July 28, 2009, 2:00 pm

I Went, They Scoped, Now Starbucks is History

lost voiceI hope you can read the print on this.

It’s a hoot!

Apparently, the Vacuum Tympan cures the most “desperate causes” of hoarseness and sore throat, massages vocal cords and gives immediate flexibility (to what?). Oh, and after it brings relief, “a permanent cure soon follows”.

Maybe it sucks out the phlegm. (Ewww…just writing that made me gag.)

It sort of looks like the old incentive spirometers we’d use for post-op patients.

Or maybe it’s a type of  nebulizer.

Frankly, it looks like a bong.


Vive le Grand Rounds!

This week Captain Atopic takes on the medical blogosphere carnival Grand Rounds using the Tour de France for a theme! Merci beaucoup, capitaine!

Next week, Grand Rounds will be right here at Emergiblog – there is a post directly under this one, but for the life of me I did not know how to make it “stick” up at the top.  Bottom line, I’m waiting for your submissions! : )

(PS – don’t forget to send your nurse-related posts to Man-Nurse over at Man-Nurse Diaries for the next Change of Shift!  Submissions can be sent to “mannursediaries at gmail dot com”.)


I’m at that age where certain tests involving scopes and colons are recommended, so I did my duty as the good custodian of my health and scheduled the pre-test appointment.

(Don’t worry, this will not be a case of “TMI”.)

I’m sitting there with the GI doc going over my health history, when he notices I’m on Protonix. Based on this fact (and the fact that my upper abdomen is sore on palpation – well, duh, you’re pushing on it!) he says “Well, you are going to be out anyway, I might as well take a look down there, too!”.

Say what? I’m here for a tube up one end and you want to put a tube down the other end, too?

I swear to (insert-your-own-deity-here), my first thought was “dude, you’re just trying to add a procedure to crank up the income.”

I’m not proud that was my first thought, but I’m being honest here. “Sure!” he said. It might be a structural problem, we can make sure you don’t have Barrett’s Esophagus (note to self: look that up) and basically just know what we are dealing with.

Well, okay. But I don’t have indigestion/heartburn when I’m on Protonix; I’m rather asymtomatic, actually.

“What kind of anesthesia would you prefer? We can use Versed/Fentanyl or if you want, we can use proprofol.

Propofol? Dude, you can stick a tube anywhere you want.  Go for it!


Easiest thing I’ve ever done. I have no idea why I waited so long. When I fell asleep Shania Twain was feeling like a woman and when I woke up, the Eagles were takin’ it easy and I wondered when the hell they were going to start!

I was done.

The procedure went well, the biopsies were taken (routine) and I would get my results by mail within two weeks.


My colon rocks. No problems except divertiulosis and I can live without nuts and seeds.

It was the endoscopy that I almost refused that showed the problem.

The biopsies showed acid-induced esophageal and gastric inflammation.

What??? How??? I thought the Protonix was taking care of that!


And then came the “treatment” boxes checked off.

“Keep taking your medicine for the next three months, then stop.”

Okay…if I have this inflammation now, why would I stop the medication? Won’t it get worse if I do?

“Please avoid Aspirin, Naprosen, and Motrin. Tylenol is okay.”

Aw man, Motrin is my best friend, my right hand! It’s gotten me through many a rough shift; 12 hours in the ER can make you ache. Tylenol isn’t worth the powder it is printed on.

I took a swig of my Diet Pepsi.

“Avoid fatty foods…”

Okay, doing that already with ol’ Richard Simmons’ plan.

“…chocolate, peppermint, spearmint and smoking”

Bah – I don’t smoke and I can live without chocolate and who wants spearmint anyway?

Took another swig of Diet Pepsi.


No biggie, I only have two Bud Lights a month, during Nascar races, and that’s only to support Kasey Kahne’s sponsor (and I know you all just doubled that to four per month…).

“Avoid caffeinated beverages…”

Uh oh.

Took a tiny swig of Diet Pepsi.

“Decaffeinated coffee…”

That…means…ohh nooooo…


Oh HELL no.

I will NOT give up Starbucks.

Damn it!

I don’t smoke, I barely drink, I don’t do drugs, my diet has more fiber that corrugated cardboard, I’ve lost close to 30 pounds and I’m working on the other 25.

My only “vice” is a total addiction to Starbucks and the goal of someday mainlining Diet Pepsi.

It will be a cold day in hell before I give those up.


I’m giving them up.

I know the effects of chronic esophageal and gastric inflammation can lead to bigger problems.

And in the scheme of things, given the impact a diagnosis can make on a life, this borders on laughable.

But we all talk about how the patient has to take responsibility for their health. I could keep on downing Starbucks twice a day and Diet Pepsi in my sleep and then whine because my Protonix isn’t working.

Or I can make the changes suggested and see if they will make a difference.

But how ironic that the main problem was found in a test I didn’t even know I needed; and how scary that I was essentially asymptomatic, but the inflammation was still there!

Kudos to the doc for being interested enough to find out why I had needed to be on Protonix to begin with.

I shudder to think what things would have looked like had I been on no medication.


Who knows?

Maybe I can go off Protonix if these changes work.

And I can still go to Starbucks, only my new drink will be a Grande Skinny Vanilla Steamed Milk.

With a little cinammon on top.

Hey, a girl’s gotta have something to look forward to…

11:33 am

Grand Rounds Here On August 4th

grandroundsblankGrand Rounds will be hosted here at Emergiblog next Tuesday, August 4th.

No theme, all topics and all takers.  I’ll come up with a theme and work the submissions around it.

Deadline is noon on Monday, August 3rd, PDT (working a bunch of night shifts and have to get my beauty sleep, doncha know).

Don’t forget to put “Grand Rounds Submission” in your email subject line – just click on the “Contact” button at the top of the blog and it will come right to my mailbox!

Looking forward to reading!

Bring ’em on!

July 24, 2009, 10:00 pm

Valerie Jarrett, White House Senior Advisor Talks to Bloggers at BlogHer09

Valerie_Jarrett_official_portrait_smallI was honored to receive an unprecedented opportunity to hear a Senior Advisor to President Obama speak about his health care reform efforts at BlogHer 09.

Valerie Jarrett, Senior Advisor and Assistant to the President for Public Engagement and Intergovernmental Affairs, spoke to an intimate group of bloggers at a luncheon today.

And I was 15 minutes late.

How humiliating! This was definitely not the event where one should be “fashionably late”.

Ms. Jarrett was totally cool though, and said “Come on in and tell us who you are!” Apparently I had just missed intros; the discussion was just starting.

(Photo credit: Wikipedia)


Now I’ve been pretty clear about not wanting a government run health care system, and I attended the luncheon knowing I did not have a clear grasp on the President’s proposal. (I have downloaded the Bill, have not had a chance to finish it.) I wanted to keep an open mind; I wanted to learn as opposed to opine.

The best way to learn is to keep your mouth shut and listen. That is exactly what I did.

It was not easy.


Ms. Jarrett is warm, sincere and truly passionate about the President’s efforts at health care reform;  Ms. Jarrett has full faith in the ability of the President to positively reform our health care system.

Now, if I heard and understood correctly, what the President wants is a public plan as an option; a choice to obtain health care coverage through the government should you find yourself unemployed/without any health care coverage.  Ms. Jarrett was adamant that the goal is not a single-payer government run plan, but there was some group questioning of (1) why the idea of a government plan is perceived as scary and (2) whether or not it would be tantamount to socialism and indeed, what would be wrong with that anyway. One blogger noted that she knew many Canadians who were happy with their health care.

These questions were more rhetorical in nature. Honestly, I don’t think time would have permitted in-depth discussion.


There was discussion on how bloggers can get out the message of health care reform and ideas on how the President can best communicate his ideas to the public.  It was noted that the President is holding press conferences for which he is asking full coverage because he wants the entire story told, not just sound bytes.  (Side note: I found this interesting because just recently ABC News encamped in the White House for an entire day – and the topic was health care reform.)

I actually did have a question enter my mind, as I was intrigued by the idea that the public plan was an option: I wanted to know if one could move in and out of the public plan as desired, or were you stuck in the public plan once it was chosen.

I didn’t get a chance to ask, as the discussion moved forward with two bloggers sharing stories of their personal experiences with the health care system.  Very personal, heart wrenching stories. Their frustration and anguish was palpable. Ms. Jarrett listened with empathy; she truly cared about what my fellow bloggers had/were enduring.

I found out later that both bloggers left with her personal business card with her office number for them to call her directly after the conference.  That was impressive.


So, some final thoughts.

I like Valerie Jarrett.  It was amazing that she took time to come and speak to us, and it was informative. She speaks straight, she is sincere and she seems very passionate and compassionate regarding health care reform.  I’m a bit more informed about what the President is looking for.  This was the advantage shutting up and listening. I don’t necessarily agree but I’m starting to at least get a hold of the concept.

Gratuitous political commentary: I think a little too much time was spent decrying the last administration. It’s over; time to move on.

Now for my totally off-the-cuff observation. I could not help but notice this was the exact opposite of my experience in DC last week. This was a full-on Obamafest, last week seemed like an “anything BUT Obamafest”. This week the “opposition” was putting out misinformation, last week the “opposition” was trying to cram a bill through before Congress could read it.

Is there no middle ground? Does it have to be this contentious? Maybe it’s the way of politics and I’m just now realizing it.

Between the two events, I guess I have now been exposed to a “fair and balanced” view of health care reform by Washington insiders.

So….why does it still feel like I have vertigo?


This post was written from my own notes and memory. It was actually live-blogged in real time and if you would like to read the entire transcript, it is written here: Valerie Jarrett/Health Care Reform Live Blog BlogHer 09.

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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