Today’s post is inspired by Calmkate’s response to her story about where one may prefer to die.
So back during my nursing school days, one of my professors told us this story.
Her mother was to have surgery on her leg and had surrendered herself to the mercy of the hospital the previous evening. Her surgery would take place very early the following morning.
My Professor said as she laid in bed that evening a horrific thought crossed her mind.
What if the surgeons operated on the wrong leg?
She began remembering all the stories of surgical mistakes she had ever heard. Stories of surgeries on the body part that was normal and leaving the diseased one intact.
So with the horrors fresh in her mind, she got out of bed and drove to the hospital to find her mother in bed. She took the marker we use in the hospital to write on the skin (it takes days to come off), and she wrote: “NOT THIS LEG”!
She stated she was not about to let them operate on the good leg.
We all had a nervous laugh about it at the time, but in reality, these things can and do happen. Processes are in place to prevent mistakes, but since to err is human … we can help them to ensure they operate on the “right” body part.
So yes, make a mark and let them know … “Not this leg”!
A staple of my childhood. Though I could not appreciate its goodness until much later in life.
Back then I was not a fan of the taste.
It is bitter!
But whenever my grandma cooked bitter melon or, anything else for that matter, you ate it without question.
There was no room for argument.
Bitter melon grows on a vine and, one side of the fence was always littered with the stuff.
It was everywhere!
No one ever actively planted the karela (bitter melon), it was as perennial as the grass around. It just was.
I would later come to understand that the ripe vegetables would shed their seeds. These seeds would be scattered by one way or another, so an effortless truce was in place. Karela was always in abundance.
My mother, God bless her love to drink the juice of karela and she does so to this day. She would steam the vegetable and drink the bitter juice.
The folks from my world were almost never ill, they died in a good old age with all their working parts.
Older and wiser
As I matured and became a healthcare professional I would wonder about my childhood and the health of the older population versus the sickness I see in the new world. I am in a unique position to observe the ills that plague the population old and young.
I began looking into the foods and activities I grew up with to see where some benefits may lie.
Bitter melon is an interesting fruit, it grows on a climbing shrub and is found in many parts of the world. The fruit is also found in tropical South America, Asia, East Africa, and the West Indies.
It is from a family known as Cucurbitaceae (bitter properties), scientifically called Momordica charantia. Karela has several known species.
Though bitter melon is a fruit, it is utilized as a vegetable in many parts of the world. It is also used as a traditional medicinal plant for the treatment of various diseases in Bangladesh as well as other developing countries like Brazil, China, Colombia, Cuba, Ghana, Haiti, India Mexico, Malaya, Nicaragua, Panama, and Peru.
Composition of bitter melon
Perhaps its most common traditional use is in the treatment of diabetes. Other diseases bitter melon is used to treat are; dysmenorrhea, eczema, emmenagogue (stimulate blood flow to the pelvis), galactagogue (promote lactation), gout, jaundice, kidney stone, leprosy, leucorrhea, piles, pneumonia, psoriasis, rheumatism, and scabies.
Momordica charantia is also documented to possess abortifacient, anthelmintic, contraceptive, antimalarial, and laxative properties.
Bitter melon extracts are effective against cancer and were found to be effective in the treatment of ulcers, pain and inflammation, psoriasis, dyslipidemia, and hypertension.
Momordica charantia also contains biologically active chemical compounds such as glycosides, saponins, alkaloids, fixed oils, triterpenes, proteins, and steroids. Several other biologically active chemical constituents have so far been isolated from different parts of the plant, including the leaves, fruit pulp, and seeds.
Karela is reported to contain vitamins, minerals, antioxidants, and other phytochemicals, that is, glycosides, saponins, phenolic constituents, fixed oils, alkaloids, reducing sugars, resins, and free acids.
The immature fruits are also a great source of vitamin C, vitamin A, phosphorus, iron, and contain insulin-like properties.
Aids in the: —
The reduction of body fats prevents the hypertrophy of fat cells.
Increases insulin secretion and prevents insulin-producing cells from damage
Recently I had a patient that impacted me deeply. Not to say that many don’t make an impression, but some more so than others.
My patient was a 41 year old young woman who within the past 2-weeks had surgery to her neck. She presented to the ER some days ago with her husband due to nausea and vomiting.
Often post-surgical patients can have nausea and vomiting due to many reasons. The pain medication as well as the pain itself are among some of the reasons why patients may experience nausea and vomiting.
Though upon further investigation we realized that she had been suffering with nausea, vomiting and headaches for many weeks prior to her surgery. This was thought to be symptoms related to her neck issues that would correct themselves after surgery.
She was acting very sedate and somewhat withdrawn. Usually cervical (neck) patients patients are often discharged the same day as the surgery and do very well.
I also noticed the way she let her hand just kind of stayed where I placed it and her fingers has a mild inward curling quality to them suggestive of cerebral injury . There seemed to be a lack of self concern and in the way she appeared emotionally detached from the present inconsistent with a person of her age.
She complained of a headache and consistent nausea. She had been taking nausea medication at home that did nothing to alleviate her symptoms. She denied any pain to her neck.
The doctor and I discussed the fact that she may have taken too much pain medication per her demeanor but when we requested some urine, she stated she did not know if she could urinate.
So we discussed getting a CT of her head and one was ordered along with images of her neck to rule out any post-operative problems.
More follow up testing for confirmation and then we would have to transfer her to another hospital for follow up care.
While she was having the MRI of the brain done, I went over to give her some nausea medication. The radiology tech showed me some of the images already taken and the tumor was clear to see.
We felt a palpable distress for this young woman.
The doctor and I had discussed the diagnosis and the prognosis. She told me of a colleague’s husband who had had a resection for glioblastoma and was doing well now some 2 years later.
We felt some hope.
As I walked back through the radiology depart toward my home in the ER, I said a quick prayer, “Dear God, please let this young woman be okay!”
The next workday the ER doctor gave me an update on the patient. The neurologist updated the ER doctor that a biopsy had confirmed she had glioblastoma and it was inoperable. He also said the patient was so confused.
We were filled with sadness for this lady and her family.
Glioblastoma is the most aggressive tumor of the brain. It is one of the most deadly types of brain cancer.
A glioblastoma may occur at any age, though they usually occur after the age of 40 years. There is a peak incidence between the ages of 65 and 75 years.
They occur more frequently in males with a ratio of 3:2 M:F and Caucasians are affected more other ethnicities.
The current standard of care, inclusive of consisting of surgery, radiation and chemotherapy is quite simply ineffective.
The survival rate of a person diagnosed with a glioblastoma is about 15 months.
Without treatment, survival rate is approximately 3–6 months. Though radiation and chemotherapy may prolong life, they greatly reduce quality of life. With this reduction in quality some patients decide against treatment to spend their remaining time the way they choose with their family.
Research has found that each glioblastoma is different and developing drug therapies must be focused to treat each occurrence individually.
The Temporal Lobe
The temporal lobes aids the processing of speech and sound. It is also vital to the comprehension of language and speech.
Another primary role of the temporal lobes is in processing memory and emotion. The limbic structures of the temporal lobes are responsible for regulating emotions and the forming and processing of memories.
Patients with temporal horn injury may present in several ways:–
with focal neurological deficits
exhibiting symptoms of increased intracranial pressure, e.g., confusion.
may have seizures
Treatment and prognosis
The treatment for glioblastoma includes:
Surgery to remove the glioblastoma. Your neurosurgeon will remove the the glioblastoma if it is possible and beneficial to do so. Because glioblastoma grows into the normal brain tissue, complete removal is not possible. For this reason, therapy will include additional modalities focused to target the remaining cells.
Radiation therapy. Radiation uses high-energy beams, such as X-rays or protons, to try and kill the cancer cells. During therapy, beams deliver radiation to precise points in your brain.
Radiation combined with chemotherapy. For people who can’t undergo surgery, radiation therapy and chemotherapy may be used as a primary treatment.
Chemotherapy. Chemotherapy uses drugs to kill cancer cells. In some cases, thin, circular wafers containing chemotherapy medicine may be placed in your brain during surgery. The wafers dissolve slowly, releasing the medicine and killing cancer cells.
Drug Therapy. Chemotherapy as a pill form known as temozolomide (Temodar) — is used during and after radiation therapy.
Tumor treating fields (TTF) therapy. TTF uses an electrical field to disrupt the ability of the tumor cells’ to multiply.
TTF may be combined with chemotherapy may be recommended after radiation therapy.
Targeted drug therapy. Targeted drugs focus on specific abnormalities in cancer cells that allow them to grow and thrive. Targeted therapy prevents collateral blood vessel formation to feed cancer cells.
Supportive (palliative) care. Palliative care is specialized medical care that focuses on providing some relief from pain and other symptoms.
We care for patients every day. We do our best and often think of them and wonder how they are doing. Many times I have come home with a patient on my mind and cannot wait on the next day to get an update. Sometimes I do not wait and call my peers for an update.
Many we will soon forget.
There are however those who will always stay with us. You wish you could do more, help more, heal more…
You feel helpless and very human.
You feel sad, defeated and eventually hopefully you will reconcile that you are only human, incapable of really changing the outcome. All you can do is your job to the best of your abilities.
It is within your power to be empathetic, supportive then you must let go and let God.
The final decision is always his.
Emotionally there will always be those who remain with you, you will always recall specific details and you will always feel a little sad and helpless when they are called into remembrance.
Governor Abbott decided to end pandemic restrictions within the state of Texas. As of next week, the mandate will be lifted and Texans will be free to move about mask-less.
Restaurant occupancies will return to 100%. This move is made especially dire as this move comes on the eve of spring break.
No one needs reminding that we are still waist-deep in the throes of the pandemic. And the percentage of Texans vaccinated is a mere 13%. The lowest percentage of any state in the US according to NPR news.
The President, CDC, as well as many other medical professionals, have condemned the move urging Texans to keep wearing masks and to continue social distancing.
I can tell you from personal experience that many Texans were not wearing masks or social distancing even when it was a mandate. Each day persons would show up to the hospital, the stores, or other public spaces without a mask on their face, one under their nose, under their chins, or just a plastic shield that is open on both sides.
A shield protects the wearer from fluids or droplets splashed directly to the front of your face, it provides no protection from airborne or droplet precautions as it is open on both sides.
There have been many reports that the most vulnerable populations still facing many challenges trying to schedule an appointment.
Apparently even getting through to many sites to even schedule an appointment requires so much time, skill, and manpower that many are unable to continuously remain online or simply do not have the means to even go online.
My 73-year old mother nor any other eligible persons with clear co-morbidities, some with several qualifying factors have not been vaccinated.
My co-worker’s husband is well into his 60’s, he is diabetic, suffers from gout, has a history of cancer, high blood pressure and they have not secured an appointment to be vaccinated.
So how then are we no longer required to adhere to the rules that have kept some of us safe thus far?
You should note that the Governor has been fully vaccinated…
We can clearly see where the concern lies, not preserving lives but the quest to fatten the pockets. Nowhere in that declaration was the loss of life addressed!
This kind of reckless management only seems to exist in Texas! When the pandemic was in its infancy with regard to social distancing Texas was the first to shed its cloak of protection. This resulted in a spike in COVID cases and many deaths.
Two weeks ago the world again saw that Texas plays by its own rules with the winter stop that left roads impassable, widespread blackouts and Texans froze to death while laying in their beds.
Why are we repeating the same action at an even worse time while hoping for a different result?
It seems that the concern to fatten the pockets outweigh the loss that will surely be visited upon us.
I am persuaded that by now individuals have been practicing these safety measures for almost a year and that they will continue to do so. More of us will continue to wear our masks, practice hand hygiene, and social distancing.
Until more widespread vaccinations have been done and COVID numbers have declined for a consistent number of months, we will choose the path of proven science and commonsense.
I thought the image of this boat says what seems to have become the norm in my time and space.
We had a couple of sunny days in Texas, a matter of fact it was 70°. There is a bit of coolness to the air but we are no longer in the deep freeze.
They say everything is bigger in Texas, I guess that applies to the extremes in temperatures as well.
Last week -3° with snow and ice, today 70° and sunny. Where did I hear that global warming was not real?
Another thing that is bigger in Texas is the reported electrical bills some have received, the rest of us are waiting and afraid to exhale. Since Texas always plays by its own set of rules, we saw widespread blackouts, destruction, and even death during the past week’s deep freeze.
With everything we are all dealing with currently, let’s add another item to the mess.
We did appreciate the sunny days.
Then yesterday the cool weather returned and last night’s thunderstorm was complete with hail (small). So Texas is hitting one extreme to another.
My mom and my aunt, and I have been tinkering with a couple of Etsy shops, making food items, and crafts from their native land. Surprisingly it has garnered some attention.
I have begun making two items from my childhood, Fudge and Sugar cake. These were items I made growing up with my friend and I thought I had lost the touch for good fudge-making, but to my delight, I seem to have retained the skill.
Last night I even dreamed of opening my very own fudge shop!
The above images are various colors by somehow my camera had a reddish hue.
Sugar cake image by AuthorAnother version of the sugar cake. You can add various flavors as in fudge.
Lemon-Flavored Fudge by Author
I have been creating a few different options for fudge
Somehow I have really been in a writer’s slump. Though there is a lot of noise in my head, I cannot stay still long enough to organize them. So I have been getting a little creative with my daughter, my mother, and my aunt.
Credit image by Author
Image credit – Author
Gives my mom something to do as well, she worked until COVID kept her out of the workforce, so now she has a little outlet. My daughter has been making her jewelry and selling on a site that the young folks frequent.
My mom made these as a young girl, so did I as well. Growing up we made what was known as “Rag mats”. Now a lost art, the younger folks no longer make any of these things.
Recently we have been hit with some extreme temperatures. Cold temps with combined wind chill factors of -3° F. It has been cooold in these parts.
We were ill-prepared.
The rolling black outs left us dressed like we lived on the North Pole. Three days and nights without electricity, internet and the ability to stay warm.
I was bored stiff.
For some like myself it was the intermittent electricity and heat. For many others it was total blackout where people were completely left out in the cold unable to keep their children warm or even fed.
The power situation has left the food spoiling at an alarming rate when many are already facing a dire financial situation and hunger is already too real for so many.
Imagine the horror of watching what little food you have go bad.
A parents’ nightmare.
I have an electrical stove, so with the power gone, that stove is rendered useless. That meant we had to be ready for action, as soon as the power came on in 30-minute increments, you quickly cooked some ramen noodles or heated some water.
Like clockwork the power was cut off way to soon and immediately the house would be plunged into gelid temperatures.
The barren whiteness of the outdoors reminded me so much of those Alaska shows I love watching. Suddenly it seemed I was living outside the grid, lol.
A lot more fun as an observer.
Image by Author
Image by Author
What the past year have brought to the forefront are the deficits within our systems.
We are ill prepared for any extreme circumstances that last beyond a day it seems.
How in this day and age we are unable to supply adequate power to our customers.
The winter storm while not the norm in Texas was still expected. Yet the roads are not (never) prepared and driving was a nightmare. As evidenced by the 133 car pile-up of last week that left several persons dead or injured.
I spent many an anxious hour on those words trying to get to work and home safely.
The roads were much better yesterday after the second deposit of snow. We were able to drive and the constant stream of traffic left a nice dry trail in the center on most of the common roadways.
On Sunday and Monday the drive was rife with dry snow blowing everywhere, icy conditions that left the weary white-knuckled traveler trudging along at 17 – 23 mph.
Nerves frayed to the breaking point as we struggled to remain vigilant as we constantly reminded ourselves not to instinctively slam on our brakes.
I drove with God’s words reminding me that He manages my going out and my coming in.
I think we have made it through the worse, now back to the times of COVID and the continued work of vaccinations.