Monthly Archives: November 2013

Peals

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Many moments in my life ring in my ears
Things that I’ve done
Things I’ve not done
Words that I’ve said
Not said

I hear the voices, the conversations
Sometimes they keep me up at night thinking what if
If only
If I could do it over
If I’d had the chance to do it
Once

Sometimes the conversation is only with myself
My now self and my past self
Other times, it’s with that other person
I hear the words as I relive the moment in my head,
the voices clear as day deep in darkest
night

Some are joyous to remember
and I bask in memory’s glow
sinking deep into my pillow
as it lulls me gently into such sweet
sleep

Some have the force to make me cry
as if they were happening anew
As though time reversed itself
and sent me back to suffer pain, again
Why?

One can never know
I can never know
But I’ve learned to live
with the sounds of bells’
peals

Until this last continuous sound,
a noise which cannot be
contained,
maintained,
sustained

No, this incessant din
I will not abide
For it is naught
but an artificial ring
caused only by my
pill

 

***Tinnitus, ringing in the ears, compliments of Plaquenil.
     I’m jumping ship, until disproven.

The Worst Patient

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When I was delivering direct patient care, we were given a two-hour window during which to administer medications. If a med was scheduled for 1 p.m. (1300 in hospital-speak) it could be given between noon and 2 p.m. (1200 to 1400). It was one of the ways Administration acknowledged that we nurses had a lot on our plate and the day was only so long.

I don’t know if this is still the case at the bedside as I’ve been gone a long while now, and I don’t expect to ever return. The curtain has lowered on those days, but I am reminded of that window every time I take my own meds late. Or forget to take them at all.

These days I have only one patient’s needs to meet. There is only one patient for me to give primary care to. Only one patient whose meds I have to keep straight in my head. Me.

And I find that it’s not any easier. One does not simplify things, especially when that one researches and investigates every little thing. And at times does not even comply with the treatment.

I once confessed to the Nurse Practitioner taking my history that I was noncompliant with one medication. She paused in her note taking to look up at me, then we locked eyes and laughed. It’s common knowledge that doctors and nurses make the worst patients.

As it stands, the nurse in me is trying to come up with a workable plan of care for the patient in me. For a while now I’ve been toying with the idea of making a MAR for myself (Medication Administration Record). Or would that be on myself?

We used to get the MARs every day from the pharmacy; they covered 24 hours’ worth of documentation. I don’t need to get as specific, but I would at least need to list all my meds and the times they are due. That way I would be able to check them off, sign off on them so to speak, as I take them. And thereby no longer wonder did I take that calcium this morning? Or that Gabapentin last night?

As it is, there’s no way to tell. I have so many things on my mind, so many things that need to get done. And subconsciously, I don’t want to take my meds. Or more accurately, I don’t want to have a reason to need to take my meds.

But alas, I do.

I already have my phone set to alert me that Wednesday is Methotrexate Day. Unfortunately, every day is Plaquenil Day and noon seems to come around all too quickly. I swear there are less than 24 hours between noons. Or maybe it just seems that way. It’s that old noncompliance thing tugging at me.

So I’m thinking a “MAR” should keep me on the daily straight and narrow. Back when I supervised three separate nursing units, my last task each day was to list all the things that needed to get done the next day. Those were the steno-pad days, before the now ubiquitous computers. I would leave the hand-written list on the center of my desk so it was the first thing I saw upon opening my office door.

And it really worked. I got so much done that first year; it still makes me tired just thinking about it. But they do say that if you write down your goals, they are more likely to get accomplished.

It’s definitely come time to make myself another action plan. I just have to decide on the form, or the format. A dry erase board comes to mind. But I don’t think I can find room on the wall for one that big. Anyway, I don’t want it front and center, spoiling the “décor” of my home office. So I’ll design it on my laptop, then print it out so it can join the jumble on my desk.

I’ll program my phone to remind me to look at it. Or for it.

Paperless Woes

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Has your doctor gone paperless?

You know, no actual paper lab order form that tells you exactly what tests will be performed. The paper that clues you in as to whether you should not eat beforehand so your results won’t be skewed. Or lets you know to drink a lot before getting there so you can deliver that urine sample. Last time I had to go back to the lab the next day; I was, ahem, not prepared to deliver.

I’ve gotten used to him not having to plop down a thick, heavy paper chart on the desk in front of me. Instead he reviews my notes and history on a sleek new laptop. I just hope that it’s backed up somewhere. The Cloud? Carbonite? A master hard drive? I really don’t care who finds out about my medical history. I care more that it not get lost into the ether.

In a way, this blog helps me keep track of where I am on the RA continuum. It’s a record, granted a digital record. But after this last visit, I decided I am going to do something more; I’m going to keep a written log: Star Date, blah, blah, blah . . .

And I am going to do one more thing, be more proactive with my plan of care.  I started to on this last visit. When the check-out clerk tried to do the “this is your appointment card and this number on it is your lab order” routine. I said, no, I need the actual order form. I don’t like this computer code number thingy and neither does the lab. So I got my piece of paper.

But (big but), I didn’t insist on at least verifying with him what, if anything, he was going to order for me at the pharmacy with his one click of a button. I understood he was and I waited for the text from the pharmacy telling me it was ready. Nada, zilch.

I called them this morning; they’d received no clicks in my direction. I called the office. They verified my old prescriptions. But, but, but, I said. There was to be something else. For my bursitis of the foot. After he made me jump a foot off the exam table by pressing into the most painful area of my heel, I understood he was going to order a prescription-strength anti-inflammatory. True I couldn’t think straight or hear right after that, but I swear he said he would.

Well he did mean to and they are now, and I once again await the pharmacy text. I appreciate the digital era I live in, but I’m a writer. I have a love affair with paper. It’s hard to let go.