I need a beach

I grew up 25 minutes from the Pacific Ocean. Once I got out of college, I stopped going to the beach very often. Too sandy, too busy, too much traffic on the way.

I took it for granted.

Now I live smack-dab in the middle of the US where the nearest beach is a 3-hour plane ride away, and I feel desperate for it.

My friends have told me to go to a lake.

A lake.

Sigh.

Aisling and I in Carlsbad, 2004.

Worst semester ever is OVER

I have spent 11 years of my life in college. While doing my Masters', I worked full time, Liam was a toddler, and I was pregnant with Zing for part of it, too. I have faced school-related challenges and I have felt stressed out of my mind before.

But this semester. This semester was the worst of all these 11 years. Between getting sick over and over again, starting a new job halfway through the semester, and having classes I actually had to study for, I thought I was going to lose my mind. Then Aaron got laid off - all I wanted to was crawl in my bed and cry, but because I'd gotten so far behind, all I could do was cry in my car on the drive home when I couldn't do anything else anyway and then get right back to work.

Anyway, I got through it. I did end up with one B, which would normally mortify me, but at this point, I'm just glad I survived.

Now it's time for another nap.

Running lessons

I started running today. Lessons learned:

1. Running with chest congestion does not feel good.
2. 8 year olds run faster than me.

What I learned about electroconvulsive therapy

I got to observe electroconvulsive therapy yesterday. What I learned (not all of which is related to ECT itself)*:

1. It's not as "shocking" as you might expect. (Or, at least, it did not provide the drama I feared it might.)
2. The patients get lots of meds ahead of time, like about eight.
3. Some patients get IV caffeine because it makes the seizure stronger.
4. Just before the procedure, the patients get a sedative and a muscle relaxant.
5. The muscle relaxant ensures that the patient's seizure remains confined to their brain, so they don't flop all over the bed. The nurse anesthetist uses a muscle stimulator on the patient's arm; when the arm stops twitching in response to the stimulator, they know the muscle relaxant has kicked in.
6. The nurse anesthetist inserts a bite block after the patient's sedation has taken effect to protect their mouths.
7. The anesthesiologist manually ventilates the patient using a bag and mask attached to oxygen before, during, and after the procedure to "hyperoxygenate" them.
8. When the seizure starts, you see the patient's jaw suddenly clench. If the blood pressure cuff had inflated when the nurse anesthetist administered the muscle relaxant, you might see that hand twitch during the seizure because those muscles did not get the muscle relaxant.
9. They can place the electrodes in three configurations: both on the front of the forehead above each eye, one on each temple, or one on a temple and the other on top of the head.
10. When I asked how they knew where to place the electrodes, the technician answered, "Wherever the doctor orders."
11. When I asked how the doctor knows where to place them, I got silence, even from the doctor. [Hm.]
12. The anesthesiologist then jumped in and said, "They use whatever works." [This bit disturbed me a little. I know there exist many things in medicine that we don't understand - we simply know they work - but if I decided to allow someone to pour voltage through my head to make me have a seizure, I would want to know that they knew exactly where to put the damn electrodes. On the other hand, this therapy usually remains a last resort for patients; many of them have already demonstrated that they pose a danger to themselves or others.]
13. Manually ventilating a real person with a bag and mask takes a lot more work than ventilating a mannequin in CPR class. [Human heads are heavy!]
14. People "hiccup" when they start to come out of the sedation.
15. Some patients get wicked headaches after the treatment [go figure]. 
16. The FDA just recently approved IV acetaminophen. Countries in Europe have used it since 2002. 
17. Patients can have treatments as often as every other day. As they improve, they start spacing out the treatments. Some patients have had hundreds of individual treatments. [I didn't know a person could survive even ten, much less hundreds.]

Other notes, plus some commentary:

I mentioned in #12 that the patients getting ECT are at their last resort. Some of them have attempted suicide or have seriously thought about committing suicide. Others have seen their lives implode. They elect to get ECT after they have tried everything else, when medications, counseling, and other interventions have failed. They don't make this decision lightly.

Every ECT patient I saw looked absolutely normal. If we saw them walking down the street, we would never know they went in for regular ECT treatments. They looked like dads, grandmas, and college students.

If you don't know a lot about mental health issues, think of them this way: when someone has diabetes, their pancreas either does not produce any or enough insulin, or the body doesn't use insulin effectively. Mental illnesses work much the same, only the problem lies in the brain; the brain either does not produce enough of the hormones (for example, serotonin or dopamine) it needs to regulate moods, or the receptors for those hormones don't work right. Both diabetes and mental illness are physiological problems.

This reality highlights how very important it is to avoid assuming that someone is "normal" just because they look it. We never know the feelings or thoughts another person has unless they tell us. I've seen patients with depression who appeared outwardly gregarious and engaging; we wouldn't know that on the inside, they felt utterly hopeless - unless they told us. 

* Everything I've written here comes from what I observed or what I was told during the procedures. For more information, try these sites:

The Mayo Clinic

Mental Health America

Words with Mother Nature

Earlier today, as I cupped my hands around a mug of stevia-sweetened hot green tea, I gazed out the window at the falling snow and marveled at how wondrous the world  can be.

I opened the front door to better see the majesty of the blowing snow and found this mound of snow standing against the door in neat little layers.

I called the kids to come see our front porch. The stairs had seemingly disappeared.

See? We really do have stairs.

Then.

I shoveled.

The driveway.

That high point you see there is taller than Aisling.
Approximately 4.5 feet.

I had serious words with Mother Nature as I did so, admittedly with many cuss words thrown in. It's really quite interesting how much better a good four-letter word can make you feel.

Mother Nature responded by blowing my entire shovel-full of snow right back into my face.

It didn't feel good.

When I finished (here's another pic),

What you cannot tell from this picture is that the snow at the end of
the driveway is about 12 inches high.

I came inside, declared that I was not making dinner that night, and got straight into a hot bubble bath. Ahhh.

And then, pondering the depth of the snow, I realized that it was taller than Flea, our shih tzu, who would most certainly need to pee at some point. The thought of having one's nether parts encased in snow while attempting to relieve oneself made me get out of the bath (although not immediately, I admit) to go shovel a path for him in the backyard.

Then I went to admire my wonderful shoveling job, and this is what I saw:

It's only been about an hour, and it's already covered again.

Sigh.

Rainforest Adventures

I got my wish! Feeling much better now. However, I was in so much pain that (1) I researched GI pain to verify that, yes, plain ol' gas and diarrhea can make you feel like you are going to die, and (2) I wondered what I was going to do if I needed to go to the hospital in the middle of the night when (a) I did not know where the hospital was, and (b) I did not know who to call to find out. Yep. Pain was that bad.

I did learn in all my researching that acetaminophen is the painkiller of choice for GI pain. However, the symptoms of acetaminophen toxicity are, beautifully, the same symptoms you would take it for. You can, though, take all the acetaminophen-combination drugs, too, like hydrocodone. Unfortunately, I (1) did not have any, and (2) was not going to put anything into my system unless I was guaranteed relief. I mean, what if it made it worse??

Anyway, I was well enough to go on our rainforest tour. We went to the Manuel Antonio National Park. It was, of course, beautiful, and our guide knew just where to look to show us the animals. He had a telescope, too, so we could see them "up close." The sloth was my favorite. Very cute.

The capuchins were cute until one of them snatched Olivine's carrots. Kat was sitting with her back to one of the monkeys, trying to shield them from seeing her open the packet of carrots. I turned to her just in time to see one of the monkeys dart forward, leap into Kat's lap, snatch the packet of carrots, and run back to his perch. Took maybe 2 seconds tops, certainly not enough time for me to get out a warning shout. Kat was a tad surprised and from then on, the capuchins were my enemies. No one takes carrots from Olivine! The damn monkeys didn't even like the carrots, either. They each tried one and then threw them on the ground. Stupid monkeys. The raccoons were aggressive about stealing bags, too, but they were easier to scare away. And really, raccoons?! I don't need raccoons in my rainforest. Got those at home. :-)

But the best news of all -- I got to go ziplining today!! It was awesome. I almost threw up after the first line simply because of all the adrenaline, but, as you know if you've read my previous post, I don't remember how to throw up, so I didn't. We took 12 ziplines total to get down the mountain, and it felt fantastic. So fantastic, in fact, that I thought I'd have a lot to write about it, but I am finding I do not. It was fantastic. Just ... fantastic. Liam liked it so much he told me he's going to move to Costa Rica after he graduates and work at the zipline place.

A couple of our guides had some fun with us. One of them hollered, "Hold on!" and then twisted the platform. The platforms are hung from the trees by thick cables; they're not nailed down. So when he grabbed the cable and pushed with his feet, the whole platform twisted -  not a lot, but certainly enough to surprise us. The same guide gave me a friendly tap on the shoulder as I took off on the last line - just enough to set me spinning slowly around all the way down the line.

Tomorrow: a yacht out to Tortuga Island.

The Amazing Zipline Excursion - Not

*** Warning: Contains references to vomit and diarrhea. Read at your own risk. *** 

I was planning to write today about our amazing zipline adventure through the canopy. Ziplining through the rain forest is something I have wanted to do for about 10 years, ever since my friends Karla and Paul told me about their trip to Costa Rica. The trip was planned for today.

Sam, the smallish, but not smallest, iguana

And I had to stay at the Compound enduring burning stomach pain while almost everyone else went. I lay awake most of the night trying to convince myself that throwing up would really make me feel so much better. However, I have not vomited in 24 years, and I am apparently (and quite happily) out of practice. I failed in the convincing, so I tried to make it go through the other way. I have never wished for diarrhea like I did last night. Please, please, please . . .

Unfortunately, it appears that my GI system had turned off. Nothing was going anywhere. I endured the racing heartbeat followed by the super-slow, irregular, pounding heartbeat, the sweating, the chills, the nausea, hoping, hoping, hoping that I would feel better by morning.

I didn't, and while I'm starting to feel better, I'm still not back to normal. However, I am going to hike through the rain forest tomorrow no matter what. I may need to rest every 2 minutes, but I am not letting another day go by with me just sitting. Granted, I am sitting among beauty and watching iguanas, which is pretty damn cool, even with an upset stomach.

It looks like I will get to zipline on Thursday or Friday. Cross your fingers for me!