sapped

just 4 straight days of flares, while i’m working and also the quite a first since i went back to work the ward, i am feeling absolutely miserable. the pitiful Celebrex doesn’t work!

the time passes so slowly and thus my pain seems so long drawn. i guess having been in a near remission state for so long makes me so accustomed to it that my threshold is much lower. but it’s not that my threshold is any much higher at any time anyway. i feel that it’s just a matter of whether i choose to tolerate and/or express it, and whether i am still comfortable.

i’m in a perpetual state of pain, if not, discomfort. i hate it. my wound is still healing too and it’s added pain because it’s healing- burn wounds always hurt. just coping with all the pain makes me physically tired… :(

RA, why do i never fail to want to strangle you so that you can suffocate and die off? i know though that you are laughing and fun, because you know i can never be rid of you.

not just flares

i have been back at work for 2 days already. i was on hospitalisation leave for 8 days, and i had a coincidental off day right after. so it was 9 days away from work, having to rest from the nightmare i had suffered at work.

in the 2 days that i am back, i very quickly knew my body is bearing the brunt of me being stressed and stretched. yesterday, i had slight flares towards finishing my shift. today, i had several joints flaring, with my hip on fire. having to go out, i popped tramadol 150mg and celecoxib 200mg. when i decided i was still in too much pain and i need my oxycodone, i was already waiting for the bus, and there was none in my bag.

when i have such escalations of flares, i become very angry and bitter rather quickly. of course i am upset at the same time. till today, i don’t know why i still react this way even though this has been the way my entire life. i understand it has to do with the loss of control. but i wish i could react to these escalations in a softer and kinder manner to myself. because when i react by being angry and bitter especially, i fall and tumble very quickly and i hit the ground hard. with being upset, i beat myself up for being ‘sick’ with RA, even though on good days i’m relatively on terms with having RA now.

yes all these can be very humbling, and it is good to have these once in a while to be grounded. but surely this is not the way to go right Steph? what if your escalations become more common, seeing that you are getting more stressed and worn out? your mood will just go down down down into the pits and then that’ll will see you getting into some trouble too.

times like this, i wish i have some prednisolone on hand to terminate the flare. today, when the hip started to burn, sitting and standing both hurt, and so did walking. i was so miserable and helpless at the same time. and then i wonder where are all the doses of methotrexate that my body has accumulated. i think i need at least a few more weeks to feel a difference in the disease activity.

having a fibromyalgia-like flare on my thighs that are quite unexplainable and peculiar as well.

work will only be more challenging as i hold on till my last day. i have already decided as to when i should tender my resignation. the stress will pile up. the fatigue and insomnia will not go away. the pain is very draining. and i’m still trying to cope with the aftermath of the nightmare (the acute phase is over since i left the hospital), and my psychiatrist and i think that it will take long to get over it.

le sigh.

abiding in God

i’m at home now.

it’s Thursday today and i’ve actually spent 3 nights in a place i swore i’ll never step back in.

part of surrendering to God is knowing when i need help, and knowing how to be kind to myself. it may not be something i like, and in fact it may be something i detest. but i guess it’s my way of abiding in God’s love this time, where there seemed no place else physical to seek reprieve in.

before i set my heart on going to the hospital, i knew i had to consider several things. i know there will be a silent outcry at work; at my sudden disappearance on the day of internal audit, and silently being admitted for something i did not reported to the ward managers. then, i also know my parents will be displeased at the “why again?” despite 1.5 years out of the psychiatric hospital.

i secretly think i’ve let myself down. but for all the tears i’ve shed, and all that i’ve tried to scrub because i felt so dirty, i found the clarity of mind to tell myself to say that i needed an immediate time out. i needed to stay safe, and needed time to be with God.  so bravely i packed my bags once again and left for the hospital with my parents, insisting to be dropped off at the Emergency Department so that i could be alone.

in the 3 days and 3 nights that i was in the psychiatric ward, i’ve left too big a portion of myself to be angry and frustrated. i forgot again what it’s like to be incarcerated (although this isn’t really an incarceration) and to lose control. much of my anger and frustration was directed at the multidisciplinary team, especially the psychiatric consultant, whom i have lost all respect for, and will be writing in a complaint about.

i brought in 2 Christian books to read, a (Catholic) guide to Healing, a diary to write in, my Bible, my praying Cross, my Rosary (which they confiscated) and of course stationary. very much different from what it used to be in the past. i was glad though, for i found a lot of peace with them. following what C had asked me to do, i wrote to God, uninhibitedly. on my first day spent there, i wrote for pages and pages, often accompanied with tears that other patients would ask me why i was crying. all the questions i had for God, i wrote it all down in my diary. on my 2nd day, writing became much easier. and then on the 3rd day, there was barely even any time to write. reading the Christian book titled Made To Count, which also talks following a person’s calling/vocation, there were many references to “callings” (which i took to as my nursing job), and also about vocations (something i’m discerning about and considering), it led me to many Scriptures that i found immensely helpful.

this difficult period, one which i decided to spend in the psychiatric hospital seeking God alone, was one i never had before. and i have no words for it. i don’t know how is it that i could feel better “so quickly”, but God works His ways. i keep reading about how i should abide in God and in God’s love, and how God will abide in me. is this how it works?

i’ve gotten my magnolia tattoo for my triumph over my blades. it’s on my left shoulder.

and i’ll be resting a bit more before i return to work. i have to see my social worker tomorrow, and my psychiatrist again on Tuesday (although i saw him right after discharge). there is a one-day retreat called The Gift of Caring which i am so blessed to be able to attend because my manager gave me an off day to attend it. so i’ll be back to work right after. i’m praying i’ll be ok after, no matter how long or short i intend to stay on in nursing till i know what my direction is.

invaded

i felt a hand on my butt today, while myself and 2 other colleagues transferred a hemiplegic patient from the chair to the bed. it was a big hand belonging to a patient in his 30-40s, in its entirety, on my whole buttcheek. and while i was not groped, the feeling of having a hand other than my own on my ass is greatly distressing.

i am a person who values my own personal space. although i like hugs and arms over shoulders with people whom i love, any other physical contact make me cringe, let alone with strangers. sometimes, i can’t even tolerate inanimate objects belonging to others touching me.

so when my patient’s hand came in contact with my butt, i gave a loud cry in my heart while i could only let my eyes widen. i had to be professional. moreover, i couldn’t be sure if it was deliberate. in patients like him, we tend to give them the benefit of doubt. it might be the hand on the paralysed side. or it might be accidental. i confided in my colleague. we agreed that we will share and quietly amongst our colleagues, that if it happens to anyone else again, it will be reported.

i try to find excuses for my patient to write off the explosion of feelings that was in me that i could not terminate. but no matter how i try to kind and forgiving, i cannot forget what he had left on my right buttcheek. it is not something visual. it is something so palpable, it can literally be felt.

oh dear Lord, forgive me when i say that i just cannot find it in me to say that he did it accidentally. for his hand on me was not just for a second. it was for more than that, and longer than necessary for something accidental.

sigh. i don’t know how i’ll survive working till my next off day on Friday. i have therapy tomorrow, and i’m seeing my social worker, J, on Friday as well. maybe seeing them and talking to them will help.

some respite please?

i know my blog has been really boring. it used to be more interesting, if it was even, in the first place.

since wanting to leave nursing, my reaction to my own decision about it has been lukewarm. God has spoken to me in a way that i cannot ignore, and that is through my current work as a nurse. it’s like a booming voice that tells me to stay. yet i do not know if it’s mere coincidence. it’s only but a week or two. it’s mentally a struggle that i sometimes switch off just so that i can properly function at work, and also have some rest at home. because of that and thus the lesser time i’ve spent thinking about it, i need even more time now.

i am really fighting with my body against fatigue. for now it’s not a problem in that i will not fall asleep at work because of the nature of my work (actively moving around and thinking), although i do feel tired while working. once i get out of the hospital, i literally feel my body starting to crash. when i get home, i nap if i can. sometimes, i take a long nap, wake up for half an hour, and then spend the rest of the night on the sofa because i’m too tired to move to my bed. then there are times when i’m so bushed but i can’t even take a nap nor fall asleep with benzodiazepines.

i am beginning to think that the fatigue is past RA and fibromyalgia and i am glad i have seen a neurologist and am waiting to do a sleep study. i’ve been falling asleep while eating again and sigh i really hate it.  so actually i’m even thinking that the sleep study is a little too far since i’ve already waited so long. it’s end of this month, and i might need to reschedule because my ward sister didn’t grant me the proper shifts to do it. sigh.

i’ve had headaches for months already but i always thought it wouldn’t be an issue. now, it seems to be as more painkillers don’t seem to quell it. i used to just use plain paracetamol and it’ll be fine. now i have to take tramadol on top of the regular 50mg of tramadol, and still it doesn’t work. since i last saw my anaesthetist, i’ve been taking my breakthrough dose of 150mg rather frequently, and honestly it is sometimes hard to keep count of how much tramadol i am taking a day. all these because of? headaches.

things seem to be rather out of control now. equilibrium is never something i am able to strive for- it always seems so out of reach i daren’t even dream of it. i just want the pain to go away, and to finally feel rested you know. the pain, whatever pain it is, has been for years. the tiredness and the insomnia, going into 2 years. i don’t pray that i discern quickly, because that takes time. half a year to one. more even. but the rest, i pray for some respite.

please?

but i’m blessed to be both a patient and a nurse

i am physically and thoroughly tired from my relentless insomnia and the fatigue from RA and fibromyalgia.

since deciding that i’ll be putting down yet another love of my life, my mood hasn’t been to great. on one hand, it’s an emancipation, on the other, it’s grief. how many times do i have to put down the things i love because i have to make choices that i do not have to make if i am not in my situation (of having RA and depression)?

i had only an off day after 7 straight days of shift work, and i chose to go out to the sea to paddle. i paddled 3.5km to paddle away all my stress, but alas it wasn’t enough. i enjoyed myself though,and i tried out a touring board, which i liked a lot.

i crawled back to work today. disheartened. i’m just like that. i admit i desire instant gratification. but i know i need time to discern. told myself to be patient with myself, and to keep praying.

i had a patient today who was terrified of tramadol because it makes her vomit, although she really needed it because she was visibly in pain. she already had 2 IV anti-emetics on board. i had to beg her to take the tramadol, although i told myself i would still respect her decision. i don’t like to bring my own medication background when i talk to my patients, but with her, i needed to. for me, helping and caring for her was to relief her of her pain. so i shared with her my experiences with tramadol, from when i first had to try it when i was 17. with metoclopramide and all, beyond 100mg makes me nauseous. i told her i understood that even the 50mg she should take would make her very nauseous. it took me 2 over years of being nauseated to get used to it, with little anti-emetics to tide me through. then i shared with her that now i also take ondansetron with 150mg of tramadol, that tramadol still affects me till today. but i had to reassure her she had 2 IV anti-emetics of metoclopramide and ondansetron to cover her, and that we nurses will be prudent in making sure she’ll get her anti-emetics in time. i spent more than 30 minutes talking to her before she agreed. and i’m glad she gave in to the tramadol.

for the rest of my shift, she was pain-free and relatively free from nausea. she appeared much happier. ate all her food for the first time in 4 days. she’s a Christian, and because of the complexity and complications of her stay, i told her i’ll keep her in my prayers.

and then i am reminded again today of the difference i can make as a nurse and as a patient. so many times within this 1.5 months in the new hospital, have i shared my experiences to make a difference in my patients, no matter how small. i won’t say i am special. i am just that blessed to be a patient and a nurse at the same time.

this was how i held on. that no matter how sad i was, i could still make a difference to my patients. with my patients, they give me life, as much as i give them life (if they perceive so). they are my Bread and they sustain me. but once i walk away i am nothing. i’m just a person who wants-to-do-everything, and a person who-always-says-yes, and a person who-cannot-say-enough-is-enough, and a person who-wants-to-please-everybody.

it’s tearing me apart. just talking about it on Whatsapp to a friend had me crying on the bus. i grief for long periods. i haven’t gotten over RA. i haven’t gotten over giving up ballet which is one of the loves of my life. and now, nursing… yes it’s my choice this time again. but from all the insight i’ve gained in 5 years, it would be more than foolish of me to continue to fight when i was already wounded to begin with.

i’ve done my best. i’ve tried my best. i’ve given it my all despite everything- all the illnesses and unimaginable admissions and treatments. and God forgive me, that i am not doing Your will. but this sea of sadness is becoming an ocean. i need to overcome it before it drowns me out.

i have so many dreams. i have 5-year, 10-year, 20-year goals. i want to make changes happen so that patients will benefit. i want to make changes so that healthcare in Singapore can improve. i have so many dreams. but oh well. i told my friend, that one day, i’ll be back. once i’m much better.

putting down my calling

a time for discernment.

(please note that as this post is published, no action as been taken yet. still discerning!)

it’s the time for me to finally say, that i am putting nursing down and aside.

it’s been 5 years since near graduation that my life changed, although i really thought my life had changed when i heard and heed God’s calling to be a nursing in 2008. it wasn’t too far apart- merely 2.5 years and it fell apart. each time i came out of the hospital as an inpatient i returned as a nursing student or a staff nurse, only to fall apart. my graduation got delayed. my growth as a staff nurse got delayed. these when everything pointed to my capabilities to being otherwise. i was always doing well, most times pushed to limits others weren’t even, although they were at the same pace at me. i see that at my saving grace, but i also see that as nothing. i couldn’t survive psychologically.

caring for my patients heal me, and it is probably my Bread. but working in an environment with that much tension, i admit, that all that healing runs into negativity. there are too many to ‘please’, too many people to listen to, not good enough for all of them. and i am but only me. i am rather odd when i am nursing my patients. i am stubborn, and very stubborn at that. it can be troubling to my colleagues when i’m new and i do and decide things alone. but i do so with my own knowledge. i trust what i’ve learnt and read extensively- textbooks, journals, peer-reviewed papers etc.  i trust what i’ve experienced and what i’ve learnt not to do when i was younger as a student. but people take offense, and so take offense at me. i can’t change and lower myself to please them in that way, because i don’t want to compromise patient’s care, although i can ask more and be receptive. but it’s been imprinted. done and dusted.

i keep believing that with my recent recovery efforts, it’s enough for my psychiatrist to lift off the major depressive disorder(MDD) diagnosis. but it never seems enough no matter how severe or how minor my symptoms are. i get upset sometimes this year when he says he can’t lift it and i have to make him go through the entire diagnostic criteria to convince me. after so much of medications, ECTs and therapy, i’m still in depression. it’s sad to say with my own insight that perhaps i really am not recovered enough to handle the toxic work environment of a hospital (although i choose to work in a hospital). i want to choose happiness, finally. because of 5 years even though nursing is my lifeline, it’s made me so so so sad. it made me cry so much, and it made me hurt myself (triggered by nursing school).

it really came to light when i’m only 1.5 months into my current job and i’ve already broken down in the ward in front of my Nurse Clinician. there are too much things i cannot reconcile in this workplace and it causes me great tension. and already there are colleagues who are hating on me because i’m not picking up their (bad) practices fast enough, or for whatever immature reason it is. i have enough on my plate (health issues). and i sense that the Ward Managers/Clinician are wanting to push me too, accelerating my progress a little fast. it’s like, i already hate my job, other than my patients who sustain me.

i keep talking with God, asking Him to grant me His grace of His wisdom of what His will is of me. i know He wants me to be a nurse. but things can change, and i want to choose to be happy. 2 years ago when i was spending 6 months in the hospital, my treatment team kept asking me to change careers. they almost begged me not to return to nursing anymore. but i told them with conviction that it is my calling and that i have to follow it. i was never a staunch Catholic, but i would never understand why i would heed God’s calling so faithfully. perhaps this is it. this is my time to switch.

i don’t know where i’ll go, but i know that God has carved a path for me. i will never stop caring, because as a patient, i can never ignore what patients feel. so now, i’m sitting on Counselling, and praying as much as i can, asking for as many friends to pray for and with me as i discern where i should go.

(a little over a year ago i wanted to do Social Work. this year, i suddenly switched my mind to Counselling and i see that firstly as a sign from God. as many of my friends, colleagues and family have told me, i love to talk and i am very eloquent. with the empathy i have built across the years, i am hoping Counselling will have a place for me, if God wills.)