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Tuesday, May 8, 2012

Hold Everything Lightly #9 {Sickle}




Sickle Cell Disease is a cruel, complex, and debilitating disease.
The hemoglobin cells are in the shape of a sickle and look like little  crescent moons. A sickle is used on a farm to fell crops like wheat and is crescent shaped.  Sickled cells do not flow normally and get stuck in vessels and joints causing lack of oxygen and tremendous pain.  This puts patients in "sickle cell crisis." This disease harms organs, muscles, and bones. I took care of these patients for seventeen years.
 Here are two of their stories.


Ruthie
I met Ruthie when I was young and so was she. 
 Ruthie was eighteen to my twenty years. She was in sickle cell crisis, needing IV (intravenous) fluids and IV narcotics. Sickle cell patients often required copious amounts of pain medications. They could be difficult to care for because the pain medicine prescribed did not work fast enough or good enough. When morphine and Demerol on demand pumps came along they helped but we were still constantly adjusting the dosage and calling the Hematologist who cared for these patients. Ruthie was admitted, in crisis, frequently to 5 South and later to 5 North, 3 North, and 5 West. All general medicine units where I was the charge nurse. The hospital became her second home. Her physician, Dr. K was and is truly a  kind and gentle man. He had compassion for his hurting patients. I always marveled that sometimes they fired him because he did not give them more Demerol. Ruthie never fired Dr. K she had too much smarts for that. She had a sense of humor too and smiled often. There develops a kind of rhythm to caring for the same patient over the years and Ruthie and I had that. 

One hot Georgia summer Ruthie was admitted to the corner room of 3 North 
with abdominal pain and kept asking for warm compresses on her tummy. Warm compresses did not exist in our hospital and so we would heat a wet towel in the microwave (this was not a brilliant plan). Ruthie's abdominal pain seemed difficult to access and hard to medicate. She wanted those warm soft compresses. She began to demand them. Then her abdominal skin was burned by one of them (incident report). "First do no harm" was all I could think of at that point.  She did not care. She wanted another one when I said "No" and Dr. K said "No." Dr. K wrote a psychiatric consult. The psychiatrist came the next day to see Ruthie and went to her room and after a minute stepped into the kitchen and heated her a wet towel. 
I was taken aback.
He had not read the consult.


Ruthie died, at home, before age thirty due to sickle cell disease.

Reggie
Reggie, a free spirited guy, was admitted to our 
medicine units over the years in sickle cell crisis many times too.
 He was an older patient for this awful disease.  One time, at age forty, he was admitted to the emergency room in crisis and they tuned him up with IV fluids and IV pain medications. Then they sent him off on his way. Reggie did not go home that day, he had other plans, he told me mysteriously. When the emergency room doctor got his lab results back  he had a shock as Reggie's hemoglobin was 3.0 (should be at least over 8). He could not reach Reggie so he sent the Sheriff to his house and scared Reggie's mama to death. When the Sheriff found Reggie, having fun downtown drinking a few cool ones he confessed later, Reggie was appalled they had scared his mama because Reggie lived with a chronically low hemoglobin his entire life. A low hemoglobin that would be deadly to most of us his body had learned to adjust to because of his disease. He was admitted to my floor that day and I gave him a couple of units of packed red cells. 
Then he was really tuned up.


I do not know what happened to Reggie. 
I hold out hope he is still with us.


"Hold everything in your hands lightly, otherwise it hurts, when God pries your fingers open."
---Corrie Ten Boom 1892-1983 


thank you for reading
Olive
 

22 comments:

  1. Dear Olive - we have so much to be grateful for if we have our health.
    I love the unconditional care you gave to your patients and the way you have written so movingly about them.
    Am I right in thinking that Sickle Cell Disease mainly affects people with an African or Hispanic ancestry?

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    1. I believe there are some European people of Jewish origins that can have SSD as well but I am not an expert.

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  2. Oh Olive,
    It's stories like these that make me so grateful. Some people have to live with so much pain and difficulties.....and, you must have helped so many people during your career and your writing is such a joy to read ( even though it is sometimes sad).
    Have a lovely week Olive. XXXX

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  3. We are the same with the birds and wildlife in our garden Olive......I think that we spend more on food for the birds than we do on ourselves !! haha XXXX

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  4. Thanks for sharing these stories Olive. Sickle Cell isn't a disease you hear much about. Heartbreaking for those who have it.

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  5. Gosh life is so hard for some people. Makes you put things in perspective. My daughter comes home with stories of things folks have to go through at the hospital and I just can't bare it sometimes.

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  6. Oh cute header. It keeps getting cuter and cuter.

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  7. Olive,
    I think you are quite the amazing lady. I appreciate your visits and your uplifting comments.

    Carol

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  8. My daughter is a nurse. You are some amazing people.

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  9. Thank you for sharing such human and heartfelt stories. You are an amazing woman and have so many gifts, than you for taking the time to tell us about these wonderful patients. I hope too that Reggie is out there living a full life. Sad Ruthie's life was cut so short. Bless you, Olive~

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  10. I have the utmost respect for nurses like you. You are considerate, caring and compasionate. forms more than she see the patients.

    Bless you and all nurses!

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  11. I love reading these little bits of your life, Olive. SCD sounds a horrible disease. I can only echo Cindy's comments.

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  12. I can't imagine how nurses manage...there are so many ways people suffer. Thank God for you nurses.

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  13. Olive, It's hard to not become attached to some of your patients, isn't it? Both stories were sad. I bet you were the nurse they all wanted.xo, Susie

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  14. We all know how important a good and caring nurse is when we are very ill. To think that one would remember us long after we are gone is something extraordinary! ~ Maureen

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  15. Such a cruel, cruel disease.

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  16. I've never know much about this disease, olive...thanks for sharing...

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  17. I read this post a couple of days ago but was away and couldn't leave a comment at the time.
    Your writing is so wonderful and you have shared amazing stories with us. Your understanding and compassion is extraordinary both in your nursing career and in your life. It is such a pleasure to know you. XO

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  18. "First do no harm". Goodness, if only that could be our mantra in life as well.
    God bless you.
    Debbie

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  19. I remember years ago seeing a documentery on PBS on sickle cell - It was heartbreaking to see the children especially. Thank you for caring for and the compassion you've shown to your patients.

    Blessings!
    Gail

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  20. I never knew what this
    disease was/did ~ thank
    you for this. Also, thank
    you for telling Ruthie and
    Reggie's stories....There are
    so many people living with
    these types of chronic
    illnesses who are truly
    brave, brave people. I
    like to think that Reggie is
    still plugging along with
    his 3.0 : )

    Love ya, girlie!

    xo Suzanne

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  21. I've heard so much about this disease and how horrible it is. Sad for Ruthie - so young.

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I adore your comments. They are like finding unexpected chocolates. olive