By The Gypsy Nurse

May 26, 2014

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Memorial Day- Thanking Our Country’s Military

A Day of Remembrance 

“Memorial Day is a US federal holiday celebrated every year on the final Monday of May.[1] Memorial Day is a day of remembering the men and women who died while serving in the United States Armed Forces.[2] Formerly known as Decoration Day, it originated after the American Civil War to commemorate The Union and Confederate soldiers who died in the Civil War. By the 20th century, Memorial Day had been extended to honor all Americans who have died while in military service.[3]It typically marks the start of the summer vacation season, while Labor Day marks its end.”

The Gypsy Nurse is a proud supporter of our American Military.  There are many ways that you can show your support. Consider donating in honor of our nation’s military this year to Fisher House, The USO, or the Wounded Warriors Program.

Check out these additional articles on people that served: Specialty Nurse: A SALUTE TO The ARMY NURSE CORP, Memorial Day: Celebrate and Remember, Thank a Nurse Veteran 

Please take a moment to remember those that sacrificed their lives for your continued freedoms.

Memorial Day. (2014, April 29).Wikipedia. Retrieved April 30, 2014, from http://en.wikipedia.org/wiki/Memorial_Day

To all those serving and those who have given their lives keeping us free, thank you for your service.

By The Gypsy Nurse

May 24, 2014

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A Travel Nurse Volunteer in Liberia: The Acclimation

The Gypsy Nurse Volunteering in Liberia.  A travel nurse volunteer with Cross Cultural Care

As you probably already read, The Gypsy Nurse is volunteering in Liberia.  I plan to bring you along with me; virtually and give you a ‘feet on the ground’ accounting of the entire process.

Acclimation Phase: The Language

The first week here in Liberia has reminded me of the first week of a new hospital contract. Getting to know the staff at work and remembering names is always a challenge for me.  Simply figuring out the general processes and workflow at any hospital is always a challenge.

Here, it’s just slightly more difficult.  Even though the local language is English, the English spoken here is much different than US English.  I would equate it to a somewhat ‘Caribbean’ feel.  The words are jumbled together, and the pronunciation is slightly different.  Sentence structure is totally ignored; sounds are left off of the ends of words, and for me, their speech seems very fast.  An example would be ‘How are you doing?’  In the local dialect, they would say something similar to ‘How ooo gittinon?

Please realize, I don’t bring this up to make fun, degrade, or anything of the sort.  The language here has been a major challenge for me.  I’ve traveled quite a lot to foreign countries where English is not a primary language and several of them where English is seldom spoken.  I anticipated some difficulties in acclimating to the local community, but I never expected the language to be as big of a barrier as it has been for me.

I’ve been very frustrated with myself and my lack of comprehension of the language.  It’s interesting when I travel (for example) in a Spanish-speaking country, I don’t have much difficulty understanding and getting my needs met.  Rarely do I get frustrated with conversation or my lack of understanding.  Here, I have been completely frustrated with my inability to understand the locals.  I find that I have to request that they repeat nearly everything that is said.  Following a conversation between several locals is nearly impossible and speaking to someone via phone is a lost cause.

Acclimation Phase: The Nurses Role

C3 is a young organization.  They have been serving St Timothy’s Hospital in Robertsport for (I believe) only two years. Most of the previous volunteers have been physicians or advanced practice RNs. Due to this, the role of the RN is not clearly defined.  During my first few days at the hospital, I felt I was pushed extremely beyond my comfort level.  Working in the emergency department, the nurses basically appear to run with little to no physician or P.A. (Physician Assistant) assistance.  The nurses are ordering treatments, medications and making decisions on admissions.  In the O.P.C. (Outpatient Clinic), where I worked on Tuesday, I was operating basically as a general practitioner/physician, doing assessments, ordering lab work, writing prescriptions to be filled, and determining the time-frame for the patient to follow-up.

This was extremely stressful for me.  I do not operate this way in the states, and something felt wrong about making decisions of my own accord.  I will say that I asked MANY questions and had the P.A. on duty check over my assessments and orders.

Acclimation Phase: Why am I here?

As I mentioned previously, C3 is a young organization and newly operating in Robertsport.  The Nurse volunteer’s role has not yet been fully defined, and I’m feeling the lack of definition as I begin my volunteer time here.

Having worked at St Timothy’s for the past several days, I have asked myself this question time and time again.  Why am I here? The ER appears to run well, the OPD meets the community needs, and the inpatient unit (which is mostly pediatrics) nearly has more nurses at a given time than they have patients.

I’ve spent a lot of time considering what the Nurse’s role ‘should’ involve here in Robertsport.  Working alongside the current staff has enabled me to identify several areas in which there could be some improvements from sanitation to general processes.  I do not feel that the community needs me as a staff member; they really have adequate staff as far as the nursing staff is concerned.

The community and the hospital need better processes, organized procedures, and suggestions on how to improve.  How does this get achieved?  This is the bigger question. I’m totally unsure at this point how receptive the current staff is on ‘change.’  Having worked as a Travel Nurse for the past 10 years, it’s been ingrained in me to ‘leave it alone when it comes to attempting any changes.  As a traveler, the hospitals are generally not very receptive to changes and certainly not from someone (like myself) that is only at the facility for a short period of time.

Will the staff here react the same?

It’s also interesting to note that I feel my acclimation is phasing out exactly like a typical travel contract.  See my recent article Life: 13 weeks at a time – as a Travel Nurse.

Personally Speaking:

I think it’s important for the reader to note that I am on a solo volunteer trip.  There is no C3 support staff here in Robertsport.  I am currently the only volunteer (although there is another volunteer arriving at the end of the week).   I am in communication via email and phone with Dr. Montana (founder of C3) who is available to me 24/7 as needed.

I consider myself a pretty independent person when it comes to traveling solo.  I’ve traveled solo in multiple developing countries including: Vietnam, Guatemala, Mexico and Panama.  I have to say that so far, this experience has been quite a challenge for me on a personal level and has pushed me near my limits.  I’m hopeful that these feelings are all a part of my ‘acclimation’ phase and will soon pass as I adapt to the local environment.  It’s also interesting to note that the things (lack of supplies/patients dying/local living conditions/etc.)that I thought would be my biggest challenges in adaptation, have not been.  So, perhaps once I am through the acclimation phase and figure out what my role here is, I’ll feel less pushed to the limit.

By The Gypsy Nurse

May 20, 2014

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A Travel Nurse Volunteer in Liberia: The Adventure Begins

The Gypsy Nurse in Liberia with Cross Cultural Care.  A travel nurse volunteer.

As you probably already read, The Gypsy Nurse is volunteering in Liberia.  I plan to bring you along with me; virtually and give you a ‘feet on the ground’ accounting of the entire process.

CHECK OUT THE PREVIOUS SEGMENTS OF THIS SERIES IF YOU WOULD LIKE TO READ MORE ABOUT MY EXPERIENCE AS A TRAVEL NURSE VOLUNTEER IN LIBERIA.

It’s nearly dark upon my flights arrival into Monrovia.

A small international airport set about an hours drive from the city. Not unlike most developing countries that I’ve been in there is a myriad of others standing at the airport exit calling out and hoping to charm me into their car for the trip into the city.  My driver Alpha is there as planned with a sign and a smile and a small wave of relief comes over me.

The drive is simple, one main road from the airport to the city with a couple of turns until we arrive at the expat apartment that Dr. Rob (as Alpha refers to him) has set up for me.  The road is well paved and I attempt to gaze at the darkened surroundings as we weave in and out of traffic and around the many pedestrians waiting for taxi’s on the side of the road or casually walking to their destinations.

Along the ride, Alpha and I talk about our families and other simple subjects. After hearing that I’ve never been to Africa before, Alpha comments that ‘black’ people surround me.  I’m learning the dialect and catch only part of what he is expressing but I think he is concerned either for my safety or my comfort in being one of only a few ‘white’ people. He expresses how he would be uncomfortable surrounded by only ‘white’ people if the situation were reversed. We laugh together about how drastically I stand out in the crowd.

The arrival at the apartment

It’s a bit uncomfortable…this is someone else’s home and I’m here alone. The current resident is likely ‘in the bush’ and I’ve been unable to call him (as Dr Rob recommended) because the phone that is left for me is uncharged.

I’m thankful that I saved the sandwich from the flight for my dinner as it’s full darkness, I am tired and I’ve been told that it isn’t safe to wander from the apartment on foot after dark.  My first concern is the water…is it safe to drink the tap water?  I haven’t gotten any bottled water other than the small amount that is left over from my flight.  Finding an empty water bottle in the cabinet, I fill it and add one of the water purification tablets that I’ve brought with me.  It takes 4 hours before it’s safe to drink so I shower and climb into bed to read.

The first morning after my arrival is beautiful.

The sun sits low in the sky and the heat and humidity are tolerable. I manage to make a cup of coffee and sit on the deck to take in the surroundings.  I’m staying in an ‘expat’ apartment. It’s air-conditioned and very nice.  The apartment complex consists of 16 units and is fully gated with a local ‘manning’ the gate to allow residents in/out.

As I sit on the balcony drinking my coffee and having my last granola bar for breakfast, the locals are beginning their daily work; a housekeeper arrives at the apartment across from me and begins sweeping, a young boy cleans one of the cars from a small bucket of water and another young boy tends to the plants, watering them. The activities put me mildly at ease…it’s all very normal.

By The Gypsy Nurse

May 12, 2014

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Volunteering In Liberia: Educating the Community on Ebola

The Gypsy Nurse is heading to Liberia with Cross-Cultural Care as a travel nurse volunteer.

As you probably already read, The Gypsy Nurse is going to volunteer in Liberia.  I plan to bring you along with me; virtually and give you a ‘feet on the ground’ accounting of the entire process.

IN THE PREVIOUS SEGMENT OF THIS SERIES OF ARTICLES, I SHARED RECENT INFORMATION ON THE EBOLA OUTBREAK AND MY DECISION TO FOLLOW THROUGH ON MY COMMITMENT TO C3 TO VOLUNTEER. Find out more about the Ebola outbreak here!

Post by Cross Cultural Care.

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Along with volunteering, The Gypsy Nurse plans to bring to you; the reader, an inside peek at this volunteer opportunity.  With an emphasis on the people served, the cultural differences, and the impact that Cross Cultural Care is providing to the communities of Grand Cape Mount. Liberia.  I am excited to have this opportunity to utilize my nursing skills to assist Dr Montana in his vision to provide training, mentoring, and growth of skills as a strategy towards lasting change and improved healthcare access for the communities served by St Timothy Hospital. If you would like to contribute to the ongoing efforts of C3, you can donate HERE.

As always we will keep you updated here on our volunteer trip and what transpires.  And keep you informed on the Ebola outbreak.  Keep checking back for more information.

THERE WILL BE MUCH MORE INFORMATION TO COME AS I SHARE WITH YOU THE ENTIRE PROCESS TO GIVE YOU A “FEET ON THE GROUND” PERSPECTIVE.

By The Gypsy Nurse

April 28, 2014

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Volunteering in Liberia: Obtaining Supplies from SOS

The Gypsy Nurse is volunteering – heading to Liberia with Cross Cultural Care

As you probably already read, The Gypsy Nurse is going to volunteer in Liberia.  I plan to bring you along with me; virtually and give you a ‘feet on the ground’ accounting of the entire process.

In the Previous segment of this series of articles, I shared recent information on the Ebola outbreak and my decision to follow through on my commitment to C3 to volunteer. In this segment, I’m going to share some additional preparations that are being taken.

As you may already know, this is my first such trip.  I’ve traveled extensively through many impoverished areas but haven’t until now, volunteered. I was totally unaware of the resources available.  In light of the Ebola outbreak in Western Africa, I wanted to bring along some PPE (personal protective equipment) for use at St Timothy’s hospital where I’ll be volunteering.

A SPECIAL THANK YOU TO ATLAS MEDSTAFF

Upon hearing about the upcoming medical mission trip to Robertsport, Liberia; I was contacted by Rich Smith, Senior Managing Partner at Atlas Medstaff with a request to assist. After some discussion, Atlas Medstaff agreed to cover the cost for the hand-carry supplies that I was able to obtain.

Now…where to find supplies?

My first stop…a former employer; Floyd Memorial Hospital (FMH). I checked in with the staff that I previously worked with at FMH in the Home Health Department.  They were excited to hear about my upcoming trip, unfortunately…they were unable to provide any supplies.  FMH (as well as many other hospitals in the Louisville, KY and Southern IN area) send all of their medical surplus supplies to an organization named Supplies Over Seas (SOS)

The staff at FMH directed me to SOS

Supplies Overseas (SOS) “Delivering a World of Health and Hope”

SOS IS A 501C MEDICAL SURPLUS RECOVERY ORGANIZATIONS (MSRO) LOCATED IN LOUISVILLE KY THAT SUPPORTS SHORT-TERM MEDICAL MISSION TRIPS FOR INDIVIDUALS AND GROUPS THAT PROVIDE HEALTHCARE ALL OVER THE WORLD. SOS IS ONE OF A GROUP OF MSRO’S  LOCATED THROUGHOUT THE US.

We were given a wonderful overview of the mission and day to day activities at SOS. Having arrived to the facility with no appointment, I would like to give a special thank you to the Volunteer staff members that assisted us; Melissa Mershon, President & CEO and Bill Roof, Warehouse Specialist.  Both of these individuals showed the upmost excitement in sharing the mission of SOS.

SOS was able to provide us with a variety of much needed supplies to hand-carry with me to St Timothy’s Hospital. The entire process was very simple.  A quick application, a small fee for the supplies and we were off with a loaded trunk full of gloves, gowns, and masks.

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Along with volunteering, The Gypsy Nurse plans to bring to you; the reader, an inside peek at this volunteer opportunity.  With emphasis on the people served, the cultural differences and the impact that Cross Cultural Care is providing to the communities of Grand Cape Mount. Liberia.  I am excited to have this opportunity to utilize my nursing skills to assist Dr Montana in his vision to provide training, mentoring, and growth of skills as a strategy towards lasting change and improved healthcare access for the communities served by St Timothy Hospital.

THERE WILL BE MUCH MORE INFORMATION TO COME AS I SHARE WITH YOU THE ENTIRE PROCESS TO GIVE YOU A “FEET ON THE GROUND” PERSPECTIVE.

By The Gypsy Nurse

April 14, 2014

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Volunteering in Liberia: Understanding the Risks

The Gypsy Nurse is heading to Liberia with Cross Cultural Care

As you probably already read, The Gypsy Nurse is going to be volunteering in Liberia.  I plan to bring you along with me; virtually and give you a ‘feet on the ground’ accounting of the entire process.
“Cross Cultural Care (C3) is an international non-government organization (NGO) that pairs western health care providers with medical staff in areas of the developing world to assist with medical training and health capacity building.

Cross Cultural Care (C3) was founded by Dr. Robert Montana, an American Emergency Medicine physician who decided to create such a program while volunteering in North India.”  – http://www.cross-culturalcare.org/about/

The Gypsy Nurse will be spending the entire month of May 2014 in Liberia. I’ll be volunteering with C3 in Robertsport, Liberia.

In the previous article, we discussed the ‘To-Do List.’  I’m still working through all of the paperwork. My renewed passport came back and is now on it’s way to the Liberian Consulate in D.C. for my visa.  I’ve filled out all of the appropriate forms for my Liberian Nursing Permit. I’ve faxed, emailed, and made copies of everything I can think of. I think I’m done with the paperwork!  Now it’s just a waiting game to see if my Visa and Nursing permit come back without any issues.

Understanding the Risks

I knew that heading into Liberia would expose me to many diseases that I’m unaccustomed to. From Malaria, Dengue Fever, Yellow Fever, Typhoid, etc., there are certain risks one takes when traveling to a developing country.  This is not totally new to me as I’ve previously been vaccinated for many of these due to my personal travels in Vietnam and South and Central America. It is best to understand the risks beforehand to educate yourself about these diseases.

What I didn’t know was that an outbreak of the Ebola Virus would be spreading in the wake of my arrival.

I have to be honest…hearing about the outbreak of this highly contagious hemorrhagic fever gave me a moment of pause. I had to seriously weigh the options on whether or not to follow through with my commitment to C3 to volunteer. Dr. Robert Montana, the founder of C3, personally emailed me to update me on the situation and informed me that “You should be aware that there is NO CRITICAL CARE in Liberia even in the capital and air evac may be impossible if you are suspected with the disease.” and allowed me to back out of the trip if I so chose.

I’ve spent the past week researching the disease and considering my options. As of April 4th, there were two confirmed and several un-confirmed Ebola cases in Monrovia (the capital in which I’ll be arriving). There were no current reported or suspected cases in Robertsport, where I’ll be volunteering. Guinea’s bordering country is where the outbreak is currently the worst, with a few cases in both Liberia and the border country of Sierra Leone. Many agencies are currently assisting the Liberian Ministry of Health in efforts to confine the spread. UNICEF, MSW/Doctors without Borders, WHO, and multiple NGO’s are involved in the containment efforts.

Based on the current information available…

I’ve decided to follow through with my commitment to C3, baring any drastic changes in the current situation. I knew when I volunteered that there was a possibility of contracting a deadly disease; the fact that there is a current outbreak will make me more vigilant in my personal protection and care of others. Understanding the risk has made me more aware of the situation and cautious.

In light of the information I’ve received, my packing list has changed slightly to include: masks, gloves, goggles, and a supply of hand sanitizer.

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Along with volunteering, The Gypsy Nurse plans to bring the reader an inside peek at this volunteer opportunity.  With an emphasis on the people served, the cultural differences, and the impact that Cross Cultural Care is providing to Grand Cape Mount’s communities. Liberia.  I am excited to have this opportunity to utilize my nursing skills to assist Dr. Montana in his vision to provide training, mentoring, and growth of skills as a strategy towards lasting change and improved healthcare access for the communities served by St Timothy Hospital. If you would like to contribute to the ongoing efforts of C3, you can donate HERE.

There will be much more information to come as I share the entire process with you to give you a “Feet on the Ground” perspective.

By The Gypsy Nurse

March 17, 2014

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Travel Nursing Challenges: “Where Do I Find That Dr’s Number?”

Travel Nursing Challenges

There are many travel nursing challenges; leaving new friends behind, negotiating contracts, finding housing, etc.  One of the most frustrating for me is figuring out which physician I’m supposed to call, who I can’t call, which Dr’s prefer to be text’ed, etc.

You would think that a hospital that frequently uses travelers would have some sort of quickie ‘cheat sheet’ for all of us newbies?  Not necessarily the case.  So how do you manage finding the appropriate number and method of physician contact?

The first couple of weeks on the floor can be nearly overwhelming…even for this experienced traveler.  Learning a new charting system, where to find the IV fluids or dressing supplies and simply getting through the first several shifts with everyone and everything still intact can be a major challenge in some facilities.  But then what happens when you need the Dr?  And…need him/her NOW?

One of the ways that I combat this ‘unknown’ is to ask during my floor orientation (which is usually only one day), and take vigorous notes.

These 3 questions should give you the basics to cover any immediate physician needs:

  1. What is the standard process of contacting a physician at this hospital? Page? Text? Phone?
  2. Which physicians are ‘excluded’ from the standard process and how do they prefer to be contacted?
  3. Is there a listing of the physicians and their numbers?  It’s a long-shot but sometimes you’ll get lucky!

Not knowing or not following the hospitals standard operating procedure in this matter can sometimes cause a development of bad relations between yourself and the physician.

Personally Speaking: 

At one hospital I recently worked at; the night shift Hospitalist had given strict ‘orders’ to NOT be notified via text, pager or phone.  We (the staff nurses) were told to write our requests down on a sheet of paper at the nurses station and he would address them during his rounds which were done at 9pm, 12am, 3am, and 6am. I personally thought that this was a totally crazy and potentially unsafe procedure.  I once dis-regarded his orders due to a patient experiencing a potential blood transfusion reaction (as per the standard protocol orders) and thoroughly got my @$$ chewed.  Being an experienced RN, this didn’t phase me much and if the situation arose again, I would have notified him again…regardless of the consequences.  This experience did leave me concerned about the ‘New’ nurse and how he/she might have handled this situation or a potentially more threatening situation: Call the Dr and reap the repercussions or put the concern on a note and hope the patient survives until the Dr rounds?

– Gypsy

What interesting standard operating procedures have you seen in how hospitals handle the ‘call’ situation for their physicians? Do you have an interesting story you would like to share involving contacting a physician? Advice on how you mange this challenge?

We would like to hear your story!  Leave your comment here.

By The Gypsy Nurse

June 20, 2013

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Nurses “Eat Their Young”?

I did a phone interview the other day for a Healthcare Magazine in Chicago. The interviewer asked me about the saying, ‘nurses eat their young? and what does it mean?’  She also wanted to know where/why this term started.  I was stumped.  How do you explain this type of behavior within your profession? It’s actually embarrassing…

I began to reflect on this question after the interview was over, and I still can’t say that I understand the ‘why.’  Is it jealousy?  Perhaps we don’t want to see others succeed?  Maybe it’s just a rush to get our own work done under stressed-out, short-staffed conditions?  

The morning of the interview, I had just completed a pretty challenging (for me) hike with a new friend here in Panama.  If you know me, you know that I’m not a great hiker.  I love to hike, but I’m certainly not in ‘hiking’ shape.  My skills are that of a brand new nurse comparatively.  The hiking friend “Richard” was forewarned and agreed to support me through this hike.  Richard gave me the option to take a flat hike without a view or a ‘more challenging’ hike with a great view.  Of course, I choose the great view.  Warning Richard of my lack of skills…he was supportive, and off we went.

How did the hike go?  

I made it as far as I could….with a lot of verbal support, a little hand-holding, and lots of patience from Richard. He slowed his hike to keep my pace, gave me tips and pointers along the way, and exhibited a grand attitude of teamwork and camaraderie.  In turn, when it got to a point where I couldn’t go any further, I encouraged Richard to go ahead and get the ‘great view.’  We worked together, both supporting and respecting the skill levels each possessed.  He held back to help me gain a little experience, and I let him forge ahead when I knew I had reached my limit.

I didn’t’ reach the summit that day…

I did, however, gain some great experience and confidence as well as a wonderful view.  I finished the day feeling motivated, energized, and encouraged.

Why am I telling you about hiking?

Later that afternoon, while reflecting on all of the day’s events, I began thinking about how the hike with Richard and working with a new nurse are very similar.  Like me (when it comes to hiking), a new nurse needs lots of encouragement, support, a little hand-holding, and a lot of patience.  I’ve been on hikes where the others forged ahead, left me behind, and didn’t work with me to help build my hiking skills, and these hikes were never enjoyable.  Not only were they not enjoyable, but they also left me with a feeling of defeat and want to give it up.  We’ve all seen nurse preceptors that will forge ahead with their work, never stopping to explain or allow a much slower new nurse an opportunity to attempt a skill or procedure. I’ve worked with nurses who will completely ignore questions from a new nurse while forging ahead to get their tasks completed.

The lack of camaraderie in nursing is disheartening and embarrassing.  It pains me to be associated with a career of ‘carers’ who carry a stigma of ‘eating their young.’  

I would encourage you, the next time you encounter a new or inexperienced nurse; think of my hike and the support provided by Richard and help that new nurse reach her summit, it only takes a bit of your time, and perhaps one by one, we can attempt to change the culture from “Nurses Eat Their Young” to “Nurses support their young…” Let’s work together to help the new nurse walk away from her shift feeling motivated, energized, and encouraged instead of defeated.

Do you have any insight into why many believe ‘nurses eat their young?’

By The Gypsy Nurse

January 23, 2013

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My Cervical Cancer Journey – Guest Post by Kelly Creager

In recognition of Cervical Cancer Awareness Month, I sent out multiple requests to bloggers to find someone that would provide a personal story about this disease. Kelly responded and has provided the story below. I want to say thank you to Kelly for sharing her experiences.

When I first read what Kelly had written, I was brought to tears. We see patients in med/surg (the specialty that I work) only for brief amounts of time. As a traveler, we may never see these patients again. Full time staff nurses will sometimes follow these patients along their entire journey as they are in and out of the local hospitals. Having only a glimpse into the struggles of these patients (as a travel nurse), I appreciate hearing the entire story and feel that it has given me some insight into the ongoing struggles that can occur with diseases like Cervical Cancer.

Kelly’s story is also a great testament to the need for preventative care in relationship to Cervical Cancer. HPV vaccines which have recently come on the market as well as annual exams are a must for our female patients….let’s all remember to continue to encourage and educate our female patients to not take these issues lightly.

Here is Kelly’s story:

In early 2010, I had two major things going on. I had blown out my left knee due to Rheumatoid Arthritis (RA) and I had been bleeding vaginally constantly for about 4 to 5 months. The HPV had been found in late 2009. I went in for my annual exam and showed her a bump – she biopsied it and it came back as high-grade dysplasia. I had to make a decision – knee replacement or hysterectomy. I decided on the knee replacement first because I could not walk without severe pain. After discussing it with my gynecologist, she said it would be ok to wait on the hysterectomy.

A little background on HPV:

Almost everyone gets it. If their bodies are healthy, then the body is strong enough to slough it off in two to three years. If they are immunosuppressed, the body is compromised and usually is not able to slough off the HPV. There are four types of HPV that cause cervical cancer – mine was one of them. They did not type and screen it as it was clear that I had cancer. The RA meds make me immunosuppressed. So, my body was not able to fight it off. So on May 19th, 2010, I had a hysterectomy. She only took the uterus and cervix since I was so young (41). They left the ovaries so I would not have early menopause.

I barely remember the gynecologist coming in that night and saying something to the effect that things did not look good. I went home the next day – I am not a good patient and I hate staying in the hospital any more than I have to. The phone rang around 5 – it was the gynecologist. She called to tell me I had stage 2b cervical cancer. She was even crying. She said in the surgery room that she cut the uterus and cervix open and found the tumor in the cervix. I felt like the air had been knocked out of me. I immediately called my mom. She lives 5 minutes down the road. She came immediately. We were scared and just needed to be around each other for support.

Before I could see a genealogical oncologist, they wanted me to wait for my hysterectomy to heal. I was sitting on pins and needles waiting it out. I think my appointment was 4 weeks out. Close to the appointment, the doctor ordered a PT/CT scan. I wanted to see the results so bad. I called the records department and got a copy “to take to my doctor’s appointment.” I wanted to see if it showed anything about the cancer being in the lymph nodes. They were clear. I just sat there and cried with joy.

So, I was off to meet the oncologist around the second week of June. I was told that radiation was the workhorse for treating cervical cancer and that chemo boosted the effects of the radiation. I was then sent to see the radiation oncologist. The plan was for 6 weeks of radiation and 5 rounds of chemo. It finally got to the point in time to start the treatment. I first had a port put in to deliver the chemo. The first week was not so bad.

As the treatments progressed, I was to do weekly blood tests to make sure my body was strong enough to withstand the chemo treatments. The second week of chemo, I started going downhill fast. Radiation was kicking my butt. I had dropped 30 pounds. One of my weekly blood test came back not so good. The oncologist’s nurse called me and said go the ER immediately. Once there, they started doing blood tests and such and then all of a sudden they were coming in the room with face masks. They wore the face masks because my muscles, my brain, my immune system was wiped out along with other very serious issues. They gave me fluids and meds and I went home. I only went home because I begged and pleaded to get out of there. I am a very bad patient. We had to stop all radiation and chemo treatments for two weeks. During those two weeks, I had to wear a face mask anywhere I went. I was going to the hospital daily getting blood tests to see if my counts went too low and would need a blood transfusion. If the counts didn’t get low to the point of needing blood, they gave me shots to help boost my immune system.

I was finally nearing the end of treatments when I got a call from the radiation oncologist. She said they didn’t like how my right ovary looked and wanted to add eight more treatments. I just broke down and cried. I was so sick, could barely walk, used a wheel chair and could do little else but rest. All during this time, I had to go in for IV fluids. I was so low in my counts. I felt depleted and defeated. I had nothing else to give – my body was done in.

In September 2010, I was finally done with treatments. I bounced back pretty good – still fatigued but okay. The chemo did not make my hair fall out. It was the radiation – so my hair was pretty thin from malnutrition. I went back to work in October 2010. It wore me out but I did not want to show it. Things were strange at best at work as the company had been taken public. I got laid off in March 2011.

In January 2011, I started to have constant diarrhea and was not able to eat much or not at all. What I was able to eat I just lost it anyway. I had an appointment with my oncologist. He sent me to gastro doctor. In February, I had an endoscopy and a colonoscopy, only a little polyp was found and that was removed. Nothing was found to determine what was wrong with me. I just progressively went downhill.

After I was laid off in March 2011, I decided to take a month off and then look for work. At the end of March, I had my first intestinal blockage. If you have ever had one of these, you know how awful and painful it is. They put in a NG tube – they stick it up your nose and then down your throat to where the block is. It is nasty stuff they pull out of you. As uncomfortable as the NG tube is, it helps to relieve the pain of the blockage. I can best describe the pain as rolling sharp pain up and down my abdomen.

I was hospitalized twice more for blockages. The doctors did a laparoscopic surgery through my belly button and moved some things around and took out my appendix. The surgeon was trying to do as little damage as possible to try to fix it. After that, one of the tests I had to do was lay on an x-ray table for four hours and they would give you meds at intervals and see how it traveled down. I have a bad back – laying there about killed me. The fluids they gave me cause diarrhea – at the fourth hour, I had severe diarrhea – blockage solved. Finally my third block, the doctors decided it would be best to open me up and go inch by inch through my small intestines. They ended up cutting out 18 inches and re-sectioning my small intestines. It cured the pain but did not help my being able to eat without diarrhea. Also after the second blockage, they started me on TPN. It is delivered through my port – it provides a mix of protein, carbs, fats and vitamins.

In May 2011, I was diagnosed with bladder cystitis. This is another side effect of the radiation. It is like an UTI on steroids. My bladder hurts all the time. Rest and meds are the only things that help. I am on high doses of morphine and diazepam. Just sitting here now – I can feel it. I have been told by the urologist that it may stay as is or get worse over time.

After the re-sectioning, I started somewhat to get a little better. However, I did not get out of jail card very easily. I would have problems with my blood pressure going too low and I would pass out. Hurt myself pretty good on the tiled floors – much better to fall on carpet. I was on 12 hour TPN feedbags. I would get up at least every hour to tinkle. So my mom and I got a great idea to switch from night to day. We waited a couple of hours after my night time bag finished and then started my new routine. I blew up and gained 30 pounds overnight. They gave me diuretics and got rid of the excess fluid that my body did not know what to do with – it took about 3 days.

One morning I couldn’t breathe well, an ambulance took me to the ER. Theory was that the TPN fluid got caught up around my heart and lungs and made it difficult to breathe. I had to stay one night. Diuretics again and I was out of there. Other things happened- just can’t remember them all except the big one. All during this time, I got a total of three pints of blood. It is amazing how quickly a blood transfusion works. Thanks to everyone that can donate blood and do so.

It was a weekend. The kids were with their father. I wasn’t feeling great and checked in with mom and let her know. We made arrangements for her to call me around 8. My fever spiked to 105.5 – I know I should have just gone to the hospital then. I took naproxen and it brought down my fever to 101. I slept all day. I woke up somewhere between 7 and 8 – so thirsty. I made it to the kitchen and got my drink to the table. I then went down face first on the ceramic tile. I chipped two teeth, broke my right femur in 4 places and it all went down from there.

I remember the ambulance ride, I remember them cutting off my shirt and the last thing I remember is that I looked at the clock and it was 12:30 am and I could see my mom’s face in front of mine – she was telling me that she was going home since I couldn’t stay awake. This all happened on a Saturday night. I do not have any recollection until the following Wednesday. Shortly after I got out of the hospital, I went to see my internist. He told me I almost died from sepsis. My organs and brain were shutting down and I was lucky to have the ICU doc that I did. My internal med doctor said that the ICU doctor saved my life. I think this is why I lost Saturday night until the following Wednesday.

I hate going to the oncologist – it hurts.

When you have pelvic radiation, you are supposed to use dilators to keep the vaginal wall supple. If you don’t, your vaginal canal will shrink, in length and width, and skin will die. They have to put me under to do anything they need to do in the vaginal canal. I did not use them – very stupid decision. My canal is about an inch and a half long and barely any width. If you have had radiation to your pelvic region, please use the dilators or have intercourse at least 3 times a week. At this point, he said if I start using them I might get some width back but not any length. Almost every pap shows high grade dysplasia. This is one step away from cancer. At first, we tried a topical chemo. It burnt me very badly. I had to stop it quickly. So now, when I have pap comes back it always shows high grade dysplasia. Sometimes, I have to have an outpatient procedure so the doctor can cut out the bad parts.

“HPV is a nightmare that will not go away.”

I have checked the web for support groups and there are some in the San Antonio area, but I am not a support group person. I should go at least once to see what it has to offer. There is also a website that I like: www.cancercompass.com. From the research that I have done, only 10%-15% of patients that have radiation to their pelvic region get these side effects. Some have the side effects get better and others, like me, are chronic. So much has happened.

I never thought at 41 my life would turn upside down.

I can’t eat or have a glass of wine. This has taken all social events with friends and families away. My whole social world has changed. I used to get up every morning, get my triplets up and we all would get ready. I would go out with friends and my ex-boyfriend. I am now 43 – soon to be 44. My life consists of taking care of my children with a lot of help from mom. I am so lucky to have her. She helps me with anything – I am forever grateful. I would like to work again someday and have a somewhat normal life. I am also grateful for all my prayer warriors.