I LOVE...

I Love Trees  I enjoy Pictures  I desire the male body  I Love Music melody & Lyrics  I Love Windows  I Love Wooden Floors  I Love Art work  I Love the Magical eye of a Photographer  I Love + and =  I Love Cats & Dogs  I Love to Dance   I Enjoy Food  I Love to Read  I Love Song writers  I Love Men in Uniform  I Love to make up words to songs   I Love All Electronics  I Love the Movies  I Love The Snow & Rain  I Love the River I Love the Mountains   I Love being Married  I Love Children  I Love GrandChildren  I Love My Mommy  I Love My Daddy  I Love Dennis Jay Dalton

Veteran's Day The Meaning...

     The meaning of Veterans Day has changed for me these last few years; I have always had respect for our Veterans due to my Father. He would be sure to buy the pansies being sold by the various retired Veterans in front of the random stores. The sale of these small flowers is a way of raising money for different Veteran projects. No matter the donation the Veteran would hand you a red pansy.

     Pansies are known for their hardiness and ability to produce a flower of striking beauty even in harsh weather and adversity. The French word “pensee,” meaning thoughts, in particular the thoughts of loved ones. The myth grew that you could see a loved one in the face of the pansy.

     These days I see a Veteran in a different way, I am amazed at the extraordinary havoc the military placed upon them. I have heard many experiences’ told by WWI, WWII, Korean, Vietnam, OIF, OEF, DS, OND and So many other operations handed to our armed men and women. Each of these operations holds specific and Unique Health Risks. They Combined Penetrating, Blunt Trauma, and Burn Injuries. The Vietnam time gave way to chemicals we all know as Agent Orange.

     Our Veterans gave more than most, they still live the memories. The smell of dirt brings back the reminders of underground tunnels. The site of a random act like taking out the trash places a trigger of memories of the body bags. The smell of the pesticides at your local hardware store gives memories of Vietnam. So many basic actions we think nothing of are daily reminders of excruciating physical and mental pains.

     The Veteran just deals with it, by keeping to self. Drinking,drugs,anger issues, and commitment problems are just a few on-going battles that are continued. Most WWI, WWII and Korean War Vets never seem to open up, and a Vietnam Vets would never talk due to persecutions.   I personally remember a conversation between my Daddy and my oldest brother. My brother asked, “How did you handle the memories Dad? You never seem to have problems.” my Dad answered, “I drink a few beers and just try and think of the good things.”

     I have had the Honor and Pleasure of working for U.S. Department of Veterans Affairs at VA Montana and now for VA Salt Lake City. Being a nurse taking care of these Men and Women, well it has been an honor and I really enjoy the character and depth in their personality. I admire their true Hero mentality. I am blessed to have met many hear the truths and feel just a bit of the pain as they have attempted to open up. God Bless the Men and Women that fight for our rights. God Bless the real mark of heroism.

     So do me a favor, Next time you meet a Veteran Say, Thank you. Next time you hear a Mom say her son is in the military, Say, Thank you. Next time you look in the eye of a Veteran selling the red pansy give up a buck or two but be sure to say, Thank you for your service. May God bless our families who give their sons and daughters

Sincerely and with Great Honor,

Shannon

Flowers I love them!!!

Flowers! I love Flowers !!! I love the colors, Bright, Sharp, Brisk, and real. A flower is such an amazing part of life. I have to say the color is alive and each peddle has an unique shape feel and the fresh aroma...Mmmmm so Wonderful!
How could anyone say they would rather not have FLOWERS
How could anyone deny  a gift of FLOWERS.

Why?

When I lived in the Bay area, I recall driving by this really cool place called Neve Brothers Greenhouse in Petaluma. I Crazy Loved visiting there. D.J. would drive us all over so we truly understood where we lived. The Flower Growers have rows and rows of greenhouses and the excitement of seeing what is growing inside, well makes me So Happy. Neve Brothers  have two locations in Petaluma and we visited the main area which has 400,000 square feet of greenhouses!  Their other location has 100,000 square feet of greenhouses. Plus, every inch of the outside areas have plants growing.

     They grow, Tulips, Daffodil, Hyacinth, Pansy, Roses long stem well all kinds. Plants too! ALL FOR ME!!! there are Growers like these all over the world.

Flower

Flower, flower grow for me,
Become a flower from a seed,
Grow your roots and a stem,
Let the water come right in

Flower, flower you are true,
You make me happy when I am blue,
You became a flower from a seed,
You did all that just for me

by Olivia Taylor

Dear Daddy

Dear Daddy,

     I was thinking of you today. I think of you all the time. In fact every time I am in the Kitchen I am wondering if you are observing, in hopes that I am following a recipe just right. Often I decide how I will continue the dish according to what you might think.

     I was so bless to have had you for my Daddy. I remember your smile, laugh, and hugs. So many things I see have me recall special memories we shared, like the time you told me you had something for me…  We sat on the back porch at 1140 Melville and there you gave me a gold necklace watch, with a Victorian style picture of a woman in the setting with a red background. It was a few days before my birthday.

     Another memory like thousands came to mind, Christmas eve you came home with 7 Christmas trees! You told me that no one bought them, and you had to bring them all home because they would spend Christ birthday all alone. We had the biggest one in the house and all the others were in the front yard. You were sure to decorate each one with a little something. That was the house with the cul-de-sac, where Mrs. Reed lived.

     Time and again during the Christmas season you would paint pictures and greetings on poster board, John and I would sell them to the neighbors for a buck. We sold enough to buy gifts and a few bags of food. Also it never seemed like the holidays unless we had the large mirror all painted with greetings too!

     Dad, I am to this day very respectful of our heavenly Father and his son Jesus Christ because of you. Although I only recall you in a church maybe five times in my life. You told me on more than one occasion that the bible was true, and you told me to read the words in red because those are the parts where the son of God speaks, and he is the closest thing we have to being close to our Father.

     I Miss you Dad, I just wanted you to know. Happy Father Day… I could not have asked for a better Daddy.

Love you,

Your Shannie Town

So you think you know your Fruits n Veggies

So last night on my Pre-Juice Fast Stage, So worried and not eating as much the last few days Found out that KNOWLEDGE will set you Free!
      Talking with this woman in the produce area of the store, I explained what my daughter and I were up to and then told her about my headache and telling her this could be a set back for me.
 The lady, her name was Beatrice, told me, "Passion fruit and Mango have caffeine in them and that raw juiced will bring about the natural  caffeine" I was always told only cola beans and coffee beans have caffeine, but the lady told me the seeds hold the value. I have not been able to find any info on the seeds of any fruits, only the flesh of them.
      So I took home the two and found that the Mango seed was ENORMOUS so only juiced the flesh. The Passion Fruit was seedy and tart, but I juiced the whole thing. Now maybe the passion fruit has no caffeine but it is HIGH in Niacin like 1500mg.
      Now get this, This Amazing fruit has other values like Harmala alkaloid, some say this derivative had the ability to lower blood pressure and  suppressing metabolism of monoamine compounds like serotonin and norepinephrine.These properties would most likely account for my blood pressure drop and my headache going away. Oh and My Excellent mood!

Apples Peaches Pumpkin pie, If your Not ready Hollar I I I I

Okay, No Pie, but strawberries, apples, ginger, and KALE. Ha ha ha kale, that amazing green that cooked with diced onions, balsamic vinegar, and bacon bit has the most amazing taste. Oh Don't forget the butter or better yet use the fat from the bacon. LOVE !!!!
    Anyhow, I will be adding this radiant blue-green colored, tight curled leaf to my daily juice, and knowing all these terrific bits of information makes swallowing that Extra Deep Green tint So much easier.
Here is more knowledge...if you pour water on Kale you will find it is water resistance. Another cool thing about this leaf is it is packed with vitamin K so if your on blood thinners let your doctor know.
      The best thing about this excellent plant is One cup of kale contains 36 calories, 5 grams of fiber, and 15% of the daily requirement of calcium and vitamin B6 (pyridoxine), 40% of magnesium, 180% of vitamin A, 200% of vitamin C, and 1,020% of vitamin K. It is also a good source of minerals copper, potassium, iron, manganese, and phosphorus.How could you go wrong!!!

101st Zazzle Bay to Breakers

11 Days 4 Hours & Counting down

Are we ready? Well I am never ready I try though, just not as hard as I can. But I will finish slightly better than last year, maybe not by much ha ha ha

101^st  Zazzle Bay to Breakers  

Glady and I will be there with our shoes on. I know as last year I will regret not working harder to do better, but I continue to jog daily and eat less in hopes for last minute results.

The historic Zazzle Bay to Breakers is a USA Track and Field Certified 12k (7.46 miles).
From sea level at the Embarcadero the course rises steeply along the Hayes Street Hill. Around the 2.5-mile mark runners climb an 11.15% grade between Fillmore Street and Steiner Street. The remainder of the course gradually flows downhill alongside the Panhandle through Golden Park to the Finish Line at the Great Highway.
Don’t forget Glady!!! We also have a most likely 2 mile walk to our Metro/Muni ride back to the Hotel LOL!!!!
But we are going to have FUN!!! We will relax maybe eat at the Zazzle B2B Final Mile Activities

“The course will close at 11:30 a.m. at the intersection of JFK Drive and Chain of Lakes Drive in Golden Gate Park. Participants who have not passed the intersection of JFK and Chain of Lakes by 11:30a.m. will not have the opportunity to cross the finish line or collect a Finisher’s Medal. The finish line closes promptly at noon as stipulated by the race's road closure permit.”

We got there last TIME we will get there before TIME again!!!

Any How Can’t wait Going to be FUN!!! As long at the HOTEL room is roach free, LOL and gross people free Otherwise I might need to Open a Can of Whip Ass

Tomorrow I Jog

WALK  RUN  JOG  CRAWL

My Favorite thing about getting out there and moving is…

That feeling after you pushed and accomplished your task at hand. I find excitement looking forward to a run/walk or a new pair of shoes. I look forward to knowing I need to work for something and when I have success it was me.

     I can’t say I am having too much success with weight loss, but the more I run stay active the better chance I have in dropping pounds.

     Yes, I do have a training regimen, it is hard and with each week the miles increase. I can’t really say I like the long run, but I do LOVE that feeling when it is completed. Like I said before, I don’t feel like a “runner” but I do feel like a Fan. Being a fan gives me the desire to accomplish and expand my own PR. I get a thrill knowing I CAN walk/jog 5K in 47min for me this is amazing. I get a thrill knowing I CAN speed walk a 2K 15min and participate with a purpose. When I participate at the VA fun runs I get to generate donations for the Veterans here at the Fort.  I will never be an Olympic-Class Athlete, but I never had a desire to. Well, Okay maybe when I was 11. Anyhow I only want to improve my own Personal Record. I feel great! I get my motivation from my daughter. I get it from Runner’s World, Running TIMES, and Map my Run.

     I guess I am having a difficult time explaining the feeling I get going outside and moving miles behind me. I really don’t even mind the treadmill. Happy to have it around when it is 20 below 0 or Wow even ZERO really sucks. So the treadmill is a good friend.

     Tomorrow I walk/Jog 6.22 miles, in preparation for the Montana’s Governors Cup here in Helena.  

2012 Montana Challenge

I just started the 2012 Montana Challenge; this challenge requires a team of 5 people.  Jerry and I here on the night shift found three others that are just as excited.

Patty

Lisa

Suzan

We came up with a name; “The Psycho Babblers”

 Our team is to exercise a minimum of 150 minutes per week each to reach a goal of 10,000 minutes.

This challenge will start April 29^th to July 28^th

We get extra points for drinking water, participating in active events like the VA2K which is on May 16^th and then another one June 2^nd  The whole team will attend to gather extra points!

All in all we plan to have fun. I was made team captain and this will entail logging our team minutes and bonus points.  We will take pictures and be sure to beat every other unit FOR SURE!!

     On another subject this challenge kind of helps me out with a goal I have. The goal is like a pie if you will, in that one piece of pie equals a small goal and as each goal is accomplished they all will make me whole.

     The book my daughter told me to buy is called, The Happiness Project by Gretchen Rubin. I found myself saying I would only read, “The note to the reader”, and then Glady and I would start the project.  After reading that intro I really started to think, How can I start this project without acknowledging or in Gretchen’s words, “identify what brings you joy.”

     I had to take time to think about that. Should I start with generality? Then move to a more detailed look at the whole pie? Well, I just did not know. But as it goes…I am happy to be sharing this with my daughter, because I am lost at times.  Never the less I did come up with what my goals are and it will take many pieces in the pie to make me fully happy.

Me again!

These days all I do is think about D.
     I am trying to keep up with the Skinny on my Fat, but no slimmer for it. I have to say a visit to my doctor had me asking, why? Why is it so hard for me to drop weight and keep it off or continue loosing? All he could say is, "At your age unless you have a complete flip on Diet, Nutrients, moreover Exercise you will yo yo."
     I have changed my routine and decreased my caloric intake, not even a dietitian could attempt the best  nutritious make over. She told me your next step might have to be a drastic change.
     Drastic? Okay, like what the heck does that mean!
    
I have to really change the way I look at food, what I put into my mouth must be worth every bit of amazing and all along EXERCISE ALWAYS! see I have no problem dropping the weight, I understand the whole reasoning of how to, increase exercise decrease calories. But how do I maintain this?
     I have been in and out of the gym all week, I feel burnt, yet No thinner for it. SO I get this trainer, she says the spill about increase exercise decrease calories...OK! OK! OK! I get it you... 23 year old born perfect never had a child shit head....
     So off I go back to the gym,              WHAT EVER
 Well, I am happy to have the GYM, and I am happy to have the ability to try and try again. I guess. I will continue till I just trick my body into thinking I am skinny.

The Power to make a Choice is Coping

Coping, hum?
     I guess it is time to make decisions. This process is so hard, so much information out there. I know it is best to get your info from your doctor, but how do you know what to ask if you don't read everything you can get your hands on?
    In case you have not figured this out yet, my hubby and I are in this together. We want to make the most qualified guess. We want the Best of the Best. See we have a wonderful urologist, but he only does open prostatectomy. With the help of the nurse at  Dr.Grossmen's office, they sent us to Five Valleys Urology  in Missoula. Next we researched the office and Dr.Simmons. We searched him, from opinions of previous clients to malpractice situations. Dr.Simmons seems to be A number 1 on paper and referral.
    Of all the research we looked over the Da Vinci surgery system   this seems to be the best most accurate, at least we hope. Also Dr.G.R.Simmons is certified in the Da Vinci system.
 
     Now, you might think all is taken care of, the plan is in motion. The next step will be an appointment to the Dr. Simmons. And yes we have made the appointment called the insurance and the hospital to be sure they are on our PP list.
     But, due to the seriousness of this issue we continue to read. I was reading through the American Cancer Society  and I then came upon a page...

Study: Robotic Surgery Does Not Lessen Common Side Effects from Prostate Removal 

      So, what am I to do with this information? Do I show D, will this bring us back to the beginning after we found out? Will it confuse him giving him less optimistic outlook on an already confusing situation. or just show him?
     Well, I sent him the study, and he read it through and through, then he came upon another study that had him rethinking everything...

Study: Dutasteride Helps Men Undergoing Active Surveillance for Prostate Cancer

     I Don't know about you, but I am so confused. I can't imagine how D feels. All we do know is D is going to keep his appointment with Dr.Simmons and go over these studies with him.
    The Coping in my eyes is knowledge, and the only power D has with cancer is making his own choice. Thank God for the researchers, the men in the studies and their outcomes.
 
     The active part I play is the same part I have always played, Shannon, Shann, wife, best friend, Just all around partner in life. I would be no where else. I only want to be with him. We will get through this and move on to all the really cool things we have planned. I know from experience emotional health is the best support. Men that have a good support of family live longer than those who are divorced, widowed, or single.
     

Part 2 The Prostate and my thought process

Afraid,
     That better explains the feelings I have, but did not know how D felt. I asked many times on the way home, but he would just say, "Okay" Now I know he had thoughts he did not know what to do with. I felt helpless.
     When you grow up in the time line D and I have, "The Big C" Is the worst thing that can happen to anyone.

     This all started when we went to see the doctor for other reasons. Mainly to change D's blood pressure medication because his regimen had side effects like a nagging dry cough, and poor control. Of course the doctor ordered blood work.
      D's PSA (Prostate Specific Antigen) was with in normal limits, yet slightly under 4 nanograms/millaliter. But between 4-10 men have a 25% chance of having prostate cancer. Following a PSA level the next screening is DRE (Digital Rectal Exam) at that point the urologist noted a hard palpable area, and  a biopsy was recommended.
     I think the first thing we did was go home and call D's Dad, come to find out his dad has prostate cancer and underwent a prostatectomy.

     We really did not want to think about the outcome. D and I felt we would deal with things as they evolve. Then a call came to see the doctor for a followup. When we arrived we were kind of nervous but laughing as usual and D is his comedic self, always making me laugh.

     The Doc went right into the final Diagnosis. out of the 12 specimens collected ONE, specimen  number 3 concluded Adenocarcinoma involving 2 of 2 cores, Gleason Score 3+3=6 of 10 carcinoma involves approximately 60% of right apex biopsy tissue.

     The Gleason Score
Gee How to explain that, well lets say this method is used to classify how the cell looks in cancerous tissue. The less the cells look like normal cells the more malignant the cancer, two numbers each from 1 to 5, are assigned to the two most predominant types of cells noted. The two numbers are added together they give us a Gleason Score. Higher numbers indicate more aggressive cancers.
So D's is 6
the scale
Low 2,3, or 4
Intermediate 5,6, or 7
High 8,9,or 10

Next time we will talk about COPING & TREATMENTS  

The Only thing on my mind is Prostate Cancer

The Only thing on my mind is Prostate Cancer.
     Prostate cancer is cancer that starts in the prostate gland. The prostate is a small, walnut-sized structure that makes up part of a man's reproductive system. It wraps around the urethra, the tube that carries urine out of the body.
     I am so upset when I hear people say, well if your going to have a Cancer this is the one to have. So completely bullshit in my eyes.
 My husband and I are so happy these days we have our worries and concerns about life, but all in all we have this amazing fun sex life, we have an amazing bond with each other and share an enormous respect for each other. After all we have been through so much in the last 30 years.

     Imagine if some one came up to you and your best friend and said, " I know your only in your fifty's but I am handing you an expiration date, first the sexual aspect of your relationship will end soon. then we are knocking off 15 to 20 years of your life expectancy. Oh and that is pending on the success of the path you take in respect to treatment and the gifts and abilities of your surgeon, you may or may not have complications, of;
Difficulty controlling bowel movements and in some cases the use of a colostomy.
Difficulty controlling urine, and in some cases having a super pubic catheter placed indefinite
Infection, including in the surgical wound, lungs, bladder or kidney
Injury to the rectum, spasms in your bladder.
This also depends on co morbidness, Like... Diabetes and High Blood pressure, Both of which my husband has.
 Let me put this in perspective, What will you be doing in 15 years?
The relative 5-year survival rate is nearly 100%
The relative 10-year survival rate is 98%
The 15-year relative survival rate is 91%
Last Medical Review: 02/27/2012
Last Revised: 02/27/2012 studies from the American Cancer Society

My Hubby will undergo 
Robotic-assisted laparoscopic prostatectomy 
 1, The surgeon removes the prostate gland from the surrounding tissue. The seminal vesicles, two small fluid  sacs next to your prostate, are sometimes also removed.
2, The surgeon tries carefully not to damage nerves and blood vessels.
3, The surgeon reattaches the urethra to a part of the bladder called the bladder neck. The urethra is the tube that carries urine from the bladder out through the penis.
4, Many surgeons will also remove lymph nodes in the pelvis to check for cancer.
5, The surgeon may leave a drain, called a Jackson-Pratt drain, in your belly to drain extra fluids after surgery.
6, A tube or urinary catheter is left in your bladder to drain urine.

I am angry sad and mad all at once. I am also thankful and blessed. we have much to be thankful about, like insurance.

Just Thinking

SO many things go through your brain when you’re sitting at home after work, and no one is home. D is at work and Jayk is in Mesquite. Years have gone by too fast, seems like yesterday I was playing Barbie World with Glady or making a Starship Enterprise out of duct tape and cardboard for Jaymes. I can picture Jaymes running around, Glady involved with her many toys and Jayk dynamically participating in any activity his Big Bro/Sis was into.
     The main concerns on my mind then were what is for dinner? Do I have enough lunch stuff for the week? I need to get laundry done, and this house is a mess. What time will D be home? I am Fat. I hate working, because I wanted so badly to spend every moment with them. I also have a list forever long of things I want for the family.
     How can I be sitting here doing nothing? My laundry is done. The house is clean and I have a plan for dinner, for just the two of us.
     I miss Jayk, I feel like he needs the time away though. His testing is done, but he was missing his sis and bro too much. Jayk also wanted to spend some time with Mesquite friends. So his visit is good.
     This time in our life is so different, D looked at me in the kitchen and said, “Is this a prequel to how we will be?"
     I guess it is like the empty nest sort of thing, but we are still working and we continue to desire an active life with our kids and Grand kids. I look forward to family gathering, Holidays, and babysitting. I know D and I need to direct Jayk and encourage him into making decisions that will have him create a successful life. I also know that with Jaymes and Glady around the age of 17 they pretty much started their independence. I know we continued to direct or dictate, but we also worried all the time and when I look back I wish I would have participated more and not backed off as soon as I did. However I have amazing children and Excellent Grand kids. I will continue to encourage Jayk in a path best for him and his safety.
     So I sat, and wondered what does life have in store? Was worrying about my weight all those years that important, my real concern should have been health. My wish is that all my kids and their kids are healthy and safe and make the most excellent choices. I will Love my children no matter what and I sure Hope they know that no matter where I am that is Home for them and their family. If they ever need a place to stay, go visit, or whatever they can come home and Dad and I will have their back.
     I miss the days gone by. I have the best memories of each child’s life. I have so many stories to tell, and I hold these memories of each child’s face at specific times in their lives imbedded in my mind.
     I also have to say, that the enjoyment of growing older with your kids Dad is the enormous delight and laughter when reminiscing about each child. D brings memories I forget. These thoughts are priceless.
     I look forward to family gatherings because the kids also have memories. I truly am blessed. I love my family, and I know that is all due to the fact that I had an amazing childhood too and I wanted nothing less for my kids.
     Don’t get me wrong my Mom and Dad would fight my siblings too would knock out drag out boxing matches.
 I know D and I have many yelling matches and maybe even a sugar bowl being thrown to the ground but after acknowledging my wrong and with D’s apologies we changed and after a while no throwing things just yelling but always making up after somehow evolved. I hope to have many years together with D. I pray we get many years to grow old with each other.
     I seen my Daddy taken away from my Mom just when they would be able to only have each other to worry about. I had met D and we would soon be out of the house. Leaving Mom and Dad with no kids at home. Time to enjoy!
     We have many years ahead, Jayk has a few more at home, and I am excited about the future.
 Our family is marvelous
    

    

Number 27

I have a new favorite quote...." Many of life's failures are people who did not realize how close they were to success when they gave up."
This is the story of my Life.
I really need to get back on the horse

My Upside Down Life

For years I have worked the Night Shift. I have pulled off 12 hour shifts, 8 hour shifts. These shifts have  started many different times, my favorite would have to be those 12 hours 1900 to -730 North Vista Hospital. Sweet! only three required. Working Three shifts would allow me 4 WONDERFUL days off with Family. These days I work the 2330 to 0800 shift. I enjoy a fast shift believe me 8 hours is nothing compared to 12, Oh and the patient load at North Vista, although Done well and effective, these days with my SBAR I am on easy street. I enjoy my random float to the Med/Surg unit, this gives me a sense of clinical importance LOL. I really like the on-going monitoring of an IV and the fluids infusing. I enjoy the patient that just needs a hand and listen moment. I like the ability to know the drugs that are to given and what to look for as the effect of the drug. I like understanding side effects and adverse reactions and working with the physician with the report of ether. I feel good knowing what I am watching for and not being afraid to call my physician on call.
    With this new appointment I am seeking in the VA southern Nevada, I know the knowledge I have from the years of health care experience I have. I will contribute a wide base of skill in total patient care from every area of the Hospital, physician and mental health setting. I am Amazing and I really enjoy my career.         

Nursing and Being Floated

Working as a nurse being floated is just something that happens from time to time. Last night I was sent to the medical surgical floor. I don't mind because this allows me to keep up with my clinical skills, it also looks good on a resume.
Unfortunately when you are the float you seem to get the patients everyone else had that no one else wants. Let me explain,
     I was given report on a patient with major wound care issues where dressing changes are necessary. (this entails  following a treatment plan, with seriously detailed description of each wound). Document the type of wound and location, is it a partial or full thickness wound. One of hers included a thin blister over a dark wound bed. This wound is covered by thin eschar. Next was a Stage I intact skin with non-blanchable redness of a localized area we call it bony prominence.her Stage III aka, (Full thickness tissue loss). Subcutaneous fat was visible but her bone, tendon,and muscle were not exposed. Slough was present.Amazingly so No undermining and tunneling.well all in all No camera too bad, measuring each wound and depth is completely necessary. 
     Another favorite is the patient with pain control problems. (The Opioid Dilemma) you will spend about every hour in that room.The use of opiates (or for that matter any treatment) makes sense when the benefits outweigh the risks and negative side effects. Benefit is suggested when there is a significant increase in the person’s level of functioning, a reduction or elimination of pain complaints, a more positive and hopeful attitude, and when side effects are minimal or controllable.
Opiates are not harmless drugs. The dilemma with the long-term use of opiates are so bad that the hospital opened a whole new wing in the hospital called SATS (substance abuse treatment program). The treatment team, along with the person in treatment, develops a treatment plan based on the assessment. A treatment plan is a written guide to treatment that includes the person’s goals, treatment activities designed to help him or her meet those goals, ways to tell whether a goal has been met, and a time frame for meeting goals.The treatment plan helps both the person in treatment and treatment program staff stay focused and on track.
The treatment plan is adjusted over time to meet changing needs and ensure that it stays relevant.
But before all that goes on, we as nursing staff feel pain is a vital sign, and what ever the patient says their pain is, it is what it is... we ask, "What is your pain scale on a scale of 1 to 10, 10 being the worst most imaginable pain?" and of course they say 10 or my favorite 20.  SURE okay who am I to judge, so going over the patients PRN and Scheduled pain medication and anxiety meds I find that he has Maxed out his 3g acetaminophen allowed in a 24 hour period so giving him another percocet ( his break through pain drug) is out of the question now explaining to him that all he has left is an IV push Dilated in 1 hour. Now don't let me fool you, these patient know every pill they have available to them and when they are due. But they push their agitation to the limits in hopes they get the new grad or unseasoned nurse will call the doc and just maybe the doc will grant a added dose or 1 x Now dosage of an amazing wonderful drug (like dilated IV Push) because they desire to reach that euphoria feeling, aka, (chasing the silver dragon) seeking the High of Highs.
      On top of that  the agitated highly animated post surgical procedure patient. See anesthesia sometimes hands you back a patient with altered mental status, coordination and balance problems, and changes in mood or behavior, among other ...Oh and when handed that patient you would most likely want him on a 1:1, but the NOD says, "sorry not enough staff". Oh! and did I mention the family of the post surgical patient, ha ha ha.

But Wait!!! There's More!!! I also got four low acuity patients, yea right, what ever...

Time management, yes this is an important ability over all nursing talents. juggling 7 and I am Sorry but you Family members are like extra patients.so 8 I don't mind patient and family education, it improve family comfort and sometimes you can get the family to help out. I really think it takes about an hour to educate a family on what is going on with their Dad, but after they get it they are full of heavy emotions and that is what continues through the tour. some members really want to help. Only problem is the redirection and time spent explaining why the surgery went well but the anesthesia altered the brain and Daddy is no longer himself. This is one of the hard parts of nursing. See the doctor gets to tell them, "The Surgery went well, but he is not fully out of anesthesia" The family has no idea what that means so they ask the doc, and of course, he says, " these things are unknown, sometimes it wears off" What turds, they really need to sit down and spend time explaining the whole picture and NOT in five minutes. So the real education starts when the patient arrives to the floor, aka Med/Surg.

DON'T forget I did have 4 other patients with their own serious situation, and an extra long list of medications. Please remember in doing all this amazing nursing I had IV to start, fluids to hang and meds to give at specific times see a hour before and hour after any more you are derelic of duty
I can say no more, I get to go back tonight...

Time to get Serious 2012

My Personal Record Needs to Improve, and I am willing to work hard at it. I have increased my gym time to 90min 4 x week. I also decided cold (anywhere from 10 degrees to 30) weather is not too bad, and the burn it leaves on my face only last for a day.
 My new gym workout session starts with Jog/Run 3 to 5 miles and I really try to stay at 4mph average with bits of 5mph to 6mph with the push of a button when on the treadmill. I follow this with upper/lower body weight training two times a week. Thanks to Glady, my daughter I now understand reps vs weight and believe me I feel the muscles with the increase in Rep not weights.
 Ending every workout with Yoga, this is one of the best things! I feel stronger and I am noticing an improvement on recovery time. Running outside took some getting used to, I have a red face for about a day, not the normal red more like a burn. Cold Burn. I have learned to never run on ice, stay on the snow. my time as of now 1:53  7.3miles treadmill but out doors with hills 1:59.
     The plan is to drop ten min off my 7.3miles by end of March and for my hard work I get a pair of Saucony's! Really can't wait, I want the Triumph 8 I need to capture my goal by end of March due to Bay to Breakers come the following May! break in my shoes maybe 3-4 weeks?

Okay let me go over my Training Regimen
My week starts on
Sunday:  after work 0800 3-5 miles easy jog/run, upper body free weights total 30min, Wrap-up with basic Yoga
Monday:  Rest day Long walk with Hubby
Tuesday:  Hike 3-7 miles mountain terrain,  basic Yoga 
Wednesday: after work 0800 Jog/run 3-5 miles avaerage 3.8mph, lower body weights 8 reps of 50lbs X 8 focus 4 areas, Wrap-up with basic Yoga.
Thursday: Long Jog /Run anywhere from 4-6 miles is long for me I try to do this Outside, staying out of the gym, but pending on weather. Wrap-up with basic Yoga at home. ( thanks Glady for the Mat and the Tara Stiles yoga)
Friday: Rest day Cross train. This is a good day to take a long walk with Hubby, We normally walk about 4 miles. End with Couple's Yoga
Saturday:  after work 0800 2 miles at 4mph average, 30 min elliptical, Basic Yoga.

All in all I am feeling really good!