DRUGS, THE ROAD TO NOWHERE

I graduated from nursing school and received my Registered Nurse license in 1972. Newly married, and pregnant with my first child, I accepted a transfer to work at a new drug treatment center on the grounds of the Los Angeles County hospital. Patients were initially admitted into the detoxification unit where we helped them withdraw from whatever drug they were addicted to. At that time the favorites were barbiturates, sedatives, and heroin. These patients writhed in bed for the better part of seven to ten days, hallucinating, sweating profusely, vomiting, and having diarrhea. There really wasn't a good way to withdraw from drugs. Eventually they would recover enough to be transferred out of the acute ward and onto the general ward. If they progressed well during therapy sessions, and stayed clean and drug free, they would then move to the next unit where therapy was more intense and they enjoyed a bit more freedom. The ultimate goal was to be able to transition to a halfway house on the hospital grounds before being reintroduced into the community. Sadly, there were many failures and few successes. I remember some of the failures vividly.

     The first one that comes to mind is a young black female prostitute who was seven months pregnant when she came in for detoxification from heroin so her baby wouldn't be born addicted. She didn't last through the first three days of withdrawal and was packing her bags to leave AMA, (against medical advice) when I noticed her syphilis test had come back positive. I notified the doctor right away and before she left I injected her buttocks with more penicillin than I'd ever given anyone before or since. I've wondered all these years if that poor little baby was born alive and what happened to it. I can only imagine.

     One weekend I was working when the lab technician came up to me and said someone had stolen all of the used needles and syringes off of his lab tray. Alarm bells went off in my head. I figured that someone most likely had gotten ahold of some heroin and was planning a party. I had to work fast. I called the medical director and told him what had happened, and then gathered all of the patients together. Of course no one admitted to stealing the syringes and needles, so I mobilized the staff to search every inch of the unit. We finally found the stash hidden inside the zippered vinyl cushions on the chairs in the sun room. However, it was too late. The patients were already exhibiting signs of being high. Using drugs while going through drug rehabilitation was a violation of their individual contracts. I called the medical director again and he told me to discharge every patient that showed signs of being high on drugs and to do drug testing on all of the other patients. I still don't know where I found the courage to stand up to all those people who didn't want to leave, but with the help of my staff, I somehow managed to escort them out and lock the doors behind them. In retrospect, I was so angry at what they'd done on my watch that the adrenaline was flowing and most likely kept fear at bay. I was a bit worried when I left to go out to my car at the end of my shift, but no one was lying in wait. Once the weekend was over, several of the people came back, were remorseful, and were readmitted to the program where they had to start over from the beginning.

     One of the young men who returned was a teenager. He was a really cute little guy with blonde curly hair and big blue eyes. He’d been fun to have on the unit as a recovering drug addict. He was accepted back in, but changed his mind and left. Shortly after he left, another man came to the door and told us the teenager had shot up with heroin and overdosed. Someone dragged him inside and the doctor and I started working on him. He was in full cardiac arrest but we managed to resuscitate him and inject him with a medication to reverse the effects of the heroin. We saved his life, but I often wonder how long he lived. I still think about him and whether or not he managed to become drug free make it to adulthood.

HEARING IS THE LAST SENSE PEOPLE LOSE

     Mr. Ames was a 64 year old man who’d come into the hospital for rectal cancer surgery. The surgeon elected to put Mr. Ames in the knee-chest position on a special operating table. He was face down with his butt in the air for hours due to the operation being more complicated than the surgeon had anticipated. As a result, he had nerve damage to his legs from the bent position and compression and also developed blood clots in the femoral arteries. This wasn’t discovered until he’d been in our intensive care unit for a few days and was awake enough to tell us he had no feeling in his legs. They’d also become very swollen leading us to suspect blood clots.

     Unfortunately, one complication led to another and the blood clots traveled to his lungs and brain. He ended up in a coma and on a respirator. He remained that way for three more months in the intensive care unit until it was finally determined by an electroencephalogram he was brain dead. As difficult as it was for them, his large loving family made the decision to remove him from life support.

     The day came and the respiratory therapist turned the machine off and removed the endotracheal tube from Mr. Ames’ mouth. But he didn’t die. He took a deep breath, then another. His wife and children looked at each other in amazement. Hope could be seen on their faces.

     He continued breathing on his own so we moved him from the noisy intensive care unit into the quieter cardiac care unit. He was placed in a private room. It had glass walls and a glass door so we could see inside, but it also had a curtain that could be pulled for privacy when his family visited. He was a ‘no code’, so if his heart stopped beating we weren’t going to resuscitate him. This went on for another month, then we began seeing signs that he was getting closer to death. His family made us promise we would call them when he was within hours of death so they could be by his side.

     One night when I was working in the cardiac care unit, I could tell by the changes to his breathing pattern, his heart rate increase, and blood pressure dropping that he was going to die on my shift. I called his family as promised and they said they would be in as soon as they could get there. It was the middle of the night and they’d been asleep. I watched the heart monitor anxiously, hoping he would remain alive until they got there.

     Forty five minutes passed and they still hadn’t arrived when suddenly, his heart stopped and the monitor showed a straight line. I jumped up and ran into the room. He’d stopped breathing as well. I put my hand on his shoulder and leaned close to his ear. The last sense to go is the sense of hearing. I spoke loudly into his right ear, “Don’t go yet, Mr. Ames. Your family is on their way in. They want to be here with you. Hold on a little longer.” I watched as he took a big, deep breath and started breathing again. I looked up at the heart monitor and his heart began beating again. I stayed there another ten minutes until his family burst through the door. When they entered the room and gathered around I said, “Okay, Mr. Ames, they’re all here with you now.”

     The man who was brain dead smiled a brilliant smile, stopped breathing, and his heart stopped beating. He had a beautiful, peaceful expression on his face. I pulled the curtains closed and pulled the door closed behind me as I left the room so his family could grieve privately.

Musings on Turning 65 and becoming a SENIOR. YIKES!

            I’m 65 years old today. I’m on Medicare. I’m suppose I’m now officially a senior. I ignored AARP when they started contacting me at age 50. I’ve taken advantage of all the senior discounts at movie theaters and everywhere else they are offered but since the ages vary so much, I’ve pretended that it didn’t really apply to me. Now I can no longer ignore it. Now I’ll be watching to MAKE SURE I get my discounts.

            I was fine with turning thirty. I was terribly depressed when I turned forty. Fifty was great. I even had a big birthday party for myself to celebrate fifty. I made sure I had colorful flowers, balloons, table cloths, and nothing black was allowed. None of those silly “you’re over the hill” decorations entered my house. It was lots of fun. Sixty was a very bad year because my father had just passed away a couple of weeks before my birthday. I ignored that birthday as much as I could. My family and best friends wouldn’t let me ignore it completely, though. Bless them. Sixty four was bad, too. My mom passed away that year just before my birthday. I ignored it, too.

            This year I’m celebrating again. I’m healthy and life is good. What’s not to celebrate? I’ve noticed people seem to be nicer to me as I’m getting older. Is that my imagination? I hope not. Or, maybe I’ve gotten nicer since I’ve gotten older, so it’s coming back to me. Whatever: I hope it continues.

            I did have one encounter this past week that ticked me off. Signing up for Medicare and switching from my primary insurance has been confusing and I’ve had a lot of questions. I received a letter from Social Security with a telephone number for the Brea, California office if I had questions. I called one day about a month ago and a very nice woman talked to me and answered my questions completely. Then I got another confusing letter from Medicare so I called again. This time I got a really impatient little twit that talked to me like I’d lost all my marbles. I had to get very stern and parental with her before she finally stopped talking to me like I was an idiot and answered my question. I wanted to tell her my years of experience and college education trumped hers any day, but I held back. I remained nice and patient even though she wasn’t. I hope she doesn’t talk to all the seniors like that.

            Anyway, I’m now on to a new stage of life. I’m a SENIOR! I guess I’ll have to embrace it. I don’t have much choice, do I?

Cooking for two: easy crock pot chicken recipe

Most of the time I'm cooking for just two people. I've been cooking for a lot of years and I'm pretty tired of it. The thrill is gone, so to speak. I look for tasty and easy recipes, and this one fits the bill.

CROCK POT CHICKEN

4 chicken breasts (frozen is okay)

1 package dry Good Seasons salad dressing mix

1/4 cup of Sherry

1/2 cup of water

1 8 ounce block of cream cheese

Put chicken breasts in the crock pot. Pour sherry and water on. Sprinkle Good Seasons salad dressing all over the chicken breasts. Cook on low setting while you're at work or away playing golf.

When ready to eat, remove breasts and set aside. Cut cream cheese up in squares and melt it in the crock pot. Once it is melted, stir until smooth, then put the chicken breasts back in.

I like the chicken breasts shredded and mixed with the sauce. Rex likes them whole.

Serve over rice or noodles. I like it over steamed broccoli and cauliflower (carb free zone).

Next time I'm going to try adding artichoke hearts and maybe a few sun dried tomatoes. Mushrooms would also be good, or black olives. It's great plain!

Afghans in Perris

I'd worked as an RN for about 20 years when I decided to return to school to get a degree. In addition to earning a bachelor’s degree in Registered Nursing, I also was to receive a Public Health Nurse Certification upon graduation from California State University in Fullerton. I spent one semester studying public health and received my clinical training from the public health department in Corona, California. Riverside County, I was soon to find out, was NOT Orange County.

Towards the end of my semester I was assigned Afghan duty in Perris. It was 1990 and when the soviets invaded Afghanistan and civil war erupted, millions of refugees tried to get out of the country. I was to go see a large group that had somehow made it to Perris, California. There was one adult male that spoke English, and he was the only person that was able to work, so he wasn’t in the home most of the time. All of the refugees had tested positive for tuberculosis and the Public Health Department had been trying for months to get them in to have chest X-rays to check for active disease. In many countries of the world, people are vaccinated against TB with BCG vaccine, which isn’t highly effective. However, once vaccinated, the person will have positive skin test results for the rest of their lives. So, the only way to find out if they have TB is to X-ray.

     Perris is a dusty little desert community out in the middle of nowhere. I drove around and finally found the house. I parked my car and knocked on the front door. No answer. I walked around to the back of the house and found two mobile homes, up on blocks in the yard. I knocked on the door of one and it was answered by three women who did not speak English. They did understand I was there on some kind of official business...the white lab coat has that affect...and they led me to the main house. We went inside and they invited me to sit on the only piece of furniture in the place, a dirty white sofa. I did, and then all of the refugees gathered around and seated themselves on the floor in front of me. They smiled, offered ‘juice,milk,tea’, the only English words they knew. I smiled but declined. The place wasn’t exactly clean. I gave them the name of the man I was supposed to contact, and they pantomimed calling him on the phone. They gave me the phone and the man said he would leave work and be there in fifteen minutes.

     That fifteen minutes was the longest of my life. There I sat, perched on the edge of the sofa, surrounded by refugees that couldn’t speak a word of English. And they all just sat there looking at me, smiling every now in then. The most disconcerting person was an elderly man. He wore traditional afghan clothing, a long white caftan and pajama pants, and had a white turban wrapped around his head. He was obviously blind in one eye and that eye was scarred and clouded white, so when he looked at me, all I could see was the scarred eye.

     Finally, the man in charge arrived home and we were able to have a conversation. I provided him with all the information on where to take the people to get their X-rays, and how important it was to get it done. He was upset because he said they had all been checked prior to arriving in California and no one had TB. I apologized but stressed that they still needed to be cleared in California, now that they were living there. I made an appointment to return in two weeks to follow up, and rose to leave. All the Afghans stood, too, and followed me out to the car. They watched as I put away my briefcase in the trunk, then got into the car. They were still standing there as I drove away.

     Two weeks later I returned to the same situation, and no, they had not gone to get their X-rays. But I was at the end of my semester, so the problem reverted back to the head nurse.