Sunday, February 24, 2008

Heart Attack and Angioplasty...

The heart is becoming my favorite nursing preoccupation. I could write pages about the pathophysiology of a heart attack (myocardial infarction/MI), or you could just watch this really good video. In a heart attack, the heart essentially essentially chokes itself to death.

To correct for the "choking", the coronary arteries must be widened, which can be done by placing a Stent, or artificial tube, in the coronary arteries to widen it. An excellent explanation:

Here is the actual video of someone's angiogram where they are injecting the dye in order to see various parts of this guy's vasculature.

Wednesday, February 6, 2008

Stress and Tachycardic, Psychedelic Dreams

Reflecting on: Nursing, stress, and psychedelic dreams…

Lately, I’ve come to the conclusion that MEPN, for me, is like running a race where the finish line is gradually being pulled further away from me. Sometimes I feel like I’m gaining ground—most of the time, really—but then there are the times where my legs are cycling in a sick, nightmarish pantomime that approximates running, but gets me exactly nowhere—as if I’m stuck on a quicksandish treadmill and the finish line disappears into the horizon.

I’ve actually had this dream before and it sucks every time.

The key to overcoming such nightmares, I’ve found out, is to become self-aware while still in the dream. It doesn’t happen as much as I would like.

In the nightmare, I spin my legs so fast and become so agitated and over-rot with emotion that I actually wake myself up—heart beating as though I actually were running an endless mile. I can hear the blood pounding in my ears…I take a moment to soak up the relief that I am not actually stuck—that I am in my bed with my ridiculous cat and beautiful wife and that everything will be alright. My wife snorts and shifts her pillow. The cat rouses and looks at me as if I were crazy. Possibly. But not so far gone that I’m afraid to go back to sleep. I look around and slow my breathing. I close my eyes…

…I fall back asleep and drift off into the same dream.

Given a second chance, I become self-aware—“lucid dreaming” I think professionals call it. The sensation of lucid dreaming is akin to the same relief that I had when I woke, but quickly transitions into being exceedingly tickled that I can laugh at the ground I was once stuck on. Chuckling to myself, solid matter blurs into sky and I fly off through clouds and over towns I vaguely I recognize. Total exhilaration of the dream fuzz flies past my face. I feel victorious that I have overcome physical boundaries. But then, while flying, I sometimes am bothered by the notion that “this isn’t real” and will falter—even fall. Gravity regains its hold on me and I plummet. As I rush towards the earth, I am reminded that I am still dreaming, and go into my best dive formation. Hurdling towards the ground, there is no impact because I dive into the earth’s crust and through the center of the earth. I am now in an entirely new dimension.

I want to do it again. And again…

Sometimes my dreams mean something and sometimes they don’t.
Sometimes I don’t wanna know (seriously).

This one, however, has some pretty obvious symbols.

Clearly, I’m racing my ass off to be the best damn nurse I can be in one year. It’s kind of ridiculous when I say it out loud, but since that is what I am, in fact, doing, it’s better to be clear about my intentions. The overall experience is a lovely mélange of being completely overwhelmed but, now faced with a challenge, exhilarated that I am alive and in the middle of something meaningful and stimulating.

Baptism by fire.

The finish line is nonsense though; it is nothing more than a self-imposed limit that I created because this accelerated RN experience is done in one year. Time to laugh and become self-aware: I am built for this. I love doing this. So why would I ever stop? Why would I even want a finish line? I think I’d rather keep on running, jump in a limo, get out, and, I don’t know, do the freaking running man or something. I mean, let’s evolve, right?

Right.

The endless, never ending run that doesn’t allow me to move anywhere: that’s my battle with perfectionism—a huge limitation. I am operating under the incredibly unrealistic notion that I have to be perfect in 6 weeks. Ridiculous. More ridiculous than my cat. So what do I do? Let’s challenge those expectations…let’s laugh at them—or rather, laugh with them! Maybe I’ll fly. Maybe I’ll forget…more than likely I’ll do both…but whatever…let’s breakdown and build up and get back to basics. Let’s evolve. I said that already. How about relative perfectionism instead? How about I be as good as I can be in 6 weeks without losing my mind and making my quicksand treadmill a reality? How about a little reminder that I can continue to reform and dive into the challenges that present themselves to me…

It’s a beautiful thing to be stressed and overworked and running with your pants around your ankles because although it makes me crazy, it forces me to think and learn: it is here that I am reminded that I can fly and that I will fly again.