A Second Thank You Note

There are many nursing specialties. I mentioned a few of them in my blog post ‘A Thank You Note’ from yesterday. The specialty that I failed to mention is that of nurses working in Detox facilities. We seem to be a special breed. Our brand of nursing involves the neurobiological management of alcohol and substance withdrawal. That’s a mouthful! We are caring for an individual experiencing the rapid brain changes that occur due to withdrawal from long term alcohol and/or drug abuse. We collaborate with and care for clients from an extremely intoxicated or substance affected state, through an acute withdrawal period and into sobriety. Many, many times they do not remember that they had even been in a Detox.

Detox nurses monitor and manage extreme states of anxiety, work at preventing seizures and manage states of high blood pressure for these clients. We educate, or attempt to educate, our folks on how to eat. That sounds kind of odd, even as I write this, but many people in active addiction have very little interest in, and sometimes opportunity for, regular eating. Many unpleasant gastric effects with the various forms of substance withdrawal requires a finesse that allows Detox nurses to minimize the discomfort, averting medical emergencies. All of this in 24 to 48 hours for the most acute stages in a young and relatively healthy individual. The older the individual, more medically compromised or a longer period of active addiction can extend this short phase. 

Nurses in other nursing areas also see withdrawal on a far too regular basis. From the Emergency Room to the Operating and Recovery rooms and all the nursing units in between. Not to be forgotten are the Neonatal Intensive Care units with the wee tiny babes sadly born into withdrawal. To wade through the stigma of addiction, to push past it to evaluate, assess and collaborate with all these clients is an extremely difficult part of this job. To encounter violence and yet offer kindness is another extremely difficult part of this job. 

We are often the last bastion of care to be offered and accepted willingly. Establishing an individual’s physical and mental health allows them to take the next step into the foreign land of recovery. In this continuum, Detox is relatively easy yet often the most physically painful, compared to ongoing recovery from active addiction. So far, to my knowledge there is not a formal Addictions Nursing Specialty in Canada, so I say to all nurses, thank you for your good care of those individuals of any age and in any state of health to arrest active addiction and provide respite from an extremely chaotic world. Thank you for seeing the person beneath active addiction.

“The future depends on what you do today.”

~ Mahatma Ghandi

Nothing Like It!

Nothing like it! I’ve been nursing for five decades. I’ve been nursing in withdrawal management since 1989. I was asked last week what sort of changes I’ve seen since I started working in detox facilities.

And there has been nothing like it. From Saskatchewan to Texas to British Columbia there has always been alcohol abuse at the top of the list. The list of the substances that kill has grown longer and more deadly. Cocaine, crystal meth, heroin in all their many forms. Smoking, snorting, IV drug use and just plain pills. Pills. Pills like oxycodone, hydromorphone and now fentanyl. Did I forget to mention all the benzodiazipines?

Everyone of these drugs, and in whatever form, have a certain withdrawal syndrome. When they’re mixed, the withdrawal syndrome is confusing and more dangerous. Some people actually survive. Some may have their lives saved, but their bodies and brains are damaged. Damage that is reversible or damage with long lasting consequences. And too many people of any age die. They just die.

Controlling drugs and alcohol has not stopped the use and development of more refined drugs and alcohols. In all of this mess, where are the studies, research and treatment for addiction and the medical effects of substance abuse? Short stay in a detox is barely a bandaid. Long stays to give the body, psyche and brain a chance to heal are what is really needed. My only satisfaction as a detox nurse is to help someone survive to live another day whether the services are out there or not. I depend on each individual to navigate our myriad of inadequate systems.

There has been nothing like it. Who do I blame? All of us. Our health care systems, our pharmaceutical companies, our families, our very cultures. Am I angry? I don’t have time to be angry when I am shepherding a youngster, a mom or a dad, or sometimes even a grandparent through a complex withdrawal. At some point, these dangerous, toxic substances trump survival.

“We’d stared into the face of Death, and Death blinked first. 

You’d think that would make us feel brave and invincible. It didn’t.”

~ Rick Yancey, The 5th Wave

How Can I?

How can I respect?
Behaviour 
   Irrational or rude
      Annoying or mushy
        Aggressive or violent

When the child that was
    has been lost 
      in an emotional and chemical vortex.

Sweetness and love ~
  vanished as though never there.
    Addiction to alcohol or drugs a catalytic converter.

“Respect must be earned”
     An old adage learned at an adult’s knee

What if respect once earned 
     is torn and tattered,
        frayed and ragged

How can I respect?
    An individual heart and soul is not lost
        merely trapped 
          in need of peace, calm and kindness.

To see life reborn
   Baby steps being taken 
      Eyes shining again
Self-respect regained deserves anyone’s respect.

“I never meet a ragged boy in the street without feeling 

that I may owe him a salute, for I know not what 

possibilities may be buttoned up under his coat.”

~ James A. Garfield

Keeping Silent

Sitting across from a
  A son or a daughter
    A mother or father
      A grandma or grandpa
Cousins, nieces or nephews

My curiosity is kept in check
  for all but medical details of
    alcohol misuse
       drug misuse

prescription, illicit or from the cabinet at home.

Sitting across I watch
  tears and exquisite sadness of life gone so very wrong
    the exhaustion of years buried in chemicals
      fear and nervousness about coming sickness
withdrawal from chemicals is the easy part of recovery.

“At the bottom of every person’s dependency, 

there is always pain. Discovering the pain and 

healing it is an essential step in ending dependency.”

~ Chris Prentiss, The Alcoholism and Addiction Cure

When Blossoms Return

Revolving doors spin and turn
Revolving lives grasping and gasping
In and out
Up and down
Come and go

Relationships tangled and drowned
in chemical mixes of drugs and alcohol
until slowly, slowly
mixes and tangles separate and float apart
some to never return

Belief and trust in others builds by ones and twos
as belief and trust are offered in health’s direction.
And so, health and smiles return with gratitude ~
revolving doors open,
revolving lives blossom.

“The return is one of the hardest shots to make 

when you come back from an injury.”

~  Lindsay Davenport

Believing is Not Enough

Most of us know that 
abuse of drugs and abuse of alcohol leaves the brain demanding more.

Many of us believe ~
Just Stop! And carry on with life like the rest of us do.

What many do not know is that
early sobriety does not bring emotional security with it.

What many cannot know or feel is
waving, spiking moods with rages or tears or just plain numb
the wondrous clear eyed days of energy and motivation
unpredictable or non-existent sleep
waking up knowing that your life is your own again
tripping and staggering when not drunk or stoned
playing hop-scotch with your children without a miss
nightmares and dreams noisy with past days and nights of drinking or drugging.
Many a good nights sleep.

Early sobriety does not equal emotional security.
Emotional security can be built.
Day by day
Friend by friend
Self-help or professional - or maybe both

Detoxing is the easy part.
The first years of sobriety are a challenge.
The first years and all that follow are living life like the rest of the world.

“People still question my sobriety, my commitment to the program, 

and that hurts. I take things day by day, and sometimes I take them 

minute by minute, but I honour my commitment to stay sober.”

~ Tom Arnold

'Demon Rum' vs Happy New Year!!

In the world of consuming of alcohol or drugs, the word spirit is often heard, very often in jest when one’s spirits have been elevated, sullied or dampened by ‘demon rum.’ There is no time, and definitely not in these holidays, for alcohol or other drugs to be consumed in quantities that allow for one’s personal spirit to be seconded to these chemicals. 

There are many that would disagree, and disagree heartily, with me. Possibly even accompanied by guffaws and raucous laughter. However, I have seen, know and very likely been related to many who have ultimately succumbed to some form of chemical spirits, forever leaving only memories of the lives they lived ~ the fragments of their true spirits shining through a watery, wavering chemical aura.

This time of year, and especially this evening, has too great a potential for tragedy to arrive suddenly and without warning while spirits are altered. 

Please be careful out there, don’t drink, drug and drive - and have fun!!

“All that spirits desire, spirits attain.”

~  Khalil Gibran

Reposting: “The Information Age, Pregnancy and Epilepsy”

This is a repost from March 3, 2013.  Seems I was not well at that time either!  I would like to think, the virus has given way to full blown allergies to pollen as flowers are hesitatingly coming into bloom here on the Island. When I read this post from last year, I thought it an appropriate repost for this year - maybe only because of the darn virus! But really, I had opened it to update the address and title, listed at the bottom of the page, of the Parkinson and Epilepsy organization, in Victoria with new street and web address.
Thanks for your time!
Susan

~~~~~~~~

This nasty cold virus has given me a lot of time on my hands today and yesterday. My energy level determined my ability for mind browsing (I think that’s called day dreaming) and browsing the world wide web. 

History of women was a direction that I took with my blog post last night. I wanted to know more about the history of epilepsy specific to women, so began to browse epilepsy sites. Pregnancy intrigued me. My sons, that I love so dearly, are both miracles for having survived my epilepsy and I would not trade either of them for the world. They each had a different experience with me, in relation to my epilepsy. One was conceived and carried to term after I had been on medication for about two years.  

The sites that google popped open were full of details about epilepsy, pregnancy, life, medications, and other treatments. It was so much that I felt a certain amount of information overload. I can also say that I felt frightened with some of the details that pertained to my situation so long ago, and that are issues to be dealt with today for other young families.

I’m getting old enough now to say that I have some history behind me and what the roving cursor reminded me of was how little I knew, and was told, about pregnancy and epilepsy in 1970. Not just pregnancy itself, but the possible effects of a seizure on the child. And from there it was a short trip to what would be the potential effects of anticonvulsant drugs (AED) on the child. To my recollection, these things were not discussed with me. I don’t know if anyone even thought about them, which I find rather odd as I was in the middle of nurses training with nurses and doctors all around.

There was definitely no world wide web with it’s present wealth of information in 1970. Now, when I think of all the homes in our communities, I think of the young families where epilepsy may be that not so silent companion. So I would encourage anyone with epilepsy planning a family, or the family of someone with epilepsy, to research pregnancy and epilepsy. I also am aware that not everyone has, or has access to, a computer. However, libraries, schools and universities usually welcome those requiring such services.

Since the initial post of epilepsy information in BC, it has changed - epilepsy has not changed. Contact the BC Epilepsy Society on Google for a provincial phone number and a local phone number for Victoria.

“In pregnancy, there are two bodies, one inside the other. Two people live under one skin......when so much of life is dedicated to maintain our 

integrity as distinct beings, this bodily tandem is an uncanny fact.

~ Joan Raphael-Leff

Author's note:

~ Edited December 03, 2023

~ This information and links are no longer valid. 

In Victoria, a local source of information and support is at the 
Headway (previously Victoria Epilepsy and Parkinson’s Centre)
202-1640 Oak Bay Ave. (previously on Darwin Ave)
Victoria BC V8R 1B2
Phone:  250-475-6677

Email:  help@vepc.ca  (email is unchanged)

Web: www.headwayvictoria.com (previously www.vepc.bc.ca)

Re-connecting Humanity

A heart torn by thoughts swaddled

in past present future

and what if 

and must do 

and no one else will help.

Finding the spot of care and logic

in a careworn and illogical life

to bring focus and calm awareness

no matter if a bit cloudy.

Communication is challenged.

Sanity, order and respectful kindness

delve into swirling unreliable thoughts

without disturbing too much of the muck.

Thoughts that should not be disturbed 

threaten to eddy into a vortex filled

with muddied voices and hum

pulling even stability inside.

A nugget of humanity glows faintly, faintly

in hearts dulled by years of abuse whether 

    alcohol or drugs, 

    physical or mental

    emotional or spiritual.....or maybe all.

“You must not lose faith in humanity. Humanity is an ocean; 

if a few drops of the ocean are dirty, the ocean does not become dirty.”

~ Mahatma Gandhi

Description Wanted.........

Let’s see if I can describe active addiction:

Hmmmm - it must start with craving.

No - craving would only weasel it's way in to the brain, the body, after drugs or alcohol had been used for awhile.

Knowing a specific delicious taste wouldn’t happen until after tasting something delicious.

So let’s back up - 

when would the ‘first taste’ be?

As a teenager with the obligatory drink at the ‘legal age’? 

But what about marijuana, pain pills, benzodiapines for anxiety?

No - any teens that I have known certainly have had some form of alcoholic beverage, marijuana - maybe prescribed medications.

OK, so I don’t know what I’m talking about.

That first ‘taste’ can’t be in childhood!

Surely drugs and alcohol would be kept away from children - wouldn’t they?

Oh, yeah there was that guy that started using crystal meth when he was seven, because his parents were dealers and it was all over the house. But his sister didn't get addicted, so where does that fit?

But babies? Surely there’d be no ‘first taste’ there.

Except - some babies have a teeny tiny taste of alcohol in their bottles to help them get to sleep. (In days gone by, a colic preparation had a pretty high alcohol content.)

Oh, I forgot - 

Fetal Alcohol Syndrome, 

Fetal Alcohol Effects, 

Fetal Drug Effects

No ‘taste’ there, merely systemic effects that can haunt an individual’s life affecting learning, sleeping, and socializing - until an opportunity for a ‘first taste’ shows up.

In any or all of those years, 

surely somebody would have taught their children

how to drink responsibly

not to use illegal drugs

to follow, to the letter, the doctor’s prescription.

Then if cravings occurred, it wouldn’t be a problem.  Right?

“Between good sense and good taste there lies

the difference between a cause and it’s effect.”

~ Jean De La Bruyere

The Information Age, Pregnancy and Epilepsy

This nasty cold virus has given me a lot of time on my hands today and yesterday. My energy level determined my ability for mind browsing (I think that’s called day dreaming) and browsing the world wide web. 

History of women was a direction that I took with my blog post last night. I wanted to know more about the history of epilepsy specific to women, so began to browse epilepsy sites. Pregnancy intrigued me. My sons, that I love so dearly, are both miracles for having survived my epilepsy and I would not trade either of them for the world. They each had a different experience with me, in relation to my epilepsy. One was conceived and carried to term after I had been on medication for about two years.  

The sites that google popped open were full of details about epilepsy, pregnancy, life, medications, and other treatments. It was so much that I felt a certain amount of information overload. I can also say that I felt frightened with some of the details that pertained to my situation so long ago, and that are issues to be dealt with today for other young families.

I’m getting old enough now to say that I have some history behind me and what the roving cursor reminded me of was how little I knew, and was told, about pregnancy and epilepsy in 1970. Not just pregnancy itself, but the possible effects of a seizure on the child. And from there it was a short trip to what would be the potential effects of anticonvulsant drugs (AED) on the child. To my recollection, these things were not discussed with me. I don’t know if anyone even thought about them, which I find rather odd as I was in the middle of nurses training with nurses and doctors all around.

There was definitely no world wide web with it’s present wealth of information in 1970. Now, when I think of all the homes in our communities, I think of the young families where epilepsy may be that not so silent companion. So I would encourage anyone with epilepsy planning a family, or the family of someone with epilepsy, to research pregnancy and epilepsy. I also am aware that not everyone has, or has access to, a computer. However, libraries, schools and universities usually welcome those requiring such services.

Since the initial post of epilepsy information in BC, it has changed - epilepsy has not changed. Contact the BC Epilepsy Society on Google for a provincial phone number and a local phone number for Victoria.

“In pregnancy, there are two bodies, one inside the other. Two people live under one skin......when so much of life is dedicated to maintain our 
integrity as distinct beings, this bodily tandem is an uncanny fact.

~ Joan Raphael-Leff

Author's note:

~ Post edited on December 03, 2023

~ This following information and links are no longer valid:  In Victoria, a local source of information and support is at the 

Victoria Epilepsy and Parkinson’s Centre now Headway as of 2013

202-1640 Oak Bay Ave. (previously on Darwin Ave)

Victoria BC V8R 1B2

Phone:  250-475-6677

Email:  help@vepc.ca

Web: www.headwayvictoria.com (previously www.vepc.bc.ca)

Chocolate and Butter...

       

Since at least 500 B.C. dietary changes have been posited as a treatment for epilepsy. With the advent of anticonvulsant drugs, diet was discounted and disputed,

and so passed out of favour. Many centuries later, favour was restored, but reservedly so, with a Ketogenic Diet designed by physicians in the 1920's. It was not curative, but supportive. 

I'll not attempt to explain here this complex and medically monitored diet that is used mostly for children and was often found to be effective in aiding control of seizures.

Researchers with their spy glasses consider benefits for adults who carry this disorder. For many years, I have avoided many low-fat products and most no fat products. Eating regularly, moderately and with otherwise balanced meals has proved much more comfortable than low or no fat options. Has it made a difference for epilepsy management in my life? I believe it has, the only proof is in how I feel.

    

(It is good reason to eat chocolate and real butter!)

Feed sparingly and defy the physician.

~ James Howell