This IS the Unimaginable Future

This IS the Unimaginable Future

For my birthday last year I had a friends and family get together and, together, we created a 365 link, colorful, paper chain.  On the day the last link is torn, I will start my retirement after 43 years as an RN. 

Given that I never intended to become an RN, or do anything in medicine, it is somewhat shocking to think how fast the time has gone and how far off course from my original goal I have strayed. Oh well, still time for a second run at the first goal but, before I sign off from nursing, it has become obsessively important to me to share some of what I have learned with the world. Before I do though, a little review of how I got here. 

A very brief segue into piano conservatory, at age 17, had more to do with my mother's excited dreams for a concert pianist daughter than any aspirations or talent I might have had. Thankfully, my theory instructor recognized my misery and alerted my parents that it might be better for me to pursue a different path especially given the cost of tuition and my clear lack of interest in 6 hours of daily practice; along with other course work. 

Enter the real dream!  Finally, I was able to enroll at university in pursuit of an English degree and, seemingly life was about to correct itself but, no.  Having been raised in a conservative, authoritarian home, this girl quickly found out that the unsupervised life of an 18 year old in disco happy 1978, would be VERY eye opening. 

I teamed up with the nicest people!  They loved to dance. I loved to dance!  They knew all of the fun places to go and I had not been to any of them! Within weeks of starting my first semester I was socially excelling and academically scraping by.  Despite my reasonable level of intelligence I somehow miscalculated the reality of being able to sustain that much fun!  

At the end of the semester my grades were just barely passing.  Since my parents were paying my tuition they had access to my college information and, after seeing my first semester results, both Mom and Dad declared, “we aren't paying for this.”  In my mind that meant I needed to clean up my act and improve my grades but, in reality they meant, they were finished paying altogether. Given that I was 1 of 7 children, it was stupid (naive) on my part to think that my blue collar parents were going to work hard to shell out money for poor outcomes from this member of the litter. 

So, in the accepted parenting style of the day, my parents instructed me to get a job so that I could continue my classes and pay my own way, or,  just get a job and figure out my future; because I wasn't going to live with them forever. Does anyone else feel the sense of irony in knowing that one of my favorite dance tunes was Gloria Gaynor's, I Will Survive? 

And now, the rest of the story (miss you Mr. Harvey). 

As timing would have it, my mother (an RN) noticed an ad in the local paper, (placed by the hospital she worked for no less) inviting all comers to sit an exam to determine aptitude towards a medical career. Per the ad, a fixed number of those who passed would be offered 2 years of paid college tuition towards a future in some type of medical field. The winners would also be offered an entry level job at the hospital to support learning and life expenses. 

While this seemed a serendipitous event and a reasonable suggestion,  to my very motivated mother, I need to reinforce that a career in medicine had NEVER, not never, crossed my mind and, Mom already had an aspiring nurse established in my next to the oldest sister.  That particular sister rolled out of the womb knowing she would join the Nightingale elite but my heart belonged to words, stories and imaginary lands, complimented by all types of creativity nourishing music. Having said that, and if you go back up there and see the type of parenting alive and well at the time, I signed up, sat the test and was one of the “lucky” ones to, not just pass the test, but somehow displayed “a clear aptitude for health care.” 

Suffice it to say that the events that rolled out next happened so fast that there was no stopping the train. In short order I was enrolled in a 2 year nursing program, got married, went on to finish the requirements for my RN and moved 3000 miles away where I enhanced my fledgling nursing career with practice in Orthopedics, Urology, Cardiology (23 years) and most currently, Home Health. 

At every turn and in every specialty I saw phenomenal saves and incredibly sad losses.  While I have to admit to developing a nerd-like awe at the perfect machine the body can be, there is the equal and opposite feeling of being appalled at what patients seemed to willingly do to destroy that machine. So many times I listened as nurses, doctors, dieticians, nurse practitioners, physical therapists, occupational therapists, speech pathologists and pharmacists imparted hours and hours and hours of advice and ideas for redirection in hopes to improve the health of a large population of, ?unwittingly, self destructive people. One of my favorite conversations went something like this. 

Cardiologist- “Well Mr. Smith, it has been a year and you are still smoking.” Patient- “Doc, I have tried patches, gum, hypnotism and acupuncture.  None of it works.”  Cardiologist- “Have you tried not smoking?” 

Another overheard attempt at reason went something like this.  Cardiologist,  in conversation with a 50 year old woman who was recovering from her recent MI (heart attack) and onset of Atrial Fibrillation (irregular heartbeat which can lead to a stroke or death).  “Mrs. Jones, I would like you to work harder on decreasing your cholesterol because you are in generally good health, but have already had one heart attack and are now prone to another.  If your efforts at diet control are unsuccessful we can talk about a cholesterol lowering medication.”  Mrs. Jones-"that sounds too hard, just give me the cholesterol pill.”  Cardiologist, with great resolve, moves onward to discuss the need for Mrs. Jones to start a blood thinning medicine, to prevent stroke.  Mrs. Jones, “well, I already bruise a lot so I don't want to start that medicine besides, people recover from strokes all the time (I swear, she said that).”  

Now, I am not making fun of those people up there.  I was absolutely stunned to hear these kinds of responses from people who were, at least at the time, celebrating a decent recovery from high risk health problems. Also, please don't think for a second that me and mine are in any way sainted, top notch healthy people (despite having 9 RN's across the tree).   Myself, and many of the people I love, are living with the result of bad choices or unwillingness to change old habits, and some of those very loved people have died. 

With those honest to God true points made,  I can get to the point of this review, and that is, before I sign off of nursing, I would like to share some information and ideas in case someone might have a better outcome.  

Given the volume, this will have to be a brief but packed bit of information.  Let's start at the top and work our way down. 

No hair tips for you but, take care of your head and your brain. Very simply, if you are doing some activity which you know could lead to a head injury, at least wear a helmet.  I bet you think that is idiotically simplistic but, hand to heart, I have seen the helmet in place saves and I take care of the no helmet in place people. 

 No kidding folks, there are a lot of families and caregivers out there looking after a whole lot of people suffering the life long results of “if they had only…”. 

Let's throw in your emotional well being while we are up here.  I'm not a good touchy, feely kind of person but working on being happy with your life and lot goes a long way towards good health.  In the course of years of people observation, the roll with it attitude and realization of how much a person has (however little in the scope of our supersized world) is some of the best medicine on the market, very few side effects too. 

Travel on down to your spine. Treat it well. Work to keep it in place or, if you do some damage here, find a way to recover it and prevent more damage. The ability to stand up, walk and comfortably accommodate other positions, via this stacked but curvy tower, is worth thinking about. 

Continuing on, let's talk heart, lungs, liver, pancreas, guts/bowel and the like. Let me step back and control my inner nerd here.  Oh-my-gosh people!  If you want to take the time to study any of those organs you would be BLOWN AWAY at how magnificent they are.  If you are fortunate enough to start out with healthy innards, many of them come with back ups and fail safes but, don't be fooled, even those practical parts have a warranty. 

A healthy heart is so spectacularly made that you don't even know how much it takes care of you.  Do your best not to over eat it into having clogged arteries or, the equally popular alcohol and caffeine saturation of it into faulty stops and starts. If, by the time you read this you have inadvertently damaged it, go get help.  Remember that comment up there about the heart being spectacularly made, under the right circumstances and, with qualified medical care, you can find out for yourself then, spread the word. 

There is no other way to say this- DON'T SMOKE, DON'T VAPE, and beware of what is in your environment that will also be inhaled into your lungs.  Side note here, the lungs are not the only system affected when a person inhales crap into them.  That nastiness travels to your blood stream then affects your blood flow system.  One of the saddest situations I ever saw was a 40ish year old man slowly losing his limbs, nose and jaw to a vascular disease initiated via cigarette smoking.  It's real people and it is gruesome. 

Treat your liver and pancreas well. If you don't, they will surely let you know how miserable their slow destruction can make you feel.  In my personal opinion, (and not that I am promoting a cancer diagnosis) but, Diabetes is one of the most heinous diseases and is often one of the most preventable whereas,  Cancer can often be treated into remission or cured.  

Pay attention to your guts.  No one needs to obsess over their poop but that stinking excrement says a lot about your health.  Have at least some idea of what your particular normal is so when you have a big change (color, odor, consistency, BLOOD) you will know to go get help. It's embarrassing stuff but better to be embarrassed than dying of bowel cancer. 

While we are in the lower vicinity, let's contemplate treating your bladder and sex organs with some consideration.  Are you peeing enough urine and is it light yellow vs. dark yellow, brown or red? If you are having sex, are you staying protected and, if not, are you getting some help for the pain, itching or drainage that has resulted.  Again, embarrassing stuff  but we all have these parts and, especially in this day and age, they are well discussed except when it comes to them needing some medical assistance.  It's okay.  Call or go in and say the words.  You will feel so much better for having followed through. 

Let's get a little tangential so we can cover a bit more territory, before the upcoming last paragraph (aka, my retirement).  Are you practicing nutritional self abuse, or overeating?  Well now would be a good time to learn about portion size and self control.  What an odd group of beings we are when the very thing that should be fueling our good health is instead causing so much grief.  The British used to refer to larger people as stout and Americans used to say portly or “full figured.”  Well folks, those adjectives cannot be applied to the epidemic of obesity which seems to be a hot ticket goal.

Without getting too weighty (sorry, told you I'm not very touchy feely), your joints, your organs and your life are all suffering when the simple effort of portion control, basic exercise and general self control are chronically ignored.  Come on people!  Don't let yourselves live in a bariatric version of the Emperor's New Clothes.  We are not just fat, we are massive and lazy, especially when it comes to the simplest things like reasonable caloric intake, holding in our stomach and standing up straight. 

Continuing the tangent, let's talk health care and the help you might need.  It's not pretty folks.  

Fewer and fewer people seem interested in pursuing health care as a career. Even if those altruistic souls are out there trying to get into the few programs available, and affording the tuition, the competition for jobs where a person can sit at a desk, in their home and make outrageous amounts of money makes the appeal of dealing with humans at a, let's just say,  very personal level lose its appeal by the second.  

From a Home Health point of view, it is becoming more and more difficult to safely navigate travel to and from patient homes, not to mention that the homes vary tremendously.  Patients are occasionally being treated for health problems in their cars or in hotel rooms because that IS HOME.   I won’t elaborate on that mammoth problem here but know it is a day to day reality in most cities. 

Consider the people you are surrounded by.  Do you have a good friend who will hold your beer while you…?  If so, will that same friend step up and tell you what a stupid idea that might be, and stop you or, would they be willing to help you out with dressing changes or, better yet, changing the urinary catheter that might become your very own in certain catastrophic outcomes.  

Do you get along with your family?  If so, great, keep that connection and be an equal opportunity support person.  Some of the dearest scenarios I have seen involve a loved, or loving, family member getting gold standard care. Some of the saddest situations happen when there is “no one” to help and money is limited. 

Oh my gosh. So much more to say and, actually feeling a little choked up at the finality of this liturgy but, my time grows short. 

I had a professor once who opened a lecture with the words, “This is the unimaginable future.”  His delivery of that line gave me chills and has stayed with me on a daily basis. With those words in mind, I know I have helped people during my nursing career and likely I have let some down.  Regardless, I send out to anyone who takes the time to read this my sincere hope that you will look at yourself, see where you can make a positive, healthy change and, if at all possible, avoid the minefield of a preventable and debilitating disease.  If you get knocked down by an unavoidable health crisis, may you be served by the good hearted people of medicine and may you acknowledge their efforts in response. 

Today IS your unimaginable future.  Plan for it and be well.