Friday, February 07, 2014
One of the changes is relatively recent; I started working in the Emergency Department at Catholic Medical Center in Manchester a couple of weeks ago. I was hired for 24 hours per week to work up front, and I am orienting in the department now. It will take me approximately 5-6 weeks to get through the department orientation, but I think once it is done it should be a pretty interesting job. It will certainly add to my experience, and that is something I look forward to. More learning, but it is good to learn new things. Learning is like exercise; the more you learn, and the more different things you learn, the more well-conditioned the brain becomes. And I believe the folks at Lumosity have gotten it right, in terms of the word "neuroplasticity"; the neural networks we possess expand exponentially when they are stressed. And that is as it should be.
We got a load of snow out here yesterday. My back step had a total fall of approximately 10 inches, which was more that what was predicted. And the temperatures reflect the snow counts as normally when there is no snow the air is a bit warmer. Not now, I'm afraid; it is simply cold. But it is winter in New England; shouldn't it be cold? And this one is as I remember it when I was growing up.
As I write this I am working. Not a surprise there; it is technically Friday morning, and I have been here for a bit shy of 7 hours. We got in from a call a little while ago: an elderly male with mental status changes. Hallucinations and visual disturbances, to be more accurate. Pretty interesting and diffucult at the same time. History of end stage kidney disease - he is supposed to have a dialysis shunt implanted soon. Maybe that will take care of some of the issues, but it is hard to know. Also a diabetic; this always compounds things because of the nature of diabetes. It is an insidious, vicious disease that destroys organ systems over time because of the damage done to peripheral nerves if glucose levels are not controlled. And there is no such thing as age discrimination as it can affect anyone no matter how healthy the person is. But it has to be tough to deal with when you're already compromised metabolically, not to mention physically. And the damage to his kidneys is already pretty much complete. Between the two pathologies that are present, he will likely continue to have a rough row to hoe as time goes on.
I am hoping not to have to deal with the cold again tonight. Hopefully I'll be able to get a nap in. But anything can, and usually does, happen, so if I expect crazy things to happen I won't be disappointed when they do.
Tuesday, January 21, 2014
Or at least very little....
I took this photo right outside of my front door. The only real color that is present is in three distinct areas. The first is the fire hydrant at the bottom left. The second is the stop sign. The third is on the building across the street.
They are splashes, at best. Note that there is really not much else in the picture. The white SUV in the middle of the shot was accidental; I couldn't have planned that if I tried. All I wanted to do was capture the dirty whiteness of the old snow on the ground, the deep gray of the pavement, and the off-gray in the sky. The white building across the street actually jumped out a little more than it usually does because of the lack of color present.
I took this shot because of the conditions of the day. It is roughly 10 degrees Farenheit outside as I write this. Actually, 9 degrees according to the digital thermometer outside my door. There is a major winter storm on the way. Depending on who is providing the forecast, those of us in Southern New Hampshire fortunate enough to live here can expect to see anywhere from a dusting to about 10 inches (25cm for my Canadian and European friends) over the next 24 hours. It is12:45PM as I look at my clock. Snow hasn't started here yet, but I expect to see it anytime.
I am worried a bit about Martha; right now she is in a meeting with a client in Brattleboro, Vermont. She had to cross both Temple Mountain and the Monadnock Region of New Hampshire to get there, not to mention the Connecticut River. I truly hope she gets a head start on the snow. And I don't expect to see her for the next 3-4 hours, depending on what other work she might have to do.
So I found an outlet for my frustration about not being able to start PA school. One of my friends told me about a website that is a hub for online learning, mostly at no cost. So I investigated it, and discovered there were some things I could do to at least keep my mind from withering on the vine. The site is called Coursera. The course offerings are varied as are the institutions offering them. It is all online. And while the courses themselves are provided at no cost, to get what they term "verified certification", or actual proof of completion, there are nominal fees for that if one so chooses to go down that road. I haven't decided about that yet, but we'll see how it goes and whether or not I like what I get out of it. I don't know if any of these can be used for credit or not. That, in itself, doesn't concern me. Right now I have close to 170 hours of undergraduate credit under my belt; I don't think I need any more. But it would be good to know if that is an option. If I become so inclined, I will check that aspect of it out.
I had forgotten how much pleasure I take in writing for its own sake. I have been told that I write well and that I express myself better than most. While I truly appreciate the compliment (and I really, really do), the real reason I write is because it is an outlet for me. Plus, it is a way that I can organize the absolute spider's web of stuff in my mind by putting it down, looking at what I said, re-arranging it in a way that makes sense, looking at it again, then letting it sit. Sometimes I go back to it, look again, discover that I either misspelled a word or two or repeated a phrase, and fix the errors. It is good exercise for the mind.
In some ways, it is sort of like prayer; once I put whatever is on my mind out there, I can let it go. And I find that if I write to pray rather than speak to pray, it is easier for me to do that. I tried to explain that to a priest friend of mine once, and he understood what I meant, but he is really old school; he didn't agree with me. We ended up having a rather spirited discussion where my point was made by using the following teaching of Jesus as an example: "but when you pray, go to your inner room, close the door, and pray to your Father in secret. And your Father who sees in secret will repay you" (Matthew 6:6 NAB). While writing for an audience is not the same thing by any means, there is a parallel. If I kept a private journal - sometimes I consider that in addition to writing this, but I don't think it's a good idea simply because it would be duplication of effort - that could be considered a form of writing that is in secret, like prayer. And that was the crux of the discussion. I don't think he will ever agree with me on this, but that's okay; he knows where I stand, and I feel like maybe that is enough. And I will still ask him to hear my confession from time to time...
On that note, and at the risk of running the battery on my keyboard down, I think this is a good place to end it for the day. More to follow on the weather. And think about the lack of color in the photo. It makes me want to see Spring really soon....
Sunday, January 19, 2014
I hate writing hard posts. Unfortunately, this is one of them. While I haven't written one like this in a long time, I find that doing so helps me work through the difficulty I have dealing with what is in front of me. And this is one of those times where I feel a real need to do that.
This past Thursday I worked one of my shifts at the firehouse. Normal, not too difficult. Went out once at 7:15PM-ish for a call. Chris, my partner, and I had planned grab dinner, but we got sent out. I forgot to mention that we had a third rider, a department member that has ridden with me in the past. Andy - nice guy, really bright, but needs to get some more experience. I like him; he simply needs more grooming.
Anyway, we went out to do this call. Ended up taking care of a fall victim. We got back, were finally able to get a bite to eat, and we were for the rest of the evening. We were up until 11:30-ish. Our third rider headed out at that time, so Chris and I settled down to try to get some sleep.
We were woken up at a little before 4:00AM. We were sent to one of the assisted living facilities in town. Fall victim. We arrived on scene, and the patient - a 75 year-old male - had fallen out of bed. As we were walking up to the room our patient lived in, we heard the cries of, "Help! Help" coming from inside. We found our patient sitting on the floor next to his bed. The one thing I thought was interesting was the posters on the walls. All from Broadway shows. Plus, a very extensive collection of CD's and DVD's. Show tunes. Broadway soundtracks. Plus the DVD's were musicals, movies, etc.
We checked on our patient; he wasn't injured, but he couldn't get up. The house custodian told us he was down on the floor for probably 15 minutes before we arrived on scene. So we got him off of the floor. His legs were underneath him; I suspect they had fallen asleep. When we got him on his feet, he was able to move around without difficulty. And he didn't want to go to be evaluated. That was fine; he wasn't injured. So he signed a refusal of treatment and transport, and we were on our way.
Got back to the firehouse about 4:40. I attempted to sleep until my alarm went off 40 minuts later. I packed up and got ready to end shift. As I was walking into the day room, I caught some radio traffic on the police department channel that got my attention. The dispatcher said, "we got a medical call coming in from __ _________ St. I can't understand the caller; she sounds pretty hysterical." About 10 seconds later we got an incoming call tone.
"Respond to __ ___________St. Echo level medical call. Individual not conscious, not breathing. PD en route."
As soon as we got on the road, about a minute later, dispatch came on the air and asked us to call. When I did, I was told that we were headed to the scene of a suicide. We just needed to declare death and help establish a time. When we arrived, we were directed to the basement of the house where we found a man hanging. It was easy to confirm death as he had all of the obvious signs that I was looking for: rigor mortis had set in, there was dependent lividity (pooling of blood) showing in his hands, he was pale, and he had an angle of about 45 degrees at his neck.
Police officers on scene had his information, and when I asked for it and was given his name, it was like I got hit in the face with a brick. This person was somoene I had known for close to thirty years. I hadn't seen him in a very long time, and I didn't recognize him. Plus, this was someone that others I know also knew well.
I spoke with his wife prior to leaving the scene. Apparently there had been an argument the night before. Not the first, from what I gathered. And it was pretty intense. Intense enough, in fact, where she was scared for her safety. She had planned to leave him, and whether or not she intended to follow through with that, he must have gotten scared himself. On my part, however, that is purely conjecture. I have no idea what was in his head. But that doesn't matter now.
I feel badly for his family. Really badly. And while I am less upset than I was before, I am still pretty angry. But it doesn't matter what I feel or think.
If this were someone I didn't know, it would still be difficult, but when it is personal, it is much harder.
Tuesday, January 14, 2014
Interesting. It is winter in New England, but you wouldn't necessarily know it. It isn't cold, but it isn't warm, either - about 42-43 degrees Farenheit. Raining. The rain probably explains why I don't feel especially well. Mild sore throat and a little bit achy. I'm hoping that the concoction of over-the-counter medication I took earlier does its job. The sooner the better; I have to work tonight.
Yesterday should have been the first day of classes for me in PA school. I've been a bit sad because of not being able to go. While I'm hopeful that I'll be able to go next year I'm not terribly certain about it happening. Mainly because I haven't been able to re-apply due to lack of funds for application fees. I'm going to try to get it done by the end of this week, however, and I hope I didn't wait too long. But all I can do is wait and see what happens. If I don't get in to next year's class, then what? The honest answer is that I don't know what I will do. I have to think about it. And thinking about that uncertainty bothers me.
I am working tonight. Goffstown both tonight and Thursday for each overnight. And I volunteered to do a transfer tomorrow in town - a discharge out of one of our local nursing homes to a residence in town. Unless there is something funky about it there shouldn't be a lot of hassle with it; it should be straight-forward. Most discharges are; the only time they aren't is if the patient has some sort of chronic medical problem that complicates lifting and moving. Or if the patient is morbidly obese. Then it will require more than just the two of us that are assigned to do the call. Since I don't know what's going to happen, I'll just wait and see. At least the other person who picked up the transfer is a good, solid EMT. It should be okay.
Yesterday I worked with a Paramedic that I know but had never worked with before. Good man. Solid Paramedic. We only did two calls, but I was extremely impressed with what we did and what I saw. First one was a chest pain call coming out of a medical practice that is on the hospital property. A relatively young man - early 40s - but a number of health-related problems. And it could have gone either way, in terms of whether or not the complaint was legitimate. While more often than not the complaint or nature of illness is indeed real, sometimes that isn't the case. Kind of interesting; his ECG was abnormal and he had some associated symptoms, but something wasn't right about his presentation. I can't quite put my finger on it. But in any case, it doesn't matter; any patient with that sort of complaint needs to be treated as though it is legitimate. It has to be that way, mainly because if the patient is not treated properly and there really is a problem or something goes wrong, the results could be disasterous. And nobody wants that.
The second patient came out of an area nursing home. An 87 year-old male wth a lot of complicating medical problems. The original dispatch was for difficulty swallowing, but when we arrived it turned out that the issue wasn't so much the problems with swallowing (that ended up being secondary) as that he was having difficulty breathing. The reason for that was because he was in the beginning of an episode of congestive heart failure. Wet lungs. Low oxygen levels. Oddly enough, no hypertension. Plus he was able to speak in full sentences. Regardless, he needed help. And the facility originally wanted to wait until this morning to send him out. That would have been a mistake; if they had waited he would have been in fully-blown failure, and the problems associated with that can ultimately be fatal. We weren't having any of that.
Tonight working in town hould be interesting. With the wet weather conditions, visibility could be limited. I'm not convinced that there won't be mishaps with cars on the local roads. But we'll see how it goes. Plus there is a training class tonight that I would like to attend. Getting my partner to go could be an interesting adventure. But we'll see what happens.
Friday, January 10, 2014
Sometimes we end up going down roads we don't expect to travel on. Other times we know that we're going to have to go places thinking that we'll take a certain path and then discovering that we have to travel to places we hadn't planned on going. It is certainly that way with life; here I expected to be doing something now that is totally different than what I am doing. While I'm not especially happy about the detour I am on, I figure that there has to be a reason for it.
As many of you know, I was planning on starting PA school this week. As you also know, that didn't come to pass. I'm still smarting over that, but I've gotten past the major upset and disappointment I initially felt when I discovered I wasn't going to be able to attend. Since I had to give up my spot in this class start, there have been a number of things that have happened, either to me or to my loved ones, that made me realize that there was probably a good reason why I couldn't go. The people in my life that I'm referring to are my mother and Martha, my wife.
First, my mom. I'm pretty sure I've talked about this in past posts. If not, bear with me.
My mom is in failing health. Among other things, she has dementia. Her short term memory is almost completely gone, her energy levels are nearly non-existent, and she depends on others - namely my siblings and me - for much of her care. It is only a matter of time before she ends up in a situation where she will need to be in long term care. Additionally, she has been dealing with an issue related to internal blood loss, requiring her to undergo regular blood transfusions.This has been ongoing; we noticed the decline in her cognitive function a number of years ago and we've watched her slowly deteriorate further as time has gone on. To make things more interesting, my sister, who as been her primary caregiver for quite some time now, was injured at work back during the late part of the summer. She is still recovering. And while she's been out, my brother and I have picked up much of her load. This actually, at least for me, has been a blessing because while I knew what was going on, I didn't really know the full scope of the issues my mother faces. And my brother has been absolutely wonderful as he has picked up much more than I ever could. Plus, he handles her incredibly well, which is a blessing in itself. Between us we do what we can for her. And it is challenging.
As sick as she is, my mother continues day to day. We are constantly amazed that she is still plugging along the way she is. That said, we figure it is due to one of three things: she either has an incredible will to live, she has an ingrained fear of death, or some combination of the two. I don't know which it is.
The other thing I've dealt with is helping my wife through a difficult period. She had to deal with a terrible situation at her workplace. While I can't discuss details, suffice it to say that it has been really hard for her because of the personalities involved. Ultimately, she has to change jobs because of the issues involved. And she did this at great personal sacrifice. Consequently, it has resulted in some financial losses for us, making life a bit more challenging than either of us would like. But we're getting through it, and we're grateful for the patience we've been shown.
As it turns out, I have student loans coming due starting next week. I'm now having to pay the price for my education. While it has been totally worth it I'm finding that I have to work a little more - actually, a lot more - so that I can cover that debt. I am hopeful that when I actually can start PA school (with any good luck I'll be able to start a year from now, but we'll see) I'll be able to defer the debt or, if possible, find a way to get as much as possible paid off prior to starting the program. But when all is said and done, that simply remains to be seen. I'll just have to do what I can for now.
One sort of positive in this is that I am starting a new, additional job on the 27th of January. I was hired to work as a Paramedic in the Emergency Department at Catholic Medical Center in Manchester. It is part time; I'll be working 24 hours each week there, and I don't know what my schedule will be as of yet. It comes at a good time; with some of the changes we've undergone, the additional income will be helpful.
So the bottom line of this is simple. We don't always have control of the things we plan to do in our lives. Often in fact we have no control. And you can either fight it or roll with it. I've found over time that rolling with it is less injurious, plus we can find when we handle changes in a positive way we are sometimes given gifts as a result. I'm not sure that this will be the case, but I'm interested in seeing if I'm right. If I am, I'm sure I'll talk about it.
Wednesday, January 01, 2014
We are now officially into 2014. I can say that 2013 has been a weird year; to characterize it has been difficult at best. Truthfully I don't quite know how to do that.
Personally, I am still reeling with not having been able to go to PA school this year. I honestly don't know what I'm going to do next year; if I can pay for it (and I'm able to get accepted again, which I should be able to do) I will go. God willing of course. But I have to get there first. It is a part of the journey that I absolutely didn't expect to take. And I am not happy about it. But I'll do what I have to, I suppose.
One thing that has been a total joy is watching Peyton, my granddaughter, grow up. She will be four years old this February, but she doesn't act or even look four. She is very tall for her age, plus she speaks really well. It is not hard for people to see her as being six instead of four. She is inquisitive, which is a two-edged sword because while it is great to answer the multitude of questions she asks, there are days that it is a challenge to keep up. But I treasure this because a day will come when she will want nothing to do with me. I remember going through that with my children as they were growing up, and now that they are adults it is like I have them back again.
I'm incredibly happy about that.
Yesterday was a busy day. Between taking care of my mom and working, it was a long, non celebratory kind of day. But we do what is necessary, regardless of when we have to do it. And I understand that this is the way of life right now.
I realized that the title of my previous post referenced Christmas of 2014 instead of 2013. I'll have to fix that.
In the event that nothing else gets written, I wish you all a happy and prosperous 2014.
Wednesday, December 25, 2013
Another Christmas is here.
To be honest, I wasn't expecting much. Not the material stuff; I could care less about that. I guess I didn't know how the day would be. Considering the mad insanity the whole month preceding today has been, I think I was expecting more chaos. But there has been none of that. Today has been, at least so far, a fulfilling, quiet day. I expect it should stay that way. The best part is that I am not working, which I am very happy about. I am spending the day with my beloved, and I am most happy about that. It is a great gift.
On that note, I will keep this a short post; I can write more another time.