Reason # 24

This was copied from an email I sent to a friend in December of 2008.

Earlier this week I had a patient come in by ambulance at about 6:30 am.  The medics called in a radio report of a 30-something female with anxiety-induced chest pain,  vital signs okay.....  They seemed amused by something and trust me,  it is NEVER a good sign when EMS is snickering.  While they were still in route our charge nurse got a call from some wild-talking guy who said he was coming up there to "be with J because we used to be married and I think she is real sick.  I've been holding her tongue for two hours!"  Then he hung up.  Needless to say the charge nurse had a bemused look on her face, and we spent the next few minutes trying to imagine what that might have been about.   Was the woman having a seizure?  Was he trying to shut her up?  What? WHAT?

 

While we were still speculating, the medics rolled in with this tiny, frazzle-haired, wild-eyed woman on the cot.  Except for looking extremely freaked out, she seemed to be just fine.  I went in with one of the MSAs and as we were hooking her up to monitors, doing assessments and taking vital signs, the medics (with some interjections from the patient) told me this story.

 

It seems that the patient, hereafter known as J, was having a sleepover with her ex-husband, hereafter known as D.  They are still on friendly terms and had decided to do a little crystal together.   Fine, so far.  The problem cropped up when the party ended and they tried to go to sleep.  Poor J, who has a problem with anxiety and was having a nasty cough at the time, couldn't sleep.  (I'm not sure but I think the methamphetamines MIGHT have been a factor)  Anyway, she took a couple of Xanax bars to help her relax, and went to sleep on the couch.

 

A couple hours later, Mr D gets up and finds her asleep on the couch.  Having crashed from the meth letdown and the Xanax, she was very difficult to awaken (read that as "nearly comatose") so he called 911.  All well and good so far.... .but now comes the utterly, unfathomably crazy part.  J was deeply asleep and breathing heavily, and one imagines, noisily due to the respiratory and sedation issues.  So D decides that she "can't breathe" and his solution for that was to stick the first three fingers of his right hand into her mouth and throat UP TO THE THIRD KNUCKLE.   Holding her tongue out of the way, you see.  At which point she awakens, finds herself choking on his fingers, throws up and begins to struggle with him.   Even though she was fighting him tooth and nail - and I mean that literally, he had bite marks on his knuckles-  he did NOT give up on his life-saving efforts.  He held her down and continued to "keep her from swallowing her tongue because then she started having a seizure".   So for twenty to thirty minutes, he held this poor woman down with his fingers jammed down her throat. She was spotted with blood, hers and his.  She had scratches on the back of her throat! She was (naturally) hyperventilating and began having carpo-pedal spasms, as well as being partly asphyxiated by this well-meaning but drug-crazed idiot. 

 

So there you have it.  Reason # 24 not to do drugs.  Because your fellow users MAY be the people on whom your life depends later.  It is a bad deal if your primary rescuer is, quite literally, smokin' crack. 

 

When Mr D showed up later I went to talk to him before letting him into our department and into the presence of the patient.  He was upset and worried, so I assured him that the patient was fine.   He wanted to visit, and since she had said she was okay with that (she swore he was only trying to help)  I told him he could come in IF he would remain calm.  He agreed.  But then.... he wanted to talk about what happened and tell me how he "held her tongue down so she could breathe".  I tried to explain to him, slowly and patiently and repeatedly, that this was SUCH a very bad idea.  Not surprisingly, he didn't get it.  When he assured me for the 11th time that he "HAD to because she couldn't breathe!!!"......  I snapped.  "LISTEN, don't EVER do that again, you could have KILLED her, do you underSTAND me?????"  The silly crackhead looked at me with spaced out eyes very solemnly for a second, nodded ... then burst into tears.

 

Here I had to heave a HUGE mental sigh.  It wasn't even BREAKFAST time fercrissake, and I was in some surreal Twilight-Zone sort of space with these people who didn't understand such simple concepts as why sleep was difficult after doing methamphetamines, and why a  person "couldn't breathe" with half a grown man's hand jammed in their airway. 

 

They were discharged not long afterward, she with a diagnosis of bronchitis, upper airway contusions, and the recommendation to stop using drugs before she had a cardio-pulmonary event that proved fatal.   D had his bitten hand and scratched arms cleaned, and was advised to stop doing drugs before he did something else completely hare-brained and dangerous.   Because, as we pointed out to him, his judgement was less than stellar while under the influence.  Though personally, I doubt it was a whole lot better even when (if ever) he was clean.

 

In the ER, truth is indeed stranger than fiction!!!

Put down the Oreos and move to Canada.

Today the Supreme Court upheld the healthcare mandate commonly known as the Obamacare ruling.  Government mandates and the healthcare system are both terribly complicated, multi-faceted issues and I can understand some points on both sides of this argument.  But good heavens, at the uproar.  Social media sites and workplace conversations are all atwitter (pun intended) over it.  Some people have even gone so far as to say- or tweet - or post- that they are so disgusted with our government that they are considering moving to Canada.

Canada. Really?  The country that already has socialized healthcare?  You are going to move there to avoid a socialist system?  Well, at least you will avoid having to live in a country where English isn't the ONLY official language. I'm sure that will be a relief. Oh, wait.... Parlez vous Francais?

This same afternoon I saw several posts/tweets about a gay pride ad that featured a multicolored, six-layered Oreo.  I thought it was really pretty and hey, it had six layers of gooey stuff in it.  I wanted one.  Or seven.  But some people really disliked that ad because of it's inclusive message.  So much so, that they are "boycotting" Oreos.

Oreos. Really?  A cookie made from totally unhealthy processed food by a multinational company often accused of environmental insensitivity and exploiting low-wage workers?  Okay, maybe a boycott is not crazy, here.  But you are boycotting a cookie.  I am sorry, but it is hard for me to take that seriously. Especially since you are against the cookie because the cookie was used to symbolize something you don't like.  Yeah, that is important.

Can we take a step back and try to gain a healthy perspective here?  Is it sane and reasonable to leave a country because they passed a law that you don't like?  Unless you are schizophrenic or horribly confused, this can't be the first one that disgusts, irritates or scares you.  No matter what you deem important or sacred, there is a United States law or tenet that violates it, somewhere.  If you reject every commercial product that at sometime, somewhere, was used to promote something you don't like, you are going to be reduced to eating homegrown food,  catching lightning bugs for entertainment and wearing.... uh.... well, you won't be wearing anything.  There is no fabric, clothing manufacturer or fashion line that hasn't promoted or been promoted by just about everything.  Eating homegrown food, spending more time outside and being mostly naked might actually be a healthier lifestyle for you.  But I bet you aren't going to stick with it for long.

Let's be clear, I am not making fun of these people for disapproving of homosexuality or for worrying about the direction of our government.   No, I am making fun of them for implying that they are going to completely reject and/or leave a snack food or a country because, basically, they didn't get their way.  It is the adult equivalent of "If you won't play my way I'm taking my ball and going home".   It's juvenile.  It's obnoxious.  It's just silly. 


There is no institution, no country, no religion, government, organization, no person, place or thing that is going to do everything just the way you want it all the time.  This is called reality.  Get used to it. Grow up.  Do you file for divorce the first time you lose an argument with your spouse?  Do you leave a church the first time the sermon rubs you the wrong way?  Do you give up your child for adoption the first time she blatantly defies you?   Do you refuse to drink water because your enemies drink it too?  What kind of petulant, spoiled child ARE you exactly?  I think you should put down the Oreos, pack your bags, and move to Canada.  We won't miss you.


Those of us that remain will hopefully continue to struggle for what we believe individually to be right and best.  Maybe we can do it in a way that is respectful, even of those with whom we disagree.  In a way that is conscious that our way is a good way, but it is not the only way.  

The horse wreck - from Sept 2011

Am posting some old notes to the blog. New stuff later!

The horse wreck

It's been fifteen years or more since I started trail riding.  So I've been lucky.  Although I've been thrown, had a horse fall, been run thru countless briar patches, slid down some hills that made me want to throw up, had my arms and knees whacked on countless trees, and made a couple of slightly terrifying river crossings, this was my first major wreck. 

Gwen and I decided to tag along with the Arkansas Trail Rider's Association on a ride from Woolum to Mt Hersey.  Since this trail is near our new cabin, we wanted to see it.  The ATRA gang was very welcoming and we had a nice ride out to the Mt Hersey river access, where we had lunch.  We were halfway back to Woolum when disaster struck. 

This trail had plenty of steep, rocky places, narrow trails and about 6 river or creek crossings. There were also lots of places wide enough for the 30+ riders to get bunched up and get everyone's horses stirred up. But that is not what happened. No, Rocky and I were the victims of plain bad luck.  We were walking calmly down a smooth, flat trail.  There was a washout in the trail and when he stepped down into it, like he has done 1000 times before, the loose dirt slid under his feet, and he turned a somersault. I say "he" turned it, because I only participated in about the first half.

As he went down, my right leg hit the ground with the force of a woman and a horse behind it. Crunch. I came off and hit the ground while he completed the somersault, partly in the gully and partly on me.  OOF was the last coherent thought I had for a while.  When everything stopped moving I was on the ground with one leg under the horse, staring at his hind legs. In a distant sort of way, I knew I should move before he started kicking me in the head.  I understood the implications.  I just couldn't move.   Gwen (who had apparently teleported into the trail beside us) was simultaneously holding onto Rocky, pulling on my leg and yelling at me to get away from the horse.   Somehow, she got my leg free of the horse and the tangle of reins. (No, my foot was not caught in the stirrup. I am not a greenhorn!)  I scrambled to my feet, and my right ankle did this weird crunchy, wobbly thing. 

Now, I am forty-five years old, and a combination of luck and good genes has so far prevented me from having broken bones.  But it took my mind only a nanosecond to register crunchy/wobbly as WRONG.  So I fell back down.  A woman from the ATRA group sort of dragged me out of the trail.  Then I was looking up at Gwen (who was still doing the teleportation thing) and said "my leg is broken, my right leg". Then everything was sort of gray for a while. 

That nice little gray hazy feeling was very brief.  Then several things returned all at once.  Hearing, vision, clear thought.... I saw a group of trail riders getting Rocky up.  And he was able to get up!  And he was not, apparently, broken.  I was so relieved at that!  

Along with my other senses, however, my sense of PAIN!!!! had also returned.  My ankle hurt. A lot.  And it was still wobbly.  Gwen had, on hearing me say that I had broken my ankle (not my leg, I was pointing to ankle and saying leg), had gone to get a splint and ace wrap out of her saddle bags. In the mean time, the other riders had gathered around Rocky and I to brush off the dirt, gather up far-flung equipment, and assess damage.  Not knowing me, or that I was an ER nurse, they were not willing to accept my self-assessment!  Gwen splinted and wrapped my ankle for me. Then the fun really began.

We must have been at least a couple of miles from the trail head. Maybe more.  And there was no place accessible by vehicle. So.  I was either going to ride out, or I was going to wait an hour or more for a rescue crew to get to me, then package me, then carry me out.  Over a mountain and thru a river.  No. Huh uh. Not.  So back on the horse I must go.  One of the riders asked me if I thought I could ride out.  "Yes," I said  "I think I can ride. I just don't know how I'm going to get on."  As it turned out, I was going to be hoisted up and over by a group of gentlemen now collectively known as "my heroes".  Someone gave me a couple of Aleve.  I petted and praised my poor, shaken up, bruised and sore horse, and down the trail we went.  Slowly.  Very carefully dodging trees and bushes and anything else that might hit my foot.

Most of the other riders had gone ahead, some to alert the emergency services. But there was a group of about eight, all strangers to Gwen and I, who rode along with us, helped me navigate obstacles, offered advice and encouragement, distracted me with talk and jokes, and were just wonderfully supportive.  I didn't even catch the names of most of these people but they were marvelously kind to us and in spite of the fact that I must have put a huge kink in their plans for the day.  Someone mentioned that I would make the next edition of the "Roundup" in their trailride article. I sincerely hope they won't be quoting me.

Once we arrived to the truck the question was "How do I get OFF the horse?"  Apparenlty the answer was to have someone swing my injured leg over and then sort of fall backwards and hope these guys catch me. Which they did, of course. But for someone with control issues, that was a bit much.  However I was so extremely very glad to get down from that horse. The hour or so we spent riding back with my throbbing ankle dangling and bobbing around and feeling the bone clicking around in there had just about exhausted my supply of pithy remarks and patience.

Once I was stuffed into the back seat of the truck with jackets stuffed under my head and ankle,I looked up to see a Park Services Ranger standing at my head.  He was about 12 years old.  And had that big hat......  Anyway.  He took my name and number, and let me know that there was both an ambulance and a HELICOPTER on the way for me.  Do you want to go in the helicopter, ma'am?  No. No I don't.  And I'm not going in the ambulance either. This truck right here is taking me to Conway ER.  Yes, I will sign your waiver. Yes, I'm sure.  Goodbye now, little ranger boy.

And then Sherry, one of the ATRA riders and my new best friend, stuck HER head in the truck to ask if I could take hydrocodone. Oh heck YES. Yes I can!  And no, I don't mind drinking after you to take it with your water bottle. Not at all.  Did I mention that I love you?

So after a brief stop at the cabin to pick up my purse and the dogs, we were off to the ER. Poor Gwen, who had been serving as nurse, wrangler, rescuer and driver, was tired and hungry but wouldn't stop to get her dinner.  By this time, the drugs had kicked in, and propped up with pillow and ice on my ankle, I was pretty content in the back seat of the truck. Except for the fact that Gwen had declared me NPO after a few sips of peach tea with my pill.  

When we got to the ER, Gwen pulled up in the ambulance bay, where we were met by Kenneth, Persey and a wheelchair.  Riding in a wheelchair when stoned is fun.  Anyway...... they got me on a stretcher and got me properly tagged and identified and ordered an Xray.  Then Kenneth, with a raised eyebrow and a hand on my boot, silently poses the question.  Do we pull this off over your injured ankle and listen to you scream?  Or do we cut it off and listen to you whine about your favorite boots?  (and they really are, they are lined, waterproof Ariats and I love them)  No, he didn't verbalize any of this. I understood the choices.  And I picked option A.  So with Ashley stablizing my leg and Kenneth pulling on the boot... well, it was still horrible.  I yelled and said profane things.  So they stopped.  And I gritted my teeth and said "Just do it".  So with a shrug (it's your leg, sister) they went on pulling and the boot was saved!!! 

My coworkers and, in this case, nurses and doc, were great.  But they did laugh at me a lot. I'm not sure why, tho I did hear Brooke say something about me being "hilarious when she's on drugs".  Hmmm. I get his from my mom, who is also not a frequent drug user, and also a nut job when so medicated.  Gwen suggested that I might hush, and save myself the later embarassment, but I heard Ashley say "oh no, let her talk!"  There may be some blackmail in my future. But I don't care. Because once my Xrays were done, and my ankle officially broken, but not "surgery tonight" broken, Ashely gave me her own, cold, Diet Mt Dew.  So I love her too.

We left the ER with my ankle in a boot, crutches and a lortab prescription in hand.  My medial malleoulus is broken and the ligaments on the lateral ankle sprained and swollen.  I have numerous small bruises and sore spots from the fall. But both my horse and I will live to ride again so I am calling myself lucky.

More than lucky, I am blessed.  I have been the grateful recipient of numerous phone calls, texts, Facebook postings, visits and gifts of food, flowers, wine, shower chairs, and books.  A bit of bad luck on the trail is no match for my wonderful friends, family and ER family.  Though I am sure my patience will wear thin with forced chair rest in the coming weeks, and my butt may be permanently molded to the recliner, it is all only temporary!

What goes on in my head.

Hello, and welcome to "what goes on in my head".  I lead a busy, happy, entertaining, challenging and sometimes confusing life in the real world.  Then there is THIS place, inside my head, where a lot more stuff happens. I observe and absorb all kinds of things that then rattle around in my head, mix with other things, and pop out at unexpected (and sometimes inappropriate) times.  Now I will try to put them into some sort of  coherent form for your entertainment.

I chose "A Mare's Nest" for the title because I like the imagery of something rare and improbable, complicated, disordered, illusory, multi-faceted and intriguing.  A mare's nest can be all of this.  Mirriam-Webster defines it as a hoax or illusion, a muddle or medley.  This is my life, inside and out.  The "mare" also refers to a horse, and horses are something you will read about here.  There are four of them here in my "nest", which also includes a three other resident humans and many transient ones,  young and old, big and little, of all colors, shapes, sizes and persuasions.  Dogs are here too, and cats, goats and chickens.  The numbers vary from day to day, the personalities are as varied as snowflakes, and together we make joyful noises and hideous messes.  

When I leave my nest for work, I go to the Emergency Department at my local hospital, where I am an RN, a triage nurse, a patient educator, a grumpy coworker, and at times a traffic cop, referee, and bossy mother figure.  All these things are interesting, fun and extremely irritating by turns.  ER stories can be disgusting, infuriating, mind-boggling, sad or hilarious. They are endlessly entertaining. 

My doctor, who is also a friend, tells me that most middle-aged, chubby, uncoordinated women prefer to be sedentary, but I do not.   I like to be outside, and at times raise flowers and a garden, foals, kittens, puppies and fawns.  I have big rowdy dogs.  My partner and I are working on a cabin we are restoring as our someday retirement home.  Lots of friends and family are lending their hands and knowledge. I love to ride horses, especially up mountains and thru streams.   I love to swim and kayak and ride in boats.   Of course there are many mishaps.  No, they are NOT part of the fun, but they do make good stories.

The people in my life are also many and varied.  I have a large, clannish, loving, conservative, fundamentalist, loud-mouthed extended family.  Time with them can be wonderful, or completely hideous.  My roots came from these people, raised in a small town and a small world, with many values that I have absorbed. In other ways we are sort of aliens to each other and along with family dinners, card games and campouts, there are arguments and misunderstandings and clashes in world-views of epic proportions.  

Most of important of all in my mare's nest of a life, are my "chosen" family.  These are the people that have something special and unrecognizable that makes me happy to be with them.  Some of them really are biological family. Several are cousins who feel like siblings, and their spouses, who do as well.   One is the remarkable person who shares my life.  One is a friend of 20-plus years who has the same kind of busy, frenetic brain as I.  One is a twenty-year-old guy who is the "child of my heart".  Another is not really my niece... but she is mine.  A woman not really old enough to be my mom.... but seems like a second mom to me.  Kids and babies that aren't mine at all but call me Meme and know where "their" toys are, at my house.  These people are the best of everything about my life. But that doesn't mean that sharing a life with them is always simple.  No...  I am not drawn to simple, uncomplicated, easy people.    

Take all these "ingredients" and add many random thoughts and interests, dozens of repressed smart-assed remarks per day, and a heavy dose of sarcasm.  Mix them up in a frenetically busy, multi-tasking,  tangentially inclined brain.  Let it stew in the fog of an introvert's secret internal life for a day or two.....  We will see what results.