About Laura

With five kids, one with special needs, a handsome son-in-law, a perfect grandchild (seriously, aren't ALL grandchildren perfect??), a even handsomer husband, my career as a NICU RN....what else would I be doing but juggling?

catharsis

Bill is home!

We couldn’t be happier. Now the entire circus can hopefully get a good night’s sleep and maybe eat a decent home-cooked meal. I’m not sure about other things like laundry and other chores around the house. Maybe after we all catch up on some sleep.

In the meantime begins the recovery process and new reality. Five to ten minute easy walks as tolerated and lifting nothing more than ten pounds are acceptable activities which means no working, yard work, Krav Maga classes or dog walking for at least the next month or so.

Six prescribed and two over the counter meds every morning and every night. Nitroglycerin if he has chest pains. The cardiologist also recommends a home AED (naturally not covered by insurance) and CPR for all the kids.

Going over the post cardiac cath diagnostic tests, Bill’s cardiologist told us approximately 40% of his heart muscle has suffered damage. She is hopeful with some radical changes and medications, we can hopefully see some healing in time. This include working on lowering his bad LDL cholesterol and raising his good HDL cholesterol with medication and Bill sticking to the dietary changes that I have already been forcing on him. Then there is the big one…the smoking. The cardiologist made it very clear that he must stop smoking. He must never smoke again. Bill agrees telling her that he quit smoking at bedtime Monday night and that since then he has had no desire or craving to smoke. The hard part, the hardest part will be once he is home, she tells him. He agrees as she advises everything and anything smoking related should be removed from his home environment. As he nods his head in agreement, I offer to take care of that before he comes home and he tells me to do that for him.

I guess he missed my eager enthusiasm to fall on that sword for him…or maybe he did not. Who cares! He told me to get rid of those f-ers!

I tell Daniel as we were driving down to Modesto to see his dad yesterday.

Can I help? I want to smash them with a sledge hammer! No, I want to blow them up with dynamite!

I guess he has strong feelings about his dislike for cigarettes…like his mama. I assure him that he can easily destroy them all for his dad…without dynamite or a sledge hammer.

You can’t imagine how cathartic shredding these felt for my son and me.

And thus begins a new day here under the Big Top for my darling husband and our circus.

Everyone, family, friends near and far, lurkers who bravely reached out, total strangers who don’t know us at all but perhaps know one of our children or a friend, my estranged brother, even our mail carrier who offered kind words, prayers, hugs, texts, calls and visits — thank you, thank you, thank you! You can’t even begin to imagine how good your kindness was to us all…usually during a moment when one of us, or all of us needed it the most.

THANK YOU!

 

a coincidental Throwback Thursday

Twenty three years ago today, Bill, Zoë and I found ourselves together in a hospital.

What fun we had that day!

And although we certainly did not plan it, nor did we really want it to be this way, here we all were again today in a hospital celebrating life.

As you can see, Zoë now has the ‘fro and Bill has the “brand new Zoë” ‘do.

What a great birthday gift it was that her Daddy is up and walking, feeling better and hugging his little girl on her 23rd birthday!

Happy birthday to our wonderfully weird, gorgeous force of nature that is Zoë Elizabeth!

heart thoughts

Working as Vampira, The Night Shift Nurse, I am used to 3 o’clock in the morning phone calls because there’s always a mommy of one of my tiny human patients at any given shift calling because she woke up and thought of her baby. They are usually pumping the liquid gold that is mommy milk and naturally their thoughts are on their tiny baby wondering how he is doing…did she gain weight…did he have yet another episode where he stopped breathing or dropped his heart rate to delay (again) his discharge that was anticipated the day after tomorrow…is she crying… So around 3 AM Tuesday morning as I’m taking mental inventory of what I need to do before my last rounds with my patients when the phone rings I am not surprised. It’s probably baby boy’s mama calling to see if he gained weight.

Room 1. This is Laura. Can I help you?

Mom?!

Abby?…??!!??

Dad had a heart attack. We’re at Doctors in Manteca. It’s bad.

What?!

His nurse needs to talk to you.

And Patrick comes on the line calmly explaining that my darling husband has suffered a STEMI and needs a stat cardiac catheterization. Unfortunately, the hospital where he is at is not set up to do the procedure so he is going to be transported by ambulance to my hospital, its sister hospital. He carefully explains what has been done and given to Bill so far, how Abby is and that he, Patrick, will be accompanying Bill to Modesto. He adds that because we are “family” within our hospital system, he is going to be calling me during the transport to update their arrival time.

OMFG!!!!

Patrick gives me his cell number telling me that is the number he will be calling my cell so I’ll know it’s him…because who else is going to call my phone around 3 AM?…looking at my silenced phone I see that Abby tried to call me…Oh. Yeah….Patrick tells me he will call as they leave Manteca and again as they approach my hospital so that I can meet them in the ER.

OMFG!!!

Inside I am freaking out…majorly freaking out saying “fuck” often. Outside I tell my charge nurse what is going on. I’m too calm. At least I think that I am too calm.

She immediately calls our resource nurse to take over my patients’ care and directs me to update her on what needs to be done for the next few hours. I give the handoff to our resource and accept the hugs and promises of prayer from co-workers and the family of one of my patients as I blankly wander to our nurses’ lounge to wait for Patrick to call me.

I’m too calm, I think again. My husband just had a heart attack and needs an emergency cath procedure. Why am I not freaking out? Why am I not crying? My phone rings. It’s Patrick. They’re on their way he tells me. He adds that Abby is following in her car. And so I wait while my mind races…and wonders why am I not crying, screaming, throwing something…my husband has had a heart attack and is coming by ambulance to my hospital.

Patrick soon calls again telling me that they are getting off the freeway so I hug coworkers once more and head to the ER. There the STEMI Alert team is waiting and ready…nurses, doctor, phlebo, x-ray tech…

This is serious.

Before I can think to ask a thoughtful question, the ambulance arrives with Bill and Patrick. Bill is pale, much too pale but joking with me as he does, as we do.

Freak, freak, fucking freaking out inside I am again.

I’m calm as Patrick explains what meds Bill has had so far…aspirin, morphine, heparin. He tells me he went over consents with Abby and she has signed them so he’s good to go to the cath lab. Numbly, I thank Patrick for everything so far as he says goodbye while I watch Bill receive a new IV, have labs drawn, get a chest x-ray and have his pants removed all in the matter of a few minutes.

Mrs. Scarborough? We’re heading upstairs now.

Holding Bill’s hand, my mind moves from “OMFG! This is for real” to “He’s seriously high right now” as we head up to the cath lab. As they push the bed with my husband through the double doors, they direct me to sit and wait.

So, I can cry now?…

A text from Abby pops up on my phone. She’s here. I tell her where to go so that we can meet. What she tells me is so hard to believe to be real. Bill woke her up after 2 AM telling her that he needed her to drive him to the hospital.

Why, she asked?

His arm hurts and he needs to go now. Bill’s arm and shoulder has been bugging him for a few days. He blames it on overdoing it at Krav Maga, as does the family doctor who prescribed rest and a muscle relaxer. Abby tells me that he was a bit breathless and coughing a lot…as he has been because allergies and the cold Bill believes he caught from Daniel (who has not had a cold). Abby gets him to the ER close to home where they begin to triage and take his vitals…

It all changed when he was placed on a monitor. The nurse abruptly leaves the room calling a doctor in. Soon a party gathered in his room, Abby tells me. A doctor tells her that her dad is having a serious heart attack and need to be sent to another hospital.

My mom is at work at Doctors in Modesto. She will want him there.

You know the rest.

Can I just say here how impressed I am with my Abigael Rose? I am! She remained calm through all of this. I imagine that she was freaking out inside with a steam of OMFG and fuck, fuck, fuck happening because she is her mother’s daughter. Still she remained calm and even advocating for her dad and mom when they first planned to transport him to a hospital in Stockton rather than where I work, where the Central Valley cardiology rock stars are. I am so proud and so impressed with this child of mine.

The cardiologist soon comes out and tells us that his right coronary artery was 100% blocked but she was able to open it up with the cath procedure. She adds that his heart went into v-tach and he had to be shocked three times before his heart converted to a normal rhythm.

yeah…inner major freakout happened.

As the sun rises, Abby and I meet Bill in the ICU. He is on several drip medications with a venous and arterial line in his groin along with an IV. He’s pale…so pale…and he’s trying to tell jokes.

Stop!

I hold his hand as I remind myself that this is his turn for the in  sickness and health part of our vows. Yeah I am mad because he never seemed to listen to me about my worries so here we are but here we are, together in sickness and in health.

Dammit!

The family starts to call as they wake to receive my texts to call me because it’s an emergency. I want to cry and scream and curse and sleep because now I am tired, so tired, but I can’t because our daughters are calling, his sisters…

Sleep is for the weak…and people who had a heart attack…the most severe type of heart attack…and for people who needed to be shocked several times after cardiac arrest. I’m not sleeping now.

The family comes. The friends check in. Bill is awake then asleep then awake then asleep and all the while looking so pale. Everyone who sees him cries a little or a lot. I don’t.

Clearly I am defective.

I know I did way too much in sickness and in health events having babies and preterm labor and anaphylaxis episodes and meningococcal meningitis but, dammit, this is too much. His heart. I told him. I did. I nagged and I begged.

As the day progresses, he slowly stabilizes.

Thank god!

We settle into what is right now our normal and perhaps the most awkward, surreal date night ever.

As a wild, wild party seems to be commencing under The Big Top.

What can I say?

You cope your way.

And this circus will cope ours.

The good news is that by Wednesday night, Bill is much improved. no chest pains, rare arrythmias, femoral lines and drip medications discontinued and, after more than 36 hours for the first time he is sitting up in bed.

So. Damn. Lucky.

The adventure continues…

the perks of being a Snow Queen’s mommy

It’s cold out there today. I know because Al Roker told me so…it was 47° in Miami, Florida where he was reporting this morning. I also know because of everyone sharing this morning.

Oh you Siberian Express, you! I don’t miss the kind of cold that freezes the snot inside your nose…Not. At. All. This blast of icy cold is getting serious because in Kentucky there is a warrant for the arrest of a certain Snow Queen.

All points bulletin!!! Harlan Police Department has issued an arrest warrant for Queen Elsa of Arendelle, Suspect is a blonde female last seen wearing a long blue dress and is known to burst into song “Let it Go!” As you can see by the weather she is very dangerous. Do not attempt to apprehend her alone.

Clearly she can’t be bothered because she is much too busy making appearances here in the Central Valley and the Bay Area making little girls and boys wishes come true. Also she wouldn’t dare freeze my neck of the woods because the cold does bother her mommy!

I’m sorry everyone else seems to be freezing…really. For what it’s worth, it’s foggy and snowing here in the Central Valley right now.

At least it looks like snow.

Don’t worry, I might not be freezing but I am suffering because almond blossoms and allergies.

Stay warm my friends.

 

parenting NICU style

Wa-ay back when I was a nursing student, one of my professors shared a cautionary tale about patients and medical abbreviations. A nurse, preparing to assess her patient, sets down her clipboard. While she is carefully assessing her patient, the patient spies his name on her clipboard with the word “SOB” next to it. What followed, the professor shared, was more than awkward for nurse and patient.

In case you didn’t already know, “SOB” is a medical abbreviation for shortness of breath. The nurse’s patient had emphysema and indeed was struggling with shortness of breath. He might have also been an SoB too…then again, he might have been an all around nice guy. Who knows?

There were many takeaways for us to learn from that scenario that the professor shared. For me, the biggest one was to not let my patients or loved ones see my shift notes. I keep them in my pocket.

This lesson came to mind the other day while reading through one of the micropreemie parenting forums I participate in. A parent shared her frustration of over-hearing her baby’s nurse share with the nurse taking over her baby’s care that she had been crying. Not understanding what that had to do with anything, she vented that they should not be worried about her because their job is to take care of her baby. Who cares if she was crying? The NICU nurse in me wanted to comment as to why the nurses might have been talking about her during their hand-off report. The NICU parent in me knew that she just needed to vent because for many micropreemie parents, there are few, if any, safe places to vent off some of the tears, fears, pain, frustrations and anger that is life as a parent in the NICU.

As a parent in the NICU, I know too well that feeling of being watched over, scrutinized even. In the NICU where Daniel was, where I also worked, parents had access to the bedside chart and were more than welcome to look at it. It was not uncommon to see a note or more about Bill or myself visiting Daniel. Weird to be under a microscope and analyzed in that way…especially because we already felt intense pressure from social workers, family and friends who questioned our motives to want to be Daniel’s family. Stir in the fact that a number of my own colleagues were against our plans (and quite vocal about it) and my being called into my manager’s office a couple of times because staff and administration had a number of concerns about my wanting to adopt a patient in the unit because something like this had never happened at that hospital before. “People might think we are ‘giving babies away at Good Sam’!” 

The horror of such a thing! 

Not fun it was.

If only there was a forum like the one I participate in thirteen years ago!

With most NICUs in the US focused on Family-Centered Care and many hospitals keeping an eye on overall patient and family satisfaction, odds are families are going to be right there during change of shift hand-offs and rounds…unlike the “old” days when I was a baby NICU RN and the unit was closed to family visits and calls during change of shift so that we could focus on the hand-off of patient care.

Being a parent in the NICU is hard. Other people seem to know more about your own baby than you do. They tell you when you may touch them, when you can hold them, feed them, change their diaper. You feel guilt that your baby was born early, that you can’t be at their bedside 24/7, that your other children need you, that your husband needs you, that everything else going on in your life is being ignored. You deal with questions…questions all the time as to why the baby was born early, what did YOU do to cause that, what’s going on currently with the baby, why isn’t the doctors and nurses doing what your co-worker’s nephew’s baby had done to her, why aren’t you at the hospital right now, why aren’t you spending time with your other children because they need you too….and on and on and on. Doctors and nurses and staff either seem to act as though you’re not even there or are hovering not giving you just a quiet moment alone with your baby. And god help you if you break down and cry or yell and scream in the NICU, at home, in church, at the school drop-off, in front of your parents or your in-laws.

NICU parents, am I close?

For what it’s worth, speaking as a NICU RN, when we share with colleagues that mom was crying today, or dad keeps asking the same question repeatedly or the family’s only car broke down or almost anything else family-related it is because the care we give is Family-Centered Care. Our role is to care for the baby first but we also are caring for and supporting the family during one of the most stressful times in their lives as a family…until their baby is a moody teenager. It helps the staff to know that mom is having difficulty producing breast milk or that her mother in law doesn’t want to drive her to the NICU anymore or dad just got laid off or little brother is sick with the flu so that we can better address what the family and the baby needs right now…and what they need to be ready for discharge because, god-willing, discharge will happen sooner than a NICU parent can hope to imagine.

What an amazing day that is when your baby is finally free of every single wire, tube and tape that is attached to his body and you pick him up and hold anytime you want to!

It’s a day that every NICU parent and NICU nurse, doctor, respiratory therapist, social worker and unit coordinator looks forward to as well.

Meanwhile, dear fellow NICU parents, cry if you want to, vent away too, but most of all, hang in there. Your journey is just beginning and this right now is preparing you for the weeks, months and years after the NICU.