My Uterus

This is what I have been diagnosed with: "disordered proliferative endometrium with glandular irregularity and crowding consistent with simple to complex hyperplasia without atypia plus associated glandular metaplastic changes and a focal suggestion of slight polypoid features." In other words, I'm going to live.

I'm officially postmenopausal now. Bleeding after menopause is never normal, so when that happened, I made an appointment with the doctor. It took a month to get in to see him. He then referred me to a ob-gyn. It took nearly two months to see her. I could have used some tricks to speed up the process, but I was confident that the problem was hormonal, rather than cancer. I've been using estrogen cream to deal with menopause. That can cause the lining of the uterus to grow thick with gunk. Progesterone will trigger a period to correct the problem, but I was never prescribed it.

The uterine biopsy was the worst part of the experience. A narrow tube was snaked through the cervix into the uterus and tissue was scraped out. The doctor also found a polyp on the cervix and used forceps to extract it, after several tries. I still get cramps when I think about it. And no, pain killers were not used for the procedure.

I haven't spoken with the doctor since the procedure. I sneaked a look at my chart online to see the biopsy results. I expect that she will prescribe progesterone which will be followed by a period of epic proportions. I'm starting to understand why so many women get their uterus removed. I'm keeping mine, but they can be so much trouble at times.

Calling In Sick

Getting people to show up for work has reached near crisis proportions. People call in sick in higher numbers in my nursing department than in almost any other nursing unit in my employer's California hospitals. This is nothing new. Management has tried everything from threats to rewards to get people to come to work, all to no avail.

The bigwigs in charge of all of the hospitals have stepped in. To their credit, they are conducting a full investigation to hear everyone's side of the story. They appear to be operating under the assumption that something is terribly wrong at our hospital and if they can find the problem and fix it, then the calling in sick problem will be resolved.

First, we had to fill out an online survey. Now, they have a live person interviewing everyone privately to hear their stories. I'm one of the few people who rarely calls in sick, but I was interviewed along with everyone else. That poor interviewer got an earful. There are many desperately unhappy nurses. Some cried, one even yelled so loudly that the interviewer tried to give her the phone number of someone to talk to. It would be reasonable to conclude that the nurses who call in sick are really sick, although not physically ill.

Aside from rarely having aides to help us, my number one pet peeve is not giving us good staffing even when there are enough nurses. Our department has a new trick for saving money. They give each nurse the maximum number of patients allowed by state law and then put the extra nurses on "training". The nurses on training just do busy work and their time gets charged to the training department. It doesn't save our employer any money, it just changes whose budget the salaries come from.

The official staffing in our hospital is supposed to be four patients per nurse. Management has changed it to five, which is California law. If we are short-staffed, I'm more understanding, but to pull nurses off the floor and then violate our patient ratios annoys me. On the days when staffing is good, it gives us a chance to recover from the bad days. Now, there are no easy days, so the stress just keeps building, day after day. No wonder nurses are calling in sick.

Another Fire Day

The freeway re-opened yesterday, so I was able to get to the Valley to visit my parents and boyfriend. Today, I'm still feeling the effects of the bad air. My snot is still grayish from all of the ash and it hurts to take a deep breath.

I tried to get my parents to come home with me. My dad has emphysema and is probably going to end up back in the hospital due to breathing all of that gunk, but they refused to leave. They won't even close the doors and turn the air conditioner on. The bottom of their pool is black from ash. I'm guessing their lungs look the same.

While in the Valley, I made a drug buy, my first. It was embarrassing. I took my mom on a Costco run and sneaked into the cigarette cage to buy a carton for my dad. I hate being an enabler and doing something that is going to make my dad sicker, but at age 87, he has the right to live his life as he sees fit. He needs cigarettes like a heroin addict needs heroin.

This morning, as soon as I sort of woke up, I clicked on the TV to check on the fire. My eyes weren't open yet. I was just going to listen to the news. Instead of broadcasters speaking, there was just an annoying sound. It was the emergency alert system.

Bolting upright, I squinted at the screen. Was it saying this is not a test? Scooting to the foot of the bed to get a better look, I saw the screen say this was a test. What a way to wake up.

Now wide awake, I got up, got dressed and walked to the end of the street to get a better look at the fire. I already knew it was bad. From my house, I could see smoke billowing. It also hadn't escaped my notice that my house kept vibrating from the helicopters flying overhead.

The wind direction has changed. The wind is now blowing the fire down the mountain towards Sand Canyon, an area of multi-million dollar homes. I'm still upwind from the fire, but feel uneasy. I watched a super scooper dropping orange fire retardant on the hillsides and helicopters making water drops. I assume that ground crews are in place to put out spot fires. The area is thick with oak trees and brush. With so much to burn, the fire could easily overwhelm the firefighters.

If the wind changes a bit more, the embers could be flying towards my house. I may have to drop the dogs off someplace before going to work today, just for peace of mind.

Nature Woman Faces Nature

My shift was mostly uneventful. Well, there was the crazy patient who said that I looked like "nature." When she looked at me, she saw mountains, trees and, well, nature. Of course, I must hear that all of the time, she said. She was shocked to hear that she was the first to mention it. She figured that people must think it all the time, but just not say anything. I thanked her for her complement. She was sweet, but as I said, crazy. Do you ever get odd complements?


There was only one real problem, which occurred during the last hour of my shift. Sylmar caught on fire. The news was on all of the patient's TV's. I happened to glance out a window and gasped when I saw the flames. Of course, the first thing I did was grab my camera and take a picture from a patient's window.

It didn't pose a direct threat to me, but the wind was blowing it towards the Newhall Pass. That is the only realistic route between the San Fernando Valley and Santa Clarita. Soon enough, I was on the freeway heading north, roughly towards the fire. I passed through some heavy smoke and violent winds, but made it home safely. A few hours later, the freeways going through the pass were all closed. I'm stranded at home and alone on a Saturday night because I don't have anyone to play with in Santa Clarita.

But, once again, I'm lucky. Nearly 700 homes were lost in the fire. I stayed up half the night watching the fire on TV and from my windows. Even though I live on the opposite side of the mountain, I could see shimmering orange clouds swirling above the mountain top, lighting up the sky. My camera, unfortunately, couldn't capture the eery, gates of Hell effect.

This was the view this morning afternoon when I woke up. The fire was burning on my side of the mountain, but the wind was blowing it back where it came from. The danger isn't entirely over, but things are looking up.

The Sign

We have a new sign at work. It has a photo of a nurse on it and says to see the nurse before entering the room. We are supposed to hang it outside of any rooms that has a dead person in it. It seems like an obvious thing to do, but no one ever thought about it before. The reason why someone thought of it now is because of an ugly incident involving the patient I wrote about it in "Stiff."

There were some extra details that came to light after I wrote a post about the untimely death of a young woman after routine surgery. Her family was notified by phone of the death, but they lived a good distance away and were not going to come to the hospital. It didn't occur to anyone that she might have friends who would come see her.

The patient worked in our clinic across the street. On the lunch break, nine of her coworkers walked across the street, came up the elevator and walked into her room. What they found was their friend lying dead on the floor.

Codes are messy. The gowns tend to come off in the process of attaching leads. Litter gets thrown all over the floor as packages of stuff gets opened and tossed. There can be blood if lines are inserted or pulled out. Urine, poo or vomit may be present. This isn't a sight that visitors should see.

Because she was such a large woman, they just left her lying on the floor until they could get enough staff together to lift her. It took several hours and six men to get her off the floor. We do have some mechanical lifts for such situations, but no one knows where they are.

The visitors didn't take the situation very well. The visiting nurses from across the street were hysterical and the floor nurses were mortified. No one wants to go through anything like that again, so now we have a new sign, but no one knows where it is.

Money For Nothing

My house came with an annoying thing in the garage. It was a water softener, which I had no use for. I drink tap water which I prefer without added salt, so I shut off the softener. It has sat in my garage for the last eight years.

It still annoyed me, though. It took up space and presented a challenge in maneuvering my car into the garage. I was also forced to park too close to my other car, which has resulted in my cars dinging each other.

I wanted to be rid of the softener, but I would have had to hire a plumber to disconnect it and someone else to haul it away. It was never a priority, plus I was too cheap to spend the money.

Then, one day I got a letter from the water company. They wanted to pay people to get rid of their water softeners. They would not only remove it for free, but pay the value of the machine. It sounded too good to be true. I downloaded a form, filled it out and mailed it to them. They responded that they would give me $275 for my worthless piece of junk water softener. Woohoo!

The annoying thing is now gone and I'm so happy about the extra room. Even if I never get the check, I'll be happy. It cost me nothing to do something that I've wanted to do for years. I do feel a little guilty, using the water company that way, but it won't stop me from cashing the check.

Ticked Off Over Tics

With all of our medical records stored online, with only a few clicks, we can view our patient's full medical histories. I routinely check the snapshot page which lists all of the patient's medical problems. I don't do that just to be nosy, but to also help take better care of the patient.

Doctors are human and make mistakes. A good nurse will call the doctor if the doctor forgot to address a problem or made an order that could harm the patient. An example would be if the doctor forgot to write an order for blood sugar checks for a diabetic patient or ordered huge amounts of IV fluids for a dialysis patient. If the doctor makes a mistake like that, it is the nurse, not the doctor who gets in trouble. The buck stops with the nurse.

The diagnosis page, though, also provides me with endless entertainment. We have one patient right now who has a history of "recurrent pregnancy loss." Another patient has "unspecified hemorrhage of newborn." You're probably wondering what is so entertaining about those sad medical problems. The answer is that both of those patients are male.

Because I get my health care from my employer, I can also access my health records. It violates some rule to look at one's own records, but I don't care. I'm as entertained by my records as by my patient's records. Like some of the patients, I have my own rogue diagnosis. According to the official records, I have "tic disorder." I'm sure that I don't. Well, I don't think I have it. Is it possible to have tics and not know it?

I've asked two friends to tell me honestly if they have ever noticed if I have tics. They said they have never noticed that. I'm left wondering if the doctor confused me with someone else or if perhaps at a doctor's appointment, I was twitching and totally unaware. The doctor who labelled me is gone, so I can't ask him about it. I wonder if it is possible for me to erase a diagnosis and how much trouble would I get in for altering my medical record, assuming they caught me?