January, 2008 Archive

the very first thing i heard when they were talking about him was: “his parents should be in jail!”

he is 20 years old, i would say approximately a little over 5 feet, and weighs 589 pounds. he has multiple wounds on his buttocks. his skin is scaling off. he is unable to turn to his side by himself, not able to clean himself, and admits being extremely embarassed that we had to do almost everything for him.

one thing that breaks my heart about the whole thing is that he is so young. at his age, he should be living the good life…fun, friends, endless possibilities. but he isn’t, because he can’t. literally.

people in our unit have a lot of sympathy towards him, and they also have a lot of things to say about him. they mostly agree on one thing: his parents should be blamed.

unable to make a strong opinion about it, i wonder what exactly compelled everyone to conclude, without a doubt, that it was his parents’ fault that he gained all that weight.

i don’t know what to think. i am a parent. i also don’t know what to say, because i have parents.

as a parent, the line to cross is very thin. i worry about saying anything that will impress my kids that eating and weight is the end all, be all of life. i worry that they will think if they gain a little weight they should be ashamed to the point of killing themselves slowly by being anorexic. i worry that if i don’t say anything, they will end up in a hospital, lie in that big boy bed, stinking and humiliated because it takes four to five  nurses just to clean their butt.

as a parent, everything extreme worries me. the challenge to maintain a balance is difficult, it keeps me awake at night. it bothers me that we are living at such a time when the simple act of eating becomes such a stressful, sensitive issue.

as somebody’s child, where does one stand? when your weight gets out of control for all sort of reasons, is it really that easy to put the blame on your parents for not taking control?

he has wounds that shouldn’t have been there. he can’t breathe just because of his size. i help three other nurses so he doesn’t lie on his own poop. he puts a washcloth on his mouth so we won’t hear him scream in pain. he keeps saying sorry for being such a pain, he said we have no idea how embarassed he is.

i want to blame someone, or something. 
but i don’t know how, and i don’t know who, or what.

“WHAT HAPPENED TO YOU?”
“WHERE DID YOU GO?”
“I WAS WORRIED!”

since she wasn’t hard of hearing, i concluded that the patient assumed i was deaf. i also thought she was talking so loudly and slowly because she assumed i can’t understand english. everybody asked me why she was shouting, and i didn’t really have a valid answer, so i told them she thought i was deaf. i didn’t really have the guts to ask why.

although the yelling got into me sometimes, this post is not about her yelling the whole night. this is about how she blatantly refused ANYBODY to help her. “i just want MAY!”, she said a number of times.

i caught her at the brink of falling, wobbly and weak on her left leg with necrotic toes, trying to put the bedpan on the floor after she refused to be helped when the patient care assistant (PCA) came to answer her call.

“D, i don’t think you are strong enough to do that by yourself. didn’t somebody come to help you when you called?”

she answered with a few questions. she wanted to know where i was, what i have been doing when she called, why didn’t i come to see and help her right away. she then explained that two people answered her call, and she asked them to leave because they both looked so stupid.

she didn’t tell me directly, but she implied that if it was not me, she would rather fall and get hurt than be helped by anybody else. the whole night, she wanted me. just ME! “just MAY!” even taking her off the bedpan, was solely MY job. when she got desperate, tired of waiting for me, she endlessly criticized the PCA for not doing anything right.

i can’t put my finger to it, but i did not really like the whole idea. even when she told me over and over that i was the only one who can do what she wanted, i knew this was not a compliment. this was not something that flattered me or stroked my ego. i saw it as a subtle but certain way to manipulate me, because hey, i obviously did not show i had intentions of stopping her, no matter what she asked for.

i cannot lie about this. there were a lot of instances when i felt smothered, in a very bad way. she had me in the palm of her hand, and to think we were only together for 12 hours. she had that power. or rather, i allowed her to have that power. it made me wonder…what kind of power did she have over her family, or friends?

honestly, i didn’t mind the back rubbing and lotion scrubbing every 2 to 3 hours. i didn’t even mind the “can-you-stay-in-the-room-while-i-pee” request. not even the demand for gown washed only with hypoallergenic soap rattled me. i brushed her hair without questions. i was there everytime she needed me, not because i had to, but because i was this scared little girl who was warned, in between the lines, that  it will be my fault if something bad happened to her. to signify the importance of my presence, i was supposed to respond to all her calls right away, or it will be my fault if she gets agitated and her blood pressure shoots up.

the point of the matter is, i didn’t mind giving in. i didn’t feel bad doing the extra mile. i didn’t mind pampering her. i knew she was scared. i knew it terrified her that she will lose a couple of her toes, or maybe even her foot. i knew all that and it didn’t bother me that she wanted things done because she actually thought she might die during her surgery. 

what bothered me was the fact that somehow, even after all that, after giving her all that she asked for, it was not enough. a few times, i was severely reprimanded for not seeing her right away. even when i told her i was with another patient, she was livid, saying “but i need YOU!” over and over. it was almost impossible for her to accept that i cannot be in two places at the same time. it didn’t help that she liked bashing my coworkers. considering they were just trying to help, it was not pleasant to hear her talk trash about them. it annoyed me that she say something bad about other people who were just trying to answer her call.

it didn’t make me feel special that she thought and said i was the best nurse. when my shift ended, and she hugged me, crying tears of sincere gratitude, i didn’t feel like i made a difference. i didn’t feel good. on the contrary, i felt like everything was a fraud. i found the whole scene overly dramatic and unreal. it was supposed to be an emotional experience. it looked like it was for her, but for me, it wasn’t. i am embarassed to admit that i felt that way, but that is the truth.

there was something about her that reminded me of those who love to the point of violent possession and obsession. she was very generous with her words of praise and thanks, but i had all the reasons in the book to disregard her every word.

she was nice and she was mean. she was sweet, and she was rude.
most of the times, i do not get it.
i do not get people who consciously contradict themselves.
they confuse me. and they scare me.
even if they call me angel.

there is a very simple explanation why nurses in our unit, even if they want to, will never ever think of having gastric bypass.

our hospital doesn’t do gastric bypass but post bypass patients with problems beyond comfortable reasons always seem to end up in our unit.

we steadily have one or two patients who had gastric bypass either a few months ago, or a few years ago. for one reason or another, most of them are messed up. some physically, some psychologically, mostly, both.

i had one patient a couple of weeks ago who had it done about three years ago. she lost over 250 pounds, and at approximately 100 pounds, with a height of 5 feet 4 inches, she was seriously messed up. she was admitted because she was severely dehydrated and said she has hasn’t gone to the bathroom for number 2 for almost a month. i guess one doesn’t have to be that smart to figure out why. even she knew why, but she said she just can’t make herself eat. she hasn’t eaten anything reasonable for days or even weeks. she told me she just didn’t have the appetite. no nausea or anything, just no appetite.

when i weighed her and she found out that she gained almost three pounds in the two weeks that she was in our unit, she was so upset her blood pressure went up to the 170s.

we had patients who have fistula everywhere, nonhealing dehisced wounds, all sorts of surgery complications, all of them depressed. and they keep on coming. one lady, who was so sick a few months after the surgery cried out to me once: “why do i have to be so stupid and suffer?”

there is an endless list of stories about messed up post gastric bypass patients. they all break our heart. and also, what happened to them scare the guts out of anybody who ever even thought or thinks about it.

it is an unreasonable fear i guess, because we all know there are more people who had  successful, positive experiences after losing weight with gastric bypass. the thing is, we never get to see those happy, slim, smiling, patients whose surgeries and recoveries went so well, they all get to recommend gastric bypass with full confidence.

are there gastric bypass patients who end up happy and satisfied after their surgery? i bet you there are thousands of them out there. we sometimes see them on tv, in the magazines, or we hear about them. unfortunately, in our unit, we never get to see, touch, or feel them, like we do everytime we get to see the other side. we don’t get to hear their success stories that often, but what we always see are faces of pains, emotionally and physically scarred by the same surgery that lifted others up.

it is true that there is a risk with ANY kind of surgery. to be afraid to go under the knife is a normal reasonable response. to be terrified of it is a result of seeing all the risks happening like they are very common. nurses see all those things, and sometimes, it makes us irrationally scared. such close encounters with reality obviously leads to undeniable fear.

that’s why i don’t think those nurses in our unit who have been talking about having it done for years now, will never have it done. they will keep talking about it, yes. but they will never have the guts. scared, like little kids. terrified, that’s what they are. but that’s just my opinion.

it could also be the reason why i didn’t get the flu shot. but that’s another story. for another time.

now, on to a totally unrelated topic…i am reading the book “The United States of Walmart”. this was published in 2005. i am so behind. i know. that’s because i’m lazy and random, and i just pick any available book from the library. i pick anything with a title that can potentially keep me awake on a slow night at work, like last night.

i’ve only done a few chapters, and already, i cannot settle down.

i mean, what do you do with informations like that?

do you keep buying from walmart because you think it is stupid to buy the same stuff from another store for a higher price? who cares about a store’s story?

or do you stop buying from walmart because you believe there is something wrong with it all and you will make a difference by not patronizing it? why shouldn’t you care about a store’s story?

what do you do with informations like that? it rankles in your soul, but it doesn’t reason with your brain.

this is weird. not in a creepy kind of way, but in a different, but nice kind of way.

the other day, the kids were busy with their millions of thomas trains and stuff, (well, not really literal about the number, but considering there are so many, i just have to be hyperbolic about it) i was able to sneak in the family room and watch rachael ray’s 30 minute meal show.

my husband asked me what i like so much about her. i have no real answer to that question, but i explained to him that it is not so much that i like her, but it is that i envy her for doing something that looks so fun, and on the side, getting a lot of money for it.

i then boldly said this: “you know what, if i’m only pretty like her, i can do what she does like i really know what i’m doing. i can cook. not fancy foods like everyone does, but at least something edible and not poisonous. i can talk. nonstop if asked to, about nothing and about something. i can do both at the same time. i have made meals in 30 minutes even before i knew rachael ray existed. i have talked ever since i knew there were words.”

so there. i said it. it’s not that i like her, it’s that i think i can be like her. i know, i need to wake up

so, if you and read shrimplate’s blog title description, you’ll know why i say this is indeed a shrimplate moment. thanks for the plug mr. shrimplate! i guess it is safe to return your kindness by telling everyone that if they have some slyvia plath or just plain poetry love in their heart, added to their possible love/hate for anything related to politics, they should head over to your blog and be entertained, or be inspired by some nursing stories in between.

in an unrelated note, if you are wondering why everybody and every body is at the gym today, it is because just like me, everybody thinks the same way: new year, new start.

don’t hate us all for thinking the same way.