In Repose Blog

Triage, a Definition.

tri·age /triˈɑʒ/ Pronunciation Key - Show Spelled Pronunciation[tree-ahzh]  

1.	the process of sorting victims, as of a battle or disaster, to determine medical priority in order to increase the number of survivors.

2.	the determination of priorities for action in an emergency.

–adjective 

3.	of, pertaining to, or performing the task of triage: a triage officer.

–verb (used with object) 

4.	to act on or in by triage: to triage a crisis.

If life wasn't busy enough...with impending visits from relatives, parties to throw and attend, work to do, end of year events to go to...I have come to consider myself a triage nurse of late.

Here, lets list the current patients.

1. Myself  (details later...maybe.)
2. Cielo the rat. Had some sort of stroke. I thought he was going to die within hours. Not only did he not die, he has improved, but needs some pretty constant care. We carry him around in a basket. Vet visits in the past 10 days: Two. Prescriptions: Also 2. Imagine administering drops to a little rat....not easy.
3. Angelo his brother. Always a needly dental patient Angelo has now decided to add bleeding eye to his repetoire. Believe it or not he needs his teeth ground down, about twice a month. Every time I walk in for this service I think to myself this little rat has better dental care than most of the planet's human population. The irony is totally not lost upon me.
3. Nicky the cat. Bacterial and fungal ear infection, vet visit Tuesday and ear drops daily.
4. Ellie the cat. Allergies so intense she licks her belly to infection. 101 degree May days do not help the matter at all. She needed a shot this week, antibiotic pill daily.
5. Literally five minutes after making the appointment to have Nicky's ear looked at, I notice Raven the dog has a bloody growth on her eye. I call the vet back, they say, sure, bring her in with Nicky.  Raven needs eye surgery ...TOMORROW, says the vet, before any more corneal abrasion.
6. And just when I considered myself filled to the brim with crisis, this afternoon I discover my mare Belle, has really messed up her leg with severe lacerations and swelling. I don't think anything is broken, I am calling the vet first thing in the morning. I have come to think that a horse could hurt itself in a padded stall with pillows on the floor. Sheesh.

I am just plain tired.

Now I Lay Me Down To Sleep

I am most pleased to announce that my application to volunteer for the organization, Now I Lay Me Down to Sleep, was approved yesterday.

Those of you who know me well, know that I had two high risk pregnancies.  I spent many months hospitalized, bedridden and terrified. Twice. At one point when I was 26 weeks along with my son, I thought we both were going to die. In the end, I gave birth to two completely normal children, at 37 and 36 weeks gestation. These experiences changed my life. They have also left me beyond grateful. My children were born perfectly healthy and normal. They are both beautiful and kind and accomplished, intelligent young adults.

What more could a parent want?

I have decided I am in a unique position to offer my photographic services to others not as fortunate.

     This nationwide non-profit organization that  aims to help parents who lose babies in early infancy has expanded its services.  In order to help families heal, Now I Lay Me Down To Sleep provides parents with heirloom photographs and DVDs of their infants free of charge. NILMDTS cofounders Cheryl Haggard and Sandy “Sam” Puc’ want families across the country to know that there are now 2000 photographers nationwide willing to volunteer their services, and that number is growing each week.

     Now I Lay Me Down to Sleep (NILMDTS) was founded after Cheryl and her husband Mike made the heartbreaking decision to take their six-day-old son, Maddux, off of life support on Feb. 10, 2005.  Knowing they wanted to remember their baby through photographs, Mike called Sandy’s company, Expressions Photography, after seeing her portraits of babies displayed at Presbyterian/St. Luke’s Hospital in Denver.  Sandy and her staff gently accommodated the Haggards’ request that photos be taken both before and after baby Maddux’s respirator was removed.  The remarkably distinctive photographs and extraordinary DVD set to music created by Sandy filled Cheryl with a sense of peace and pride.  Almost immediately, she knew she wanted to help provide other grieving parents with the same types of precious memories that are helping her heal.  The experience proved to be a profound one for Sandy as well.  She and Cheryl co-founded NILMDTS on April 8, 2005, exactly one month before Mother’s Day.

      “The purpose of Now I Lay Me Down to Sleep is to connect families experiencing an early infant loss with photographers throughout the nation,” said Cheryl.  “Calling a photographer to take pictures of a dying baby is the last thing most parents think of during such a traumatic and confusing time.  Since Maddux was our fourth child, we knew we wanted to remember him through photographs.”

     “Having those precious photos and DVD brought us a sense of closure,” she added.  “This organization comes from our hearts and our experiences, in the hope that other families will find a shorter path through heartache to healing.”

     Sandy said photographers from all over the nation, and several from other countries, are volunteering their services because they understand the power of the memories they create.

     “When there’s a hurricane or a fire, what is the one thing besides their children that people try to save?” she asked.  “Their photos.”

     “When a family loses a baby, their bodies and their minds are in shock.  They can barely remember the experience.  But with these photos, they can go back and really look at their babies--their faces, their hands, their toes.  They can see who the baby looks like.  It takes away some of the pain.”

     “Photographers who have taken pictures of these babies tell us it’s the hardest, most difficult thing they’ve ever done,” she added.  “Yet when they turn those images over to the families, they are never more proud.  Those images will last forever.”

      NILMDTS volunteer photographers will visit interested parents at any hospital in the photographer’s general vicinity (listed on the web site), providing a printable CD file of the images, plus a DVD set to music, free of charge.  Tax-deductible donations may be sent to Now I Lay Me Down To Sleep, 1153 Bergen Parkway, #M103, Evergreen, CO 80439. 

 Now I Lay Me Down to Sleep

Are you Ready for the "Ride of Your Life"?

This year about 565,650 Americans are expected to die of cancer, more than 1500 people a day. Cancer is the second most common cause of death in the US, exceeded only by heart disease. In the US, cancer accounts for 1 out of every 4 deaths.

I am pleased to have been contacted by Equesse and the American Cancer Society to help sponsor the "Ride of Your Life" in 2008 by donating use of my photography in the campaign. The event will be held May 10 of this year.

This is a photograph of the beautiful and talented country singer Templeton Thompson riding Kawlidja at SpiritReins Ranch in Liberty Hill Texas. You can find out more information about the Ride of your life HERE.

The Leading Cause of Death in Horses: Colic

Those of you out there not familiar with these animals might not know that a horse has a very delicate digestive system. Equines are incapable of vomiting, and many things you might not think would matter very much can cause colic and kill a horse. (Things like changing its feed, exercise or any type of stress.) 90% of colics are benign, but its hard to know if a colic is going to be severe or not and you don't have much time to help your horse if it turns out to be life-threatening.

My beautiful mare, Belle, colicked yesterday.

Photograph copyright Candace Craw-Goldman

From the looks of her stall and paddock when I arrived in the morning, it looked as if Belle had been rolling around...a lot. This was not a good sign. She could have been in distress for many hours before I discovered her. I called the vet immediately. Thankfully, Dr. Beau was there in about an hour.

And, happily, today Belle is doing just fine today after pain medication, colon evacuation, and about a gallon of mineral oil put into her belly via a tube down her nose. I'm a little tired. I checked on her all night long.

Most colics can be classified into three types:

• Intestinal dysfunction – the horse’s digestive tract is not working properly. This is the most common category, and includes gas distension, impaction, spasms and paralysis (ileus).

• Intestinal accidents – where the intestines are injured or torn. These are less common than the category above, and include displacements, torsions and hernias. The intestinal accidents almost always require surgery.

• Enteritis or ulcerations – these are colics caused by infections, inflammations and other intestinal disease, including parasitism and stress. 

Sadly, I cannot know for certain what caused her abdominal stress, it might have something to do with her anatomy according to Dr. Beau and a horse that colics, tends to be one that colics again.

I'll be watching her closely and so, no rodeo for me today.

Dang, Willie Nelson is in concert tonight too! I would have liked to add his image to my growing list of musicians. Perhaps another time.

(update, March 5: I couldn't miss Willie afterall. I am so happy to have photographed him!)

 

Dreaming of Death

I had the following dream last night:

I was very tired. I was fighting my body, my health, (something I do in my every day life.)

I decided enough was enough and I was going to do something radical. I felt like I was being pushed into considering desperate measures to save myself, because time was running out.  All conventional roads had been taken, explored, and were failures. There was something I could do to save myself but it was a very ugly last resort.  I knew it was despicable, but I had no choice, unless I was prepared to succumb to death and I was not ready for that at all.

I went to see my identical twin. (Now in real life I have no such thing, I don't even have a sister.) I was envious of her health and vitality. She was always strong and glowing, had never dealt with chronic pain or the myriad of other health complications that I have had to deal with for most of my 46 years. From afar I have been jealous of her almost my whole life. I felt slighted and cheated. Why did she deserve health and I did not?

I decided to trick her. To kidnap her. I was going to take from her the thing I wanted more than anything.

It was twilight and I took her to the ocean. I put her on a small boat and we sailed out until we could see no land. We spoke no words. I was in control. She was wary but unafraid. She did not know my plans. When we were all alone, and had no view of anything save ourselves and the circle of the sea that surrounded us, I made my move.

I took her body by the shoulders. I shook her, and wrestled her surprised soul from her physical self. I set it free to the dark sky above and then leaped quickly into her body while my own crumpled to the floor of the boat. My timing was perfect. I kicked the sick and worn out body that I used to occupy into the water and watched it slowly sink. I stood with the breeze of the ocean blowing through my hair, looking to the moon and clouds and thought to myself that my new life had just begun. I felt strong and healthy and full of energy in a fresh, lean, unbroken body.

Almost Immediately, my elation turned into incredible guilt, and then, paralyzing terror. In my rush to complete the act of stealing my twin's body I forgot the tide and the direction of the sea currents! My old body would surely float to shore. My secret would be discovered. I would be found out. I would be labeled a murderer and have to spend the rest of my long and healthy days in prison. Oh what have I done?

I sailed the boat back to the wooden dock with my stomach in knots, and a shaking with a cold sweat of fear covering my body. The only thing to do now was wait for the inevitable.

This dream has followed me closely today. I am trying to acknowledge the good symbolism in it, a desire to be healthy and leave some old bad habits behind and become healthy. The murdering of my non-existent identical twin is still pretty much creeping me out, though. I don't think I have killed anyone before in my dreams!

Have you?

Anesthesia

I have been thinking about anesthesia again. Maybe it was the radio program that I was listening to while I was in my truck running errands. They were discussing plastic surgery for teenagers, and the risks involved. Especially the risks of anesthesia. So once again I start thinking of our dear Lennon.

I have lots of vets. I have my horse vet, my dog and cat vet and I have my rat/bunny vet. I happened to have to see my cat vet just after Lennon's death and before I had a chance even, to speak with Lennon's vet about what had happened to our lovely sweet boy.

I asked the vet tech to leave when Buddy (Dr. Urbanzcyk) came into the room to talk about my cat. The cat was going to be fine, but I was welling up with tears over Lennon. Buddy had been there before when a pet was dying...my beloved cat Foxboy. He had seen me like this before. In any case, I cried my eyes out to him about what had happened to Lennon.

We talked for a nice long while. One sentence he said to me rings like a bell in my ear very often since. He said:

"You know when we use general anesthesia, on pets or on humans, we bring that live person or animal down to the brink of death, so that they do not feel pain. But bringing them down to that place has serious and significant risks."

Risks, I think sometimes, we as a society do not completely acknowledge. Surgery is RISKY, people!

Having it to do over again, I probably still would have still chosen surgery for Lennon. He had a fast growing tumor and having it out sooner than later was the best bet for his health. Unfortunately, the anesthesia was too much for him.

I have a very good friend who is facing brain surgery soon to remove a tumor. I have been thinking about her constantly since hearing the news. Happily, the odds are completely in her favor and most healthy people have no problems with anesthesia, and she needs her tumor OUT. But what about those who go under the knife for cosmetic reasons, for god's sake? Why, why, why risk it???

I am no stranger to anesthesia myself, having undergone several procedures in my life and a few just in the past handful of years.  The latest was my two bouts with kidney stones in 2006. I had two lithotripsies, a procedure where kidney stones are blasted with ultrasound. You need to go under because your kidney gets beat up good while the stones are being crushed. I felt it afterward, boy-howdy, did I.

So, I have been recalling what it felt like to "go under". For those of you who have not experienced it, it is nothing at all, like going to sleep.

I have a very active dream life. As a matter of fact, if I do not remember my dreams from the previous night, upon waking, I feel very strange. Sort of like passing out drunk or something, (not that THAT is something I know very much about, but the analogy holds true in any case). If I cannot remember my dreams I feel like something big is missing from not only my memory, but my life.

Usually something during the day prompts me to remember the dreams if I do not automatically do so upon awakening. Its a good feeling to know where I was all those hours!

But having anesthesia is nothing like sleeping, at all. Going under is leaving existence and entering a big, black, deep, and silent hole where there is no marking of time and no sense of self or place or anything, any THING at all. It is really the oddest feeling to go under...and disappear, only to re-appear with no feeling of time passing whatsoever. I feel the night go by and my dreams being played out in some semblance of time passage, but nothing like that happens in surgery.

I met a man not long ago who was in his late 70's, raising his granddaughter, because his own daughter came out of HER kidney stone procedure too brain damaged to ever be normal again. Sad.

It occurred to me today while driving (I have some of my best thoughts behind the wheel) that many people who do not believe in an existence after death, probably believe that the experience of death is much like that of going under anesthesia. And how awful, if that were to be the case. That everything just, disappears and existence ceases.

I cannot and I will not believe that death would be like this.

It is just too awful to contemplate.

 

Too Late for Lennon...

...but interesting nonetheless. I just read where some American researchers say they have coaxed hearts from dead rats to beat again in the laboratory...days after they had died.

Read about it HERE.

Necessary Surgery, or IS it?

We lost our boy Lennon to surgical complications. No, he was not a human being, he was a rat. The risks for surgery, however, remain similar and I have found myself thinking about them.

If you ask me, Americans think of the idea of surgery far too lightly. Any surgery, where there is anesthesia, general or even something lighter, there are real and significant risks.

It is instructive to know the mortality rate associated with different medical and surgical procedures. Even though we must sign release forms when we undergo any procedure, many of us are in denial about the true risks involved. We seem to hold a collective impression that since medical and surgical procedures are so commonplace, they are both necessary and safe. Unfortunately, partaking in allopathic medicine itself is one of the highest causes of death as well as the most expensive way to die.

-Death by Medicine (Gary Null, PhD ~ Carolyn Dean, MD, ND Martin Feldman, MD ~ Debora Rasio, MD, Dorothy Smith, MD)

I had to go through two lithotripsies last year. (Kidney stone treatment procedures involving ultrasound). Well aware of medical complications as they seem to be a given for me, I was not happy about "going under" and having a machine pound my kidney, not once but twice. I came out of them okay but it was only a few days later I met an elderly man who was raising his toddler granddaughter and having to provide 24/7 care for his now brain-damaged daughter. He mentioned to me his daughter had gone in for a simple lithotripsy and came out brain damaged.

Yikes.

This is why I don't even consider something I dream of daily: laser eye correction. I abhor my glasses. I finally, after 35 years of using them, hate my contact lenses and utterly envy those who can see clearly or just even across the room without an appliance of some kind. I wish so much I could be one of those people who go to the eye center nearly blind (and I am obscenely nearsighted) and come out able to exist without glasses or contacts.

But alas, I think lasik is not in my future. Just keep me away from the lasers and the ultra sonic kidney pounders and the drugs and the hormones and the knives and oh my gosh keep me away from the surgeries, and the hospitals and the doctors and all the invasive ways to "help" me.

Unless absolutely necessary, of course.

Doctors and Hospitals, US third leading cause of Death

The Journal of the American Medical Association reports recently that doctors and hospitals cause 250,000 deaths in the United States every year. This is about six times the number caused by auto accidents, and comes in behind heart disease and cancer, the number one and two causes of death.

Here are some additional numbers.

• 12,000 deaths from unnecessary surgery
• 7,000 deaths from medication errors
• 20,000 deaths from other hospital errors
• 80,000 from infections in hospitals
• 106,000 from non error, negative effects of drugs
• Total 250,000 deaths from a physician's activity, manner or therapy.

Gee, with numbers like this, who needs to call Kevorkian?

See more about this subject and the JAMA report from Dr. Joseph Mercola HERE.

Mother's Milk Saves Babies

The Mother's Milk Bank in Austin Texas says Tammy Duclow is their top donor. Over 6 years she donated 1562 gallons of breast milk to help save babies' lives.

Premature and sick babies are 6 to 10 times more likely to contract life-threatening intestinal infections when fed formula rather than human milk. Last year the Mother's Milk Bank had 280 donors and sent more than 57,400 bottles of milk to 30 hospitals.

Not only do breastfed babies derive greater health benefits throughout their lives, so do their mothers, who enjoy a reduced risk of breast and ovarian cancer.

August is National Breastfeeding Awareness Month.

"I will never be a brain doctor or save anyone that way," says Tammy. "But this was one time I could say, 'I'm helping save a life.'"

Good job Tammy, I bet you helped save a lot more lives than just one.