as soon as i think i've finally run out of tears, i'm hit with a rushing flood.

couldn't have said it better :)

beep. beep. beepbeepbeep. beeeeep.

i'm clearly pretty terrible at keeping this thing updated. oops. maybe i should work on it.

i suppose i could do a better job keeping track of all the things cardiac related - things in that area are all kinds of crazy! or i could track just how painful it's been trying to get a job...but other than saying i keep hearing "no", there's not much to say. you're caught up. haha. (ps - on that note, anyone looking for an incredibly awesome peds RN? hit me up.)

it'd be more exciting to write about the other things i'm doing while waiting for a job to appear. (that makes it sound like i've just been waiting for one to come to me - know that's not the truth. i stopped counting the number of applications i've submitted after #265)

maybe i'll make it my goal to document the fun hobbies and projects i've been working on since graduating nursing school. in the mean time, i'll update below about where things are health wise...since that's kind of how this all came to be anyways.

since my pacemaker was implanted last march, i've developed a rare complication called pacemaker syndrome. unfortunately, my cardio np said that it's good in that it's not life threatening, but it's bad in that it really just makes you feel like crap. to which i attest to the truth behind that. sigh. we've been trying to find a balance between my metoprolol and flecainide and the settings on my pacemaker. what we're trying to combat is the retrograde arrhythmia that has developed. there's also suspicions that i've got another accessory pathway causing troubles. if you've read the last few posts from forever ago you might remember that i grow accessory pathways like crazy.

we're really hopeful that the increase in meds & higher pacer rates will be enough to keep the arrhythmia in control to where it's not bothersome. it's hard trying to be productive when i keep getting dizzy & have chest pain. we've got some plans in case this course doesn't work, but i'm crossing my fingers that it does. the last option would be another cath/ablation - but because i've been so incredibly overablated i'd have to go out of town to get it done :/

we'll see what happens i suppose.

this is the song that never ends...

...it goes on and on my friends...

i spoke with the NP from EP (ha.) about the swelling in my arm since my pacemaker was implanted. the last time we spoke, the ruling was the increase from 1 baby aspirin a day and a trial blood thinner to just 1 full aspirin a day (325mg vs 81mg).

it helped some, not enough. the verdict is i'm either throwing intermittent clots (since my ultra sound the other day didn't show a stable one) or it's due to my subclavian vein being notably small. it could be causing insufficient venous return.

the game plan:

increase to 2 full aspirin a day until monday. i'm to watch and document episodes of swelling.

if that doesn't work, we'll go back on a blood thinner (most likely plavix)

if thaat doesn't work, we'll go onto coumadin. the reason we're waiting until almost last ditch for that one is due to me being only 24 and still having a relatively active life. she doesn't want me having to worry about diet, activity, etc if we absolutely don't have to.

those are our pharmacological efforts that we're using as diagnostic methods really. should they not work, we know it's def insufficient return due to vein size and there being the two wires in there.

to fix that? we're lookin at invasive methods. either removing one lead and using a different route for that one; taking them out from an internal route and placing them on the outside of my heart; and the last option being a subclavian vein balloon angioplasty.

i'm really really hoping for the pharmacological methods to do the trick. i was REALLY trying to make it one semester of school without being sent to the cath lab or the OR!

EDITED TO ADD:

oh, i also went and had my CT today to R/O a pulmonary embolis. i knew i didn't have one, but due to being so short of breath lately and this whole swelling debacle, they wanted to just double check and have assurance. they got it; no PE! it was confirmed, once again, my veins are shot though. it took longer to get an IV in than the to get the whole scan. oiy.

60 to 100.

what a week.

i had some troubling symptoms the last - oh, i don't know - couple weeks? maybe a month.

i called my cardiologist...i knew individually they could have been/be anything, but coupled together? my instincts said call cardio.

i was supposed to be on 6 months between appts with my regular cardiologist, 3 months with my EP.

i made it a month between EP appts, and 3 months now with cardio. sigh.

anyways. after discussing symptoms at length with him, and reviewing meds, we made a plan.

echo.

blood work.

chest xray.

all relatively standard, but i had a stat in office echo for him to review later that night, and then the rest today.

i go back in a week. as his assistant told me, "oh, you must be acting up."

from what i could tell, and what the tech could tell me, my echo showed tricuspid regurg, mostly likely to my pacemaker.

and speaking of pacemaker, i'm now paced 100% of the time. that's up from 60-70% just in march when they implanted it.

few thoughts on that:

1) i'm super thankful i pushed my new EP to implant it, this proves it was, in fact, necessary.

2) not only is my degeneration of my sinus node extremely rare for someone under the age of 60, it's severe. it's supposed to take years and years to progress as rapidly as mine has in 2 months.

the plan is to review size/function of my heart, chemistry levels and kidney function, and compare my chest xray from the hospital stay in march to see what my sneaky lungs are up to.

my cardiologist has a few ideas as to what's going on, but he isn't 100% certain on any of them. he even said he's kinda stumped. swell.

we'll see what the plan is on wednesday. in the meantime - it's thinking happy thoughts and realizing all of this has already been committed and known by God.

'he heals the brokenhearted and binds up their wounds. he determines the number of stars and calls them each by name. great is our lord and mighty in power; his understanding has no limit.' - psalm 147:3-5

safe in Your arms.

to the one who's dreams are falling all apart

and all you're left with is a tired and broken heart

i can tell by your eyes you think you're on your own

but you're not alone

have you heard of the one who can calm the raging seas

give sight to the blind, pull the lame up to their feet

with a love so strong He'll never let you go

oh you're not alone

you will be safe in His arms

you will be safe in His arms

cause the hands that hold the world are holding your heart

this is the promise He made

He will be with you always

when everything is falling apart

you will be safe in His arms

did you know that the voice that brings the dead to life

is the very same voice that calls you to rise

so hear Him now, He's calling you home

you will never be alone

these are the hands that built the mountains

the hands that calm the seas

these are the arms that hold the heavens

they're holding you and me

these are the hands that healed the leper

pulled the lame up to their feet

these are the arms that were nailed to a cross

to break our chains and set us free

you will be safe in His arms

you will be safe in His arms

cause the hands that hold the world are holding your heart

this is the promise He made

He will be with you always

when everything is falling apart

You will be safe in His arms...

alto.

The TV is talking
The telephone’s ringing
The lights are all on
And the radio’s screaming
A million distractions are stealing my heart from You
I’m tired and empty
This life is relentless
It weakens my knees
And breaks my defenses
It’s wearing me down and I’m desperate to hear from You

Stop the world I wanna get out
I need an escape away from this crowd
Just to hear You speak to me

I need to be still before I make a move
I need to be humble with nothing to prove
I need Your Word to show me the truth
And I need time, precious time

Stop the world I wanna get out
I need an escape away from this crowd
Just to hear You speak to me
Stop the world I’m ready to listen
Show me sign, give me a vision of heaven
I can hold on to
Stop the world I need some time with You

Before I can find my voice
I need to hear Your voice
Above all the senseless noise

compassion...

A student asked anthropologist Margaret Mead for the earliest sign of civilization in a given culture. He expected the answer to be a clay pot or perhaps a fishhook or grinding stone.

Her answer: "A healed femur."

Mead explained that no mended bones are found where the law of the jungle, survival of the fittest, reigns. A healed femur shows that someone cared. Someone had to do that injured person's hunting and gathering until the leg healed. The evidence of compassion is the first sign of civilization.

-taken from "Nurses: 2011 Desk Calendar"

prizes!

head over to Carolina Carters Blog to check out a chance to win a CSN gift card!

it'd be cool to have $35 card to use on virtually aaaanything.

seriously. derrick's mom talked about swingsets, garbage cans, other people had mentioned l-shapped desks even!

csn stores have just about anything you can imagine and then some.

so what am i leaning towards if i win the gift card?

well. i need some new shoes for when i'm done w/ clinicals and am working as a floor nurse. the beauty of thaaat is that i don't have to stick with white. i can branch out. so i'm leaning towards these bad boys. brace yourself. remember nursing shifts are at least 12 hours. usually more. they're a new level of sexy...haha. they're comfy. and that's what i'm going for. i'm in it to save lives. you'll thank me when it's your baby's life i'm saving ;)

i think this set is super cute too. but $35 doesn't put a huge dent in the super expensive price tag. i'd have to find a twin at ikea instead =)

those are two of my ideas. i mostly like the shoes best. haha, plus they're def cheaper on csn than if i were to go to the scrubs store and buy them. and that's an idea i like!

so head over to carolina carter's and enter for a chance to win! or don't...that way i have a better chance =)

starting from scratch.

i met with my new EP this week.

i'm "tricky" and "complicated".

unfortunately he says so much has been done during all the cath surgeries and ablations that it's hard to tell what's good data to go off of and what's not...so for these first 3 weeks, he's adding more meds to try and control the arrhythmias and collect the even more recent monitor print outs i've had. then, he'll either base his next moves off those, or he'll collect his own.

part of him believes he will find i have the dueling pacemaker business going on again and that the normal sinus node is not behaving like it should. and by "behaving" they mean working. a relatively scary thought. it tends to be lazy and take a few seconds to kick in when it needs to. performance anxiety, lol.

i'm torn and frustrated. he brought up the potential for a pacemaker should he find that there's damage or defect to my sinus node (which he said seems highly possible). however. he said he'd also like to see medication manage that if entirely possible due to only being 23 and active; that i'd be dependent on this device for life and what kind of life would that be having to go in every 7-9 years for lead and battery replacements and the worry for infections, etc etc.

i wish i knew how to stress to these guys that. here i am, 23, spending every 3-4 weeks in countless doctor's offices, shoving pills into myself that VERY few 23 year olds do, i'm miserable. i have insane chest pain, i can't live a normal active 23 year old life. i want to be able to run without getting so tired, to not have to so methodically plan out my day around what i'll be able to physically handle.

so really.....what amount of "normalcy" are they trying so hard to preserve? as far as i'm concerned? it's been long gone.

a look back...

2010 was a rough year.
i told myself i was going to do my best to find positive events and happenings in each month and not dwell on the crappy hand i was dealt the last half of the year. let's see...

JANUARY:
i started nursing school!!! (and yes. it freaking rocks)

FEBRUARY:
heart disease and CHD awareness month. LOTS of hearts and LOTS of walks =)
i went to ohio! and saw grammy and snow and family.

MARCH:
cardiac cath ablation #4. semi-successful. we went from SVT/tachycardia to bradycardia and passing out.

APRIL:
open the discussion of the potential need for a pacemaker.

MAY:
finish my first semester of nursing school, seemingly as quickly as it started!

JUNE:
summer school. yawn.

JULY:
summer school. yawn.
all kinds of tests and scans are run to try and figure out why i was having all kinds of chest pain.
scans come back clean, was even told my arteries were spectacularly clean. pass the fried chicken.

AUGUST:
block 2 starts! (which will end up being the semester from hell...)
Theo got implanted - my loop recorder (which will end up being the device from hell...)

SEPTEMBER:
spend the entire month on antibiotics since my incision had yet to close.
clinicals in the hospital start - real patients, real nursing skills.

OCTOBER:
back to the cath lab to have a pocket revision of Theo - infection "hadn't reached" the monitor yet (i will later find out that wasn't true...)

NOVEMBER:
Theo finally has to come out as the incision STILL hasn't closed.
the next week infection spreads quickly and i spend 3 days in the hospital on IV antibiotics.
have an I&D and become a wound care patient.

DECEMBER:
BLOCK 2 IS OVER!!
still a wound care patient - what was to be 2 weeks of healing and packing is quickly 4+.
find a surgeon who cares enough to follow up and he closes my incision! after 5 long months, it's closed.
heart arrhythmia is still there. getting worse. i lose hope that "my body will adjust" to newer rates after march's ablation.
find new ep. haha.

the last 5-6 months sucked. i can't deny it. but. it's all looking up from here....let's see if we can't have a better 2011.

my own Jingle Bells

ooooh, SVT, SVT,
how i hate your guuuts!
you make me hurt,
and cannot breathe,
and i really wish you'd goooo!

oh! SVT, SVT,
i think you really suuuck!
i thought you'd left,
but you're still here,
always bothering meee!

i hate chd.

it's always wondering, "why me?"
it's looking at others who are just like you, seeing they are worse, but still feeling bad.
it's no one ever understanding: you look good, you look fine and healthy and when people see you, they don't even know you're sick.
it's them wondering why you're sitting out.
it's them wondering why you never do the normal things people your age do.
it's them thinking you're lazy.
it's them knowing that you're sick and still wondering why the hell you're sitting down all day.
it's them thinking you're faking it.
it's the feeling you ARE faking it.
it's them not believing.
it's feeling so tired, and so bad, but you can't express the feelings to anyone, not even yourselves sometimes.
it's worrying.
it's knowing that everyday you could be getting worse.
it's never knowing when something will go wrong.
it's that feeling inside that something is wrong and the fear of what now...
it's never knowing if the cough will turn into full blown pneumonia.
it's the scar, knowing you should love it, knowing it's there and it saved your life and it's loving it.
it's the medicine you take everyday
it's the new lifestyle you have to learn because of it.
it's the side effects of the medicine, the bruises, the need to pee, and even headaches and nausea.
it's the pain.
it's the rapid heart beats that just come out of no where
it's sitting still, breathing, trying to wait it out.
it's taking deep breaths that hurt.
it's having to do breathing treatments.
it's the cost of the medicines, the cost of the doctors.
it's fear.
it's the emotions you feel watching your loved ones having to go through these emotions with you.
it's the fact you see how hard your spouse, parents, siblings, children all want to help, but can't.
it's the upcoming years of knowing the long term effects of it.
it's the depression that no one understands.
it's the days you spend in bed because you're so exhausted for no reason.
it's the sadness you feel when you see others doing all the things you want to do but are told no from your doctor.
it's the love you get from strangers.
it's the instant connection you feel with complete strangers.
it's life.
it's the fight.

peds is hardcore.

“this is not general surgery in miniature. these are tiny humans. these are children. they believe in magic. they play pretend. there is fairy dust in their iv bags. they hope. and they cross their fingers. and they make wishes. and that makes them more resilient than adults. they recover faster. survive worse. they believe. in peds we have miracles and magic. in peds anything is possible.”

dear PSVT, PVCs, angina, and migraines,

i am sleepy. i would like to sleep. asking too much for you to go away occasionally? i think not.

thanks.

yours exhaustedly,

me.

a good friend is like a good bra...

...it's all about the support.

“This guy’s walking down the street when he falls in a hole. The walls are so steep he can’t get out. A doctor passes by and the guy shouts up, ‘Hey you. Can you help me out?’ The doctor writes a prescription, throws it down in the hole and moves on.

Then a priest comes along and the guy shouts up, ‘Father, I’m down in this hole can you help me out?’ The priest writes out a prayer, throws it down in the hole and moves on.

Then a friend walks by – ‘Hey, Joe, it’s me! Can you help me out?’ And the friend jumps in the hole. Our guy says, ‘Are you stupid? Now we’re both down here.’ The friend says, ‘Yeah, but I’ve been down here before… and I know the way out.’”

there are plenty of pitfalls, random potholes, or slippery slopes in life. what makes all the difference is the support you lean on and look to.

loop-de-loo

it looks as though everything comes full circuit (ha, no pun intended...) cardio related. today was my follow up cardio appointment and, after looking over everything, and considering the newer symptoms that have begun causing the chest pain, my doc is convinced it's all electrical.

cool.

the problem with that? well. we thought we had covered, and FIXED, everything electrical.

that being the case...i go in friday to discuss this bad boy:

it's called an 'implantable loop recorder'. fancy, huh? haha. it's a quick, easy, relatively simple surgery. that lil sucker goes into a doctor-made pocket in my upper chest, just beneath my left collar bone. it'll hang out there for....weeks, months, even years if needed. it's like a 24/7, 365 EKG (electrocardiogram). i'd go in every few weeks or month and have everything downloaded and looked at. if i have symptoms i can go in earlier.

that's just 1 doctor's recommendations. it'll ultimately come down to the discretion of my EP (electrophysiologist. he's like an electrician for my heart).

so, who knows?

either way...i'm ready to get back (ok, ready to start) feeling good.

from the trenches

"then it came to me. not the idea that 'things could be worse' - because i agree that being in a concentration camp would be "worse" than having your patient bleed out in pittsburgh - but that, the relative worseness of particular situations, is irrelevant. what comforted me while one prisoner beat another to death in "The Counterfeiters" was the realization that, with so much cruelty in the world, all any of us can do is try to make our own piece of it better. the violence and the cruelty, the illness and the blood, will not stop. but i can put my hand on my patient's shoulder and ask if she's in pain. i can look into her eyes as she dies and then try to pump life back into her. i can offer up my own hope, regardless of how futile that hope is, and whenever it is needed, keep offering it. i can, within the limits of my own life and limb, always try."

-excerpt from Critical Care by Theresa Brown, RN

-emphasis mine

'normal'

i know i should be relatively thankful that all test results came back normal...and on one hand, i totally am.

but on the other hand. i'm pretty sure finding the something that has been the cause of all this, and that something being a thing that can be actually fixed...yah, i'm pretty sure that'd be more settling at this point.

for the time being (until my real doctor comes back and i see him in 3 weeks) we're calling 'this issue' a matter of costrochondritis. it sounds much cooler than it really is, i promise.

treatment? high doses of ibuprofen. rest. cold/heat applications. no heavy lifting. patience. (it should also be known that at this point in the appointment, when the doc asked if i had tried any of these and gotten relief, i said yes. tried them all. and gotten absolutely zero relief. he looked puzzeled. awesome.)

so much patience is needed, in fact, that it can take months to feel any sort of relief. i guess i could be happy about that, considering we're entering month 5 as of tomorrow.

i think i'm MOST happy to report that, in many cases, it's often recurrent.

good. i was hoping this was something that would remain with me for eons.

on the upside? my arteries are unremarkably healthy. sweet - pass the bucket of fried chicken.

you know you can relate....

-I wish Google Maps had an "Avoid Ghetto" routing option.

-Have you ever been walking down the street and realized that you're going in the complete opposite direction of where you are supposed to be going? But instead of just turning a 180 and walking back in the direction from which you came, you have to first do something like check your watch or phone or make a grand arm gesture and mutter to yourself to ensure that no one in the surrounding area thinks you're crazy by randomly switching directions on the sidewalk.

-I totally take back all those times I didn't want to nap when I was younger.

-Is it just me, or are 80% of the people in the "people you may know" feature on Facebook people that I do know, but I deliberately choose not to be friends with?

-Do you remember when you were a kid, playing Nintendo and it wouldn't work? You take the cartridge out, blow in it and that would magically fix the problem. Every kid in America did that, but how did we all know how to fix the problem? There was no internet or message boards or FAQ's. We just figured it out. Today's kids are soft.

-There is a great need for sarcasm font.

-I think everyone has a movie that they love so much, it actually becomes stressful to watch it with other people. I'll end up wasting 90 minutes shiftily glancing around to confirm that everyone's laughing at the right parts, then making sure I laugh just a little bit harder (and a millisecond earlier) to prove that I'm still the only one who really, really gets it.

-How the heck are you supposed to fold a fitted sheet?

-I would rather try to carry 10 plastic grocery bags in each hand than take 2 trips to bring my groceries in.

-The only time I look forward to a red light is when I’m trying to finish a text.

-Was learning cursive really necessary?

- Lol has gone from meaning, "laugh out loud" to "I have nothing else to say".

- Whenever someone says "I'm not book smart, but I'm street smart", all I hear is "I'm not real smart, but I'm imaginary smart".

- How many times is it appropriate to say "What?" before you just nod and smile because you still didn't hear what they said?

- Every time I have to spell a word over the phone using 'as in' examples, I will undoubtedly draw a blank and sound like a complete idiot. Today I had to spell my boss's last name to an attorney and said "Yes that's G as in...(10 second lapse)..ummm...Goonies"

- While driving yesterday I saw a banana peel in the road and instinctively swerved to avoid it...thanks Mario Kart.

- MapQuest really needs to start their directions on #5. Pretty sure I know how to get out of my neighborhood.

- Obituaries would be a lot more interesting if they told you how the person died.

-Shirts get dirty. Underwear gets dirty. Pants? Pants never get dirty, and you can wear them forever.

-I can't remember the last time I wasn't at least kind of tired.

-Can we all just agree to ignore whatever comes after DVDs? I don't want to have to restart my collection.

-I'm always slightly terrified when I exit out of Word and it asks me if I want to save any changes to my ten page research paper that I swear I did not make any changes to.

- "Do not machine wash or tumble dry" means I will never wash this ever.

-I hate being the one with the remote in a room full of people watching TV. There's so much pressure. 'I love this show, but will they judge me if I keep it on? I bet everyone is wishing we weren't watching this. It's only a matter of time before they all get up and leave the room. Will we still be friends after this?'

-I hate when I just miss a call by the last ring (Hello? Hello? Dang it!), but when I immediately call back, it rings nine times and goes to voicemail. What'd you do after I didn't answer? Drop the phone and run away?

- I hate leaving my house confident and looking good and then not seeing anyone of importance the entire day. What a waste.

-I like all of the music in my iTunes, except when it's on shuffle, then I like about one in every fifteen songs in my iTunes.

-Sometimes I'll look down at my watch 3 consecutive times and still not know what time it is.

-I keep some people's phone numbers in my phone just so I know not to answer when they call.

-Even under ideal conditions people have trouble locating their car keys in a pocket and Pinning the Tail on the Donkey - but I’d bet you anything that everyone can find and push the Snooze button from 3 feet away, in about 1.7 seconds, eyes closed, first time every time...