Monday, December 29, 2014
Friday, December 26, 2014
Let the test tell you the results, not the other way around
Just a reminder. When it comes to testing, walk through the door with an open mind. People with chronic illness often do a lot of research on their condition (or suspected conditon). We read the literature and we find symptoms that are eerily similar to our own. In doing this we start to develop presuppositions about what is going on with us. For many of us diagnosis is years in coming. And this time we are sure we know what had been going on in our bodies. We walk through the door just knowing what the test results will be.
And then they are the opposite of our expectations. And we are angry and tired and heartbroken. We question our sanity, we question the competency of those working on our case, and it is easy to spiral into blame and bitterness.
Please, learn to go into your testing with an open mind. After all, you don't want your symptoms to conform to a certain disease pattern. You want to find the disease pattern that causes your symptoms and fix it. Being diagnosed with a disease that you don't have may vindicate you, but in the end it doesn't help you improve your health or quality of life.
That being said, if you think your test was not preformed correctly or light have been influenced by some other factor, request that it be redone. Ask that your doctor revisit the dingosis.
Wednesday, December 10, 2014
Saturday, September 27, 2014
Wednesday, September 24, 2014
A higher standard.
So a common phrase muttered in the ER is "this is not burger king".
They are right; this is not burger king. As a patient you cannot walk up to the counter and order rocephin-burger with a side of prednisone for your (very likely viral) laryngitis. There are a lot of good reasons for this. 1. You don't need antibiotics, especially strong antibiotics for a viral infection. 2. Overuse of antibiotics has lead to superbugs that are bad for the community as a whole. 3. If your only symptom is that you can't talk, you will be just fine until Monday when you can follow up with your primary care provider.
But let's talk about us healthcare providers. We mutter in disgust when someone asks for something unreasonable, because it's annoying that people don't trust us with their health even after they have signed in and gotten the blood work. So here's the other side of the coin. This is NOT BURGER KING. We don't serve slabs of greasy beef between sesame seed buns. We have a standard to uphold. We have to give these people a reason to trust their health to us. If we mess up, someone could get really sick, their life could be seriously altered or they could die. For example, Walgreens has screwed around getting my prescription refilled for 6 days. They can't manage to figure out how to get my beta blocker, my SSRI or my whelcol refilled. (Beta blocker is a heart medicine that should not be suddenly changed or stopped, abruptly stopping an SSRI can cause suicide ideation and stopping my whelcol prevents me from eating anything for the last 6 days). I am very diligent with my medications to keep my body working to the best of it's ability. Being out of medications for almost a week is doing serious damage to me.
So, here's the deal. Next time you mutter that this is not burger king, take a look around and make sure you are running a 5 star restaurant.
They are right; this is not burger king. As a patient you cannot walk up to the counter and order rocephin-burger with a side of prednisone for your (very likely viral) laryngitis. There are a lot of good reasons for this. 1. You don't need antibiotics, especially strong antibiotics for a viral infection. 2. Overuse of antibiotics has lead to superbugs that are bad for the community as a whole. 3. If your only symptom is that you can't talk, you will be just fine until Monday when you can follow up with your primary care provider.
But let's talk about us healthcare providers. We mutter in disgust when someone asks for something unreasonable, because it's annoying that people don't trust us with their health even after they have signed in and gotten the blood work. So here's the other side of the coin. This is NOT BURGER KING. We don't serve slabs of greasy beef between sesame seed buns. We have a standard to uphold. We have to give these people a reason to trust their health to us. If we mess up, someone could get really sick, their life could be seriously altered or they could die. For example, Walgreens has screwed around getting my prescription refilled for 6 days. They can't manage to figure out how to get my beta blocker, my SSRI or my whelcol refilled. (Beta blocker is a heart medicine that should not be suddenly changed or stopped, abruptly stopping an SSRI can cause suicide ideation and stopping my whelcol prevents me from eating anything for the last 6 days). I am very diligent with my medications to keep my body working to the best of it's ability. Being out of medications for almost a week is doing serious damage to me.
So, here's the deal. Next time you mutter that this is not burger king, take a look around and make sure you are running a 5 star restaurant.
Wednesday, September 17, 2014
Changing perceptions from the inside out
I want to address something that really irks me as both a medical professional and a patient with a rare disease.
So if you've read this, you know that I work at an ER. I've worked in the hospital, as a medical assistant and done some EMS work. We are trained to follow algorithms that indicate what is most likely to be wrong with our patient. The key words here are most likely. Yes, the old adage is usually correct. When you hear hoof-beats, think horses, not zebras. Most patients are horses, but that doesn't mean zebras don't exist. It takes a critical eye to catch the elusive zebra, but we are often so stuck on the flow chart that we miss these patients. They deserve to have someone think critically about their case.
In emergency medicine, the first glimpse of a patient we get is usually another persons notes. In EMS, we get our dispatchers notes, information they got from the caller. In the ER, we get triage notes, again another person's interpretation of the situation. It usually includes the persons age, sex and chief complaint. This initial assessment greatly influences the way we view the situation. A 19 year old female with chest pain is less of an emergency than a 67 year old male with chest pain. They may put the 19y/o down as a level 3 and the 67y/o as a level 1. 98% of the time, their assessment is dead on. The 67 year old is almost always more acute than a 19 year old.
Here is what I'm asking. Look closer. As much as I respect triage nurses and dispatchers, they can be wrong (so can I). Don't allow your mind to dismiss the 19 year old until you have looked at the vitals, the whole nurses note or laid eyes on the patient. Don't dismiss that patient and go to lunch because they will be fine until you get back (and I know about how hard it is to get a minute to eat, but you can ask the nurse how they are or poke your head in the room first).
Sometimes, the 67 year old, has a burning pain that began 10 days ago and is relieved by TUMS and the 19 year old has a connective tissue disorder and ripping pain with an acute onset an hour ago. We have all coded a young person and had no idea why they were in our ER. We need to learn to go into a patient encounter without presuppositions as to what is wrong with the patient, so we can catch the zebras. In the end, we are more than just a person following a flow chart.
So if you've read this, you know that I work at an ER. I've worked in the hospital, as a medical assistant and done some EMS work. We are trained to follow algorithms that indicate what is most likely to be wrong with our patient. The key words here are most likely. Yes, the old adage is usually correct. When you hear hoof-beats, think horses, not zebras. Most patients are horses, but that doesn't mean zebras don't exist. It takes a critical eye to catch the elusive zebra, but we are often so stuck on the flow chart that we miss these patients. They deserve to have someone think critically about their case.
In emergency medicine, the first glimpse of a patient we get is usually another persons notes. In EMS, we get our dispatchers notes, information they got from the caller. In the ER, we get triage notes, again another person's interpretation of the situation. It usually includes the persons age, sex and chief complaint. This initial assessment greatly influences the way we view the situation. A 19 year old female with chest pain is less of an emergency than a 67 year old male with chest pain. They may put the 19y/o down as a level 3 and the 67y/o as a level 1. 98% of the time, their assessment is dead on. The 67 year old is almost always more acute than a 19 year old.
Here is what I'm asking. Look closer. As much as I respect triage nurses and dispatchers, they can be wrong (so can I). Don't allow your mind to dismiss the 19 year old until you have looked at the vitals, the whole nurses note or laid eyes on the patient. Don't dismiss that patient and go to lunch because they will be fine until you get back (and I know about how hard it is to get a minute to eat, but you can ask the nurse how they are or poke your head in the room first).
Sometimes, the 67 year old, has a burning pain that began 10 days ago and is relieved by TUMS and the 19 year old has a connective tissue disorder and ripping pain with an acute onset an hour ago. We have all coded a young person and had no idea why they were in our ER. We need to learn to go into a patient encounter without presuppositions as to what is wrong with the patient, so we can catch the zebras. In the end, we are more than just a person following a flow chart.
Monday, September 1, 2014
Tips for talking with the ER doctor about pain (for chronic illness patients)
Do not say "everything hurts"
Try to localize your pain, even if it is a very long list. If you really have pain everywhere, call it body aches instead. It helps to differentiate sharp pains from aches. If you have pain it your joints, say joint pain. These docs think we are being literal when we say pain all over and there isn't any disease documented that makes absolutely everything hurt (and before you jump on me about fibromyalgia, think about it. Does your inner ear, your head, your genitals ect. hurt? fibromyalgia does make almost everything hurt, but it mainly affects muscles, so we have to be specific and say "my muscles hurt".) A good example of getting the right pain control is sciatica, if you can say, I have this pain that starts in my low back and shoots down my buttock to my leg, you are more likely to get the appropriate pain control. Sciatica hurts like a beeyatch and the ER docs know it. If you simply say my leg hurts, and they don't find a break in it, you are probably going to go home with pain medication for a 3/10 instead of the 7/10 you would get if you were diagnosed with sciatica.
Be honest about your pain
ER doctors are living bullshit detectors. These guys will ignore you in a second if you say you have 10/10 pain and you have your cell phone in your hand. Your body has gives off physiologic signs of pain. For example if you have 10/10 pain, you will likely be crying, sweaty, have an increased heart rate and respiration rate. Your doctor will look for these, but he will discount them if you don't appear uncomfortable. It sucks for those of us who have trained ourselves to not look like we hurt when we do. You are more likely to get the pain medication you need if you are real about it. 7/10 with some tachycardia or laying quietly is more likely to get you the meds than saying 10/10 and not showing any indicators of pain. If you repeatedly give the 10/10 line, you will be labeled a drug seeker and you will not get the pain relief you need. Remember 10/10 is supposed to be the worst pain imaginable or the worst pain you have ever felt (depending on who you ask) statistically you will only get that pain once or twice in your life. It is OK to tell the doc that your pain was a 10/10 but is better now that you aren't moving or since some medication. On the flip side, if you don't tell them you are in pain, they can't fix it. It's not good for your body to be in a lot of pain for a long period of time, let them help.
Don't rely on the pain scale to communicate your pain level (I hate the pain scale!)
The pain scale is subjective, which means it is not something that other people see or feel. It's only what you tell them. Because of this, it is not a reliable measure of pain. One persons 5/10 may be the same as another persons 10/10. It's almost impossible for the ER doc to understand exactly what you are feeling. Add other descriptors. Is the pain sharp, is it dull? Does it come and go or is it always there? Does it feel like someone is stabbing you?
Anxiety medication is not just for anxiety
Let them give you the Valium/Xanax/other anxiety medication. It isn't always used just for anxiety, it can help with pain, especially the muscular kind. When we are tense, or body knots up and hurt us even more, the anxiety medications help us relax so that some the pain can naturally dissipate. Accepting these medications also helps rule out a psychosomatic (when the body responds to mental stress) condition causing your pain, and help lead to the correct diagnosis and treatment.
Don't discount non-narcotic medications
Ultram and tramadol help sometimes, and can be very good in conjunction with other medications. Motrin is a better medication for pain than narcotics in a lot of situations because it reduces inflammation, instead of just masking pain. Medications like neurontin are often a better medication for nerve pain than a narcotic. Narcotics have their place, but we shouldn't be looking at them for long term use. Think of them as band-aids, they can cover a wound, but it wont actually heal the wound. The goal is to heal the wound.
Some medications take time
If you go to the ER and are given a non-narcotic med, give it a chance before you decide it doesn't work and go back. Some medications take time to really start working. Don't discount a medication after taking just one or two doses. If you have inflammation, it takes a while for the medication to get to the site of inflammation and bring that inflammation down, reducing your pain. When you have muscle pain, keep on top of taking those medications on a schedule for the first few days, then move to taking them only when you have pain, weaning down.
Don't expect pain to disappear
Sorry. Pain sucks and it's not going to just disappear. Pain medications are designed to help bring the pain level down to something manageable. I once had a patient who took far too much pain medication and fell asleep on a light bulb. She sustained 3rd degree burns and eventually died from and infection of the burn site. The goal is to take the least amount of pain medicine necessary for you to preform normal daily functions.
The ER is not the place for chronic pain management
Most chronic pain patients freaking hate the ER. I don't blame you. If you have to go, go. Please know that the ER doctor is NOT a specialist in pain management. They don't know all of the options. As of a month or so from now, most ERs aren't going to even be able to give prescriptions for norco/vicodin. If you find yourself going to the ER frequently for pain, please find a pain management specialist (your ER doctor will be glad to give you a referral). They are best at managing chronic pain.
Ideally, we should be able to be honest about our pain level, and get appropriate pain management. Unfortunately it just isn't that simple. ER doctors have to think about before prescribing pain meds. Is the patient being real about their pain? Is this going to be good for the patient in the long run? Will it interact with other medication? Are we over-medicating this patient? Is this pain consistent with the diagnosis? What level of medication does this diagnosis usually require? We need to help them out. We need to find a way to be part of the team instead of bucking against it. ER doctors are most definitely affected by drug seekers. Some of them are so jaded that they don't seem to understand pain and its affect on life anymore. I hate that. I'm not saying that they way these guys work is the right way, just trying to give a different view point that might help next time you have to utilize the ER (so no comments about how wrong they are, I know it's not perfect, but they are doing their best). I know how frustrating it can be to try to get the right pain management from the ER doc that has been burned multiple times. But hopefully these tips can help.
Try to localize your pain, even if it is a very long list. If you really have pain everywhere, call it body aches instead. It helps to differentiate sharp pains from aches. If you have pain it your joints, say joint pain. These docs think we are being literal when we say pain all over and there isn't any disease documented that makes absolutely everything hurt (and before you jump on me about fibromyalgia, think about it. Does your inner ear, your head, your genitals ect. hurt? fibromyalgia does make almost everything hurt, but it mainly affects muscles, so we have to be specific and say "my muscles hurt".) A good example of getting the right pain control is sciatica, if you can say, I have this pain that starts in my low back and shoots down my buttock to my leg, you are more likely to get the appropriate pain control. Sciatica hurts like a beeyatch and the ER docs know it. If you simply say my leg hurts, and they don't find a break in it, you are probably going to go home with pain medication for a 3/10 instead of the 7/10 you would get if you were diagnosed with sciatica.
Be honest about your pain
ER doctors are living bullshit detectors. These guys will ignore you in a second if you say you have 10/10 pain and you have your cell phone in your hand. Your body has gives off physiologic signs of pain. For example if you have 10/10 pain, you will likely be crying, sweaty, have an increased heart rate and respiration rate. Your doctor will look for these, but he will discount them if you don't appear uncomfortable. It sucks for those of us who have trained ourselves to not look like we hurt when we do. You are more likely to get the pain medication you need if you are real about it. 7/10 with some tachycardia or laying quietly is more likely to get you the meds than saying 10/10 and not showing any indicators of pain. If you repeatedly give the 10/10 line, you will be labeled a drug seeker and you will not get the pain relief you need. Remember 10/10 is supposed to be the worst pain imaginable or the worst pain you have ever felt (depending on who you ask) statistically you will only get that pain once or twice in your life. It is OK to tell the doc that your pain was a 10/10 but is better now that you aren't moving or since some medication. On the flip side, if you don't tell them you are in pain, they can't fix it. It's not good for your body to be in a lot of pain for a long period of time, let them help.
Don't rely on the pain scale to communicate your pain level (I hate the pain scale!)
The pain scale is subjective, which means it is not something that other people see or feel. It's only what you tell them. Because of this, it is not a reliable measure of pain. One persons 5/10 may be the same as another persons 10/10. It's almost impossible for the ER doc to understand exactly what you are feeling. Add other descriptors. Is the pain sharp, is it dull? Does it come and go or is it always there? Does it feel like someone is stabbing you?
Anxiety medication is not just for anxiety
Let them give you the Valium/Xanax/other anxiety medication. It isn't always used just for anxiety, it can help with pain, especially the muscular kind. When we are tense, or body knots up and hurt us even more, the anxiety medications help us relax so that some the pain can naturally dissipate. Accepting these medications also helps rule out a psychosomatic (when the body responds to mental stress) condition causing your pain, and help lead to the correct diagnosis and treatment.
Don't discount non-narcotic medications
Ultram and tramadol help sometimes, and can be very good in conjunction with other medications. Motrin is a better medication for pain than narcotics in a lot of situations because it reduces inflammation, instead of just masking pain. Medications like neurontin are often a better medication for nerve pain than a narcotic. Narcotics have their place, but we shouldn't be looking at them for long term use. Think of them as band-aids, they can cover a wound, but it wont actually heal the wound. The goal is to heal the wound.
Some medications take time
If you go to the ER and are given a non-narcotic med, give it a chance before you decide it doesn't work and go back. Some medications take time to really start working. Don't discount a medication after taking just one or two doses. If you have inflammation, it takes a while for the medication to get to the site of inflammation and bring that inflammation down, reducing your pain. When you have muscle pain, keep on top of taking those medications on a schedule for the first few days, then move to taking them only when you have pain, weaning down.
Don't expect pain to disappear
Sorry. Pain sucks and it's not going to just disappear. Pain medications are designed to help bring the pain level down to something manageable. I once had a patient who took far too much pain medication and fell asleep on a light bulb. She sustained 3rd degree burns and eventually died from and infection of the burn site. The goal is to take the least amount of pain medicine necessary for you to preform normal daily functions.
The ER is not the place for chronic pain management
Most chronic pain patients freaking hate the ER. I don't blame you. If you have to go, go. Please know that the ER doctor is NOT a specialist in pain management. They don't know all of the options. As of a month or so from now, most ERs aren't going to even be able to give prescriptions for norco/vicodin. If you find yourself going to the ER frequently for pain, please find a pain management specialist (your ER doctor will be glad to give you a referral). They are best at managing chronic pain.
Ideally, we should be able to be honest about our pain level, and get appropriate pain management. Unfortunately it just isn't that simple. ER doctors have to think about before prescribing pain meds. Is the patient being real about their pain? Is this going to be good for the patient in the long run? Will it interact with other medication? Are we over-medicating this patient? Is this pain consistent with the diagnosis? What level of medication does this diagnosis usually require? We need to help them out. We need to find a way to be part of the team instead of bucking against it. ER doctors are most definitely affected by drug seekers. Some of them are so jaded that they don't seem to understand pain and its affect on life anymore. I hate that. I'm not saying that they way these guys work is the right way, just trying to give a different view point that might help next time you have to utilize the ER (so no comments about how wrong they are, I know it's not perfect, but they are doing their best). I know how frustrating it can be to try to get the right pain management from the ER doc that has been burned multiple times. But hopefully these tips can help.
Sunday, August 31, 2014
haunting me
The sound of a child with whooping cough will haunt me until the day I die. Please vaccinate yourself and help protect children too young to be given the immunization
Wednesday, August 27, 2014
One of my least favorite phrases
"That's just the way I was raised"
Really?
I'm sorry, no respect there.
You don't have any support for the argument except the fact that "momma said it was that way". Give me an argument. Your mother, while she may be perfectly respectable and wise, is not a valid REASON, for you to believe something. Surely you have thought about the issue for yourself and come to some conclusion. Surely you have enough presence of mind to analyze the presented data and make and informed decision.
Here are some valid reasons...
I researched it and _________________
History shows us that ________________
In my experience ______________
Really?
I'm sorry, no respect there.
You don't have any support for the argument except the fact that "momma said it was that way". Give me an argument. Your mother, while she may be perfectly respectable and wise, is not a valid REASON, for you to believe something. Surely you have thought about the issue for yourself and come to some conclusion. Surely you have enough presence of mind to analyze the presented data and make and informed decision.
Here are some valid reasons...
I researched it and _________________
History shows us that ________________
In my experience ______________
Tuesday, August 26, 2014
Money Money Money
I'm really sick of money. Specifically I'm sick of budgets. The school has a budget for you, the hospital has another budget for you. The school budget doesn't include extraneous medical bills, and the hospital budget doesn't include school bills. On top of that, my husband lives on one side of Texas and I live on the other, so he can be close to his doctors and I can go to school. Basically they both think we have tons of money we do not have. In fact, the whole world seems to think we have loads of cash just sitting around to pay for things they didn't actually do. I'm not complaining about my lifestyle. I have lived in homeless shelters and I know what it is like to be truly without the necessities of life. But, I now work on top of my grad school work in order to live a comfortable life. I live in a nice apartment complex, but I chose it because it is safe. The nice kitchen was just a bonus. I enjoy being able to go to Starbucks a few times a week, but I also eat microwave meals almost every day. I'm by no means poor, but I don't exactly have money sitting around in savings either. So all of you people who get to decide how much "disposable income" we really have, should take a peek at the fact that we pay hundreds of dollars a month for medication that keeps my husband alive and me functional. Or the fact that the old computer is in nosedive and I really needed a new one for school. Anyhow, I'm done ranting. The point is this, the limited window into my finances is just that, limited.
Friday, August 22, 2014
Battling Bad Science
"Real science is all about critically appraising the evidence for somebody elses position. That's what happens in academic journals. That's what happens at academic conferences. the Q&A session after a post-doc presents data is often a blood bath and nobody minds that. We actively welcome it. It's like a kind of consenting intellectual S&M activity" ~Ben Goldacre. I LOVE this guy!
Thursday, August 21, 2014
Monday, August 18, 2014
How to know what to believe when reading about new health treatments
People with very real medical conditions changing their treatment to something they read someplace. Some of this is legitimate research that could improve health and quality of life, but some of it is downright bullshit. Most importantly any change in treatment or start of treatment should be talked about with your medical practitioner (doctor, PA or nurse practitioner). They have the knowledge to help you decided what is the best treatment for you. They also know when a new treatment (or vitamin) will interact with other medications or treatments you are taking, so talk with them. Without further preface here are a few ways you can know that the literature out there is good.
1) Peer Reviewed
Peer review is when someone of equal education and experience as the author says that this literature is good. If a journal has "American Association of ________________" in the name, it's probably peer reviewed. A good place to find peer reviewed journals for free is here PubMed. Peer reviewing helps improve quality, credibility and relevance.
2) Date
How old is this literature? If it's medical or scientific literature, and it was published more than 10 years ago, you have one of two situations. A)It's been tested a lot, and proven to be true or B)It's not been tested and is questionable at best. Bear in mind that the scientific community once thought the world was flat. Conversely if the literature is new you always run the risk of the unknown.
3) Repeatability
We shouldn't be jumping to change our world because one experiment gave one result. What if that scientist had dirty beakers and the scum on them gave him false data? Watch and wait until there is more than one paper to back up the research. Multiple experiments or repeating the same experiment multiple times and getting the same result removes the variables so that we can know that the experiment gave an accurate result.
4) Government
If you actually think that the man is trying to keep you down by keeping you unhealthy, take your aluminum hat with you when you skip this section. As a rule, the government (the CDC, the NIH or the WHO) is very tight lipped with making announcements about advances in health, because they are looking into the above reasons to make sure they don't tell you the wrong thing. They generally won't tell you something unless they have done the footwork to make sure it is true (at the moment, to the best of our knowledge)
1) Peer Reviewed
Peer review is when someone of equal education and experience as the author says that this literature is good. If a journal has "American Association of ________________" in the name, it's probably peer reviewed. A good place to find peer reviewed journals for free is here PubMed. Peer reviewing helps improve quality, credibility and relevance.
2) Date
How old is this literature? If it's medical or scientific literature, and it was published more than 10 years ago, you have one of two situations. A)It's been tested a lot, and proven to be true or B)It's not been tested and is questionable at best. Bear in mind that the scientific community once thought the world was flat. Conversely if the literature is new you always run the risk of the unknown.
3) Repeatability
We shouldn't be jumping to change our world because one experiment gave one result. What if that scientist had dirty beakers and the scum on them gave him false data? Watch and wait until there is more than one paper to back up the research. Multiple experiments or repeating the same experiment multiple times and getting the same result removes the variables so that we can know that the experiment gave an accurate result.
4) Government
If you actually think that the man is trying to keep you down by keeping you unhealthy, take your aluminum hat with you when you skip this section. As a rule, the government (the CDC, the NIH or the WHO) is very tight lipped with making announcements about advances in health, because they are looking into the above reasons to make sure they don't tell you the wrong thing. They generally won't tell you something unless they have done the footwork to make sure it is true (at the moment, to the best of our knowledge)
Happy Blog-day to Me!
I am REALLY bad at remembering to do things like blog. In fact I am really bad at remembering to do just about everything. Buuuuut, my blog is a whole year old!
Tuesday, August 12, 2014
Oh captain, my captain... May your seas be at peace
One of my favorite actors died yesterday from apparent suicide. I wanted to address something I've been doing very wrong. Working in emergency care, it is very easy to become callous. We make jokes about things that would horrify most people, and I know that is a coping mechanism. EM workers see horror on a daily basis, so naturally we poke fun at it. What I wanted to point out is the samage it does to the people dealing with psych problems. Our line of psych rooms (affectionately dubbed psych row) are not filled with jokes, no matter how ridiculous their behavior is. When you think about it we should be really concerned for them, that crazy outburst is reality for them. They honestly might think that someone is trying to harm their loved ones or that some otherworldly being is stalking them, or be completely unable to feel any semblance of true happiness. How terrifying that has to be. The worst possible thing we can do is laugh at their very real anguish. When you think about it, it's truly heartbreaking.
I'll end with this
"What I might do is watch Mrs Doubtfire. Or Dead Poets Society or Good Will Hunting and I might be nice to people, mindful today how fragile we all are, how delicate we are, even when fizzing with divine madness that seems like it will never expire." -Russle Brand
Wednesday, August 6, 2014
Things aren't always going to be alright, and that's alright
I love running. There is nothing like turning up the music while your feet hit the pavement to its cadence. There's a little bounce as you propel forward. The wind on your face, wind that you created, is incomparable. For about 30 seconds, then the tightness begins. Your chest feels like it's collapsing in on itself. You can't catch your breath. The thudding feeling starts, it's way too fast. You slow down, hoping that your heart will get the message and do the same. The earth monitor must be wrong, my pulse can't be 170 only 1 minute into a little exercise. It's not a sprint. Is it too much to ask to go for a run? To enjoy this gorgeous morning? Next the blackness starts closing in and you know that if you don't get flat on your own right now, your body will do it for you. So you sit, on the ground, next to the treadmill, on the curb, wherever you happen to be. You curse yourself for wanting something because wanting things is only detrimental to your spirit. When it starts to clear you drag yourself back to your hole and spend the rest of the day berating yourself for wanting to do what the normal people do. But despite the fact that you know you will just repeat this process again next time, you still look longingly at your running shoes every time you decided not to punish yourself today for loving something you obviously weren't meant to have.
My favorite quote is "I will find a way, or I will make one". I have yet to find a way to run, or really to live a normal life. I really really want to be active. My soul craves it, but my body can't handle it. I'm posting this because I am hoping that someone out there will find this in the middle of their own struggle and know that they aren't the only one.
I want to challenge myself and anyone reading this to embrace those things that you love that seem as if they aren't meant for you. Look at those running shoes and know that even if you aren't meant to have them, there's no way in hell you aren't going to try.
Thursday, July 31, 2014
Get it girl!
So, I used to dance, and I used to love dancing. But I never go out anymore because I've always felt like I'm too fat to dance. Really, too fat to go out and have a good time. Anyhow, I'm going to do it (right after I work on my moves a little bit).
Wednesday, July 30, 2014
So much sodium
So after the fight with the doctors office I was unable to get a hold of my Florinef for an entire week. Florinef is the steroid that I use to get my blood pressure from "100yr old that can't get out of bed" to "wow you have really low blood pressure for such a fatty". Anyhow I've been trying to rehydrate so for the last fee days I have drank a gallon of Gatorade and are a ton of Gatorade energy chews that have sodium in them. Normally after that much sodium my ankles would swell up telling me that I can back off of the Sodium because my body is finally at it's max. No such luck yet. Cross your fingers for swollen ankles tomorrow because if I have to drink anymore Gatorade I'm going to puke.
I find your lack of faith (in doctors)... May be completely founded
So I've had this problem for a while. I try really hard but I just can't get over how stupid some doctors can be. I have been trying for 2 weeks to get the dosage on my Florinef changed. During the winter, I take 0.1mg, but during the hot El Paso summer, I take 0.4mg. My current prescription was for the 0.1mg dose. So I call the doctors office to get a new script for a higher dose, and the medical assistant calls back telling me that they don't make 0.4mg pills. I explain that I know that but I need to take 0.4mgs total a day. She says that they cannot give me a total of 0.4mgs because there is no dosage option for 0.4mg. I finally just make an appointment with the doctor and have the same discussion with him. I can't figure out why there wouldn't be an option for 0.4mgs a day, but I've been on that dose before and assure him that it's a standard dose. He leaves and asks the nurse practitioner what she thinks. After a half an hour of him trying to figure out how to write the script, he finally hands me the pen and asks me to write out what I would like. 0.1mgs Florinef, 4 tablets, by mouth, daily. He reads it and says, why didn't you just tell me that? Really people? It never occurred to you that all you have to do is multiply 0.1 x 4 to get 0.4. I'm glad I know what I need because I seriously fear for anyone who has to put their health in the hands of these idiots
Tuesday, July 29, 2014
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