Healing You

Category: Health

  • Changing from Provider to Patient- one NP’s journey

    I am writing a series called ‘Changing from Provider to Patient- one NP’s journey’. At one time or another, we have all been patients within the medical system. This is the sixth installment of my patient journey- follow along as I balance being a patient and leave my ‘provider hat’ at home.

    Day 7:

    It is the seventh day since my injury and the day after my ORIF (open reduction internal fixation) of my left lower leg fractures. I have a nerve block to two of the major nerves of my lower legs to control pain after surgery. I have been able to get some rest with occasional use of oral pain medications. I’ll be keeping the nerve block pump in for the next 3 days or until the infusion is completed. Brett and I have been sleeping on the couch and love seats in our TV room; mostly because I can get into a comfortable position, but for Brett it is so he can be near me if I were to need assistance.

    Brett is not ‘medical’ in any way, but he is a very hands-on kind of guy. One of the phrases that Brett has used in the past that our daughter Kelly and I giggle at is “I’m more of a PM (preventative maintenance) guy”. And anyone that has spent any amount of time with Brett knows, he loves to prevent issues before they are issues. I can’t tell you how many times we have left late for a road trip because Brett was making last-minute checks and changes.

    All that being said, he could not be a better caregiver. He is not aware of what medication does what and I may need to explain why I need to increase my water intake while taking pain medications; but he has been very attentive to my physical and emotional needs as well aa making sure I am getting plenty of rest. He would not be a great nurse, but is an amazing husband.

    When you are looking to find a mate, not only are you looking for someone that you are compatible with, but also someone who has your best interests at heart. Most wedding vows contain ‘for better or worse, for richer or poorer, in sickness and in health, until death do you part’. And while we are young and in love, we don’t think of the worse, poorer or sickness portion and definitely are not thinking the ‘death’ part. Most marriages start with that one person that you want to spend the rest of your life with. But again, we aren’t thinking about those years when we aren’t able to be an equal participant in the relationship.

    I have found, through the help of my injury, that I have chosen the absolute perfect person to spend the rest of my days with. In the small amount of time that I have been physically dependent on another person to help me do the most basic tasks such as bathing, dressing and fixing my meals, I have seen into the future. This injury has been more involved than when I was quarantined during COVID and Brett’s caretaking has been reassuring and soothing. I have had trouble letting go of control, I feel I should help in order to not be a burden. But Brett has been able to help me let go of the need for control and allow him to care for me.

    Being a healthcare provider, this is what defines me! I ‘care’ for people, I care for their health. Now I am dependent for my care on this person I adore. My entire being is made up of caring for others; my love language in my marriage is ‘doing’ things for Brett to show my love, whether it be cooking dinner or picking up one of his favorite drinks when I go to the store. By not being able to ‘DO’ things, I find myself feeling inadequate, therefore trying to do for myself.

    My fracture is on the way to healing, but the best part of this process is knowing that my partner in life will care for me ‘for richer or poorer, for better and worse, in sickness and health until death do us part’. Thank you, Brett, for being the absolute best husband and nurse in the world!

  • Changing from Provider to Patient- one NP’s journey

    I am writing a series called ‘Changing from Provider to Patient- one NP’s journey’. At one time or another, we have all been patients within the medical system. This is the fifth installment of my patient journey- follow up as I balance being a patient and leave my ‘provider hat’ at home.

    Day 5:

    And…..GOOD MORNING! or rather, good afternoon! Surgery has been completed and I wake up in Post-op recovery. Surgery took longer than the 1 hour that we were initially told, but Brett says that Dr. B told him the surgery went well!. I did well with anesthesia, but waking up from the medical slumber can be unnerving. Not knowing where you are, or when you figure that out, not knowing how long you’ve been knocked out is a difficult thought to wrap your woozy head around.

    I have a nerve block to two of the major nerves in my left lower leg. The two catheters in the front of my thigh are pumping numbing medication to keep the post-op pain under control. Problem is…my leg feels like a rock, a REALLY BIG, HEAVY rock. So here’s the thing, I have a huge anxiety problem with my big toe. Little known fact, my big toe has to be touching something in order for it to feel normal. Either a bed sheet, a shoe, a sock or other tactile stimulation, otherwise I feel like it is the center of attention with makes me super uncomfortable. It has been this way since I was a kid. My dad used to tease me by saying ‘Big toe, big toe, big toe!’ in a fun-loving way until I covered it up. Well now, I can’t feel my big toe and even if I grab my toe, still not there!

    I am wheeled to the lobby of the hospital and assisted into the truck. We are on the way home and now to rest. I have to give credit to Dr. B; the nerve block is taking care of the pain; I am hoping to use the prescription pain medication sparingly. We have set up a make-shift medical room and Brett has set up a perfect healing area. I have a side table with my Surface tablet, my Nintendo Switch, my cell phone and all the appropriate cables to plug into a small power inverter to keep me charged and occupied.

    Now I have to admit, I am super SUPER worried about pain. The really unbelievable thing about my initial injury was the amount of pain was surprisingly bearable. I was able to find a comfortable way to lay my leg/foot in the ED to minimize the pain and after the splint was placed again able to prop my leg and foot to sleep with minimal pain. Now, the bones in my leg and ankle have been fused, I have metal plates and ties bringing all the fractured parts of the bones together. Am I going to be able to rest let alone sleep? Will I have uncontrolled pain?

    Other worries that enter my thoughts as well as controlling my pain are constipation from needing pain medications and blood clots. I am so worried about getting blood clots; how will I know if I’m sleeping? Should I warn Brett or will that worry him more? I try to move my left leg around to prevent clots but the nerve block keeps me from moving the muscle in my lower leg effectively. I know the dangers of blood clots, the risk factor of a ‘recent long bone fracture’ and the complications of blood clots. I decide to keep watch for concerning symptoms and to try to get some sleep. Wish me luck!!

  • Changing from Provider to Patient- one NP’s journey

    I have decided to write a series called “Changing from Provider to Patient- one NP’s journey”. I think at one time or another, we have all been patients in the medical healthcare system. Not just when we were children getting our routine vaccines, but whether it was for a simple UTI or the flu, we’ve all had that interaction between being a patient and being cared for by medical provider.

    On November 5th, I became a patient. I’m not talking about the usual ‘Here for my routine physical’ with my Primary Care Provider visit.

    The visit to the emergency room was familiar, even though I was on the opposite side of the desk. I was in North Carolina for my father’s funeral service. We planned for possible mountain biking if the time was available and our spirits needed to be lifted up. I injured my left ankle at the end of an exciting ride through Brown Creek Mountain Bike Trail. I had been working very hard on both my cardiac endurance and muscle strength and the ride was turning out to be a very successful trip. I crashed, planting my left foot and turning my leg, injured my lower leg. We were able to make our way out of the woods after being piggy backed out by my hubby, and made a quick drive to the closest ED to be evaluated.

    I went through the routine registration, having my identification arm band put on and waiting in the lobby for my name to be called. I asked for an ice pack of some sort, but was told, ‘we don’t’ have those up here’. I’m guessing the pain on my face nudged her enough to seek one out.

    When the triage nurse called my name, she began a process that I have performed thoughts if not hundreds of thousands of times. Taking vital signs, asking pertinent medical history and allergies and discussing the reason for the visit. I did have an advantage versus the ‘normal’ emergency department patient. Not only having worked in the emergency department for 10+ years as a nurse but now working in the urgent care setting as a nurse practitioner, I was certain in my diagnosis of having broken my leg. I described the events leading up to the injury and the nurse was able to place the appropriate protocol-driven order for me to have an x-ray of my left lower leg.

    I was taken then to the radiology room where x-rays were performed and confirming my initial diagnosis of a broken left leg. The radiology tech was not only kind in her concern for my pain, but she was very kind in the care she provided. I was taken into an exam room, where I was assisted onto a stretcher.

    Here was when I needed patience. I was lying on the stretcher, trying to be as still as I could be, this helped reduce the pain. I was able to find a comfortable position for my leg, but it contorted the rest of my body. My initial nurse was friendly and kind, He took time to make small talk in order to distract me from the obvious pain I was in. He did let me know the name of the doctor on duty and that he would be in to see me momentarily. This of course was delayed by an overdose brought in by EMS and another unit brought in a respiratory distress patient. I knew this would push my evaluation back to allow for the more urgent needs to be taken care of.

    Unfortunately, I needed more x-rays to further evaluate the break. This was very painful as I was not able to find that ‘sweet spot’ of comfort any longer. I was ordered an IV with pain and nausea meds. This made the 2nd set of x-rays more tolerable.

    Then came shift change. It is now almost 7 pm, we have been here since close to 5 pm. My nurse came in to inform me that we should see Dr. K again in a few minutes for an update. We informed him that ‘No, we haven’t seen Dr. K even once!’ Now that charge nurse came in a gave us an ‘update’ and advised Dr. S would soon be seeing me. Dr. S soon came in, discussing the findings on my x-rays and the treatment plan. Due to the hospital being a tertiary center, any surgery could require that I be transferred to the larger hospital in the next county. We informed him that we would travel home and seek further treatment in Orlando.

    Now I wait to get a follow up with an Orthopedic surgeon to evaluate my injuries, review my x-rays and determine the next step in the plan of care.

    I’ll share the next step of the journey with you; Hope you all are safe and I hope you all enjoy my series.

    * I have decided to write this podcast series to share my experience in the healthcare system from the patient perspective with the background of a healthcare provider. Please stay tuned for the next installment of the series.

  • Are You Tired?

    Two of the four grandsons caught taking a nap-the only time they are really quiet!

    Happy Fall Y’all!! (In the ‘south’ y’all is known as singular with the plural forms being ‘all y’all’ and ‘all y’alls’! LOL!) I don’t know if you all are excited, but I for one can’t wait for the ‘fall’ temperatures to drop into the mid 80’s! In Florida, we don’t get very much cool fall weather like I am used to in N.C., but I’ll take low to mid 80’s any day!

    As much energy as the fall season seems to give me, I find that lately I am tired. And not the tired that can be solved with a quick nap or an 8 hour night of sleep. I am talking about being mentally and emotionally tired. I find that my fatigue is not physical, but rather more spiritual and it got me to wondering if anyone else is feeling this type of tired.

    This fatigue comes from the daily barrage from the nightly news, the social media feeds and other daily contacts with the public. I have heard of physical altercations over vaccination cards, wearing or not wearing masks and assaults and murders that are generally evil. The latest news that has me in a mild state of despair is the recent location of Gabby Petito found murdered. She was a vibrant and dream-filled young woman that had taken a chance to enjoy her life with whom she thought was ‘her person’. Although I was initially hopeful that she was found alive and well, my gut told me that she was murdered.

    This too disturbed me because the likelihood of her being found dead was greater in my mind than her being found alive. We sat in the living room, trying to put together a ‘timeline’, lists of motives for her being harmed/murdered as well as where she might be found. This made me wonder when I became so cynical and jaded by the past evil acts in the world and how it affected my outlook.

    I have always been an optimist, much to the annoyance of my husband, Brett. Disney songs are often my favorite to blast in the house while I clean! I often play ‘devil’s advocate’ and look for the best in people, even when the situation may look bleak. If I get yelled at by someone that appears angry, I chalk it up to that person may be worried about something or having a bad day. I rarely take someone else’s actions personally. But as the assault on my sensibilities continues daily, I find myself more tired of the Human Race.

    Disney Princess Moana with Maui- probably some of the best Disney songs to sing while cleaning house!

    How do you stop being tired when a nap won’t help? An article from December 2019 on psychcentral.com suggests ‘Six Simple Ways to Rest the Mind’. I’m sure that when this article was published, they had NO IDEA that 2020 would be the year that the Pandemic wound hit and people’s mental health would take a huge hit. The 6 ways include exercise, people-watching, getting out in nature, meditation, animals and play. This sounds like a pretty comprehensive list to get your mind reset and give it a break from the daily grind.

    The Hulk Mountain Bike trail in Myrtle Beach, SC

    As most of my friends know, exercise in my case is mostly cycling. So the first and third on this list is pretty simple for me. I like to get outside every available opportunity and would eat all my meals outdoors if I was able. This one is not as difficult for me as for others I know, but finding or rather making time is what I find the most difficult portion.

    The second suggestion of people-watching is pretty simple as well. One of my favorite movie scenes is in ‘Date Night’ when Steve Carrell and Tina Fey are in the restaurant and begin to tell the story of a couple at another table. Just by watching the couple, how they interact and their body language, a story can unfold. Even if the story is not true, it’s fun to imagine.

    The next suggestion is meditation. There are multiple scientific studies on the physical benefits of meditation and it’s use for physical and mental disease. Reduction of blood pressure, help for insomnia and relief from anxiety are just a few of the benefits of meditation. Unfortunately, medication in its best form takes work. You can not just sit in a dark room, away from people and ‘meditate’. You must practice getting in the right mindset and blocking all external stimuli – not easy for someone with ADHD like me. I do however enjoy sitting in church prior to the service starting and just letting my mind wander were it will and allow those thoughts, mostly things that are bothering me, to come to the surface and be acknowledged. This permits me to unload those concerning ideas, situations and emotions that bring my mental state down.

    • New Smyrna Beach, Florida
    • Lake Underhill, Orlando Florida
    • St. James Catholic Cathedral, Orlando Florida
    • Lake Whipoorwill, Orlando Florida
    Find a place that allows you to find a quiet time within your mind.

    The final two are animals and play. This too is easy for me. Brett and I have 5 dogs of all sizes, shapes and colors. They each have their own personalities, energy level and benefits in our household. They love to play and (mostly) make us laugh at their silliness. Play is something that comes easy for me, but I do struggle to get those around me to enjoy their playful side. I have begun to play board games with Brett in order to disconnect from external stimuli from cell phones, television and social media. It feels good to connect on a ‘fun’ level and to revert back to those simpler days.

    There is a quote that has been making the rounds on the internet and social media that says ‘Your job would replace you before your obituary was printed in the newspaper.’. This may not be completely true, but know that to your employer, you are replaceable; to your family, you are not. So take time today to enjoy one of the 6 ways to give your mind a break….heck, enjoy all 6!

    Be well, live well!

    Tracy

  • COVID Fear

    Most days I spend helping patients with COVID concerns.

    Hello everyone! The weekend is in full swing and so many things are happening. School is back in session, college and professional football is back and if you go to any retail store you will see Fall/Halloween decorations and candy. Life is trying it’s best to continue despite the ongoing COVID pandemic.

    I am continuing to see patients with positive COVID tests, but thank God, they have started to drift back down to levels we saw before the Delta variant ramped up in late July – early August. Our health system has begun to open up again after being placed in ‘black’ status August 4th. Our hospital leaders used Green, Yellow, Red and Black to communicate the hospitals bed availability (inpatient and ICU), inpatient surgery availability and to determine the flow of visitors in and out of the facilities based on the positivity rate in the community as well as inpatient admissions.

    More frequently now, I am seeing patients that want to be tested due to fear of COVID. There are not always symptoms that cause a person to seek testing, but concern for those around them. Many people have older parents, grandparents and small children/toddlers that they are concerned about spreading COVID to.

    One concern that I have not seen in my professional world day-to-day is the psychological effects that COVID has had on people. I am caring for the person with the complaints of sore throat, earaches, cough, sinus congestion and wheezing, but have not had anybody come in for insomnia or anxiety related to COVID and its’ effects on their daily lives. This got me thinking about how many people have had anxiety or insomnia concerns and how often this is happening.

    Some of the common concerns that person’s with psychological reactions toward the pandemic encompass many of the obvious issues such as feelings of fear, worry, frustration, anger and helplessness. Other reactions include difficulty concentrating and making decisions, changes in appetite, energy and activity levels, difficulty falling asleep or staying asleep, physical complaints such as stomach problems, fatigue, body aches and headaches as well as increased use of mind altering substances. More than 35% of Americans have said that their mental health has worsened, 43% said their emotional well-being has gotten worse and more than 1 in 5 people say their sleep quality has suffered. This is according to data collected early in 2020. Current data shows that approximately 1/3 of US adults reported occasional sleeplessness and anxiety weekly.

    People occasionally prefer talking to someone face to face and then there are others that wish to unburden themselves anonymously. There are many options for dealing with the psychological effects of the pandemic. Many Apps are available to download on your phone such as Calm, What’s Up, Mood Kit, MindShift, Talkspace, Happify and Headspace. Some of these apps are free, others charge a fee for their use. The key is to find the one that matches your needs and finances. There has been documentation of young adults, racial and ethnic minorities, essential workers and adult caregivers having distinctively worse mental health outcomes than the average population.

    Now we all know that a person’s mental health contributes to their physical health. So how do we help our mental health when there is an invisible ‘monster’ lurking almost everywhere we go? We have to talk to our friends and family members about issues that bother us. Getting our concerns out in the open is helpful, but in that same instance, we can not allow the mental anguish to overtake our lives. Turning off the TV, closing our social media and not reading the newspaper every moment of every day may begin to help the onslaught of TMI that we are faced with now. Between the medical issues of the pandemic including new variants as well as the political issues surrounding everything COVID, there is more information than we can safely process.

    Do anything to take your mind off the harsh reality that invades our thinking while we are awake and often while we are asleep. I have found some ‘old’ TV shows that are fun to watch. I have started watching Home Improvement, Gomer Pyle, USMC, Green Acres, Hogan’s Heroes, Petticoat Junction and Family Affair. These shows allow me to ‘mindlessly’ watch something that has nothing to do with current events. I feel better after a few of these shows, knowing I have given my mind a small break from reality.

    Sunday afternoon sightseeing

    Other ways to renew your spirit are to…..go outside! Take a hike, become a ‘local’ tourist, go to the beach or a lake, visit your family in a nearby town, or just sit down an read a magazine or good book under a shade tree. The point here is to allow yourself to reset and recharge in order to prepare for those times when you need to be alert and aware.

    I hope you find a successful way to deal with any anxieties and fears that you have related to the pandemic. You are loved and needed and deserve time away from those thoughts that cause you anything but happiness.

    New Smyrna Beach 2021

    Life is tough….But so are you!

  • Healthcare Heroes

    My fashion has changed since COVID-19 came on the scene.

    Happy September everyone! The Labor Day holiday has come and gone and we have a few more weeks until Halloween. Although if you ask my daughter Kimberly, it’s officially Fall Free-for All!

    Things have begun to settle down, for a second time this Pandemic. So I have some free time to sit, reflect and share my thoughts. It has been 1 year and 6 months since my last blog post and I will admit, it seems like much, much longer. When I looked back on my last blog post, it was surprised to read that I was talking about the closing of businesses as the quarantine ramped up.

    Now here we are, dealing with the new strain of COVID and how to maneuver our lives with it running though the population. The initial strains of the COVID virus wrecked havoc on the world, and just when it seemed we were going to be ok, the Delta variant sprung to life. Now here we are again, fighting over the right to wear or not wear a mask and whether or not to get a vaccine that may help save us and our family members.

    At the beginning of the Pandemic, doctors, nurses, medical staff, fire and police were all regarded as healthcare heroes. Everywhere you looked, everything you read and heard, people were thanking those people that were working long hours in dangerous conditions for helping others in regards to the COVID -19 pandemic. Eventually, we saw more and more people arguing, conspiracy theories and using political affiliation to deride those that didn’t feel or act the same way. If you were Republican and contracted COVID, it was because you wanted your political freedoms. If you were Democratic and contracted COVID, it was because it was ‘do as I say, not as I do’. Masks were another bone of contention. ‘My body, my choice’ became a war cry for those that did not want to wear a mask. And if you didn’t want to wear a mask, you were being ‘unpatriotic’ because our lawmakers have asked and in some cases mandated mask wearing.

    Once we had a COVID vaccine developed, the two sides of the aisle drifted father and farther apart. If you got the vaccine you were labeled a ‘sheep’, just following along with the crowd. If you didn’t get the vaccine, your were labeled ‘selfish’, not caring what happened to your friends and family. Many people have lost friends and family over this issue; not because of death or injury, but people were cutting off friendships over the views on masks and vaccines. With people becoming more and more angry at all things COVID, those on the front line slowly stopped being HEROES. I can speak of my own personal experiences and how many times I am yelled at or rebuked for the amount of time a person has been waiting to be seen in my Urgent Care. There have been racial comments from otherwise normal seeming persons. And through all this, I have to keep my sanity and pretend that I am ok.

    Typical day of patient flow at our Urgent Care

    I have gone without meals, spent my lunch at my desk seeing the sick and injured. My husband has spent many an hour worried about my safety, not so much my physical safety but my medical safety. He has lost sleep and spent a lot of time fretting over if I too will get sick despite my vaccine or mask wearing.

    So for all those that do not work in healthcare, please be kind to those of us that do. We are tired from long hours and mentally exhausted from the constant anguish of continued illness and death. Many of us are leaving the medical profession because we can no longer continue at this pace, especially in the face of so much animosity. If we all leave, there will be no one else to care for you; in the offices, in the hospital, in the very moment you need us most.

    Until the time that I can retire, I will do my best to help those that need me. Be safe everyone and most of all be kind and considerate!

  • Take a Hike….no, Literally!!!

    wellnesstree

    Thinking about my first official blog post, I ran through some ideas for what I should write about. Health, happiness, wealth and balance were all very interesting.
    These ideas are very intertwined. They are often deeply sought after and rarely found. Our health is directly impacted by our happiness and our happiness influenced by our health. While caring for persons along the spectrum of wellness, from healthy children to terminally ill elderly, I have seen this in practice. Unhealthy individuals often feel guilt and shame at the impact their health problems have on family, finances and lifestyle. This in turn directly impacts their happiness.
    Mental health and physical health are also very intermingled. A person with a mental health diagnosis can have difficulty making sure they care for their physical health and a person with a physical medical diagnosis can have difficulty caring for their mental health.
    Here are two such examples. A person with COPD is limited in the amount and type of physical activity due to having symptoms of shortness of breath, often missing out on activities that require physical stamina and may become depressed by missing on life events with family and friends. A person with a mental health disease such as bipolar disorder often will cause that person to lack the mental motivation to perform physical activities and therefore will develop medical conditions related to inactivity such as obesity, diabetes and coronary artery disease.
    How have you improved your mental health by your physical habits? What physical habits have helped your overall mental health? Research has shown that the simple act of taking a walk even as short as 10 minutes, not only helps you feel more energized mentally but physically as well. William Shakespeare wrote over 451 years ago…. ‘a turn or two I’ll walk, to still my beating mind‘ – Prospero, The Tempest
    I’d like to challenge you this week to go for a walk a minimum of 10 minutes, 3 days this coming week. Let me know what effects it has on your mental and physical health.