The Lesson I Learned on One of My Bad Days

Last week, as I drove away from and headed back home, I was contemplating on how bad my day had been. Working at a nursing home, one can easily get burnt out. In order to avoid becoming that angry, “i-hate-my-life” kinda person, I have always attempted to look at the brighter side of things in hopes that somehow I can find a silver lining. As I tried to submerge myself into that pool of positivity, I could only see myself hating my job more and more.

I originally came into this job as a means to gain experience with the healthcare setting. Everything sort of worked out, I got my nursing assistant license, and boom – I get the job at the nursing home. As a novice in the field, I found myself clinging on to the idea that I would never become one a jaded, desensitized veteran who did not seem to understand the meaning of compassion. I would promise myself that I would be a loving and caring professional at all times, no matter the situation. For a while, that was actually the case. As time progressed and I had been working there for a while, this feeling has faded away, and it wasn’t until recent that I realized it. It slipped away slowly, very gradual. Maybe because I fell into a routine, or the fact that I found myself in a constant state of being tired, I failed to keep up with my promise. I like to believe I am the person who keeps my word. This time, though, I didn’t even realized I had failed. I allowed myself to become unmoved to people’s emotions and thoughts. I had become a professional I never aspired to be.

This realization was brought about as I was driving home that night. As Delilah gave some heart-felt advice to a listener, I reminisced on why I thought I had a bad day. Appropriately enough, a song called “Bad Day” came on the radio (http://www.youtube.com/watch?v=gH476CxJxfg ). This caused my mind to be over-flooded with all these “aha” moments. At my job, there are two kind of bad days. There are those days in which you might be placed with a co-worker that you might not work well with. This is a factor one can’t control, it’s just life. Sometimes you might not have such affinity for a co-worker, but it is your duty as a professional to overcome such differences and provide the excellent service you once vowed to. That was not the case for this day! The second kind of a bad day comes from having one or more “difficult” patient/resident. I think sometimes we get lazy, and we would prefer to help those who might not actually need that much help.

In a nursing home, there are some residents who require lots of attention, while others need mere supervision throughout their day. Whenever I’m feeling lazy, I consider a good day when I’m assigned to care for residents that can be very independent, and do lots for themselves. Other residents require total care and extensive assistance in everything. These are the ones who really need us for all aspects of their stay there. Again, I think we get lazy. Taking care of the latter kind of resident requires a lot from us. While getting paid to tend to them, we tend to selfishly prefer those who might not need that much help. I became the person who measured my days as good or bad on whether I was placed with easy patients or not.

When it finally hit me, this stark realization did not settle right with me. First, I am ashamed that it took me such a long time to figure it out. Secondly, I have always been very insistent and adamant that I would not allow my personal feelings infiltrate my professional environment. I became the caregiver I despised.

Cruising back home that night, I recollected the events that had just taken place. (This might be somewhat graphic – just a head’s up!) Exactly three minutes before clocking out, the person who took over my assignment for the night called me in for help at a resident’s room. This honestly was the last thing I wanted. Having had a long day, I was all ready to get on my way home to get some sleep. This specific resident was one that required total care. Throughout my shift, she was not feeling well at all. She had been having stomach pains and nausea all throughout the evening. When I lay her in bed, she was complaining about her stomach, that there was something wrong with it. I promptly alerted the nurse, who then gave her some medication for it. For the rest of the shift, this resident would frequently call me with her call light, letting me know that she didn’t feel well. Even though we provided the care for her ailments, she still felt sick. She had never acted this way before. The nurse did inform me that she was on a new antibiotic treatment, which could possibly be the reason for her upset stomach. (This is the part that is going to get graphic.) To add on to her worries, she had been incontinent of her bowels the entire night. Because of it, she was not able to go to sleep. As I provided care for her, I tried to keep her comfortable through it all.

Everyone who works in a nursing home has a horrible poop story. This case, I believe, trumped all of them. When I came in to help the girl who took my position, I stepped into my poop story. While we believe it was because of her new medication, this lady was literally sitting in a puddle of her own feces. This was after I had just helped her clean up about thirty minutes before. Since the who called me in for help was new, she did not know where to start being this her first encounter with a situation like this. This was around 11:45pm. The best solution for this case was a shower. With the nurse’s blessing, it was exactly what we did. We put her in a shower and got her all cleaned up. As if shower had a some sort of therapeutic effect on her, it was what calmed her down. For the entire night, she was anxious and disturbed. Something was definitely not right with her. The shower not only cleaned her up, it seemed to wash her worries away. Once we put her back in a freshly-made bed with a new night gown, she thanked me for my help. Then, she asked me to pray with her. I grew up in a Christian home and I am a big believer in the power of prayer, so the idea of coming to God in prayer is very familiar to me. What hit me was the fact that I had never directly incorporated prayer into my work. When I finished praying with her, she told me I would make a great doctor someday. After that, she dozed off into a peaceful night of sleep.

Her compliment struck me. While it was very nice to her that, I honestly feel like I did not deserve it. I was pissed off that I had to stay extra to help. I was annoyed that this new girl did not ask someone else to help her. And then, I get such a compliment. As I drove home that night, I realized I was not providing the care I wanted to provide in the first place. I go to a Christian college that focuses on a holistic approach to healthcare. Our professors try to instill in us the idea that we are here to treat not only the physical ailments, but the body as a whole. This encompasses the emotional, social, and spiritual aspect of a person as well. While this seems very pretty and dandy, it can be very hard to bring those concepts together and apply them to real life. I had never prayed with a resident before, even though that is what I have been taught throughout my college education. Sitting in my car that night, I believed I had made a difference in his lady’s life, if only for that night.

Now, as I look back on all the “bad” days I have had, I consider them to be the days I made the most difference. I now take the opportunity of such “bad” days to practice this all-encompassing approach and make an impact on someone’s life. If a good day is one that everything goes according to plan and there are no residents that need help, then I don’t want to have good days. I want to have more of these “bad” days, because then I know I am making a difference in a person’s life.

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The “What If” Episode

For those who are avid fans of serialized television shows, one may have ready encountered a classic “what if” episode. It usually happens in the later seasons, when the audience has grown accustomed to the characters and their major plot lines. This specific episode centers on twist, commonly portraying what the main character’s life would’ve been like if one of their life’s pivotal event had not taken place, or happened differently. Popular shows like Friends, Scrubs, and Grey’s Anatomy have all played out this type of scenario. It usually makes the audience more appreciative of the show’s original plot line, giving it a purpose for everything that has played out in the show.
Recently, I experienced a somewhat of a “what if” episode while visiting my GI doctors. Ever since I was first diagnosed with Crohn’s disease, at the age of 17, I had been treated by specialists in Maryland. I can honestly say I’ve had the best treatment, ultimately leading up to my incredible remission. When I moved to Ohio about 2 years ago, I still maintained my treatments and my Remicade infusions in Maryland, oftentimes making the trip back home just for my doctor’s visit. After growing tiresome of such roadtrips, I decided to look into having a doctor in Ohio.
I went out of my way to get the best one. After much research and talking to people, I went with a great specialist. The thing is, it’s not the same as the one I’ve grown to respect and trust. Both are extremely qualified in the field of gastroenterology, and deliver amazing healthcare. I believe it’s more of a matter of being used to one thing, and only noticing how well you had it once it’s gone.
I felt the same as I was having my Remicade infusion last week. In Maryland, I had always gotten it at the Mercy Medical Center in Baltimore. This is an excellent facility, and I would not hesitate on recommending it to anyone. Not only do they have the infrastructure and the resources, the staff makes one feel cared for. In Ohio, I was able to get the same medication, but it was not the same way as I was used to. I am not complaining of the quality of care I was provided with, it’s just that at Mercy, everyone went above and beyond to guarantee that your needs were met. They not only met them, but exceeded and surpassed my expectations. Comparing any facility to them would only seem unfair.
I began to think what my life would be like if I had lived in Ohio all this time, if I were diagnosed here, and this was my only point of reference to my infusions. I’m certain I’d turn out alright. I began trying to picture how my life and my Crohn’s would have played out if I never came in contact with my doctor at Mercy.
I look back and feel immensely blessed to have been treated there. It may seem like I’ve been spoiled by them, and I admit it – I have. I only see it as being exposed to excellence in providing care to people. Hopefully one day I can provide the same care for others.
I also feel blessed that I was able to get my infusion here in Ohio. I am definitely not complaining about not needing the car rides back and forth. I am still getting great care here. It just takes a little getting used to. I believe that I the story of my life had taken its course here, I would still be okay and have my Cronh’s under control.

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Crohn’s Pride…

Whenever I catch the Humira commercial on TV , I feel like cheering on to the fact that Crohn’s disease is being talked about. Just like when your football team scores that touchdown, or when your hometown is featured on the Today Show, there’s a sense of pride that comes out when I hear the announcer speak of my disease. Deep down inside, it feels like a parade marching down my heart with balloons and silly strings, while I feel appreciate and represented. Even though the commercial makes us “Crohnies look like we are on constant bathroom alert, it feels nice to be out there.

Check out the commercial here: http://ispot.tv/a/7VE_

I usually get the same feeling when I get caught watching a medical drama, and somehow Crohn’s is featured on that episode. I personally have encountered it on House, Private Practice, ER, and Grey’s Anatomy. Once again, whenever such phenomenon occurs, I let my freak flag out, overjoyed for our representation out there. The media can be a great tool for getting our stories out there.

It’s always a comforting feeling knowing that someone who has the same condition and experiences some of the same symptoms has made something out of their lives. Surprisingly, there are lots of public figures who have been “coming out” with their Crohn’s issues. You can check out the list of notable figures that have been diagnosed with Crohn’s (http://en.wikipedia.org/wiki/List_of_people_diagnosed_with_Crohn’s_disease). You might actually be surprised with some of them, such as Louis XIII.

The thing is: Although this condition has been on the rise of fame lately, there are a lot of people out there who do not know about it. Whenever I mention the fact that I have it, someone always says that they have a friend with it, but are not too familiar with the disease. Most people hold on to the misconception that with our condition, we are incapable of leaving the house because we have insatiable diarrhea, so we must have our butts sewn to a toilet seat. I believe that the more we spread our experiences with Crohn’s, the more it creates awareness. And that’s all we want – for people to know what we go through!


Insanity Wolf & Autoimmune Diseases

Insanity Wolf & Autoimmune Diseases

I found this meme online and just had to post it… Pretty much sums up how i feel sometimes, or how I should feel…

Retreived from http://cellarlabyrinth.com/tag/ulcerative-colitis/


Headaches, Lethargy, and a Good Night’s Sleep: The Good, the Bad, and the Ugly Side Effects of Caffeine Withdrawal.

Since my last entry, I vowed to stop taking caffeine products for 30 days. From personal experience, quitting caffeine cold turkey was not the smartest decision. To be completely honest, I was not able to go through with it. When the headaches and tiredness came, I caved in and headed to the first Starbucks I saw. Completely removing it from my diet was not doable. Even though I did experience some of the side effects associated with caffeine withdrawal, I count it as a learning experience and it definitely opened my eyes to this infamous stimulant we all tend to consume.

Worldwide, caffeine is the most commonly used drug. Judy Fortin, CNN Medical Correspondent estimates that “80 to 90 percent of North American adults and children consume caffeine products every day” (2009). While the daily recommended dosage should not exceed 200 mg, the average amount of caffeine in a brewed cup of coffee ranges from 95-200 mg. This means that once you have your first cup of coffee in the morning, you are very likely to go over the limit if you consume certain types of sodas or energy drinks. We can easily cross that line when it comes to chocolate.

Researchers claim that the more caffeine one consumes, “the more likely [they are] to suffer from severe withdrawal symptoms when denied the ingredient” (Fortin, 2009). The severity of your withdrawal symptoms can be directly correlated with the amount of caffeine you can consume. I can admit that I am an “addict” or “dependent” on caffeine for daily function. As expected, I experienced several distasteful side effects when discontinuing caffeine use.
images The immediate symptom was the pounding headaches that came on the first day. It wasn’t your run-of-the-mill headache, but one of those that felt like someone was drilling into my brain. Then, the pain moved slower, like hot lava was slowly melting my head into pieces. Ultimately, I was very grumpy and irritable with everything. In attempt to better understand the mechanism of caffeine withdrawal, researchers from the University of Vermont College of Medicine and Johns Hopkins School of Medicine partnered up to investigate the phenomenon. To do so, they monitored blood flow and electrical activity of the brains of during caffeine withdrawal. The results indicate that “acute caffeine abstinence increased brain blood flow, an effect that may account for commonly reported withdrawal headaches” (2009).

While the headaches persisted, a great sense of lethargy loomed over my body. I felt extremely weak, with no motivation to do anything. While begin in school, that might be a common symptom experienced by an over-worked student who does not get a full night of sleep. But this was not a common fatigue. It was more like the tiredness when you feel sick. Research studies show an increased theta rhythm, or brain waves, which has previously been associated with common withdrawal symptom of fatigue. This confirms that the absence of caffeine tricks your brain into sending out fatigue signals, which are commonly reported as tiredness and sluggishness.

sleepy There is a silver lining, though. Throughout all these unpleasant events going on in my body, I was definitely able to get more sleep. While consuming high amounts of caffeine can lead to insomnia, reducing your daily intake can enhance your sleeping cycle. By the end of the day, I was able to simply lie down in bed and enjoy a night of uninterrupted sleep. I was overjoyed with this aspect of not having caffeine.

From this experience, I have learned to take it slow when reducing my intake. I can’t go cold turkey again. While this is no heroin and cocaine, it is still a stimulant and it does affect your nervous system dramatically. Researchers instruct patients to gradually substitute decaffeinated products or non-caffeinated products over time in order to reduce the likelihood of experiencing withdrawal symptoms. (Fortin, 2009). I have drastically trimmed down my daily dosage of caffeine. I am trying to only drink my coffee in the morning, leaving enough time for the substance to leave my body before I go to sleep. This ensures my good night of sleep.

Again, I am not here preaching people to abandon caffeine in general. It does have its beneficial aspect. I just think we have to be more observant on when we put into our bodies, so we can live a healthier life. I am advocating for a healthier lifestyle, not the abandonment of such stimulant. Caffeine, like other drugs, should be administered in moderation.

References:

http://www.sciencedaily.com/releases/2009/05/090501162805.htm

http://www.cnn.com/2009/HEALTH/04/06/hm.caffeine.withdrawal/


A Brake From Coffee

In attempts of fighting off the sleepiness that had been bothering me for the whole day, the first thing I did when I got home this afternoon was brew some fresh coffee. A tradition growing up, drinking coffee is not only a habit, but an integral part of my life and diet. While a good cup of coffee hits the spot and appeals to my taste buds, the act of drinking a “cup of joe” also serves the purpose of a social gathering in my household. Our afternoon coffee sessions offer us a time to kick back for a few minutes and reflect on how the day has been.

As I took my first sip, a sense of euphoria ran through my body. It’s as if my body instantly recognizes the introduction of such stimulant. Sometimes, I think that the psychological, or placebo effect, of the simple act of drinking coffee plays a huge role in it. I have tried drinking caffeinated teas and energy drinks, and while I do get a kick out of them, it is not the same as a warm cup of coffee.

Pondering on how caffeine works in the human body, I recollected my doctor telling me that I should cut back on my caffeine consumption. While I do consider the valued points that are always made on the topic of ceasing the intake of caffeine, I choose to blindly ignore it. Experience dietitians and nutritional counselors make the point what of all food addictions that people claim difficult to give up, coffee drinking can be one of the most challenging. This because “it is so entrenched in cultural habits” and this is definitely something I personally identify with (Rafetto, M., Grumet, T., & French, G., 2004).

While I experience the side effects of caffeine on a daily basis, I decided to look into it and specifically how it affects my digestive health. Although most common symptoms are experienced in the nervous and cardiovascular systems, the bowels take a huge toll when it comes to caffeine consumption. Being a stimulant, it does speed up a lot of things. Lots of people experience increased colonic motor activity, or the desire to defecate (Boekema, P., Samsom, M., van Berge Henegouwen, G., & Smout, A., 1999). This is because peristalsis, the muscular contractions of the digestive lining, is stimulated. This helps propel food through your bowels faster. Cases of loose stools or even diarrhea can occur.  Large amounts of caffeine can increase the levels of stress hormones circulating the body. To compensate this elevation, the body focuses on increasing your heartbeat, and focuses less on digesting the food in your belly. Overall, this can lead to indigestion. Also, because of the acidic nature of coffee, it can cause the “hypersecretion of gastric acids” (Rafetto, M., Grumet, T., & French, G., 2004). As food is rushed out of your stomach, it can carry and dump these acids to your small intestine, furthering the damage the Crohn’s has already done to my poor digestive tract.

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Caffeine Molecule

While regurgitating this information, I found it scary to think how harmful this substance really is. It is even scarier when you consider how we tend to overdo and overuse caffeine, especially after reading about lethal overdoses involving young people and energy drinks. I am not here declaring a war against caffeine. I know that for some people and certain conditions, caffeine has incredible positive effects. Studies ran by the FDA indicate that “moderate amounts of caffeine are not harmful.” This means that 200mg, or one to two 5-ounce cups of coffee each day is not going to kill you.

By a choice I made myself, I decided that I am starting a caffeine challenge today. To personally test out the effects of caffeine withdrawal and investigate how it affects my body and my Crohn’s, I will refrain from using caffeine for 30 days. I am aware that this is a stimulant, and withdrawal symptoms are expected in the road ahead of me. The whole purpose of this personal experiment of mine is to see if I feel better without it. Here’s to the next 30 days!

References:

Boekema, P., Samsom, M., van Berge Henegouwen, G., & Smout, A. (1999). Coffee and gastrointestinal function: facts and fiction. A review. Scandinavian Journal Of Gastroenterology. Supplement, 23035-

Rafetto, M., Grumet, T., & French, G. (2004). Effects of Caffeine and Coffee on Irritable Bowel Syndrome, Crohn’s Disease, & Colitis. Retrieved from https://secure.teeccino.com/images/uploads/pages/File/colon.pdf.


2 year anniversary of an asymptomatic life

What started off as a normal, run-of-the-mill Tuesday, the 15th of March in 2011 turned out to be a pretty epic day! For the world, it marked the beginning of the Syrian civil war. There was a pretty destructive earthquake and tsunami combination named Sendai that happened in Japan. Also, the tickets for the 2012 London Olympics began being sold. On a more personal note, I had my laparoscopic ileocolectomy done at the Mercy Medical Center in Baltimore, MD.

I remember the angst I felt inside on that day. My parents were there with me. Even though I was crapping my pants, I pretended to be strong so I wouldn’t freak them out even more. This was the first time one of their “babies” were undergoing surgery. Even throughout all the anxieties and worries, I was glad to have them there. When I finally woke up several hours later, through the morphine-induced heavy eyelids and grogginess, it felt nice to hear their voice and see outlines of their silhouettes sitting by me. I had made it.

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This is me right before the surgery. I like to point out how swollen my face was, due to the steroids.

It took me a while to get back into things. I don’t remember much after they told me to count down. I like to believe that I made it to number four. After finally coming back from the deep sleep, I can recollect several episodes of trying to make sense of it all and eventually dozing off into a delightful slumber. By nighttime, I was able to hold a normal conversation.

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This was my awesome view from my hospital room

Overall, I stayed in the hospital for five days. The first two were very pain-filled days. Although the procedure was done through my belly button, I felt gashing pains that tore through my insides. The surgeon was able to remove all the damaged areas of my intestinal lining, which came out to be about 22 inches that were part of my ileum and colon. They also had my appendix removed to prevent any future complications with it.

I did have a minor post-surgical complication. The physicians and surgeons explained to me that once you perform surgery in your bowels, your body takes it as an offense and causes the activity of the bowels to cease, as if they became paralyzed. After the procedure, the activity slowly returns. I would like to emphasize the word slowly, because it was. I was famished from not being able to eat right before the surgery, so I stuffed my face with what seemed to be one of the best meals I had ever had once I was allowed to eat. (It’s funny how anything tastes like the best meal of your life once you hungry). To simply state it, I had a really bad case of constipation. The doctors were worried about an adhesion or me being blocked up in the insides. I was under observation, and that was the main reason why my hospital visit lasted that long. I felt as if I turned into a hot-air balloon was getting larger by the minute. My abdomen was so tender to the touch. This was more stress added to a regularly stressful situation.  I remember the nurses making me walk-something I loathed at the time, especially because of the pain in my belly. After what seemed to be miles and miles of treacherous exercise, I had a bowel movement.  I have never seen so many people celebrate for one’s poop.

March 15th, 2011 marked the end to an era of numerous ER visits and hospital admittances. It was the last day I felt pain related to Crohn’s. It was a water divider. I separated my life, and my Crohn’s story into post and pre operation. After the surgery I began my Remicade treatments and with time, I was able to wean off the steroids. I was a new man. As I look back at these two last years of having no symptoms of Crohn’s and leading a close-to-normal life, I thank God for those doctors and the work they did on me. I am blessed to be in this situation and for having the opportunity to have the surgery done. Here’s to several more years to come!

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This was me about 2 months after the surgery!


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