Wise Beyond Your Years

Since I was young, people always told me that I was wise beyond my years. Either that or they told me I was a 30-year-old trapped in a teenagers body. But that's not the point.

The point is that lately I've been feeling like I must be wise beyond my years. I have a patient and he is dying. He will probably die tomorrow or the next day. He is young; he has young children and a wife; he has a terrible disease; and he is in pain.

There are things worse than death and this man is living those things. His body is failing him but his mind is intact. He knows he is dying. He has accepted it. His wife has not. She grips to every fiber holding out hope that he will survive. But he won't and he knows that and he is ready to die.

I can't imagine being his wife. I can't imagine a doctor coming to me and asking me if I was ready to let my husband go. If I had brought our children to see their father one last time. I can't imagine....

But I have to imagine that. We all have to imagine that. Because you have to know what you would do in that situation. Have you talked to your spouse or your parents about a living will? Do you know what they would want. You have to do that; you have to know. You have to do it so that you can make those decisions for your loved one when they can't make them for themselves.

I was talking to this patient's nurse today. She lost her husband to cancer when he was 40. He was a nurse as well. She told me about the day before he died - they had a party. He joked with his friends and they celebrated his life. He was pain-free and at home. Had she not known her husband's wishes, how might he have died? Alone? On a ventilator? Without saying goodbye to his family?

If you have never asked your spouse or your parents what they would want in a situation like that, you need to. Do they want a feeding tube? Do they want a tube in their neck if they stop breathing? Do they want someone crushing their chest with CPR?

When I was talking to my patient's nurse she asked me how old I was. I told her and she was shocked. "When I was younger, I thought we were all invincible." "You are wise beyond your years to know that is not the case."

Please, go visit a hospital. If your spouse has never been to the emergency room or intensive care, take them. Show them what it is like. And then tell them what you would want them to do if you were ever the patient.

In a Funk

I'm in a f-u-n-k. I need a vacation - big time. I don't know if it's work or home or a combination of both, but lately I've been feeling pretty pathetic. Now, remember, this blog is for me. So, when I post this list - a list of why I'm feeling pathetic at this particular moment - don't freak out and call my husband or parents. I'm fine - just in a funk.

1. I feel like a crummy wife.
2. I'm crabby a lot of the time.
3. I let little things bother me.
4. I have an amazing husband who takes such good care of me and sometimes I treat him poorly.
5. I feel like some of my friends put zero effort into our friendships.
6. I feel selfish that I want to make a lot of money.
7. I want kids but am terrified that I will be a crazy parent.
8. I worry about saving money but don't want to make the sacrifices required to really save.
9. I feel like crap when people call me bossy (which I am) and I don't know how to change that.
10. I'm scared about my depression and how that will affect me if/when I get pregnant.
11. I am tired - physically and mentally.
12. Sometimes I don't know why my husband stays with me.
13. I suck at life because I gossip too much.
14. It scares me to think that we might live in CS all our lives.
15. It hurts me to know that my husband isn't always compensated/acknowledged for what he does at work.
16. I hate that I can't leave work at work.
17. I'm pissed that my husband didn't like his birthday present when I thought that he would really appreciate it.
18. I feel like I have to put forth extra effort to smile and I feel fake when I do it.
19. I feel like I can't talk about my depression with my husband because he feels that it is a reflection of my feelings for him.
20. I just want to feel happy.

Now remember, this is a list for me. It just feels better to write it down.

It's all just trial and error...

I'm at a Head and Neck Cancer convention this weekend in Houston and I've quickly come to the realization that a whole lot of what we (SLPs) do is trial and error, especially in the head and neck cancer population. Granted, I am learning a lot, but I am also learning that I've been doing a really good job at teaching myself how to treat these patients (not to toot my own horn, mind you).

I think that, even more important than the material you are taught, if you are taught how to find information you can figure out how to treat almost any patient population. Now, what I'm saying isn't rocket science or a brand new theory, but I think that people should know that it can be done with the information you already have.

Ok, I know this doesn't have much content, but for all my SLP readers (yes, I know I only have a few), I think you should know that you've got what it takes to help your patients even if you think you don't.

I just can't seem to find the words...

I just can't seem to find the words these days to Blog about my work experiences. Whenever I see my patients I'm always thinking "I need to blog about this." but then never do. I need to start back up; it's good for me, it's good for my mind, and I really do enjoy it. So, enough with the pep talk and on to business.

I have been seeing a certain patient for quite a long time now. He has been hospitalized since January and currently resides in our LTAC. This man celebrated his 84th birthday in a hospital bed, which he will probably never leave. I think the one thing that makes treating this man so hard is that his mind is still so sharp. He is up to date on current events and has the quickest, funniest, wit.

I have been treating this man's dysphagia since he entered the hospital for a ruptured appendix (I know, weird combination - appendicitis and dysphagia). But, he has not gotten even the slightest bit better. I have been using VitalStim therapy on him and just recently forced myself to stop. He is still on a feeding tube and cannot take even the smallest bit of PO intake without sounding like a gurgle fish tank. IT JUST MAKES ME SO MAD! I love this little man and I cannot help him.

The other day, I had to have "the talk" with him. It's the talk that I am so good at giving but is truly terrible to give. It's the "your swallowing will never get better so you can now choose to eat and die or never eat again and live" talk. HATE IT! Anyway, my little man made it so hard to give that talk; his mind so clear and his wit so fast. And do you know what he said to me when I finished that talk? "So, should I call you the Obama death squad?!?"

Now that I cannot keep treating this man, I can barely stand to walk past his room. I know that if I enter just to say "hi" he'll ask when we're starting therapy again. I know I should go in, but it is just so hard. What do you do when you know you can't help someone?

Lots of new updates...sorry I'm a crummy blogger

So, I've been really bad about blogging, as I'm sure you can tell. I started reading all of my blogs on google reader and have become so engrossed with them that I've neglected my own blog. Sorry blog.....

So, updates. We're buying a house! It is a new home that is currently being built. We've gotten to pick out the tile, carpet, granite, and fixtures. I'm really excited about it! We close April 15th. And, to top it off, our landlord is being nice and letting us out of our lease early! I'll have to post pictures soon. This does mean, however, that we've made the big decision to stay in College Station for at least the next three years (we want that tax credit!). We just had to come to grips with the fact that right now, this (our job situations) is the best thing out there. So, we bit the bullet and are putting down roots.

Other not so big updates....Mona is really growing on us. She is such a funny dog. I'll have to get Jon to post some videos of her. Some of her not so cute habits include sucking at potty training, **screaming** when she doesn't get her way, and gnawing on your toes with her razor sharp teeth. Hopefully it's just a puppy phase and she'll grow out of it.

Work has been going well. I have a few patients I need to blog about, but again cannot find the motivation. Stay tuned to see how that works out.

MONA!!!

Well, we thought we would wait until April to get a new dog, but once we got back from our trip and came home to an empty house, we just couldn't stand it. We contacted our breeder, who graciously offered to provide us with another puppy for free, and picked out a puppy that we will bring home this weekend!

Her name is Mona and we are so excited she'll be joining our family! No dog will ever replace Toby, but we are so thankful to be receiving Mona, who I know will lift our spirits!

Quick & Healthy Chicken Enchiladas

My husband rarely gets excited about something I cook, so I was shocked when we both loved this recipe for quick and healthy chicken enchiladas. Enjoy!
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Chicken Enchiladas

This recipe can be layered to save time or you can fill each tortilla and roll in the traditional way. Turkey, pork, or beef can be substituted for the chicken, Top each serving with extra Mozzarella cheese.

2 cups cooked and cubed/shredded chicken

1 cup chopped onion

1 cup low fat Ricotta cheese

1 cup nonfat plain yogurt

2 oz. grated, low fat cheddar cheese

2 oz. grated, part skim mozzarella cheese

12 corn tortillas

2 cans (10 oz. each) enchilada sauce

Preheat over to 375 degrees. Mix first six ingredients and set aside.

Spray a 9-inch by 13-inch baking dish with non-stick cooking spray. Pour ½ can of enchilada sauce in bottom of pan. Follow either method below for layered or rolled. Bake for 20-30 minutes or until heated thoroughly.

Rolled Method: Place about 1/3 to ½ cup of filling on each tortilla and roll to enclose (cracks in tortillas are not as noticeable after cooking). Place seams side down in baking dish. Top with remaining sauce.

Layered Method: Follow this order: 1/3 of the tortillas, ½ of the filling, 1/3 tortillas, 1 can of sauce, remainder of filling, remainder of tortillas, remainder of sauce.

Yield: 8 servings

One serving: 1/8 of recipe

Calories per serving: 275

Fat: 7 grams

Disappointment

Working in healthcare, I am always faced with disappointment. My patient's test did not go well; my patient is not working hard enough at home; my patient is just not strong enough; the healthcare system is broken and my patient pays the price. The list goes on and on.

Sometimes, disappointment is easy to brush off. It is a sad fact, but all too true. This past week, I had several disappointing situations. The most disappointing of all was that my coma patient got rejected by a brain injury rehabilitation facility.

He had a heart transplant, one of the grafts failed, he suffered an anoxic brain injury, they repaired the graft, he didn't wake up, he developed a non-healing sternal wound, he went to an LTAC and got no cognitive therapy, he came to our LTAC and I did the best I could with him, he was evaluated by a brain injury rehabilitation facility, he was denied because of his poor prognosis and length of time since injury (3 months), he will go to a nursing home with no therapy, he will ROT!

This is the broken healthcare system. I know it is broken, but my coma patient makes it all the more real. I cannot tell you how disappointed I am. And the worst part of all of it.....he has a brand new donor heart.

(Sorry for the depressing post...remember, I blog for myself as a personal record. Thanks for reading!)

Whirlwind Christmas "Vacation"

Jon and I got back from our whirlwind Christmas "vacation" a week ago and we are still feeling the effects of such a draining trip. Individually, each destination was great, but roll them all together in a 10 day window of time and you do NOT have a vacation.

We started out traveling from Houston to New York (Buffalo) to spend Christmas with Jon's family. This was our first married Christmas together, so all the new traditions were being made. Before we were married, we decided to alternate Christmas each year and we're trying really hard to stick to that plan. We mostly just visited with family and relaxed. I did a little shopping with Jon's mom and we took his parents to the Melting Pot as part of their Christmas gift. I, unfortunately, still didn't get to meet Jon's brother, who didn't show up for the festivities.

The day before we were supposed to leave, we learned that Delta changed our flight to California and that we would have a 5 hour layover in the Atlanta airport. We called Auntie KK and she was nice enough to feed us and entertain us for a few hours.

We arrived in California for Morgan and Adam's wedding late. We picked up our rental car and it was pretty much non-stop from there. We helped Morgan get ready for the rehearsal dinner and Jon was even given the task of taking Morgan's wedding dress to the church! Not to brag, but we know we helped a lot and I'm sure the wedding wouldn't have gone so smoothly had Jon not taken on so much responsibility! The wedding was beautiful and the reception was fun; got to spend some time with old friends from college and make some new friends too. Jon even got an invitation to visit one of our new friends in Japan and go to Tokyo Disney.

Speaking of Disney, Jon wouldn't let us leave California without visiting the Mouse first. We spent December 30th and 31st at the parks. The 30th was cold and rainy and COLD!!! It was a good thing we packed our winter clothes for NY or we wouldn't have been able to stand it. Since it was already misting outside, we decided to ride Splash Mountain on the first day. I insisted that Jon buy us ponchos, and it was a good thing, because we got SOAKED! So, soaked in fact that it wasn't even fun. We ended up leaving the park, going back to our hotel room and drying our shoes with the hair dryer, putting on our winter clothes, and then went back to the park. The rest of the evening was pretty fun and we made sure to stay dry.

On the 31st, we knew the parks would be packed, so we made sure we had all the clothes we needed when we went in and knew that we wouldn't be able to leave. By 5:00 pm, the fire capacity was met and if you left the park you wouldn't be allowed back in. It was wall-to-wall people. Everywhere!!! They even made a majority of the walkways one-way. By 11:00 pm, we'd had enough "fun" and were ready to head back to our hotel. We had an early flight home and were in bed by midnight. Happy New Year!

We finally made it back to Texas and are so thankful to be home!