Trying to raise my kids the best I can

Saturday, August 28, 2010

testing my beliefs

I'm "quiverfull"- which is the name by which I and others like myself identify our beliefs about family planning.  I believe that every child is a gift from God and we are commanded to make them, procreation being the beautiful purpose of sex.  The word quiverfull coming from the verse:
Psalms 127:3-5 “Sons are a heritage from the Lord, children a reward from him. Like arrows in the hands of a warrior are sons born in one’s youth. Blessed is the man whose quiver is full of them.”

This isn't such a difficult  viewpoint when I want to get pregnant and given the fact that my body spaces out the pregnancies so much.  But now that I just got my dream job that we really can't afford to live without, getting  pregnant is a different ballgame.  How resolute are my beliefs?

Well, I've decided that I will stay strong in them.  That this situation will not cause me to waver in my trust in God.  We have stopped trying to get pregnant.  And awareness of cycles -a gift from God in itself- allows us some say in the matter of when, but it still allows God the final say.  And I am open to any word or nudging from him towards procreation. 

My situation might create some difficult choices.  Put the child with a caregiver or, once again, live in poverty?  .. not easy choices to make.  But God would see us through. 

My first patient death

(Details changed for privacy)

This morning my patient was excited to go home.  She was supposed to have gone home over the weekend but they kept her because she was running a slight fever.  But this morning she had 650 mg of tylenol and then I went in to take her temperature, which was, naturally going to be down, since tylenol is an antipyretic.  And it was, so me and her roommate cheered for her that she would probably be able to go home today.

An hour or two later my patient's husband flags me down in the hallway and says that his wife isn't feeling well; that she has the chills.  I go in and she's shivering.  I feel her forhead.  It's just a tad warm.  I tell them that she does have a fever and then I went out and got her the only other blanket I could find and the vital sign cart.  I tucked her in tightly and tried to comfort her.  I took her temp which was barely even elevated.  I said that it was bound to go up as she continues to shiver and that I'd get her some tylenol right away.

Then she starts struggling for her breaths and turns over on her side.  Her husband and I know, at this point, that this is getting serious.  "What's wrong?" I ask.  She said she feels "restless", which is the sign of hypoxia.  On top of that, her lips are bluish.  I immediately stick on the pulse oximeter.  It reads 93... okaaaay.  So it's not the oxygen then, (or so I thought).  The nurse I am working with, Sasha, comes in to assess for the Tylenol.  Our patient's status is getting very shaky, so we are frantically trying to figure out the cause.   She takes the blood pressure, since that's the last vital sign I didn't take.  It's normal.  I take her blood sugar, which I was supposed to do an hour ago and hadn't gotten around to yet; maybe that was it.  But no, it was 235.  That's not a number high enough to cause this sort of reaction.  We're trying to talk the patient through the situation.  Asking her what's wrong, and to stay with us and such.  I pull out my pen light and do a neuro check via pupils, only one of her eyes is stuck closed- I think from a separate diagnosis, so it's far from complete.  There was slight dilation, but it was hard to tell, given that the room was bright.  Next thing you know, her O2 sats were at 37.  I've never seen anything like that before.  Her eyes are closed.  She looks like she's really working for each breath.  There are other nurses in the room now.  They ask me to get her oxygen.  They hand me the keys.  There are a dozen on the key chain and I don't know which one opens the closet!  But I flip through them really fast and find it.  I pull out one machine with plastic and one without and ask the staff in the hallway which one is "clean".  They say I can use both.  Sasha shows up at this point, grabs one and runs off with it.  Then she's back, frantically looking for a rebreather in the clean storage room.  We end up grabbing one out of the crash cart.

When I get back in the room her O2 Sats are about 5%.  911 had been called and the paramedics were on their way.   After all the chaos, the room is now getting rather quiet and Sasha mouths the words to me that she's going to die. There was a hushed discussion about her status.  She was DNR.  The husband had been watching from a chair.  I invited him to rub her feet.  And then a little later we brought him up to her head and Sasha gently said that she's not going to make it.  The husband was emotionless. Sasha and I were standing behind him with tears running down our faces.   Then Claire came in and explained gently to the husband that the woman had signed a paper saying she didn't want to excessive measures taken to bring her back to life.  I'll never forget that the husband said "She signed that?".  It seems like something he should have known.  And maybe he did, but in the moment, who knows what you can remember.  Staff came in with the documentation.  The husband was the Health Care Proxy, which means he can make medical decisions for her if she's incapacitated.  We asked him if he wanted to honor her DNR wishes or if he would like to change that at this time.  He honored her wishes.

The EMT's were in the room.  No one was really doing anything now though because we're all just waiting for her to pass.  One of them asked what she was there for.  I opened my notes and just rattled off her diagnoses: UTI, renal failure, bla bla, bla.  I wonder if I should have been saying those things aloud right there- you know, privacy rights and all.  It was then that my boss from administration called me out of the room.  She said they didn't want me getting too emotional in front of the husband.  She told me to go for a walk with Niki (the other new nurse).  On the way out my nurse mentor said that "it never gets easier," which, actually, I found to be comforting because a) it means I'm not just a big baby and b) it is proof that I have the compassionate heart that this field requires. 

The whole incident happened in about ten or fifteen minutes.  She went from lucid but shivering to dead in seemingly an instant.  I am so so so glad that I responded to her husband's request with a sense of urgency.  There were so many other things going on and it would have been quite normal to just kind of blow him off.  You know, "We'll bring you some Tylenol in a little bit".  But I was right there the whole time, showing great concern.  Imagine if he couldn't get attention for her until she was already unconscious?  That could have easily happened given the speed of the events.  The man would always have wondered if we could have done something for her.  But he need not wonder.  He saw us do every test and every life saving measure that we could before the patient indicated that she was really leaving this earth.

I had the honor of calling her death.  Only an RN could and I'm one of the few RN's there.  They let me do it.  I listened to her heart for one full minute.  Then I called "Time of death, 11:35am".  I even signed the death certificate.


Sunday, August 08, 2010

The move!

We moved to a townhouse and it's so beautiful.  I'm so happy.  And it's smack in the middle of Lowell, which is really important to me since I'm  so passionate about city design and being able to bike everywhere.  The paint job in the place is phenomenal.  Our room is this gorgeous deep red.
We have a $4000 Mahogany four-poster bed we just purchased for $325.  And the reason it was so cheap was that it was on the third floor of a very very small apartment with the narrowest of stair cases and we had to remove it ourselves.  It's, of course, heavy and an absolute logic puzzle to get it out of there.  Definitely, worth it though.  I feel like a queen when I wake up in the morning in this room.

The boys live in an awesome "bachelor pad" in the basement, which is two floors down from me, which means I get some peace and quiet!  It has these humongous superheros sketched out on the wall, so I'm going to paint them in and then we'll paint the rest of the room a color.

Also, it means that I have a free room to decorate for Saphira.  And it's blue in case my next baby is a boy.  (Someday.  I'm not pregnant).  I have all these ideas.  I want to put our dollhouse in the middle.  My Grandpa made it for me and my mom and I collect items for it.  It's to-die-for.  And I want a dress up corner.  I have a fabulous dress up collection.  Mostly ninja costumes from Halloween, ha ha.  But nothing a few princess dresses won't balance out.  Also, silkies, which is really hot among my crunchy friends.  My mom made them for Saphira's second birthday.  Isn't she the best?

I also fantasize about a ballet bar and mirror.  My sister in law Jen* asked if I dream of her becoming a ballerina and I said that actually, not really, more gymnastics, but you can't really do a gymnastics corner, but  she pointed out that I could.  And we thought of putting in a small, just-off -the-ground balance beam and I started envisioning teaching her how to do forward and backward rolls on it, cartwheels and split leaps, full turns and someday front walk-overs and front tucks and back-handsprings and back-tucks.  I know I could teach all that if she were interested. Or I could just practice all that myself.  ha ha.  Actually, that is a very successful method of teaching a child.  That's how the Suzuki method works in teaching violin. Although, in my opinion the method has really fallen away from it's traditional successful roots. 

Speaking of music.  I should have a music corner in which I play the flute.  Maybe a stuffed animal/doll corner?  Damn this will be a nice room.  Of course there is only so much I could put in the room.  I don't know what will make the cut. 

Other nice things about the apartment: no cockroaches (which is something to be said in Lowell), central air, a balcony and grill the landlord left for us, a laundry room (!), and indoor storage for our bikes.  I'm starting to feel like we made it.  After years of struggling and just time after time of bad luck and getting screwed by life, I feel like we finally got our break.  Not only did we move to this nice place, but in three days I start my new job as a nurse.  I worked my butt off for this degree but then the economy tanked and I couldn't find a job.  After all that excruciating hard work in the hopes of a guaranteed good paying job- it just seemed like the ultimate unfairness.  And that was on top of what seemed like endless life oppression.  When we first got married our rent was $350.  In three years the going price of a two bedroom had tripled.  And unlike the generation just ten years older than us, we weren't lucky enough to ride the wave of home equity.  Sorry.  I digress.  That's a big pet peeve of mine.  How my generation got screwed. 

The move went well.  I'm so proud to say that we can pack, move and unpack in two days and with only a pick up truck.  This time was even more impressive because we did it in 2 1/2 days with a break in the middle, in which Timmy practiced for his crew team competition at the S.E. Asian water festival and I went door to door asking for donations in exchange for tomatoes.** and I washed nearly every item of clothing in the house.***  It's a testament to my decluttering and simple living, especially considering we're a family of six.   Sometimes I need to be reminded of that because often there is just stuff everywhere and I feel like such a failure in that manner (case in point: the clothes story at the bottom of the page).  Speaking of which, my friend did this awesome thing.  See, she had a baby boy and got tons of outfits for him from the baby shower.  And now she's having another boy and she pruned the closet down to seven outfits- one for every day of the week.  I think that's genius and want to do that for everyone in the family.  It wasn't possible before without a washer/dryer, but it is now.

While cleaning up the old place I was patching some holes in the walls using this foam filler.  It comes out like shaving cream and then hardens like Styrofoam.  I was smoothing it over with my fingers and I asked Timmy if that was OK as I did it and he yelled back from across the apartment that it was.  And then when I was done I went to the sink to wash it off and it didn't come off.  Yeah.  Not cool.  I tried soap and water. Lime juice.  Salt.  The bottle said to use gloves and if it gets on the skin use soap and water.  Why didn't I read the bottle first?  So I called poison control and they had no suggestions.  And in the meantime it's hardening all over my hands.  They look disease ridden and I start my new job as a nurse in three days!!!! So I'm kind of freaking out.  And I look it up online (apparently there are lots of other idiots like myself who have done this) and the unanimous answer is that you have to let it wear off as the skin sloughs off!  The good news is that apparently skin sloughs at a rather quick pace, so I'm crossing my fingers that three days should be enough.   From now on, when I'm sweeping and vacuuming all the crappy dust I will never be bothered by it again, as it is the shed skin that once saved my job.  Pumice stone is apparently helpful but I'm not using a pumice stone on my hands (the back of them anyway).  Come Tuesday night I might be desperate enough though. In the mean time, my hands are living breathing pumice stones.

*who helped us move and made us a gorgeous cake as a move-in gift.

**which was completely unsuccessful.  The first four doors no one answered.  And the next two they didn't want any tomatoes.  So I gave up.  On the positive side, I did get to see a woman recovering from a nose job.  Very interesting.

***  the background story to that is that when I found out we were going to move, three weeks ago, I stopped hanging up the laundry- figuring we'd just bag it or put it in boxes anyway.  But then as the weeks dragged on we started going through it for clothes (wasting an enormous amount of time, btw) and eventually throwing them everywhere and stepping on them.  So when we moved I didn't even bother trying to sort the "clean" from the dirty.  I just washed it all and hung it up as it came out of the dryer.  It's a nice fresh start to our new life here anyway.
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