15 October 2013

Once Again Spared

And so it was, that she, having waited long and endured patiently, realized and obtained what God had promised. Hebrews 6:15

                They say that when you give up everything: dreams, ambitions and all, that God then has the chance to bring beauty into your life. Why is it that we—stubborn, insufficient and wholly incompetent beings—are convinced to know best? After today, I have never been more convinced that God is in control, even if we wholeheartedly run away from His mercy in order to dwell in our sin. Through scars inflicted by legalism, I’ve always believed God would only accept me if I followed His commandments “to the tee”, living in false perfection and unabridged pride; I also believed pain was a result of imperfection: a punishment for falling short of God’s glory, which we are all destined to do. Through these scars, it’s been immensely difficult for me to accept God’s love after believing I’d never been worthy, which is true yet the reason for the blood shed on the Cross. I’ve been running away, fearing the extent of His punishment after the immense extent of my sins, when all He wants is for me to turn back, running like a little child into His loving and protective arms of love. Today, as I sat in my hospital bed, discouraged from hearing the news that I can’t yet be discharged, God showed me just what He means by forgetting our pasts and merely wanting to drench His children in love, mercy and beautiful profits. One thing I’ve been called to give up is my job as a nurse tech in the ICU, which was an amazing experience but just too much for me to handle right now, due to the high stress, responsibilities, and expectations of nursing school as well as fighting for my life against the lethal demons of anorexia nervosa and suffering physically from its effects on my body. As I waited to hear back from my supervisor, with anxiety building with each second, I was convinced this would be a disaster, affecting any future employment I may seek out. However, after listening to a voice-mail having come during my consultation with my doctor, I was absolutely blown away. The voice-mail was from my current supervisor in the ICU, saying she completely understands my situation and is willing to take me off of all schedules, without having to hand in my two week notice; she was sorry to see me go, and even offered to return my job back should I ever desire to come back, since I’d been “such a good addition to their staff with my optimism, bubbly attitude, hard work, quick learning & willingness to fulfill any task, as well as, apparently, many families and patients complimenting my care and positively energetic spirit”. I am still in awe of God’s mercy and grace, as nothing I have done is worthy of such credit and acknowledgement.

               Yesterday, as my physician came into my room to see how I was doing, she told me some immensely eye-opening facts, helping me to realize just how lucky I am to be alive. She told me that never, in all her years of practice with eating disorders, had she seen anyone so sick from anorexia nervosa; had I waited one more day to come in, I most likely would not have survived. She also said she’d never been so scared for a person in her life and hopes to never have to experience that again; she was torn as whether or not to send me to the ICU, which would only give me immediate IV fluids, or to send me to the regular floor which had less supervision should something happen but provided for a longer stabilization period. She explained to me that normally in anorexia, peripheral hypothermia and cyanosis is normal, but with me it was central, or all over (as indicated by thick lanugo covering my body, but especially my back), indicating my body was so malnourished that all systems were shutting down to preserve and shunt the energy to vital organs such as my brain and heart. She also explained that the reason my heart rate is normal when I’m dehydrated is because my body has learned to survive off of dehydration; now that they've hydrated me, my body has gone into panic mode, dropping my heart rate into the thirties. Through all of this stress I've put my body through, my heart has been affected, and so I may always have a low heart rate, averaging in the forties rather than the normal range of 60-100. My blood pressure has also failed to normalize, despite the large amount of IV fluids, re-hydration and nutrition, which is also a concern. So, I’ve been here a total of seven days tomorrow, and in order to be discharged, my heart rate must maintain within the forties, no nighttime episodes of drastic heart rate decelerations can occur as they have been, I must gain or at least begin to gain the weight I lost since being taken off of IV fluids, I must eat 100% of my meal plan (regardless if I like what they send up or not) and my blood pressure must remain normalized for 24 hours. They’ve also kept me longer due to starting me on a new med which has a high risk of toxicity, and due to my low weight, they want to monitor to make sure the right dose is found and make sure I don’t get overdosed with a toxic amount of the medicine in my blood. So, all in all, it’s not all bad; even though I’m beyond tired of confinement within these tight corners of a hospital room, staring at the same five walls for nearly seven days now, I’ve learned many irreplaceable lessons I’d never experienced had I not decided to make the right choice: no, not the easiest choice by any means, but instead the exact opposite—the choice to be real and seek help, losing all control in order to gain my life. Through this experience, I’ve seen many nurses and have discovered just which nurses I never want to be like; they've taught me how not to take care of and treat patients; but then there are others who have showed me how a nurse was intended to act: to care for patients in a selfless way, treating them kindly even if they may not deserve it, checking in frequently to see if they need anything, maintaining a cheerful attitude while serving, and doing the things most would consider lowly or undesirable. Each nurse has taught me something, both good and bad, allowing me to build upon my own nursing philosophy and how I want to treat patients and approach nursing in general. Also, through experiencing the philosophy of yet another physician, I have discovered what does and most of all, what doesn't work for eating disorders and can use this information in the future to help develop the best possible approach to eating disorder treatment.  Eating disorders still remain absolutely misunderstood, overlooked, minimized, stereotyped and belittled, so my goal as a medical provider is to use my own knowledge and experiences, combining it all with current evidence based practice in order to develop a protocol or customized approach to treatment, in hopes that eating disorders can be eradicated or at least better understood and treated. Right now, in this current day and age, as I suffer to find a treatment team that actually understands eating disorders but is also affordable, I’ve come to find that Ohio and even the United States in general really doesn't have many options, at least quality ones. As eating disorder prevalence only continues to increase, this needs to change; we cannot afford to offer poor care to suffering individuals and expect them to ever walk in freedom. What we need is a proven, conceptualized, holistic and most importantly faith based approach so that those suffering don’t have to be hospitalized time and time again, as I have experienced. We need to get to the root of the matter: the heart of the disease in order for any progress to be made. I believe God is still teaching me, through my past, current and future experiences, exactly what this approach resembles because He is, after all, the Healer of all and holds the key to all impenetrable locks. Maybe this is part of why I’ve been called into nursing: to provide care and advocate for those suffering from the life-threatening illness of an eating disorder. All I know is that wherever He leads, I will boldly follow, even if it brings me through more pain than this world may ever comprehend. The pain will be well worth it, as the empathy, compassion and knowledge I’ve gained and continue to gain far exceeds the temporary sensations of traumatizing pain. 

11 October 2013

All-Consuming Pain

“When you try to control everything, you enjoy nothing. Sometimes you just need to relax, breathe, let go, and just live in the moment” (Unknown).
“And once the storm is over you won’t remember how you made it through, how you managed to survive. You won’t even be sure, in fact, whether the storm is really over. But one thing is certain. When you come out of the storm you won’t be the same person who walked in” (Unknown).
 “You validation of beauty and sense of acceptance is not the width of your waist or the number you see on the scale” (Unknown).
Pain may be the only constant in life—the one thing I am incessantly destined for. How does it feel to live a moment without it, I continuously wonder, and sometimes am left terrified at the thought of going even one instant apart from my one lifetime companion. To some, pain may be a nuisance or even terrifying, but to my cruelly wounded mind, it is nothing but expected. As I sit here in the hospital bed, once more hooked up to a myriad of wires and tubes, I wonder how it feels to live a life of freedom—free from these chains they’ve inflicted upon me and even worse, the antagonistic chains I’ve freely inflicted upon myself. I know I’ve lived in freedom once before, but right now this pain has become so normal that all sense of freedom has been drowned out by the tumultuous noise of life.
On Wednesday morning, after sustaining multiple days of what we think to be the stomach virus which forbid any nutrients to enter my already malnourished system, I called my PCP (primary care physician) to see if, by any miracle, there would be any openings available for me to take; it turned out there was one available—within a half hour. Needless to say, I rushed into the shower, dried my hair in record speed, and threw on some clothes while my mom so graciously packed my bags for what we figured to be a long hospital stay. I was feeling so severely nauseous, lightheaded, and lethargic that I could scantly move but even a centimeter without having to sit back down for rest, making sure I didn’t lose consciousness. Once I arrived at the hospital office, I was directly sent to the laboratory for STAT labwork which would then be analyzed to determine the severity of my condition and the treatment regime indication. Once put in a room, I plopped my severely compromised body onto the analyzing table and lay in “fetal position” until the doctor came in. She entered in a hurry, along with a young male medical student, and frantically informed me I’d lost five more pounds; she then left the male student to examine me & ask more questions than I ever thought possible in such a short amount of time, while the lab results pended. Once his assessment was complete and all details filled in, he and the doctor discussed the findings and came up with a treatment plan. They then entered with news that I was severely, severely dehydrated, malnourished as indicated by peripheral cyanosis (bluish purple skin), lanugo (fine hair found on premature infants) covering my body, dead skin (from my body shunting its blood supply to only the most essential organs) that just stayed on my back rather than peeling off since it took too much energy of which was already maxed out, dangerously low blood pressure (hypotension) and heart rate (bradycardia), dry skin and unquenchable cold to name but a few, and critically low electrolytes—the most important, potassium, at a low of 1.89 (normal is 3.5-5.0). They then informed me I’d have to be admitted, so I was wheeled up to the all too familiar inpatient floor of which I’ve earned my status as a regular and settled into my very own room. Immediately I was hooked up to telemetry, since my potassium was such a life-threatening low, and three attempts were taken to start an IV on my nearly nonexistent veins—all of which fell short. A Doppler was then sought after to find a sufficient vein by ultrasound, since none were visible or even palpable due to severe dehydration; once a vein was found, a 22-gauge catheter was threaded into it & maneuvered until blood returned into the hub, indicating proper placement. I nearly jumped for joy when the nurse announced she’d gotten the IV in, as they’d already blown up three veins and were running out of options. My IV fluid was changed literally ten times before determining exactly what my suffering body needed, and once the final decision was made, the bag was spiked and the line primed in order to prevent air embolism—a potentially fatal complication of IV therapy. Finally, once the IV was running and all doctors had finished their many questions, I could relax, only to be told I’d be NPO (nothing by mouth) for the next twenty four hours in order to allow my nauseous belly time to rest; this was the worst possible news, as I hadn’t been able to keep anything down for three days already and could feel my intestines churning in agony and desperation for even but a sip of fluid and my lips nearly sealed shut due to dehydration.
Finally, late Thursday morning, the Dr. allowed me to eat solid foods, but there was a catch: Id no longer be able to choose what I wanted to eat, but instead all decisions would be made by a licensed dietitian of whom had no idea what I liked or disliked; so in other words, all sense of control was stripped from me and literally no decisions to be made while admitted, which is my worst possible nightmare. Not even meal times are allowed to be determined by me, as I literally have no say in anything and have never been more frustrated; I’m supposed to gain weight, but how is that possible when the majority of the food sent to me tastes like trash? Each time the tray comes, anxiety grips me like a ton of bricks, absolute panic overtaking me only to feel as if I could literally decompose from a heart attack; the unknown terrifies me and the absolute loss of control leaves me wanting to scream, as all sense of dignity is adamantly stripped from my being. I’ve already gained over eight pounds from IV fluid which leaves me wanting to curl up in a ball and die, as this is an anorexics worst nightmare, now convinced I’ll “balloon up” after but a miniscule increase in calories. I am trying with all of my strength to fight these lies, because I know I cannot live like this much longer, but the urges to restrict just keep getting stronger and stronger. “There is no magic cure, no making it all go away forever. There are only small steps upward; an easier day, an unexpected laugh, a mirror that doesn't matter anymore” (Unknown). When will this war end and will I able to eat half a sandwich in a normal amount of time rather than over sixty minutes? When will a milkshake touch my lips without trembling overtaking my compromised and fear-absorbed body? When will I allow myself water rather than relying on this needle in my vein for hydration? Will life ever be normal again, or will this hospital bed remain my safety net forever? When will I learn to put the needs of my mind, body and soul first rather than the happiness of others?
I recently started a job in the ICU as a nurse technician, in hopes it’d be the answer to my prayers and the key to happiness—all out of complete and absolute selfishness, I’ve been there for about a month now, but have never felt so incomplete and unsure; after about a week into it, I felt a still small voice telling me this was not for me, but I stubbornly ignored it, convinced only I knew best. However, each week I’ve found myself becoming increasingly less joyful and more stressed due to the strenuous demands of constantly lifting obese and comatose patients, running back and forth to meet each patient’s needs, wiping incontinent butts, stocking medical supplies, answering phones—the list goes on and on, yet there is only one of me. I find myself working more than I ever signed up for, with nearly no time left for schoolwork, which is my main priority, yet I don’t want to give this up since it’s good money and I’m a poor college student as well as informed a nurse tech job is the best thing I can do for myself in terms of experience. Despite all this, I now in my heart my malnourished body can’t take all of the drug-resistant microorganisms and heavy lifting in the ICU as well as the constant restriction of food and water I allow myself due to the constant chaos—my health is on the line and a decision must be made. I can’t afford to lose my health nor my passion for nursing, which I find is rapidly evaporating with every moment spent at work. God, I think I know what you want me to do, but how will I be sure? I’m terrified of losing control yet again, even though I know from the past only You bring true fulfillment and meaning. Please make certain which path to take and soften the hearts of my employers so as to understand what You’ve called me to do, if this truly is Your will. Lead me to something better and restore my joy, for its nearing nonexistence with each passing moment. Lead me to all You’ve called me to and help me to live in absolute victory and freedom.