Struggle No More

I promised myself to write more....then life happens.  I apologies to the small audience that might be reading for lack of an update.  Quit a bit has transpired in the past months. Lots to discuss and reveal.  So here it goes.

Shall we start on a good note.  The end of 2012 I started the process of applying to graduate school.  I am pleased to announce that I have been accepted in to the Family Nurse Practitioner program at the University of Texas Medical Branch.  It is a part time program that will take 7 semesters to complete.  I am pacing myself as I will be working full time in the process.  I am trying to savor the last few months of freedom and will start in August.  As weird as it may sound, I am excited to get back to the books.  Earning a masters degree and becoming a nurse practitioner has been an educational and career goal of mine and I getting to take one more step closer to that goal.  Of course I hear the voices of negativity that constantly follow saying "its too much, you will never finish, the RA is too severe, you can't."  And maybe it's true, maybe its a long shot for someone like me,  but I will put up one hell of a fight trying.

My health is markedly worse.  The rheumatoid arthritis has not responded to any of the treatments my doctor has thrown at it.  I have never gotten an F academically ever, but my RA report card reads something very different.  I have failed every treatment to date.  Nothing is working.  And my options are becoming more slim.  For the past 6 months the pain is constant and in most joints.  Honestly I can't remember having a day without pain in the last year.  If I am not at work, I am at home resting to conserve energy and taking pain meds to easy the discomfort.  Running errands, cleaning, laundry, and shopping are difficult.  It's bad for a girl when shopping seems like a chore!  I thank God for the strength, willingness and grace of my parents who have helped me tremendously.  I am 26 and still live at home because I need and rely on the help of my parents on the days when the pain is rough and when I am unable to walk or care for myself.  It's been tough to have to let go of the control and realize that asking and accepting help is OK.  At the beginning of 2013 my body has taken another hit.  I started having terrible pain in my stomach.  No matter what meds I took, what I ate it hurt.  Somedays I still just don't eat much due to the irritation.  I've never had indigestion in my life....until now.  One day it was so bad it felt like chest pain and I was short of breath.  I went to see a GI doc and had a procedure to take a look a my stomach from the inside.  The results of that test were what I had expected.  The entire lining of my esophagus and stomach is severely inflamed and I have the beginnings of an ulcer.  Yet another health issue that is way beyond my years.  The cause of these stomach issues is the result of years of taking medications for the RA.  The side effects of all the meds and all the treatments are showing their face.  And they are ugly ones if you ask me.  The dilemma now is... I have to continue taking the meds that have done this to my stomach.  Its the only way to control the inflammation and pain. So now I am taking an extra 7 pills a day to help protect my stomach from all the other pills.  I have had to change my diet and eliminate some things I enjoy like spicy foods, dairy products, orange juice, all acidic foods.  I eat bland to avoid any added insult to my stomach.  But all I really want to have is an ice cold glass of milk before bed and a big bowl of tomato basil soup!! The GI doc said that it will just take time for the stomach meds to kick in and slowly heal that inner lining that is so inflamed.  "It will take time," is a phrase all too familiar.  Much longer and I might go all Captain Hook on all the clocks I come in contact with!!! I just saying...it could happen. 

Today's song is Struggle No More by Anthony Hamilton. Anthony Hamilton is lucky enough to know have 2 songs on my blog.  The first 4 words of the song say it all, "I'm sick and tired."  I am so sick and tired of the constant struggle.  Somedays I just can't or don't care to deal with it all.  I hide away in my home under a haze of Vicodin and Ambien.  Some days the pain is so severe that the minute I put my feet on the ground and stand up out of bed, I know its going to be a rough day.  In the same way I get out of bed, the pain flows.  It starts in my toes, creeps up to my swollen ankles through my weak legs into my sore knees and into my tender hip joints.  From my hips I feel the sharp sting in my SI joints as the pain shoots up my back like electricity. And finally to my tight stiff neck.  This is how every morning begins and every day ends much of the same but usually worse.  I am so sick and tired of being sick and tired.  The first lyrics of this song ring honestly true for me. "Lately its been hard times. And they say when it rains it pours. Well its flooding at my door.  If it aint one thing its another, but I'm so glad we got each other.  Im so sick and tired of being stressed out Lord please help me with this mess I'm in."  Struggle No More is speaking more or less to the financial struggles he has endured.  But no matter the face of the monster we all struggle.  I love this song because its like an anthem. I can't help but lift up my arms sing loud and dance a lil bit when I hear.  To me it is like a plea for someone to intervene and lighten the load, share in the struggle if you will.  "Lift me up over the hurt and pain, deliver me from the rain. I don't wanna stress over stress no more. I don't wanna struggle no more."  Lately I feel that my words aren't reaching to the gates of heaven.  I find myself saying God can you even here me? Do you even care?! What is the purpose of all my struggle?? Will it ever end?? I feel as though God only provides silent in response.  If there ever was a phrase for my current situation it would be "I don't wanna STRUGGLE NO MORE!"

Lately It's been hard times

I'm talking about them
Financial ones aside
And they say when it rains it pours
Well it's flooded at my door
If it ain't one thang (one thang) it's another
And I'm so glad that we got each other
I'm so sick and tired of being stressed out
Lord please help me from this mess I'm in

Lord lift me over the hurt and pain
Deliver me from the rain
See I don't wanna stress over stress no more
I don't wanna strug-gle no more
So lift me up over the hurt and pain
Deliver me from the rain
See I don't wanna stress over stress no more
I don't wanna struggle no more

Every day and every night I pray
Lord help me find the way
To stay strong
And to keep my sanity
So I can provide for myself
And for my family
I'm so glad they believe in me cause the love it gives me energy 

And with out them I couldn't make it no way

So I'm a keep pressing on on and on

Lord lift me over the hurt and pain
Deliver me from the rain
See I don't wanna stress over stress no more
I don't wanna struggle no more
So lift me up over the hurt and pain
Deliver me from the rain
See I don't wanna stress over stress no more
I don't wanna struggle no more

Lord lift me over the hurt and pain
Deliver me from the rain
See I don't wanna stress over stress no more
I don't wanna struggle no more
So lift me up over the hurt and pain
Deliver me from the rain
See I don't wanna stress over stress no more
I don't wanna struggle no more

No more no more no more
No more no more no more
No more no more no more
No more no more no more

Paradise

      Have you ever found yourself in a stressful or painful situation and had someone tell you, "Close your eyes and think of something peaceful or soothing. Think of your favorite place to be and imagine yourself there."  In medicine we call this guided imagery.  Its the process of taking yourself out of the present and guiding your thoughts to a more pleasant state of mind.  We use this practice of guided imagery in the health care setting as an alternative form of pain management.  It is thought to calm the mind and distract the person from the current pain they are experience.  It can also be used as a distraction for those dealing with addiction or mental illness.  The mind is a wondrous thing.  And quit mysterious if you ask me.

      You may wonder why I bring the topic of guided imagery up.  The reason I speak of this is because at times when I am in a great deal of pain, I wish I was anywhere but in the present.  And I try to imagine myself somewhere else.  A place where no pain is felt and all I feel is joy and peace deep into my soul.  The place I choose to imagine would be atop of a mountain side.  It would be chilly and the wind would blow my hair and enter my lungs with ease.  The air would be crisp and smell fresh like it had just rained.  The only sounds I would hear are the wind passing swiftly by and a melody of all creation as it resonates and echoes. The brushing of the tree branches back and forth, the sound of the stream as its moves along by the slow and steady current. Birds would be singing in the distance and I could feel the warmth of the sun shine upon my face.  I would look down over the edge to take in the majestic view from above.  I would look right and left to survey all the beauty surrounding me.  I would lye down on the ground staring at the sky inhaling and exhaling slowly, deeply.  I would be above it all. Above all the troubles of life. Above the pain, sorrow, pressure of society.  Nothing would be able to get to me or take away my peace. And with eyes closed and arms out stretched I would just feel.  Feel the wonder of all God created. O the wonder to simply feel.  To feel no pain. To move freely; to feel free.  To be free. This is my guided image.  The place I go when the present is too hard, too painful, and too imperfect.  Some day I will make it to a place such as I have described.  Some day I will make it to my paradise.

     This week's song is Paradise by Coldplay.  I feel like this song could be written about me.  The lyrics are so perfect.  When we are young children our minds are so vivid and our imagination endless.  And as we become older things change.  We are overwhelmed with life's stuff. Reality hits us and we see the imperfections of the place in which we live.  We have these expectations of what our lives should be like. And for most we come to the realization that those expectations are unreasonable. So I guess what I am trying to say is take time each day to guide your mind to a better place.  A place free from all your stuff.  For me its living with RA and escaping from the pain that I know too well.  Find your paradise in a dream and promise yourself to one day go there in reality.  Whether it be on a beach with the ocean and sunset as a back drop or on top of a mountain side.  Find it, go there and simply feel.  Just feel.

"When she was just a girl 
She expected the world 
But it flew away from her reach 
So she ran away in her sleep 
And dreamed of 
Para-para-paradise, Para-para-paradise, Para-para-paradise 
Every time she closed her eyes 

When she was just a girl 
She expected the world 
But it flew away from her reach 
And the bullets catch in her teeth 
Life goes on, it gets so heavy 
The wheel breaks the butterfly 
Every tear a waterfall 
In the night the stormy night she'll close her eyes 
In the night the stormy night away she'd fly 
[ Lyrics from: http://www.lyricsfreak.com/c/coldplay/paradise_20980626.html ] 
And dreams of 
Para-para-paradise 
Para-para-paradise 
Para-para-paradise 
Oh oh oh oh oh oh-oh-oh 
She'd dream of 
Para-para-paradise 
Para-para-paradise 
Para-para-paradise 

And so lying underneath those stormy skies 
She'd say, "oh, ohohohoh I know the sun must set to rise" 

This could be 
Para-para-paradise 
Para-para-paradise 
This could be 
Para-para-paradise 
Oh oh oh oh oh oh-oh-oh 
This could be 
Para-para-paradise 
Para-para-paradise 
This could be 
Para-para-paradise 
Oh oh oh oh oh oh-oh-oh-oh"

Be OK

     I can't believe its been this long since I have written anything.  Well maybe I can.  I have not felt that there has been an ounce of creativity in me for a while now. I always have something to write about, but lately no energy to do it.  So I apologize.
     Since I last blogged lots of stuff has been happening.  My job at TCH ended because I could no longer do my job due to physical demands of working in the ICU setting and on night shift.  I was devastated; felt like a failure. But I knew that I had to make a change or my nursing career would be short lived.  In December I was hired for a position at MD Anderson Cancer Center.  To be honest, I never thought I would work in oncology nursing but it was an available position and so I took it.  I am working on the Stem Cell Transplant unit.  I have been learning so much and have met some really great people. So, so far so good.
    Last night as I was lying in bed having a full body RA flare and a migraine when a level of frustration hit me that I knew had been fast approaching.  I was exhausted from a days work, disappointed that I yet again could barely walk up right, in pain of course, but mostly frustrated.  I was frustrated that my head was pounding and I was fatigued from a treatment that is suppose to make me feel better.  Frustrated that I was no longer in control of my body and needed help.  And frustrated that it was yet again another bad day. You know the kind of frustration that makes you want to throw something.....but wait, my arms hurt too bad to be throwing anything.  And in that moment, lying there in the dark with my body in just the right position to cause the least amount of pain and promote the most comfort, I knew there was only one thing that would help me with the way I have been feeling lately.  And that thing is to write. I knew right then I needed to let it out with words on a page, or screen for that matter.  A common term for a stress reliever is an "outlet", and it is clear to me now why this term applies.  For me, writing is my chance to finally exhale after holding my breath and pretending to be OK in front of others.  So I have set a goal to blog once a week.  Because I need to learn to exhale more often.  Lately all of my joints have been an issue. Mainly my hips. The pain is awful and constant. I have honestly lost count of how many treatments I have tried and failed in the last 3 years.  I recently started a new treatment called Orencia.  You may have seen the overly corny commercial on tv about it with the slogan, "O yes I can!" That commercial makes me want to say some not so nice words.  The Orencia treatment is by IV infusion. I had 3 loading doses all 2 weeks apart. And now I will get a treatment once a month.  This drug takes a particularly long time to reach a therapeutic level that is effective. So I am not expecting any results any time soon. My rheumy said it will be about 4 months before we know if it has started to work.  So again I wait.  I could lie and say that I am still in "keep hope alive" mode. But I am not.  I have my doubts; can you blame me.  Only time will tell and for the record waiting sucks !!
    To start off a new song playlist I have chosen Be OK by Ingrid Michaelson.  I find myself singing this little simple song in my head as I get up in the morning.  As if it were a prayer, a plee that I just might be OK today.  That maybe only a few joints will hurt and that the pain will be minimal. I sit up on the side of the bed, close my eyes and say Lord just help me to get through this day. Or sometimes it comes out more like Damn it please just let me be OK for once. I am still waiting, impatiently waiting for the day when everything will just be OK.

"I just want to be ok, be ok, be okI just want to be ok todayI just want to be ok, be ok, be okI just want to be ok today
I just want to feel today, feel today, feel todayI just want to feel something todayI just want to feel today, feel today, feel todayI just want to feel something today
Open me up and you will seeI'm a gallery of broken heartsI'm beyond repair, let me beAnd give me back my broken parts
I just want to know today, know today, know todayI just want to know something todayI just want to know today, know today, know todayKnow that maybe I will be ok
Open me up and you will seeI'm a gallery of broken heartsI'm beyond repair, let me beAnd give me back my broken parts
Just give me back my piecesJust give them back to me pleaseJust give me back my piecesAnd let me hold my broken parts
I just want to be ok, be ok, be okI just want to be ok todayI just want to be ok, be ok, be okI just want to be ok today
I just want to feel today, feel today, feel todayI just want to feel something todayI just want to know today, know today, know todayKnow that maybe I will be okKnow that maybe I will be okKnow that maybe I will be ok"

Catching Up

Sooo a lot as happened since I last blogged in January. I am ashamed I haven't been keeping up with my posts. Time just seems to be slipping by. So this post will be bring you up to date on all that has happened since January.

On April 22, 2011 I graduated from the University of Texas Medical Branch with a Bachelor of Science in Nursing. The graduation day consisted of a pinning ceremony in which each student got to choose the faculty member that would "pin" them with a nursing school seal pin. I choose my pediatrics professor Bonnie Webster. She was my favorite professor and I learned so much from her about nursing and life. Mrs. Webster was genuine and sweet and truly invested in her students. During the pinning I was surprised with a special award. I was chosen out of the graduating class of 140 students to receive an award for outstanding clinical performance. The award was called the Clinical Excellence Award. All of the faculty voted on the student that stood out to them in all areas of clinical practice. I was completely surprised when my name was called. It didn't hit me that this award was an awfully big deal till later that day. And of course my Mom & Dad were sitting as proud parents in the stands as I accepted the award. The second part of the day was the graduation ceremony. It felt amazing to finally walk across that stage to receive my diploma with my family cheering me on from the audience. Truly a moment in my life I won't soon forget.

A few days before graduation I interviewed and accepted a job with Texas Children's Hospital on the Pediatric Intensive Care Unit......More about this to come.

After graduation I went on a MUCH needed vacation with my parents, grandma, & aunt and uncle. We boarded a cruise ship in Miami and set sail for a trip to the West Caribbean. We had so much fun. We visited the Bahamas, St. Thomas, Puerto Rico, and Grand Turk. On the ship we did lots and lots and lots of eating !! OOooo and they had a chocolate buffet one afternoon. Yummy ! We listened to live music and watched movies on the deck. I was forced into doing karaoke... in which I blew all the other singers and audience member away. Gets them every time. LoL. We got "tattoos" to show off when we got home. We took lots of pictures and of course did lots of shopping. Overall it was a well deserved fun vacation.

After the cruise I was back in full study mode preparing for my state boards nursing licensing exam. It is sooo overwhelming to study for a test such as the NCLEX. It was information overload. But I got through it and passed the exam on the first try. So its official I am now a licensed registered nurse !!! Now I can breath..... Inhale....Exhale.

There is no song for this blog. I couldn't come up with a good one that would cover all these updates. But you can enjoy this slideshow of pictures from my graduation and cruise.

Wake Up

Sorry readers for not writing in such a long time. So much has happened and school has taken me by storm this semester. I am now in my last semester of nursing school !! Woohoo !! It has gone by so fast yet I can't wait for it to be over. I am excited for the life ahead of me after graduation. Including a cruise to celebrate my finish !! As of right now my schedule is crazy busy; each day is packed with class lecture, lab, clinical, reading, studying, practicing, and NOT sleeping. Only 87 more days !!!

As for my health, I am continuing to take methotrexate treatments once a week. This winter has been tough. The combination of cold and rain is terrible for my body. I have been feeling really fatigued due to pain and stress. I don't see the methotrexate alone being enough to sustain me for much longer. Most of the times RA is best treated with conjunct therapies. I am due for an appointment with Dr. Johnson my rheumatologist to discuss needed changes in my treatment plan. The steroid injections in my back and SI joints are not effectively controlling my pain and will need to be repeated soon. So as of right now I'm just hanging in there. Plowing through each day one at a time.

Today's song is Wake Up by John Legend and the Roots. Recently I have been thinking quite a bit about how my position as a nurse will contribute to the lives of those I care for. Nurses have a unique opportunity to reach people at their most vulnerable state. They have the power to instill hope and health. In my practice I am determined that I will not only "do not harm," but that I will touch the heart of everyone I come into contact with. I don't want my nursing career to be just a pay check and good working hours. I want to use my skills to better my community, to lend a hand to those less fortunate, and to leave this world a better place. Ralph Waldo Emerson once said, "To laugh often and much, to win the respect of intelligent people and the affection of children, to leave the world a better place, to know that even one life has breathed easier because you have lived. That is to be successful." I want to live these words each day. And adopt this principle into my practice. Nursing is so much more than bed baths, giving meds, and charting vital signs. Its about making life a little easier for those who are sick and decreasing the trauma of the unexpected pains that life throws our direction. It's time that we as individuals wake up and realize that the world doesn't revolve around our selfish ways. We need to wake up to the idea that our actions speaking volumes louder than our words and its about time we realize that things won't change if we don't put forth the effort to be that change. Didn't Gandhi say, "Be the change that you want to see in the world?" Just think, if all health care providers adopted the words of Ralph Waldo Emerson and Gandhi into their practice, how many more patients would leave our hospitals and clinics with the strength and hope to improve their health with more than a few pills every day. The healing would begin from within. That is the kind of nurse I want to be.

"Wake up everybody, no more sleepin' in bed

No more backward thinkin', time for thinkin' ahead

The world has changed so very much from what it used to be

There is so much hatred, war and poverty

Wake up, all the teachers, time to teach a new way

Maybe then they'll listen to what'cha have to say

'Cause they're the ones who's coming up

And the world is in their hands

When you teach the children, teach 'em the very best you can

The world won't get no better if we just let it be

The world won't get no better

We gotta change it, yeah

Just you and me

Wake up, all the doctors, make the old people well

They're the ones who suffer and who catch all the hell

But they don't have so very long before the Judgment Day

So wont'cha make them happy before they pass away

Wake up, all the builders time to build a new land

I know we can do it if we all lend a hand

The only thing we have to do is put it in our mind

Surely things will work out they do it every time

The world won't get no better if we just let it be,

The world won't get no better

We gotta change it, yeah

Just you and me

It's the god hour

The morning I wake up

Just for the breath of life I thank my maker

My mom say I come from hustlers and shakers

My mom built it on skyscrapers and acres

He said take us back to where we belong

I try to write a song

As sweet as these arms the one the type to bare arms

And wear my heart on my sleeve

Even when I fell in God I believe

Read the days that weave through the maze

The seasons so amazing

Feed them and raised them

Seasons are aging

Earthquakes, wars, and rumors

I want us to get by but

We're more than consumers

We more than shooters, more than looters

Created in this image so God live through us

And even in this generation, living through computers

Only love love love can reboot u

Wake up, everybody

Wake up, everybody

Need a little help, y'all

Yes I do, need a little help

Need a little help, y'all ay

Wake up everybody"

Heal Over

So its been awhile since I have written. Sorry about that. Life has been crazy. So I will rewind a bit for a little update. Due to a major increase in lower back pain, in late August I went through another back procedure. I had steroid injections put in both of my sacroiliac joints. The procedure was done under deep sedation by my pain management doctor Dr. Khan. When I woke up from the procedure my legs were tingly and my right foot was completely numb. The tingling and numbness lasted till the next day. So it was quite an adventure trying to get around the house. The pain in my back after the procedure was pretty bad and lasted almost 2 weeks. Which was a major inconvenience since I started my fall semester classes just 4 days after the procedure. But I got through it and the procedure has given me relief from the terrible back and hip pain cause by sacroiliitis.

Fast forward to present day. The methotrexate has started to kick in finally. I have noticed a slight decrease in the amount of weekly flares and morning stiffness. The MTX still makes me pretty tired and weak for a few days afterwards. But I will take sleepiness and weakness over pain any day. I will be going back to see my rheumatologist Dr. Johnson after my finals are over this week.

It is hard to believe that the fall semester of my senior year of nursing school at UTMB is already coming to a close. I have finals for my OB and Community Health classes this week. And after that I only have one online class for the remainder of the semester. So I am excited that I will get to enjoy the beautiful weather and the holidays this year without the interruption of school.

Today's song is Heal Over by KT Tunstall. Heal Over is a simple song that is a daily reminder that healing takes time. Sometimes when we have physical pain or emotional hurt, we expect that it should heal quickly on our time. But healing is never mindful of our expectations. It is a physiological fact that our bodies need time to repair what's been broken, hurt, or damaged. And sometimes when the healing process is complete, we are left with a scar that tells the story of our pain or we are left with a limp as a daily reminder of how we overcome. It is our scars that make us who we are because they are a scrapbook of permanent memories of the things we have endured. I am learning that healing takes time each and every day of my life. I have scars and I have joint pain that reminds me of my strength and endurance. In due time things will get better. Not on our time.....But some day we will all heal over.

"It isn't very difficult to see why
You are the way you are
Doesn't take a genius to realise
That sometimes life is hard
It's gonna take time
But you'll just have to wait
You're gonna be fine
But in the meantime

Come over here baby
Let me wipe your tears away
Come a little nearer baby
Cuz you'll heal over
Heal over
Heal over someday

And I don't wanna hear you tell yourself
That these feelings are in the past
You know it doesn't mean they're off the shelf
Because pain's built to last
Everybody sails alone
But we can travel side by side
Even if you fail
You know that no one really minds
Come over here baby

Don't hold on but don't let go
I know it's so hard
You've got to try to trust yourself
I know it's so hard, so hard

Come over here baby
Let me wipe your tears away
Come a little nearer baby
Cuz you'll heal over, heal over, heal over someday"