Eye Update.....

Eye Update.....
I saw Dr. Vogel again this evening. He was pleased that my vision has improved. It's gone from 20/70 to 20/40. He dilated my eyes and had a look. He said the bleeding is the same, no smaller. He also said the fluid in the macula was "less" which is good. He wants me back in 3 wks for another avastin injection. He said "Your eye is no worse which is good news." Hey, I'll take it!
I asked him for a copy of my eye photos. Once I get them, I'll post them for others to view. I also asked him if it was contagious and he said no. I asked him that because I remember taking care of a patient when I was in nursing school who had histoplasmosis in her lungs. I also asked if being raised on a farm when I was little could have caused this and he said "yes". So, I guess I know where I could have contracted this from.....chickens!
I asked him if it was a chance the the bleeding would go away completely and he said "yes". I'm kinda bummed that the bleeding is no smaller. But, considering it could have been larger, I'll take "the same".
Keep your fingers crossed my vision continues to get better. Say little prayers for me.....heck, say BIG prayers for me. I need my eyes!

I posted a pic of the retinal hemorrhage above......nasty, huh?

Ocular Histoplasmosis?????

Hello guys. I'm new here. This is copied from my blog:
The vision in my right eye started getting blurry last week. I didn't think too much of it because heck, let's admit it....I'm getting old. Both my parents had to get glasses later in life. Up until last week, I've had 20/20 vision. So, I called and made an appt to have an eye exam.
I went friday for my eye exam and I was told I have a retinal hemorrhage with satellite lesions in my right eye. The eye doctor told me you usually see this in people with high blood pressure, diabetes, or some type of infection. Now, I have none of these. She did say I do not have any swelling on the optic nerve, which is good. I have an appt to see a retinal specialist first thing tomorrow morning.
Update 4/14/08: I saw Dr. Vogel first thing this morning. He is a retinal specialist and is supposed to be the best around. He seems to think I have come in contact with histoplasmosis in the past and this has scarred parts of both of my eyes. (The right eye is worse.) He says this can cause abnormal growth of blood vessels in the eye and this is what has happened in my right eye. Those vessels have burst and is bleeding in my retina. There is some edema and fluid pocket there but luckily there is no swelling on the optic nerve....yet.
My options: I have elected to proceed with 3 injections of Avastin, given 6 wks apart in the right eye. YES, a needle will go in my eye! Avastin is a cancer drug that is FDA approved to stop bleeding/growth of abnormal vessels. It is NOT FDA approved to use in the eyes but eye doctors use it off market and have great results with it. As with anything, there is side effects and possibilities of worsening. He said we will remain optomistic but worse case scenerio, I can end up losing my vision in my right eye. He said this is pretty progressive if left untreated. So, I go back tomorrow for my first injections. Keep your fingers crossed that all goes well. I'm NOT happy about a needle going in my eye!
Update 4/15/08: I went today and had my first injection of Avastin. He numbned my eye and then put a metal brace in my right eye to keep it open. He cleaned it well with betadine and flushed it out with saline. He then injected the medicine. I must admit, it was a little pressure but nothing too bad. It was over in a flash. I kept my right eye closed most of the day as it was fuzzy. It is starting to get better now. I haven't really noticed any improvement yet. I hope that will come over the next few days. My eye does feel a little "irritated" like there's an eyelash or something in it. They said this is normal and to use artificial tears along with my antibiotic drops for 3 days.
If there's anyone out there going thru what I am and would like to keep in touch, please email me at :ERRNVA@aol.com. I am 35yrs old and an ER RN. This is all new to me and very scary. I really need my eyes in my profession. I am also an avid photographer!

Crazy Ex-Bosses!

I receive a call from a nurse friend of mine last friday, who used to be my co-worker when I worked for the state. She informs me that our "old boss" who has been demoted to a "regular ole nurse" has been escorted out the building via state police and the "powers that be" in Richmond. She is on a 10 day suspension pending an investigation regarding her behaviors.

HELLO.....I tried to tell them she was CRAZY when I left. I guess what goes around, comes around. I just hope she can get some professional help because she truly is disturbed.
Maybe the "good" people I used to work with can now see some peace.

Dang it’s hard to get rid of someone once they work for the state. It’s like an act of congress to get rid of the people who suck and don’t do their job. They basically have to kill someone to get fired. And believe you me, she has threatened to do it. That’s why she was suspended.....at least one of the reasons she was.

Hit the floor

I was at work last night and was nice enough to stay over 1 1/2 hrs for a nurse who was going to be late. I was doing the narcotic count with her and suddenly felt nauseous. Then I felt really hot, like I was going to throw up. My vision started getting blurry and I turned to my left to attempt to sit down. The next thing I know, I was lying on the floor looking up at the other nurse calling my name and yelling "are you okay?"

Now, I have NEVER had this happen before. I have NEVER passed out. I don't know what the heck happened. Luckily, we have a machine there that checks vital signs and blood sugars. My blood pressure was normal and my blood sugar was normal. I go to see my surgeon in 2 wks for my 1 year check up. I will discuss this with him and see what he thinks.

Are we too busy to stop?

My friend who lives in Winston-Salem, NC called me a few hrs ago to talk about getting tickets to see Jimmy Buffett in April. She goes on to tell me that she was ran out the road the other day by a tractor trailer. She was on the interstate going 70mph in Greensboro, NC when this happened. It was 5:30am and she doubts the tractor trailer driver even knew about it. She said her car spun around on the interstate a few times and then her car ended up backwards lying on its side in the median of the interstate facing the wrong direction. Now, the next part is the part I'm having difficulties with....

SHE SAT IN THE MEDIAN, CAR SIDEWAYS IN THE DITCH, FACING THE WRONG WAY, WITH HER HEADLIGHTS ON.....FOR 45 MINUTES AND NO ONE STOPPED TO SEE IF SHE WAS OKAY. She said cars were racing by and not the FIRST person stopped to see if she needed help. No cop came.....NOTHING.

Now, I'm sorry....I realize we are a very busy society and we are all trying to get to work but what ever happened to compassion? What ever happened to checking on others to see if they're okay? She called her husband, who was 45 mins away, and he drove up and pulled her out of the ditch with his truck and STILL no one stopped to see if they needed help. At least someone could have called the cops to get them go check on her.

What have we come to? Are we too busy in our lives to stop to see if another living being is okay or needs help? I'm sorry but I'd stop. Maybe I'm one of a dying breed.

People are Strange....

I had some errands to run today so I went out to Subway to grab some lunch. I ordered a "steak & cheese" wrap. The girl asked me if I wanted "double" meat. I said "No", as I cannot eat that much anyway. I decided to eat inside because I did not want to eat in my new car.

Now, I admit.....I'm a people watcher. I think you can learn alot by watching others. Especially in today's society. One couple who came in and sat near me was quite odd. They chose to sit at a table that was dirty. There were plenty of other tables that were clean. Then, when the Subway staff ran over to clean the table, the woman spoke up and said "No, that's okay. You can spray some of that cleaner on my hands though." WHAT????? CLEANER ON YOUR HANDS??? WTF???? She proceeds to wipe the cleaner all over both hands and then she unwraps her sub and eats it.

Now, I'm sitting here thinking to myself "this woman is nuts!!!!" If she doesn't end up in the toilet puking or pooping the rest of the day, it will be a miracle. She's one of those people who will be in the ER going "I don't know what happened. I was fine when I woke up."

I just shook my head and went on to my car. If she wants to ingest "God knows what" cleaner, then so be it.


Tanya

She-Wolf

She-Wolf


Lured away. One by one.
Unaware of the danger ahead.
Innocent with the knowledge unformed.
Of the trap that leaves so many dead.
Desire and the need for attention
Leave so many wanting more.
The dangers that lie ahead
Are locked behind a closed door.
The willing cannot resist the temptations
Of the much wanted sin.
That keep them coming back
Over and over again.
What is this evil force you may ask
That leads innocent souls away, one by one?
Why it's none other than the evil She-Wolf
On her nightly She-Wolf run.


~by Tanya S. 10/18/89

Life.....

Life


Unfound trust.
Misunderstood conceptions.
Uncertain fedilities.
Unanimous love.
Unbosom beliefs.
Displeased adults.
Forbidden actions.
Timorous authority.
Unsociable companions.
Consolidated relationships.
Towering restraints.
Stupendous forgiveness.
Spectacular happiness.
Armageddon lifestyles.
Articulate understandings.
Botchable relations.
Life.


~by Tanya S. 12/27/89

How the ER staff really feels.....

1. The world of the E.R. does not revolve around you. There are sick people here, and you may or may not be one of them. We get to decide that. If its chronic, and already diagnosed by your doctor, its not an emergency. (Ex: back pain x 3 years.)

2. Our definition of sick may not be your definition of sick. If a member of the E.R. staff says that someone is sick, it means that they are in the process of DYING. They have had a massive stroke, are bleeding out, having a heart attack, or have been shot. We dont consider a toothache sick. Painful yes. Sick, no.

3. At any given time, one nurse has six patients. One doctor has up to 15 or 20. There is a law (similar to Murphys) in the E.R. If you have six patients: Two of them will really be sick. (see ..2 for definition) Two of them will constantly be whining. This includes family members who insist on reading the monitor and pressing the call bell. One of them will be homeless. And one of them will be a delightful patient. Dont be a whiner. Do not ask for a meal tray and a warm blanket before you get into a gown. This is not a bed and breakfast. Also, its rude to eat and leave AMA.

4. Physicians and nurses are not waiters. We are not customer service representatives. This is not McDonalds and you very well may NOT have it your way. Our job is to save your life, or at least make you feel better. If you want a pillow, two blankets, the lights dimmed and the TV on channel 14, go to a hotel.

5. If you have one of these four things, go to your own doctor in the morning: 1. A cold. 2. The flu. 3. A stomach virus. 4. Anything chronic.

6.If your child has a fever, you had better have given them Tylenol before coming in. Do NOT let the fever remain high just so we will believe the child has a fever. Do you want your child to have a seizure? Well, do you?

7. We have priorities. We understand that you have been waiting for two hours in the waiting room. If you dont want to wait, make an appointment with your doctor. The little old lady that just walked in looking OK to you is probably having a massive heart attack. Thats why she goes in first.

8. Do not ask us how long it will be. We dont know. We dont know whats coming through the door 30 seconds from now so we surely dont know when you'll be getting a room. Never ask the triage nurse if you'll be admitted.

9.We are not here for primary care. An emergency is something that is life or limb threatening that requires immediate attention. Get a family doctor and go see him.

10. If you have diabetes and do not control it, you are committing slow suicide. Non-compliance will not get you much sympathy. Especially the 4th time.

11. We know how many times youve been to an E.R. We can usually tell if you are faking it or just seeking drugs in the first five seconds of talking to you. Do not lie to us. If you lie about one thing, we will assume you are lying about everything. You don't want that. Coming in for detox 2-3 times a week is insincere.

12. If you are well enough to complain about the wait, then you are well enough to go home.

13. If your mother is a patient and we ask her a question, let her answer it. We are checking her level of consciousness, not yours!

14. If you see someone pushing a red cart down the hall at full speed and you hear bells going off, do not ask for a cup of coffee. Someone is dying.

15. If you have any sort of stomach pain and you ask for something to eat, you are not sick. If you are here for vomiting, we are not going to reload you.

16. If you can complain about the blood pressure cuff being too tight, or the IV needle hurting, you are not in that much other pain. PS-if you have more than three piercings or tattoos, dont tell me youre afraid of needles.

17. If you want to get something, be nice. I will go out of my way to tick off rude people.

18. Do not talk badly about the other members of the staff. I work with them. The doctor that you hate I work with every day and I know that he knows what he is doing. I trust him a lot more than I trust you. I am not here to be your friend, and neither is he. I will tell him what you say, and we will laugh about it.

19. Every time I ask you a question, I learn more about what is wrong with you. I don't care if someone has asked you what day it is four different times. Each time I ask, it is for a reason. Just answer the questions, regardless if you have answered them all before.

20. Do not utter the words, You have my records. I dont have your records, and I dont have time to call and get them. Just tell me.

21. Do not bring your entire family with you. One person at the bedside is all you need. It is really difficult to work around seven people in the event that you are really sick. This is a hospital, not a place for a reunion.

22. Bring a current list of your meds and allergies. Include the doses. Nobody should be taking medicine if they dont know what they are or what they're for.

23. I know your doctor said to Go to the E.R. and I will call and tell them that you're coming. He probably didn't. And the chances are even less that he will meet you there.

24. If your doctor sent you here because his office was busy, you may want to let him know that you waited five hours in the waiting room with 60+ contagious people and 4 more hours in the actual E.R. to get your sore throat looked at.

25. We dont do dental. Dont come here because you didnt pay your doctor or dentist for your last visit and you think you can stiff us for the bill. We will collect, and an office call at the doctors office is about $85. An E.R. visit will be around $1000.

26.Its not cool to call 911 and tie up an ambulance crew for a non-emergency call just because you dont have cab fare. On the same note, dont hit us up for a cab voucher and then ask for change for a $20 to get a Pepsi on the way out.

27. Coming to the E.R. by ambulance does not guarantee you will get right in. We routinely move folks from the ambulance stretcher to a wheelchair and triage them to the waiting room.

28. We've seen it all. Moaning, writhing, screaming, falling out on the floor or faking a seizure will not speed up the process one bit. Making obnoxious retching noises and then spitting in an emesis basin is not convincing either. If youre gonna barf, barf.

29. If you come in on Tuesday with chest pain that started Saturday, dont expect us to get excited. You didnt! Any chest pain should go to the nearest E.R. immediately.

Time

Time

Time passes.
You are gone.
My mind has erased
the memory of you.

Winds blow.
Ships depart.
Lovers walk along
the beach at night.

Hand in hand,
heart in tow.
No one could believe
this happened to me.

Time passed.
You're still gone.
My mind knows
no one by your name.


Tanya S. 2/9/90