Thursday, March 31, 2011

Allergies!

I am highly allergic to most pollen starting with hazel depending on the weather in January or February and ending with ragweed in October.

This year, due to a very long winter, I have had no problems until March. But then it started and my allergies reared their ugly head. I have never had that many problems with my eyes being affected, but for some reason this year my eyes have decided to join the fun. Starting March 8th my eyes turned into a teary, swollen, red mess (while being on oral antihistamines). I then started my antihistamine nasal spray and eye drops, but my eyes got worse. People at work were starting to comment and was feeling more and more uncomfortable. Went to see my family physician again, got steroid eye drops - worked like a charm. Stopped the eye drops (aren't supposed to be taken too long). Eyes were moderatly red for five days and than bang the next flare-up. Went to see my allergy doc on Monday, he prescribed oral steroids (5mg for one day, 2.5 mg for the next) - this was supposed to get me out of the flare and keep me flare-free for at least two weeks, then I might have to take another two-day-course. I tried explaining to him that I don't absorb oral meds very well, but he didn't really listen.
Of course it didn't get me out of the flare and my eyes became even worse. Of course I have symptoms with my nose too, but after adding my steroid nasal spray at least those very manageable. (Although I lot worse than last year.)
So, went to see my family physician again (it's very difficult to get into my allergy doc's at short notice).
She recommend a steroid depot injection. I know that my allergy doc is very opposed to those, but I have been feeling so bad in the past few weeks that I agreed to take it, even though I hate to take steroids - especially due to the potential side effects. Got 40 mg of triamcolone, and of course, once I was home my head was running hay wire with thoughts about all the side effects - especially the possibility of water retention - I was so happy to finally have lost all my water weight from protein malabsorption.
I know it probably was the right decision, I couldn't have continued like this, but still I kind of regret that I agreed.

My eyes are feeling a lot better, but I am still reacting (even though I am still on all my other allergy meds). Went for a walk with a friend and her dog today, she was amazed how much my allergies were acting up (even to the point of not being able to stop scratching due to being sooo itchy all over).

I am now off to the bath tub, trying to get rid of some of the pollen and maybe reduce the itchyness.

Oh and yes, I woke up with a sore throat this morning and since everyone around me has been sick in the past two weeks, it is totally possible that I am getting a cold on top of my allergies.

Lovely. Thank god I just bought a family size pack of tissues.

Saturday, March 26, 2011

I am a repeat offender

Ever since I have been put on fulltime j-tube-feeding and stopped almost all my oral foods, I have had significantly less nausea and other GP symptoms.

But every once in a while, I feel like I need to test my limits wanting to find out if maybe miraculously I can tolerate some foods again. After stopping all veggies (blended) after last weekend's round of nausea, I simply had to give it another go again. I had some baby jars at home (blended carrots with fennel) and even though I had promised M to only have a max. of 50g in go, I of course had almost half the jar. The problem is that when I am eating something, I really want to have it, and I don't feel sick while eating. That's why I tend to eat way more than I should. The problem always comes afterwards when I am supposed to digest whatever I just ate.

Felt sick and nauseated all afternoon, actually it's is now 8 PM, and I am still burping carrot :-(. Got really thirsty too, but couldn't drink due to being so full.

In the end I even had to skip my "dinner" - roibush tea with milk foam and cinnamon sugar. At least water is going down again.

So, yes I am a repeat offender.

Tuesday, March 22, 2011

"Graduating" another rehab patient

We only offer early rehab at my hospital, getting the patients ready to either go straight home or leave for more treatment at a rehab facility.

Yesterday one of my rehab patients that I have trained with daily for the past four weeks left for an inpatient stay at a more specialized rehab facility.

Last week I repeated all the neuropsych testing I had done for evaluation before starting neurorehab with him. My patients progress, even though often visible in our daily training sessions, is not always measurable in our neuropsych tests. You should have seen my delight when I looked at Mr. K's test results from last week. He has shown a real improvement in all training areas!!!

I met with Mr. K and his wife on Friday to discuss results and to "wrap" things up :-). It really touched me to see and hear :-) their gratefulness.

I really hope he continues to make such great strides forward in recovering from his massive stroke!

Friday, March 18, 2011

2500 kcal!!!

I am a high calorie girl, malabsorption of course doesn't help the issue.
And even though I am underweight and have low muscle mass, I need a good amount of calories to maintain and even more to gain weight.

When I started j-tube feeding I was having about 1000 kcal a day because I could only tolerate a low rate without refluxing the formula back into my stomach.

One of my mottos for the past two years (that M keeps having me repeat over and over, so I won't forget it) has been: patience and consistency. So with patience and consistency I have been able to bring my feeding rate up to 115 ml/h during the day and 100 ml/h during the night. This is my second day that I have been doing the 115 ml/h and so far it is working well. I have tried 115 a couple times last weekend and always had to turn it back down due to some bowel problems, but I hope it will keep working this time around.

2500 kcal has been my big goal for quite some time, I still might need more to gain weight, but for now I am happy that I have reached that, and I will be able to stay there for a bit before having to advance my rate again.

M promised me a new pair of shoes as a reward :-). (I very much believe in rewarding oneself for reaching goals and so does he :-)).

Thursday, March 17, 2011

Mirror neurons

Today I saw a patient who had been admitted to the hospital with a stroke a couple of days ago. I was told that this patient is severely depressed, but denying it.

It didn't take me long to find out the reason for all of that. Her teenage daughter had been diagnosed with thyroid cancer last April and required surgery to remove her thyroid. Now she has some suspicious lymph nodes. The whole family is very affected by the situation, and obviously all of this is a very distressing situation for my patient.

When she started talking about her daughter's diagnosis, she began crying. At first I was sitting opposite of her, but then asked her if I could sit down beside her. So I sat down next to her, gently patting her shoulder. By then my emotions got the better of me, and I had some tears in my eyes too. I am after all just human and hearing a story like this touches me too, even if I am the professional one here.

What do I do in a situation like this? I explaines to the patient that hearing her talk about her story touches me so much that I shed a couple tears too.

Scientifically speaking it all comes down to the mirror neurons in my brain. Seeing someone cry in a social context like this activitates certain mirror neurons and once they start firing, crying along is bound to happen. It's due to mirror neurons that humans can experience empathy.

Monday, March 14, 2011

I got an early (really, really) birthday present!

M got me a really early birthday present! Very early - as my birthday is not until July :-).
He had the brilliant idea that my life as a commuter would be a lot easier if I had a scooter to get to and from the subway and the train station. We went to look at a few scooters last Friday and Saturday and I did a bit of research and I selected this one:

It's the lightest of the Micro scooters making it perfect for commuting! So today M and I went back to the store to try it out one more time and then he bought it for me then and there even though my birthday is not until the end of July!

Friday, March 11, 2011

How do you tell someone they are going to die?

This morning at shift change we were presented with the MRI of a 40 year old man, who came to the neurology outpatient clinic, as his wife had been noticing some personality changes in the past few weeks.

The MRI showed multiple (five) metastases in his brain with his primary tumour being a lung cancer. After shift change her admitting doctor talked to my boss and I, telling us that he didn't think that the patient understood the severity of her situation, subsequently asking us to talk with him about his diagnosis.

This patient has a maximum of 6 to 12 months to live.

How do you tell someone they are going to die?

I don't have a lot of experience, actually I have none. So I mostly listened to my boss talking to her. All of that really touched me today.
Life is so precious.

Wednesday, March 9, 2011

Wanted :-)

They want me!!!
I had a wonderful job interview this morning. All my worries about my feeding tube and waistpack were unfounded.

I selected my smallest waistpack and wore a scarf, so as to not draw attention to the fact that I was sitting down with a waistpack on. We then talked about all the job related stuff and when it was determined that I was the person they were looking for for the internship, I told the neuropsychologist I was talking with that I did want to mention one more thing about me. I explained everything and showed her my waistpack, and also let her know that I have been working with this set-up with patients at my current workplace without any problems. I also mentioned that I do think that this makes me a better psychologist because I know first-hand how life-changing medical issues can be and how important good coping strategies are.

Now I just have to get through a few burreaucratic issues, please keep your fingers crossed that everything will work out!

Tuesday, March 8, 2011

Job interview tomorrow

I received a very unexpected call yesterday from the neuropsychologist at St. Pölten hospital. They have an opening for an internship starting with May for six months, paid (under-paid, but better than nothing), and I would be able to get my internship credited towards my clinical psych and neuropsych degree.

I had one internship lined up for the end of August, but that would not be enough for my neuropsych degree, and I would have four months inbetween without getting paid, but with the opportunity to continue my neuropsych internship at the hospital where I am now.

But of course financially it would be a lot better for me to be able to do the other internship in St. Pölten. Anyway, I have my interview tomorrow morning. And this is my first interview as a full time tubefeeder. I am a bit worried about how it will go, and also about how to broach the subject. I do want to tell them, as I will be coming hooked up (to my waistpack), and might look odd to them why I run around with a waistpack :-). I know I can tell the neuropsychologist that I have been working hooked up without any problems at my current hospital, but still...

I so want to get that internship!!! Please, anyone, if you have a few thoughts to spare, send over some good vibes :-).

Today on the way home from work, I was chatting on the phone with my friend while riding the train, telling her about tomorrow and about how this will relieve all my money worries at least for the foreseeable future. I then got off the phone and just chilled the last three train stations lost in thought. Suddenly, just before the stop where I had to get off too, the woman sitting across from me bent towards me, looked at me and said: "I wish you good luck for tomorrow." When I looked at her obviously speechless and I slightly confused, she said that she heard me talking on the phone about it and that she knew how all of that felt. It was so nice of her! It totally made my day!

Monday, March 7, 2011

Lighting a candle


Tonight, I have three candles burning on my window sill to represent my dear friend Iris, her fiance David, and their little boy who she miscarried last night.

Sunday, March 6, 2011

Back to work

If I could, I would stay at home for another couple of days, cuddle up with my kitties, sleep and recouperate.
I still have a touch of bronchitis and what worries me a bit is that I have to walk uphill from the train station to the hospital in the cold morning air. Spring, has not decided to stop by yet in Vienna, and we still have sub-zero tempteratures in the morning :-(.

I guess I will have to wrap up really warm!

Thursday, March 3, 2011

I turned the flu corner :-)

This is the first day I have had no fever whatsoever, and I am definitely starting to feel better. I can deal with the awful cough and fatigue, but that fever really took it out of me. Glad though that I was able to tube feed through it, as fever raises your metabolic rate by 13% - and with my raging metabolism I would have for sure lost quite a few pounds as a result of this had I not been able to feed.

Now, I am trying to deal with the sheer boredom of still being confined to my bed - although I have decided that tomorrow I will move to the living room and the couch again during the day!

The cats have been wonderful, giving me lots of cuddles and love. M, of course, has been wonderful too, giving me no cuddles though for fear of infection :-). He helped me with a quick bath yesterday, washing me off with a wash cloth and soap - the pleasures a short bath can give you after four days of fevers!