors appointments, dentist appointments, meeting your friend for lunch). All get cancelled.

Maybe I just need to go back to bed and hide until Bubba calls me again...stay tuned.

Perfect storm

My morning:

Bubba wakes up way too early and runs to the bathroom. Vomits like crazy. Says, "I feel much better" and goes back to bed.

I wake up right after, and was amazed that I didn't have anything to clean up (I really hate vomit more than anything else). Got a good enough migraine that I thought I might also be heading to Vomit Land. Interrupted such thoughts with the good old sumatriptan, instead.

Hung out and laid low. Called into work sick. School calls and says Bubba has no school. Rejoice that I don't have to play Vomit Roulette and send him to school.

Bubba did perfectly fine the rest of the day. Once I rested for a bit, so did I. Made Bubba and I a little breakfast ('cause migraines make you hungry...at least when you realize how long it's been since you've eaten).

Finally started working on my slides for the next big gig. Bubba, meanwhile enjoyed himself and read books and watched movies.

I'm just hoping they have school tomorrow. This snow day business is getting old really fast.

TGMG (Thank goodness Monday's nearly Gone)

Every day begins with an act of courage and hope: getting out of bed.~  Mason Cooley

Yes, it was courageous in RehabLand today because it's cold again. I am happy it was not as cold as Sunday, or that my sister-in-law's holiday wish (snow) did not come true. Bubba needs to go to school as long as possible.

I worked on a lot of weird stuff because I may be relocating soon due to construction. Our business manager returned from medical leave recently, so I'm hoping the construction manager will give her information on when that might take place.

I just love being in limbo.

Stay tuned...

 

What's what: this week's Sunday Stealing

Getting ready for the week and Veterans' Day. Here's the latest meme from Sunday Stealing. Enjoy!

What is on your bed right now?
Dahey. He's asleep.

What is the best ice cream flavor?
Hmm...pistachio

Did you wake up smiling this morning?
I woke up in a hurry, so I don't remember.

What time do you wake up on a typical morning?
Between 4 and 7 a.m. (varies, but alarm assisted during the week.)

What holiday makes you sad?
It depends on who is with (or not) with you.

Where does a good night’s sleep rank on your priorities?
Top 2. Must have sleep!

One song that makes you cry?
"I drive your truck" is one that gets me.

What food do you find disgusting?
Liver. Just don't like it.

Bed-lam

Yes, I'm being silly after my most recent evening shift because I can. I feel fortunate that I left with my mind reasonably intact to drive home.

It's not even a full moon, but the crazies are out. We must be running a special, and while we're not a polytrauma unit, we keep getting TBI patients, who just came off one-to-one status. We don't have enough regular staff, nor PRN agency staffing, like the mothership, but they can send us people and suddenly, they don't need that one-on-one anymore. Hmm, must be a lot of miracles going on these days at Madison. The only miracle I see is the patient leaving one place for another (our little unit).

The crazies aren't actually the TBI people. Happily, they've been quiet. The crazies are our regular, crochety characters who really need to go home. They're bored, so they create problems to get attention diverted to them from other patients.

One regular decided his bed was too hard. (Remind you of someone...maybe Goldilocks?) We called the bed vendor. They check out fancy low air loss mattress on the bed. Bed works based on all their requirements. Patient waits until bed vendor is gone. Patient goes crazy, rings lights, spews expletives and acts all sorts of silly, just below the level where we can call security and get him some nice Haldol (a spray can of that would have been a delight). Charge nurse had to get one of our regular beds and plop Crochety on it, so he'd finally be quiet, for a moment. He continued to be a regal pain all night, for one reason or another. Sometimes, I think this patient did this because he was genuinely bored and it is truly a control issue.

My patients were reasonably good, but I always wonder why the boss gives me the assignment I get. It never ceases to amaze me that I get an assignment to give out pills to half the unit and try to feed two people at once.

Besides Mr. Crochety, we had a guy get unstable on us, so he took an ambulance trip. He was diverted from the hospital we intended to send him to, so the charge had fun getting with the ambulance crew to find out where indeed he was, since she had no idea to whom to give report. Turns out this patient verbalized chest pain and they pulled off and got him to the closest hospital en route instead of trying to get him to Madison.

I ended the night by finally doing all of my charting. I usually chart as I go, but there was no way to do that on that shift. Finishing with my faculties intact was enough relief for me.

Stay tuned...who knows what wild and crazy stuff the weekend will bring!

Still going...

I had the colonoscopy patient again today. I had to try to sell the GoLytely gallon again, and I fell short of my quota (only 3/4 of a gallon went down). I did have plenty of help from the other nurses on the unit to get Mr. Colo turned and cleaned up each time.

Did I mention that Mr. Colo is big? Not just big, really big. His bariatric bed takes up most of the room. Imagine your favorite football linebacker in bed and you'll have a pretty good idea of his size. Mr. C. has very large legs and he cannot help us turn. As a result, he has the usual pressure sores: on the sacrum and legs. Surprisingly, since we're doing the prep, he's turned a lot. We have to get him clean, and we have to turn him to do it.

Mr. Colo finally got his liquid lunch after I scoured the unit looking for broth and juice. I only found broth, so we got out one of his clear sodas until it arrived. Thankfully, our dietary staff did not include red gelatin on this tray. I'm just hoping he got enough GoLytely that he's cleaned out for the procedure. If not, he gets to do it again next week.

Besides Mr. Colo, I got one of my other patients up in the wheelchair and I got the med wagon on my favorite end. Most of the people on that end are pretty mellow, but they were getting antsy today. It must have had something to do with their special monthly luncheon or something. The volunteers served it early, so they were wigging out when I wasn't down to there rooms by the stroke of 12. Eventually, they calmed down.

Happily, I got the last round of meds passed and I didn't hear a peep out of any of them. There weren't too many pills to deliver and everyone was in a good mood.

One more day...hopefully, Mr. Colo's prep is done by the time I get there tomorrow. More later. The weekend's just a day away!