New blog!

This will be my last post in this blog.  Austin and I have created our blog, instead of this one just being about me. :)  Address is onceuponachairlift.blogspot.com.  See you there!

Getting Married

Well I need to post SOMETHING before the wedding, so I can at least remember what I felt like the days leading up.  I have realized that wedding planning is like, so fun for the first month or so because you are pinning things on Pinterest and you are like, "Ya I am totally going to DIY mason jars into centerpieces and DIY my bouquet and grow my own Dahlias for it.  I can totally do this."  Then reality sets in, and you are telling your florist, "Okay ya whatever you want to put in bouquet is fine, just make sure it goes with my colors."

But things have come together nicely, I am glad I have had a lot of help and a lot of people to help me decide over the agonizing struggle about whether I want my hair up or down or what shoes I should wear.  For example, I scoured the internet for months trying to just find a rehearsal dinner dress.  I whined to Laura that I couldn't find anything, and within 10 minutes, she sends me a link to a dress I LOVE and was trying to find something like. BAM. Bought it immediately.

My friends have told me that their wives called off their weddings several times leading up to the wedding, and although I have never gone to that extreme (which is shocking because I AM extreme), I think I have to credit it to Austin.  I have loved coming home to finding him putting the little favors in boxes or taking care of the cake arrangements, pastor, or how the wedding day will run.  I feel guilty because he is in the hardest semester of nursing school, but somehow he has found time the past few weeks to cook dinner and not let me clean up because, "you need to relax. Go rest on the couch."  I don't really know where he gets the energy or drive to do all this, but he shows me how to be a good partner and put someone else first.

We met with the pastor 3 times before the wedding, each time to discuss difficult topics or topics people argue about most.  There were a few things I found most difficult.  At our first meeting, the pastor simply asked, "What do you like most about Austin?"  I was startled by the question because I felt like that is not a question you can just ask nonchalantly.  I had to stare off for a little while, and of course Austin was exclaimed, "Surely you can think of something!"  But the problem was that there are so many wonderful things about him that if I even started talking about it, I would start crying!  The other question the pastor brought up that was even more difficult was discussing end of life care.  Like, if something happened to one of us, what would the other person do in that situation.  We didn't have to share with him what we would do, but bringing that topic up was one that left me a wreck after.  How can you ask a couple that when they are just starting their life together?

Then on a lighter topic at another session, he asked us what we argue about most.  Housework.  The pastor was relieved to hear that, and we explained that we just want all of the housework to be equally divided all the time.  We both dislike housework, but share the love of one chore: Vacuuming.  Who doesn't?  The sound when the vacuum sucks up little dirt flecks and the track marks.  Our house may be a mess, but our carpets are clean!

The meetings with the pastor were actually really fun.  They left us feeling more confident as a couple and had a better understanding of how to communicate.  I don't have any nerves about being married, I only have nerves for the actual ceremony because I know that it signifies such a pivotal moment in my life that results in many 'firsts' and unique experiences that I get to share with my best friend.  It is funny that what you thought was happiness when you were a bit younger is much different than when you are a bit older.  I never thought that dancing in my living room with my soon to be spouse would incur such belly aching laughs or preparing dinner together is something to look forward to in a day, but I'll take it.  For all time.

It has been a long while since I have written anything, but this story is just too ridiculous not to share.

On Tuesday, we had our engagement pictures scheduled.  I got a LivingSocial deal for a hair salon that looked trendy and they had good reviews, so I booked an appointment to have my hair done.  How luxurious, you might say.  I just wanted to have phenomenal hair.  The appointment was going well, ish, except the lady was like "WHOA, your ends are bad, we need to cut off like 2 inches."  I don't think so.  How about you just do what I ask.  So she cut a little off and proceeded to try to style it like the picture I brought.  The picture had loose curls at the end, kind of beachy look.  Towards the end of the appointment, I told her, "Um I'm kind of nervous because this is not looking the way it does in the picture."  She consoled me by saying yes it did, and I was realizing this appointment was futile.  I eventually just said, "Ya okay, this could work," and tried to check out.  She said that it would be $90.  $90?!?!?!?!  For what? For doing a job a 6 year old could do??  I told her I was quoted $60 for the cut and hairstyle, and she was miffed and said, "Um that is not $60 work."  I felt like saying, ya I know, even that is a stretch.  She took the price down to $70, but I couldn't believe I had just paid someone for that.

I raced home and asked Austin what he thought.  He tends to err on the side of encouraging and sensitive, which is good, but when he said, "Oh, well, that is nice," I cut him off and said, "There's no time for BS! What do you really think!? It's horrible isn't it?!?!"  He started laughing and was like, "Well, it just kind of looks like a nest is on your head."  AWESOME.  We only had 30-40 minutes before we needed to leave, and I hadn't done my make up or gotten things together.  But I wasn't about to pay someone else to take pictures of me like that, so I jumped in the shower and washed all that money down the drain.  I did my hair faster than I have in my life, threw on make up, and threw everything I might need in a suitcase.  We left about 10 minutes late and raced on the freeway to Sundance.

Then.  Oh THEN, we rounded the corner and saw the south side of the valley when an enormous smoke plume erupted that looked like a spouting volcano of smoke.  The smoke was over what looked like Sundance.  We called the photographer who works behind Timpanogos, and confirmed that it would be dangerous and smoky there.  So we re-routed to Squaw Peak in Orem, I think?  And despite crazy traffic, we got there only 20 minutes late.

We followed our photographer and her husband up the peak and started hiking to a photography spot.  First of all, no where did I see in the contract that I would be hiking right before these pictures.  Also, it was like hiking through a nightmare because I think every bee in Utah was recruited to that area because, hey, Becca isn't having enough of a crazy day, so let's throw in her biggest enemy, BEES.  We started taking pictures, but I had to keep stopping because I would hear buzzing and also I was in a dress (the one day I don't wear spanks) and was concerned that things were flying up my dress.  We tried taking pictures in between my squirming and Austin smiles awkwardly most of the time so we were bickering about bees and laughing at our awkward smiles and uncomfortable head tilts, and the photographer kept laughing and saying, "You guys are like the funniest couple ever!"  Sweet.  Cause that's what every couple wants to be called in their engagment pictures, FUNNY.  But we had a good time.  I was nervous that no pictures would turn out though because there would be fear in my eyes from the bees swarming, and when she told us to kiss it felt so weird because you want to make sure it looks good in pictures, but I don't know how to turn my head to make it look good in a picture. But it looks like we got a couple good pictures.

Here is one good one...

Results Are In!!

No melanoma!  And actually, there isn't even a mole that is causing the discoloration.  But that is all confusing for the doctors, because they have no explanation for why I have this weird streak on my nail.  They have discussed my 'case' with many doctors and don't know what to say.  They want to follow up every 6 months though if it grows back.  But I am thrilled!

The Nail Biopsy Part II

Over 2 months ago, I saw my dermatologist to follow up with this nail that wasn’t supposed to grow back with this brown streak in it.  The dermatologist said I would have to go through the same procedure as last time to really figure a true diagnosis. Most likely, there is a mole underneath my skin that is dying the nail, but we have to check to see if it’s benign or melanoma.  The soonest appointment with this nail specialist was February 10^th. 

Back in December, my fears rose to a new high when one of my medical auditors saw my nail and I explained the situation, saying it was probably nothing. She stupidly replied that she used to do skin cancer trials and she read peoples’ medical records who had this and by the time they biopsied it, it metastasized in their body.  Hey THANKS *******. That makes me feel swell.

Fast forward to last Friday, and I arrived at the time and place which appeared on my appointment card. “Oh, you are at the wrong place.  Your appointment is at the U. You’ll never make it in time,” replied the secretary, acting like I was retarded and irresponsible. We frantically tried, but the secretary called me to tell me the doctor was double booked anyway. “Okay if he’s double booked and seeing the other patient now, how is this any different?”  We conversed (or civilly argued) and concluded that I would have to reschedule for an appointment…in APRIL.  I could have some serious issues by then, ma’am.

Tearfully, I called my dad to explain what happened.  He wisely counseled to write a letter to explain what happened and fax it to him.  The letter explained what happened, my extensive family history of skin cancer, and my fear about prolonging testing.  My dad also contacted his board buddies and within hours had several doctors writing their response on the matter, including one who thought a hand surgeon could do the procedure the following week.  I just love knowing my dad will always take care of me, and in Austin’s words, “Your dad knows really powerful people. That’s awesome.”  It is.

On Monday morning, I got a call from the nail specialist apologizing for what happened, and said he had no idea and would love to fit me in that day.  Pretty much the worse time because I’m starting a new study with several Alzheimer’s patients, but I went to the appointment.  I joked to Austin, “Hey, don’t pass out when you watch this!”  He laughed at that possibility since he works in the ICU.  Well, halfway through he had to take a break from watching because it was gruesome.  They pull off my nail, and cut down my finger scraping out skin in hopes that there is a small mole in there.  It hurt a lot, and I knew how much pain would be in the future.

I told the doctor that I didn’t like Lortab because it made me really sick, and I have a lot of anxiety about taking medication in the first place.  I requested Tramadol or Tylenol 3, and the doctor seemed very hesitant, and gave me 5.  Last time he gave me 25!  I reported this to the pain doctor I work with and he said, “Oh you came out sounding like you are a drug seeker.”  Fantastic.  Meanwhile, if the doctor only knew that I was being serious about how much anxiety I have and how I waited until work the next day to take the medication (you know, in case I pass out like I did with Lortab) and only took a quarter of a pill at a time. 

Anyway, I’m doing okay, just obviously in pain.  Results next week.  Send your positive thoughts my way please, and let’s hope this is just a weird nail thing.  Oh ya, and I probably won’t get my pinky nail back this time.  WAHHHH.

Narcotic Withdrawals and a Man in Tighty Whities

I have been involved in an opioid withdrawal study.  This time around, I am the one in charge of everything.  This has led to working 60+ hour work week, which I am not at all used to.  Especially when all of those hours are standing  walking  running around.  I had 10 patients/subjects that were my responsibility, but the problem is, you have to do hundreds of assessments for each subject, and you have to do each assessment on the exact minute that it is due or you get a deviation. (Kind of like getting a ticket in research)  Couple that with 8 out of 10 going through opioid withdrawal, and you’ve got some stress on your hands.

It’s been interesting though.  The point of this medication (like other opioid withdrawal studies) is to see if you put an ‘anti-opioid’ or Narcan inside of a pain medication.  If taken properly, the Narcan isn’t released into the body and the pain medication works as it should.  Taken improperly, i.e. crush it, inject it, snort it, the Narcan will overcome the pain medication and there will be no effect.  However, if someone does this who is already physically dependent on the pain medication, the Narcan will kick off all opioids already on your receptors, and cause a withdrawal.  In the study, our pharmacist crushes the drug (as an addict would) and puts it in a syringe, and I inject it into these people. (Sounds barbaric, but it has to be done and these people do understand why we are studying this and what they are getting into) Withdrawals include high heart rate, sweating, extreme anxiety and restlessness, body tremors, shaking, nausea, vomiting, goosebumps, yawning frequently, and increased pain.  Essentially, your sympathetic nervous system (fight or flight response) in overdrive.  This may not seem that extreme, but when you have a guy whose heart rate is at 180, legs flailing everywhere (and foot clonks me in my jaw while I'm trying to hold him down), streams of sweat, and body shaking violently, it can get scary.  In most cases, when they start to feel these symptoms, we reverse the withdrawal in the first 1-5 minutes of symptoms with other medications and they are just fine for the rest of the day.  But for a few people in the study, it went on for hours and had these more serious side effects.

The company who makes this medication wants people to feel some adverse effects (i.e. some anxiety, sweating, uncomfortable but not getting a ‘high’ from the med), but not throw them in such a severe withdrawal that it is considered a medical emergency.  It has been hard to watch, and the doctor who oversees everything (the Primary Investigator) tries to calm me down by saying that this is helping tens of thousands of people who could do this at home and not have anyone to help them.  I guess addiction is everywhere, but I prefer to keep my addiction to Smores ice cream instead of narcotics.

As a happier side note, during all this mayhem, I also had one of my Alzheimer’s patients in house to receive his study medication.  He is so cute and is the unofficial greeter at McDonalds with his dog that he walks 5 miles everyday.  On the morning that was especially busy, I may have neglected him some attention and pretty soon I saw him dancing down the hall in only his tighty whities and trying to dance with the other nurses.  Oh, brother.  It was a welcomed change in mood though, although I am not entirely convinced he did this as an effect from his Alzheimer’s because he is in the very mild stages right now.

Being in charge of a project like this has also led me to re-evaluate how I am as a leader.  I’ve always thought that I could be a leader, but it gets trickier when those around you have worked there longer and/or are older than you and you have to direct them to do everything.  I mean, how can you ask each person to do 10 different things without them thinking or saying behind your back that you are too demanding?  I try to say please, thank you, and tell them that I really appreciate them doing it.  But I feel bad about ordering people around who have the same title as me, especially asking them to do tasks that aren’t exactly fun. 

I’m going to have to learn what makes a good leader, because the next project I am on is even bigger.  In fact, they have hired an assistant for me (weeeee!) and if I make significant mistake, it could cost millions (waaaaaa!).  Oh boy, I guess I will sleep again when it is Christmas.

A Stroke of Luck

As I have said before, I am leading a clinical trial on an investigational antibody that they hope will stop or even reverse Alzheimer's Disease. (But of course, at least 90% of drugs in a Phase 1 trial never make it to market, but let's hope this medication actually works) I have met with a lot of fascinating people, and admired how much devotion their caregivers show.  This week, I had an appointment with a couple that was referred to me by their sister.  Their sister has already received this medication and is in the study, and she referred her brother that she was really worried about.  Her brother was not diagnosed with Alzheimer's, but she explained to me some 'weird things' that she was noticing.  She gave me their phone number, and I scheduled them to come in this last Wednesday.

This first appointment is called a screening visit, where I go over the Informed Consent that explains all the details of the study.  During the course of my explanation, this man asked me the same exact question 5 times, within 5 minutes.  He did that numerous times with other questions as well, and he definitely seemed like he was moderate AD.  I did my generic memory screen, which he actually did way better on than I anticipated.  Hmph.  Then I did some frontal reflex release signs.  These reflex signs show whether or not the frontal lobe of the brain is atrophied.  He was negative for all of those signs as well.  Double hmph.  I stole a moment with his wife, and she explained the cognitive problems that he was having, as well as the fact that he had lost 13 pounds in the last 3 weeks.  Triple hmph. I was very curious what his MRI and lab results would show.  As part of the screening visit, I scheduled him for an MRI of the brain that evening.

The MRI results and interpretation came surprisingly quick the following morning.  Then I knew why.  The radiologist called the MD in charge of my study and said that he believes that this man was having a stroke during the MRI and needed to go to the hospital immediately.  The doctor called his wife, and she was frantic because she didn't know where her husband was at the moment, but would try to get him to a hospital ASAP.

The next day, I nervously called the wife.  She was able to get him to the hospital, and he was admitted to the unit.  She didn't say what kind of stroke it was, but I am assuming it was a clot because apparently if it was slightly positioned more to the front or back, he would have had severe impairment in functioning.  They are starting him on treatment, and we believe that this MRI saved his life.

I can't even think of a word that would describe how I feel about all this.  I feel terrible for his family, especially his sister and wife that were such kind people, but of course I also feel so grateful.  It is not often that you get these kind of experiences where you just know that there is a reason that a person came into your life, and a series of events had to happen in order to discover something life changing.  Sometimes, I feel like I am not doing 'enough' because I am not in an ICU or ER saving people on the brink of death, but I definitely feel blessed to have had a hand in this.  I hope he recovers well and can start treatment to prevent this kind of event in the future.