Breaking point

It happened.

Grad school pushed me to my breaking point.

I’m talking full on emotional breakdown, anxiety attacks, re-emergence of repetitive behaviors…

It got bad.

For some reason I hit a wall and could not move past it.

I went to work and functioned as if I was ok, however mentally I was losing it!

It all started with one class… Pathopharmacology. Now let’s remember, I’m in school for my masters in nursing education. I was not prepared to cross paths with this class. It hit me like a ton of bricks. The grading rubric was 5 pages long with part “A” consisting of like, 3 of those pages. I hated it. It’s not a class I have ever wanted to take. It did not interest me. I couldn’t retain the information. The paper I turned in was basically a pompous regurgitation of information that no one wants to read.

It sucked.

The sheer weight of the paper that was due gave me anxiety so I procrastinated. The procrastination made me anxious. The anxiety made me procrastinate more. The procrastination gave me anxiety.

It was the feedback loop from Hell.

I almost broke. Quitting actually started to look like a viable option. I was literally in tears thinking about the paper.

It was the beast I could not defeat… or so I thought.

I had to have friends and family really rally around me and offer support to help pull me back from the edge. They managed to get me to take a step back, breathe, and break the monster down into manageable pieces.

I have a great support system, something I don’t acknowledge enough.

After hours of research, coming up with an outline of what was needed, and taking the paper in small chunks, I completed it. I turned in 36 pages of absolutely glorious regurgitated information. It’s what they wanted, so it’s what they got.

I passed the paper and the class.

It was if a 10-ton Boulder was removed from my shoulders. I could finally breathe. I celebrated by drinking wine and playing Final Fantasy Online with my cousin. It was amazing.

I’m now in Health Assessments. It’s at least something I have some familiarity with. I know the advanced practitioner health assessment is far more involved but it’s something I can learn and retain. It’s useful information, I mean I’ll have to teach that to nursing students one day (hopefully). So, I’m nervous about the assessment I have to record. I’m nervous but not panicking. I’m learning to breathe and take things one step at a time. I finally have a plan to move forward. It’s doable.

Alpha-gal syndrome

I learn about new disorders all the time here in MRI. Normally I’ve at least heard the name of the disease or disorder before, or I know a teeny bit about it.

I have never heard of alpha-gal. At least, I’ve never heard the name.

Turns out, I have heard of the disorder before. I had a patient once tell me he was allergic to pork because of a tick bite.

Alpha-gal is a “sugar molecule found in most mammals (except in people, apes, and monkeys)” (CDC.gov, 2019). Turns out there is a tick (lone star tick) that can transmit the molecule in blood from the animal to humans. We humans don’t normally make the molecule but apparently we can make an immune response to it. If we develop an allergy then we can no longer eat meat from cow, pork, rabbit, deer, lamb, essentially the animals work hooves! The odd thing about it, and what makes it kind of hard to diagnose, is the fact that the reaction tends to take place 3-6 hours after the ingestion of meat. It’s hard for a lot of people to make the association between meat and their allergic reactions.

I found a good podcast about the disorder. Lots of information about how it works and the ongoing research around it.

One of the things I realized while looking further into the disease is how important it is to ask your patient about allergies. Alpha-gal is uncommon, however, patients with it can’t have certain medications. Heparin is typically derived from pork. Some insulin is derived from pigs and cows as well. There are quite a few medications that have porcine or bovine derivatives. A nurse would have to make sure to take this into account for their patient with this particular allergy.

Then again, when is the nurse not taking safety into account, right?

Struggling

I’m struggling. This pathopharmacology class is killing me. I have no interest in it so it’s hard for me to focus on it. I’ve been procrastinating terribly. I can’t seem to make myself write the essay that I need to complete the class.

I can’t focus.

I am so aggravated with myself for not being able to just get this class done. I hate that I am in this funk and I’m starting to feel guilty and depressed.

I’ve got to focus. I’ve got to sit down and make sh*t happen!

I’m hoping I can get over this hump…

DiGeorge Syndrome

Have you ever heard of DiGeorge Syndrome?

I hadn’t until I had a pediatric patient with the diagnosis. So what is it?

According to the Mayo clinic, it’s a genetic disorder caused by the deletion of a section of chromosome 22. Patients tend to exhibit heart defects, cleft palate, weak immune systems, developmental delays, and behavioral problems.

I had the most adorable little 7 year old with DiGeorge. She didn’t have the cleft palates that is common with the disease but she did have cardiac issues. In fact, one of her ventricles was huge! She already had cardiac surgery before and it looked like she would need to have it again. Apparently she would be dealing with this for the rest of her life.

Working in radiology I come across at least one disease a day that I have never heard of. I like to look up the disease just for my own medical knowledge. Any diseases you’ve run across that you knew nothing about?

One down

So, term one is done.

One down, three terms to go to finally get my master’s.

I’m proud of myself. When I started school I really thought I might have been making a mistake. I didn’t think I was ready. I thought I was in over my head. My first paper got sent back and recommended for the writing center because it was so bad.

I had forgotten everything about APA formatting! I felt like an idiot. I took the recommendation and used the writing center for help. My papers are much better now. I feel more like a student, like I kind of know what I’m doing.

I still second guess myself. That’s just me. However, I feel more at ease. It’s tough, papers suck, I’m tired all the time, but I see that I can do it.

I know that it will get harder from here. More 14 page papers, projects to do, and soon, clinicals. I’m going to gripe, moan, groan, curse, and complain. I’m also going to get sh*t done.

I can do this. I’m ready…

Arch nemesis

Classes have started for me. In fact, I’ve already completed one class. I’m liking the program so far but my fight with my old arch nemesis has reignited:

APA formatting 😒😐

I despise APA. I don’t even understand its point. Margins of this size, very particular page headers, citations that are done *just* so, reference pages with indentions done differently than the actual paper, references sited differently depending on what they are…

Why can’t I just write this damn paper and send it in?!

I get that APA formatting is to help maintain consistancy with how research is published and readability. What I don’t understand is why make it so damn complicated? It almost feels like the creators made it complicated because it made them feel smart.

I hate it.

APA has always been a thorn in my side. I’ve never been very good at it. I find the rules convoluted.

As you can see, I’m already over it…

Stress

I am about to start school. Another one of my coworkers is about to start clinicals for her NP. Another coworker is about to start her NP program. Needless to say, we are all stressed. At least I’m not alone, right?

I decided, however, I’m not going to let myself break under the stress of school and work. I am going to make sure I have some kind of kind outlet.

The first time I went to nursing school my friends and I would go out as a way to celebrate completing a semester. We would dance and let loose. It helped, it gave us a little something to look forward to. When I went back for my BSN my brother would notice I was stressed and drag me to Starbucks or Barnes and Noble (two of my favorite places) to have a moment of of the house. He would also make me do my studying there where there were no distractions (like the TV 😐) to steal my attention. It worked.

So now I’m trying to figure out what my de-stress plan will be for this go round. I know I’ll be doing the “out of house” studying. I think it may be time to bring back the end of semester party night as well! I just know I can’t let myself break under pressure. I’ve got to figure out what my self care will be for this experience…

A new thing

So I’m trying something new for health reasons.

Actually, I’m closing out my fifth week of it.

I removed meat from my diet.

My blood pressure the last few times has been borderline hypertensive. My weight is higher than it really needs to be. I always felt sluggish after eating a meal with a lot of meat. I also felt like it took so long for me to digest.

I know I wasn’t eating the right proportions of meat to vegetables. My meals were always meat-heavy. So I made a conscious decision to just cut it out all together and leafn how to eat the veggies I so often avoided.

My pressure is down closer to normal the last time it was checked. I lost about 3 pounds. One thing I wasn’t prepared for was how often I’m in the bathroom! Fiber, man, fiber! But I can honestly say I do feel better. I have no idea how long I’m going to keep this up. So far I’m not missing meat. I do wish veggie bacon tasted better though. Either way, let’s see how long this lasts…

Decision made…

So…

If you remember some blogs ago, I posted about applying for NP school.

I didn’t get in.

sad failure

I felt like sh*t. I felt small. I felt insignificant. I felt like a failure. I was super bummed about it.

Was…

You know how you make a plan and then allow the opinions of others to make you veer from your plan? Yeah, that happened. Let’s go back a little, shall we?

If you have been with me for a while then you know I have been wanting to go back for a Master’s degree for quite some time. I have bounced between where in the nursing field I wanted to specialize. I have had people tell me I would make a great teacher. I love teaching people about things I know. Teaching is something I have grown to really, dare I say, love. Months ago I was talking to one of my coworkers that has been a nurse forever. I told him about wanting to get my DNP ultimately. His response? “Great! Get your MSN in education and then come back here (the academic hospital where we work) and get your DNP! You’ll make a good teacher”. Prior to even talking to him, the “education” path had been floating around in my mind. I kept pushing it away because according to everyone else, that’s not the “money making” field. As far as most people are concerned, there’s no reason to go back to school unless it’s to get a degree that is going to make you way more money. Forget doing what I like to do. Forget wanting to make a difference in the medical field. Forget wanting to help others. Will it make me more money?

I got sucked into that mindset.  A DNP will make me more money and I need to get it now. Forget getting an MSN and then a DNP, that’ll take too long. Nope, I’m going BSN-DNP STAT!

I was introduced to a program that had the BSN-DNP option. Great! I expressed interest and quickly found out I did not have the GPA currently to do the DNP program.

denied

I could do one of the NP tracks though. Oh… Okay, I guess. I mean, I wasn’t really looking to be an NP but according to everyone else, it was the way to go. So I applied for the NP option. I filled out the application (3 times because the system kept losing it which was probably my first red flag), updated and sent in my resume, completed the essay, and got glowing references (which I ended up having to scan to my email to send to the advisor because the reference link wouldn’t link back to my application because of a glitch, second red flag), and I waited…

And waited…

And waited…

For four weeks.

And then the rejection email and the pity party.

So after all of that, I had to really sit down and think all of this through.

What do I enjoy doing? Where do see my career going? How do feel I can be the best benefit to others? What do really want to do?

I. Like. Educating.

DAMMIT SHAUNELLE, YOU’RE AN EDUCATOR!!!!

I am planning to start school in April. I got accepted into an MSN in education program at the same university that I obtained my BSN from. I should have my degree in about 1.5-2 years if I can buckle down and do this full time. I am not doing what everyone else wants me to do. I am not going for the big bucks (if I wanted big bucks nursing is probably not where I should have headed anyway). I am going to do what I feel is going to make me happy in the long run. It may take an extra step or two but I am going to do things my way.

 

 

 

CIDP

In nursing, we are always learning something new. Sometimes we learn about a new med. Sometimes we learn about a new use for a med. Sometimes it’s a new side effect. Sometimes it’s a disease you weren’t aware of.

As I’m writing this, I just came across a disease I never knew existed: chronic inflammatory demyelinating polyneuropathy.

Say that five times fast!

I had a patient that had an MRI of the brain and complete spine ordered (that’s at least two hours) and the reason was “CIDP”. I have never come across this abbreviation before so I had to hit up good ol’ Google to find out what it is.

Turned out to be very interesting, at least to me.

What is it?

CIDP is rare. It’s a disorder where there is inflammation in the nerve roots and peripheral nerves. It also destroys the myelin sheath over the nerves. This inflammation and destruction interfere with signal transmission. Patients notice muscle weakness, impaired motor function, and it’s typically noticed on both sides of the body.

How is it diagnosed?

According to the rare disease database put together by NORD (National Organization for Rare Diseases), the symptoms of CIDP progress slowly. Patients notice “symmetric weakness of both muscles around the hip and shoulder as well as of the hands and feet”. These symptoms must continue for at least eight weeks without improvement to be considered CIDP. Patients may also undergo EMG’S, nerve conduction studies, lumbar punctures, and MRI’S to help lead physicians to the diagnosis.

Why do symptoms have to persist for so long, you ask? Great question.

Turns out, Guillain-Barré syndrome is kind of an acute form of inflammatory demyelinating polyneuropathy. With GBS there’s typically a preceding virus or illness. GBS progresses over three or four weeks. The symptoms plateau, get better, and don’t re-occur.

The extended period of time is to differentiate CIDP from the acute forms. With CIDP, the symptoms don’t get better without treatment. GBS is usually related to an illness while CIDP doesn’t really have a known cause yet.

How is it treated?

Corticosteroids and immunosuppresants are the standard treatments. According to the NORD article I linked to, IVIG has also been proven effective. It seems that plasma exchange has also been an effective form of treatment. However, both forms of therapy only last a few weeks and the patient may need intermittent treatments.

I spent about an hour reading about this disease because it was so new to me. That’s something I’m trying to make sure I do, read up and learn about the new things I come in contact with here in the hospital. I know I can’t learn everything. That isn’t going to stop me from trying though!