eric135

LA Fitness

More about my trip to the doctor the other day...

There are two phrases I am dreading to hear any year now. The first is, "It's about time we had a quick peek at your colon."

The other is, "You're getting to that age where we have to take a quick peek at your prostate too..."

But the one that I wasn't expecting, which for whatever reason has set my mind just a-wandering into thoughts of my own mortality, is "I want you to start taking an aspirin a day."

Stroke? What, at 43? I had never thought about it, and I tell all of my cardiac patients that it's common to start taking that 81mg ECASA qday. But me? God, wasn't I in my twenty's just a few short years ago?

So I've bought that first bottle of aspirin, at the 81mg dose.

And I've decided to start working out again. It must have been so long ago since my last visit, that when she scanned my key-fob, the machine beeped, and she had to read two screen of fine print before I could check in. Then she gave me that look that I'll just bet child-molesters get when they check in for their weekly group therapy.

They've changed the hours at my local LA Fitness, and the only place that's still open 24 hrs a day is about 10 miles down the road.

I found out my local LA fitness  no longer has towel service. For about a year and a half...

The men's and women's locker rooms have been switched (don't ask me how I know)...

Bringing a cell phone into the locker room is now considered a pretty serious offense (because of all the nudie pics weirdo's have put on the internet)...

From 0500 to 0700, there is a mandatory sharing of lap lanes in the pool (you may wonder how I found that out -- probably when I inadvertently bitch-slapped that poor woman sharing my lane in mid-lap)...

My arms and legs feel like warm jello boiled in oil whipped to a fine creme then stir fried...

The days of being able to omit the required warm-up exercises and just going with my youthful physical state are now absolutely and utterly completely over.

I went for my annual medical office visit yesterday. Things are doing fine, but I wanted to change my blood pressure medication to something I can take once a day instead of twice a day. I have been on a twice-a-day regimen for Univasc, and to be honest, getting that second dose in is a hit-and-miss sort of deal for me. I've tried everything -- setting alarms on my watch, keeping medication at work -- but I still miss that second dose about 1/3 the time (my first dose I take when I get home from work in the morning, which is a highly ritualized time for me and so I rarely miss this one).

So now I'm on Benicar (omesartan medoxomil). My doc told me it was an ACE inhibitor, but I looked it up and it's actually an ARB (antiotensin receptor blocker). I've been on both, the last ARB I was on was Diovan and it did OK, no idea why I talked someone into taking me off of it. So I'm on one again. It'll be nice to be on a once-daily dose again.

We went to see Batman. It was great, but if you're considering bringing a kid under 13-14 years, I'd suggest you go see it yourself first. It's not at all as campy as the previous installments have been. In this movie, there's a lot of punching and fighting, and the foley artists cranked the volume so high, I felt each punch, kick and slap. There were quite a few kids (around 5-6 eyars old) in the theater, and I think the movie was a bit much for them, and I don't consider myself all that prudish about such things.

Otherwise, the movie was excellent. Liam Neelson reprises his role from Star Wars Episode I, and Christian Bale is his new padiwan (sp?) learner. Of course, since the Matrix movies, you just can't have an action movie without martial arts, so there's plenty of that going on. Michael Caine as Alfred is very believable and likeable. Bruce Wayne has a love interest, Rachel, that I don't remember being in any of the comics.  There is a lot of characer development (I'm not really big on that) but it supports the story. Morgan Freeman plays Batman's gadget guy, and reminds me of the "Q" character from the Bond movies. Go see it.

Our next movie should be War of the Worlds, but all this craziness between Tom "I-Need-To-Relive-My-Teenage-Years" Cruise and Steven "I-Want-To-Be-Like-George-Lucas-Because-Watching-My-Movies-Is-A-Privilege" Spielberg is really turning me off. Tom's next girlfriend (there will be a next one, oh yeah...) will land him in jail for pedophilia. And if Spielberg really wants to limit what people have to say about his movies, he should just show them on a sheet nailed againt the side of his house and not distribute them. Whatever.

Nothing instills confidence in a patient than the nurse's ability to start an IV with the first stick. When I was a new grad, we didn't have an IV team, so I learned very quickly to start IVs on some of the toughest arms and hands in the business. At my new place, we have an IV nurse that comes around and starts IVs. He's the greatest -- I think he can get a 16-guage in a turnip. But I think it's hampering a lot of nurses' ability to start an IV. Lots won't even try anymore, and instead of using the IV nurse as a backup after the "two sticks and I'm out" rule, they just call without even looking at the arm.

It's very much a learned skill, and it takes a lot of practice (and a lot of missed attempts) before you get really "good" at it (meaning most IVs started after 1 or 2 sticks). But you've got to at least put the tourniquet on. And get the skin wet with alcohol wipes. And shave a lot of hair to clear the landscape. Maybe a few warm blankets. Maybe a few minutes dangling the arm off the edge of the bed. Maybe pumping the arm with a BP cuff.

You just have to try. Or else every IV pump will be your nemesis. Every beep in the night will set your heart into panicked tachycardia. You'll find yourself (and your patient) putting up with hours and hours of sleepless nights, while that IV pump beeps, and you never wonder why that 1000cc bag running at 150cc/hr is only 1/3 empty after a 12-hour shift.

And meanwhile, your patient wonders if you have any idea what you are doing.

So if you're a new grad, don't depend on that IV nurse (if you're lucky enough to have one). Seek opportunities to attempt really hard sticks. Enter the room with bravado, and declare that you will get that IV started with at most two sticks (you can always ask forgiveness later for lying through your teeth). Because when you get that IV...

You're Superman.

It's official. I'm out 20 bucks :-(  The damn thing won't find my Palm's COM port. Oh well. It was a long shot. I'm starting to think about that Tungsten again, but really, the cost just brings up bile. But now that I'm in a charge position again, I find myself having to jot notes down on slips of paper, miscellaneous notebooks, etc. And I really miss being able to beam something from my Palm via email without having to find a computer (although that refurbished Palm VII wouldn't be able to do that -- the wireless palm.net provider went belly-up more than a year ago).

We watched this new program called 30 Days I think on Bravo. It's produced by the same guy that did that movie Supersize Me a couple of years back. The premise of the show is placing people in new environments for 30 days, to see how they handle things. The first show starred the guy from the movie (all subsequent shows just have his commentary). He and his fiance decide to live on minimum wage for 30 days, and it DAMN NEAR KILLED THEM. I mean, working two jobs, taking the bus to work, 18-hour days. They both decide to go to emergency rooms (he hurt his wrist, she got a UTI) and it ended up costing them $1000! It's one of the rare reality shows that I will actually like, because the show (first episode, at least) seems very positive and respectful of people. He's not out to make people look silly or stupid, and it isn't demeaning.

We're also watching The Inside, another FBI show. The ensemble is a bit shakey but it takes a while to get things right. But we already like the characters, so we're hopeful.

Not much going on in the stock market, for me at least. HANS and TALX are still in play. MRVL was going nowhere, and now it's taking a hit on one of those damned downgrades, so I'll sell it Monday. I got stopped out of GOOG, but it was not a well- timed move and now that I've paid tuition for that lesson yet again, I'll try to avoid it. KBH is up 7% since their earnings announcement Thursday afternoon, so I'm hoping it will stay up. No more interesting earnings reports coming out until AAPL's report due 7/5, and I'm not sure I'll buy in this time, but it re-appeared on the IBD 100 this week so there is definitely some optimism.

OK time for bed. I'm on for another two nights...

The other night shift charge nurse was sick so I worked extra this week. By Monday morning, I'll have worked 6 shifts in 7 days. The trick is to get my sleep in, and not spend too much of the morning watching TV or reading blogs. Just eat a little bit, and hit the sack. I still have chronic insomnia, and even when I'm exhausted, my body will wake up after about 2 hours of sleep and then it's a struggle to get back to bed. Maybe it's sleep apnea. I've always had a big huge snoring problem, and so I might have to set myself up for a CPAP machine.

I've seen patients using those CPAP machines at night. One of my co-workers uses a CPAP and she swears it really helped her get a good night's sleep. I just wonder of the physician will make me consider surgery to clear my airway, something I'm not willing to do at this point.

I lost my Palm VII several months ago, and I had decided not to replace it because most of my work at home is scheduled using my computer, and I rarely find myself needing a PDA because I can just walk to my office and get whatever I need. I didn't miss it at work because I hardly ever have a minute to sit idle to where I'd even be able to consider some web surfing, or tapping out email, and none of my phone contacts are awake during my waking hours, so it can usually just wait until I get home in the morning.

But I've decided to get another one, because I do occasionally find myself needing a number or email address or some other data on my home computer while I'm at work, or out driving around. I was going to put out the bucks and get something top of the line (I like Palms, and would have considered a Tungsten). But my needs simply are not worth the 300-400 bucks the latest gadget would cost, and the cheaper models would require me to re-enter all of my data in some other program, so I had dropped the idea.

But then I was doing a search on Amazon, and found out I could get a replacement Palm VII for 20 bucks! It's a refurbished model (they don't make new ones anymore), but I decided to take a risk because, worst case scenario, I'd just be out 20 dollars. I'm really hoping I'll be able to drop the new one right into the cradle that has gone unused for so many months and just hit the button for a sync. We'll see. It's sitting in the apartment office waiting for me to pick it up when they open in a few hours.

I'm on for the next three nights.

One drug we use, Integrilin, is given IV over an 18-hour infusion after some heart catheterizations. For whatever reason, we've been having trouble getting the infusion stopped at the correct time. Oddly, we seem to like turning it off two hours too early (a 16-hour infusion) or up to six hours too late (a 24-hour infusion). I've gotten to the point of telling nurses to double check each other at the change of shift, and to go ahead and "use your fingers and count out loud and together." We cut one off 2 hours too early the last time I worked (and I blame myself since I am aware of the problems). No idea why we have such trouble with it. I tell nurses to take the start time (in military time), add 18 hours to it, and subtract 24 hours if the number you get is greater than 24. We'll have to see.

I finally got my evaluation done by the Old Place. It wasn't as bad as I had thought. I assumed it would be mostly unsatisfactory (we use a 4-point scale; 4=wonderful, 3=pretty damn good 2=needs improvement and 1=basically suck). I did get three ones (that makes my co-workers from both places absolutely GASP in horror, that's how rare they are). But I can't really buck them because they were for things like "failing to involve leadership in problem-solving," "acting too independently without checking in with the boss," "being too damn popular," and "failing to cooperate (with stupid people)". The scores were "clustered," so were I got a "1" they balanced it with lots of 4's to give me an overall score of 3. I've let a few others read the eval, and the point they found odd was how the 1's stated such a bad picture, yet they were averaged with 4's saying how I'm the greatest thing since egg roll wrappers. For me, it was just more of the same old bullshit.

Do I share it with my new boss? Dunno. A big part of me wants her to know how hellish Life With Me can be when leadership turns their backs on the souls they are sworn to serve. I also think that, if I'll be damned, it should be for what I admit I truly am, and not by what she may have heard through rumors while sitting in upper management meetings (possibly right next to My Old Boss).

I still haven't seen Star Wars III: Revenge of the Sith a second time. Gotta get going on that before it leaves the theaters. I remember the good old days when blockbusters would stay for months at a time. I didn't think ET would EVER leave town. Now they just stay for a month.

I'm still looking for an interesting nursing conference to attend.

I'm getting inbound hits from Blogshares, and I have no idea why. I don't have any idea what Blogshares is or how it works, or why such a thing would be interesting. I thought at first it had something to do with the stock market, but these are shares being traded based on individual blogs, and there are "prices" associated with it. But it's not real money. No idea.

My last shift as charge was interesting. It started out being sort of boring, and so I thought, foolishly, that I could get some of my ridiculous filing done. I had barely started when my cell phone started to ring.

• A 375-lb patient is refusing to get out of the ER stretcher because she wants an extra-capacity bedside commode. We didn't have one and offered a bedpan, but she refused and wanted me to call her home health agency and have her commode sent to the hospital. After 90 minutes, I finally got one delivered, along with a BigBoy bed.

• One of our new employees has been having conflict with his preceptors. So I had to initiate a list of written specific objectives and schedule some more precepting time. I felt for him, another Baby Boomer male that just wasn't getting the level of concrete-ness he had come to love in his previous job as a civil engineer. I think all of my gray hair set him at ease, along with my detailed bulletted enumeration of what my expectations were.

• Day shift the following day was staffed with only two nurses (we usually staff a minimum of 5). At 11pm, one of them called out sick. That's one nurse for a census of 20. That means I'll have to cook up 4 more live bodies by 0500.

• One family of about 20 people (half of them little children) were running and screaming up and down the halls, had taken residence in our visitors' lounge, was not allowing any other visitors in there, and were dropping food crumbs all over the place. I had to limit them to two adults only (visiting hours were about to end) and that all of the children would have to leave. So they hid out in our other visitors' lounge, which, to their chagrin, is still at a spot where I round about every 30 minutes.

• I ended up relieving my monitor tech at 2am due to illness, which made me charge, monitor tech, and unit secretary.

I'll never file again.

My sister and brother-in-law were in town over the weekend. I could only spend a day with them, and we went shopping for clothes at Fashion Square. We'd been there only once when we first moved here five years ago so it seemed new to us all over again. We also had lunch at the Scottsdale Cullinary Institute, and it was excellent. Later that night we had dinner at Garcia's (Vina drank about two sips of her 10-oz Marguerita). The weather cooperated nicely, it was sunny and warm but not terribly hot. We're in a mild spell with temps below average.

I finally decided to get on the Google Train today. There has been an endless flow of data suggesting another blow-out earnings report in July, with earnings growth over the next several years. I've been waiting for a dip that doesn't seem to want to happen, so I bought in today. My longs on HANS and TALX are still going strong. Every time I consider selling HANS to take some profit off the table, it makes another upward move on good volume so I leave it alone. MRVL is limping along but it's not really taking off. I'm looking at Charles River Assoc (CRAI), KB Homes (KBH), American Healthways Inc (AMHC), Chattem Inc (CHTT) and Parlux Fragrances (PARL), all announcing earnings over the next week or two.

I've been working harder than I ever have these past couple of weeks. By the end of this week, I'll have worked nine 12-hour shifts in two weeks. Our full-time requirement is for three 12-hour shifts per week.

My sister and brother-in-law are in town for a visit. We're doing some shopping and then lunch and/or dinner. Unlike their previous visits, I'm not staying out in the sun this time.

We finished watching 24.

• I was hoping they would figure out a way to avoid making the Muslims the bad guys. I mean, it's just too pat and easy.
• What happened to Beruz? He just sort of disappeared.
• The gal that was Bauer's love interest -- man did she have a bad day. Dad kidnapped. Husband tortured, shot, cardaic tamponade, then sacrificed to save a Chinese bad guy. Brother exposed as a (gasp) homosexual. Then thinking Bauer was killed while attempting escape. Oh well. At least she didn't get Taser'd.