Tuesday, May 4, 2010

Full Circle

Scratching the stiff white collar on my lab coat, uncomfortable in my dress slacks and blouse, I clipped on the badge that identified me as "Student Nurse." I started going through patient charts, selecting the patients I'd care for during the next 7a - 7p shift. X45: COPD. I closed the chart. I'd had so many COPD'ers this semester that I could recite their stories in my sleep. "No one told me smoking would do this to me. Now that I'm sick, I might as well smoke til I die. Dang it, when can I get outta here so I can get a smoke?!" No, thanks. X48: Decubitus ulcer. These patients weren't usually really sick, but they sure could be demanding. "Can't I have a Coke? I need a straw. Can you find another pillow so I can prop my legs? Can you ask my doctor if..." I didn't mind them, but I didn't learn a lot of medicine from them. I put the chart in the "maybe" pile. X47: Probable discharge in the am. Nope. X43: Scheduled for procedures in the am. Uh uh. My choices were few. Sighing, I grabbed the next one. X42: Crohn's Disease, admit for dehydration and adverse reaction to Humira. I dropped the chart like a hot coal. I didn't want this patient.

I'd been diagnosed with UC, sister disease to Crohn's, just a few months earlier. I was still trying to figure out what it meant to have UC and what life was gonna look like from here on out. No way could I be objective and take care of this patient...

Unfortunately, my fellow nursing students (who, unlike me, didn't have diving practice and could come to the hospital to choose patients whenever they wanted to) had beat me to the floor and snapped up pretty much all the other "good" patients. I didn't really have a choice, so I jotted down X48's meds and labs, then trepidatiously began perusing the Crohn's patient's chart. Her gastro doc had written a consult or admit note or something. One sentence from the note stands out in my mind: "I do not feel that anything I have tried has helped Ms. X at all." I stopped reading, and my mind reeled. No, people don't stay sick with this stuff. They get on meds and go into remission. If the traditional meds didn't work, the new big gun meds like Remicade and Humira worked like a charm.

Yet here was this lady, who'd been on Prednisone for 30 years, tried countless surgeries, immunosuppressants, and diets, without success or remission. She was on disability. She'd tried Humira and wound up in her doctor's office with a reaction and got sent to the ER, and now, here she was.

As I cared for Ms. X (I've omitted and changed identifying details to protect her privacy), I brought her pain and nausea meds right on time, yet she kept rating her pain and nausea at an 8/10. I felt sick. I talked to my nurse, "She's still really hurting and sick... can't we do anything else?" The nurse sadly shook her head and said, "Honey, I'm afraid she's just one of those chronic pain people. Don't know that there's much anyone can do for her." I was terrified, selfishly, not just for Ms. X's suffering... but for my own. I had the uncanny feeling that this could be my future. That it could be me lying there in that bed, getting sick every few minutes, in constant pain that no medicine could touch.

As time went by, Ms. X faded into memory as I learned to live life with UC. Then one day, I saw her face as TCU Dr. described to me how I feel: "So basically, you're constantly nauseated, sick, exhausted, stomach hurts, bleeding all the time, and your joints hurt so much you can't sleep." Strangely, in many ways, my life is seeming to parallel Ms. X's. And now I'm starting Humira, the medicine that sent her to the hospital with a reaction.

What does all this mean? I don't know. But I think I've come full circle.

Hannah ;)

1 comment:

  1. Oh man! You have to remember that every medication has a different reaction to every patient. I remember having UC symptoms and hearing about treatment that didn't worked for numerous patients and when my doctor brought it up, I thought, "Why even bother!" But, you know when I did try it, it worked wonders on me! Stay positive because that's really all you can do right now and you truly won't know how Humira is going to work until you're on it. I'm praying that it's going to help tremendously! Love you, Lisa