say hello to a brand-shiny new human being

I have just returned from a first-ever visit to Idaho Falls to spend time with the Kaufman family and their newest little member, Sam. Since my dear friend Jen and I graduated nursing school, our actual time together has been few and far between. That's what starting a new career, marriage, and a 1-state-away move does.

Fortunately at 2 months, Sam is a decidedly smiley and easy-going baby. At first, I was a little overwhelmed with all the simultaneous tasks Jen was deftly managing...and then awed at the level of communication, collaboration and patience she and her husband Joe share in order to manage this little mister. For such major life changes over a mere 2 month period, these two have adapted very well. They *almost* make it look easy.

Even though it was a relatively short visit, we managed to squeeze in quite a bit!

Jen and I took a walk with baby Sam and their 2 dogs to see the great and glorious namesake of Idaho Falls. Jen told me I would be 'under-whelmed'. Well, by the looks of this photo, do you think Jen was right?

On the walk home, I had a nerd moment where I couldn't resist snapping some photos of a statue at the local library honoring local writer Wilson Rawls, the author of Where the Red Fern Grows. To this day, this is the only book I have ever read that made me churn out waterworks rivaling what you see here. Luckily for you, I was also fascinated by Sam's little hand curled outside his sling and snapped a few of those too. Napping in the nice sunshine while Mom carries him around and feeds on demand--this kid is clearly enjoying the good life.

We stopped at a local bakery on the way home where Jen and I were surprised to notice that her two dogs generally received more attention than the the angelically snoozing Sam... Doc and Schatzi are pretty cute, but c'mon people! Oh, and BTW, Doc makes a great bed-buddy. He made sure I didn't miss my own doggie (too much) by cuddling up at the foot of the futon.
















Later that nite, while Mom was readying for bed and night-time baby rituals, Joe and I had some Sam on-the-floor playtime. He was giggly, coo-ey and very smiley for the camera. It was also great to spend some time talking to Joe and getting to know him a little better. By this time, I was becoming decidedly smitten with all of Sam's wee little charms...and very pleased with the fact that once any minor complication developed, I had the benefit of an unsuspecting parent available to attend his needs. Definitely not a luxury you can ever indulge in with your own child!

On Saturday, Joe loaded up the car with baby-gear and we set off on a 2 hour car ride to Jackson Hole for a day trip. My photo fascination with Sam's cute little feet was finally rewarded with this shot... (Apparently he has rather long toes for a baby, but aren't they just wee bits of perfection?)
There were some beautiful sights on the drive to Jackson Hole, interspered with some comical moments where baby-bottle feeding attempts occured with the simultaneous bends and twists that only an Idaho road can offer. Once in Jackson Hole, we were clearly in 'cowboy country' with many of the stores offering Western style leathers and cowboy hats. I later teased Andrew on a phone call home that I'd splurged on a black rhinestone-decorated cowboy hat for him. He was a little less than pleased, needless to say. We spent the day browsing the shops and discovering a little art fair at a nearby park. Here's a few highlights...
Our only 'group photo' with the ever-popular elk horns. Even though we waited for this photo to be free of extra people, some little old ladies walked up and sat down on our left--that's why it's cropped so oddly.
The best Dad n Sam photo taken while Jen and I were enjoying some hard-earned Haggen Daz milkshakes. Great minds think and crave alike: Jen had the Bailey's and I had the Belgian Chocolate (but I was hard-pressed to decide between that and Bailey's.) We spent a long enough day in Jackson Hole that Baby Sam was down to the very last diaper. These adventurous parents decided to live on the wild side and not make a diaper run prior to the 2 hr ride home. Luckily, we made it just in the nick of time.

Eventually...rather unfortunately, all good things come to an end. I had to say goodbye to this comfy little home and make the trip back to Seattle. I am in Sam withdrawals already, so hopefully I'll be able to see that baby before he gets even bigger!

Oh yeah, and maybe I'd like to see his parents too. I guess they can come along.


The last photos snapped before embarking on the trip home...notice Sam is snoozing and sticking out his tongue a bit in this last one...

blast from the past

Remember the ever-popular candy of the 80s: pop rocks? I guess I was too young to remember all the urban myths surrounding them, perhaps that's why I haven't seen them in ages. Apparently despite all the rumors, they're still around. Checking on one of my favorite foodie blogs yielded this awesome recipe.

As every grown-up knows, chocolate is infinitely better than the kiddie sugar bomb candy. But it takes a true genius to unite the two. I'm definitely gonna give this a try next time the cooking bug bites!

there's this *aMaZinG* thing called a planner!

If you're wrong about something...and it causes many of your co-workers a lot of stress, extra work, and your clients inconvenience...and particularly if it's not the first time you've made this mistake...

Please, please, for my sanity and others: admit that you messed up! Instead of blaming others and fuming at 'the system' for being 'punitive'....just deal with the fact that your mistake created problems. Resolve to change your habits and be proactive so you don't repeat the same mistake three times. This is particularly frustrating when said mistake could have been easily avoided just by doing what normal people do--keep a frickin' planner!

Ok. Nuff said on that for now.

May your palm pilot be ever-present, even in your dreams.

never say never and how i got there

Warning! Nursey Content ahead...this post is part of a Change Of Shift Submission.

When I first made the decision to pursue nursing, I had a definite preference for pediatrics. I eagerly devoured my pre-requisite human development courses. Volunteering in the nearby pediatric ward at Swedish Medical Center seemed to validate both my decision to become a nurse and preference for children. I enjoyed the playfulness of working with children and was pleased to realize that they came with some practical benefits: they were smaller, easier to lift, and the results of their body functions were much tinier.

On my volunteer days I admired the brightly-clad nurses who deftly moved from room to room, soothing a feverish 2 year old while speedily drawing blood, educating parents of a new diabetic, and taking a few minutes to chat with a sulky teen. The stages of development and creativity in altering your approach to a child and his or her family fascinated me. It also satisfied that bit of artist lurking in my otherwise innately practical self.

I remember a conversation with one of my nursing school girlfriends where we decided we each had it figured out...I never wanted to work with adults, and she could never imagine herself as anything other than an oncology nurse. In fact, I think we also announced this on a video cam her auntie had brought to our pinning ceremony. Ah, relatives with videocameras...what's not to love?

I wound up taking a few detours along the way...that led me to a very different place: oncology nursing--initially in the inpatient setting and currently in the outpatient setting. It wasn't by any conscious design but a gradual set of circumstances and choices that eventually led me to where I'm at today.

1) In my junior year of college, I landed a Nurse Technician job in Post-Partum, the closest I could get to pediatrics. The nearby peds ward did not have Nurse Tech positions--so I had to settle for the next best thing.
2) Despite the fact that I scoffed at Labor & Delivery as not being 'real nursing' because I thought it didn't involve med-surgical skills, I eventually began to appreciate its complexities. Little did I know...
3) Had my senior practicum rotation in the anesthesia recovery room at Children's Hospital...Decided that it's really important to get young kids to brush their teeth and not live on sugary liquids so they don't need anesthesia to get dental work done at 3 years of age. These are the ones that wake up trying to kick and hit you. Nevermind that you're supposed to do Q 5 minute VS for 15 minutes. Try that for your next fat-burning work-out.
4) Realized I *really* liked Post-Partum and might want to start my career off as an L & D nurse-- this was despite the weirdness of figuring out to operate hospital contraptions otherwise known as breast pumps, those poor frazzled hormonal moms and downright horny dads. Yes--that's right. Sleep deprivation and lack of sex is a dangerous combination in the average male, my friends.
5) Even though I was really drawn to L & D, I then became worried about possibly not developing a comprehensive med-surg skill base and perhaps being specialized right at the get-go, so...
6) Decided to take a job on a floor specialized in Gynecology-Oncology, Urology, and Hematology-Oncology...it seemed to have a little bit of everything and everyone. I took this job with the thought I'd spend a few years there to solidify a general skill base and then transfer to the L & D.
7) Nearly 5 years later after orienting lots of new nurses, administering chemotherapy, doing complex wound care and end-of-life care... I traded in the hospital scrubs for a nurse case manager position at specialty oncology center.

It didn't take too long for me to realize that the inpatient oncology job I had selected as a graduate nurse was everything I was looking for in nursing. I was working with an outstanding group of folks who were capable of nurturing and gently introducing a newbie into the daunting task of oncology nursing. I began to appreciate that oncology nursing offered a satisfying array of clinical tasks and rapidly changing therapies and particularly an ability to develop a unique relationship with patients. Before I knew it I became OCN certified and was decidedly hooked. So much for pediatrics. So much for small poos. Apparently bigger is not always better.

One of the most frequent comments I hear after telling someone I'm an oncology nurse is...."That is so depressing. How do you do it? Isn't there a lot of death?"

Well, the answers are
1) No, it's not.
2) It's just what I do. I happen to like it.
3) And yes, there can be a lot of death. You have to be prepared for tough conversations and really be comfortable answering questions about death and dying. But there is amazing strength displayed by most patients despite being in the face of great adversity. Even while knowing that cure is sometimes not always possible, there is always hope, promising research, and the everyday business of life to attend to.

I think one of my patients expressed perfectly to me what makes working with the oncology population so unique and rewarding. He described his past 5 years living with colorectal cancer as 'the best of his life.' Before you start to think he's crazy or riddled with brain metastasis, ponder this...

A common sentiment that is frequently expressed by patients is that life becomes innately more valuable, more defined. This is not exactly what they say, but it is the general theme. True wishes, desires, and hopes surface. Relationships are renewed; people begin to act on or resolve their regrets .

The couple that never spent time together now does. And guess what? For the first time in their marriage, they genuinely enjoy being with each other. The estranged mother is reconciled with her daughter--and meets her grandchild. The work-a-holic now realizes there is more to life than constant work and rediscovers his love of painting. The husband who berated himself for not providing enough for his wife finally receives her affirmation that what he had given her was more than enough.

I've seen this sentiment manifest in hundreds of different ways, but the basic message is unchanged. Life goes on...But it does so with a remarkable sense of clarity and newly defined purpose.

As an oncology nurse, the opportunity to educate, to alleviate symptoms, and to celebrate victories both large and small, and most of all--to be present for that journey--is a gift. Never mind the detours--eventually you'll get to the right place.

busted:: or tales of a pack rat, part one

One of the things I hate to admit is that despite the fact I love neatness and order, I have definite pack rat tendencies. I think I come by it somewhat genetically, so to a certain extent it's entirely understandable, right?

As a result of cleaning out my desk drawers the other day..(no small task for an easily distractible mind such as my own) I find a few interesting relics of the past with stories all their own.

As a typical older child growing up, I had some minor problems with darling younger sibling messing with my stuff. Clothes, toys--whatever it was--somehow it was 'borrowed' and returned not quite in the same manner in which it was last seen. Borrowed clothing eventually became a matter of enough drama that I remember at one point being forbidden from borrowing clothes. I'm sure it didn't last too long!

Remember when Pentel's Hybrid Milky gel pens first came out in pastels? And how the essential ingredients of a 9th grade girly friendship relied upon the ever-present cutely folded arrow, heart, or pull-tab note about boys, gossip, or other top secret items passed off inbetween classes? Well, once those girly-colours pens came out, a girl just simply had to have them. The best part? The pens could write on dark paper as well.

So today I was reunited with my very first ever "Milky Memo" pad. I have an overindulgent fondness for little cutesy stationary thingies. I must confess that spotting this little notepad gave an immediate little burst of creative happiness. When I opened the first page, what did I find?


Bree's bubbly handwriting and trademark little doodles all over the page. After all these years: busted! (See, it wasn't just my imagination--she really was messing with my stuff!)

Oh yeah--and for those of you that know my sis, she just started her own blog! So check out the link and send some love her way.

so this is love

About a week ago, one of my co-workers brought a dozen luscious cupcakes from the store Trophy to work. Six women, a shared office in which various cupcake-stealers come & go, and a box of 12 decadent, beautifully decorated fresh cupcakes...and what do you think happened? For my part, I will say that I was *quite* good and only devoured 1/2 of a triple chocolate (as pictured above) and 1/2 of a lemon-strawberry.

These little babies were so delightful that for the next week that like the thrill of a new love, the thought of cupcakes almost never left my waking thoughts. I think I mentioned cupcakes at least once a day. I was slowly (but decidedly) driving Andrew crazy. I don't think he was even aware of how tempting it was to just leave it all behind for a cupcake. So it was no surprise that by the time next Thursday rolled around, I simply begged to take our first journey to said store. We purchased a grand total of four for ourselves--2 triple chocolates(his-n-hers), 1 chocolate-vanilla (Andrew) and 1 lemon (me).

I warned Andrew that they were quite rich...and perhaps should only be eaten a half at a time. Also, that perhaps this was a bi-curious cupcake with which might induce uncontrollable swooning on his part. Needless to say, I went off to work and Andrew went home with the cupcakes. By the time I got home, he had 1 cupcake left and was decidedly smitten. By the next day, there was a single triple-chocolate remaining and Andrew warned me that it might not last that much longer, so I'd better eat it.

You know you really love someone when you split an amazingly rich cupcake--that can rightfully be described as chocolate mousse atop of a velevt-y chocolate devil's food cake--without a second thought. I'm contemplating returning to Trophy today today to buy some for good ol' Dad who took an overtime shift (silly man!) at the fire department on Father's Day.

For you avid bakers, never fear...Trophy has shared recipes on their website and even made the hallowed fame of Martha Stewart. If you want a reason to buy a kitchen torch, this Chocolate Graham Cupcake is the perfect one for you... I've yet to try it out, but I'm convinced it scrumptious and undoubtedly good in bed.

Alphabet (acronym) Soup Redux

Yesterday I had the privilege of attending the NCCN Conference on Anal & Colorectal Clinical Care Guidelines. It was my first time attending a joint Pharmacist/Physician/Nurse/Mid-level education event and I must say... I was a wee bit worried that it might be too saturated with tedious bits of research and other physician-specific application. I was pleasantly surprised at how useful most of the lecture content was to my practice, and that Nursing Statistics 101 wasn't a complete waste of time.

This affair took place at the Bell Harbor International Conference center which is quite luxurious and conducive to a quality experience. There were large windows overlooking the harbor just behind the speakers (excellent for disguising the fact that you just might be daydreaming) super comfy, ergonomic chairs (good for napping) and truckloads of food at the back of the room. Seriously, I do mean truckloads of food. The conference hall attendants (or whatever you call 'em) changed out the 'breakfast' foods to gourmet snacks and candy at 10am. Just what every health care professional needs to help concentrate and feed the ever-growing belly while enjoying a sedentary 4.5hr extravaganza: chocolate covered almonds, Runts (the candy), multiple cheesy-type dips, and soda pop.


Towards the last hour, though...my tenacity for percentages, p-values, and correlations to quality of life indicators and survival outcomes failed me. I became lost in a quagmire of acronyms. Even though I knew 97% of them, trying to engage in new concepts while pinging through the acronyms became extremely annoying. It really shouldn't bother me that much, because acronyms are an every-day part of life in health-care. The more acronyms we use on a daily basis, the smarter we feel. But, there I was...impulsive and impatient from an over-indulgence in lattes and caffeine-riddled, fragrant black tea; feeling slightly aphasic and mischievous.

So as useful means to pass the time, I start making a list of acronyms that originally had a far different meaning to me...had a good chuckle along the way--maybe you will too.


1) BSC: "Babysitter's Club" is now "Best Supportive Care"
2) SOB: "Son of a b#t%h" is now "Short of Breath"
3) CEA: A form of vocal-warm up for choral singing... is now "Carcinogeno Embyronic Antigen"-a tumor marker
4) DOE: "Doe, a deer..a female deer" is now "dyspnea on exertion"
5) OS: Something I learned and forgot in Anatomy 101....now "Overall Survival"
6) 5FU: Saying things that would make your grandmother blush to 5 peoples...is now the name of a common chemotherapy.
7) CAPOX: The name of Prot's alien planet from the Kevin Spacey movie, K-Pax...is now the name of a chemo regimen (oddly the "C" is pronounced as "K" in the acronym but the name of the drug in the regimen starts with "C" and sounds like "C". Go figure)
8) MI: Bad Tom Cruise movies are now... the big one--a myocardial infarction.

And some things never change....

FOS... I've experience this in both the figurative and literal sense. I prefer the former, it's more laughable, doesn't smell, and is virtually painless.