Book Hangovers

 So, there's this particular feeling I've been working through lately, and honestly, the best way that I can think to explain it is like a book hangover.

What's a book hangover?  Great question.  Glad I pretended you asked.

No, it's not an official official term.  But picture this:  you've been thoroughly enjoying a book or maybe a streaming a tv series.  You've been waiting for a spot in your day--all day!--where you can read/watch just a little bit more.  Folks suggest plans after work and while you might be happy to join them, you also really just want to get back to your book/series.  Maybe you stayed up past one in the morning for just one more chapter/episode.  There's an excitement and a drive and you very much have something to look forward to.

...And then you reach the end.  All of that energy suddenly has no where to go, and it seems to fade into a disappointment of sorts.  There are no more chapters, no more episodes.  Even if it's a book in a series or there are more seasons or spinoffs, there tends to be a wall eventually.  There isn't something to look forward to in the same way.  The ending might have been **perfect** but the depression is still the same.  

Sometimes, it's easy to find the next thing to start on; other times it takes a while, wandering unattached and listless through the day, without that clear default or direction.  

Here's where that information comes into play:  I have been working for literal years now to prepare for nursing school, get into nursing school, dedicate my energy to learning in nursing school all in the goal to land a job as a practicing nurse.  I now have a job lined up for after nursing school, part of it starting up during the remainder of nursing school, actually.  I've been working through paperwork, fingerprinting, scheduling a physical, government forms, getting my employee picture taken, etc., and barring unforeseen disasters, it's real.  And I'm excited.

But I also feel a bit untethered at the moment.  The drive I had suddenly doesn't have the same direction and urgency as before.  The goal is altered a bit; I need to find my refocus.  There are certainly still things left to do--remaining clinicals and course material for this term, completing the final term, passing the NCLEX--but it feels different with the clarity of that next step.  The push to get an A in remaining courses is not as important, for example, as ensuring that I am prepared for the NCLEX itself, which in turn will dictate how I allocate my study time.  And even after that, the push to understand and apply the information in my courses is more important to said job than responses to first-level questions in courses, meaning that how I approach studying in itself will similarly shift.   

In short:  I am beginning to process and participate in the shift from theory into practice.  Furthermore, I recognize that it's uncomfortable to refocus and find new patterns in the same breath that I'm confident I will be able to find that next great drive of energy forward.  I have a quite few goals yet to do, including WOC certification and eventually writing a book about experiences in living with a stoma, as a resource for both patients and their families going through something similar.    

But in the meanwhile, I need to experience the recalibration.  

The Cream of Tartar Story

There are family stories that are passed down and around until they practically become mythology.  And then, there is a very specific jubilance when you realize that someone you're talking to has actually not yet heard that story.  

This is one of those.  And somehow I haven't already documented it here on the blog.

My dear Andy.  My sweet, wonderful Andy.  

We had been in our apartment for about a month or so, if memory serves.  I was working on making dinner one night, and I realized partway through that I was missing an ingredient for my chicken pot pie recipe, namely cream of tartar.  Out of the goodness of his heart, Andy offers to pop to the store and pick it up for me while I keep working on the filling.  

The grocery story, mind you, is less than three minutes down the road.  So I was a little bit confused why it took closer to twenty minutes for him to get back.

The door opens.  I call out some greeting, but immediately Andy bursts out with "Did you know that cream of tartar is not a soup?!"

I started to stammer that, yes, in fact I did know that but Andy was already on a roll:  "I found cream of tomato, cream of potato, cream of cheddar, cream of broccoli, I even checked the Progresso ones to see if it was just a weird one..."

At this point, I'm DYING and unable to hold in the laughs.  

"So I pulled open my phone and asked it 'Campbell's cream of tartar' and my phone basically looked at my like 'BUHRH?'  So I asked it for 'cream of tartar' and gave me potassium bitartrate and I scrolled down like 'no, NO, maybe? Okay,' and I went over to the baking aisle and it was RIGHT THERE in front!"  

It will never not be funny to me.  My folks took a label maker and "corrected" a cream of chicken can for Andy once that stayed on our stovetop as a decoration for along time.  Some folks will fess up that they wouldn't have known that either, might even have tried the dairy section; others immediately shake their heads with that indulgent but disbelieving headshake.  

Of course, I had set a potato bag on fire a few weeks prior, and Andy hadn't let me forget that either.  And at this home, Mike and I were greatly intimidated by the pilot light of the water heater ("I don't smell gas; I just feel fear!"), which is also the stuff of family mythologies.  They're those kinds of stories that hold us closer.  

Attunement

Sometimes when Andy and I are working together in the kitchen, I can point toward the counter and he will automatically hand me the next piece I need for whatever it is I'm working on, never breaking in the conversation between us.  Other times, we have had entire conversations in sleepy, morning grunts.  Sometimes, we are planning something out for the house and entirely on the same wavelength, making the same cognitive jumps and building off of one another's ideas to make a wonderfully cohesive plan.

And other times I have to ask four times what "it" is in the sentence.  Or we find out fifteen frustrated minutes later that there was a misunderstanding about the timeline of what we were discussing, which was resulting in a much more barbed conversation than expected.  Or the response to the question included a heavy sigh because there was an implied secondary task with the first that hadn't actually been implied but was somehow there all the same.



It happens.  That synchronicity ebbs and flows.  Some days we're remarkably attuned to the others' needs.  Other days we feel disconnected, needing to find where the roadblock is but knowing that this is going to take some emotional energy that we might not have at the moment.  And to add insult to injury, we're frustrated that we're out of attunement already, not even starting on the whatever the core issue is.

It's okay to let ourselves feel that way, to mourn the moments of disconnect.  It hurts.  When both of us are ready to, we can find walk along the riverbank to find where it's blocked.  We can find that space to meet in the middle again.  We can realign.  It takes time and energy, but it restores communication, that instead of a trickle we're an efficient flow that makes all else smoother.  It takes intentionality.  

I've been thinking about this in some different ways during the pandemic.  A whole year under these new uncertainties.  I think about friendships that I long to reconnect; I chastise myself for not always having the emotional energy to act on bettering them now.  I'm grateful for persons who have reached out to me; I'm grateful to those that have responded when I can reach out.  I take time to find a middle and how far I am able to stretch at a given moment.  I wonder at what attunement needs repair that I haven't even realized.  

And I marvel at the group of persons that I have cultivated into my life, both those that will transition out and those that will stay.  

Stress Brain

I feel as though I've been slurring ideas together in my head recently, that there is a blending between what someone has told me, what I have read in case studies, and what was purely a hypothetical I made up in my head in one of those long showers where you forget that time is a thing.  

It's a temporary thing, I think mostly from stress.  But it's also in part due to my shifting understanding of my current reality.  Here are some samplings:

• My schedule has little real consistency, with clinicals slipped into various off days on the one hand and the constant need to change various activities due to COVID changes.
• I have been doing so much reading for class collectively--it's a little lighter so far this term, but there was a fair bit that preceded it in the last two--that there is some very real overload.
• March seemed to be endless last year--why does it get another go this year?
• I'm working on organizing the pieces I need to start a new job, including emails, corrective phone calls, calendar restructuring, and checking with my permanent roommate that I can have the car on that day with what his schedule needs.
• In preparation for a part of the job that is due to start before I finish my program, I have been working to get ahead on a number of different assignments and the like, meaning that I feel an extra crunch on my current due dates, further skewing my sense of time.  In other words, yes, the paper I have been working on isn't due until late April, but that could be one less thing I have to worry about in April meaning that I kind of forget that March is a thing.  
• I've also been contemplating about the shift in my identity, claiming the title of "nurse" and what that can mean.  It's a loaded train of thought.  

All in all, I'm working toward flexibility and proactivity where I am, understanding that I'm moving toward the final leg of my program with all that that transition can and will mean.

So, light, fluffy stuff, really.  ~sarcasm flag~

I know that when I eat well, exercise regularly, and utilize the coping tools I know work well for me that I genuinely feel better.  I know that.  I have also been alternating between comfort eating and eating barely anything this last month.  I have also been either forgetting to do much exercise at all or way overdoing it.  The crux of it is that I do have more to process, but I, once again, have not been giving myself the space to process it.  It doesn't seem like there's enough time.

The result:  grades have dipped slightly (i.e. midterms ate my brain) and my resting heartrate has been higher the last few weeks according to my Fitbit.  What I've been focusing on, though, are that my talking patterns have been more stream-of-conscious than usual.  I would go as far to say that I have the aftertaste of leather after putting my foot in my mouth in a few curious ways recently.  However, it's purely possible that I've been overanalyzing, that I have, in fact, been about the normal amount of weird and occasionally socially clumsy as usual.  It's confirmation bias or otherwise a hypervigilance due to the increased levels of uncertainty (because I've very accustomed to some) in this transition period.   

The solution:  honestly, I just needed to put a name to it.  There's a lot of good stress right now--I'm on the precipice of new things and genuinely intrigued by the material we're learning this term.  Stress is still stress.  I hadn't spent much time to simply acknowledge what levels I was quietly carrying, made apparent by things like my Fitbit data.  As a result, I was spending some time relaxing, but I hadn't really directed it to the right spaces.  Naming the feeling, noting how I was feeling it somatically, that acknowledgement by itself was huge, to notice and demonstrate compassion for those parts of my brain and body.  I've talked about this briefly before with regards to large grief/anxiety/depression, but I hadn't put together how well it can work for those smaller or aggregate concerns, too.  And I began to feel unblocked, that my relaxation time was much more productive to its goal.  I could comfort eat as a treat to myself rather than lay in post-carb-coma guilt; I could exercise and be grateful for the investment in myself rather than bemoan that I couldn't do six things at once to maximize the time.  I could check in with Andy and not be thinking of what else I could be doing to get ahead in my studies.

If it were anyone else, I would talk through it with them, help them name the source where possible, and insist that they not feel guilty for taking time to rest in a way that best helps them.  And once again I have to remember that I can extend that same grace back to myself.  

I don't think I'll ever be done relearning that lesson, but I am also willing to keep trying for it anyway.  With the personal wellness days we have received this week (in lieu of a spring break), I've been striking a balance between getting ahead and actually using some of that time off to relax--writing a paper but also taking a long walk with Andy and Luna; knocking out a couple of longstanding household chores but also seeing my parents.  In short, I'm balancing different ways to be kind to myself but now with a greater awareness of how it's affecting me and what it's benefits will be.  

...and a glass of wine while working on blog posts can't hurt much either.

Dinosaurs

There's an age where no one asks you what your favorite dinosaur is anymore.  And, truly, that is a great tragedy.

I had a conversation with a kiddo the other day that I had never met before that day about velociraptors for about ten minutes, learning about how they hunted in packs and how big and fast they were.  It was one of the highest points of my week.  I brought up that one of my siblings was a pachycephalosaurus for Halloween one year, and this kiddo knew immediately that that particular dinosaur had a thick skull, presumably used as a weapon, like rams smashing into one another.  Well, I had to mention my favorite dinosaur, then, and sure enough this kiddo knew immediately that the parasaurolophus has a fancy crest on its head.  

Picture from Wikipedia, used without permission

It seems that many folks I know went through some kind of dinosaur phase at some point, particularly with the timing of the release of Jurassic Park--for some, it was a couple of books and for others it was bedspread, school supplies, wallpaper, toys, etc.  I would say that I fall somewhere middle-ish; I can still remember a couple of songs from second grade, one about T-Rex and another about pterodactyl, though.  I spent more time on Egyptian culture, probably, but I do enjoy learning things regardless.  

There is something truly beautiful in listening to someone talk about something they're excited about.  And yet, we forget to give each other space to do that, to be excited about things.  

In any case, what's your favorite dinosaur?  What are your random areas of interest you don't get to talk about often?  

Caught in the Cogs

The Mayo Clinic in Rochester, MN, is a well-oiled machine, managing to fit a handful of appointments into a single week, where it would have taken several months and many phone calls to coordinate something similar with doctors' offices in the area (plus, they know the weird stuff when your local physician has reached their limit).  When I was going to Mayos it seemed every other month, there was almost always bloodwork before the first couple of appointments.  By default, this included a fasting blood test, which meant I could only have specific foods the night before AND I could not have anything to eat until the blood draw itself.  Sometimes, this was particularly difficult when the scheduled time for blood draw wasn't until 1430.  

With this particular test, I found myself getting chewed in the cogs of that well-oiled machine.  I still got through the machine, mind you, just a bit more crumpled than I needed to be.  At certain points of my Crohn's journey, I could not tolerate not eating when I was hungry--skipping one meal meant literally three days of catching up.  So, while it seemed like something simple and routine, I was emphatically not okay doing the fasting part of the bloodwork.  I suffered in silence twice, and then (with familial prompting) thought to call and ask if I that part was strictly necessary.  Turns out, it was a pretty routine piece--something that they have as part of their standing orders.  BUT given that I was the age I was and my other medical history, it, in fact, was not necessary.  They took that particular test out of the blood draw and I was clear to eat what I needed to the day of.  

All it took was one question.  All it took was knowing to ask that one question.  The kind of pain and discomfort that this standard order caused was preventable with a single, polite inquiry via phone call.  

There was another time, when I was arranging my reconnection surgery of my ileostomy (which a few years later became a permanent colostomy), and I had foolishly made an assumption:  I had assumed that I wasn't supposed to be on my medication yet, based on previous surgeries, and I had also assumed that my local doctors and Mayos doctors might talk to one another.  It made for one furious ride home, while I made multiple calls to my GI doc after Mayos delayed the surgery for about a month so I could resume the medication.  

The material point:  I have been doing this for years, and there are still places where I get caught in the cogs of the machine of healthcare.  I've learned so much, including what questions to ask and how to get answers from both the insurance company and a doctor's office that is slow to return calls, but I've come by that information through a lot of work and experience.  

Something happened in clinical lately.  I watched a patient that had very similar behaviors to my older sibling, that they were possibly on the autistic spectrum.  It worried me that this patient might get caught in the cogs.  I could see a potential breakdown in communication happening--there were different steps that had to be taken to help the patient fully understand the circumstances.  There were some significant diagnoses and prognoses happening to that patient, and I was very much focused on recognizing their humanity while honoring their neurodiversity.  With this person, I made the code switch to speak to them in a way that we could more effectively communicate, specifically changing how I asked questions to get the information I wanted in a way that minimized confusion, stripping out most of my more colloquial turns of phrase.  It made perfect sense to me what was happening, but I couldn't figure out how to help my compatriots make that code switch in a concise and/or subtle way.  

I do not want to imply that this individual received any less care--they were absolutely treated and informed--rather, I'm highlighting the emotional exacerbations to not feeling heard that could be preemptively avoided.  I wanted to tell the other caregivers with my eyes that the client wasn't being obtuse on purpose; I wanted to tell the others how to alter their questions to get the information they actually wanted and not to imply the real question; I wanted to empower the next caregiver for this patient how to do the same.  The client's needs were being met, but there was space to communicate better.

There are places where neurotypicals get caught in the cogs, too.  There are questions that we don't know to ask; there are changes we don't know are an option; there are inconveniences that we don't recognize don't have to borne.  

How do we know these places?  By asking questions, even the dumb ones.  And it's important to teach others to ask questions, too.  This is the best way to extricate yourself from the machine.  Sometimes the answer will be "no," but that doesn't mean the time it took to ask the question was wasted--occasionally, it might be a "yes."  As a blossoming medical professional, I want you to be able to trust us, but I also want patients to understand and to be able to identify pain points that I haven't the right perspective to understand.  There are things that are a simple inquiry away from resolution; there are things that are the way they are; I cannot guess which yours might be until I hear it.  

So the short version?  Again, ask questions.  I don't mean go full-Karen.  You as a patient and/or insurance recipient have a right to understand why decisions are made the way they are made, why a particular recommendation is suggested.  If you can approach these questions with grace and genuine curiosity, you have taken great steps toward self-advocacy.  

Peterson Family Update #8920-gamma

No, there is absolutely no rhyme or reason to how I label these kinds of updates, but there is a method into how I time them for myself.  Basically, I say to myself "holy crow, so much has happened lately that I don't know where to begin!"  Maybe there are a lot of small thoughts that are important but not significant enough to justify an entire blog to themselves or maybe there isn't enough time to dig into all of those ideas in a timely way.  Or sometimes it's because I've been waiting to talk about something until someone asks me the right question, and no one seems to know to ask the right question--this is a confounding habit of mine and not blame that I setting any particular direction.  As such, I have a myriad of little thoughts that require expression and it is, once again, time to deploy the bulleted list.  

• I go once a year for a dermatologist check-up.  With my medications and conditions and being as pale as I am, I have some predilection toward skin cancer, so we keep an eye on it.  Last week, we took a biopsy on a basal cell carcinoma.  Waiting on the results for that.  I'm not worried, per se, as the doc said it seemed pretty superficial, but I am a bit jostled, as I had my own suspicions on what it was (based on common Crohn's crossovers) and hadn't considered that.  It was a reminder to check my blind spots and assume nothing.  I'll be reaching out for biopsy results this week.
• Luna was spayed a couple of weeks ago, which meant that she needed some additional care that she was not always happy about.  There was the resulting weight in the household as we tried to rein her in from jumping up to her favorite spot on the couch or going down the stairs too quickly or from playing in general, lest we strain her stitches.  I'm glad to say that we are over that hump, and she's back to her normal self (and my current writing companion as I sit).  Andy set up social accounts for her, if you'd like to get some extra doses of Luna between blog posts.  

• I definitely underestimated how much relief I was going to feel after getting the vaccine.  I can make plans again as I feel my world start to open back up.  That doesn't mean that I stop all of the precautions, but I can at least remember how to stretch again.
• I have two grandparents in assisted living facilities and another that is receiving home health care.  At least one of these is DNR, but there is a real possibility that the other two have some advance directives as well.  As COVID has rolled through some of those facilities, I've been wondering whom I might be saying goodbye to first in the back of my mind.  
• It occurred to me recently that my program will be over in six months.  Six months and then I will be done with nursing school.  Holy crow.  
• Speaking of which, I got a hot tip the other day about a nurse residency program that was hiring (basically, a transition from school to real-life practice), quickly updated my resume, wrote a fresh cover letter, and had an interview the next week with another two days after that.  I'll make a broader announcement later, but, yes, it feels brilliant to have post-school plans already lining up.  :)
• Part of my clinicals involve going into schools, to consider the health needs of individual students and also the school as a community, as a system.  I happen to be at a school district that uses Skyward, so it's surreal to me in ways that are a bit different in how it's surreal to my peers.  This feels familiar to me, that I'm used to being a foreign but friendly entity in a school building.  It's...nice.  I did like that as part of my job, to see people on their home turf and in their own context, whether it was a secretary or a lunch lady.  Simultaneously, I have the chance to see what COVID protocols in a couple schools actually look like, instead of hearing about them by proxy.  Something I neglected to mention in my vaccine post last week is that it is not yet available to persons younger than eighteen, meaning that there are parts of this that will continue to be real for schools and their populations for longer than the rest.
• The weather has slowed progress on our major house projects.  I look forward to being on the other side of both of these.  
• I am not surprised by the events happening in our capital--specifically, the second acquittal of Trump--but I am increasingly disappointed.  The amount of double-think and double standards is truly appalling.  
• Black lives still matter and will always matter.
• This term moves and feels different than previous terms--Andy and I are still trying to find a rhythm for how we connect as a couple and still meet our individual needs.  It's a continual process of communication, and that continued insistence toward transparency, honesty, and empathy find ways to make it work and keep that connection.
• I feel no small amount of guilt for not keeping as well in contact with individuals during the pandemic, during school.  There's blame to share, certainly, so it comes in waves.  I'm starting to think about what post-school is going to be like, how my energy may be spread differently and how I want to utilize that.  
• I've been hosting Bob Ross Paint-a-Longs every other week or so, where we gather on Zoom with whatever art materials we have--even if it's just the paint program on one's computer--and watching an episode together, sharing our "masterpieces" afterwards.  It's been a joy just to explore and play, with persons of all skill levels.  A beautiful bright spot in the dark.  

And that's the jist of things as they are.  We've a snow day at school, and I'm using some of the time to relax a bit before another clinical shift tomorrow.