Desmopressin

Another Saturday in the trenches.  It honestly was not that bad.  One of the things I love most about being a nurse is that I am always learning something.  Today's lessons included Desmopressin as a treatment of Diabetes Insipidus.


Diabetes Insipidus is a condition caused by decreased production of antidiuretic hormone by the pituitary.  My patient had a very large tumor encircling her pituitary that had to be removed.  Before the surgery she was confused, and had a lack of balance.  Since her surgery, she is much less confused and has a much steadier gait.  The surgery on her pituitary has caused the DI condition, though.  When your body does not make enough ADH, then the body just wants to pee and pee.  A person with DI is always very thirsty and always having to pee (even worse than breaking the seal during Friday night cocktails).  We often treat with a med called DDVAP, Desmopressin. Desmopressin increase water reabsorption in the renal collecting ducts, which makes you pee less.  The main side effect of DDVAP is hyponatremia, or decreased sodium, which can led to confusion, seizures, or death.  If you are peeing so much that your sodium levels are down, you cannot receive anymore DDVAP, because the water retention will then cause an even greater "dilutional" hyponatremia.  

The kidneys are such a complex organ, it really amazes me what the body can do.  I always enjoy learning more about the kidneys and their hormone connection to the brain.  The nursing student I am training was so knowledgable about this.  Her discussion really helped me grasp this subject.  

Rites of Passage

The New Year is almost over.  My life has been traditionally marked by Burning Man as the end of one project, beginning of another.  This year I did not attend Burning Man, but interestingly enough, my connection with that particular rite of passage grew immensely.  I look forward to returning next year, and plan on making it's theme "Rite of Passage," a major learning theme in my life this year.

My career as a nurse has shown me that the rite of passage that is death has been marred and manipulated by Western medicine and the Western ideal of hospitals.  Please understand, I believe we do great work in the hospital saving lives and elongating life.  However, I have seen too many cases where a patient is so obviously on the dying process and we forgo the signs, and utilize invasive tactics to sustain life for only a bit longer and with a very low quality of life (ie hooked to machines, pt not aware of surroundings).  It is my belief that the rite of passage of death should be taken back.  Not only is the patient's life quality affected, but so is the family.  Please let me die at home.  Let me struggle to breathe, rather than unplugging a machine.

Having just completed a Rite of Passage, my marriage to Nascar, I am convinced that our community does not place as much emphasis on the "hard" rites of passage.  Marriage is something for a wedding planner to plan, birth can be scheduled as a C-section, and death should take place by unplugging the machines that are substituting for my lungs.  I refuse to live this way and look forward to investigating these thoughts both artistically and professionally over this next year.

Going with the Flow

It has been over 5 months since I last blogged. Such a shame, for this is probably the happiest I have ever been. Nascar and I are a true team, in love with living as husband and wife.

I would be amiss to say that our lives are not tiring, filled with work and school, and family negotiations. But these are not problems, these are symptoms of a healthy and active life. I wake up every day and check my temperature (family planning), and thank the heavens for such gifts.

Nascar is in Texas currently on an aquarium business trip. He is flourishing in his job, and now dives once a week in the tanks to assist the husbandry staff with the fish care. I am still working at the local trauma center, and remain inspired by the patient population and the team of health care practicioners I work with.

I am humbled that I have been given such gifts of happiness. I realize that my choices have brought me to this station in life, but I do believe there is a bit of luck and a lot of faith on this road to happiness.

Of course, there is much about the country that is driving me to tears. The new bill in Arizona, SB 1070, legalizes racial profiling and is a travesty for all our civil rights leaders have worked for. Today, a bomb was found in Times Square in New York (no one hurt thankfully), last week a huge oil spill occurred in the Gulf of Mexico. I feel bad for the folks in New Orleans and Louisiana, ever since Hurricane Katrina, they really have not had an easy recovery. This oil spill will prove to slow the recovery down even more.