Scribe Jobs

On the off chance that readers know someone who knows someone, Yakima Valley Memorial Hospital is hiring scribes.  The training is intense; it’s not for the faint-hearted, but is a tremendous opportunity for future med students.  Apply here.

Scribes allow doctors to focus on the patient, rather than on documentation.  The doctor takes the history and does the exam, while the scribe documents everything.  From the patient-side of things, it can be nice to hear little tidbits of what the doctor tells the scribe to include.  If it gives the doctor more time with patients, everyone benefits.

A Day in the Life – Now

Contrasting what my life is like now, compared to when I was diagnosed, the difference is striking. Please read Part 1 first.

Things aren’t perfect now, but they’re so much better than back when RA first made its appearance.

In the mornings I wake and can stand up without crying out in pain. Jumping into the shower, washing, dressing, and all the rest are so much easier than back then.  It’s not perfect, and sometimes my shoulders make showering and dressing take a little extra time, but I no longer need to sit down in the shower, and it doesn’t take twenty minutes just to get up in the morning.

Note that I didn’t say “get out of bed in the morning.”  That’s because, due to my back, I’m sleeping in a recliner instead of my bed.  This situation needs to change, but in the grand scheme of things, it’s minor.  I’m in a house, not under a bridge or in a car.  My back has improved some, and eventually I’ll return to sleeping in my bed.

Once I’m dressed, I’ll quickly check Facebook, but have too much to do to spend much time on the computer.  Heading downstairs, I realize that my knees don’t hurt like they used to.  Those little things are so easy to take for granted.

Quickly I grab a bite to eat, then check my in-box.  That’s where my kids stack all their schoolwork for me to check.  When I’m lucky, everything is checked and back on the appropriate shelves before the kids wake up.

I’d like to say that I exercise every morning, and I did for a while, but once the garden is in the ground, formal “exercise” fades away until fall when I no longer am doing work outside.  I fully intend to resume my exercise routine after the garden has been harvested and preserved.  For now, there’s a kitchen full of either clean dishes to put away or dirty dishes to wash, and a mountain of clothes in the laundry room.  There are animals to feed, eggs to gather, children to tend, and it seems there aren’t enough hours in the day.

The kids need to get their schoolwork done by lunchtime. Science experiments can take place in the early afternoon after lunch.  Here is where I really notice a difference. Before I got my diagnosis and effective treatment, my day was mostly done by noon. I was exhausted and couldn’t do anything else.  Now, things are different.

For most of the school  year we leave the house at 1:45 because my son plays sports and needs to be dropped at the high school for practice, then I must return at 4:00 to pick him up — except on game days, when timing is different and the whole family piles into the car so we can watch the team play. We attend all home games as well as away games that are within an hour of our house.

To some people, that might sound perfectly normal.  Six years ago it would not have been possible.  Now I can do things in the afternoon and evening without sleeping the next two days away.  I can do more than three things in a day, and don’t have to run all errands before lunchtime.

If you want more examples, consider last month (when I had zero posts). June’s schedule was different than the main school year, partly because the public schools were dismissed, and partly because sports coaches are crazy.  To tell the truth, it wouldn’t have been possible if my RA wasn’t mostly well controlled.

I am now a chauffer.  Three days a week, my son has driver’s ed from 10:00 until noon, and it’s a forty-five minute drive to get there. Then there’s summer basketball, with games played Monday and Wednesday nights, and team practice Tuesday and Thursday nights, plus travel to tournaments on the weekends. This child also has a lawn care job for which he needs transportation.

My other son is playing on a select basketball team and all-stars baseball team, which means he has weekly practices for both teams, and has weekend tournaments in far-flung cities. This requires driving. Lots of driving.  Fortunately I have two daughters who are wonderful young ladies. They agreed to help with transportation.

Before RA I never would have agreed to letting our sons have so many activities.  Now I view things differently.  This is not forever.  Since they are able to do these things now, they should take advantage of the opportunities because they might not be there in the future.  Both boys are learning how to judge what’s realistic, and this is a good age to learn not to overcommit themselves.  This has been a fantastic experience for them.

Busy? Absolutely!  And there is no way I could possibly have done it six years ago.  I am so fortunate that my doctor believes in treating RA aggressively so that I can have a life, and blessed beyond belief that I am one of those who respond well to treatment.

A Day in the Life – Then

Contrasting what my life is like now, compared to when I was diagnosed, the difference is striking.

Sleeping was hard. My hips hurt so much that I finally bought those egg-crate shaped foam cushions for some extra-soft padding.  One helped, but I found that two layers were even better.  When I managed to sleep despite the hip pain, my body’s temperature regulation would malfunction.  It was almost like having a fever.  Sometimes I’d feel like I was freezing, but other times I’d wake up drenched in sweat.  Sleeping on a large bath towel was a necessity if I didn’t want to have to change the bedding daily. Normally I’d only get to sleep 2-3 hours at a time before waking soaked, or shivering, or by a toddler who needed some middle-of-the-night TLC.

Upon waking in the mornings, I’d work my hands open and closed, first attempting to make a fist, then opening my hands and trying to straighten my fingers. Back and forth, back and forth, until finally my hands no longer felt swollen and the fingers would move as I wanted them to move.

I’d lay there waiting until my husband went to shower, then I’d roll over and slide out of bed.  As soon as my feet hit the floor, I’d yelp and fall back onto the bed.  Then, after recovering from the pain, I’d gingerly lower my feet to the floor and gradually add weight — a little at a time – until I could stand.

Once vertical, I’d shuffle to the computer and sit there, checking email and catching up with friends’ & relatives’ Facebook pages while awaiting my turn for the morning ablutions routine.  While sitting at the computer, occasionally I’d lean forward and rest an elbow on my desktop, then quickly jerk my arm back while searching fruitlessly for the needle or push-pin or whatever it was that had jabbed me.

In time I discovered tricks to make mornings easier:  sitting down in the shower, staying in the shower to comb my hair before rinsing out the conditioner, slipping into a terry-cloth robe as a simple way to dry off (no more trying to reach my back with a towel), setting clothes out the night before instead of having to bend down to reach low dresser drawers first thing in the morning when I was stiff, and rearranging the closet so that all my clothes were on the waist-high rods (my husband’s shirts and slacks got moved to the top because his shoulders work just fine).

Eventually I’d make my way down the stairs.  The occasional stab of pain in my knees would make me think of my father, and how (even in his 40′s) he’d joke about being “old and decrepit.”  It’s not quite so funny when you’re the one who seems to be falling apart prematurely.

On his way out the door, my husband would tell me, “I love you. Don’t overdo it today!”  Then I’d sit down to figure out exactly how much I might be able to accomplish. That usually involved examining both the chore list and the calendar to see what was most pressing.  I knew that if any errands had to be run, they had to be done between 9 and noon; I couldn’t have the kids ready to leave before 9:00, and I’d be out of energy by noon.  Another constraint was that I could go a maximum of three places; after that, I would be too exhausted.  Little did I know that things would get worse.

I recall going to see my grandfather in eastern Washington one weekend. It was a miniature family reunion, and although it was great to see people, all I’d done was sit and talk, but I was wiped out. On the last day, we cleaned up our meeting hall and everyone was ready to leave right after lunch. Me, though?  I was ready for a nap and dreaded having to drive back across the mountains when all I wanted to do was collapse.  When it was time to get into the car, my daughter got sick.  I felt awful for her, but a little part of me was thrilled to phone my husband and tell him we were staying another night.  We got to sit in the hotel room and rest, and I was fresh for our drive home the next morning.

Things got worse.  I was teaching swimming lessons two half-days a week, and was also head of the kids’ program at our church’s midweek service. What people didn’t realize was that I was getting worse and couldn’t do anything else.  I would drag myself to the pool, then go home and collapse.  Aside from those teaching commitments, I didn’t leave the house. I went from three-errands a day to three a week.

Back then, it was hard to get things done.  When you have the flu, you have no energy.  It was just like that.  I could wash the laundry one day and fold it the next, but never get it all done in one day.  I’d make a grocery list and email it to my husband, who would stop and do the shopping on his way home from work.  Just about all the meals went into a crockpot right after breakfast, because by mid-afternoon I’d be too tired to cook supper.  If I didn’t manage to get the crockpot started, everyone knew we’d be eating either beef-n-beans or pancakes (because I can whip up a batch of pancakes nearly as fast as you can pour a bowl of cold cereal).  We had always had a garden, but that year never got one planted. I was perpetually exhausted.

Exhausted… and confused. Why did it feel like there was something sharp poking my elbows even though there was nothing there? Why did raising my arms make my shoulders hurt? Why were my feet and hands swollen in the mornings? Why did my hips hurt so much?

That was then.

Continue to Part 2