Known Knowns

Good lord. I haven’t posted this few times since…I don’t know, probably since I started blogging. It’s just that the distinction between school and life is becoming less and less clear, no matter how hard I try to keep them separate. It seems that this semester, I have less and less time to think about things other than school, which is funny because I thought things were going to let up once I was done with pharmacology and pathophysiology. Instead, the clinical work is getting more and more detailed. Someday, I may end up merging my blogs, but I really do think that knownknowns.org helps me keep some perspective that isn’t totally based in nursing. I value that a lot.

The sad thing is, I don’t have a lot to say, unless you want to hear about my OB rotation, which is boring as hell. It’s not all bad, it’s just that floppy vaginas aren’t really my thing, and I like sick patients, not healthy ones.

I’ve been paying some attention to the election, although I didn’t get to participate on Super Tuesday for the previously  mentioned reasons. I have to say that I think the democrats would be making a huge mistake to put Hillary up as the candidate, given her incredibly divisive nature, and her propensity to cry on command if it means someone will vote for her. I also have to say that although I hate, hate, hate John McCain’s love of the Bush administration, I would seriously consider jumping ship if it meant I didn’t have to vote for Hillary.

I. Will. Not. Vote. For. Hillary.

I also dislike John McCain’s policy on the war, but the bottom line is, for me this election is all about finding someone who is honest (a total U-turn from what we have now.) I will likely never find a candidate that matches my ideals in every way, so honesty is my compromise. I don’t believe that John McCain is a liar, nor do I believe that  Barack Obama is a liar, although I think he has more potential than John McCain to end up there. I fully believe that Hillary Clinton is typical politician: scheming, conniving,  and a liar. And for once, we need someone to tell us the truth, whether we want to hear it or not.
I still wish Joe Biden was running, though. Or John Edwards. Wah.

• On top of all the crap we went through with our vet last week, Roland now has kennel cough. My poor baby hacks like an old man all night long, and during the day he lays on his doggie bed and sulks. I think we’ll be finding ourselves a new vet after this. Because kennel cough is so contagious, Roland can’t go to the dog park until he’s completely cleared up. Until he stops eating and drinking altogether, I refuse to put him on antibiotics because he’s young and healthy and should be able to fight on his own. I feel terrible for my little guy, and so does Josh, who even let Roland ride in the back seat instead of the hatch of our Suburu. Despite that, I admit that it’s kind of nice having a normal dog for once; meaning, one who doesn’t have an agenda for the first time in his life, and is content to lay on his bed and just hang out with us.

• I actually watched the Super Bowl last night, although I didn’t know who was playing (or that there even was a game) until that morning. It was the best game I think I have ever watched. I love seeing the underdawgs pull-through. The Patriots clearly had some karma coming their way (with their cheating and Tom Brady’s little stunt.) If all football games were that exciting, I would definitely be a fan.

• Instead of football, my family raises me on politics, and thus, we are all looking forward to Super Tuesday tomorrow. We plan on being glued to the television all night long, and I can’t wait. Unfortunately, Colorado doesn’t have a primary election; instead, they use a caucus. Normally that’s not such a bad thing, but I’m registered as a libertarian so I don’t get to participate tomorrow. DAMNIT. In my heart, I AM a libertarian, but if that means I don’t get to go out and play on Super Tuesday, forget it.

• I’ve been exercising. A lot. And the best part is I’ve been enjoying it and really making an effort to make it part of my schedule. I found a fun kickboxing class at the rec center (makes me realize how much I miss karate) and we play dodgeball on Friday nights. We haven’t won yet, but at least it’s good exercise. I’m also doing this program called CrossFit which is a pretty intense routine that a lot of gymnasts and police officers use, apparently. I love it because it causes me enough pain to make me feel like I’ve done something. I also like the varied routines, not having to come up with any of it myself, and my favorite part is that I can see tangible, real progress, which is so important to immediate-gratification-types like myself. Check it out for yourself at www.crossfit.com. I vowed to try it for at least a month, and now my month is past, so I’m going to keep on it for another month and re-evaluate then.

This month has been ridiculous. So ridiculous that I haven’t even been blogging, which means it’s been really ridiculous.

I had the worst day today that I’ve had in a long time. We got a huge vet bill from boarding Roland over the weekend. He tested positive for giardia again despite being vaccinated, and they treated him again despite the fact that he didn’t respond last time. They gave him a bath but they didn’t trim his ten-foot-long toenails, which was part of the deal. They didn’t put him in doggie day care like we requested, so he was probably kenneled most of the weekend. And on top of that, he’s lost weight and muscle mass (probably because we haven’t been exercising him enough since I started school) and now they think he has pancreatic insufficiency and want him to have a $200 blood test to prove otherwise, even though I pointed out that he doesn’t have the main symptoms: constant diarrhea that is grey and slimy, and a total lack of energy from not getting any nutrients. Quite the opposite: he’s hyper to the point of me wanting to euthanize him (I’m kidding) and his poop is solid aside from when he gets emotional about something. So I’m pretty frustrated with the vet right now.

After that, I went to a new dentist who’s advertisement stated that she had lots of cool stuff for people who have dentist-phobias. It was cool that I got to watch Barack Obama on the ceiling, yes, but I was going to get out of there cavity-free until they used a frickin’ laser beam that showed that I had a cavity that was so small it wasn’t showing up on an xray yet. Bleh. Frickin’ laser beams.

Then I went to the post office and apparently bumped into the rudest woman in my life who told me that my mother would be sorry if she knew she’d raised me with no manners. This was after I evidently bumped into her twice without realizing it, although there were about 40 people in line. I set her off when I accidentally put a piece of paper over something of hers while we were sharing a tiny space to write addresses on. I had a few choice words for her, but her young daughter  (or niece or whatever) was there so I refrained. I cannot tell you how badly I wanted to swear, and how loudly, too. Mostly, I just wanted to tell her that she better hope and pray that she is never my patient. Karma will beat that woman over the head some day, preferably with a large blunt object. I probably wouldn’t have been so pissed, and would have been ultimately more clever, if I hadn’t been having such a bad day to begin with. If there’s a god, he or she was without a doubt testing me today. I believe I passed when I chose not to tailgate that woman all the way home or sic my German Shepherd on her.

After that, I went to the dog park, and I swore that if anyone jacked with me, I was really going to lose my temper. It happens very rarely but it can be quite earth shattering. Luckily, everyone got my vibe and stayed away.

I hope you’re all having a better day than I am. Admittedly, I feel much better after an hour of hard kickboxing. I hope to post more in February and it won’t all be negative, either!

When I was a little kid, I wanted to be Katie Couric. Or, maybe an actress or an orthopedic surgeon. Or a writer. Or a psychologist, lawyer, nurse, or tap dancer. I really wasn’t that different from any other kid.

As I grew up, life took me places and my dreams changed. I took my ACT in high school, did moderately well, and went on to study theatre, as many moderately-well scorers might do, at least until their parents threaten to stop their funding unless they change their major to biology. Still, it wasn’t a terribly atypical teenaged dream, really.

Until today, I thought that my childhood aspirations were special, or at the very least, semi-interesting. That was, until I read an article today about a pair of twins who received perfect scores on their ACTs. It’s rare enough that one person gets a perfect score (according to the article, it’s only one in 4,000) but to have identical twins who receive honestly perfect scores, well, that’s something else. Although ACT scores certainly aren’t everything, it takes more than your average dingbat to do well on them. You don’t get a perfect score out of luck. These boys certainly have the world at their feet, and many exciting decisions await them.

I continued reading the article, assuming they would be attending Yale, Harvard, or some other out-the-butt expensive school. The type that has a Crew and Sailing team, and where famous-but-kind-of-washed-up people like Burt Reynolds make the commencement speech. That type.

The twins suprised me with their apparent desire to attend a small, private school like Creighton. No shame in it, thought lowly-achieving, 75th percentile ACT scoring I. In fact, good for them. I happen to be a huge fan of small private schools, having attended one myself, and quite enjoyed it despite the fact that I wasn’t able to participate in lightweight Crew and despite the fact that the commencement ceremony music was a previously recorded harpsicord.

I continued to read the article, interested to hear about the aspirations of such intellectually-blessed high schoolers. Certainly they didn’t want to be Katie Couric or a tap dancer, but maybe a doctor or a lawyer? That’s the type of thing I expected.

The boys continued to exceed my expectations. While one of the boys; Ross, did express a desire to become a doctor or a psychiatrist (and lord knows we need more psychiatrists), the other twin, Brian, was the one who’s response made me blink at least twice.

Brian, evidently, has always dreamed of becoming…drumroll please…

An actuary.

After my double-blink, I had to look up what an actuary is. Or does. I guess I’m not alone in my perceptions of this career, as there is actually a  website called beanactuary.com with an entire section devoted to “What is an Actuary?” just in case you happened to be googling random phrases and this one popped into your head. (Like “strategery.”) Apparently, an actuary is a “career without boundaries.” And, in case you’re wondering, here’s a little bit of text that I stole directly from beanactuary.com :

The future is full of uncertainty. Some of the events that can happen are undesirable. “Risk” is the possibility that an undesirable event will occur. Actuaries are experts in:

• evaluating the likelihood of future events,
• designing creative ways to reduce the likelihood of undesirable events,
• decreasing the impact of undesirable events that do occur.

And just so we’re clear, I did not add those bullet points for effect. But it is reassuring that the word “risk” is defined for you, isn’t it?

I would just like to say that if there is a real, live actuary reading this post, or if one of these magnificently scoring twins has stumbled upon this blog, I certainly mean your profession absolutely no harm. It’s just that as a writer, I am constantly on the lookout for things that amaze me. I have never met an 18-year-old who wants to be an actuary.  Professional football player? Yes. Actuary? Huh.

As much as I jest, after Brian receives his B.S.A (Bachelor of Science in Actuariness) he is undoubtedly going to be making a crapload more money than I will ever hope to make wiping the butts of the patients in my care.  My own high school aspiration as a theatre technician involved pointing a high-powered lightbulb at someone’s face. Brian is light years ahead of me. No, I can definitely see how actuariosity would be a much cushier, cleaner, and financially more stable career. I wish Brian much luck in his quest for actuariness, and I invite him to flick a booger onto the windshield of my 1992 Toyota Corolla with the screaming alternator belt, when he flies past me in his bright red, leather interiored Ferrari, with the sexy-voiced GPS, and which will, of course, have not a speck of dog hair on it because the servants take care of the pets, no doubt.

I still don’t really know what an actuary does, but I also just want to say that if it has anything to do with calculating the rate on my life insurance policy, then I take back everything I said and I’m thrilled and completely unsurprised that someone with your brains and talent is choosing a career of this magnitude. Best of luck to you, Brian, and may your life be full of risk-free riches. I have no doubt that actuaries have really bitchin’ office parties.

• POLITICS: I don’t appreciate John Kerry’s endorsement of Barack Obama. It just seems snide. Although there’s obviously no rule that he has to endorse John Edwards. ::sigh:: I also don’t appreciate Hillary Clinton’s good ol’ cry. I don’t begrudge her the cry, itself, but I trust her so little that I can’t fully believe that she didn’t do it on purpose.

• DEATH: I’ve been thinking a lot about death lately, since we recently had the pediatric hospice lecture, and there is a kid on ECMO in the NICU where I’m working who is about to bite it. (If you don’t want to click on the link, ECMO is basically a last-ditch form of bypass where machines control the heart and the lungs entirely.) I’m not a religious person. I try to be spiritual. But mostly, I need to put my thoughts together regarding this issue because I’m only going to see more of it, where I’m going. I only know that I don’t believe the actual event of dying is painful. Maybe everything leading up to it is, but not the death, itself.

• GUITAR HERO: My husband is officially obsessed but I’m not quite there yet. I do enjoy it, though. One of the things I plan on doing when I finish school is picking up my guitar again. I’d like to take lessons, too. Come to think of it, I need to make a list of things I’d like to do when I graduate, because the official day is December 12, 2008. Just had to slip that in. Don’t ask me what it has to do with Guitar Hero.

• HARRY POTTER: Warning: Spoiler alert. Move on to the next blogbit if you haven’t read them. I finally finished all seven, six months after I began.The final book was good but you can definitely feel it getting more “Moviefied” by the end. The very last chapter, though, made me want to toss the book into a fiery pit. Everyone had grown up and named all their kids after the characters that died. It was quite possibly the most contrived chapter I have ever read in my life. Other than that, the series was fine.

• SCHOOL: Oh, c’mon. I couldn’t do a blogbit without mentioning it. I’ve finished my first week in the neonatal intensive care unit and I actually surprised myself by really enjoying it. Two weeks to go, and hopefully next week I’ll have a baby in an isolette who’s a little more sick. Is it weird that I prefer ‘em sicker, no matter what?

• ROLAND: Poop. Haha. Gotcha. He’s fine. Not liking the fact that I’ve been so busy this month, but he’ll live. We have started leaving him out of his crate for short periods of time while we’re out of the house. I’m please to report that he has neither killed a cat or had explosive diarrhea.

I apologize for my total lack of posts. I actually have been posting a bit more on my nursing school blog, but still…

I had planned on spending a few more days on the couch than I actually did, after the knee surgery. I recovered a lot faster and thus, a lot of my plans for things to do never materialized. Well, here’s to fast recoveries! :::clink:::

After that, I was whisked away to my parent’s house in Kansas City where I did very little posting mostly because I was spending so much time with my most darling niece. I flew home on January 1, and was at school by 9:00am on January 2. We had eight hours of lecture that day, eight hours of hospital orientation the next day, and eight more hours of lecture yesterday, bringing me to today.

I may have to take January off from this blog, as I am going to be totally inundated with nursing school. January is my intensive pediatric clinical and so I may not have much else to talk about besides being in the NICU at the Children’s Hospital. I dunno. I’m going to do the best I can at posting once a week or more, but if this week was any indicator, I just don’t know if it’s going to happen.

**Note: I actually wrote this post on New Year’s Eve. Then, my computer ate it. Three days later, after much mourning and even after writing half of a new post, WordPress coughed up the original out of nowhere. Happy New Year to you, too! (I am going to backdate the timestamp.)**

I have actually been thinking about writing my 2008 Goals for several weeks; it is now five hours until 2008 so here goes nothing. The first thing I’d like to do is re-evaluate my goals from last year to see how I did.

Goal: Expand my food palate and, in particular, eat more fish.

Outcome: Good! I now consider salmon to be one of my favorite foods and try to eat it at least once a week. I even order it at restaurants where I can’t watch how it’s prepared. I also like other fish: halibut, swordfish, tilapia, and mahi mahi. So, great progress there. However, I still hate onions, so no progress there (but I wasn’t really trying.)

Goal: Do the Pike’s Peak Ascent again.

Outcome: Yes, I did it again, and you can read all about it here. All I have to say is that at one point, I seriously wished someone would just shoot me in the face. I did NOT train for it, but I did complete it. So there.

Goal: Get Roland his Canine Good Citizen certification.

Outcome: Not even close. He’s not even in any formal training right now due to my weird schedule. Also, mentally he is very much a puppy (even though he’s one year old) and very silly and nowhere near mature enough to be certified. I don’t mind though; he’s still doing really well and this is just going to be more of a long term goal.

Goal: An unstated GPA goal for nursing school.

Outcome: Well, I got all A’s, so I guess I did okay. I’m still not so good at letting the pressure off myself, especially now that I’m two semesters in and still doing so well, academically.

Goal: Improve bowling score from a 56.

Outcome: Rocked it. I bowled a 62 a few weeks ago. Boo y’all.

So, all in all, I’d say I did really well on these resolutions. In fact, 4 out of 5 ain’t too shabby at all, and I have to say I’m proud of myself. What do I have in store for 2008, you ask?

• Exercise. I know, I hate to be one of the one gazillion people vowing to go back to the gym in 2008 but maybe if I do it now, I can just maintain it and never have to use it as a resolution again. The truth is I’ve already started, so it’s not quite as cliche since I won’t be officially starting on January 1, 2008. I’m trying out this new program called CrossFit and plan to re-evaluate in three months. If I hate it, I’ll try something else, but I want to really focus on staying active.
• I’d like to make a gift to Harlaxton College, where I studied abroad and had the most amazing semester of my life, bar none. I don’t know when I’ll make that gift, and I don’t know how much, but this year I’ll do it.
• I would like to start composting. Also, I’m not going all hippie, but I did get some reusable grocery bags for Christmas, and I think I should be using the bus a little more. I’ll work on that.
• I’d like to continue the success I’ve had in nursing school in several ways: keep my mind open to things that may not initially seem appealing (like pediatrics) and refrain from gossiping.
• I will make a real effort to clean the litterbox once a week at least. I plan on doing it when I do my own laundry,which is every weekend almost without fail.

Today is my third wedding anniversary. What does it mean to me, you ask? Another day to celebrate how lucky he got when I stuck with him after he called me the wrong name. Only kidding. He’s the best thing that ever happened to me and I’m still crazy about him. Here’s the 2007 Josh n’ Caroline Photo Collage to celebrate.

I LOVE YOU, JOSH.

 January: I wouldn’t want a New Year’s Kiss from anyone but him!

 February: A facial for Valentine’s, and it wasn’t even a hint. (Or if it was, I missed that.) And a party to celebrate my acceptance to nursing school right after.

 June: Our first scuba trip to Bonaire.

 June again: Hawaii!

 July: The hottest groomsman at the wedding! (And the hottest bridesmaid, too…)

 August: The couple that suffers together stays together.

 September: Drunken karaoke. And he still likes me!

 October: I don’t know how I got the bike helmet on, or what it had to do with my costume, but, I wouldn’t want to be wearing it with anyone else.

 November: Our first $90, 10 lb. fried turkey.

 December: Still together after another cold camping trip.

I got my stitches out today and have been cleared to go back to the gym, although I can’t swim until next week. As a self-titled “layman’s expert” on arthroscopic knee surgery, I’ve decided to write a Patient-to-Patient Guide on Survival. My mom and I always got a kick out of the lame tips that the local news was always giving out, such as “drink lots of water when it’s hot out!” and “wear a hat in cold weather.” Now I’ve decided to throw out some tips of my own. This is in no way medical advice, and may not apply to every situation; just mine.
1. Take your pain meds! If they make you ill, tell your doctor. Well-controlled pain is a hallmark to good healing. Try taking the narcotics with a large meal if they make you sick. Make sure you talk to you health care team (nurse, anesthesiologist, doctor) about your pain management right after surgery. If you have a history of nausea, let them know. We have drugs to help these kinds of things!

2. When elevating your knee after surgery, put the pillow under your ankle (not your knee) to regain full extension. Do it right away, while the anesthesia is still kind of in effect, to lessen the pain. This will help you regain the motion in your knee quickly, and is also key to getting off crutches and making a full recovery.

3. Listen to your body! This may be the most important thing. If you feel like you need crutches, use them. If you feel like you can go without, do so. Your body is an amazing communicator and will let you know almost immediately if you have overdone it. That being said, plan on spending at least two or three days on the couch with your leg up. Do not go back to work and try to move scenery 72 hours post op like I did the first time. Give yourself time. Your body will thank you.

4. Do your PT exercises. It definitely sucks during the first few days because of the stiffness and swelling, but if you concentrate on things like very slow heel slides and straight leg raises, just a few times a day will really improve your recovery and get you back on your feet in no time. If necessary, take your pain medications 30 minutes before you do your exercises.

5. RICE. I cannot extol the virtues of RICE enough. That would be rest, ice, compression, elevation. I felt that my compression stocking did a lot to reduce the swelling. I also slept with an ice bag on it, and I’ve already mentioned the minimum two to three days on the couch. If you’re going out, consider wrapping your whole leg in an ace bandage to reduce the swelling. Less swelling equals less pain equals more movement equals better recovery. Your knee will tell you when it can tolerate anything less than constant icing. Seriously.
6. Don’t forget to wiggle your foot a lot. You don’t want to end up with a blood clot in your calf, which can happen when there’s not much movement of the blood in your lower extremity. A good way to prevent this is to pump your foot up and down a few times an hour. It doesn’t even hurt.

7. Trust your team but don’t be afraid to ask questions. I’m not saying that there are never royal screw-ups, but for the most part, your health care team probably knows what they’re doing. They are there for you, to answer your questions and get you back on the road to climbing mountains, or whatever it is you need your knee for.

8. It will get better. It is hard to imagine that when you’re looking at a c antelope where your knee used to be, but pretty soon, you will not even remember what it was like right after surgery. The body is amazingly good at forgetting pain. Just don’t push your luck.

Despite the fact that my DVR/Tivo is totally devoid of anything interesting to watch, and I’ve now seen Father of the Bride at least three times, I support the writer’s strike.

People think that the actors they watch on TV make up every line that they speak, in every sitcom or movie. They don’t realize how hard it is to write funny material, week after week, with the pressure of ratings never far away. What they don’t know is that Hollywood is a collaborative effort, just like health care is. Nurses and physicians must work together to get a patient healthy, although they have differing roles. Writers and actors also work together to make sure the shows are funny or serious or poignant or what have you. If the line isn’t funny to begin with, no actor can make it funny. Likewise, a bad actor can ruin a fantastic script. It’s a big job, and I think this strike is finally beginning to call attention to that fact, especially now that the Guild is refusing to allow certain video clips be shown at the Oscars, as well as refusing to work on the Golden Globes broadcast. Good for them.

I don’t care how long it takes and how many episodes of bad reality TV I have to watch. I will support these people till they get what they deserve.