The Beginning of the End

One margarita later and my dear friend and I giggled thinking about the beginning of the end.

While the tequila therapy was working very well for us, the giggling was a relief considering the stress and tears of the previous 20 months. Especially considering, the previous 20 hours consisted of hysterical crying.

Let me explain:

I don't consider myself a bitter person but my experiences since June have aged me considerably. Being blatantly lied to was never on my to do list. And naive faith in "the system" just isn't cutting it for me any more. I have been separated from my husband (physically, not legally) and my emotions have been tossed around like a young cat with a yarn ball. All of this on top of a grueling work schedule.

I know that "I asked for it." And believe me, I would endure the heart ache over again because I know the end result. But, unless you are going through this experience (such as said tequila friend and tequila friend's husband), I'm sure all of my problems seem trivial. But,when it is your reality, there is no such thing as problems too small or large.

I now stand on top of the hill for the beginning of the end. I have an escape plan (and plan B and plan C). I see the light. Unfortunately, this light is going to course across the United States away from Aaron once again. I sure hope it gets stronger and stronger or I might just go crazy.

Feverish

From time to time, my uterus skips a beat.

...

From time to time, I also consider birth control Russian roulette (It fell down the drain?)

....

But I have sunk to an all new low.

I have begun, a baby box.

I never intended to do it. I was forced to by fate. Er...I mean, by Old Navy. Today, they had a sale where if you bought adult items, you recieved a child's item for free. Come on fate. SERIOUSLY? Not even I can pass up free.

So now, baby Morrow has a snow outfit. And jeans. Don't judge me.

She's As Cold As Ice*

When I first told the world I wanted to become a CRNA, I remember one ICU nurse in particular discouraging me stating that the OR was too cold of an environment for someone like me.

I'm not sure what he meant by that. Especially, the someone "like me" part.

So here is the solution I came up with in my head (please keep in mind my math stills are rusty and include lots of creative rounding**):

How to deal with cold OR environments
1. Increase your ambient temperature. This is a good idea also if you are in situations that include trauma, coagulopathies not related to trauma, coagulopathies related to trauma, pediatrics, burns, pediatric burns, and pediatric coagulopathies. (Author's note-never let anyone find out that it was you who increased the ambient temperature...the OR really is a "cold" place and they'll yell at you)
2. Under Armor. I am quite a fan of this stuff. Not only because it looks stylish, but because it has the ability to seal heat in and in the event of being stuck in the trauma OR, it wicks away sweat so you always look like you are maintaining your cool (while throwing up inside your mask because you're secretly terrified)
3. Steal the Bair Hugger from your patient. Once their core temperature has been successfully stabilized over 36.5 degrees, I feel it is fair to play the game of "one for you, one for me." That is, one minute (or so) of warm air blowing on you, one for me.
4. Huddle next to the lamp on the anesthesia machine. Beware, because if you are wearing gloves, they may melt and burn you....not that I would like know about that or anything***.
5. This is my favorite. The way to overcome the coolness in the OR-be nice and caring to your patients. Yes, the OR is an impersonal, cold, and sterile**** environment. That is why I take the skills I learned as a nurse and show each and every patient the compassion and empathy they deserve. I was recently approached (er...accosted) at FedEx by the worker who noticed that I was mailing anesthesia related paperwork. One thing lead to another and he ended up asking me if it was okay to use illegal drugs and undergo anesthesia. Let me tell you (NO-it isn't!! DUH!), I don't really care why he asked me and no, I don't care if you do drugs at home. I don't care what you do at home. I care that you are honest with me so I can appropriately take care of you.

Let me hop on my pro-CRNA soap box yet again. One reason why I love been a CRNA (*student*) is that I am able to take the caring and compassion I learned as an ICU RN and translate it into caring for someone during the scariest times of their life-surgery. I literally hold some one's life in my hands everyday. My career choice was reaffirmed the other day. I was working in GI doing colonoscopies when I was called to do a larger procedure that required the patient to be intubated. The patient looked at me (no clue who she was), and said-Oh thank god it is you. Do whatever you did last time because I felt great afterwards. Even though I didn't remember her, obviously she remembered the care (and extra Zofran) I gave her. It made my day and hers too.

*Allegedly
**No worries, my math skills in the OR are really quite good. Plus, I can whip out a calculator so fast it'd make your head spin.
***Seriously, you'll only be allowed this technique once. Ouch.
****I actually don't believe in sterility. Unless you are talking vasectomy. I like to think of it as really clean instead.

I don't always HAVE to win*

*I'm just a more pleasant person when I do!

No Harm Found When Nurse Anesthetists Work Without Supervision By Physicians
Brian Dulisse1 and Jerry Cromwell2,*
1 Brian Dulisse is a health economist at the Research Triangle Institute, in Waltham, Massachusetts.2 Jerry Cromwell (jcromwell@rti.org) is a senior fellow in health economics at the Research Triangle Institute.
In 2001 the Centers for Medicare and Medicaid Services (CMS) allowed states to opt out of the requirement for reimbursement that a surgeon or anesthesiologist oversee the provision of anesthesia by certified registered nurse anesthetists. By 2005, fourteen states had exercised this option. An analysis of Medicare data for 1999–2005 finds no evidence that opting out of the oversight requirement resulted in increased inpatient deaths or complications. Based on our findings, we recommend that CMS allow certified registered nurse anesthetists in every state to work without the supervision of a surgeon or anesthesiologist.


Full article:
http://content.healthaffairs.org/cgi/content/full/29/8/1469?ijkey=ezh7UYKLtCyLY&keytype=ref&siteid=healthaff

The Quarter Life Grown Up

I had this conversation with a good friend a few months ago, for some reason, I do not feel like a grown up.

*Now, lets just start off on the right foot with a first amendment disclaimer-I can only speak for my life and my situations. I DO realize how fortunate I am in this life, I'm just sharing a story.*

Back to me (second child syndrome, I don't like having the attention taken away!), I just have never felt capable of grown up decisions. Sure, I bought a house, got married, got into graduate school, and choose which life saving drugs to administer on a minute by minute basis, -but does that make me a grown up? Sometimes, while driving in my car, I get strange pangs of anxiety like I should have asked permission before running to Target for toilet paper. (What would my mom think?)

Recently, I hit the quarter life mark. 25 is such a nice number, but I haven't quite figured out how it fits into my life yet. Quarter life seems so grown up, but still riddled with teen angst (exactly my situation). And worse, if you asked me my age, I'd reply 23 without hesitating. Not because I want to shun the quarter, but rather because I honestly feel mentally blocked at 23**. Or did.

Now that I have lived on my own for the very first time in my whole life, I reluctantly entered adulthood as reluctantly I cross the state line to Florida (sunshine state my ass*). While I moved to Albuquerque when I was 18, I was never "technically" alone. I always had someone and somewhere to fall back on. Even for the few months I lived in a ghetto apartment by myself (a stupid, rash act of defiance and proving I was an "adult"-ha!) but I could almost always be found at a friend's dorm room instead. I'm still figuring out what this adult stuff means. I just hope becoming an adult doesn't mean I have to start wearing high waisted jeans and quit cursing. Because then, I just don't think it'd be worth it.

*Dear State of Florida, I'm sure you are a very nice state. It sure is green here. However, I just wish we met under better circumstanes. That, and I've noticed it sure does rain every day I want to go to the beach. Have you been to Arizona? It NEVER rains there, the sun is ALWAYS shining in the Grand Canyon state. And that Land of Enchantment? Enchanting...also, boasts quite a few days of sunshine...hmmm....
**Not really sure what happened to 24. It might have been like how my maturity level when from an 18 year old to a 30 year old? Was I ever 21? Nope, just 18 :(

The time I fell

Sure, I told Marianna that I loved you and would marry you before we officially met. I just knew (but, I also knew that I would make Matt Damon fall in love with me so I'm not sure of my accuracy...).

But, the moment that I ABSOLUTELY fell in love with you is probably not what you would expect. But, this relationship has had quite a few unexpected surprises (*gifts?) along the way.

I had just started working as an ICU RN among the wolf pack. I remember that day like no other. I remember the pit in my stomach as one she-wolf had her teeth out in full force. She never liked me...sometimes I think it is really because she liked you. But I had you and I hadn't yet realized what exactly it was I had.

I came home to you, though, we were not quite "living together." You saw the tears in my eyes and said nothing at all. You just pulled me into your arms and whispered, "everything will be alright." And my insides melted....because I believed you. That's when it happened.

Like a message from above

I recently received an email from my next clinical rotation site. It contained explicit information about what is to be expected from me in my next three months. And it was looooong and detailed. I should be terrified. I'm not. It was like a message from God, himself (or herself/itself/itselves...whatever...I'm not a hater) telling me to hold on for two more weeks.

Thanks God (Buddah/Allah/etc)-I needed that!

Befriending a wildebeast

When I was a little girl, oh..probably kindergarten-ish or so, a woman approached my mother and asked her which child was hers. My mom pointed to me. The woman smiled and said, "Oh, she is lovely and so nice to everyone." I think that was my mother's shining moment.

Fast forward twenty-ish years and I feel like I am still that girl. I know I am. I try my best to be nice to everyone. And this has rewarded me with overwhelming joy but it has also blown up in my face from time to time.

Recently, I did something I felt was very nice and I honestly had no alterior motive. I thought I was truly helping a friend out of a sticky situation.

Side note: I have always felt the need to overcompensate and be too nice-it's really a fault. I don't know why I do this. I just want you to like me...you do like me, right?

Back on track-this nice deed blew up in my face so I told said person I could not longer do said nice task. Said friend must not really be a friend because me being nice (sans thank you for nice task...ever...) has turned into me being at eye level with Satan(or George W. Bush-you pick). Like I have said before, there are two sides to every story-obviously this is my blog (MINE MINE MINE) and if you are reading this you are probably either my friend or a complete stranger. Naturally, either of those would lead you to be on my side. Strangers love me.

However, I did not feel regret for loosing this friend. I felt....RELIEF. Sweet relief. I no longer feel like I have to tip toe said person.

I lost a friend but I gained Teflon. Let it slide off baby, let it slide.

In one week

I miss those blue eyes
How you kiss me at night
I miss the way we sleep
Like there's no sunrise
Like the taste of your smile
I miss the way we breathe-Colbie Caillat

The sun streams through the windows and I fight the sleep out of my eyes. I turn to look at you, still sleeping. You're smiling in your sleep. I gently touch a soft curl on your forehead. So many emotions, mainly pure joy, surge through my being. They come to a head and my eyes overflow with tears. I quickly bat them away because I know that still after four years, "womanly" emotions still make you skiddish. You murmur something in audible and pull me in closer. And my heart is happy.

Warning: Being Bitter Gives You Wrinkles

Author note: Unfortunately for me, my learning curve involves doing things the "hard way." Luckily, I usually only get burned once until my little synapses say-"Hey lady, WTF?! That's HOT!"


While I understand that I am a 25 year old dorm dweller, I didn't understand that I would also return to the land of dorm politics. For those of you not lucky enough to experience these the first go around, let me refresh your memory:

1. Home sick and whiny.
2. Unable to leave high school and all this entails
3. New found freedom
4. Lonely in a new city
5. Dumb, dumber, and what the hell were you thinking?
6. Common sense and nonsense

While these seem like apt titles to any teen angst drama, they are currently my quarter life situation. I own up to two on the list-home sick and whiny and lonely in a new city. I feel like I got shit on by number 2. Oh dear Internet, I knew I was coming to Tampa, but I never saw a sign that said I was going back to high school politics. By this, I mean the mean girls club.

Allow me to digress for a moment, I have had plenty of experience with the mean girls club. I was a brand new nurse entering into the world of intensive care. Those girls are mean. Why? I don't know. I think it is equivalent to one part hazing, one part jealousy that the new blond nurse was also shacking up with the hot pharmacist, and one part bitterness in their own lives. Not to mention the additional flack I got for getting into CRNA school. Apparently, education is like anthrax to the mean girls club. And of course, there was always the mean girls club when I was actually in high school. But I block those memories like a bad dream.

I am now officially back in high school. Living in a little house with other girls is like being in high school. There is back stabbing, whispering, and secret meetings. Naturally, rumors are spread and claws are out.

I consider it my uphill battle towards better karma. I try not to be bitter (*see wrinkle comment above). If I have anything to be bitter about, it is having my heart torn in half and thrown all the way from Tampa to Phoenix. Currently, my IPOD mix consists of a repeating thread of Colby Callait's "I Miss Everything About You," and Heart's "All I Want To Do Is Make Love To You." Slightly masochistic, slightly soothing.

Rise above....rise above...

Hopping on the Soapbox

Dear World,

I realize that with any profession you have the good, bad, and the ugly. Of course I know the same is true for anesthesia but this is my blog and my side of the story...

I was getting ready to induce a patient for anesthesia when a tall, geekey, MDA (MD-Anesthesia), walked over and started to tell me where to put the EKG leads.

#1-I have done more EKGs (12 leads, 5 lead monitoring, 3 lead monitoring) in one month than this man will his entire life. I worked in CVICU for SIX YEARS.
#2-I am not your assistant. While I may be a student...I am an anesthetist too.

WORLD hear me-there is NO difference in the anesthesia you recieve from an MDA or an anesthetist. We are held accountable to the exact same standards of care. If anything, your anesthetist is held to HIGHER standards-we must get better GPAs in school, the admissions process is more rigorous, and we can never fail a class...ever. If this guy fails in med school, he has the oppurtunity to make the class up or slide by with a barely passing grade. Your anesthetists can never fail and must maintain better than a B average to pass...hmm...how does that make you feel? (*Author's note...I don't know this guy's past...I just know his presence stinks)

I wanted to whip him with the cord (or wrap it around his neck) but he has a limp, and I didn't want people to think I picked on the less fortunate. Because I don't...

Yesterday working with this man (whose claim to fame is "CRNAs: can't live with them or without them"...wanker...) reinforced my decision to return to an opt out state...that would be you New Mexico. I refuse to think that this journey (total of 8 years) is going to lead me to any where but independent practice. That is the goal and the idea behind this profession. I am confident in what I do and I love doing it.

The Imperfect Day

It had all the makings of a perfect day: ocean breeze, windows rolled down with the stereo blasting, and toes in the warm ocean tide. As I walked along the shores edge, talking to you on my phone, I wanted to try and crawl inside it's tiny plastic to be near you. I would do ANYTHING to be near you right now. It had all the makings of a perfect day, but my perfect day was imperfect 2,300 miles away from where I truly am ALL the time-with you.

24 year old dorm dweller

Author's note: I'm a bad blogger. But since I'm more of a blog stalker* than a blogger, I'll forgive myself and my two followers. Hopefully this number will increase as I get more interesting.

I will yet again become a dorm dweller. My first experience with dorm rooms can be traced back to yester-year 2003. A scorching August day in New Mexico, you could find me hauling a TV up the flight of stairs in Laguna deVargas to be met by a bubbley, blond, gorgeous cheerleader. I was sporting a limp pony tail and was drenched in sweat. Nice...
...I hated her. Perfect, perky, and bringing designer dorm ware to our suite. I sneered at my mismatched, hand-me-down XL twin set.

Next week I will be a bridesmaid in her wedding. She was the MOH in mine. BFF...but that's a story for a different day.

My return to the dorms is not voluntary. Instead, I feel like I have been exiled to Tampa, Florida. Florida, you say? Florida was supposed to be the fountain of youth...the tropics of the United States. But Florida is missing my wonderful husband...

Okay, I'll admit to the melodrama. Here is the story: unfortunately, Phoenix lacks CRNA training sites because the anesthesiologists are dominating the field. This is a whole other story that I will hop on the soapbox later. But for now, this is my situation and in spite of my bitter, whiny, and sometimes childlike attitude, it is reality that I will face.

The reality is actually an amazing opportunity. I will be a student at one of the largest trauma facilities in the country...the world maybe! They do the kind of surgeries you only see on those wild, wacky, out of this world shows on Discovery Health. I will be doing those kinds of surgeries! Well, not personally, because blood and guts freak me out. I will be comfortably perched behind a drape praying that the blood and guts stay internally tucked in where they belong.

Florida is VERY CRNA friendly** and it will be an amazing opportunity.

I feel like my life has done a 180. A year ago, I was homeless, jobless, and found myself in a new city. 365 days later, I'm jobless and finding myself in another new city in spite of setting some pretty deep roots in Phoenix.

I just pray that I don't accidentally send sexts to the wrong person. I'll apologize in advance now.


*I don't identify with the term "stalker." To me, this implies felony...and I don't accessorize well with steel.
**Allegedly

Crushing dreams and taking names

I'm not opposed to the crushing of all dreams, per say...just the bad ones. Unfortunately for me, those are usually my dreams. Case in point-my recent endeavour to run a half marathon. I have lied to you (*and if I don't personally know you, I'm not the best of liars but will do it from time to time). I have lied to you by letting you think I'm an uber runner. The truth, whole truth, and nothing but it-I DO enjoy to run but uber isn't a word to describe me. Unless you are talking about cupcakes. Then it fits...well....mmm..cupcakes....

Anyway (wiping drool), the REAL reason why I got into running (*besides words like "chubby" from someone who may or may not remain nameless) is because my 16-year-old-not-chubby-in-my-own-mind-self was in love with a boy. A boy who did cross country. Note: I did not join cross country to lose the chub I wasn't aware I had, but rather to spend time with said boy.

At first, it began with 10 minute jogs that left my breathless and covered in sweat. Not attractive, especially for someone trying to attract the opposite sex. But, the sweat dried up and I began to get better (*long process). The better I got, the more attention I got. Not from said boy who ended up being gay (*that's a whole other psyche ruiner), but from everyone else. My fit physique got me noticed. By other boys that were straight. So I continue to run and continue to "enjoy" it- 75% of the time...

Well, this "enjoyment" leads me to the challenge extended of a half marathon. I've done 5Ks up the yin yang and even thrown in a couple of 15Ks-so what's a couple more miles?!

Set the scene now 8 years after my cross country debut:

Morning of 1/2 marathon is a gorgeous spring in the winter Phoenix day. Thousands of people are gathered to run and thousands more are the cheerleaders. Even John McCain was there (*don't get me started)! The first few miles (6 to be exact) were what I remembered from the cross country days of my youth-easy, feet floating, enjoying the crowd. I look at my watch and am pleased with my athletic self. Cupcake who, I'm a bad ass! Well, that is until mile nine. The stomach turned (*medical professionals should read ischemic bowel) and the feet gained all the weight. I managed to drag my ass the rest of the way there. At mile 12, people cheered for me (*and or the other 24,000 participants) and told me the finish was just around the corner. Liars-I HATE you all. As I crawled to the finish (*crawled=10+ minute miles), I reached Aaron and my mom but then regained by speed as I ran to the port-o-potty (*sub 8 minute mile time, I'm sure). Needless to say, my belly would rather be full of cupcakes than ischemic for two hours.

I survived and you can't take it away from me....but I'm going to crush your dreams, right now. If words like ischemic and bowel won't scare you off from running, this will...look at the horror in my dogs face (*Author's note-I got a new dog!!! Isn't he adorable?!).

(**Author's note-I don't believe I was chubby, but I've ALWAYS believed that I have ugly feet, don't judge me)

Rugby the wonderdog

I lead a charmed life. I have an unusually attractive dog. It isn't bragging, it is a fact. People take pictures of him when we are out and about on their cell phones.

How much do you think I could pimp him out to Hollywood for?