Hey All!

Wow! It's been a while since I've blogged.... Guess I need to get back into it.... This summer will bring many adventures so I'll try to keep it updated...

So…. I was at a Singles’ Bible Study tonight at one of the local churches, and we sang this song as part of the opening worship and it got me really thinking about my heart, passions, and how I portray Christ, etc… I’ll let you read the words first and then I’ll comment afterwards.

From The Inside Out
by Hillsong United
album: United We Stand (2006)
A thousand times I've failed
Still Your mercy remains
And should I stumble again
I'm caught in Your grace
Everlasting
Your light will shine when all else fades
Never ending
Your glory goes beyond all fame
Your will above all else
My purpose remains
The art of losing myself
In bringing You praise
Everlasting
Your light will shine when all else fades
Never ending
Your glory goes beyond all fame
In my heart and my soul
Lord I give You control
Consume me from the inside out
Lord let justice and praise
Become my embrace
To love you from the inside out
Everlasting
Your light will shine when all else fades
Never ending
Your glory goes beyond all fame
And the cry of my heart
Is to bring You praise
From the inside out
Lord my soul cries out

I had never heard this song before and as I was worshipping, the Lord would not let the words “inside out” leave my mind. As I pondered, even throughout the message that was brought, a deep conviction of how we are to live our life is because Christ has changed us. He sacrificed his life so that I may be changed from inside my heart to the outside actions that I demonstrate every day. Lately, I’ve been challenged with my actions and how I portray Christ. As most of you know, a majority of the patients that I treat in the ER are addicted to narcotics, benzos, or some other addictive medication. They flood my rooms seeking drug after drug, and not just on a monthly basis but with multiple visits within a week. As a medical professional and for the patient’s best well-being I do not prescribe them just to add to their addiction. However, they become belligerent and cause me to be forceful and I come across very hateful at times because I continually have to tell them I am not prescribing those drugs. And even though I have the best interest and health of the patient in mind, I don’t see how I am showing them Christ’s love outwardly. In my heart, I’m doing what’s best, but my actions don’t show it to the patient. So, I’ve been praying about this a lot lately, and haven’t found the best solution. I can’t call them drug addicts because that will just make them worse, so I’m not too sure what to do…

Anyways, so back to the song… I was challenged with how if we let our hearts and minds be controlled by the Holy Spirit, all our actions will be from an inward longing of wanting to give the ultimate glory to Christ. It’s easy to get caught up in the daily rituals of Christianity…. Get up, quiet time, daily activities, show love to someone, but really never truly worship God in a new and refreshing way because it becomes so common place. How often do we do things just for the sake of doing them because we know it’s the right thing to do? Or do we really think about each decision and prayerfully consider which way God is leading us to go? Granted there are spur of the moment decisions to be made, but if we consult the Holy Spirit who dwells within us for just a brief second it could change the decision altogether. So, I guess I’m just rambling on about how I’m being broken to the fact that I tend to let my selfishness and longing to please others to guide some of my decisions and that’s wrong. This song brought that to light, and I hope you all got something out of it as well (there are so many other things that could be said of the song)! So remember allow your soul to cry out to God so that all your actions and decisions will come from the inside and just be an overflowing to the outside world!

Praying for you all!
Jen

Who Can Find Wisdom?

Reading in the Book of Proverbs today and Chapter 2 explicitly explains how one can find wisdom... I'll let the Scripture speak for itself:

"1 My son, if you accept my words and store up my commands within you,
2 turning your ear to widom and applying your heart to understanding,
3 and if you call out for insight and cry alound for understanding,
4 and if you look for it as for silver and search for it as for hidden treasure,
5 then you will understand the fear of the Lord and find the knowledge of God.
6 For the Lord gives wisdom and from his mouth come knowledge and understanding.
7 He holds victory in store for the upright, he is a shield to those whose walk is blameless,
8 for he guards the course of the just and protects the way of his faitful ones.
9 Then you will understand what is right and just and fair - every good path.
10 For wisdom will enter your heart, and knowledge will be pleasant to your soul.
11 Discretion will protect you, and understanding will guard you."
Proverbs 2:1-11

Have a blessed day! :-)

Phone Calls and Pinto Beans

Yesterday was quite humorous around the house. We had two phone calls before 10am and both times the caller hung up on Granny before she could even get out a full "hello." So she asked if I was expecting any calls because maybe they would hang up if they didn't hear my voice. But, unfortunately I was not expecting any calls. Then around 20:00 she called Aunt Sheila because she got another "hang-up" to see if there might be something wrong with her phone. So, now I have a worried granny because she has no clue why people keep hanging up on her. The things older people find to worry about amaze me!

So this morning, I was telling Granny about my plan to scan some of her old photos into my computer and make a CD for Mom and Aunt Sheila. She then asked, "how do you keep all that stuff straight and know how to do everything on the computer?" I just responded saying that I've been working on a computer since I was 8 years old so I just kinda know. And her response was... "It's like me and pinto beans... I grew up on them and so that's why I like them so much.... So that's like you knowing how to use a computer!" Great analogy Granny....he he! :-)

Gone with the IV and an ER Pow-Wow

Hospital life continues to be interesting. Here are two stories I'd like to tell you all about!
Patient 1: A 67year old frequent visitor to the ER comes in with a sycopal episode. She stated she was really dizzy when she stood up, passed out and doesn't know how long she was unconscious. Her husband (who is in his 40s) found her and brought her to the ER. As I do with a lot of my patients, I took a thorough drug history. The only medicine she stated she has taken was tylenol yesterday for her chronic back pain, and that was it for the week. Still, due to her history, I ordered a urine drug screen which as I expected came back positive for benzodiazepams (valium, xanax, klonopin, etc) and opiates (percocet, lortab, demerol, morphine, etc). I confronted her about the opiates and she said she did have one three days ago but only one because she still had 1/2 a bottle left over from her last visit three weeks ago. So, I then asked if she had taken any xanax's at all. She said she did have some nerve medicine, she thinks valium but it was months ago. I confronted her again and she said she didn't know who's urine that was, but she couldn't possibly have been positive. I continued by telling her that since her urine drug screen was positive, she would not receive any narcotics. She was quite upset with me. While I was waiting for all her lab work to come back, I had her hooked up to an IV to give her some fluids. About two minutes after I left her room, the nurse came running down the hall to tell me to come see, my patient had pulled out her IV. I went in and asked her why she did it and all she said was that it fell out. Not two minutes ago was that IV completely intact! So now there's blood all over the place. The patient was washing her hands at the sink when the nurse went to check her BP again because it had been elevated. As the nurse was taking her BP, the patient decided she wanted to go home, and got very beligerant with the nurse and said, "I'M LEAVING AND YOU CAN"T STOP ME!" Knowing that nothing was wrong and her vitals were stable, I didn't try to stop her. Maybe I should have, but I know she'll be back in two days anyway. Gotta love making people mad especially when they aren't getting drugs!

Patient 2: 22year old male who presented with hemoptysis. Of course anyone who says they are coughing up blood, a pulmonary embolism has to be suspected. So, I ordered a CXR, blood work, influenza screen, etc.. As I was awaiting lab results my patient came to the desk ALL upset because he wanted to leave. I told him he was welcome to, but it would be against medical advice and I would not suggest it. He then proceeded to tell me that he was the elder of the Cherokee nation and he missed one of his council sessions!! To give you a picture of this patient, he is a 22 year old (by no means an elder)... pale skin, whiter than me!... with dyed black hair! (seems like he was trying to grow it out).... a single dreamcatcher earring in his left ear! Very odd character! Not only was he talking about this elder position, but he talked about how he was a health care professional as well. Delusions of grandeur I do believe...maybe he has a Vitamin G (geodon) deficiency! :-) As I was driving home, I remembered that he had initially asked me for work excuse to a local BBQ restaurant! So this elder/health care professional works at a BBQ stand, huh? Interesting.... Then I got to thinking further, I think the whole reason he was in the ER was to get a work excuse so he could make his council meeting as a Cherokee Elder!!!

Wow, fun times in the ER!!!! Glad I'm off tomorrow, will enjoy a much needed break!

Busted and Almost Busted...

I worked night shift last night and what an experience. When your mom says nothing good happens after midnight, take her advice and believe her! :-) Two patients come to mind. First patient was a mid-30s male who was brought in by ambulance due to right foot pain. As the patient was in triage, a local ER called and said they had just discharged that patient from their ER and he asked if he could make a phone call. He did and called EMS to come pick him up and bring him to our ER. As the story unfolds, there is a warrant out for his arrest and the other local ER had called the cops to pick him up at discharge, so in order to dodge the police he called EMS for a ride to our hospital. There ended up being nothing wrong with his foot, at least by physical exam or by x-ray. But unfortunately, for him, the cops knew of his whereabouts and as he was discharged he was cuffed and sent to jail! I guess this guy wasn't so smart after all. Can you say BUSTED!

The second patient I had was a late 20 year old male who had been assaulted 5 hours prior to his visit at our ER. The patient had gotten into an argument with another man who then decided to beat him with an ax handle and bite him. So this man presented with deep flesh wounds to his left thumb secondary to a human bite along with a laceration to his scalp and his bottom lip split wide open. The patient refused staples/sutures in his head lac, which I was comfortable with allowing it not to be closed, even though he could have used two staples. I threw four vicryl stitches in his lip and debrided and thoroughly rinsed the bite as it could not be closed. This may not seem like a funny story, but as I was talking with the patient and his sister while I was suturing, his sister kept asking tons of questions. One of my favorites was, "will his teeth get hard again?" I had know idea what she was talking about, so I asked her. She said in her slurred extremely southern accent, "when he got punched, his teeth got knocked loose, will they get hard again?" I thought I was going to roll on the floor laughing but I kept my composure and told her that his teeth didn't seem to be loose, but to follow up with a dentist. The juicy part of the story comes when I asked him if he filed a police report and was pressing charges. He said he did not want the cops called, he didn't care. So I didn't think much of it, but it is hospital policy to report it to PD anyway and they would decide whether to investigate. PD was called in his community and the cop already knew about this man. He had been at a local ER and saw two cops walk in so he left because he was scared he would be recognized, which brought him to our ER 45minutes from his home. As the plot thickens, the cop continued her story- my patient had allegedly been a part of an assault on a man that happened a week ago. That patient was transferred to UAB with severe burns and multiple lacerations and had sustained other injuries. So my patient had worked with another man to beat that guy up. Now, my patient was assaulted by his accomplice in the other attack because one had decided to turn themselves in. But all parties were still under investigation, so my patient was never interrogated by the cops and they said if he wanted to press charges, he could file them at their office. I highly doubt my patient will do that since he's already scared he's going to be arrested!

Many other funny stories, but I'm tired of typing right now.... More to come later!

Early Birds

The other day, I had the privaledge of taking my grandmother to have a bone scan done to see whether she had osteoporosis. Usually, she likes to leave super early so she has plenty of time to find the place, etc, etc. Fortunately, I was able to talk her into leaving 45minutes early instead of an hour and a half since it only takes 20minutes to get to the hospital. All went well at the doctor's appointment, and after overhearing a conversation while I was waiting, I realized how thankful I am for my grandmother in that she isn't always the early bird. Around 8:30am I was in the waiting room, an elderly couple entered the office to sign in. When the lady behind the counter asked what time the couple's appointment was, the husband responded "10:30 ma'am." The young lady had quite a startled look on her face and said okay if you could fill out these papers, we'll try to get you in on time. The man then explained that he has to fill out all the papers for his wife because her arthritis is so bad, so he was there early just to make sure all the papers were completed correctly! 2 HOURS early, unbelievable! At that point in time, I became very thankful that my grandmother doesn't make me get there 2 hours early for her appointments....

Scenarios like this make me wonder why it is that the elderly community insists on being early for everything? It must have been something in their generation that taught that promptness must be next to godliness, but I don't know. I know the saying goes the early bird catches the worm, but if you catch the worm and have to wait to eat it, wouldn't that be more tormenting than just waiting to get somewhere when you are suppose to and eat it? Okay, I'm beginning to ramble, so I'll stop. I'm happy that my mother raised me to be on time, but not hours early! Hopefully the generation to come will learn the value of promptness in a respectful way.

Enough for now....

They will know we are Christians by our Love....

Encouragement in the hospital over the past week! I entered a patient's room and a middle-aged African American was comfortably sitting on the bed. After a thorough examination, I informed the patients that she has a TMJ disorder and the continuous jaw popping was due to arthritis in the joint. As I was about to leave the room, she all of a sudden said, "You favor your mother, don't you?" Taken slightly by surprise I told her that yes, some people do believe me and my mom look alike. She further told me that God informed her of that while I was examining her. I found this slightly strange. Then she continued and asked confidentally, "You are a good Christian lady, aren't you?" I explained that I'm not the best of Christians, but yes I am a Christian and strive to live out God's will for my life. So she then said, "Well, God told me that and also that you are pure.... you don't run around with males and you're still waiting for the right one before you get married." Of course, by this time I have chills all over my body and felt like I was about to pass-out. I actually had to lean against the doorframe due to my dizziness. Straining for words, I told her that was all true. And she just responded with encouragement and said that she had been praying for whomever would be taking care of while she was in the waiting room and then as she awaited me in her private room. Continuing with encouragement she said she's very blessed to have been treated by another "strong" Christian and hopes that I will continue to stand for my beliefs and to live for Christ alone. How amazing! I was so blessed with these words that I know that the Lord has me in this profession to serve others. All it takes is a smile and Christ's love to be a servant....

Yesterday, I had a patient who was so very excited to see me! I had drained a couple of her abscesses in the past and had recently opened another one last week. On the day of her last draining, she asked when I would be working again because she only wanted to see me. I accidentally told her I was working on Monday from noon-10pm when I was actually working nights Monday night. Well, yesterday she shows up and tells me that she came on Monday and asked the nurses at triage when I would be back, because she didn't want anyone else taking care of her. Then she presented me with a package of candies and cookies in boxes that had Faith, Hope, Peace, and Love printed on the outside. As I was repacking her abscess, we had a few good conversations about her life in Chicago and what God has done in her life through those experiences and her life here in Alabama. What an amazing time for me to talk about Christ and encourage other believers that He is Lord!

So, those are two of my favorite stories over the past week. I need to continually remind myself that I am not a practitioner that treats only physical illness, but also emotional and spiritual aspects of my patient's lives. It's hard to remember that in Americanized medicine, for me at least... Trips to third-world countries where medical needs are so great, it's easy to remember to share Christ but I have the roughest time with some of my patients here in America.... I love my profession and am praying that God uses me to the best of my ability no matter what country I am in...

Sunday and Rain

Hi All!

What a wonderful today is! I love waking up to the sound of rain outside and I was off today. Not to mention today is the Lord's day and I get to go to church. The past couple Sundays I have been out of town and I got to go back to the small church I now call my home church. The pastor is 84, I think, and he truly has a heart for the church. I can't wait until I can get involved with the youth. My passion is kids, molding them into the person Christ wants them to be. Oh, my prayer is that I am effective and that I don't underestimate by abilities, as I know Christ will give me the words and strength to handle whatever situation may arise.....

As much as I love the sound of rain, I'm ready for it to be either winter or spring. We have yet to have a good cold winter....when's the snow gonna come? Oh I know it's Alabama, rarely do we get snow, but it's fun to imagine. Spring would be nice so I can wear my Chacos again without my toes freezing, even though I have gotten to wear them a lot lately without any problem. Spring also brings my hammock where I can go to the park and spend the afternoon in a nice spring breeze reading a book, studying, etc.... Its hard to do that in the rain....

So, I'm just in a complacement mood and very happy to be where I am in my life right now. Praise the Lord! For it's only through Him do I find peace and assurance and purpose in this life.....

Enjoy your Sunday and don't take advantage of the time you have been given as a gift....

Hair Dye and A Relentless Pain Patient

Today was quite interesting in the ER. It was busy as usual for this time of the year, but the doctor who was my attending for the day is very efficient and enjoys seeing some of my patients as well when he gets in a grid-lock in his area. Anyway, that's besides the point. One of my first patients this afternoon was a middle-aged white female who is complaining of having an allergic reaction. Guess to what? None other than the hair dye that she has used for years. This occurred about two weeks ago, her daughter applied the hair dye as usual. The patient claims she felt like it was burning more than normal so immediately washed her hair. Unfortunately, it had done enough damage to cause her whole scalp to be inflammed. One week later, she began to break out in a generalized rash over her entire body. Now she presents to the ER, lacking a PMD (as most patients I see), wanting help. She presently is losing a lot of her hair and her ears are swollen to twice their size with fluid draining from the cracks around her ears. Her vitals are stable, as expected since it's a 2 week old rash. The generalized eruption on the rest of her body was a commonly seen delayed allergic reaction (erythematous, papular, well-demarcated, blanching rash). Upon further history, the patient called the hair dye company and found out that the company had added more avacado oil to their new products. The patient has never eaten avacado before so I felt it was safe to tell her maybe she should avoid them just in case it was the avacado oil that caused the reaction. After reassuring my patient that her ears were not going to fall off and it was only a mild cellulitis that could be treated with antibiotics and steroids, she was a happy camper. I love patients who are thankful and nice! Very few that enter the gates of my "Hall of Pain" in the ER.

Speaking of the "Hall of Pain," a relentless drug seeker appears for the third time in the past week for more drugs. He is a middle-aged white male who has a history of a broken ankle. 4 months ago, surgery was performed and he then developed a post-operative infection and was being treated by the orthopedic and infectious disease doctor. However, the infection resolved and the orthopedic informed the patient he would have recurrent problems with the ankle due to the permanent pins that are in there (nothing atypical after a surgery). (For background, before this patients ankle injury he has been treated multiple times in the ER for chronic back pain and drug-seeking behavior). The patient now presents to the ER with ankle pain. The patient walks into his room without any difficulty and still gives a 10/10 on the pain scale. The first time I see this patient, I informed him he needs to see his surgeon again, if the pain is that intense but will not prescribe narcotics for his chronic pain. Five days later, I see him again in the ER, with the same complaint. This time he has an ace-wrap around his ankle so tight that it has made an indention just superior to the wrap and he is complaining that it's swelling terribly now. After removing the ace wrap the swelling "miraculously" disappears. I once again reiterated no narcotics for his chronic pain and to stop wrapping his ankle so tightly. This visit was yesterday. And lo and behold who graced my presence today with the same complaint. No other than the same patient!! Except this time he added his back is starting to hurt now because of his ankle pain. Yet, I have visibly seen him walk up to my desk to ask how long it would be before I saw him. And yes, once I again he received no narcotics and a referral back to his orthopedic doctor! I'm off tomorrow, hopefully I will not see him again when I go back on Monday! Wouldn't that be just lovely?

So the moral of today's lesson.... Don't visit the ER for non-emergent situations and Don't Dye Your Hair (Chrissy that means YOU!)

Buckling Under Peer Pressure

After an unusual 2006, and many requests to journal some of my life experiences, I've buckled. Living with an 82 year old and working in an emergency room as a practitioner is not the normal life of a 26 year old single female. So, as my new years resolution (which I don't usually make), I will try to keep an up-to-date journal on many of the stories that keep me laughing as I meander through my life's experiences while searching for the Lord's will in my life.....

Today I drove back home (OXR, Al) from my parents in Louisiana. The whole town that I grew up in is now completely different. They are finally widening the road my subdivision is on to 4 lanes and so many trees were cut down in the beginning process. It's amazing how many houses are on the road between my house and school that I have never noticed before. (I travelled that road almost everyday of my life for 13years and never knew people actually lived behind what I thought was all woods!) And, word on the street is that we are going to get chain restaurants where the new Wal-Mart was just built!!! My little town just outside Baton Rouge is about to be metropolitan area....AUGH!!!

Doesn't everyone really dislike 18wheelers that throw rocks up on your windshield? Well, it wasn't exactly an 18-wheeler, that would have been too easy. Instead a old dump trunk that was carrying a back-hoe on the oldest trailer I've ever seen threw a huge rock and cracked part of my windshield. Unfortunately, the antiquity of the vehicle must have been the reason why there was no license plate number to write down... Hopefully insurance will cover it, because I've put enough money into my car the past year. Okay enough gripping....

OH GUESS WHAT?? I found out today that I get to go snow skiing!!!! I'm so excited, I didn't think I was going to have the chance this season, but fortunately Libby and I are going to go north of Las Vegas for a weekend. I know it's not Colorado snow, but hey at least I get to be on skis again!! :-)

Okay, I start work tomorrow so hopefully I'll start some interesting medical stories tomorrow.....

Blogs...

So, I really don't enjoy writing very much so I don't know if I'll actually keep this blog going, but I thought I would give it a try. I've read quite a few people's blogs now but they are all journalism people so they actually write well with correct punctuation and stuff, which won't be found on this blog site. But oh well... We'll see how this goes......