... borrowed from another mother

another. sleepless. night. 

while work does occupy my mind while i am at the hospital or when i am on-call, it is when i am alone in my sparsely furnished apartment that my mind wanders to worrying about my son. i hope he slept. i hope he ate. i hope his "brothers" are ok. i hope it's not too hot. i hope he is keeping hydrated. i hope his body has adjusted to the new environment and he's going #2 ok. the shit that plagues. (no pun intended)

i pray. but... sometimes... it's just a ramble. it always goes back to begging. please keep my son safe. áshinee' shiyázhí, please be safe. imploring father sun to shield my son with blessings of protection and guidance and pleading mother earth to ground him with her warmth and love. and... i know i am not the only mother who shamelessly prays for her soldier son. with that thought, i began searching and found a prayer, poem, mantra, call it what you will... but it came close to what i have been feeling.

i give to you, my son

i held him as an infant, i hugged him as a boy,

and through the years he has become my greatest pride and joy.

i love him more than i can say, his life more precious than my own,

but gone are the whims and notions of the little boy i had known.

for the years have passed so quickly from the time it all began,

and now he stands before me with the convictions of a man.

he wants to serve his country, he states aloud with pride,

as i try to sort out the emotions that i'm feeling deep inside.

a union of the uncertain fear, which i cannot control,

and the allegiance, which lies deep within my patriotic soul.

i trust that my years of guidance will serve as a strong foundation,

as he performs the duties requested from his beloved nation.

god please guide him as he travels to the places our soldiers have bled, 

and walk with him through pathways where those heroes' feet have tread.

oh sweet land of liberty, humbly i give to you, my son,

praying you'll return him safely home when his work for you is done.

~ author unknown ~

as memorial day passed, i thought of and prayed for the families who have within the last week experienced combat-related losses of their soldier. each time i get an email from the family readiness group of another combat fatality, i check my email incessantly until i hear from my son again. and... breathe a sigh of relief. 

this is the path my son chose. as his momma, it is an honor to be on this journey with him. ❤

a mother's hope

the mothers of our uncles and grandfathers who fought in various wars of past were most definitely hardcore tough cookies. how strong they were. there were no www and mobile phones. they were fortunate to have someone write a letter for them and even afford the paper and writing utensils. how. did. they. do. it.

my son has been on the other side of the world for less than a week, and i about put myself under, worried & stressed. i have been reminded the experiences of migraines & insomnia. with the advent of technology, i have been able to speak with him a couple of times when he called and email with him to keep telling him to be safe as i cling to the audacity of hope that my son will come back to us, whole.

as mothers of past, i will pray with my white corn to the east each morning and yellow corn to the west each evening. i will have faith. i will be strong. i will be full of hope. i will be positive. 

estrogen reload

in other words... girl time. today, a female colleague who is also a dear friend called because she needed a break from all the testosterone at home. it was good for me to talk to someone as well. i am actually quite introverted, meaning that i deal with my emotions in solitude. i am not shy nor am i a gregarious person. an old high school friend at a recent lunch meet up told me i was a very social person. it gave me pause and then i realized i am social in the superficial sense. in my line of work, i come across many personalities and i want to be able to get along with as many people as possible so i am pleasant & i make small talk. in my book, there is nothing worse than a grouchy coworker. it seems i have the gift of shmooze, if you will, but i keep my cards very close. i do not divulge my most inner personal sentiments because people GOSSIP. furthermore, i am not there to make friends or talk about my issues, dilemmas or worries unless they pertain to my learning and training as a resident. and... as i have grown older, i have learned to arrive at my own resolution on matters without much counsel. med school teaches to you to assess what is most important and that which is not does not get an ounce of thought. however, every once in awhile, it is nice to talk and interface with those that i trust. they are few but these friends i value and i would never breach their trust as i know they would never breach mine.

we set out to browse at the old tuba city trading post. i learned late that it was open on sunday! just as i was rushing off to get there before closing at 1700 hours, my friend texted and inquired how i was. i told her my plans and she asked if i wanted company. i invited here along. just as we came to the door, the sales clerk turned the "open" sign to "closed". we said, "bummer!" and i knew she was not ready to go home so we agreed to go to denny's. we ordered our usuals and just sat and took turns talking -- substantive discussion. there are profound differences between the genders. neither of us are bashers of menfolk and it is unfair to attribute a label to all males for one man's quirks, in some cases, flaws. and, we both know we cannot judge others because we do not know what goes on in their lives. so... we just talk. we laugh. we cry. we rejuvenate. we reload. we are women. sisters. in this case, it is the sisterhood of the white coat.

as physicians, you cannot just unload to anyone. any self-respecting physician does not do that. there are expectations and standards to which we are held. consequently, it is hard to find friends who are real and who can be trusted. it is interesting how we can adhere to confidentiality standards for our patients but for colleagues, it is free for all. it is the strangest thing. there are too many examples and i do not even know where to begin. what i do know is which doctor not to tell anything that i do not want repeated. the rule is not to share what is not protected by doctor-patient privilege. if that should be breached, there is recourse.

this makes a fellow white coat sister friend a priceless commodity. 

fat is not wealth

back in the 1800s and 1900s, a robust girth in any society was an indicator of wealth. in this day & age... fat is fat! it is not a sign of wealth. as a matter of fact, it is the opposite. it is most definitely a sign of laziness. okay... in certain medical conditions, it may not be helped. but... in many navajos these days, it is simple... too many conveniences and ready access to fast food and lots of it. what the f***?! it is nuts!! even most of the miss navajo contestants for this year were obese. 

it is a huge concern. excuse the pun. but... it is a ginormous health concern. obesity for people of native american descent especially navajos is one of the first steps on the fast track to becoming a type 2 diabetic. now... type 2 diabetes mellitus is completely preventable through healthy eating and plenty of exercise. it is so maddening to hear people with diabetes present it as an illness that happened to them as if they did not have a choice in it! arrrggghhh! 

when they end up in our clinic because we are a specialty service, it is hail mary time. we are usually trying to save a few toes, half a foot or a long stump. studies have shown that the more proximal the amputation, the heart works harder in an ambulatory patient. also, there is a 50% mortality rate within 5 years of an amputation. it is the hardest thing to convince people that an amputation is really in their benefit. that once their infected toe comes off, they can heal much faster and go back to their normal life. if people could see what an infected bone looks like they would not resist surgery and fight so hard to keep a dead digit or half a foot. when the soft tissue is no longer viable, the muscle does not even contract when you prod it with the bovie. when the bone is necrotic, you grasp it with a forcep and it just breaks off -- you don't even need a saw blade. i do feel for my patients. part of me is upset and angry at them for allowing to just give into this illness but i understand their circumstances. many don't have indoor plumbing and electricity. and even when they do, they don't have a budget for good, healthy food. 

in any event, smaller portion sizes and less bread -- meaning white bread, and that includes náneeskaadí, would really help our people. even blue mush is straight up carbs! i tell my patients, they cannot go wrong with boiled eggs, chicken w/o skin or any fresh vegetable & fruit which are high in carbs but they have a high fiber content which moves unnecessary calories along the alimentary canal to its exit. and... encouraging drinking water instead of gatorade or all those fancy fruity drinks that are supposedly good for you. one thing about navajos, especially today's navajos, they really don't do things in moderation. and... i swear there is something in those drinks that make you want more. water is the best. except out here, it's probably radioactive. ha! sadly true. that's another battle for another time. and... lots of physical activity. start with walking 30 minutes. that's what i tell them. 

when patients actually implement what i tell them, i am so happy for them. they always say, "i'm doing it!" and... that's all i can ask of them. in the end, they are doing it for themselves. they are the first and foremost important health care provider. we can tell them what they need to do and give them the tools and instructions. it is up to them to make it happen. t'áá hó ájít'éego t'éiyá ádoonííł! =)

no joking!

first, i ran 10.5 miles. while rummaging through my clothes for something to wear, i came across this gray dress capri pants that i bought close to two years ago. back then, they fit me snug. i actually wore them to my daughter's graduation at the end of may, 2010. when i left for rotations in june, 2010, they went with me because they were one of the few dress pants i had for clinical rotations. it was also the time when i started changing what and how much i ate and became more physically active. close to 2 years later, i am 50, yes fifty, pounds lighter and here is a photo of what those pants look like on me. omg! and, i have not reached my goal yet. i am well aware my body will never look nor feel as it did when i was 17 or 23 years old before i had babies but i aim to weight what i did then. the interesting twist is that i am way more physically active and possibly more fit than i was at 17 and 23! if someone told me i would be running the miles i am now even a year ago, i would have said, "no... i only walk. i am not a runner. i prefer walking." even running started as a challenge from one of the docs i work with. she had just converted to running from walking and was running up to 4-5 miles. so... i tagged along and before you knew my strides just got faster and she was working at keeping up with me, and by running standards, i am pretty slow. in any event, i am going on 45 years this year and heck... i am proud of my age. some of my patients 10 years my junior look older than me. the bigger picture that helps me stay focused on this goal is that i impact lives and i want my patients to know that i understand their struggles and that they can do it, too! and... of course, my own family, too. =)

1/2 mary

i did it! yay! =) 

i am so stoked because i think back to the first 1/2 mary i walked! at that time, i was about to give up near the finish & i wanted to cry! if someone would have told me when i crossed that finish line back then that in a few years i would be running a complete 1/2 mary, i would never have believed them! i have come a long way & for that i am thankful!

coming up to the week of the run, i was planning to just run the 10k. then... i got a challenge from my tender footed sis from up north when she posted on my fbook page, "the race is practically coming to you and you're only tempted. um, helloooo?..." when one of your sisters calls you out, man... you can't hide! lol! honestly, i had not run the distance. actually, i had not run more than 7 miles in one run. i was splitting my runs into 3-4 miles in the mornings and 4-5 in the evenings. when i showed up on race day... for me, run day... there were so many runners that looked so FAST and i thought, "OMG! i am coming in dead last and they are going to wait for me to crawl across the finish line!" i didn't fool myself into thinking about the time. all i wanted to do was get across the finish line. the only stop i made was at the half way point where i took the top layer off & shook the sand out of my shoes. but according to my runkeeper app, i kept a pace of 11:55 min/mi throughout the run, and that's including a stop during which i did not pause my run. not too shabby. and... i did not come in dead last. i actually passed 2 guys within the last 2 miles. they gunned out passing me in the same first 2 miles, and i kept them in my sight the last 6 miles. they kept walking & running intermittently. i know there are training programs out there that offer that running style but it would never work for me. i keep on trekking even when i am running on fumes. if i stop, i might as well just quit and get my fat hiney hauled back in humiliation! 

man... was i famished after! i ate like a pig for a day. this morning, i was energized enough for a 3-mile run in the morning and a 2-mile walk in the evening. 

for no reason...

this morning my day started with the call phone ringing. the strange thing was i had just looked at it a few minutes before wondering, "why has this phone not rung yet? is it even working?" as i started getting out of bed to dress for a morning run, the blasted phone decides to ring. it was a call from the emergency room to inform me that a patient with a gun shot wound was there. i must have gotten there fairly quickly because the e.r. staff were thrilled that i was there right off and they lined up to help with whatever i needed. my patient was a young man not quite out of his teens yet with an accidently self-inflicted gsw. the police were there interrogating him. i was a little incensed with the insistent questioning when we're trying to get the patient settled as he came in admittedly & obviously intoxicated. his labs revealed a bac of approximately 4x legal limit! was i ever annoyed. i was annoyed with my patient for coming in at that hour which resulted in my not running. i was annoyed with the cop's interrogation, as he kept interrupting. i was just plain irritated. as the day progressed, i admitted that the morning e.r. call and admission was a good experience for me. i also did a bit of suturing and salvaging the huge gaping hold the young man left in his foot. later in the day, i walked a brisk 4.5 miles which made up for missing the morning run. after all was said & done, i was embarrassed by my own lack of cool. :-/ 

my family. my love.

"a happy family is but an earlier heaven."
~ george bernard shaw ~

if i had known how complete i would feel to have my family back together, i would like to think that i would have helped fate along. however, i must also appreciate & recognize that all things happen in due course. and at is is often said, things unfold &  happen as they do for a reason. in a few posts dating back to june/july 2010, i may have alluded to going my own way meaning separating from the person to whom i was legally married at the time. thereafter, i was by myself for awhile and quite frankly enjoyed being "single". the more time i spent away from my marriage, it became clear that while i respected the institution of marriage, i did not like the person to whom i was married for many reasons which are better left untold; suffice it to say they were not frivolous nor inconsequential. and... let it be known that wiser & more confident women would never have stayed as long as i did nor endured as much as i did. as way lead to way, i ended up alone & came to love the freedom. and... as way lead to way... i happened upon a road less traveled by... which resulted in a reconciliation with the father of my children. it was not an easy feat, nor has it been smooth cruising but faith has kept us committed to mending & healing our family. giving our love another chance is making all the difference. ♡

wound care conference

half of this past week, i attended a wound care conference focusing on diabetic foot ulcers. the epidemic of type 2 diabetes mellitus in the american indian population and [this is as far as i got when i started this post way back when]. 

what a day...

it started with not being able to sleep around 0300, and then finally nodding back to sleep and having difficulty getting up for my morning run at 0445. instead, i was able to get up for my run at 0500. it was 27º f, is what my phone noted to be the temp at that hour in good old tuba city. the slush from the evening before had frozen down to the sidewalk so it was road running. =P thankfully, no wile e. coyote to creep me out. i trudged along at a cautious pace because i did not want to crack my noggin.

got to the floor to start pre-rounding at 0640, only to find the attending on-call to already be on the floor starting his rounds. so... i joined him and we were almost done with our acu patients when the students and the other attending showed up. while changing the dressings on an ex fix frame, one of the attendings was paged to inform that the first elective surgical patient had already arrived and was ready to be pre-op'ed. while the attending on-call went to pcu to finish rounding, i accompanied him. it was 0730, when he was paged to inform that the patient was already in the o.r. this was a huge surprise. a pleasant surprise. we are usually waiting around for our 0730 start time until 0830. a new world coming. yeah! so... we finished up on pcu and then proceeded to the o.r. i scrubbed in but observed mostly because one of the students was also scrubbed. it is nice to review but also anticipate the next steps so that i can at least assist anticipating the next step in the surgical procedures. they were turning over the room between cases rather quickly so i did not get a chance to have lunch until 1500. then we had a workshop on assembling ilizarov external fixation frames. we were done by 1700. by this time, i trudged home and was changing into regular clothes when a friend called saying she was in town. last minute calls such as this can be a bit annoying. certainly, i am not a neurosurgeon or a cardiothoracic surgeon but... i am still busy. a heads up would be nice. i don't like it when people expect you to just drop everything to visit with them and if you don't they're offended. wtf? anyhow... i made an effort to meet up for a quick chat. fortunately, she was just passing through & needed to get on home to phoenix tonight. then, i went to meet up with my friends with whom i had made plans. we chatted. when i started fading, i drove home. just as i was getting ready for bed, i received a call from my son.

the second i saw his caller id, i knew it it had to be some difficult news because we were not supposed to hear from him until he was done with this pre-deployment training. it was a call to inform me that he is ok but he was involved in a rollover of the combat vehicle he was in which involved the fatality of a member of his crew. while i am tremendously relieved that my son survived the incident with only bumps & bruises, this is the very first time he has had to experience witnessing & experiencing the death of a comrade.

what is a mother to do but pray. offer up smoke. be thankful that my son was spared and pray for healing for the family of the soldier who perished. while anyone can say this happens and is the risk that exists so matter of factly, it is still an outcome no family welcomes. and... we can all get on our political rants on both sides, the bottom line is... if you do not have a loved one serving and only have negativity driveling out of your trap, you best just shut the f--k up! especially around me. i am not a war monger. and, i am not pleased with the manner in which our country entered into this war. but... i love my son and i support him. and, i will pray for him and those serving with him every day. especially when sleep is elusive, as it is now. :-/

hear my prayers

lately, i am having trouble sleeping. each night i wake early and am unable to go back to sleep which was never a problem before. my thoughts immediately go to my son. like this morning, i woke thinking about him. as the wind sloshed raindrops and rattled against the windows, i thought, "please let my yázhí be warm," knowing full well that he is training for deployment. the last two evenings, i spent some time looking at videos on youtube that demonstrate a minute portion of all that which my son will be exposed during deployment. it is more real now then when he called to tell me that he was sworn in and he had signed all his papers. it is more real now then when i stood in the freezing humidity at fort benning to pin my son during the turning blue exercises. i replay the moments when i have been selfish as a mother and try to forgive myself because i want to be strong for him. i relive the moments when i have been the best mommy and hear his laughter and feel his warmth. the reality of my son going to a foreign place where people are diabolically mad, crazed, fanatical & suicidal just wrenches my heart. i pray. i beg. i implore. i plead. i pray some more. i beg some more. i implore more. i plead more. so... when i seem deep in thought, i am.

this all makes everything that i am going through as a resident miniscule. my attending physicians can yell and rip me a new one as much and as often as they so desire. even in front of the entire tuba city community. i do not care. it does not hurt my feelings anymore. i will simply get up earlier. i will rise to the occasion & immerse myself because i believe that if i am good, my prayers will be heard. my pleas will be honored. my son will walk that tádídíínk'eh atiin back to the center of our universe -- our family.

i am sure it sounds silly, insane... you know... whatever! and, i never say that even if i am thinking it until now. all i care about is that my son remains intact spiritually, mentally, emotionally & physically. and... i will cling to whatever i can grasp to hold me steady with hope and faith.

the important things

it's been a rough couple of weeks for my family. my dad ended up in the hospital. after much cajoling by my mom, he finally went in to be seen. he was flown down to phoenix the same day and was scheduled for surgery. my mom & i got down there last thursday. while many were having fun enjoying the mesa powwow, arizona state fair & asu homecoming festivities, our family was huddled with eyes glued to the computer screen tracking our dad's transfers from one part of the surgery center to another. breathing a sigh of relief after we were told a tumor the size of a baseball was excised from his abdomen in the whipple procedure. only to learn that he needed to go back the second day because his blood pressure would not stabilize. and... a third day. and... then had to have the endotracheal tube remain in place until he was determined a low risk for contracting a nosocomial respiratory infection. the fourth day post-op was dad's 65th birthday. we had a prayer done for him. the next day, the et tube was removed and dad got up to walk. a couple of days later, he was transferred from the icu to inpatient status. we remain positive. all the while, being fully aware that dad may still need to go through chemo & radiation therapy. the surgeon intimated that the extent and size of the tumor indicates a prognostication of combo chemo & radiation.

going through this with my family, i had a profound revelation. i will fiercely protect my family. i will pray for my family. i will make the best of everyday that i have with my family. i will make the best of this life that the gods have bestowed upon me to help others. this time we have is more finite than we realize. we all age from the moment we take a breath in this world. we can color our hair, we can dress up pretty, we can get as cosmetic as we want but what matters most is what is inside. relentlessly aspiring to compassion, humility, forgiveness, love, peace. that is what matters most. living the present and accepting the impending with grace. that is important.