I might be dying

One of the things about nursing is that whenever presented with an issue, we need to look at the worst possible outcome first.  We focus on that until we can eliminate it.

For example, when someone at works falls and hurts their leg at work, my first thought is to eliminate a broken bone.  If they broke their leg, it requires fairly swift action to avoid a long term disability.

With all the possible 'broken bones', probably around 50, I've experienced exactly one.  And that one wasn't from a fall on the basketball court or baseball field, it was the result of an assault.  It wasn't even a major broken bone, although it was in the interior of the skull so it had it's own issues.

But until I can eliminate those worst case scenarios, I have to keep it at least in the back of my mind.  Sadly, that means that whenever I have a personal health problem, I'm constantly worried about a major health crisis.  And right now, I have myself scared shitless.  You see, I've had a cold for the past week and a half.  Last Thursday (my day off) I woke up with a burning in my chest.  It extended up to my throat and was worse when I breathed deeply.  This pain was accompanied by a lot of phlegm, some body aches, and a feverish feeling (although no actual fever).  The phlegm lead to a lough of coughing and sneezing which only made the burning in my chest and body aches worse.


I wasn't any better on Friday, so I called into work.  When I'm this sick, I find it hard to concentrate.  If I find it hard to concentrate, I could easily misdiagnose something and that could put my patient in harms way.  Plus I have no desire to spread some cold to my thousands of patients (with their close proximity to each other, a cold spreads like wildfire at the prison!).  My supervisor took the opportunity to remind me that I seem to call in a lot on or around the weekend.  She added that she knows we can't control when we get sick, but that another supervisor is keeping track.

Now, at the back of my mind I know what's going on.  We're short staffed and anybody calling in can be a minor crisis.  We just don't have enough people working at any given moment to simply cover the shift.  That means someone will have to stay over and cover my shift, or worse yet someone will  have to be called IN to cover my shift.  Those aren't easy calls to make and they're worse on the weekend.  So of course they'd notice people that call in on the weekends.   But if you think about it.... 'near the weekend' (Friday, Saturday, Sunday, Monday) is over half of the week.  By pure statistics I SHOULD be calling in more often near the weekend.

So the proper response should be to acknowledge what she said, and then promptly ignore it.  I only call in sick when I'm too sick to work.  Hell... I sometimes go into work when I'm to sick to work and end up going back home (which everybody at work agrees is fucking stupid since I live an hour away from the prison).  But I didn't do that... I let her comment get under my skin.

So when Saturday rolled around, I still felt like shit.  The burning in my chest wasn't nearly as bad, but I had a LOT of phlegm, a lot of coughing, and just felt 'under the weather'.  Technically that's called malaise and IS a symptom of being sick.  If my supervisor hadn't mentioned anything, I probably would have called in on Saturday.  Another day of rest would have helped me get over this cold faster.  But she DID mention it... and I DID feel guilty.  So I went into work.

Sunday I didn't feel any better, but went to work anyway.

Monday I didn't feel any better, but went to work anyway.

Tuesday was my day off.  I rested and slept a lot that day.

Wednesday I didn't feel any better, but went to work anyway.

Thursday I didn't feel any better, but went to work anyway.

Friday I didn't feel any better, but went to work anyway.

Yesterday was my day off.  I rested and slept a lot.

Today is also my day off... and I still don't feel any better.  I feel 'sick'.  A deep breath still makes my chest rattle and inspires me to cough up a wad of phlegm.  I believe I've actually blown my nose about 30 times in my life.  I despise the feeling of blowing snot out through my nose and into my hands while they're only covered by a thin piece of tissue.  It's warm, slimy, and nasty.  I'd rather just snort the snot back and swallow it back down.... but since last Thursday I've blown my nose several times a day.  I'm having trouble breathing if I don't do that.

In times past, I would have just considered this a bad cold.  I've had colds last a week or more before and this situation doesn't have anything to separate it from any previous long cold.

Except that I'm a nurse now.  I have to consider the worst possible situation and eliminate it.

Some things that have crossed my mind... Pneumonia.  Influenza.  MERS, Tuberculosis, Pulmonary Embolism....

Cancer

Nursing wise, let's see if I can eliminate any of these.

Pneumonia;  normally pneumonia starts in the lower lungs.  It progressively gets worse or you get better.  Seeing as this has stayed pretty constant for a week now, I think I can reduce my chances of having pneumonia.  It's still a possibility, but it's a low possibility.

Influenza;  no fever.  Timing is also all wrong... we're out of flu season.  But other than that, I can't really do anything to eliminate that as a possibility.  The only good thing about the flu is that in my general healthy state I should get over it soon enough.

MERS;  that's just a scare from the recent news that it's getting pretty bad in South Korea.  There have only been two cases in the united states and they've both been directly from someone who was recently in the middle east.  I haven't been in contact with anybody recently in the middle east, nor anybody who has been in contact with anybody recently from the middle east.

Tuberculosis;  this is a scary one as tuberculosis is so hard to diagnos.  The symptoms can be incredibly varied and these symptoms would certainly qualify.   Thankfully I'm going to be getting my annual TB test next week, so I'll know then.

Pulmonary Embolism;  the pain only lasted a day or so.  It's fairly rare for a PE to not grow into a life threatening event within hours.

Cancer;  umm.... no.  Not 'no, it's not Cancer', but 'no, I can't eliminate Cancer'.

In January of 2006 just before my Mom and Dad went down to Florida for their winter stay, my Dad came down with a cold.  He went to the doctor, got on some antibiotics, and proceeded with their long planned vacation.  After a couple weeks most of his symptoms went away but he was left with a wet phlegm producing cough.  He went to see a doctor down in Florida, but was just prescribed some more antibiotics.

When he got back to Michigan he went back to his doctor complaining of the same symptoms he had months ago.  Test after test after test.... he had Lung Cancer.  More than likely the Cancer had been growing in my Father's lung for months before any symptom occurred, but that 'cold' in January was almost assuredly the first symptoms of the Cancer.

I smoke.  I have a high chance of getting Lung Cancer.  There's really nothing I can think of to eliminate that or even reduce the possibility of this being Cancer.

Lemme break into my own stream of consciousness and say this.  Do I think I have Lung Cancer?  No.  I do not.  I DO NOT.  But once a possibility like this comes into your mind, it's very difficult to shake.  That's what this post is about... not me contemplating going to the doctor and getting 'checked out'.

Since that possibility came to me mid last week, it seems like all I hear about is Cancer and/or death.  We have a patient that was recently diagnosed with Cancer.  His diagnosis is terminal which is all the sadder considering he's in prison.  I recently listened to a pod cast that involved a debate about doctor assisted suicide.... one of their examples was a patient with terminal lung cancer who wanted to die rather than live out the last few painful months gasping for air.  The Vice President's son recently died from Brain Cancer... he was only five years older than me.  I'm reading a book where one of the secondary characters is heavily hinted at having Cancer.

I can't shake it.  As a person, I can't shake the thought that I might be experiencing the first symptoms of my death.  And worst of all as a nurse I can't eliminate that as a possibility.

Man.... writing this out hasn't made me feel any better.