Bipolar in transition

Christian, Registered Nurse in training, father to 3, husband of 1, music snob, Southampton & Richmond FC tragic, parkrunner, diagnosed bipolar type II, now attempting to move to triathlons. Amateur idiot and purveyor of sarcasm

[wiferhi]

For those who are afraid to become a nurse because they have a weak stomach,It won’t be the vomit or needles or blood or urine or feces that turns your stomach. You’ll get used to that. You’ll come to accept it’s just part of the job and get to the point where you’re thinking of the 38 different things you have to do while absentmindedly cleaning up a bowel movement. What will turn your stomach will be 40 shallow breaths a minute in a patient in respiratory distress. A freshly born infant that is limp and blue and hasn’t cried yet. Tripled troponin levels on your sweating and anxious patient as you realize they’re having a heart attack. Feeling cord during a cervical check, then trying to hide from your patient the shaking in your voice as you call for help. The pale skin of a Jehovah’s Witness with a hemoglobin of 4 as she declines a blood transfusion and says goodbye to her family because they haven’t found the source of the bleed and she’s running out of time. A blood alcohol level of .18 on a 4 year old who is barely responsive and being intubated after getting drunk on mouthwash and then hitting his head. An elderly woman in the ICU signing her DNR while her sobbing daughter begs her to reconsider, knowing if treatment is stopped then her mother will die. A child in the pediatric ICU who hasn’t had a visitor in months. Not being able to find the heartbeat on a pregnant mom who hasn’t felt the baby move in a while. In the face of everything else that comes with being a nurse, I promise you’ll get used to the poop.

Andrea Pellerin

[nurse-x-ramblings]

Nursing Facts (that didn’t make any textbook cut)

1. Instinct will save your patient, it will save your coworker’s you’re covering for, and it will save your own ass.

2. If a doctor asks you to do something and it feels wrong, it probably is. See #1.

3. Patients lie, families lie, everybody lies.. sniff out the truth with your detective nose.

4. If you even mention you hate taking one type of case to a charge nurse you don’t get along with, guaranteed you will see nothing but those cases once word gets out.

5. Some of the strongest nurses, the people you would inherently trust with your patients, your family, your loved ones, yourself with - aren’t preceptors, they aren’t charge nurses, they are likely the neighboring nurse who never gets the unit award, but everyone wishes silently would be the nurse if they were to ever look up frightened from a stretcher.

6. Half the shit you do in Nursing school isn’t reality, and you won’t always have time to do it in the same way; but that doesn’t mean you’re compromising care, quality or integrity of your profession. It just means you’ve found a more proficient, effective, and just as safe way to do it that textbook authors won’t admit to.

7. You do actually have a choice to speak up when someone is intensely rude to you, despite what surveyors, management, and all the circus of politically correct people will tell you - there isn’t a law or standard of practice in nursing that says take all the crap from people and stay silent. Setting boundaries with patients, families, and coworkers doesn’t mean you’re disrespectful, it means you respect yourself and your place in this profession.

8. Protect your patients, but protect your license just as hard - you can’t protect anyone if you’re not protecting yourself.

9. Nursing management often complains the loudest about things they’ve forgotten how to do themselves.

10. You can make mistakes, have a snitty day, be off point, miss all the IV’s, miss a subtle sign in diagnosis,  and wish you’d chosen another career - but it doesn’t take away from the days that you’re the one to catch someone’s error before it harms their patient, or their license, it doesn’t take away from the days when you sort of think in the back of your mind, I simply love what I do,  it doesn’t take away from the all the times you snagged an impossible IV, but no one really needed to see it for it to feel good, it doesn’t take away from all the moments you caught subtleties that made you remember why nursing is a vital piece of hospital function, and it doesn’t take away from the moments you reminded yourself that hey, it’s a good thing to stick with this profession that you never quite know what to expect of next.

And none of that will ever make any textbook.

[licensetomurse-deactivated20200]

Can’t say that I disagree with a word of this. And number three is absolutely true. In the short time I’ve been a nurse, I’ve learned not to trust everything my patients me. If something feels wrong, it probably is.

Signal boost this post, it’s good stuff.

[santo-0]

Noted, and soon to be applied

[santo-0]

The long weekend has landed #solongsuckas

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Mt Clarence parkrun 105 - 24:32. First bit of anything for two weeks (run or bike), due to a combination of crappy headspace, bad weather and apathy. Catching up with the parkrun crew helps keep the legs turning over, and I'm still on target to hit my planned 1000km for the year. The trusty @altrarunning Torins should see me through, and then be retired for a new pair (or two). #retailtherapy For the @parkrunadventurers following along at home, this shot was taken half way up the last climb on the course, hitting over 15% gradient at its most "pleasant" - a true heartbreak hill before the 1km dash to the finish. One thing is for certain however - I'm not going to win any prizes for having the most elegant of running styles... #parkrunau @parkrunau #gracefullikeagazelle (at Mt Clarence parkrun)

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Dat moment you get "sponsored". Honoured and humbled that I can wear this on a jersey and support @stupassmore and @julezpass from @passmorecycles. These guys have been super supportive and made it a joy to get on a bike and stay there. #passmorecycles #localbikestore #chestday

[santo-0]

Well, poo. 2k run with pain after a week off everything (including the bike) and an epic roller session last night. Put the ice on and if anything the pain has gone up a touch in the last 10 minutes. Sports doctor appointment on the 10th of August, so everything runwise is on hold until then. #cri #ouch #injuredrunner

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Mt Clarence parkrun #97 - 29 minutes and 16 seconds of utter agony. I might be smiling here, but truth be told I was in a world of hurt and internally screaming. My lower right leg has gone from a semi-sore "hot spot" to full blown pain upon load. Next week will be spent booking a physio appointment and contemplating my next move, which may involve withdrawing from Fifth Leg. #devastated #parkrunau #injuredrunner

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Summit of Toolbrunup Peak (1052m)

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Summit of Mt Trio (856m) in the Stirling Ranges. #amazingalbany #mountaingoat #shutuplegs (at Mount Trio)

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Stability in my hands…

This week I’m spending time with both my Psych and my GP, discussing life, the universe and everything. One thing I feel we have sorted is my medication regime. While three tablets doesn’t seem like a lot, each one has a very specific role to play. Strap yourselves in…

[science talk stuff]

The large, ovalish shaped tablet is Fluvoxamine (marketed as Faverin, Fevarin, Floxyfral, Dumyrox or Luvox) - a selective serotonin reuptake inhibitor (SSRI) antidepressant. Serotonin is a neurotransmitter usually associated with feelings of well-being and happiness. I have previously been on different SSRI’s to treat unipolar depression prior to my current diagnosis. This is quite common for those with type 2 bipolar disorder, as hypomanic episodes are often mistaken by individuals and family as a “return to normal” function. Consequently, the use of antidepressants without a stabiliser may lead to more manic episodes.

The round, white tablet is Lamotrigine  - a broad spectrum mood stabiliser and anticonvulsant. It is most effective at preventing or delaying the transition to mania or depression, and also the rapid cycling between the two extremes, possibly due to it’s inhibitory effect on brain sodium channels. Recent studies have recommended Lamotragine for the maintenance of bipolar when depression is most prominent. It also comes with some lovely big warnings on the box and in the handout regarding life-threatening skin reactions, including Stevens–Johnson syndrome and toxic epidermal necrolysis. If you’re going to Google what these conditions are, make sure you brace yourself first. The tablet tastes like sugar drops.

And lastly, the teeny, tiny little tablet is Quetiapine (also known as Seroquel). This is an atypical (second generation) anti-psychotic. It’s what my GP refered to as a “dirty drug”, making me super drowsy and is one of the reasons that I don’t function especially well in the mornings  - especially when I forget to take it early at night. Mostly, it’s used to keep a lid on my manic episodes. If you remember back a little while ago, I had a sustained hypomanic episode of roughly 48 hours. This came about after we had first increased, (with terrible drowsiness issues) and then decreased, my dose in a short period of time. It is usually recommended that Quetiapine be gradually withdrawn to avoid issues. I currently have quite a small dose but it is one which has best efficacy for me. Unfortunately, one of the rare (<1%) side effects of Quetiapine is “restless leg syndrome”, which usually plagues me after a particularly heavy run or ride. #Iamtheonepercent (

[/science talk stuff]

This is my daily intake, one that allows me to function on roughly a level playing field. They seem to be doing the job, and I am slowly relearning how to push myself to run longer distances after the medication stripped the extreme and damaging desire I had to run myself in to the ground while training and in events. I still have significant alterations in mood - I’m never going to be “cured” of bipolar. It’s still me, just a more stable version of me.

[santo-0]

Six semesters down, one to go. We're at the business end now. #nurselife #nursingschool #nurse

[santo-0]

Dem goals tho

I always respond best when my training has structure and an end goal. Left to my own devices, I will flit about with no rhyme or reason and end up getting myself wound up in knots over HOW BADLY I AM RUNNING AND WHY IS THERE NO END GOAL AND NOW EIGHT YEAR OLD KIDS ARE FASTER THAN ME AT PARKRUN SO I'M JUST GOING TO GO LIVE IN A CAVE!!!1!

Obviously, during these times I am a joy to live with.

I have also been notoriously bad at goal setting. Quite often in a burst of mania I stumble across something that takes my fancy and make it my mission to achieve - the cost be damned. Six Inch 2014 is the perfect example. I drove myself to the ragged edge mentally (and possibly physically) to achieve something that I had grabbed on a whim.

Obviously, during these times I am also a joy to live with.

Now that I am on a bit more of an even keel, I try to filter my whims through my wife, who is my mood barometer. When she states that I should give something a few days to think about it, I do. Or at least, I try to. Which leads me to the point... 

A few days ago I was randomly googling "running events NSW ACT VIC January 2017" (as you do) to coincide with a family holiday. I wasn't having much luck, until I came across the Two Bays trail run - a 56km event on Victoria's Mornington Peninsula from Cape Schanck to Dromana and return. 8hr cut off. January 15. *hyperventilates*

A quick perusal of the details came up with a minor problem... I need to qualify. Aside from last years Two Bays, or a couple of other East coast events, the main qualifying option is a marathon time of 4:30:00 in the preceding 12 months.

Bugger. More furious googling for WA marathons before the end of the year. City to Surf. Rottnest. Busselton... all kinda doable, but not really my cup of tea. I have a beef with C2S as they seemingly have replaced the iconic Port to Point event here in Albany. Technically they haven’t, but the naming sponsors are harder to find and C2S has a statewide series going on. Rottnest is a bit too difficult to organise, and Busselton falls in the middle of my final nursing prac placement. Something that ticks the boxes of a social, nothing too serious business not a massive corporate event would be nice. Again, I digress...

A couple of friends (tick) have done the Fifth Leg Cape to Cape marathon (tick). It’s a trail run (tick), not especially stupid (tick) and after some correspondance with the organisers of Two Bays has a gettable 6:30:00 finish time to qualify. Awwww yiss. Run Fifth Leg to qualify for Two Bays. Now the goal(s) has been set. Which brings me to the plan.

A while ago I drafted up a 50 miler plan with the intention of getting myself in to shape to go long. That fell by the wayside. When I was training for my 50k birthday present in April I modified it a little, but injury/apathy/all just a bit too hard really got to me and I found it quite difficult to stick to, missing runs here and trying to cram more distance there. Too often I’m tempted to go that little bit extra on top of a scheduled run because “I feel good”. Wonder why it fell apart? Anyway. This time I have the plan, and I have the goal(s). Now I need the discipline, which is often the hardest part to maintain. As I have a bit of time off coming up with semester break, I should be able to set a decent pattern to stick to when Uni starts back up again. Fifth Leg happens to coincide with a day where I’m scheduled to run 50k. How convenient. 

So off to it then. Hopefully I’ll see you out there.

[santo-0]

21st Elleker Half Marathon 2016 - 1:59:12. It was never about how fast we could get around, but being able to pace my friend Trish around to a sub 2hr (and 20min Pb) was as good as it gets. Thanks to Jeff for the company and @becravenhill for the great photo.

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Them birthday feels... #officiallyoldnow #birthdayboy

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Did someone say surprise parkrun party?! #parkrunau #loveparkrun #willrunforcake (at Mt Clarence parkrun)

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when one of your running idols starts following you on Instagram...

[copingnurse-deactivated20240217]

ICU nurses...