MedWorm.com provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest items from the 'NeoNurseChic' source. Sun, 05 Oct 2008 18:05:15 +0100 http://neonursechic.blogspot.com/2008/09/talk-like-pirate-day-and-some-updates.html Arrrrr Mateys! I've posted before about me love of the sea and of pirate talk, but I think I deleted me posts about such things! In honor of Talk Like a Pirate Day, Drink up me hearties, Yo Ho!OK enough of that. Seriously? My blog needs updating. BADLY! The most important thing is that I need to update my list of blogs links. Half of those links are dead because people moved to new blogs and such or just stopped altogether. And since meeting a whole new group of medbloggers, I need to start adding their blogs to mine! I know my blog turned into a patient blog more than a nursing blog - that's the trouble with the double role! Just so you know, I WILL be updating the links section soon. Since "coming back" (we'll use that term loosely!!), I'm still learning myself all the new blogs that are out there! And let me just say, there are some great ones!! So I shall make an Unbreakable Vow to update my links. That means I've really gotta do it, right? All you fans of Harry Potter ought to know that!There is SO much more to tell. I did, sadly, lose the nerve stimulator to infection - but I'm not getting into that now. I have to quickly get ready and get over to a local hospital where my grandfather is in a CardioVascular Unit after having open heart surgery Wednesday for double valve replacement. And I have to also take care of some things as I'm living in a brand new apartment as of this past Saturday. It's all been a bit chaotic! That at least partially explains the lack of blogging. I haven't had much time to spare recently. But I will when I can!And to conclude on this Talk Like a Pirate Day:"Nobody move! I've dropped me brain!" (That would explain a LOT!) (Source: NeoNurseChic) NeoNurseChic blogs http://www.medworm.com/rss/comments.php?id=1809685 Fri, 19 Sep 2008 16:56:00 +0100 1809685 http://neonursechic.blogspot.com/2008/06/migraine-and-headaches-in-news.html Tomorrow begins the 50th Annual Scientific Meeting of the American Headache Society. This meeting brings together all of the world's experts in the field of headache. I had the opportunity to attend the 47th Annual Scientific Meeting when it was in Philadelphia back in 2005, and I have to say it was one of the most interesting and informative conferences I've ever been to! Obviously, I'm a bit biased by my passion for the study and research of headaches, but I truly feel that this annual meeting brings to light a lot of very exciting research in the field of migraine and headaches. Image Credit As of this week, there are a few exciting developments in the news for the treatment of migraine. The first is rather close to my heart, having received my bilateral occipital and right supraorbital nerve stimulator implant on May 13 for the treatment of neuritis/cluster headache/chronic migraine. Medtronic, a medical device company, has put out a press release today about a presentation being made tomorrow at the American Headache Society meeting. They have sponsored the first clinical data on occipital nerve stimulation for chronic migraine. The best part is that the results are positive! Clinical data has been obtained on occipital nerve stimulation for the treatment of cluster headache, but this is the first study to look at the ONS for chronic migraine. If future study results remain positive, showing efficacy with few negative effects, then hopefully occipital nerve stimulation will receive FDA approval for the treatment of chronic head pain disorders. This will increase access to this therapy for many people who are currently suffering from intractable headaches that do not respond sufficiently to medication. Here is a Medscape article that presents an overview of two studies showing the success of occipital nerve stimulation for chronic cluster headache. Image Credit The other migraine story in the news refers to a device called the Migraine Zapper. This is a device which uses transcranial magnetic stimulation in order to abort migraine with aura. It is currently being used for migraine with aura due to the fact that the aura phase allows for an initial warning that the migraine has started before the pain sets in. Initial data has shown that the Migraine Zapper has shown some success for aborting migraine with aura, and investigators are looking into whether or not this could be used in preventive fashion for migraine without aura and other headache types. A video about the Migraine Zapper can be found on Philadelphia's WPVI 6 ABC with accompanying story here. And finally, here is another story from WPVI where the Migraine Zapper had previously been discussed. (Source: NeoNurseChic) NeoNurseChic blogs http://www.medworm.com/rss/comments.php?id=1551282 Fri, 27 Jun 2008 03:20:00 +0100 1551282 http://neonursechic.blogspot.com/2008/06/away-for-weekend.html Sorry that I haven't really posted since returning to the blogosphere! Been a very busy week, even though I am still out of work recovering from my surgery. I found out this week that I actually need to stay out for 2 more weeks since I'd had an infection and some minor issues after surgery, but things are getting better. We just don't want to push too much and create any further problems! I stopped by work yesterday and the day before as I was trying to get things situated, and it was nice to see my friends. :)I will start posting more after this weekend! I'm actually going a wedding tomorrow - one of my boyfriend's classmates from Physical Therapy school. It will be great to finally meet some of his college friends, and we're going to take a tour of his school on Sunday. I'm really looking forward to it!As I said, it's a slow return to the blogosphere for me, but I'll get back into it and start posting more regularly as time goes by! Thanks for stopping by! :) (Source: NeoNurseChic) NeoNurseChic blogs http://www.medworm.com/rss/comments.php?id=1535694 Sat, 21 Jun 2008 03:01:00 +0100 1535694 http://neonursechic.blogspot.com/2008/06/happy-fathers-day.html Happy Father's Day to all of the fathers out there! I am very lucky to have an absolutely wonderful father, whom I am very close to. My dad is a role model in so many ways, and I know that no matter what ever happens, he is always there for me and my family. I owe him so much, and I have come to the conclusion that there is simply no way to pay back thanks for all of the things my parents have done for me. The most important thing is that I try to live my life in the way that he and my mom taught me, and I tell both my parents that I love them at every chance I get.Tim Russert's very untimely death on Friday was yet one more reminder of just how precious and fragile life can be. My dad is very close in age to Tim Russert, and I cannot imagine losing my father at his age. But then, I can't think of when would be an acceptable time to lose a father, to tell the truth... I read something this morning by a friend who wrote about his father's death, and the fact that he couldn't remember ever telling his dad that he loved him, even though he honestly did love him. When his mother remarried a man who also proved worthy of the title "Dad", he made sure to tell him he loved him at every chance he got. I know that no matter what, my dad knows I love him, as I tell him all the time!Hope everyone has a wonderful Father's Day! I'll be going out to my parents' house to have dinner to celebrate with my dad. :) (Source: NeoNurseChic) NeoNurseChic blogs http://www.medworm.com/rss/comments.php?id=1521988 Sun, 15 Jun 2008 05:13:00 +0100 1521988 http://neonursechic.blogspot.com/2008/06/im.html So I haven't blogged here in over a year, although I have blogged sporadically in a couple of other ways, and I continue to follow a couple of my favorite blogs closely! The fact of the matter is that I have missed blogging so much! And blogging on other sites in other ways just hasn't been the same as it was when I had my active blog here at NeoNurseChic. Any return readers will remember why I took my blog private - it was being read at work, and nobody would let me know who was reading it so much, and I started to get paranoid about the information on my blog being used against me in some way. Taking the blog private did ease up on those feelings, but then I felt like I lost a lot of the enjoyment of having a public blog! So, in coming back, I have removed most of my old posts (they're not gone, exactly - just in hiding). I have kept some of the more general posts up - posts which don't make me feel nervous about being read!It's going to take some time for me to feel comfortable about blogging publicly and not anonymously again! I don't think I will touch on topics of neonatal nursing for quite some time, if at all, although I did leave up a couple of posts relating to neonatology. While I never broke any laws or rules with anything I ever wrote about my job, I still worried about the constant readings of my blog from work, without anyone ever saying a word to me about it. I had visions of them printing out all the posts and taking them to some higher-up and putting my head on the chopping block! Don't laugh - there have been many bloggers who have lost their jobs due to their blogs, and I don't want to be one of them, no offense!Speaking of work, I am actually not working at the moment. Since May 13, I have been on short-term disability because on May 13, I had a right supraorbital and bilateral occipital nerve stimulator implanted to treat my headaches, through using the stimulator to combat neuritis, and subsequently aid in the reduction of all my various headache types. I'm returning to work in a couple of weeks, as long as all things are continuing to improve! Unfortunately I did hit a little snag this past weekend, and now I'm on a strong antibiotic for 10 days and we're watching some things quite closely, but actually I'm already seeing a little bit of improvement since starting the antibiotic!As for the headaches, I do believe that the stimulator is helping, even at this early stage. Theories on this vary quite a bit. My neurologist and some neurologists that I met with from England who have done extensive research on Occipital Nerve Stimulator Implants (ONSI) have stated that the stimulator doesn't reach its true potential until about 6 months to a year after implantation. But then I was told by the pain center who ran my trial stim, the company representative, and my neurosurgeon that I needed to see at least 50% improvement with the trial stim, which I did back in January, in order to even consider the permanent implant. When I posed the theory the neurologists held, they said there wasn't enough evidence to say either way, but that the current findings show that if you're not getting at least 50% relief from the pain with the trial stimulator, then the permanent implant will not do much better.Lucky for me, I did get at least 50% improvement with the trial stimulator! At the time of my trial, the company, Advanced Neuromodulation Systems had a representative working with me who used a new programming technique to program the 3 leads I had in place. (Only a small handful of people with headaches have had both occipital and supraorbital leads placed for this - most people who have had the surgery have only had unilateral or bilateral occipital leads placed.) The way the company rep programmed my trial stim, I had stimulation over almost my entire head! It was amazing!! I was able to abort some cluster headaches by turning the stimulator up to a level that was stronger than the pain I was feeling. The hard part about the trial is that there is some post-op pain from insertion of even the sub-cutaneous stimulator, and by taking pain medication for that, it kinda lowered my migraine pain. So I kept the trial for a few extra days (a week, in total) so that I had time to get off the pain meds and really test out the stimulator. I was quite happy with the results!Word came to me that a new battery was being developed that was much smaller than the current battery on the market, so I decided with my family, the company rep, and my neurosurgeon to wait for this smaller battery to come onto the market, since I have a small frame with not a lot of body fat to implant the battery into. (Well, I personally think I have way too much body fat on my abdomen - but apparently my view is a bit distorted, since 3 years ago I was told that one of the reasons I couldn't have the surgery was because I didn't have enough body fat to implant the battery pack! Fortunately, batteries have come down in size since then!) Initially, all we were waiting for was FDA approval of the new battery, and then the hope was that it would be out shortly after that and available for implantation. The speculation came about that the battery would be out in late-March, so my neurosurgeon and I planned my surgery for April 22.The week before our anticipated surgery date, the battery was finally approved by the FDA. I was thrilled about this! I went about my pre-admission testing day on April 15 as planned. Unfortunately, by the end of the week, I learned that the battery would not be available in time for the April 22 surgery, so we then pushed the surgery back to May 13. I then found out the next week that, while the new battery was FDA approved, the company was holding release until August at the earliest! So that threw me..... I figured I probably looked dumb or irrational for not waiting for a battery that was a better size for me, but at the same time, knowing that there was a treatment that could significantly help me and improve the quality of my life, yet having to wait so long for it, was driving me mad! So, with the blessing of the company rep and the neurosurgeon (and my family!), I decided to go ahead and get the battery already on the market implanted. Initially we were going to implant the smaller battery in my chest just below the collar bone, so that it would be in closer proximity to the leads, but then by going with the slightly larger battery, we decided instead to implant it in my right abdomen - all the body fat lying there, and all. ;)The fact of the matter was, when I first decided to go ahead with the trial stimulator, I had no idea that a new, smaller battery was even a possibility, and we were going to go ahead and implant the current battery on the market. So why should news that a newer, smaller battery is coming out - but not for some time - be a deterrent to moving ahead with the original plan? I decided that the benefit of going ahead with the surgery outweighed the wait for the new battery. The good news is that if I ever run into problems with my current battery or come to a time when I need it replaced, then the technology is all compatible, and I can have the smaller battery implanted down the line. So it all works out in the end!All the waiting around was quite wearing on my nerves, but when the time finally came for the implant, I was well ready for it! My neurosurgeon arranged for me to be the 1st case of the day, so we had to be at the hospital at some ungodly hour - I think it was around 5am. I think the surgery took between 1 and 2 hours, but I can't be sure, not knowing exactly what time I went into the OR and what time they started! Having them take your glasses before you even go to pre-op holding really sucks when you're blind as a bat! hahaMy surgery went without complication, under general anesthesia. (Much more comfortable than the trial, which was under a lighter sedation, during which I awoke while they were jamming (I'm sure it wasn't jamming, but to me it felt like jamming!) one of the electrodes into the back, right of my scalp - which was a pain like none other I had ever experienced, but without any control to do a thing about it! Fortunately when they went to insert the supraorbital electrode, I asked for a little more sedation, and I can't remember the rest of the procedure! I couldn't imagine feeling the jamming feeling on my face and not being able to move or do anything!)So for the permanent implant, it was actually an outpatient procedure, which was good because then I could rest at home. The bad part was that I had about an hour ride home in the car on the Schuylkill Expressway and the Pennsylvania Turnpike to get to my parents' house. And if anybody knows what the Schuylkill is like during rush hour on a weekday, they know that this is not a pleasant ride by any stretch of the imagination, and wayyyyy worse when just a few hours post-op! So, I have one electrode above my right eye, in the supraorbital position. This is great because of the constant bruised feeling I have in that area from years of chronic migraine and cluster headache, and the fact that much of my pain is concentrated in the front half of my head. As I said, the majority of stimulators for headache are implanted occipitally, but my neurosurgeon is researching the possibility that having both occipital and supraorbital leads may be more helpful. One of the theories about the way the stimulation works is that by stimulating the occipital nerves, you are indirectly stimulating an area of the brain related to migraine and cluster headache, so I don't know how the supraorbital electrode works into that theory, but I can say that during the trial, that electrode made all the difference! Another theory of how the stimulation works for headache is that the brain cannot integrate two different types of major input, so the stimulation literally blocks the pain from being felt. In my unprofessional opinion, I am really thinking (and hoping!) that both of these forces are in play. That means that I will feel immediate effects of relief with the stimulator blocking the pain I would normally feel, but also that the stimulation of these extracranial nerves will indirectly stimulate areas of my brain associated with these headaches, and perhaps it will not only shut down the pain, but also the other symptoms associated with clusters and migraine, and maybe will make the attacks less in frequency. That would be the best possible outcome I could hope for!There is a tiny incision in my hairline for the insertion point of the supraorbital lead, and then unfortunately I do have a tiny scar on my forehead where the needle poked through my skin during insertion, but it's not a big deal! I had one dissolvable stitch there that has since dissolved. Then the supraorbital lead wire was run back behind my ear, where there was another, larger incision to anchor the supraorbital lead in place. I have an incision up the back of the base of my head which was made to insert both occipital leads, which were anchored together (I think?). Then, all three wires were guided to a point in the back of my right shoulder, where they were anchored together (through another incision) - so each lead has 2 anchoring points. This is to prevent an unfortunate complication post-op where the leads migrate out of the desired area. The neurosurgeon had had a patient where the supraorbital lead migrated actually quite a distance, so getting the anchoring of these leads right is an important part of the surgery! The wires then run down my upper back and around to my mid-right abdomen. Another incision was made here, and the battery was placed actually pushed up into the abdomen a bit - not right at the incision site. I think extra wire also coils in that area to prevent too much tension on the wires, if I'm not mistaken.When I woke up from the surgery, the abdomen is what hurt the most - in fact, it was nearly unbearable in the very beginning. I received several doses of fentanyl while in the recovery room which helped a bit, but then by the time I was back in ambulatory care, the pain was already quite bad again, and they gave me 2 percocet. This again helped a little bit - and fortunately I slept through the majority of the car ride home (awaking only to moan in nausea and pain). I couldn't find a comfortable position to lie in once I got home, but my mom helped me by adding and rearranging pillows until it finally felt right. I initially got into a schedule of staying on top of taking the percocet every 4 hours, even through the night (alarms were set), and finally the pain was under control. By the day after the surgery, I felt okay enough to go sit downstairs to eat breakfast. My mom stayed home with me that day, and we mostly laid in bed and watched movies - although we did venture outside at one point to walk to the end of the driveway and back! We had a heck of a time changing the bandages in the initial days, and discovering which type of tape hurt the least when pulled out of hair. (FYI, it's the paper tape!) I was told that I didn't need the bandages once the wounds stopped draining, but we kept them on for the first near-week so that my clothes against the incisions (or even rubbing my head against the pillow during my sleep) wouldn't hurt as much. I had quite a few stitches in all places. I couldn't really take a shower or wash my hair - so for the first 2 weeks, I took baths sporadically. Twice, my mom helped me with washing my hair in the sink using a cup of warm water and being very careful to avoid getting shampoo near the incision sites. It was interesting, but I should note that my mom is quite the post-op hairdresser! My mom has been a saint through the surgery and recovery!At the 2 week post-op appointment, they removed the stitches. Unfortunately, my skin had actually healed over one of the stitches on the back of my neck, so that one was a bit of a rough removal! We were concerned about the fact that there was a tiny pimple-sized bump on my forehead where the lead was actually sticking up some. Once the neurosurgeon saw it, he recommended wearing a headband (like they wear in tennis, or if you're in for a real laugh, like what Olivia Newton John wears in her video for the song "Let's Get Physical"! haha) 4-6 hours a day for a week to see if this would help hold the lead down and allow scar tissue to form to hold it properly in place. He was concerned about it sticking up. At first, I found the headband unbearable because it gave me bad headaches, but then I started wearing it at night and sleeping through whatever pain it caused, and in the end, it has done wonders! When I saw the neurosurgeon on Monday, he was pleased with the results of wearing the headband. He said he was at a conference and spoke with a few other neurosurgeons about the issue, and all of them said the lead would most likely need to be replaced. So far, we're defying the odds - all with the use of a headband! Who'd have thought! He wants me to continue on with the headband for now - we're not out of the woods with that lead yet, but progress has definitely been made!On the day of the surgery, the company rep put in 3 programs for me to use with the stimulator, but we wanted to keep it light so as not to cause me any discomfort in the initial post-op period and not to further aggravate the tissues where the leads had been implanted. I worked through all 3 programs over those first 2 weeks, and I found them all to be helpful to some extent. I did not feel stimulation all over my head, as I did with the trial, which was an initial disappointment. Keep in mind, my own trial was the first time they achieved that kind of stimulation that covered most of the head, by the company rep using a different method of programming the electrodes. The stimulator allows you also to adjust the balance of the electrodes individually, so you can turn up or down each electrode to maximize comfort and effectiveness. The first 3 programs allowed me 5 different combinations of balance adjustments. The only problem was that I couldn't really tell the difference between them, so I knew we needed to investigate that or clarify that a bit further.When I went to my first post-op appointment after 2 weeks, I met with another company rep (my usual rep was on vacation that week), and she spent quite a lot of time with me. She taught me how to charge the battery, which consists of basically an external A/C adapter, a recharging box, and a wire that goes to a round disc that you place directly over the battery site in order to recharge the battery through the skin. This is an important development in the past few years of implantable neurostimulators. I have friends who had ONSI devices implanted, but had to have the subsequent surgeries to replace the batteries far more frequently than I would have liked. With the rechargeable battery, I can go about 10 years before I will need a replacement! I will have to charge for approximately an hour every week - but I've been told that the more frequently you recharge, the longer the battery's life will last. This is contrary to everything I have ever been told about batteries and recharging, but apparently the technology is different and the battery life improves in this device with frequent charging! As of right now, I've been charging just shy of a week apart for approximately an hour each time. It's really no big deal as that means I get to sit glued to the tv not moving for the length of the recharge, and I'm always up for mandated relax time! haha The recharging period does make the stimulation feel differently - and I have not yet asked if that is normal or not.So after learning how to recharge the battery, the company rep for that day put in 4 more programs and worked with me very extensively. She attempted to program the device in a way that I would feel the stimulation sweep up over the back of my head and connect with the front electrode. In some instances, I was able to feel a little bit of electric stimulation going up the back of my head, but the majority of the stimulation I feel is still localized to the placement of the 3 leads. The back left electrode, incidentally, feels as if it moves up the left side of my head and occasionally the stimulation reaches around my left eye - so that's kinda cool! This past Monday, the neurosurgeon asked me if I felt stimulation connecting between the leads, and I said I didn't at this point, but I wasn't sure if further programming could possibly achieve that. He said that getting the stimulation to extend over all those areas and connect between the leads is very challenging, and if they could achieve that, it would be excellent. We are not without hope! I can tell a difference between the first 3 programs created and the last 4 programs created. The first 3, with the supraorbital electrode, I feel stimulation go directly up from my eye to the top of my forehead - almost in a straight line up. In the last 4 programs, I feel stimulation on the right side of my head (still directly in a line from the eye region) and up to the top of my head. Both of these areas of stimulation are helpful to me, but I am actually hoping that we can adjust the programming so that I have both areas covered with the same program!The company rep I have worked with most frequently said that it is not uncommon to need adjustments in the programming in the 1st 3 months especially. We are going to work together next week to try to make a few more changes to the programs. So when someone asks me if the stimulator is helping, I have a hard time answering. It definitely has helped - I am taking far less abortives than I ever was before, and I'm actually having fewer cluster headaches at least at this point. But - all that being said, there are still programming adjustments needed, and I hope with those changes we can achieve even better results. And if I take into account what the neurologists have proposed, then I really won't feel the optimal benefit for a few more months. But yes, the stimulation is helping! Almost a week after surgery, I had my first cluster headache since the surgery (whenever I receive anesthesia, it seems to stop my clusters for a few days up to a little over a week, and it also reduces the baseline of my migraine pain for a few days up to a week or so). This particular cluster headache came on even faster than the norm. I was sitting on the couch watching tv, and it felt like someone walked up next to me and slammed a hammer and railroad spike into the side of my head. I actually reached my hand up without really thinking about it, almost expecting to feel a cracked skull with blood pouring out. It was that severe and sudden onset of pain. Usually I have at least a few minutes' warning before my clusters ramp up to such a severe level! But I guess they felt like returning with a bang! I didn't have the remote (I'll get to this!) sitting downstairs with me, so I went upstairs to retrieve it. By the time I got it on, I was able to turn the stimulation up to a much higher level, and the attack went away completely. I wasn't pain free because I always have my migraine baseline, but the cluster headache was gone. I didn't need oxygen or triptans to knock it out. Amazing! So that's just some of the initial benefit I've seen from the stimulator, this early in the game.The way you control the stimulator is through an external remote control of sorts. It is a little black handheld remote with a handful of buttons on it and a little screen. There is then a long black wire that goes out to a round little paddle. (The actual remote disconnects from the wire/paddle for storing in a nifty little case.) The only complaint is that it isn't the easiest thing in the world to insert the wire into the actual remote, for some odd reason, and occasionally takes me a few more seconds of tinkering around with than I would like! You basically place the paddle over the site of the battery (can be done through clothing), and then turn the remote on. The remote locates the battery first and runs through a few checks. It beeps a few times, and with each beep, I feel a little mild flash of stimulation from each lead. Then, it gives one final, louder beep, and you're in. From there, you use the screen to do whatever you want to do. You can even check the battery life of both the implanted battery and the remote to see how they are faring. You can switch between programs and adjust the stimulation up and down, as well as adjust the balance between the electrodes. There is a final menu which allows you to obtain information about the remote and the internal device, and allows you to make a few changes to the remote screen, etc. The remote shuts off after 1 minute of no buttons being pushed. If you pull the paddle away from your body, the remote usually beeps to let you know that it has lost communication with the implanted device. You can then place it back over the battery to reconnect or just wait for that minute for it to turn off so you can disconnect it and put it away. The one annoying thing, which is actually supposed to be a benefit, is that it beeps loudly if you disconnect the wire/paddle from the actual remote. It beeps once every 15 seconds or so, until the minute goes by where it shuts off. So, after you adjust your programming and pull the paddle away, if you want to immediately put the remote away, you will have to put up with those beeps. Otherwise, you just wait for a minute to pass and the remote to shut off, and THEN disconnect and put it away. That's what I've been doing the most lately. A minute does go by rather quickly, afterall!The other really awesome way you can turn the stimulator on and off is with this big magnet they give you! You place the magnet over the battery site, and it shuts the stimulator off instantly. In order to turn the stimulator back on, you place the magnet over the site for 2 seconds and then pull it away (if you leave it there longer, it will simply shut the stimulator back off). Once you pull the magnet away, the stimulator gradually turns on and increases to the level it was last set at. Obviously you can't do any further adjustments of stimulation level and programming with the magnet, but it is an awesome way to turn the stimulator on and off quickly! The only drawback is that it is a giant magnet, so you do have to be rather careful with where you leave this lying around! The first time I went out of the house after the surgery, I put the magnet in my purse with the magnet bar in place and in the box, but then I still worried that perhaps it would destroy my cell phone or iPod. I've already been warned extensively not to put it even within a few feet of my laptop. So for now, the magnet sits on my dresser until I decide how to best make use of it for now! I do really like the ability to turn the stimulator on and off very quickly with the magnet, though! Very cool technology!So have I rambled on enough yet for my 1st post back to blogging here? If you've read this far, then I'm actually rather impressed, as I'm sure this subject probably doesn't interest the vast majority of people. I, however, find it really fascinating and also the best hope I've had in years, so I do hope that it intrigues some readers as much as it does me - or even a fraction of as much as it intrigues me! Nerve stimulators are used most frequently as spinal cord stimulators (Go to the ANS website, and you will find that all the information is about Spinal Cord Stimulation exclusively), and it can also be used to stimulate peripheral nerves in other parts of the body. The mechanism is a bit different for spinal cord stimulation, but the same devices are used. Deep Brain Stimulation is another type of stimulation newly being used for headache (deep brain stimulation of the hypothalamus, when it comes to cluster headache - not sure if DBS has been used for migraine yet). DBS for headache is still a VERY new field, and not all of the results have been positive. While DBS actually appears to be more effective than ONSI, it is much more risky - and people have been reported to die after that surgery (while the deaths are very few in number, the entire sampling size is small, so the evidence is currently not strong enough for me to jump into DBS! DBS is most commonly used for parkinsons and epilepsy, as well as a few other conditions. I'm not even sure if my neurosurgeon has performed DBS for anyone on headache yet. 3 years ago when I went for my initial consult about the ONSI, my neurosurgeon felt that my best hope would eventually be DBS - but not for a few years. By the time I went back for my 2nd ONSI consult, the technology and procedure (and data) had been advanced to show that this was a promising option for me, and with far fewer risks than DBS. My mom has stated flat out that she will never support my going for DBS - it is just too scary! I'm hoping that my stimulator will do the trick, and that I will never have a need to consider DBS at all!So the next plan is that I see both my neurologist and my neurosurgeon next week for final appointments before returning to work. I'm jumping back into work at 40 hours a week (2 12's and 2 8's rotating days and evenings), and my job is very physical - with the biggest risk being that the leads could migrate under stress and pull out of position. Because of that, I want to be certain that they feel the time is right to return. I do, however, miss the work, even though it has been very nice not working for the past 4 weeks! After 2 months, my neurologist wants to start decreasing the 2 meds I'm on for daily headache management, as long as all is going well with the stimulator. We will decrease the meds slowly over time, but hopefully I will be able to completely get off both meds. With those meds out of my system, I should also be able to cut back on 2 of the 3 GI meds I take - which largely treat complicated reflux and gastroparesis as a side effect of the headache meds. This will be a great thing. I take domperidone for gastric motility, and this has drastically raised my prolactin level. Initially, it only raised it into the 40s, but a few weeks ago, I had a level checked, and it was 138. The normal level for my particular lab is less than 30. My OB/Gyn was concerned because I also have a small (8mm) mass on my pituitary, which has not significantly grown in the last 7+ years, but is a potential prolactinoma. However, the endocrinologist truly believes that the domperidone is the culprit, even of this higher prolactin level, whilst I was on my smallest dose of domperidone yet. The OB/Gyn was giving me provera to restart my periods every 3 months, as is the recommendation. This had typically worked up until this spring. I went through the 1st course on the max normal dose for a week, and never had a period. So then, she checked the prolactin level to see if it had climbed (which it had) and started me on a 2nd course of the provera at the same dose for another week in the meantime to see if that would kick my ovaries and uterus into gear. So far, it's been about a week and a half and nothing has happened, but we don't expect anything to happen with a prolactin level that high! I just saw the endocrinologist Monday, and he believes, as I said, that this is all from the domperidone. However, he is checking a CT scan with contrast just to be sure the mass on my pituitary hasn't changed at all. Normally, a dedicated MRI with contrast is the gold standard for examining the pituitary, but now that I have the stimulator, I can no longer have MRIs, so a CT will have to do. However, he feels that nothing will change until I come off the domperidone. The reason I even mentioned this whole ordeal at all is because by coming off the headache meds over the next few months, I should be able to stop the zantac I'm on as well as the domperidone. This should allow my prolactin level to come down and then will restart my menstrual cycle - which has never been regular, but never been absent for months at a time unless restarted as it is now! So this stimulator could end up having a huge impact on several different systems of my body! And the greatest thing is that meds all have side effects and possible long term implications, whereas the stimulator has none once implanted and recovered from, so my body finally has the opportunity to feel somewhat normal! My rheumatologist is even planning to start decreasing my methotrexate if all continues to go well with my joints, too! By this time next year, I could be a totally new woman!!After over 7 years of all this insanity, I have no idea what being nearly med-free could even possibly feel like. I really hope that I continue to see benefits from the stimulator so that I can reach this outcome. I know that's the best possible outcome, and I don't expect the headaches to completely go away with the stimulator, but I do hope that it helps me manage them with little or no medication - and especially no need to take daily preventive medication for headaches, and subsequently GI distress (minus the fact that I'll always need some med for reflux, since I've had it my whole life - but one med is better than the three I'm on currently!), and subsequently hormonal distress so that one day I can even get pregnant! How could I not move forward with possibilities such as these?!?! I'm totally stoked!Before I close, in other news, I have been dating my current boyfriend for a year now, whom I started dating shortly after making the blog private and stopping blogging altogether. My last posts on the blog refer to a brief month-long relationship I had, but I had never mentioned this current one as I stopped blogging before it started. My boyfriend's name is Jason, and he is a physical therapist. We are moving in together this September to take the next step in our lives together! It's so incredibly exciting and wonderful to have someone to share your life with - the ups and downs together - but mostly to just enjoy being in our 20s and experiencing all the new things of being adults with careers and advancing our relationship together. He is my best friend, and he is such an asset to my life - I love him dearly! :)Sorry for the length of this, my first post returning to this blog! Hope I haven't put anyone who reads this to sleep! There is so much more left unsaid from the past 4 weeks even, let alone the past year! Maybe I'll get into some of it here and there over time. I will really really appreciate anyone who comes back to reading my blog from the old days, and I welcome anybody who newly comes to my blog to read about my life. If anyone comes to my blog because they were searching about neurostimulators for headache, then please enquire! I'd be happy to share my story, even though a great deal of it can be found in this post! G'nite!! (Or good morning, since I've spent the last 5 hours going through posts and then writing this one! haha) Officially time for bed! ;) (Source: NeoNurseChic) NeoNurseChic blogs http://www.medworm.com/rss/comments.php?id=1508209 Wed, 11 Jun 2008 07:11:00 +0100 1508209 http://neonursechic.blogspot.com/2007/03/new-music.html Yesterday I sat down at the piano for the first time in a long time to play and sing. Just haven't really felt like doing it lately amongst everything else. I think the last time I actually really sat down to play and sing was the day JoAnne died (my mom's best friend). I've played a little bit last weekend out at my parents' house, and I guess that got me thinking that I wanted to play again. So yesterday, I re-recorded 3 songs that are already on my music downloads: "I Can't Make You Love Me", "Memory", and "I Know The Truth". I hadn't been happy with those 3 recordings, even though "I Can't Make You Love Me" is one of the best songs I had reocrded before. I had some changes that I put in after that first recording, and I wanted to record my new version! The other two just had some bad notes and passages in them that I was unhappy with, so I sat down to re-do those!I also recorded a new song - Faith Hill's "There You'll Be". Awhile back, Sara (Sarebear) asked me if I would do that song, and at the time, I wasn't ready to work on anything else. The day JoAnne died, I went digging through my music for things I could play at the funeral if they wanted me to play. I wasn't going to sing - but I figured I would play for them if they wanted. I came across that song, and I sat down to play and sing it. I had a hard time with it - I'd get about halfway through and breakdown in hysterical crying... I love that song, and I thought the words were so fitting... My recording of it isn't perfect or anything, and there are some notes that probably warrent re-recording it, but I'm putting it up as is. The highest note in it is a belted e-flat, and because of my mic setup, it comes out a little "hot," but I hit it, and that's important to me! It only took 2 takes to get it... I'm singing that song for JoAnne......she was such a special person in all of our lives, and I miss her every day.All four songs have a little bit of "blare" in them - I'm not sure I recorded them with the same decibel setting as the other songs. I just didn't feel like re-doing them one more time when I was finally happy with my performances!! On play-back, I couldn't hear the blaring until I listened to them later on itunes, otherwise I would have re-recorded right away! At any rate, I hope you enjoy! Here's the link: My Music (Source: NeoNurseChic) NeoNurseChic blogs http://www.medworm.com/rss/comments.php?id=1508210 Sat, 24 Mar 2007 19:00:00 +0100 1508210 http://neonursechic.blogspot.com/2007/03/tonys-first-blog-post.html In case you can't remember, Tony is my cat. He's a bit of a wild one, I must say! I've had him since November of 2005, when he was 8 weeks old. He weighed only 1.2 pounds when I first got him, and now he is 14 pounds! He is a very loooooong cat, so he probably only needs to lose a couple of pounds. With all the trouble he gets in and energy he expends, you'd think he'd burn off some more calories, but he's had a pot belly since the very beginning! I'm letting Tony make his first blog post tonight, as he has some pictures to share with you! Enjoy!*****************************************************OK - hi everybody - Tony here. Over the past few days, I have been a very good kitty and posed for some pictures that mom wanted to take. She snapped a few of them before I even noticed she was there! They're kinda fuzzy because she took them with her cell phone, which doesn't have a flash! I've had a busy couple of weeks, I must say!! First of all, the other day I figured out how to open one of the lower kitchen cabinets, and mom had some crunchy cereal in there! I chewed up a box of cheerios and a box of rice krispies, and I even ripped up the plastic bag so that cereal spilled all over the cabinet and even onto the kitchen floor! It sure was fun!! But mom wasn't too happy about this, so then she put a giant box in front of the cabinet so that I couldn't get back in it. Well, she didn't know that I've been working on this little problem. I was chewing on the box earlier today, but she kept making me get off of it, and she pulled off some of the old packing tape so that I couldn't chew on that. But then, while she was in her room (where she doesn't let me play!), I figured out how to move the box and get back into the cabinet!! I started chewing on a box of apple jax, but then mom came out. She was looking everywhere for me, but she couldn't find me.... But when she called my name, I felt like I should come out of hiding. At first, mom didn't realize I was in the cabinet - she thought that I had been hiding on top of the refridgerator - that's my other favorite spot. I really like to go on the refridgerator when she plays the piano, because then I can poke my head around the wall and watch her play. It's safe up there, too - the music can't get me! I also learned how to open the freezer door earlier this week! I don't really understand why mom gets annoyed when I learn how to do these new things! Afterall, I'm just tryin to play around!! That turning on the stove thing awhile back was truly an accident, though, and I'm glad mom pulled all the knobs off the stove! So here are some pictures of what I've been up to this week!This one is from tonight... I was sitting on our new couch watching tv with mom:This one is me under the piano. Mom was sitting in front of the piano bench, and I thought it was fun to suddenly hop onto the piano bench to attack her hands! I'm so sneaky...and my cat like reflexes makes me very good at games like this!Then Nana (mom's grandma) gave me this big long tunnel to play with! It has 2 holes that are usually on top unless I roll around in it so they end up on the side or the bottom. It has strings on each end to play with. It even had a fuzzy ball on a string at each end, but I chewed one off, so now it just has one left! It has some crinkly crunchy stuff at the end, and the very stiff wires in it make it stay open all the time so I don't get hurt! It's so comfortable that I even took a nap in it earlier this week! I really love this new toy!! Now when I want to run across the room, I dive through the tunnel first! Sometimes I hide in the tunnel and then attack mom as she walks by!! haha Here's me, peeking out of one of the holes - I'm actually hunting in this picture!This next one is also me in the tunnel! I had rolled it over a little, and I had my back paws out the one hole and my front paws out the other! I'm so silly! Sometimes I bat at my toys while I'm laying like this because it's more entertaining! Mom thinks it's hilarious!Next up is a picture from when mom put my spring toy on my bed (only 1 of my 3 beds!). I had a lot of fun flipping it over and chewing it. I was really attacking this! Sometimes I would run through the tunnel, leap onto my bed, flip on my back and grab my spring toy! I got very good at this after practicing lots of times in a row!After all that playing, I was really tired!! Even though we have a nice new comfy couch, I still kinda like our old one because it has mom's scent on it. I'm starting to like to lay where she sits on our new couch, though! Here's two pictures of me lounging on the old couch after I wore myself out!I was so tired that I didn't even realize my head was hanging off the pillow! I slept pretty soundly for at least a good 20 minutes! A nice cat nap! See how long I am? Oh this is just half of our old couch - grandpop took the other half home to give to the goodwill, and he's going to pickup this half soon, so I am trying to get used to the new couch!So after a long day, here's one pic of mom, too! I've been keeping her company lately, and really tried to be snuggly - especially when she feels sad. I know she's had a rough couple of months, so I'm trying really hard to be good!Thanks for looking at my pictures!! I try to do lots of silly, funny, and cute things so that I make everybody laugh! (Source: NeoNurseChic) NeoNurseChic blogs http://www.medworm.com/rss/comments.php?id=468918 Thu, 08 Mar 2007 03:28:00 +0100 468918 http://neonursechic.blogspot.com/2007/03/grand-rounds-is-up.html Grand Rounds 3:24 is up over at GruntDoc, and it was an excellent edition! GruntDoc has organized the links into various groupings, and each post has a short description. It's easy to read, and this is the first time in a long time that I've actually looked at an entire grand rounds all at once! I skimmed the list, and I've been reading a few posts at a time, but I liked being able to very easily view the list and get an idea of what each post was about quickly!I'm very grateful to GruntDoc for including my post on the relationship of patent foramen ovale (hole in the heart) to migraine. So head on over for an excellent edition of Grand Rounds - and this is also his 4th time hosting! Thanks for the hard work, GruntDoc! (Source: NeoNurseChic) NeoNurseChic blogs http://www.medworm.com/rss/comments.php?id=468919 Wed, 07 Mar 2007 06:42:00 +0100 468919 http://neonursechic.blogspot.com/2007/03/my-great-aunt-connie-october-13-1918.html My Great Aunt Connie died today in a hospital in Tampa at around 2:45pm. Her daughter and son-in-law were there (My Aunt Judi and Uncle Shlomi) as well as my grandparents. Connie is my nana's oldest sister. I have written before about Connie here in a tribute sense and also here and here about her recent health issues.Two days after leaving the ICU, Connie was transferred to a rehab/skilled nursing facility. She had papers for a living will and DNR. My family did not want her to have to go through intubation again or any other life-prolonging measures. (Note that I did not say life saving, as at this point, it would just be prolonging the inevitable...) However, a few days ago, she turned blue in the rehab facility (at a time when her daughter wasn't there), and EMS was called. Because the papers for her DNR and advanced directives could not be produced by the facility in time, the paramedics ended up intubating my aunt on the way to the hospital. Once her daughter and my grandma arrived at the hospital, they provided the documentation, and after discussion and meeting with the doctors, she was taken off the ventilator. She was admitted to the hospital for comfort care.Yesterday, I almost blew a gasket after hearing how the day had gone. I spoke with my grandma around dinner-time, and she had been at the hospital all day long. She said that a nurse had been in the room in the morning to turn Connie and to give her some morphine. Then, as the day went on, despite multiple attempts to get a nurse to come back in the room for pain medication and positioning help, the nurse kept blowing them off. Nobody went in the room to turn my great aunt until dinner time. At that time, they turned her, rubbed her back, and gave her some morphine. I told my grandma on the phone that my great aunt should be turned every 2 hours...she said that was certainly not happening. She told me of my great aunt's pain, and how Connie would thrash and throw her arms into the air in pain. I was absolutely devastated hearing about how this nurse, an experienced nurse who had been in the field for several years at that, had treated my dying great aunt. After talking about this with a couple of colleagues at lunch today, if my great aunt had still been alive when I got home from work today and things had not improved with respect to her care, I was going to have to call the hospital and speak with the supervisor or else their patient services department. My intent was not to yell or freak out, as I know I'm hundreds of miles away, but I really wanted to be sure that my great aunt was being taken care of. She was dying - and it breaks my heart that a nurse in charge of her care did not have any compassion and did not care to provide comfort and pain relief. While I was talking about it at lunch today, I started to cry just thinking about it. I became a nurse because I wanted to alleviate suffering. I also feel that I am blessed to take part in such monumental moments - such as death. Tonight on the phone, my grandma said to me that I must never become a nurse like that, and I said that I could never be that way. It really hurts my heart just to hear about someone in my profession treating my family like that....But not to dwell on the negatives - the rest of the nurses they had were phenomenal. They stayed on top of Connie's pain medication. When it seemed like the morphine every 2 hours just wasn't working well enough, they added ativan (at least I think it was ativan...based on the description by my aunt and grandma!). They said that it had a lot of side effects, but it really calmed Connie. She was thrashing so much at times during the night (before they gave her the ativan) that my grandma kept getting up to hold her because she was afraid she would fall out of bed or hurt herself. The night shift nurse ended up putting up all the bedrails and also padded the bed with rolls of sheets and blankets so that Connie wouldn't bang her knees. That's compassion... The nurse they had today was going to change assignments shortly before Connie died, and she gave each and every one of my family members a hug and was very sweet to them. They made every effort to keep Connie as comfortable as possible and also to support my family in this difficult time. I was sooooooo relieved to hear that things improved as far as nursing care throughout the night and during the day today.Connie had continued to be agitated during the day today. My family tried to calm her down, but it just got to the point where they really couldn't. The ativan was helping at least some. Judi had stepped out of the room for a few minutes, and it was then that Connie took her last breath. My uncle Shlomi and my grandfather were there. I truly think that sometimes our loved ones wait to breathe their last breath until we are out of the room - as it is their last act in sparing us the pain of watching them die. My grandfather told me on the phone tonight that yesterday, Judi said to Connie, "Can you feel all of the love we are sending you?" - and Connie nodded her head 4 or 5 times. My grandfather said this was proof that she could still hear what they were saying and sense that they were there. I'm glad.... Judi has been with her mother around the clock for the past few months.My grandfather told me that this was a very emotional goodbye. Judi and I spoke on the phone tonight, and everybody knew that this was the best thing - and Judi said that they were even praying that she would go so she could be at peace - but the loss is still sooooo hard. When I called my grandma tonight, the second she heard me say, "Hi Nana...It's Carrie," she burst into tears - which of course made me burst into tears. We talked a lot about these final days and also about Connie in other times. We know that Connie is up in heaven with her parents, her first husband Jimmy (who died in WWII in the Phillippines and was Judi's father), and her second husband Al (who was the brother of Bishop Fulton Sheen). Connie lived a great life - a sad life in some respects because of the losses she faced - but also a happy, fun life. I can picture her now - dressed in a dress that she would have worn in the 1940s or 1950s, makeup on, including red lipstick, hair done, glasses - waiting for Jimmy in his uniform...and they are so happy. I'm sure that's how she is now. Happy. No longer in pain. Still with us...always.I'm not able to go to the services due to financial reasons and also my work schedule. My mom is going to fly down on Wednesday, and several members of my family will be there. The viewing is on Thursday and the funeral is Friday. I plan to go down to Sarasota (by way of Tampa) in June to stay with my grandparents, and I will visit with them and my Aunt Judi at that time. At first, I was upset about not going to the funeral, but they are going to need continued support and love as the months go by, and I'm glad I will be there in June. That works out better for all of us. I said that my spirit and my heart is with them now. My mom is also bringing it down for me.It's been a difficult few months with some very significant losses. Again, I say Godspeed. Godspeed Aunt Connie. I will love and miss you always. Rest in peace... (Source: NeoNurseChic) NeoNurseChic blogs http://www.medworm.com/rss/comments.php?id=468920 Tue, 06 Mar 2007 04:20:00 +0100 468920 http://neonursechic.blogspot.com/2007/03/patent-foramen-ovale-hole-in-heart-and.html I'm a member of the Organization for Understanding Cluster Headaches (OUCH US), and last year, an article I wrote on Migraine and Patent Foramen Ovale (PFO) was published in the November 2006 Newsletter (pdf). The possible association between PFO and migraine was all the rage in the news for awhile due to the proposed potential that closing the PFO would lead to a significant reduction in migraine. For those of us with the most severe migraine and headache types, we were holding our collective breath in hope that this might actually lead to something. At the time I wrote this article, the most up-to-date info on migraine and PFO appeared to be a disappointment in that it was determined that closing the PFO wouldn't significantly impact migraine frequency or severity, and the risks of closing the PFO for migraine alone were not worth taking. However, research continues to be ongoing on this subject, so this may not be the last word on PFO and its association to migraine. Therapies to treat cluster headache are even more scarce than those for migraine, so when the connection between migraine and PFO came out in the news, many cluster headache sufferers wondered if this might not also be a possibility for treating cluster. This is the background behind why I wrote the article for the OUCH newsletter, and you'll find that the wording I've used in the article is geared towards the cluster population. Since migraine and PFO continues to be a "hot topic" in the headache world, and one that a lot of sufferers still want to learn about, I've decided to also publish this article to my blog. I have received permission from Helen Kemp at OUCH US prior to doing so! Without further ado, here is my article:Update on the Relationship of Patent Foramen Ovale (Hole in the Heart) to HeadacheInitially written on 14 October 2006, and published in the OUCH US newsletter in November 2006On 17 September 2006, I attended the public session of the Migraine Trust International Symposium held in the Kensington Town Hall Conference Center in London, UK. A number of professionals were brought in to give public discussion on a variety of topics related to headache. Since this was a migraine-related public session, the topics were all relevant to migraine in some way. Professor Hans-Christoph Diener of University Esson Germany presented two talks. I would like to focus here on the first of these talks, which was about Patent Foramen Ovale (PFO) in Migraine. The reason that I feel this topic is important for all headache sufferers is that over the past few years, the topic has come up in a variety of news articles and websites, and many migraine sufferers asked their physicians if they should be tested for PFO and have it subsequently closed if it was found to be present. Since many treatments for migraine are carried over for cluster headache, several cluster sufferers also wondered whether or not this might be a viable treatment option. Those who suffer from head-pain conditions are constantly in search of new treatment options that might bring relief from debilitating pain. This article will present the most updated theory about PFO closure in migraine, in which the end conclusion is that PFO closure is currently not warranted for treatment of migraine with aura or any other headache type.When a fetus is developing inside the womb, the lungs are not in use. The fetus depends upon fetal circulation through the umbilicus to the placenta for all needs. When a baby is born, at the exact time of cord clamp, a number of physiologic changes must take place in the baby’s body for the baby to live. One such change is a functional closure of the patent foramen ovale (hereafter referred to as the PFO). The PFO is commonly referred to as a hole in the heart because it is literally a hole between the left and right atria. The atria are the upper chambers of the heart. For the purposes of this article, I will not go further into the physiology of the heart, but the significance of the PFO is that it allows deoxygenated blood from the right atria to shunt into the left atria and mix with oxygenated blood returning from the lungs during times of stress. This can lead to deoxygenated blood being pumped into circulation. But furthermore, tiny clots can form in the location of the hole between left and right atria, and when blood shunts between the two atria, this could potentially dislodge a clot that would then be pumped into other areas of the body, and if the clot went to the brain, this could lead to a stroke.Studies have shown that approximately 17-23% of the population may have a PFO as found on autopsy. However, other studies done that detected the PFO with transesophageal echo showed the incidence to be 25.6% (Seib, 1934; Meissner et al, 1999). It was found that PFO and migraine are conditions with a high chance of overlap. Obviously this presented a variety of concerns. Migranous stroke is a small but very significant risk of migraine that can cause anywhere from minor problems to death. Furthermore, studies in recent years have looked at migraine as a potentially progressive disease due to uncovering the presence of nonspecific white matter lesions in the brain of migraine sufferers. Since the cause of these lesions is not fully understood, some have hypothesized that ischemia occurring during migraine attacks may lead to the plaques. If the PFO were setting off a series of small clots to the brain, then this could, in theory, lead to areas of ischemia. However, the talk by H-C Diener showed that these beliefs are actually incorrect.MIST I and II are studies that have been done to look at the relationship of migraine and PFO as well as the effect that closing the PFO might have on migraine. At the conclusion of the MIST I study, that looked at 113 migraine with aura sufferers, 53 migraine without aura sufferers, and 25 controls, the researchers stated that patients who have migraine with aura may have an increased risk of migrainous stroke due to having a higher chance of paradoxical cerebral embolus (Anzola et al, Neurology, 1999). A paradoxical cerebral embolus would be a clot that travels to the brain. Professor Diener proposes that in actuality, both migraine with aura and PFO are genetic conditions that may be inherited together. A person is 3.5 times more likely to have a PFO if he or she has migraine with aura. Both conditions have dominant inheritance. This would give the conclusion that migraine with aura has an increased prevalence of PFO (Wilmhorst et al, Heart2004; 90). However, further studies have shown PFO does not directly cause migrainous strokes. An increased stroke risk is related more to risk factors such as hypertension, smoking, etc.Closure of the PFO is done in cardiac catheterization labs where a catheter is introduced in the body via a large vein in the groin. This catheter then travels to the heart where the PFO can be closed with one of three different devices. However, this procedure is not without risks. In one study, two people died from fatal thromboembolisms and 9% had serious complications (Onorato et al, J Interventional Cardiology2003). In addition, insurance companies are not likely to pay for this procedure to be done specifically for migraine without other cardiac reasons to necessitate this surgery.Professor Diener continued to discuss why some studies regarding PFO closure and migraine might have come to the conclusion that study participants had 50% reduction in headache days. Every person who has the procedure receives 100mg of aspirin for 6 months. Aspirin is known to have a prophylactic effect on migraine for some people. In some cases, the PFO closure was done at a time when females might be going through menopause. For some women, migraine changes at menopause and can result in fewer migraine days. The benefits from PFO closure may have been due to other natural processes (Mortelmans et al; EuropHeartJ, 2005). The downside is that, for unknown reasons, some people actually got migraine after PFO closure when they had never had it before. Ultimately, the primary endpoint for complete reduction of headache was not achieved. The implant group in the study that showed 50% reduction of headache days had more headache days to start with, so this reduction was not statistically significant. When this data was adjusted to look at more conventional migraine trial endpoints, it was found that the reduction in headache days was significant (50%), but still not necessarily from PFO closure alone and may have related to other factors. All data from the major studies done were retrospective, and the one randomized trial was negative for reduction in migraine after closure of the PFO.So in conclusion, Dr. Diener stated that for a person under age 45, an echo to look for PFO is only indicated if this person has had a prior stroke. The studies only discussed migraine with aura, and PFO closure is not considered for any other headache type. Ultimately, according to Dr. Diener, the risk of the procedure is not worth any possible benefits this may have for migraine with aura. While this is disappointing for those of us with severe headache disorders that were hoping for a promising new treatment, it is better to know that this procedure is not worth the risk. This prevents any of us from learning the hard way by having the procedure and ending up with complications, while still not receiving beneficial treatment of headache.Sources:Migraine Trust International SymposiumPublic Session 17 September 2006, 1230“Patent Foramen Ovale in Migraine”Talk given by Professor Hans-Christoph Diener, University Esson Germany (Source: NeoNurseChic) NeoNurseChic blogs http://www.medworm.com/rss/comments.php?id=468921 Mon, 05 Mar 2007 03:28:00 +0100 468921 http://neonursechic.blogspot.com/2007/02/update-on-my-aunt.html Well yesterday proved why we don't just give up on people on ventilators - even at 88 years old. They extubated my aunt to nasal cannula yesterday. My grandma said she was more alert than she has been in quite a long time. She was asking my grandma how long she'd been there, and she kept saying how hungry she was. She was looking around, and she was asking where her daughter was and all sorts of things. My grandma said that it was a wonderful day. Ever since my great-aunt moved into the assisted living place, she has been sleeping more and not quite as clear, but yesterday my grandma said she was so much better.She isn't eating right now, but she does have a PICC line in. She has quite a bit of monitoring equipment on her. She is to have a swallowing test tomorrow I believe. They are talking about placing a feeding tube because she appears to be at such high risk for aspiration pneumonia. I'm now wondering if aspiration is what caused this severe bout of pneumonia. It also took them several tries to find an antibiotic that really worked. My grandma was concerned that the feeding tube wouldn't be what Connie wanted, but this was because my grandma was thinking of the way a feeding tube was used for Terri Schaivo. This is not at all the case with my great aunt as she is fully alert and not brain dead. So - I had a long talk with my grandma last night about how the feeding tube would probably improve Connie's quality of life because then she would be at less risk of aspiration and would also probably get calories she needs more easily. My grandma felt a lot better about it after we talked.So in the end, this is why I never give up on people - it's not over until it's over. Yes, I know she was very sick, is 88 years old, and was on a ventilator. But look - now she's doing better than she even was before. This isn't to say that she'll be able to live on her own, but she's not just going to be an invalid for the rest of her time. Even though she is elderly and needs some help, I don't think this means that her life isn't worth living. So I'm glad they didn't just let her die. I was wrestling with thoughts about having her just stay on the ventilator indefinitely, and if there was no chance of her ever getting better, then that's not what I would have wanted. However, she was able to get through the pneumonia, and now she's doing a lot better. It's a big relief...Our 2nd concert last night was great! My family and a ton of people I know were all there. So that was fun. It was at one of our local high schools - the building actually used to be my junior high when I was younger. It was weird to be back performing there for the first time since I was in 9th grade! I had made brownies with York Peppermint Patty topping on them, and they were quite tasty. :) In another couple of weeks, we'll start up rehearsing again for the spring. It's a lot of fun, so I'm really glad that the plan is to continue building the program onward and upward. We are actually going to have a "home" in our own theater at some point down the line. My choir director says that will just be in a year, but I don't know that they'll pull it together quite that quickly!I'm now about ready to head back to my apartment before a big snowstorm hits today. Just have to pack some things up! I plan to get some cleaning and organizing done once I get back - but we'll see! Thanks for the responses to my other post. I've been thinking about it all - and will probably reply more at some point. Have a great day. :) (Source: NeoNurseChic) NeoNurseChic blogs http://www.medworm.com/rss/comments.php?id=468922 Sun, 25 Feb 2007 17:01:00 +0100 468922 http://neonursechic.blogspot.com/2007/02/winter.html In November, I auditioned for a community-based choir being directed by my former high school choir director. This man was my mentor while I was in high school, and he is the reason that I went on to initially major in music education in college. He retired recently and decided to start up a community-based choral program, and I am a member of the first "Masterworks" choir. The members of this choir are varied - current high school students, current college students, former grads of our high school, parents of current/former students, and other members of the community. I can't recall the exact number, but I'm thinking we may have around 60 participants. There are several people in the choir that I graduated high school with. My best friend is one of the accompanists. Tonight was the first of two concerts. The other one is tomorrow night. I have had a ton of fun being a member of this choir, and I plan to continue to be a member for as long as I stay in the area.Our concert is centered on a theme of winter. Many of the pieces are about winter - including a beautiful piece by Eric Whitacre named "Winter" that also has an instrumental accompaniment. I have always loved Eric Whitacre's choral music. I would really strongly suggest that anyone interested listen to "When David Heard" also by Eric Whitacre as this piece is absolutely astonishing. He composes his pieces using a lot of polyphony and the effect is other-worldly. Another song that we are singing at the concert is "The Snow" - I'm blanking on the composer at the moment, but this is a 3-part women's piece. This is another favorite of mine that I have also sung in other settings.And while I listen to the astounding beauty of winter as played out in music, I am also reflecting on some deep thoughts about this winter. For some reason, this particular winter seems to have held a lot of sadness and loss in it for so many people. I alluded to one such loss that I personally suffered - and that was the death of my mom's best friend at age 53. Her middle son is my brother's absolute best friend. She had 3 sons - the youngest just recently graduated from college. She was a really great person. She'd been diagnosed with lung cancer back at Thanksgiving, but ultimately what took her life was a fungal pneumonia that was not responding to any antibiotics whatsoever. Even though she slept about 80-90% of the time, when she was awake, she was still her same self. In the end, her family was at her bedside and she drifted off to sleep and stopped breathing. The week of her viewing and funeral was a hard one... I said to my mom at the graveside that it seems like everyone we love that has died has died in winter. It is always so bitterly cold. My grandfather died in winter, as did my great-aunt, and a few other close family friends. This winter, my mom has known several friends who have lost relatives, and I know that other friends of mine have also lost people close to them. I don't know what it is about winter. The darkness of winter has played itself out very clearly to me this year.I had planned to start blogging again after I finished my 3 12's in a row last Saturday, Sunday, and Monday. However, then other things began to happen again. My great aunt Connie, whom I have blogged about before is currently in the hospital again. However, this time it is much worse. She's in the intensive care unit on a ventilator. She also has pneumonia. Apparently, the doctor told our family that they would only keep her on the vent for 2 days. However, she has begun to awaken, albeit in an agitated state. There is this part of me that knows how the medical personnel probably are viewing my family. They are probably wondering why someone would keep their 88 year old relative alive, on a ventilator, suffering, instead of just gently letting her go. And in some ways, I cannot blame them for thinking that. But my aunt Judi (my great aunt's daughter) is not yet ready, and I think that's okay. I spoke with my grandma tonight, and we both talked about quality of life. Connie had a really wonderful and full life. It was hard at times - losing a husband in WWII while she was a new mother and then later being widowed one more time. However, from the stories I have heard, she did have a great life. If this is her time, then my hope would be for her to be comfortable and to have her loved ones there (which she does) for her journey home. Every second that I hope she is okay and comes off the vent, I have to also ask myself what I am wishing for. It is so much against human nature to just simply say you are ready to let go. But I am also not there. I cannot imagine the strength that my aunt Judi is drawing on during this time. I dread the day when I have to face the aging of my own parents. It's not something I want to think about at all. And it was something I struggled with when my mom's best friend died - leaving behind 3 boys, all close to my age.So I still want to know what is it about winter. I can picture times in the still of winter. The snow has fallen and night has come over. The full moon shines down and glistens off the snow covered ground. Icicles hang from the branches of the trees. All is silent, except for the crunch of snow under the soles of shoes of those that have wandered out in the cold. Inside houses, flames are dancing in the fireplaces. Families snuggle close to one another to keep out the cold. And yet inside this serene beauty is also sadness. Even the toughest and fiercest of spirits are sometimes overcome by the winter. During a time when people draw so close to one another, it is the hardest time to lose someone - to stand at a graveside, knowing that you must walk away, leaving your loved one there in the cold. To feel that tear sliding down a frozen cheek. What is it about winter that breaks our heart? Is it the symbol of the winter of our own lives - that time when the light grows dim and we must leave this earth. It puzzles me that the season holds so much happiness at times, yet such profound sadness - sadness that is often not felt in other times of the year, at least in a metaphoric sense.Sorry I've not been around much. I really am going to try to return to blogging more often! I just have had a lot of personal things going on lately, and it was a good time to take a bit of a break from blogging. I am really glad that I decided not to continue with school this semester, as I doubt I would have had extra energy to devote to school, too. I still have been reading here and there on various other blogs with varying frequencies - and even posting some. But I am certainly going to try to blog more often. Thanks to those who continue to stop by to see if I've put up anything new. I appreciate it. :) (Source: NeoNurseChic) NeoNurseChic blogs http://www.medworm.com/rss/comments.php?id=468923 Sat, 24 Feb 2007 04:33:00 +0100 468923 http://neonursechic.blogspot.com/2007/02/stay-tuned.html Sorry for the long blogging hiatus. I think that was what I needed for the past couple of weeks. I'm just about to leave for the 2nd of 3 12's in a row at work, but after this weekend, I plan to start blogging again and even put back some of my old posts. I know you've all been losing sleep since I stopped blogging! (Ha...j/k!) So sometime after Monday, I'll be back on the blog! :) (Source: NeoNurseChic) NeoNurseChic blogs http://www.medworm.com/rss/comments.php?id=468924 Sun, 18 Feb 2007 11:22:00 +0100 468924 http://neonursechic.blogspot.com/2007/02/godspeed.html You're all still 3 angels - it's just that one of you went on ahead a little sooner than the rest. J, we all love and miss you. I'm glad you're not in pain and suffering any longer. You were one hell of a special person, and you will always be remembered.Rest in peace and godspeed...Love,Carrie :)(Just something I needed to do. Maybe someday later on, I'll write some more... But for now, just needed to do this.) (Source: NeoNurseChic) NeoNurseChic blogs http://www.medworm.com/rss/comments.php?id=468925 Sat, 03 Feb 2007 16:45:00 +0100 468925 http://neonursechic.blogspot.com/2007/02/thoughts-on-friday-night.html First, thank you - all of you who have commented and emailed me. I really appreciate it. Oddly enough, nobody has viewed my blog from work ever since I took down most of the blog and put up that last post there. But I still think this was the right thing for me to do, for now. For those who haven't heard about this on some other site yet, let me post the pic of what I did on Wednesday:Bummer, huh? It was my fault - bad intersection merging onto a busier road. Guy in front of me had stopped and then started again, and I looked over my shoulder to make sure the road I was merging onto was clear, but the guy stopped in the meantime and by the time I looked back forward, bam. Nobody was injured and his car had absolutely no damage whatsoever. The front of mine crumbled like a cookie. So I ended picking the pieces out of the road and putting them in my trunk. (That wide gaping hole across the front is where a row of headlights should be!) Fortunately, I have AAA and the guy who came and towed my car was very nice. He dropped me off only 2 blocks from my apt, too! At first I thought perhaps the damage was worse as after the accident, I saw a puddle of radiator fluid forming under the car, but nothing under the hood was damaged. (As you can see, they had to cut into the hood in order to get it up, and it looks to me like they banged it down in order to try to get it up without having to cut at it first - because this picture looks much better than how the car looked right after it happened!) The guy at the autobody shop thinks that the fluid leaked because of the impact. While financially, this couldn't have come at a worse time for me, I am extremely grateful that nobody was hurt and that the other guy's car was completely fine.But aside from that. I've been home from work now for about 6 hours. And until about 10 minutes ago, I was basically glued to one spot on my bed - almost too tired to move - and didn't even change out of my scrubs for all that time. I sat and thought about a lot of different things. I read some. I watched some tv. I wrote some. And I thought some more. And while a lot of this will probably mean nothing to anybody but me, I still want to write it. So these are just my random thoughts at the moment...*As a nurse, I might refer to someone as "dying" at some point. But for a loved one, I cannot bring myself to say that they are dying because then I feel that it might come true. I guess there are two ways to look at this. Some say that we're dying since the day we're born. But I prefer to view it as we're living until the day we die. So I can't refer to someone I love as dying.*But the flip side of that coin is that we will often say that someone might make it through one more day/week/month. I can say that as a nurse. But for a loved one, I cannot say that. Because then I feel like I am hoping for my loved one to live with terrible pain and suffering for one more day/week/month.*I am not the first, nor the last, to think these things and have these feelings. But they still hurt.*It's a cliche, but...it is far better to have loved and lost, than never to have loved at all. True for all things in life, I believe - not just romantic love or relationships gone bad - but in a life sense. *It extremely painful to lose somebody we love, but it is painful because we love them. And by loving them, we never lose them completely.*********I am very grateful for my friends. I am especially grateful for two friends lately who have been here for me through every major thing I've had happen in the last several months. When I need to cry, you two are there for me. When I need someone to distract me with something funny, you're there for me. When I need to bitch about something, at least one of you is very good at bitching about stuff with me. I love it. I just wish the other one of you was not 700 miles away. ;)*********I have more thoughts, but I'm having trouble putting them down. Since I had taken down almost everything I'd written and basically vowed to stop blogging for now, the fact that I'm writing at all is good I guess. I'm still not comfortable blogging as much as I was before, though - so I'm going to leave out some of the more negative thoughts that ran through my mind at various points tongiht.*One nice thing is that I found this really gigantic blank journal at Staples yesterday. I don't know how many pages it has - but I'll be able to write a lot in it! And what I realized is that in reality, I'll be able to get out so many more thoughts than I ever could have put on the blog. I actually started keeping my first diary when I was like 6 or 7 years old, and I have filled up 3 Hallmark diaries completely over the years. But this is not going to be a diary - it's a journal. :) Aside from music, writing is my outlet. Of course, writing short and sweet is not my forte, but there's always a need for big long novels. I've read quite a few of them over the years. Brevity is not for everyone. And the nature of my mind does not allow it, unfortunately. It takes me a painstakingly long amount of time and space to get my thoughts out at times! So I'm quite happy that I found such a nice journal!*Of course I must write in my journal with my Pilot G2 gel pens. Either blue or black will do. Gel pens for me are a must! I'm very particular about my pens. I dated someone once who was also very particular about pens - but he collected pens from all over the world...some very expensive pens! I'm not that particular about pens - but I do like a nice gel pen! ;)*One thing the journal cannot replace is the interaction of the blog, which is why I don't think I can completely give up blogging. I don't know that the blog will have to become private - I guess because things have slowed down with respect to my concerns over the past few days, I'm starting to think that maybe it'll be ok, but I am not ready to re-publish all I took down yet! So I guess I haven't really decided yet if I want to make the blog private or not. Time will tell! *********Of all the crazy things that have happened in my life recently, I'm left to think about the fact that as big as they are, none of them are as important as the thoughts on life and loss that I wrote about above. It's not that the rest of the things going on aren't important, but I just cannot get one particular thought off my mind.*I am keeping a candle lit in my heart.*May love and peace be with all of you. (Source: NeoNurseChic) NeoNurseChic blogs http://www.medworm.com/rss/comments.php?id=468926 Sat, 03 Feb 2007 07:21:00 +0100 468926 http://neonursechic.blogspot.com/2007/01/why-i-took-it-down.html Sorry that I took down almost all of my blog. I realize that the posts are in draft mode and can probably still be accessed somehow, but I cannot deal with my blog being read by people at work who aren't even telling me they've read it. It doesn't bother me that it's being read by colleagues - that isn't the point. It bothers me that people are reading it and not letting on, even when they read it on shifts where I am also there! I guess my mind just wonders why someone would read this and keep it as some major secret from me! Afterall, it's my writing! If someone has an issue with something I've written here, then I would hope that they would please just tell me!!I will gladly put my posts back up once I know who from work is reading the blog and have established that it's not going to be spread all around the entire unit. Until then, I'm afraid that it has to stay down. I've only left up the posts that I promised I would write for various things. The rest aren't deleted, but they are taken down for now.Sorry.... The other thing I can do (and will do) is make it so that only people I allow to view the blog can view it by signing in. So if you're interested in viewing it that way, then please email me at lizzpiano (at) gmail (dot) com. As soon as I have given enough time to hear from people, then I'll make the blog private except to those who I'm allowing to sign in and then I'll put all the posts back up! Sorry that it's having to come to this, but obviously my job is more important to me than the blog. This is true, even though the blog was a great source of comfort and outlet for me! Frustrating.... Take care! (Source: NeoNurseChic) NeoNurseChic blogs http://www.medworm.com/rss/comments.php?id=468929 Tue, 30 Jan 2007 18:18:00 +0100 468929 http://neonursechic.blogspot.com/2007/01/music-update.html OK so I just finished playing and recording for about 4 hours straight - maybe even longer! It was fun, but now I'm tired of sitting at the piano! haha I have uploaded all the songs into my idisk folder here and I think all of the new songs are at the bottom beneath my recital songs. The only one that might end up in the middle is 100 Years (solo piano). I recorded 2 solo piano pop songs (100 Years and How to Save a Life) and then a mix of pop and broadway piano/vocal songs. See the post below if you want the order for my 2 recitals so that the songs make sense. Now that I have 16 new songs recorded of the pop/broadway variety, I can make a cd to give to my family and friends! Yay... I feel like I accomplished something! Hope you enjoy! :) (Source: NeoNurseChic) NeoNurseChic blogs http://www.medworm.com/rss/comments.php?id=468927 Tue, 16 Jan 2007 23:04:00 +0100 468927 http://neonursechic.blogspot.com/2007/01/finally-muses-have-been-hard-at-work.html At looooong last, I have put together advice from Roy and Clink over at Shrink Rap and also Dr. A regarding podcasts and file sharing. I'm interested in creating podcasts at some point, but in reality, what I wanted was a venue to replace audioblogger - some way I could record my music with relatively good quality so that I could share it publicly! And now I've finally done that!! There are still things I need to improve on (such as using Roy's suggestion for how to edit out the last second of my recordings where you can hear me press the stop key), but for now, I'm happy with it. I mean, this is quite a step up from my recording over the telephone for audioblogger or on cassette tape for my friends and family.So here's the link to the songs I've created and uploaded so far: My MusicIf you don't have time to listen to all 3 songs that are there, then I would strongly recommend listening first to "I Can't Make You Love Me" as that's the best one I've done so far. Now is the time to admit that I take my music influences from a lot of places. For that song, my music influence is most definitely Leslie Henstock. Her music is available on itunes, and I absolutely love her voice. I've been singing "I Can't Make You Love Me" for years, but it was nice to have a few added nuances to incorporate. Her voice is also a reminder that smooth, soft singing is just as powerful and moving as belting out high notes. I love it!Perhaps tomorrow I will begin to upload songs from my solo piano cds - so if I don't mention it here, those will probably be added and on the file list as well, which means you'll have to look for the 3 vocal songs... "I Can't Make You Love Me", "A Thousand Miles", and "Kissing You" are all on there now. More to come in the future, however! Leave me a comment on what you think of the songs! Thanks!*Edited - I have added my 2 piano cds. Unfortunately, there is no way for me to adjust the order that the songs appear in - so that means that the two recitals are mixed together and all the new piano/vocal songs are at the bottom of the list. I'm going to put the proper order of the piano recitals here so that people don't end up listening to a movement of one Beethoven piano sonate here and another movement there!Junior Recital Pieces:Prelude in C Major (Bach - WTC Book 1)Fugue in C Major (Bach - WTC Book 1)I. Mit Lebhaftigkeit und durchaus mit Empfindung und Ausdruck (Beethoven - from Sonate Op. 90)II. Nicht zu geschwind und sehr singbar vorgetragen (Beethoven - from Sonate Op. 90)Prelude No. 6 in E-flat Major (Rachmaninoff - from Op. 23 Preludes)Prelude No. 7 in c minor (Rachmaninoff - from Op. 23 Preludes)Scaramouche Mvts 1, 2, and 3 (Milhaud) - Duo for 2 pianosI. Pagodes (Debussy - from "Estampes")II. Soiree dans Grenade (Debussy - from "Estampes")III. Jardins sous la pluie (Debussy - from "Estampes")Scherzo No. 2 in b-flat minor (Chopin)Senior Recital Pieces:Prelude and Fugue in b-flat minor (Bach - WTC Book 1)I. Allegro (Beethoven - from Sonate Op. 31 No. 3)II. Scherzo, Allegretto Vivace (Beethoven - from Sonate Op. 31 No. 3)III. Menuetto. Moderato e grazioso (Beethoven - from Sonate Op. 31 No 3)IV. Presto con fuoco (Beethoven - from Sonate Op. 31 No. 3)I. Novelette in C Major (Poulenc Trois Novelettes)II. Novelette in b-flat minor (Poulenc Trois Novelettes)III. Novelette in e minor on a Theme by Manuel de Falla (Poulenc Trois Novelettes)Polonaise No. 2 in e-flat minor Op. 26 No. 2 (Chopin)Gnomenreigen (Dance of the Gnomes - Liszt Etude)Widmung (Dedication) (Song by Schumann/piano transcription by Liszt) (Source: NeoNurseChic) NeoNurseChic blogs http://www.medworm.com/rss/comments.php?id=468928 Tue, 16 Jan 2007 04:26:00 +0100 468928 http://neonursechic.blogspot.com/2006/12/change-of-shift-vol-1-no-14.html Welcome to Change of Shift, Volume 1, Number 14! Change of Shift is a nursing blog carnival started by Kim over at Emergiblog, and I'm feeling lucky to be this week's host! I received about 9 submissions, if I counted correctly! I really have no theme planned for this week, but I would like to highlight three of my favorite posts as this week's editor's picks. So sit down with your cuppa joe (nurses must always have their coffee, eh? Too bad I haven't quite gotten with that program!) and enjoy this week's Change of Shift!Editor's Picks:My first editor's pick is from one of my fav fellow bloggers, Mother Jones RN over at Nurse Ratched's Place. She has come up with her own solutions for how to solve the nursing shortage and I have to say - some of them are quite hilarious. I can get down with the fast-track idea...afterall, I got my BSN in a year's time! My favorite suggestion is the recycling of retired nurses - look out Great Aunt Kay who hasn't been a nurse in about, ohhhhh, sixty years or so! She may be forced into taking care of you if we can't solve this nursing shortage! And check out the comments because one commenter has a great incentive - if all of us single women could be given the return promise of meeting hot single doctors, then OF COURSE we'd become nurses!Next up is a post that ended up in a discussion tonight with my mom, grandma, and me. This has to be a pretty stellar post because my mom didn't even know I had a blog until I decided to tell her about my hosting Change of Shift and then read her various parts of the following post. Over at Universal Health, our nurse blogger writes a tale of emergency nursing on the rails. This story is about a vacation-gone-wrong-but-right-in-the-end (my interpretation!) as our nurse heroine takes a railway trip across Canada, only to have to take care of a fellow passenger who is bleeding from the nose, mouth, and ear. What spurred the family discussion was my amazement that she thought to allow a drop of blood to fall from the patient's ear to a paper towel, and then checked this drop for a halo to make sure it didn't have glucose or CSF in it. I just wouldn't think to do this kind of thing, and I'm kinda hoping that's because I'm a baby nurse! But what my family and I decided in the end is that now, after reading this post, I'm well-informed with how to deal with this situation, and I'll never forget this info if I ever run across it in my own traveling! (See...I knew blogging was good for something!) I think another great point of the story is a reminder for patients to always give their nurses and doctors all of their pertinent medical background! (Yes dear, that heart attack you had back in 1996 is still important!)My third and final editor's pick is by a fellow neonatal blogger, Judy over at Tiggers Don't Jump. She tells the tale of a birth story with a surprise ending that reminds all of us in nursing that we can never get too comfortable with what we think we know. As a neonatal nurse, I've gotta say that I'm constantly surprised by the resiliency of even the tiniest and sickest of babies. Check out her post for a great birth story!Now, just because I had my editor's picks doesn't mean I didn't enjoy the rest of the posts submitted. I thoroughly enjoyed reading all of this week's submissions. Each of the stories meant something to me, and hosting change of shift for the first time was a blessing in that I got to learn about other nurse bloggers that I hadn't yet met! So here is the rest of the group:Too Fat for Ponies tells of his end of semester trials and tribulations between his car breaking down and having to take his hypochondriac mother to the emergency room. The story had me laughing - but no worries, I'm definitely laughing with you! After reading the story, I have to say that I'm very glad my mother isn't a hypochondriac! I hope you've gotten your car situation straightened out also! Just so you know, since mummy dearest is a retired RN, according to Mother Jones's nursing shortage solutions, your mother is going to have to rejoin the work force! Wonder what she'd say to that one! ;)Next up is a post from Ian over at ImpactedNurse. The post, entitled Slayer is about a coworker who tackles a psychotic patient who is trying to flee the ER. His words of wisdom are that "you've got to watch the quiet ones." I agree!Then we have a submission from Patti, who writes at NursingAssistants.net. Her post is very well written and full of good advice for CNA's, entitled Tips and Timesavers for CNAsOur Change of Shift creator, Kim over at Emergiblog, has submitted a post on what she thinks it takes to be an ER nurse. It's a great post, and I agree with everything written - I almost became an ER nurse! I must say, that it takes a certain type, but the environment also molds that type quite well - when I worked as an ER patient registrar, I became a different person as the month's went by! Kim says she couldn't do the NICU, but I don't think I could do the ER - so we're even! Many of my favorite bloggers are ER docs and nurses, so keep on savin those lives on the front lines!Nancy, from Unpaid Writer, sends a submission that speaks about nurses. When she was going through the decline of her grandmother's health, she came across an angel in the ER. The post is a beautiful example of how nurses can advocate for patients. Our actions DO matter, sometimes more than we even know.Susan Palwick at Rickety Contrivances of Doing Good is a volunteer ER chaplain, and while her post about a patient with voices is not about nursing exactly, it is a really good example of how to work with a patient who hears voices. She writes with a great deal of compassion.Finally, I'd like to highlight our nurse bloggers over at MedScape. While not submitted posts, Medscape is a very important part of the medical blogging community, as many of you already know! I'm linking to Beka's post on living with dystonia because of the fact that the focus of my blog here is very often to highlight what it's like to be a nurse with chronic health problems. While we may not all suffer the same issues, we can relate to what it is like to see both sides of the patient-nurse relationship. I truly believe that we should all keep in the front of our minds that nobody is immune to illness, not even health care workers, and we must be thankful for the health that we have! I'm also linking to Julie's Medscape post about NPs and PAs opening doors. This is exciting as I'm also on track to become a nurse practitioner, even though I'm planning to take a slower path to get there than originally planned. Nurses wear a wide variety of hats, and we have the ability to make an impact in so many special ways!Before I close, I'm going to link to a post I wrote back in May. I know that's ancient history, but the topic is one that I feel is very important, and I'd like to revisit it! This post is actually a paper I wrote for school on the topic of the theory of chronic sorrow as it applies to neonatal nursing, but it can apply to any nursing really! I'd like to point out that one of the original creators of the theory, Georgine G. Eakes, left a comment on my blog! I really need to contact her to thank her, as that made it very special for me!So that's it! I hope you've all enjoyed this week's version of Change of Shift. I really enjoyed hosting, and I hope to do it again someday! I've definitely gotta be a more active submitter! Please let me know if there are any errors or problems. If there is anyone who made a submission but wasn't included, please also let me know as I didn't intentionally omit anybody! Hope everybody has a happy and healthy new year! Peace! (Source: NeoNurseChic) NeoNurseChic blogs http://www.medworm.com/rss/comments.php?id=468930 Thu, 28 Dec 2006 06:00:00 +0100 468930 http://neonursechic.blogspot.com/2006/09/in-memoriam-of-daniel-james-shea-911.html September 11, 2001 is a date that not only Americans will always remember, but also many people around the world who watched in horror as terrorists took the lives of 2996 innocent people. While we have just now reached the 5th anniversary of that horrific event, there will someday be a 50th and 100th anniversary, and it is up to those of us who have lived through this event to tell the story of what happened that day to our children and our children's children. The 2996 Project, created by D. Challener Roe, was designed to honor the memory of all 2996 victims by assigning each name to a blogger. I am blogging in memory of Daniel James Shea, 37 years old, who was a beloved father, husband, brother, son, friend, and businessman who died in Tower One of the World Trade Center as an employee of Cantor Fitzgerald. While the terrorists may have murdered nearly 3000 of our loved ones, they did not succeed in killing the American Spirit, which seems to only have grown stronger since that horrible day.The day I found out about the 2996 project by reading an announcement on Emergiblog, I felt a flutter in my stomach. I clicked on the list of names and began scanning to look for the names of Daniel James Shea and Joseph Patrick Shea. Joseph had been assigned to Dori at The Ups and Downs of Our Life who has written a lovely tribute in memory of Joseph Shea.Danny and Joe Shea were brothers - the youngest and the oldest of the Shea family respectively - who left behind their young widowed wives as well as 7 children between the two of them. Danny was survived by his wife Ellen of 6 and 1/2 years, as well as their children Colin, Abigail, and Margaret Jean, who at the time were ages 4, 2, and 7 months respectively. While I did not know Danny or Joe personally, they were best friends with my Aunt Sally and her then-partner Suzanne, both magazine executives from the same community of Pelham Manor, NY. Danny and Joe's sister, Kathy Munson, was a frequent tennis partner of my Aunt Sally's. Even prior to 9/11, I had heard many stories about the Shea family, so while I had not met them, I felt their loss very profoundly. Earlier, I re-posted something I'd written last year, sharing my personal memories of 9/11/01, and this included the fear and worry about my aunts, whom we hadn't been able to contact, as well as another aunt who was a flight attendant for American with a base out of NYC. As the days unfolded and we learned of the deaths of Danny and Joe Shea, we were truly heartbroken by their loss.Nancy Shea, Joe's wife, recalls that Joe and Danny had "classic birth order personalities." She states that while Joe seemed to have been "born a grown-up," Danny was generous and the fun-loving life of the party. Ellen, Danny's wife, recalls that Danny "had the Irish gift of storytelling," and that "he would walk in, and people would say, 'All right, the party can start.'"Ellen remembers Danny as a very kindhearted and generous person. She tells of the time when 3 firefighters were killed battling a blaze on Father's Day of 2001. Danny called her and said, "I'm thinking of giving everything I earn today to those widows. What do you think?'" Ellen recalled her reply by saying, "I started to cry and said, 'That's why I love you. Yes, do it.'" This was only one example of Danny's big heart and generosity.Daniel Shea had worked for Cantor Fitzgerald since 1991, and at the time of the attacks, he was a management director and partner. Joseph Shea had been with the company for 12 years and had been a senior executive management director. Joe was on the 105th floor of Tower 1 at the time of the plane crash, and Danny was one floor below. While many of the quotes of my memorial here have been quoted from this September 23, 2001 Newsday article in memory of Joseph and Daniel Shea, I clearly remember my mom telling me about Joe's last phone call home to his wife, Nancy. Joe had said to her, "Don't worry. You're going to see this on the news, but I'm all right." When Nancy asked about Danny, Joe said he was going downstairs to get him and then they would both be home. This was the last time she ever spoke with her husband. When my parents told me about that phone call, I remember sitting down and crying, unable to deal with my own grief for this family's profound loss. Cantor Fitzgerald lost all of their 658 employees that were in the tower that morning. The firm had offices on the 101st through 105th floors of Tower 1. For the longest time, I had an article about the memorial service held for the firm's employees tacked to a message board in my room.While I never met Danny or Joe Shea prior to their death on 9/11, I did have the honor of meeting both Nancy and Ellen, and all 7 of the children, in the summer of 2003. My aunts had rented a house in Nantucket, and the Shea's also vacationed up there. My family and I had gone up for a long weekend to visit my aunt, and we finally met the Shea's, whom we had heard so much about. I remember both Nancy and Ellen as strong and beautiful women. Their children were also lovely - they seemed happy - running around, laughing and playing. I know the memory of their fathers was very present with them at that time, as it always will be. At the conclusion of the Newsday article, Ellen shares that she remembers the time she and Danny spent together as a way to help her get through the devastating loss. "There was a lot of laughter," she said. "I've probably lived a fuller life in just those few years than a lot of people have lived in 99 years. And that helps me. It helps."Danny and Joe were 2 of 2996 taken from us on 9/11/01 at the hand of heartless terrorists who sought to destroy the American Spirit. They did take the lives of many fathers, mothers, sisters, brothers, sons, daughters, friends, and upstanding citizens, but they will never take away the American Spirit. And the lives of all who died that day will forever live on in our hearts. I would like to again credit the Newsday article that provided such excellent quotes from Ellen and Nancy Shea about their husbands' lives. While I relied on that article for particulars, it is amazing how much of the story I remember hearing firsthand from my aunt and parents in the days following 9/11. Even though I never met Danny or Joe Shea, I still felt their loss deeply and I still keep their family in my prayers. My aunt often talks about how many from Pelham Manor were lost in the attacks, and I know the absences will always be felt in that community. They will forever remain in my prayers.Here are the links to fellow bloggers from my list of links who participated in the 2996 project:Dori's post in memory of Joseph SheaCathy's post in memory of Adam K. RuhalterMay's post in memory of Paul InnellaLadybug's post in memory of Joseph MaggittiKim's post in memory of Brenda C. GibsonAnd while not part of the 9/11 project, Dinah also posted a tribute to a former classmate of hers in her post Thinking of CarlosIf you read this and would like me to link to your tribute, please let me know via comment!You can find the complete list of victims as well as the bloggers who are honoring them by clicking here.Here is a page for the Cantor Fitzgerald blog for linking their lost: Linking the Lost9/11/01...Never Forget...My other related posts are:9/11 - Rememberance In My Own WordsNational Anthemand the music clip of me singing the National Anthem a capella found here (Source: NeoNurseChic) NeoNurseChic blogs http://www.medworm.com/rss/comments.php?id=468932 Mon, 11 Sep 2006 05:22:00 +0100 468932 http://neonursechic.blogspot.com/2006/09/national-anthem.html After reading Dr. A's post about theNational Anthem and the subsequent comments about various versions that readers enjoy listening to, I decided to record my own a capella version on audio blogger. (Same ole gripe about the quality of how I sound as recorded through my phone, but it turned out pretty well!) I think my version is largely shaped by the Martina McBride version that I love so well. However, I have about 5 different versions of this recorded on a cd I made after 9/11, so it may be bits and pieces of all of those! Enjoy... :) (Source: NeoNurseChic) NeoNurseChic blogs http://www.medworm.com/rss/comments.php?id=468933 Mon, 11 Sep 2006 00:24:00 +0100 468933 http://neonursechic.blogspot.com/2006/09/911-rememberance-in-my-own-words.html **I wrote the following post on a Xanga site I used to have on 9/11 last year, but I thought it pertinent to repost this year, as I wrote about how I remembered that day. Although this is not my official tribute, I did mention the names of my aunt's best friends, Danny and Joe Shea, who died in the WTC - employees of Cantor Fitzgerald. I will be blogging in honor of Danny Shea, and Dori of The Ups and Downs of Our Life will be blogging about Joe Shea. But for now, here is the account of how I experienced 9/11/01.**9/11/01 - Rememberance In My Own WordsI'll never forget how I learned that 2 planes had crashed into the World Trade Center and sent them crashing to the earth, the plane that crashed into the pentagon, and the plane that crashed into rural Pennsylvania - the last, a successful attempt at stopping the terrorists in their tracks - at a great cost.That morning, I was in chemistry lab (Penn State main campus) from 8am-noon. Nobody told us. Perhaps they didn't know. Perhaps they wanted us to finish our lab in peaceful calm before learning of the tragic disaster unfolding before America's very eyes. Either way, we weren't informed of what happened - not even at the end of lab.I walked up to the music building, and on my way in the building, I saw two of my good friends. I told them I was headed to piano pedagogy class - they told me I should check to make sure I still had class. My response? "It's a Tuesday. Why wouldn't I have class?" Then the look - the sad and hurting look - as my 2 friends said, "Oh you didn't hear...." and relayed to me the story of what had been happening throughout the morning.I couldn't believe what I was hearing. How could it be possible. And then terror inside me took over - my 2 aunts worked in Manhattan and another aunt was a flight attendant for American Airlines. Fear for my family immediately took over, and I called my dad - who again verified what had happened. I remember him saying, "They're gone. The buildings are gone. There is no more World Trade Center." He hadn't been able to get in touch with my aunts - who didn't work in the trade center. We found out that Judi wasn't flying that day, which was at least one relief.I was schedule to accompany a voice lesson that day. Much to my surprise, the lesson was still taking place. The voice teacher made a comment about my looking so distraught, and I said..."Well, family in New York..!" He said, "It's only the World Trade Center that was affected so if they didn't work there, then they were fine." I was horrified by his response. He continued to behave in the same way in the days after the tragedy. Many students questioned this response. But maybe this was just his way of dealing with unthinkable loss. He was a kind and religious man, and I couldn't imagine that the tragedy just did not affect him.I went back to my apartment in State College Park after that. I shared a 4 bedroom apartment with 3 other girls. I sat down to turn on one of the news channels, and proceded to eat about 2,000 calories in 30 minutes. I believe it was the sheer distress over what I was seeing. The tears just wouldn't stop pouring. I went to my room and continued to watch the television - tears continuing to stream down. Eventually I drifted off to sleep for awhile - having nightmares about people jumping from very high floors in the trade center because they felt that it was better to jump than to die by burning up in fire. It only took 21 minutes for the buildings to come crashing down - while I'd missed seeing all of this while in class, I saw the scene repeating again and again on the news channels. Before leaving campus, I'd been told that students were piled into Kern (the grad student building) - some standing on tables and chairs - all completely silent and watching events unfold on the one large television.When I awoke from my sleep, I thought for a split second that it was all one horrifying dream. Then I saw the continued news coverage and was jolted back to a frightening reality. I called my friend Erin who was another music student, and a good friend of mine from our music fraternity. Finally, Erin and I couldn't bear to sit still and watch the reports any longer. We decided to meet up at the HUB (student union building) to see if we could donate blood or help in any other immediate way. On the corner outside the HUB, we found our friend Erik - another music major. He was angry - said he was going to join ROTc like he'd always planned. His brother was in the service, and Erik vowed to do the same. We all hugged and Erin and I went on to the HUB.Inside, the HUB was packed - many students were watching the big tv there. The line for blood donation was incredibly long, and they weren't taking any more volunteers that day. It felt good to be there, though - back with people - not to face this horror alone. We could cry together and hug together and pray together.I spoke with my mom on the phone. She said my brother wanted to join the military as well. The news in the months and years after would focus on United Flight 93 which crashed in Shanksville in Somerset County, PA - as it was so close. The news from Johnstown covered the story year after year as the memorial was designed for the heros who took down Flight 93 in moments of extreme courage. Todd Beamer had been a student at the same college my cousin attended in suburban Chicago. The intended destination of Flight 93 was later thought to be the White House.We learned in the days after 9/11/01 that two of my aunts' best friends had died in the WTC. Their names were Danny and Joe Shea, and they worked for Cantor Fitzgerald, who lost over 600 employees on the 101-105 floors of Tower 1. One left behind 3 small children and the other left behind 4. Their young families and widowed wives would be left to deal with the tragedy without their husbands/fathers. Many men and women died in the towers who had lived in Pelham County, NY - the same county my aunts lived in. It was devastating.The day after 9/11, I had a piano lesson. My teacher and I talked about the entire event, and more tears were streaming down. Towards the end of the lesson, Dr. Shafer asked if I wanted to play the piano at all. He left it up to me. I said I did want to play - I took out my concerto - Saint-Saens 2nd Piano Concerto in g minor. This concerto seemed very fitting for me to play on that day. It was very sad, full of desparation, and also loud crashing cords. It ranged over the entire gamut of emotions - and today it still represents in music the tragedy of 9/11 for me, personally.So that's my immediate personal account. I'll never forget 9/11, what I was doing that day, and the time after it - as well as the years after it. Nothing has ever been the same since - and nothing ever will be the same. The one thing that touched me was the outpouring of pride in our nation that occurred after 9/11. If the terrorists had sought to destroy our nation's morale, they did not. They forced millions to join together and fight the force that worked to pull us apart. American flags flew everywhere. The photos of scenes around the United States were very moving.These are my own personal memories of 9/11....or at least part of my memories....I wanted to write my story as many others have written their story of that day - it will serve us all to remember these stories - Never EVER to forget.In loving memory of all who died that day, and especially for Danny and Joe Shea and their family left behind.9/11/01 - Never Forget... (Source: NeoNurseChic) NeoNurseChic blogs http://www.medworm.com/rss/comments.php?id=468931 Mon, 11 Sep 2006 00:02:00 +0100 468931 http://neonursechic.blogspot.com/2006/09/my-great-aunt-connie.html That's my great-aunt Connie. Her real name is Mary Margaret, but she changed it to Connie a long time before I was ever born. Her last name, these days, is Sheen. Sheen for her late second husband, Al Sheen, whose brother was the revered Bishop Fulton Sheen. Connie was married once before Al, as I alluded - her first husband's name was James Cain...otherwise known as Jimmy.Jimmy went to WWII in the South Pacific. He died in the Phillippines, serving this country. We still have some of his old letters and the flag given to my great-aunt in service for his death. It wasn't all that long ago when a friend of mine whose parents came to the US from the Phillippines thanked me for my great-uncle's service while we were walking around Philadelphia, discussing the history. I thought that was kind. I love reading Uncle Jimmy's letters and the papers that were saved from the military. Even the letter sent to my great-aunt from the President, thanking her for his service and for giving his life for his country.Jimmy and Connie had a daughter who was only a few years old at the time of his death - her name is Judi. As an adult, she went on to be a flight attendant for TWA for over 35 years until TWA went bankrupt and was bought by American Airlines. She has been furlowed by American for some time now as they are also in a good bit of financial trouble. At one point, she was married to a man from Spain, and now she is married to my Uncle Shlomi from Israel. The latest I heard, Shlomi's mother is on life support in Haifa, and if she dies, then Judi and Shlomi will both go to Haifa for a week, a fact that I'm not overly happy about, given all that has been going on in Israel these days. Since Judi has been furlowed, she has worked in a facility for juvenile rehabilitation, and she found that she really enjoys this. In her earlier years, she spent time with the peace corps and traveled to a number of places before being disillusioned by the fact that many of the supplies sent to foreign countries for people in need were in fact confiscated by governments or rebel troops. She has a strong tie to our own cultural background as Blackfoot and Sioux. She and I actually are so much alike - sharing similar interests, a deep love of studying people and cultures, for traveling, and for interest in our heritage.Back to my great-aunt Connie. She is the oldest of 3 sisters - herself, Kay, and Mildred, or Mid, as she goes by. Mid is my grandmother. Their parents, Agnes and John, were second generation Americans, mainly from Ireland although they do have a small fraction of the Native American blended in. I've heard so many stories over the years from their growing up. I'm proud to say that all 3 are still alive. Connie was born in 1917, Kay in 1920, and Mid in 1922. (I hope I have those years right - I know the last one is right and I'm going by ages for the other 2!)Aunt Connie (easier than re-typing Great-Aunt every time, and we call her Aunt Connie) has lived in Clearwater, Florida for as long as I've been alive, and I've been to her condo many times. In fact, I took that first picture at the top of this post in June of 2005 when I went to visit my grandparents down in Sarasota after graduating from nursing school and having my bilateral knee surgery. My trip to Florida was a rehab for me, of sorts, but also a great time to spend with my family. I try to go at least once a year. The picture at left here is of Aunt Connie, my grandparents Mid and Frank, and me. Judi was taking the picture. :)Connie lived her life wearing high heeled shoes every day. To the point where now, her achilles tendon has actually shortened and heels are all she can wear! We've tried to gradually get her to wear flat shoes for her own safety, but this is definitely a challenge! She also volunteered at the local nursing home and went every single week. The residents there absolutely loved her. She did this until she had a stroke and was no longer able to drive. She continued to live at home, but she is alone and wasn't eating well and continued to have some problems that worried her daughter and my grandparents.This past July, about a week after my family's vacation down the shore, my grandparents flew back to Florida to move Connie out of her now sold condo into the first tier of an assisted living place. However, if I'm not mistaken, the place they chose has no nursing home - only the first and second tiers. She's only been in the place for a couple of weeks and twice she's been taken to the hospital and admitted. The first time, she passed out while walking into a store with Judi, and she was dehydrated so they admitted her. (It's really hot in Florida in July....and my aunt tends to turn the heat on because she's always cold.....oy)Last time was this past week. Judi had taken her out and while she went to run into the store quickly, she left Connie in the car with the car running. Connie turned off the car, and was sleeping when Judi got back out - obviously alarmed that the car was off. They got her back home, and she again collapsed going into her apartment. She was taken to the hospital again, and things haven't been exactly right with her. They weren't sure if perhaps she had another TIA or stroke. The doc explained to Judi and Shlomi that Connie should not be living alone. They admitted her and then transferred her to the rehab unit for her to gain some strength. She never eats much - my mom told me that she has always been t