12/16/2010

Storytime With Freckles #1

Ckemtp was bored the other night on twitter so I offered to tell him a story. This is the story I made up to learn the roles of cells in the immune system.

So once upon a time there was a ninja training ground we shall call Bob. Bob was not just any ninja training ground he was a human!

As Bob had gone about his life he had become sick, and then gotten better, he had been injured, and then gotten better. For this reason Bob never thought about the ninja training facility in his body called his immune system. At some point he had been told of the awesome ninjas living inside of him but as they was always doing their job Bob never really thought about them.

Well one day Bob sustained a particularly nasty cut and he decided to figure out just what was happening inside his body. So he got a friend to use a shrink ray and go inside with a camera and this is what he saw...

There were millions and billions of Ninjas everywhere. And then he spotted them, the invaders, and he was not the only one. At that very minute a Macrophage named Mac walked up to an invader and gobbled him up. Now Mac was a messy eater so he got the invader all over him like he was a 2 year old child.

At that very minute a Helper T cell ninja named Hank spotted the invaders. Now there are T ninjas and B ninjas and they never talk. However Hank talked to both sides even though he was technically a T ninja.

So doing his job he started elbowing the T and B ninjas. At first they were like.. "WTF Hank". And then he pointed to the invades and to Mac and his friends who were having a feast. At that moment they sprung into action the B cells tried to find a matching antibody to the antigens the invaders had on. Finding the right antibody is slow work but eventually they did find the right one. As soon as they did they began mass production of it so that they could fight the invaders by making them unable to replicate or move. They needed more workers to do this fast enough to kill the invaders before they killed Bob. So they began cloning themselves along with the antibody weapons needed.

As all this was happening the cooler T cells began slicing and dicing the invaders where they stood. It was a blood bath and pretty awesome to watch. The T cells also cloned themselves over and over to have a large enough army to fight the invaders off.

Finally the battle ended. Mac and his friends were gorging themselves by eating all the invaders and the invader bits left over from the battle. They then became globby puss that oozed out of Bob's wound.

Hank and his friends managed to recruit many many ninjas of both kinds to help in the fight and he even made clones to help them in the recruiting process.

Once they checked the perimeter and posted guards to prevent furthur invaders from entering the T ninjas and B ninjas had story time.

The T ninjas and the B ninjas sat down all their new children. The ones they had cloned out that second/ minute/ day (all 8 billion of them). And they passed down the story of those invaders. The B ninjas also gave all the children the weapons that had killed the invaders in the end.

However the much cooler T ninjas did not have to pass down weapons, as their children are born killers and do not need weapons to kill.

This passing on of the stories and weapons was tradition among the ninjas. This tradition exists in the hopes that if the invaders ever returned there would be T and B ninjas to remember how to fight them. And hopefully if they remembered and had the tools necessary already they would get up an army faster and make their clone daddies proud by having their own massacre. The End

The scars we all hide.

I have always been surprised by how many people will, when someone is hurting, be like yeah I have been there and have the scars to prove it. I also love the fact that most people have scars, both those that can be seen and those that cannot be seen.

I have had friends who have been too close to the edge of their sanity for any of their friends to be comfortable. That is usually when they get taken aside and are subjected to "show and tell". That is when we give the "We understand a bit of what you are going through... look at my scars... this is what I have been through... we are here for you" speech and they are also told that we love them and want them to be safe.

This solution has worked with 14 out of my last 16 friends. We had one friend that his did not work for and this is her story.

We went to school together and that summer we were working at the same place. She was my best friend and we had know each other for years. Me and her were 2 peas in a pod, inseparable and a little crazy. We were preparing for our freshman year of college trying to make some money for fun at school. We loved our summer job working at camp, playing with kids all day, swimming and teaching swimming lessons.

And then her world came crashing down around her. It was horrible to watch this sweet, wonderful, energetic, charismatic, outgoing 18 year old girl change before our eyes. When we had hung out on Saturday she had been one person and on the Monday after it happened she was completely different. In one day she went from loud to quiet, from a daredevil to skittish, from outgoing to reserved, from being some one who was always hugging others and giving back rubs, to a girl that could not be touched. In 15 minutes of sheer terror she lost everything that made her who she had been. She was a shell of herself and she knew it and hated herself for it.

She told not one of us what had happened that day. She just said she had a bad day and asked us to leave it at that and we respected her wishes. And despite the fact that she was so different, and wearing long sleeves and pants in the middle of summer we let it go for awhile.

Slowly we watched her move baby-step by baby-step closer to who she had been before that summer. She moved at her own pace and week by week she let us know what she needed from us. She would tell us that we were to remind her to stay out of corners, not bit her lips, we were to begin hugging her again, calling her to hang out and telling her that she was to come with us.

And she did it. In 3 months she battled her way back to the point where most of us could forget about the change we had seen that summer and all the events after it.

And then 3 months later she came into my room like she did most days. This day was different though, she told me that she needed to go to the store right then and asked if I would go with her. So I agreed, we went to the store weekly to get food for the week so this was not unusual. As we were walking there I asked her what was so urgent that we needed to go right then. The look she gave me told me that I should let it go. We went into the store and she purchased 3 pregnancy tests. We spent the entire walk home in silence, both of us lost in our own worlds trying to think about how to bring up the elephant in the room.

When we got back to the dorm she stashed the tests and we went to dinner like we did every night. We spent the rest of the night together. I did not know what to say so I simply stayed with her making idle chat. At 2 in the morning she got very quite, grabbed her teddy bear and started to talk in a very quiet but determined voice. She said "I need you to not talk until I am done." Then she started the story I had been waiting 3 months to hear. "On that Saturday night my entire life changed. That night was the night I lost my virginity. That night my whole world fell apart. I did not want to believe it was real. I wanted to pretend it was all a dream."

At that moment everything that I had seen in the past months made more sense. I told her that I was sorry that that had to happen to her and that I was there if she needed anything. She demanded my silence, I was not allowed to breathe a word of what I knew to anyone. After I told her that I would keep her secret she asked if I would keep 2 more secrets for her in the next 24 hours. I once again told her that I would do whatever she needed.

So with no warning she said "Secret number two.". As she said this she rolled up her right sleeve and pulled her shirt up to expose her left hip. The marks there left me speechless. I did not know how to convey how sorry I was that she was hurting herself without sounding like I was condemning her and her actions so I simply said "ouch". She dropped her shirt, grabbed her teddy bear and crawled onto the futon next to me and just started crying. It threw me for a loop. I had NEVER seen her cry before. I had watched her sit on the dirt of a softball diamond with a dislocated knee, I had seen her break both feet in gymnastics, and an arm snowboarding and I had yet to see her cry. All I could do was hold her and tell her I was there for her no matter what. That I always had been and that I always would be there, whether she needed me standing next to her, beating people up for her, hugging her, or just listening.

We talked for hours about why she was hurting herself. She tried to explain that it seemed to help her and that it was the only thing she had found that seemed to help her cope with everything that was going on. I was worried about her but she said she was not suicidal just that it was the only way to deal in her world. She said the only way to block out all the emotions she was feeling was to feel physical pain instead.

Then we talked about the need for the tests she purchased and we figured out a game plan for the outcome neither wanted us to happen. She decided to carry it to term if she was pregnant, get the doctors to obtain a sample of the baby's DNA so that it could be put on file, and then give it up for adoption because she knew she would not be able to handle loving the child created in such a horrible way.

By the time we had talked through all of this it was 6 am. She decided it was now or never to take the test. We went to the bathroom on a different floor of the dorm and I waited for her. She came out without looking at it because she couldn't. As soon as I looked at it my face fell and she knew what it showed. She took two more just to be sure. And with that she whispered "secret number 3". At 8 am when the clinic opened we made an appointment for the doctor to confirm what our tests had shown and to get her prenatal vitamins.

Waiting for that appointment was the longest 2 hours of my life. We got dressed and walked to the clinic. I helped her fill out paperwork and by the time we got into the room she was shaking like a leaf. The doctor confirmed that she was pregnant. And then she told us that she would not need the prenatal vitamins as the fetus was not viable. My friend chose to go home and let what was going to happen, happen. We spent the next 48 hours together and we talked, ate ice cream, watched movies, and generally took it easy so that what was going to happen could be a private affair.

Over the next few weeks her mood got better and she seemed to go back to her old self. I helped her catch up on the school work she missed staying home to recover. We giggled talking about what was happening in class and with our friends while doing our homework. This improvement carried over through finals week and through us going home for winter break. We did not see each other over winter break due to the fact that we were both busy with our lives, working, and family.

When we got back to school she was the girl I remembered from years before. We had no classes in common that semester so we only saw each other at night and usually it was just dinner or a study party in our dorm rooms. Because I was so distracted with classes and life and so wrapped up in my own little world I missed it. I completely missed the signs that something was going wrong, that despite all appearances she was not ok. She was just putting on a brave face and pretending she was fine. She had been going to class, hanging out with people, being able to laugh and joke, and doing decent in school. She seemed to be doing well coping with it, even without cutting.

And suddenly she stopped. And by stopped I mean she dropped out of life. She stopped going to class, stopped doing home work, stopped eating, stopped sleeping, she became unable to open her door to even go to the bathroom alone. She began cutting with a vengeance to feel anything. In a room full of friends she knew and trusted she often ended up under a piece of furniture or in a closet crying and completely out of touch with reality.

When we could get her to even agree to try to sleep it had to be broad daylight out, with 2-3 of us in the room, there had to be music or a movie on to distract her, and no one could touch her or get near her. And she would never sleep for more than 30 minutes without waking up screaming her head off. The flashbacks became longer in duration, and more intense for her.

We took turns staying in her room with her keeping guard over her when she was sleeping. We also took turns walking her to the bathroom and standing guard over the stall she was in showering or using the facilities. We also took turns trying to get her to eat and drink enough to keep her going. We were in over our heads and had no clue what to do for her. We tried multiple times to get her to talk to someone who knew what they were doing. She was wasting away in front of us and there was nothing we could do.

Finally we reached our limit. As far as we could tell we were the only reason she had not killed herself yet, whether on purpose of not, and we finally got up the courage to do something none of us had ever considered before. We had to tell her that we would be involuntarily committing her if she did not get help. She went voluntarily but none of us felt good about it and she was angry at us for quite awhile. But we wanted her to get better and she was getting closer and closer that final mistake.

She dropped out of school to get herself better and her life back in order. Eventually she got to a point where she realized that we did it for her, that it hurt us to see her like that, and to have to give her that ultimatum. When she got to that point she made contact again and apologized for being angry with us.

Today my best friend is working for a great company. She is living on her own. She has a fiance who knows everything and loves her and her quirks. We talk every night, and share everything with each other to this day. She is the strongest person I know and I love her to bits.

12/05/2010

First day without Traing wheels

On my first day without training wheels my White cloud exploded and so much happened and it was bad. BAD for me may not be what most people consider bad. However before yesterday I had never had a code, never had a pediatric patient alone, never been the lone ALS provider on a scene, never had a parent in the bad of the ambulance crying as they and I watched the child die infront of us despite everything I was trying to do, I just wanted a hug so bad after that call.

I want my my training wheels back.

11/04/2010

My first month.

So I am a Paramedic fully licensed and certified and accredited.

I spent my first month doing Dialysis transports and inter-facility transports to get a feel for the paper work and procedures that my particular ambulance service uses. I work for Blauer Stern Ambulance Company, this is not it's real name however in our town the german heritage is more than abundant.

Blauer Stern Ambulance Company has many different shifts and different ambulance stations.

Red Station- The 9-5 Ambulance does mostly discharges and dialysis transports and is usually staffed by IV techs and Basics. The 24 hour trucks out of the red station do some 911 calls but mostly advanced inter-facility.

Orange station does 911 for the surrounding area and some inter-facility and discharge transports.

Yellow Station- this station is where our dispatch is located and our office and billing staff are located. Ambulances only run out of here when we are over taxed at all other stations.

Green Station- This station runs most of the 911 volume for their response area

Blue Station- This is the station most critical care runs out of due to it's proximity to major teaching hospitals.

I have mostly been working at Red Station to increase my basic level skills. I was only technically allowed to do IV Tech level skills. I was also running as a third on an ambulance crew to allow me to be observed. I had great teachers and preceptors while working in this station. They taught me how to drive and ambulance and the ins and outs of how to properly document what my patient does and says. I went through a driving course that allows me to drive lights and sirens with and without patients and in adverse weather conditions. I ran 9-5 weekdays for my first month and can now write almost entire reports for certain patients without seeing their paperwork at all.

As of 2 days ago I was cleared to run as a full Paramedic. That means I get to run with just me and another Paramedic. So 2 days ago for the first time in my life I was allowed to run code 3 to a call. Full on lights and sirens and speeding. I was told of the fact that in Wisconsin there is no limit for how fast you can go while running Code 3 as long as you are traveling with due regard and have the safety of yourself and others in mind. I was too scared to go more than 10-15 mph over the speed limit, I just did not feel safe doing it.

I got my first four 911 calls in my first day and I learned a few important lessons.
1. Always put your day bag in the ambulance first thing in the morning
as you are getting in to do rig check.
2. If you will need food, a glucometer, medication, caffeine or anything
like that for you to get through the day it needs to be in your day
bag before you get to work.
3. The second you punch in CHECK YOUR RIG...and restock it immediately.
If you do not your first call will be within 10 minutes of the
beginning of your shift.
4. If you think you need to go to the bathroom go to the bathroom.
5. When you get a chance to eat... EAT
6. If you want a call... Heat up food, sit down, drink lots of water,
and take off your boots you will get a call within 10 minutes.

I am sure there are many more truths about EMS that I have not learned yet. But I am working on it and i will post as I learn them.

10/02/2010

Pink

I decided to make my background pink in honor of all of the people out there with boobs. Many of the people who's blogs I read every day decided to do it so I figured I would play along. So for Aunts J and J. Grandma, and Great Grandma. This is for you, and all the other people out there who have chesticals.

9/11/2010

How far

Today as everyone is posting reflections about those who died on 09/11/2001. Where they were, what they were doing, what they remember. I figured I would post some reflections of my own.

*Nine years ago I was 13 and in 8th grade.
*Today I am now 22, I am 2 classes short of a degree, and will soon have a full time job.

*Nine years ago I sat in my class room in a small catholic grade school watching in disbelief all the coverage on the television. My teacher, my 10 classmates, and I watched all day.
*Today I made care packages and talked to my brother and friends on the phone.

*Nine years ago my little brothers were 9 & 11 and in 4th and 6th grade. They had hot tempers and were always getting in fights.
*Today one is a Marine. He has been to war and come back a man. They both started their freshman year of college this week. They still have hot tempers and get in fights But they have grown so much.

*Nine years ago every member of my family, and all my friends were civilian or retired.
* Today in the Air force I have, Jacob, Giana, Kelsey, Katherine.
In the Marines I have, Kyle, Brian, Carl, Mark, Justin, Ross, Ryan, Nate, and Steve.
In the Army I have, Shauna, Travis, Rob, Alex, Caitlin, James, Bob,and Eric.
In the Navy I have Jeremiah, Rebecca, and Travis.

These people are friends, uncles, cousins, fathers, brothers, sisters, mothers, aunts. These are the people I call and send care packages to on this day. The people I am so proud to say I know.

On this day I remember the events that brought me and all the people I care about to this point. However I celebrate the people that were willing to give up what they had in order that I remain free.

6/18/2010

Ta Da

As of today I have...
ACLS
PHTLS
PALS
CPR
And I have passed both the written and practical versions of the Paramedic exam.
Just waiting on my state to send the sparkely patch and the paperwork to me so that I can be officially licensed here.

I also still really need a job. So if anybody is looking for a Paramedic in the beautiful state of WI let me know I will be your lady. A full time job would be awesome but at this point I will settle for any job that will help pay my bills.

Well back to filling out job applications.

5/26/2010

The End is Near

Today my friend and I took the NREMT-P test. Now we are both officially one step closer to the end of this crazy year. And one step closer to being big girls and getting big kid jobs and use the sparklely patches that will soon be on their way through the mail. We were so excited we both barely slept last night and we were both at the testing site an hour early. Finally got called for an interview the other day but they want to wait until I am all done with testing and have a license before they even consider hiring me.

I am so nervous though for the tests and then the interviews and then having to prove myself to a large group of new people. I am also nervous because over the last year so much has been crammed into my head that sometimes I feel like I have learned nothing at all.

But on that note I should go back to studying and filling out job applications.

I promise to update this more once I have the time to remember more funny incidents and anecdotes that were relayed to me over the last year.

4/23/2010

The Job Outlook

So recently I have been filling out and handing in large quantities of job applications hoping to find a place to use the license I will be graduating with in a little over a month. The first 5 were rejected outright for lack of experience. In there job descriptions nowhere did it mention the amount of experience needed to apply for the job. But I had another thought... Okay so you are rejecting me because I do not have experience as a Medic. I get that and that is totally your right. However, if no one is going to hire a brand spanking new Medic, how is she supposed to get this experience that they all want?

So I figured someone had to be hiring those of us out there who are just being given our patches and being punted out into the world. So I kept applying and yesterday I got a phone call asking me if I could come in for an interview. Now I do not know much more than I am supposed to show up at a place at a time for an interview because I was sleeping when the phone rang. So my first impression on that particular member of the board of trustees is a semi-unconscious, hoarse voiced, mildly confused, paramedic in training, trying to hold a conversation in her sleep. I did wake up enough to get the details and a name of who called but It was 7 in the morning and I had been awake until 5 am due to pregnant sisters and false labor.

However now I have to figure out how formal this interview is and what I should do to prepare for it. I was a ride-along at this ambulance service for 7 months so although I know all the people for the most part I am not sure what to expect from the interview. I have to go into the dreaded "Office". In all my time as a ride-along the "Office" was a place preceptors disappeared to to complete paperwork and the boss man spent most of his time. Rarely people were called to the office to do QA and be informed of things I was not supposed to be privy to. However most of the time I as told within 10 minutes anyway.

But all of this had me feeling positive until class. Yesterday we had the dreaded talk about how we have to work extra hard from here to the end because it is going to kick our butts from here to kingdom come. Our teacher is desperately trying to put fear in us and scare us and push us hard enough that come the Practical and Written we all find it easy. (Okay well not easy but at least we will not be barfing our guts out or failing epically)

4/21/2010

Things I am afraid of

There are things that I am afraid of now that I am graduating.

*I have never done CPR on anything except for a manikin. I am terrified that my first time will be when I am incharge/lead and that I will freeze.

*I am nervous about finding a job. So many places will just flat out reject you until you are completely finished. I just want a place that says when you graduate we will have a job for you.

*I need to find a new place to live but with no money in my name anymore because of school, and no job right now I am just working on keeping food on the table and gas in the car.

*I am worried that the people in my life who I care about will not understand how much I love this.

*I wonder if I am worth the man who is putting up with my whining. The one who knows the secrets I hide from the rest of my friends and family. The wonderful man who listens when I am crying or talking 90 miles a minute.

4/20/2010

The End of Clinicals

Well it is official I am done with clinicals. I have met many amazing people during my time in and out of hospital ER's and OR's and Ambulance Services. A few shout outs to the ER Tech's I was constantly stealing keys from to get into supply closets and who were constantly giving me advice and tips so that I was more efficient in my IV starts and so that I was not constantly blood letting pt's. To the nurses that put up with my constant begging to do everything that they would let me do and then begging for signatures for all skills I begged to be allowed to do in the first place. To all the RN's willing to sign for pt's they saw me at least check on at the end of the night. To all of the ambulance preceptors who joked with me, pushed me to do and say what was needed for pt care, to the preceptor who yelled at me in private when I left a sharps sitting between the bench and wall without telling anyone. To the preceptors who sat through my sometimes ridiculous questions and who went over EKGs and pt scenarios over and over and over.

Now onto some numbers...
630 hours at a clinical site.
57 shifts
30 ambulance shifts
22 ER shifts
5. OR shifts
225 Pts
16 Pediatrics
3 confirmations of death
175 IV starts
20+ IV Fails
108 Drug pushes (1/2 Zofran, 1/3 MSO4)
5 Neb treatments
12 ETT
40+ hours of clinicals a week
30 hours of class a week.
12 the number of times I did class to clinicals to clinicals to a 4 hour nap to class to clinicals.
2800 cups of coffee the coffee maker has kicked out for our class.

Tons of inside jokes. Lots of laughs. Quite a few new friends made along the way.