Today is National Nurses Day. In fact, the entire week, we honor the caregivers who follow the orders given by the doctors in our care, make sure that we follow those orders, and with all the care in their heart. In fact, for the last year, their career choice has exposed and challenged them to no levels ever expected when the first stepped foot inside of med school.
I often brag of the fact that in my fifty-five years of age, that I have had only three primary care doctors, my current one going on over thirty years. And any specialists I see, I am just as loyal to them. These doctors know me inside and out. I do not have to waste time, reciting my health history every time, because of a new doctor I have to see. The same can be said for the nurses that have cared for me.
I remember nearly every one of my nurses in my adulthood, and most of my childhood. My family doctor nurses, my oncology nurse (an irreplaceable team member for my cancer), and the multiple nurses that have taken care of me during each and every one of my health crisis and surgeries. I remember them all by name, and what they did for me.
Today, many of my friends in my circle are nurses.
The challenges that nurses face, I can only understate, because I truly have no idea what is a part of their average day, only what it took to care for me and my current issue. I know that in the hospital environment, they often worked at minimum, a twelve hour shift, multiple days in a row. I know that regardless if in a clinic or office setting, or in the hospitals, nurses suffer losses of those that they care for, and are needed to continue on with their care for others.
I know that many of these heroes are selfless caregivers, prioritizing their careers over their families. Most, would not do anything else with their lives.
My last interaction with nurses occurred earlier this year, and I had to deal with three of them. All of them were nurses less than three years, two of them, just over a year. Which means, in just their short career, they had to work through one of the worst crisis in over a hundred years. Welcome to nursing.
As I am prone to do, I love to talk to my nurses, because it gives me an opportunity to let them know, that I appreciate everything that they do for me (as a frequent patient especially). All three nurses were young, as I said, but they had no issue sharing their grief and sorrow at the things that they had seen over the last year, not only wishing that things had gone differently, but that others would have taken it more seriously. They did not complain about the exposure risks caring for those who denied the virus as serious. They did their job. But there is not doubt, the impact this crisis has already had on their short careers. They have already seen in one year, suffering and death that most nurses would likely experience in their entire career. And yet, these nurses have no intention of giving up. And that is what makes nurses so special. They have a gift, to care. And they do it well.
I will come across many more nurses in my lifetime of that I am sure. And it will not be just May 6th every year that I make sure that they know that I appreciate them, but every day of the year.
No, I am not cursing anyone out. I could. But I am not. Instead, I am frustrated by a health condition that I have had for many years, related to my treatments for Hodgkin’s Lymphoma decades ago, shortness of breath, or what we call in short “SOB.” When one of my fellow survivors mentions “SOB,” we often do a double take just to make sure what they are talking about.
To give you the sensation of what it is like to have SOB, imagine you went for a jog or run and completed it. Chances are likely that you are panting, trying to catch your breath. SOB, at least in my case, occurs within the most minimal activity: tying my shoes, a short walk up an incline, carrying groceries, even walking from the kitchen table to the refrigerator. Besides the actual exertion levels, the main difference between the two situations, you expect to have to catch your breath after an extreme physical act, not after something so minimal.
I have a couple of possible causes and conditions that do not make it any easier on me. Weather happens to play a role in that extreme temperatures such as high heat and humidity or cold and blustery can trigger one of my attacks.
Stress also has an impact on this condition, because if I am already stressed out, the effects are quadrupled and recovery is three times as long. So, in the heat and humid conditions, I need to get into air conditioning as soon as possible, and when it is cold, I need to get into temperatures in the seventies.
Physiologically, there are also reasons I have SOB. I have a reduced lung capacity from my radiation treatments doing long term damage over the decades, with the lower left left of my lung referred to as “dead.” The more prominent cause however, is likely my heart.
Back in 2008, when my cardiologist realized I had a fatal condition involving my heart, he was unaware of the cause and the cumulative and collateral damage, cancer treatment late effects. In fact, what was originally supposed to be an emergency triple bypass involving two of the three major arteries of the heart, the surgeon opted to let the other artery alone because it was not blocked enough, leaving me only to undergo a double bypass. The problem is, that unrepaired artery would continue to get worse, and need surgery in 2019, but that is another story.
The thing is, had my doctors been more aware of my treatment history, other studies would have been done as well, including giving more concern to the artery that they left alone. The actual heart had been impacted as well, but not until it was studied later, did doctors realize there were more problems. But now, because of the risks involved with Hodgkin’s survivors and second heart surgeries (major risks), any corrective action taken, is only done so when it has to be. Think of it as a ticking time bomb.
In other words, it has to be bad enough that the risk of the surgery is less than the risk of the condition.
Further heart studies soon after my heart surgery revealed that three of my heart valves have been impacted over time from my treatments, aortic, mitral, and tricuspid. They are actually listed in the order of the severity of damage. What I find odd, is they were all exposed to the same amounts of treatments, yet one is coming close to finally needing some sort of action, the others, are just continuing to gradually progress.
The valves are often described as “leaflets” on my reports. And after “leaflets”, comes the descriptions and conditions, calcified and stenosis. These can be seen on the studies. The fact is, it can also be heard. Evidently, I have a very strong heart murmur, which always draws a crowd when I am in a hospital, giving anyone nearby the opportunity to hear a well defined murmur. I should charge admission for this.
Anyway, this “calcification” is actually a stiffening of the leaf of the valve. This can allow the blood to leak back into the chamber of the heart it came from, instead of where it was meant to go. And because of that, that means your heart has to work harder, and your body is not getting the oxygenated blood that it needs. The result, a shortness of breath, called dyspnea.
It does not take much to trigger these episodes of SOB for me. And as I am aware of what does, I do my best to either avoid or mitigate them. And if by some chance, an attack does come on, my response must be quick to minimize the recovery time. Hot and cold conditions each take their own different times to recover, though the coldness does take longer to recover from.
I am encouraged to exercise, and I do try. But I have my limitations, not just physically, but thanks to Covid19, accessibility. I cannot get to a gym (indoors) to use a treadmill even for the lightest of exercise, walking. The hotter months are now coming, which means even morning or evening walks will not provide me any comfort.
It has been this way for years now. I know the time is coming. And I am hoping as it does, technology continues to advance, to make any surgery less risky, and less invasive. I am not sure when it will need to be done, it is not a question of if.
Frustrating to experience? Yes. But with so many long term survivors out there who have no idea what is happening to their bodies, because they have no follow up care, I am lucky if you want to call me that. At least I know my SOB is not in my head.
Do you remember, when as I child your parent would scold you, “did I say you could do that?”, and perhaps you might have responded with “you didn’t say that I couldn’t.” Semantics. We knew the right answer, and it was not our response.
The definition of semantics is a bit complex, because it all depends on what type of semantics that you are talking about. There are formal, lexical, and conceptual. Simply put, formal semantics is basically a reference or implication.
Two more definitions, “optional” and “recommended.” I am not going any more in depth than Google because we all know what these words mean. Optional, of course refers to being able to choose, or not. Recommended means advised or suggested. Now, you can have the “option” whether or not to follow a recommendation, but something being “optional” versus “recommended” are not the same at all, even though the “implication” is being pushed on a recipient.
What the Hell am I talking about? Well, obviously, with the mask on the cover of this post, we had something occur last week where I live. Our local representatives had chosen to let a “mask” mandate expire without renewal, a move cheered by many, still scoffed at as “never should have happened by others.” But to the rest of the public, this decision will have an impact.
We are all still in the middle of this pandemic. Yes, there are still plenty of naysayers out there still even claiming this is not real. And the truth is, our daily numbers are just as high as last year when the mandate was put in place. Of course, this opens a door for those against to masks to cry out, “see! The mask mandate did not help!” Wrong. With not enough people wearing the mask, it was not expected that 100% of the people would wear masks, but more needed to wear them, the concept was simple. It is as much the difference of trying to put out a brush fire with a garden hose versus an actual fire hose. There is no chance.
Yet, here we are. We are more than double the daily cases we had last year at this time, when the mask mandate was put in place. We are approaching a staggering 33 million cases in the US alone, and will easily break 600,000 dead fairly soon. Yet the one thing we can do, to at least help, is wear a mask.
Yes, I get it. It has been over a year we have been asked to sacrifice, and many have done that. But, over 587,000 have paid the ultimate sacrifice.
The only thing quicker than a trip to the bathroom after eating at Taco Bell, was the actions of our local community once the mask mandate expired. Social distancing stickers on the floor, gone. Signage reminding of mitigation efforts, gone. Masks, at least a 75% reduction in usage. Remember, we are double in cases where we were last year at this time, and we are just under where the numbers would be during the summer, before the huge spike kicked in. We are far from this being over, in spite of vaccines being administered. Vaccines are only part of the plan. There are still too many in denial, too many fighting common sense. And only time will tell. But if yesterday is any indication of how ignorant and selfish the population has become to Covid19, it is going to be bad.
I need to offer a couple of qualifications before anyone tries to argue with me. I get my information from the doctors that handle my care, not the media, not from friends. I do not live in fear, afraid to live my life. To the contrary, I have lived through so many virus outbreaks, and because we knew how to handle them, I was able to live “with” the conditions. And that has been the difference with Covid19. We had no idea what we were dealing with in the beginning. Now we do, to a degree. Mistakes may still happen as experts try to adjust from the constantly changing developments. But for the last eight months, I have made the adjustments to carry on in the most important areas of my life that matter most to me, including seeing my children. No, I am not living in fear. I am following guidelines that are recommended because they make sense, and they work.
So, as I mentioned, yesterday, I went into a restaurant to pick up some takeout as I had done previously, before the mandate had expired. Before last Tuesday, it was not uncommon, in spite of the local mandate, that there were some people who “opted” or chose not to wear a mask. Honestly, the mask was a toothless tiger, in that enforcing the requirement was pretty much non-existent with a major business flaunting his rebellion against the mandate, scoffing at any measure of safety against Covid19. For me, I know you will not get 100% of the people on the same page, but at least I felt comfortable enough, to support my local businesses either getting curbside pickup or take-out.
Then Tuesday hit. No more local mask mandate. I walked into one of my favorite places to pick up my dinner for the night. And as I often do, as I entered, I scan the room, so that I know where inside I need to try to avoid. It was not overly crowded inside. But I saw no one wearing a mask, not one person. Okay, understandable, they were all eating. Then I saw the staff. Not one staff member was wearing a mask either.
I was beginning to feel uncomfortable, that I actually thought about turning around and thinking of a plan B for dinner. But I had confidence knowing that I had eaten food from here before, and it was fine. But it was a reaction that I got, that I had not experienced in over thirty years. I was being glared at by a waiter because I was wearing a mask. “Oh, great, you are one of those,” I imagined the waiter thinking. Their eyebrows were dropped, so I definitely had a feeling from them of disgust.
This business had been one who had been honoring the mandate previously, and likely reluctantly. Now, throwing away any concern for clients, they saw the face mask as something that would have a negative impact on their business. They want clients who are ready to forget nearly six hundred thousand dead Americans. Covid19 never happened. Stop reminding them it did.
Having gotten food from the restaurant several times before, because I felt with my vulnerabilities, I could do so without the likelihood of contracting Covid19, that is no longer the case. While I am sure the manager would take exception to my claim, his employees are underneath him, and they are a reflection of the business.
As I have always stated, I am one of the vulnerable. I have also delayed getting the vaccine, because I believe in research, and more needs to be done before I get the vaccine. I now know of one other fellow survivor like myself, who got the vaccine, and a couple weeks later, tested positive for Covid19. The decision I make wearing a mask, or coming into a business imposes on no one. I still have my freedom, a frequent false war cry of anyone asked to help do the right thing, to care for others. And we have learned so much more from a year ago of how to deal with Covid19. There is clearly a lot more to learn. But as we advance, certain recommendations are being made, others are being relaxed. Clearly, had there been a plan last January or February, we would not be in this situation that we are today.
A headline reads today, President Biden to announce easing of outdoor mask wearing recommendations. You see? Mask recommendations were not a mistake, they were using recommendations to mitigate, and control the spread. Some of us helped, some of us hindered, and at times, quite rudely.
Just as I had to through SARS, bird flu, swine flu, and everything else, I learned to live with the risks, only after the recommendations were made. And that was my option, my choice. There is a difference. That is not living in fear. That is not a loss of freedom. That is concern for myself and those around me.
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