Don't get plutoed

In 2006, the American Dialect Society voted "plutoed" as the word of the year. According to the society, to pluto is to demote or devalue someone or something, as happened to the former planet Pluto when the General Assembly of the International Astronomical Union decided Pluto no longer met its definition of a planet.

I realize it's been way too long since I last posted anything. I haven't been up to anything exciting. Next week I have to go back to school...which I'm not excited about, but it IS my last semester. I had a wonderful Christmas. John and I went to my parents' house for Chritmas Eve dinner and Christmas morning breakfast. I went to Grandma's for Christmas day lunch. Then I went to John's mom's house with him for Christmas dinner. It was a busy couple of days! After Christmas, John started his hunt for a house. My friend Cassie is a real estate agent, so we went tromping around town the day after Christmas looking at condos. He found one that he liked and actually made an offer on it yesterday. I think it's exciting. He's mildy terrified. For New Years Eve, some people that John works with got a suite at the Westmark Hotel downtown and we all went over there, played Wii Fit, ate, and laughed in the New Year. I made it to about 12:15am and then had to call it a night. Apparently I'm not the party animal I used to be.

The last week or so has been frigid (-20 as a low temp and if we're lucky, 0 for a high). So I've been hiding inside trying to stay warm and hoping that my car starts. The forecast says it's going to warm up by Friday...I'll believe that when I see/feel it!

Word of the Day

From dictionary.com's "Word of the Day:"

laggard \LAG-erd\, adjective, noun:
1. a person or thing that moves too slowly or falls behind
adjective:
1. falling behind; slow

Yep, that describes me today. I sat on the couch and did almost nothing all day long. Technically, I'm not falling behind because I have nothing that needs accomplishing, but I would definitely say that not showering or getting ready for my day until 4:00pm counts as moving too slowly. I watched some quality daytime television, ate leftovers for lunch, made myself some coffee around 2:00, and showered at 4. So now that it's 6:00 I'm ready to start my day...

Good thing there's always tomorrow to accomplish all the things I didn't manage to accomplish today (a few last minute Christmas things, the gym, and some serious present wrapping)!

May the punishment fit the crime

http://www.washingtonpost.com/wp-dyn/content/article/2008/12/13/AR2008121302147.html?hpid=topnews

What an interesting concept of justice...

The First Anniversary of my 25th Birthday

This year on my birthday, in addition to thinking about how OLD I am getting...I was thinking about how much things change in a year.  It's kind of amazing really.  I wonder what things will be like in another year...

As for the rest of my life, things are chugging along.  I ONLY HAVE ONE MORE SEMESTER LEFT UNTIL I'M DONE WITH SCHOOL.  I am more than thrilled about that.  I thought the end would never come...and here it is, staring me in the face.  Only 14 weeks of school stand in my way.  That might sound like a lot, but when you've already endured 14 weeks x 4, it really isn't so much (I'm not in the mood to actually do the math).  

Also, John comes home from his 5 week grand tour of Eastern Europe TOMORROW.  Hooray!

That's about it...

A new perspective

Yesterday in clinical I spent the day in the Intensive Care Unit (ICU).  I think I am going to get "DNR" tatooed across my chest.  The patient that I helped take care of was on a ventilator and was sedated.  He had been sedated for nine days.  He was in respiratory failure because he had pneumonia in addition to acute liver failure (his body couldn't process fluid very well and it overwhelmed his lungs).  The theory behind his treatment was that once he got over the pneumonia, he would be able to be taken off the ventilator.  My thoughts were...what if he couldn't be taken off the vent?  Did he say goodbye to his family before they intubated and sedated them?  What sort of mental repurcussions does being sedated for nine plus days have on a person?  This experience really made me reconsider what actions I want taken if I am ever sick or injured.  

Mid-semester vacation

My trip to Seattle a couple of weeks ago was wonderful.  I met John in Seattle the day his post-season meetings ended (Wednesday), he came to pick me up from the airport and then we headed south to The Dalles, OR.  We drove through central Washington instead of taking I-5.  We've both seen that stretch of I-5 more times than we care to count.  The drive was pretty.  Unfortunately John was not excited about stopping at the Historic Mural Museum in Toppenish, WA.  Also, despite what you might think (and contrary to what the billboards tell you), Yakima is definitely NOT the Palm Springs of Washington.  Definitely false advertising.  

We got to The Dalles, ate dinner, and headed out to John's aunts house.  She lives on a farm about ten miles outside of The Dalles.  The next day we headed in to Portland (about a 2 hour drive West) where we went to visit his Grandma in the hosptial.  She had bypass surgery about a month ago and then suffered a stroke about three weeks ago.  She's doing well.  She was unable to speak when we saw her, but she was all smiles when we showed up.  One of John's cousins was there too.  He has been sending out daily updates on how she is doing, and when he sent one that mentioned that John and I had been there...he got more emails back about me than he did about grandma!  After we left the hospital we had dinner with Courtney (my roommate before she moved to Portland) and then we headed to Margaret's house (a friend from college).  Friday we visited John's grandma again and then went to a Blazers game with Margaret.  After the game we met one of John's friends from college and went out on the town (well...one bar).  It was amusing, being Halloween and all.  Saturday, after a DELICIOUS breakfast, Margaret took us to OHSU where we rode the tram down the hill and back up.  Then John and I headed back to Seattle.  

In Seattle we stayed with Kerra (my roommate in college...she still lives in the same house I lived in too).  We did a lot of eating there.  Thai food for dinner, Molly Moon's for dessert (http://www.mollymoonicecream.com/).  I had balsamic strawberry ice cream.  It was amazing.  Sunday we went to Zoka for breakfast, had some Vietnamese noodle soup for lunch, did some shopping at UVillage, and went to Etta's (a restaurant in the market) for dinner.  Monday we said our goodbye's to Kerra and David (they had to go to school) and headed back to Zoka for breakfast.  They had my favorite...ginger peach scones!  We ate at Aladdin's Falafel Corner on the Ave for lunch.  I had the most amazing falafel I've ever had (sorry grandma) and John had a gyro that was rather large and very tasty.  We stopped by the Museum of Flight since we had some time to kill before going to the airport and then returned our car and came home.  

It was a short and relatively busy trip (although I feel like we didn't DO much of substance...but that was kind of the point), but wonderful and much needed.  Now John has run off to Europe for five weeks and I'm slogging through the last five weeks of my second to last semester of school!  

For Greg

I recently recieved some very sad news.  A good friend of mine killed himself last week on Thrusday.  It's one of those things that you hear about all the time and hope dearly that it never happens in your circle of friends.  I worked with him at Royal Celebrity Tours for the past four summers and he and I briefly dated last year about this time.  Most recently we were on good terms.  Given the fact that I worked at RCT again this summer, I decided it was just easier to forgive and forget and go on being friends.  

I'm having a really hard time dealing with this.  Actually, I'm not dealing with it all.  I don't know HOW to deal with it.  How do you deal with the death of someone who, at one time, cared about very deeply.  I guess part of the issue is that since we ended things, I have been the standoffish one and I feel like if I had more time, I could have gotten over that and we could have gone back to being "normal" friends again.  

I thought that writing him a letter might help.  But it didn't...because now I have this letter and nothing to do with it.  So, I've decided that I'm going to cast my letter into the abyss of the World Wide Web.  I'm pretty sure that the dead don't check their email, but maybe they can read things that are floating around on the electronic superhighway.  The internet does everything else...why wouldn't you be able to use it to tell those who have died how you feel?  So...here it is...

Dear Greg,

I have so much that I want to say...and yet it all seems so pointless. I am sorry for whatever 

happened to you that made you feel like you just couldn't take it anymore.  You were always 

so generous in giving help to others, it is unfortunate that you never were able to ask for it or 

accept it on your own behalf. You always said that you didn't really like to talk about things.  

Neither do I, and if nothing else, I guess I will take this this as a lesson in how important talking 

about things can be. Sometimes it helps just to tell someone else what you are feeling. It makes

it a little more bearable, even if the other person says or does nothing.

I want you to know that I am extremely sad. I am sad not just because I lost a good friend, but 

also sad for all the other people who have lost a good friend too. There are so many people out 

there that would have done anything keep a good friend around. I am heartbroken at the thought 

of you out there all alone.  The image of you lying in the bushes in the dark truly breaks my heart.  

No matter how much you do not want to live, you should NEVER have to die alone.

I am also angry. I'm angry at you. Did you think that no one cared? Or that we wouldn't miss you? 

Did you care that we would miss you?  I realize that you probably were not thinking of anyone else, 

but you must have been because you called someone. Someone knew where to find you. I know 

you have been through a lot, especially this last year. Were you just tired of waiting around for it 

to get better? Were you afraid that it might just get worse? Again, I know you were probably not 

thinking of anyone but yourself, but did you ever consider what those of us you left behind have 

to go through? I can't help but wonder if I, at any point in the four years that I have known you, 

contributed to your decision in anyway. I'm pretty sure I'm not the only one either. Now we all are 

all left wondering how we could have missed all the pain you were experiencing. We all want to 

know if there was anything we could have done, something we should have noticed. But worst

of all...did we have anything to do with it?

Were you scared? Was it hard for you to do? Have you been planning this for a long time or did 

you just decide at the very last minute that you couldn't take it anymore? Did you think about 

what would happen to your dogs? Your house? Did you think about what everyone else would 

have to do to take care of all you things? Did you even care? Did it hurt?

This may sound terrible, but I would also like to thank you. Thank you for making me realize 

how incredibly important it is for me to tell the people in my life how I feel about them. I guess 

I never know when I might be seeing them for the last time. I am going to try my hardest not to 

let my feelings go unsaid. With that said, I want to tell you that I'm sorry if I haven't been the 

most pleasant to you over the last year. First I had to deal with the fact that you hurt my feelings 

pretty badly by lying to me. Then I had to deal with the fact that every time I talked to you I felt 

like you were trying to wriggle your way back into my heart again. I dealt with that by being 

standoffish. Not the best choice, I know. Nothing hurts me more than knowing that if I had more 

time I could have gotten over all of this...and then maybe we could have gone out for coffee again 

like we used to. Asfriends.

I wish that when you came to get coffee on Monday I would have known that I would never see 

you again. I wish that I could have said goodbye. Given you a hug. Or wished you all the best.  

I hope that wherever you are now is better than wherever you were before. Please know that we 

all cared and that you will be missed.

Always,

Martha

My triumphant return to the gym

So I finally got my act together and joined the gym.  It's amazing what some good music and 45 minutes of gut busting exercise can do for the mind.  I'm glad that the gym has declared itself the "judgment free zone" because I might have been dancing while I was stretching (I can only imagine what people thought in spite of the judgement free environment).  

John made me go both Saturday AND Sunday (such a slave driver...I know!) but I had to force myself to go alone today.  But now after my 45 minutes of hell, a shower, and some delicious food...I'm feeling much better!

Something to chew on...

Just something to think about from a blog I read (www.dooce.com) 

Why any woman who intends to vote for McCain should reconsider

FRIDAY, OCTOBER 17 2008 FILE UNDER: DAILY

Two of my favorite bloggers in the past couple of days have explained in succinct detail why we (women in particular) should be sickened by John McCain. I implore you to take the time to read these, they're not just a bunch of liberal propaganda or pro-choice cheerleading. These are stories of people's lives.

From Alexa at Flotsam:

McCain states that he would deal with the issue of abortion with “courage and compassion.” I quote: “the courage of a pregnant mother to bring her child into the world and the compassion of civil society to meet her needs and those of her newborn baby.” As if terminating my pregnancy would be the easy way out, the way not requiring his precious “courage.” As if dictating my medical care based upon his religious beliefs is compassionate. And I find it interesting to note that his “compassion” for this newborn does not extend to guaranteeing it health insurance.

And Julie from a little pregnant:

He means us when he holds up his hands and says with that single scornful gesture that we don't matter. That we are a figment of the "pro-abortion movement's" imagination. That — what, we're making this whole "staying pregnant might kill me" thing up?

... even if you're implacably, unconditionally opposed to abortion, a matter on which reasonable people disagree, I don't see any way a thinking person can look at those air quotes and see anything but pandering, contempt, and a dangerous willful ignorance.

"Fall" in Alaska

This picture is from last week.  I love "fall" in Alaska!

On death and dying

I learned today that a patient I took care of a couple of weeks ago died.  She was 8 years old and had a brain tumor.  This was the third time that she had a recurrence.  Her radiation therapy and chemotherapy gave her an infection in her lungs that she was not able to overcome.

I know death is a normal part of working in the field of medicine, but that doesn't make it any less sad.  The saddest part is that her parents didn't want to tell her that she was most likely not going to make it.  I realize this conversation would be extremely difficult to have with an 8-year-old, much less your own child.  But kids have amazing intuition and she probably knew that something bad was going to happen.  I think that having that conversation with her could have relieved a lot of anxiety for her.  Her parents just wanted her to be happy, but it's hard to be happy when you're scared because you don't know what is going on.  I know this isn't my decision, but I think I would feel differently about her death if I could believe that she wasn't scared.  

I doubt that having patients die will ever get any easier.  In fact, I hope it doesn't, because death is not something that I ever want to be desensitized to.  

Pictures

I FINALLY uploaded the pictures from my camera from John and my trip to Copper and our hike on Powerline Pass.  You can view them by clicking the link on the right to "My Pictures"

Getting political...again

So I acted like an adult today and watched the first round of presidential debates...big mistate...they just made me mad.  Not that I was ever going to vote for McCain, but he DEFINITELY lost my vote with his little plan to stop spending money on anything but defense and taking care of our veterans.  Excuse me?!  What about the rest of us?

http://www.slate.com/blogs/blogs/xxfactor/archive/2008/09/27/i-like-veterans-as-much-as-the-next-girl-but.aspx

Back to school

After a WONDERFUL two week vacation from school, I'm back to the grind again.  During my break I got a chance to play a little and work a little extra.  John and I took a trip to the Copper River Princess Lodge (http://www.princesslodges.com/copper_river_lodge.cfm) just outside of Copper Center, AK.  We lucked out and got a room there the one week that they weren't completely full (in order to get the$25/night employee rate, they have to have at least 10 empty rooms...and there's only 80 rooms in the whole lodge).  It was so nice to just relax and not have to worry about anything.  I will post pictures as soon as I get them onto my computer.  We took a couple of walks, a late morning walk down to the Klutina River (about a mile each way) and an after dinner walk on the "Back 40" Trail...but that one was cut short by a torrential downpour, in which we got completely soaked.  We warmed up by ordering some chocolate fudge cake, sitting in front of the fire in the lobby, and playing cribbage.  On our way home the next day we went to the Tolsona Mud Volcanoes (http://www.nps.gov/wrst/planyourvisit/upload/Mud%20volcanoes.pdf).  It was a short trip (and a long drive, 3.5 hours each way), but exactly what I needed.  

Two weeks John and I hiked up Powerline Pass from Indian (usually people start in town and go out to Indian, we went out and back from Indian).  It was nice to get out in the almost fall weather.  Again, I will post pictures when I get them onto my computer.  It was supposed to be a "training" hike for me because I was going to run a race that goes over the pass (13 miles total).  However, last week I was running with a dog (who shall remain nameless so as not to tarnish her otherwise spotless reputation) and she decided to stop dead in front of me.  I proceeded to trip over her and fly through the air and landed smack onto my knee.  So now I am nursing and injured knee...and will not be running the race.  

Anyway, I'm back in school now.  I start my Psych rotation in clincal tomorrow and on Wednesday's I'll be in Pediatrics.  Those should both be good for some stories...

Please make it stop...

NOTE: If our relationship will be greatly affected by the fact that we may have different opinions on certain sensitive subjects...please do not read this. However, I will respect your beliefs if you will respect mine.

I hate politics and I try not to get too worked up about political issues. But recently that's gone out the window. I am tired of hearing about Sarah Palin. Really, I'm just tired of her in general. As a woman, I'm offended at McCain's choice of Palin for VP. He needed a woman...any woman would do...so why not chose a good-looking woman that's much younger than him and 75% of the people who are going to vote for him. Who cares if she knows what she's doing, people will be so distracted by her looks that they won't care what she is or is not saying or doing. Makes perfect sense, right? I'm even more annoyed that the whole "hockey mom" role is being played up as a good thing. When do you think was the last time she took her kids to a hockey game or school? I'm pretty sure she's been a little busy running the state and now she's a bit preoccupied with this whole VP thing. Yes, she's a mom, but she sure is heck isn't BEING a mom right now. I'm pretty sure she's too busy traipsing across the country trying to win an election.

McCain and Palin's take on many things scare me. They are definitely for abstinence only sex education...because IT WORKS. And now her daughter is pregnant. Sex ed is not condoning pre-martial sex, it's simply a way of telling young people how to protect themselves from disease and pregnancy whenever they do decide to have sex. How many teenagers (ourselves at one point in our lives included) do you know that wouldn't do something if you told them not to? I don't know that very many would. We don't let kids drive cars until they are at least 16, but we teach them how (with a learner's permit) before we let them loose. Sex ed is kind of the same deal. We are simply teaching them how to be safe even if we aren't going to allow them to participate is such activities.

Let's also take away a woman's right to chose whether or not she can have an abortion. And make birth control even more expensive then it already is. Expensive birth control + abstinence only sex education + the outlawing of abortion = more overpopulation, illegal/botched abortions, lots of pregnant women who can't afford or don't care to get prenatal care (which is dangerous for babies and mom's), and abandoned babies. That sounds like a world I want to live in. Not to mention the fact that Palin's daughter CHOSE to have her baby (or maybe it was Palin who chose since she thinks minors should not get to make that decision on their own either)...but if McCain and Palin were in charge SHE WOULDN'T HAVE HAD A CHOICE! Interesting article: http://www.slate.com/id/2199258

Wait...don't Republican's tend to believe in less government involvement...but let's get the government involved in really important things that affect women's bodies. I don't want the government to decided what I can and cannot do with my body. While we're at it, we should outlaw obesity, alcoholism, and smoking.

I think I'll move to Canada.

Halfway done!

Last week I officially past the halfway mark of the nursing program. Only 2.5 more semesters to go! We have finished up our first round of Med-Surg, which I will definitely be adding to my list of things I don't want to do. This week we started our OB rotation, where we will spend three weeks before moving on to community.

Today was my first day in OB, I was on the mother baby unit, which is where mom's go after they have delivered and stay until they are discharged home. It was very different from all of the other clinical experiences I have had, mostly because I was not assigned a patient, but instead I followed a nurse. There were also babies involved, and I know very little (medically) about babies, so pretty much everything was new to me today.

Only 289 more days left!

Finally

So I am finally getting around to updating this. It's been a crazy couple of weeks (well, four weeks actually). My class is only 7 weeks long (followed by another 7 week class to finish the summer semester), but we have to fit 15 weeks worth of material into it, so I have lecture for four hours twice a week and clinical twice a week, plus a two hour lab, and work on the weekends.

Clinical is going well. We just finished our rotation through the medical unit and I will be moving to the surgical unit next week. I've had a couple of interesting patients. The most interesting of which was a huge ethical issue. She has a history a mile long, but was brought into the ER for abdominal pain. She coded en route and required 25 minutes of CPR and was put on a ventilator when she got to the hospital. About a month ago she had been in the hospital for other intestinal problems and had a J tube (feeding tube in the jujenum) and an ostomy put in. She's been in the hospital for over a month, is fairly unresponsive, has a trach, and the doctors have determined that she will never recover. Her husband has accused the nursing staff of trying to kill her and the ethical committee had a meeting and was going to stop all of her life saving measures (but for some reason, probably the husband) they never did. Last week when I took care of her, her J tube was leaking copious amounts of bile everywhere and compromising the integrity of the skin around the opening. The husband was also ordered by the doctor to not be involved in any of her care while she is in the hospital - he was doing her tube feedings (mostly legal reasons I would assume). Taking care of her was an interesting lesson in putting your own personal ethics aside and doing what you have to for a patient in any given situation.

This week I had a couple of interesting experiences. I got to take out a chest tube on a deceased patient, and I had a patient that had a 3cm x 3cm abscess on her butt...it was over 8cm deep! I watched the wound therapist when she did a dressing change and repacked it. It was pretty gross.

Since Thursday's are my short days of class, John and I have been doing some hiking which has been great. Our hike last week was an interesting mix of excessive mud and snow. But it was nice to get out and do something!

Faithful Readers

Dear Faithful Readers,

I have not forgotten about you. I have much to tell. What I don't have, is time to tell it. I will try to locate some before I forget what I have to tell. Perhaps there is some smashed between clinical and dinner somewhere, or maybe after dinner but before breakfast? No wait...that's when I sleep...

Reality bites

As my good friend Allison pointed out today when we talked..."your readers are waiting." Although I question the number of faithful readers I have, never fear, your wait is over.

Tomorrow is the last day of a much needed three weeks off from school. I started out my break on a cruise with a college friend, Margaret. We spent seven days in the Caribbean on the biggest passenger ship on the ocean. We went to Puerto Rico, St. Thomas and St. John, and St. Maarten.

Here are Margaret and I having a lunch of sushi and fries

San Juan, Puerto Rico


A view from the Castillo Juan Felipe del Morro in San Juan
Another view from the "castle"
On a ferry from St. Thomas to St. John (about a 40 minute ride)
We went on a hike on St. John to Honeymoon Beach. According to National Geographic, this is the seventh best beach in the world.
Back on St. Thomas, a street in Charlotte Amalie
We went kayaking in St. Maarten. This was our French guide who deemed us "Team M&M" and made it known that we were, in fact, his favorite.
I had a little bit of a hard time adjusting to life again when I got off the ship. It's hard to go from eating a five or six meals a day (included in the cost of the cruise) and having your bed turned down and mints left on your pillow every night, to eating cereal for breakfast, leftovers for dinner, and not sitting on the beach the entire day. But, after the initial shock, and numerous compliments on my carefully acquired tan (yes, my white Alaskan skin tanned, even through SPF 45!), I've come to terms with reality again.

Upon receiving an email last weekend outlining the things I needed to turn in on the first day of class, I quickly un-came to terms with reality (I realize that is far from grammatically correct, but I feel it is the only way to truly capture the essence of my situation). Thus, I have spent the last week in blissful denial that I have to go back to school. In said state of denial, I have accomplished something. I've read two books. The most recent of which I would highly recommend (Three Cups of Tea by Greg Mortenson and David Oliver Relin).

That's about all the updating I have for now. I'll try not to keep everyone waiting for so long next time!