This is how I feel so often;  a small boat, which is fine as long as the seas are calm but there are always storms.  There are many days when I struggle to just stay afloat.  I'm not depressed now but it always lurks there, in the background, ready to strike when I'm at my most vulnerable.

External stress, lack of control in particular, rocks my boat.  Work has been short staffed again.  Last Monday, my first line patient of the day was a woman two years older than me with metastatic colon cancer.  I asked her if her chemo had started and she said no, there was no more chemo.  She was here for MAID.  I had no idea what that was so I asked her.  It's an acronym for medical assistance in dying.  My eyes teared up and I started crying. 

Her body was riddled with cancer.  She was in constant pain and it was only going to get worse.  She opted to end her life when the time was right for her, not when the cancer had destroyed her.  I apologized to her for crying and we were able to talk.  She had terrible veins.  The doctor and she decided to put in a central line to ensure there were no problems on the day of her death. 

I fully support a person's right to choose their time of death and to be honest I think that when people are given back that control, it can allow them to live more fully until they do decide to die.  My patient died on Friday, with her friends and family beside her.  She was at peace with her decision and it was not an easy decision to make she told me.  She died at home, her husband beside her.  A good death.  It's what we all hope for.

When we don't have enough people at work it's difficult to spend time with the patients who need it but I refuse to rush some things.  It is a disservice to my patients but it takes it's toll on me.  This past week I decided to stop rushing.  Coworkers, techs, docs, managers, they'll all have to wait because the work I do is important and I'm not going to short change my patients.  They deserve better.

And this decision helped me to right my boat.  The water calmed itself.  The storm was self induced.  I just need to remember this.  I can calm myself.  I can slow down.  I can make a difference in the world one person at a time and that's important. 

This is one of my favorite photos of Miss Katie, taken before the anxiety and self abuse took hold of her.  She has no calluses on her wrists from banging her mouth and no permanent bruise on her forehead from banging her head against the walls or floors.  The big guy warns me not to turn my back on Katie and he's right but a part of me can't let go of this imagine of my beautiful, happy daughter.  I grieve for my lost daughter all over again.

This is Miss Katie out celebrating her birthday with three lovely young women who used to be Katie's caregivers.  Three sisters who still care enough to take Katie out for supper on her birthday.

This reminds me that there is love and kindness all around us.  Sometimes I can forget.  It's so easy to see the meanness, the hatred, the fear.  It's so easy to go there but I don't want to.  I want to see the goodness in others.  I want to believe people can be their best selves.  I want to hope.

I'm on holidays this week which is lovely.  I have time.  Time to waste, time to be productive, time to do as I please and that is a gift for which I am deeply grateful.

Katie is healing, getting better.  When we stopped by on Tuesday to check on her she had vomited everywhere.  Everywhere includes the walls in her case.  Poor bugger.  I changed her bedding and cleaned her room while her caregiver gave her a shower.  On Wednesday, her hand was still tender and she wouldn't take off her coat for her caregiver.  I convinced her to take off her coat by offering up a lovely, warm fleece blanket.  I haven't seen her since Wednesday.  Tomorrow, the big guy and I will pick her up and take her out for a few hours.  We'll drive, watch people, walk and have lunch.  And then we'll take her back home.  In my fantasies, I bring her home and she lives with us.  In reality, she pinches me, pulls my hair and bangs her face when she's upset.  She requires more attention than one person can give her and I still feel bad that she doesn't live with me.  I would love to tuck her in at night, but fantasies are not reality.

I took four hours off on Thursday and got caught up on life.  I shopped for last minute gifts.  Filled my windshield wash thing with fluid.  Bought cat kibble so that the cat doesn't starve to death, even though she is often convinced that her death from starvation is imminent.  Wrapped presents.  Cleaned the apartment. I feel peaceful.  I hate the feeling of undone things hanging over my head.  It causes me stress.

The laundry is done.  The apartment is clean.  Christmas cookies have been made.  Presents are wrapped.  Cards have been sent.  Snow has fallen.  And this morning we're off to see our granddaughter for a few hours. 

Life is not perfect or free of stress but it is good.  I'm thankful.

What are you thankful for today?

This is Miss Katie's wrist.  It doesn't look that bad in the photo.  She has another staph infection.  When she's upset she bangs her wrists against her mouth.  The calluses and scars have built up over time.  She never used to do this.  You can see old bruises on her wrist.

She also has a callus built up on her forehead, except right now it's a huge sore because she hit her head so hard that she split the skin.  When she's upset she bangs her head against the floor or the wall, or another person's head if need be.  Katie gets upset a lot.  She is chronically anxious.  We tried weed and we have tried anti-depressants with only limited success. 





Katie also won't keep her fingers out of her nose.  She doesn't pick her nose, she just sticks her fingers up her nose all the time.  I think that's how she's reinfecting herself. This is either the fourth or fifth staph infection this year.  We tried decolonization which worked for about five months but now she has another infection. 

She saw a doctor at a walk in medical clinic on Friday who took a swab and put her on oral antibiotics.  I find walk in medical clinics to be quite useless but her staff had already taken Katie there.  The doctors in those clinics don't appear to really care that much, at least that's how I feel.  Anyway, she got started on the oral antibiotics and they are slowly working.  She had a fever Friday and Saturday but the fever is gone now thank goodness.  The swelling and redness are worse but it's not spreading.  It is however painful.  Katie doesn't usually complain of pain but she does get very grumpy. 


Infection spreading up her arm prior to antibiotics.

 

I did some research on recurrent staph infections.  Decolonization is not overly effective, especially with non cooperative patients, a category which Katie would definitely fall into.  She won't keep her fingers out of her nose and has small abrasions on her skin constantly from her self abuse.  I'm not really sure what to do.  I do worry about her becoming septic or her bacteria becoming antibiotic resistant.  I feel like I'm failing my daughter but I don't know what to do. 

Poor girl was crying on Friday when they took the swab, they had to poke the blister with a needle.  She was inconsolable.  She also had a fever and probably felt like shit.  Yesterday was the same.  When she cries, I cry.  Today she looked much better but was still crying because I put a bandage on her wrist.  She hates bandages, screaming, crying hates bandages.  But the wound is open and weeping now and I don't want anything else to get into the wound.  So the two of use have been crying a fair bit these past few days.  I feel helpless.

I was out for a walk the other morning before work when I got a phone call from Katie's caregiver.  He rarely calls so I was worried when I answered.  I could hear Katie fussing in the background so I got even more worried.  Turns out he was just calling to let me know that he had gotten Katie's table for her wheelchair fixed and that the bill was $300.  He wanted me to know and had forgotten to email me.  I was relieved.

When I went to say goodbye, I asked him to say hi to Katie for me and to tell her that I love her.  Katie hates phones and won't have anything to do with them.  I overheard him passing along my message and then I heard her blow me a kiss.  She's never done that.  Of course I started crying as soon as I hung up the phone.  She surprises me still and I'm thankful for that.  So often it seems as if I don't really matter to her and then she does something surprising. 

I love this photo of her, down at Fort Edmonton park.  She's running, not in her wheelchair and that's how I like to see her. 

I continue to work on my stoicism with some success.  I'm getting better at standing back and asking if I have any control over "this", whatever "this" may be.  It's getting easier.  Less fatigue at the end of the day.  Less bitching and complaining, from me.  My coworkers remain unchanged but my reaction to them has changed, which is all I really have any control over.

Winter is settling in here.  The temperatures have dropped.  We had some snow the other day which brought the city to a virtual standstill.  Only a little snow and everyone forgets how to drive apparently.  One of our young nurses was two hours late for her shift and came in just vibrating.  I told her that it was ok.  She had no control over it.  Let it go.  The days are getting so short now.  Dark for the drive to work and dark for the drive home.  Sigh.  I miss the light.

A few weeks ago I was listening to Tapestry on CBC radio and one of the interviews was with a philosophy professor,  Massimo Pigliucci.  The interview struck a chord with me and I looked into it a bit more.  I came across a handbook, "Live Like A Stoic For A Week" and I thought I'd give it a shot.  I tried a bit.  Did a little meditating.  Thought about myself in the grand scheme of things. 

Then I got shingles and  I fell down and hit my head but I still tried to remember one key concept, the question I need to ask myself always, "Is this in my control?"  And if the answer is no, to let it go.

So far, not so bad.  I work with a couple of nurses who would not win any nurse of the year awards.  One is oblivious and lazy, while the other is rude and a drama queen.  Neither one are exactly competent.  They push all my buttons and I usually lose it on them about once a year.  I'm tired of having my buttons pushed. 

Last week, even though I felt like death warmed over, I asked the question, "Is this in my control?"  And if it wasn't, and it usually isn't, then I let go of it.  That's pretty good for me.  When I feel like crap my patience for bullshit is very low. 

This week I feel like a human being again.  My head is still a little scrambled from hitting it but not too bad.  Although I did ask a friend about her pretzels, instead of her shingles this morning. 

Most of all though I'm trying to remember to stand back and ask myself that question and then move on.  I also try to remember that in the history of the earth, my life has about as much significance as a squirrel or a thistle for that matter.  So when things are bugging me, I think about the squirrel and the thistle.  Sounds like an English pub to me but it makes me feel better.  Then I ask myself, "Is this in my control?"

At least I know I'm not alone.  Turns out the Greeks where thinking about this kind of stuff five thousand years ago.  It's kind of comforting.

When I rolled over to get out of bed this morning the whole world started spinning.  I have vertigo, benign paroxysmal positional vertigo, which means it comes and goes and it isn't going to kill me, unless I fall down the stairs.  Sometimes it's mild, sometimes it's stomach turning.  This morning I walked out to the kitchen like a toddler, unsure of my footing.  I sat down and my stomach started churning.  I tried the Epley Maneuver, three times and the vertigo improved only slightly.  Finally I gave up and lay down. 

The big guy went to work without me and I dreamed of a very nice doctor who came and helped me with my vertigo.  He was an older man, so kind and tender it was lovely.  I felt so safe, the kind of safe you feel when you're a kid and your mum can still give you that feeling.  I'm still a little dizzy but I can walk now without hanging onto walls which is nice. 

I went to see my doctor the other day to try and figure out why I'm so tired all the time.  We talked about life, work, stress, exercise.  She's a lovely woman who actually listens and doesn't rush you.  She suggested I figure out a way to work less and told me to relax more.  I don't relax.  I do.  I go.  I always have a list of things that that need to be done.  The big guy laughs at me because of my lists.  Maybe I need to let go of my lists. 

For so many years I took care of Katie.  Then I took care of my mum.  Now I'm taking care of my patients.  I'm not good at taking care of myself.  So today my poor body made me lie down, slowed me down.  Time to find a better balance for myself.