Speaking in Code.

She wasn't a young woman, but she seemed strong enough. She wasn't thrilled to be here, but nobody ever comes willingly. We joked in the afternoon, and then her pressures seemed to spiral down. Docs weren't thrilled, so in went the lines. We went to CT with a sense of impending doom. We'd just got her pressures above 100, and we ripped her from the relatively safe confines of her room. This. Was not. Going to be good.

First round of pictures went fairly well, she was still not happy to be here, and even less happy to be on that board. We reassured her, and we started to get the second set of pictures. She was really upset with us- wanted badly to go back to her room, she begged us to take her back. We couldn't, we needed to figure out what was wrong with her.

We got the last pictures, and took her out of the machine. She was quiet. Her eyes lost their focus, even though she was looking right at me.

Shit.

She's not responding.

SHITshitshitshitshit!

She's not responding, and now she's puking all over my watch. Shit. Where's the ambu bag? Where's the O2? Call it! Call it!

I turned her as best I could as they started compressions, and kept her over as they bagged her. Within seconds, the room was full of people. I suctioned her mouth, and got out of the way, her emesis all over my hands.

V-fib. Shock. V-tach. Shock. No pulses. No respers. Drugs. Compressions. ET tube. Organized chaos. Yelling. Running. Hold it!

Nothing.

Called it.

And as quickly as they came, the room was empty again.

We were left to pick up the pieces and put her back in bed. Here's the chaplain, who's telling the family? How much time do I have to make her look better?

We get her back upstairs, clean her as best we can, cover her with a warm blanket, and give her back a little of the dignity she lost earlier. I want this damn ET tube out, and the NG too, but they say "no", in case they need an autopsy. I want dignity for her and for her family. Her face is mottled, her tongue is not cooperating. I try the art of towel propping to make her face a look little more normal, but the damn tube...

We're finished at last, the pastor comes in, then family arrives. Their once-jovial faces now streaked with tears. I ask myself "what more could I have done?" I don't have any answers for them, or myself.

I got... Ssssteam heat?

Actually, I got NO heat. The freakin' unit froze solid after the ice storm last night. I now have a space heater, and am debating between sleeping on the couch (in front of the heater) or burrowing under the electric blanket in the bedroom (where the heater won't do an effective job).

And this will be the SECOND time the furnace guys will be out in a week. The problem before still isn't fixed right, and now this. And NO, I am not going to run emergency heat until they get it right- I am not selling a freakin' kidney to heat this shithole.

(Hm. Getting hot under the collar isn't helping me feel any warmer.)

Updates when they come. *eyeroll* Lets hope they FIX the problem this time.

YESSSSS!

It feels really good to make a goal for yourself, and meet it.

To wit: I had made the goal at the beginning of the year to have straight As this semester. And, with the confirmation of my math grade, I will have done so. (It was an 89.56 or something close, before the final, and I got a 98% on the final [DUDE!]) so all my grades are As or A-, which I can live with.

Hell, I am absolutely giddy right now. Like, "thank god my downstairs neighbor isn't home so I can jump up and down and squeal with glee" giddy.

Heh. I am so durned happy. Take THAT admissions folks. (And put me in the program already.)

Hoo, do I love vacation days.

First off- HELLOOOOOOOOO LINA!

So today I finally got to clean the apartment. Well, some of it. The back room is still repulsive, but I scrubbed and organized everything that wasn't nailed down Now, if I only had a kitchen table...

(G. Monkey moved out, and I gave her kitchen table back. I'm just waiting to get my mom's old table from her house. )

I also treated myself for making it through the semester (and the de-funking of the apartment) by taking a bunch of books to the book rack to sell- and get NEW ones of course. Then lunch/supper from 5 Guys to round out the day.

Tonight, I study math for Friday's final, tomorrow we decorate my mom's tree, and I'll leave you with my train wreck story for this entry... I feel really bad for the nurse who had this patient- she's new.

So.

Guy is intubated at the beginning of the shift. Not that he was JUST intubated, but he's chillin' on the vent when I get there. We have to dash him down to someplace where they wear lead vests for somethingorother as soon as I get there. So I quick get his vitals, but get hung up on his temp. (Oral, axillary, nothin' doing.) I figure I'll get it when I come back upstairs.

Should I mention that we discover that he's had a giant C-diffy poop on the way down to lead-vestville? Yeah.

So, we get him upstairs after whatever he had done, clean him up, settle him in, and I try AGAIN to get a temp. Nothing doing. I try every piece of thermometer-fu in my arsenal, because it's personal now. I've never been unable to get a temp on someone. After about 10 tries in various orifices and folds, even trying THREE different thermometers, I ask the nurse to take over for me. And SHE can't get it. So she gets another nurse who has his black belt in thermometer fu, and even he couldn't get it. (at least I feel a little better now.)

So we hold off on the temp for a moment, because I check his blood sugar and it's 29. (Anything below 70 and the nurses get a little feisty...) And it's not like I can feed this guy the revolting sugar gel we give folks with low blood sugar. So... no temp, sugar's 29... what else can go wrong?

Funny you should ask... this is about the time he decides to play Houdini. He's got his arms in restraints- pretty low down too- no WAY this guy is getting his hands anywhere near his bellybutton, much less his face. So of course, he manages to extubate himself. We pull anesthesia out of a case to come up and reintubate the guy, but while they're on the way, we notice... "Gee, his O2 is ok. He's breathing fine. Maybe he doesn't need the tube..." I don't think anesthesia loved us for running them up for nothing, but...

So lets recap so far:
1. the man's got no temperature sensible by any modern thermometer-type device.
2. His sugar's out of whack.
3. He has managed to extubate himself.


So eventually, he ends up with a thermister foley (basically, a catheter with a thermometer in it, that's awesome for getting temps on A. really cold people, B. people who can't handle thermometers in their mouths, or C. THIS guy.) And it's STILL not reading anything from the realm of reality. Alternately it reads 66 degrees and 92 degrees (which I'm more inclined to believe). sheesh.

So we bundle him up in a bear-hugger blanket (imagine if an electric blanket had a threesome with a hoover upright and an air mattress) and heat the poor guy up. THIS is when he wakes up some more, and proceeds to illustrate how out of touch with reality he is. (Not bad, if you're quiet about it. He? Was not.)

So now we can add 4. Confused as shit to the list.

By the time i left, his temp came back up to something approaching the outskirts of normal-ish. (95). I still felt really bad for his nurse. And that? Is a pretty standard night. Though usually all that crap is spread out over 4 patients, instead of all in one.


And I just heard that Ike Turner died. Remeber Ike, boys and girls. Bitchslap someone you love, then buy them something pretty...

Finals, part 1.

The A&P test was really simple, so lets hope my grade reflects this. I'd really like the A. (OK, A-.)

(Also, the finger is still a bit off, so forgive the weirdness in typing.)

Tonight is the Psych final. I don't have to take it- my grade was high enough through the year to avoid taking it. (Hooray for achieving my goal!) I am, however helping with the study group beforehand. That will be fun. Also, I made my tasty good mexican spiced brownies for the class. (I loved them...). The recipe is dead simple, and makes your whole kitchen smell like a big mug of Mexican hot chocolate.

Easy Mexican spiced brownies with caramel cream cheese frosting

1 box brownie mix (whatever's on sale, but not the really cheap stuff) To make a 9x13 pan
2t to 1T cinnamon
1 pinch of cayenne
whatever fixins it takes to fix your mix (according to the box)

Add the spices to your dry ing. and make brownies as usual. You can top with chocolate chips or nuts if you so desire. Bake as directed and cool.

Once the brownies are cool, make the ridiculously simple frosting

1 can dulce de leche
1/2 brick cream cheese

beat the two together till light, and spread over the brownies. Done! Yum!

(Also, watch your cayenne. You really don't need a ton- I just put a tiny pinch in the ones I took to class, the ones I made for me had a heftier pinch, and they're more kicky than dessert should be, but still really tasty.)

Why I have the best boyfriend evah.

So I'm making dinner tonight, and whack a pretty substantial portion of the top of my middle fingertip off. It's held on by a little flap, and it's down through the nail- it's ugly, and it won't quit bleeding. Kids, USE YOUR GARLIC PRESS. Do not use the nice big knife, like you always do, just because it is out and you don't want to wash something else. USE THE GARLIC PRESS. Anyway.

After a few minutes, it still is bleeding and I'm starting to worry a bit. That's when I have the following phone conversation.

Me: Hi... um... so... how long do you think I should let something bleed before I just go to the emergency room?

P: Uh, WHAT?

Me: Well, I kinda whacked the top of my finger off, and it won't stop bleeding, and it really is freakin' me out.

P: How bad did you cut it?

Me: (describes it) I've got it up over my head and everything.

P: what do you have to bandage it up? And if it doesnt stop in a few more minutes, just go over and get it looked at.

Me: (Looking in the first aid kit) Well... really crappy bandaids, and.... that's it. Ans... I don't think they can put stitches in it- this is through my nail and into the nail bed.

P: Alright, I'm coming over. You need what. Tape? Gauze?

Me: Neosporin? and better bandaids? But you need to study!

P: Shush. I'll be there in a bit.

Not only did he come over, but he stopped at walgreens for me, brought me better first aid stuff, a card, an CHOCOLATE, but he finished

Damn, I love this guy.

The End is Nigh.

Of the semester, that is. I'm reviewing for my A&P final, which takes place Monday at 0800. I'm not terribly freaked out. I need 122 points out of 150 to keep an A- in the class, which works for me. So lets take a moment and talk about non-class stuff...

A little note to the woman in front of me at Weis. Judging by the well-worn state of your WIC folder, you're no stranger to the check system. In fact, what you can buy is written RIGHT ON THE CHECK for your convenience. So, lets buy what you have to buy, and not try to split your check, and do all kinds of stupid shit, because my ass is in a hurry, mhmkay?

To the people who brought the Five Guys franchise to Lackluster. May Elvis bless you richly. Holy hell your hamburgers are good. Your fries are good. My ass is going to get really big if I give into the temptation to eat there. You must mix crack in with your fresh ground beef. (Fiber, they make veggie burgers and grilled cheese too.)

To el douchebaggio in bed 12. You managed to pee OK on your own when you had a male aide all day. You peed while your male nurse was in the room. While it was dark outside when I was born, I can assure you, it was not last night... YOU are perfectly capable of holding mister winky in the urinal on your own, and I will NOT be helping you. Also, lay off the GD bell, as you're driving everyone insane, and you are capable of moving your leg a quarter inch to the left. (If you were maybe just a modicum more pleasant, I'd be inclined to gown up and fluff your pillows more often, but you're in isolation AND an asshole, so... no.)

Cheese, in all its permutations, is good.
Knowing more about your heat than the repair guys is not good. Having the exact same problem every single year (which is why you know what to fix) is not good either. Nor is the repair guy's "solution" of setting on the emergency heat on 70 for the weekend. (Uh, hi- are you going to pay the exorbitant bill?)

Having your best friend finally be happy, is very good.

The steelers beating the patriots today will be very good. The dolphins losing againw ill be good. Being done with finals will be good. Yep.