lamentations44

[lamentations44]

Happiness is a simple thing....

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I can only assume you mean “hemoptysis”? 😂

#nurse #rn #nursing #registered nurse #icu #fails #doctor #nurblr #medblr #typosmakemelaugh

[lamentations44]

So, my husband had his surgery this past Tuesday.  That monstrosity in the pictures is what they called his surgical incision.  In all fairness, the surgeon didn’t know if he would be able to close the leg at all and thought he may need a skin graft.  But, he was able to prevail and close the calf with some very aggressive suturing.  If you have never had or known someone who has had a malignant melanoma removed you may not realize how HUGE the amount of skin they have to take is.  The incision is usually 11cm long and they call the width a “wide excision”… Which means they take an enormous football (American football that is) shaped amount of skin and then sew the edges back together.

SJ (the husband) also has a 2 inch incision in his right groin where they had to remove 2 sentinel lymph nodes and send them for biopsy. (I decided to spare you all a groin picture- haha).  We find out, hopefully, on Monday what the biopsy shows. 

The surgeon said he was optimistic after seeing and handling the lymph nodes that they will be clear… So, I am going to be optimistic, too.

In case you missed my earlier post before the surgery…   He had that mole for as long as he can remember but it had started changing in the last 6 months- growing, becoming raised and darkening in color.  He went to my dermatologist, incidentally the same one who found melanoma on my back 2 years ago, and the mole was quickly removed and sent for biopsy.  Because of the depth of the melanoma and the placement of the mole, my husband was referred to a general surgeon who specializes in cancer surgery. 

My husband and I owe all the gratitude in the world to our dermatologist who may have saved both of our lives.

And… just in case you have missed my yearly rants and posts about skin cancer… I want you to scroll back up.  

Scroll up and look at that ghastly incision.  

Think about the pain.

Think about the scarring.

Think about the fact that the gruesome incision may be the easiest part of having a melanoma. 

Think about how you can avoid a similar fate.

Please don’t be foolish.  Please don’t think , “it won’t happen to me…”

Get screened.  Get educated.  Take precautions.  Wear sun protection.  

BE AWARE.

((( My husband and I have every intention to get “before” pictures of our melanoma moles from our dermatologist so we can share with friends and family… and you all!)))

As always- here are some starter links for those who want to look up information.

www.cancer.org

www.skincancer.org

https://www.cancer.org/cancer/melanoma-skin-cancer.html

https://www.webmd.com/melanoma-skin-cancer/guide/skin-cancer

https://www.aad.org/media/news-releases/how-to-check-your-skin-for-skin-cancer

#nurse #nursing #melanoma #personal #melanoma awareness #bepale #getscreened #dermatology #adermatologistsavedmylife #whenindoubtcutitout

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Relevant. Watch… please!

#this #rn #nurse #nurblr #medblog #medblr #medicine #melanomaawareness #melanoma

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Hey hey hey- its MELANOMA AWARENESS MONTH!

Put your sunscreen, hat, longsleeve, full coverage bathing suit, etc on!

April 2016 I had a malignant melanoma removed from my back- I still have a significant scar as a reminder. My husband had a melanoma removed a few years after that and we have been vigilant since.

Unfortunately- I had a mole come back after my last visit as a “severely atypical nevi” and had to have a surgical excision( today). These moles or nevi are not ALWAYS cancer or dangerous- but from what I gather, convert easily to melanoma. Given my sordid history with melanoma- the choice was a 2.5cm surgical incision/ removal. I was grateful it was less than the 11cm from the previous melanoma. However- this one is slap dab in the middle of my abdomen. So now, thanks (likely) to my idiotic youth and bikini choices- I will sport- not a cute bikini- but a large surgical incision on my back from 2016 and a medium sized one on my abdomen from today.

Please- be careful. No matter what beautiful skin tone you are- be careful and get SCREENED.

We can PREVENT two cancers- SKIN and COLON. Be smart and screen regularly for both.

(Abdomen from 5/5/23). Back from (4/2016)

#melanoma #skin cancer #melanomaawareness #skincancerawareness #np #prevention #surgery #nurse #rn #nursing #registered nurse #nurblr #medblr #doctor #patient

[lamentations44]

Snowy break from reality.

#snowday #ski #skiing #yardsale #igetknockeddownbutigetupagain #rest #rr #nurse #np #rn #msn

[lamentations44]

All I know since yesterday Is everything has changed- Taylor Swift

Stairways in hospitals.  They are the same everywhere.  Hot, muggy and with random locked doors.  It’s a strange constant in an otherwise new beginning. I reach the 5th floor and open it, letting the air conditioning roll over me.  I glance at my list and head towards the room.

I quit bedside nursing.  I tucked into a graduate program in 2019, finished and landed a job.  I left bedside for more reasons than I can count but the main one is a little over 3 feet tall with shiny red hair and deep brown eyes. I told myself for 11 years in the ICU that when I became a mom I would leave bedside nursing.  I don’t regret it. Not even a little.

I now work as a nurse practitioner in a bustling community hospital about 25 minutes from the downtown hospital I spent so many years in. My specialty is something I would have never picked and yet do not regret one day.  I spend my days talking about pancreatitis, cirrhosis and GI bleeds.  I can explain entire procedures that I had never heard of before a year ago.  It’s a strange existence. Both harder and easier than my prior career.

Maybe when my son is older I will find something else. Something that takes me back to the excitement of ICU or cardiac. But I doubt it wholly.  I’m home every weekend and only work 4 days a week.  I’m off by 5:30 and never work nights or holidays. 

I write this from my living room where my almost 3 year old is grinning while bouncing on a ball and showing me a family of dinosaurs. French press coffee is steaming beside me and homemade rolls are cooling on the stove.  It’s a quality of life I never dreamed possible when I first started in nursing, but now it is my reality.

#dontsettle #RN #NP #Cardiology #gastroenterology #liver #buttsnguts #registered nurse #nurse practitioner #hoyasaxa #nursing #nurblr #medblr

[lamentations44]

😔

#covid 19 #public health #doctors #medicine

[lamentations44]

Healthcare workers are no longer heroes, they are haunted.

#nurse #rn #icu #nursing #registered nurse #cardiac #intensive care #nurblr #doctor #nursing staff #medblr #burnout #healthcareheroes #haunted

[lamentations44]

Please note the number of shocks…. That wasn’t in the whole existence of the aicd- it was just today. The patient finally stopped vf arresting and being shocked after 115 defibrillations. The patient actually wore the aicd out and we had to turn OFF the aicd to preserve the battery for the pacer portion. We attached the external defibrillator and hoped for the best.

I left with the pt 100% paced, no ectopy, vented on lido, amio, levo and heavily sedated. We also gave quinidine … so he is both protected from malaria (haha) and has every anti-arrythmic on board.

#nurse #rn #icu #nursing #registered nurse #cardiac #intensive care #nurblr #doctor #nursing staff #np #vfarrest #mostshocksiveeverseen

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Call me simple… but all I see when I look at this….

Is this….

#nurse #rn #nursing #icu #registered nurse #dog #funny #nurblr #headct #still giggling

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Some days you just breath in Just try to break even Sometimes your heart's Poundin' out of your chest

Sometimes it's just beatin' Some days you just forget What all you've been given Yeah, some days you just get back

And some days you're just alive

~ Dierks Bentley

I walked through the door, the familiar sounds of my baby laughing and husband talking filled the room. The smell of dinner hung in the air as I kicked off my shoes and set my bag on the floor.

“Hi babe. How are you?” he asked with a smile in his gray eyes. I paused and shrugged my shoulders.

A dozen moments from the day raced through my head.

The look of panic on a daughters face as she watched us hold her mother down so she didn’t bleed out or rip out tubes. The monitors incessant screams as she went into ventricular tachycardia in the 220s and I exchanged glances with my orientee. The feeling of calm as I explained to the daughter what happened after we had a steady rhythm and stabilization.

The death hovering in the air as a different patient went into Torsades and we started CPR.

The feeling of those ribs shattering under my hands.

One. After. The. Other.

The feeling of surprise when a pulse appeared and the frustration when it disappeared and then appeared again... after 19 minutes.

The flash of tears and blue eyes as I knelt beside his wife who was surrounded by kids and asked her if she wanted us to code him again if he arrested. The look of heart wrenching sadness in her eyes when I told her that we would do everything she wanted us to do… but if it was my husband, I would not allow us to code him again.

The relief I felt when she asked for him to be a DNR...

I looked at my husband and smiled as I shrugged…

“I’m fine.” I said as the moments faded and my son toddled up to me. “Just fine.”

#Nurse #Nurblr #medblr #NPsoon #Nursing #ICU #Death #Cardiac #Cardiac ICU #Intensive Care unit #ICURN #RN #Registered Nurse #CCRN #Critical Care #Codeblue #VT

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Interesting ECG from my admission today. Started out atrial fibrillation with rapid ventricular response ( afib with rvr) and you will notice that half way through he changes morphologies and went into a (pulseless) ventricular tachycardia (VT).

#nurse #rn #icu #nursing #registered nurse #cardiac #intensive care #doctor #nursing staff #nurblr #medblr #ecg #ekg #afib #np #vt

[lamentations44]

I wouldn’t mind this weekend being over.

This patient had myocarditis from a chemo drug. He was devastatingly sick and would go asystolic randomly. We ended up having a fantastic electrophysiology cardiologist come and do a bedside rescue. He floated a pacing pa catheter and we were able to run the patient to the ep lab to get a pacer placed. 🥵.

#nurse #rn #icu #nursing #registered nurse #cardiac #intensive care #nurblr #doctor #nursing staff #epdoc #cardiology #cards #badassdoc #ihatethisweekend #ventricularstandstill #onlyPwaves #whoops #asystole

[lamentations44]

Not a cave... thats a very large VSD that is getting surgically repaired. 😮.

#nurse #rn #icu #nursing #registered nurse #cardiac #intensive care #nurblr #doctor #nursing staff #np #surgery #vsd.

[lamentations44]

Patiently

Grave men, near death, who see with blinding sight Blind eyes could blaze like meteors and be gay, Rage, rage against the dying of the light.- Dylan Thomas

The moment my pen started writing your story. I knew that your life was nearing the end.

Your body was done. You couldn’t fight any more.

Your eyes were unseeing, unfocused and dulled by a sickness deeper than we could touch.

Your voice was replaced with a tube that dangled from your cracked lips. Despite the 90% oxygen and high support, your lungs were flooding with fluid and couldn’t keep up.

Your heart was the strongest part of you. It beat deeply, regularly, rapidly… it tried so hard.

Despite the continuous dialysis filtering, the steady bicarb drip infusing and the other 12 medicines fighting to stave off death… It slid along your body like a shadow. The infection we couldn’t find. The infection we couldn’t treat… despite 4 antibiotics.

I don't think of death as anything other than brutal, ugly, marring... It is a mess of screaming and tears... Grief and heartsickness. But, sometimes death is painfully patient.

Death patiently waited while we picked up piece after piece and tried to fix the unfixable.

Death patiently waited while the surgeons inspected your intestines for the reason your body was poisoning itself. Their instruments slicing through your abdomen as a last resort to try and save you.

Death waited patiently until your family made you a DNR so you wouldn't have to suffer more. It waited until you were maxed beyond a rational level on medications.

Death let me leave my shift, come home and let me avoid seeing your end.

Death patiently let us try to save you in every possible way... and then swept you away to where no more pain or suffering could touch you.

#Death #Nurse #Nursing #Nurblr #ICU #intensive care #RN #NP #MD #Medblr #Medicine #Dying #Cardiac #Sepsis

[lamentations44]

That isn’t a run in his pantyhose... that is an honest to goodness type A & B aortic dissection from iliac to subclavian....

#nurse #rn #icu #nursing #registered nurse #cardiac #intensive care #nurblr #doctor #nursing staff #medicalpics #medblr #heart #dissection #aortic #aortaalert