Monday, February 1, 2016

Groundhog Day: One Mom's Story of Stroke Survival

Disclaimer: This isn't my story. This is Amy's story. I was fortunate to be her caregiver, and now her friend. I have Amy's permission to share her story because stroke awareness is so very important.

If you have seen the movie "Groundhog Day", you know that Bill Murray gets endless attempts to live the same day over and over again, until he gets it right. Many of us in healthcare wish we got "do-overs" when we think we could have diagnosed a problem sooner, or treated it differently. But we don't. On Groundhog Day 2006, things went exactly right on the first try...

Amy's story could have gone so differently. It could have been the story of a young mother who suffered a debilitating stroke, unable to use one side of her body and unable to speak. Perhaps with extensive physical and speech therapy, her condition would have improved. It would have been a long time, if ever, before Amy returned to work. Amy's husband Chuck would have been supporting her recovery and parenting their two young sons.

Instead, thanks to an astute coworker, educated EMS providers, and a push to give tissue plasminogen activator ("tPA" or the "Clot buster") to stroke patients, Amy's story is very different. Amy was working at a local school when she developed the weakness and inability to speak clearly. Her colleague recognized the signs and called 9-1-1. EMS providers rushed her to the Emergency Department with extensive detail about her "time last known normal" and her symptoms. In the Emergency Department, staff acted quickly to perform the necessary tests and begin tPA administration. This is when I met Amy, as I helped to support the staff in giving the tPA. This was our second time ever administering it, and frankly, tPA scared us. The concerning side effect is bleeding, especially in the brain, but without it the recovery prospects may be dismal.

Within hours, Amy was moving both arms and legs...soon she was able to begin speaking. I will never forget her telling me how bothersome the bright lights had been, and how loudly everyone spoke to her because she couldn't talk back. Amy left the hospital with minimal disability. She underwent follow up care and management of her stroke risk factors, but ten years later she is a Mom of two wonderful young men, who now travels the country as a consultant to train teachers.

Simply because someone recognized the signs of stroke and acted "FAST", Amy has been able to impact countless others.
- How many swim meets has she attended in ten years, cheering on her sons?
- How many teachers has she impacted with her training?
- How many people were able to recognize the signs of a stroke in someone else because they heard Amy's story?

Ten years later, stroke care has been refined and tPA use, as well as advanced neurological intervention, are much more widespread. The key is for stroke patients to get to the hospital as soon as possible.

So what can you do? Don't ignore the warning signs of stroke. Even if you aren't sure, call 9-1-1 and get checked out. Remember to "Act FAST". The most beneficial stroke care is time sensitive.
Have more questions? Check out the Stroke Association or the American Heart Association.

Sunday, January 3, 2016

I made another Mom cry...and I'm so glad I did!

After a wonderful family getaway, I rushed to the grocery store to pick up food for diner and the coming week. Our kids have reached the age where they can be left home unless they have a burning desire to shop with me.

My first stop is always the produce aisle. As I was choosing my vegetables, I noticed a Mom with a toddler (a boy around 3) in one of those car carts.

Any parent knows those carts...beloved by children and IMPOSSIBLE TO STEER!!! The benefit of an entertained child (or two) weighs out over the muscle strain caused by trying to drive the cart.

Said Mom was picking out squash, and had placed it on the scale and gone to get a plastic bag. She stopped mid-step, and looked back at her son. "I'm sorry, did you want to help me?" He struggled to get out of the car, and Mom reached over to help him. She took him over to the scale, where she asked him to count the squash and they began to talk about how much it weighed.

I thought to myself "What an awesome Mom". I thought of the dozens hundreds of times I coaxed my kids through the grocery store with promises of "five more minutes", or a donut if they behaved. I thought of how few times I took the time to involve them in the process. I thought again, "What an awesome Mom". Anyone who knows me knows that I am a bit of an raging extrovert, and have been known to strike up a conversation just about anywhere. I didn't want to intrude on her Mom moment, so I went about my shopping.

Three aisles later, Mom and her car cart were coming toward me amidst the Taco Tuesday fixins. She apologized for her large cart. I told her she had nothing to apologize for, and that I had seen her in the vegetable aisle and thought she was an amazing mother.

With tears in her eyes, she said "My whole family has been sick. My younger daughter, me, my husband. We are finally getting out of the house after days at home and I feel like I have been so impatient with my son. You made me cry."

I told her again what a wonderful Mom I thought she was, and went about my shopping. All evening, I have been thinking to myself about how much more we could do to build one another up as mothers (or parents). So often we feel inferior because we don't make pinterest-worthy crafts, or we feel impatient, or we feel like we are barely holding it together.

All it takes is someone occasionally saying "you are doing a good job", or in my case a snowboard instructor who tells me that my son was a really good listener...It just takes a minute to make a Mom feel like they are getting it right. Why don't we do it more often????

Monday, September 28, 2015

I always said I make a good Wingman...

I'm dusting off the blog to share my latest passion. Funny enough, I blogged about being a Wingman in 2010, The meaning was a little different, but I've always said I make a good wingman, or "right hand man". Give me a task and I will do whatever I can to make it happen. After watching Melinda, a fellow triathlete, on her journey as a Wingman for some time now, I finally joined Athletes Serving Athletes. This organization helps disabled athletes experience the thrill of athletic competition.

I lost the passion for racing some time ago, but I love having a goal. Watching Melinda help some amazing athletes reach their goals got the fire going in my belly again, this time to pursue helping someone else complete their race. On a recent training run, one of the coordinators was telling me that hearing a disabled athlete speak about his races was truly incredible. I've had the pleasure of seeing Sean on each of my Annapolis training runs. When Sean speaks publicly about his experience, he says that even though he can't run, he feels the adrenaline before a race. He feels the pre-race nerves and excitement, and gets to experience the rush of the wind and the thrill of racing.

On my first training run as a Wingman, I ran with Sean, who gave me investment advice and critiqued my driving of the Jogger in which he was riding. This young man was brimming with personality. He shows up week after week for training runs, and loves participating in races with ASA. This article was written about Caleigh, another athlete I have had the pleasure of running with. If you wonder why this organization is worthwhile, this explains it. The amazing thing about these athletes? There isn't talk about race times, or equipment, or PRs, or competition (although some are known to tease the wingmen out if they "aren't going fast enough"). There is just a love of the sport... A love of being able to do something they might not otherwise be able to do. Each training run I have attended, there is great camaraderie between the athletes, wingmen, and families of athletes. Some of the parents run with us, other times they catch up with one another while their athlete is out running.

How does being a wingman work? Usually you run with 3 wingmen and an athlete in a jogger. The wingmen take turns pushing the jogger, rotating as the group determines. Each time I've run, we have settled into a rhythm of trading off the jogger. The pace isn't record breaking, but set to the comfort level of the slowest runner. In this situation, it is truly about the journey, not the time. I have left every training run feeling beyond blessed to have been given this opportunity. For all my runner friends, I encourage you to consider this... even one race in the next year could mean an incredible adventure for a disabled athlete.  The motto of Athletes Serving Athletes is "Together We Finish".

For more info about Athletes Serving Athletes, click here.

To visit my Athletes Serving Athletes fundraising page, click here.

Wednesday, October 29, 2014

Four Years Later...

This Saturday is the four year anniversary of my ectopic pregnancy. For some reason the anniversary is particularly raw for me this year. I have theories on why that is, but I think a lot of it has to do with our ability as nurses to think "things could always be worse". We minimize our own struggles because we see so much pain and struggle every day. Our situation can't really be that bad. I did this a lot in the days, weeks, and months after my ectopic. I explained it away, and told myself and anyone I talked to that it happened for a reason.  A couple months later, my hair was falling out, I lost some of the hearing in my left ear (it has never come back, and they never found a cause), and my SVT (abnormal heart rhythm) was flaring up regularly. I'm certain that the mind-body connection and the emotional stress contributed to these things. I would say it was at least a full year before I really dealt with things emotionally... I would also say that I continue to deal with this loss and I likely always will, as anyone in my situation does.

Here is what happened in 2010 in my words:
I found out last week that I was pregnant. We have two beautiful, amazing children. Lately, we have been enjoying the fact that our youngest is becoming more and more independent at 4 years old. We hadn't planned on a third, but apparently that plan was going to change. I selfishly thought about the things that I would put on hold for a few years. No triathlons in 2011... "Ok, I'll shoot for 140.6 when I turn 40" (that would give me 6 years). No more disaster medical team.... "Ok, that can be put on hold. I can still attend the trainings and keep up my skills." "We can't afford three kids in childcare...Ok, we will revise our schedules to eliminate before and aftercare for the two older kids." In a week, I had come up with a potential plan. It was a rough week. A lot of crying. A lot of guilt, for being shocked by this pregnancy when I know there are so many people who are trying so hard to have children. I felt tired, and nauseated, but tried to push through. Of course I started to become attached to this new little one.

On Monday, I started to feel uncomfortable. Pregnancy can make you uncomfortable, so I prescribed myself a dose of "Suck it up". Hours later, the pain was intense. (It should have been a sign when I put my jacket on the floor of my office and lay down for a few minutes trying to get comfortable). Eventually, my OB sent me to the ER. I was an emotional and physical disaster. I always feel fortunate to work with such amazing people, but even more fortunate to experience their skill and compassion when I needed it most. It took a ridiculous amount of pain medicine to get me comfortable, but they did. Tests showed that the pregnancy was ectopic (it was taking place in the fallopian tube rather than the uterus). This can be life-threatening, but thankfully they caught it in time. They were able to give me medicine and avoid surgery. It took an overnight stay to get the pain and nausea under control. The medicine (methotrexate) is a chemotherapy agent. It stays in my system for over a week, and causes nausea and other symptoms. I still have a fair amount of discomfort, but it gets a little better every day.

Three days later, I don't think I've begun to process it all. I went from thinking about how life would change with a baby, to not being pregnant in a week. I know I need to grieve, but I think I am too emotionally exhausted to be there yet. I do know that I don't have control over when it will happen, and just have to let things come as they may. 

Above all, I am thankful for the love of my family and friends. Tommy has taken time off to take care of me, the kids have kept their fighting to a minimum, and everyone has been so wonderful with their offers for help. I couldn't ask for more. I am sure there is some lesson in all of this for us, I just don't see it yet.

Four years later, I still haven't figured out that lesson. What I do realize and appreciate so much more is the loss experienced by those who lose a pregnancy. While Tommy and I weren't trying for a third child, it was still a loss, and it catches me off guard at unexpected times. Perhaps the lesson is that the loss has to be acknowledged. Sometimes we have to sit with it, no matter how hard that is, and let it be felt. And we don't always have to live in a world of "could be worse" and "things happen for a reason". Sometimes, things can just suck for a while... and then we have to pick up and give thanks for the amazing things that balance out the loss.

Friday, September 5, 2014

Sometimes You CAN Ask for Help

Those who know me well know I don't keep much to myself....

I do worry that sometimes I over share, but then I get positive feedback on a blog post from an unexpected source. My hope in sharing this story is that I explain the past 6 months of my life and perhaps help someone along the way. This May, I had the opportunity to hear Brene Brown speak about vulnerability. In a room full of 6,000+ nurses, I felt like she was speaking to me. I have often tried to "do it all", and do it on my own....without asking for help or admitting to vulnerabilities. Tommy and my family have always been an unwavering source of support for my endeavors (whether it was Hurricane Katrina relief, or school, or professional endeavors), but I never really relinquished control or asked for help. While I have a longtime love of Wonder Woman, when people have jokingly called me that I think to myself "if only they knew what a mess I can be". After hearing Brene Brown, I felt permission to share more of my vulnerabilities and to acknowledge that I am by no means perfect. 

Yes I do a lot...and am involved in a lot, but so many times I feel like I have dropped a ball. One of my greatest challenges is feeling like a good and supportive friend to some of the amazing women in my life... I don't think I show some of them nearly enough how important they are to me. This resulted this Spring in the loss of a friendship that I had always considered dear. 

This February, I tried an antidepressant (amitriptyline) to treat my migraines. I asked my headache specialist what the side effects were if I wasn't depressed. It turns out that irritability is the big issue. I made it about a week before my co-worker held an intervention. I was downright nasty at times on the med. (Some might say it wasn't the med...)

The following month, I developed really significant PMS symptoms. I have had hormone issues before, but I felt downright depressed. Every month, it got a little worse, until I had 3-4 days of feeling clinically depressed  and anxious every month. By July, I was feeling very distraught about it. While depression carries with it a stigma for some people, I felt surprisingly unthreatened by the idea of asking for help. I just wanted help. I did research and realized it was probably Pre-Menstrual Dysphoric Disorder (PMDD). Literally PMS on crack. Over the course of a few days, I melted down to Tommy and my family, and made an appointment with my MD. I went into the appointment with the goal of describing my symptoms, but not self-diagnosing. My MD is very well respected among staff in the hospital, but I have never loved her more than I did that day. She immediately said "I think it is PMDD". I cried with relief when she said "You have been trying to deal with this for you want to try a medication?" I'm not a fan of throwing medications at every problem, but I knew that is what I needed. Zoloft (sertraline) is indicated for the treatment of PMDD, so we went with that. She told me that it wouldn't eliminate the problem, but significantly improve my threshold for dealing with the symptoms. When I thanked her profusely for her help, she said "You did the hard work by showing up, I just wrote the prescription." This is my doctor but also a colleague whose patients I care for on a regular basis. To leave there feeling just as competent and respected as I did when I walked in meant the world to me. 

One month later, I weathered my hormones in much better fashion. I know that I am getting off easy in comparison to people who struggle with depression every day of the month. I also know that there may be more difficult months ahead. This will certainly be a journey, but being able to ask for help was a HUGE first step. A pivotal moment for me came this week when a patient's family member asked "Are you always this perky?" I'm glad to have my perkiness back. 

This concludes my oversharing, but if you are one of those "balls" I dropped along the way, or one of the people who put up with me through some of my least desirable moments, I'm Sorry, and THANK YOU for sticking around. 

Tuesday, May 6, 2014

"I don't know how you do it"

This is an absolutely true story. Yesterday, I was walking through the hospital lobby in my lab coat and stethoscope when a man in his 30s started walking next to me. Out of the blue, he said "I don't know how you all do this. I could never do it."
Me "You mean work in a hospital?"
Him "Yes. My Mom died here a month ago and now my girlfriend is having surgery. I know you all save lives and stuff, but how do you deal with all the other stuff?"
Me "Everyone has something they are really good at. For a lot of us who work here, this is the thing we are really good at"
Him "I still don't know how you do it"
Me "There are days this job is really, really hard... but then there are those moments when you know that you have helped someone, either by saving their life or easing their suffering. You carry those moments that touch you and rejuvenate you forward, to help you deal with the bad days."
Him "That makes sense, but I still don't know how you do it"

We talked for maybe a moment more, and then went our separate ways. Obviously he was a young man who needed someone to talk to. As I read all the Nurses Day posts this morning, I thought of my conversation. Being a nurse is a calling. It can be thankless, and exhausting, and emotional... but at the end of the day, week, or month, you have absolutely touched someone, and made someone's life easier.

Happy Nurses Day!

Saturday, April 19, 2014

Key to Keys 2014

It is hard to put the experience that is Key to Keys into words. Take 8 days of the best summer camp you could ever go to, with amazing friends, and add more laughter and tears than you could imaging packing into that time frame. Everyone on the journey has a story. This year we had three volunteer drivers, all with connections to cancer, the Ulman staffers who all have their own stories, and 25 riders. There were survivors, and many who had lost loved ones to cancer. Some days we laughed a lot... using levity to get through the day. Other days, we would ride in our SUVs and someone would say to a rider or support staff "tell me your story". You cannot hear the story of someone losing a child, spouse, parent, or loved one to cancer, and not be moved. Every day, I was surrounded by people who picked up the pieces of unimaginable loss and moved forward to help others. I was humbled to be with these amazing folks. I also know that we touched people at every stop along the way.

Having completed the ride last year, I definitely had a different focus. The aspects of the ride that brought me the most joy (aside from that moment when you peeled off your bike saddle at the end of a long day), were those in which I could help someone achieve a new distance. Several people rode longer than they ever had on Day 1, and continued to shatter their personal records on subsequent days. This trip is truly about the journey, and I am so thankful to Tommy and my kids for supporting me on this journey once again.

How it Works
Each day, we woke up and were split into 5 riding groups. To me, the beauty of Key to Keys is that we never know where we are riding until that morning. We were assigned our groups, and each group rode 25 to 70 miles each day (one group pulled a century on their longest day). The shorter rides were associated with visits to cancer centers along the way (6 in all this year). We had business cards with information about the ride, and used them to help people follow along with the journey. The challenge was to give out as many cards as you could.

Each morning starts with a dedication circle. Everyone who wants to speaks about who they are riding for that day. It is powerful and emotional and inspiring. To have a purpose and a person in mind each day provides focus. It also provides insight into what is motivating your fellow riders on that day.
Dedication circle in Charleston, SC

SUV selfie...Chris and the ladies

The ride itself was not about being fast, and I feel like we saw amazing sites along the way. Some days were back country roads and avoiding being chased by dogs, while others were more well-traveled roads and beach towns. We stopped and saw the sights, including the Navy Seal museum, a Revolutionary War era church, and even the Oscar Meyer mobile.
Riding with the boys, Day 2
In 8 days, strangers become family, random people on the street donated cash when they heard what we were doing, and we laughed and cried on a regular basis. As a group, we raised enough to fund the cancer navigator position at Walter Reed Military Medical Center. Meg is that navigator, and her program will provide services to young adults (ages 18-40) in the military who are dealing with a cancer diagnosis. 

Riding into Key West
The most bittersweet part of our journey was the ride into Key West. You want to pedal backward, to delay the inevitable. Even though friends and family are there at the finish, you want to enjoy the ride just a little longer. Inevitably the Southernmost point arrives in the distance, and we pedal to the finish of our journey. While Key to Keys 2014 has ended, there is still much to do in the young adult cancer fight. We ended our dedication circle every day with the UCF slogan: 
"Cancer Changes Lives....So Do We"

Many thanks to all of you who supported me on this journey, and to those who were support staff or riders, thank you for sharing those 8 days with me. If you would like more information about the Ulman Cancer Fund for Young Adults, click here.

Riding the bridge into Savannah (much steeper than it looks here)

We had just passed Kennedy Space Flight Center and seen a rocket launch.

No one can ever pass up an amazing photo op!

Day 8... Getting ready to saddle up for our ride into Key West.