Rest In Peace American Turkey

Happy Thanksgiving.

My first thought today was focused on the high number of birds that have lost their life in preparation for the years most filling meal. Don't get me wrong, I am by no means an activist for poultry nor a lover of fowl. It was just what I was thinking, as I ready myself for another Thanksgiving at work - pumping out the butterballs. A slightly depressing day but at least I am not a turkey.

Turkey has never been my favorite. I am more drawn to the sides: Green beans, shrimp cocktail (and you don't eat this?) and of course the Carrot souffle. Not many people know what carrot souffle is because it is a family secret, a hidden gem that induces both salivating cheeks and love handles. I am not sure where the recipe originated, I think it was Aunt Glo? But it is the only tradition we hold onto in my immediate family. We waved goodbye long ago to going to church every christmas and just sometimes we send out holiday cards. I would rather lose a limb or have braid-length nose hairs than to pass a season without this delicious side dish (doubling as dessert).

Of course I will not reveal the ingredients as they are top secret. You have to marry me if you want it so think hard boys. I can share though that it is the finest combination of carrots and spices, blended to a creamy consistency and baked for 45 minutes, whipped to a perfected silky texture...no more, no less. It is the closest thing to heaven one will ever taste. My mom makes it the best. She practically does it with her eyes closed and talking on her blackberry. One year Sam and I were given the task. While blending the mixings, sam stuck the wooden spoon directly into the moving blender. By the laws of physics, we soon had carrot mush (minus the egg we forgot to add) splattered all over the kitchen cabinets along with one splintered spoon. I am surprised no one was rushed to the hospital for swallowing a wooden shard as we just cooked the lot.

Unfortunately, as duty calls, I will not have the pleasure of eating it this year as I will be busy attending birthday parties for people I don't even know. I am starting a new Thanksgiving tradition and it is called "eat what you have in the fridge". Looks like I will blend some beets, sprouts, old lettuce and a lemon into something unforgettable. 

What also crossed my mind is that one day, maybe soon, I will be have to cut the lifeline. I can't forever be just a participating eater in the feast. At some point, I will need to man the ship. Oh god, I fear when that time will come. How moms for years have been doing this baffles me. 

No need to feel sorry for me. Nope. I may be lonely but I am surely not alone. The Macy's 82nd annual parade is showcasing right in my backyard and an expected 3.5 million people are expected to attend. I generally don't care about this event but they have three brand new additions to their enormous balloon collection and one of them includes Buzz Lightyear. I would be a fool to pass up such a golden opportunity.

But really, don't feel bad for me. I will be flying tomorrow to Florida. (fun) I just heard on the news that the Long Island Railroad, the train I would take to the airport, is receiving multiple terror threats intended for this holiday weekend. So not only will I be eating nothing good today, but tomorrow I will be spending my entire paycheck on a taxi ride.

Honestly though, you shouldn't feel bad for me. Because even though none of them are clean, I have clothes. I tried to do all my laundry last night...which is every article I own...but I seemed to have lost my laundry card. Dirty clothes and Florida for my day late thanksgiving celebration.  Woe-is-me.

Please! Stop feeling bad. It is really not that awful. I just got a bill in the mail saying that my insurance isn't covering my checkup at the dentists office (the one I hate) like they said they would. Looks like I will never save money. So, I guess the bright side is that I have teeth? Right?

Forgetting all about these minor issues I have much to be thankful for this year. You have read this blog. My life is easy. My life is good.

But what I am really thankful for this year is what I witnessed yesterday. While walking home from the subway, I saw a tiny, very skinny old lady on a motorized cart("it's true what they say...they can serve a purpose"). She was rolling at lightning speed, much faster than any of the walkers, bee-lining straight ahead (going somewhere?) when all of a sudden she took a sharp turn right. The momentum made her pop a wheelie and had her gliding on the two side wheels for a good 5 seconds. Her limp body leaned so far over her armrest it looked like she may fall off. No expression of fear on her face. Her dark shaded sun glasses hid her eyes but I could sense that this was fun for her. Like a kid on a roller coaster. I was really tired but I laughed out loud all the way back to my apartment, so happy that I had just witnessed this.

I hope that you are all fasting for the meal that it yet to come. I will get my fill, of both side dishes and family, just a bit delayed and with the possibility of a hurricane instead of an avalanche. Perhaps I will learn why people choose to make Florida their home in the first place. Maybe they are thankful that each year they get rocked by tropical storms so as to make them appreciate what can not be swept away by bustling wind and stomping rain. Plus, they are close to Cuba.

Just maybe I will treat myself to something delicious like a blueberry smoothie...and another for seconds...and a third for dessert. Because when you are a party of one on the most consuming of consuming days, what else sounds better? Only carrot souffle.

Move over butt cheeks

It was a rough night at work.

I started off in the recovery room, the post-anesthesia holding cell, where all women who have c/sections must pass through. In other hospitals...or maybe I should say better hospitals, there is never more than one patient per nurse during the recovery phase; vaginal or c/section. This patient:Nurse ratio is standard as the likelihood of a patient bleeding after they deliver the baby can be relatively high given all our ridiculous interventions. After a cesarean section, where a large incision is made in your low abdomen, that likelihood increases even more.

In true Methodist fashion, they staff one nurse per 1-8 patients in the recovery room. Of course it is a staffing issue but it has shown to be a standard practice as, even on well covered nights, only one nurse is in there. 

The range of patients is vast. Some of the c/sections are scheduled and planned because their previous deliveries were via c/section, or the baby is breech, or the baby is macrosomic (too big to fit the intended way) or the mother has HIV and her viral count is too high for a normal delivery. I have even seen a few cases where the mother opts for the surgery, not even giving herself the opportunity or possibility to labor. I thought that was illegal, but maybe just highly advised against? Most of them though are unplanned due to non-reassuring fetal heart tones, arrested dilatation or failure to descend (I hate that term...it is so defeating), or the doctor has dinner plans and wants to make it home for the basketball game. 

Some have been placed under general anesthesia, the process of putting the patient completely to sleep due to emergent factors that couldn't wait for an epidural to be placed. If this is the case, the recovery process can take much longer. Grogginess and a heavy head is what they wake up to. It is really funny to watch. They will lift their head, try to open their eyes, mumble something as off the chart as "Is daddy in that house?", and then slump back down. It repeats a few times, which I enjoy. 

When epidurals are used for pain management, it is the best situation. The catheter that sits in the little epidural spaces of the spine allows for constant medication to infuse providing longer lasting relief. The anesthesiologist can dose them up pretty quick pending they know what the hell they are talking about. Not to scare you people, but sometimes, they don't know what the hell they are talking about. Not too long ago, one of the anesthesia residents 'forgot' to administer duramorph, a strong narcotic that works like a charm. I found this out the hard way by trying to gently press on this women's uterus to check for bleeding. She slapped my arm hard enough that I was scared to ever check again. Maybe next time I will forget to administer his duramorph when he goes in for surgery.

Anyways, the other night I had three patients in the recovery room. This post delivery period should be, at most, 2 hours (in good hospitals) but the fear of bad post-partum care is high so we keep them longer to assure life after delivery. I was back and forth all night long monitoring the high blood pressures of two while pushing all sorts of narcotics in the IV for one. I was pretty tired when 6:30 came around. 

This is when I got a break from the recovery room for some action in the OR. And action it was. This patient had labored all day and finally made it to the grueling pushing stage. For 2.5 hours she grunted and bear-ed down to get that child out. No progress was being made. The head was stuck. So a c/section was called.

The woman was frantic. Feeling every contraction and bawling hysterically. When they would pass, she would smile and resume normal conversation. I swear, labor beings out the she devil in everyone.

We roll her back to the OR and gear her up for surgery. There is always the fear that after a patient pushes for an extended amount of time, the head of the baby will be so engaged in the pelvis, that an outsider will have to reach in and push the head through the belly...vaginally. I was not that person. Pam was. My job was to unfasten the safety belt that secured the patients legs to the table and position is just right so that an arm could comfortably make its move. As Pam gowned up, I squatted under the table to remove the belt and propped the leg for easy access. In this position, crouched down on the OR floor, I feel her Foley catheter bag (urine storage) rub against my arm. I set my knee down and realized it landed in a pool of blood. But the worst was yet to come.

In order to get a good hold and a sturdy position on the babies head, Pam (not a small girl) had to literally stand on her tows, shift her hips and SIT ON MY FACE. I am not sure if it was really all that neccesary, but as her butt cheek rubbed up against the left side of my face, I thought it better be. I am talking life or death. I was hearing some commotion, as I sit being sat on under the drapes and realize it must be a tricky grip. I couldn't retort as that would just be rude. I couldn't move or the sterile field would be tainted. I was helpless.

I am sure you could picture it...

 Almost time to go home. The clock reads 7:27 am. I have just been up all night, on my feet with a pain of what feels like a screwdriver slowly twisting into my heel. I am pretty hungry. But I know, because this is a change of shift delivery, I will be here way over my time. It smells a little bit like sour milk. My eyes are burning, my knee is sitting in a cauldron of someone elses blood, my arms are shaking because I am holding up the dead weight of a pregnant leg...and Pam's butt cheek just made long and direct contact with my face. 

Fun times.

Gotta get me some Melatonin

The night shift... a carcinogen.

I recently read a study conducted by Englands' National Health Service. It looked at the incidence of cancer in night shift workers and correlated the cause to suppression of Melatonin (also known as "the hormone of darkness"). You see, at night, when the sun is down and heads should be found resting on a pillow, your internal hormone production pumps this 'hormone of darkness' through the endocrine network, inducing a yawning domino effect. This is why people are (generally) tired at night and awake during the day. As nature intended, humans are a creature of daytime activity and nighttime snoozing. Its what is known as the circadian rhythm.

This poses a scary reality for the graveyard folk. This study shows that those who are awake at night and under the constant buzz of artificial light, have a much lower melatonin production thus throwing off the hormonal balance. Not only does this royally screw with sleeping patterns but melatonin is also known to suppress cancer growth. Less melatonin = less cancer fighting abilities.

Then of course there is also the problem that most night-shifters don't see the sun enough. We all know that the recommended daily dose of sunlight...for vitamin D production...is a must. Let's add that sleep deprivation slumps the bodies immune system, which is an MVP in warding off cancers. And it goes on and on. Of course, more research is necessary.

So in short...I am screwed.

Just three days ago I was up for 31 straight hours. My circadian rhythm has been placed directly into the garbage disposal. Even when exhaustion has hit me like an upper cut in the face, I still have a very challenging time falling asleep. I toss and turn. I turn and toss. It is excruciating. When I am awake and functioning in society, I notice that it is almost always under a constant haze. I never seem fully aware. More than once, I have caught myself having full-blown conversations with...myself...slightly confused about the situation. Hand gestures included. both times in broad daylight on the street.

When desperate, I will take a 5 mg (extra strength) melatonin supplement, natures remedy to insomnia...particularly when I am working to assure a well-rested RN. I love it. The strong stuff works immediately and I drift off. I try to use is as conservatively as possible. I can't be known as a "hormone of darkness" junkie. But what I have discovered is that it induces some crazy dreams. 

google calls them nightmares...see for yourself.

(A snippet of my dream yesterday)

I am in a very large vehicle, a suburban type, and it is slowly rolling down the street. There are houses one after another, side-by-side with green yards swarming with hundreds of people. American flags are swaying in the breeze and the people are waving to me in slow motion (my logic is that they are Mormon because there are no black people, they have the same face and most of them are kids). There is no one else in the car...I am alone...but not driving. The car is some how moving itself. Suddenly rows and rows of babies line the curbs...each of them hugging their neighbor baby. The car stops and I get out to pick one up, but they will not let go of each other. I turn to find a parent or responsible adult but see no one. I put the babies down, I get in the car and we drive off.

Flash forward to next scene. 

Now I am in a cave with cylinder shape holes in the tall dark walls. Again I am alone and I am attempting to repel down the wall. Fat juicy rats and squirmy mice start crawling through the openings.

Flash forward to next scene.

I am on a date with a tall, dark skinned man. We are at his apartment and I go to sit on the couch. I am not alone. His roommate is also sitting on the couch and his roommate is Adam Sandler.

Flash forward to next scene.

It is my wedding day and I am dressed in a beautiful gown. I guess I am marrying the tall, dark skinned man, but I am unsure and this really confuses me. My mom seems to be quite mad at me so she is not talking. My sister is not around because she is socializing with the guests. My bridesmaids are two girls that I am not really friends with and they are pushing me away from the mirror to put their own makeup on. Meanwhile, my hair looks greasy as if I just got done sweating a lot and my attempts to make it look better with bobby pins is failing. The whole time I am trying to recall the name of the man I am about to make the ultimate commitment to and it never comes to mind. I then realize...oh no...vows? I pull aside a friend of his...who I have never met and ask him if I am to write vows. He looks sacred by the desperation in my voice and answers...'yeah, I guess, that is what you do, right?'  I start to panic a bit. That is what I do?Do I do that? So I pull a paper towel out and start to write my vows for the man I apparently love and can't remember where we met, when we met, if he is funny, if I know his family, how long we dated.  I try to dig really deep but his face never comes into focus. 

And then I wake up. Nightmare? Borderline. First off, rows of babies hugging is some creepy business. They seemed premature and worm-like. Second, rats. Ewwwww. Third, getting married...to someone you don't know...when family is not there...with friends you don't like...in hair that looks like a buttery mess...and vows written on a paper towel? I have yet to have such a vivid dream turn to reality....it better be no indication of what my future holds.

And it wasn't the first. I would say it is one of many bizarre dreams surely induced by the disruption of my melatonin supply. 

As much as I love my night time coworkers, I am glad that I am on a 7 shift countdown. It was intriguing at first to be a night owl in a city that buzzes around the clock, but I am over it. How I long for early morning wake up calls and a non-carcinogenic schedule. 

What is keeping my head in the game is that in less than three weeks (17 days to be exact) I will be heading West towards one Big Island of Hawaii where I will gladly hang my stethoscope for 5 weeks and toss my melatonin pills in the big blue sea.  I will lay a towel on the sand, after riding a daytime wave, and soak in all the Vitamin D my white skin can handle. Perhaps I will eat breakfast in the morning and maybe even dinner in the evening. If all goes as planned, the conversations I have been having with myself can shift to wild turkeys who are much louder in response. 

Yes, I am strong. I can stand the carcinogen for a bit longer.