Living with Sleep Apnea

San Jose, Costa Rica, November, 2006

“My soul, wait thou only upon God; for my expectation is from Him.” Psalm 62:5

It’s hard to believe that I’m finally in Costa Rica after wanting to visit this country for the past ten years, ever since I worked with Dr. K. who mentored me when I was in graduate school. He grew up in Costa Rica and moved to the USA when he was 16 years old. I signed up to go on a tour last April but had to cancel it when I had complications after cataract surgery. The Lord sold my condo after ten months on the market and I was able to buy another house. They are fixing my new house over the next few weeks while I tour Costa Rica for 10 days and then stay with a friend from church for a couple weeks. It is so kind of the Lord to give me this break between moves.

My flight last night was smooth and on time. I sat next to a Costa Rican grandma and her teenage grandson. She only spoke Spanish, but he spoke excellent English. She asked me what time it was and I told her in Spanish! I’m glad I finished my 16 Spanish lessons on CD. How I wish I would have learned Spanish as a child. It’s kind of tough to learn at my age.

I fell into bed last night at midnight at this beautiful hotel in downtown San Jose. It took about an hour to go through customs followed by a 30 minute taxi ride. The only electrical outlet in the room is about 7 feet from the foot of the bed. So I  blew up my air mattress and switched all the sheets and pillow around so my head was at the foot of the bed. I put my CPAP (Continuous Positive Air Pressure) machine on a chair and stretched the cord to the outlet as far as it would go. I should have brought an extension cord. It worked well and I slept soundly which was a blessing. I remembered to get out of bed on the opposite side so I wouldn’t trip over the taught cord. I was cold and there is no heat in the room so I slept in my heavy sweatshirt. San Jose is the city of “eternal spring” with average temperature of 70 degrees since they are at 3800 feet elevation.

I enjoyed seeing beautiful Lake Arenal in Costa Rica.

Reflection

At the age of 40, I told my doctor I couldn’t stay awake during the day and often woke up tired with headaches or choking. He ordered an all night sleep study at a sleep center. They glued electrodes all over my head, put a belt around my chest, and then told me to sleep as they recorded me all night on video and by electroencephalogram (EEG). They concluded that I stopped breathing many times during the night, my oxygen level dropped, and I had no deep stage sleep. The doctor prescribed a CPAP machine which blows humidified air into my lungs all night to keep my airway open. He said I was born with a small airway which collapses as I’ve aged. It took me several months and several different masks before I was able to sleep all night. I always encourage newly diagnosed patients to keep trying to sleep with CPAP for several months and not to give up. Many people say the mask makes them feel claustrophobic.

If a person does not treat his sleep apnea, he has a much higher incidence of heart attack, stroke, depression, and death. They now can diagnose it with a simple sleep test that can be done at home with a pulse oximeter attached to your finger. It is much easier to sleep in your own bed at home rather than go to a sleep center.

I discovered very comfortable nasal pillows (Swift Fx) rather than a mask. The mask actually made a permanent bump on my nose that had to be removed by a plastic surgeon. Occasionally, I still have trouble going to sleep some nights so my pulmonologist prescribed Lunesta that does not affect my apnea. I never take it two nights in a row since it can be addicting. It also helps me adjust to a new time zone when I fly east or west and have jet lag.

Transcend travel CPAP with 3 night battery and Swift nasal pillows.

I’ve learned how to travel internationally with my CPAP machine. The airlines allow you to carry your machine on board in a separate bag since it is medical equipment. I never put it in my checked bag because it is a fragile machine and could break as they toss your bag around, or your luggage could be lost. In the USA, most insurance companies will only pay for a new machine every five years. They cost $400-$700.

Four years ago before I went to Ecuador, I invested in a small travel CPAP (Transcend) and a three night rechargeable battery since they have frequent power failures there. Insurance does not cover the cost, but I like to do international travel so the small size and rechargeable battery was worth it to me. It includes converters for different electrical outlets around the world. I wish I would have had the battery when we lost power for six nights during a blizzard six years ago. That was tough to go to work every day without any sleep.

This is a humidifier that attaches to the hose, but it only lasts for a week and doesn’t humidify the air very well for me.

 

The water chamber humidifier for the travel CPAP is quite large unfortunately and requires a separate electrical cord. It does not run off the battery.

I also used it for ten weeks in Costa Rica last year and it worked well. The battery solves the problem of outlets far from my bed. I just recharge it the next day. I forgot to bring extra filters for my machine. The active volcano ash in the air clogged the filter so I washed it daily until it fell apart. It’s almost impossible to get medical equipment through customs, so I placed a paper tissue over the air intake port to try and filter the air as much as possible.

I also forgot to bring normal saline nasal spray with me for my dry nose. I couldn’t find it in the pharmacy or make the pharmacist understand what I needed. I finally went to the school doctor and paid him $40 for an office visit. He told me to ask for “Steri Mar” (sterile sea water). I did and finally purchased it for $30. So for $70 I had sterile saline nose spray which I normally buy for $3 at Walmart.

My $70 sterile saline for my dry nose. It’s called Sterimar in Spanish.

I hope these hints I have learned the hard way over the years can help you instruct your patients. If anyone has symptoms of sleep apnea, encourage them to tell their health care provider and have a sleep test. Our bodies heal during deep stage sleep and are refreshed. If you would like more information about sleep disorders, go to http://www.mayoclinic.org

Sleep is such a gift from the Lord. I thank Him that these devices are available for us in this day and age.

“I will both lie down in peace, and sleep; for You alone, O Lord, make me dwell in safety.” Psalm 4:8

Advertisements

A Chinese Atheist Receives Christ

Midwest, USA – 1989

About two years ago, my friend and I were going door to door calling to share the gospel with my neighbors. One lady from China named Nina (pseudonym) invited us to come in. She was formerly a radiologist in China, but had moved to the Midwest recently with her husband for his new job in research. She said she was very lonely and was so happy to have some friendly visitors. We spoke slowly so she could understand our English better, and I told her how much I had enjoyed visiting China three years ago. We also shared the good news about Jesus Christ; how He died for our sins on the cross, was buried, rose again, and lives today. We shared how He wanted her to receive Him as her Savior. We asked if she had ever heard this before? She said that she had as a girl when she attended a school run by missionaries. After the communist takeover, the school was closed and the missionaries were forced to leave. We invited her to Bible class and she eagerly began to attend.

After about 6 months of faithfully hearing the Bible taught, Nina received Christ as her Savior. She was so happy and really began to grow in grace. We all were praying that her husband, Daryl, would also receive Christ as Savior. One Saturday evening, I invited them to my home to dinner to get to know them better along with a couple other people from church. We had a pleasant time together and the others left first. As Nina and Daryl were getting ready to leave, I mentioned something about how thankful I was that God loved us so much. Daryl said angrily, “How can God love us? I saw hundreds of people starve to death in China during the famines!” I softly replied that the important thing was that he had the opportunity to receive Christ now and that God wanted all men to be saved, but He wouldn’t force Himself on anyone. Nina stood there silently with a pained expression on her face. I bid them both good night. All I could sadly think about was Psalm 14:1:

The fool has said in his heart, There is no God.

About a year later, Daryl burned his legs during an accidental fire at work, and his legs became badly infected. They did not have a primary care doctor, so he continued to return to the emergency room for treatment. Nancy called me and asked if I had any suggestions? I called Dr Pete, my friend who was a Christian surgeon, and he asked Daryl to meet him at the ER where he was on staff. After examining Daryl, Dr Pete admitted him so he could receive intravenous antibiotics.  While Daryl was an inpatient, one of the elders from church visited him daily and read scripture to him and prayed with him. Nina shared that Daryl was deeply touched by the kindnesses of Dr Pete and the elder, even though he was a total stranger to them and an atheist.

In January, Nina told me that Daryl was being transferred by his employer to Miami, Florida. I was heartbroken as she seemed to be growing so much in her faith and he seemed so much more open to the gospel. But we prayed for them to be guided to a good church.

In March, Nina called me and said how much they enjoyed attending the Chinese Baptist Church! She said Daryl had something to tell me and she handed him the phone. “Miss Pam, I heard the gospel in Chinese at the church from the Chinese pastor. Now I understand what you were trying to tell me. I received Jesus Christ as my Savior! I am so thankful that my sins are forgiven and that I have a home in heaven and that I will be with Jesus forever! I am so sorry I yelled at you when you tried to tell me about God.”

I replied through my tears, “Daryl, I am so thrilled that you are now a Christian and my brother in Christ. Let’s pray together right now and thank God.” We had such a precious time in prayer together on the phone, thanking God for His wonderful grace and mercy to us.

March, 1990 – Miami, Florida

The Lord opened the door for me to visit my parents, who now live in Florida, as well as Nina and Daryl and attend church with them at the Chinese Baptist Church. For my sake, they took me to the English service rather than the Mandarin one so I could understand the service. We entered the large bright sanctuary and were greeted by friendly Chinese believers. The service began and after the opening hymn, the pastor asked for visitors to be introduced. Daryl motioned for me to stand up among the hundreds of Chinese brethren. He began, “This is Miss Pam who first gave me the gospel of Jesus Christ when I was an atheist. I hated the gospel back then and yelled at her. But she did not give up on me and now she is my sister in Christ.” My tears rolled down my cheeks as I marveled at the wonderful work of grace God had done in Daryl’s heart as well as my own!

But God commends His love toward us in that, while we were yet sinners, Christ died for us. Much more then, being now justified by His blood, we shall be saved from wrath through Him. Romans 5:8-9

Reflection

Nina and Daryl returned to China

Nina and Daryl returned to China

After about a year, Daryl and Nina moved back to China. For a number of years I received a card from them every Christmas. One year, Daryl shared with me how his elderly mother also received Christ. I don’t know exactly when Daryl and Nina went to be with the Lord, but it will be wonderful to be reunited with them in heaven above some day and worship the Lord together!

Face to face with Christ my Savior, Face to face –what will it be? When with rapture I behold Him, Jesus Christ who died for me. Face to face I shall behold Him Far beyond the starry sky; Face to face in all His glory, I shall see Him by and by! –by Carrie Breck

 

The Atheist Physics Professor

Diabetes Nurse Educator – Midwest, USA -1980

I exited the elevator on the cardiology unit and asked the head nurse if they had any patients with diabetes they would like me to see? She said Richard was admitted with congestive heart failure (CHF), but also was newly diagnosed with diabetes. I knocked on his door and entered his room.

He was a stout 70 year old white haired man sitting up in bed who appeared weak and weary. I sat down in the chair next to him and began to teach him about his diabetes and how he could control it with diet, exercise, and an oral medication which his doctor had prescribed for him. He paid good attention and asked some very specific scientific questions.

I asked, “Richard, what kind of work did you do before you retired?” He replied, “I was a physics professor at the University for 35 years.” I replied, “That was my Alma mater where I graduated from the School of Nursing! I never took any physics classes since I was so busy with my nursing courses. I really loved attending the Bible class on campus and meeting students from all over the world.” We continued our conversation which I concluded a few minutes later.

As I was leaving, I asked Richard if I could give him something to read with some Bible verses that told how he could have a personal relationship with Jesus Christ? He answered, “Well, Pam, I have to tell you that I’m an atheist. I don’t believe God even exists. But I will take it and read it.” He put the gospel tract on his bedside table.

As I left the room, I silently prayed, Dear Lord, You know all about the poor condition of Richard’s physical heart. I pray He would read those verses and receive You as his personal Savior so He can have a new spiritual heart.” I wondered if he would throw the tract in the trash can as soon as I left. I also thought about Psalm 14:3:

The fool has said in his heart, “There is no God.”

Richard was discharged home the next morning, so I didn’t have an opportunity to visit him again.

A few months later, I was sitting in my office in the diabetes classroom when my phone rang. The man introduced himself and said, “Pam, do you remember me? I’m Richard, the retired physics professor who told you that I’m an atheist.” “Oh, yes! I remember you Richard. How are you doing with your diabetes?”

“Pam, about a month after I came home, I was readmitted to the hospital because my heart failure flared up again. But while I was going for a heart test, I had a heart attack and my heart totally stopped. They did CPR (cardiopulmonary resuscitation) and brought me back from the dead! I was so terrified to die again. I couldn’t wait to get home and read that little paper you gave me with the Bible verses. As soon as I read it, I knew I was a sinner, and I prayed and received Christ as my Savior. I am so happy now and full of peace and joy! I know the next time I die, I will go straight to heaven to be with Him! I just wanted to thank you for giving me that paper.”

I listened in dumbfounded silence, hardly able to believe my ears. Then I told Richard how thrilled I was that he now knew Jesus Christ as his own Savior. I asked him a few more questions, and it appeared that he truly understood the gospel and had done business with God. He certainly sounded like a totally different man. I asked him if I could visit him at home to meet his wife and study the Bible further with him? He said he would absolutely love for me to visit him.

The next evening I entered his spacious lovely home and met his wife. We all sat down at the kitchen table and began to read Bible verses together. It was such a delightful time of fellowship as Richard asked me many questions as a newborn babe in Christ. I asked if one of the elders from church could come and teach him the Bible? He said that would be marvelous!

Richard grew rapidly in the Lord in his spiritual walk, but his physical heart continued to decline. About a year later, his wife called me and told me through thankful tears that Richard had passed on and was now home with the Savior in heaven above. We rejoiced together that he was no longer suffering physically. She sent me a beautiful note which said, “I feel good I know he has gone to join the Savior above and is at rest.”

I wrote in my journal that night “Richard is the first person I know of that is in heaven as a result of my testimony. What a privilege to be used of the Lord. May I labor in love more zealously and sacrificially.”

“Salvation is of the Lord.” Jonah 2:9

Reflection

It still amazes me how God allows us sinners who are saved by His grace to share the good news with others. Like Paul said:

“I have planted, Apollos watered, but God gave the increase. So, then, neither is he that planteth anything, neither he that watereth, but God that giveth the increase.” I Corinthians 3:6-7

Some of my favorite gospel tracts to give to people.

Some of my favorite gospel tracts to give to people.

I always carry gospel tracts in my purse so I’m ready to hand them out at restaurants, the airport, to store clerks, etc. The following are some good websites where you can obtain gospel tracts.

Moments with the Book: http://www.mwtb.org

Print My Tract: http://www.printmytract.com

Good News Publishers: http://www.crossway.org

Gospels of John in several languages can be found at the Pocket Testament League at http://www.ptl.org

I would love to hear of your opportunities God has given you to share the gospel with your patients. Please email me at pamela.aprn@gmail.com

Amputations – “Thy will be done!”

Midwest, USA – 1978

The phone rang and I answered. My dear friend Enid was calling who lived an hour away. “Pam, One of my former coworkers is a patient at  your hospital and I was wondering if you would visit him and share the gospel with  him? For many years he was the chauffeur for one of the wealthiest men in the city and is now retired. He seldom has any visitors.” “Sure! I would love to visit him!” I replied.

The next day after I finished work, I knocked on Yock’s hospital room door and entered. He was a thin elderly man who stared at me with his big sad brown eyes. I introduced myself  and sat in the chair beside his bed. I told him a little about myself, and then he told me more of his story. He had smoked all of his adult life and now had decreased circulation in both his legs which caused him severe pain. He had been in and out of the hospital several times the past year as they did surgery to implant artificial arteries to bypass the clogged ones to try to get more blood to his feet. Sadly, they weren’t working very well and he was still having a significant amount of pain from the lack of blood and oxygen to his legs.

I shared with Yock how much God loved him that He had died on the cross for his sins, rose again, and lived today. Jesus Christ wanted Yock to receive Him as his personal Savior. I asked Yock if I could read some Bible verses to him, and he asked me to please do so. I then read the following verses,

“For all have sinned and come short of the glory of God.” Romans 3:23

For God so loved the world, that He gave His only begotten Son, That whosoever believeth in Him, should not perish, but have everlasting life.” John 3:16

“For by grace are ye saved through faith; and that not of yourselves, it is the gift of God– not of works, lest any man should boast.”  Ephesians 2:8-9

I then prayed for Yock. As I said goodbye, he gripped my hand and asked me to please visit him again because he wanted to hear more from the Bible.

I continued to visit Yock after work every day and often after he went home. One afternoon, after we finished studying the Bible at his kitchen table, I asked him if he would like to receive Jesus Christ as his personal Savior? He said he would and he was ready. He bowed his head and prayed out loud, “Dear Lord, I come to you now as a sinner. Thank You for dying on the cross for me to pay the price for my sins. Thank You that You are the Son of God. I now receive You as my very own Savior! Amen.” He looked up and was smiling widely. His big brown eyes were no longer sad, but beaming with joy!

Jack was so happy after he received Christ as his Savior!

Yock was so happy after he received Christ as his Savior!

The road ahead of Yock was not an easy one as he went through numerous surgeries over the next months and much pain. The grafts were not successful and they had to amputate his left leg below the knee. His right leg continued to be very painful and his doctor told him that he needed to also have it amputated. The day before his second amputation, we were reading the Bible together and he said to me. “Pam, I read this morning how Jesus Christ said to the Father before He went to the cross, “O my Father, if it be possible, let this cup pass from me; nevertheless, not as I will, but as thou wilt.” Matthew 26:39. That is what I told God today also. “Thy will be done!” he said with steely determination and tears in his eyes. His growth in the Lord was a great blessing to me to behold!

Several months after Yock’s second leg amputation healed, he received two new prostheses (artificial legs). I visited him in his apartment a few days before Christmas, and he said, “I have a surprise for you!” He wheeled himself into his bedroom. After about 15 minutes he WALKED out of his bedroom on his two new legs while leaning on his walker. He was grinning from ear to ear as my tears of joy flowed.

Reflection

The Lord took Yock home to heaven several years later. It was truly wonderful to watch how the Lord transformed him from an angry bitter man into one full of joy and peace as he grew in God’s grace. The memory of his sweet testimony of submitting his life to God while going through very difficult trials with his health continues to bless me today.

Since then, I have worked with quite a few patients who have amputations. Those who have done the best in handling the trauma are those who trust in the Lord for the grace and strength to adjust to this major change in their life. Others who do not trust in the Lord usually become very bitter and say, “Why me?” Only Christ can transform us when we receive Him as personal Savior!

Therefore, if any man be in Christ, he is a new creation; old things are passed away; behold, all things are become new.

II Corinthians 5:17

Blizzard of 1978

January 26, 1978 – 10 a.m.

I turned on the TV and watched the weather prediction. They told us to brace ourselves for a terrible storm that was coming with high winds. We usually only get 10-15 inches of snow all winter, so this was very unusual. I have never seen a blizzard. It’s about 50 degrees Fahrenheit right now. The wind began to pick up, the snow began to fall, and the temperature plunged.

The phone rang and I answered it. My nursing supervisor, Marie said, “Pam, pack a bag to prepare to stay overnight at the hospital. The National Guard will be at your house in 30 minutes to bring you in for the evening shift tonight.” I quickly packed a couple extra uniforms, toiletries, and my Bible, and watched out my front window. When I saw a 4 wheel drive Jeep pull up, I put on my warmest hooded coat and ventured out. I had to lean into the wind,because it was so difficult to walk. I climbed in the back seat and said hello to the driver and three other nurses he had already picked up.

We drove slowly through the deepening snow on the deserted streets and arrived safely at the hospital five miles away. I took report from day shift and began my evening rounds. My head nurse, Mrs. H. and I were the only staff that made it in for evening shift. Thankfully, they had cancelled all routine surgeries, but all our 30 beds were occupied. There was a friendly air of comradery with all the patients that night. Those who were there for their week of diabetes classes helped us pass dinner trays to the patients who were bedbound.

I went down to the cafeteria for dinner, and was amazed to have the hospital administrator serve us our food on the tray line. He smiled and thanked me for working through the blizzard. No charge for dinner tonight!

The Guard brought in the night shift nurse and aide, so I was thankful to sign off at 11:30. Marie told us there were some empty patient rooms on the 9th floor, and to pick whichever one I wanted. I grabbed my bag, found an empty room, and closed the door. I turned on the TV and watched the blizzard. I watched the unbelievable pictures of 15 foot snowdrifts from the high winds of 69 miles per hour. The roads were nearly impassable and the temperature had dropped to -30 degrees Fahrenheit. I could hear the howling wind as I looked through the window and watched the snow blow sideways in the dim street light. It was nearly a whiteout!

I put on my pajamas and climbed into bed. I had never been a patient in a hospital, so this was a very strange experience. I was too wound up to sleep. Then I heard a patient in the next room start to scream. I lay awake and prayed.

The alarm went off at 6 a.m. I guess I dozed off at some point. I got dressed, read my Bible, and committed the day to the Lord. I went out to the nurses’ station and asked my nurse friends about the patient next to me. They said he was an alcoholic going through withdrawal. They had to put his arms and legs in leather restraints, but he broke out of the restraints and nearly destroyed the room. Finally the medications took effect and he slept.

I went down to the cafeteria and ate my free breakfast and then went back to the fifth floor. I was totally exhausted from little sleep and asked the Lord to give me strength for the day and to bring in the evening shift. Mrs. H and I were the only staff again so we split the floor in half. After we passed the medications and trays, we began the bed baths. We were running out of linens so we only changed the patient’s gown and sheets if they looked soiled. I was so happy when the evening shift arrived courtesy of the National Guard! I gave report, and then found a coworker who lived near me and volunteered to give me a ride home.

I could barely get in my front door from the drifts. My roommate, Jane, had shoveled out as much as she could. We looked at our cars that were buried in the parking lot and decided to wait until the next day to shovel them out since we were both off of work.

My car was buried after the Blizzard of 1978!

My car was buried after the Blizzard of 1978!

I fell into bed after a quick supper, thanked the Lord for carrying me safely through the blizzard, and fell into a deep sleep.

God is our refuge and strength, a very present help in trouble.

Psalm 46:1

 

Reflection

That was the only time that I  needed the National Guard to bring me to work. Sadly, 51 people died in my state in the blizzard of 1978; 22 died when they left their trapped car and froze to death while trying to get to cover.  But I still remember the comradery of the staff and patients as we all helped each other through that terrible storm.

I survived several more blizzards during the years I lived in New England. Later in the blog, I will share some of my harrowing tales of reaching my patients in the community as a visiting nurse.

 

Lord, Be My Vision

January 18, 2006

I’m having trouble with my eyesight again. I pulled out my pocket eye card and could only see 20/200 with my left eye and my glasses on. This means I have to be at 20 feet to see what most people can see at 200 feet. My right eye is better at 20/25. Through all of this, I want to rest in the Lord. He knows all about my eyes and is in control. If I go blind like my uncle, God will continue to provide for me like He always has through the years. I am so glad that He goes before me.

January 27, 2006

The retinal specialist said my eye looked healthy on the inside, so he is not sure why my vision has decreased so much. He decided to review my head scan from a year ago when I fell and was unconscious for awhile. He also is sending me for a second opinion to another retinal specialist.

February 11, 2006

I will instruct you and teach you in the way which you should go; I will guide you with My eye. Psalm 32:8

I saw Dr. N. yesterday for the second opinion and he said I have a cataract. He did a test on me where I looked through a pinhole and could see 20/20 which confirms it! This means the lens in my eye has become cloudy over the years. It’s a relatively easy outpatient surgery to remove my lens and place a new one in my eye which should give me 20/20 vision so I no longer need to wear glasses! I can hardly believe this news. I have worn thick glasses since I was 6 years old and have uncorrected vision of 20/1000.

April 8, 2006

Beloved, now are we the children of God, and it does not yet appear what we shall be, but we know that when He shall appear, we shall be like Him, for we shall see Him as He is. I John 3:2

I had my left cataract removed two days ago. I returned to the eye doctor’s office yesterday to have my patch removed. It was an amazing experience as the whole world appears so bright with beautiful colors, and I can see 20/20! Dr. E. said my vision might not stay quite 20/20 after the lens settles in. I can hardly believe the difference in all the colors. It’s like the yellow haze was removed. I think it’s a little taste of how beautiful everything will appear in heaven when I see the Lord and have my new body. Even so, COME, Lord Jesus!”  Revelation 22:20

April 20, 2006

So much has changed since I last wrote. I’m having a terrible time with nausea and headaches because I see two different sizes with each eye. I wear a contact lens in my right eye that still has the cataract. My brain is having a hard time adjusting to 20/20 vision in my newly implanted lens. Then I got a head cold and was so sick that I missed all the Easter services which was sad. This is my third week off of work, so my Dad flew up from Florida to help me out. Dr. E. is on vacation so I saw his partner who told me to patch my right eye and learn to drive and work with one eye. He also said to call Dr. E. to do the other eye as soon as possible.

I drove down the highway with one eye patched which was really scary since I have no depth perception. I asked my Dad to drive home which was just as scary. He has a shuffling gait and can’t remember directions at all. His hearing has also decreased. I think he has early dementia or Parkinson’s disease which is so sad. (See previous post.) He went with me to prayer meeting last night for which I was thankful. On the way home, the stars and glare around all the oncoming headlights was awful. I wonder if I will be able to drive at night anymore? Maybe that will go away once I’m off all the eye drops. I called Human Resources at work to check on short term disability, but they said I don’t have it since I haven’t worked there a year yet. God always provides and won’t test me above what I can bear.

It was difficult to drive with only one eye because I had no depth perception.

I’m thankful for this extra time with my Dad as we look at the beautiful spring flowers in bloom, walk through the woods together, and see historic sites nearby.

My Dad came to help me for 3 weeks. We enjoyed seeing all the spring flowers in bloom.

May 9, 2006

The Lord upholds all who fall, and raises up all who are bowed down. Psalm 145:14

How I praise God for the work He has done in my life the past few weeks. Dr. E. removed my right cataract on May 4, four weeks after my left cataract was removed. The next day after the patch was removed, my eyes began working together. We also stopped the Nevanac (NSAID) eye drop which was causing the nausea. What a relief to be rid of the nausea! It was such a joy to rejoin the choir yesterday at church and sing The Solid Rock.

When darkness veils His lovely face, I rest on His unchanging grace;

In every high and stormy gale, My anchor holds within the veil.

On Christ, the solid Rock I stand – all other ground is sinking sand,

All other ground is sinking sand.    –by Edward Mote

Christ is my solid Rock!

Reflection

How I thank God every day for giving me corrected unclouded vision. I later was told I developed cataracts at the age of 51 because I have a disorder which caused calcium deposits to cloud my lenses.  I still need to wear thin glasses to read to correct my astigmatism. One of the unexpected treats is to be able to see clearly when I go swimming. I can still drive at night as the glare and stars around all the headlights went away once I finished the eye drops. But most of all, I look forward to that day when I will see my dear Savior face to face in heaven above with perfect vision in my new body.

 

 

 

S-O-A-P Charting

March, 1978 – 11:30 p.m.

I had just finished walking rounds with the night shift nurse, clocked out, and sat down beside the chart rack to begin my charting before I could go home. I usually was able to complete some of my assigned five patient charts during my shift, but it had been nonstop all evening so I barely had time to gulp down my dinner. Each nurse was assigned five charts and must chart on two of the patient problems before going home. We were not paid overtime to complete our charting.

I wearily began writing using the S-O-A-P format in the heavy 3 inch thick chart under the tab marked “Nurses Notes” with my blue ink pen. Day shift charted in black ink, evening shift used blue ink, and night shift used red ink.

S is for subjective- what the patient says. soap bar

O is for objective – what you observe.

A is for assessment.

P is for plan.

I remembered my college instructor’s words about charting.

“If it’s not charted, it’s not done. Try to paint a concise picture with words of exactly what you did using only approved abbreviations. If you are ever sued, you likely won’t remember the patient several years from now. The lawyers and jury will scrutinize your every word.”

Mrs. K. in Room 515 had had a below the knee amputation two days previously. I scanned her problem list and chose Pain and Diabetes from her list. I began writing using approved abbreviations:

#1. Pain

S: c/o moderate RLE pain. (complains of moderate right lower extremity pain)

O: RLE incision intact. Moderate swelling, slight erythema. VS (vital signs): 99.2-76-18-136/84. (temperature-pulse-respiratory rate-blood pressure)

WBC (white blood cell count) 7.4. Given 2 Percocet.

A: Moderate post-op pain. Pain relieved with Percocet. No sign of infection.

P: Continue to monitor incision qs (every shift), medicate for pain prn (as needed). Instruct pt (patient) about phantom pain.

I completed my last chart at midnight, put on my coat, walked out to the parking lot, climbed in my car, and drove home through the black night.

Reflection

Charting has changed over the years, but the saying of my instructor still holds true in the litigious American society, “If it isn’t charted, it isn’t done.” After Xerox copies were invented, we switched to black ink for charting so the notes were more legible when copies were made.

When I worked in labor and delivery, I had to write my initials and time on the fetal monitor strip whenever I entered the mother’s room, and whenever I gave any medication or did a procedure. Only once was I called to the office of the hospital attorney to review my charting I did on a mother who we sent home in false labor. She later came back that night, but delivered the baby in the hospital parking lot before she made it to the labor and delivery unit. She was now suing the hospital for sending her home, and I was the nurse who did the last assessment. I reviewed my charting about a year after the incident and my instructor’s words came back to my memory. Thankfully, my charting was complete and I never heard the outcome of the lawsuit. They likely settled out of court.

When I was a visiting nurse in the 1990’s, we used a check list system for the daily visits and left a carbon copy in the home for the next nurse. When I worked in the nursing home as a nurse practitioner, we had a dictation service with secretaries which worked very well. We returned once again to the S-O-A-P format. We used both paper charts and electronic medical records which was confusing at times.

In my final job with the federal government, we only had an electronic patient record. The days of heavy paper charts in racks had ceased. I had machine dictation which was only about 70% accurate, so it took quite awhile to correct all the mistakes. But at least we  could read everyone’s notes and never had to go hunting for lost charts. However, when the computer system crashed, it shut down the whole system because we had no access to the patient records. Thankfully, that didn’t happen often. I felt sorry for the providers who had never taken a typing class and had to spend long hours at home in the evening completing their patient’s charts for the day with the old hunt and peck method of typing.

When I called a doctor’s office to request a copy of a patient’s records, his assistant said she would fax them over, but warned me we would not be able to read his handwriting! Over the years, I’m afraid my handwriting has deteriorated also as I have spent countless hours writing in patient charts. Charting isn’t the most satisfying part of nursing, but it is necessary for communication and a required part of every job, so I always tried to do it thoroughly and above all, honestly, to honor God.

“Not with eyeservice, as menpleasers, but as the servants of Christ, doing the will of God from the heart, with good will doing service as to the Lord, and not to men.” Ephesians 6:6-7

When I toured hospitals in China in 1986, I was amazed that they only had one sheet of paper with a few characters on a clipboard hanging on the end of each patient’s bed. The patients were not allowed to sue their provider, so the documentation was very minimal. A Chinese friend told me each person keeps their own medical record in a notebook and takes it with them each time they go to the clinic for the doctor to write in. It sure seems like a much simpler system!