Advocate

Bats, people.  Apparently these sonar-using, miniature Chihuahuas with wings are some of the most stealthy creatures on this Earth.  I say this because within the past few weeks I got to participate in administering several of the shots in the Rabies vaccine series.  This sounds terribly glamorous, I know.  But let me reassure you and your jealousy that it was actually very boring and routine from a clinical point of view.  It was, however, interesting to me because I had never given it before and so I was overly excited to learn a new thing.  (Trust me when I tell you that you DO NOT want to have this series of injections.  Ever.  The number of injections varies based upon the patient’s weight, but suffice it to say that it involves multiple injections over a period of days.  I would rather have a high colonic, but that’s just me.)  At any rate, the patient who received the shots didn’t actually know if he had been bitten.  He had no bite marks, and stated only that the bat had “bumped into his head.”  So this was where I scrunched my eyebrows together in an attempt to look concerned/as if I needed clarification, but which was really a very thinly disguised “You, Sir, are a moron” face – until he proceeded to state that his wife had looked this situation up on the world wide interwebs and various sites asserted that, if you were to wake up in a room and find that you had been double-bunked with a bat, you should just assume you had been bitten and get your self to the nearest ER pronto.  Well.  Finding it hard to believe that an animal which looks like God created it out of the spare parts of a whale, a moth, a rat, and a seed pod could somehow manage to puncture human flesh undetected, I consulted with my fellow nurses (and by “consult” I really mean “mock the patient”) who told me that they have heard the same thing.  Apparently my patient was right, and because of his diligence will live to tell the tale and/or turn into a bat.

One of the questions we must ask our patients when gathering information about their medical history is: “Do you have anything implanted in your body that you weren’t born with?”  This always gets a strange look from the patient, so I add: “Such as a port, a pump, a shunt, a stent, or orthopedic hardware?”  I used to think that the bewildered expression on their faces was because, like me, the first thing that sprang to mind when hearing that question was, “Is this nurse seriously asking me if I have had an alien probe/tracking device inserted into my rectal vault?” (okay, okay.  So yes, I did watch an overabundance of Buck Rogers, Star Trek, and “V” growing up.)  But now I realize that it’s because they truly don’t have any idea what some surgeon has placed in their body, or removed, or manipulated.  They barely know what they put into their own bodies, for Pete’s sake.  For instance, the other day a female patient of mine was reviewing her history with me, and when I asked her the above question, the conversation went something like this:

Patient: “Um, yeah.  I have some valve-thingy.”

Me:  “Do you mean you had a valve replacement?  Which one? (because, you know, you’ve got more than one!) What type of valve replacement was it?”

Patient:  “Oh, I don’t know.  They doctor went in there and stuck something inside me.  I’ve got to come in next week to have them put a balloon up somewhere in there, too.”

 

Okay.  Now I totally get that non-medical people may not know all the hospital verbiage and surgical jargon, that their understanding of body parts/procedures/physiological responses may be very simplistic and limited.  BUT.  You are seriously laying in that stretcher telling me that you allowed another human being (albeit a highly trained and knowledgeable one) to cut into your body, take out a “part,” insert a new, foreign part, then sew you up and send you on your merry way???  And you have no idea what was done or whether it was even necessary???

Sigh.  The same type of situation occurs when we ask our patients whether they are currently taking any medications, and, if so, what the names/dosages might be.  My favorite response is along the lines of, “Um, let’s see.  Well, I take something for my blood pressure.  I can’t remember the name.  It’s a little green pill.”  Which would be a fantastic bit of information if your medication regime consisted entirely of Tic Tacs.  Then I could at least narrow it down to wintergreen or lime.  But since there are probably four pharmaceutical companies currently manufacturing your mystery blood pressure pill, the fact that the only information you can provide is its color is of extremely little value.  Of course I don’t say it with that snarky tone, though.  I do at least try to be professional.  So I ask whether they have a list of their meds, or whether their spouse might be able to “fill in the blanks,” which is often met with a lot of head rubbing, a sheepish grin, and the words, “Gosh, I don’t know.  I just take them cause the doctor told me to.”  And here’s where I really have to bite my tongue, because the mother in me has her chin down, her eyebrows raised, her arms crossed, and she’s saying, “Really.  Really?  You are ingesting, on a daily basis, a substance about which you know nothing simply because your doctor told you to?  What if I pulled out a dusty Tylenol from under the med machine, cleaned it off, and gave it to you?  Would you take it, simply because I am wearing scrubs and don’t look like a serial killer?  If your brother told you to jump off a bridge, would you do it????”

My mother (whose entire medical knowledge comes strictly from Prevention Magazine) always told me that, when it comes to health care, I needed to “be my own advocate.”  No one else was going to be my voice, that I needed to be educated and aware and speak up for my health.  I saw her do this with her own mother, who, at 96 and with dementia, could no longer advocate for herself.  So when my grandmother’s PCP attempted to schedule her for a mammogram and a pap smear (both great diagnostic tools for preventative medicine, to be sure – but, let’s face it – what exactly are you hoping to find on a 96-YEAR-OLD?  I mean, at that stage of life your cervix and what were once called “breasts” are pretty much just organized collections of dust and old cells.  And if you do find an abnormality, or a tumor, what are you going to do about it?  Radiate the poor woman out of existence?)  So my mother, Prevention Magazine in hand, triumphantly defied said PCP by refusing to put my demented but otherwise healthy grandmother through the unnecessary trauma of having her boobs squashed and her cervix scraped.

The sad thing is, though, that too many people are willing to abdicate responsibility for their own health and blindly do whatever it is that their doctor tells them is best.  People don’t want to think for themselves; they want to be directed, to have this test ordered or that body part cut out, or eat this combination of pills.  They mistakenly believe that good health lies in the doing, not the thinking. That if I just take this BP med and this cholesterol pill life will be sunshine and rainbows and I will live forever and ever.  Or, if I could just get that part of my body removed/shortened/cleaned/burned off I won’t be depressed and unhappy anymore.  But it doesn’t work that way.  Life and health are about treating your mind and body with dignity, and living with dignity means speaking up for yourself.  It means telling the doctor “No” when he wants you to take a pill for your blood pressure – but it also means making the choice to exercise and change your diet and putting down the cigs in order to make your heart happy.  And finally, it means, when those changes haven’t helped and your blood pressure is high enough to stroke out a whale, you go back to your PCP and you take the meds as prescribed – and you fill your script regularly and familiarize yourself with potential side effects.  And, for goodness sake, you keep a list of the meds you take in your wallet, in your wife’s purse, in your glove compartment, and at your neighbor’s house.  This is what “being your own advocate” means.  It is not opting to eat tree bark and yogurt and meditating on the meaning of life instead of getting that quadruple bi-pass your doc recommended.  It is partnering with your MD to achieve the best, most realistically-attainable goals for your health.  It is being honest with yourself and your loved ones about the quality of life you’d like to have and to maintain, and then doing your level best to achieve that.

Okay, stepping down from my soapbox now to resume packing (yes, we ARE moving!  More details to come.  Suffice it to say, though, that the new house is triple the square footage of our current home, and the kids’ minds were blown away by having two basins in one bathroom.) Cleaning and tossing out 13 years’ worth of stuff is a dusty, dirty business.  No bats so far.  If I do manage to have one fly into me, though, no worries – I’ll just head to my medicine cabinet and down a bunch of orange Tic Tacs.

Advertisements