May, 2006 Archive

May 16, 2006, 2:37 pm

There’s No Playin’ Around at Grand Rounds!


Hey, these kids are pretty well stocked with equipment!

I had to use “pretend” stethoscopes growing up!

But you won’t have to pretend anything when you visit our good friend dr.ibear at Doc Around the Clock where you will find this week’s edition of Grand Rounds.

And, of course, a big thanks to Nick at Blogborygmi for keeping GR up and running

And a HUGE hug from me for Dr. ibear for not linking sooner!

You da man!

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May 14, 2006, 4:14 am

It’s Done: Life Goes On


Would someone tell me why a company for anesthesiology equipment would call themselves “Air Reduction”?

I’m just askin’.


Well she wasn’t male.

And she wasn’t in white.

Tonight Dr. God-the-Surgeon removed a very infected gallbladder from my husband.

Two small stones. I guess with gallstones, it’s like real estate: location, location, location.

She had been up all night last night and at the hospital most of today. Weekend call for general surgery has to suck big time.

She came in ready to do the surgery early because of elevated liver enzymes and an inability to keep hubby’s blood sugar normal, only to discover that he had been receiving an ADA diet and not a clear liquid diet as ordered.

She had to wait until 2100 to begin the surgery.

She’s tiny, she’s tough, she’s all business and I wouldn’t want to be on the receiving end of her wrath.

That was saved for the day nurse whom she called at home after she found out about the diet.

She finished her work at the desk in the recovery room as I joked with my husband. She was exhausted. She wanted to go to bed. She needed to go to bed.

And sometime tomorrow morning she will go to place flowers on the grave of her mother.

You see, Dr. God-the-Surgeon is also human.

But then I knew that all along.

Tonight I’ll say a prayer for her and her family and one of thanks that my husband was in such capable hands.


Sitting at the right hand of our surgeon, more more specifically, at the head of my husband was his anesthesiologist.

How often do you get to talk and joke with the anesthesiologist post op?

He was young (where are all the old doctors these days?) and handsome (they don’t let ugly guys or gals into med school anymore, apparently).

With a friendly concern that was touching to hear (he had just met my husband pre-op), he listed the risk factors that we had already heard along with a nasty triglyceride level and a cholesterol level that needs a date with Lipitor.

He said that my husband could live another five years, “my friend” if you go on as you are, or you can change your lifestyle and live to enjoy your retirement. “Thirty years!”

All said with a wonderful Russian accent.

Now hubby was higher than the proverbial kite. All the potheads in the entire Haight-Ashbury district in 1967, taken at once, were not as high as my husband.

I don’t know how much of the conversation John will remember.

But I will never forget that anesthesiologist.


What this means is that tomorrow my husband and I begin a new lifestyle of healthy choices and excercising together.

I can’t even begin to express my thanks to all of the Emergiblog vistors who left such nice sentiments and best wishes.

My sincere thanks to Amy over at Diabetes Mine who was the first person I emailed when I got home last night in an absolute panic. Your email was the first thing I saw this morning and just knowing you were there helped tremendously.

If you are ever dealing with a patient with new onset diabetes, in addition to having them speak to your hospital’s Diabetes Educator, I would suggest giving them the web address of Amy’s site and the site of the American Diabetes Association.


I am a firm believer (when I can get a grip on myself) that all things work to the good.

Two things that confirmed this belief tonight:

  • If hubby had not developed those two gallstones, he would not have discovered his diabetes. Who knows how long he has had it? As it turned out, it was discovered before his blood sugar reached a dangerous/lethal level. Now we can be proactive and control it.
  • I have a few risk factors myself that hubby has been encouraging me to mitigate and all I could say was “stop nagging me”. Now we can mitigate our risk factors together. And I understand his concern was for my future health and not nagging. And because I know what it is like to be “hounded” over health issues, I will help hubby take control, but I cannot do it for him.

Our house is now an official ADA house.

My teenaged daughter thinks this will help her lose weight.

She’s so fit as a distance runner, I get a full anatomy lesson of the musculature of the legs every time she walks by.

Oh, to be that young again……………

Now, this will be the last post on this family illness that will be on Emergiblog. I have one more post in my head that may touch on it slightly. If I get the urge to write a blog on our experiences with Diabetes as we work on our lifestyle changes, I’ll start another blog.

Maybe I’ll name it after the old Guess Who song, “No Sugar Tonight”!

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May 13, 2006, 3:16 am

When the Rock Crumbles: the ER Nurse as the Family Member

jelloI actually remember getting Jello, handmade in the hosptial dietary department, molded into this wonderful mound of cherry goodness!

No pre-packaged generic gelatin in cups back then, no siree!

They called it a clear liquid, but I called it a treat.

I had a head injury with LOC, vomiting and photosensitivity. No CT to confirm an intact cerebral cortex, of course. It was 1963.

But my roommate had a broken leg in traction and I was so jealous of her because she got real food.

Let me tell you the smell of those scambled eggs in the morning as they passed my bedside still waft through the nares of my memory.

Unfortunately, the midnight rectal temps that woke us up from a sound sleep are still, um, inserted in my memory, too. Blech!

You said you can’t have it all?


The majority of the following post was written on a paper towel in a local emergency room. And while no names of doctors or the facility are noted, I received the permission of the patient to tell his story in detail.

The patient is my husband.


It is 1630 and I am sitting in “Local ER With Trauma Center”. The same ER that “treated” my chest pain.

Only this time, I’m the family member.


I had gone to bed at 0600, having returned home from my shift at 0430.

At 1030, I was roused by my husband, who reported to me that he had come home from work after one hour because of severe bilateral upper quadrant abdominal discomfort that radiated into his back, bilaterally, under both scapula.

I woke up enough to ask if he had chest pain, nausea, diaphoresis or shortness of breath. Negative answers to all. Positive increase in pain with right upper quadrant palpation, abdomen non-distended and soft. No change with movement. Bowel movements normal. Color good, skin warm and dry. (Who says you can’t assess when you are half asleep?).

Tums ineffective. I gave him Protonix, which they felt would be so helpful to me with my left anterior chest pain. Must be dynamite on abdominal pain.

And then the man who blanches at the word “doctor” and at age 51, has never seen one, said the words that gave me goosebumps.

“I’m going to the ER.”

No, he said, I didn’t need to drive him. Besides, I had to work at 1900 and he’d call me with the results. I needed to sleep.

Given this ERs stunning treatment of my chest pain, I figured he’d wait for two hours, then get called in, given a GI cocktail (with viscous xylocaine, if he was lucky), wait for a few lab results and then get a referral to an internist.

Well, he waited 90 minutes, was roomed and waited two hours before the doctor saw him. By then I had to wake up to pick up my daughter from school and hubby wans’t home. I called the ER.

They just now had drawn his blood.

Brought daughter home, threw on an outfit that just “screamed” professional – my Journey tour T-shirt from last year – and went to the ER.

Hubby was in ultrasound when I got there. But his roommate was nice enough to let me know they had given hubby pain medicine and taken him to ultrasound. And that his blood sugar was almost 300.


(Ah the joy of a roommate – HIPPA eat your heart out, you don’t stand a chance!)

We did not know the results of the ultrasound for two hours.

It had now been seven hours since admission.

Hubby had gallstones. Nobody said…the “D” word…yet.

It was not easy leaving my husband briefly to go get the kids dinner, get my son to drive me back to get hubby’s car. By that time hubby had been waiting 45 minutes for a pain shot. After the nurse had asked the doc three times to write it.

I started bawling the minute I left the ER. My husband is a healthy, active man. To see him sedated in a hospital gown ripped me apart. I was shocked at my emotionalism for a diagnosis of gallstones. The “D” word was looming. And I knew it.

I pulled myself together and ordered dinner through the KFC. I was pretty out of it, I guess. I ordered the 21 piece meal for three people. What was I thinking?

I get back to the hospital in time to meet Dr. NiceYoungMan, the hospitalist. Nine hours after rooming. The usual pleasantries, the usual H and P. Gonna check in and manage his medical issue. Says that hyperglycemia is not unusual in stressful situations.


Then came Miss GodtheSurgeon. Ten hours after rooming, approximately three hours after the diagnosis of cholecystitis.

God Bless this woman.

She didn’t smile, she never wavered from her H and P and she couldn’t have cared less if I was a nurse or the First Lady of the USA. She would have treated me the same either way, like a side attraction.

But…. she gave a fantastic description of what was wrong with hubby, the surgery and if we can put if off for a week. She knows her stuff blindfolded, and she laid it on the line.

She basically said he was fooling himself to think he was healthy with his dramatic family history, never going to a physician in his entire adult life, told him his BP was elevated, he had probably get on a statin pronto and…..with no if, ands or buts……

She used the “D” word”

My husband has diabetes.


He is devastated.

I am devastated.

I cried all the way home and I’m ready to start again.

Diabetes is what happens to other people. When I see you in crisis, I start the insulin and put up the drip….and send you on your way to ICU.

Why, as a professional nurse am I so devastated at the diagnosis of diabetes?

I know you can live with it. I know that with good control you can avoid the pitfalls and end-organ failures. I know active, vibrant people who could be ADA poster folk!!

I think I’m grieving.

Not for me, but for my husband, who wore his healthy status like an Olympic medal and now has to come to grips with a chronic disease.

“I am a rock.”
“I am an island.”
“And a rock feels no pain.”
“And an island never cries.”
(as sung by Simon and Garfunkle)

Well I’m not.

And I do.


Today I found out that my eldest daughter, Lillian, is engaged.

In a week my son graduates from the University of Notre Dame in South Bend, Indiana.

So in the midst of stress, joy.

We just have to get hubby to that graduation, if it means moving hell and high water.

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About Me

My name is Kim, and I'm a nurse in the San Francisco Bay area. I've been a nurse for 33 years; I graduated in 1978 with my ADN. My experience is predominately Emergency and Critical Care, and I have also worked in Psychiatry and Pediatrics. I made the decision to be a nurse back in 1966 at the age of nine...

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