Sunday, February 11, 2007

Body Fluids or So THIS is Why I Left Kauai

A friend has talked about bloggers block. It is real. This is how I combat it...I appologize wholeheartedly.
Why the hell have I been getting sick so often? I asked the question again all night last night as I kept myself up coughing and sputtering. Then it all started to piece together...like an infected puzzle; the lack of vigorous physical exercise, the stress of crowded cities, crowded trains, and crowded planes and basically just crowds. But the biggest piece of the puzzle was the hacking woman, coughing moistly and incessantly, on the Petri Express to Hanoi, Viet Nam. She kept coughing without covering her mouth but since it was on my sister I felt pretty OK about it all. Instant Karma I guess as Samantha is healthy and back in the US and I am stuck here coughing up pieces of lung tissue.
Viet Nam has had several outbreaks of bird flu this year and as much as I think the whole bird flu pandemonium (not pandemic) is a media driven non-event {be afraid and support pfeizer and the economy with a trip to the doctor to get an immunization} the fear of it entered my mind as pieces of crap keep getting hacked up from deep inside my body. As an aside...I know!...there are countries in SE Asia that now have millions of outdating immunizations and they are trying to decide wheather to spend millions of very limited health dollars on a "maybe" when there are so many critical issues facing them that are NOT maybe. Remember Y2K!! Anyway, the crap that is coming out of me is a lot like...crap...thick green bird crap. I think I've got a case of bird crap flu...the first case noted anywhere! Call the CDC and have them analyze my phlegm (by the way, I used to live in a house with a guy who did that for a living...analyze peoples' phlegm...he hated his job) and it can be confirmed. I swear, if I hacked up one and spit it onto your windshield you'd think a bird had just flown by...with diarrhea.
Phlegm. The laymans term for what respiratory therapists and medical professionals call sputum. It has always been my least favorite bodily fluid. It is referred to us (read ER or ICU nurses) who use the term "professional" a little more irreverently, as lung butter. In many, many ways it's not the worst of the effluents that spill from our bodies...certainly not the smelliest. That prize would have to go either melena ( a very nasty runny, black stool of digested blood) or emesis (plain old barf). A little tangent here to meditate on the word stool. It has always been a mystery to me how two nouns could have the same name and be so different. For one is something you step on and the other is the last thing you'd ever want to step on! But where was I...oh, vomit. The word can be a noun or a verb but either way it is a powerful thing. I mean, when you smell someone elses poop, do you suddenly have to poop too? Everytime I clean up a trauma patients' barf encrusted hair (and sure I generalize here but trauma=alcohol ingestion and alcohol ingestion=a recent pizza meal...trust me I'm a nurse), I start to wretch. I've never actually vomited on the job but I've wretched a lot...with some serious close calls! And even hearing someone throwing up (having an emesis lacks punch don't you think? I mean, it sounds like they could be ordering something from a cocktail menu...OK not really) kind of makes you curl your toes right? You set your jaw hoping you won't be next. That's why I hate it when a poor sick patient gets those watery, bugged out eyes and desperately says, "Oh God, I think I'm going to throw up!" I fear the ER chain reaction as I reach for the amplifier that is their barf bucket. It's like a megaphone for the gastro-intestinally challenged to broadcast their condition. I've never measured how far the sound actually carries but half a football field down a narrow hospital hallway would not be exagerating. The heart monitors of those unlucky patients closest, speed up...it's like an epicenter of nausea spreading outwardly and dissipating as it gets quieter. It is an odd thing really as we don't react that way when we hear a burp...or a fart. So yes, vomit is way up on my list of least favorite bodily fluids.
Melena is just as bad. When one digests their own blood and then passes it, (and why God, does it almost always have to be incontinent?) there is an odor that is indescribably foul. It is a good thing that a patient in this condition is so desparately ill and needing emergent care. Otherwise the instinct {called self-preservation} of every nurse, to barely slide the door open, slip in a bucket of soapy water and a can of glade(with the instructions to hit the call light when finished) would take over. Even in the most caring RN. So yes, again, Melana is not a favorite.
Sputum, however is the worst. This is a personal ranking of course as we nurses in the ER have this discussion not infrequently. For me the greyish creamy color, and most of all the tenacious consistancy of sputum, gets me gagging all the time. A slimy and thick gob of lung butter can alternatively slide down a napkin onto your unsuspecting arm. Yet once there it will fight all the water pressure in the hospital to hang on to it. Yeah, it's like that.
Oh I could go on reminiscing...but since no one is left reading this thing (I hope), why should I bother. And even if it isn't what I wanted to blog about, at all, it has helped me to remember one of the reasons (OK 3) for leaving nursing for hopefully cleaner pastures. It also, unfortunately for you, has helped to break up the bloggers block like a good old enema...but I'll save that story for later.

8 comments:

Anonymous said...

Oh,James! Shades of gabbing with my Dad- a helluva good doctor and story-teller! He had the BEST (ok- worst!) stories ever! Spitum, poop, upchuck...you name it, he
-um- 'worked' with it on a daily basis...and embellished his accounts with descriptions revolting enough to cause loud "EEEEEEOOOOOOWWS" and wretching from all us kids...oh, how we loved it! So, THANKS, James, for a wee reminder of the Old Man......and I hope you're feeling better!

Anonymous said...

Yep, I knew it was that coughing woman on the train. I have had the thought of bird flu myself, so I think you may want to get checked for that.
I sat here grimacing and making faces as I read your blog today and I bet dad stops reading it before he gets to the bottom.
I am glad the blockage has gone and you are back at it. We miss you and want to know your plans. I'll send a personal email later.

Don't forget to get the Thai flag for us if you can before you leave the country.

Love ya,

Anonymous said...

Just truying to share some misery with us? Go ahead spit it out you'll feel better I'm sure.
I remember on the playground as a kid, one kid got sick on the merry go round and started a chain reaction of five others. Myself almost included. The sound of chunck splattering in thick liquid with sounds of uncontrolable cramping does it every time. It is kind of strange why it does that? Maybe because you know exactly what it is and how it feels. Other sounds are more difficult to pin on one particular feeling.

Anonymous said...

James,

Well, your sister doesn't know me very well. I did finish the whole thing and never thought of stopping, even though it was painful. I have a very fertile and strong imagination. I also have strong empathy for the physical and emotional experiences of others. I find my emotions stronger and much more active these days. I have talked with others near my age, and they all say the same thing. The emotions have grown and are much nearer the surface than when younger.

Thanks for a little insight into what that part of nursing is like. I hadn't thought of much of what you wrote. I admired you for being a caring person, and giving aid and comfort to others, but I hadn't thought much about the cost to you.

Please take care of whatever illness is bothering you.

A concerned loving parent,

Dad

Anonymous said...

The barf reflex is even stronger than you described. Heck I damn near lost my breakfast just reading about it. My in-depth description of the various types of boogers pales incomparison to this latest entry. Good job. Now if you'll excuse me... I have to... EEEEEEEAAAAAAOOOOWWW!

Anonymous said...

ok, I guess I am of the weak. That is your 1st entry that I couldn't really read more that once. Honestly, I didn't even read the whole thing! Just kinda skimmed over it! To repeat the other comments, EEEEOOOOOWWWW
anyways, hope you feel better soon!!!

Anonymous said...

Oh James you had me on the edge of my seat..... wanting not to head for the head but quivering with anticipation of the reflex. I just finished dinner and you almost finished me off. Ack ack ack!!!!!!!!!!!!!!!!!!

claudia b said...

Cousin James:

You are cracking me up. I love the way you write..your images are so vivid (ranging from the scenery, the strains and stresses of your biking, but now sort of trumped by your descriptions of your, how shall we say, gastrointestinal observations of late.) good gosh. The other nit I'll pick is (and I guess I have to say this, since I work at the CDC these days)....about that bird flu mythology. Well, that can be another conversation for another day...Go climb a mountain and gaze down in a quiet valley. And take very good care of you! And hey I finally got to visit Kauai for 8 days, with your mom and sister Martha and niece Jules. Just got back last week. An amazing place. But I am so intrigued by your journey~~keep up the good work. More soon, Cousin Claudia