Tag Archives: United States

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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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Key West and The Voices in My Head

Old painting from around 2001 - "Voices i...

Old painting from around 2001 – “Voices in my head” (Photo credit: jelene)

 

There was a time when the voices in my head delivered a running commentary on my performance as a human being. Most of the time the consensus was I did a pretty crappy job. Now, the voices weren’t the auditory hallucinations of mental illness nor were they the intercepted signals of aliens being broadcast through my fillings. No, they were my own tortured mind.

 

 

 

What did the voices say? Most of the time they kept up an incessant barrage of all of the things I had or would do wrong on a variety of topics. They were well-informed and knowledgeable about proper social behavior, normal parenting skills, and health and beauty concerns. It was a little like having the entire editorial board of a women’s magazine in my head, constantly pointing out my shortcomings. The voices seemed to enjoy their full-time job as the background chorus of my life.

 

 

 

I maintain there is only so much second guessing one can do, but the voices never tired of it. The comment made at work in anger? The voices would chew that like a juicy morsel of steak, deriving every last meaty bit of satisfaction before letting it go. Going to a conference? A scathing look at my wardrobe, my weight, and my inability to have a “look” occupied the hours it took me to pick out an outfit. Social cues? The voices assumed I had Asperger’s syndrome rendering me unfit to make friends or attend social events. If there was a fault to find, the voices found it.

 

 

 

Surprisingly, I put up with this for a long time. I would have put up with it for my entire life. But then Key West happened.

 

 

 

If you haven’t been to Key West, go. Now. Don’t wait. Stay at the Southernmost Hotel on the Beach. I’d tell you to say I sent you, but they’d only look at you blankly. Go anyway.

 

 

 

Southernmost Hotel in Key West

Southernmost Hotel in Key West (Photo credit: MarkelConnors)

 

Because in Key West, the most amazing thing happened. The voices stopped. One minute they were there, chattering away in the background, the next minute gone. In retrospect, as soon as we got off the plane in Key West they started to quiet. Maybe it was the view from the tarmac.

 

 

 

Key West Airport

Key West Airport (Photo credit: Wikipedia) The first thing I saw in Key West after getting off the plane

 

Or maybe it was the Gay Pride parade, or the frosty drinks, or the drag queen show, or the roosters, or even the sunset. Whatever it was, the voices chilled. Day by day, they had a little less to say.

 

 

 

gay pride chickens frosty drinks gay pride parade itty bitty key west sunset

 

 

 

And then, on our third day there, we went on a snorkeling trip. Imagine being piled onto a boat with a group of strangers and the promise of diving in the cool offshore waters and seeing all variety of marine life. Exciting, right? Even better, on the way back to shore the crew would provide all the beer or wine one could drink. Who wouldn’t enjoy this experience?

 

 

 

My voices, that’s who. Yes, what should I wear that would be appropriate to snorkel while hiding the parts of me that needed hiding? How was I going to see the shark that was sure to attack me when I had to take off my glasses to put on a facemask? How could I breathe through a snorkel when my gag reflex kicked in every time I put the snorkel in my mouth? What if I got separated from the group and was left in the ocean? What if  I couldn’t follow the directions on jumping in and everyone laughed at me?  By the time I got to the boat in my carefully picked out bathing suit/shorts combination with strategic coverup, every scenario on how to die or be humiliated snorkeling had been painstakingly considered and accepted. I walked up the plank as if I was, well, walking the plank. And then we were off.

 

 

 

Glancing around the boat, I noticed a couple animatedly chatting in German. He was tall, dark haired, great looking, and, when he removed his t-shirt, I saw he was incredibly well muscled.  She was short and squat. Her hair was cut indifferently and held back with an elastic band. She wore a shapeless white cover up that contrasted nicely with her sunburnt face. Then she pulled off the cover up.

 

 

 

She wore a one piece cut high on the thighs, low on her cleavage. Her skin had the porcelain whiteness of someone that didn’t get a lot of sun exposure. She had fat rolls. Not to be unkind, but to report the facts,  she had back rolls and side rolls and thick, chunky thighs. Thick, chunky, white thighs.

 

from website c'mon fatso

 

http://cmonfatso.com/2011/06/22/fat-girl-in-a-swimsuit/

 

The voices in my head, coming out of their heat and/or alcohol induced torpor, tried to chime in, but for once, I shut them down. And, without the voices giving their opinion, I thought, why the hell not? Why shouldn’t she relax on a boat in her swimsuit when the temperature’s over 95 degrees. Why shouldn’t she be comfortable in her own skin. Why shouldn’t she enjoy a day on the water with a man who obviously adores her.

 

And with that, the voices in my head disappeared, never to be heard from again. I spent the rest of my time in Key West wearing what I wanted and doing what I wanted. I was finally free. Not only that, but the voices kept gone even after I left Key West and returned home.

I am sure there are all sorts of rational, science based explanations for the transformation I underwent, but I give the credit to Key West. There are sacred places in the world, full of magic and wonder. For me, Key West is one of those places. Some nights I imagine the voices, seven miles off shore under the white sand of the ocean floor, making nasty comments to each other to pass the time while they wait for me to return and retrieve them.

Their wait will be in vain. There’s no room in my head for them any more.

 

 

 

 

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A Magic Pill

Pills

Pills (Photo credit: madcowIV)

 

Pills (white rabbit)

Pills (white rabbit) (Photo credit: erix!)

 

 

At least twice a week someone tells me about a magic pill. They discovered it on Dr. Phil or Dr. Oz, an infomercial or a magazine, from the recommendation of a friend or with the help of an alternative healer. No matter what the magic pill cures/heals/improves, it never requires the taker to do anything except remember to take the pill.

 

I’m always a little skeptical. Most things in life, to me at least, require some effort.

 

And it’s not like the people who believe in a magic pill are dumb. Incredibly intelligent people look me straight in the eye and tell me about the latest one. On some level, we all desperately want to believe there’s a shortcut to our dreams or a work around to our pain. But that’s not the case.

 

Life isn’t easy, it isn’t fair, it’s full of pain. If a magic pill could cure that, wouldn’t we all take one?

 

Except there’s something to be said for fighting the good fight and emerging successful. Whether it’s losing fifty pounds, marrying the man of your dreams, or conquering an addiction, the journey is the part that helps us to grow. The magic pill takes that away from us. It makes us believe in trickery.

 

It’s time we value the work of improving ourselves and our lives more than we value the magic pill. Yes, working through our problems is hard, but it is only when we fully accept and embrace the tough times and the difficult choices that we move forward.

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Dealers Gotta Protect Their Turf

English: Vicodin tablets Italiano: Pillole di ...

English: Vicodin tablets Italiano: Pillole di Vicodin. (Photo credit: Wikipedia)

In New Hampshire, more people die of prescription drug overdoses than car accidents. CDC statistics report that prescription drugs are involved in 75% of all drug-related deaths in the United States. In 2011, the Centers for Disease Control estimated 14,800 deaths related to opioids (opioids or opiates defined as morphine, heroin, oxycodone, codeine, methadone, hydrocodone and hydromorphone.)  Note that with the exception of heroin, all drugs of abuse are available from your friendly healthcare provider.

Whether drug sales are illegal enterprises selling vials on the corner or a transaction that takes place in an exam room, it’s all about numbers and turf. Getting people hooked and keeping them coming back are the keys to a thriving business. For people with insurance, getting narcotics (opiates) from their local doctor or Emergency Room is easier and less expensive than going to the corner drug dealer, particularly since drug dealers don’t settle for a co-pay. Just as dealers rename their products to generate interest,  Big Pharma continues to feed the appetite of addicts with new medications and new formulations of old medications.

Narcotic painkillers have been combined with over the counter meds because of  the belief that the two medications together provide better pain relief than either of the medications taken alone. Unfortunately when people take two Vicodin (hydrocodone and acetaminophen) every 4 hours for pain round the clock (12 pills daily), they run the risk of liver damage because of the amount of acetaminophen bundled in the pill.  The makers of Tylenol (brand name acetaminophen) are so concerned about acetaminophen overdoses that they have decreased the recommended maximum daily dose from 8 pills daily (4000 mg)  to 6 pills daily (3000 mg). This change forces the makers of Vicodin to lower their recommended maximum dose to stay within the new guidelines and will result in Vicodin users having their daily dose decreased.  Sad that in the face of increasing numbers of overdose deaths due to prescription narcotics and the increasing number of prescription drug addicts,  the push to change labeling is due to the potential for a Tylenol overdose resulting in liver damage, rather than concern about overdose or addiction.

Of course the makers of Vicodin don’t want to see their business cut in half. They want to keep on selling the same number or more pills every year. Faced with the very real possibility that providers will decide to switch patients on Vicodin to a drug without any pesky daily maximums, the makers attempted the business affirming move of  trying to get approval for a pure hydrocodone pill. Luckily the FDA panel on pain relief voted against it.

The panelists agreed the higher dose of hydrocodone would be an effective pain reliever, but they felt uneasy providing another formulation of a drug in a class that is already widely abused. According to the Drug Enforcement Agency (DEA), hydrocodone is on the top of the list of most abused drugs in the United States. Sounds like a no-brainer.

Hopefully the FDA will agree with the panel and prevent a new dangerous drug from flooding America’s streets, school yards, and homes. In the war on drugs, our government has gone after the dealers of meth, pot, heroin, and crack. Somehow the legal dealers, Big Pharma, are allowed to thrive while they destroy lives.

opioid prescriptionsDo some people need narcotic painkillers to control their pain? Of course.  In the face of increasing narcotic use, do we need to add more potential drugs of abuse to the marketplace? I think not.  Big Pharma seems to be doing pretty well with what they have.

chart courtesy of the National Institute on Drug Abuse.

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