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Cats: Not to be Trusted

Image

Please note: No cats were hurt in the writing of this blog post.

My daughter’s dog has a cat. He loves his cat. Yes, that’s his picture above. He’s grooming his cat. He enjoys it. The cat appears to enjoy it too.

There are many things I love about sharing a house with my daughter. I love how she accentuates the positive. I love how she tells my inner mean girl to shut up. I love that she pay attention to what I have to say. I even love her dogs.

I just hate her dog’s cat.

Cat

Cat (Photo credit: @Doug88888)

It’s bad enough that cats cause depression, use litter boxes, and indiscriminately kill birds and rodents, but her cat sneaks into my office late at night when I’m asleep and messes with my stuff.

At first I blamed the dogs (cats are expert at shifting blame), until I realized if one of the big dogs leapt onto my desk it would collapse and the mini beagle can’t jump that high. No way dogs were dancing on my desk at night and leaving my papers in a disarray. My suspicions were confirmed the morning I opened my office door to find the cat guiltily looking up from a pile of papers. He fled through a secret entrance back into his bedroom before I could react. After I picked up the papers and straightened out my desk,  I found the cat pee.

Luckily he missed the laptop, kindle and ipad. His watery destructiveness was limited to the desktop calendar, my favorite Grammar Girl book, and a few pages of miscellaneous  notes. Enough to tick me off, but not enough to ruin my day.

Kattenbak

Kattenbak (Photo credit: Wikipedia)

And it certainly didn’t ruin the cat’s day, mainly because cat’s are hard to discipline.

A dog will drop into a submissive pose and look guilty even if he isn’t. A cat won’t.

A dog will understand he’s done something wrong and attempt to worm his way back into your good graces. A cat doesn’t.

Cats are resistant to having their nose rubbed in something, their snouts lightly tapped, or hearing the words “bad cat.” Almost like their egos are so large they can’t conceive of doing wrong. Cats are very egocentric, possibly sociopathic.

Which is why, in spite of the cat’s bad behavior, I’ll take no further action than to block his secret tunnel. As the bad boys of domesticated animals, I can’t spend the rest of my life looking over my shoulder and wondering how he plans to take his revenge. You know, like entwining himself in my feet as I descend the stairs or pinning me under the blankets and smothering me. And that’s only the cat tricks I know about. Imagine how many devious little feline machinations remain secret.

On second thought, don’t imagine that. If you do and there’s a cat in your house, you’ll never sleep well again. And if there is a cat in the house, sleep with one eye open. Cats aren’t to be trusted.

(Evil) cat

(Evil) cat (Photo credit: zven-ug)

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Can You Hear Me Now?

Vaseline Glass Bowl-Hat

Vaseline Glass Bowl-Hat (Photo credit: Paul Garland)

When I was younger, I thought wearing glasses was the biggest humiliation I would have to suffer. Without glasses I can’t see the computer screen I’m sitting in front of, but glasses have a downside. In cold New England a walk from the chilly outside to toasty inside results in a thick layer of condensation that renders glasses wearers temporarily blind. In the summer, going from air conditioning to humidity does the same thing. Aquatic endeavors require a decision to either see what’s going on (my preference in a lake) or swim blind (my preference in the ocean. I believe if I don’t see the shark, it won’t see me).

PhotonQ-Under the Shark

PhotonQ-Under the Shark (Photo credit: PhOtOnQuAnTiQuE)

I’ve made my peace with wearing glasses, but now I’m confronted by a problem many of my fellow baby boomers are also facing,  hearing loss. Yes, we didn’t wear helmets when we biked/skied/played sports and we didn’t wear hearing protection when we shot guns, listened to our Walkmans at full blast, or spent time in noisy environments. Our youthful ignorance of the damage caused by loud noises has led to an explosion in the number of baby boomers with hearing loss.

The National Institute for Health reports that 18% of adults in the 45-64 year old category, have hearing loss. The percentage of Americans with hearing loss increases in the 65-74 year old group to 30%, and for adults over 75, a whopping 47% of them are struggling to hear.

How many of those hearing impaired people are wearing hearing aids? Less than 15 percent. There’s a lot of people out there who have no idea what you’re saying.

Seems like a minor problem until you read the early studies that indicate adults with hearing loss are 3 to 5 times more likely to develop dementia than those with normal hearing.

Scary.

So why don’t we embrace hearing aids in an attempt to increase our thinking skills and ward off dementia (as well as not blowing out the volume controls on the TV)?

Hearing aid

Hearing aid (Photo credit: Soitiki)

Maybe it’s because hearing aids are equated with old people and we’re a nation dedicated to never growing old.  Not all of us can afford facelifts, botox, or tummy tucks, but we can dye our hair, buy anti-wrinkle cream, and pretend we can still hear.

And most people don’t know how much sound they’re missing. When I trialed hearing aids, I couldn’t believe what a noisy house I lived in. The refrigerator cycled on and off, the dryer had a strange squeak, and with the windows open I could hear my neighbor’s children playing outside. All sounds that hadn’t existed for me before the hearing aids.

I wanted to turn the volume down.

But without hearing aids I struggle to carry on a conversation in certain decibel ranges. I lean in closer and keep a semi smile on my face because I’m not sure if the correct response is to laugh or to  cry. Most of the time I can piece together what’s being said through context, but once in a while I can’t. It’s embarrassing when someone asks me a question and I don’t understand enough words to even guess what they’re saying. It’s like suddenly I’m hearing a foreign language and my ears can’t process it.

As easy as it is to downplay hearing loss or make a joke about it, the sad truth is that it has a profound effect on quality of life and, it seems, the risk of dementia. Maybe instead of being fixated with the idea that wearing hearing aids makes us old, we should think about all of the sounds we miss without them. If it’s a choice between hearing my daughter whisper “I love you” as she leaves the house or looking and feeling old, I think I’m going to choose to hear.

There’s only a finite number of “I love you’s” we’re privileged to hear and I’d like to hear every single one of them.

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I’m a Nurse, not a Saint

Priest

Priest (Photo credit: Wikipedia)

I am continually amazed and astounded by the things patients feel comfortable saying to me. It’s as if they think a nursing degree is equivalent to a counseling degree, a white set of scrub pants akin to a white collar, and a hospital or outpatient clinic room is the same as a confessional. It’s not.

Confessional

Confessional (Photo credit: cliff1066™)

Don’t mistake my words for a renunciation of confidentiality. My lips are sealed when it comes to protected health information and you, but, as in real life, there are times when people provide too much information. I’ve provided some examples so you can judge whether you need to be a little more discreet on your next hospital or doctor’s visit.

When I ask you to undress down to your underwear and cover yourself with a sheet, you don’t need to tell me, “I don’t wear underwear.” That is a surprise best left for the doctor. I’m not coming back in to check that you disrobed appropriately.

If I ask you to take off your shoes to be weighed, don’t apologize for the holes in your socks. Our office is only responsible for checking sock holes on alternate Thursdays in months that end in -Z. Any other time, don’t worry. We won’t be putting it in your permanent record nor will I be calling your mother (or the Emergency Room) to rat you out.

If I come in with an shot for your child, don’t tell them it won’t hurt. Chances are it will. I’ll try to minimize the pain, but since I can’t tell them to “suck it up, buttercup,” I’m hoping you’ll have your big girl panties on and shush them rather them tell them you’re sorry the “mean nurse” hurt them.  The mean nurse can’t do shit unless you give me permission, but I’m not telling your toddler “your mean mom made me do it.”

If I do a cervical check on your pregnant girlfriend, don’t ask her if she’s enjoying it. She’s not. Neither am I. Creep.

Never ask me to rub “extra hard” down there if you’re unable to clean yourself off. There are non-medical devices and non-medical personnel who can meet your needs much better than I can. Once you ask, the only “happy ending” I’ll think of is your discharge or death.

Don’t ask if you can strip down to your underwear to ensure your weight is “accurate.” I personally don’t want to see you half naked and believe stripping down for non-medical reasons should happen in your home, not in the exam room.  You can buy your own scale for the cost of a co-pay.

Going Down?

Going Down? (Photo credit: billhd)

Don’t expect me to believe that you need an early refill on your methadone, oxycontin, oxycodone, percocet or vicodin because the bottle you just filled fell into the toilet with the cap off, ruining all of the pills. Unless a major study at a prestigious medical center proves that toilets have a preference for narcotic painkillers, I’m suspicious. This never happens to anyone’s heart, allergy, or diabetic medicine. If you have to lie, go big or stay home. Don’t let drugs kill your creativity.

Remember I’m a nurse, not a saint.

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Forget Florida, Vacation in New Hampshire

Living in New Hampshire is boring. Our weather leans heavily to cold, ice, snow, and mud interspersed with brief bouts of sunshine and black flies. We rarely get hurricanes, tornadoes, or earthquakes. When we do, we’re usually too busy doing something else to realize it until we pick up a newspaper or watch the Weather Channel. Our climate is ill-suited to man-killing gators or lions. We post warnings about moose (deadly if hit with a car) and bears. The bears don’t scare us, we just want out-of-staters to know we’re hard-core. Probably the most fearsome creature in New Hampshire is the skunk.

 

Striped Skunk

Striped Skunk (Photo credit: Wikipedia)

 

Our relative lack of natural disasters and scary predators leads many of our citizens, myself included, to regard the other 49 states as a veritable smorgasbord of danger and potential death. Still, many of our snowbirds make an annual trek to Florida, and most of them make it back alive. Even so, I believe that Florida is the most dangerous of the fifty states, ill-suited to a restful vacation.

 

Reason #1 – Sinkholes

 

Sure, there are sinkholes in other places, but Florida’s devour people in bed and make houses disappear. No way I can get a decent night’s sleep waiting for the earth to open up and swallow me whole.

 

sinkholetype-near-map

 

Reason #2 – Pythons

 

It’s estimated that the Florida Everglades is home to over 150,000 Burmese pythons. Florida’s recent Python Hunt captured 68 of them. Burmese pythons are among the largest snake species, growing to 7 feet or more and weighing up to 200 pounds. They hang out in trees, until they become too large to be airborne, and then they slither along the ground, strangling and swallowing whole small mammals and birds. In Florida, if the sinkhole doesn’t swallow you, a python might.

 

Python

Python (Photo credit: Aoife Cahill)

 

Reason #3 – Hurricanes

 

Florida’s hurricane season runs from June 1st to November 30. In the twentieth century,  158 hurricanes hit the US. Florida had the most landfalls at 57.  In 2004, Florida played host to four hurricanes. If the nature of tornadoes is to find and destroy trailer parks, the nature of hurricanes is to find Florida.

 

The MODIS sensor aboard NASA's Terra satellite...

The MODIS sensor aboard NASA’s Terra satellite captured this true-color image of Hurricane Charley on August 13 at 12:35 p.m. EDT. At the time this image was taken Charley was rapidly gaining strength and would reach category 4 status just 90 minutes later. Maximum sustained winds at 2:00 p.m. were at 145 mph and Charley was moving towards the north-northeast at 20 mph. (Photo credit: Wikipedia)

 

Reason #4 – Disney World.

 

Cinderella Castle in the Magic Kingdom at Walt...

Cinderella Castle in the Magic Kingdom at Walt Disney World. (Photo credit: Wikipedia)

 

Disney World is ground zero for a viral or bacterial apocalypse. Hordes of people eating junk food and suffering sleep deprivation, jammed together for hours in rides, lines, and around Goofy are the perfect fuel for a terrorist attack. Once released into the depressed immune systems of Disney-goers, a short incubation period should help spread the disease as vacationers crowd into airports, roadside diners, trains, and cruise ships. I have seen this apocalypse (in my dreams) and curse Disney World in advance for the demise of civilization.  Watch out for the coughing guy in a wheelchair, he’s patient zero.

 

Reason #5- Super-sized mosquitoes

 

The Midwest has locusts, the Northeast has black flies, but Florida is gearing up for an invasion of giant mosquitoes. Hungry mosquitoes, the size of a quarter, will make Florida an even more uncomfortable place, with or without insect repellant. Think of the sheer expanse of flesh available to Florida’s mosquitoes. Flesh exposed on beaches, golf courses, and in convertibles, easily accessible due to  tank tops, shorts, flip-flops, and bathing suits. It’s not wild speculation to think that Florida’s mosquitoes will get bigger each year, until, like in a SyFy movie, they’re big enough to swoop down and carry people into the air. Visiting Florida is only adding fuel to the fire.

 

If you’re looking for a lovely, non-lethal vacation, instead of Florida, consider New Hampshire. As the Granite State, we stand firm on our policy against sinkholes. In honor of our Live Free or Die motto, we are armed and willing to exterminate any pythons or poisonous  snakes that would ruin your quiet enjoyment. Though our weather might be overcast, cold, and windy, we don’t evacuate and, if we did, there’s plenty of ways to get out of town. New Hampshire’s own amusement park, Canobie Lake, isn’t a target for world destruction, mainly because only people from New Hampshire and Massachusetts go there. And don’t listen to what people say. Massachusetts might annoy us, but we’re not ready to get rid of them yet.

 

As far as bugs go, we’re pretty proud of our black flies. They might not be super-sized, but they’re like New Hampshire, they pack a big punch in a little package. Come and see us. Chances are, you’ll survive your vacation with nothing worse than a few bug bites and some windburn.

 

Live Free Or Die

Live Free Or Die (Photo credit: jcbwalsh)

 

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What We Shouldn’t Do For Love

A heart being used as a symbol of love. Photo ...

A heart being used as a symbol of love. Photo modified by author using Photoshop. (Photo credit: Wikipedia)

Urban legends and medical lore are full of the things people do for love. The 22-year-old girl who lifts the car crushing her father. The mother who rushes into a burning building to rescue her children. The father who doesn’t know how to swim, but jumps into the water to save his drowning son.

There are some things, however, that push us to the edge of what we will do for love. Loving an addict is one of those things. It’s tough wondering when the phone call asking for bail money will turn into the one asking you to identify a body. No one’s morning should start in a bedroom doorway worrying if the person inside is passed out or dead.  Life is hard enough without a daily routine of second guessing whether to argue or remain silent. After a while, silence is easier.

Because, after a while you realize that no matter how much you love the addict, you can never make the right decision, say the right thing, or provide the missing ingredient to keep them clean and sober. No one is  capable of stopping the addiction except the addict. Until they admit their problem and get help, no amount of love will make them whole.

It truly is not you, it’s them.

And when you make the decision to leave, the heartache doesn’t stop. Who will take care of them if you’re gone? Make excuses to the few friends that are left? Divert the phone calls from work? Pick up the slack when they spend days in bed recovering from binges?

The pull to go back is stronger than a riptide. It sucks you back and keeps you in place.  To apologize, to make excuses, to take the blame. It’s familiar, comfortable, and as reassuring and necessary as the booze or pills are to the addict.

Until one day you realize that in order to save anyone, you have to save yourself first. You can’t move the car off a loved one if you’re pinned beside them. You can’t save someone from a burning building dressed in gasoline-soaked clothes. You can’t rescue a drowning man when he’s pulling you down with him.

You can’t.

Read all the fairy tales, urban legends, and medical myths you want on the power of love, not all of love stories have happy endings. There are some things love can’t fix. Addiction is one of them.

All you can do is save yourself.

Want more information? Check out the links below:

Alcoholics Anonymous, Narcotics Anonymous, Al-Anon Family Groups, Nar-Anon Family Groups

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Who Gets to Decide to Withhold CPR?

I’m not sure what I’d do if a patient collapsed in front of me and the administrator said, “No CPR. It’s our policy.” Since I’ve been a nurse, I’ve heard of slow codes, where the unspoken agreement is that if the person stops breathing the staff will purposely react as slowly as possible to give the person a chance to die, but I’ve never participated in one. The decision to either be resuscitated or be a DNR (do not resuscitate) is a personal one and the slow code takes that decision away from the individual. That goes against my philosophy of nursing.

English: CPR training

English: CPR training (Photo credit: Wikipedia)

Today’s news involves a nurse who did, in fact, stand by and refuse to do CPR when a patient went down. The facts seem simple. A woman collapsed in the dining room of an independent living facility. A nurse called 911 to report the incident. The 911 dispatcher asked the nurse to start CPR. The nurse refused, stating it was against company policy.

The 911 dispatcher didn’t give up. She asked the nurse to find someone who would start CPR, asking “Is there anybody that’s willing to help this lady and not let her die?” Again the nurse said no. The dispatcher continued to plead, as if the provision of CPR was the only surefire way to prevent this woman’s death.

Seven minutes 16 seconds later, emergency personnel arrived. The woman had no pulse and was not breathing. They started CPR.  The 87-year-old woman was declared dead at the hospital.

This has upset a lot of people. Upset some to the point that the police are trying to figure out if they can charge the nurse with a crime. The belief is that CPR would have saved this woman and the absence of CPR caused her death, and that’s not entirely correct.

According to Dr. Robert Shmerling in a post entitled, CPR: Less Effective Than You Might Think

“As opposed to many medical myths, researchers have reliable data concerning the success rates of CPR (without the use of automatic defibrillators) in a variety of settings:

  • 2% to 30% effectiveness when administered outside of the hospital
  • 6% to 15% for hospitalized patients
  • Less than 5% for elderly victims with multiple medical problems”

Another study that looked at out of hospital cardiac arrests found that successful resuscitation decreased with age. 40 and 50 year olds had a 10% chance of a successful resuscitation while patients over 80 only had a 3.3% survival rate.

No magic bullets here. There is no guarantee that CPR would have prevented this woman’s death. If she’d survived, there’s no guarantee of the quality of life she’d enjoy afterwards.

In this case, the independent living facility (not assisted living, not a nursing home, not a rehabilitation unit) maintains the residents are advised that in the event of a medical emergency staff members will call emergency services, but not provide CPR.  Employees are told the same thing.

The dead woman’s daughter said, “I don’t believe if CPR were done it would’ve helped or changed the result. This is not about my mother or me, this is about the policy of the facility, and we understood the policy, and I agree with what was done.”

Which brings me back to the original question. If the woman collapsed in front of me and, as a condition of living in the facility she’d agreed the staff wouldn’t perform CPR, would I have stood by and done nothing? With an underlying belief that the patient gets to make the decisions, I very well might have.

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