Waiting over, now real work begins

The time seemed to pass so slowly leading up to my boy’s surgery, and then the last two days flew by so fast! We spent last Thursday doing preoperative requirements–blood draw, chest X-ray, physical with the surgical team. All day long I was counting down in my mind: “In 24 hours, they will be wheeling him into the operating room. In 12 hours, we will be leaving for the hospital.” Thursday evening was pretty laid back, with visits from friends and time spent just being together. I let him pick his favorite for dinner, so we dined on soft-shell tacos and watermelon!

The morning of surgery, we headed for the hospital early, and things moved quickly from then on. Our pastor was there waiting for us, as well as my college roommate. (Yes, we both settled in this area, a thousand miles from Indiana where we met.) After some quiet time together, it was time for them to wheel my little boy away. That was the hardest part. I kept it together until he couldn’t see me anymore and then gave into a couple of tears. Even knowing he was in good hands, it was hard to watch him go. But the staff was wonderful, and we were updated several times during the procedure. I shed a few tears again—this time, tears of joy when we got word he was off bypass, and everything was working great. Five short—but very long—hours after he was wheeled away, we were at his bedside in the cardiac intensive care unit.

I didn’t recognize him at first; he was just so small in that big bed with all the monitors and IVs. Thankfully, he was extubated already and breathing well on his own. Throughout the rest of the day, he woke up occasionally, but it wasn't until Saturday that he really started to make progress. His chest tubes were removed that morning and, by afternoon, his central lines were pulled as well. He was up in a chair and sipping water before we knew it. And, surprisingly, he moved to the step-down unit that evening. Sunday was spent with visitors and coaxing my already picky eater to eat. Nothing sounded good on his upset tummy—poor boy—but, by Sunday evening, he was nibbling on strawberries and bread and, by Monday, was willing to eat some yogurt.

I was shocked on Monday when the staff wrote discharge orders. My first thought was, “There is no way I am ready to have this kid at home!” But they felt he would eat better and we would both rest better at home. (I had been sleeping at his bedside every night with just a few short breaks each day to get some fresh air.) I think I drove 10 miles under the speed limit the whole way home; my cargo just seemed so much more precious to me!

And now, two days later, he is eating better and walking almost like his normal self. (He has lost at least four pounds, though, and looks skeletal.) He is also getting sassy, a sure sign he is feeling better. I am still watching him like a hawk. As I write this, I am sitting in the same room he is, and I confess I slept the last two nights on the trundle bed in his room. I continue to entice him with all the foods I can think of—How long can a boy live on Otter Pops?—and we even ventured outside to water the flowers together this morning. Now I fear he is feeling too good, and it will be tough to keep him calm the next couple weeks. Already, he misses riding his bike and doing jumps on his scooter!

Wonderful friends and having my parents here has been instrumental in his quick healing. We have been wrapped in prayer, well fed, and his sister has been entertained, if you call soccer camp in 100-degree weather entertained! Thank you all for the support. We couldn't have made it this far this fast without each and every one of you!

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International. 

Boys will be boys!

“Mommy! Mommy!” I could hear my boy screaming, but couldn’t see him. Just seconds before, he had been swinging in a friend’s swing while we grown-ups relaxed on the patio. I looked at my friend. “Where is he?” I asked as we both stood up—and there he was, lying under the swing, on his belly with his arms folded under his body.

Apparently, his friend had dared him to jump out of the swing—on the back swing. (His sister also broke her arm while swinging. She was attempting to tie her shoe—another hard-learned lesson in gravity.) We ran over, brushed him off and all appeared fine. His left arm hurt all over, but he could move it, and there was no swelling, no apparent broken bones, We set him up on the couch with some ice and went back to relaxing.

The next day was pretty busy—church most of the morning and a Cub Scout barbecue in the afternoon. He was favoring the arm but not really complaining of pain, and it still wasn’t swollen. At the barbecue, the boys were to work on their athlete badges. Sit-ups, push-ups, a long jump and some running was involved.

My boy did great on everything but push-ups. He refused to put weight on his arm. So, off to Urgent Care we went, 30 minutes before they closed and—surprise—discovered the poor boy had a buckle fracture of his left radius. The good news? It wasn’t displaced, so surgery wasn’t needed and, once the arm was splinted, he really had no pain. The bad news? We were just 12 days out from his open-heart surgery!

Monday morning, I spoke to his surgical team, and we agreed that surgery could go as scheduled. If he has significant body swelling afterward, we can just have the cast removed. We also arranged to have the arm casted, and he is now sporting a purple “Rockies” cast. I have struggled to keep him grounded over the last week but, in typical boy fashion, he has tried to ride his bike, has been cruising the street on his scooter and has even hit baseballs. Maybe this is a sign of how his post-op recovery will go, and he will just bounce back to being the active little boy he’s always been!

The irony of this story: Last week, I was on call for our clinic, which involves being available for medical advice and approving all urgent-care requests. We are pretty cognizant of not providing care to our own family members. (It can be bad medicine, as providers sometimes lack objectivity when caring for those they love.) So, on Monday morning, I joked with our medical director: “If my kid breaks his arm while I’m on call, can I enter his urgent care referral?"

Yep, boys will be boys!

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.

I did it!

I run for many reasons. I run because I have to. (The Air Force requires a biannual assessment of fitness, part of which is a 1.5-mile run.) I run because it is easy. (All I need is a good pair of shoes, some music 30 minutes of spare time, and my workout is done.) I run for stress relief. (I miss those endorphins if I skip more than a day or two.) I run to spend time with friends. (When time is limited and both a workout and a chat are needed, a run is a great way to accomplish both at once.) And I run because I am competitive and enjoy accomplishing a goal, beating my last time or achieving a new distance.

But even with all that, I never wanted to run in races. The thought of all those people, the adrenaline that comes with a race and doing “my” run on someone else’s schedule just never appealed to me.

In January, my running partner at work suggested we do a half marathon. I gave the excuses listed above and said, “No, thank you.” But, shortly afterward, when my sister and her son completed their first half marathon and loved it, my mind opened to the possibilities. Besides, my runs had started getting a little stale, the stressors at work had started piling up and I needed a new challenge. So I acquiesced, and my running partner and I signed up for the Colfax Half Marathon—three months away at the time—and started training.

Friends who had done marathons and half marathons gave advice—one sent a training plan— and we fit runs into our afternoons as much as possible. Even with the plan, it was tough to fit too much distance into my week. Between, homework and ski season, there was little time for long runs. And, with my boy’s recent health concerns, I didn’t relish the idea of running on weekend mornings and leaving the kiddos home for very long. Another friend was kind enough to find a few afternoons free, and we managed an eight-mile loop around a local reservoir, my longest runs leading up to race day.

Race day actually started in what I normally consider the middle of the night–4 a.m! With a 6 a.m. start, I needed to be at a friend’s house by 5:15 to walk to the start. Yes, we walked two miles to the start of the 13.1 mile course, ran the race, and then walked the two miles back to our cars. Crazy! But, it all culminated in a great morning. Although the crowd was big, it was part of the experience and, with friends around. it wasn’t nearly as intimidating as I had feared. I finished in 2:07, running a sub 10-minute mile the entire way. The sense of accomplishment is still with me a week later.

I think our next half will be the Rock and Roll in late September, with a few shorter races—and maybe even one of those mud runs — before that, as well. It is true: Once you do one, you’re hooked!

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.

A second opinion, and life goes on

It is hard to believe it has been just a month since we discovered my boy has two heart defects that will require surgery to repair. Life continues to fly by with science fair projects, end-of-year school performances and wrap-up of our spring sports schedule. Sometimes, I can even forget we have this major event staring us in the face!

Not so, last Monday. My boy and I met with a cardiologist for a second opinion and a repeat echocardiogram. Not surprisingly, the second opinion was the same as the first. Yes, there are two large defects that need to be repaired to prevent further compromise of my son’s heart function. Knowing that I’m a nurse practitioner, this cardiologist even took the time to do the echo himself, walking me through the pictures and showing me the defects and altered blood flow. He also included me in the assessment, putting my hand on my boy’s chest so I could feel the force of his heart beating against his ribs, not a typical assessment finding!

We talked about how healthy my son seems, and the doctor explained that because my boy is always working at an increased effort, he has less reserve. Light bulb moment! That explains why he struggles more than I would expect to peddle up a mountain on his mountain bike and why I’ve twice had to carry him the last 100 yards up Mt. Evans, a 14,000-foot mountain you can drive up most of the way. I would frequently get frustrated with him during these times. Often, the biking was at his request, and then he “refused” to keep up, often throwing a fit when the rest of us peddled on ahead. Pile on the “mommy guilt!”

Although I really appreciated the second physician’s time and patience with us, I will stick with the original doctor’s office. It is more convenient and is associated with one of the best children’s hospitals in the country. So, surgery is scheduled for the third week of June with the chief of the cardiothoracic department. He comes highly recommended and he has an NP as his assistant. (He can’t be all bad!)

Years ago, I worked in an adult ICU doing open-heart recovery and was the lead on the balloon-pump program. The up side is, I am prepared for the surgery, knowing what to expect. The down side is, I keep remembering all the complications, all the times people returned to the unit still “open,” the times I rushed to the OR with the balloon pump praying for a miracle, the times I sat with families after passing along the news that “things are not going well.” I keep holding to the truth that my boy is healthy and strong, and that this is corrective and planned surgery—not an emergent response to an ailing heart with blocked blood flow.

In the meantime, life goes on with Cub Scouts and camping trips that were planned prior to surgery, together with baseball practice and building of bike ramps, using construction debris scavenged from around our cul-de-sac—typical, active boy fun.

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.

From practitioner to parent of a patient

Seems I always start a post with a statement of how long it has been since I have managed to write or how busy life tends to become. It seems I blink, and time just flies past—between school projects, spring sports, a big inspection at work and training for a half marathon, there is barely time to breathe some days.

But summer is just around the corner and, thanks to a fluke episode, my boy is ensuring that we will slow down over the school break. He just turned 9 and is an active, typical little boy—playing baseball and riding his bike over any jump he can find. A few weeks ago, he had what appeared to be a minor viral illness but then suffered what is now being termed a fainting episode. Because it mimicked seizure activity, off to the ER we went.

A routine ECG turned up some thickening of the right side of his heart, so we saw a cardiologist a few days later. A long afternoon spent in the cardiologist’s office ended up in a surprise diagnosis of two congenital heart defects that could result in significant damage if we don’t repair them. Needless to say, I was in shock and still am two weeks later. My healthy, typically wild but extremely kind-hearted boy is shunting oxygenated blood back into his right heart with every beat!

Yes, we are getting a second opinion in a week but, because I have confidence in the diagnosis, the surgery is scheduled for the middle of June—a week after school ends. He will spend the summer being spoiled rotten, and the goal is to be back in school when it starts in mid-August. The cardiologist even said we could sign up for fall baseball. I think he is as optimistic as I am about all this, something I really appreciate.

In the meantime, my son has no activity restrictions, so we are pressing on with life. We fill our free time with baseball and soccer, bike rides and yard work, Cub Scouts and Girl Scouts. We have tickets to see the Rapids and the Rockies and hope to throw a big presurgery party in June. I firmly believe attitude can affect outcome, and we will enter this with the best attitudes we can muster! I will do my best to keep this site updated with our progress on this new adventure in life and know we are wrapped in prayer every day by so many people, something I am very thankful for and believe is contributing to my calm emotions.

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.

'Forever friends'

Do you have “forever friends”? You know the ones—people who have known you since high school or even elementary school, people who know you better than your spouse does, the people you reach for in those life moments when you need to cry or celebrate. Not that, when you first meet someone, you actually define them as a “friend for now” or a “friend forever,” but you often know pretty quickly if this is someone who will fade away when the circumstance that brought you together is history.

I recently saw on Facebook a post that occasionally circulates, the one about people who touch your life and either stay or move on. Many posts also comment on military friends, those people who are brought into your world because of an assignment or deployment and become a forever friend. Whether it is a circumstance or common culture, shared events or true connection, these people are the ones you invite to your promotion or retirement, the ones you travel cross-country to visit, or celebrate with when your paths cross again, perhaps to spend another assignment or tour together.

We have had a busy summer, and I was lucky enough to spend a few days connecting with a few of my forever friends. There are five of us from college who still keep in close touch, who shift schedules and move mountains to spend a short weekend together every year. Some years, the mountains won’t move and someone has to miss—in my case, “Uncle Sam” sometimes has a different plan—but we continue to make the effort.

This year, I was the lucky host and the girls spent a short 48 hours in my new house, sharing stories of kids and significant others, tears over the same and sightseeing around these beautiful mountains. We decided two days is not nearly enough; that once we get the youngest off to college, we will spend an entire week together, soaking our toes in the sand somewhere. And we were reminded that, although 363 days may pass before we get together again, because life is full and we rarely have time to connect, there will always be those two days when time stands still and we can surround ourselves with those who know us best.

Thank you to all my forever friends!

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International. 

Shopping blues

I, like many women out there, like to shop. I also like a bargain and rarely buy unless I think I have gotten a “deal,” so shopping has been difficult lately. It might be what I’m shopping for—a house, some furniture—or simply my perception of a deal!

The area where I am house hunting has weathered the financial storm pretty well, looking at it from my side of the fence. I hear stories from people who live here that most home prices have fallen more than a hundred thousand dollars, but they still seem pretty pricey to me!

The issue is the elementary school. It’s rated at the top in the state and I firmly believe it has helped maintain property values, because people want to start their children off here. I refuse to move my kids from this school, as they have settled in nicely, love their teachers and are thriving in the before- and after-school care program. And what a program! They’re taking TaeKwon-Do, participating in science clubs and my girl has attended two sessions of cooking classes—all this in addition to homework assistance (run by the teachers) and an excellent staff! Needless to say, we are not changing schools, so the search continues. So far, I have seen several homes I like, but none I love and, since this is, potentially, a home we will live in for several years, I want to love it!

One thing I did manage to buy yesterday—a new car! I had been driving a 2001 Suburban, which I loved and hated to give up. It was comfortable, old enough that I had ceased caring about the kids eating in it, and I knew how it responded in most conditions. It responded poorly. It was not a four-wheel drive, and it had a tendency to slip-slide on almost anything. Having been built in 2001, it lacked any significant safety equipment for the rear seat, where my most important riders sit.

All of these drawbacks led to some pretty white-knuckled drives down from the mountains. Many days, I was thankful for the heavy traffic, because it kept speeds down and I could drive slow, not feeling pressured to push the limits of my aging ’burb! So, last night the kids and I headed off to see our friendly Ford dealer and we are now the proud owners of a new 2010 Explorer—old body style, truck frame, all the bells and whistles for safety and heated seats! We are pretty darn excited!

But—out of the mouths of babes—my boy just told me, “Mom, you should have bought the more expensive thing first; the house, then the car.” Thanks, son. Maybe you will stay home today while I go out and test our new toy, driving to the mountains! We will table the home search for a few weeks; we have nothing but time!

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.

Keepin' on bloggin'

Maintaining this blog often competes with other priorities—cleaning house and grocery-shopping, to name two. I am so thankful to Sigma Theta Tau International for providing this forum and for Jim Mattson, editor of Reflections on Nursing Leadership (RNL), who ensures that what I say makes sense and helps keep me on track. A couple times, he has sent an e-mail asking if I plan to continue posting, a very polite way of encouraging me to get typing!

So, recently, in the midst of a rare Saturday morning without my children, I managed to write three posts and even looked over the blog design and statistics. I had no idea there was a way to see how many people had accessed the site and where they were from. I was pleasantly surprised to see there have been more than a thousand hits since my blog was created almost two years ago. Now, I realize that really isn't much when compared to many others out there, but it gave me a little lift to think of all those people reading what I write.

What was fascinating to me was all the foreign countries where people access my blog: Malta, South Africa, China. What do those people think when they look at what I write? Why did they land on this page? Are they nurses? Are they looking for information on Afghanistan? Are they Americans living abroad or are they native to those places?

I also took time to update the “blogs I am following” link (click on "Lori" under "Contributors" in the right-hand column) and was a little sad to see that some people had stopped posting blog entries. One of the soldiers on the team we replaced had stopped updating his blog when he returned home from Afghanistan, in the summer of 2009. I enjoyed his writing and hope he has returned to the “peace-loving lifestyle” he was so looking forward to.

I also added a favorite website—“The Pioneer Woman.” If you’ve never visited the site, I encourage you to check it out. Several months had passed since I had last viewed it but, after receiving her cookbook for Christmas, I plan to become a regular again. Her humorous reflections on farm living always lift my spirits. I also—finally—updated the link to Meg’s blog, “Soup is not a finger food.” Meg is an old friend who frequently has a sassy way to state the obvious. Reading her posts brings a smile to my face, as I remember the days I spent hanging out in the ’hood.

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.

Greener pastures

Many of us who spend the majority of our time in military medicine see private practice as so much better. No inspector general visits, no “working for the man” and no threat of deployment. We often feel as though, with meeting access demands, completing medical evaluation boards and fulfilling all the required military training (frequently on our own time because of patient care demands) with no end in sight, we are on a hamster wheel.. But, as two of my good friends have discovered, the grass is not always greener!

One of my friends, a physician, left the military to join a large group practice connected to a large hospital. He enjoys the time off, choosing his own hours, and the increased time he haswith his family, but he is considering rejoining the Air Force, because he senses something is missing. There is no camaraderie within the practice, and he misses feeling that he is serving a greater purpose. He still has pressure to see patients and sees changes to insurance reimbursement limits as potentially detrimental to private practice. He also realizes the impact of walking away from the retirement money. As he puts it, “I still work for the man; it is just a different man and I get to choose the clothes I wear to work!”

Another friend left the military just a few years short of retirement. She was dissatisfied with future assignment opportunities and wanted her spouse to have stability in his non-military career. After a recent move, she struggled to find a job. Medical-provider positions are not typically listed in a newspaper and she almost resorted to going door-to-door or hiring a headhunter. Now, working in a practice she enjoys, she can still tell stories that would make most of us military medical members’ toes curl! She discovered the medical assistant wasn’t wiping her exam tables after every patient, and my friend recently returned to work after a vacation to discover she was double booked and, because a colleague unexpectedly needed time off, had been volunteered to take on that provider’s schedule.

So, on those days when I feel like the hamster wheel is more challenging than usual, I remind myself that the grass is not always greener. When it comes to medicine, you can change the clothes you wear to work or the “man” you work for, but that elusive “perfect” job or practice may not exist. Sometimes, you have to find the “perfect” where you are and focus on that; and hope you don't fall off the wheel!

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International (STTI).

When words hurt

My daughter’s school is doing a special series on bullying—appropriate as another child recently took her life in what appears to be a bullying-related incident. My girl just finished a book that describes a situation in which each student had to draw a names of a fellow student, and then, after a few weeks, sit face to face with that partner and give him or her a series of compliments. The book’s title character discovered that a “mean girl” was actually very resourceful, brave and dedicated to her family.

This led to a discussion about why it is so easy to believe the negative things people say to us—those hurtful things that keep us awake at night, questioning our self-worth, rather than having faith in all the kind things people say. At age 9, my girl was already aware of this—that mean words hit harder and affect her more than all the kind words she hears every day. We spent some time talking about her positive qualities, and how to handle a bully who can only see the negative in life and in the people around him or her.

After getting my daughter in bed, the conversation stuck with me and today, as we celebrate Veterans Day in the United States, continues to touch me even more. For so many veterans, their service has been sullied by the attitudes of their fellow citizens and, sometimes, even their families. So many people seem to forget we don’t join the military because we have a vision of destroying lives; we do it because of the commitment we have to our country, for the camaraderie with our military family and, sometimes, for the money, the latter not such much but, in a failing economy, it’s a job.

So, today and every day you can, thank a veteran and know it may take lots of kind words and thanks to overcome the negativity they may have suffered over the years. Many service members (and their families) have paid prices we can never imagine in an effort to protect the freedoms we all hold so dear.

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.