Tuesday

Keeping my fingers crossed, but I think in many ways today is better, so far. Sunday was a looong repeat of Saturday, except I did get to go for a long walk with the dog.S was home napping, and so was J.

Monday was my 8am interview with the NP I would be working with, and it went very very well. I liked her right away, we had a lot in common background-wise and work-wise, and after the 30 minute interview I left feeling pretty good. I was driving home thinking about how different and nice my work-life would be if I were working with someone I could talk to as an equal, when I remembered I hadn't turned my phone back on. When I did so, there was a voice  mail offering me the job, with a dollar per hour raise.  

I arrived home in shock that they'd called me  that quickly. My sister said something so nice: "they must have been waiting for the right person, you, and knew it right away", or something along those lines. I felt so validated affirmed, and am really looking forward to working in a smaller health care system from Samaritan with its 5000 employees. My own personal doc is a NP in TCC (capitalized the corvallis clinic, as it's called) and I love her. TCC has approximately 670 employees, and it felt like a good fit at both interviews.

So today I had to give a UA, and they will do a background check, and then the manager will call me with the official offer, start date, etc. Then I will give notice, and see if they want me to work out the two weeks or just...leave. I will be negotiating the three days pre-planned vacation I already have into my start time at the new job; I will not give up those days with my sister!

Monday was also J's first physical therapy at home visit by the HomeHealth person, Marilyn. She worked him hard. She was very nice, but kept him on task, and he hadn't done that before. I've been trying to keep the ice machine working through the wrap around his knee, and he's also supposed to be on the CPM at least 6 hours daily but since it's so painful he tries to wiggle out of it. And because of his pain level I haven't pushed.

Monday also the HomeHealth RN came in response to another issue, the severe itching he is experiencing. Turns out to be a reaction to the morphine. (On Sunday, a HomeHealth RN came out to change his dressing, and he'd complained of dizziness, nausea, and loopy feeling that the dilaudid gave him. So we'd discussed the options and agreed to drop that and try additional morphine for his breakthrough pain until we could contact the office on Monday and speak with the PA-C about what to change to.) 

So Monday's HHRN while getting the info about the pain management issue, also told him officially that he was in atrial fibrillation, another complication which had developed that morning. He felt so sick, so weak, that eventually after discussions with the PCP and cardio's office, and the PA-C, we called 911. They were out in 4 minutes flat, and evaluated him. He was right on the border: lots of fluttering, but not quite severe enough to shock him. They suggested options: they could take him to the ER, I could drive him there, or he could go to Immediate Care, which is similar to Urgent Care but it's on the hospital campus.

They ended up helping him into our own car (despite his wish to ride in the ambulance with the sirens screaming--they said no, sir, only if you are dying!  Oh, yes, there was a lot of joking and humor...)  He really didn't want to go anywhere, but since they were quite firm about the recommendation to get checked by an MD, he finally agreed.  So we arrived over there at 4, and he used the walker for the longest distance so far, in the rain. He was immediately seen and there was some discussion over whether to head straight to the ER. But they did take him in back and hooked him up to IV fluids and an EKG, and got lab samples (to see if something unusual was causing this or if this was just another of his usual episodes, which normally do resolve on their own within a few hours).

 We were released by 630. I'd in the meantime run up to my office to pick up the written rx for pain meds they were switching him to, and on the way back to ICC ran into a dear friend, who is also experiencing a lot of difficulty with our employer. (She and I have talked a lot about what to do, how to handle, whether it's Us or Them that's making us crazy-anxious and depressed. She was really down that day and had texted me  to vent.) So it was heaven-sent to run into her and be able to tell her about my job offer, and bring her up to date on J's condition at the moment, and encourage her to also think about leaving.

So I brought J home, our neighbor met us to help him up the porch steps, and we got him into bed. Then I ran out again to take the rx to the pharmacy. Of course they were short staffed and it was going to be a half hour wait.... I grabbed some groceries and fixings for dinner, and raced home again where I just collapsed and cried.

 Then I had a glass of wine, and started a quick dinner. S went back to the store to get the filled rx. She had cleaned up, washed the dishes, kept the fire going, checked on and then locked up the chickens, reassured Murphy, got the house warm, all after working a longer day than usual at the daycare. J was still very weak, very dizzy, worried about his AF. And during all that suddenly the stool softeners began working! So we had to get him up again, and he hobbled to the bathroom. First time in 6 days. He felt a lot better afterwards.

S and I had our dinner after I brought him his. He'd wanted meatloaf for the protein, and a baked potato, but only ate about 3 bites and quit. He hadn't had any pain meds for almost 8 hours so he was really hurting, and couldn't focus on anything else. 

Eventually we all settled in, and decompressed.  Hell of a day.

And at midnight he woke with a panic attack: Terribly afraid we'd lose the house and be homeless because of "something stupid" he thought he'd done, having trouble breathing, shaking, cold and clammy-- it was crazy. I've never seen that happen to him.  Fortunately we have anti-anxiety meds, and I ran and got one.

What Else Can Happen.

Today, everything seems to be doing well. The ice machine is working fine, he was on the CPM for almost 2 hours before taking a break, no more AF but a lot of high blood pressure, probably due to the pain. No more nausea, but the itching persists, so we've added benedryl to the med cocktail.  No appetite, but he's drinking just fine. He called the insurance company to discuss the "something stupid" he thought he'd done, and was reassured--whatever it was didn't affect anything he thought it was going to. I'm not clear on the details of why he was panicking, but at least it was resolved, and he isn't worrying anymore.

I'm trying to figure out if I can, if I should, how I can, take the rest of the week off. I definitely have the time available. Gotta think.

Saturday night

Lord, I am so tired. I hate this fatigue.

Jeremiah's surgery went well. It was a very long day. He/we checked in at 11:30, and he got all prepped, IV'd, met with the anesthesiologist, had the spinal block. Everyone was nice, no rush at all, made sure we understood everything that was happening. Dr R came in, seemed very comfortable, relaxed,  and in good spirits; I introduced him to V, J's daughter, who had decided to spend the day with us/me during this time. My daughter also joined us later, and the three of us camped out on two sofas in the waiting room, browsing on smart phones or Kindles, leafing through magazines, talking occasionally  as we waited for news of the surgery.

 At 4, Dr R came up to the waiting room and said everything had gone perfectly, no signs of AF during the procedure,  there was "major damage" to the knee itself so that explained the amount of pain he'd been having.  It was another 90 minutes before we finally were allowed to head up to his room, and see him installed. Didn't have to share a room which was wonderful; he seemed loopy but in good spirits.

V and my daughter left around 6 I think, S to go home and lock up the chickens and be with Murphy who had been alone all day.  I stayed only til about 7, as he was very tired, and starting to not make sense due to not being completely out of recovery.

The next day I returned to work. For the rest of the week I worked all day and then would stop in to see J at lunch or before and after work. Thankfully the hospital is literally steps away from my office, so a quick 5-minute walk and I could be in his room. But each day after the surgery was bad; he was in agonizing pain, and the morphine, dilaudid, and IV meds were not controlling his pain. He was also having severe nausea: couldn't keep food down (what little he could eat), and it was all heartbreaking to see. Plus--hello--scary!! I have never seen anyone in that much pain.

The PA-C and Dr both thought that once he got home and was back on his MM it would be better for his pain control and nausea.  Unfortunately, the hospital and surrounding offices are "smoke free", so even medical marijuana is not allowed. But each day,  Wednesday, Thursday, and Friday, both the doc and the PA-C would make a  point of talking about this with me, or reassure me, or discuss the various options. They were also of course speaking with him in his room twice a day, and encouraging him.

He'd hardly eaten anything, and when I did visit he was visibly shaking from the pain, or utterly depleted, very loopy. I was concerned, but thankful he was in the right place to deal with this. The nurses were wonderfully attentive, and very responsive to me as well. I was beginning to be a bit fearful about how we'd manage at home.

In the meantime, I'd gotten a call from T, one of the people I'd interviewed with. She wanted me for the second interview to meet the neurologist's NP, and so we agreed on 8am on this coming Monday.That's partly why I am feeling so stressed: Interviewing is maybe not the best thing right now; on the other hand...why wait to try to improve  one's life? Yeah...life is complicated right now.

Friday I worked just til noon, after dealing with a lot of um...drama...Thursday, in the office. I won't even go into details--I'm just so tired of it all. But  I left at noon, and then J and I waited in his room til after 2 (before the paperwork and final session with the PT had been completed).

His son Z was supposed to meet us at the hospital to help J with getting up the porch steps at home, but despite texts and phone calls he didn't show up. (In his defense, he does work the night shift at the hospital, and normally sleeps during the day...so I can quite understand why he didn't make it. What I don't understand is why he said he *would* be there, and *then* didn't show up: Why bother promising something if you know you probably won't be able to keep that promise?)  In any case, we got him into the car, and I drove the Cadillac, and we made it home. Fortunately S was there, and despite J's extreme pain, we did manage to get up the steps to the house, and he made it to the bedroom, and collapsed.  

I'm not going to bother to detail what we have been doing since then. Okay,  yes, I will:   We have been struggling to manage his walker, the ice machine (which is supposed to be on his knee for the majority of the day), the 5 extra meds (which are given twice daily... or every four hours... or prn... daily), the Continuous Passive Motion machine (which moves his knee for him which he is supposed to be on at least 6 hours daily), and the best thing for him (which is actively using the walker being up and around). He's not actually throwing up---but that first day was still filled with nausea. And shakes, and chills, and bouts of sweating due to the pain, and the small house which is suddenly filled with all kinds of dangerous hazards, and the complete lack of interest in food, and the wood stove which needs very frequent tending, and the dishes which pile up amazingly quickly, and the ice machine which has been a problem, and on and on and on. 

I'm so tired. And I'm so concerned about what will happen during the week, when I have to return to work and J will be alone. S has a part-time job, and really isn't interested in helping here, although she has done her best; I really can't expect her to help much. She makes it clear that she is resentful at being asked to help. At other times she is sweet, and funny, and thoughtful, and cheerfully cooking meals,  and working the wood stove. I have a lot of trouble with moody people.   Part of me wants to just sit and cry, and the other part tries to just grit my teeth and get through this. I'm feeling down, obviously.

J is in bed, sleeping. My back is aching. The chickens are in the coop asleep. The wood stove I think is doing okay, although I have trouble manipulating the heavy logs. S is gone visiting a friend and won't be back til late. I know this is my exhaustion speaking, and it will get better each day.

This too shall pass.

Sunday

Friday afternoon  was an intense experience. I wasn't actually nervous about the interview, but I was excited to learn more about the position.

I felt slightly guilty about saying I had a doctor's appointment to get off work, and I even still feel slightly guilty about interviewing elsewhere. But I consoled my thinking by realizing I did have an appointment in a doctor's office. Technically, anyway.  And I read the askamanager blog archives, and discovered many, many people feel guilty at interviewing and then leaving. I was reassured.

It's more difficult to consider leaving because recently people have been extra nice to me at work. This always happens. I don't know why, but it's similar to whenever I am about to move. Suddenly I discover many good things about the current location, and have second thoughts about changing. Is it about the change process, or just the necessary grief over letting go of one to move to another? I don't know.  It didn't help that Friday  all of us CMAs got a completely unexpected dollar an hour raise, effective two weeks ago. Now I am at exactly where I was when I left ProResearch.  If this neurology position doesn't work out, I of course am not quitting ortho, and the raise will definitely help.

I reminded myself that nothing is set in stone. I don't have to move on if I don't want to. But I immediately remembered the reasons for looking elsewhere, even if I can't articulate all those reasons in an interview. 

The very first question was  "Why are you considering leaving your current position?"  I paused to gather my thoughts, and then said part of what is true: that in ortho the vast majority of patients are transient: you'll see them for a period of time while they recover from surgery, and then that's it. I said that I imagined in neurology these are long term patients, and one would develop strong connections to this population over time, and that's what I was looking for--more of an emotional connection to my patients. They seemed pleased with this, and verified my impression that patients are generally seen over a period of years as their issues progress and new medications are tried to help manage their conditions.

In fact they seemed pleased with everything!  I first met with S, the HR rep. We'd remembered each other from the last time I interviewed there almost 2 years ago.We reestablished our good connection, and she typed everything I was saying in response to her questions into her laptop. I felt pretty comfortable; it was about 20 minutes long.

Then the director of nursing and the dept manager came in, and both alternated with questioning me.  I felt pretty comfortable with my answers, and was honest when they asked the dreaded "what is your biggest weakness and how do you over come this?". My big weakness is the damned phone: I hate it, but have developed techniques  to manage this part of the job (such as doing it quickly and not procrastinating, organizing my thoughts ahead of time, taking notes, summarizing and then checking with the doc or the provider for the answer and returning the call promptly). I didn't add the part where I tell myself to put on my "It's Business!" hat and just freakin' DO IT, but this is also true, that I force myself to do it without thinking overmuch  about it.

They explained the process, that in a couple of weeks I'd either get a phone call asking me to come in for a second interview to meet the doctor, or I'd get a rejection letter.  The first two women said in so many words that I would probably not get the rejection letter... Susan said to me that she remembered thinking (at my first meeting with her 2 years ago) that all I needed was a little more experience. She was happy to learn what I'd been doing since then.

So, all done. Afterwards  I went home and changed, and reported to J, and then headed out to the dentist. This was just my annual cleaning. At which it was discovered that I have a cracked filling so I need to return for that to be fixed. Ugh. It was also determined that I would do better with twice yearly cleanings, instead of the once a year, so I will make that for July.

Then home, for a glass of wine or two, and a pizza, and relaxing evening with TV. J's CPM machine was delivered earlier that day, and he learned he won't be completely bed-bound and hooked up to  the machine 24/7: instead it's only recommended for 6-7 hours daily.

J's pre-op appt was disappointing to him: the PA for that Dr had a very rare migraine and was still determined to see all her patients despite her extreme ...discomfort. On top of that someone had mistakenly listed J as a HIP replacement instead of a knee, so the PA had planned  on that discussion, only to find out that of course it's a knee...paperwork had to be redone, different forms needed, the whole thing. She was very embarrassed.  Plus she hadn't realized J had already spoken with the cardio about his use of Pradaxa; she has her own set of requirements based on the anesthesiologist's demands for these patients and so had to explain the reasoning to J, etc. He wasn't happy but this is required.  The next day the PA called J at home and apologized, reassuring him the appt doesnt usually end uncomfortably, that it's  not an indicator that surgery won't go well, that there were mistakes made and she was on top of it all now. He felt a lot better.

In truth, I've never, ever seen this PA make an error like that, nor have I ever seen her with a migraine. I could also reassure J that I totally trust the doc (who is not the Doc I work with). (Not that I don't trust him either--all the docs there are excellent surgeons and I admire all of them.) It just happened to be a bad day.

But we are counting down the days now; J goes in Tuesday morning. We've done our shopping and prepping, and gathering wood so S and I can manage the woodstove on our own, we have the medical equipment he will need,  the car of course which will be easier for him to navigate in and out of. J's been attending the gym almost daily getting his knees and back ready for rehab.

 We are heading there this morning, the three of us, as soon as I finish this. Then at 1, two of my friends are coming over and we will all walk in BaldHill. It's dark and damp and cold and foggy-- miserable weather. But having company makes it easier to get through this. Supposed to be this way all week long. An "Air Stagnation Advisory" is what it's called. Bloody cold  and frustrating is what I call it.

We've also decided to "cut the cable" as the ads say, and use Netflix instead. I feel much better about the money aspect for sure--cable is $120 a month (for what we tried this past month), compared to Netflix's free trial month which we began last night. Now, cable here includes hi-speed Internet, so that's about $40 of the $120. Still, it will be far less expensive overall.

And!  I was able to send a check for $600 toward my school loan this month. I felt so good about that. Next week I will go through our paperwork and get the files ready so we can schedule our income tax prep appt in February. Whatever we get back as our refund will also go to the school loan. I'm breathing better now, as far as finances go.

Yoga is easier too. I look forward to it, and will have to decide whether to continue my gym membership if I get this new job. Obviously my old employer won't cover my membership, so I'd be paying for it myself. Have to think about it.

Lots to consider.

Wednesday

I have an interview Friday afternoon (with the company I sent my resume to in response to their search for a CMA in Neurology). This is a field I've always been fascinated by. I'd almost forgotten I'd sent the resume: I sent it last Friday, and there was so much happening over the weekend that when the call came Monday afternoon, I was just  a bit surprised. But in a good way.

So my interview is 3pm. The HR person said to allow an hour or 90 minutes. Gulp.

At 5 I have an annual dentist appt. What a full day this will be.  She sent me a questionnaire which I filled out today during a slow time at work, and I have to email that to her before my appt. Then I meet with her , and then the manager of the dept.

Tuesday, yesterday, coworker S was out, which meant I got to work with the crazy RN, and DrSK and PAD. I roomed 35 patients that day for the doc and the PA. 35.  I can't even explain how tired I was at the end of the day. Along with my other duties, and along with helping one of the other docs because *his* CMA was out. I couldn't even talk when I got home.  I sat there with a glass of wine. My hip was aching, my head was pounding. So tired. Then, during the night, the damn leg cramps attacked 4 separate times.

Today was a lot better. I had less patients, and the day ended by 330 for me; I am not allowed overtime so I *had* to leave. I got home and walked for an hour in the deep thick fog with Murphy.

S is sick, so she was very quiet.

Hope we get through the week peacefully. J's pre-op appt is tomorrow.

Saturday night

Today J and I went to the gym for the first time together, also meeting his son Z and the son's gf A. We all pretty much did our separate things, but Z and J alternated with teaching me how to use various machines. We all had a great time for an hour, and it felt good to get more familiar with the place. S and I had gone the previous Monday night, to sign up officially and attend the yoga class. This one will be weekly. There's another yoga class but it's during the day and I obviously can't make that one.

Both my sons have jobs now, in a Sam's club Warehouse in Columbus, working in the electronics department and manning a DirectTV kiosk. They had to pass a background check, and clearly did. (yay!)  Both are aware that they have debts to pay back (the student loans from their terms at Denver's community college), and both plan on doing this--I'm so relieved.

I did apply for the neurology office job;created a cover letter and updated my resume, and filled out the required application. I don't know what will happen, but all I can do is the next step, and then trust that the right thing will present itself. I haven't told anyone at work that I'm applying for other jobs. I guess I feel there's no point unless and until I get an offer. If people are aware that I'm not planning on staying, that could have a ripple effect on my time here.

Today I led my AlAnon meeting, and my dear friend/sponsor drove up from my old town to attend by my side.  It was one of the most powerful meetings I've ever been in; somehow I managed to choose a topic that everyone resonated with. So much emotional sharing, so many people publicly thanked me for the topic. I just felt humbled that so many people could relate to what I'd said and shared. One of my favorite male members shared last, and when I went to speak to him afterwards, he just threw his arm around me and said he'd miss me (he has to be gone for a month for work). That felt good. I actually heard that from a lot of people;  I am so blessed to be a part of this group.

J and my daughter are playfully bickering in the next room. I need to go and separate them. Sigh. It's funny, but it's frustrating that they can't get along better.

Sunday

Happy 2014!    It's another Sunday, and sunny. Very cold though. We wear lots of layers, and I wear 2 pairs of socks along with my slippers.

Last week was my new cube mate's first week; and she is going to do just fine. I will refer to her as K. She's calm and collected, and organized. She seemed very comfortable with the wide variety of things tossed at her. Monday and Thursday were clinic days for her, and that left Tuesday and Friday to catch up on paperwork generated by those two days plus the ongoing surgery scheduling.

Meanwhile I had clinic days every day as usual. We were closed on NY Day. I actually got to leave work for the day at 2pm on Tuesday so I could attend the Joint Education Class with J. This class is required for all knee and hip replacement patients. It lasted  less than an hour, and covered the hospital stay, and what kinds of rehab equipment we'd need. Our neighbor has a walker J can borrow, but we will need to buy or rent some items.

After it was over, we went home and walked in the daylight hours--that's a wonderful feeling. Then S and I took down all the Christmas stuff--the outside lights, the inside lights, the decorations, the ornaments, tree, creche, everything. Packed it all away in my brand new ornament boxes. S did a wonderful wonderful job with organizing. Then we did the cleaning and vacuuming, and I made spagetti and meatballs with garlic bread.

We were going to have champagne, but somehow never got around to it. J was utterly exhausted and went to bed; S and I stayed up a little later watching one of those YearInReview shows. Then I fell into bed too. I read though, and heard the fireworks being set off by neighbors at midnight.

The next day, January 1, we three and Murphy went to the coast to do some whale watching. This is the time of year when the whales are heading south in hundreds of thousands, and so we were full of anticipation and excitement. But while we saw many whale-watching boats and crowds of people all along the view points with binoculars, we didn't see any whales.  It was a gorgeous day: clear skies, no wind, sunshine. We drove up to Lincoln City, and then slowly headed back south to Newport stopping at all the official whale watching stations. Nothing. But it sure was beautiful, and hearing the gulls is something I never get tired of.

Home again by 4:30, and the worst part of that drive was that last 30 minutes; descending back into Corvallis and the thick thick fog which has been so pervasive, depressing and gloomy and cold. Brrr.

Then back to work Thursday and Friday.   S spent Friday night down in Eugene at her grandmother's house for dinner. I'd had an emotional day, and felt very teary for some reason. But just as J and I sat down to eat dinner, my phone rang. It turned out to be my granddaughter in Phoenix. We had an actual phone conversation. She had called to thank me for the items she got to choose from the Amazon gift card I'd sent them for Christmas.  After a few minutes on the phone with her, her mom got on and we talked; A is teaching G about budgets,  so G did pick out her own items with value in mind. She chose hair bands, slippers, and a doll.

A is also the new accountant for the local Girl Scout troop, and G is a new member (I think they are called Brownies when they are this young). So I will be buying cookies from my very own granddaughter! Then A told me since she'd gotten a very nice raise and wasn't getting married after all, she and a friend who also has a young daughter decided to spend that money on a cruise to the Caribbean this summer!   Turns out she has been on 3 other cruises in her life, and firmly believes this will give Gabby a broadened perspective on how the rest of the world lives.  I Am So Impressed with A.  My son chose an amazing young woman to get involved with. Too bad he wasn't ready to commit to it, but at least Gabby has a phenomenal mom.

After we'd hung up, sending much love and hugs and kisses, I burst into tears again. I'm so grateful, so humbled that Gabby loves me, and that even though it's now been two years since I've seen her, she remembers me. I'm so blessed. Somehow I need to find a way to visit.

But the first priority is paying off the school loan. That has to be the most important goal this year. I am determined.

Then I can start saving for the down payment for the house in FL.

I also decided that I'm going to apply for other jobs. There's one as a CMA in a neurology office, and that does appeal to me. I have to print out the application, and then submit it. Haven't done this for awhile; guess I need to work on my resume. Nothing ventured, nothing gained.

Here we go.  Happy New Year. Wonder what will happen?